Superior segmental optic nerve hypoplasia accompanied by progressive normal-tension glaucoma

Abstract

This is the first case report of a superior segmental optic hypoplasia (SSOH) combined with normal-tension glaucoma accompanied by a progressive glaucomatous visual field defect. A 40-year-old man, incidentally diagnosed as having bilateral SSOH, had disc hemorrhage associated with expansion of the width of a retinal nerve fiber layer defect and deterioration of a visual field defect in the right eye during the follow-up period. His left eye showed a stable visual field. The diurnal variation in intraocular pressure (IOP) showed a higher mean IOP in his right eye compared with his left eye, although both IOPs remained under 21 mmHg.

Rule Out Normal Tension Glaucoma in a Young Woman

“…SSOH is non-progressive, and no treatment is necessary. There have been case reports of SSOH that is also accompanied by NTG with progressive glaucomatous visual field defect [7].…”

The Different Characteristics of Cirrus Optical Coherence Tomography between Superior Segmental Optic Hypoplasia and Normal Tension Glaucoma with Superior Retinal Nerve Fiber Defect

“…Myopia is one of the risk factors of glaucoma [ 20 , 21 ], but no previous reports suggested that high myopia may be associated with glaucomatous progression in SSOH eyes. In one previous case report of progressive SSOH, the patient had a high myopia of −8.0 D [ 8 ], so it might not be coincidence that glaucoma with SSOH had a high myopia, and it seems necessary to evaluate whether coexistence of SSOH and high myopia can lead to glaucomatous changes or progression.…”

“…However, it is not easy to differentiate the two diseases because SSOH and glaucoma have similar features, such as localized RNFL thinning and neuroretinal rim thinning [ 6 ]. Furthermore, the two diseases sometimes exist simultaneously [ 7 , 8 ].…”

Comparing Structure-Function Correlations in Superior Segmental Optic Nerve Hypoplasia and Juvenile Open Angle Glaucoma Using Spectral-Domain Optical Coherence Tomography

“…While SSOH is nonprogressive in nature and is an important entity in the differential diagnosis of childhood glaucoma, there is an isolated case report of SSOH accompanied by NTG in an adult after five years of annual follow up, necessitating long-term monitoring even in low-risk patients [7]. Sequential SD-OCT surveillance and visual field testing are useful tools in detecting progressive glaucomatous changes.…”