Anterior ischemic optic neuropathy with internal carotid artery occlusion

We examined three patients who had anterior ischemic optic neuropathy and ipsilateral internal carotid artery occlusion. Each patient had transient cerebral ischemic attacks associated with the occluded carotid artery. In two patients there attacks were in temporal proximity to the anterior ischemic optic neuropathy. Carotid angiography showed retrograde filling of the ophthalmic artery through the external carotid artery demonstrating altered perfusion and, perhaps, hypoperfusion of the distal optic nerve head.