[OCT Article] Low Tension Glaucoma with Multifactorial Ocular Complications

Patient description

34 year old male. Past history is significant for hypertension, arteriosclerosis and sleep apnea.

Clinical results

On examination, best corrected vision was 20/20 in both eyes. The intraocular pressure was 15 the right eye and 14 in the left eye.
The anterior chamber angle was grade 4 and open. Under fundoscopic examination, optic nerve atrophy and pallor were present. Arteriolar narrowing was also present with signs of retinal ischemia. Visual field testing was carried out, with normal results.
Ophthalmodynamometry was performed. The ocular perfusion pressure was reduced at 23mmHg in the right eye and 20mmHg in the left eye. Outflow facility was abnormal with 0.13 OD with a P/O ratio of 200 and OS 0.13 with P/O ratio of 211. The ERG was normal OU and VEP showed slight latency OU.
Patient has low tension glaucoma (NTG OU).
Patient was referred out for Transcranial doppler and Carotid doppler imaging.
Additionally, we discussed the management options to improve the ocular perfusion pressure
and he declined the use of outflow medication and elected to have a laser trabeculoplasty in
both eyes. Pt was referred to Glaucoma surgeon for surgery.

OCT OS	OCT OD

Dr Luiza Youssefi

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