| Arteritic anterior ischemic optic neuropathy | |
|---|---|
| Specialty | Ophthalmology, rheumatology |
Arteritic anterior ischemic optic neuropathy (arteritic AION,A-AION orAAION) isvision loss that occurs ingiant cell arteritis (also known astemporal arteritis). Temporal arteritis is an inflammatory disease of medium-sized blood vessels that happens especially with advancing age. AAION occurs in about 15-20 percent of patients with temporal arteritis. Damage to theblood vessels supplying theoptic nerves leads to insufficient blood supply (ischemia) to the nerve and subsequent optic nerve fiber death. Most cases of AAION result in nearly complete vision loss first to one eye. If the temporal arteritis is left untreated, the affected eye will likely suffer vision loss as well within 1–2 weeks. Arteritic AION (AAION) falls under the general category ofanterior ischemic optic neuropathy (AION), which also includesnon-arteritic AION (NAION). AAION is considered an eye emergency, immediate treatment is essential to rescue remaining vision.[1]
Sudden visual loss is the most common symptom in AAION,[1] and is most often accompanied by other symptoms oftemporal arteritis: such asjaw claudication, scalp tenderness, unintentional weight loss, fatigue, myalgias and loss of appetite.[1] A related disease calledpolymyalgia rheumatica has a 15 percent incidence of giant cell arteritis.
AAION is almost always caused bytemporal arteritis (also known asgiant cell arteritis).[1] In rare cases, AAION may be caused by other types ofvasculitis, such aspolyarteritis nodosa,systemic lupus erythematosus andherpes zoster.[1] In AAION, theposterior ciliary artery becomesinflamed which results in athrombotic occlusion of the main blood supply to theoptic nerve head with a risk ofvisual loss in the affected eye or eyes.[1]
Diagnosis is primarily made by examination by anophthalmologist.[1] The diagnosis may be suspected in people withvisual loss oramaurosis fugax.[1] AAION occurs in elderly and late middle-aged people.[1] Certain blood tests are usually elevated which may help identify AAION as part of temporal arteritis:erythrocyte sedimentation rate (ESR) andC-reactive protein (CRP).[1]
AAION requires urgent intervention with a very long course ofcorticosteroids to prevent further damage.[1]