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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.
Optic-disc edema will be graded based on the Frisén Scale [48] as below: Stage 0 – Normal Optic-disc Blurring of nasal, superior and inferior poles in inverse proportion to disc diameter. Radial nerve fiber layer (NFL) without NFL tortuosity. Rare obscuration of a major blood vessel, usually on the upper pole. Stage 1 – Very early optic ...
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 ]
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.
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.
Non-arteritic anterior ischemic optic neuropathy (NAION) is a medical condition characterized by loss of vision caused by damage to the optic nerve as a result of ischemia, or insufficient blood supply. The key symptom of NAION is optic disc swelling, which typically resolves within 2 months, but often leads to optic atrophy. The likelihood of ...
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.
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.