Kinky Normal Tension Glaucoma

Yes, you read that right...

There appears to be a significantly higher incidence of optic nerve kinking in individuals with normal tension glaucoma (NTG) compared to healthy controls. This finding was discovered after retro-bulbar/orbital optic nerve imaging utilizing CT cisternography and MRI in 57 NTG patients vs 57 age and gender-matched controls.

The results were extraordinary with 86% of NTG patients showing optic nerve kinking in the axial plane, compared to only 18% of controls. In the sagittal plane, 49% of NTG patients exhibited kinking versus just 2% of controls. These findings suggest a likely link between altered optic nerve anatomy and NTG pathophysiology. Kinking may influence cerebrospinal fluid dynamics within the subarachnoid space of the optic nerve, contributing to the development and/or progression of glaucomatous optic neuropathy.

While further studies are needed to fully understand and confirm this relationship, these results highlight potential anatomic retro-bulbar pathophysiology in NTG patients. We now may want to consider ordering orbital MRI's, particularly for NTG patients with progressive optic neuropathy and/or visual field loss.

-JRM

Go to article in Nature: HERE