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Glaucoma‐like optic neuropathy in patients with intracranial tumours
Author(s) -
Qu Yuanzhen,
Wang Ya Xing,
Xu Liang,
Zhang Liwei,
Zhang Junting,
Zhang Jianguo,
Wang Lina,
Yang Liu,
Yang Anchao,
Wang Jian,
Jonas Jost B.
Publication year - 2011
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.02118.x
Subject(s) - medicine , glaucoma , visual field , ophthalmology , fundus photography , optic nerve , optic neuropathy , optic disc , population , fundus (uterus) , visual acuity , fluorescein angiography , environmental health
. Purpose: To examine frequency and associated factors of glaucoma‐like appearance of the optic nerve head in patients with intrasellar, suprasellar or parasellar tumours. Methods: This retrospective clinical observational study included patients who were consecutively treated for intrasellar tumours ( n = 143), suprasellar tumours ( n = 321), parasellar tumours ( n = 36) or retrosellar tumour ( n = 1), and all of whom had undergone fundus photography and full‐threshold visual field examination. The tumour spectrum included 336 pituitary gland tumours, 32 meningiomas, 89 craniopharyngiomas, 9 chiasmal gliomas and 35 other types of tumours or lesions. An age‐matched control group was formed from the population‐based Beijing Eye Study. Using fundus photographs and visual field examinations, glaucoma was defined by a neuroretinal rim shape not following the ISNT rule (Disc glaucoma group) and by an abnormal rim shape plus glaucoma‐like visual field defects (Field glaucoma group). Type and size of the tumours were assessed on neuroradiological images. Results: Five‐hundred and one patients fulfilled the inclusion criteria. Disc glaucoma and Field glaucoma were detected significantly more frequently in the study population [34 (6.8%) patients and 31 (6.3%) patients, respectively] than in the population‐based control group of the same ethnicity (1.3% ± 0.5%; p < 0.001). In multivariate analysis, presence of Disc glaucoma [odds ratio (OR) = 2.64; p = 0.016] and presence of Field glaucoma (OR = 3.01; p = 0.027) were significantly associated with tumour location [suprasellar > parasellar > intrasellar]. The same held true for tumour width (OR = 1.08; p = 0.002; and OR = 1.08; p = 0.003, respectively). Conclusions: Large perisellar tumours were associated with a glaucoma‐like appearance of the optic nerve head in eyes. It may diagnostically and pathogenetically be of importance.