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
