[Optic nerve neuropathy in the course of giant cell arteritis]

Anterior ischemic optic neuropathy (AION) is the result of infarct of the optic nerve head, caused by occlusion of one or more short posterior ciliary arteries. On the base of different treatment and prognosis there are two forms of AION: arteritic and non-arteritic (NAION). Arteritic ischemic optic neuropathy is caused by giant cell arteritis (GCA). The most typical symptoms are: the sudden and deep vision loss and headache, scalp tenderness, jaw claudication, muscle ache, fever and weight loss. The ophthalmologist usually finds an abnormal pupil, a swollen optic nerve (disc edema), and peripheral or central vision loss (or both). About 70% of cases are not progressive, i.e., the vision remains stable, but reduced. The ESR is usually markedly elevated. Temporal artery biopsy is useful in confirming the diagnosis of arteritic AION. Treatment involves the immediate administration of systemic steroids. Though steroid therapy rarely results in the return of vision, it is beneficial in protecting the fellow eye from vision loss and improving long-term systemic health.