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Table 1 Overview of the different aetiologies of optic neuropathy.

From: Unilateral optic neuropathy following subdural hematoma: a case report

Optic Neuropathy Pathophysiology Diagnostic Means Diagnostic Parameter Ref.
AION (anterior ischemic optic neuropathy) Infarction of the ONH due to perfusion deficit of the SPCA Infrared pupillography Latent period of the pupil light reflex [6]
   Goldmann perimetry Visual field impairment, (cecocentral) scotoma [7]
   VEP Retarded P100 latency, diminished potential amplitude [8]
   Color fundus photography Crowded, edematous disc, peripapillary hemorrhage [7]
   Fluorescein angiography (i.v.) Vascular morphology and topology; discal perfusion delay [7, 8]
   Ocular blood flow system Pulse synchronic alterations of intraocular pressure [9]
   Optical coherence tomography, e.g. by HRT Circumferential scan of the ONH for quantitative, morphological analysis, e.g. cup size/volume, RNFL thickness [10]
   Scanning laser polarimetry, by confocal scanning laser ophthalmoscope Estimation of RNFL thickness by retardation of polarized scanning laser beam [11]
   Laser doppler flowmeter, e.g. by HRF Capillary blood flow of retina and choroidea via transpupillary laser scanning ophthalmoscopy [12]
   (Color) doppler imaging Blood flow of intraorbital, retroorbital, small choroideal vessels including SPCA [13]
   MRI DWI restriction, reduced ADC map [4]
   Fundoscopy Edematous disc, macular infarction, subsequent disc pallor [3, 4]
PION (posterior ischemic optic neuropathy) Retrolaminar ischemia due to hypo-perfusion of the Zinn-Haller circle (pial, choroideal vessels, PCA) Fundoscopy Initially normal disc, pallid after weeks [14]
   MRI   [14]
CRAO (central retinal artery occlusion) Perfusion deficit of the central retinal artery Clinical examination fundoscopy Absent papillary reflex or RAPD, cherry red spot of the macula [15]
SAH (subarachnoid hemorrhage due to intracranial aneurysma rupture) Perfusion deficit during surgical procedure (e.g. clipping), emboli, vasospasm Cerebral angiography Vessel calibres: aneurysm, emboli, vasospasm [16]
CST (cavernous sinus thrombophlebitis) Venous infarction due to thrombosis of ophthalmic veins Venography Absence of contrast filling in orbital veins [5]
   MRI DWI restriction, ADC reduction along optic nerve [5]
Compressive optic neuropathy Mucus in paranasal sinus Orbital CT Erosion of optic canals [17]
Toxic e.g. IFNα therapy Fundoscopy Edematous disc [18]
  1. Pathophysiological concepts and key diagnostics as well as diagnostic parameters are provided together with selected references from the literature.
  2. ADC, attenuated diffusion coefficient; AION, anterior ischemic optic neuropathy; CRAO, central retinal artery occlusion; CST, cavernous sinus thrombophlebitis; CT, computed tomography; DWI, diffusion weighted imaging; HRF, Heidelberg-Retina-Flowmeter; HRT, Heidelberg-Retina-Tomogram; MRI, magnetic resonance imaging; ONH, optic nerve head; PION, posterior ischemic optic neuropathy; PCA, posterior ciliary arteries; RAPD, relative afferent pupillary defect; RNFL, retinal nerve fibre layer; SAH, subarachnoid hemorrhage; SPCA, short posterior ciliary artery; VEP, visual evoked potential.