Optic Atrophy and Papilledema

Abstract

Optic atrophy is a misnomer. Although the term atrophy generally refers to physiologic involution or reduction in size, optic atrophy refers to cell death. In particular, optic atrophy represents the permanent loss of retinal ganglion cell axons in conjunction with retinal ganglion cell death. Optic atrophy should not be considered a diagnosis; it is a pathologic endpoint that is clinically discernible but does not imply cause. Optic atrophy may be from injury of the optic nerve head; however because of anterograde and retrograde degeneration, it may reflect upstream injury of the retinal ganglion cells or downstream injury of the posterior optic nerve, optic chiasm, or optic tract. Optic atrophy has been divided into primary and secondary varieties, and the distinction between them may have diagnostic value.