Comparison of Visual Field Progression Rates Among the High Tension Glaucoma, Primary Angle Closure Glaucoma, and Normal Tension Glaucoma

Abstract

PURPOSE. To compare the visual field (VF) progression among high tension glaucoma (HTG), primary angle closure glaucoma (PACG), and normal tension glaucoma (NTG) subjects in routine clinical care. METHODS. All patients had ‡5 VF tests using HFA, 24-2, SITA-standard strategy. We compared the progression between glaucoma subtypes after matching the VFs for baseline severity (mean deviation [MD]) and the age at presentation. Global VF progression was evaluated by linear regression analysis (LRA) of MD. For local VF progression, scotoma expansion (SE) defined as appearance of new scotoma and scotoma deepening (SD) defined by pointwise LRA were calculated. SE and SD were analyzed in three VF zones: superior arcuate (SA), inferior arcuate (IA), and central (C). RESULTS. A total of 310 HTG, 304 PACG, and 165 NTG eyes were included. When VFs were matched by baseline MD, a greater number (n ¼ 20/76) of eyes with HTG showed significant progression compared to PACG (n ¼ 9/76; P ¼ 0.04). The number of progressing eyes were not significantly different between HTG and NTG (n ¼ 11/76; P ¼ 0.10) and between NTG and PACG (P ¼ 0.65). When the baseline VFs were matched by age, the number of eyes showing significant progression were similar in all the subtypes. SA zone in HTG and NTG showed greater SE and SD compared to other zones (P < 0.05), whereas IA zone in PACG showed greater SE and SD compared to other zones (P < 0.05). CONCLUSIONS. In our cohort of treated primary glaucoma with matched baseline severity, a greater proportion of HTG eyes progressed faster compared to PACG. SA zone in HTG and NTG and IA zone in PACG showed greater VF progression.

Relationship between nailfold capillary morphology and retinal thickness and retinal vessel density in primary open‐angle and angle‐closure glaucoma

“…The highest IOP shown in the diurnal IOP curve was used to distinguish NTG (untreated IOP ≤ 21 mmHg) and HTG (untreated IOP > 21 mmHg). Primary angle‐closure glaucoma (PACG) was defined by occludable anterior chamber angles in 2 or more quadrants on gonioscopy with goniosynechiae or elevated IOP with glaucomatous optic nerve head changes at the time of diagnosis (Ballae Ganeshrao et al 2019). Acute angle‐closure glaucoma was not included in this study.…”

“…Some researchers also found that nailfold morphological abnormalities such as haemorrhages and dilated capillaries exist in POAG (Pasquale et al 2015; Cousins et al 2017). Recent publication showed that even IOP under standard clinical care, visual field in both POAG and PACG still progress (Ballae Ganeshrao et al 2019). Consequently, we hypothesize that besides IOP, vascular theory might be participated in pathogenesis of PACG.…”

The Genetic and Endoplasmic Reticulum-Mediated Molecular Mechanisms of Primary Open-Angle Glaucoma

“…Among the above-mentioned factors, an elevated level of IOP constitutes the most common cause of POAG development. As the IOP patients are categorized into high tension glaucoma (HTG) or normal tension glaucoma (NTG) subgroups [38], the NTG constitutes one of the POAG subtypes, comprising a special form of glaucomatous neurodegeneration or glaucomatous optic neuropathy (GON) almost exactly the same as that in POAG, whereas the IOP remains in the normal range, thus it equals 21 mmHg or less [39][40][41]. Most NTG individuals suffer from adult-onset disease, however, the disease may sporadically have early onset with autosomal dominant inheritance [42][43][44].…”

Mouth-nose masks impair the visual field of healthy eyes

“…Visual field can be impaired due to diverse diseases mostly by ocular (e.g. glaucoma [ 1 , 2 ], retinitis pigmentosa [ 3 ], diabetic retinopathy [ 4 ]) and neurological disorders (e.g. stroke [ 5 ], cancer [ 6 ]).…”