Treatment for Ischemic Neuropathy of the Retina

Ischemic neuropathy is a condition that affects the eye. Typically, it afflicts middle-aged or elderly parents and often begins without warning. Often caused by a stroke of the optic nerve, ischemic neuropathy may effect one retina or eye initially but often progresses and effects both over time. The extent of the vision loss varies, and treatment may or may not be effective at preventing or correcting vision loss.

Causes

• The most common type of ischemic neuropathy that affects the retina and causes vision loss is non-arteritic ischemic neuropathy, or NAAION. Ten percent of NAAION patients are under 45, with the remaining 90 percent of patients 45 and over. It affects both men and women equally and is caused by impaired circulation in the artery supplying the optic nerve. The impaired circulation causes a reduction in blood pressure, and the blood vessels supplying the optic nerve do not get enough blood. This causes damage to the optic nerve, and vision is impaired, often permanently.

Prevention

• Ischemic neuropathy can't generally be prevented. However, it is speculated that as much of 75 percent of the associated vision loss occurs during sleep, and that this loss is caused by a drop in blood pressure. Thus, adjusting blood pressure--lowering medications and stopping smoking may help to decrease the extent of vision loss.

Treatment

• Currently, the treatment options for ischemic neuropathy are not extensive. Taking baby aspirin after ischemic neuropathy affects one eye may help to prevent the condition from occurring in the other eye as well. Doctors might also prescribe medication to lower intraocular pressure, in order to increase blood flow to the optic nerve. Finally, if patients are diagnosed with a more rare cause of ischemic neuropathy, called GCA, steroids may be prescribed.

Low Vision Rehabilitation

• Because the vision loss associated with ischemic neuropathy is often permanent, doctors typically try to rehabilitate or treat the resulting low vision. Special rehabilitators, including glasses, sun filters, magnifiers and even closed-circuit television systems with magnifying properties, may be recommended to help patients cope with the loss of magnification, contrast, glare control and visual field.

Prognosis

• Between 20 and 25 percent of patients with ischemic neuropathy in one eye will experience the condition in the other eye within three years. However, the good news is that approximately 40 percent of patients with ischemic neuroapthy may experience some improvement in vision in the time following the initial loss of vision.