Recurrence of non-arteritic anterior ischemic optic neuropathy in the same eye

The study presents the case of a 58-year-old white man who was referred for evaluation of optic nerve head (ONH) edema in the right eye. Three months earlier, he had been seen for superior visual field loss and inferior ONH edema in the right eye and diagnosed with non-arteritic anterior ischemic optic neuropathy (NAION). The edema resolved within four weeks, and the superior visual field defect remained unchanged. For his second visit, many tests were done but no intervention was undertaken.  Two weeks later there was a decrease in the superior ONH swelling,  and two months after the onset of symptoms the right ONH swelling was completely resolved and was replaced with pallor. The visual field defect remained unchanged.

The authors conclude that the initial episode of visual loss appears to have been typical NAION. He had acute visual loss, sectoral optic disk swelling with a small optic disk cup in the fellow eye, and a stable visual field defect with resolution of the optic disk edema after one month. Since recurrence of NAION in the same eye is considered rare, diagnosis of NAION the second time  could only be made retrospectively based on the spontaneous resolution.

Development of NAION animal models offers the hope of expanding the understanding of the basic science of the disease and the development of future therapeutic options. The rodent model suggests that inflammation may play an important role in damage to the ONH after the initial ischemic event. It is not clear, however, if this inflammatory response is detrimental by perpetuating inflammation or beneficial by promoting the healing process.