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Diagnosis requires exclusion of other neurological, ophthalmological, and systemic conditions. [3] Any cause of optic neuropathy should be ruled out, including demyelinating ( MOG antibody disease , multiple sclerosis , and neuromyelitis optica ) and systemic disease (diabetic, toxic, nutritional, and infectious causes). [ 3 ]
The mechanism of injury for NAION used to be quite controversial. However, experts in the field have come to a consensus that most cases involve two main risk factors. The first is a predisposition in the form of a type of optic disc shape. The optic disc is where the axons from the retinal ganglion cells collect into the optic nerve.
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In children, optic disc drusen are usually buried and undetectable by fundoscopy except for a mild or moderate elevation of the optic disc. With age, the overlying axons become atrophied and the drusen become exposed and more visible. They may become apparent with an ophthalmoscope and some visual field loss at the end of adolescence. [7]
Drusen, from the German word for node or geode (singular, "Druse"), are tiny yellow or white accumulations of extracellular material that build up between Bruch's membrane and the retinal pigment epithelium of the eye. The presence of a few small ("hard") drusen is normal with advancing age, and most people over 40 have some hard drusen. [1]
Cupping of the optic disc was found in 89% of DOA patients in at least one of their eyes. [ 6 ] With loss of the central visual fields, there is impairment of color vision in addition to loss of visual acuity varying from mild to severe, typically ranging from 6/6 (in meters, equivalent to 20/20, ft) to 6/60 (20/200, ft) with a median value of ...
Another symptom is metamorphopsia. [1] Signs include polypoidal lesions, orange-red lesions in fundus, subretinal fluid, retinal detachment, subretinal hemorrhages, subretinal fibrinous material, hard exudates and drusen .
Major symptoms are sudden loss of vision (partial or complete), sudden blurred or "foggy" vision, and; pain on movement of the affected eye. [4] [5] [2]Many patients with optic neuritis may lose some of their color vision in the affected eye (especially red), with colors appearing subtly washed out compared to the other eye.