Clinical pectrum of poterior ichemic optic neuropathy

PURPOE : To decribe the ytemic and viual characteritic and prognoi in patient with poterior ichemic optic neuropathy (PION). DEIGN : Obervational cae erie. METHOD : Retropective chart review in a multicenter etting. eventy-two patient (98 eye) with a clinical diagnoi of PION. Co-morbid ytemic dieae and viual function were recorded at both initial preentation and after mean viual follow-up of 4.1 year and ytemic follow-up of 5.4 year. REULT : PION occurred in three main etting: in the perioperative period following a variety of urgical procedure (28 patient), aociated with giant cell (temporal) arteriti (6 patient), and aociated with nonarteritic ytemic vacular dieae (38 patient). Patient with perioperative and arteritic PION were more likely to have evere, bilateral viual lo that did not improve. Among eye with nonarteritic PION, 34% experienced improvement in viion, 28% remained table, and 38% worened. Among patient with nonarteritic PION, carotid artery dieae and a hitory of troke (with or without carotid artery dieae) were both aociated with a tatitically ignificant increaed rik of poor final viual outcome. CONCLUION : There are three ditinct ubtype of PION: perioperative, arteritic, and nonarteritic. Patient with PION that i unaociated with urgery hould undergo an evaluation for ytemic vacular dieae, including giant cell arteriti, that may or may not be apparent at the time of viion lo. The viual prognoi for patient with perioperative or arteritic PION i poor, wherea that for nonarteritic PION i imilar to that for patient with nonarteritic AION