Optic neuropathies may be disguised as glaucoma
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Clinicians may refer suspicious glaucoma diagnoses to neuro-ophthalmologists, according to a presentation at the virtual Women in Ophthalmology Summer Symposium.
“Distinguishing between glaucomatous optic nerve head damage and non-glaucomatous damage can be challenging, especially in cases where intraocular pressure is normal,” Dana Schneider, MD, of the University of South Florida, and colleagues wrote. “Multiple studies have investigated whether seeking neuro-ophthalmologic diagnoses in patients with low-tension glaucoma or glaucoma suspects is warranted; however, in these studies, results are mixed.”
In a single-center, retrospective, quality improvement study, 62 subjects who were glaucoma suspects or had low-tension glaucoma were referred to the neuro-ophthalmology service at the University of South Florida for suspicion of neurologic causes of optic neuropathy.
Study results yielded 31 patients with glaucoma as the cause for their optic neuropathy diagnosis and 28 patients with a cause other than glaucoma for their optic neuropathy. Three patients were lost to follow-up.
“The fact that so many patients in our study ended up having an alternate diagnosis speaks to the expertise of our glaucoma specialists,” Schneider and colleagues wrote. “A prospective study could be initiated to help more carefully discern the specific reasons for referral and eventual outcomes.”
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Schneider D, et al. Optic neuropathies masquerading as glaucoma. Presented at: Women in Ophthalmology Summer Symposium; Aug. 21-23, 2020 (virtual meeting).
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