Changes in Visual Fields in Normotensive Glaucoma

Abstract

To find the effect of prostaglandins and beta blockers on medium-term progression of changes of visual fields in normotensive glaucoma in a retrospective study. We evaluated three groups of patients with normotensive glaucoma (NTG). The first group consisted of 28 eyes of 14 patients (8 females and 6 males) of mean age 59 years (37-75 years) who were treated with prostaglandins. The second group consisted of 20 eyes of 10 patients (5 females and 5 males) of mean age 64 years (52-79 years) who were treated with beta blockers. The third group consisted of 36 eyes of 18 patients (8 females and 10 males) of mean age 57 years (33-75 years) who underwent no ophthalmological therapy. All patients were compensated for cardiovascular status and had no other internal or neurological disease. Visual acuity was 1.0 with a possible correction (less than 3 dioptres) in all patients.If hypotensive ophthalmological therapy was initiated, it had remained stable for the last five years. In all patients, central corneal thickness (CCT), excavation of the optic nerve papilla (c/d), ganglion cell complex (GCC), retinal nerve fiber thickness (RNFL), pupillary defect (PD) and overall defect (OD) of visual field were monitored by us. Statistical analysis found the highest progression of changes in the visual fields (PD) in patients without therapy (p=0.0001) and in patients treated with prostaglandins (p=0.04). In patients who were treated with beta blockers, the progression of changes in the visual fields was statistically significant (p=0.7). We did not find a statistically significant progression in any group. The correlation analysis found the highest correlation with GCC in PD (r=0.33; p=0.44). We did not find any correlation between the evaluated parameters in OD. Our results show that therapy with beta blockers is more convenient for NTG, compared to prostaglandins or no topical therapy. All patients were compensated for cardiovascular status and had no