Abstract

FR.18.05

Who tells the truth about the optic disc: electrophysiology or morphology?

Ruether K., Schroeter J.
Charité-Augenlinik Campus Virchow-Klinikum, Berlin

Objective: In some cases swelling of the optic disc as well as optic atrophy are difficult to classify. Beyond visual acuity and visual field testing there is a growing number of functional and morphological techniques for the classification of the papilla. Here, the potential of some morphological and electrophysiological procedures in this regard will be discussed.
Methods: By means of consecutive patients examined in a neuroophthalmological clinic the relevance especially of ultrasound and optical coherence tomography as well as of VEP and electroretinography will be highlighted.
Results: Key diagnostics for the classification of optic disc alterations are history, visual acuity, visual field testing and ophthalmoscopy. Optic disc drusen are best diagnosed by ultrasound. The optical coherence tomography has shown to be relevant for the monitoring of optic disc swelling. In cases of optic atrophy electroretinography may be of essential impact for the differential diagnoses (e.g. after central artery occlusion, patients suffering from macular or retinal dystrophy etc.). Visual evoked potentials (VEP) may help to classify optic disc swelling but it has limitations in terms of specificity.
Conclusions: Morphological as well as electrophysiological methods play an important role for the management of patients suffering from optic neuropathy. Morphological techniques play are essential for the diagnosis of optic disc drusen and the monitoring of optic disc swelling. Electrophysiological methods may be crucial for the differential diagnosis of papillary diseases.

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