title: [Acute optic neuropathy: differential diagnoses].
abstract: BACKGROUND
  Functional impairment of the optic nerve is characterized by visual loss, dyschromatopsia, visual field defects, relative afferent pupillary defect, and swelling or atrophy of the optic nerve.
  
  
  OBJECTIVE
  To describe the spectrum of acute optic neuropathies, focusing on clinical features, diagnosis and treatment with an emphasis on pediatric entities.
  
  
  METHODS
  Optic neuritis may be monophasic, recurrent, or part of a polysymptomatic demyelinating process. The aim of the treatment is to reduce number and severity of attacks and prevent future disability. Infectious neuritis is secondary to different microorganisms (bacteria, virus, fungi, or protozoa). Treatment is related to etiology. Nonarteritic ischemic optic neuropathy or idiopathic optic neuropathy is the most frequent form and is secondary to a disorder of small retinal vessels. Leber hereditary optic neuropathy is an important cause of chronic visual impairment and is characterized by selective involvement of the retinal ganglion cells. Until now, no curative treatment is available. Visual acuity is frequently conserved in papilledema associated with intracranial hypertension. The aim of treatment is to reduce intracranial hypertension and risk factors in case it is secondary.
  
  
  CONCLUSIONS
  Acute optic neuropathies are broad group of entities, of different etiologies, and with a variable visual prognosis. Findings of neurological examination, fundoscopy, and neuroimaging guide diagnosis and prompt treatment.
authors.affiliation: Hospital de Pediatria SAMIC. Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina.
authors.forename: María Celeste
authors.initials: MC
authors.lastname: Buompadre
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D003711:Demyelinating Diseases / Q000150:complications; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D009877:Endophthalmitis / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D019586:Intracranial Hypertension / Q000150:complications; D059906:Neuroimaging; D029242:Optic Atrophy, Hereditary, Leber / Q000175:diagnosis / Q000235:genetics; D009900:Optic Nerve / Q000098:blood supply; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis; D010211:Papilledema / Q000209:etiology; D011379:Prognosis; D011559:Pseudotumor Cerebri / Q000150:complications; D012173:Retinitis / Q000175:diagnosis; D014792:Visual Acuity
chemical_list: D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors