Posterior ischaemic optic neuropathy (PION): management

Evidence-based neurology checklist on posterior ischaemic optic neuropathy (pion): management: Investigations C-reactive protein (CRP): this is raised in arteritic PION Magnetic resonance imaging (MRI): this shows enhancing posterior optic nerve lesions Magnetic resonance angiography (MRA): this…

Investigations

  • C-reactive protein (CRP): this is raised in arteritic PION
  • Magnetic resonance imaging (MRI): this shows enhancing posterior optic nerve lesions
  • Magnetic resonance angiography (MRA): this shows absent ophthalmic artery flow
  • Electroretinogram (ERG): this is normal
  • Fluorescein angiography: this is normal

Treatment: steroids

Treatment: others

References

  1. Kawabe K, Nagaoka T, Iguchi H, Ikeda K, Iwasaki Y. Optic nerve MRI enhancement in posterior ischaemic optic neuropathy due to internal carotid artery dissection. Clin Neurol Neurosurg 2010; 112:350-352.
  2. Sadda SR, Nee M, Miller NR, Biousse V, Newman NJ, Kouzis A. Clinical spectrum of posterior ischemic optic neuropathy. Am J Ophthalmol 2001; 132:743-750.
  3. Murphy MA. Bilateral posterior ischemic optic neuropathy after lumbar spine surgery. Ophthalmology 2003; 110:1454-1457.
  4. Hayreh SS. Posterior ischaemic optic neuropathy: clinical features, pathogenesis, and management. Eye (Lond) 2004; 18:1188-1206.
  5. Steigerwalt RD, Cesarone MR, Belcaro G, De Angelis M, Pascarella A, Nebbioso M. Non-arteritic Posterior ischaemic optic neuropathy treated with intravenous prostaglandin e1 and oral corticosteroids. Neuroophthalmology 2011; 35:81-84.
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