|Year : 1967 | Volume
| Issue : 6 | Page : 236-237
Pseudoneuritis with optico-ciliary veins
KS Mehra, PN Dwivedi
Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi-5, India
|Date of Web Publication||22-Jan-2008|
K S Mehra
Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi-5
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mehra K S, Dwivedi P N. Pseudoneuritis with optico-ciliary veins. Indian J Ophthalmol 1967;15:236-7
A woman, aged 38 years, having two congenital anomalies is being presented-pseudoneuritis in both eyes and opticociliary veins in the left eye.
| Case Report|| |
A female aged, 38 years teacher by profession, attended the out-patient department with no other complaint except that of difficulty in doing the near work for the last 3 months. There was no history of any headache, vomiting or nausea.
Examination of all the systems showed no abnormality. The central vision and peripheral fields in both the eyes were normal.
| Fundus|| |
[Figure - 1],[Figure - 2] are reproductions of the fundus appearance of the right and left eyes respectively. Both discs appeared swollen in appearance, the right one by 3D and the left one by 5 D. The colour was normal and the margins ill defined.
In the left eye [Figure - 2], besides the normal branches of the central retinal veins two other veins could be seen, one at 9 o'clock and the other at 4 o'clock. The former emerged a little away from the disc margin and entered the inferior nasal vein the latter emerged from within the disc margin and opened into the inferior temporal vein.
No other abnormality was present in the fundi.
| Discussions|| |
Presence of optico-ciliary veins is a congenital defect and is quite rare. These veins bring blood from peripapillary portion of choroid and enter at the disc margin of optic nerve and then either anastomose with small branches of central retinal vein or open into it. LAWFORD has shown that these vessels are visible during part of their course across optic disc but then disappear from view at margin of disc. Sometimes these veins can even be traced in the portion of retina near to the disc margin and then they disappear. ELSCHNIG is of the opinion that these are represented at capillary level and are uveo-retinal venous anastomosis.
The other congenital anomaly of the optic nerves is blurring and swelling of disc margins-pseudoneuritis. Incidence of pseudoneuritis according to DUKE-ELDER is 0.2% in human beings. The swelling of disc may even appear up to 10 D. On going through the literature it was seen that cases of pseudoneuritis associated with psammoma of optic nerve, dermoid cyst of orbit, drusen, cholestrin cystals, medullated fibres or micro-ophthalmos have been reported, but no case of pseudo neuritis associated with optico-ciliary veins has yet been reported.
Our patient had bilateral pseudoneuritis and two optico-ciliary veins in the left eye only. The point of clinical interest in our case was that the swelling of disc was more in the left eye, in which optico-ciliary veins were present. It may therefore be argued that pseudoneuritis might be due to the presence of these vessels at capillary level from the choroid entering into disc behind the level of lamina cribrosa and might be responsible for giving the appearance of a swollen optic nerve head.
We are highly indebted to Shri Pandey, Photo Artist, for his help in preparation of the figures.
| References|| |
DUKE ELDER-System of Ophthalmology, Vol. III, Part II, Henry Kimpton, London. p. 673.
ELSCHING (1898), Klin. Mbd. Augenheilk, 36, 93 as quoted in 1.
LAWFORD (1895) Trans. Ophth. Soc. U.K. 15, 195, as quoted in 1.
[Figure - 1], [Figure - 2]