Anterior ischemic optic neuropathy not uncommon in patients younger than 50

My colleagues at Emory University and I conducted a retrospective study of all patients with anterior ischemic optic neuropathy (AION) seen at our site during a 17-year period. We found that patients age 50 and younger represented 23 percent of AION patients.
 
We also found AION in younger patients to be similar in many ways to older patients. But younger AION patients had better visual acuity outcomes and a higher risk of fellow eye involvement than has been reported among older AION patients.

With the exception of giant cell arteritis, ocular and systemic risk factors were similar to those described in older AION patients. Younger patients were overwhelmingly Caucasian with a small optic disc, most had at least one cardiovascular risk factor, and there was a slight male predominance.
 
Because AION is not uncommon in younger patients, it should be considered in the differential diagnosis of younger patients with a painless optic neuropathy with disk edema at presentation. These patients require a thorough systemic evaluation for underlying vascular risk factors.