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Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management

Normal tension glaucoma (NTG) has similar optic neuropathy as primary open-angle glaucoma (POAG), but intraocular pressure (IOP) is within the normal range. Compared with high-pressure POAG, the development of NTG is possibly a consequence of a complex interaction of several ocular and systemic fact...

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Autor principal: Chen, Mei-Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787092/
https://www.ncbi.nlm.nih.gov/pubmed/33437596
http://dx.doi.org/10.4103/tjo.tjo_30_20
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author Chen, Mei-Ju
author_facet Chen, Mei-Ju
author_sort Chen, Mei-Ju
collection PubMed
description Normal tension glaucoma (NTG) has similar optic neuropathy as primary open-angle glaucoma (POAG), but intraocular pressure (IOP) is within the normal range. Compared with high-pressure POAG, the development of NTG is possibly a consequence of a complex interaction of several ocular and systemic factors. Recent data have shown higher translaminar pressure gradient due to impaired cerebrospinal fluid dynamics may account for the pathogenic mechanism. Insufficient blood supply and vascular dysregulation may also be the cause of the disease. In clinical evaluation, NTG is a diagnosis by excluding other nonglaucomatous optic neuropathies. NTG is characterized by larger and deeper optic-disc cupping, more central visual field defects and a higher incidence of disc hemorrhage compared with POAG. In clinical practice, controlling IOP as low as possible (with medication, laser trabeculoplasty, or surgery) is the key to manage NTG patients. In addition to IOP reduction, the control of systemic risk factors or improving ocular perfusion may be beneficial therapies. NTG is more prevalent in Asia than in the Western countries. Due to increasing old population and underdiagnoses in the clinical settings, NTG became a great challenge for ophthalmologist in Asia. Therefore, the aim of this article is to focus on the epidemiology, to update pathogenesis, diagnosis, and management for NTG.
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spelling pubmed-77870922021-01-11 Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management Chen, Mei-Ju Taiwan J Ophthalmol Review Article Normal tension glaucoma (NTG) has similar optic neuropathy as primary open-angle glaucoma (POAG), but intraocular pressure (IOP) is within the normal range. Compared with high-pressure POAG, the development of NTG is possibly a consequence of a complex interaction of several ocular and systemic factors. Recent data have shown higher translaminar pressure gradient due to impaired cerebrospinal fluid dynamics may account for the pathogenic mechanism. Insufficient blood supply and vascular dysregulation may also be the cause of the disease. In clinical evaluation, NTG is a diagnosis by excluding other nonglaucomatous optic neuropathies. NTG is characterized by larger and deeper optic-disc cupping, more central visual field defects and a higher incidence of disc hemorrhage compared with POAG. In clinical practice, controlling IOP as low as possible (with medication, laser trabeculoplasty, or surgery) is the key to manage NTG patients. In addition to IOP reduction, the control of systemic risk factors or improving ocular perfusion may be beneficial therapies. NTG is more prevalent in Asia than in the Western countries. Due to increasing old population and underdiagnoses in the clinical settings, NTG became a great challenge for ophthalmologist in Asia. Therefore, the aim of this article is to focus on the epidemiology, to update pathogenesis, diagnosis, and management for NTG. Wolters Kluwer - Medknow 2020-07-13 /pmc/articles/PMC7787092/ /pubmed/33437596 http://dx.doi.org/10.4103/tjo.tjo_30_20 Text en Copyright: © 2020 Taiwan J Ophthalmol http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Chen, Mei-Ju
Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title_full Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title_fullStr Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title_full_unstemmed Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title_short Normal tension glaucoma in Asia: Epidemiology, pathogenesis, diagnosis, and management
title_sort normal tension glaucoma in asia: epidemiology, pathogenesis, diagnosis, and management
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787092/
https://www.ncbi.nlm.nih.gov/pubmed/33437596
http://dx.doi.org/10.4103/tjo.tjo_30_20
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