Abstract
Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients aged over 50 years and results from ischemic damage to the anterior optic nerve. Proposed treatments for NAION presumably target thrombosis, blood vessels or disc edema or may have a neuroprotective effect. However, no controlled prospective clinical trials have shown benefit for any medical or surgical treatments. Most of the literature on the treatment of NAION consists of retrospective or prospective case series and case reports. IONDT is the only large multicenter prospective randomized controlled trial performed for NAION and it found no benefit for surgical intervention. There is a debate over the utility of steroids, both oral and intravitreal, and over the use of intravitreal injections of antivascular endothelial growth factor agents. Similarly, therapies aimed at secondary prevention of fellow eye involvement in NAION remain of unproven benefit.
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