Zusammenfassung
Die Differenzialdiagnosen bei Papillenrandunschärfe sind zahlreich. Harmlose Ursachen
und Normvarianten müssen von pathologischen Ursachen abgegrenzt werden. Die Papillenschwellung
und insbesondere die Stauungspapille erfordern zeitnah weitere Diagnostik und Therapie.
Abstract
Correct differential diagnosis in cases of blurred optic disc margins is a challenging
task for ophthalmologists. The reliable differentiation of pseudopapilloedema and
true papilloedema has significant implications for proper patient management. Conditions
that give rise to pseudopapilloedema include small crowded discs, tilted discs and
optic nerve head drusen. Conditions that cause bilateral true swelling of the optic
nerve head with initially good visual acuity include those that are secondary to raised
intracranial pressure (optic disc edema, ODE). The majority of cases, however, present
with unilateral optic nerve head swelling and normal intracranial pressure. They have
systemic signs or symptoms which either precede ocular manifestation or have ophthalmoscopic
signs other than elevation of the optic disc pointing to its diagnosis. Ancillary
testing has been utilized to aid in identification of true ODE or swelling, including
ultrasonography, fluorescein angiography, cranial and orbital MRI with venography,
and lumbar puncture. Optical coherence tomography is also evolving as a modality for
differentiation of buried optic disc drusen from ODE. This presentation will discuss
each modality, with examples, advantages, and disadvantages for each.
Schlüsselwörter
Papillenschwellung - Stauungspapille - Drusenpapille - Diagnostik - Sehnerv
Key words
Optic disc schwelling - papilloedema - pseudopapilloedema - optic disc drusen - optic
nerve
