Internal carotid artery aneurysm mimicking normal-tension glaucoma

Netto, Mário Pincelli; Ferrari, Pedro Vanalle; Herrerias, Bruno Torres; Hirai, Flávio E.; Gracitelli, Carolina P. B.

doi:10.5935/0004-2749.20180032

Cited by 4 publications

(6 citation statements)

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“…Two of them were diagnosed with NTG [9,11], and another with secondary high-tension glaucoma initially presenting with unilateral anterior uveitis, converting from negative to positive RAPD within several months [10], as did our patient. Other findings were dyschromatopsia in one case [9], unilateral visual field defects in two [10,11], bilateral visual field defects in one [9], and unilateral optic disc pallor in two cases [9,11]. One patient had a 2-year history of low vision in one eye with significant frontal headaches [11].…”

Section: Discussionsupporting

confidence: 68%

“…Our literature search revealed 3 case reports describing patients found to have an internal carotid-ophthalmic artery aneurysm with asymmetric cup-to-disc ratio [9][10][11]. Two of them were diagnosed with NTG [9,11], and another with secondary high-tension glaucoma initially presenting with unilateral anterior uveitis, converting from negative to positive RAPD within several months [10], as did our patient. Other findings were dyschromatopsia in one case [9], unilateral visual field defects in two [10,11], bilateral visual field defects in one [9], and unilateral optic disc pallor in two cases [9,11].…”

Section: Discussionsupporting

confidence: 49%

“…Other findings were dyschromatopsia in one case [9], unilateral visual field defects in two [10,11], bilateral visual field defects in one [9], and unilateral optic disc pallor in two cases [9,11]. One patient had a 2-year history of low vision in one eye with significant frontal headaches [11].…”

Section: Discussionmentioning

confidence: 95%

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Normal-Tension Glaucoma Complicated by a Giant Internal Carotid-Ophthalmic Artery Aneurysm

Ashok,

Pilling,

Lee-Kwen

et al. 2024

Case Reports in Ophthalmological Medicine

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Purpose. We describe a patient with normal tension glaucoma (NTG) of several years whose management was complicated by the presence of a giant internal carotid-ophthalmic artery aneurysm. Observations. A 72-year-old woman presented to our glaucoma clinic with accelerated deterioration of her vision in her left eye (OS) over a 1-month period. Her ophthalmic history was most notable for bilateral NTG diagnosed 3 years prior which had been treated with several laser trabeculoplasty OS and topical bimatoprost 0.01% eye drops in both eyes (OU). Upon evaluation, her visual acuity OS had worsened, and visual field (VF) testing showed extensive progressive losses temporally and pericentrally OS over a year with stable IOP measurements and no neurological complaints. Given her atypical NTG progression, she was referred for an urgent neurological evaluation which revealed an unruptured giant left internal carotid-ophthalmic aneurysm. Following the successful treatment of the aneurysm with platinum coils, she continued to demonstrate additional bilateral ophthalmic changes including further progression of VF loss and RNFL thinning OS>OD on follow-up. Conclusion and Importance. Overall, this report describes a unique complication in the management of a patient with chronic bilateral NTG in the form of a giant internal carotid-ophthalmic aneurysm. Moreover, it highlights the need for clinicians to maintain a degree of suspicion for compressive lesions of the optic nerve when presented with atypical progression of VFs and/or visual acuity loss in glaucomatous patients.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 49%

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Normal-Tension Glaucoma Complicated by a Giant Internal Carotid-Ophthalmic Artery Aneurysm

Ashok,

Pilling,

Lee-Kwen

et al. 2024

Case Reports in Ophthalmological Medicine

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“…Compression of the optic nerves by tumors, aneurysms, or normal blood vessels has been reported to cause an optic neuropathy that resembles glaucoma (9–12). In this case series, we describe 3 patients who carried a diagnosis of NTG that had unequivocal and significant radiological compression of the affected optic nerve by a tortuous or dolichoectatic ICA.…”

Section: Discussionmentioning

confidence: 99%

Optic Disc Cupping Due to Dolichoectatic Internal Carotid Artery Optic Nerve Compression

Micieli¹,

Margolin²

2020

Journal of Neuro-Ophthalmology

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Background: To determine whether significant compression of the optic nerve by the internal carotid artery (ICA) can produce an optic neuropathy with optic disc cupping that resembles glaucoma in patients without elevated intraocular pressure (IOP). Methods: This was a retrospective case series of patients referred to neuro-ophthalmology for a possible nonglaucomatous optic neuropathy. Patients were included in the study if they had preserved visual acuity, optic discrelated visual field defects, optic nerve cupping, IOP less than 21 mm Hg, open angles, and unequivocal radiological compression of the ipsilateral optic nerve by an intracranial blood vessel. Results: Three patients were included with a mean age of 56.3 (range 29-82) years. Patient 1 was a 58-year-old man incidentally noted to have left optic nerve cupping on a routine examination. He had an inferior arcuate defect and the left prechiasmatic optic nerve was elevated and compressed by a tortuous left ICA. Patient 2 was a 29-year-old man with a normal-tension glaucoma (NTG) diagnosis for 7 years in the right eye treated with latanoprost. He had a superior greater than inferior arcuate defect and there was vascular compression of the optic nerve between the supraclinoid ICA and A1 segment of the anterior cerebral artery. Patient 3 was an 82-year-old woman with an NTG diagnosis for 10 years who had progression of her visual field defects despite low IOPs. MRI showed mass effect on the right optic nerve by a dolichoectatic right supraclinoid ICA. Conclusions: Significant compression of the optic nerve by a normal, tortuous, or dolichoectatic ICA may result in an optic neuropathy with optic disc cupping that resembles glaucoma.

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“…The assessment of factors including age (less than 50 years old), complaints such as headache or pain around the eye, visual field defects involving the vertical midline, rapid decline in visual acuity, disproportionate neuroretinal rim pallor relative to disc cupping, asymmetric visual acuity and/or visual field loss, and asymmetric cupping can be useful in the differential diagnosis. 7 These factors may increase the likelihood of detecting an intracranial compressive lesion.…”

Section: Discussionmentioning

confidence: 99%

Sphenoid Bone Dysplasia: A Rare Cause of Compressive Optic Neuropathy Mimicking Glaucoma

Kıyat¹,

Karti²,

Esen³

et al. 2023

tjo

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Internal carotid artery aneurysm mimicking normal-tension glaucoma

Cited by 4 publications

References 0 publications

Normal-Tension Glaucoma Complicated by a Giant Internal Carotid-Ophthalmic Artery Aneurysm

Normal-Tension Glaucoma Complicated by a Giant Internal Carotid-Ophthalmic Artery Aneurysm

Optic Disc Cupping Due to Dolichoectatic Internal Carotid Artery Optic Nerve Compression

Sphenoid Bone Dysplasia: A Rare Cause of Compressive Optic Neuropathy Mimicking Glaucoma

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