Featured Article for February 14, 2020
Papilledema
Papilledema refers to swelling of the optic disc from increased intracranial pressure (ICP). It must be distinguished from optic disc swelling from other causes which is simply termed "optic disc edema." Papilledema must also be distinguished from pseudo-papilledema such as optic disc drusen. Since the root cause of papilledema is increased intracranial pressure (ICP) this is an alarming sign which may presage such entities as brain tumor, CNS inflammation, or idiopathic intracranial hypertension (IIH).
As noted above, papilledema is due to increased intracranial pressure from any cause. Normal ICP is typically less than 250 mm water when measured with a manometer in the recumbinat position. Papilledema results from orthograde axoplasmic flow stasis at the optic nerve head leading to edema of the nerve from the increased intracranial pressure pressing on the nerve behind the eye. Continued pressure can result in loss of axons and eventual optic atrophy secondary to intraneuronal ischemia ultimately causing vision loss.
