What can we learn from the disc appearance about the risk factors in glaucoma?

The author has been involved in 3 studies, the multicentre collaborative normal-tension glaucoma study, a study of 4 phenotypes of glaucomatous disc appearances and their associations, and a study reporting on biostatistical evidence for 2 distinct chronic open-angle glaucoma populations. These studies have some common threads whose clinical implications are discussed.

Some clinical implications of the collaborative normal tension glaucoma study.

This is to present the results of randomized multicenter normal tension glaucoma study. The primary aim of the study was to establish whether a 30% or greater pressure reduction altered the course of NTG compared to untreated controls. Our study confirms that in glaucoma patients even with normal intraocular pressures the pressure is involved in its pathogenesis and that pressure reduction favourably affects its course in a significant proportion of cases.

Visual field and optic disc progression in patients with different types of optic disc damage: a longitudinal prospective study.

Objective: To evaluate the incidence of visual field and optic disc progression in glaucoma patients with distinct patterns of optic disc damage.

Design: Prospective, observational case series.

Participants: One hundred five patients with open-angle glaucoma.

Factors that predict the benefit of lowering intraocular pressure in normal tension glaucoma.

Purpose: To study whether the benefit of lowering of intraocular pressure (IOP) varies according to certain traits.

Design: Randomized clinical trial, secondary analysis.

Methods: Visual field data were analyzed from 144 subjects (144 eyes) randomized not to receive IOP-lowering treatment or to have the IOP lowered by 30%.