Long-term clinical course of normal-tension glaucoma: 20 years of experience

Purpose. the purpose of this study was to investigate the long-term clinical course of ntg patients who initiated intraocular pressure- (iop-) lowering therapy. methods. the present study included 72 normal-tension glaucoma (ntg) patients. the mean deviation (md) was measured with visual fields. nocturnal hypotension with weighted standard deviation (wsd) was determined by 24-hour ambulatory blood pressure monitoring. to identify risk factors for ntg progression,linear logistic regression analysis was employed. results. the mean follow-up period was 21.2 ± 1.1 years. the mean md progression rate was -0.28 ± 0.24 db/year. the mean ocular perfusion pressure (opp) was 52.1 ± 5.9 mmhg. the mean wsd was 14.5 ± 2.2. in the univariate model,disc hemorrhage (rr 7.12; p=0.004),iop reduction rate (rr 2.12; p=0.045),and opp (rr 1.94; p=0.027) were associated with glaucomatous visual field progression. however,in the multivariate model,the iop reduction rate (rr 2.45; p=0.048) and opp (rr 2.02; p=0.004) were detected to be significant factors associated with progression. conclusions. the mean rate of visual field progression was -0.28 db/year in ntg patients treated with medical therapy. the iop reduction rate and opp were associated with glaucomatous visual field progression. © 2017 sang wook jin and seung yoon noh.