Glaucoma

Case 5

Patient Presentation: A 73-year-old female presented to a comprehensive ophthalmology clinic for her annual follow-up visit. Her visual acuity was 20/20 OU. IOP was 16 OD and 26 OS. ONH/RNFL OCT and Macular Cube OCT analyses were completed and shown below:
 

Glaucoma 5-1.png
Glaucoma 5-3.png
Glaucoma 5-2.png

Question: What main abnormality is seen on ONH/RNFL OCT OS?

Question: What features on OCT suggest glaucoma in the left eye?

Glaucoma 5-7.png
Glaucoma 5-8.png

Visual Fields were performed and shown below.

Question: What is the likely diagnosis in this patient?

Learning Objectives:
1. Interpreting OCT RNFL and macular cube images in patients with pre-perimetric glaucoma.
2. Identifying RNFL deficits corresponding to the inferior and superior vulnerability zones.
3. Identifying reduced retinal thickness corresponding to the macular vulnerability zone.
4. Correlating OCT deficits with visual field changes.