A clinical case of newly detected far-advanced primary open-angle glaucoma against the background of optic disc drusen

Reflection ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 52-57
Author(s):  
R.A. Burya ◽  
◽  
E.L. Sorokin ◽  
◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Optic Disc ◽  
Clinical Case ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Optic Disc Drusen ◽  
Optic Disc Swelling ◽  
The Brain

Aim. To present a clinical case of glaucoma development against the background of optic disc drusen (ODD), demonstrating the difficulties of differential diagnosis between such nosologies as glaucomatous optic neuropathy, optic disc swelling, and chronic optic neuropathy caused by ODD. Methods. Patient S., 72 years old, was referred to clinic with suspected optic disc swelling, initial senile cataract of both eyes. The patient underwent additional investigations: Maklakov tonometry registered an increase of intraocular pressure level exceeding permissible norm; perimetry which has revealed narrowing of visual field boundaries in both eyes; ß-scan ultrasonography has visualized morphological changes with highly reflective drusen in both eyes; optical coherence tomography of optic nerve and ganglion cell layer revealed decrease in nerve fiber layer thickness on nasal side. For differential diagnosis, the patient underwent magnetic resonance imaging (MRI) of the brain, according to which intracranial pathology was excluded. Results. Using modern diagnostic methods it was possible to establish clinical diagnosis: newly detected primary open-angle glaucoma (POAG) III b, explicit ODD, initial senile cataract, pseudoexfoliation syndrome grade 2. Hypotensive regimen did not result in target pressure; therefore, the patient was prescribed surgical treatment (microinvasive non-penetrating deep sclerectomy on both eyes). Conclusion. The presented clinical case showed that against the background of ODD creating the picture of pseudo-swelling and masking the changes in optic nerve because of glaucoma process, the patient had POAG in far-advanced stage. MRI of the brain, as well as additional ophthalmological investigations using modern technologies, made it possible to establish correct diagnosis and prescribe the necessary therapy for this nosology. Key words: optic disc drusen; primary open-angle glaucoma; perimetry; optical coherence tomography.

scholarly journals Optic disc microvasculature dropout in primary open-angle glaucoma measured with optical coherence tomography angiography

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201729 ◽  
Author(s):  
Tadamichi Akagi ◽  
Linda M. Zangwill ◽  
Takuhei Shoji ◽  
Min Hee Suh ◽  
Luke J. Saunders ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Optical Coherence ◽  
Open Angle

Optical Coherence Tomography Angiography of Optic Disc in Eyes With Primary Open-angle Glaucoma and Normal-tension Glaucoma

2019 ◽  
Vol 28 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Anani P. Toshev ◽  
Alexander Karl-Georg Schuster ◽  
Shahzada N. ul Hassan ◽  
Norbert Pfeiffer ◽  
Esther M. Hoffmann
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Optical Coherence ◽  
Open Angle

scholarly journals The Role of Optical Coherence Tomography Angiography in Moderate and Advanced Primary Open-Angle Glaucoma

2021 ◽  
Author(s):  
Yadollah Eslami ◽  
Sepideh Ghods ◽  
Massood Mohammadi ◽  
Mona Safizadeh ◽  
Ghasem Fakhraie ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Vessel Density ◽  
Mean Deviation ◽  
Optical Coherence ◽  
Open Angle ◽  
The Mean ◽  
Inferior Quadrant

Abstract Purpose: To evaluate the relationship between structure and function in moderate and advanced primary open-angle glaucoma (POAG) and to determine the accuracy of structure and vasculature for discriminating moderate from advanced POAG.Methods: In this cross-sectional study 25 eyes with moderate and 40 eyes with advanced POAG were enrolled. All eyes underwent measurement of the thickness of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex (GCC), and optical coherence tomography angiography (OCTA) of the optic nerve head (ONH) and macula. Visual field (VF) was evaluated by Swedish interactive threshold algorithm and 24-2 and 10-2 patterns. The correlation between structure and vasculature and the mean deviation (MD) of the VFs was evaluated by a partial correlation coefficient. The area under the receiver operating characteristic curve (AUC) was applied for assessing the power of variables for discrimination moderate from advanced POAG.Results: Superior cpRNFL, superior GCC, whole image vessel density (wiVD) of the ONH area, and vessel density in inferior quadrant of perifovea had the strongest correlation with the mean deviation (MD) of the VF 24-2 (r= .351, .558, .649 and .397; p< .05). The greatest AUCs belonged to inferior cpRNFL (.789), superior GCC (.818), vessel density of the inferior hemifield of ONH area (.886), and vessel density in inferior quadrant of perifovea (.833) without statistically significant difference in pairwise comparison.Conclusion: Vasculature has a stronger correlation than the structure with MD in moderate and advanced POAG and is as accurate as structure in discrimination moderate from advanced POAG.

scholarly journals Rare variants in optic disc area gene CARD 10 enriched in primary open‐angle glaucoma

2016 ◽  
Vol 4 (6) ◽  
pp. 624-633 ◽  
Author(s):  
Tiger Zhou ◽  
Emmanuelle Souzeau ◽  
Shiwani Sharma ◽  
Owen M. Siggs ◽  
Ivan Goldberg ◽  
...  
Keyword(s):  
Optic Disc ◽  
Primary Open Angle Glaucoma ◽  
Rare Variants ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Disc Area

Clinical case of diagnosis of primary open-angle glaucoma in a patient after previously performed anterior radial keratotomy

2021 ◽  
pp. 126-131
Author(s):  
R.A. Burya ◽  
◽  
A.A. Fil ◽  
E.L. Sorokin ◽  
◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Clinical Case ◽  
Primary Open Angle Glaucoma ◽  
Low Vision ◽  
Open Angle Glaucoma ◽  
Clinical Signs ◽  
Primary Diagnosis ◽  
Applanation Tonometry ◽  
Open Angle ◽  
Radial Keratotomy

The article describes a clinical case of diagnosis and detection of primary open-angle glaucoma (POAG) in a patient after previously performed anterior dosed radial keratotomy (ADRK). The reasons that hampered the primary diagnosis of POAG in the presented patient at an outpatient appointment with an ophthalmologist were: inadequate assessment of the ratio of the state of the lenses and low vision; a falsely underestimated level of tonometric intraocular pressure (IOP), as well as the absence of an in-depth ophthalmoscopic assessment of the condition of the optic nerve head, failure to comply with the mandatory perimetric examination in such cases. It should be especially remembered that there is a high likelihood of underestimation of applanation tonometry indices after performing ADRK, therefore, the assessment of its results should be treated with caution, identifying other clinical signs characteristic of glaucoma. This will make it possible to diagnose glaucoma in time and prescribe pathogenetic treatment in a timely manner. Key words: anterior dosed radial keratotomy, primary open-angle glaucoma, intraocular pressure.

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