title: [Current aspects on the management of normal tension glaucoma].
abstract: In a considerable proportion of glaucoma patients (25-50 %) the intraocular pressure (IOP) is not elevated higher than 22 mmHg at first diagnosis and during subsequent follow-up controls. Although the IOP level remains in the low range < 22 mmHg, progression of glaucoma can still occur. A multitude of different factors are assumed to be involved in glaucoma progression, such as very low nocturnal diastolic blood pressure values, a low mean ocular perfusion pressure, extensive fluctuations in perfusion (e.g. in cases of vascular dysregulation), an increased vulnerability of the optic nerve support structures, an increased translaminar pressure gradient and various underlying systemic diseases. The most important evidence-based aspect of treatment in normal tension glaucoma is pharmaceutical or surgical reduction of the IOP by 30 % or more in comparison to the initial pressure level. Vascular and neuroprotective concepts of treatment for normal tension glaucoma have been strongly advocated and the object of experimental and clinical studies. As yet a clear clinical benefit has not been proven by large prospective randomized studies.
authors.affiliation: Augenklinik, UniversitätsSpital Zürich, Zürich, Schweiz.
authors.forename: M
authors.initials: M
authors.lastname: Töteberg-Harms
authors.affiliation: Universitäts-Augenklinik Münster, Münster, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Rosentreter
authors.affiliation: Zentrum für Augenheilkunde, Universität Köln, Joseph-Stelzmann-Str. 9, 50931, Köln, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Lappas
authors.affiliation: Augenklinik, UniversitätsSpital Zürich, Zürich, Schweiz.
authors.forename: J
authors.initials: J
authors.lastname: Funk
authors.affiliation: Zentrum für Augenheilkunde, Universität Köln, Joseph-Stelzmann-Str. 9, 50931, Köln, Deutschland. Thomas.Dietlein@uk-koeln.de.
authors.forename: T S
authors.initials: TS
authors.lastname: Dietlein
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D057066:Low Tension Glaucoma / Q000175:diagnosis* / Q000628:therapy*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Glaucoma surgery; Intraocular pressure; Ocular perfusion; Risk factors; Therapy