Insights into Ocular Emergencies: case Series on Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) Secondary to Acute Angle Closure Glaucoma

Alia Arianti,1,* Emma Rusmayani,2,* Viona Viona3,* 1Department of Neuro-Ophthalmology, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia; 2Department of Glaucoma, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia; 3Department of Research, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia*These authors contributed equally to this workCorrespondence: Alia Arianti, Department of Neuro-Ophthalmology, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Terusan Arjuna Utara/ 1 Kedoya, West Jakarta, Jakarta, 11520, Indonesia, Email alia.arianti@jec.co.idAbstract: This case series aims to report the manifestation of acute secondary optic neuropathy attributed to optic nerve injury associated with a singular episode of markedly elevated intraocular pressure (IOP) during an acute glaucoma attack. The correlation between acute primary angle-closure (APAC) and non-arteritic anterior ischemic optic neuropathy (NAION) remains uncertain within the context of current knowledge. Definitive conclusions regarding the causal relationship between APAC and NAION or their mutual influence cannot be established based on the current evidence. The association between these conditions is recognized as a potential link, and comprehensive research is imperative to elucidate their interrelationship thoroughly. This case series emphasizes the importance of promptly addressing acute optic nerve injury and neuropathy associated with elevated intraocular pressure (IOP) in patients with crowded disc anatomical risk factors. It underscores the need for proactive interventions to prevent irreversible damage, highlighting the infrequent yet vision-compromising occurrence of non-arteritic anterior ischemic optic neuropathy (NAION) in acute primary angle-closure (APAC).Keywords: AACG, NAION, Acute Glaucoma Attack, Neuropathy