Pseudopapilledema

Excerpt

Optic disc edema and papilledema are critical examination findings as they can be the first sign of a variety of disease processes with potential for vision loss, neurological impairment, or death. Optic disc edema refers to swelling of the nerve fiber layer at the optic nerve head due to an optic neuropathy of any etiology (inflammatory, infiltrative, compressive, etc.) whereas the term papilledema refers to optic disc edema caused by raised intracranial pressure. True disc edema must be differentiated from pseudopapilledema, where there is an elevated appearance to the nerve head without edema of the nerve fiber layer, as pseudopapilledema has drastically different clinical implications. A variety of optic disc abnormalities can create the appearance of pseudopapilledema including optic disc drusen, congenital disc anomalies, myelinated nerve fibers, and peripapillary masses such as astrocytic hamartomas. This review will focus on optic disc drusen as careful examination, and ancillary testing can usually easily identify these other causes of pseudopapilledema.