Optic Disc Abnormalities – Diagnosis, Evolution and Influence on Visual Acuity

Abstract

Congenital abnormalities of the optic disc are not so rare. The etiology for the most of them is unknown. Visual acuity of affected eye may be minimally or severely affected, depending on the extent of lesion. All of these conditions can be unilateral or bilateral. Children who have unilateral optic disc abnormalities generally present during the preschool years with sensory esotropia. Visual acuity may be unaffected like in optic disc pit, optic disc drusen, fibre medullares, ect. However, during the evolution they may cause a decrease in visual acuity like serous retinal detachment in optic disc pit, atrophy or subretinal neovascularisation in optic disc drusen. Some of them like fibre medullares needs only a good diagnose and they do not have any evolution. Fluorescein angiography and ultrasonography may be crucial diagnostic procedures to discover some of them, like optic disc drusen. Optic disc abnormalities may be associated with other congenital disorders of the eye and often central nervous system malformations. Secondary they may be associated retinal detachment, retinochisis, macular edema, choroid neovascularisation and lipid exudation. Some of these conditions may be found on routine ophthalmologic exam such as optic disc drusen and fibre medullares and often are diagnostically problem. The aim of our study was to present some of our cases with different optic disc abnormalities such as fibre medullares, optic disc coloboma, hypoplasio disc, optic disc drusen and optic disc pit.

Papilledema as a diagnostic challenge — report of three cases

“…Clinical entities that can cause elevated intracranial pressure include a variety of inflammatory, infectious, toxic, metabolic, genetic, or vascular conditions, such as hypertension and intracranial tumours [1][2][3]. ONSM is a rare tumour.…”

“…It may be bilateral or unilateral. Bilateral optic disc edema is an important clinical sign that can reflect various inflammatory, infectious, toxic, metabolic, genetic, or vascular conditions, such as hypertension [1,2]. Unilateral papilledema is observed in patients with tumours of the optic nerve and with external compression of the optic nerve, such as endocrine orbitopathy, retrobulbar tumours, and ethmoidal cysts [3,4].…”

Optical coherence tomography in optic disc pit diagnosis

“…Впервые подобное состояние описал T. Wiethe в 1882 г. Как правило, ямки ДЗН бывают одно-сторонними, однако в 15 % случаев патология носит билатеральный характер [1][2][3].…”

“…Офтальмоскопически ямка ДЗН выглядит как круглый или овальный участок углубления размером 0,1-0,7 диаметра ДЗН, расположенный преимущественно по его нижне-темпоральному краю. В 1 [1][2][3][4][5]. Вопрос патогенеза формирования ямки ДЗН до сих пор остаётся открытым.…”

“…Большинство авторов считает, что ямка ДЗН формируется вследствие неполного закрытия эмбриональной щели зрительного нерва и чаще всего развивается в первом триместре беременности. Формирование её объясняют внедрением рудиментарной сетчатки в межоболочечное пространство зрительного нерва [3,4,6].…”