Management of ischemic optic neuropathies

Introduction: Ischemic optic neuropathy (ION) is the most common acute unilateral optic neuropathy in older patients. Areas covered: A complete review of the literature was performed for ischemic optic neuropathy, including nonarteritic anterior ION, arteritic anterior ION, and posterior ION. The most recent information concerning epidemiology, pathophysiology, and management was included in the review. In particular, the management of each form of ION is discussed, including in special patient populations such as post-surgical patients and hemodialysis patients. Expert commentary: Differentiating arteritic and nonarteritic forms of ION is crucial for appropriate patient management, as those with arteritis should be started on steroid therapy as soon as possible. Nonarteritic ION patients benefit from control of cerebrovascular risk factors, and may benefit systemically from low-dose aspirin therapy.