Ellis M F, Scott M, Erwin G
Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Clin Exp Ophthalmol. 2001 Feb;29(1):44-6. doi: 10.1046/j.1442-9071.2001.00367.x.
A 60-year-old smoker presented with high intraocular pressure in the right eye with a right afferent pupil defect and visual field suggestive of primary open angle glaucoma in the right eye only, when an examination 2 years earlier had revealed no hint of ocular pathology. Radiological investigations demonstrated prominent ectasia of the internal carotid arteries extending into the proximal middle cerebral arteries. The changes in the carotids extended throughout the cavernous sinus regions, encroached on the under surface of the optic chiasm and were closely related to the internal aspects of both optic canals. In primary open angle glaucoma management, neural imaging is not normally recommended; however, neural imaging investigations should be considered if the presentation is not typical of a chronic bilateral optic neuropathy
一名60岁的吸烟者，右眼出现高眼压，伴有右眼传入性瞳孔缺陷和视野缺损，提示仅右眼患有原发性开角型青光眼，而两年前的检查未发现任何眼部病变迹象。影像学检查显示颈内动脉显著扩张，延伸至大脑中动脉近端。颈动脉的变化延伸至整个海绵窦区域，侵犯视交叉下表面，并与双侧视神经管内部密切相关。在原发性开角型青光眼的治疗中，通常不建议进行神经影像学检查；然而，如果临床表现不典型，不符合慢性双侧视神经病变，则应考虑进行神经影像学检查。
