Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION)

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Overview

Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common optic nerve disease in patients over age 50 years. It's characterized by a lack of blood flow to the optic disc which is the head of the optic nerve. Since the optic nerve is the nerve that carries visual information from the eye to the brain, patients present with vision loss that is usually unilateral. Anterior ischemic optic neuropathy (AION) involves the 1mm segment of the optic nerve head (optic disc), and damages the nerve fibers causing optic disc swelling and ischemia around the area.

Causes

NAION is idiopathic. But strong risk factors are:

  • Sleep apnea
  • Hypertensive drugs taken at night
  • Age>50
  • Small optic disc and cup
  • Hypertension
  • Diabetes
  • Optic disc drusen
  • Interferon alpha
  • Phophodiesterase type 5 inhibitor (Sildenafil)

Treatment

At this moment there is no treatment for NAION. Observation and management of sleep apnea, hypertension, and diabetes are recommended as well as prevention of taking sildenafil and hypertensive drugs at night.

Prognosis

Depending on the lifestyle modifications the patient can regain vision or permanently lose vision. NAION can worsen during the first days but it usually stabilizes by 2 months.

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