Which ophthalmoscopy findings in acute anterior ischemic optic neuropathy (AION) indicate giant cell arteritis (GCA) (temporal arteritis)?

Updated: Sep 03, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Ophthalmoscopy in acute AION may show sludging of blood in retinal arterioles, which can be orthostatically sensitive. The optic disc may show chalky white pallor and edema, with or without splinter hemorrhages along the disc margin. See the image below.

Anterior ischemic optic neuropathy. Image courtesy Anterior ischemic optic neuropathy. Image courtesy of Richard Kho, MD, Q.C. Eye Center, Quezon City, Philippines.

As AION evolves, the absolute amount of disc elevation tends to be modest (< 3 diopters in most cases), with infrequent areas of disc hemorrhage. Edema resolves within 10 days or so; within 2-4 weeks, it is replaced by optic atrophy.

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