Secondary Open Angle Glaucoma after Systemic Corticoid-Therapy of Encephalitis disseminata (MR-, MR-DTI-, HRT-, FDT-, w-w-perimetry, fundus photo)
Brain and Optical PathwayMale, 63 years, multiple sclerosis. Visual acuity: OD 1.0 and OS 0.4; IOP: OD 13 mmHg and OS 14 mmHg.
Assessment: The pronounced cerebral participation after many years of systemic corticosteroid therapy of multiple sclerosis is evident by the typical signs of encephamyelitis disseminata. The 4th neuron appears affected as shown in the DTI. The 3rd neuron of the visual pathway is also damaged. A differentiation between glaucoma-related and multiple sclerosis-related impairment is not definitely possible.
| Advanced visual field defects in advanced glaucomatous optic atrophy OD>OS in SOAG (FDT) |
| Disseminated encephalitis, MRI |
| Disseminated encephalitis, MRI |
| Disseminated encephalitis, MRI |
| Glaucomatous visual field defects OD>OS in SOAG (white- on-white perimetry) |
| OD: advanced finding typical for glaucoma, fundus photography |
| OD: reduced nerve fiber layer and still normal morphology of the papilla, HRT |
| OS: advanced finding, typical for glaucoma, fundud photography |
| OS: reduced nerve fiber layer and impaired morphology of the papilla, HRT |
| Vigorously developed right optic radiation, rarefied left optic radiation in SOAG (3T Diffusion Tensor Imaging (DTI), colored FA map) |
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