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normal pressure glaucoma; normal tension glaucoma
glaucoma with normal intraocular pressure
Etiology:
- hypotheses
- vascular insufficiency at the optic nerve head
- metabolic disorders
- neurodegenerative disorders
- oxidative stress
- abnormal biomechanics of the lamina cribrosa
- risk factors
- older age
- family history
- female gender
- above-average intraocular pressure
- thin central corneal thickness
- systemic hypertension
- nocturnal hypotension
- migraine headaches
- raynaud phenomenon
- frontotemporal dementia
- Alzheimer's disease
- obstructive sleep apnea
Epidemiology:
- East Asia: 95% of 1-4% prevalence of primary open angle glaucoma
- Europe: 1/3 of 2% prevalence of primary open angle glaucoma
Pathology:
- optic neuropathy characteristic of glaucoma
Genetics:
- aberrations in Optineurin (OPTN), TANK binding kinase (TBK1), Myocilin (MYOC)
Clinical manifestations:
- similar to open-angle glaucoma Complication:
- increased risk of Alzheimer's disease (RR=1.5) [2]
Management:
- lower intraocular pressure (see open-angle glaucoma)
General
primary glaucoma
References
- Gosling D, Meyer JJ
Normal Tension Glaucoma
StatPearls[Internet] National Library of Medicine. Dec 12, 2022
https://www.ncbi.nlm.nih.gov/books/NBK576377/#:~:text=Normal%2Dtension%20glaucoma%20is%20a,visual%20morbidity%20in%20most%20patients.
- Chen YY, Lai YJ, Yen YF et al.
Association between normal tension glaucoma and the risk of Alzheimer's disease:
a nationwide population-based cohort study in Taiwan.
BMJ Open. 2018. Nov 5;8(11):e022987
PMID: 30397009 PMCID: PMC6231573 Free PMC article.