Bilateral optic disc edema (ODE) with preserved visual function is typically a result of papilledema, but the causes of this finding in the absence of raised intracranial pressure have not been systematically evaluated. The goal of this study was to determine the causes of bilateral ODE with preserved visual function not related to intracranial hypertension to help in developing a differential diagnosis for this finding. We retrospectively reviewed 221 consecutive patients presenting to a tertiary neuro-ophthalmology practice over a period of 2 years. Four patients met the inclusion criteria with a mean age of 53 years (range 43 to 63), 2 patients were men and 2 were women. The final diagnoses were bilateral optic perineuritis secondary to p-ANCA vasculitis, bilateral incipient non-arteritic anterior ischemic optic neuropathy (NAION), hypertensive emergency, and intermediate uveitis. The patient with NAION developed an inferior altitudinal defect 4 months after presentation, but all other patients maintained normal visual function. The ODE resolved in all cases at a mean follow-up of 4.5 months (range 3 to 6 months). Optic disc edema with preserved visual function may not be related to papilledema, and this series indicates that optic perineuritis, incipient NAION, hypertensive emergency, and intermediate uveitis be considered in the differential diagnosis of these cases.

中文翻译：

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双侧视盘水肿，保留视觉功能，与视乳头水肿无关

具有保留视觉功能的双侧视盘水肿 (ODE) 通常是视乳头水肿的结果，但尚未系统地评估在没有颅内压升高的情况下这一发现的原因。本研究的目的是确定与颅内高压无关的保留视觉功能的双侧 ODE 的原因，以帮助对该发现进行鉴别诊断。我们回顾性地回顾了 221 名在 2 年内就诊于三级神经眼科诊所的连续患者。4 名患者符合纳入标准，平均年龄为 53 岁（范围 43 至 63 岁），2 名患者为男性，2 名患者为女性。最终诊断为继发于 p-ANCA 血管炎的双侧视神经周围炎、双侧初期非动脉性前部缺血性视神经病变 (NAION)、高血压急症和中间葡萄膜炎。NAION 患者在就诊后 4 个月出现下高度缺陷，但所有其他患者均保持正常的视觉功能。平均随访 4.5 个月（范围 3 至 6 个月），所有病例的 ODE 均得到解决。保留视功能的视盘水肿可能与视乳头水肿无关，本系列提示视神经周围炎、初期 NAION、高血压急症和中间葡萄膜炎可在这些病例的鉴别诊断中考虑。