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Ischemic optic neuropathy in chronic papilledema
Archives of Ophthalmology (Chicago, Ill. : 1960)
|March 1, 1980
Summary
Sudden visual field loss in papilledema may signal ischemic optic neuropathy. This occurs when optic disc pressure compromises blood flow to the optic nerve head, potentially causing permanent vision damage.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Background:
- Papilledema, often associated with increased intracranial pressure like in pseudotumor cerebri, typically presents with optic disc swelling.
- Chronic papilledema can lead to various visual complications, but sudden visual field defects require urgent investigation.
Observation:
- A patient with chronic papilledema experienced a sudden onset of a permanent, monocular, inferior, altitudinal visual field defect.
- Clinical examination and fluorescein angiography were performed to investigate the cause of the acute visual field loss.
Findings:
- The visual field defect was attributed to ischemic optic neuropathy.
- Findings suggest that elevated optic disc tissue pressure in papilledema can lead to occlusion of prelaminar arterioles, causing ischemia.
Implications:
- This case highlights a potential mechanism for vision loss in papilledema, emphasizing the risk of ischemic optic neuropathy.
- Early recognition and management of elevated intracranial pressure are crucial to prevent irreversible optic nerve damage and visual field deficits.