[Papilloarterial ischemia]

Papilloarterial ischemia (PI) is the designation for a clinical picture characterized by circulatory insufficiency of the optic disk and the retinal arteries. Optic disk ischemia leads to visual loss, altitudinal field defects, pale papilledema and fluorescein angiographic filling defects of the disk capillaries. Retinal ischemia manifests itself by ophthalmoscopic and angiographic signs of caliber variations, focal constrictions or even occlusions of peripapillary retinal arteries. PI occurs more frequently in young females, in whom an inflammatory origin must be suspected in view of the angiographic staining of arterial walls, elevated sedimentation rates and clinical remission with systemic corticosteroids. Medical check-ups rarely relate PI convincingly with systemic disease, except in the elderly, where arterial hypertension or arteriosclerosis are often seen, and where the condition may improve after medical treatment of the cardiovascular status. PI was first described by the author in 1981; 10 cases are described in this paper and nosologically differentiated from other diseases of the optic disk and the retina.