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Klin Monbl Augenheilkd 2015; 232(11): 1260-1269
DOI: 10.1055/s-0035-1558170
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Die nicht arteriitische anteriore ischämische Optikusneuropathie (NAION)

Non-Arteritic Ischemic Optic Neuropathy (NAION)
H. Wilhelm
1   Augenheilkunde, Universitätskliniken Tübingen
,
F. Beisse
2   Augenheilkunde, Universitätskliniken Heidelberg
,
K. Rüther
3   Augenarztpraxis, Dorotheenstraße 56, Berlin
› Institutsangaben
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Publikationsverlauf

eingereicht 29. Juli 2015

akzeptiert 07. September 2015

Publikationsdatum:
17. November 2015 (online)

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Zusammenfassung

Die nicht arteriitische anteriore ischämische Optikusneuropathie (NAION) ist außerhalb der Augenheilkunde nahezu unbekannt. Ihr Merkmal ist eine akute einseitige Sehverschlechterung ohne Augenbewegungsschmerz mit obligater Papillenschwellung. Die Papillenschwellung bildet sich, eine Atrophie hinterlassend, innerhalb 1–2 Monaten zurück, das Sehvermögen bessert sich i. d. R. kaum. Die NAION entsteht mit großer Wahrscheinlichkeit durch das Zusammenwirken lokaler Besonderheiten der Blutversorgung der Sehnervenpapille und allgemeiner vaskulärer Risikofaktoren. Unter diesen Risikofaktoren spielen Diabetes, Hypertonie und vor allem das Schlafapnoe-Syndrom eine wichtige Rolle. Rezidive am betroffenen Auge sind selten, aber am Partnerauge kommt es in ca. 15 % zum Rezidiv. Es gibt keine durch Studien abgesicherte Therapie, aber allgemeinen Konsens, dass die Bekämpfung aller Risikofaktoren sinnvoll ist.

Abstract

Non-arteritic ischemic optic neuropathy (NAION) is virtually unknown outside ophthalmology. It is characterised by acute unilateral visual loss, no pain on eye movements and virtually always optic disc swelling. Optic disc oedema resolves within 1 to 2 months, leaving behind optic atrophy. Vision hardly improves. NAION is the product of local abnormalities of the vascular supply to the optic nerve and general vascular risk factors. Of these, diabetes, hypertension and especially sleep apnoea syndrome are the most important. Recurrences in the involved eye are rare; contralateral recurrence occurs in approximately 15 % of patients. There is no clear scientific evidence for any specific therapy. However, there is general agreement that it is reasonable to control risk factors.

Schlüsselwörter

Sehnerveninfarkt - Riesenzellarteriitis - Schlafapnoe - Neuroophthalmologie

Key words

optic nerve infarction - giant cell arteriitis - sleep apnea - neuroophthalmology
 

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