The Effect of Optic Disk Edema On Spontaneous Venous Pulsations In The Absence Of Elevated Intracranial Pressure

Abstract

Abstract: : Purpose:To evaluate the effect of optic disk edema on spontaneous venous pulsations in the absence of elevated intracranial pressure. Methods:Twenty consecutive patients with unilateral optic disk edema due to anterior ischemic optic neuropathy (n=11) or optic neuritis (n=9) and a normal contralateral optic nerve were evaluated for the presence of spontaneous pulsations of the superficial veins of the optic nerve head in both eyes. The proportion of subjects with spontaneous venous pulsations present in both eyes, in the involved eye only, in the uninvolved eye only, and in neither eye was determined. Exact McNemar's test was used to evaluate an effect of optic disk edema on the presence of spontaneous venous pulsations. Results:Spontaneous venous pulsations were observed in 60% (12/20) of uninvolved eyes and 5% (1/20) of eyes with optic disk edema. This difference was statistically different (p<0.005). Venous pulsations were absent in both eyes of seven subjects, and present only in the uninvolved eye of twelve patients. No subject had venous pulsations present in both eyes. One patient with ischemic optic neuropathy and segmental optic disk edema had a venous pulsation present on the non-edematous half of the nerve. Conclusion: Optic nerve head edema may cause the cessation of spontaneous venous pulsations in the absence of elevated intracranial pressure.

Keywords: 498 optic disc • 487 neuro-ophthalmology: optic nerve • 486 neuro-ophthalmology: diagnosis