Ten cases of optic vasculitis

Abstract

Optic disc vasculitis is an idiopathic, usually benign condition in young healthy adults. Hayreh suggested that the condition is to be divided into two types: type 1, with optic disc edema and a benign course as the dominant features and type 2, a condition resembling a central retinal vein (CRV) occlusion with a variable outcome depending on the extent and the site of the lesion. Differential diagnosis with other causes of one-sided papilledema (type 1) and other vascular conditions (type 2) is very difficult but important. We suggest performing extensive ophthalmological and neurological examinations to exclude major diseases. In this article we will give a review of the literature and a description of the ten patients with optic disc vasculitis who were seen in our clinic between January 1983 and August 1986.

Optic disc vasculitis

“…Our critical evaluation of the cases reported under the eponyms of "retinal vasculitis" [26], "papillophlebitis" [25], "mild retinal and papillary vasculitis" [8], and "benign retinal vasculitis" [10] reveals that in fact all of them belonged to the category of non-ischemic CRVO in young persons. Similarly, cases described by some authors as "optic disc vasculitis" [2,4,6] and "optic disc vasculitis type II" [12] were in fact CRVO in young persons and not true ODV as described in the present study. Histopathological evidence indicates that inflammatory infiltration of the intraneural part of the central retinal vein may cause CRVO in young adults either by its invasion of the lumen or by thrombosis [2,3,7,8,24].…”

“…Thus, from Hayreh's original description [12], only ODV type I could be considered true ODV. To date, only three additional papers have been published describing cases of "optic disc vasculitis"; however, a critical review of those papers revealed that in two of them the patients had non-ischemic CRVO [4,6] and in one, ischemic CRVO [2].…”

Papillophlebitis and the differential diagnosis of unilateral optic disc oedema

“…5 Patients with papillophlebitis are otherwise healthy in the majority of cases. 4 Each of these factors, with the exception of the central scotoma, is consistent with the presentation of this case and as the other possible diagnoses have been ruled out, I consider that papillophlebitis is the most probable classification of this patient's condition.…”

“…3 The ophthalmoscopic appearance of papillophlebitis consists of unilateral optic disc oedema, venous dilatation and variable amounts of haemorrhage on the disc and in the peripapillary region. 4 Patients are largely asymptomatic, although some may report a vague fogginess of vision. 4 Two possible causes of papillophlebitis have been identified.…”

“…4 Patients are largely asymptomatic, although some may report a vague fogginess of vision. 4 Two possible causes of papillophlebitis have been identified. 5 The first is that the veins of the optic disc become irritated and inflamed by some unknown cause.…”