June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Optic Nerve Head Cavernous Voids in Glaucoma Suspect and Glaucoma Patients
Author Affiliations & Notes
  • Bennett Hong
    Ophthalmology, Legacy Devers Eye Institute at Legacy Good Samaritan Medical Center, Portland, Oregon, United States
    Ophthalmology, Oregon Health & Science University, Portland, Oregon, United States
  • Robert Kinast
    Ophthalmology, Legacy Devers Eye Institute at Legacy Good Samaritan Medical Center, Portland, Oregon, United States
  • Brad Fortune
    Ophthalmology, Legacy Devers Eye Institute at Legacy Good Samaritan Medical Center, Portland, Oregon, United States
  • Claude F Burgoyne
    Ophthalmology, Legacy Devers Eye Institute at Legacy Good Samaritan Medical Center, Portland, Oregon, United States
  • Steven L Mansberger
    Ophthalmology, Legacy Devers Eye Institute at Legacy Good Samaritan Medical Center, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Bennett Hong, None; Robert Kinast, None; Brad Fortune, None; Claude Burgoyne, None; Steven Mansberger, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3394. doi:
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    • Get Citation

      Bennett Hong, Robert Kinast, Brad Fortune, Claude F Burgoyne, Steven L Mansberger; Optic Nerve Head Cavernous Voids in Glaucoma Suspect and Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3394.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Structural changes of the optic nerve head (ONH) such as lamina cribosa defects, prelaminar schisis, and peripapillary retinal schisis have been associated with glaucoma. We describe cases of previously undescribed ONH cavernous voids that were found on routine optic nerve head imaging (spectral domain optical coherence tomography [SD OCT], Spectralis, Heidelberg Engineering).

Methods : We include a case series (n=5 eyes, 4 patients) of ONH cavernous voids with demographic and clinical information. Visual field (SITA Standard 24-2 or 30-2) progression was defined by the clinician's analysis of the final scan and averaged 13 years of follow up. Visual acuity, recorded cup to disc ratios, and intraocular pressures (IOP) were noted.

Results : The SD OCT images (Figure 1) demonstrate cystic, hyporeflective spaces that are sharply delineated from surrounding tissue. They appear to be located anterior to the lamina cribosa. Cases 1,2, and 3 may be situated within Bruch’s membrane opening (BMO), while case 4 is clearly situated lateral to BMO. They are all located inferonasally and can extend ~3 clock hours (cases 1 and 4) or ~6 clock hours (cases 2 and 3). In cases 1, 3, 4 this is found exclusively in the right eye. Case 2 had simultaneous nasal presentation of similar size in the left eye. In all cases there was no clinically significant global RNFL tissue loss over time. Vision remained stable in cases 1,3,4, except case 2 who developed macular degeneration requiring anti-VEGF injections. Visual field progression was observed in Case 1 and 4, while Case 2 and 3 had stable and/or full fields over 13 and 20 years of follow up, respectively. IOP averaged 15.9 +/- 4.7 mmHg across patients and all timepoints. Cup to disc ratio remained stable in all cases, except case 2.

Conclusions : Large optic nerve head cavernous voids can present in glaucoma suspects and glaucoma patients. Longitudinal volumetric analysis may shed light on whether the size of these voids change over time.

This is a 2021 ARVO Annual Meeting abstract.

 

Optic nerve head cavernous voids are noted by the asterisk.

Optic nerve head cavernous voids are noted by the asterisk.

 

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