Title |
Pathogenesis of Nonarteritic Anterior Ischemic Optic Neuropathy |
Creator |
Arnold, AC |
Affiliation |
Jules Stein Eye Institute, 100 Stein Plaza, UCLA, Los Angeles, CA 90095-7005, USA. arnolda@ucla.edu |
Abstract |
Based on histopathology, electron microscopic corrosion cast studies, optic nerve blood flow studies, and clinical data, the pathogenesis of idiopathic nonarteritic ischemic optic neuropathy includes the following features: (1) structurally crowded optic discs are predisposed; (2) laminar and retrolaminar regions are the most common locations for infarction; (3) there is flow impairment in the prelaminar optic disc during the acute phase; (4) lack of consistent choroidal flow impairment and the retrolaminar location of infarcts suggest vasculopathy within or distal to the paraoptic branches of the posterior choroidal arteries; (5) diabetes is the most consistently identified vasculopathic risk factor; (6) impaired autoregulation of the disc circulation by atherosclerosis, with a possible contribution from serotonin and endothelin-mediated vasospasm, may play a role; and (7) progression may be caused by secondary cell death after the initial ischemic insult or compression from cavernous degeneration and mechanical axonal distortion. |
Subject |
Corrosion Casting; Fluorescein Angiography; Humans; Microscopy, Electron, Scanning; Optic Disk/blood supply; Optic Neuropathy, Ischemic/diagnosis; Optic Neuropathy, Ischemic/etiology; Optic Neuropathy, Ischemic/pathology; Optic Neuropathy, Ischemic/physiopathology; Regional Blood Flow; Risk Factors; Ultrasonograph |
Format |
application/pdf |
Publication Type |
Journal Article |
Collection |
Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/ |
Publisher |
Lippincott, Williams & Wilkins |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
Rights Management |
© North American Neuro-Ophthalmology Society |
Setname |
ehsl_novel_jno |
ID |
225161 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s63f7vpw/225161 |