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Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause. [1] The swelling is usually bilateral and can occur over a period of hours to weeks. [2] Unilateral presentation is extremely rare. In intracranial hypertension, the optic disc swelling most commonly occurs bilaterally.
Unilateral or bilateral optic disc edema may occur. The exact etiology, pathogenesis and mechanism of the disc edema is unknown. [ 1 ] [ 2 ] Theories suggest that the dis edema is due to retinal vascular leakage into and surrounding the optic nerve and disruption of axoplasmic flow resulting from microvascular disease of the optic nerve head. [ 2 ]
Advanced retinopathy lesions, such as microaneurysms, blot hemorrhages and/or flame hemorrhages, ischemic changes (e.g. "cotton wool spots"), hard exudates and in severe cases swelling of the optic disc (optic disc edema), a ring of exudates around the retina called a "macular star" and visual acuity loss, typically due to macular involvement.
In patients with headaches, the finding of swollen optic discs, or papilloedema, on fundus photography is a key sign, as this indicates raised intracranial pressure (ICP) which could be due to hydrocephalus, benign intracranial hypertension (aka pseudotumour cerebri) or brain tumor, amongst other conditions. Cupped optic discs are seen in glaucoma.
Schematic diagram of the human eye, with the optic disc, or blind spot, at the lower left. Shown is a horizontal cross section of the right eye, viewed from above. A normal optic disc is orange to pink in colour and may vary based on ethnicity. [3] A pale disc is an optic disc which varies in colour from a pale pink or orange colour to white. A ...
Macular edema; Other names: Macular oedema, [1] familial macular edema: A 61-year-old man with medical history of type 2 diabetes that presents a macular edema, evidenced by an OCT (the edema marked with arrows). The central image is a 3D reconstruction of the retinal thickness (the edema is coloured in red). Specialty: Ophthalmology
Ischemic optic neuropathies are classified based on the location of the damage and the cause of reduced blood flow if known. [3] Anterior ischemic optic neuropathy (AION) includes diseases that affect the optic nerve head and cause swelling of the optic disc. These diseases often cause sudden rapid visual loss in one eye.
disc edema in the contralateral eye; central scotoma (loss of vision in the middle of the visual fields) in the ipsilateral eye; The presence of anosmia (loss of smell) ipsilateral to the eye demonstrating optic atrophy was historically associated with this syndrome, but is now understood to not strictly be associated with all cases. [4]