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Low-tension glaucoma (LTG) is manifested by glaucomatous optic nerve damage and visual field loss despite normal intraocular pressure (IOP). We describe 62 patients with classical signs of LTG. Computed tomography (CT) was performed in all patients. In 56 of the patients (90.3%), pathology of the intracavernous carotid arteries adjacent to the intracranial opening of the optic canal could be demonstrated. In 28 patients (45.2%) a clear asymmetry of the optic nerve cupping was found and could be correlated with the severity of the carotid artery pathology. A control group of 24 age-matched patients included five (20.8%) with intracavernous carotid artery calcification and only one (4.2%) with intracavernous ectasia. We suggest that calcification, dilatation and ectasia of the carotid artery into the optic canal may play an important role in the pathogenesis of many cases of LTG. The close proximity of the carotid artery to the optic nerve at this location may result in compressive neuropathy with subsequent glaucomatous damage of the optic nerve head.

SUMMARY We report the case of a 22-year-old white female who presented for a routine ocular examination and displayed Best's disease in her right eye and butterfly-shaped macular dystrophy in her left eye. These diagnoses were confirmed by fluorescein angiography, EOG, and ERG. The fact that these 2 disorders are present in one person suggests that they are only different manifestations of the same underlying disease process.Vitelliform macular dystrophy (Best's disease) and butterfly-shaped epithelial dystrophy of the macula (Deutman's dystrophy) have been described as 2 separate heredodystrophic diseases affecting the retinal pigment epithelium and the outer retina. 2 We report a patient who has vitelliform macular This is the first case that suggests these 2 rareCorrespondence to 1. Gutman, MD.diseases may be different manifestations of the same heritable disorder. Case reportThe patient is a 22-year-old white female who presented to the eye clinic for a routine examination. She had no visual complaints. Medical and ocular histories were unremarkable. Ocular examination showed an uncorrected visual acuity of 6/6 (20/20) 170 X.1.40N

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