title: Prospective study on the efficacy of treating normal tension glaucoma with a single session of selective laser trabeculoplasty.
abstract: OBJECTIVE
  The purpose of this study was to investigate the efficacy of selective laser trabeculoplasty (SLT) in the treatment of normal tension glaucoma (NTG).
  
  
  METHODS
  This prospective cohort study recruited consecutive cases of NTG on antiglaucoma medication. Cases were excluded for previous glaucoma surgery or laser. All patients underwent a 1-month washout of medication followed by a mean baseline intraocular pressure (IOP) measured at 9 AM, 1 PM, and 5 PM. A 30% reduction from baseline was set as the target IOP. A single session of SLT was performed to 360 degrees of the trabecular meshwork. IOP phasing was repeated at 1 month after SLT and medication was resumed to achieve the target IOP. Patients were followed up to 6 months after SLT.
  
  
  RESULTS
  In 83 eyes of 46 subjects, the mean prestudy IOP was 14.2 ± 3.1 mm Hg when on 1.5 ± 0.9 antiglaucoma medication. The mean baseline IOP without medication was 16.1 ± 2.2 mm Hg. The mean SLT shots applied was 187.8 ± 27.5 using a mean energy of 1.0 ± 0.07 mJ. At 1-month post-SLT, the IOP was 12.7 ± 2.0 mm Hg (21.6% IOP reduction) from baseline without medication (P<0.05). The 6-month IOP was 11.4 ± 1.6 mm Hg when on 1.1± 1.0 medications, representing a 19.7% reduction from prestudy IOP, a 29.6% reduction from baseline IOP, and a 26.7% reduction in antiglaucoma medication (all P< 0.05). A higher baseline IOP was correlated with greater IOP reduction with SLT (r=0.3, P=0.009).
  
  
  CONCLUSIONS
  A single session of SLT for NTG achieved an additional 20% reduction in IOP with 27% less medication at 6 months compared with prestudy levels while maintaining a 30% reduction from baseline IOP.
authors: *Department of Ophthalmology, University of Hong Kong †Department of Ophthalmology, Caritas Medical Centre ‡Department of Ophthalmology, Queen Mary Hospital, Hong Kong, SAR, People's Republic of China.
authors: Jacky W Y
authors: JW
authors: Lee
authors: Rita A
authors: RA
authors: Gangwani
authors: Jonathan C H
authors: JC
authors: Chan
authors: Jimmy S M
authors: JS
authors: Lai
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D057066:Low Tension Glaucoma / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014794:Visual Fields