Salvage of vision after hypotension-induced ischemic optic neuropathy

Am J Ophthalmol. 1994 Feb 15;117(2):235-42. doi: 10.1016/s0002-9394(14)73082-x.


No effective treatment has been established for nonarteritic anterior ischemic optic neuropathy. Although most cases occur spontaneously, acute hypotension plays a clear role in a subset of patients. We examined three patients with severe visual loss from ischemic optic neuropathy induced by hypotension. The first patient developed anterior ischemic optic neuropathy after excessively rapid correction of malignant hypertension. In the second patient, anterior ischemic optic neuropathy occurred after an episode of orthostatic hypotension from systemic hypovolemia. The third patient developed anterior ischemic optic neuropathy after becoming hypotensive during a routine hemodialysis session. Measures were undertaken immediately to reverse the hypotension in all three patients. This intervention resulted in partial recovery of vision in each patient.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Female
  • Humans
  • Hypotension / complications
  • Hypotension / physiopathology*
  • Ischemia / etiology
  • Ischemia / physiopathology*
  • Male
  • Optic Disk / blood supply*
  • Optic Disk / physiopathology
  • Optic Nerve Diseases / etiology
  • Optic Nerve Diseases / physiopathology*
  • Vision, Ocular / physiology*
  • Visual Acuity / physiology
  • Visual Fields / physiology