Abstract: Anterior ischaemic optic neuropathy (AION) is a significant cause of acute vision loss, characterized by ischemic damage to the optic nerve head. This article provides a comprehensive review of AION, elucidating its pathophysiology, clinical manifestations, diagnostic approaches, treatment strategies, and recent innovations. By enhancing our understanding of AION, ophthalmologists can improve diagnostic accuracy and optimize management strategies for better patient outcomes.

Introduction: Anterior ischaemic optic neuropathy is a sight-threatening condition associated with various systemic and ocular risk factors. Recognizing the underlying mechanisms and implementing appropriate management strategies are essential for preserving vision and preventing recurrence.

Pathophysiology: AION is typically caused by impaired blood flow to the optic nerve head, leading to ischemic damage and subsequent optic disc edema. The pathophysiology involves a multifactorial interplay of vascular, anatomical, and hemodynamic factors, resulting in compromised perfusion and oxygenation of the optic nerve.

Clinical Features: Patients with AION commonly present with sudden, painless vision loss, often unilateral, accompanied by visual field defects and optic disc edema. Clinical examination may reveal a swollen optic disc with a pale or hyperemic appearance, relative afferent pupillary defect (RAPD), and variable degrees of visual acuity loss.

Diagnostic Approaches: Diagnosis of AION relies on clinical evaluation, including visual acuity assessment, visual field testing, optic disc examination, and imaging studies such as optical coherence tomography (OCT) and fluorescein angiography (FA). Distinguishing between arteritic and non-arteritic AION is crucial for guiding further management.

Management Strategies: Management of AION aims to stabilize visual function, alleviate symptoms, and address underlying risk factors. Treatment modalities may include systemic corticosteroids, antiplatelet agents, vascular risk factor modification, and neuroprotective interventions. Close monitoring of visual function and optic disc appearance is essential for assessing treatment response and detecting complications.

Recent Innovations: Recent advancements in AION research focus on novel therapeutic approaches targeting inflammatory pathways, neuroprotection, and vascular modulation. Innovations such as stem cell therapy, gene therapy, and neuroprotective agents offer promising avenues for improving visual outcomes and preventing disease progression.

Conclusion: Anterior ischaemic optic neuropathy represents a challenging clinical entity requiring prompt diagnosis and management. By staying informed about the latest research and innovations in AION, ophthalmologists can provide comprehensive and effective care to patients, ultimately improving visual outcomes and quality of life.

For further reading and reference:

• American Academy of Ophthalmology – Anterior Ischaemic Optic Neuropathy: https://www.aao.org/eye-health/diseases/ischemic-optic-neuropathy
• National Eye Institute – Facts About Ischemic Optic Neuropathy: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/ischemic-optic-neuropathy
• Journal of Neuro-Ophthalmology – Recent Advances in Ischemic Optic Neuropathy: https://journals.lww.com/jneuro-ophthalmology/pages/default.aspx