In anterior ischemic optic neuropathy (AION), the arteritic form (A-AION due to giant cell arteritis) differs from non-arteritic AION (NA-AION) in which of the following ways?
- A NA-AION causes bilateral simultaneous optic nerve involvement in the majority of cases
- B A-AION causes more severe and often total visual loss with chalk-white disc edema; it is a sight-threatening emergency requiring systemic corticosteroids ✓
- C A-AION predominantly affects young diabetic patients under 50 years
- D NA-AION is associated with ESR >100 mm/hr and requires temporal artery biopsy
Explanation
Arteritic AION (GCA-related) causes severe, often complete and irreversible visual loss due to occlusion of posterior ciliary arteries supplying the optic nerve head. The optic disc edema is classically chalk-white (ischemic pallor rather than hyperemia). ESR is markedly elevated (often >100 mm/hr), CRP elevated, platelets raised. Temporal artery biopsy is diagnostic (skip lesions require adequate biopsy length >2 cm). High-dose systemic corticosteroids (IV methylprednisolone 1 g/day × 3 days followed by oral) must be started IMMEDIATELY — even before biopsy — to protect the fellow eye (30–60% risk without treatment). NA-AION occurs in the 'disc at risk' configuration, affects one eye, with spontaneous partial recovery common.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.