Quantitative perimetry in compressive optic neuropathy and optic neuritis

Area of Science:

• Ophthalmology
• Neurology
• Visual field testing

Background:

• Differentiating compressive optic neuropathy from optic neuritis is clinically important.
• Goldmann perimetry is a standard visual field test used in neuro-ophthalmology.

Purpose of the Study:

• To analyze and compare Goldmann perimetric defects in compressive optic neuropathy and optic neuritis.
• To identify reliable perimetric signs for distinguishing between these two conditions.

Main Methods:

• Analysis of Goldmann perimetric defects in 20 cases of compressive optic neuropathy and 54 cases of optic neuritis.
• Evaluation of defects involving the papillomacular bundle and sparing of the fixational area.
• Identification of hemianopic defects using kinetic and static Goldmann perimetry and tangent screen testing.

Main Results:

• Papillomacular bundle defects were common in both conditions.
• Sparing of the fixational area occurred in 24% of optic neuritis cases but none of the compressive neuropathy cases.
• Hemianopic defects were present in 75% of compressive optic neuropathy cases, but absent in optic neuritis cases.

Conclusions:

• Hemianopic defects are a key differentiator for compressive optic neuropathy on Goldmann perimetry.
• Goldmann perimetry provides valuable information for the differential diagnosis of optic nerve compression versus inflammation.