What is the role of neuroimaging in the workup of low-tension glaucoma?

Updated: Jun 10, 2020
  • Author: Mitchell V Gossman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

MRI is the preferred imaging modality compared with CT scanning because of its higher sensitivity in ruling out tumors that cause compressive optic neuropathy. [12]

Controversy exists as to whether neuroimaging should be performed routinely. Consider referral to a neurophthalmologist upon doubt.

Neuroimaging should be performed in any patient with the following:

  • Markedly asymmetric disease
  • Increased optic disc pallor relative to cupping
  • Unusual visual-field defects, particularly those with respect to the vertical midline
  • Rapid progression of visual fields
  • Rapid progression of optic neuropathies
  • Dyschromatopsia
  • Afferent papillary defect with mild cupping

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