Etiology and pathogenetic mechanisms of optic disc swelling with visual loss - An interdisciplinary prospective pilot study of 102 cases

A nonrandomized, prospective, interdisciplinary pilot study of 102 patients with noncompressive optic disc swelling with visual loss (ODSWVL) was perf ormed in order to investigate etiologic and pathogenetic mechanisms. Forty- six patients suffered from underlying inflammatory disease. Seventeen patie nts suffered from highly probable cardiogenic embolization, 16 patients fro m multiple vascular risk factors. The remaining patients of the noninflamma tory disease group suffered from leukemia, previously unknown or severely d ecompensated diabetes mellitus, acute arterial hypertension, different kind s of coagulopathies and others. Ninety-six of the 102 patients required med ical treatment according to general medical standards. Inhomogeneity of the underlying disease processes explains the ineffectiveness of different mon otherapies in previous studies. Interdisciplinary search for the underlying causes allows causative treatment. ODSWVL and anterior ischemic optic neur opathy in particular seem to be a common final pathway of various pathogene tic mechanisms due to different etiologies rather than a disease entity by itself.