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[DOI] [PubMed] [Google Scholar] 24.Onofrj M., Ciccocioppo F., Varanese S., di Muzio A., Calvani M., Chiechio S., Osio M., Thomas A

Although it is not clear how these injectables are causing NAION, it is hypothesized that the drugs effect on blood pressure and vascular tone may contribute to reduced blood flow to the optic nerve in susceptible users

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Nevertheless, the increase of PyroGlu and decrease of Glu seems more reflecting the low ATP cellular content leading to a locking of the gamma-glutamyl cycle from the first step requiring ATP after PyroGlu synthesis