[Differential diagnosis of optic nerve atrophy]

Diseases of the visual pathway: early detection and therapy. Manual kinetic perimetry is faster in the detection of lesions of the visual pathway than automated static perimetry. When cases with a comparable reduction of visual acuity are considered, color desaturation is more pronounced in lesions of the visual pathway than in opacities of the optic media. Search for an afferent pupil defect allows the differential diagnosis between functional and unilateral organic visual impairment: in the case of bilateral visual impairment, a combination of VEP and pattern ERG is suitable for this differentiation. In chronic papilledema, secondary atrophy can best be detected in the arcuate retinal nerve fibers. Fistulation of the dural sheath of the optic nerve prevents visual loss in chronic papilledema. A similar operation could be useful in the progressive form of anterior ischemic optic neuropathy. Recently, the mitochondrial DNA mutation associated with Leber's hereditary optic neuropathy was identified. Prolactin secreting pituitary adenomas shrink with bromocriptine treatment.