Optic Nerve Head Findings: How a Neuro-ophthalmologist can aid the Neurologist?

Abstract

Context: Specific pathological patterns of neurological diseases can be studied in the optic nerve.

Aims: To study the demographics, etiology and clinical characteristics in neuro-ophthalmic optic nerve head disorders with their systemic correlation in adults in India.

Settings and Design: In the study period of 18 months; all patients presenting to our institute with unilateral or bilateral optic nerve head disease were included in the study.

Methods and Material: Retrospective review of prospectively collected data

Statistical analysis used: The results were analysed using Microsoft Office Excel (Microsoft Corporation, 2010, Louisville KY) software with filters applied on the Master Chart to enable a Sub-Group Analysis.

Results: A total of 195 patients received specialist neuro-ophthalmology consultations during the study period, of which 170 patients met the inclusion-exclusion criteria and were reviewed. The age range was 16 years to 72 years. There were 98 (57.64%) males & 72 (42.35%) females.

Headache was the presenting complaint in 97 (57.05%) patients. Etiological diagnosis was achieved in 161 (94.70%) patients. From a Neurological perspective, commonest diagnosis was Benign Intracranial Hypertension in 32 (18.82%) patients. From a Neuro-surgical perspective, Pituitary Adenoma was the commonest Space Occupying Lesion which was seen in 18 of the 44 patients with Space Occupying Lesions (i.e. 25.88% of the total 170 patients).

Conclusions: This study highlights how a Neuro-ophthalmic examination can provide sight and life-saving insight to the Neurologist and the Neuro-Surgeon into underlying disease processes in the optic nerve in neurologic diseases.

Key-words: Neuro-Ophthalmology, Optic Nerve Head Disorders, Visual Field Analysis

Key Messages: Specific pathological patterns seen in the optic nerve can help the Neuro-ophthalmologist provide insight to the Neurologist and the Neuro-Surgeon underlying disease processes in the optic nerve. This helps affords early detection of neurologic disease and can help have better outcomes while managing them.