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2.1
Secondary Optic Atrophy
Optic Atrophy Secondary

Presentation

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

Case 2 A 27 year old man presented with a 4 months history of generalised headache. Five days prior to presentation he awoke with left sided facial and limb weakness which improved spontaneously though incompletely over the subsequent days. [ispub.com]

Presentation of ophthalmic disease Ocular manifestations in SLE are fairly common, potentially sight threatening and may be the presenting feature of their disease [ 4, 5 ]. SLE may affect almost any part of the eye and visual pathway. [academic.oup.com]

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]

Entire Body System

  • Asymptomatic

    After the secondary stage, there is a dormant (asymptomatic) stage, known as Latent Syphilis which may last for many years (even decades). All infections do not progress to the final (tertiary) stage. [dovemed.com]

    In myopia that is no longer progressing, the crescent may be asymptomatic except for its presence on ocular examination. [decisionmakerplus.net]

    Mild retinopathy may be asymptomatic but more severe disease may cause loss of vision, field defects, distortion or floaters. Such visual symptoms are therefore an indication for urgent ophthalmic review. [academic.oup.com]

    This clinical entity initially presents with asymptomatic optic disc edema and no visual loss attributable to NA-AION. [webeye.ophth.uiowa.edu]

  • Malnutrition

    The mechanism is unclear, but this has been reported to be more common in individuals who are already suffering from malnutrition. [en.wikipedia.org]

    Nutritional disorders: malnutrition, malabsorption, and B12 and other vitamin deficiency. In: Merritt’s Neurology 12 th Edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. Schrier SL. [journal.opted.org]

    The toxic factors on the degenerative processes due to malnutrition may cause selective affection of the inner portion of the nerve,-axial neuritis. [ijo.in]

Cardiovascular

  • Hypertension

    The most common cases seen in the examination is benign intracranial hypertension. ) Unilateral disc swelling inflammatory causes: papillitis vascular causes: arteritic or non-arteritic ischaemic optic neuropathy, central retinal vein occlusion neoplastic [mrcophth.com]

    Changes in retinal vessels Changes in retinal vessels - disruption and the caliber of retinal vessels - are observed more often with hypertension, sclerosis of cerebral vessels. [minclinic.ru]

    Hypertensive encephalopathy 5. Intracranial vascular lesions: sub-arachnoid hemorrhage, sagittal sinus thrombosis, etc. 6. Head-injury - long standing contusions, carotid-cavernous fistula 7. [thamburaj.com]

    Kaye AH, Galbraith JEK, King J: Intracranial pressure following optic nerve decompression for benign intracranial hypertension: Case report. J Neurosurg 1981;55:453–456. [karger.com]

    Other associated systemic diseases have also been reported, including sleep apnea, arterial hypotension due to a variety of causes, malignant arterial hypertension and migraine. b. [webeye.ophth.uiowa.edu]

Eyes

  • Visual Impairment

    In addition ethambutol toxicity may also contribute to visual impairment. Sub-clinical visual impairment can be detected by visual evoked potentials [ 11 ]. [omicsonline.org]

    Impairments that occur with BOA can affect multiple visual processes, including: Central vision Contrast distinction Overall visual acuity The disorder may additionally cause a range of other symptoms, some of which may be present at birth, including [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. http://call-centre.cogsci.ed.ac.uk/SSC/VISPAGES/5/VIS576634. [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

    The visual field defect of a maculopathy is almost invariably a central scotoma with a zone of metamorphopsia that surrounds it. [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]

  • Eye Pain

    Diplopia and facial pain suggest multiple cranial neuropathies due to inflammatory or neoplastic lesions behind the eye. [patient.info]

    EYES - PAIN - nerves, optic cedr. clem. pip-m. sarr. EYES - PAIN - pressing - nerves, optic clem. EYES - PAIN - sore, bruised - nerves, optic sarr. EYES - PARALYSIS - nerves - optic nerve, amaurosis - brights disease, in APIS ARS. CANN-I. colch. [homeopathyworldcommunity.ning.com]

    Symptoms of optic neuritis in the affected eye include pain on eye movement, sudden loss of vision, and decrease in color vision (especially reds). [en.wikipedia.org]

    It may be associated with eye pain worsened by eye movement. It is more common in young to middle-aged women. Some patients with optic neuritis may develop multiple sclerosis later on in life. Leber's hereditary optic neuropathy. [medical-dictionary.thefreedictionary.com]

  • Retinal Hemorrhage

    Diabetics tend to have more peripapillary retinal hemorrhages than non-diabetics [ 23, 70 ]. [webeye.ophth.uiowa.edu]

    Splinter hemorrhage at the disc margin may be observed (Psora). [homeopathyworldcommunity.ning.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]

Visual Field Test

  • Central Scotoma

    The visual field defect of a maculopathy is almost invariably a central scotoma with a zone of metamorphopsia that surrounds it. [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]

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]

Etiology and clinical manifestations of vitamin B12 and folate deficiency. In: UpToDate, Mentzer, WC (Ed), UpToDate, Waltham, MA. Accessed Oct. 6, 2015. [journal.opted.org]

Epidemiology

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

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]

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

Conclusion: Early diagnosis and prompt treatment with penicillin is essential to prevent visual impairment in syphilitic optic neuropathy. [ispub.com]

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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2.1
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