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Updated: May 5, 2026
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Optic Nerve Transection: A Model of Adult Neuron Apoptosis in the Central Nervous System
Published on: May 12, 2011
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Optic nerve cupping and the neuro-ophthalmologist
Clare L Fraser1, Andrew J R White, Gordon T Plant
1Save Sight Institute (CLF, AJRW), University of Sydney, Sydney, Australia; Westmead Millennium Institute (AJRW), University of Sydney, Sydney, Australia; Moorfields Eye Hospital (GTP), London, United Kingdom; and Cambridge University Teaching Hospitals NHS Foundation Trust (KRM), Cambridge, United Kingdom.
Summary
Differentiating glaucomatous from non-glaucomatous optic disc cupping is challenging. Clinical examination and imaging of the optic disc and retinal nerve fiber layer aid in diagnosis.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
Background:
- Optic disc cupping is commonly associated with glaucoma.
- Congenital and acquired optic neuropathies can also cause optic disc cupping.
- Distinguishing between glaucomatous and non-glaucomatous cupping is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To review the differential diagnosis of optic disc cupping.
- To highlight the challenges in differentiating glaucomatous from non-glaucomatous optic disc cupping.
- To discuss the role of clinical examination and imaging in this differentiation.
Main Methods:
- Literature review using PubMed.
- Synthesis of clinical experience from tertiary glaucoma and neuro-ophthalmology referral centers.
Main Results:
- Differentiation between glaucomatous and non-glaucomatous cupping can be difficult, even for experienced clinicians.
- A combination of careful clinical examination and various imaging techniques is often necessary.
- The review discusses potential mechanisms underlying optic disc morphology changes.
Conclusions:
- Differentiating glaucomatous from non-glaucomatous optic disc cupping presents a significant clinical challenge.
- Comprehensive patient examination, including imaging of the retinal nerve fiber layer and optic disc topography, is essential for resolving this diagnostic dilemma.
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