LOW-TENSION GLAUCOMA - A COMPARATIVE-STUDY WITH RETINAL ISCHEMIC SYNDROMES AND ANTERIOR ISCHEMIC OPTIC NEUROPATHY

In low-tension glaucoma (LTG), nerve-fiber-bundle defects are assumed to result from ischemia of the choroidal branches of the posterior cil iary arteries, due either to local vascular changes or, presumably, he modynamically occlusive carotid artery disease. To study the possible hemodynamical origin of LTG, we examined and compared, clinically and by ultrasound (continuous-wave Doppler and duplex-scanning), the extra cranial carotid arteries of (1) 21 patients (34 eyes) with LTG, (2) 48 patients (49 eyes) with retinal ischemic syndromes (RIS), and (3) 15 patients (17 eyes) with anterior ischemic optic neuropathy (AION). Hig h-grade stenoses and occlusions of the internal carotid arteries ipsil ateral to the affected eyes were significantly more frequent in the RI S patients (17 of 49) than in the LTG patients (2 of 34; P < .01) and the AION patients (0 of 17; P < .01). Among our relatively small group of LTG patients, we found no striking evidence supporting a hemodynam ic origin of LTG.