Papillendiagnostik mithilfe der optischen Kohärenztomografie

Zusammenfassung

Hintergrund: Die Untersuchung des Sehnervenkopfs mit der optischen Kohärenztomografie (OCT) ist beim kooperativen Patienten schnell und einfach durchzuführen und erleichtert die Erkennung und Verlaufskontrolle verschiedener pathologischer Veränderungen der Papille deutlich.

Material und Methoden: Anhand von Beispielen sollen Möglichkeiten und typische Befunde der OCT-Untersuchung der Papille dargestellt werden, um die Erkennung auch seltener Erkrankungen des Sehnervs zu vereinfachen und korrekte Therapieentscheidungen fundiert treffen zu können.

Ergebnisse: Pathologische Veränderungen an der Papille und typische Papillen-OCT-Befunde bei Glaukom, bei verschiedenen Papillenanomalien, bei nicht glaukomatös bedingten Optikusatrophien und bei Papillenschwellungen unterschiedlicher Genese werden beschrieben. Darüber hinaus werden diejenigen OCT-Parameter und Untersuchungsmodalitäten dargestellt, mithilfe derer sich die jeweiligen Krankheitsbilder am einfachsten durch den Untersucher erkennen lassen.

Schlussfolgerung: Die Untersuchung der Papille mittels OCT ermöglicht eine schnelle Diagnostik auch seltener und ophthalmoskopisch schwierig zu erkennender Pathologien des Sehnervenkopfs und genaueste Verlaufsuntersuchungen chronisch-progredienter Erkrankungen. Mithilfe der OCT-Untersuchung der Papille können bei richtiger Anwendung und Auswertung die richtigen Diagnosen korrekt gestellt werden und wichtige Therapieentscheidungen deutlich vereinfacht werden.

Abstract

Background: With a cooperative patient, examination of the optic nerve head using optical coherence tomography (OCT) is fast and easy to perform and facilitates identification and monitoring of different pathological changes in the optic nerve head.

Materials and Methods: Characteristic findings and scanning options are illustrated using case examples to simplify recognition of infrequent diseases of the optic nerve head and to facilitate treatment decisions using OCT results.

Results: Pathological changes and characteristic OCT findings are shown for glaucoma, for different anomalies of the optic nerve head, for non-glaucomatous optic atrophies and for optic disc swelling for different reasons. The most suitable OCT parameters and examination modes are listed to differentiate between specific pathological changes.

Conclusion: Optic nerve head examination using the OCT facilitates rapid diagnosis of infrequent and hard to distinguish pathological changes, as well as exact monitoring of chronic progressive diseases of the optic nerve. Correct application and evaluation of results gathered using OCT examination of the optic nerve head facilitates accurate diagnosis and correct decisions.

Schlüsselwörter

Glaukom - optische Kohärenztomografie - ophthalmologische Bildgebung - Sehnervenkopf

Key words

glaucoma - optical coherence tomography - ophthalmic imaging - ocular nerve head

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