Classification Of Papilledema

Early

  1. Hyperaemia, indistinct margins (lower pole first).
  2.  Blurring of peri-papillary retinal nerve fiber layer.
  3. Splinter haemorrhages in the peri-papillary region.
  4. Absence of SVP ( not always, may be absent in 20% of normal)

 

Established

  1.  Obvious swelling, numerous haemorrhages.
  2. Engorged veins, obscuration of surface vessels.
  3. Paton’s lines, cotton wool spots, macular fan or star.

 

Chronic

  1. Haemorrhages and exudates resolve.
  2. Disc has rounded appearance, milky gray colour.
  3. Obliteration of cup, NFL defects .

 

Atrophic

  1. Pale disc.
  2. Narrow and sheathed vessels.
  3. Peri-papillary pigmentary changes / choroidal folds.

 

 

 

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