Increase ER Stress in Ischemic Optic Neuropathy: Implications in Diabetes and Effects of Insulin Treatment

Non-arteritic anterior ischemic optic neuropathy (NAION) is due to loss of oxygen to the anterior optic nerve, a watershed area (1-2) and leads to degeneration of retinal ganglion cell (RGC) body and axons as well as loss of optic nerve oligodendrocytes and demyelination (3-6). NAION in animals with diabetes mellitus (DM) leads to significant increase in retinal edema, VEGF levels, and greater loss of RGCs (7). Diabetes is also associated with increased risk of metabolic stress, which is particularly prominent in cells with high metabolic activity such as RGCs and oligodendrocytes and may contribute to the development of NAION and bilateral involvement. In this study, we investigated endoplasmic reticulum (ER) stress responses after experimental NAION.