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The repetition of an idiopathic optic neuritis is considered a distinct clinical condition, and when it shows demyelination, it has been found to be associated to anti-MOG and AQP4-negative neuromyelitis optica. [20] When an inflammatory recurrent optic neuritis is not demyelinating, it is called chronic relapsing inflammatory optic neuropathy ...
Retrobulbar neuritis, an inflamed optic nerve, but with a normal-appearing nerve head, is associated with pain and the other findings of papillitis. Pseudopapilledema is a normal variant of the optic disk , in which the disk appears elevated, with indistinct margins and a normal vascular pattern.
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.
hemorrhages over and/or adjacent to the optic disc; blurring of optic margins; elevation of the optic disc; Paton's lines (radial retinal lines cascading from the optic disc) On visual field examination, the physician may elicit an enlarged blind spot; the visual acuity may remain relatively intact until papilledema is severe or prolonged.
Optic neuritis involving internal fibers of the optic nerve causes central scotoma. [ 4 ] lf unilateral central scotoma is detected, careful observation of the temporal visual field of other eye is essential to rule out the possibility of compressive lesions at the junction of optic nerve and optic chiasm.
This optic nerve must penetrate through the wall of the eye, and the hole to accommodate this is usually 20-30% larger than the nerve diameter. In some patients the optic nerve is nearly as large as the opening in the back of the eye, and the optic disc appears "crowded" when seen by ophthalmoscopy. A crowded disc is also referred to as a "disc ...
Examination findings may include microaneurysms, cotton wool spots, dot and blot hemorrhages, and neovascularization. [8] [10] Dilated fundus exam is the preferred method of diagnosis, as undilated exam may be too limited to visualize lesions or neovascularization that are more peripheral. [11]
Magnetic resonance imaging can capture optic nerve inflammation, but this finding is not present in all patients, [1] [3] [13] Diffusion tensor imaging has been shown to detect widespread white matter abnormalities in CRION patients with normal MRI findings. [14] Five diagnostic criteria had been proposed in 2014: [3] History of optic neuritis ...
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