Glaucoma, Low Tension Follow-up
- Author: Jacqueline Freudenthal, MD; Chief Editor: Hampton Roy Sr, MD more...
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
Complications
- Permanent loss of vision can occur if low-tension glaucoma is not detected early.
Patient Education
- For excellent patient education resources, visit eMedicine's Glaucoma Center. Also, see eMedicine's patient education articles Normal-Tension Glaucoma, Glaucoma Overview, Glaucoma FAQs, and Understanding Glaucoma Medications.
Kim KCY, Ahn AMD, Seong SGJ. Does redefining of high intraocular pressure (IOP) according to IOP distribution change prevalence of normal tension glaucoma in Korea? [abstract]. World Glaucoma Congress, 2009. Available at http://www.worldglaucoma.org/WGC/WGC2009/index.php. Accessed July 24, 2009.
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].
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.
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.
Su WW, Cheng ST, Hsu TS, Ho WJ. Abnormal flow-mediated vasodilation in normal-tension glaucoma using a noninvasive determination for peripheral endothelial dysfunction. Invest Ophthalmol Vis Sci. Aug 2006;47(8):3390-4. [Medline].
Delaney Y, Walshe TE, O'Brien C. Vasospasm in glaucoma: clinical and laboratory aspects. Optom Vis Sci. Jul 2006;83(7):406-14. [Medline].
Plange N, Kaup M, Remky A, Arend KO. Prolonged retinal arteriovenous passage time is correlated to ocular perfusion pressure in normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol. Aug 2008;246(8):1147-52. [Medline].
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].
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].
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].
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.
[Guideline] Screening for glaucoma: recommendation statement. US Preventive Services Task Force. National Guideline Clearinghouse. Mar 2005.
[Guideline] Primary open-angle glaucoma. American Academy of Ophthalmology. National Guideline Clearinghouse. 2005.
[Guideline] Comprehensive adult eye and vision examination. American Optometric Association. National Guideline Clearinghouse. 2005.
Orgul S, Zawinka C, Gugleta K, Flammer J. Therapeutic strategies for normal-tension glaucoma. Ophthalmologica. Nov-Dec 2005;219(6):317-23. [Medline].
Cheng JW, Cai JP, Wei RL. Meta-analysis of medical intervention for normal tension glaucoma. Ophthalmology. Jul 2009;116(7):1243-9. [Medline].
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].
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.
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].
Fraunfelder FT, Roy FH. Current Ocular Therapy. Philadelphia: WB Saunders; 2000:488-9.
Hitchings RA. Low tension glaucoma--its place in modern glaucoma practice. Br J Ophthalmol. Aug 1992;76(8):494-6. [Medline].
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].
Stewart WC, Reid KK. Incidence of systemic and ocular disease that may mimic low-tension glaucoma. J Glaucoma. 1992;1:27-31.
Werner E. Progressive normal-tension glaucoma. I. Analysis. J Glaucoma. Dec 1996;5(6):422-6. [Medline].
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.

