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. 2004 Oct;63(10):1276–1278. doi: 10.1136/ard.2003.013540

Increased prevalence of ocular glaucomatous abnormalities in systemic sclerosis

Y Allanore 1, C Parc 1, D Monnet 1, A Brezin 1, A Kahan 1
PMCID: PMC1754752  PMID: 15361386

Abstract

Background: Cardiovascular diseases, vasospasm, and dysimmunity have been implicated in normal tension glaucoma (NTG).

Objective: To investigate the prevalence of ocular abnormalities suggestive of glaucoma damage in systemic sclerosis (SSc).

Methods: 61 patients with SSc (mean (SD) age 56.2 (12) years, mean (SD) disease duration 9.9 (9) years; 41 with limited cutaneous disease) and 37 control subjects with osteoarthritis (mean (SD) age 55.9 (12) years) were studied. They were systematically referred to an ophthalmologist. The evaluation was based on aplanation tonometry, ophthalmoscopy with retinal photography (evaluation of cup/disc ratio (c/d)), and automated static perimetry (determination of mean defects (MD)). Statistical analyses were performed with the χ2, Mann-Whitney, and Spearman tests.

Results: The mean visual acuity and intraocular pressure were similar in both groups. An excavation with a c/d >0.3 was found in 27 eyes from patients with SSc and 5 eyes from controls (p = 0.009); a c/d >0.7 was found in 4 eyes from patients with SSc and none in the controls (NS). Visual field defects (MD <–2 dB) were found in 55 eyes from patients with SSc and in 18 eyes from controls (p<0.0001). A concomitant c/d >0.3 and MD <–2 dB was found in 21 eyes from 12 patients with SSc but in none of the control eyes (p<0.0001).

Conclusion: Ocular abnormalities suggesting glaucomatous neuropathy without ocular hypertension were dramatically more prevalent in patients with SSc. These abnormalities seem to be mild but justify long term follow up. They are consistent with the vascular pathogenic hypothesis for NTG.

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Figure 1.

Figure 1

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 (A) Normal papillar from one control patient with OA. (B) Optic disc photograph of the left eye of one patient with SSc with excavated papillar: an enlarged optic cup is seen, with concentric loss of the neural rim.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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