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Lessons From the Ischemic Optic Neuropathy Decompression TrialA Decade Later
Leonard A. Levin, MD, PhD
Arch Ophthalmol. 2007;125(11):1570-1571.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Nonarteritic anterior ischemic optic neuropathy (NAION), the most common cause of acute optic nerve disease in the older population, is a peculiar disorder. It has a predilection for eyes with very small cup-disc ratios, causes predominantly inferior altitudinal visual field defects, and, like Thor's hammer, rarely strikes the same eye twice. Vision is lost rapidly, usually within days. However, in a small fraction of patients, visual acuity or field worsens over weeks, ie, "progressive NAION."
The pathophysiology of NAION remains a mystery, and worse, there is no treatment established to be effective. Thus, it can be understood why there was so much hope when a 1989 publication in the Archives reported that 12 of 14 patients with progressive NAION enjoyed visual improvement after optic nerve sheath decompression.1 Patients with a progressive course compose only a small fraction of NAION cases, and it was only the . . . [Full Text of this Article] AUTHOR INFORMATION
Author Affiliations: Departments of Ophthalmology, Neurology, and Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia.
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