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Beitragstitel How electro-diagnostics can help differentiating ischemic optic neuropathy from normal tension glaucoma
Beitragscode P06
Autor:innen
  1. Sascha Jung Kantonsspital St Gallen Präsentierende:r
  2. Margarita G. Todorova Kantonsspital St. Gallen
Präsentationsform ePoster
Themengebiete
  • Glaucoma
  • Neuroophthalmology / Strabology
Abstract-Text Case report: A 57-years old woman was referred with newly appeared relative scotoma, OS: Her Snellen visual acuity had been 1.2 @ near and distance. She suffered glaucoma, treated since years with Travatan (1xOU) and Timolol (1xOS).
Her visual field examination (Octopus, M2) revealed inferior altitudinal paracentral scotoma, OS. Pupillary responses were normal, no RAPD. An automated intraretinal segmentation of SD-OCT revealed a corresponding suspected thinning of the ganglion cell layer, OS. Fluorescein- and ICG angiography were unremarkable, OU. The RNFL-OCT shows also a normal pattern in the beginning.
The full-field ERG was in the range of normal compared to control group. MfERG amplitudes were centrally slightly reduced, OS. Pattern VEP P-100 amplitudes (7.5´ and 15´) were reduced and their corresponding latencies were slightly delayed (ca. 10ms). At this point neurologic testing of the patient was performed, which ruled out a demyelinating process. In addition, Aquaporin-4 and anti-MOG antibodies were negative. In the presence of pre-existing glaucoma and positive history of migraine attack, an underlying vascular dysregulation was postulated. However, dynamic vessel analyses (RVA, IMEDOS) revealed an unremarkable venous and arterial dilation to flicker of +6.2 and +5.9%, OS.
In summary: A combined electro-diagnostic approach enabled the diagnosis of ischemic optic neuropathy and ruled out a disturbed simultaneous vascular regulation.