Yazdanie Fahd, Sims Jeffrey R, Ying Stephanie, Misra Poonam, Shah Manjool, Panarelli Joseph F
Department of Ophthalmology, NYU Langone Health, New York, NY, USA.
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Clin Ophthalmol. 2025 Mar 31;19:1175-1182. doi: 10.2147/OPTH.S490512. eCollection 2025.
To determine the characteristics of normal tension glaucoma referrals at a tertiary care center and risk factors associated with unilateral versus bilateral disease.
Medical records were reviewed of patients who were referred to a single glaucoma provider at a tertiary care center and were given a presumptive diagnosis of normal tension glaucoma (NTG) between the years 2018 and 2021. Data collected included demographics, medical and family history, ophthalmic history, ophthalmic examination findings, neuro-ophthalmology referrals, and magnetic resonance imaging (MRI) results.
A total of 98 patients were included in this study. The majority of patients (82%) had bilateral disease at initial presentation. Most patients (65%) had a history of systemic disease, including hypertension (32%), cardiovascular disease (19%), diabetes (12%), obstructive sleep apnea (10%), or orthostatic hypotension (4%). Conditions associated with vascular dysregulation were identified in 24% of patients. Sixty six percent of patients had a family history of glaucoma, while nearly half (49%) were myopic. Of patients with unilateral disease, 39% had workup or consideration of other neuro-ophthalmic diagnoses compared to 13% of patients with bilateral disease (P = 0.01).
Patients referred for NTG commonly present with disc changes in both eyes. Clinicians should assess for the presence of systemic diseases associated with vascular dysregulation, myopia, and a family history of glaucoma. Patients with unilateral disease consistent with NTG may benefit from additional workup including neuroimaging or a neuro-ophthalmic evaluation.
确定三级医疗中心正常眼压性青光眼转诊患者的特征以及与单侧和双侧疾病相关的危险因素。
回顾了2018年至2021年间被转诊至三级医疗中心的一位青光眼专科医生处并被初步诊断为正常眼压性青光眼（NTG）的患者的病历。收集的数据包括人口统计学信息、医疗和家族史、眼科病史、眼科检查结果、神经眼科转诊情况以及磁共振成像（MRI）结果。
本研究共纳入98例患者。大多数患者（82%）初诊时患有双侧疾病。大多数患者（65%）有全身疾病史，包括高血压（32%）、心血管疾病（19%）、糖尿病（12%）、阻塞性睡眠呼吸暂停（10%）或体位性低血压（4%）。24%的患者存在与血管调节异常相关的疾病。66%的患者有青光眼家族史，近一半（49%）为近视。单侧疾病患者中，39%进行了其他神经眼科诊断的检查或考虑，而双侧疾病患者中这一比例为13%（P = 0.01）。
因NTG转诊的患者通常双眼视盘均有改变。临床医生应评估是否存在与血管调节异常、近视和青光眼家族史相关的全身疾病。符合NTG的单侧疾病患者可能受益于包括神经影像学检查或神经眼科评估在内的进一步检查。
