Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures
Main finding: Lowering intraocular pressure may be beneficial in patients with NTG who are at risk of disease progression
Purpose: To determine if intraocular pressure plays a part in the pathogenic process of normal-tension glaucoma.
Study type: Randomized controlled trial
Condition: Normal Tension Glaucoma
Participants: 20-90yo median IOP ≤ 20 with no reading > 24mmHg with glaucomatous optic neuropathy (disc abnormality and VF defects) with evidence of progression
n=140
Intervention:
Group 1: Systemic carbonic anhydrase inhibitor/trabeculectomy (one eye) – Aim for IOP lowering of 30%
Group 2: observation (fellow eye)
There was a significantly higher rate of glaucomatous optic disc progression or visual field loss in the control (35%) vs treated (12%) eyes
Of 34 cataracts developed during the study, 11 (14%) occurred in the control group and 23 (38%) in the treated group, with the highest incidence in those whose treatment included filtration surgery
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