[Vascular changes within the proximal optic nerve in children suffering from glaucoma].

Paraffin-embedded sections of eyes enucleated because of hydrophthalmos (23 cases) or retinoblastoma (59 cases) were examined for vascular changes within the proximal optic nerve. Globes of adults, enucleated because of secondary glaucoma (146 cases), were studied for comparison as well as 19 myopic and 11 microphthalmic eyes enucleated for other reasons, and 19 autopsy eyes of newborns. Microscopic examination revealed an accumulation of dilated thin-walled blood vessels within the septae of the proximal optic nerve of 6 eyes with hydrophthalmos and 11 eyes with retinoblastoma; sometimes the vascular changes appeared somewhat similar to an angioma racemosum. A common finding in all 17 cases was an elevation of the intraocular pressure. There were only 2 cases among the eyes studied for comparison showing dilatations of the optic nerve capillaries: 1 was in a stillborn baby with general hyperemia, and the other was a case of secondary glaucoma in an adult. 9 similar cases have hitherto been published describing vascular dilatations in the optic nerve of children suffering either from glaucoma or retinoblastoma; none of the authors had related these changes to an increased intraocular pressure. It seems likely that hemodynamic changes play an important role in the pathogenesis of these vascular reactions in the proximal optic nerve of infants with flaucoma. A lower arterial blood pressure in infants as well as anatomical and morphological features may be further factors of significance.