Pressure-dependent neuroretinal rim loss in normal-pressure glaucoma

Am J Ophthalmol. 1998 Feb;125(2):137-44. doi: 10.1016/s0002-9394(99)80083-x.


Purpose: To evaluate whether, in normal-pressure glaucoma, the level of intraocular pressure is correlated with the degree of glaucomatous optic nerve damage.

Methods: Color stereo optic disk photographs of 98 eyes with the focal type of normal-pressure glaucoma, 17 eyes with the highly myopic type of normal-pressure glaucoma, and 36 eyes with the age-related atrophic type of primary open-angle glaucoma were morphometrically evaluated.

Results: In all three study groups, neuroretinal rim area declined significantly (P < .05) with increasing maximal intraocular pressure values.

Conclusions: In different forms of open-angle glaucoma with normal intraocular pressure, eyes with relatively high intraocular pressure have more pronounced optic nerve damage than do eyes with relatively low intraocular pressure. This suggests a barotraumatic aspect in the pathogenesis of optic nerve damage in the normal-pressure glaucomas. It implies that therapeutically, an intraocular pressure in the low-normal range may less likely be associated with glaucoma damage than an intraocular pressure in the upper-normal range would be.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrophy
  • Female
  • Glaucoma, Open-Angle / pathology*
  • Humans
  • Intraocular Pressure*
  • Male
  • Middle Aged
  • Optic Disk / pathology
  • Optic Nerve / pathology*
  • Photography
  • Retina / pathology*