[A Case of Normal-tension Glaucoma with Impaired Eye Movements in a Young Patient]

Background: We report a case of normal-tension glaucoma(NTG) with impaired eye movements in a young patient.

Case: A 22-year-old man with enlarged optic disc cuppings and visual field defects was suspected to have NTG, and was found, upon examination, to have impaired eye movements. Intraocular pressure recordings, including diurnal variation, were under 21 mmHg. Gonioscopic findings were normal. Magnetic resonance image(MRI) showed no particular findings. The patient was diagnosed with NTG. Using the 123I-iodoamphetamine single photon emission computed tomography (123I-IMP SPECT), decreased cerebral blood flow was detected in the patient's occipital lobe and an electro-oculogram showed impaired eye movements during smooth pursuit. The patient's visual field defects have increased over the last two years, but, no accompanying change in his eye movements has been observed.

Conclusion: The patient in this case has NTG with impaired eye movements and decreased cerebral blood flow suggesting that some disorder of the central nervous system may be one of the causative mechanisms of NTG.