Wydanie 3/2013
str. 65

Nietętnicza przednia niedokrwienna neuropatia nerwu wzrokowego

Non-arteritic Anterior Ischemic Optic Neuropathy

Wojciech Lubiński, Monika Drobek-Słowik

Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. PUM

Summary: Purpose: To present the current knowledge concerning non-arteritic anterior ischemic optic neuropathy.
Material and methods: Based on data from literature and own experience pathogenesis, clinical features, diagnosis and management are discussed.
Results: The most common cause of non-arteritic anterior ischemic optic neuropathy is transient nonperfusion or hypoperfusion of the optic nerve head circulation mostly in middle-age and elderly patients. The major role in the development of the disease has nocturnal arterial hypotension. The main symptoms are: the sudden and painless deterioration of vision usually on walking in the morning, distance visual acuity better than 0.5, relative inferior altitudinal defect with absolute inferior nasal defect, optic disc edema associated with splinter hemorrhages. For diagnosis, fundus examination, visual field and fluorescein angiography are necessary. Management of non-arteritic anterior ischemic optic neuropathy is highly controversial. It has been suggested that systemic corticosteroid therapy can be a cause of visual acuity and visual field improvement in the very early stages of the disease.
Conclusions: Non- arteritic anterior ischemic optic neuropathy is one of the major cause of blindness among the middle – aged and elderly population. Fast, correct diagnosis of this disease and systemic corticosteroid treatment results in better visual outcome. Recognition of systemic risk factors is essential in its prevention and management.

Słowa kluczowe: nietętnicza przednia niedokrwienna neuropatia nerwu wzrokowego, patogeneza, objawy, diagnostyka, leczenie.

Keywords: non-arteritic anterior ischemic optic neuropathy, pathogenesis, symptoms, diagnosis, management.