Papillary stasis – causes, symptoms, treatment
Optic nerve papilla is round disc-shaped, whitish color, with a diameter of about 1.5 mm, slightly excavated, visible on fundus examination and corresponds to the point of penetration of the optic nerve and central vessels (arteries and veins) by shells of the eye-ball. It is also called optical disk.
Papillary stasis is a non-inflammable edema emerged from the liquid impregnation of the papilla. This impregnation with liquid of the optic nerve papilla may be the consequence of a circulatory embarrassment or cerebrospinal fluid pushed into the optic nerve sheaths due to increased intracranial pressure.
Papillary stasis may be bilateral and unilateral.
Causes of papillary stasis
Bilateral stasis is usually caused by endocranial processes, tumors (brain tumors, tuberculoms, parasites), encephalitis (inflammation of the brain), meningo-encephalitis (inflammation of the brain and meninges), brain hemorrhage, brain abscess , cranial deformities causing intracranial hypertension.
Unilateral papillary stasis is local (eye hypotonia, ocular contusion, intraorbital injuries causing compression on the optic nerve at this level).
Papilledema may still occur due to general diseases such as atherosclerosis, hypertension, retinopathy in pregnant, some syndromes of anemia.
The clinical picture of papillary stasis varies during its evolution.
A characteristic sign of papillary stasis is the disagreement between obvious ophthalmoscopic changes and minimal functional disturbances during the onset of the disease, visual acuity is usually normal.
At first papilla is hyperemia (red), with edges that are deleted because of swelling installed in the nasal territory and subsequently spread including throughout papilla. Papilla has increased diameters. Retinal arteries are thin, barely visible, veins are turgid (swollen). Radial haemorrhages and exudates papilo -retinal appear later .
Subjective symptoms at first consist of transient visual dizziness. Visual acuity is long preserved. Visual field changes towards a concentric trouble. Papillary stasis if develops leads to atrophy post-stasis with impaired vision.
If papillary stasis is produced by endocranial processes that accompany of intracranial hypertension then the clinical picture is completed by headache, dizziness, vomiting in jet, bradycardia (heart rate decreased below the normal range of 60 contractions / min).
In the diagnosis of papillary stasis it can perform the following investigations:
– determination of visual acuity;
– study of color sense;
– Field of vision;
– fundus examination;
– Doppler ultrasound of the eye;
– CT (computer tomography);
– MRI (magnetic resonance).
Treatment is of the causing disease(if papillary stasis is caused by endocranial processes the treatment is neurosurgical ).
Disease prognosis depends on etiology.