discödem

Disc oedem, also known as optic disc edema or disc edema, is the swelling of the optic nerve head (the optic disc) due to fluid accumulation or impaired axoplasmic transport at the nerve head. It may be isolated or part of a broader syndrome such as papilledema.

Common causes fall into several categories. Increased intracranial pressure can lead to papilledema, a representative form of disc edema. Other etiologies include inflammatory or ischemic optic neuropathies (for example optic neuritis or anterior ischemic optic neuropathy), infectious or inflammatory conditions affecting the optic nerve (such as neuroretinitis or sarcoidosis), and rarer disorders such as infiltrative or toxic/metabolic insults. Hypertensive or vascular factors and retinal vascular occlusions can also produce disc swelling.

Clinical features vary with the underlying cause. Patients may notice transient or persistent visual changes, including reduced visual acuity, visual field defects, or metamorphopsia, sometimes accompanied by headache or nausea if intracranial pressure is elevated. On examination, the disc may appear pale or swollen with blurred margins, sometimes with retinal hemorrhages or cotton-wool spots and venous congestion.

Diagnosis relies on a combination of ophthalmic examination and systemic evaluation. Optical coherence tomography can quantify swelling and nerve fiber layer thickness; fluorescein angiography may show disc leakage or vascular changes; visual field testing assesses functional impact. Neuroimaging (typically MRI with or without contrast) is indicated to exclude intracranial mass, venous sinus thrombosis, or other structural causes. In suspected papilledema, measurement of intracranial pressure via lumbar puncture may be performed.

Management targets the underlying cause. Treating raised intracranial pressure, addressing inflammatory or vascular etiologies, and mitigating systemic risk factors are central. Prognosis depends on the cause and extent of optic nerve damage, with potential for partial or full recovery in some conditions and permanent vision loss in others.