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Secondary Optic Atrophy


Presentation

  • Experts from Harvard Medical School and the Massachusetts Eye and Ear Infirmary present authoritative, state-of-the-art recommendations in a rapid-access outline format.[books.google.com]
  • It presents two divisions. Of these one lies freely open to the numberless vicissitudes and agencies of the environment. That is to say, it is co-extensive with the so-called external surface of the animal.[books.google.com]
  • An abnormal fundus examination on initial presentation is a significant predictor of visual impairment at 3 months after presentation.[omicsonline.org]
Inflammation
  • It may be secondary to disease within the eye or it may follow damage to the nerve itself resulting from injury or inflammation.[medicine.academic.ru]
  • Introduction Aetiology of optic atrophy may be hereditary, [1] vascular, demyelinating, compression, inflammation or trauma.[explainmedicine.com]
  • Anterior uveitis ( intraocular inflammation of the anterior part of the eye) seldom occurs in isolation. It is more commonly associated with scleritis or posterior intraocular inflammation.[academic.oup.com]
  • Optic neuritis - inflammation of the optic nerve along its entire length, including the optic disc. Postbulbar optic neuritis Postbulbar optic neuritis - inflammation of the optic nerve, not extending to the optic disc.[minclinic.ru]
  • For instance, intraocular pressure control in glaucoma, control of inflammation in sarcoid, etc.[eyewiki.aao.org]
Swelling
  • True disc swelling (Always look at both eyes as the presence of bilateral swellings suggest an intracranial process, whereas an unilateral swelling suggests a lesion either in the optic nerve or in the orbit.[mrcophth.com]
  • Following treatment, the left optic disc swelling had almost fully resolved six weeks later (Figure 1.2). Figure 1 Figure 1.1: Left eye optic disc swelling at presentation (case 1).[ispub.com]
  • Subretinal fluid has also been described from other causes of optic nerve head swelling including diabetic papillopathy and papillitis.[bjo.bmj.com]
  • These lesions may compress the optic nerve, resulting optic disc swelling and progressive visual loss.[en.wikipedia.org]
  • Papilledema is a, non-inflammatory passive swelling of the optic disc, produced by raised intra-cranial tension (ICT).[thamburaj.com]
Pallor
  • It is visible as pallor of the optic nerve… … Medical dictionary Optic atrophy — Infobox Disease Name PAGENAME Caption The left optic nerve and the optic tracts.[medicine.academic.ru]
  • (A) Bilateral temporal disc pallor; 26. Fig. (B) bilateral diffuse pallor 27. Thank You All[slideshare.net]
  • […] in those with a history of optic neuritis Disc is pale with a clear, demarcated margin and normal vessels Physiologic pallor temporally is more distinctly pale Temporal Optic Disc Pallor — Right Eye Patient is a 39-year-old black female with multiple[decisionmakerplus.net]
  • Temporal pallor Temporal pallor may be observed in traumatic or nutritional optic neuropathy, and it is most commonly seen in patients with multiple sclerosis, particularly in those with a history of optic neuritis.[emedicine.medscape.com]
  • Primary Optic Atrophy: These patients had pallor of the disc involving the entire disc or temporal pallor extending upto the disc margin, with well defined borders of the papilla; normal calibre or slight constriction of the bigger vessels and disappearance[ijo.in]
Physician
  • Quickly reference information with help from a convenient outline format, ideal for today’s busy physician.[books.google.com]
  • *Medscape Business of Medicine Academy Survey, September 2015 Learn from Experienced Professionals Courses were developed especially for physicians by business health experts and experienced physicians.[medscape.org]
  • History History is critical in the diagnosis of optic atrophy since the physician needs to know how the eye arrived at this juncture.[eyewiki.aao.org]
  • If visual problems occur once treatment has started, patients should be advised to stop treatment, attend their optometrist and seek advice from the prescribing physician who would refer on to the ophthalmologist.[academic.oup.com]
  • Am Fam Physician. 2011 Jun 15;83(12):1425-30. Sawicka-Pierko A, Obuchowsak I, Hady RH, Mariak Z, Dadan J. Nutritional optic neuropathy following bariatric surgery. Wideochir Inne Tech Maloinwazyjne. 2014 Dec;9(4):662-6. 17.[journal.opted.org]
Muscular Atrophy
  • atrophy MeSH … Wikipedia Atrophy — Wasting away or diminution.[medicine.academic.ru]
  • الصفحة 320 - Atonic muscular atrophy is, at least in many cases, the visible expression of a tendency to decay of the whole motor path, from the cortex of the brain to the muscles. ‏ الصفحة 320 - ... fibre, terminal distribution.[books.google.com]
Visual Impairment
  • […] correlated with visual impairment ( Tables 2 and 3 ).[omicsonline.org]
  • For instance, in infants born with tumors in the optic pathways, surgical removal of tumors is typically performed to reduce the long-term effects of the condition and potentially limit the level of visual impairment.[disabilitybenefitscenter.org]
  • She complained of having visual impairment for the past 2 months. The visual loss was nonprogressive and there was no history of color desaturation. She did not have a pain in her eye with ocular movements.[ruralneuropractice.com]
  • Impairment Service, Leber's Amaurosis. .[www-personal.umd.umich.edu]
  • Conclusion: Early diagnosis and prompt treatment with penicillin is essential to prevent visual impairment in syphilitic optic neuropathy.[ispub.com]
Central Scotoma
  • […] m) may make the identification of a small central scotoma much easier.[medtextfree.wordpress.com]
  • SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS.[journal.opted.org]
  • However, in high-degree myopia, it may extend to the upper and lower borders, or form a complete ring around the optic disc and form a central scotoma. Tilted Disc A tilted optic nerve occurs when the nerve exits the eye at an oblique angle.[decisionmakerplus.net]
  • LHON affects prevalently young males, who suffer an acute/subacute loss of central vision that leads to rapid decrease of visual acuity due to central scotoma.[journals.plos.org]
  • However, the prognosis is worse in SLE associated optic neuritis, with more than half having a persistent central scotoma and progressing to optic atrophy.[academic.oup.com]
Blurred Vision
  • The symptoms of optic atrophy relate to a change in vision, specifically: Blurred vision. Difficulties with peripheral (side) vision. Difficulties with color vision. A reduction in sharpness of vision.[my.clevelandclinic.org]
  • Symptoms Blurred vision Abnormal side vision Abnormal color vision Decreased brightness in one eye relative to the other The symptoms described above may not necessarily mean that you have optic atrophy.[umkelloggeye.org]
  • If an individual has optic atrophy, he or she can exhibit the following symptoms: Pallor Disc cupping Blurred vision Reduced field of vision Difficulties in color vision Change in vision patterns Difficult peripheral vision Reduced sharpness of vision[hxbenefit.com]
  • Structural Damage to the Eye Visual Pathway Retina Optic nerve Optic tract Lateral geniculate nucleus Optic radiations Visual cortex Functional Damage to the Eye Some of the symptoms that may be associated with optic atrophy include: Blurred vision Abnormal[decisionmakerplus.net]
  • vision, headaches and nosebleeds.[bjo.bmj.com]
Blepharospasm
  • All chapters have been updated to include the latest information on new disease entities, diagnostic techniques, drugs, and treatments, including LASIK and LASEK surgery, cataract extractions, intraocular lenses, use of botulinum for blepharospasm, and[books.google.com]
  • Blepharospasm is also reported and may be troublesome.[academic.oup.com]
Impulsivity
  • It does not subserve exclusively impulses generated at one single receptive source... ‏ الصفحة 290 - The extero-ceptive arcs appear in most segments less closely connected with the visceral musculature than with the skeletal musculature.[books.google.com]
  • The optic nerve is composed of nerve fibers that transmit impulses to the brain. In the case of optic atrophy, something is interfering with the optic nerve's ability to transmit these impulses.[my.clevelandclinic.org]
  • It interrupts the nerve impulses that communicate visual information to the brain. It can develop slowly and progress gradually, or can, in some instances occur suddenly and progress rapidly.[disabilitybenefitscenter.org]
  • Optic atrophy is an ophthalmic condition that affects the optic nerve, which is responsible for carrying impulses from the eyes to the brain. The term “atrophy” indicates the process of deterioration or wasting away.[hxbenefit.com]
Papilledema
  • Post papilledema, secondary optic atrophy Identifier P_54b Title Post papilledema, secondary optic atrophy Subject Papilledema - Complications; Post Papilledema Description Right eye. Post papilledema with chronic gliosis. arterial narrowing.[collections.lib.utah.edu]
  • MANAGEMENT: Papilledema could be VISION THREATENING.[thamburaj.com]
  • Papilledema Papilledema - is a noninflammatory edema caused by increased intracranial pressure. In this case, there are congestion, papilledema, prominentsiya it in the vitreous of wear limits. Retinal vein dilated, tortuous.[minclinic.ru]
  • H47.10 Unspecified papilledema H47.11 Papilledema associated with increased intracranial pressure H47.12 Papilledema associated with decreased ocular pressure H47.13 Papilledema associated with retinal disorder H47.14 Foster-Kennedy syndrome H47.141[icd10coded.com]
  • Optic atrophy following papilledema (secondary).[emedicine.medscape.com]
Excitement
  • Thus, the property of brightness and the property of odour belonging to an object of prey may then better excite in unison a reaction in the distant reagent, or excite more potently than would either property alone. ‏[books.google.com]
Neglect
  • Additionally, although neuro-ophthalmic evaluation for associated optic neuritis is often part of multiple sclerosis disease management, the ophthalmologist must be careful to not neglect associated vasculitis or uveitis that may also cause retinal abnormalities[bjo.bmj.com]

Workup

  • A thorough examination of the retina, with appropriate imaging when indicated, is an important component in the workup and management of all optic neuropathies, and patients with retinopathy should have periodic OCT scanning of the retinal nerve fibre[bjo.bmj.com]
Central Scotoma
  • […] m) may make the identification of a small central scotoma much easier.[medtextfree.wordpress.com]
  • SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS.[journal.opted.org]
  • However, in high-degree myopia, it may extend to the upper and lower borders, or form a complete ring around the optic disc and form a central scotoma. Tilted Disc A tilted optic nerve occurs when the nerve exits the eye at an oblique angle.[decisionmakerplus.net]
  • LHON affects prevalently young males, who suffer an acute/subacute loss of central vision that leads to rapid decrease of visual acuity due to central scotoma.[journals.plos.org]
  • However, the prognosis is worse in SLE associated optic neuritis, with more than half having a persistent central scotoma and progressing to optic atrophy.[academic.oup.com]
Gliosis
  • Post papilledema with chronic gliosis. arterial narrowing. ""high-water"" marks. Man. Anatomy Optic disc Pathology Post papilledema Disease/Diagnosis Post papilledema with optic atrophy Clinical Unknown Imaging NA Creator William F.[collections.lib.utah.edu]
  • A small degree of gliosis is usually present and primarily represents a proliferation of astrocytes. This gliosis is not as severe as in inflammations of the optic nerve.[test.aneskey.com]
  • General Pathology In optic nerve atrophy there is loss of axons and shrinkage of myelin leading to gliosis and widening of the optic cup. Primary prevention Optic atrophy is the end stage of a process causing damage to the optic nerve.[eyewiki.aao.org]
  • Histopathologic changes noted in optic atrophy include the following: Shrinkage or loss of both myelin and axis cylinders Gliosis Deepening of the physiologic cup with barring of the lamina cribrosa Widening of the subarachnoid space with redundant dura[emedicine.medscape.com]
  • In cases of secondary atrophy, the disc margin may be poorly delineated (due to gliosis rather than oedema). The appearance may offer some clues to the pathology. Where the atrophy is glaucomatous in origin, disc cupping will also be present.[patient.info]

Treatment

  • […] medical treatment of glaucoma.[books.google.com]
  • What can I expect my treatment to include? Before treatment begins, we have a comprehensive discussion with you about your options, and we perform a vision exam.[restore-vision.com]
  • Proliferative retinopathy usually requires treatment with laser (panretinal photocoagulation) akin to the treatment of proliferative diabetic retinopathy [ 23 ].[academic.oup.com]
  • Treatment of the optic nerve and retina diseases Treatment options for diseases of the optic nerve and retina is chosen individually in each case.[minclinic.ru]

Prognosis

  • 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]
  • Optic atrophy secondary to vascular, traumatic, degenerative, and some toxic causes has a negative prognosis.[tsbvi.edu]
  • Surgical repair with lysis of adhesions and packing of the sella has been reported to improve visual prognosis. Delayed radionecrosis of chiasm and optic nerves Late delayed radiation effect on the central nervous system is well known.[pituitary.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]

Etiology

  • 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]
  • 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]
  • 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).[emedicine.medscape.com]
  • Table 3 lists additional etiologies that can contribute to an acquired vitamin B12 deficiency. Pathophysiology of B12 deficiency Vitamin B12 has several vital roles in the body.[journal.opted.org]

Epidemiology

  • EPIDEMIOLOGY AND CAUSES OF OPTIC ATROPHY IN GENERAL OUTPATIENT DEPARTMENT OF LUMBINI EYE INSTITUTE. Journal of Universal College of Medical Sciences , 3 (2), 26-29.[nepjol.info]
  • Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies.[frontiersin.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]
  • The case report explores multiple facets of vitamin B12 deficiency including pathogenesis, epidemiology, manifestations, differential diagnosis and treatment modalities.[journal.opted.org]
  • EPIDEMIOLOGY AND PATHOGENESIS The most common optic neuropathies in young and older adults are optic neuritis and nonarteritic anterior ischemic optic neuropathy, respectively.[medtextfree.wordpress.com]
Sex distribution
Age distribution

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]
  • Pathophysiological mechanisms which relate these two distinct disease entities include compressive optic neuropathy secondary to mucoceles, direct extension of sinus infection to the optic nerve from suppurative paranasal sinusitis, from osteomyelitis[ruralneuropractice.com]
  • The pathophysiology of non-arteritic anterior ischemic optic neuropathy is not known, but is related to impoverished circulation in optic nerve head.[hxbenefit.com]

Prevention

  • Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: Older adults should have their provider carefully manage their blood pressure. Use standard safety precautions to prevent injuries to the face.[medlineplus.gov]
  • 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]
  • Conclusion: Early diagnosis and prompt treatment with penicillin is essential to prevent visual impairment in syphilitic optic neuropathy.[ispub.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]
  • With others, there is no treatment, or treatment may only prevent further vision loss. Optic glioma (Medical Encyclopedia) Optic nerve atrophy (Medical Encyclopedia) Optic neuritis (Medical Encyclopedia) [ Read More ][icdlist.com]

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