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Chonnam Med J 2021 May 24;57(2):144-151. Epub 2021 May 24.

Department of Ophthalmology, Chonnam National University Hospital, Gwangju, Korea.

To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. Read More

Graefes Arch Clin Exp Ophthalmol 2021 Apr 30. Epub 2021 Apr 30.

Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.

Purpose: To investigate how the central visual field would be changed after fornix-based trabeculectomy with mitomycin C in Japanese normal-tension glaucoma (NTG) patients monitored for more than 10 years including before surgery.

Methods: This is a retrospective cohort study. We identified twenty-eight eyes of 28 NTG cases regularly monitored for more than 5 years and examined static visual field (VF) tests for more than five times before and after fornix-based trabeculectomy (including combined surgery). Read More

PLoS One 2021 15;16(4):e0250085. Epub 2021 Apr 15.

Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.

Purpose: To investigate the association between peripheral vasospasm and the visual field (VF) progression rate in patients with normal-tension glaucoma (NTG) with low-teen intraocular pressure (IOP).

Methods: The finger temperature of 113 NTG patients was measured before and after exposure to ice water using a Temperature gun (cold pressor test). These patients had confirmed VF progression, despite a low-teen IOP during a follow-up period of >5 years. Read More

Chin Med J (Engl) 2021 Mar 31;134(9):1087-1092. Epub 2021 Mar 31.

Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China.

Background: Normal tension glaucoma (NTG) is a less pressure-dependent type of glaucoma with characteristic optic neuropathy. Recently, the biomechanical mechanism has been thought to account for glaucomatous optic neuropathy to some degree. We intended to compare dynamic corneal response parameters (DCRs) among patients with primary open-angle glaucoma with normal tension or hypertension and controls. Read More

Zhonghua Yan Ke Za Zhi 2021 Mar;57(3):228-231

Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China.

The study aimed to introduce a new analysis method of 24-hour intraocular pressure (IOP) and to propose the concept of overall IOP. Data of 24-hour IOP of a patient with a confirmed diagnosis of normal tension glaucoma was selected. Based on the present indexes including peak IOP, trough IOP, maximum difference, and mean IOP, new indexes were proposed, which included main IOP, duration of main IOP, and rate of IOP increase. Read More

Clin Ophthalmol 2021 9;15:453-460. Epub 2021 Feb 9.

The Comparative Health Outcomes, Policy and Economics (CHOICE) Institute, University of Washington, Seattle, WA, USA.

Purpose: To estimate the healthcare resource utilization (HCRU) and costs for patients with normal tension glaucoma (NTG) as well as their payers across various levels of disease severity.

Patients And Methods: Our study was a retrospective cohort study of 6330 US NTG patients. Patients were enrolled if they were 40 years or older and had two or more qualifying NTG diagnoses within the enrollment period, October 1st, 2015 to December 31st, 2017. Read More

Jpn J Ophthalmol 2021 Mar 16;65(2):295-305. Epub 2021 Feb 16.

Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To assess the 12-month efficacy and safety of fixed-combination brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT) with or without bimatoprost 0. Read More

Taiwan J Ophthalmol 2020 Oct-Dec;10(4):250-254. Epub 2020 Jul 13.

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.

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. Read More

Korean J Ophthalmol 2020 12 3;34(6):425-431. Epub 2020 Dec 3.

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice.

Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Read More

Medicina (Kaunas) 2020 Nov 30;56(12). Epub 2020 Nov 30.

Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania.

Glaucoma is a progressive optic neuropathy in which the optic nerve is damaged. The optic nerve is exposed not only to intraocular pressure (IOP) in the eye, but also to intracranial pressure (ICP), as it is surrounded by cerebrospinal fluid in the subarachnoid space. Here, we analyse ICP differences between patients with glaucoma and healthy subjects (HSs). Read More

J Clin Med 2020 Nov 26;9(12). Epub 2020 Nov 26.

Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea.

The purpose of this study was to investigate the function of the renin-angiotensin-aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were included in this study. Renin and AngII were measured in the blood samples of all subjects by enzyme-linked immunosorbent assay (ELISA). Read More

Transl Vis Sci Technol 2020 11 5;9(2):58. Epub 2020 Nov 5.

Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.

Purpose: To develop and assess an automatic procedure for classifying and staging glaucomatous vascular damage based on optical coherence tomography angiography (OCTA) imaging.

Methods: OCTA scans (Zeiss Cirrus 5000 HD-OCT) from a random eye of 39 healthy subjects and 82 glaucoma patients were used to develop a new classification algorithm based on multilayer and multisector information. The averaged circumpapillary retinal nerve fiber layer (RNFL) thickness was also collected. Read More

J Med Case Rep 2020 Nov 19;14(1):224. Epub 2020 Nov 19.

Hospital Jerez de la Frontera, Ronda de Circunvalación, Jerez de la Frontera, 11407, Cádiz, Spain.

Introduction: Normal-tension glaucoma is known as a multifactorial optic neuropathy. A number of lines of evidence suggested that vascular factors played a significant role in the development of normal-tension glaucoma. The mechanisms underlying the abnormal ocular blood flow in normal-tension glaucoma are still not clear. Read More

Sci Rep 2020 11 5;10(1):19222. Epub 2020 Nov 5.

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.

Microcirculatory insufficiency has been hypothesized in glaucoma pathogenesis. There is a scarcity of data to comprehensively examine the changes in retinal microvasculature and its role in normal tension glaucoma (NTG). We conducted a cross-sectional case-control study and included 168 eyes from 100 NTG patients and 68 healthy subjects. Read More

Sci Rep 2020 11 4;10(1):19042. Epub 2020 Nov 4.

Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Gyeongsang National University, School of Medicine, 11 Samjeongja-ro, Seongsan-gu, Changwon, Gyeongsangnam-do, 51472, Republic of Korea.

We aimed to classify early normal-tension glaucoma (NTG) and glaucoma suspect (GS) using Bruch's membrane opening-minimum rim width (BMO-MRW), peripapillary retinal nerve fiber layer (RNFL), and the color classification of RNFL based on a deep-learning model. Discriminating early-stage glaucoma and GS is challenging and a deep-learning model may be helpful to clinicians. NTG accounts for an average 77% of open-angle glaucoma in Asians. Read More

J Neuroophthalmol 2020 Oct 27. Epub 2020 Oct 27.

Department of Ophthalmology and Vision Sciences (JAM, EAM), University of Toronto, Toronto, Canada; Division of Neurology, Department of Medicine (JAM, EAM), University of Toronto, Toronto, Canada; and Kensington Vision and Research Centre (JAM), Toronto, Canada.

Background: To determine whether significant compression of the optic nerve by the internal carotid artery (ICA) can produce an optic neuropathy with optic disc cupping that resembles glaucoma in patients without elevated intraocular pressure (IOP).

Methods: This was a retrospective case series of patients referred to neuro-ophthalmology for a possible nonglaucomatous optic neuropathy. Patients were included in the study if they had preserved visual acuity, optic disc-related visual field defects, optic nerve cupping, IOP less than 21 mm Hg, open angles, and unequivocal radiological compression of the ipsilateral optic nerve by an intracranial blood vessel. Read More

Cesk Slov Oftalmol 2020 ;76(3):120-123

Aims: To investigate the dependence of blood vessel density and velocity in ophthalmic artery and arteria centralis retinae of the same eye in patients with normotensive glaucoma.

Methods: The sample consisted of 20 patients with normotensive glaucoma (NTG). There were 17 women (mean age 56. Read More

Korean J Ophthalmol 2020 10 5;34(5):353-360. Epub 2020 Oct 5.

Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.

Purpose: To explore the clinical characteristics and profiles of newly diagnosed glaucoma subtypes in urban Korea.

Methods: All newly diagnosed glaucoma patients enrolled in the participating ophthalmology outpatient clinics were included. A review of medical history including family history of glaucoma was conducted. Read More

Korean J Ophthalmol 2020 10 5;34(5):347-352. Epub 2020 Oct 5.

Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Purpose: To evaluate the effects of each subgroup of prostaglandin analogues (PGAs) on central corneal thickness (CCT) in patients with normal tension glaucoma (NTG).

Methods: We retrospectively reviewed 55 eyes of 55 patients with NTG who were receiving PGA therapy. Patients who were treated with 0. Read More

Eur J Ophthalmol 2020 Oct 23:1120672120965469. Epub 2020 Oct 23.

Department of Ophthalmology, Dünyagöz Ataköy Hospital, Istanbul, Turkey.

Purpose: To investigate the effect of capsular tension rings (CTRs) on postoperative refractive results in patients with pseudoexfoliation (PSX) syndrome.

Materials And Methods: Sixty-nine patients with PSX syndrome who had uncomplicated cataract surgery between March 2016 and February 2019 were reviewed retrospectively. The patients were divided into two groups. Read More

Vestn Oftalmol 2020 ;136(6):57-64

Research Institute of Eye Diseases, Moscow, Russia.

Glaucoma is a chronic progressive optic neuropathy that causes irreversible loss of visual functions. From the clinical point of view, normal-tension glaucoma (NTG) is regarded in Russian taxonomy as a clinical form of standard primary open-angle glaucoma in which the IOP values stay within the normal range, but the typical progressive visual functions loss is still present. The results of the latest studies put in question the traditional views of NTG pathophysiology that are based solely on intraocular pressure values. Read More

Respir Res 2020 Oct 8;21(1):258. Epub 2020 Oct 8.

Sleep Medicine Center, Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center of the University of Mainz, 55131, Mainz, Germany.

Background: Both glaucoma and obstructive sleep apnea (OSA) are widespread diseases. OSA may presumably partly cause or worsen glaucoma, although the etiopathogenesis is unclear. Here we analyze for the first time the possible association between different glaucoma phenotypes and OSA. Read More

Am J Ophthalmol Case Rep 2020 Dec 28;20:100947. Epub 2020 Sep 28.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA.

Purpose: To provide the first report of effective use of bilateral XEN Gel Stent implantation using an ab externo open-conjunctival approach designed to improve bleb function and meet the uniquely low intraocular pressure requirements of a Japanese patient with normal-tension glaucoma refractory to topical medical therapy.

Observations: A 54-year-old phakic Japanese woman with severe normal-tension glaucoma on maximally tolerated medical therapy of four topical agents presented with above-goal intraocular pressures and new medication intolerances. She underwent bilateral ab externo open-conjunctival XEN Gel Stent implantation with tenectomy and sub-Tenon's injection of 40μg of mitomycin-C, which resulted in reduction of intraocular pressures by 41. Read More

PLoS One 2020 2;15(10):e0240109. Epub 2020 Oct 2.

Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

Purpose: To compare the properties of the lamina cribrosa (LC) and the peripapillary vessel density between branch retinal vein occlusion (BRVO) and normal-tension glaucoma (NTG), using swept-source optical coherence tomography and optical coherence tomography angiography.

Methods: This retrospective study included 21 eyes of 21 patients with BRVO and 43 eyes of 43 patients with NTG who were treated from June 2016 to September 2017. The anterior LC depth (ALCD) and LC thickness (LCT) at the mid-superior, central, and mid-inferior levels; the mean difference in ALCD; and the peripapillary vessel density in the superficial and deep capillary plexuses and the choriocapillaris were compared between groups. Read More

Biomed Res Int 2020 18;2020:9093206. Epub 2020 Aug 18.

Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Lublin, Poland.

Aim: The aim of the study was to determine the frequency of pathologies which can mimic normal-tension glaucoma (NTG), observed in neuroimaging of NTG patients, and to evaluate the frequency of pathologies in determined additional indications for neuroimaging. . The studied group consisted of 126 NTG patients who met at least one of the following criteria: unilateral NTG, damage in the visual field (VF) inconsistent with optic disc appearance, fast VF progression, worsening of visual acuity, predominant optic disc pallor rather than optic disc excavation, diagnosis under the age of 50, and scotoma in VF restricted by a vertical line. Read More

Exp Eye Res 2020 11 6;200:108220. Epub 2020 Sep 6.

Department of Ophthalmology, Shamir Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Matlow's Ophthalmo-genetic Laboratory, Department of Ophthalmology, Shamir Medical Center, Israel.

Our study describes the glaucoma phenotype in a family with Axenfeld-Rieger syndrome (ARS) and a FOXC1 variant. Included were 20 subjects from a large three generation family of Jewish Indian ancestry. Subjects underwent a comprehensive ophthalmic examination including automated perimetry and optical coherence tomography. Read More

Br J Ophthalmol 2020 Sep 5. Epub 2020 Sep 5.

Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of).

Background/aims: To investigate clinical characteristics and risk factors for glaucoma conversion of the contralateral eye in unilateral normal-tension glaucoma (NTG) patients.

Methods: A retrospective observational cohort study was conducted on a total of 76 subjects who had been diagnosed with unilateral NTG at the baseline and followed up for more than 5 years. Glaucoma conversion in the contralateral eye was defined as increased thinning of neuro-retinal rim, development of retinal nerve fibre layer defect and/or development of glaucomatous visual field defect. Read More

Expert Opin Pharmacother 2020 Dec 24;21(18):2225-2230. Epub 2020 Aug 24.

Wills Eye Hospital, Glaucoma Research Center , Philadelphia, PA, USA.

Introduction: Treatment of glaucoma and systemic hypertension requires careful balancing of ophthalmic and systemic medications. This report offers background on various common therapies and considerations to minimize undesirable systemic and ophthalmic outcomes.

Areas Covered: Key considerations relating to medical treatments for systemic hypertension and glaucoma chosen from a review of the literature are included. Read More

Biochem Biophys Res Commun 2020 09 30;529(4):943-949. Epub 2020 Jul 30.

Laboratory of Molecular Neuroscience, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan; The Center for Brain Integration Research, Tokyo Medical and Dental University (TMDU), Tokyo, Japan. Electronic address:

Glaucoma is one of the leading causes of blindness characterized by progressive loss of retinal ganglion cells (RGCs) and their axons. We reported that glutamate/aspartate transporter (GLAST) knockout mice showed progressive RGC loss and optic nerve degeneration that are similar to glaucoma. To explore the possibility that rare variants in the EAAT1 gene (the human homolog of GLAST) cause susceptibility to glaucoma, we performed targeted sequencing of EAAT1 in 440 patients with glaucoma and 450 control subjects. Read More