Arteritic Ischemic Optic Neuropathy

Ischemic optic neuropathy is an important cause of blindness. There are two types of ischemic optic neuropathy: posterior and anterior ischemic optic neuropathy (AION). The arteritic type of AION (AAION) is usually due to giant cell arteritis. Giant cell arteritis can present with visual loss alone in up to 25% of cases. AAION is considered a neuro-ophthalmologic emergency. Early recognition and treatment of AAION is crucial to prevent severe visual loss. The gold standard of treatment is corticosteroids. There is no consensus in the literature on the optimal treatment approach in steroid-resistant or steroid-contraindicated cases. Biologic agents, especially tocilizumab, show promise in resistant cases.