Optic Neuropathies and Papilledema
The diagnosis of optic neuropathy is typically made on clinical basis. The history and pattern of onset of an optic neuropathy often points to the diagnosis and etiology, with a rapid onset typical of demyelinating, inflammatory, ischemic and traumatic causes, while a gradual onset is more suggestive of compressive, toxic/nutritional and some hereditary causes.
Clinical features characteristic of optic neuropathies include afferent pupillary defect, vision loss of varying degrees, dyschromatopsia and visual field defects. Ancillary testing in optic neuropathies includes visual field testing, and the pattern of the visual field defect is often characteristic of the underlying disease. Neuroimaging is also often critical to the diagnosis of optic neuropathies. OCT is emerging as an increasingly important ancillary test in the diagnosis and follow-up of disorders of the optic nerve. OCT patterns vary depending on the clinical findings of the optic neuropathy as well as its stage. Since many optic neuropathies manifest as disc edema and/or optic nerve head atrophy, the characteristic OCT findings in these are summarized below.
Optic Neuritis
Optic neuritis or inflammation of the optic nerve is the most common cause of optic neuropathy in young adults. Optic neuritis can be idiopathic or associated with demyelinating lesions (e.g. multiple sclerosis), infectious and para-infectious conditions, inflammatory and post-vaccination conditions and autoimmune diseases. OCT B-scans through the optic nerve head can document disc edema
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
