Anterior ischemic optic neuropathy risk factors

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Differentiating Anterior ischemic optic neuropathy from other Diseases

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The second "hit" involves cardiovascular risk factors. The most common are diabetes, hypertension and high cholesterol levels. In patients with "a disc at risk", these vascular risk factors lead to ischemia (poor blood supply) to a portion of the optic disc. The disc then swells, but the crowded conditions don't allow space for this, so compression occurs and this leads to more ischemia. Since both eyes tend to have a similar shape, the ophthalmologist will look at the good eye to assess the anatomical predisposition. There is evidence that genetic factors may play a role in NAION. (see the OMIM link). A number of studies have linked Viagra use with NAION.[1][2][3][4][5][6]


  1. Pomeranz HD, Bhavsar AR. "Nonarteritic ischemic optic neuropathy developing soon after use of sildenafil (viagra): a report of seven new cases." J Neuroophthalmol. 2005 Mar;25(1):9-13. PMID 15756125.
  2. Egan R, Pomeranz H. "Sildenafil (Viagra) associated anterior ischemic optic neuropathy." Arch Ophthalmol. 2000 Feb;118(2):291-2. PMID 10676804.
  3. Pomeranz HD, Smith KH, Hart WM Jr, Egan RA. "Sildenafil-associated nonarteritic anterior ischemic optic neuropathy." Ophthalmology. 2002 Mar;109(3):584-7. PMID 11874765.
  4. Cunningham AV, Smith KH. "Anterior ischemic optic neuropathy associated with viagra." J Neuroophthalmol. 2001 Mar;21(1):22-5. PMID 11315976.
  5. Boshier A, Pambakian N, Shakir SA. "A case of nonarteritic ischemic optic neuropathy (NAION) in a male patient taking sildenafil." Int J Clin Pharmacol Ther. 2002 Sep;40(9):422-3. PMID 12358159.
  6. Akash R, Hrishikesh D, Amith P, Sabah S. "Case report: association of combined nonarteritic anterior ischemic optic neuropathy (NAION) and obstruction of cilioretinal artery with overdose of Viagra." J Ocul Pharmacol Ther. 2005 Aug;21(4):315-7. PMID 16117695.

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