An optical coherence study on optic disc parameters and peripapillary retinal nerve fiber layer thickness in patients with optic disc edema.

PURPOSE: This study aimed at evaluation of patients diagnosed with optic disc edema (ODE) in terms of demographics, etiology, clinical presentation, and optical coherence tomography parameters. METHODS: An observational cross-sectional study was conducted from August 2021 to July 2022. Patients diagnosed with ODE underwent comprehensive ophthalmic evaluation. Peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters were assessed using optical coherence tomography. Radiologic investigations were done as deemed necessary. RESULTS: One hundred and forty-eight eyes with ODE (134 eyes from 67 patients with bilateral ODE and 14 eyes from 14 patients with unilateral ODE) and 148 eyes of age- and gender-matched control group were included in the study. The mean age of the study population was 31.51 ± 13.33 years, with 44 (54.3%) males and 37 (45.6%) females. Bilateral ODE was seen in 82.7% of patients. Idiopathic intracranial hypertension was the most common cause of bilateral ODE, and nonarteritic anterior ischemic optic neuropathy was the most common cause of unilateral presentation. Decreased vision and headache were the main symptoms reported by a majority of patients. Peripapillary RNFL thickness was significantly increased in the ODE group compared to controls. CONCLUSION: The current study provides the clinical profile and optic disc and RNFL measurements of ODE patients in an Eastern Indian population. Detailed history and careful evaluation are necessary, as the treatment strategy is highly dependent on the underlying etiologies.

Bilateral disc edema: An unusual presentation of renal tuberculosis in a child.

Renal tuberculosis (TB) is a rare clinical disorder in the pediatric population. A 15-year-old female presented with intermittent blurring of vision in both eyes associated with fever, abdominal pain, and weight loss. Fundus examination showed bilateral disc edema. Her blood pressure was 220/110 mmHg. Renal parameters were deranged with bilaterally enlarged kidneys. Renal biopsy was suggestive of epithelioid cell granuloma with Langhans type giant cells. The patient was diagnosed with as a case of refractory hypertension due to tubercular interstitial nephritis with bilateral Grade IV hypertensive retinopathy. She was started on antitubercular therapy and antihypertensives. There was a complete resolution of disc edema 2 months following initiation of therapy. Optic disc edema can be a presenting sign in renal TB. Early diagnosis and prompt referral can be associated with good visual and systemic outcomes.