title: [Normal pressure glaucoma: a diagnostic challenge].
abstract: OBJECTIVE
  Normal-tension glaucoma (NTG) is a frequently discussed optic neuropathy. The purpose of this retrospective study was to evaluate the final diagnosis of patients with presumed NTG and to select the best distinguishing examination methods.
  
  
  METHODS
  All patients with presumed NTG hospitalized for diurnal IOP curves from 1987-1992 were studied. We evaluated retrospectively which diagnostic tests contributed most to the final diagnosis.
  
  
  RESULTS
  In 26 out of 50 patients with presumed NTG the final diagnosis had to be changed, mainly because the diurnal IOP curve showed a dysregulation; often only the early-morning IOP in supine position was elevated.
  
  
  CONCLUSIONS
  We suggest that early-morning IOP spikes are one of the important pathogenetic factors in patients with glaucomatous changes without other pathology. Early morning IOP measurement in supine position before rising should therefore be a mandatory part of diurnal IOP curves in patients with presumed NTG.
authors.affiliation: Augenklinik, Universitätsspital, Zürich, Schweiz.
authors.forename: F
authors.initials: F
authors.lastname: Meier-Gibbons
authors.forename: J
authors.initials: J
authors.lastname: Stürmer
authors.forename: B
authors.initials: B
authors.lastname: Gloor
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D009898:Optic Disk / Q000503:physiopathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D010348:Patient Care Team; D012189:Retrospective Studies; D014794:Visual Fields / Q000502:physiology*