Clinical and Radiology Finding of Patients with Bilateral Optic Disc Swelling

Abstract

Introduction: Optic disc swelling (ODS) is a pathological condition with a variety of causes, including optic neuritis (ON), anterior ischemic optic neuropathy, and papilledema. Determining the causes of ODS is critical due to the possibilities of vision-or life-threatening diseases, such as space-occupying lesions. Objective: To assess the clinical and radiology finding of Patients with Bilateral Optic Disc Swelling. Methods: This cross sectional study was conducted in the Department of Ophthalmology, Ad-din Akij Medical College Hospital, Khulna, Bangladesh from January to June 2019. One hundred patients with bilateral disc swelling were selected as study population where bilateral disc swelling due to congenital disc anomaly, pseudo disc edema or need emergency medical care had been purposively excluded from the study. All patients were subjected to detailed ophthalmic examination, including visual acuity (VA), red saturation, bright sensitivity, color vision, and detailed slit lamp examination. All the information’s were recorded in a pre-designed data collection sheet. Results: Total 100 patients included in our study. Most commonly affected age group was between 21-30 years in which 32% case are observed, least common affected age group was 51-60 yr. in which 6% cases are observed. Male patients were 33% and female were 67%. The patients by presenting complaints were headache 71.0% followed by dimness of vision 63.0%. Nausea/ vomiting were present in 42.0% patients and ocular pain had 21 (21.0%) patients. Few (5.0%) had transient loss of vision. Among the patients who had IIH 34 (34%), ICSOL were 25(25%) and grade 4 Hypertensive retinopathy 9% respectively. Among the patients who had bilateral optic neuritis and VKH majority of them 13% and 13% respectively. In right eye, 44 (44.0%) had Visual acuity >0.3 while in left eye, 40 (40.0%) had Visual acuity >0.3. One third had (33.0%) sluggish pupillary response in both eye. Majority of the patients (right: 67.0%, left: 64.0%) had only disc swelling. Seventy-three patients (73.0%) did not have any ocular manifestation other than optic disc swelling while 14 (14.0%) had diplopia, 12 (12.0%) had uveitis and 1 (1.0%) had ptosis. Out of 100 patients, 70 patients (70.0%) did not have any space occupying lesion while 9 (9.0%) had meningioma and 6 (6.0%) had Cerebellopontine (CP) angle tumor. Conclusions: Among them headache is the most common presenting complaint and IIH is the most common clinical diagnosis.