Acquired Optic Neuropathies

Transcription

1 Acquired Optic Neurpathies Jseph J. Pizzimenti, OD, FAAO Carl J. Pelin, OD, FAAO GOAL The gal f this presentatin is t prvide the participant with useful clinical infrmatin in the diagnsis and treatment f acquired ptic nerve disrders. OBJECTIVES At the cnclusin f this curse, the participant shuld be able t: 1. Discuss the functinal anatmy f the ptic nerve. 2. Describe the mst cmmn diseases f the ptic nerve. 3. Diagnse and manage ptic nerve cnditins, using labratry testing and neurimaging when necessary. 4. Apply new knwledge abut the pathgenesis and wrk-up f these ptic neurpathies. 5. Apply new knwledge abut the treatment and management f diseases f the ptic nerve. ABSTRACT The primary eye care prvider plays a crucial rle in the diagnsis and treatment f cnditins that can result in significant visin lss r even lss f life. Diseases f the ptic nerve frequently fit int these categries. Cvered tpics include demyelinating, ischemic, cmpressive, inflammatry, and infectius ptic neurpathies.

2 Curse Outline Anatmy and Physilgy f the Optic Nerve Functinal Anatmy f the Optic Nerve Intracular Optic Nerve Nerve Fiber Layer Lamina Chridalis Lamina Cribsa Intrarbital Optic Nerve Intracanalicular Optic Nerve Intracranial Optic Nerve Axnal Physilgy Clinical Testing f Optic Nerve Functin Evaluatin f the Patient Histry Taking Visual Activity Visual Field Clr Visin Brightness Cmparisn Pupillary Testing Phtstress Recvery Test Cntrast Sensitivity Opthmamscpy Electrphysilgy Imaging Studies Acquired Optic Neurpathies Jseph J. Pizzimenti, OD Carl J. Pelin, OD Papilledema Pathgenesis f Papilledema Opthalmscpic Findings Classificatin f the Papilldema Early Papilldema Fully Develped Papilledema Chrnic Papilledema Pst-papilledema Optic Atrphy Assciated Clinical Features Visual Symptms Visual Acuity Visual Field Defects Pupillary Functin Diplpia Visual Prgnsis Fster Kennedy Syndrme Neurlgic Symptms Causes f Papilledema Patient Evaluatin Idipathic Intracranial Hypertensin Management f Papilledema Optic Neuritis Visual Symptms

3 Clr Visin Pupillary Functin Visual Field Defects Optic Disc Abnrmalities Uhtff s Symptm Visual Evked Respnse Neurimaging Abnrmalities Optic Neuritis and Multiple Sclersis Optic Neuritis Treatment Trial The CHAMPS Trial Differential Diagnsis Demyelinating Disrders Infectius Agents Intracular Inflammatin Systemic Diseases Ischemic Optic Neurpathy Nn-arteritic Anterir Ischemic Optic Neurpathy Idipathic NAION Risk Factrs Clinical Characteristics Prgressive Disease Recurrent and Sequential Disease Visual Acuity Outcme Treatment Atypical Features Differential Diagnsis Nn-arteritic Anterir Ischemic Optic Neurpathy Attributable t a Specific Cnditin Pst-cataract Extractin Amidarne Txicity Sildenafil Txicity Emblic Occlusin Hyptensin Uremia Diabetic Papillpathy Migraine Arteritic Anterir Ischemic Optic Neurpathy Giant Cell Arteritis Serlgic Markers Treatment Tempral Artery Bipsy Psterir Ischemic Optic Neurpathy Cmpressin f the Anterir Visual Pathways Causes f Cmpressive Optic Neurpathy Symptms f Cmpressive Optic Neurpathy Signs f Cmpressive Optic Neurpathy Optic Disc Findings Patient Evaluatin Glima Optic Nerve Glima Histpathlgy

4 Natural Histry Management Optins Cranipharyngima Clinical Features Histpathlgy Management Optins Pituitary Adenma Clinical Features Visual Signs Endcrine Signs Neurimaging Management Optins Therapy f Prlactinma Therapy f Other Secreting Tumrs Therapy f Nnsecreting Tumrs Adverse Outcmes Meningima Suprasellar Meningima Neurimaging Management Optins Optic Nerve Sheath Meningima Neurimaging Management Optins Intracranial Aneurysm Clinical Features Neurimaging Management Optins Develpmental and Hereditary Optic Nerve Disrders Develpmental Optic Nerve Disrders Anmalus Elevatin f the Optic Nerve, r Pseudpapilledema Optic Nerve Hypplasia Superir Segmental Optic Hypplasia Hemiptic Hypplasia Clbma Optic Pit Tilted Disc Mrning-Glry Syndrme Astrcytic Hamartma Melancytma Hereditary Optic Neurpathies Dminant Optic Atrphy Recessive Optic Atrphy Leber s Hereditary Optic Neurpathy Neurlgic Syndrmes Metablic Disease Miscellaneus Optic Neurpathies Radiatin Optic Neurpathy Neurretinitis Carcinmatus Optic Neurpathy Diabetic Papillpathy Papillphlebitis

5 Optic Perineuritis Autimmune-Related Retinpathy and Optic Neurpathy Syndrme (AARON) Nn-glaucmatus Optic Disc Cupping