Volume: 2 Issue: 3
Year: 2014, Page: 37-40,
Introduction: The terms papilloedema has been reserved for the passive disc swelling associated with increased intracranial pressure which is almost always bilateral although it may be asymmetrical.
Materials and Methods: 9 cases of bilateral disc oedema presented to the department of ophthalmology, Prathima Institute of Medical Sciences, Karimnagar from June 2013 to January 2014 were included in the study. Comprehensive eye examination was done. Fundus examination was done by slit lamp biomicroscopy with 90 D lens. All the patients were systemically evaluated. Radiological investigation like MRI scan of the brain was done and the diagnosis was established and treated accordingly.
Results:A total 9 cases were diagnosed with bilateral disc oedema. Of the 9 cases, 6 were females and 3 males; age range was between 19-55 years. Most of the patients had good visual acuity at presentation. The most common complaint was headache associated with blurring of vision. Of the 9 cases, 3 patients diagnosed as idiopathic intracranial hypertension, 1 each was diagnosed as malignant hypertension, pituitary adenoma and craniopharyngioma. Two cases were diagnosed as cavernous venous sinus thrombosis and one was diagnosed as optic neuritis.
Conclusion: It is important to evaluate fundus in each and every case presenting with headache and transient visual obscuration to rule out any underlying cause of raised intracranial pressure.
Keywords: Optic disc oedema, Idiopathic intracranial hypertension, Cavernous venous sinus thrombosis
1.Hayreh MS, Hayreh SS. Optic disc edema in raised intracranial pressure. I. Evolution and resolution. Arch Ophthalmol 1977; 95:1237- 1244.
2. Hayreh SS. Optic disc edema in raised intracranial pressure. V. Pathogenesis. Arch Ophthalmol 1977; 95:1553-1565.
3. Minckler DS, Bunt AH. Axoplasmic transport in ocular hypotony and papilledema in the monkey. Arch Ophthalmol 1977; 95:1430-1436.
4. Tso MO, Hayreh SS. Optic disc edema in raised intracranial pressure. III. A pathologic study of experimental papilledema. Arch Ophthalmol 1977; 95:1448-1457.
5. Marcus DM, Lynn J, Miller JJ, Chaudhary O, Thomas D, Chaudhary B. Sleep disorders: a risk factor for pseudotumor cerebri. J Neuroophthalmol 2001; 21:121-123.
6. Lee AG, Golnik K, Kardon R, Wall M, Eggenberger E, Yedavally S. Sleep apnea and i n t r a c r a n i a l h y p e r t e n s i o n i n m e n . Ophthalmology. 2002 Mar;109(3):482-5.
7. Brourman ND, Spoor TC, Ramocki JM. Optic nerve decompression for pseudotumor cerebri. Arch Ophthalmol 1988; 106:1378-1383.
8. Corbett JJ, Nerad JA, Tse DT, Anderson RL. Results of optic nerve sheath fenestration for pseudotumor cerebri: the lateral orbitotomy approach. Arch Ophthalmol 1988; 106:1391-1397.
9. Tytla ME, Buncic JR. Recovery of spatial vision following shunting for hydrocephalus. Arch Ophthalmol 1990; 108:701-704.
10.Kei Lijima, Shimiju K. A study of the causes of bilateral disc oedema in Japanese population. Clin Ophthalmol 2014; 8: 1269–1274.
11.Wall M. Idiopathic Intracranial Hypertension. Neurol Clin. Aug 2010; 28(3): 593–617.
12.de Bruin S, de Haan R, Stam J. Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients. J Neurol Neurosurg Psychiat2001; 70:105–8.
Arvind R, Prasanna L, Ingle S, Ch.JaganMohanRao. A case series of bilateral optic disc oedema. Perspectives in medical research 2014;2:37-40