Discriminators for Optic Neuropathy and Maculopathy

doi:10.15406/aovs.2017.07.00249

Advances in

eISSN: 2377-4290

Ophthalmology & Visual System

Editorial Volume 7 Issue 7

Discriminators for Optic Neuropathy and Maculopathy

Burak Turgut,¹

Verify Captcha

Regret for the inconvenience: we are taking measures to prevent fraudulent form submissions by extractors and page crawlers. Please type the correct Captcha word to see email ID.

Fatoş Altun Turgut²

¹Department of Ophthalmology, Yuksek Ihtisas University, Turkey
²Elazig Training and Research Hospital, Turkey

Correspondence: Burak Turgut, Professor of Ophthalmology, YuksekIhtisas University, Faculty of Medicine, Department of Ophthalmology, 06520, Ankara, Turkey, Tel +90 312 2803601

Received: December 08, 2017 | Published: December 11, 2017

Citation: Turgut B (2017) Discriminators for Optic Neuropathy and Maculopathy. Adv Ophthalmol Vis Syst 7(7): 00249. DOI: 10.15406/aovs.2017.07.00249

Download PDF

Editorial

Optic neuropathies and maculopathies are more common causes of visual loss. However, as optic neuropathies and maculopathies can share some common characteristics, the overlapping of the features of these pathologies occur sometimes and this can cause the difficulty in diagnosis and even the important challenges in the management of the underlying exact pathology. The early diagnosis of some neuro-ophthalmological emergencies such as arteritic anterior ischemic optic neuropathy (AION) and optic neuritis is critical. There are several discriminator aspects providing to distinguish between optic neuropathies and maculopathies.^1–9 The comparison of all aspects and discriminators of optic neuropathy and maculopathy was given in Table 1.To apply the highlights and discriminators given in table will facilitate to distinguish the optic nerve disease from macular diseases.

Feature	Optic nerve disease	Macular disease
Onset	Variable (often acute, subacute)	Variable
Course	Variable (Progressive, transient, or stable)	Mostly slower progression
Visual experience	Shading, clouding, graying, darkening	Central blurring, glaring, photophobia, metamorphopsia
Ocular pain	Maybe occur in eye movements	No usual
Refractive change	No usual	Maybe develop hyperopic shift
VA loss	Variable reduction, even to NLP level	Significantly reduction but not to NLP
Pupils	RAPD in case of unilateral or asymmetrical ON disease	No RAPD, if severe unilateral retinal involvement is absent
CS and brightness	Significantly reduced	Mildly reduced
Color vision	Significantly reduced	Mildly reduced
VF defect	Variable (Central, centrocecal, altitudinal, blind spot enlargement)	Central scotoma
Amsler Grid	Variable scotoma	Central scotoma, metamorphopsia
Pulfrich phenomena	Novaluable	Central macular disease (hole, cyst)
PSR time	Normal (under 30 sn)	Prolonged recovery time (over 90sn)
VER	Abnormal (Large delayed latency and decreased amplitude)	Normal or mildly abnormal (small latency delay)
ERG	Normal	Full field ERG is often normal while multifocal ERG is usually abnormal
FFA	Late phase disc leakage in optic disc edema, peripapillary filling delay or ischemia in AION	Dependent on cause of maculopathy
FAF	Hyperautoflorescence (ON drusen, astrocytic hamartoma)	Variable depend on macular disease
SD-OCT	Increasing or decreasing in RNFL thickness (edema or atrophy) Increasing in peripapillary RNFL thickness (myelinated nerve fiber or cotton wool spot) Decreasing macular GCC (optic neuritis)	Vitreo-retinal interface abnormalities Various intra- or sub-retinal/sub-RPE pathologies in macular region Altering macular retina thickness Altering macular choroid thickness Decreasing macular GCC (antimalarial maculopathy)