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optical properties; "the optics of a telescope"
the branch of physics that studies the physical properties of light
relating to or affected by ischemia (同)ischaemic
any pathology of the peripheral nerves

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/09/12 22:11:37」(JST)

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Arteritic anterior ischemic optic neuropathy (AAION or arteritic AION) is the cause of vision loss that occurs in temporal arteritis (aka giant cell arteritis). Temporal arteritis is an inflammatory disease of medium-sized blood vessels that happens especially with advancing age. AAION occurs in about 15-20 percent of patients with temporal arteritis. Damage to the blood vessels supplying the optic nerves leads to insufficient blood supply (ischemia) to the nerve and subsequent optic nerve fiber death. Most cases of AAION result in nearly complete vision loss first to one eye. If the temporal arteritis is left untreated, the fellow eye will likely suffer vision loss as well within 1–2 weeks. Arteritic AION falls under the general category of anterior ischemic optic neuropathy, which also includes non-arteritic AION.

An exhaustive review article published in March 2009 described the latest information on arteritic and non-arteritic ischemic optic neuropathy, both anterior (A-AION and NA-AION) and posterior (A-PION, NA-PION, and surgical).^[1]

Symptoms and diagnosis

There are several constitutional symptoms of temporal arteritis that may aid in diagnosis of AAION such as jaw claudication (spasms of the jaw muscle), scalp tenderness, unintentional weight loss, fatigue, myalgias and loss of appetite. However, many cases are asymptomatic. There are also elevations in three blood tests that help identify AAION: erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and platelet count (thrombocytosis). A related rheumatic disease called polymyalgia rheumatica has a 15 percent incidence of giant cell arteritis.

Prompt diagnosis is critical, since the sudden blindness in the one eye is often followed, within days, by similar sudden blindness in the second eye. Treatment may prevent further damage (see below). Any patient diagnosed with non-arteritic AION over the age of 50 must be asked about the constitutional symptoms mentioned above. Furthermore, AION patients over the age of 75 should often be blood tested regardless.

Treatment

AAION requires urgent and critical intervention with a very long course of corticosteroids to prevent further damage. While this treatment is in itself problematic, non-treatment leads to bilateral blindness and strokes.

There is much research currently underway looking at ways to protect the nerve (neuroprotection) or even regenerate new fibers within the optic nerve.

References

Myron Yanoff et al., Ophthalmology, 2nd ed. (C.V. Mosby, 2004), chapt. 191.
UpToDate article "Clinical manifestations and diagnosis of giant cell (temporal) arteritis"

^ Sohan Hayreh, "Ischemic optic neuropathy", Progress in Retinal and Eye Research (2009) 28(1):34-62. PDF article

External links

University of Iowa - Anterior Ischemic Optic Neuropathy

UpToDate Contents

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1. 巨細胞（側頭）動脈炎の臨床症状 clinical manifestations of giant cell temporal arteritis
2. 非動脈炎性前部虚血性視神経症：疫学、発症機序、および病因 nonarteritic anterior ischemic optic neuropathy epidemiology pathogenesis and etiologies
3. 視神経症 optic neuropathies
4. 後部虚血性視神経症 posterior ischemic optic neuropathy
5. 非動脈炎性前部虚血性視神経症：臨床的特徴および診断 nonarteritic anterior ischemic optic neuropathy clinical features and diagnosis

English Journal

Changes in macular layers in the early course of non-arteritic ischaemic optic neuropathy.

Keller J1,2, Oakley JD3, Russakoff DB3, Andorrà-Inglés M2, Villoslada P2, Sánchez-Dalmau BF4,5.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie.Graefes Arch Clin Exp Ophthalmol.2016 Mar;254(3):561-7. doi: 10.1007/s00417-015-3066-3. Epub 2015 May 28.
PURPOSE: To characterise the changes of the retinal layers in patients with acute anterior ischaemic optic neuropathy (AION), aiming to identify imaging markers for predicting the residual visual function.METHODS: This was a retrospective review of consecutive patients with unilateral AION from Janu
PMID 26016810

Associations between thrombophilic risk factors and determinants of atherosclerosis and inflammation in patients with non-arteritic anterior ischaemic optic neuropathy.

Zotz RB1, Finger C, Scharf RE, Unsöld R.
Hämostaseologie.Hamostaseologie.2016 Feb 10;36(1):46-54. doi: 10.5482/HAMO-15-10-0028. Epub 2016 Jan 18.
Non-arteritic anterior ischaemic optic neuropathy (NAION) is caused by ischaemia of the optic nerve head. The pathophysiology of NAION is unclear, and no proven effective treatment exists.PATIENTS, METHODS: We analyzed thrombophilic risk factors and determinants of atherosclerosis and inflammation i
PMID 26778257

Macular choroidal thickness in non-arteritic ischemic optic neuropathy.

García-Basterra I1, González Gómez A2, García-Ben A3, Morillo Sánchez MJ2, Soler García A2, Ríus-Diaz F4, García-Campos JM5.
Archivos de la Sociedad Espanola de Oftalmologia.Arch Soc Esp Oftalmol.2016 Jan 29. pii: S0365-6691(15)00394-9. doi: 10.1016/j.oftal.2015.12.019. [Epub ahead of print]
OBJECTIVE: To analyse macular choroidal thickness (MCT) in non-arteritic ischaemic optic neuropathy (NAION).MATERIALS AND METHODS: An analysis was made on 22 patients diagnosed with NAION (22 eyes) and 42 healthy controls (42 eyes) using enhanced-depth imaging of spectral-domain optical coherence to
PMID 26832627

Japanese Journal

Ischemic optic neuropathies and their models : disease comparisons, model strengths and weaknesses

Japanese journal of ophthalmology : the official international journal of the Japanese Ophthalmological Society 59(3), 135-147, 2015-05
NAID 40020461414