Internal carotid artery aneurysm mimicking normal-tension glaucoma

• Autor(a) principal: Pincelli Netto, Mario [UNIFESP]
• Data de Publicação: 2018
• Outros Autores: Ferrari, Pedro Vanalle [UNIFESP], Herrerias, Bruno Torres [UNIFESP], Hirai, Flavio Eduardo [UNIFESP], Gracitelli, Carolina Pelegrini Barbosa [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492018000200148&lng=en&nrm=iso&tlng=en; https://repositorio.unifesp.br/handle/11600/55842
• topic: Glaucoma/diagnosis; Carotid artery, internal; Ophthalmic artery/pathology; Aneurysm/diagnosis; Visual field; Differential diagnosis; Glaucoma/diagnóstico; Carótida interna; Artéria oftálmica/patologia; Aneurisma/diagnóstico; Campo visual; Diagnóstico diferencial

Differentiating glaucomatous from nonglaucomatous optic disc cupping remains challenging. We present a case of a 48-year-old woman with an internal carotid aneurysm of approximately 3.5 mm x 6.5 mm that mimicked normal-tension glaucoma. The patient had a 2-year history of low vision acuity in her left eye and frontal oppressive headache. Owing to the carotid aneurysm, she developed an asymmetric vertical cup-to-disc ratio above 0.2, and marked inferotemporal neuronal rim loss and pallor of the residual rim were noted in the left disc. She also developed a visual field defect with an arcuate scotoma in the left eye. The patient was referred to a neurosurgeon and underwent endovascular aneurysm occlusion. This case highlights the diagnostic importance of recognizing that many neurological defects remain underdiagnosed.