Combination of structural and functional ophthalmological and radiological methods for differentiating normal-tension glaucoma: clinical case

Abstract

Glaucoma is only partially associated with increased intraocular pressure. Normal-tension glaucoma (NTG) is a form of open-angle glaucoma in which optic nerve damage and visual field defects are present despite a baseline intraocular pressure of less than 21 mmHg. The exact mechanism by which anatomical and functional damage occurs remains unknown in patients with NTG. The proposed theories, mechanical and vascular, do not fully explain the pathogenesis of the disease. This dictates the need to perform both structural and functional ophthalmological and radiological diagnostic methods in differentiating the diagnosis. The authors analyzed a clinical case of NTG in 66-year-old patient over 3-year period of the disease. The results presented in the article allow us to conclude that traditional ophthalmological examinations remain relevant. Energy metabolism and dysfunctional neurodegeneration metabolic pathways play a role in the pathophysiology of NTG. The role of cerebral glucose metabolism is not fully understood and requires study in NTG. It may provide clinicians with additional opportunities for diagnosing and treating the disease.