Diagnose the Underlying Condition shown in the Fundus Photograph
A. Retinal artery occlusion
B. Normal fundus
C. Hypertensive retinopathy
D. Optic atrophy
Ans: D. Optic atrophy
- Optic atrophy refers to the death of the retinal ganglion cell axons that comprise the optic nerve with the resulting picture of a pale optic nerve on funduscopy. Optic atrophy is an end stage that arises from myriad causes of optic nerve damage anywhere along the path from the retina to the lateral geniculate.
- In optic nerve atrophy there is loss of axons and shrinkage of myelin leading to gliosis and widening of the optic cup.
- Optic atrophy is a sign and typically is noted as optic nerve pallor. This is the end stage of a process resulting in optic nerve damage. Because the optic nerve fiber layer is thinned or absent the disc margins appear sharp and the disc is pale, probably reflecting absence of small vessels in the disc head.
- The main symptom of optic atrophy is vision loss.
- Visual Field Testing – to help localize the location of the lesion.
- Optical Coherence Tomography (OCT)- to assess the thickness of peripapillary retinal nerve fiber layer and/or ganglion cell layer.
- ERG, mERG to rule out retinal disease.
- Neuro-imaging (MRI, CT)