Q. Will crowded optical disc lead to NAION?

Answered by
Dr. Dada Peer K
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 22, 2020

Hello doctor,

The question I have is concerning the retina photographs that I have attached to this question. From those can you tell if I suffer from a condition known as "disc at risk" or "crowded optical disc"? I understand that it is possible for people with this condition to suffer from non-arteritic anterior ischemic optic neuropathy (NAION) when also taking ED medication. I have had an eye test done but the person who did the test could see no problem with my eyes but seemed unaware of crowded disc or NAION. I am 60 years old, not taking any medication and no previous history of eye problems or NAION.

Dr. Dada Peer K

Ophthalmology (Eye Care)


Welcome to icliniq.com.

I reviewed your history and the photos of the retina attached to the question. (attachment removed to protect patient identity).

The fundus picture does not appear like disc at risk and hence no need to worry about it. In the fundus photo, the disc is showing is peripapillary atrophy surrounded by the tesselated background of the retina. These changes are commonly seen in myopia.

People with a small disc with crowding of nerve fibers are at the risk of development of non-arteritic ischemic optic neuropathy, called NAION. The compression of the small capillaries at the optic disc because of overcrowding will result in ischemia resulting in NAION. In your case, the fundus picture the disc does not appear like a disc at risk. Hence no need to worry.

Hope the information is helpful to you.

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