Differential Diagnosis of Optic Neuropathy.

Lee, Yong Jae; Kim, Mee Kum; Hwang, Jeong Min

Original Article

Journal of the Korean Ophthalmological Society 2001;42(4):614-617.
Published online April 1, 2001.

Differential Diagnosis of Optic Neuropathy.

Yong Jae Lee, Mee Kum Kim, Jeong Min Hwang

Department of Ophthalmology, Seoul Municipal Boramae Hospital, Seoul National University College of Medicine.

시신경병증의 감별진단

이용재(Yong Jae Lee),김미금(Mee Kum Kim),황정민(Jeong Min Hwang)

Abstract

PURPOSE
In order to prospectively investigate the causative mechanisms of visual loss in 42 patients referred to rule out optic neuropathy or diagnosed with optic neuropathy in other hospitals. METHODS: Thorough history taking and ophthalmologic examinations were performed. In some patients, evaluation of extraocular movement, nerve fiber layer photography, contrast sensitivity, visual evoked potential, electroretinogram and visual field were tested. RESULTS: Functional visual loss was most common(18 patients), followed by retinopathy(nine patients). Three patients suffered from amblyopia and glaucoma, respectively, two from keratoconus, pseudopapilledema, miscorrected refractive error, and Leber's congenital amaurosis, respectively, and one from cortical visual impairment. In the differential diagnosis of optic neuropathy, history taking and ophthalmologic examinations including pupillary light reflex, color vision test, nerve fiber layer photography, funduscopy and visual field test were useful. Especially the color vision test was very simple, but useful. CONCLUSION: Clinical entities including functional visual loss and retinopathy should be considered when diagnosing visual loss of unknown etiology.

Key Words: Causative mechanisms;Misdiagnosed optic neuropathy;Functional visual loss