Glaucoma

Case 2

Patient Presentation: A 68-year-old female was referred to an ophthalmology service due to decreased vision in her left eye. She had no past ocular history, but did not regularly see her optometrist. On assessment, her visual acuity was 20/25 OD 20/60 OS. IOP was 14 OU (on 0/0 classes or glaucoma medications). Fundus examination showed cup-to-disc ratios of 0.7 OD and 0.8 OS. ONH and RNFL OCT analysis is shown below. 

Glacoma2_1.png.tif

Question: What features on OCT are concerning for glaucoma?

Ganglion cell complex analysis and macular cube OCTs are shown below.

Glacoma2_4.png
Glacoma2_5.png

Question: What additional features on OCT are seen?

Question: What is the most likely diagnosis?

Learning Objectives:

1.    To differentiate between changes seen in glaucoma vs retinal vein occlusion.