Low-Tension Glaucoma

Updated: Jun 16, 2016
  • Author: Mitchell V Gossman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Background

Low-tension glaucoma (LTG) is a chronic optic neuropathy that affects adults. Its features parallel primary open-angle glaucoma (POAG), including characteristic optic disc cupping and visual-field loss, with the exception of a consistently normal intraocular pressure (IOP), ie, less than 22 mm Hg. [1] Although the upper limit of "normal" is fuzzy and arbitrary, cases of low-tension glaucoma tend not to be with truly low pressures but rather with pressures considered to be in the moderate or upper-normal range, however "normal" is defined.

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Pathophysiology

Low-tension glaucoma is an optic neuropathy with chronic loss of retinal ganglion cells (RGC) due to a genetic hypersensitivity to IOP. Low-tension glaucoma also is due to vascular factors, including vasospasm and ischemia.

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Epidemiology

Frequency

United States

Up to 15-25% of patients with POAG experience low-tension glaucoma. According to the Baltimore Eye Study, 50% of individuals with glaucomatous disc and visual-field changes had an IOP of less than 21 mm Hg on a single visit, and 33% had an IOP of less than 21 mm Hg on 2 measurements.

International

The prevalence of low-tension glaucoma is higher in Japan and Korea. [2]

Mortality/Morbidity

Loss of peripheral vision is associated with low-tension glaucoma.

Race

The prevalence of low-tension glaucoma is higher in Japan and Korea. [2]

Sex

Low-tension glaucoma is more common in females than in males.

Age

The mean age of patients with low-tension glaucoma is 60 years; they typically are older than patients with POAG.

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