Arteritic posterior ischemic optic neuropathy (A-PION) arising from giant cell arteritis, in individuals aged 50 years or older. In this population, ruling out giant cell arteritis is the critical first step whenever posterior ischemic optic neuropathy is encountered.
Management of A-PION is similar to that of arteritic anterior ischemic optic neuropathy. High-dose systemic corticosteroid therapy must be started immediately, as an emergency measure. The complete regimen — including specific agents, dosing strategy, and the criteria for tapering — is set out in the full structured protocol.
DOI: 10.4103/0301-4738.77024
Arteritic PION (A-PION): due to GCA.
In all cases other than surgical PION, as in AION, the most important first step in persons aged 50 years or older is to rule out GCA always.
A-PION: Management is similar to that of A-AION discussed above.
high doses of systemic corticosteroid therapy must be started immediately, as an emergency measure.
High-dose steroid therapy must be maintained until both the ESR and CRP settle down to a stable, low level, which usually takes 2–3 weeks – CRP usually settles much earlier than the ESR.
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