Differentiating Leber Hereditary Optic Neuropathy from Normal-Tension Glaucoma

ABSTRACT

Glaucoma is a neurodegenerative disorder characterized by thinning of neuroretinal rim, enlarged cup-to-disc ratio (CDR) and visual field damage. Although raised intraocular pressure is main risk factor for development of glaucoma, it can occur with consistently normal measurements in the intraocular pressure as normal tension glaucoma (NTG). Enlargement of CDR is a classical sign of glaucoma, but it can also result from non-glaucomatous optic neuropathies such as Leber hereditary optic neuropathy (LHON). We describe a case of LHON with increased CDR, discuss its differential diagnosis with NTG and highlight the reasons for misdiagnoses between these two entities.

KEYWORDS:

• Differential diagnosis
• Leber hereditary optic atrophy
• low-tension glaucoma

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This study was conducted at the Department of Ophthalmology, Faculty of Medical Sciences, University of Campinas (FCM -UNICAMP) and supported by grant Fapesp 02/11575-0.