Neuroradiologic Screening in Normal-Pressure Glaucoma: Study Results and Literature Review

Abstract

PURPOSE: To determine if there was an increased prevalence of intracranial compressive lesions in patients with clinically diagnosed normal-pressure glaucoma compared with a group of patients with progressive primary open-angle glaucoma. PATIENTS AND METHODS: In a prospective, comparative, observational case series, the authors performed cranial magnetic resonance imaging in patients with consecutively diagnosed normal-pressure glaucoma (n = 62) and progressive primary open-angle glaucoma with controlled intraocular pressures (n = 70). The prevalence of intracranial compressive lesions, demographic data, and clinical characteristics were compared between both groups. RESULTS: Four of the 62 (6.5%) patients with normal-pressure glaucoma had clinically relevant intracranial compressive lesions involving the anterior visual pathway, compared with none of the 70 patients with primary open-angle glaucoma (P = 0.039). CONCLUSIONS: Intracranial compressive lesions are an important diagnostic consideration in the workup of normal-pressure glaucoma.