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Cited by 34Glaucoma and retinal disordersAcute Ischemic Stroke ManagementCerebral Venous Sinus Thrombosis

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Unraveling the Enigma of Nonarteritic Anterior Ischemic Optic Neuropathy

Rizzo, Joseph F.·2019·Journal of Neuro-Ophthalmology
DOI 10.1097/wno.0000000000000870
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Abstract

Non-arteritic anterior ischemic optic neuropathy (NAON) is the second most common optic neuropathy in adults. Despite extensive study, the etiology of NAION is not definitively known. The best evidence suggests that NAION is caused by an infarction in the region of the optic nerve head (ONH), which is perfused by paraoptic short posterior ciliary arteries (sPCAs) and their branches. To examine the gaps in knowledge that defies our understanding of NAION, a historical review was performed both of anatomical investigations of the ONH and its relevant blood vessels and the evolution of clinical understanding of NAION. Notably, almost all of the in vitro vascular research was performed prior our current understanding of NAION, which has largely precluded a hypothesis-based laboratory approach to study the etiological conundrum of NAION. More recent investigative techniques, like fluorescein angiography, have provided valuable insight into vascular physiology, but such light-based techniques have not been able to image blood vessels located within or behind the dense connective tissue of the sclera and laminar cribrosa, sites that are likely culpable in NAION. The lingering gaps in knowledge clarify investigative paths that might be taken to uncover the pathogenesis of NAION and possibly glaucoma, the most common optic neuropathy for which evidence of a vascular pathology also exists.

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Metadata

Authors
Rizzo, J. F.
Affiliations
Massachusetts Eye and Ear Infirmary (US)
Corresponding author
Rizzo, Joseph F.
Venue
Journal of Neuro-Ophthalmology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-12
Volume
39
Issue
4
Pages
529-544
ISSN
1070-8022 (ISSN-L)
DOI
10.1097/wno.0000000000000870
OpenAlex
W2991071634
Cited by
34
References
2
Citations by year
2026: 7 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 3
FWCI
2.22
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Neuro-Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Clinical Neurology › Cerebral Venous Sinus Thrombosis
Keywords
nonarteritic anterior ischemic optic neuropathy, optic nerve head, posterior ciliary arteries, optic nerve head blood flow, sclera, glaucoma, optic neuropathy, fluorescein angiography
MeSH terms
Animals, Arteritis, Chronic Disease, Glaucoma, Open-Angle, Humans, Ophthalmic Artery, Optic Disk, Retinal Artery, Optic Neuropathy, Ischemic, Ciliary Arteries

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