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SD-OCT-histopathologic correlation in Schnabel's cavernous optic nerve atrophy.

C Weber1, K Mercieca1, J M Weller2

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Schnabel's cavernous optic nerve atrophy (SCONA) is now detectable using spectral domain-optical coherence tomography (SD-OCT). This study correlates histopathology with SD-OCT, identifying unique imaging features for this rare optic nerve condition.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • Schnabel's cavernous optic nerve atrophy (SCONA) is a histopathological diagnosis.
  • Characterized by optic nerve (ON) atrophy and cavernous spaces filled with acid mucopolysaccharides.
  • Previously lacked in vivo diagnostic correlation.

Purpose of the Study:

  • To correlate histopathologic findings of SCONA with spectral domain-optical coherence tomography (SD-OCT) imaging.
  • To identify distinct SD-OCT characteristics for SCONA.
  • To enable in vivo detection and clinical study of SCONA.

Main Methods:

  • Examined an index patient with histopathologically confirmed SCONA.
  • Correlated in vivo SD-OCT images with histopathological findings.
  • Compared findings to normal and glaucomatous optic discs.

Main Results:

  • Histopathology revealed pre- and intralaminar SCONA extension with inner retinal atrophy.
  • SD-OCT showed small intralaminar hyporeflective pseudocysts in affected areas.
  • These SD-OCT findings were unique to SCONA, absent in normal or glaucomatous ON.

Conclusions:

  • First correlation of clinical and pathological findings in SCONA.
  • Identified distinct SD-OCT characteristics for SCONA.
  • Potential for in vivo diagnosis and clinical research of this rare condition, pending further studies.