Evaluation of visual field sensitivity and optical coherence tomography in pseudoglaucomatous optic neuropathy

Abstract

Objective The aim of the study was to evaluate the protocol of optical coherence tomography (OCT) and visual field (VF) sensitivity testing in the diagnosis of pseudoglaucomatous optic neuropathy and avoid misdiagnosis with glaucoma. Background Pseudoglaucoma is defined as false or deceptive glaucoma with or without ocular damage. Multiple entities can produce 'pseudoglaucomatous optic disc' and care should be taken to differentiate it from glaucomatous eyes that, for the present, do not reveal symptoms of glaucoma.Patients who have pseudoglaucomatous optic disc cupping should be invitigated well. Patients and methods This study was conducted on 39 eyes (of 24 patients) to assess the protocol of OCT and VF sensitivity testing in the diagnosis of pseudoglaucomatous optic neuropathy. Results In this study the average age was significantly lower in patients with pseudoglaucomatous cupping (24 years). Best-corrected visual acuity (BCVA) did not significantly decrease in patients after pseudoglaucomatous optic neuropathy. Patients with nonglaucomatous optic nerve cupping had better VF mean deviation and pattern standard deviation. Eyes with pseudoglaucomatous optic nerve cupping had a lower mean retinal nerve fiber layer (RNFL) in both the nasal and temporal quadrants. Conclusion VF sensitivity and OCT appear to be of value in the evaluation of pseudoglaucomatous optic disc cupping. The pattern of RNFL loss varied on the basis of etiology and appeared more diffuse in nonglaucomatous optic nerve cupping. The nasal and temporal RNFL thicknesses were lower in patients with nonglaucomatous optic nerve cupping compared with the reported results in glaucoma patients. The pattern of VF defect varied depending on etiology and the VF mean deviation and pattern standard deviation were better compared with the results reported in glaucoma patients.