A 70-year-old man with giant cell arteritis presents with sudden painless visual loss and a pale, edematous optic disc with disc sector infarction visible on fundus examination. What distinguishes this condition from the non-arteritic form?
- A Arteritic AION shows segmental disc pallor while non-arteritic shows diffuse hyperemia
- B Non-arteritic AION occurs in younger patients with larger cup-to-disc ratios (disc at risk)
- C Arteritic AION is associated with a chalky white disc, cup-to-disc ratio >0.5, elevated ESR/CRP, and risk of fellow eye involvement without treatment ✓
- D Arteritic AION is bilateral at onset while non-arteritic is always unilateral
Explanation
Arteritic anterior ischaemic optic neuropathy (A-AION) due to giant cell arteritis produces a chalky white disc (compared to the hyperemic swelling of non-arteritic AION), is associated with markedly elevated ESR (>50 mm/hr) and CRP, jaw claudication, scalp tenderness, and temporal artery thickening/tenderness. Without urgent systemic corticosteroids, the fellow eye is at extreme risk (up to 50% involvement within days). Non-arteritic AION (NA-AION) occurs in the small, crowded 'disc at risk' with small cup-to-disc ratio and is associated with systemic hypertension and diabetes.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.