Current perspectives on nonarteritic anterior ischemic optic neuropathy.
BACKGROUND
The traditional view of nonarteritic anterior ischemic optic neuropathy (NAION) has been challenged. Progressive forms of the disease and spontaneous improvements in vision have been reported with increasing frequency. The pathogenesis of the disease has been refined. Treatment in the form of optic nerve sheath decompression has been advocated and dismissed by a major study.


METHODS
The pathogenesis, presentation, risk factors, and associated conditions, differential diagnosis, and management of NAION are reviewed.


RESULTS
NAION is currently considered an untreatable, ischemic disorder of the optic nerve head. In most cases, it results from a drop in optic nerve head perfusion pressure, below a critical level. No treatment is available to restore perfusion before loss of vision and visual field takes place.


CONCLUSIONS
Despite changes in the reported natural history and pathogenesis of NAION, there is still no available treatment. Management involves reduction of risk factors to prevent development of the disease and differentiating it from the arteritic type.
Kellett
S C
SC
Valley Professional Center, Jefferson Valley, New York 10535, USA.
Madonna
R J
RJ
D000368:Aged; D001167:Arteritis / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009898:Optic Disk / Q000098:blood supply*; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012161:Retinal Artery / Q000473:pathology; D012307:Risk Factors; D014794:Visual Fields