Clinical profile and aetiology of optic atrophy in Malaysia

Abstract:

AIM:To describe the aetiology and clinical profile of non-glaucomatous optic atrophy in a tertiary hospital in Malaysia.

METHODS: A retrospective case series was conducted on patients diagnosed with non-glaucomatous optic atrophy who presented to the Eye Clinic of Hospital Universiti Sains Malaysia from 2007 until 2011 with a minimum of one year follow-up. Medical records of these patients were reviewed and the findings compiled.

RESULTS: Of the 100 patients who met the selection criteria, 56% had bilateral involvement. The chief presenting symptom was visual blurring(61%), followed by visual blurring with neurological symptoms(18%)and visual field constriction(9%). Most patients(63%)had a presenting visual acuity worse than 3/60 in the affected eye. The main aetiologies were space-occupying intracranial lesions(26%), congenital/hereditary diseases(13%), hydrocephalus(12%), trauma(12%), and vascular causes(12%). The majority of cases(67%)were managed conservatively. Regardless of aetiology, optic atrophy was associated with variable degrees of visual dysfunction. At the end of one year, 50% of the patients had some degree of visual impairment.

CONCLUSION: The main aetiology of optic atrophy was space-occupying intracranial lesions, followed by congenital/hereditary, trauma and vascular problems. Visual or neurological symptoms usually preceded the diagnosis, and visual acuity was significantly affected by the disease. A high level of suspicion is required in order to make an early diagnosis of optic atrophy, as the main complaint of visual blurring is usually non-specific.

Key words:optic atrophy; aetiology; optic nerve diseases; blindness; brain neoplasms; Malaysia