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October 1997

Large Cups in Normal-Sized Optic DiscsA Variant of Optic Nerve Hypoplasia in Children With Periventricular Leukomalacia

Author Affiliations

From the Department of Ophthalmology, Karolinska Institute, Huddinge University Hospital, Huddinge (Dr Jacobson); Department of Clinical Neurosciences, Section of Ophthalmology, Department of Pediatrics, International Pediatric Growth Research Centre, Gothenburg University, Gothenburg (Dr Hellström); and Department of Neuroradiology, Karolinska Institute, Karolinska University Hospital, Stockholm (Dr Flodmark), Sweden.

Arch Ophthalmol. 1997;115(10):1263-1269. doi:10.1001/archopht.1997.01100160433007

Objective:  To evaluate optic disc morphologic features in children with periventricular leukomalacia (PVL).

Patients and Methods:  Seventeen children with PVL (patient group) were compared with 17 sex- and age-matched, full-term healthy control children (control group). Clinical ophthalmological examination and digital image analysis of fundus photographs were performed in all children. In children with PVL, cerebral imaging was performed.

Results:  Children with PVL had larger optic disc cupping (P<.02) than did control children. A large proportion of the children with PVL had strabismus, nystagmus, and restricted visual fields.

Conclusion:  Our study indicates that optic nerve hypoplasia in children with PVL is often associated with a normal-sized optic disc with a large cup. This unusual form of optic nerve hypoplasia most likely results from transsynaptic degeneration of optic axons caused by the primary bilateral lesion in the optic radiation.