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Vol. 96. Issue 4.
Pages 219-223 (April 2021)
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Vol. 96. Issue 4.
Pages 219-223 (April 2021)
Short communication
DOI: 10.1016/j.oftale.2020.05.016
Compressive optic neuropathy. Not everything that progresses is glaucoma
Neuropatía óptica compresiva. No todo lo que progresa es glaucoma
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K.G. Sotelo-Mongea, G. Espinosa-Barberia,b,
Corresponding author
glenda_eb@hotmail.com

Corresponding author.
, L.M. Pinilla Cortésa, A. Puntí Badosaa, A. Antona,c
a Institut Català de Retina, Departamento de Glaucoma, Barcelona, Spain
b Escuela de Doctorado y Postgrado, Universidad Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
c Universitat Internacional de Catalunya, Barcelona, Spain
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Abstract

Three clinical cases are presented of compressive optic neuropathy secondary to meningiomas of different locations, initially diagnosed with normal tension glaucoma (NTG). All patients were middle-aged women, with excavations, as well as asymmetric, rapidly progressive defects in the visual field (VF), and deterioration of the visual acuity (VA), despite presenting with intraocular pressure (IOP) correctly controlled with topical hypotensive therapy. Due to the atypical progression of the glaucoma disease, and suspecting a compressive lesion of the optic nerve, neuroimaging tests were performed, with which the correct diagnosis was reached.

In cases of NTG, it is necessary to take into account compressive optic neuropathy as a differential diagnosis. Differentiating both pathologies is a diagnostic challenge that should be suspected due to the atypical decrease of the VA and deterioration of both functional and structural tests, and asymmetrically, despite the normal IOP.

Keywords:
Intraocular pressure
Glaucoma
Meningioma
Optic neuropathy
Resumen

Se presentan tres casos clínicos de neuropatía óptica compresiva secundarias a meningiomas de diferente localización, diagnosticadas inicialmente de glaucoma de tensión normal (GTN). Todas las pacientes eran mujeres de edad media, con excavaciones, así como defectos en el campo visual (CV) asimétricos, rápidamente progresivos y deterioro de la agudeza visual (AV), a pesar de presentar cifras de presión intraocular (PIO) correctamente controladas con tratamiento hipotensor tópico. Debido a la evolución atípica de la patología glaucomatosa y sospechando una lesión compresiva del nervio óptico, se realizaron pruebas de neuroimagen, con las que se llegó al diagnóstico correcto.

En casos de GTN, hay que tener en cuenta como diagnóstico diferencial la neuropatía óptica compresiva. Diferenciar ambas patologías constituye un reto diagnóstico que se debe sospechar ante la disminución atípica de la AV y deterioro de las pruebas tanto funcionales como estructurales, de manera asimétrica y pese a las cifras de PIO normales.

Palabras clave:
Presión intraocular
Glaucoma
Meningioma
Neuropatía óptica

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