Optic cupping secondary to periventricular leukomalacia: A potential mimic for normal pressure glaucoma

We herein present a case of periventricular leukomalacia (PVL) with secondary optic pathway denervation atrophy, which was initially labeled as normal tension glaucoma. However, given the discordant clinical and ophthalmologic findings, brain magnetic resonance imaging was requested which proved PVL to be the underlying process to the patient's decreased visual acuity. In addition to presenting the ophthalmologic findings, we are emphasizing the pivotal role of neuroimaging in ruling out central causes of optic atrophy/hypoplasia and making this clinical distinction by demonstrating optic pathway atrophy associated with PVL.