Glaucoma‐like optic neuropathy in patients with intracranial tumors

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Abstract Purpose To examine frequency and associated factors of a glaucoma‐like appearance of the optic nerve head in patients with intrasellar, suprasellar or parasellar tumors. Methods The study included patients who were consectutively treated for intrasellar tumors (n=143), suprasellar tumors (n=321), parasellar tumors (n=36), or retrosellar tumor (n=1), and all of whom had undergone fundus photography and full‐threshold visual field examination. An age‐matched control group was formed from the population‐based Beijing Eye Study. Glaucoma was defined by neuroretinal rim shape plus glaucoma‐like visual field defects. Results Five‐hundred and one patients fulfilled the inclusion criteria. Disc‐Glaucoma and Field Glaucoma were detected significantly more frequently in the study population (34 (6.8±1.1%) patients and 31 (6.3±1.1%) patients, respectively) than in the population‐based control group of the same ethnicity (1.3% ± 0.5% (0.3%‐2.3%); P<0.001). In multivariate analysis, presence of Disc‐Glaucoma and Field‐Glaucoma was significantly associated with tumor location (suprasellar > parasellar > intrasellar (OR=2.64; P=0.016; and OR=3.01; P=0.027, resp.)) and tumor width (OR=1.08; P=0.002; and OR=1.08; P=0.003, resp.). Conclusion Large perisellar tumors were associated with a glaucoma‐like appearance of the optic nerve head in eyes. It may diagnostically and pathogenetically be of importance and may give insight into the pathogenesis of normal‐pressure glaucoma.

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