Desai Priya V, Caprioli Joseph
Jules Stein Eye Institute, UCLA, 100 Stein Plaza, Suite 2-118, Los Angeles, CA 90095, USA.
Prog Brain Res. 2008;173:195-210. doi: 10.1016/S0079-6123(08)01114-X.
Normal-tension glaucoma (NTG) is generally defined as visual field loss and optic nerve defects consistent with glaucoma and an intraocular pressure (IOP) that does not exceed 21 mmHg (Allingham, R.R., Damji, K., Freedman, S., Moroi, S., Shafranov, G., Shields, M.B. (2005). In: Pine J. and Murphy J. (Eds.), Shields' Textbook of Glaucoma, 5th edn., Lippincott Williams & Wilkins, Philadelphia, PA, pp. 197-207, Chapter 11). If a patient has an atypical presentation (unilateral disease, decreased central visual acuity or visual field loss not consistent with optic disk appearance) then the clinician should rule out medical or neurologic etiologies. IOP-dependent and IOP-independent mechanisms play a role in NTG nerve damage. The exact mechanisms of IOP-independent damage are not currently known. Research has shown that vascular etiologies, such as vascular insufficiency and vasospasm, may be possible mechanisms for IOP-independent damage. The mainstay of glaucoma treatment remains robust IOP reduction. The chief goal of ongoing glaucoma research is to more clearly identify IOP-independent mechanisms of damage and to find neuroprotective treatment strategies to prevent retinal ganglion cell death and consequent visual loss.
正常眼压性青光眼（NTG）通常被定义为与青光眼相符的视野缺损和视神经损害，且眼压（IOP）不超过21 mmHg（Allingham, R.R., Damji, K., Freedman, S., Moroi, S., Shafranov, G., Shields, M.B.（2005年）。载于：Pine J.和Murphy J.（编），《Shields青光眼教科书》，第5版，Lippincott Williams & Wilkins出版社，宾夕法尼亚州费城，第197 - 207页，第11章）。如果患者有非典型表现（单侧疾病、中心视力下降或视野缺损与视盘外观不符），那么临床医生应排除医学或神经学病因。眼压依赖性和非眼压依赖性机制在NTG神经损伤中起作用。目前尚不清楚非眼压依赖性损伤的确切机制。研究表明，血管病因，如血管供血不足和血管痉挛，可能是非眼压依赖性损伤的潜在机制。青光眼治疗的主要方法仍然是有效降低眼压。当前青光眼研究的主要目标是更明确地确定非眼压依赖性损伤机制，并找到神经保护治疗策略，以防止视网膜神经节细胞死亡及随之而来的视力丧失。
