Optic Disc Swelling

By posted on July 2, 2014 8:21AM
Optic Disc Swelling

Optic Disc Swelling

Optic disc edema is seen as blurring of the disc margins.

Nerve fibers anterior to lamina cribrosa swell due to
obstruction of axoplasmic flow at level of lamina
choroidalis or lamina scleralis
Orthograde transport (ganglion cells to LGB): slow
component = 2mm/day; fast component = 500mm/day
Retrograde transport (LGB to ganglion cells)

Mechanism: ischemia, inflammation, increased
intracranial pressure, compression

Findings: elevated hyperemic nerve head (3 diopters =
1mm), blurred disc margins, loss of physiologic cup,
peripapillary NFL edema, chorioretinal folds,
dilatedtortuous veins, peripapillary flame-shaped
hemorrhages, exudates, cotton wool spots (nerve fiber layer
[NFL] infarcts)
Chronic swelling may cause Paton’s lines (radial or
concentric folds of peripapillary retina), gliosis, high water
marks, pale disc, disc pseudodrusen, attenuated vessels,
vision loss

DD of optic disc edema /pseudoedema: papilledema, ischemic optic
neuropathy, optic neuritis, central retinal vein occlusion
(CRVO), diabetic papillitis, malignant hypertension,
neuroretinitis (cat-scratch disease), infiltration of the optic
disc (sarcoidosis, tuberculosis, leukemia, metastases), optic
disc drusen, optic nerve head tumors (astrocytic
hamartoma, gliomas, capillary hemangioma), orbital
disease,compressive optic neuropathy (thyroid-related
ophthalmopathy, orbital pseudotumor, orbital mass),
inflammatory diseases (syphilis, acute posterior multifocal
placoid pigment epitheliopathy [APMPPE], Vogt-Koyanagi-
Harada [VKH] syndrome), Leber’s hereditary optic
neuropathy

Optic Disc Swelling
Optic Disc Swelling

Source: 

Ophthalmology Atlas(Photos of cases)

Optic Disc Swelling 

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