Bilateral Optic Disc Edema

Bilateral Optic Disc Edema

Article
Brain & Nerve
Eye & Vision
+6
Contributed byKrish Tangella MD, MBAMar 12, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Bilateral ODE
  • Bilateral Optic Disc Swelling
  • Bilateral Papilledema

What is Bilateral Optic Disc Edema? (Definition/Background Information)

  • Bilateral Optic Disc Edema is an eye condition that describes swelling of the optic disc of both the eyes. The optic disc is a circular region inside the back of the eye, where the optic nerve connects the retina
  • Bilateral Optic Disc Edema may arise due to a variety of factors such as increased intracranial pressure, uncontrolled diabetes, and optic disc drusen. In general, optic disc edema (ODE) involving one eye is more commonly observed (termed unilateral ODE); Bilateral ODE is slightly uncommon
  • An early recognition and prompt treatment of the underlying condition causing Bilateral Optic Disc Edema can prevent progression of the condition to permanent vision loss from optic nerve atrophy

Who gets Bilateral Optic Disc Edema? (Age and Sex Distribution)

  • Individuals of all ages may be affected, although many cases of Bilateral Optic Disc Edema are noted in adults
  • Both males and females are affected
  • Worldwide, individuals of all races and ethnicity may be affected

What are the Risk Factors for Bilateral Optic Disc Edema? (Predisposing Factors)

The risk factors for Bilateral Optic Disc Edema may include:

  • Conditions causing an increased intracranial pressure (ICP)
  • Infections such as cat scratch disease, Lyme disease, and syphilis
  • Inflammatory conditions that include giant cell arteritis and neurosarcoidosis
  • Autoimmune conditions that include neuromyelitis optica (NMO) and myelin-oligodendrocyte glycoprotein (MOG)
  • Certain medications including chemotherapy
  • Optic neuritis
  • Ischemia
  • Certain genetic and mitochondrial conditions
  • Malignant hypertension
  • Diabetes mellitus
  • Iatrogenic factors include long-term use of cerebrospinal fluid shunt (due to shunt failure)
  • Brain tumors

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Bilateral Optic Disc Edema? (Etiology)

Bilateral Optic Disc Edema is known to develop secondary to several health conditions that include genetic disorders, infections, autoimmune diseases, medications, exposure to chemicals, brain lesions, metabolic conditions, among others.

What are the Signs and Symptoms of Bilateral Optic Disc Edema?

The signs and symptoms of Bilateral Optic Disc Edema may vary from one individual to another. It may be mild or severe and is typically related to the underlying cause. Some individuals may even be asymptomatic.

The signs and symptoms may include:

  • Swollen optic disc (increase in fluid buildup)
  • Visual field defects
  • Blurred vision
  • Headaches
  • Vision impairment

Associated signs and symptoms of the underlying condition/disorder may also be observed.

How is Bilateral Optic Disc Edema Diagnosed?

Bilateral Optic Disc Edema may be diagnosed by the following observations and tests:

  • Complete physical examination with comprehensive evaluation of medical history
  • Assessment of the presenting signs and symptoms
  • General eye exam
  • Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
  • Visual acuity test using a special and standardized test chart (Snellen chart)
  • Slit-lamp examination
  • Visual evoked potential (VEP) test
  • Fundus fluorescein angiography
  • Optical coherence tomography (OCT) of eye
  • Imaging studies including CT and MRI scans of the head and neck region

Additional tests and procedures to diagnose the underlying causative condition may be needed.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Bilateral Optic Disc Edema?

The complications of Bilateral Optic Disc Edema may include:

  • Severe and irreversible vision impairment
  • Loss of vision due to optic atrophy
  • Decreased quality of life

Complications arising from the underlying/associated condition, if any, may be noted.

How is Bilateral Optic Disc Edema Treated?

The treatment of Bilateral Optic Disc Edema depends on its severity and the presenting signs and symptoms. However, the most important treatment consideration is managing the underlying causative factor.

  • Infections may be treated using suitable medications such as antibiotics
  • Tumors in the brain may be surgically removed, as appropriate
  • Antihypertensive medications may be needed to manage increased blood pressure
  • Autoimmune disease may be treated using immunosuppressive drugs
  • Corticosteroids may be used for inflammatory conditions
  • Discontinuing causative medications and/or using suitable alternative medications

How can Bilateral Optic Disc Edema be Prevented?

Presently, it is difficult to prevent Bilateral Optic Disc Edema. However, the following steps may be considered towards lowering one’s risk for the same:

  • Undertaking early and adequate treatment of any health issues is important
  • If there is a family history of a medical condition, then genetic counseling will help assess risks, before planning for a child
  • Avoid self-medication or bringing about any changes to one’s medication dosage without consulting the healthcare provider
  • Leading a healthy stress-free life

What is the Prognosis of Bilateral Optic Disc Edema? (Outcomes/Resolutions)

  • The prognosis for Bilateral Optic Disc Edema is usually good upon promptly addressing the underlying cause factor
  • Taking adequate and appropriate treatment for the underlying condition can stop progression of optic disc edema to optic atrophy and blindness, due to irreversible damage to the optic nerve

Additional and Relevant Useful Information for Bilateral Optic Disc Edema:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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