Bruch's Membrane Opening Minimum Rim Width in the Differential Diagnosis of Optic Neuropathies

Joana Braga; Ricardo Soares; Mónica Loureiro; Lígia Ribeiro; Dália Meira

doi:10.1080/01658107.2019.1650075

Bruch's Membrane Opening Minimum Rim Width in the Differential Diagnosis of Optic Neuropathies

Neuroophthalmology. 2019 Aug 21;44(2):76-88. doi: 10.1080/01658107.2019.1650075. eCollection 2020 Apr.

Authors

Joana Braga¹, Ricardo Soares¹, Mónica Loureiro¹, Lígia Ribeiro¹, Dália Meira¹

Affiliation

¹ Ophthalmology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Porto, Portugal.

Abstract

Observing optic disc pallor during a patient's first visit frequently raises a diagnostic challenge, particularly in regards to whether the cause is due to glaucoma or another form of optic neuropathy. Bruch's membrane opening (BMO) was recently discovered as the anatomical border of the optic disc. BMO minimum rim width (BMO-MRW) seems to be a reliable representation of the neuroretinal rim. In our study, we demonstrate the ability of BMO-MRWs to differentiate between glaucomatous and non-glaucomatous. Additionally, we propose an MRW ratio which may allow discrimination of open angle glaucoma from either non-arteritic anterior ischaemic optic neuropathy or compressive optic neuropathy.

Keywords: Glaucomatous neuropathy; compressive optic neuropathy; minimal rim width; non-arteritic anterior ischaemic optic neuropathy; non-glaucomatous neuropathy.