Magnetic resonance imaging in patients with low-tension glaucoma

Document Type

Article

Abstract

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.

Medical Subject Headings

Aged; Aged, 80 and over; Brain (pathology); Brain Ischemia (complications, diagnosis); Female; Glaucoma, Open-Angle (etiology, pathology); Humans; Magnetic Resonance Imaging; Male; Middle Aged; Optic Disk (pathology); Optic Nerve (pathology); Orbit (pathology)

Publication Date

2-1-1995

Publication Title

Archives of ophthalmology (Chicago, Ill. : 1960)

ISSN

0003-9950

Volume

113

Issue

2

First Page

168

Last Page

72

PubMed ID

7864748

Digital Object Identifier (DOI)

10.1001/archopht.1995.01100020050027

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