Optic Atrophy

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Optic Atrophy

• Prof. V. RAJARAM
• Sri Balaji Medical College
• Chennai.

Presentation at CME on Neuro-ophthalmic
Disorders. at Regional Institute of
Ophthalmology and Government Ophthalmic
Hospital, Chennai. September 16, 2006.
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OPTIC ATROPHY

• When the pale disc is associated with def.visual
  function (V/A, Pup.reaction, VF,CV and VEP) -
  OPTIC ATROPHY

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PATHOLOGY

• Optic nerve shrinkage from any process that
  produce degeneration of axons in the ant.visual (
  Retinogeniculate) pathway

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CLASSIFICATION OF OPTIC ATROPHY

• PRIMARY
• SECONDARY
• post- papiloedemic optic atrophy
• Post-Neuritic optic atrophy
• Glaucomatous Optic atrophy
• consecutive optic atrophy

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CRETERIA TO CALL POA

• Ophthalmoscopically cause could not be detected
• Anatomically damage should be in the second order
  of neuron in the visual pathway( from ganglion
  cell to geniculate body )

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ETIOLOGY OF POA

• Idiopathic
• Demyelination
• Post inflammatory
• Toxic
• Inflammation of orbit, sinus and meninges
• Compressive
• Nutritional
• Hereditary

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FUNDUS APPEARANCE OF POA

• Pale disc
• Clear margin of disc
• Normal cup
• Well seen lamina cribrosa
• Normal retinal vessels- Macula

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INVESTIGATION

• V/A
• CV
• VF
• CBC
• MX

• BLOOD SUGAR
• VDRL
• VER
• CT/MRI
• LP/CSF analysis

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POSTOEDEMIC/NEURITIC OPTIC ATROPHY

• Ophthalmoscopically difficult to differentiate
  both will have almost similar appearance
• Pale waxy disc
• Margin ill defined
• Cup filled with glial tissue
• Narrowed retinal vessel close to the disc due to
  sheathing and normal caliber beyond( reverse
  taper sign)
• Investigation same as POA

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POST OEDEMIC/NEURITIC OPTIC ATROPHY
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• Unilateral -Fundus picture CRAO
• May present with contalateral hemiplegia
• Do investigation for carotid artery occlusion

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Thank You