optic nerve 1
TRANSCRIPT
![Page 1: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/1.jpg)
Other causes of optic neuritis
• Parainfectious ON (Viral)• Infectios ON (sinus related,syphlis,lyme,…
![Page 2: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/2.jpg)
![Page 3: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/3.jpg)
signs
• Pale disc
• Diffuse or sectoral edema
• Localized disc hyperfluorescence
• V/A in 1/3 of patient is normal in remainder have moderate to sever impairment
• Visual field defect is typically altitudinal
• Color vision is diminished
![Page 4: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/4.jpg)
managment
• Serologic study
• Fasting lipid profile
• Blood glucose, fibrinogen & packed cell volume
![Page 5: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/5.jpg)
Treatment
• Treatment of any underlying diseases
• Stop smoking
• Low-dose aspirin
![Page 6: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/6.jpg)
Arteritic anterior ischemic optic neuropathy: clinical features of
giant cell arteritis• Scalp tenderness• Jaw claudification• Polymyalgia rheumatica• Neck pain, weight loss,
anorexia fever, night sweets, malaise depression
• Superficial temporal arteritis
• Arteitis of other arteries• Occult arterritis
![Page 7: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/7.jpg)
Arteritic anterior iscxhemic optic neuropathy
• Uniocular sudden and profound loss of vision
• Periocular pain
• Transient visual obscuration
• Flashing lights
![Page 8: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/8.jpg)
Signs
• pale and swollen optic disc
• Splinter hemorrhages
• Finaly optic atrophy
![Page 9: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/9.jpg)
Special investigation
• ESR• C-reactive protein • Temporal artery
biopsy
![Page 10: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/10.jpg)
treatment
• Intravenous methylprednisolon 1g/day for 3 day together with oral prednisolon 80 mg
• After 3 days 60 mg for 3 day than 40 mg/days
• Than daily dose reduced 5 mg weekly
• Maintanance is 10 mg
![Page 11: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/11.jpg)
![Page 12: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/12.jpg)
Papillodemacauses
• Space-ocupaying lesion
• Blockage of the ventricular system
• Obstruction of CSF absorption
• Benign intracranial hypertention, diffuse cerebral edema, sever hypertention
• Hypersecretion of CSF
![Page 13: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/13.jpg)
Early papillodema
• Visual symptom are absent ,V/A normal
• Hyperaemia and mild elevation in optic disc
• Indistinct disc margin• Absent spontaneous
venous pulsation• Nasal margin is
blured in first
![Page 14: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/14.jpg)
Estabilished papillodema
• Transient visual osscuration• V/A is normal or reduced • Sever hyperemic optic disc• Smal vessele obscured• Venous engorgment flam
shap hemorrhage• Cotton-wool spots• Hyperfluorescence• Retinal fold• Hard exudates• Enlarge blind spot
![Page 15: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/15.jpg)
Long standing papillodema
– V/A variable– V/F constriction– Cotton-wool and
hemorrhage absent– Optociliary shunts
![Page 16: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/16.jpg)
Atrophic papillodema
• V/A sever diminish• White optic disc
![Page 17: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/17.jpg)
Differential diagnosis
• Malignant hypertention
• Bilateral papilitis
• Bilateral compressive thyroid orbitopathy
• Bilateral simultaneousanteriorischemic optic neuropathy
• Bilateral compromisedvenous drainage
![Page 18: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/18.jpg)
Congenital optic nerve anomalies
![Page 19: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/19.jpg)
![Page 20: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/20.jpg)
![Page 21: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/21.jpg)
![Page 22: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/22.jpg)
![Page 23: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/23.jpg)
![Page 24: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/24.jpg)
![Page 25: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/25.jpg)
![Page 26: Optic nerve 1](https://reader034.vdocument.in/reader034/viewer/2022050922/5596619d1a28abed178b4644/html5/thumbnails/26.jpg)