Case Study 1
A 59 year-old woman presents with:
- Visual acuity: 20/20 (6/6)
- Tonometric Assessment: 18mm Hg
- Central Cornea Thickness: 437µm
- Refraction: plano
AND
- GHT outside statistically normal limits (Mean Deviation -1.31 dB; Pattern Standard Deviation 2.34 dB; P<0.05)
Where would you place this patient on the glaucoma continuum? Select the stage by clicking on the appropriate radio button.
What is your strategy for dealing with this patient?
Now consider the following:
1. Heidelberg retina tomography is significant for a borderline nerve fiber layer defect superiorly as well as inferiorly.
2. GDx identifies a structural defect superiorly, consistent with findings of ocular exam. A mild nerve fiber layer defect is also present inferiorly.
View large
3. Optical coherence tomography demonstrates a nerve fiber layer defect superiorly.
View large
4. Frequency-doubling technology perimetry (FDT) demonstrates a defect inferiorly, which corresponds to the superior defect noted on the initial funduscopic exam, as well as with imaging. The FDT does not, however, demonstrate any deficits superiorly.
5. Short-wavelength automated perimetry (SWAP) demonstrates a significant inferior hemifield defect and a mild superior hemifield defect.
Where would you place this patient on the glaucoma continuum now? Select the stage by clicking on the appropriate radio button.
What is your strategy for dealing with this patient?
|