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A Decade Later

Leonard A. Levin, MD, PhD

Arch Ophthalmol. 2007;125(11):1570-1571.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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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