Optic disc edema symptoms?

summary

The swelling and swelling of optic disc caused by increased intracranial pressure is called optic disc edema, which is non-inflammatory obstructive edema of optic disc. About 80% of it is caused by intracranial space occupying lesions. Other causes such as inflammation, trauma or congenital Cranioorbital malformation can also be caused. Optic disc edema symptoms? Let's talk about it

Optic disc edema symptoms?

The pathological changes were based on swelling of nerve fibers, accumulation of extracellular fluid and dilation of optic disc vessels. The nerve fiber layer around the optic disc was swollen and turbid, with linear white reflective stripes lost or bent. The color darkens and blurs. Hyperemia or superficial hemorrhage of optic disc is caused by dilation or rupture of microvessels on the surface of optic disc. Generally, the fundus can be distinguished by ophthalmoscope. It is better to use contact lens and slit lamp examination, which is of great value in the diagnosis of this type. The blurring of optic disc edge usually starts from the lower part to the upper part of optic disc, then extends to the nasal edge, and finally blurs, because the density of nerve fiber layer in each part of optic disc is different, and the parts with high density appear swelling earlier. The presence or absence of spontaneous retinal vein pulsation is of certain significance in the diagnosis of this type. Fundus fluorescein angiography showed microvascular leakage and arteriole formation in optic disc, even leakage around optic disc, which was caused by increased capillary permeability. In the later stage, it showed strong fluorescence. The characteristic of physiological blind spot enlargement is that the horizontal diameter is helpful for diagnosis.

The surface of the optic disc is obviously raised, which can be as high as 3-4d, showing mushroom shape. The microvascular tumor and telangiectasia on the surface of the optic disc are very obvious. Spot or flame bleeding can be seen around the disc. The edge of the disc is blurred and obvious. The veins at the edge can be distended and bent, and can be intermittent. If the intracranial pressure increases rapidly, large areas of flame like bleeding and flocculent exudate can be seen, even subvitreous hemorrhage. There are also hard pointed out objects and bleeding in the macula. In severe cases, Paton line can be seen, which mostly occurs in the optic disc, showing a semi arc shape. The swelling of the optic disc tissue pushes the retina at the edge of the retina, resulting in the folding of the retina, wrinkles and varying degrees of reflection in the inner boundary of the retina. In patients with persistent optic disc edema, neovascularization can be seen under the retina around the disc.

This type is different from the progressive type only in degree, such as the sharp rise of intracranial pressure, the maladjustment of optic disc tissue and retinal vessels, and then a large number of flake hemorrhage and exudates, the swelling degree of optic disc edema can reach more than 5D, but there are also cases with or without hemorrhage and exudates. Visual acuity often decreases to a certain extent, and the visual field may shrink centripetally.

matters needing attention

Try to find the cause of disease, timely treatment. Brain tumors should be removed early. Symptomatic treatment includes hypertonic dehydrating agent. If the intracranial space occupying lesions can be excluded, the diagnosis of optic disc vasculitis and optic disc edema type can be made. Corticosteroids can achieve good results. For patients with severe headache, optic neuropathy and dehydration agent, decompression, inferior decompression, external orbital incision of optic nerve sheath decompression can be selected, which can only achieve temporary pressure relief. Now, lumbar peritoneal shunt is often used. Farnsworth Munsell 100 color test and VEP can be used to monitor the visual function.