Anterior ischemic optic neuropathy is not associated with carotid artery atherosclerosis

Background and Purpose: The relation between anterior ischemic optic neuropathy and carotid artery atherosclerotic disease is unclear. We studied patients with anterior ischemie optic neuropathy to determine if they had an increased occurrence of carotid artery stenosis. Methods: Fifteen consecutive patients with anterior ischemie optic neuropathy were evaluated prospec-tively for cervical carotid artery stenosis and compared with 30 age- and sex-matched asymptomatic patients and also with 11 age- and sex-matched patients experiencing transient monocular blindness. Results: There was no difference in the mean stenosis of the internal carotid artery between patients with anterior ischemie optic neuropathy (mean carotid stenosis, 19%) and asymptomatic patients (mean carotid stenosis, 9%;p>0.05), whereas patients with transient monocular blindness had significantly more stenosis (mean, 77%) in the cervical carotid arteries than both control subjects (p< 0.0001) and patients with anterior ischemie optic neuropathy (p < 0.0001 ). There was also no difference in the percentage of patients with stenosis ≥30% in anterior ischemie optic neuropathy (two of 15) and asymptomatic patients (five of 30), whereas 10 of 11 patients with transient monocular blindness had stenoses ≥30%, significantly more than patients with anterior ischemie optic neuropathy (p<0.0001) and asymptomatic patients ( p < 0.0001 ). Conclusions: Anterior ischemie optic neuropathy is not a marker for atherosclerotic carotid artery stenosis. The pathogenesis of nonarteritic anterior ischemie optic neuropathy does not involve carotid artery stenosis in most patients.