advertisement
Abstract #66740 Published in IGR 17-4
Ophthalmic segment of internal carotid artery aneurysm mimicking normal tension glaucoma
Nucci C; Aiello F; Giuliano M; Colosimo C; Mancino RInternational Ophthalmology 2016; 36: 907-914
A 41-year-old caucasian male was referred to the Glaucoma clinic at our tertiary referral centre with a diagnosis of normal tension glaucoma after the finding of increased bilateral asymmetrical cup/disc ratios, with normal intraocular pressures. On examination, the authors confirmed the presence of bilateral reduced optic disc rims alongside a left pale residual rim, and a further discovered a positive dyschromatopsia with a bilateral visual field alteration. The left visual field showed a relative scotoma confined to the vertical midline. After initiating investigation for suspected glaucoma, the authors ordered a magnetic resonance imaging that evidenced an internal carotid aneurysm along the ophthalmic segment, stretching across the optic chiasm with a major involvement of the left optic nerve and partial involvement of the right optic nerve. Aneurysm embolisation was performed with complete resolution of signs and symptoms achieved 5 months post-operatively. Despite glaucoma being the most frequent condition causing optic disc atrophy and visual field loss, it is not the only cause. Any atypical visual field defect not in keeping with a glaucomatous field loss should be further investigated. The ophthalmologist should thoroughly assess all signs that could lead to different diagnosis.
Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. nucci@med.uniroma2.it.
Full articleClassification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
