SALVAGE OF VISION AFTER HYPOTENSION-INDUCED ISCHEMIC OPTIC NEUROPATHY

No effective treatment has been established for nonarteritic anterior ischemic optic neuropathy. Although most cases occur spontaneously, ac ute hypotension plays a clear role in a subset of patients. We examine d three patients with severe visual loss from ischemic optic neuropath y induced by hypotension. The first patient developed anterior ischemi c optic neuropathy after excessively rapid correction of malignant hyp ertension. In the second patient, anterior ischemic optic neuropathy o ccurred after an episode of orthostatic hypotension from systemic hypo volemia. The third patient developed anterior ischemic optic neuropath y after becoming hypotensive during a routine hemodialysis session. Me asures were undertaken immediately to reverse the hypotension in all t hree patients. This intervention resulted in partial recovery of visio n in each patient.