Corticosteroids for the treatment of non-arteritic anterior ischemic optic neuropathy

Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of an acute unilateral optic neuropathy in patients older than 50 years of age. Its consequences range from temporarily disabling to permanently blinding. Unfortunately, the pathophysiology of NAION is incompletely understood and no proven effective treatment for NAION currently exists. Numerous theories have been proposed regarding the pathophysiology of NAION including hypoperfusion of the optic nerve, nocturnal hypotension, and in rare cases thrombotic or embolic etiologies. Notably, newer evidence has implicated possible inflammatory processes in NAION leading to potential, theoretical benefit from corticosteroid treatment. This review will spotlight the pros and cons of corticosteroid treatment in NAION.