Optic Disc Hypoplasia

Case 3:
Optic Disc Hypoplasia

A 62-year-old man was referred for consultation by his optometrist because of a suspicious-looking optic nerve head in the left eye. The patient felt that his vision was good, and he had no history of unusual eye findings. This was his first dilated eye examination.

The patient's corrected visual acuity was 20/20 in both eyes. His intraocular pressure and external eye findings were normal. Funduscopic examination revealed a normal optic disc and retina in the right eye (A). The left eye had a smaller optic disc than the right (B). A peripapillary halo, known as the double-ring sign, can also be seen. The outer ring represents the junction between the sclera and lamina cribrosa where the choroid is discontinuous; the inner ring represents the termination of the retinal pigment epithelium.¹ Because this is a stationary condition, the patient's prognosis is excellent.

Optic disc hypoplasia is a developmental anomaly that can affect visual acuity and visual fields in patients with a more severe optic nerve defect. Children who have optic disc hypoplasia require a thorough neurologic evaluation, because this finding is often associated with neuroendocrinologic abnormalities and CNS anomalies, such as chiasmal malformations (de Morsier syndrome).²

References:

REFERENCES:

1.

Mosier MA, Lieberman MF, Green WR, Knox DL. Hypoplasia of the optic nerve.

Arch Ophthalmol.

1978; 96:1437-1442.

2.

Skarf B, Hoyt CS. Optic nerve hypoplasia in children: association with anomalies of the endocrine and CNS.

Arch Ophthalmol.

1984;102:62-67.