PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the necessity of neuroimaging in patients with neurological or atypical findings of normal tension glaucoma (NTG) who do not exhibit typical glaucoma manifestations.
METHODS: A retrospective analysis was conducted on 90 atypical NTG patients who underwent cranial magnetic resonance imaging (MRI) due to atypical symptoms. The demographic characteristics, clinical parameters, and radiological findings were recorded.
RESULTS: Among the patients, 66.7% had abnormal radiology results, with the most common findings being gliosis (34.4%), sequelae of cerebrovascular events and vascular malformations (14.4%), and benign intracranial mass lesions (11%). Non-glaucomatous visual field defects were more frequently observed in patients with abnormal neuroimaging results. However, there were no significant differences in intraocular pressure, optic disc parameters, retinal nerve fiber layer thickness, and visual field indices between patients with normal and abnormal radiological results. The mean age of the patients was 58.74y. Interestingly, there was a significant age difference, with the abnormal radiology group having a higher median age (P=0.021).
CONCLUSIONS: The study highlights the importance of cranial imaging in older NTG patients to detect underlying pathologies and prevent misdiagnosis. It suggests that neuroimaging may be warranted in NTG patients with atypical visual field defects incompatible with glaucoma. However, routine neuroimaging in all NTG patients without classic neurological signs may not be necessary.
METHODS: A retrospective analysis was conducted on 90 atypical NTG patients who underwent cranial magnetic resonance imaging (MRI) due to atypical symptoms. The demographic characteristics, clinical parameters, and radiological findings were recorded.
RESULTS: Among the patients, 66.7% had abnormal radiology results, with the most common findings being gliosis (34.4%), sequelae of cerebrovascular events and vascular malformations (14.4%), and benign intracranial mass lesions (11%). Non-glaucomatous visual field defects were more frequently observed in patients with abnormal neuroimaging results. However, there were no significant differences in intraocular pressure, optic disc parameters, retinal nerve fiber layer thickness, and visual field indices between patients with normal and abnormal radiological results. The mean age of the patients was 58.74y. Interestingly, there was a significant age difference, with the abnormal radiology group having a higher median age (P=0.021).
CONCLUSIONS: The study highlights the importance of cranial imaging in older NTG patients to detect underlying pathologies and prevent misdiagnosis. It suggests that neuroimaging may be warranted in NTG patients with atypical visual field defects incompatible with glaucoma. However, routine neuroimaging in all NTG patients without classic neurological signs may not be necessary.
摘要：
目的：评估神经或不典型表现为正常眼压性青光眼（NTG）的患者神经影像学检查的必要性。
方法：对90例因症状不典型而接受头颅磁共振成像（MRI）检查的不典型NTG患者进行回顾性分析。人口特征，临床参数,并记录放射学结果。
结果：在患者中，66.7%有异常的放射学结果,最常见的发现是胶质增生（34.4％），脑血管事件和血管畸形的后遗症（14.4％），颅内良性肿块病变（11%）。在神经影像学检查结果异常的患者中，更经常观察到非青光眼视野缺损。然而,眼压没有显著差异，光盘参数，视网膜神经纤维层厚度，放射学结果正常和异常患者之间的视野指数。患者的平均年龄为58.74。有趣的是,有显著的年龄差异，异常放射学组的中位年龄较高（P=0.021）。
结论：该研究强调了老年NTG患者头颅成像对检测潜在病理和防止误诊的重要性。这表明，对于与青光眼不相容的非典型视野缺损的NTG患者，可能需要进行神经影像学检查。然而,所有无经典神经系统体征的NTG患者可能不需要进行常规神经影像学检查.
方法：对90例因症状不典型而接受头颅磁共振成像（MRI）检查的不典型NTG患者进行回顾性分析。人口特征，临床参数,并记录放射学结果。
结果：在患者中，66.7%有异常的放射学结果,最常见的发现是胶质增生（34.4％），脑血管事件和血管畸形的后遗症（14.4％），颅内良性肿块病变（11%）。在神经影像学检查结果异常的患者中，更经常观察到非青光眼视野缺损。然而,眼压没有显著差异，光盘参数，视网膜神经纤维层厚度，放射学结果正常和异常患者之间的视野指数。患者的平均年龄为58.74。有趣的是,有显著的年龄差异，异常放射学组的中位年龄较高（P=0.021）。
结论：该研究强调了老年NTG患者头颅成像对检测潜在病理和防止误诊的重要性。这表明，对于与青光眼不相容的非典型视野缺损的NTG患者，可能需要进行神经影像学检查。然而,所有无经典神经系统体征的NTG患者可能不需要进行常规神经影像学检查.
