Pathology of Ischemic Optic Neuropathy

Patel, Hershel R.; Margo, Curtis E.

doi:10.5858/arpa.2016-0027-rs

Cited by 40 publications

(28 citation statements)

References 28 publications

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“…Another explanation for the spare of the AION might be the higher self-adjusted abilities of the anterior arteries compared to the posterior parts, although the anterior and posterior arteries all come originally from the ICA. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Zheng

Wang²,

Chen³

et al. 2020

Medicine

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Rationale: Ischemic optic neuropathy (ION), due to diseases of the arteries supplying the optic nerve, is an ischemic damage of the optic nerve. This report highlights a case with monocular decreasing visual acuity caused by dissection of the internal carotid artery (ICA), which is a relatively rare cause for ION. Patient concerns: A 44-year-old woman presented with a decreasing visual acuity and defected visual field in the right eye for 1 week. The best corrected visual acuity (BCVA) was 20/400 in the right eye, and 20/20 in the left eye. In the right eye, the pupil showed little reaction to light with a relative afferent pupillary defect. The visual field test disclosed a defect in the inferior field connecting to the blind spot. Electroretinogram recording showed no obviously declined retinal function. No recognizable waveforms were presented in pattern visual–evoked potential (PVEP) examination, whereas the flash visual–evoked potential result revealed a delayed peak time and a reduced amplitude of P2-wave. Diagnosis: The patient was diagnosed as ION with the aid of computed tomographic angiography of the brain and neck, which revealed a stenosis in the right ICA and an occlusion in the right cerebral middle artery. The stenosis was verified as dissection of the ICA by digital subtraction angiography. Interventions: Based on the clinical findings, stent implantation inside the right ICA was performed. Outcomes: The ICA was recanalized soon and the BCVA of the right eye was improved to be 20/25 five months later. A second PVEP examination revealed a recognizable waveform in the right eye, although the peak time and amplitude of the P100-wave was a bit abnormal compared to that of the left eye. Lessons: ION with the sign of decreasing monocular visual acuity could occur due to dissection of the ICA, with no obvious neurologic symptom at the beginning. The present case emphasizes the importance of suspicion of ICA problems as the underlying cause for ION, which could help to take in-time measure to save the vision and avoid further complications.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Zheng

Wang²,

Chen³

et al. 2020

Medicine

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“…Molekularpathologisch wird der "Point of no return", ab dem, nach heutigem Wissensstand, der Zelltod in den betroffenen Ganglienzellen unumkehrbar eintreten wird, durch den Zusammenbruch der mitochondrialen Atmungskette markiert. Dieses Ereig-nis tritt bei den am schwersten betroffenen Neuronen wahrscheinlich innerhalb der ersten Stunden nach der AION ein, sofern sie nicht direkt durch Nekrose absterben [30].…”

Section: Pupillenreaktion Funduskopie Und Optische Kohärenztomografiunclassified

Pathogenese und Therapie der nicht arteriitischen anterioren ischämischen Optikusneuropathie

Oterendorp

Lagrèze

Feltgen

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungDie nicht arteriitische anteriore ischämische Optikusneuropathie (NAION) ist eine akute Sehnervendegeneration, deren Pathogenese in großen Teilen unerforscht ist. Für sie existiert derzeit keine allgemein akzeptierte Behandlungsmöglichkeit. Die Etablierung von AION-Tiermodellen sowie die Ergebnisse größerer epidemiologischer Studien ermöglichten es in den vergangenen Jahren, ein besseres Verständnis der Pathophysiologie und möglicher Einflussfaktoren zu gewinnen. Basierend auf diesen Erkenntnissen testeten und testen klinische und tierexperimentelle Studien eine große Bandbreite möglicher Behandlungsansätze. Unabhängig von ihrem jeweiligen Ergebnis können diese Untersuchungen unser Verständnis der NAION erheblich erweitern und auch für andere Sehnervendegenerationen von großer Bedeutung sein.

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“…Ischemic optic neuropathy refers to infarction of any portion of the optic nerve from the chiasm to optic nerve head. Clinically, it is divided into anterior and posterior forms by the presence or absence of swelling of the optic nerve head, respectively; findings in unilateral ischemic optic neuropathy include a relative afferent pupillary defect and demonstrable visual field loss (Patel and Margo, 2017).…”

Section: Diagnosismentioning

confidence: 99%

Updating traumatic optic neuropathy

Fuentes¹,

Pelier²

2018

Int. J. Med. Med. Sci.

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Traumatic optic neuropathy (TON) is the affectation of the visual function, secondary to a damage caused by a direct or indirect traumatic mechanism over the optic nerve. It occurs in approximately 0.5 to 5% of closed head injuries, and in 2.5% of patients with maxillofacial trauma and mid-face fractures. The types of TON are direct, anterior indirect, posterior indirect, and chiasmal. This work aims to offer an updating in traumatic optic neuropathy. We made a search in international data bases such as PubMed, ClinicalTrial, Ebsco, Hinari and so on, and found 32 articles which were used in this review article. We used the following keywords: traumatic optic neuropathy, optic nerve, trauma, visual loss, visual disease. 70% of the articles correspond to the last five years. This review was redacted using Microsoft Office Word 2016 in a laptop Asus with Window 10 system. We made a compilation with diverse therapeutic options based principally in axonal regeneration developed by researchers during the last decade. The present review article provides an updating regarding potential strategies for axonal regeneration and optic nerve repair, focusing on the researches of many investigators around the world. Nowadays, therapeutic options have advanced in many fields, but still more researches must be done to find a definitive solution for traumatic optic neuropathy in a near future.

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Pathology of Ischemic Optic Neuropathy

Cited by 40 publications

References 28 publications

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Pathogenese und Therapie der nicht arteriitischen anterioren ischämischen Optikusneuropathie

Updating traumatic optic neuropathy

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