Intraocular pressure reduction in normal-tension glaucoma patients. The Normal Tension Glaucoma Study Group.
BACKGROUND
In a collaborative study, patients with untreated normal-tension glaucoma were randomly assigned to a marked intraocular pressure reduction group or to a no therapy group. It was anticipated that medical therapy and laser trabeculoplasty would generally not achieve adequate pressure lowering and that fistulizing surgery would be required. This hypothesis was examined using current observations in the study.


METHODS
Patients randomized to the therapy group had a pressure reduction of at least 30% from their last prerandomization level. This was achieved within 6 months by means of fistulizing surgery or with pilocarpine and/or laser trabeculoplasty. Beta-blockers and adrenergic agonists were excluded from both eyes.


RESULTS
Of 30 patients with documented stable 30% pressure reduction, 17 (57%) achieved this with topical medication and/or laser trabeculoplasty: 8 with pilocarpine alone, 2 with laser trabeculoplasty alone, and 7 with laser trabeculoplasty after initial topical medication. The remaining 13 (43%) patients required a single fistulizing procedure. There was no statistically significant difference between the mean follow-up time for the nonfistulized group (533.8 +/- 437.6 days) and for the fistulized group (502.7 +/- 344.7 days). Both treatment groups had similar baseline profiles.


CONCLUSIONS
Marked pressure reduction can be achieved and maintained on a long-term basis by means other than fistulizing surgery in a large proportion of patients with untreated normal-tension glaucoma.
Schulzer
M
M
Department of Medicine, University of British Columbia, Vancouver, Canada.
D000368:Aged; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010862:Pilocarpine / Q000627:therapeutic use; D014130:Trabeculectomy
D010862:Pilocarpine