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2.1
Primary Optic Atrophy

Presentation

Up to 4-10% of patients with untreated syphilis may develop NS. [1] These days NS rarely presents in its classical forms, tabes dorsalis or general paresis, and often presents with atypical features. [2] The clinical and laboratory features of NS have [annalsofian.org]

An abnormal fundus examination on initial presentation is a significant predictor of visual impairment at 3 months after presentation. [omicsonline.org]

Two cases of the disease with other central nervous system involvement are presented and briefly discussed as to nosology and relationship to the heredofamilial group of diseases. [link.springer.com]

Strabismus and latent nystagmus are often present. Up slanting palpebral fissures and epicanthal folds have been noted. Visual acuity levels have not been reported. [disorders.eyes.arizona.edu]

Less than five percent of patients only present with sole ocular involvement at diagnosis. [japi.org]

Entire Body System

  • Plethora

    This segment is resistant to ischemia because of a plethora of pial vessels. Middle meningeal artery, branch of the external carotid artery forms collateral circulation at the orbital apex. [ijri.org]

Eyes

  • Central Scotoma

    scotoma OS Orthophoric Minimal amplitude horizontal pendular 10 CF 5′ CF 5′ 0 0 Diffuse optic atrophy OU Central scotomas OU Orthophoric None 11 20/200 20/100 Small discs with diffuse optic atrophy OU Unable OU Modest XT Moderate amplitude horizontal [iovs.arvojournals.org]

    SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]

    (Case 6) 1 remember an experience in my early days of practice at an age when youth is synonymous with rashness, of having seen a case of optic neuritis with a central scotoma first in one eye then in the other. [ijo.in]

Workup

Our case report highlights the fact to incorporate serum and CSF VDRL screening in workup of noncompressive myelopathy. [annalsofian.org]

Visual Field Test

  • Central Scotoma

    scotoma OS Orthophoric Minimal amplitude horizontal pendular 10 CF 5′ CF 5′ 0 0 Diffuse optic atrophy OU Central scotomas OU Orthophoric None 11 20/200 20/100 Small discs with diffuse optic atrophy OU Unable OU Modest XT Moderate amplitude horizontal [iovs.arvojournals.org]

    SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]

    (Case 6) 1 remember an experience in my early days of practice at an age when youth is synonymous with rashness, of having seen a case of optic neuritis with a central scotoma first in one eye then in the other. [ijo.in]

Treatment

Treatment Guidelines There is no local (retinal) treatment for primary optic atrophy so no referral to a retinal specialist is warranted. The key to proper treatment is determining the etiology of the optic atrophy. [decisionmakerplus.net]

One of the reasons for pessimism is that there is too often an excessive delay in starting treatment and that, as a result, optic atrophy may progress to blindness before adequate treatment is instituted. [nejm.org]

Treatment depends on which disorder that you have. With some optic nerve disorders, you may get your vision back. With others, there is no treatment, or treatment may only prevent further vision loss. [icdlist.com]

Until recently, there was no treatment indicated for LHON. [santhera.com]

However, after established optic neuropathy and visual loss there is little chance, if any, for visual recovery and no definitive treatment exist for treatment in these cases. [clinicaltrials.gov]

Prognosis

Atrophic (BR)- atrophic pallor, edema, attenuated vessels, no hemes, opacified NFL - profoundly reduced VAs, color vision, VF defects, + APD Prognosis and Management of Papilledema 1. Brain scan - rule out SOL 2. [studyblue.com]

Prognosis is variable, with moderate to severe visual loss and nystagmus. Systemic abnormalities include spastic gait, ataxia and mental handicap. 23. [slideshare.net]

It was found that the prognosis for useful vision is in general favorable in this group of cases. [pediatrics.aappublications.org]

Unfortunately, a prompt diagnosis is of extreme importance, since the sooner an appropriate treatment is initiated, the better the prognosis and the less probability of permanent visual damage. [frontiersin.org]

Visual prognosis following optic neuropathy is generally poor. Renal biopsy provided a clue for the diagnosis in the absence of clinical findings other than ocular involvement in these patients. [japi.org]

Etiology

Optic nerve damage may be reversible, so early detection and treatment of the underlying etiology is critical. Correction of an underlying nutritional deficiency and discontin... [5minuteconsult.com]

In 27 % of the cases no cause could be found while in the rest of 73% cases definite etiological factor was present. [ijo.in]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Etiology and Pathophysiology Genetic etiologies usually involve defects in mitochondrial function. Exposure of retinal nerve cells to light normally results in the generation of free radical species. [unboundmedicine.com]

Etiologic classification Regardless of etiology, optic atrophy is associated with variable degrees of visual dysfunction, which may be detected by one or all of the optic nerve function tests (see Other Tests). [thehealthscience.com]

Epidemiology

EPIDEMIOLOGY AND CAUSES OF OPTIC ATROPHY IN GENERAL OUTPATIENT DEPARTMENT OF LUMBINI EYE INSTITUTE. [nepjol.info]

The epidemiology of Leber hereditary optic neuropathy in the northeast of England. Am J Hum Genet. 2003;72:333-9. Horvath R, Abicht A, Scoubridge EA, et al. [rarediseases.org]

Epidemiology Frequency United StatesAccording to Tielsch et al, the prevalence of blindness attributable to optic atrophy was 0.8%. [3] According to Munoz et al, the prevalence of visual impairment and blindness attributable to optic atrophy was 0.04% [thehealthscience.com]

Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. [frontiersin.org]

Epidemiology Acquired ONA is more common than hereditary and congenital ONA and tends to occur later in life: Glaucoma, ischemic optic neuropathy (older), optic neuritis (younger), compressive (any age), and toxic/nutritional are leading causes in adults [unboundmedicine.com]

Pathophysiology

Pathophysiology The optic nerve comprises approximately 1.2 million axons that originate at the ganglion cell layer of the retina. [thehealthscience.com]

Traumatic optic neuropathy The exact pathophysiology of traumatic optic neuropathy is poorly understood, although optic nerve avulsion and transection, optic nerve sheath hematoma, and optic nerve impingement from a penetrating foreign body or bony fragment [emedicine.medscape.com]

Pathophysiology There is a loss of axons and shrinkage of myelin, leading to widening of the optic cup. Presentation [ 1 ] This depends on the causative condition. Optic disc atrophy in isolation results in the following symptoms and signs. [patient.info]

Etiology and Pathophysiology Genetic etiologies usually involve defects in mitochondrial function. Exposure of retinal nerve cells to light normally results in the generation of free radical species. [unboundmedicine.com]

The pathophysiology of NAION is unknown, but it is related to poor circulation in the optic nerve head. [en.wikipedia.org]

Prevention

With others, there is no treatment, or treatment may only prevent further vision loss. [icdlist.com]

They have to be also aware of the preventive measures and precautions to be taken, which include: Avoidance of multiple sex partners Practice of safe sex (use of condoms that prevent entry of the syphilis bacteria) Excessive craving for drugs and alcohol [dovemed.com]

Primary prevention (removal of the process causing the damage) is the goal to prevent loss of axons and optic atrophy (neuropathy). [eyewiki.aao.org]

For example, early diagnosis and aggressive treatment can prevent further damage in patients with compressive and toxic neuropathies. Intravenous steroids are helpful in some cases of optic neuritis or anterior ischemic optic neuropathy. [decisionmakerplus.net]

Página 310 - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. ‎ [books.google.es]

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