Joint Position Paper on Anterior Ischemic Optic Neuropathy (AION). Vascular Risk Group and Systemic Autoimmune Diseases Group (GEAS) of the Spanish Society of Internal Medicine (SEMI) together with the Spanish Retina and Vitreous Society (SERV).

TL;DR

AION is a leading cause of sudden monocular vision loss in patients over 50, with arteritic (GCA-associated) and non-arteritic forms requiring different management approaches. This joint position paper provides consensus recommendations for improved clinical management emphasizing ophthalmology-internal medicine collaboration.

Key findings

• Arteritic AION (associated with GCA) is a medical-ophthalmological emergency requiring urgent evaluation
• Non-arteritic AION is more common but lacks specific effective treatments; secondary prevention of vascular complications is emphasized
• Management heterogeneity exists across providers; standardized care pathways and etiological assessment are recommended
• Close collaboration between ophthalmology and internal medicine is essential, with internists playing a key role in evaluating vasculitis and systemic disease

Why this matters at the bedside

High—provides consensus-based recommendations for a common cause of acute vision loss in older adults, addressing diagnostic and management gaps in routine care, particularly regarding early detection and prevention of systemic complications.