Normal-tension glaucoma – the features of diagnostics and treatment (literature review)


  • L.P. Tutchenko National Medical Academy of Postgraduate Education named after P.L. Shupyk of the Ministry of Public Health of Ukraine Kyiv, Ukraine



normal-tension glaucoma, vascular factors, pathogenesis, diagnostics, treatment


Using PubMed and own database, the literature on the issues of investigations of normal-tension glaucoma from 1857 to the present has been extensively reviewed here. The article includes the history of the normal-tension glaucoma study, the sights of domestic and foreign ophthalmologists at the topic. Data about theories of pathogenesis of normal-tension glaucoma, infl uence of different factors on its development have been covered.
In the article normal-tension glaucoma is viewed within the general volume of the glaucomatous knowledge, as well as in the structure of primary open angle glaucoma forms. The kinds of normal-tension glaucoma, its diagnostic criteria and defi nition, problems connecting with its differential diagnostics have been considered.
The author of the article has noted differentiation between normal-pressure glaucoma and other forms of primary open angle glaucoma. The divergence between normal-pressure glaucoma and various ocular and neurological disorders has also been shown. The general and local risk factors of normal-tension glaucoma development, the role of tolerant intraocular pressure and vascular factors are indicated. The features of functional and morphometric changes in normal-tension glaucoma patients including optic nerve and visual fi elds alterations, presence and time changing of β-zone and versions of their origin are listed. Different classifi cations of normal-tension glaucoma according to the optic nerve changes are considered in the article. Various theories of normal-tension glaucoma appearance including ischemic ones are described. The mechanism of the normal-tension glaucoma origin according to the theory of the primary vascular deregulation is reviewed. The role of vasospasm, its symptoms and the role of vasospastic syndrome in the low-tension glaucoma appearance in different populations are mentioned. Psychological characteristics of patients with normal-tension glaucoma are described. The defi nition of target intraocular pressure, principles of its calculation and the role of its receiving from the normal-glaucoma patients are listed in the article. The sights at the hypotonic treatment issues according to the target intraocular pressure achievement, including medical, laser and surgical treatment have been taken up. The role of neuroprotection and vascular therapy fulfi llment in the low-tension glaucoma patients has been described. The important role of knowledge about normal-tension glaucoma for new understanding of glaucoma on the whole, its better diagnostics, observation and treatment has been mentioned. In this review the author of the article summarizes the explored issues of normal-tension glaucoma and raises questions about its uninvestigated aspects.


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