Abstract

Distinguishing glaucomatous from non-glaucomatous optic neuropathies based on optical coherence tomography (OCT) can be challenging as test results of both pathologies may show similar loss patterns. The differential diagnosis between glaucomatous and non-glaucomatous optic neuropathies is important as misdiagnosis in such cases may result in unnecessary glaucoma treatment in patients who previously suffered from various optic nerve disorders such as anterior ischemic optic neuropathy, optic neuritis or traumatic optic neuropathy. In addition, the differential diagnosis is crucial so that treatable lesions such as compressive lesions of the visual pathways, which can have life treatening consequences, are detected in a timely manner. Subtle differences in pattern of the RNFL damage, absence of significant cupping, presence of optic nerve pallor, visual field test results and other clinical findings may be helpful in differential diagnosis. This chapter summarizes the key points for differentiating glaucomatous and non-glaucomatous optic neuropathies and presents OCT test results of sample cases for some of the common non-glaucomatous optic neuropathies.

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