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Abstract #9876 Published in IGR 5-3
Schnabel cavernous degeneration: a vascular change of the aging eye
Giarelli L; Falconieri G; Douglas-Cameron J; Pheley AMArchives of Pathology and Laboratory Medicine 2003; 127: 1314-1319
CONTEXT: Schnabel cavernous degeneration is a histological finding originally attributed to glaucoma; however, its cause and significance have been controversial. OBJECTIVE: To determine the basic cause of the formation of cavernous spaces in the proximal optic nerve and its clinical significance. METHODS: A retrospective analysis of 4500 autopsy eyes processed for histological evaluation between 1967 and 1991. RESULTS: Ninety-three (2.1% of eyes examined) cases of Schnabel cavernous optic atrophy were identified. The majority of the eyes were from females (81%). The mean age of the entire group was 88 years (reference range, 54-103 years). Severe vascular anomalies were present in 75% of the individuals. Cavernous degeneration was unilateral in 82% of the cases. Loss of ganglion cells and nerve fiber layer consistent with glaucoma was found in 23.7% of the individuals. Clinical information was available for 15 individuals (16%). Half of them were thought to have some clinical optic nerve damage; in the remainder, no specific optic disc abnormalities were noted. Histological findings of arteriolosclerosis in the optic nerve circulation were common. The prevalence of glaucoma was low. CONCLUSIONS: Schnabel cavernous optic atrophy appears to be a unilateral condition of elderly women with systemic vascular disease and few characteristic ocular features. These data indicate that a chronic vascular occlusive disease of the proximal optic nerve is more involved in cavernous atrophic pathogenesis than is a sustained increase of intraocular pressure.
Dr. G. Falconieri, Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, General Hosital S. Maria Misericordia, I-33100 Udine UD, Italy
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy