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Carl Ellenberger, Jr, MD
Cleveland

Arch Ophthalmol. 1985;103(11):1633.

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

To the Editor.

—In the August ARCHIVES Guyer et al¹ instructed us to perform "tests of carotid artery patency" on patients with nonarteritic ischemic optic neuropathy (ION). I presume they recommend these tests to detect a carotid atheroma, the excision of which would reduce the patient's risk of stroke. The evidence does not support this recommendation.

During their follow-up period, 19 of 200 patients with nonarteritic ION had "cerebrovascular events" (either "cerebrovascular accidents" or "transient ischemic attacks") in undisclosed proportion. Thus, the exact risk of cerebral infarction among these patients cannot be determined, but is possibly about 3% per year. Although this risk is greater than the risk in the general population, it is close to or lower than the combined risk of angiography and endarterectomy in many institutions.² Furthermore, many of the "cerebrovascular events" were probably caused by a variety of mechanisms not treatable by endarterectomy: lacunar . . . [Full Text PDF of this Article]

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