Fuad Ahmad Khan Niazi, Muhammad Afzal Khan Niazi.
Normal-Tension Glaucoma: Identification of Associated Factors
J Rawal Med Coll Jun 2005;9(1):5-11.
Holy Family Hospital and Rawalpindi Medical College, Rawalpindi
Background: Normal-tension glaucoma (NTG) is a primary open-angle glaucoma characterized by intraocular pressure within `normal range`, glaucomatous cupping, retinal nerve fiber` type of visual field loss and no antecedent history of eye disease with raised intraocular pressure. We focused on patterns of presentation, ocular and systemic risk factors, identification of difficulties/ limitations in conducting such a study and comparison with findings of other studies on NTG. Methods: The study was conducted in the Department of Ophthalmology, Rawalpindi Medical College and its allied hospitals, Rawalpindi General Hospital, Holy Family Hospital and District Headquarters Hospital. Subjects for diagnosis of NTG were patients having an untreated IOP 21mmHg at diurnal phasing (at least 8 readings allowing a single IOP reading not > 23 mmHg.), a reproducible visual field defect typical of glaucoma (retinal nerve fiber layer type) and glaucomatous optic nerve head cupping. Interventions included medical treatment with timolol 0.5% or latanoprost or surgical treatment. Main outcome measure was improvement in the visual acuity of the subjects. Results: We found 87.5% subjects had a suspicious glaucomatous cupping, 50% of eyes had splinter hemorrhages, 42.9% of eyes had peri-papillary atrophy and 37.5% of the eyes in the group with none of the two defects showed localized retinal nerve fibre layer (RNFL) defects. Conclusion: An association exists between NTG and splinter hemorrhages, peri-papillary atrophy, and unidirectional cupping. Presence of splinter hemorrhages and peri-papillary atrophy implies a high risk of progressive visual field loss with or without treatment.
Category: Eye
Keywords: Normal Tension Glaucoma. Glaucoma. Intraocular Pressure.
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