Ischemic optic neuropathy and giant cell arteritis.
Acute loss of vision due to anterior ischemic optic neuropathy, both arteritic and nonarteritic, demands investigation and where indicated, treatment as an emergency. While advances continue in the understanding of the pathophysiology and investigation of arteritic anterior ischemic optic neuropathy, the nonarteritic form presents a major therapeutic problem, particularly in the absence of a satisfactory clinical technique for the measurement of optic nerve head blood flow. Because of steroid resistance and side effects of chronic steroid therapy in giant cell arteritis, alternative immunosuppressive agents are being explored. In nonarteritic ischemic optic neuropathy, etiologic factors such as activated protein C resistance raise the possibility of evaluation for prothrombotic states, while calcium channel blockers offer prospects for the relief of ischemic effects at the cellular level.
McFadzean
R M
RM
Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland.
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D013700:Giant Cell Arteritis / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018917:Optic Neuropathy, Ischemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D014792:Visual Acuity
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents