J Korean Ophthalmol Soc.  2008 Jan;49(1):125-134. 10.3341/jkos.2008.49.1.125.

Intra-individual, Inter-ocular Comparison In Normal Tension Glaucoma with Unilateral Field Loss

Affiliations
  • 1Department of Ophthalmology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea. cwkee@smc.samsung.co.kr

Abstract

PURPOSE: To investigate whether there are differences in ocular risk factors reportedly associated with the development of normal tension glaucoma (NTG) between glaucomatous eyes and normal visual field (VF) eyes of monocular NTG patients.
METHODS
Thirty-six patients who had NTG in one eye and normal RNFL and VF in the fellow eye were included in this hospital-based cross-sectional retrospective survey. We analyzed the difference between glaucomatous eyes and normal VF eyes according to an intra-individual, inter-ocular comparison of ocular parameters, including intraocular pressures (IOP), central corneal thickness (CCT), optic disc size, myopia, optic disc hemorrhage, and zone beta of peripapillary atrophy. Measurements of optic disc size and area and the angular and radial extent of zone beta were obtained using a Heidelberg Retina Tomograph. We also evaluated the correlation of each parameter with mean deviation (MD) and pattern standard deviation (PSD).
RESULTS
There were no inter-ocular differences of IOP, CCT, optic disc size, or myopia (n=36). Optic disc hemorrhage was found in only three glaucomatous eyes. The area of zone beta was greater in glaucomatous eyes than in normal VF eyes (p=0.003). No parameters were correlated with MD or PSD.
CONCLUSIONS
Except for optic disc hemorrhage and zone beta area, all other parameters showed no inter-ocular differences. The asymmetry of disc hemorrhage and zone beta area in monocular NTG patients implies that optic disc ischemia might play a role in the pathogenesis of NTG.

Keyword

Ischemia; Normal tension glaucoma; Optic disc hemorrhage; Zone beta

MeSH Terms

Atrophy
Eye
Hemorrhage
Humans
Intraocular Pressure
Ischemia
Low Tension Glaucoma
Myopia
Retina
Retrospective Studies
Risk Factors
Visual Fields

Cited by  1 articles

Evaluation of Ocular Risk Factors Related to Asymmetric Visual Field Defects in Normal Tension Glaucoma
Jin Ho Yim, Sung Chul Park, Chang Won Kee
J Korean Ophthalmol Soc. 2008;49(9):1507-1514.    doi: 10.3341/jkos.2008.49.9.1507.


Reference

References

1. Shields MB. Textbook of glaucoma. 5th ed.Baltimore: Lippincott Williams & Wilkins;2005. p. 197–207.
2. von Graefe A. Über die Iridectomie bei Galucom und über den glaucomatöusen Prozess. Albrecht von Graefes Arch Ophthalmol. 1857; 3:456–650.
3. Drance S, Anderson DR, Schulzer M. Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol. 2001; 131:699–708.
Article
4. Jun JY, Hwang JH, Park HJ, Uhm KB. Accuracy of optic disc parameters obtained by the Heidelberg Retina Tomograph in the diagnosis of glaucoma. J Korean Ophthalmol Soc. 2004; 45:1503–14.
5. Jonas JB. Clinical implications of peripapillary atrophy in glaucoma. Curr Opin Ophthalmol. 2005; 16:84–8.
Article
6. Ehlers N, Hansen FK. Central corneal thickness in low-tension glaucoma. Acta Ophthalmol. 1974; 52:740–6.
Article
7. Caprioli J, Spaeth GL. Comparison of the optic nerve head in high- and low-tension glaucoma. Arch Ophthalmol. 1985; 103:1145–9.
Article
8. Caprioli J, Spaeth GL. Comparison of visual field defects in the low-tension glaucomas with those in the high-tension glaucomas. Am J Ophthalmol. 1984; 97:730–7.
Article
9. Levene RZ. Low tension glaucoma: a critical review and new material. Surv Ophthalmol. 1980; 24:621–64.
Article
10. Cartwright MJ, Anderson DR. Correlation of asymmetric damage with asymmetric intraocular pressure in normal-tension glaucoma (low-tension glaucoma). Arch Ophthalmol. 1988; 106:898–900.
Article
11. Crichton A, Drance SM, Douglas GR, Schulzer M. Unequal intraocular pressure and its relation to asymmetric visual field defects in low-tension glaucoma. Ophthalmology. 1989; 96:1312–4.
Article
12. Haefliger IO, Hitchings RA. Relationship between asymmetry of visual field defects and intraocular pressure difference in an untreated normal (low) tension glaucoma population. Acta Ophthalmol. 1990; 68:564–7.
Article
13. Shah S, Chatterjee A, Mathai M, et al. Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic. Ophthalmology. 1999; 106:2154–60.
14. Tuulonen A, Airaksinen PJ. Optic disc size in exfoliative, primary open angle, and low-tension glaucoma. Arch Ophthalmol. 1992; 110:211–3.
Article
15. Yang JG, Park KH. A comparison of optic nerve head topography in primary open-angle glaucoma and normal-tension glaucoma in Korean. Korean J Ophthalmol. 1997; 11:79–83.
Article
16. Eid TE, Spaeth GL, Moster MR, Augsburger JJ. Quantitative differences between the optic nerve head and peripapillary retina in low-tension and high-tension primary open-angle glaucoma. Am J Ophthalmol. 1997; 124:805–13.
Article
17. Yamagami J, Araie M, Shirato S. A comparative study of optic nerve head in low- and high-tension glaucomas. Graefes Arch Clin Exp Ophthalmol. 1992; 230:446–50.
Article
18. Park HJ, Choi BG. The quantitative evaluation of optic nerve head of normal tension glaucoma. J Korean Ophthalmol Soc. 2000; 41:1203–9.
19. Iester M, Mikelberg FS. Optic nerve head morphologic characteristics in high-tension and normal-tension glaucoma. Arch Ophthalmol. 1999; 117:1010–3.
Article
20. Jonas JB, Sturmer J, Papastathopoulos KI, et al. Optic disc size and optic nerve damage in normal pressure glaucoma. Br J Ophthalmol. 1995; 79:1102–5.
Article
21. Tomita G, Nyman K, Raitta C, Kawamura M. Interocular asymmetry of optic disc size and its relevance to visual field loss in normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 1994; 232:290–6.
Article
22. Jonas JB, Fernandez MC, Naumann GO. Correlation of the optic disc size to glaucoma susceptibility. Ophthalmology. 1991; 98:675–80.
Article
23. Klein BE, Klein R, Linton KL. Intraocular pressure in an American community. The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1992; 33:2224–8.
24. Jonas JB, Berenshtein E, Holbach L. Lamina cribrosa thickness and spatial relationships between intraocular space and cerebrospinal fluid space in highly myopic eyes. Invest Ophthalmol Vis Sci. 2004; 45:2660–5.
Article
26. Rasker MT, van den Enden A, Bakker D, Hoyng PF. Deterioration of visual fields in patients with glaucoma with and without optic disc hemorrhages. Arch Ophthalmol. 1997; 115:1257–62.
Article
27. Airaksinen PJ, Tuulonen A. Early glaucoma changes in patients with and without an optic disc haemorrhage. Acta Ophthalmol. 1984; 62:197–202.
Article
28. Jonas JB, Xu L. Optic disk hemorrhages in glaucoma. Am J Ophthalmol. 1994; 118:1–8.
Article
29. Miyake T, Sawada A, Yamamoto T, et al. Incidence of disc hemorrhages in open-angle glaucoma before and after trabeculectomy. J Glaucoma. 2006; 15:164–71.
Article
30. Healey PR, Mitchell P, Smith W, Wang JJ. Optic disc hemorrhages in a population with and without signs of glaucoma. Ophthalmology. 1998; 105:216–23.
Article
31. Kitazawa Y, Shirato S, Yamamoto T. Optic disc hemorrhage in low-tension glaucoma. Ophthalmology. 1986; 93:853–7.
Article
32. Heijl A. Frequent disc photography and computerized perimetry in eyes with optic disc haemorrhage. A pilot study. Acta Ophthalmol. 1986; 64:274–81.
33. Derick RJ, Pasquale LR, Pease ME, Quigley HA. A clinical study of peripapillary crescents of the optic disc in chronic experimental glaucoma in monkey eyes. Arch Ophthalmol. 1994; 112:846–50.
Article
34. Buus DR, Anderson DR. Peripapillary crescents and halos in normal-tension glaucoma and ocular hypertension. Ophthalmology. 1989; 96:16–9.
Article
35. Jonas JB, Fernandez MC, Naumann GO. Glaucomatous parapapillary atrophy. Occurrence and correlations. Arch Ophthalmol. 1992; 110:214–22.
36. Park KH, Tomita G, Liou SY, Kitazawa Y. Correlation between peripapillary atrophy and optic nerve damage in normal-tension glaucoma. Ophthalmology. 1996; 103:1899–906.
Article
37. Jonas JB, Naumann GO. Parapapillary chorioretinal atrophy in normal and glaucoma eyes. II. Correlations. Invest Ophthalmol Vis Sci. 1989; 30:919–26.
38. Araie M, Sekine M, Suzuki Y, Koseki N. Factors contributing to the progression of visual field damage in eyes with normal-tension glaucoma. Ophthalmology. 1994; 101:1440–4.
Article
39. Jonas JB, Xu L. Parapapillary chorioretinal atrophy in normal-pressure glaucoma. Am J Ophthalmol. 1993; 115:501–5.
Article
40. Puska P, Harju M, Liebkind R. Peripapillary atrophy in the unilateral exfoliation syndrome. Graefes Arch Clin Exp Ophthalmol. 2004; 242:301–5.
Article
41. Fantes FE, Anderson DR. Clinical histologic correlation of human peripapillary anatomy. Ophthalmology. 1989; 96:20–5.
Article
42. Hayreh SS. The 1994 Von Sallman Lecture. The optic nerve head circulation in health and disease. Exp Eye Res. 1995; 61:259–72.
Article
43. Law SK, Choe R, Caprioli J. Optic disk characteristics before the occurrence of disk hemorrhage in glaucoma patients. Am J Ophthalmol. 2001; 132:411–3.
Article
44. Ahn JK, Kang JH, Park KH. Correlation between a disc hemorrhage and peripapillary atrophy in glaucoma patients with a unilateral disc hemorrhage. J Glaucoma. 2004; 13:9–14.
Article
45. Tezel G, Kass MA, Kolker AE, Wax MB. Comparative optic disc analysis in normal pressure glaucoma, primary open-angle glaucoma, and ocular hypertension. Ophthalmology. 1996; 103:2105–13.
Article
46. Kono Y, Jonas JB, Zangwill L, et al. Agreement of measurement of parapapillary atrophy with confocal scanning laser ophthalmoscopy and planimetry of photographs. J Glaucoma. 1999; 8:105–10.
Article
47. Wang Y, Xu L, Zhang L, et al. Peripapillary atrophy in elderly Chinese in rural and urban Beijing. Eye. 2006.
Article
48. Ramrattan RS, Wolfs RC, Jonas JB, et al. Determinants of optic disc characteristics in a general population: The Rotterdam Study. Ophthalmology. 1999; 106:1588–96.
49. Daugeliene L, Yamamoto T, Kitazawa Y. Risk factors for visual field damage progression in normal-tension glaucoma eyes. Graefes Arch Clin Exp Ophthalmol. 1999; 237:105–8.
Article
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr