Hoffman Brent B, Rosenfeld Eldar, Grajewski Alana L, Chang Ta C
The Brody School of Medicine at East Carolina University, 600 Moye Boulevard, Greenville, NC, 27834, USA.
Bascom Palmer Eye Institute, The University of Miami Miller School of Medicine, 900 NW 17th Street 450N, Miami, FL, 33136, USA.
Am J Ophthalmol Case Rep. 2018 Dec 14;13:104-109. doi: 10.1016/j.ajoc.2018.12.012. eCollection 2019 Mar.
We describe a case of normal tension glaucoma in the setting of sickle cell disease in a 9-year-old patient with a five-year follow up.
A 9-year-old male patient with a history of sickle cell disease presented initially at the age of 4 years for evaluation of a brief episode of nonspecific eye pain that had spontaneously resolved prior to the clinic visit. Over the course of several years, the patient was noted to have progressive optic disc cupping bilaterally, retinal nerve fiber layer thinning bilaterally, and has developed a corresponding inferior arcuate defect on automated visual field testing in the right eye, all without elevated intraocular pressures (IOP). After neuro-ophthalmic pathologies were ruled out, the patient was diagnosed with glaucoma associated with sickle cell disease and normal baseline IOP, and brimonidine therapy was initiated.
To our knowledge, this is the first reported case of normal-tension glaucoma in a pediatric patient. Normal-tension glaucoma may be a consideration in the evaluation of pediatric glaucoma suspects, but remains a diagnosis of exclusion.
我们描述了一例9岁镰状细胞病患者发生正常眼压性青光眼的病例，并进行了为期五年的随访。
一名有镰状细胞病病史的9岁男性患者最初在4岁时因短暂发作的非特异性眼痛前来就诊，该眼痛在就诊前已自行缓解。在数年的病程中，该患者被发现双侧视神经盘进行性凹陷，双侧视网膜神经纤维层变薄，并且右眼在自动视野测试中出现了相应的下方弓形缺损，所有这些均未伴有眼压升高。在排除神经眼科疾病后，该患者被诊断为与镰状细胞病相关的青光眼且基线眼压正常，并开始使用溴莫尼定治疗。
据我们所知，这是首例报道的小儿正常眼压性青光眼病例。在评估小儿青光眼疑似患者时可能需要考虑正常眼压性青光眼，但它仍然是一种排除性诊断。
