Save 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.
J Neuroophthalmol. 2013 Dec;33(4):377-89. doi: 10.1097/WON.0000000000000080.
While glaucoma is the most common cause of optic disc cupping, it can also be seen in a number of congenital and acquired optic neuropathies. It behooves both glaucoma and neuro-ophthalmic specialists to be able to differentiate glaucoma from neurological conditions, which give a similar ophthalmoscopic appearance to the optic disc.
This review is a combination of the authors' clinical experience from tertiary glaucoma and neuro-ophthalmology referral centers, combined with a literature review using PubMed.
Even for experienced observers, differentiation between glaucomatous and nonglaucomatous cupping can be difficult. In the majority of cases, this distinction can be made following a careful clinical examination combined with a variety of imaging techniques. Possible mechanisms, which lead to changes in optic disc morphology, are reviewed.
Differentiating glaucomatous from nonglaucomatous optic disc cupping can be a formidable challenge for the clinician. Examination of the patient combined with imaging of the retinal nerve fiber layer and optic disc topography provides a basis to resolve this clinical conundrum.
虽然青光眼是视盘凹陷最常见的原因，但在许多先天性和获得性视神经病变中也可以看到。青光眼和神经眼科专家都有必要能够将青光眼与具有相似眼底外观的神经状况区分开来。
本综述是作者在三级青光眼和神经眼科转诊中心的临床经验与使用 PubMed 进行文献综述的结合。
即使对于有经验的观察者，青光眼性和非青光眼性杯状凹陷的区分也可能很困难。在大多数情况下，通过仔细的临床检查结合各种成像技术可以做出这种区分。综述了导致视盘形态变化的可能机制。
将青光眼性与非青光眼性视盘凹陷区分开来，对临床医生来说可能是一个艰巨的挑战。对患者进行检查，并对视网膜神经纤维层和视盘地形图进行成像，可以为解决这一临床难题提供依据。
