Normal Tension Glaucoma (NTG) suspects and pre-perimetric NTG
Conditions
Interventions
Single intervention group:Adjustment of IOP-lowering medication
Sponsors
Faculty of Medicine, The Chinese University of Hong Kong
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >=18 years; 2. BCVA >=20/40; 3. 360° gonioscopically open anterior chamber angles; 4. 6 median untreated IOP reading consistently 24 mmHg. At least 2 readings were obtained at a different time of the day from the rest (IOP measurement for eligibility assessment are obtained after washout of pre-study topical IOP-lowering medication for 4 weeks); 5. Three reliable VF results without VF defect; 6. PNTG: Fundus photography or OCT show glaucomatous changes: narrowed neuroretinal rim, optic disc cupping, presence of disc hemorrhage, RNFL defect, or GCIPL defect. RNFL defect is defined when (1) >=20 contiguous superpixels (1 superpixel = 4x4 pixels, instrument default) were encoded in red (i.e., RNFL thickness below 1st percentile) in the RNFL thickness deviation map, and (2) the abnormalities were also observed in the RNFL thickness map at the corresponding location); 7. NTG suspect: Patients without the above structural glaucomatous features but was diagnosed NTG. 8. One eye or both eyes of each patient could be recruited for the study.
Exclusion criteria
Exclusion criteria: 1. Patients unwilling to be monitored without treatment; 2. Second cause of glaucoma (e.g., previous trauma, steroid use, uveitis); 3. Ocular or systemic disease that may cause VF loss or optic disc abnormalities; 4. High myopia (spherical error <-10.0D); 5. history of glaucoma surgery, glaucoma laser procedure, or corneal refractive surgery; 6. Patients who had previous ocular surgery or laser procedure (except uncomplicated cataract surgery, laser capsulotomy, or retinal barrier laser); 7. Inability to perform reliable VF; 8. Suboptimal quality of OCT images; 9. VF defect that fulfills the minimal criterial of glaucomatous VF defect: glaucoma hemifield test result outside normal limits, pattern standard deviation with P<0.05 or a cluster of 3 or more points in the pattern deviation plot in a single hemifield (superior or inferior) with P<0.05 one of which must have P<0.01. Any one of the preceding criteria, if
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| The number of patients that require resumption of medication.; | — |
Primary
| Measure | Time frame |
|---|---|
| The potential cost-saving that could be achieved with a systematic approach of adjusting medication for PNTG and NTG suspects.; | — |
Countries
China
Contacts
Public ContactCHAN Pui Man Poemen
Department of Ophthalmology and Visual Sciences
Outcome results
None listed