Sathya Priya, P (2020) An Etiological Analysis of Pale Optic Disc and Its Correlation with Visual Outcome in Patients attending a Tertiary Care Hospital. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
INTRODUCTION: The death of the retinal ganglion cell axons that comprise the optic nerve leads to optic atrophy and giving the resultant picture of a pale optic nerve. The term optic atrophy describes a group of clinical conditions which have an abnormal pallor of the disc as a common physical sign. Optic atrophy is not a disease; it is the end result any pathological process that damages the retinal ganglion cells and axons of reticulogeniculate pathway. The axons of the retinal ganglion cells make up the optic nerve and continue onto the optic chiasm, optic tract and up to the lateral geniculate body where they synapse. Injury to the retinal ganglion cells and axons anywhere along their course from the retina to the lateral geniculate body may result in optic atrophy. Clinically, optic atrophy is associated with a decrease in visual acuity and visual field defect. There are numerous causes of optic nerve damage anywhere along the path from the retina to the lateral geniculate. The etiological factors like intracranial tumors, meningitis, optic neuritis and toxic atrophy could lead to optical atrophy. AIM OF THE STUDY: Pale optic disc is mainly due to damage to optic nerve anywhere from retinal ganglion cells to lateral geniculate body. The need for identifying etiological cause of pale optic disc is important as each optic nerve disease is different and also has varied prognosis and visual outcome. The pale optic disc may due to many causes like ischemic optic neuropathy, optic neuritis, infectious neuropathy, infiltrative neuropathy, toxic or nutritional neuropathy, hereditary neuropathy, any compressive lesions of optic nerve, traumatic neuropathy, long standing papilloedema due to intracranial lesion. This study was conducted to analyse the etiology of pale optic disc and its visual outcome MATERIALS AND METHODS: Study was conducted at the Department of Ophthalmology, Coimbatore Medical College Hospital, Coimbatore. This was a prospective observational study. A total of 50 patients with nonglaucomatous pale optic disc were included in the study. Detailed history including the past medical history was recorded. A comprehensive Opthalmological examination is done including visual acuity, colour vision, visual fields, slitlamp biomicroscopy, ophthalmoscope examination, fundus photograph, Contrast sensitivity Biochemical investigations and neuroimaging were ordered when indicated to identify etiology and patients were followed up over a period of 6 months for visual outcome. RESULTS: The main etiology observed for pale optic disc among the study population was traumatic optic neuropathy. Majority of study population were young adults and observation of traumatic optic neuropathy may be attributed to their age group. Improvement of visual outcome was less in the study population when compared with other similar studies .Best corrected visual acuity of atleast one line improvement in Snellen’s chart after 6 months was observed only in 34% of study population which was contributed by 16% Optic neuritis, 12% Tumour, 3% Trauma etiology. Hence visual acuity outcome can be concluded to be poor among study population after treatment. CONCLUSION: Definitive diagnosis of optic disc pallor which itself is a sign of an underlying disease is very important. Identification of actual cause of optic disc pallor will help in its appropriate management.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221713202 |
| Uncontrolled Keywords: | Pale Optic Disc, Visual Outcome, Tertiary Care Hospital, Etiological Analysis. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Feb 2021 12:32 |
| Last Modified: | 14 Feb 2021 12:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14181 |
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