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Chapter-16.6 Optic Nerve Anomalies and Neuropathies

BOOK TITLE: Postgraduate Ophthalmology (2 Volumes)

Author
1. Dhawan Munish
2. Sethi Harinder Singh
3. Nair Akshay G
4. Gandhi Rashmin A
5. Sachdeva Virender
6. Kekunnaya Ramesh
7. Mittal Vaibhev
8. Gupta Malvika
9. Shyamsundar K
ISBN
9789350252703
DOI
10.5005/jp/books/11051_83
Edition
1/e
Publishing Year
2012
Pages
46
Author Affiliations
1. Dr R P Centre for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Dr RP Centre for Ophthalmic, Sciences, AIIMS, Ansari Nagar, New Delhi, India, Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, India, Dr RP Centre for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, India, RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
2. Dr RP Centre for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi 110 029 (India), Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr RP Centre for Ophthalmic, Sciences, AIIMS, Ansari Nagar, New Delhi, India, Dr RP Centre for Ophthalmic Sciences AIIMS, Ansari Nagar New Delhi, Dr RP Centre for Ophthalmic Sciences, AIIMS Ansari Nagar, New Delhi, India, Dr R P Centre for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, India, Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, India, Dr RP Centre for Ophthalmic Sciences AIIMS, Ansari Nagar, New Delhi, Vardhman Mahavir Medical College, New Delhi, India, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
3. Sankara Nethralaya A Unit of Medical Research Foundation, Nungambakkam, Chennai, Tamil Nadu, India
4. The Sankara Nethralaya Academy, Sankara Nethralaya A Unit of Medical Research Foundation, Nungambakkam, Chennai, Tamil Nadu, India
5. LV Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
6. LV Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
7. LV Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
8. Dr Ram Manohar Lohia Hospital, New Delhi, India
9. Army Medical Corps, United Nations Hospital (MONUSCO), Congo, Africa
Chapter keywords
congenital optic disk anomalies, optic nerve hypoplasia, excavations of the optic disk, optic disk coloboma, morning glory disk anomaly, optic disk pit, peripapillary staphyloma, megalopapilla, congenital tilted disk syndrome, myelinated fiber, inherited optic neuropathies, visual impairment, optic neuropathies, Mendelian recessive optic atrophy, systemic and neurologic disease, optic neuritis, demyelinating disease, optic nerve, papillitis, retrobulbar neuritis, neuroretinitis, multiple sclerosis, sarcoidosis, chronic relapsing inflammatory optic neuropathy (CRION), atypical optic neuritis, ischemic optic neuropathy, infarction of the optic disk, retro-laminar portion, fundus fluorescein angiography, management of aion, optic nerve compression, axonal transport disruption, compressive lesions, optic canal, traumatic optic neuropathy, visual loss, deformational forces, nutritional deficiency, toxic neuropathies, toxic optic neuropathies

Abstract

Congenital optic disk anomalies are broadly classified into two types, namely optic nerve hypoplasia and excavations of the optic disk. Exacavations of the optic disk discusses optic disk coloboma, morning glory disk anomaly, optic disk pit, peripapillary staphyloma, megalopapilla, congenital tilted disk syndrome, and myelinated fiber. Inherited optic neuropathies constitute a significant cause of visual impairment in children and young adult. Optic neuropathies inherited by Mendelian principles, Mendelian recessive optic atrophy, optic neuropathies not associated with Mendelian inheritance patterns, and miscellaneous optic neuropathies associated with systemic and neurologic disease are discussed. Optic neuritis is an imflammatory, infective or demyelinating disease affecting the optic nerve. Morphologically, optic neuritis is classified into papillitis, retrobulbar neuritis, or neuroretinitis. Optic neuritis in multiple sclerosis, optic neuritis in sarcoidosis, and chronic relapsing inflammatory optic neuropathy (CRION) are discussed. Atypical optic neuritis is discussed. Ischemic optic neuropathy results from the infarction of the optic disk or uncommonly of the immediate retro-laminar portion. Fundus fluorescein angiography, diferential diagnosis of ischemic optic neuropathy, and management of aion are discussed. Optic nerve compression leads to ischemia or axonal transport disruption in the nerve. Compressive lesions occurring in the orbit, the optic canal and, rarely, intracranially, may result in disk dwelling. Traumatic optic neuropathy is a rare but devastating cause of partial or complete visual loss caused by deformational forces that injure the optic nerve. Nutritional deficiency and toxic neuropathies are an important but uncommon cause of optic neuropathies worldwide. Toxic optic neuropathies are discussed.

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