Ischemic Optic Neuropathy in Chronic Papilledema

Cup-Disc Ratio and Ischemic Optic Neuropathy

“…Feit et al2 pointed out that the cases of AION preceded by disc edema probably have some nonvascular explanation for the edema. The occur¬ rence of AION in papilledema sug¬ gests that local factors in the optic disc may contribute to infarction 10. …”

Reversible Visual Loss in Pseudotumor Cerebri

“…(Arch Ophthalmol 1984;102:403-406) Tt is estimated that of 10% to 20% of -*-patients with chronic pseudotumor cerebri suffer permanent visual loss.14 The pathogenesis of impaired visual function of sudden onset in these patients is primarily related to chron¬ ic changes in the axoplasmic flow in the optic nerve in conjunction with circulatory alterations that could result in anterior optic nerve ische¬ mia. 5 We describe a patient with chronic pseudotumor cerebri and optic atrophy who had a sudden dete¬ rioration of vision in the only seeing eye secondary to an incomplete cen¬ tral retinal vein (CRV) occlusion that coincided with a massive rise in intra¬ cranial pressure and a fall of the mean systemic arterial BP. Several mechanisms were responsible for the patient's visual loss: (1) long-standing alterations of axoplasmic flow, (2) long-standing increased CRV system pressure, and (3) sudden impairment of venous and arterial blood flow sec¬ ondary to a massive increment in the intracranial pressure.…”

Flow velocity and pulsatility of the ocular circulation in chronic intracranial hypertension

“…Although visual field loss in papilledema could be unrelated to blood flow, the typical inferonasal visual field defect in pseudotumor patients may resemble anterior ischemic optic neuropathy (AION) (38), consistent with retrolaminar ischemia secondary to chronic stasis of axoplasmic flow (4, 39, 40). In our study visual field defects were mostly of a mild‐moderate degree (−5 to −15 dB) and not correlated with actual ICPs.…”