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Related Concept Videos

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Related Experiment Video

Updated: Dec 16, 2025

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Compressive optic neuropathy. Not everything that progresses is glaucoma.

K G Sotelo-Monge1, G Espinosa-Barberi2, L M Pinilla Cortés1

  • 1Institut Català de Retina, Departamento de Glaucoma, Barcelona, España.

Archivos De La Sociedad Espanola De Oftalmologia
|July 2, 2020
PubMed
Summary

Meningiomas can mimic normal tension glaucoma (NTG) by causing optic nerve compression. Prompt neuroimaging is crucial for differentiating these conditions, especially with atypical visual field defects and declining visual acuity despite controlled intraocular pressure.

Keywords:
GlaucomaIntraocular pressureMeningiomaNeuropatía ópticaOptic neuropathyPresión intraocular

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Area of Science:

  • Ophthalmology
  • Neurology
  • Oncology

Background:

  • Normal tension glaucoma (NTG) is characterized by optic nerve damage and visual field loss with normal intraocular pressure (IOP).
  • Compressive optic neuropathies can present with similar visual deficits, posing a diagnostic challenge.
  • Meningiomas are slow-growing tumors that can arise from the meninges surrounding the optic nerve.

Observation:

  • Three middle-aged women initially diagnosed with NTG presented with asymmetric, rapidly progressive visual field defects and decreased visual acuity.
  • Despite controlled IOP with topical hypotensive therapy, their conditions showed atypical progression.
  • Optic disc excavation and asymmetric visual field deterioration were noted in all patients.

Findings:

  • Neuroimaging revealed compressive optic neuropathy secondary to meningiomas in all three cases.
  • The atypical presentation, including rapid visual acuity decline and asymmetric functional/structural test deterioration despite normal IOP, was key to diagnosis.
  • Meningiomas were identified as the cause of optic nerve compression, mimicking NTG.

Implications:

  • Compressive optic neuropathy from meningiomas should be considered in the differential diagnosis of atypical NTG.
  • Early neuroimaging is essential for accurate diagnosis and timely management of optic nerve compression.
  • Differentiating these conditions is critical to prevent irreversible vision loss and guide appropriate treatment strategies.