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Magnetic resonance imaging (MRI) is a very important tool that can be used when making a differential diagnosis between normal-tension glaucoma (NTG) and optic nerve disease. However, if the MRI used to detect the focal lesion of the optic nerve is not precise, optic nerve disease can be misdiagnosed as NTG. Therefore, when visual field defects do not result from optic disc abnormalities, socalled glaucomatous disc, or peripapillary nerve fiber layer defects, it is necessary to perform very detailed diagnostic imaging of the optic or peri-optic nerves. Coronal images from the orbit to the chiasm, which are obtained by MRI, are very useful in the evaluation of the retrobulbar portion of the optic nerve. Evaluations should include MR sequences that consist of two points that exhibit morphologic changes of the optic nerve and an examination of the qualitative changes of the nerve itself, for example, whether there is the presence of edema or gliosis. MRI may be a critical method that can be used for the differential diagnosis between NTG and optic nerve disease. LA: Japanese
Dr. M. Hashimoto, Department of Ophthalmology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Japan
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy