Normal tension glaucoma – case report

A. Levi; S. Kostova; A. Toshev; N. Dakov; G. Dimitrova; A. Oscar

doi:10.14748/bro.v64i1.6671

Normal tension glaucoma – case report

A. Levi, S. Kostova, A. Toshev, N. Dakov, G. Dimitrova, A. Oscar

Abstract

Normal tension glaucoma (NTG), reffered to also as low-tension glaucoma, represents a glaucomatous optic neuropathy classified as a type of Primary open angle glaucoma (POAG). It is characterized by a higher tendency of damage to the optic nerve at relatively low levels of intraocular pressure (IOP), as well as asymmetric pathological process in both eyes of the same patient. A number of IOP-independent factors play a significant role in the progression of the disease and often lead to difficulties in diagnosis and optimal therapy in these patients. We report a typical clinical case of a patient with NTG.

Keywords

normal tension glaucoma, hypotension

Full Text

References

Von Graefe A. Uber Die Iridektomie Bei Glaukom. Und Uber den Glaukomatosen Process. Von Graefe‘s Arch Ophthalmol, 1857, 3:456.

Toshev AP, SchusterAK-G, Ul Hassan SN, et al. Optical Coherence Tomography Angiography of Optic Disc in Eyes With Primary Open-angle Glaucoma and Normal-tension Glaucoma. J Glaucoma, 2019;28(3), 243-251. doi:10.1097/ijg.0000000000001184

Fazio P. Optic Disc Topography in Patients With Low-Tension and Primary Open Angle Glaucoma. Arch Ophthalmol, 1990;108(5), 705. doi:10.1001/archopht.1990.01070070091042

Costagliola C, Agnifili L, Mastropasqua L, et al. Low-Tension Glaucoma: An Oxymoron in Ophthalmology. Prev Chronic Dis, 2019 Jan 24;16:E10. doi: 10.5888/pcd16.180534. PMID: 30676934; PMCID: PMC6362709.

Anderson DR. Normal-tension glaucoma (Low-tension glaucoma). Indian J Ophthalmol, 2011 Jan;59 Suppl(Suppl1): S97-101. doi: 10.4103/0301-4738.73695. PMID: 21150042; PMCID: PMC3038511.

Trivli A, Koliarakis I, Terzidou C, et al. Normal-tension glaucoma: Pathogenesis and genetics. Exp Ther Med, 2019 Jan;17(1):563-574. doi: 10.3892/etm.2018.7011. Epub 2018 Nov 26. PMID: 30651837; PMCID: PMC6307418.

Shields MB. Textbook of glaucoma. The University of Michigan: Williams & Wilkins, 1998, 3.

Plange N, Kaup M, Daneljan L, et al. 24-h blood pressure monitoring in normal tension glaucoma: night-time blood pressure variability. J Hum Hyper-tens, 2006;20, 137-142.

Ishida K, Yamamoto T, Kitazawa Y. Clinical factors associated with progression of normal-tension glaucoma. J Glaucoma, 1998 Dec;7(6):372-377.

Ishida K, Yamamoto T, Sugiyama К, et al. Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma. Am J Ophthalmol, 2000, 129(6), 707-714.

Kamal D, Hitchings R. Normal tension glaucoma a practical approach. Br J Ophthalmol, 1998;82:835-840.

Mallick J, Devi L, Malik PK, Mallick J. Update on Normal Tension Glaucoma. J Ophthalmic Vis Res. 2016;11(2):204-8. doi: 10.4103/2008-322X.183914. PMID: 27413503; PMCID: PMC4926570.

Kanski JJ, Bowling B, Nischal K, Pearson R. 7th ed. Edinburgh: Elsevier Saunders; Clinical Ophthalmology: A Systematic Approach, 2011. 346-348.

Shetgar AC, Mulimani MB. The central corneal thickness in normal tension glaucoma, primary open angle glaucoma and ocular hypertension. J Clin Diagn Res, 2013; 7:1063-1067.

Konareva-Kostianeva MI, Atanassov MA. Central corneal thickness in patients with normal-tension glaucoma. Folia Med (Plovdiv), 2007;49(3-4):36-41.

Henry E, Newby DE, Webb DJ, O’Brien C. Peripheral endothelial dysfunction in normal pressure glaucoma. Invest Ophthalmol Vis Sci, 1999; 40:1710-1714.

Nesher R, Kohen R, Shulman S, et al. Diastolic double-product: A new entity to consider in normal-tension glaucoma patients. Isr Med Assoc J, 2012; 14:240-243.

Wax, Martin B, et al. Increased Incidence of Paraproteinemia and Autoantibodies in Patients With Normal-pressure Glaucoma. Am J Ophthalmol, 117(5), 561-568.

Kremmer S, Kreuzfelder E, Klein R, et al. Antiphospha-tidylserine antibodies are elevated in normal tension glaucoma. Clin Exp Immunol, 2001;125(2):211-5. doi: 10.1046/j.1365-2249.2001.01578.x. PMID: 11529911; PMCID: PMC1906120.

Allingham RR, Damji KF, Freedman SF, et al. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins; Shields’ Textbook of Glaucoma, 2010, 180.

Heijl A, Leske MC, Bengtsson B, et al. Early Manifest Glaucoma Trial Group. Reduction of intraocular pressure and glaucoma progression: Results from the early manifest glaucoma trial. Arch Ophthalmol, 2002; 120:1268-1279.

Anderson DR. Collaborative Normal Tension Glaucoma Study. Current Opinion in Ophthalmol, 2003, 14(2), 86-90. doi:10.1097/00055735-200304000-00006.

DOI: http://dx.doi.org/10.14748/bro.v64i1.6671