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Acute Ischemia of the Optic Nerve

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Book cover Amaurosis Fugax

Abstract

Acute ischemia of the anterior part of the optic nerve is one of the most common causes of impaired vision in persons past middle age—a fact not fully appreciated by most physicians. I have called it anterior ischemic optic neuropathy (AION) (1). In contrast, I have designated acute ischemic lesions of the posterior part of the optic nerve as posterior ischemic optic neuropathy (PION) (2); this is, as far as one can tell, much less common than AION. Acute ischemia of the optic nerve, particularly of the optic nerve head, is an important cause of amaurosis fugax, which commonly is seen with giant-cell or temporal arteritis (3–9) and with marked optic disk edema due to raised intracranial pressure (10–23) or any other etiology. In these cases the development of amaurosis fugax is an ominous sign of impending AION and permanent visual loss in that eye, particularly in patients with giant-cell arteritis in whom blindness may occur within the next few hours or several days. Amaurosis fugax in these cases frequently is precipitated by a change in posture, e.g., suddenly standing up from a prone position (orthostatic hypotension) or stooping. Thus, the onset of amaurosis fugax in these conditions is usually a sign of impending AION and visual disaster.

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Authors
  1. Sohan Singh Hayreh
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Editors and Affiliations

  1. Division of Vascular and Thoracic Surgery, Scripps Clinic and Research Foundation, 10666 North Torrey Pines Road, 92037, La Jolla, California, USA

    Eugene F. Bernstein M.D., Ph.D. (Adjunct Professor of Surgery) (Adjunct Professor of Surgery)

  2. University of California, San Diego, 92037, La Jolla, California, USA

    Eugene F. Bernstein M.D., Ph.D. (Adjunct Professor of Surgery) (Adjunct Professor of Surgery)

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© 1988 Springer-Verlag New York Inc.

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Hayreh, S.S. (1988). Acute Ischemia of the Optic Nerve. In: Bernstein, E.F. (eds) Amaurosis Fugax. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3776-1_8

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  • DOI: https://doi.org/10.1007/978-1-4612-3776-1_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8345-4

  • Online ISBN: 978-1-4612-3776-1

  • eBook Packages: Springer Book Archive

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