Unequal Intraocular Pressure and Its Relation to Asymmetric Visual Field Defects in Low-tension Glaucoma

Crichton, Andrew; Drance, Stephen M.; Douglas, Gordon R.; Schulzer, Michael

doi:10.1016/s0161-6420(89)32721-7

Cited by 151 publications

(60 citation statements)

References 6 publications

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“…Rather, the current result indicates that the magnitude of risk because of IOP was smaller than that because of disc haemorrhage or extent of myopia in the current series of nonhighly myopic NTG eyes. Prior retrospective reports have demonstrated the correlation of asymmetric visual field damage with asymmetric IOP in patients with NTG (Cartwright & Anderson 1988;Crichton et al 1989). In the current findings, there was no correlation between IOP asymmetry and visual field asymmetry, agreeing with the findings of the Low-pressure Glaucoma Treatment Study (Greenfield et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

Araie

Shirato²,

Yamazaki

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To prospectively study prognostic factors for normal-tension glaucoma (NTG) under treatment with topical b-blocker. Methods: One hundred and forty-six eyes of 146 patients with NTG with a mean untreated intraocular pressure (IOP) of 14 mmHg, mild to moderate visual field damage and mean spherical equivalent refraction of )3.5 ()8.0 to +2.0) dioptre were randomized to topical nipradilol or timolol and followed for 3 years. The Humphrey full threshold 30-2 visual field test was performed every 6 months, and optic disc photographs were obtained every 12 months. Progression was defined as visual field progression, optic disc and ⁄ or peripapillary nerve fibre layer change, and factors relating to progression were evaluated using Cox proportional hazards models. Results: IOP decreased by 1.0 mmHg over the 3-year period, during which 35% showed progression according to the aforementioned criteria. Optic disc haemorrhage (hazard ratio [HR] 4.00, p < 0.001) and less extent of myopia (per dioptre, HR 1.15, p = 0.013) were significant risk factors. When progression was defined by visual field progression only, less extent of myopia was again a significant risk factor (HR 1.17, p = 0.038). Conclusion: Beside optic disc haemorrhage, less extent of myopia was a risk factor for progression in the current NTG population where most patients were mildly myopic and IOP during follow-up averaged 13.2 mmHg under topical b-blocker.

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Section: Discussionmentioning

confidence: 99%

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

Araie

Shirato²,

Yamazaki

et al. 2012

Acta Ophthalmologica

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“…Nowadays, pathogenesis of NTG is considered multi-factorial. The risk factors for progression of NTG list IOP, 6 presence of disc haemorrhage, 7 larger area of peripapillary atrophy, 8 myopia or myopic disc appearance, 9 and lower blood pressure or peripheral vasospasm. 10 IOP is the only treatable risk factor in the management of NTG at the time of investigation.…”

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confidence: 99%

A three-year prospective, randomized and open comparison between latanoprost and timolol in Japanese normal-tension glaucoma patients

Tomita

Araie

Kitazawa

et al. 2004

Eye

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Purpose To compare the longitudinal effects of treatment on intraocular pressure (IOP) and visual field performance in Japanese normaltension glaucoma (NTG) between latanoprost and timolol. Patients and methods This is an open-label, randomized, study. A total of 62 NTG patients were prospectively, consecutively enrolled. All study subjects were randomly assigned to 0.005% latanoprost instillation once daily in the morning or 0.5% timolol instillation twice daily for a prospective 3-year follow-up, and underwent a routine ocular examination every month. Automated perimetry was performed every 6 months using Humphrey field analysers. Stereophotographs of optic discs were also obtained every 6 months. Results Percentage of IOP reduction or the magnitude of IOP reduction showed no intergroup differences either at any time point (13-15%). In the visual field, the estimated rate of change in the MD value (dB/year) was À0.3470.17 (SE) for the latanoprost group, and À0.1070.18 (SE) for the timolol group. The estimated rate of change in MD showed no significant difference from zero in both groups, and there were no statistical intergroup differences. No changes in the optic nerve head topography in the vertical cup-to-disc ratio and rim area measured by image-analysis techniques were observed in either group. There were no patients who dropped out due to the side effects of treatment regimens.Conclusion Both latanoprost and timolol single treatments reduced IOP by 13-15% at their trough effects for 3 years in Japanese NTG patients; both showed similar effects on visual field performance.

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“…Especially the discrimination of progression from fluctuation relies on corroboration of visual field change with the appearance of the optic nerve [19]. Visual field asymmetry studies have suggested that IOP might contribute to the observed damage in some normal-tension glaucoma patients [5, 6, 7]. Probably because patients with vasospasm might have marked functional fluctuations in visual field [1, 10, 11], the previously described relationship between interocular IOP asymmetry and interocular asymmetry in visual field damage was not obvious in an earlier study from our group [8].…”

Section: Discussionmentioning

confidence: 99%

“…There are patients with glaucomatous optic neuropathy but without increased IOP (normal-tension glaucoma) whose disease process is markedly slower down by the traditional intervention of IOP reduction [2, 3, 4]. In addition, despite measured IOP values within the statistical limits of normal range, many patients with normal-tension glaucoma show a more marked deterioration of the visual field in the eye with the higher IOP [5, 6, 7], although such a relationship was not confirmed in all studies [8]. The difference in visual field loss between the two eyes in normal-tension glaucoma has been suggested mainly to reflect morphometric changes in the superior half of the optic disc [9].…”

Section: Introductionmentioning

confidence: 99%

“…Although visual field asymmetry studies suggested that IOP might contribute to the observed damage in normal-tension glaucoma, this relationship was not valid for all patients [5, 6, 7], and has even been questioned in one study [8]. Such discrepancies might be due to the fact that many normal-tension glaucoma patients with vasospasms might have marked variations in light sensitivity, due to functional alterations, which could mask the asymmetry in organic damage [1, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

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Asymmetry in Intraocular Pressure and Retinal Nerve Fiber Layer Thickness in Normal-Tension Glaucoma

Gugleta

Orgül²

1999

Ophthalmologica

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The etiology of glaucoma is most probably multifactorial. This study intended to investigate the asymmetry in intraocular pressure (IOP) and that in retinal nerve fiber layer (RNFL) thickness in normal-tension glaucoma patients. Two diurnal tension curves, obtained within 3 months and counting at least five IOP readings each, including an early morning IOP measurement upon awaking, were obtained in 15 normal-tension glaucoma patients. None of the patients received IOP-lowering therapy. IOP asymmetry was present in at least three readings and was always in the same direction. The optic nerve was imaged in both eyes in each patient by means of confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph). The interocular difference in RNFL thickness and the RNFL cross-sectional area were correlated with the interocular difference in IOP by means of Spearman’s rank correlation factor. Nine female and 6 male normal-tension glaucoma patients (mean ± SD age was 62.4 ± 16.9 years) were included in this study. Interocular IOP asymmetry varied between 0.30 and 4 mm Hg. Strong negative correlations were found between interocular asymmetry in IOP and interocular asymmetry in RNFL thickness asymmetry (R = –0.652, p = 0.0083) and interocular asymmetry in RNFL cross-sectional area (R = –0.702, p = 0.0034). The present results demonstrate for the first time a more marked thinning of the neuroretinal nerve fiber layer in the eye with the higher IOP in normal-tension glaucoma patients.

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Unequal Intraocular Pressure and Its Relation to Asymmetric Visual Field Defects in Low-tension Glaucoma

Cited by 151 publications

References 6 publications

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

A three-year prospective, randomized and open comparison between latanoprost and timolol in Japanese normal-tension glaucoma patients

Asymmetry in Intraocular Pressure and Retinal Nerve Fiber Layer Thickness in Normal-Tension Glaucoma

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