Bilateral Optic Disc Edema in Patients With Severe Systemic Arterial Hypertension: Clinical Features and Visual Acuity Outcomes

Purpose: To evaluate the etiology and clinical presentation of cases with optic disc edema presenting to a tertiary eye center of Nepal. Background: The etiology of optic disc edema ranges from relatively benign to potentially sight and life threatening conditions. Till date very few studies have been done on disc edema in Nepal. Method: The authors conducted a prospective, descriptive study at B.P. Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Nepal. All cases with disc edema presenting to the out patient department (OPD) from January 1, 2014 to June 30, 2015 were included in the study. Results: Total 112 patients were included in the study, out of which diagnosis could be established in 99. The mean age of the patients was 32.54 ± 13.97 years with the majority being female. The most common cause of disc edema was idiopathic intracranial hypertension (IIH) (37.5%,). Majority of the patients complained of isolated diminution of vision (38.4%). Among the eyes affected, 78.3% had best corrected visual acuity (BCVA) 6/6-6/18, 36.6% had color vision defect and 31.4% had reduced contrast sensitivity. The most common visual field defect was isolated enlarged blind spot (39.7 %). Conclusion: IIH followed by optic neuritis (ON) are the most common causes of disc edema. Conditions with disc edema mainly affect the age group 21-40 years with females affected 2.5 times more than males. Visual acuity, color vision and contrast sensitivity are deranged in majority of cases of ON and normal in majority of cases of IIH.

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Clinical and Etiological Profile of Patients with Optic Disc Edema in Tertiary Care Centre of Nepal

Journal of Institute of Medicine ◽

10.3126/jiom.v41i1.28588 ◽

2019 ◽

Vol 41 (1) ◽

pp. 24-30

Author(s):

Ritish K Shah

Keyword(s):

Visual Acuity ◽

Visual Field ◽

Optic Neuritis ◽

Color Vision ◽

Optic Disc ◽

Optic Neuropathy ◽

Tertiary Care ◽

Ischemic Optic Neuropathy ◽

Optic Disc Edema ◽

Disc Edema

Introduction: Optic disc edema can be a manifestation of various neurological disorders. Identification of those causes is possible in most cases using tests like visual acuity, color vision, visual field and suitable radiological imaging. Study in Nepalese population with regard to optic disc edema is scarce. Hence this study aims to act as a guideline for evaluation of such cases and help in further studies in this regard. Methods: A descriptive, cross-sectional study was conducted in all cases of optic disc edema presenting to neuro-ophthalmology clinic of B.P. Koirala Lions Centre for Ophthalmic Studies from January 2011 to June 2012. A detailed history was obtained and proper ocular and nervous examination was done by ophthalmologist and neuro-physician. Assessment of visual acuity, color vision, contrast sensitivity and visual field along with radiological tests were done in all possible cases. Results: Out of all the cases evaluated, 38 cases where causes of optic disc edema could be established were included in the study. The commonly affected age group was 31 to 40 years (26.3%) and most of them were males. The commonest cause observed was optic neuritis (36.8%). Others were papilledema, idiopathic intracranial hypertension, toxic optic neuropathy, non-arteritic anterior ischemic optic neuropathy (NA-AION), compressive and traumatic optic neuropathy. Conclusion: Optic neuritis and papilledema should be considered as common differential diagnosis in patients with optic disc edema. NA-AION is a relatively uncommon disease among Nepalese population.

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