Despite that many doctors and clinics are not aware of this, treating NAAION is an emergency situation, at least for those approximately 60% of patients who will not see improvements or stabilization of the vision loss occur without intervention.
The one sole existing and potentially working (not with all NAAION patients but the majority) treatments available to try stop loss of vision – even possible blindness in one eye or both – by reducing the disc edema faster than occurs naturally, must be started at the latest within 14 days of the NAAION event, preferably a week or more earlier, when optic disc swelling is still present. The earlier the better.
This sole one potentially working treatment is:
Oral steroids following the protocol advised by neuro-ophthalmologist at the University of Iowa (USA) and ‘father’ of NAAION, Prof. Sohan Hayreh, who researched this subject for many decades, second to none.
For the details of the oral steroids treatment, please consult the section Management of NA-AION of Prof. Hayreh’s excellent online article for clinicians on AION’s. The oral steroids course (not IV, as those were shown not to work!) starts with 2 weeks of 80 mg daily followed by tapering off in weekly steps). The purpose is to speed up the resolution of the optic disc edema to break the cycle of destruction of axons and retinal ganglion cells faster than with letting it run its course without treatment..
Note: Some doctors do not inform the patients of this option to let them decide on their own out of not knowing this or some are very opinionated about the orals steroids treatments, some even provide outright misinformation on that treatment not working based on a flawed tiny study with a prejudiced investigator or they refer wrongly to studies with IV injections of steroids which are not the same as oral steroids in effectiveness and some doctors simply wrongly scare off patients exaggerating side effects while millions of patient, the great majority, never encounter such side effects or have some lightly and temporarily. Other doctors are completely on board of using thr orals steroids treatment with the restriction that patients with diabetes or other immune system related issues correctly may not qualify.
Other treatments: Unfortunately other attempts at treating NAAION in the acute phase and beyond have FAILED, some were even never working but were (or are still) sold under outright misleading unscientific premises. A few of such failed treatments with drugs or devices are:
– RPH201 (injected)
– QPI-1007 (injected)
– Hyperbaric oxygen therapy
– Electrical stimulation
– Stem cell therapy
– Topical brimonidine tartrate (Alphagan)
– Levodopa
– intravitreal injections of bevacizumab
So remember: Time is of the essence! This is an emergency treatment disease, not one to be gradually diagnosed and treated via appointments.
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