Anterior ischemic optic neuropathy is not associated with carotid artery atherosclerosis.

Abstract

Background and Purpose: The relation between anterior ischemic optic neuropathy and carotid artery atherosclerotic disease is unclear. We studied patients with anterior ischemic optic neuropathy to determine if they had an increased occurrence of carotid artery stenosis.Methods: Fifteen consecutive patients with anterior ischemic optic neuropathy were evaluated prospectively for cervical carotid artery stenosis and compared with 30 age-and sex-matched asymptomatic patients and also with 11 age-and sex-matched patients experiencing transient monocular blindness.Results: There was no difference in the mean stenosis of the internal carotid artery between patients with anterior ischemic optic neuropathy (mean carotid stenosis, 19%) and asymptomatic patients (mean carotid stenosis, 9%;/»>0.05), whereas patients with transient monocular blindness had significantly more stenosis (mean, 77%) in the cervical carotid arteries than both control subjects (p<0.0001) and patients with anterior ischemic optic neuropathy (p<0.0001). There was also no difference in the percentage of patients with stenosis >30% in anterior ischemic optic neuropathy (two of 15) and asymptomatic patients (five of 30), whereas 10 of 11 patients with transient monocular blindness had stenoses >30%, significantly more than patients with anterior ischemic optic neuropathy (p<0.0001) and asymptomatic patients (p<0.0001).Conclusions: Anterior ischemic optic neuropathy is not a marker for atherosclerotic carotid artery stenosis. The pathogenesis of nonarteritic anterior ischemic optic neuropathy does not involve carotid artery stenosis in most patients.

Perioperative visual loss: what do we know, what can we do?

“…In a prospective study of nonsurgical patients, ION was not associated with carotid artery disease. 34 Although a basis for the notion that perioperative ION is related to atherosclerosis is that the optic nerve vasculature autoregulates abnormally, this association has not been studied in humans, and animal data are sparse and inconclusive. 43 Because of these unknowns, it appears advisable to approach patients undergoing highrisk procedures cautiously.…”

Nonarteritic Anterior Ischemic Optic Neuropathy: An Update on Demographics, Clinical Presentation, Pathophysiology, Animal Models, Prognosis, and Treatment

“…Smoking also does not appear to be an independent systemic risk factor [31], nor does carotid artery occlusion [32].…”

Postoperative vision loss during off-pump coronary artery bypass grafting

“…In a prospective study of nonsurgical patients, ION was not associated with carotid artery disease. [22] However, Shapira et al [23] showed an association between prolonged epinephrine infusions or long bypass time and ION in patients undergoing open-heart surgery. One can possibly conclude that the presence of diabetes, intraoperative and postoperative low hematocrit and hypotension, need of epinephrine to support circulation independently need not necessarily cause POLV.…”