Normal Versus High Tension Glaucoma: a Comparison of Functional and Structural Defects

Overview

Journal J Glaucoma

Date 2009 Feb 19

PMID 19223786

Citations 30

Authors

Oraorn Thonginnetra

Vivienne C Greenstein

David Chu

Jeffrey M Liebmann

Robert Ritch

Donald C Hood

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare visual field defects obtained with both multifocal visual evoked potential (mfVEP) and Humphrey visual field (HVF) techniques to topographic optic disc measurements in patients with normal tension glaucoma (NTG) and high tension glaucoma (HTG).

Methods: We studied 32 patients with NTG and 32 with HTG. All patients had reliable 24-2 HVFs with a mean deviation of -10 dB or better, a glaucomatous optic disc and an abnormal HVF in at least 1 eye. Multifocal VEPs were obtained from each eye and probability plots created. The mfVEP and HVF probability plots were divided into a central 10-degree radius and an outer arcuate subfield in both superior and inferior hemifields. Cluster analyses and counts of abnormal points were performed in each subfield. Optic disc images were obtained with the Heidelberg Retina Tomograph III. Eleven stereometric parameters were calculated. Moorfields regression analysis and the glaucoma probability score were performed.

Results: There were no significant differences in mean deviation and pattern standard deviation values between NTG and HTG eyes. However, NTG eyes had a higher percentage of abnormal test points and clusters of abnormal points in the central subfields on both mfVEP and HVF than HTG eyes. For Heidelberg Retina Tomograph III, there were no significant differences in the 11 stereometric parameters or in the Moorfields regression analysis and glaucoma probability score analyses of the optic disc images.

Conclusions: The visual field data suggest more localized and central defects for NTG than HTG.

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References

LEVENE R . Low tension glaucoma: a critical review and new material. Surv Ophthalmol. 1980; 24(6):621-64. DOI: 10.1016/0039-6257(80)90123-x. View

Eid T, Spaeth G, Moster M, Augsburger J . 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(6):805-13. DOI: 10.1016/s0002-9394(14)71698-8. View

Graham S, Klistorner A, Goldberg I . Clinical application of objective perimetry using multifocal visual evoked potentials in glaucoma practice. Arch Ophthalmol. 2005; 123(6):729-39. DOI: 10.1001/archopht.123.6.729. View

. Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group. Am J Ophthalmol. 1998; 126(4):487-97. DOI: 10.1016/s0002-9394(98)00223-2. View

Hood D, Greenstein V . Multifocal VEP and ganglion cell damage: applications and limitations for the study of glaucoma. Prog Retin Eye Res. 2003; 22(2):201-51. DOI: 10.1016/s1350-9462(02)00061-7. View

Gloster J . Incidence of optic disc haemorrhages in chronic simple glaucoma and ocular hypertension. Br J Ophthalmol. 1981; 65(7):452-6. PMC: 1039548. DOI: 10.1136/bjo.65.7.452. View

Kiriyama N, Ando A, Fukui C, Nambu H, Nishikawa M, Terauchi H . A comparison of optic disc topographic parameters in patients with primary open angle glaucoma, normal tension glaucoma, and ocular hypertension. Graefes Arch Clin Exp Ophthalmol. 2003; 241(7):541-545. DOI: 10.1007/s00417-003-0702-0. View

Chauhan B, Drance S, Douglas G, Johnson C . Visual field damage in normal-tension and high-tension glaucoma. Am J Ophthalmol. 1989; 108(6):636-42. DOI: 10.1016/0002-9394(89)90854-4. View

Yamazaki Y, Koide C, Miyazawa T, Kuwagaki N, Yamada H . Comparison of retinal nerve-fiber layer in high- and normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 1991; 229(6):517-20. DOI: 10.1007/BF00203313. View

10.

Ferreras A, Pajarin A, Polo V, Larrosa J, Pablo L, Honrubia F . Diagnostic ability of Heidelberg Retina Tomograph 3 classifications: glaucoma probability score versus Moorfields regression analysis. Ophthalmology. 2007; 114(11):1981-7. DOI: 10.1016/j.ophtha.2007.01.015. View

11.

Kremmer S, Kreuzfelder E, Klein R, Bontke N, Steuhl K, Grosse-Wilde H . Antiphosphatidylserine antibodies are elevated in normal tension glaucoma. Clin Exp Immunol. 2001; 125(2):211-5. PMC: 1906120. DOI: 10.1046/j.1365-2249.2001.01578.x. View

12.

Cartwright M, Grajewski A, Friedberg M, Anderson D, RICHARDS D . Immune-related disease and normal-tension glaucoma. A case-control study. Arch Ophthalmol. 1992; 110(4):500-2. DOI: 10.1001/archopht.1992.01080160078035. View

13.

Caprioli J, Spaeth G . Comparison of visual field defects in the low-tension glaucomas with those in the high-tension glaucomas. Am J Ophthalmol. 1984; 97(6):730-7. DOI: 10.1016/0002-9394(84)90505-1. View

14.

Drance S . Disc hemorrhages in the glaucomas. Surv Ophthalmol. 1989; 33(5):331-7. DOI: 10.1016/0039-6257(89)90010-6. View

15.

Javitt J, Spaeth G, Katz L, Poryzees E, Addiego R . Acquired pits of the optic nerve. Increased prevalence in patients with low-tension glaucoma. Ophthalmology. 1990; 97(8):1038-43; discussion 1043-4. DOI: 10.1016/s0161-6420(90)32466-1. View

16.

Thienprasiddhi P, Greenstein V, Chen C, Liebmann J, Ritch R, Hood D . Multifocal visual evoked potential responses in glaucoma patients with unilateral hemifield defects. Am J Ophthalmol. 2003; 136(1):34-40. DOI: 10.1016/s0002-9394(03)00080-1. View

17.

Iester M, Mikelberg F . Optic nerve head morphologic characteristics in high-tension and normal-tension glaucoma. Arch Ophthalmol. 1999; 117(8):1010-3. DOI: 10.1001/archopht.117.8.1010. View

18.

Araie M, Yamagami J, Suziki Y . Visual field defects in normal-tension and high-tension glaucoma. Ophthalmology. 1993; 100(12):1808-14. DOI: 10.1016/s0161-6420(93)31394-1. View

19.

Kitazawa Y, Shirato S, Yamamoto T . Optic disc hemorrhage in low-tension glaucoma. Ophthalmology. 1986; 93(6):853-7. DOI: 10.1016/s0161-6420(86)33658-3. View

20.

De Leon-Ortega J, Sakata L, Monheit B, McGwin Jr G, Arthur S, Girkin C . Comparison of diagnostic accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to discriminate glaucomatous and nonglaucomatous eyes. Am J Ophthalmol. 2007; 144(4):525-32. PMC: 3928044. DOI: 10.1016/j.ajo.2007.06.021. View