Comparison of Optic Disc Appearance in Anterior ischemic optic neuropathy and Optic neuritis

ABSTRACT

PURPOSE: Optic disc edema in anterior ischemic optic neuropathy (AION) and optic neuritis (ON) have overlapping features. To determine whether characteristics of optic nerve swelling help to differentiate ON from AION. METHODS: A medical records were reviewed retrospectively for the patients who had been diagnosed as AION or ON in which photographs for acute phase were available. Color of optic disc, distribution of edema, presence of hemorrhage and caliber of artery and vein was analyzed in each fundus photograph. RESULTS: AION was diagnosed clinically in 67% of the cases with altitudinal edema, in 77% of the cases with disc hemorrhage, in 87.5% of the cases with pallid optic disc and in 77% of the cases with vascular abnormality. A pale optic disc with hemorrhage, regardless of the type of edema, always represented AION (100%). Normal-colored optic disc without hemorrhage always also represented optic neuritis (100%). CONCLUSIONS: Analysis of disc characteristics may enhance diagnostic accuracy and help to differentiate AION from ON.