Glaucoma, Low Tension Follow-up

  • Author: Jacqueline Freudenthal, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jan 29, 2010
 

Further Outpatient Care

  • After obtaining baseline optic disc photos and/or analysis and visual fields, patients should receive regular follow-up care (ie, every 6 mo) to monitor for progression of low-tension glaucoma (LTG).
  • Evaluate risk factors for defective visual-field progression linked to the following 4 independent predictive factors determined by the Canadian Glaucoma Study[18] :
    • Abnormal anticardiolipin antibody level
    • Higher mean intraocular pressure (IOP) at follow up
    • Higher baseline age
    • Female sex
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Complications

  • Permanent loss of vision can occur if low-tension glaucoma is not detected early.
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Patient Education

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Contributor Information and Disclosures
Author

Jacqueline Freudenthal, MD  Co-Investigator, Ophthalmic Consultants Centre, Toronto

Jacqueline Freudenthal, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, and Canadian Ophthalmological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Iqbal Ike K Ahmed, MD, FRCSC  Clinical Assistant Professor, Department of Ophthalmology, University of Utah

Iqbal Ike K Ahmed, MD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Canadian Ophthalmological Society, and Ontario Medical Association

Disclosure: Nothing to disclose.

Baseer U Khan, MD  Staff Physician, Department of Ophthalmology, University of Toronto, Canada

Baseer U Khan, MD is a member of the following medical societies: Canadian Ophthalmological Society

Disclosure: Nothing to disclose.

Khalid Hasanee, MD  Glaucoma and Anterior Segment Fellow, Department of Ophthalmology, University of Toronto

Khalid Hasanee, MD is a member of the following medical societies: Canadian Medical Association, Canadian Ophthalmological Society, and Ontario Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Neil T Choplin, MD  Adjunct Clinical Professor, Department of Surgery, Section of Ophthalmology, Uniformed Services University of Health Sciences

Neil T Choplin, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Association for Research in Vision and Ophthalmology, and California Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Martin B Wax, MD  Clinical Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Ophthalmology Research and Development, Head, Ophthalmology Discovery Research, Alcon Labs, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Society for Neuroscience

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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  2. Caprioli J, Coleman AL. Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology. Jul 2008;115(7):1123-1129.e3. [Medline].

  3. Paul T, Radcliffe N, Shimmio M. Reclassification of normal and high tension glaucoma eyes using corneal compensated IOP [abstract]. World Glaucoma Congress, 2009. Available at http://www.worldglaucoma.org/WGC2009/. Accessed July 28, 2009.

  4. Akopov E, Astakhov Y, Nefedova D. Retinal vessels calibrometry in normal pressure glaucoma evaluation [abstract]. World Glaucoma Congress, 2009. Available at http://www.worldglaucoma.org/WGC/WGC2009/index.php. Accessed July 28, 2009.

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  8. Harris A, Siesky B, Zarfati D, et al. Relationship of cerebral blood flow and central visual function in primary open-angle glaucoma. J Glaucoma. Jan 2007;16(1):159-63. [Medline].

  9. Chauhan BC, Mikelberg FS, Balaszi AG, LeBlanc RP, Lesk MR, Trope GE. Canadian Glaucoma Study: 2. risk factors for the progression of open-angle glaucoma. Arch Ophthalmol. Aug 2008;126(8):1030-6. [Medline]. [Full Text].

  10. Asano E, Mochizuki K, Sawada A, Nagasaka E, Kondo Y, Yamamoto T. Decreased nasal-temporal asymmetry of the second-order kernel response of multifocal electroretinograms in eyes with normal-tension glaucoma. Jpn J Ophthalmol. Sep-Oct 2007;51(5):379-89. [Medline].

  11. Michelson G, Waerntges S, Engelhorn T, Doerfler A. Reduced optic radiation volume measured by DTI is correlated by arterial hypertension in normal tension glaucoma [abstract]. World Glaucoma Congress, 2009. Available at http://www.worldglaucoma.org/WGC/WGC2009/index.php. Accessed July 28,2009.

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  16. Cheng JW, Cai JP, Wei RL. Meta-analysis of medical intervention for normal tension glaucoma. Ophthalmology. Jul 2009;116(7):1243-9. [Medline].

  17. Netland PA, Chaturvedi N, Dreyer EB. Calcium channel blockers in the management of low-tension and open-angle glaucoma. Am J Ophthalmol. May 15 1993;115(5):608-13. [Medline].

  18. Takako Nakagami, Yoshio Yamazaki, Fukuko Hayamizu. Prognostic Factors for Progression of Visual Field Damage in Patients with Normal-Tension Glaucoma. Japanese Journal of Ophthalmology. January, 2006;Volume 50, Number 1:38-42.

  19. Abedin S, Simmons RJ, Grant WM. Progressive low-tension glaucoma: treatment to stop glaucomatous cupping and field loss when these progress despite normal intraocular pressure. Ophthalmology. Jan 1982;89(1):1-6. [Medline].

  20. Fraunfelder FT, Roy FH. Current Ocular Therapy. Philadelphia: WB Saunders; 2000:488-9.

  21. Hitchings RA. Low tension glaucoma--its place in modern glaucoma practice. Br J Ophthalmol. Aug 1992;76(8):494-6. [Medline].

  22. Kawabata K, Kimura T, Fujiki K, Murakami A. [Ocular pulse amplitude in patients with open-angle glaucoma, normal-tension glaucoma, and ocular hypertensionby dynamic observing tonometry]. Nippon Ganka Gakkai Zasshi. Dec 2007;111(12):946-52. [Medline].

  23. Stewart WC, Reid KK. Incidence of systemic and ocular disease that may mimic low-tension glaucoma. J Glaucoma. 1992;1:27-31.

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  25. ²Kurtz S, Haber I, Kesler A. Corneal Thickness Measurements in Normal-tension Glaucoma Workups: Is It Worth the Effort?. J Glaucoma. Apr 15 [Epub ahead of print] 2009.

 
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