Arteritic anterior ischemic optic neuropathy (AAION) secondary to giant cell arteritis (GCA)
Contributor: Jesse Vislisel, MD
Photographer: Cindy Montague, CRA
Arteritic anterior ischemic optic neuropathy (AAION) is the leading mechanism of vision loss caused by giant cell arteritis (GCA). This is an 82-year-old woman with significant vision loss secondary to bilateral AAION. She subsequently had a temporal artery biopsy confirming the diagnosis of GCA. AAION is caused by inflammatory and thrombotic occlusion of the short posterior ciliary arteries and subsequent ischemia to the optic nerve. This photo exemplifies the characteristic "pallid disc edema" of AAION in contrast to the hyperemic appearance that usually accompanies edema of the optic nerve head. The fluorescein angiogram shows delayed and patchy choroidal filling which is also characteristic of GCA.
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