Optic disc edema in raised intracranial pressure. V. Pathogenesis
S. S. Hayreh
The pathogenesis of optic disc edema (ODE) in raised intracranial pressure
is discussed in the light of recent observations on the subject. The
findings indicate that ODE is a mechanical phenomenon. The raised
cerebrospinal fluid pressure (CSFP) in the sheath of the optic nerve
produces axoplasmic flow stasis in the optic nerve head. This results in
swelling of the axons, which manifests as early ODE and secondarily
produces the well-known optic disc and retinal vascular changes associated
with ODE. The pathogenesis of ODE seen in different conditions without
raised CSFP cannot be explained by any single mechanism in spite of the
occurrence of axoplasmic flow stasis in most cases, because the stasis in
different situations has different mechanisms.
