The Relationship between Ischemic Optic Neuropathy and Internal Carotid Artery Dissection: A Systematic Review

TL;DR

This systematic review explores the rare but important link between internal carotid artery dissection and ischemic optic neuropathy, especially in young adults with vision loss and head pain.

Contribution

The study systematically reviews evidence linking internal carotid artery dissection to ischemic optic neuropathy, highlighting its rarity and clinical relevance.

Findings

Only 16 patients with ION following ICAD were identified across 14 studies.

Most cases involved spontaneous ICAD, with ages averaging around 49 years.

Ophthalmologists should consider ICAD as a potential cause of ION in young adults with vision loss and head pain.

Abstract

Background: To evaluate and review the current evidence regarding the association between ischemic optic neuropathy (ION) and internal carotid artery dissection (ICAD). Methods: We systematically reviewed studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA), searching three databases (Scopus, Pubmed, and Embase) for relevant articles that clearly described the correlation between ION and ICAD. All studies that examined the association between ICAD and the development of ION were synthesized. Quality assessment using the Newcastle–Ottawa Scale (NOS) and Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and Case Series were conducted. Results: Our search yielded 198 manuscripts published in the English language. Following study screening, fourteen studies were selected. The number of participants with ION following ICAD ranged from one to four, with sixteen patients experiencing either anterior ION, posterior ION, or a combination of both. The anterior or posterior ischemic optic neuropathy (AION and PION) patients’ ages were 48.75 ± 11.75 and 49.62 ± 12.85, respectively. Fourteen out of sixteen patients experienced spontaneous ICAD, whereas the traumatic etiology was ascertained in two patients. Conclusions: Hence, albeit rare, ophthalmologists should consider ICAD a potential cause of ION, especially in young adults with concomitant cephalic pain and vision reduction.

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