Magnetic resonance imaging in patients with low-tension glaucoma
G. A. Stroman, W. C. Stewart, K. C. Golnik, J. K. Cure and R. E. Olinger
Department of Ophthalmology, Medical University of South Carolina, Charleston.
OBJECTIVE: To study diagnoses and anatomic findings found on magnetic
resonance imaging in patients with low-tension glaucoma. PATIENTS: We
included in this study magnetic resonance images of 20 consecutive patients
with low-tension glaucoma. We individually matched each patient with
low-tension glaucoma to a control with normal ocular findings who had
magnetic resonance imaging for reasons unrelated to the visual pathway.
DESIGN: We studied axial and coronal images of the orbit and optic nerve
with digitizing software (Image-Pro Plus, Media Cybernetics, Silver Spring,
Md). Statistical evaluation was with a Wilcoxon Signed Rank Test for
anatomic findings and a McNemar Test for diagnosis. RESULTS: We found no
difference between groups in the optic nerve diameter or length, the
carotid artery area, or the distance from the optic nerve to the carotid
artery (P > .05). Left optic nerve area was greater in the control
patients than patients with low-tension glaucoma (P = .026). The prevalence
of intracranial abnormalities, including meningioma, aneurysm, and
arteriovenous abnormality, was similar between groups (P > .05).
However, diffuse cerebral small-vessel ischemic changes were found more in
patients with low-tension glaucoma (n = 8) than control patients (n = 1) (P
= .0196). CONCLUSIONS: This study proposes a hypothesis that cerebral
small-vessel ischemia is more common in patients with low-tension glaucoma
and potentially reflects indirectly a vascular cause of the optic nerve
head damage at least in a subgroup of patients. Importantly, further
research still is required to provide direct evidence for a vascular cause
involved in low-tension glaucoma.
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Wallace et al.
British Journal of Visual Impairment 2008;26:7-23.
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Stewart et al.
Br. J. Ophthalmol. 2007;91:1263-1264.
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Lagreze et al.
IOVS 2007;48:1913-1917.
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Ogata et al.
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Purvin et al.
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Borras et al.
IOVS 2002;43:2513-2518.
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Br. J. Ophthalmol. 2002;86:429-433.
ABSTRACT
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UMIHIRA et al.
Br. J. Ophthalmol. 1999;83:1306b-1306.
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Peripapillary retinal blood flow in normal tension glaucoma
Chung et al.
Br. J. Ophthalmol. 1999;83:466-469.
ABSTRACT
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Normal tension glaucoma---a practical approach
KAMAL and HITCHINGS
Br. J. Ophthalmol. 1998;82:835-840.
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