Comparative Study of Brain Magnetic Resonance Imaging Findings in Patients with Low-tension Glaucoma and Control Subjects

Ong, Keith; Farinelli, Adrian; Billson, Frank A.; Houang, Michael; Stern, Michael E.

doi:10.1016/s0161-6420(95)30816-0

Cited by 80 publications

(61 citation statements)

References 17 publications

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“…It has been reported that normal-tension glaucoma patients may suffer from confluent lesion and cerebral atrophy as well as diffuse cerebral small-vessel ischemic changes visible on cerebral MRI [25, 26]. This finding may suggest a relation between intracranial ischemic changes and normal-tension glaucoma.…”

Section: Discussionmentioning

confidence: 92%

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Magnetic Resonance Imaging of the Brain in Patients with Pseudoexfoliation Syndrome and Glaucoma

et al. 2006

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Purpose: To evaluate ischemic changes in brain magnetic resonance images in patients with pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) and compare them with age- and sex-matched control subjects. Methods: This case-control study involved 16 consecutive patients with PXS, 21 patients with PXG and 18 healthy age- and sex-matched control subjects. Each subject underwent a comprehensive ophthalmological examination. In all participants, an axial T₁-, T₂- and proton-density-weighted and coronal cerebral 1.5-tesla magnetic resonance imaging (MRI) scan was made. White matter hyperintensities (WMH) were considered present if these were hyperintense on both proton-density- and T₂-weighted images and not hypointense on T₁-weighted images. White matter lesions were classified into two parts as the subcortical and periventricular regions. We used a validated rating scale of subcortical WMH: 0 = absent, 1 = punctuate foci, 2 = beginning confluence of foci and 3 = large confluent areas. Periventricular white matter lesions were classified on a scale of 0 (no white matter lesions), 1 (pencil-thin periventricular lining), 2 (thick lining) or 3 (large confluent white matter lesions). Results: The proportions of persons with WMH were 93.7% for patients with PXS, 95.2% for patients with PXG and 55.5% for control subjects. The numbers of white matter lesions in patients with PXS and PXG were significantly greater than in the control subjects (p < 0.05). White matter lesions at subcortical locations in patients with PXG were significantly more frequent than in the control subjects (80.9 vs. 33.3%; p < 0.05). The proportion of patients with subcortical WMH was 56.2% in PXS; no significant difference was found in subcortical WMH between PXS and controls. The proportions of patients with periventricular WMH were 93% in PXS, 90.4% in PXG and 44.4% in controls. White matter lesions at periventricular locations in patients with PXG and PXS were significantly more frequent than in the control subjects (p < 0.05). The difference between the pseudoexfoliation groups and controls with regard to the size of periventricular and subcortical white matter lesions was statically significant (p < 0.05). When patients with PXS were compared with PXG patients, there was no statistically significant difference in the number, size and scale of white matter lesions. Conclusion: We found a significantly higher prevalence of MRI-defined WMH in patients with a clinical diagnosis of pseudoexfoliation with or without glaucoma versus control subjects. We think that the findings in this study may shed light on a possible link between ischemic brain lesions and pseudoexfoliation, which is not related with the presence of glaucomatous optic neuropathy. Further investigations are required to resolve the underlying associations.

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Section: Discussionmentioning

confidence: 92%

“…They are attributed to degenerative changes of long penetrating arteries [21, 22]. MRI studies have demonstrated diffuse small-vessel ischemic changes, cerebral infarcts or corpus callosum atrophy in brains of normal-pressure glaucoma [25, 26]. …”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Brain in Patients with Pseudoexfoliation Syndrome and Glaucoma

et al. 2006

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“…The risk of myocardial and cerebral ischemia is increased in patients with normal-tension glaucoma [20, 21, 22], as well as in patients with sleep apnea syndrome [19, 23, 24, 25]. Therefore, in normal-tension glaucoma patients with evidence of myocardial and cerebral ischemia, the prevalence of sleep apnea syndrome might be particularly high.…”

Section: Discussionmentioning

confidence: 99%

Normal-Tension Glaucoma Is Associated with Sleep Apnea Syndrome

et al. 2002

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Introduction: In normal-tension glaucoma, optic nerve damage occurs without elevated intraocular pressures, hence vascular and pathogenic mechanisms other than intraocular pressure effects have been postulated. However, the exact cause(s) remain unknown. We have looked for an association between normal-tension glaucoma and sleep apnea syndrome, a disease characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of late cardiovascular and neurological sequelae. Methods: We performed overnight polysomnography in 16 consecutive Caucasian patients with normal-tension glaucoma. The respiratory disturbance index (RDI) during night sleep was used to diagnose and grade obstructive sleep apnea. Patients with an RDI of 10 or more were diagnosed as having obstructive sleep apnea. Results: We observed the following prevalences of obstructive sleep apnea in normal-tension glaucoma patients: 0% (0 of 2) for the group of patients younger than 45 years, 50% (3 of 6) for the age group 45–64 years, and 63% (5 of 8) for the group older than 64 years. Prevalences in the middle and older age group were significantly higher than in a historic control group (p < 0.025 for both, binomial test). Conclusion: Normal-tension glaucoma patients constitute a high-risk population for sleep apnea syndrome. Therefore, they should be screened for sleep apnea syndrome, and, if necessary, be treated to avoid late cardiovascular and neurological sequelae.

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“…In a comparative study involving brain magnetic resonance imaging, 9 patients with LTG were found to have a greater extent of cerebral infarcts and corpus callosum atrophy. This may imply a greater degree of neuronal degeneration, possibly on an ischaemic basis in LTG.…”

Section: Commentmentioning

confidence: 99%

Cessation of migraines in a woman with low-tension glaucoma following the use of latanoprost: a favourable side effect?

Karagiannis

Venkatesh

Kirkpatrick

2006

Eye

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Comparative Study of Brain Magnetic Resonance Imaging Findings in Patients with Low-tension Glaucoma and Control Subjects

Cited by 80 publications

References 17 publications

Magnetic Resonance Imaging of the Brain in Patients with Pseudoexfoliation Syndrome and Glaucoma

Magnetic Resonance Imaging of the Brain in Patients with Pseudoexfoliation Syndrome and Glaucoma

Normal-Tension Glaucoma Is Associated with Sleep Apnea Syndrome

Cessation of migraines in a woman with low-tension glaucoma following the use of latanoprost: a favourable side effect?

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