By Sohan Singh Hayreh
"No attainment is ever ultimate" Vascular issues of the optic disc and nerve are very important not just to the ophthalmologist but additionally to the neurologist and the internist. To the 1st distinctiveness staff they signify one reason for blindness or serious visible impairment; to the second one team the optic disc edema and optic atrophy obvious in those issues can pose severe difficulties of prognosis, or provide indica tions of the involvement of the cerebral stream; whereas to the final workforce they're often indicative of systemic affliction, fairly of the cardiovas cular process. contemporary advances in our wisdom of the blood offer of the optic nerve head have shed an important new mild at the topic. With the new introduction of fluorescein fundus angiography, an additional measurement has been further to the examine of the ocular and optic disc circulations, and we have now entered right into a new period within the realizing of ocular vascular problems "in vivo". within the pre-angiography period, postmortem injection experiences, even supposing very necessary, didn't thoroughly exhibit the vascular trend of the optic disc within the dwelling, in well-being, and sickness. The ophthalmoscope, absolutely, has been beneficial in assessing optic disc lesions, yet couldn't supply us informa tion at the stream of the attention and optic disc "in vivo".
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Extra info for Anterior Ischemic Optic Neuropathy
A stereoscopic fundus color photograph was taken and intravenous fluorescein angiography of the fundus was performed at the first examination, or at the earliest possible time, in all eyes. Systemic prednisolone, 40 to 80 mg daily, frequently with an initial dose of 40 units of adrenocorticotropic hormone (ACTH) intramuscularly, was given to 19 patients, and none to six patients. In six patients with progressive deterioration of visual acuity or fields at a later date, long-acting acetazolamide (Diamox) (500 mg twice daily) was given.
C) Retinal arteriovenous phase showing filling of nasal choroid, temporal peripapillary choroid, and complete filling of the optic disc. No filling of the temporal choroid is seen. d) Retinal venous phase showing better filling of the choroid than seen in (c) although temporal choroid is still empty. Nasal half of the optic disc shows staining with fluorescein. The optic disc margins are not seen except in inferior temporal region. e) Late phase showing diffuse staining of the optic disc with blurred margins except for the inferior temporal margin.
Vision improved in four eyes (three patients). In case 4 vision improved to hand motion in a small area in both eyes in two weeks; the area of hand motion gradually increased so that the patient had only a central scotoma in one eye and vision in the lower temporal field in the other. In the right eye of patient 1 vision improved in two days to perception of light in the temporal part. The right eye of patient 5 improved from 6/12 to 6/6 in three days with corticosteroids. b) In Unilateral Anterior Ischemic Optic Neuropathy: 1.