scholarly journals The coloboma of the choroid simulating optic nerve duplication

2013 ◽  
Vol 6 (2) ◽  
pp. 67-74
Author(s):  
Yuriy Sergeyevich Astakhov ◽  
Yevgeniy Vladimirovich Butin ◽  
Nataliya Vladimirovna Morozova ◽  
Vitaliy Olegovich Sokolov ◽  
Svetlana Sergeevna Florentseva
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Radiographic Analysis ◽  
Chorioretinal Atrophy ◽  
Adjoining Area ◽  
Retinal Artery ◽  
Work Up ◽  
Optic Discs ◽  
Blind Spots

In the article, a coloboma of the choroid is described simulating optic disc duplicaton as well as modern possibilities of instrumental work-up methods, which allowed to make a diagnosis. A coloboma (from the Greek koloboma, meaning defect) — is a defect of lid tissues, iris, choroid or optic nerve. A coloboma may be сongenital or acquired. A typical coloboma of the choroid is localized in the lower part of the eye fundus. At times, it comes down to the optic disc, and sometimes involves it as well. The white color of the defect is due to the show-through of the sclera, because the choroid here is completely absent. Corresponding to the coloboma of the choroid, the retina is hypoplastic or absent at times. An optic disc duplication — at this anomaly there are two optic discs on the eye fundus. Sometimes, both may be phtitical and hypoplastic, but more often one of them is hypoplastic, and the second one is performing its function. A true optic disc duplication comes out of the optic nerve partition into 2 or more fascicles. The duplicated optic nerve is pointed out by two optic foramens in one orbit by radiographic analysis, two blind spots in the visual field of one eye, simultaneous central retinal artery pulsation on both optic discs. Ultrasonic B-scanning or OCT and MRI may confirm the existence of a true optic nerve and optic disc duplication. A pseudo-duplication of the optic disc is also very rare and represents a well delineated defect, close to the normal optic disc and simulating an ancillary optic disc with an adjoining area of chorioretinal atrophy.

Automated Perimetry in Glaucoma

Visual Fields ◽  
2010 ◽  
Author(s):  
Hylton R. Mayer ◽  
Marc L. Weitzman
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Structural Damage ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Glaucomatous Damage ◽  
Retinal Fibers ◽  
Field Defects

Clinical experience and multiple prospective studies, such as the Collaborative Normal Tension Glaucoma Study and the Los Angeles Latino Eye Study, have demonstrated that the diagnosis of glaucoma is more complex than identifying elevated intraocular pressure. As a result, increased emphasis has been placed on measurements of the structural and functional abnormalities caused by glaucoma. The refinement and adoption of imaging technologies assist the clinician in the detection of glaucomatous damage and, increasingly, in identifying the progression of structural damage. Because visual field defects in glaucoma patients occur in patterns that correspond to the anatomy of the nerve fiber layer of the retina and its projections to the optic nerve, visual functional tests become a link between structural damage and functional vision loss. The identification of glaucomatous damage and management of glaucoma require appropriate, sequential measurements and interpretation of the visual field. Glaucomatous visual field defects usually are of the nerve fiber bundle type, corresponding to the anatomic arrangement of the retinal nerve fiber layer. It is helpful to consider the division of the nasal and temporal retina as the fovea, not the optic nerve head, because this is the location that determines the center of the visual field. The ganglion cell axon bundles that emanate from the nasal side of the retina generally approach the optic nerve head in a radial fashion. The majority of these fibers enter the nasal half of the optic disc, but fibers that represent the nasal half of the macula form the papillomacular bundle to enter the temporal-most aspect of the optic nerve. In contrast, the temporal retinal fibers, with respect to fixation, arc around the macula to enter the superotemporal and inferotemporal portions of the optic disc. The origin of these arcuate temporal retinal fibers strictly respects the horizontal retinal raphe, temporal to the fovea. As a consequence of this superior-inferior segregation of the temporal retinal fibers, lesions that affect the superotemporal and inferotemporal poles of the optic disc, such as glaucoma, tend to cause arcuateshaped visual field defects extending from the blind spot toward the nasal horizontal meridian.

Is a virtual clinic model a safe and effective way for assessing patients referred with suspiciously blurred optic discs? The blurred disc clinic

2020 ◽  
pp. 112067212097604
Author(s):  
Joanna M Jefferis ◽  
Nigel Griffith ◽  
Daniel Blackwell ◽  
Ruth Batty ◽  
Simon J Hickman ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Direct Contact ◽  
Visual Fields ◽  
Referral Letter ◽  
Face To Face ◽  
The Face ◽  
Optic Discs ◽  
Eye Clinic ◽  
Virtual Clinic

Background: There are increasing numbers of referrals to ophthalmology departments due to blurred optic disc margins. In light of this and the COVID-19 pandemic we aimed to assess whether these patients could be safely assessed without direct contact between the clinician and patient. Methods: We retrospectively reviewed the records of consecutive patients seen in our ‘blurred disc clinic’ between August 2018 and October 2019. We then presented anonymous information from their referral letter, their visual fields and optic nerve images to two consultant neuro-ophthalmologists blinded to the outcome of the face-to-face consultation. In the simulated virtual clinic, the two consultants were asked to choose an outcome for each patient from discharge, investigate or bring in for a face-to-face assessment. Results: Out of 133 patients seen in the blurred disc clinic, six (4.5%) were found to have papilloedema. All six were identified by both neuro-ophthalmologists as needing a face-to-face clinic consultation from the simulated virtual clinic. One hundred and twenty (90%) patients were discharged from the face-to-face clinic at the first consultation. The two neuro-ophthalmologists chose to discharge 114 (95%) and 99 (83%) of these respectively from the simulated virtual clinic. The virtual clinic would have potentially missed serious pathology in only one patient who had normal optic discs but reported diplopia at the previous face-to-face consultation. Conclusions: A virtual clinic model is an effective way of screening for papilloedema in patients referred to the eye clinic with suspicious optic discs. Unrelated or incidental pathology may be missed in a virtual clinic.

scholarly journals Optic nerve head retinal artery macroaneurysm: Report of a case

2019 ◽  
Vol 7 ◽  
pp. 2050313X1986947
Author(s):  
Ramesh Venkatesh ◽  
Prachi Gurav
Keyword(s):  
Optic Nerve ◽  
Fluorescein Angiography ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Hypertensive Retinopathy ◽  
Fundus Examination ◽  
Elderly Male ◽  
Spontaneous Involution ◽  
Retinal Artery ◽  
Retinal Artery Macroaneurysm

A 61-year-old elderly male, hypertensive patient presented to the retina clinic with sudden drop in vision in the left eye for 6 days. His best-corrected visual acuity at presentation was counting fingers close to face. Fundus examination of the left eye revealed the presence of subretinal and preretinal haemorrhage at the macula along with hypertensive retinopathy changes in both eyes. Fluorescein angiography was done, which showed a retinal artery macroaneurysm at the optic nerve head. Optical coherence tomogram through the optic nerve head also confirmed the presence of retinal artery macroaneurysm. The patient was treated with injection of 0.4 cc of 100% C3F8 to displace the blood off the macula. At final follow-up visit at 2 months post treatment, his vision improved to 6/12, N8. Fundus examination showed a small residual altered blood nasal to the fovea. No treatment was however done to the retinal artery macroaneurysm due to its atypical location and chance of spontaneous involution. In conclusion, retinal artery macroaneurysm at the optic disc is extremely uncommon. Identification of the retinal artery macroaneurysm lesion is more difficult in glaucoma patients due to the large and deep optic cup. Fluorescein angiography remains the main investigative modality to confirm the diagnosis. Spontaneous involution still remains the mainstay of treatment in optic disc retinal artery macroaneurysm.

scholarly journals Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

2014 ◽  
Vol 67 (5-6) ◽  
pp. 185-189
Author(s):  
Marija Trenkic-Bozinovic ◽  
Predrag Jovanovic ◽  
Gordana Zlatanovic ◽  
Dragan Veselinovic ◽  
Aleksandra Aracki-Trenkic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Ganglion Cells ◽  
Therapeutic Interventions ◽  
Visual Field Defects ◽  
Retinal Hemorrhages ◽  
Optic Disc Drusen

Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

A classic temporal optic disc pit showing progression in the corresponding optic nerve fiber and visual field defects

2012 ◽  
Vol 57 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Akihiko Tawara ◽  
Rie Miyamoto ◽  
Norihiko Tou ◽  
Shingo Ishibashi ◽  
Hiroyuki Kondo
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Visual Field Defects ◽  
Optic Disc Pit ◽  
Optic Nerve Fiber ◽  
Field Defects

scholarly journals Different IOP, different diseases?

2016 ◽  
Vol 1 (2) ◽  
pp. 97-102
Author(s):  
Michele Iester ◽  
Elisa D’Alessandro
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Progressive Disease ◽  
Clinical Findings ◽  
Nerve Fibers ◽  
Visual Field Defects ◽  
Chronic Progressive Disease ◽  
Field Defects

Glaucoma is a chronic, progressive disease characterized by typical optic nerve head changes and visual field defects. These alterations are caused by an intraocular pressure (IOP) being too high for the wellbeing of the specific optic disc. Typical clinical findings in glaucoma patients include thinning of the optic disc rim (Fig. 1), loss of retinal nerve fibers in the inferior sector with subsequent visual field defects in the superior sector.

scholarly journals Pearls for Correct Assessment of Optic Disc at Glaucoma Diagnosis

2017 ◽  
Vol 10 (02) ◽  
pp. 104
Author(s):  
Burak Turgut ◽  
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Open Angle Glaucoma ◽  
Visual Field Defects ◽  
Open Angle ◽  
Correct Evaluation ◽  
Optic Nerve Damage ◽  
Glaucoma Diagnosis ◽  
Field Defects

The correct evaluation of the optic disc, and related structures in ophthalmoscopy, is critical for the diagnosis of open angle glaucoma because usually glaucomatous optic nerve damage firstly occurs in the optic disc before detectable visual field defects become apparent; however, some studies have demonstrated that visual field defects can also be found without any glaucomatous changes in the optic disc. The purpose of this review is to provide a guide to clinicians for the evaluation of the optic disc in glaucoma suspects and patients. This guide can facilitate the diagnosis and exclusion of glaucoma in these subjects.

Clinical Spectrum of Ocular and Visual Dysfunction in Children with Periventricular Leukomalacia: A Need for an Interdisciplinary Approach

2021 ◽  
Author(s):  
Zeynep Kayaarasi Ozturker ◽  
Sezin Akca Bayar ◽  
Sibel Oto ◽  
Sibel Aksoy ◽  
Imren Akkoyun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Periventricular Leukomalacia ◽  
Interdisciplinary Approach ◽  
Field Testing ◽  
Ocular Motility ◽  
Visual Disabilities ◽  
Median Birth Weight

AbstractThe study aimed to evaluate the ocular motility and visual and optic disc abnormalities in children diagnosed with periventricular leukomalacia (PVL). A retrospective analysis was performed on 51 consecutive children who had ophthalmic symptoms and were diagnosed with PVL by using magnetic resonance imaging. The patients were assessed for visual function, strabismus, cycloplegic refraction, fundus examination, and if appropriate, spectral-domain optical coherence tomography and visual field testing were applied. The primary outcome measures were the prevalence and visual and ocular motility dysfunctions. Mean age was 5.72 ± 2.6 years (range = 1–12), median birth weight was 2,740 g (range = 1,240–3,460), and median gestational age was 34 weeks (range = 28–38). In total, 21 patients (39.6%) had neurological deficit, 11 (21.5%) had intellectual disability, and 19 (37.2%) had no neurological symptom. In the spherical equivalent refractive error and cylinder power analysis, 10 patients had ≥3.0 D myopia, 15 had ≥3.0 D hyperopia, and eight had ≥2.50 D astigmatism. Thirteen (25.4%) children had a best-corrected visual acuity between 20/40 and 20/20 for Snellen card, while 9 (17.6%) had strabismic amblyopia and 6 (11.7%) had anisometropic amblyopia. Manifest strabismus was present in 35 patients (68.6%); of whom 12 had esotropia (23.5%), 16 had exotropia (31.3%) and 6 had vertical deviation (11.7%). Manifest or latent nystagmus was detected in 14 patients (27.4%). In 28 patients (54.9%), there was optic nerve abnormality. Two patients had hypoplastic disc, 14 had optic disc pallor, 7 had large cupping, and 5 had total optic atrophy. Six subjects underwent reliable visual field (VF) examinations, and all six had abnormal VFs, with inferior fields being most affected. Ocular motility disorders, optic nerve abnormalities, VF defects, and low visual acuity are common findings in this cohort of PVL patients and maybe the only presenting signs of the disease. The recognition of the visual disabilities and implementation of early rehabilitation may have a significant benefit in these children.

scholarly journals Optic Nerve Head Microcirculation in Eyes with Vogt-Koyanagi-Harada Disease Accompanied by Anterior Ischemic Optic Neuropathy

2021 ◽  
pp. 899-908
Author(s):  
Yui Yamashita ◽  
Yuki Hashimoto ◽  
Kenichi Namba ◽  
Kazuomi Mizuuchi ◽  
Susumu Ishida
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Swelling ◽  
Vkh Disease ◽  
Field Defects

Anterior ischemic optic neuropathy (AION) is infrequently complicated with Vogt-Koyanagi-Harada (VKH) disease. We quantitatively examined sequential changes in the morphology and circulation hemodynamics, using a C-scan of optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION. A 65-year-old female complained of blurred vision in both of her eyes. The patient presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. The diagnosis of VKH disease was established based on the presence of pleocytosis detected in the cerebrospinal fluid and hypofluorescent dark dots scattered all around the fundus, detected by indocyanine green angiography. Goldmann perimetry detected visual field defects, similar to superior altitudinal hemianopsia in the right eye and similar to inferior altitudinal hemianopsia in the left eye. The patient was suspected to have developed AION in both eyes. The patient received methylprednisolone pulse therapy, followed by oral prednisolone. With these treatments, the optic disc swelling disappeared. However, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed the decrease in optic nerve head (ONH) tissue microcirculation. These results supported the occurrence of AION in this patient with VKH disease. The analysis of GCC and cpRNFL thickness and ONH microcirculation would be useful for supporting the occurrence of AION in a case of VKH disease.

scholarly journals Historical aspects and current views of the etiopathogenesis and clinical manifestations of optic nerve pits

2022 ◽  
Vol 14 (4) ◽  
pp. 158-163
Author(s):  
E. V. Muskatina ◽  
D. Yu. Samsonov ◽  
S. I. Zhukova ◽  
А. G. Shchuko
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Processing Technologies ◽  
Functional Changes ◽  
Non Invasive ◽  
Digital Scanning ◽  
Optic Discs

Optic nerve pits are a mono- or bilateral congenital anomaly represented by optic disc depressions of various sizes. In half of the cases, the pits are complicated by edema, central retinal detachment and retinoschisis, and cause visual function decrease. Visual acuity losses can be either insignificant or pronounced. Optic discs pits have been investigated massively over the last century and a half, but their etiology is still underresearched. In recent years, however, due to the development of digital scanning and data processing technologies and the emergence of non-invasive highly informative diagnostic methods, it has become possible to reveal structural and functional changes of the optic disc in vivo, in addition to the traditional detection of histological changes in cadaveric eyes.

Sign in / Sign up

Export Citation Format

Share Document