Range of Clinical Neuro-Ophthalmopathology: more than Tumors

Gerhard Franz Walter

doi:10.31579/2578-8868/215

Abstract

The importance of close co-operation of ophthalmologists, neurologists, neurosurgeons and neuro-ophthalmopathologists as well in clinical as in scientific settings is underlined. Typical neuro-ophthalmopathological examples of frequent and rare cases from pathology of the eyelid, the cornea, intraocular tumors, ocular trauma and tumors of the orbit are presented as well as systemic pathologies such as inflammatory diseases of the eye, phakomatoses, malformations and mitochondrial disorders in which the histopathological investigation by neuro-ophthalmopathologists may contribute to diagnosis and therapeutic decision-making. The chosen examples should provide a narrow focus on some clinical queries answered by neuro-ophthalmopathology and exemplify methodological options, but – in the given frame – cannot represent the full range of eye pathology. Relevant literature is included for further reading. Ophthalmologists, neurologists and neurosurgeons should be aware from the additional value of a concise neuro-ophthalmopathological diagnosis for the optimal treatment of eye diseases and should insist in a professional neuro-ophthalmopathological investigation whenever and wherever possible.

Highlights

Aim of this overview is to interest ophthalmologists and clinical neuroscientists in neuro-ophthalmopathology and to make them aware that a close co-operation with neuro-ophthalmopathologists on clinical as well as scientific questions can valuably contribute to the improvement of diagnostic and therapeutic decisions
It is well known to all ophthalmologists that a pathological investigation of surgically removed tumor tissue is indispensable for a complete diagnosis and may decisively influence the subsequent therapy
Another common vasculitis directly involving the eye, in single cases leading to visual loss and to be differentiated from Granulomatosis with polyangiitis (GPA), is giant cell arteritis (GCA), synonymously Horton’s arteritis

Summary

Introduction

Aim of this overview is to interest ophthalmologists and clinical neuroscientists in neuro-ophthalmopathology and to make them aware that a close co-operation with neuro-ophthalmopathologists on clinical as well as scientific questions can valuably contribute to the improvement of diagnostic and therapeutic decisions. It is well known to all ophthalmologists that a pathological investigation of surgically removed tumor tissue is indispensable for a complete diagnosis and may decisively influence the subsequent therapy. Ophthalmologists may be less aware of that pathology can contribute to ensure the diagnosis in a broad range of non-tumorous eye diseases by use of various methods such as conventional histological staining, enzyme-histochemistry, immunohistochemistry, immunofluorescence, molecular pathology, in-situ hybridization, ultrastructural methods, such as transmission and scanning electron microscopy, and more and more methylation profiling, the latter a recent method to improve tumor classification.

Material and Methods

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Conclusion