Walsh & Hoyt: Postpapilledema Atrophy

With time, untreated papilledema subsides, the disc becomes atrophic, and the retinal vessels become narrowand sheathed. In such cases, the nerve fiber layer can no longer be visualized by either direct ophthalmoscopy or slit lamp biomicroscopy. Some patients have persistent pigmentary changes or choroidal folds in the maculae. If the papilledema has been particularly severe, these changes may resemble those caused by a hamartoma of the pigment epithelium