ONH - COMPRESSIVE OPTIC NEUROPATHY (TUMORS) Flashcards
what are general symptoms of compressive optic neuropathy?
- slow progressive vision loss
- dyschromatopsia
- painless proptosis
what are general ophthalmic signs of compressive optic neuropathy?
- ON pallor /edema / cupping
- collateral vessels
- APD
- VF defects
best way to dx compressive optic neuropathy?
MRI
what is optic nerve glioma?
tumor involving the ON glial tissue
what are the 2 types of ON glioma?
1. glioblastoma multiforme – rare malignant form found in adults that leads to blindness within months and death within a year.
2. juvenile pilocytic astrocytoma – most common intrinsic neoplasm of the ON that is typically dx in children & associated with neurofibromatosis 1.
signs of ON glioma?
- general signs + ON enlargement
tx for ON glioma?
- stable w/ no vision changes & no cosmetic distubrance – monitor
- if unstable – surgical excision + chemotherapy
what is ON sheath meningioma?
tumor of the ON meninges or ON sheath
who gets them?
middle aged women
additional signs of ON sheath meningioma?
- tumor may compress the globe and cause:
- EOM restriction
- increased IOP
- metamorphopsia
tx for ON sheath meningioma?
- treat IOP
- radiation + chemo or surgical excision
what is a pituitary gland tumor (PG tumor)?
tumor that involves the pituitary gland
what area does a pituitary gland tumor compress?
optic chiasm
additional symptoms of PG tumor?
- HA
- reduced libido
- malaise
- infertility
signs of PG tumor?
- bitemporal hemianopia VF defects
- optic atrophy
- APD
- pituitary apoplexy
what is pituitary apoplexy?
- rupture of the pituitary tumor which causes a pool of blood and can lead to pt having a stroke.
tx for PG tumor?
- refer to neurosurgeon – surgical excision, radiation or hormone replacement therapy.
- pituitary apoplexy – tx with systemic steroids & surgical decompression
what is optic disc melanocytoma?
benign melanocyte tumor of the ON – can rarely become metastatic
who gets optic disc melanocytoma?
- darkly pigmented >50 yr old patients
symptoms of optic disc melanocytoma
asymptomatic
signs of optic disc melanocytoma
- jet-black area with fuzzy edges found adjacent to the ON
- may be flat or slighlt elevated
tx for optic disc melanocytoma
observe or refer to oncologist is malignant characteristics.
