J Korean Ophthalmol Soc.  2001 Apr;42(4):614-617.

Differential Diagnosis of Optic Neuropathy

• Lee YJ
• Kim MK
• Hwang JM

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.

Keyword

Causative mechanisms; Misdiagnosed optic neuropathy; Functional visual loss

MeSH Terms

Amblyopia
Blindness
Color Vision
Contrast Sensitivity
Diagnosis, Differential*
Evoked Potentials, Visual
Glaucoma
Humans
Keratoconus
Nerve Fibers
Optic Nerve Diseases*
Photography
Prospective Studies
Reflex
Refractive Errors
Vision Disorders
Visual Field Tests
Visual Fields