Anwendungsgebiete für die Optische Kohärenztomografie (OCT) in der Neuroophthalmologie

Zusammenfassung

Die optische Kohärenztomografie (OCT) hat die Augenheilkunde revolutioniert. Auch bei neuroophthalmologischen Krankheitsbildern gibt es dank moderner, hochauflösender Geräte immer mehr Anwendungsfälle. In dieser Übersichtsarbeit werden die im OCT feststellbaren Veränderungen und deren Relevanz für den klinischen Alltag bei folgenden Krankheitsbildern besprochen: autosomal dominante Optikusatrophie (adOA), Lebersche hereditäre Optikusneuropathie (LHON), toxische, traumatische und kompressive Optikusatrophie, Drusenpapillen, anteriore ischämische Optikusneuropathie (AION), Grubenpapillen, Stauungspapillen, Neuritis nervi optici (NNO) (isoliert, im Rahmen einer Multiplen Sklerose oder Neuromyelitis optica), neurodegenerativen Erkrankungen und Netzhautdystrophien. Oftmals ist eine Diagnose allein aufgrund der Veränderungen im OCT nicht möglich, jedoch finden sich bei einigen Krankheitsbildern pathognomonische Befunde, die klar auf eine bestimmte Genese hindeuten. Gerade bei den oft komplexen Sachverhalten in der Neuroophtalmologie ist das OCT – mehr noch als sonst – jedoch immer als zusätzliche Modalität und nicht als Ersatz anderer Untersuchungen zu sehen.

Abstract

Optical coherence tomography (OCT) has revolutionised ophthalmology. Due to modern instruments with extremely high resolution there are more and more applications also in neuro-ophthalmological disorders. This review gives an overview on typical changes in OCT for the following diseases: autosomal dominant optic atrophy, Leber hereditary optic neuropathy, toxic, traumatic and compressive optic neuropathy, optic nerve drusen, anterior ischaemic optic neuropathy, optic disc pit, papilledema, optic neuritis (isolated or associated with multiple sclerosis or neuromyelitis optica), neurodegenerative diseases and hereditary retinal diseases. A diagnosis exclusively based on an OCT examination is not always possible, but in several diseases there are pathognomonic changes that directly lead to the correct diagnosis. Particularly with the often complex settings in neuro-ophtalmology the OCT should be seen as a supplementary modality and not as a replacement for other techniques.

Schlüsselwörter

optische Kohärenztomografie - Optikusatrophie - Optikusneuritis - Drusenpapillen

Key words

optical coherence tomography - optic atrophy - optic neuritis - optic disc drusen

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