16.10.2024
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5 mins

optic nerve infarction

An optic nerve infarction can have various causes and must be clarified and treated as an emergency

Dr. Valery Vinzent Wittwer

The optic nerve transmits the light stimulus from the photoreceptors in the retina of the eye to the brain so that an image can be perceived. When there is an infarction of the optic nerve, there is a circulatory disorder, which is divided according to location and cause. If the front part of the optic nerve is affected, this is referred to as anterior ischemic optic neuropathy (AION), analogously, a rare infarction of the posterior section of the optic nerve leads to a so-called posterior ischemic optic neuropathy, PION). Various reasons can be the cause of an optic nerve infarction.
A non-arteritic AION (naAION) is caused by a clot from the heart or from a “calcified”, arteriosclerotically altered vessel. Very rarely, such clots can also occur during surgery, e.g. on the heart or spine.
In an arteritic AION (aAION), an inflammatory disease of the vessels leads to an undersupply of the optic nerve. Both types require detailed medical clarifications, although emergency treatment is usually only necessary for inflammatory optic nerve infarctions.

Frequently asked questions - FAQs

How does an AION express itself?

There is typically a sudden loss of vision in the affected eye; either the upper or lower visual field is often affected. The inflammatory form of optic nerve infarction can cause headaches, particularly in the area of the jaw, temple or forehead. Weight loss, muscle and joint pain are also common.

What do I have to do if I suddenly stop seeing?

In addition to other diseases, an optic nerve infarction can be the cause, so you should immediately seek an ophthalmological examination.

What are risk factors for an optic nerve infarction?
  • Increased blood pressure
  • Diabetes mellitus (sugar disease)
  • sleep apnea
  • arteriosclerosis (calcification of blood vessels)
  • Increased blood lipid levels
  • Horton's disease (giant cell arteritis)
Can an optic nerve infarction be treated?

naAION

  • Only risk factors can be improved

aAION

  • Rapid treatment with high-dose cortisone can improve vision and prevent the other eye from also becoming ill
What is the prognosis after an optic nerve infarction?

naAION

  • At 65%, visual field loss and vision impairment persist
  • 35% may get worse after days to weeks
  • 40% see a slight improvement in symptoms after 3 to 6 months

aAION

  • If you start high-dose cortisone therapy quickly, the visual field and eyesight can be improved again and the occurrence of AAIon in the partner eye can be prevented
  • Cortisone therapy should last for 6-12 months; it may be possible to switch to steroid-sparing therapy

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