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Visual outcome in eyes with asymptomatic optic disc edema
Yehoshua Almog1, Michaella Goldstein
1Neuro-Ophthalmology Unit, Meir Hospital-Sapir Medical Center, Tchernikovsky 59 Street, Kfar-Saba 44281, Israel. Almogy@clalit.org.il
Summary
Asymptomatic optic disc edema often resolves without vision loss, but one-third of patients may develop anterior ischemic optic neuropathy (AION). Diabetes is common in these patients.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Asymptomatic optic disc edema can persist for months before potentially progressing to anterior ischemic optic neuropathy (AION).
- The natural history and conversion rate of asymptomatic optic disc edema to AION have not been prospectively evaluated.
Purpose of the Study:
- To prospectively determine the conversion rate of asymptomatic optic disc edema to anterior ischemic optic neuropathy (AION).
Main Methods:
- A prospective cohort study followed 23 patients (aged 47-74) with incidentally discovered asymptomatic disc edema.
- Patients were monitored at a single ophthalmology clinic in Israel from 1991 to 2000.
Main Results:
- Optic disc edema progressed to AION in 36% of eyes (mean latency 16.8 weeks).
- Optic disc edema resolved without vision loss in 64% of eyes (mean latency 15.5 weeks).
- Conversion rates varied: 40% in patients with prior AION in the fellow eye, 31% with diabetes, and 43% with diabetic retinopathy.
Conclusions:
- While asymptomatic disc edema typically resolves without visual impairment, a significant proportion (one-third) may progress to AION.
- Diabetes mellitus is frequently observed in patients with asymptomatic optic disc edema.
- Diabetic papillopathy may represent a form of impending AION that does not fully develop.