Purpose: Outcome of transvitreal optic neurotomy application in a patient with nonarteritic anterior ischemic optic neuropathy(NAION).

Case Report: 55 year old patient had vision loss in his left eye for 1 week with 2 meters finger counting visual acuity. He had afferent pupillary defect; edema, pallor, flame shaped hemorrhages on the optic disc. Fundus Fluorescein angiography (FFA) showed intense fluorescein leakage in the optic disc. With systemic, ophthalomologic examination and blood tests, he was thought to have nonarteritic anterior ischemic optic neuropathy. He had no systemic pathology that predisposed to NAION. Following informed consent we applied transvitreal optic neurotomy (TON). Two weeks later his visual acuity increased to 5 meters finger counting. Fundoscopic examination showed no disc edema, FFA showed decrease in fluorescense leakage from the optic disc. Eight weeks later his visual acuity increased up to 0,2; his goldmann perimeter showed widening of blind spot and paracentral scotoma not related to his illness.

Discussion: So many medical and surgical treatment modalities have been tried in patients diagnosed as NAION but still no successful results have been achieved. Central retinal vein occlusion has similar pathophysiologic mechanisms with NAION and radial optic neurotomy application to these patients showed successful results. Application of the same method to NAION patients also showed promising results. Studies with large patient population and longer follow up should be done in order to evaluate this method's reliability and effectivity.