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Pressure-dependent neuroretinal rim loss in normal-pressure glaucoma
J B Jonas1, A E Gründler, J Gonzales-Cortés
1Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Germany. Jost.Jonas@augen.med.uni-erlangen.de
Purpose:
To evaluate whether, in normal-pressure glaucoma, the level of intraocular pressure is correlated with the degree of glaucomatous optic nerve damage.
Methods:
Color stereo optic disk photographs of 98 eyes with the focal type of normal-pressure glaucoma, 17 eyes with the highly myopic type of normal-pressure glaucoma, and 36 eyes with the age-related atrophic type of primary open-angle glaucoma were morphometrically evaluated.
Results:
In all three study groups, neuroretinal rim area declined significantly (P < .05) with increasing maximal intraocular pressure values.
Conclusions:
In different forms of open-angle glaucoma with normal intraocular pressure, eyes with relatively high intraocular pressure have more pronounced optic nerve damage than do eyes with relatively low intraocular pressure. This suggests a barotraumatic aspect in the pathogenesis of optic nerve damage in the normal-pressure glaucomas. It implies that therapeutically, an intraocular pressure in the low-normal range may less likely be associated with glaucoma damage than an intraocular pressure in the upper-normal range would be.