Normal-tension Glaucoma and Ne rve Fiber Layer Atrophy

Kim, Mee Kum; Park, Ki Ho; Kim, Dong Myung

Abstract

We investigated differences in clinical findings among normal-tension glaucoma(NTG)patients between those with wedge-shaped nerve fiber layer(NFL)defect and with diffuse atrophy. Forty-one eyes of patients with NTG having diurnal intraocular pressure < 21mmHg, glaucomatous visual field defect, optic disc analysis with Heidelberg Retina Tomograph(HRT), and brain magnetic resonance imaging were divided into wedge-shaped defect group and diffuse atrophy group according to the types of NFL atrophy. We found no difference between two groups in the mean deviation of visual field, area of peripapillary atrophy measured with HRT, and presence of peripapillary atrophy. The patients with diffuse atrophy were older than those with wedge-shaped defect(p=0.01). The intraocular pressure was slightly higher (p=0.02)and maximal cup depth was larger(p=0.03)in patients with wedge-shaped defect compared with diffuse atrophy. Cerebral small vessel disease was more frequent in patients with diffuse atrophy than with wedge-shaped defect(p=0.02). This study suggests that cerebral small vessel disease is more common in patients with diffuse atrophy and potentially suggests indirectly ischemia may cause more diffuse damage than localized damage in patients with NTG.