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Advances in
eISSN: 2377-4290

Ophthalmology & Visual System

Editorial Volume 7 Issue 7

Discriminators for Optic Neuropathy and Maculopathy

Burak Turgut,1 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

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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.


Optic nerve disease                                                                                                                                                     

Macular disease                                                                                                                 


Variable (often acute, subacute)



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


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


Central macular disease (hole, cyst)

PSR time

Normal (under 30 sn)

Prolonged recovery time (over 90sn)


Abnormal (Large delayed latency and decreased amplitude)

Normal or mildly abnormal (small latency delay)



Full field ERG is often normal while multifocal ERG is usually abnormal


Late phase disc leakage in optic disc edema, peripapillary filling delay or ischemia in AION

Dependent on cause of maculopathy


Hyperautoflorescence (ON drusen, astrocytic hamartoma)

Variable depend on macular disease


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)

Table 1 The comparison of all aspects of optic neuropathy and maculopathy.1–9



Conflicts of interest

The author declares that there is no conflict of interest regarding the publication of this paper.


The author received no financial support for the research, authorship, and/or publication of this article.


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©2017 Turgut, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.