Optic disc edema in raised intracranial pressure. II. Early detection with fluorescein fundus angiography and stereoscopic color photography
S. S. Hayreh and M. S. Hayreh
Optic disc edema (ODE) due to chronic intracranial hypertension was
produced experimentally in rhesus monkeys. Serial studies of fundus changes
at frequent intervals, by routine ophthalmoscopy, steroscopic color
photography, and fluorescein angiography, revealed that swelling of the
optic disc was the first sign of ODE. Other early signs were striation of
nerve fibers on the optic disc margins and peripapillary retina, blurring
of the disc margins, hyperemia of the disc and capillary dilation,
hemorrhages, and other retinal vascular changes; these usually appeared in
that sequence. The classically described signs of early ODE were almost
always absent. A normal fluorescein fundus angiogram during the incipient
stage did not rule out ODE. Stereoscopic color fundus photography was the
most sensitive means of detecting early ODE. Fluorescein angiography did
not show changes till edema was of a mild to moderate degree; routine
ophthalmoscopy was the least reliable method.
