Abstract
To say that diabetic papillopathy and nonarteritic anterior ischemic optic neuropathy both have an ischemic component is not equivalent to saying that they are the same disease. Diseases are classified according to clinical presentation, precipitating factors, natural history, and etiology. Although the precipitating factor (ischemia) is the same for both diseases, the clinical presentation, natural history, and etiology are distinct, as outlined in our article. 4 Vaphiades MS. The disk edema dilemma. Surv Ophthalmol 47:183–8, 2002 Google Scholar At most, these two disorders occupy a spectrum of ischemic disease. Unlike diabetic papillopathy, most cases of nonarteritic anterior ischemic optic neuropathy represent an infarctive process. 1 Burde R.M. Optic disk risk factors for nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1993; 116: 759-764 Abstract Full Text PDF PubMed Scopus (175) Google Scholar An analogy would be the distinction between angina versus myocardial infarction, where ultimately they may share the same precipitating factors, however, their severity of presentation are distinctly different as is their treatment.
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