1220hrs Session 2 Panel Discussion, Duncan Anderson, MD moderator

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Dr G Haye: What Tx would you take yourself

- Dr Arnold responds ASA and maybe avastin has some hope for future

- Dr Cockerham responded she would go for Hayreh approach with steroids even though little support

- Dr D Anderson opts for ASA

Dr D Anderson: 2nd eye in younger patients, is this 'disc at risk' patient

- Dr Arnold does believe in disc at risk idea and every one of the younger patients had this so called disc at risk; none of prothrombotic or homocystein factors

- Dr Cockerham adds: FDA advised makers of Viagra to do study to look for causative association of it and NAION. Notes ALL patients who took drug and got NAION had disk at risk, took pill and had sex at night. Therefore, consider sex in AM if disk at risk

Dr V asks: myositis not a listed topic but how would one treat this? Can you have optic nerve glioma with enophthalmos?

Dr Kazim responds: configuration of the orbit can allow for a relative enophthalmic appearance with the glioma just not producing enough volume to produce proptosis. The myositis question is much bigger. In children, some respond to high dose NSAID but others need adjunctive treatment like TGNalpha blockers. In adults with myositis, most respond to steroid and those that recur should be biopsied. Also, in adults, methotrexate can help for those who fail to respond.

Dr Cockerham, says Tx anagous to uveitis eg if recur, more likely to treat, etc.

Dr McFadden: Any CSR related to Viagra seen?

Dr Arnold not aware of any.