Clinical Spectrum, Diagnostic Modalities, Management, and Outcome of Bilateral Optic Disc Edema: A Retrospective Analysis

Purpose: To evaluate the clinical spectrum, etiologies, management, and outcome of bilateral optic disc edema. Methods: This is a retrospective review of patient records presenting with bilateral disc edema and various clinical symptoms and etiologies. Various methods were employed, and the overall outcome was evaluated based on the best-corrected visual acuity at the last follow-up and patient survival. Results: The records of 234 eyes of 117 patients with an age range of 12–72 years were reviewed. Maximum 62 (52.79%) patients belonged to the age group of ≤40 years with female preponderance presented with headache. A maximum of 41 (35.045%) patients had idiopathic intracranial hypertension (IIH) in this series. Severe disc edema was observed in a maximum of 111 (47.44%) eyes. There was a statistically significant association of the grades of disc edema with various etiologies with a P = 0.00. The age range, visual field defects, and grades of disc edema showed a significant impact on the overall outcome with a P = 0.00 each. Conclusions: The current study reports that etiologies of bilateral disc edema influence the clinical presentation and outcome. IIH is the leading cause of bilateral disc edema. Brightness scan and optical coherence tomography can be a helpful noninvasive modality for detecting papilloedema by observing the doughnut and sleeping V signs. Timely, appropriate, prompt, and integrative management results in good outcomes, as evidenced by both visual regain and patient survival.