Treat the patient, not just the eye pressure

Leung, Dexter Y.L.; Kwok, Anthony

doi:10.12809/hkmj144309

Cited by 2 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…139 Time is ripe now for ophthalmologists and patients alike to not only concentrate on managing IOP for the sick eye, but management of the sick body. 140 It is time too for us to reconsider the definition of glaucoma. A vague and perhaps erroneous definition of normality in glaucoma has been with us for an entire generation, which we should perhaps not pass on to our next generation.…”

Section: Discussionmentioning

confidence: 99%

Normal‐tension glaucoma: Current concepts and approaches‐A review

Leung

Tham

2022

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

Normal tension glaucoma (NTG) has remained a challenging disease. We review, from an epidemiological perspective, why we should redefine normality, act earlier at lower pre-treatment intraocular pressure (IOP) level, and the role of ocular perfusion pressures, noting that perfusion is affected by defective vascular bed autoregulation and endothelial dysfunction. The correlation of silent cerebral infarcts (SCI) and NTG may indicate that NTG belongs to a wider spectrum of small vessel diseases (SVD), with its main pathology being also on vascular endothelium. Epidemiological studies also suggested that vascular geometry, such as fractal dimension, may affect perfusion efficiency, occurrence of SCI, SVD and glaucoma. Artificial intelligence with deep learning, may help predicting NTG progression from vascular geometry. Finally, we review latest evidence on the role of minimally-invasive glaucoma surgery, lasers, and newer drugs. We conclude that IOP is not the only modifiable risk factors as, many vascular risk factors are readily modifiable.

show abstract

Section: Discussionmentioning

confidence: 99%