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.

Nucci, C., Aiello, F., Giuliano, M., Colosimo, C., Mancino, R., Ophthalmic segment of internal carotid artery aneurysm mimicking normal tension glaucoma., <<INTERNATIONAL OPHTHALMOLOGY>>, 2016; (36(6)): 907-914. [doi:10.1007/s10792-016-0206-7] [http://hdl.handle.net/10807/93270]

Ophthalmic segment of internal carotid artery aneurysm mimicking normal tension glaucoma.

Colosimo, Cesare
Penultimo
;
2016

Abstract

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.
2016
Inglese
Nucci, C., Aiello, F., Giuliano, M., Colosimo, C., Mancino, R., Ophthalmic segment of internal carotid artery aneurysm mimicking normal tension glaucoma., <<INTERNATIONAL OPHTHALMOLOGY>>, 2016; (36(6)): 907-914. [doi:10.1007/s10792-016-0206-7] [http://hdl.handle.net/10807/93270]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/93270
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