Optic Neuropathies and Vascular Occlusions

In evaluating the optic nerve, we first review the respective roles of B-mode, standardized A-mode and color Doppler imaging. Then we cover inflammatory lesions, such as papillitis and optic neuritis and then vascular optic neuropathies: arteritic and non-arteritic anterior ischemic optic neuropathy; central retinal artery occlusion, according to embolisms (with its B-mode translation as an hyperechoic spot sign), thrombosis, or bleeding disorders; and central retinal vein occlusion with the four distinct forms (edematous, ischemic, mixed, or regressive in young patients). After that, pseudopapilledema (optic disc drusen) and stasis papilledema are considered with a diagnostic decision tree in case of an optic disc elevation on ocular fundus displaying the major and initial role of ultrasound versus other imaging modalities. Finally, we discuss the role of color Doppler imaging in the evaluation of the glaucomatous neuropathy.