Optic disc findings in normal tension glaucoma

Yamazaki, Yoshio; Hayamizu, Fukuko; S, Miyamoto; Nakagami, Takako; Tanaka, Chizuru; Inui, Shigeru

doi:10.1016/s0021-5155(97)00052-x

Cited by 17 publications

(4 citation statements)

References 28 publications

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“…While there is literature suggesting that the clinical phenotypes of glaucoma that occur at normal and elevated levels of IOP are different, 49–52 we propose that glaucoma represents a continuum of ONH susceptibility to IOP, IOP-related, and non–IOP-related risk factors. Within this continuum, IOP should be a substantial risk factor at normal levels of IOP, 53 its contribution to risk should increase as it becomes elevated, 54 and the presence of IOP-related and non–IOP-related risk factors at any level of IOP should increase the risk of IOP, alone.…”

Section: Discussionmentioning

confidence: 78%

Cupping in the Monkey Optic Nerve Transection Model Consists of Prelaminar Tissue Thinning in the Absence of Posterior Laminar Deformation

Ing

Ivers

Yang

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PurposeTo use optical coherence tomography (OCT) to test the hypothesis that optic nerve head (ONH) “cupping” in the monkey optic nerve transection (ONT) model does not include posterior laminar deformation.MethodsFive monkeys (aged 5.5–7.8 years) underwent ONH and retinal nerve fiber layer (RNFL) OCT imaging five times at baseline and biweekly following unilateral ONT until euthanization at ∼40% RNFL loss. Retinal nerve fiber layer thickness (RNFLT) and minimum rim width (MRW) were calculated from each pre- and post-ONT imaging session. The anterior lamina cribrosa surface (ALCS) was delineated within baseline and pre-euthanasia data sets. Significant ONT versus control eye pre-euthanasia change in prelaminar tissue thickness (PLTT), MRW, RNFLT, and ALCS depth (ALCSD) was determined using a linear mixed-effects model. Eye-specific change in each parameter exceeded the 95% confidence interval constructed from baseline measurements.ResultsAnimals were euthanized 49 to 51 days post ONT. Overall ONT eye change from baseline was significant for MRW (−26.2%, P = 0.0011), RNFLT (−43.8%, P < 0.0001), PLTT (−23.8%, P = 0.0013), and ALCSD (−20.8%, P = 0.033). All five ONT eyes demonstrated significant eye-specific decreases in MRW (−23.7% to −31.8%) and RNFLT (−39.6% to −49.7%). Four ONT eyes showed significant PLTT thinning (−23.0% to −28.2%). The ALCS was anteriorly displaced in three of the ONT eyes (−25.7% to −39.2%). No ONT eye demonstrated posterior laminar displacement.ConclusionsSeven weeks following surgical ONT in the monkey eye, ONH cupping involves prelaminar and rim tissue thinning without posterior deformation of the lamina cribrosa.

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Section: Discussionmentioning

confidence: 78%

Cupping in the Monkey Optic Nerve Transection Model Consists of Prelaminar Tissue Thinning in the Absence of Posterior Laminar Deformation

Ing

Ivers

Yang

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…38–41 For instance, in NTG, optic disc phenotypes are more often described as senile-sclerotic or focal-ischemic. 42,43 …”

Section: Discussionmentioning

confidence: 99%

Nocturnal Systemic Hypotension Increases the Risk of Glaucoma Progression

et al. 2014

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Objective The objective of this prospective, longitudinal study of patients with normal-tension glaucoma (NTG) was to determine whether patients with nocturnal hypotension are at greater risk for visual field (VF) loss over 12 months than those without nocturnal hypotension. Design Prospective, longitudinal study. Participants Consecutive patients with NTG with at least 5 prior VF tests were screened for eligibility. Methods The baseline evaluation assessed demographic and clinical characteristics, covering systemic comorbid conditions, including systemic hypertension. All oral and ophthalmologic medications were recorded. A complete ophthalmological examination was performed at baseline and follow-up. Patients had their blood pressure (BP) monitored every 30 minutes for 48 hours with an ambulatory recording device at baseline and 6 and 12 months. Main Outcome Measures The primary outcome was based on the global rates of VF progression by linear regression of the mean VF threshold sensitivity over time (decibels/year). Results Eighty-five patients with NTG (166 eyes; mean age, 65 years; 67% were women) were included. Of the 85 patients, 29% had progressed in the 5 VFs collected before study enrollment. The nocturnal mean arterial pressure (MAP) was compared with the daytime MAP. Multivariate analysis showed that the total time that sleep MAP was 10 mmHg below the daytime MAP was a significant predictor of subsequent VF progression (P<0.02). Conclusions Cumulative nocturnal hypotension predicted VF loss in this cohort. Our data suggest that the duration and magnitude of decrease in nocturnal blood pressure below the daytime MAP, especially pressures that are 10 mmHg lower than daytime MAP, predict progression of NTG. Low nocturnal blood pressure, whether occurring spontaneously or as a result of medications, may lead to worsening of VF defects.

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“…Focal ischaemic glaucoma is a disease subtype characterised by focal notching of the neuroretinal rim with a congruous visual field deficit, which threatens fixation early in the clinical course ("split-fixation" visual field defect) [2,3]. Female gender, earlier age of onset, recurrent optic disc haemorrhages and primary vascular dysregulation syndromes (nocturnal hypotension, vasospasm, migraine and Raynaud's phenomenon) are associated with the focal ischaemic glaucoma subtype [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%