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Short-term Optic Disc Cupping Reversal in a Patient With Mild Juvenile Open-angle Glaucoma Due to Early Idiopathic Intracranial Hypertension

Umfress, Allison C., MD; Mawn, Louise A., MD; Joos, Karen M., MD, PhD

doi: 10.1097/IJG.0000000000001151
Online Articles: Case Report/Small Case Series

Purpose: The purpose of this study was to report a case of optic disc cupping reversal in an adult without significant intraocular pressure–lowering treatment.

Patient: A 20-year-old female with a history of mild juvenile open-angle glaucoma who developed subjective blurred vision and a decrease in cupping of her optic discs.

Results: Dilated examination demonstrated decreased cup-to-disc ratios in both eyes with a slight blurring of the disc margin in the right eye. The appearance of both optic discs returned to baseline after weight loss therapy.

Conclusions: An unexplained reduction of optic nerve cup-to-disc ratio should prompt a workup for other etiologies, such as increased intracranial pressure. Baseline photographs not subjected to computerized scan obsolescence are extremely useful in monitoring the long-term appearance of asymmetric optic discs as an adjunct to the clinical examination.

Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN

Presented in part at Southeastern Vision Research Conference, December 11, 2018, Birmingham, AL.

Unrestricted Departmental Grant to the Vanderbilt Eye Institute from Research to Prevent Blindness Inc., NY. The William Black and Joseph Ellis Research funds. Vanderbilt Vision Research Center Core Grant—P30EY008126.

Disclosure: The authors declare no conflict of interest.

Reprints: Karen M. Joos, MD, PhD, Vanderbilt Eye Institute, 2311 Pierce Avenue, Nashville, TN 37232 (e-mail:

Received August 19, 2018

Accepted November 27, 2018

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