[Normal pressure glaucoma: a diagnostic challenge].

PURPOSE

Normal-tension glaucoma (NTG) is a frequently discussed optic neuropathy. The purpose of this retrospective study was to evaluate the final diagnosis of patients with presumed NTG and to select the best distinguishing examination methods.

PATIENTS

All patients with presumed NTG hospitalized for diurnal IOP curves from 1987-1992 were studied. We evaluated retrospectively which diagnostic tests contributed most to the final diagnosis.

RESULTS

In 26 out of 50 patients with presumed NTG the final diagnosis had to be changed, mainly because the diurnal IOP curve showed a dysregulation; often only the early-morning IOP in supine position was elevated.

CONCLUSIONS

We suggest that early-morning IOP spikes are one of the important pathogenetic factors in patients with glaucomatous changes without other pathology. Early morning IOP measurement in supine position before rising should therefore be a mandatory part of diurnal IOP curves in patients with presumed NTG.