congested optic disc

A congestive optic disc is a non-inflammatory edema. It is a sign of increased intracranial pressure, but does not indicate its cause. With a long existence, stagnation of the optic nerve can turn into atrophy of the optic nerve.

The reasons

The causes of increased intracranial pressure are:

  • tumors in the cranial cavity
  • cerebral edema
  • inflammation of the brain tissue and its membranes
  • brain injury
  • skull bone changes
  • leading to a decrease in the volume of the cranial cavity.

Edema of the optic nerve with the formation of a congestive disc of the nerve can lead to:

  • allergic diseases
  • blood diseases
  • arterial hypertension
  • kidney disease.

It is possible that the edematous papilla of the optic nerve may occur with injuries of the orbit, the eye, with eye diseases accompanied by a decrease in intraocular pressure. Congestive optic disc occurs when there is a violation of the outflow of interstitial fluid from the part of the optic nerve located in the orbit. Normally, the outflow of this fluid is carried out into the cranial cavity. With a decrease in intraocular pressure, fluid retention may occur due to a lack of pressure on the optic nerve in the eye cavity.


Complaints from the organ of vision are traditionally absent, sometimes short-term (10-20 s) “blurring” of vision is periodically noted. Visual acuity in all stages of the disease remains unchanged; in the advanced stage, a slight uniform narrowing of the boundaries of the visual field may appear. The only sign of damage to visual functions typical for this disease is a progressive increase in the size of the blind spot. Ophthalmoscopy of the optic disc in the initial stage of the optic nerve disc reveals moderate hyperemia and varicose veins, blurring of one of the borders (usually nasal) and prominence of the corresponding half of the disc into the vitreous body. In the advanced stage, the disk is enlarged in size, protrudes into the vitreous body in the form of a “mushroom cap” by 2.0–3.0 D, has a grayish color, fuzzy borders, physiological excavation is smoothed or disappears, the veins are dilated, tortuous, bent along the edge of the disc. In the advanced stage, the ophthalmoscopic picture is supplemented by the appearance of multiple streaky hemorrhages and white-yellow deposits in the tissue of the edematous disc. Perhaps a non-cardinal deterioration in vision, indicating developing atrophy of the optic nerve.


The diagnosis is established on the basis of the determination of visual functions with mandatory campimetry (determination of the boundaries of the blind spot), ophthalmoscopy, and the results of a neurological examination. In doubtful cases, fundus fluorescein angiography (differential diagnosis with pseudocongestive disc or disc drusen), CT or MRI of the skull and orbit is additionally performed. When making a differential diagnosis of ODZN and optic neuritis, the main argument in favor of ODZN is the safety of visual functions, while with neuritis there is a decrease in central vision, changes in color perception, narrowing or local damage to the boundaries of the visual field on white and colored objects, deterioration of electrophysiological parameters, less pronounced prominence of the disc into the vitreous. The degree in the following days is expressed in diopters,


Timely elimination of the main cause of increased intracranial pressure.

The prognosis for vision with timely treatment is favorable, with long-term ODZN – poor (bilateral incurable blindness).

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