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

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.