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Nonarteritic Anterior Ischemic Optic Neuropathy - An Update

Shani Golan, Michael Waisbourd and Anat Kesler

Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common optic neuropathy in the elderly. Despite considerable research efforts, much remains unclear regarding the pathogenesis, risk factors and treatment options, with numerous contradicting reports and no consensuses among physicians. The more established risk factors include hypertension, diabetes mellitus, hypercholesterolemia, characteristic optic disc morphology, and perioperative visual loss. Several case reports suggested a link between certain phosphodiestrase-5 inhibitor erectile dysfunction medications and NAION, but this possible risk factor remains controversial.
There is no established therapy for NAION, and many treatments have been proposed for the acute phase of the disease, of which some failed and others are considered experimental. This review summarizes the proposed pathogenesis theories, risk factors, diagnostic and imaging modalities and proposed treatment options for this blinding disease.