Asymmetric Progressive Glaucomatous Optic Neuropathy in a Patient With a Rare Developmental Variant of the Ophthalmic Artery

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PurposeTo report a case of a developmental anatomic finding of the ophthalmic artery (OA) in a patient with ipsilateral progressive advanced glaucomatous optic neuropathy and visual field loss.MethodsA 59-year-old Asian man with normal tension glaucoma had progressive asymmetric visual field loss OD. Magnetic resonance imaging and angiography of the orbit were performed because of continued progression despite medical and surgical intervention.ResultsMagnetic resonance angiography revealed an anomalous OA, lateral to the carotid artery and emanating from a branch of the middle meningeal artery.ConclusionOA anomalies should be added to the differential diagnosis of risk factors for unilateral progressive glaucomatous optic neuropathy, and neuroradiologic imaging should be considered to detect such anatomic variants.

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