The upper record shows that when she was using verapomil at bedtime, there was marked degree of fall of blood pressure during sleep which improved markedly on stopping the bedtime dose, as seen in the lower chart. We have discussed this at length elsewhere. 22,25,28,32,36,39 Typically patients with non-arteritic and often those with arteritic AION discover visual loss on waking in the morning. In view of all this evidence, it seems that in some persons non-arteritic AION may possibly be occurring as an iatrogenic disease. This brief discussion, then, gives some idea of the great complexity of mechanisms of development of non-arteritic AION and the role of nocturnal arterial hypotension in it.
Nocturnal hypotension seems to be an important precipitating factor in the susceptible patient.
There is a significant association between non-arteritic AION and a number of eye and optic nerve head conditions. Reproduction of any part of this material is not permitted without express permission from Dr. Hayreh. The University of Iowa. All Rights Reserved.