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Early-Onset Normal-Tension Glaucoma in Patients Under 40 Years of Age: Risk Factors for Progression
1Glaucoma, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, IND.
Cureus
|May 7, 2026
Summary
Normal-tension glaucoma (NTG) in young adults is linked to reduced macular vessel density. High myopia and decreased macular vessel density are key risk factors for disease progression in early-onset NTG.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Vascular Imaging
Background:
- Normal-tension glaucoma (NTG) typically affects older individuals.
- Early-onset NTG in patients under 40 presents unique clinical characteristics.
- Understanding progression factors in young NTG is crucial for timely intervention.
Purpose of the Study:
- To investigate the clinical features of NTG in patients younger than 40.
- To identify specific patterns and risk factors for progression in early-onset NTG.
- To analyze the role of ocular and systemic factors in young NTG.
Main Methods:
- Retrospective study of NTG patients under 40 (2006-2023).
- Analysis of visual field indices, intraocular pressure, corneal thickness, refractive error.
- Inclusion of OCT and OCT angiography (OCT-A) parameters, and glaucoma progression analysis.
Main Results:
- 41 eyes from 26 patients (mean age 32) studied; 72% had myopia.
- Affected eyes showed significantly worse visual field indices (MD, VFI).
- Progression observed in 9 eyes; high myopia and reduced macular vessel density predicted progression (p=0.03, p=0.002).
Conclusions:
- Early-onset NTG in young adults is associated with significant macular vessel density changes.
- High myopia and reduced macular vessel density on OCT-A are potential risk factors for NTG progression in this age group.
- Further research is warranted to confirm these findings and guide management.
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