Im 1. Teil des Artikels wurden typische Optikopathien im Rahmen verschiedener syndromaler und nicht syndromaler retinaler Dystrophien beleuchtet [1]. Dieser 2. Teil analysiert nun Zusammenhänge zwischen unterschiedlichen erblichen und erworbenen mitochondriopathischen Optikopathien und möglichen begleitenden Netzhautveränderungen sowie deren Pathogenese und diskutiert relevante Differenzialdiagnosen.
Abstract
Due to the close anatomical, functional and trophic relationships between the optic nerve and retina, a wide variety of diseases affecting both structures have reciprocal effects on each other, which must be considered in the differential diagnosis to avoid misdiagnosis. Therefore, it is essential to assess pathological changes in both structures in context to differentiate the type and location of the primary lesion from its consequences, as well as to correctly classify coincidences and disease-specific lesion patterns in both organ components.
This article highlights the typical symptom constellations and lesion patterns of optic neuropathies and retinopathies. An attempt is made to identify the reciprocal characteristic relationships of the respective lesions in both structures in various disease groups, as well as to present their respective roles in the differential diagnosis.
In this second part, acquired optic neuropathies in the context of vascular and systemic diseases and possible accompanying retinal findings, as well as symptom constellations and courses, are differentiated, discussing arteritic and non-arteritic (anterior) optic neuropathies, their causes and differential diagnosis. The combined involvement of the optic nerve and retina in the context of posterior infectious and non-infectious uveitis is also shown. Finally, various dysgenetic optic neuropathies, their differentiation and possible retinal sequelae are presented.
It is demonstrated and exemplified how important it is in general, but also specifically in regard to the disease groups discussed in this article, to have a careful and targeted diagnostic approach in each case, considering both the retinal and optic nerve findings, in order to avoid misdiagnosis.
Schlüsselwörter
Papillendysgenesie - (N-)AION - vaskuläre Optikopathie - toxische Optikopathie - Grubenpapille - Drusenpapille
Keywords
optic disc dysgenesis - (N-)AION - vascular optic neuropathy - toxic optic neuropathy - optic disc pit - optic disc drusen
