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Treatment of Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION)

  • Jonathan A. Micieli
  • Valérie Biousse
  • Dan Milea
  • Nancy J. NewmanEmail author
Chapter

Abstract

Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in older individuals and usually occurs in patients with vascular risk factors and a “disc at risk” (i.e., a small optic nerve head and an absent or small physiologic cup). Potential areas for intervention in NAION include correction of underlying risk factors, improving perfusion to the optic nerve, reducing the pressure at the level of the optic nerve head, and limiting axonal injury. There remains no established treatment for NAION and most studies are of low quality with high risk of bias. The only Class I large multicenter prospective treatment trial, the Ischemic Optic Neuropathy Decompression Trial (IONDT), found no benefit from surgical intervention. A large retrospective trial using oral prednisone found a statistically significant improvement in patients presenting with a visual acuity of 20/70 or worse compared to no treatment. However, this study should be interpreted with caution due to its methodological design flaws. Aspirin for secondary prevention also remains of unproven benefit, but is a reasonable option in patients with vascular risk factors since it is well-proven in the prevention of other ischemic events. Clinicians are encouraged to enroll their patients in well-constructed Class I clinical trials, when available, to facilitate the discovery and validation of effective therapies for NAION.

Keywords

Ischemic optic neuropathy Optic disc Optic nerve diseases Glucocorticoids Aspirin Non-arteritic anterior ischemic optic neuropathy Optic disc edema 

References

  1. 1.
    Hattenhauer MG, Leavitt JA, Hodge DO, Grill R, Gray DT. Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997;123:103–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Johnson LN, Arnold AC. Incidence of nonarteritic and arteritic anterior ischemic optic neuropathy. Population-based study in the state of Missouri and Los Angeles County, California. J Neuroophthalmol. 1994;14:38–44.PubMedCrossRefGoogle Scholar
  3. 3.
    Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the Ischemic Optic Neuropathy Decompression Trial. Arch Ophthalmol. 1996;114:1366–74.Google Scholar
  4. 4.
    Lim SA, Wong WL, Fu E, Goh KY, Seah A, Tan C, et al. The incidence of neuro-ophthalmic diseases in Singapore: a prospective study in public hospitals. Ophthalmic Epidemiol. 2009;16:65–73.PubMedCrossRefGoogle Scholar
  5. 5.
    Repka MX, Savino PJ, Schatz NJ, Sergott RC. Clinical profile and long-term implications of anterior ischemic optic neuropathy. Am J Ophthalmol. 1983;96:478–83.PubMedCrossRefGoogle Scholar
  6. 6.
    Boghen DR, Glaser JS. Ischaemic optic neuropathy. The clinical profile and history. Brain. 1975;98:689–708.PubMedCrossRefGoogle Scholar
  7. 7.
    Hayreh SS, Joos KM, Podhajsky PA, Long CR. Systemic diseases associated with nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1994;118:766–80.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Preechawat P, Bruce BB, Newman NJ, Biousse V. Anterior ischemic optic neuropathy in patients younger than 50 years. Am J Ophthalmol. 2007;144:953–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Hayreh SS, Podhajsky P, Zimmerman MB. Role of nocturnal arterial hypotension in optic nerve head ischemic disorders. Ophthalmologica. 1999;213:76–96.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Hayreh SS, Zimmerman MB. Incipient nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2007;114:1763–72.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Hayreh SS, Zimmerman MB. Optic disc edema in non-arteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2007;245:1107–21.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. The Ischemic Optic Neuropathy Decompression Trial Research Group. JAMA. 1995;273:625–32.Google Scholar
  13. 13.
    Hedges TR 3rd, Vuong LN, Gonzalez-Garcia AO, Mendoza-Santiesteban CE, Amaro-Quierza ML. Subretinal fluid from anterior ischemic optic neuropathy demonstrated by optical coherence tomography. Arch Ophthalmol. 2008;126:812–5.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Wu Y, Zhou LM, Lou H, Cheng JW, Wei RL. The association between obstructive sleep apnea and nonarteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. Curr Eye Res. 2016;41:987–92.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Jacobson DM, Vierkant RA, Belongia EA. Nonarteritic anterior ischemic optic neuropathy. A case-control study of potential risk factors. Arch Ophthalmol. 1997;115:1403–7.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Biousse V, Newman NJ. Ischemic optic neuropathies. N Engl J Med. 2015;372:2428–36.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Murphy MA, Murphy JF. Amiodarone and optic neuropathy: the heart of the matter. J Neuroophthalmol. 2005;25:232–6.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Fivgas GD, Newman NJ. Anterior ischemic optic neuropathy following the use of a nasal decongestant. Am J Ophthalmol. 1999;127:104–6.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Pomeranz HD. The relationship between phosphodiesterase-5 inhibitors and nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2016;36:193–6.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Irak I, Katz BJ, Zabriskie NA, Zimmerman PL. Posner-Schlossman syndrome and nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2003;23:264–7.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    McCulley TJ, Lam BL, Feuer WJ. Nonarteritic anterior ischemic optic neuropathy and surgery of the anterior segment: temporal relationship analysis. Am J Ophthalmol. 2003;136:1171–2.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Purvin V, King R, Kawasaki A, Yee R. Anterior ischemic optic neuropathy in eyes with optic disc drusen. Arch Ophthalmol. 2004;122:48–53.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Arnold AC. The 14th Hoyt Lecture: ischemic optic neuropathy: the evolving profile, 1966–2015. J Neuroophthalmol. 2016;36:208–15.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Micieli JA, Lam C, Najem K, Margolin EA. Aqueous humor cytokines in patients with acute nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 2017;177:175–81.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Luneau K, Newman NJ, Biousse V. Ischemic optic neuropathies. Neurologist. 2008;14:341–54.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Atkins EJ, Bruce BB, Newman NJ, Biousse V. Treatment of nonarteritic anterior ischemic optic neuropathy. Surv Ophthalmol. 2010;55:47–63.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Katz DM, Trobe JD. Is there treatment for nonarteritic anterior ischemic optic neuropathy. Curr Opin Ophthalmol. 2015;26:458–63.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    French J, Gronseth G. Lost in a jungle of evidence: we need a compass. Neurology. 2008;71:1634–8.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Botelho PJ, Johnson LN, Arnold AC. The effect of aspirin on the visual outcome of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996;121:450–1.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Kollarits CR, McCarthy RW, Corrie WS, Swann ER. Norepinephrine therapy of ischemic optic neuropathy. J Clin Neuroophthalmol. 1981;1:283–8.PubMedGoogle Scholar
  31. 31.
    Francois J, Verriest G, Neetens A, de Rouck A, Hanssens M. (Vascular pseudopapillitis). Ann Ocul (Paris). 1962;195:830–85.Google Scholar
  32. 32.
    Bonamour MG. (Apropos of “vascular pseudo-papillitis”). Bull Soc Ophtalmol Fr. 1966;66:846–50.Google Scholar
  33. 33.
    Calmettes L, Deodati F, Bechac G. Pseudo-papillite vasculaire. Rev Oto Neuro Ophtal. 1963;35:64–5.Google Scholar
  34. 34.
    Georgiades G, Konstas P, Stangos N. (Study of numerous cases of vascular pseudopapillitis). Bull Mem Soc Fr Ophtalmol. 1966;79:506–39.Google Scholar
  35. 35.
    Haas A, Walzl M, Jesenik F, Walzl B, Berghold A, Bergloff J, et al. Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study. Graefes Arch Clin Exp Ophthalmol. 1997;235:14–9.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Guerriero S, Giancipoli G, Cantatore A, Sacco G, Brescia P, Saliani MT, et al. LDL apheresis in the treatment of non-arteritic ischaemic optic neuropathy: a 6-month follow-up study. Eye (Lond). 2009;23:1343–4.CrossRefGoogle Scholar
  37. 37.
    Ramunni A, Giancipoli G, Saracino A, Guerriero S, Saliani MT, Gentile MC, et al. LDL-apheresis in acute anterior ischemic optic neuropathy. Int J Artif Organs. 2004;27:337–41.PubMedCrossRefGoogle Scholar
  38. 38.
    Zhu W, Liao R, Chen Y, Liu L, Zhang Y. Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2015;253:127–33.PubMedCrossRefGoogle Scholar
  39. 39.
    Steigerwalt RD Jr, Cesarone MR, Belcaro G, Pascarella A, De Angelis M, Bacci S. Nonarteritic anterior ischemic optic neuropathy treated with intravenous prostaglandin E1 and steroids. Int J Angiol. 2008;17:193–6.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Prokosch V, Thanos S. Visual outcome of patients following NAION after treatment with adjunctive fluocortolone. Restor Neurol Neurosci. 2014;32:381–9.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Sanjari N, Pakravan M, Nourinia R, Esfandiari H, Hafezi-Moghadam A, Zandi S, et al. Intravitreal injection of a rho-kinase inhibitor (Fasudil) for recent-onset nonarteritic anterior ischemic optic neuropathy. J Clin Pharmacol. 2016;56:749–53.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Foulds WS. Visual disturbances in systemic disorders. Optic neuropathy and systemic disease. Trans Ophthalmol Soc U K. 1970;89:125–46.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Hayreh SS. Anterior ischaemic optic neuropathy. III. Treatment, prophylaxis, and differential diagnosis. Br J Ophthalmol. 1974;58:981–9.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Hayreh SS, Zimmerman MB. Non-arteritic anterior ischemic optic neuropathy: role of systemic corticosteroid therapy. Graefes Arch Clin Exp Ophthalmol. 2008;246:1029–46.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Rebolleda G, Perez-Lopez M, Casas LP, Contreras I, Munoz-Negrete FJ. Visual and anatomical outcomes of non-arteritic anterior ischemic optic neuropathy with high-dose systemic corticosteroids. Graefes Arch Clin Exp Ophthalmol. 2013;251:255–60.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Kinori M, Ben-Bassat I, Wasserzug Y, Chetrit A, Huna-Baron R. Visual outcome of mega-dose intravenous corticosteroid treatment in non-arteritic anterior ischemic optic neuropathy—retrospective analysis. BMC Ophthalmol. 2014;14:62.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Pakravan M, Sanjari N, Esfandiari H, Pakravan P, Yaseri M. The effect of high-dose steroids, and normobaric oxygen therapy, on recent onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial. Graefes Arch Clin Exp Ophthalmol. 2016;254:2043–8.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Bennett JL, Thomas S, Olson JL, Mandava N. Treatment of nonarteritic anterior ischemic optic neuropathy with intravitreal bevacizumab. J Neuroophthalmol. 2007;27:238–40.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Pece A, Querques G, Quinto A, Isola V. Intravitreal ranibizumab injection for nonarteritic ischemic optic neuropathy. J Ocul Pharmacol Ther. 2010;26:523–7.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Bajin MS, Selver OB, Taskin O, Yaman A, Saatci AO. Single intravitreal ranibizumab injection in eyes with acute non-arteritic anterior ischaemic optic neuropathy. Clin Exp Optom. 2011;94:367–70.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Prescott CR, Sklar CA, Lesser RL, Adelman RA. Is intravitreal bevacizumab an effective treatment option for nonarteritic anterior ischemic optic neuropathy? J Neuroophthalmol. 2012;32:51–3.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Rootman DB, Gill HS, Margolin EA. Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial. Eye (Lond). 2013;27:538–44.CrossRefGoogle Scholar
  53. 53.
    Saatci AO, Taskin O, Selver OB, Yaman A, Bajin MS. Efficacy of intravitreal ranibizumab injection in acute nonarteritic ischemic optic neuropathy: a long-term follow up. Open Ophthalmol J. 2013;7:58–62.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Ayhan Z, Kocaoglu G, Yaman A, Bajin MS, Saatci AO. Single intravitreal aflibercept injection for unilateral acute nonarteritic ischemic optic neuropathy. Case Rep Ophthalmol Med. 2015;2015:783241.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Kaderli B, Avci R, Yucel A, Guler K, Gelisken O. Intravitreal triamcinolone improves recovery of visual acuity in nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2007;27:164–8.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Jonas JB, Spandau UH, Harder B, Sauder G. Intravitreal triamcinolone acetonide for treatment of acute nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2007;245:749–50.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Yaman A, Selver OB, Saatci AO, Soylev MF. Intravitreal triamcinolone acetonide injection for acute non-arteritic anterior ischaemic optic neuropathy. Clin Exp Optom. 2008;91:561–4.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Sohn BJ, Chun BY, Kwon JY. The effect of an intravitreal triamcinolone acetonide injection for acute nonarteritic anterior ischemic optic neuropathy. Korean J Ophthalmol. 2009;23:59–61.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Radoi C, Garcia T, Brugniart C, Ducasse A, Arndt C. Intravitreal triamcinolone injections in non-arteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2014;252:339–45.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Entezari M, Ramezani A, Pakravan M, Mahmoodi A, Hassanpour H, Yaseri M. Anterior ischemic optic neuropathy. Ophthalmology. 2012;119:879–80.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Fesharaki H, Kianersi F, Shoyoukhi S. Therapeutic effect of posterior sub-tenon methylprednisolone in anterior ischemic optic neuropathy: a randomized clinical trial. Iran J Ophthalmol. 2011;23:50–6.Google Scholar
  62. 62.
    Ulusoy MO, Kıvanç SA, Atakan M. Can subtenon methylprednisolone acetate be a choice for the acute non-arteritic ischemic optic neuropathy treatment? Rom J Ophthalmol. 2016;60:275–8.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Soheilian M, Koochek A, Yazdani S, Peyman GA. Transvitreal optic neurotomy for nonarteritic anterior ischemic optic neuropathy. Retina. 2003;23:692–7.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Ellenberger C Jr, Burde RM, Keltner JL. Acute optic neuropathy. Treatment with diphenylhydantoin. Arch Ophthalmol. 1974;91:435–8.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Johnson LN, Gould TJ, Krohel GB. Effect of levodopa and carbidopa on recovery of visual function in patients with nonarteritic anterior ischemic optic neuropathy of longer than six months’ duration. Am J Ophthalmol. 1996;121:77–83.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Johnson LN, Guy ME, Krohel GB, Madsen RW. Levodopa may improve vision loss in recent-onset, nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2000;107:521–6.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Simsek T, Eryilmaz T, Acaroglu G. Efficacy of levodopa and carbidopa on visual function in patients with non-arteritic anterior ischaemic optic neuropathy. Int J Clin Pract. 2005;59:287–90.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Lyttle DP, Johnson LN, Margolin EA, Madsen RW. Levodopa as a possible treatment of visual loss in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2016;254:757–64.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Fazzone HE, Kupersmith MJ, Leibmann J. Does topical brimonidine tartrate help NAION? Br J Ophthalmol. 2003;87:1193–4.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Wilhelm B, Ludtke H, Wilhelm H. Efficacy and tolerability of 0.2% brimonidine tartrate for the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION): a 3-month, double-masked, randomised, placebo-controlled trial. Graefes Arch Clin Exp Ophthalmol. 2006;244:551–8.PubMedCrossRefGoogle Scholar
  71. 71.
    Arnold AC, Hepler RS, Lieber M, Alexander JM. Hyperbaric oxygen therapy for nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996;122:535–41.PubMedCrossRefGoogle Scholar
  72. 72.
    Fujikado T, Morimoto T, Matsushita K, Shimojo H, Okawa Y, Tano Y. Effect of transcorneal electrical stimulation in patients with nonarteritic ischemic optic neuropathy or traumatic optic neuropathy. Jpn J Ophthalmol. 2006;50:266–73.PubMedCrossRefGoogle Scholar
  73. 73.
    Esfahani M, Harandi Z, Kiumehr S, Gholmi A, Tabasi A, Piri N, et al. Memantine treatment in acute nonarteritic ischemic optic neuropathy: a randomized clinical trial. Iran J Ophthalmol. 2011;23:11–20.Google Scholar
  74. 74.
    Moster ML, Sergott RC, Leiby BE. Dalfampridine treatment in nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2017;37:348–9.PubMedCrossRefGoogle Scholar
  75. 75.
    Modarres M, Falavarjani KG, Nazari H, Sanjari MS, Aghamohammadi F, Homaii M, et al. Intravitreal erythropoietin injection for the treatment of non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol. 2011;95:992–5.PubMedCrossRefGoogle Scholar
  76. 76.
    Beck RW. Does Levodopa improve visual function in NAION? Ophthalmology. 2000;107:1431–4.PubMedCrossRefGoogle Scholar
  77. 77.
    Hayreh SS. Does Levodopa improve visual function in NAION? Ophthalmology. 2000;107:1434–8.PubMedCrossRefGoogle Scholar
  78. 78.
    Kupersmith MJ, Miller NR. A nonarteritic anterior ischemic optic neuropathy clinical trial: an industry and NORDIC Collaboration. J Neuroophthalmol. 2016;36:235–7.PubMedCrossRefGoogle Scholar
  79. 79.
    Ahmed Z, Kalinski H, Berry M, Almasieh M, Ashush H, Slager N, et al. Ocular neuroprotection by siRNA targeting caspase-2. Cell Death Dis. 2011;2:e173.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Newman NJ, Scherer R, Langenberg P, Kelman S, Feldon S, Kaufman D, et al. The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study. Am J Ophthalmol. 2002;134:317–28.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Beri M, Klugman MR, Kohler JA, Hayreh SS. Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors. Ophthalmology. 1987;94:1020–8.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Beck RW, Servais GE, Hayreh SS. Anterior ischemic optic neuropathy. IX. Cup-to-disc ratio and its role in pathogenesis. Ophthalmology. 1987;94:1503–8.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Kupersmith MJ, Frohman L, Sanderson M, Jacobs J, Hirschfeld J, Ku C, et al. Aspirin reduces the incidence of second eye NAION: a retrospective study. J Neuroophthalmol. 1997;17:250–3.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Salomon O, Huna-Baron R, Steinberg DM, Kurtz S, Seligsohn U. Role of aspirin in reducing the frequency of second eye involvement in patients with non-arteritic anterior ischaemic optic neuropathy. Eye (Lond). 1999;13:357–9.CrossRefGoogle Scholar
  85. 85.
    Behbehani R, Mathews MK, Sergott RC, Savino PJ. Nonarteritic anterior ischemic optic neuropathy in patients with sleep apnea while being treated with continuous positive airway pressure. Am J Ophthalmol. 2005;139:518–21.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Guirguis-Blake JM, Evans CV, Senger CA, O’Connor EA, Whitlock EP. Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016;164:804–13.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Kajiwara K, Tsubota K, Hara Y. High dose urokinase thrombolysis and stellate ganglion block for anterior ischemic optic neuropathy. Fola Ophthalmol Jpn. 1990;41:59–64.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jonathan A. Micieli
    • 1
  • Valérie Biousse
    • 2
    • 3
    • 4
  • Dan Milea
    • 5
  • Nancy J. Newman
    • 2
    • 3
    • 4
    • 6
    Email author
  1. 1.Department of Ophthalmology and Vision SciencesUniversity of TorontoTorontoCanada
  2. 2.Department of OphthalmologyEmory University School of MedicineAtlantaUSA
  3. 3.Department of NeurologyEmory University School of MedicineAtlantaUSA
  4. 4.Neuro-Ophthalmology Unit, Emory Eye CenterAtlantaUSA
  5. 5.Singapore National Eye Centre, Singapore Eye Research Institute and Duke-NUSSingaporeSingapore
  6. 6.Department of Neurological SurgeryEmory University School of MedicineAtlantaUSA

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