Large cups in normal-sized optic discs: a variant of optic nerve hypoplasia in children with periventricular leukomalacia

L. Jacobson, A. Hellstrom and O. Flodmark
Department of Ophthalmology, Karolinska Institute, Huddinge University Hospital, Sweden.

OBJECTIVE: To evaluate optic disc morphologic features in children with periventricular leukomalacia (PVL). PATIENTS AND METHODS: Seventeen children with PVL (patient group) were compared with 17 sex- and age-matched, full-term healthy control children (control group). Clinical ophthalmological examination and digital image analysis of fundus photographs were performed in all children. In children with PVL, cerebral imaging was performed. RESULTS: Children with PVL had larger optic disc cupping (P<.02) than did control children. A large proportion of the children with PVL had strabismus, nystagmus, and restricted visual fields. CONCLUSION: Our study indicates that optic nerve hypoplasia in children with PVL is often associated with a normal-sized optic disc with a large cup. This unusual form of optic nerve hypoplasia most likely results from transsynaptic degeneration of optic axons caused by the primary bilateral lesion in the optic radiation.

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