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Symptoms and Signs – Differential Diagnosis of Atrophy Optic disc
Optic neuritis (MS)
Raised lntracranial pressure: 2' to long-standing papilloedema (e.g. tumours)
Toxic metabolic drugs: tobacco, alcohol, vitamin B12 deficiency, diabetes, ethambutol
Infection/infiltration: spread from sinuses, syphilis, sarcoid
Compression: intra-orbital (e.g. optic nerve tumours), tumour of pituitary or
sphenoid sinus, carotid aneurysm
Anterior ischaemic optic neuropathy
Trauma: orbital fracture, indirect trauma
Retinal disease: retinitis pigmentosa, macular degeneration
Occlusion of retinal artery
Raised Pressure inside the eye (glaucoma)
Hereditary: Leber's optic atrophy, hereditary ataxias, e.g. Friedreich's, DIDMOAD
Optic neuritis (MS)
Raised lntracranial pressure: 2' to long-standing papilloedema (e.g. tumours)
Toxic metabolic drugs: tobacco, alcohol, vitamin B12 deficiency, diabetes, ethambutol
Infection/infiltration: spread from sinuses, syphilis, sarcoid
Compression: intra-orbital (e.g. optic nerve tumours), tumour of pituitary or
sphenoid sinus, carotid aneurysm
Anterior ischaemic optic neuropathy
Trauma: orbital fracture, indirect trauma
Retinal disease: retinitis pigmentosa, macular degeneration
Occlusion of retinal artery
Raised Pressure inside the eye (glaucoma)
Hereditary: Leber's optic atrophy, hereditary ataxias, e.g. Friedreich's, DIDMOAD
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