Visual Outcome in Eyes With Asymptomatic Optic Disc Edema

Abstract

Asymptomatic disc edema generally resolves with no visual loss, but one third of patients progress to full-blown AION. Diabetes mellitus is common in patients with asymptomatic optic disc edema. Perhaps patients diagnosed as having diabetic papillopathy actually have an impending AION that does not progress to overt disease.

Diabetic Papillopathy in Pregnancy

“…8 In pregnancy, a finding in all cases described was the presence of minor background retinopathy when papillopathy was diagnosed, and subsequently three of the patients had proliferative retinopathy develop during their pregnancies. The proliferations regressed in the early postpartum period in two of them, but the third patient required laser treatment.…”

“…[2][3][4] In rare instances, it can precede the development of anterior ischemic optic neuropathy, which usually presents in older patients with atherosclerosis, has acute onset and permanent visual loss, and diabetic papillopathy may be a mild and reversible form of it. 8 Diabetic papillopathy can be easily misdiagnosed and thus may lead to unnecessary and inappropriate investigations and management.…”

Progression of asymptomatic optic disc swelling to non-arteritic anterior ischaemic optic neuropathy

“…Spontaneously resolving swelling in diabetic subjects has been termed ‘papillopathy’. Observation of swelling with serial examinations and documentation of later vision loss typical of NAION has been described in a cohort of largely diabetic subjects 8. We present four examples of initial disc swelling without visual loss in subjects without diabetes and its progression over weeks or months to produce typical findings of vision loss in NAION and discuss the potential use of this information in therapeutic decision making.…”

Neuro-Ophthalmic Emergencies for the Neurologist

“…A variety of cardiovascular, neurologic, and metabolic changes can result when significant hypoxia and hypercarbia develop, including increased ICP. 156 Possible mechanisms include hypercarbia-induced vasodilation with secondary increased cerebral blood volume and venous hypertension. Obstructive SAS was found to be an associated and perhaps contributory condition in 6 of 18 adult men (33%) with IIH 157 and in 7 of 37 patients (18%) with IIH and symptoms of sleep disturbance.…”