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Related Experiment Video

Updated: Feb 26, 2026

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Real-world management patterns and outcomes in normal-tension glaucoma.

Aparna Rao1, Pallavi Ray

  • 1Glaucoma Service, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.

Indian Journal of Ophthalmology
|February 25, 2026
PubMed
Summary

Real-world normal-tension glaucoma (NTG) treatment shows significant visual field progression in 22.2% of treated eyes. Current clinical factors do not predict progression, necessitating research into novel risk factors for managing NTG.

Keywords:
Absolute risk reductionintraocular pressurenormal-tension glaucomapragmatic studytreatment efficacyvisual field progression

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Clinical Practice

Background:

  • Normal-tension glaucoma (NTG) poses challenges in real-world clinical settings.
  • A significant proportion of NTG patients present with advanced disease (45% severe glaucoma).

Purpose of the Study:

  • To evaluate clinical outcomes of normal-tension glaucoma (NTG) in real-world practice.
  • To analyze the clinical profile, treatment preferences, and visual field progression patterns in NTG patients.
  • To identify factors influencing treatment decisions and disease progression.

Main Methods:

  • Retrospective analysis of 875 eyes (476 patients) with NTG.
  • Data collection included ocular/systemic associations, medications, intraocular pressure (IOP), and visual field parameters.
  • Visual field progression was assessed using guided progression analysis in 496 eyes.

Main Results:

  • 45% of eyes had severe glaucoma at baseline (MD = -13 ± 8.7 dB).
  • 22.2% of treated eyes exhibited visual field progression over a mean follow-up of 32 months.
  • Progression rate in affected eyes was -2 ± 0.9 dB/year; no clinical or systemic factors predicted progression.

Conclusions:

  • Real-world NTG management faces challenges, with many patients presenting with severe disease.
  • The lack of identifiable predictors for visual field progression underscores the need for further research.
  • Discovering novel risk factors is crucial for effectively halting NTG progression.