Etiology and diagnostics of compressive optic neuropathies

Abstract

To determine the causes and study the clinical manifestations of compressive optic neuropathy (CON). The study included 24 male and 36 female patients with CON (in total 60 patients, 97 eyes). All patients underwent standard ophthalmic examination, as well as computer perimetry, magnetic resonance imaging (MRI), and/or computed tomography (CT) of the brain and orbit and magnetic resonance angiography (MRA). Tumor or infiltrative lesions of the anterior optic pathway were detected in 60 patients (97 eyes). In 2/3 of cases, the brain and orbit diseases were established for the first time as the cause of optic neuropathy. Adenoma of the pituitary gland and meningioma as the most common cause of CON was diagnosed in 66%. According to the results of computed perimetry, in 65.9% of cases patients with CON are diagnosed with hemianopsia, while in other cases, other forms of scotomas characteristic for the defeat of any part of the optic nerve may be observed. Computed perimetry is the most important study for detection of optic neuropathy. An optic nerve disease of unknown origin is an absolute indication for radiological examination of the brain and eye orbits.