Publication: Situs inversus del nervio óptico. A propósito de un caso
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Publication Date
2017-06-01
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Hoz Montañana, Rosa de
Rojas López, Blanca
Ramirez Sebastian, Jose Manuel
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Viguera Editores S.L.
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Abstract
Introducción. El situs inversus del nervio óptico es una anomalía congénita caracterizada por la emergencia de los vasos de la retina en dirección nasal en lugar de temporal. Es causado por una anómala inserción del tallo óptico en la vesícula óptica que da lugar a la variación de disposición de la cabeza del nervio óptico. No es una condición aislada y suele aparecer junto con el síndrome del disco inclinado y en pacientes con miopía. Se caracteriza por la presencia de un cono de atrofia inferior, defectos en el campo visual temporal, defectos de refracción y ambliopía.
Caso clínico. Mujer de 22 años, que acude a revisión oftalmológica por presentar fuertes cefaleas frontales acompañadas de halos y pérdida de nitidez en la visión. Tras un examen optométrico y oftalmológico se llega al juicio clínico de que padece un cuadro compatible con esta anomalía anatómica congénita.
Conclusiones. El situs inversus del nervio óptico es una condición rara que puede aparecer aislada o acompañada de otras patologías. La aplicación de la campimetría y de nuevas técnicas diagnósticas, como la tomografía de coherencia óptica, facilita el diagnóstico diferencial de esta situación. No se conoce su prevalencia, pues no se encuentra en el registro de las enfermedades raras. Además, el escaso número de pacientes estudiados y la exigua bibliografía existente sobre esta anomalía no permiten conocer si los defectos causados progresan en el tiempo, por lo que sería importante realizar un seguimiento oftalmológico de los pacientes con situs inversus del nervio óptico.
INTRODUCTION: Situs inversus of the optic nerve is a congenital anomaly characterised by the emergence of the vessels in the retina towards the nose rather than in a temporal direction. It is caused by an anomalous insertion of the optic stalks into the optic vesicle that gives rise to dysversion of the head of the optic nerve. It is not an isolated condition and usually appears jointly with tilted disc syndrome and in patients with myopia. It is characterised by the presence of inferior conus atrophy, deficiencies in the temporal visual field, refraction defects and ambliopy. CASE REPORT: A 22 years-old female who attended an ophthalmological examination due to severe frontal headaches accompanied by halos and loss of sharpness in her sight. From the results of the ophthalmetric and ophthalmological examination she was diagnosed as suffering from a condition consistent with this congenital anatomical anomaly. CONCLUSIONS: Situs inversus of the optic nerve is a rare condition that may appear in isolation or accompanied by other pathologies. Application of the visual field test and new diagnostic techniques, such as optical coherence tomography, facilitates the differential diagnosis of this situation. Its prevalence remains unknown, as it is not included in the register of rare diseases. Moreover, the scant number of patients studied and the scarce literature on this anomaly do not allow us to know whether the defects it causes develop over time. It would therefore be important to perform an ophthalmological follow-up of patients with situs inversus of the optic nerve.
INTRODUCTION: Situs inversus of the optic nerve is a congenital anomaly characterised by the emergence of the vessels in the retina towards the nose rather than in a temporal direction. It is caused by an anomalous insertion of the optic stalks into the optic vesicle that gives rise to dysversion of the head of the optic nerve. It is not an isolated condition and usually appears jointly with tilted disc syndrome and in patients with myopia. It is characterised by the presence of inferior conus atrophy, deficiencies in the temporal visual field, refraction defects and ambliopy. CASE REPORT: A 22 years-old female who attended an ophthalmological examination due to severe frontal headaches accompanied by halos and loss of sharpness in her sight. From the results of the ophthalmetric and ophthalmological examination she was diagnosed as suffering from a condition consistent with this congenital anatomical anomaly. CONCLUSIONS: Situs inversus of the optic nerve is a rare condition that may appear in isolation or accompanied by other pathologies. Application of the visual field test and new diagnostic techniques, such as optical coherence tomography, facilitates the differential diagnosis of this situation. Its prevalence remains unknown, as it is not included in the register of rare diseases. Moreover, the scant number of patients studied and the scarce literature on this anomaly do not allow us to know whether the defects it causes develop over time. It would therefore be important to perform an ophthalmological follow-up of patients with situs inversus of the optic nerve.