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- Atypical form of nonarteritic anterior ischemic optic neuropathy (NAION).
- Symptoms include:
- No visual symptom
- Non-specific minimal visual disturbance such as painless mild blurring or distortion
- Visual acuity is usually normal or mildly diminished, except coexisting diabetic maculopathy occurs
- Optic nerve appearance:
- Non-specific hyperemic disc swelling or a prominent dilated vessels mimicking neovascularization on the disc surface
- In the setting of bilateral disc swelling, it is important to distinguish this finding from papilledema, therefore neuroimaging and if needed lumbar puncture to rule out increased ICP can be performed
- Visual fields test may show enlarged blind spot with occasional arcuate or central field defect.
- Disc edema may be bilateral.
- The optic disc swelling usually resolves within 2-10 months with residual mild optic atrophy
- Long-term visual prognosis depends on the presence of diabetic retinopathy and, very rarely, the progression of this papillopathy to anterior ischemic optic neuropathy.