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Photo Essay
April 2001

Periventricular Leukomalacia: An Intracranial Cause of Pseudoglaucomatous Cupping

Arch Ophthalmol. 2001;119(4):626-627. doi:10.1001/archopht.119.4.626

A 13-YEAR-OLD boy with large optic cups and normal intraocular pressures was being followed as a glaucoma suspect. He had a visual acuity of 20/25 OD and 20/20 OS. He was able to identify all Hardy-Rand-Rittler pseudoisochromatic color plates. Pupillary responses to light were brisk and there was no afferent pupillary defect. He had an intermittent exotropia of the right eye, latent nystagmus, and dissociated vertical divergence. Optic disc examination showed large optic cups with bilateral thinning of the superior, inferior, and lateral neuroretinal rims and diffuse nerve fiber layer loss with relative sparing inferiorly (Figure 1). Humphrey 30-2 visual field examination results showed diffuse bilateral constriction with an inferior depression that spared fixation (Figure 1).