Prognostic Factors for Progression of Visual Field Damage in Patients with Normal-Tension Glaucoma

Nakagami, Takako; Yamazaki, Yoshio; Hayamizu, Fukuko

doi:10.1007/s10384-005-0273-1

Cited by 51 publications

(25 citation statements)

References 23 publications

(11 reference statements)

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“…Normal-tension glaucoma (NTG) is defined as chronic open-angle glaucoma with progressive optic nerve damage and corresponding visual field (VF) defect, despite an untreated intraocular pressure (IOP) that is always measured below 21 mmHg (Tanna & Krupin 2009). Several risk factors have been found to be associated with the prevalence and progression of NTG, such as IOP (CNTGS 1998a,b;Drance et al 2001;Nakagami et al 2006;Aoyama et al 2010), central corneal thickness (Morad et al 1998;Copt et al 1999), disc haemorrhage (Daugeliene et al 1999;Ishida et al 2000;Drance et al 2001;Park et al 2009), disc size (Tuulonen & Airaksinen 1992;Tomita et al 1994;Jonas et al 1995), betazone peripapillary atrophy (Jonas & Xu 1993;Park et al 1996;Daugeliene et al 1999;Kawano et al 2006), myopia (Perkins & Phelps 1982;Drance et al 2001;Suzuki et al 2006;Araie et al 2012) and ocular perfusion pressure (Sung et al 2009(Sung et al , 2011. Of these, IOP is the only modifiable risk factor and has been an important target of NTG treatment.…”

Section: Introductionmentioning

confidence: 99%

Intraocular pressure reduction with topical medications and progression of normal‐tension glaucoma: a 12‐year mean follow‐up study

Kim

Park

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To investigate whether the amount of intraocular pressure (IOP) reduction with topical medications is associated with the progression of normal-tension glaucoma (NTG) and to identify risk factors for NTG progression. Methods: The medical records of 121 eyes of 121 NTG patients, who were treated with topical medications for more than 7 years, were reviewed. NTG progression was defined by either structural (optic disc or retinal nerve fibre layer) or functional (visual field) deterioration. Patients were divided into tertile groups according to the percentage IOP reduction from baseline, and the cumulative probability of NTG progression between upper and lower tertile group was compared using Kaplan-Meier survival analysis. Multivariate analysis with Cox's proportional hazard model was performed to identify the hazard ratio (HR) of clinical factors for NTG progression. Results: The average follow-up period was 12.2 years, and 56 of 121 eyes (46.3%) showed the NTG progression. Kaplan-Meier analysis revealed that upper tertile group (percentage IOP reduction >22.1%) showed a greater cumulative probability of non-progression than lower tertile group (percentage IOP reduction < 13.3%; p = 0.012). Multivariate Cox's proportional hazard model indicated that percentage reduction of IOP (HR = 0.964; p = 0.007) and the occurrence of disc haemorrhage (HR = 2.410; p = 0.008) were significantly associated with NTG progression. Conclusions: The amount of IOP reduction using topical medications was related to NTG progression, and lower percentage reduction in IOP was a consistent risk factor for progression.

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Section: Introductionmentioning

confidence: 99%

Intraocular pressure reduction with topical medications and progression of normal‐tension glaucoma: a 12‐year mean follow‐up study

Kim

Park

et al. 2013

Acta Ophthalmologica

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“…Optic disc hemorrhage has previously been reported to have a predictive value in patients with glaucoma; in these studies, development and progression of visual field defects were seen more often in patients with hemorrhage than in patients with equal levels of IOP but without hemorrhage 13–16. Optic disc hemorrhage was described as present on the border or adjacent to the border between the RNFL defect and the apparently healthy-looking RNFL 17,18.…”

Section: Discussionmentioning

confidence: 93%

Superior segmental optic nerve hypoplasia accompanied by progressive normal-tension glaucoma

Yamazaki¹,

Hayamizu²

2012

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This is the first case report of a superior segmental optic hypoplasia (SSOH) combined with normal-tension glaucoma accompanied by a progressive glaucomatous visual field defect. A 40-year-old man, incidentally diagnosed as having bilateral SSOH, had disc hemorrhage associated with expansion of the width of a retinal nerve fiber layer defect and deterioration of a visual field defect in the right eye during the follow-up period. His left eye showed a stable visual field. The diurnal variation in intraocular pressure (IOP) showed a higher mean IOP in his right eye compared with his left eye, although both IOPs remained under 21 mmHg.

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“…The differences in MD between the two groups were not statistically significant at the last visit. Previous studies reported that lowering IOP slowed the advancement of visual field damage in glaucoma patients [23–25]. However, even if the IOP can be substantially lowered, the reduction of mean and peak IOPs does not always prevent visual field progression [26].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

Liu

Zhang

et al. 2017

Journal of Ophthalmology

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Purpose. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). Design. This is a retrospective case series comparison. Participants. This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. Methods. In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. Results. After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8 ± 7.3 mmHg to 15.0 ± 5.6 mmHg in the DM group and from 27.3 ± 6.0 mmHg to 12.4 ± 5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4 ± 1.3 and 3.3 ± 1.2 preoperatively (P = 0.587) whereas it was 1.7 ± 1.5 and 1.1 ± 1.4 at the 5-year follow-up (P = 0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups (P = 0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group (P = 0.041). Conclusion. PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

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Prognostic Factors for Progression of Visual Field Damage in Patients with Normal-Tension Glaucoma

Abstract: The rate of progression of visual field damage differed according to the severity of the initial visual field damage. IOP reductive medication may be effective in preventing glaucomatous visual field progression in patients with NTG.

Cited by 51 publications

References 23 publications

Intraocular pressure reduction with topical medications and progression of normal‐tension glaucoma: a 12‐year mean follow‐up study

Intraocular pressure reduction with topical medications and progression of normal‐tension glaucoma: a 12‐year mean follow‐up study

Superior segmental optic nerve hypoplasia accompanied by progressive normal-tension glaucoma

Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

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