Optic nerve compression by carotid arteries in low-tension glaucoma

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 in...

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Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 1993-12, Vol.231 (12), p.711-717
Main Authors: GUTMAN, I, MELAMED, S, ASHKENAZI, I, BLUMENTHAL, M
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Calcinosis - complications
Calcinosis - diagnostic imaging
Carotid Artery Diseases - complications
Carotid Artery Diseases - diagnostic imaging
Female
Fundus Oculi
Glaucoma and intraocular pressure
Humans
Intraocular Pressure
Male
Medical sciences
Middle Aged
Nerve Compression Syndromes - etiology
Ocular Hypotension - etiology
Ophthalmology
Optic Nerve
Orbit - diagnostic imaging
Tomography, X-Ray Computed
Vasodilation
Visual Fields
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Summary: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.
ISSN:0721-832X
1435-702X
DOI:10.1007/bf00919286