PURPOSE: To evaluate the corneal biomechanical properties and clinical characteristic of normal tension glaucoma (NTG) in young patients. METHODS: We compared corneal biomechanical properties using an Ocular response analyzer (ORA) of under age 40 of 37 eyes of patients with NTG and 42 eyes of normal group. RESULTS: The mean corneal resistance factor (CRF) and mean corneal hysteresis (CH) were significantly lower in NTG eyes (CRF, 9.2 +/- 2.1 mm Hg; CH, 9.8 +/- 1.8 mm Hg) than in normal eyes (CRF, 10.7 +/- 2.3 mm Hg; CH, 10.9 +/- 2.0 mm Hg; p = 0.01, p < 0.01). CH and CRF were associated with central corneal thickness (CCT) (CH; beta = 0.354, p < 0.01, CRF; beta = 0.348, p < 0.01) and glaucoma status (p < 0.01, p < 0.01). CONCLUSIONS: The CRF and CH were significantly lower in NTG group while IOP cc was not significantly different between the group. In diagnosing the NTG in young patients, ORA maybe useful for distinguishing between the glaucoma eyes and normal eyes.
Eye ; Glaucoma ; Humans ; Low Tension Glaucoma

PURPOSE: To analyze the diurnal change in intraocular pressure (IOP) and corneal biomechanical properties measured using the Ocular Response Analyzer (ORA; Reichert Inc., Depew, NY, USA) in Korean patients with normal tension glaucoma (NTG) patients. METHODS: Intraocular pressure (Goldmann applanation tonometer IOP [GAT IOP], Goldmann-correlated IOP [IOPg], corneal-compensated IOP [IOPcc]) and corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) were measured in 21 eye of NTG patients (12 males, 9 female) at 3 hour intervals for 48 hours using ORA. We recorded the time of each parameter that showed the lowest and the highest values of during the 48 hour testing period (Day 1 and Day 2) and evaluated the change of diurnal variation using Repeated measures analysis of variance (Re-ANOVA). RESULTS: Peak IOP measured with GAT and ORA occurred at 6 AM-9 AM, 3 PM-6 PM and the trough IOP at 9 PM-12 AM during the 48 hour period. CCT, GAT IOP, IOPcc and IOPg measurements showed statistically significant variations (p<0.05). CH and CRF variations were not statistically significant (p>0.05). CONCLUSIONS: In Korean NTG patients, IOP exhibits significant diurnal variation, with higher values during the dawn and afternoon and lower values before retiring. Clinically, measurements of IOP performed in the afternoon could aid in the detection of relatively elevated IOP.
Humans ; Intraocular Pressure* ; Low Tension Glaucoma* ; Male

A clinical study was carried out on 206 glaucomatous patients(295 eyes) from July 1982 to December 1985 in the Department of Ophthalmology of Hanyang University Hospital. The results were as follows: 1. The glaucomatous patients consisted of 34.0% of primary open angle glaucoma(P.O.A.G.), 32.5% of secondary glaucoma, 20.9% of primary angle closure glaucoma(P.A.C.G.), 73% of ocular hypertension, 3.9% of congenital glaucoma and 1.5% of low tension glaucoma. 2. The mean intraocular pressure(IOP) of P.O.A.G. and acute stage of P.A.C.G. was 33.4 +/- 15.5 and 55.2 +/- 8.4mmHg, respectively. 3. 43.1 +/- 16.3 years was the mean age of P.O.A.G. and 61.6 +/- 9.5 years was that of P.A.C.G. 4. In overall glaucomatous patients there was no remarkable sex-difference except P.A.C.G. which showed higher prepondrence of females. 5. There was no significant difference in laterality between left and right eyes with glaucoma or ocular hypertension.
Female ; Glaucoma ; Humans ; Low Tension Glaucoma ; Ocular Hypertension ; Ophthalmology

PURPOSE: This study evaluated the effect of a fixed combination of 0.0015% tafluprost-0.5% timolol (Tapcom®, Santen, Osaka, Japan) in glaucoma patients. METHODS: This study included 23 patients who were diagnosed with normal tension glaucoma and treated with a fixed combination of 0.0015% tafluprost-0.5% timolol as the first therapy. Diurnal intraocular pressure (IOP) was measured every 2 and 0.5 hours between 9:00 am and 4:30 pm. The IOP change with respect to body position (positional IOP) was measured at baseline and at 6 months after eye-drop instillations. IOP fluctuation was defined as the standard deviation of IOP measurements. Throughout the study, all side effects were recorded and monitored by the investigators. RESULTS: The mean reduction in IOP in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes was −3.37 ± 2.39 mmHg (−19.70 ± 13.97%) for the right eye and −3.22 ± 2.27 mmHg (-18.81 ± 13.28%) for the left eye (paired t-test, p < 0.001). The mean positional IOP measured at 4 pm at 6 months after 0.0015% tafluprost-0.5% timolol fixed combination instillation showed statistically significant reduction from the mean positional IOP at baseline. There was a significant difference in the number of patients with ≤3 mmHg IOP variation over four time points between baseline and at 6 months in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes (McNemar test, p < 0.001). There was no serious adverse event causing ocular damage. CONCLUSIONS: Use of 0.0015% tafluprost-0.5% timolol fixed combination was effective and well tolerated in reducing IOP and in maintaining its effectiveness in glaucoma patients.
Glaucoma ; Humans ; Intraocular Pressure ; Low Tension Glaucoma ; Research Personnel ; Timolol

PURPOSE: To compare the central corneal thickness (CCT) in eyes of Korean subjects with primary angle-closure glaucoma (PACG) to other patients with glaucoma and control subjects. METHODS: Medical records of patients who underwent examination for glaucoma and pre-operative examination for cataract surgery between March 2009 and August 2012 in our clinic were reviewed. CCT was compared in normal control eyes, primary open angle glaucoma (POAG) eyes and normal tension glaucoma (NTG) eyes. RESULTS: The mean CCT of POAG eyes was significantly larger than that of normal control eyes, NTG eyes and PACG eyes (p = 0.027, 0.009 and 0.008, respectively). There was no significant difference in mean CCT between normal control eyes, NTG eyes or PACG eyes. CONCLUSIONS: PACG eyes had a CCT similar to that of NTG or normal eyes in Korean subjects.
Cataract ; Glaucoma ; Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Medical Records

PURPOSE: To compare the measured values of anterior chamber depth and angle in glaucoma patients using Ultrasound Biomicroscopy (UBM) and Orbscan(TM) IIz Topography. METHODS: We measured the anterior chamber depth and angles of four directions in 26 eyes of 13 primary open angle glaucoma (POAG) patients, 26 eyes of 13 normal tension glaucoma (NTG) patients, and 20 eyes of 10 angle closure glaucoma (ACG) patients, with UBM and Orbscan. RESULTS: The values of anterior chamber depth did not show any difference between UBM and Orbscan. The values for anterior chamber angle in POAG and NTG eyes were not different between UBM and Orbscan, but the values for all anterior chamber angles except the superior angle, measured with UBM were significantly larger than those for ACG measured by Orbscan. CONCLUSIONS: Both UBM and Orbscan showed similar results in the measurement of anterior chamber depth and angle in POAG and NTG patients, but showed different results in the anterior chamber angle for ACG patients. UBM will be more useful in evaluating the anterior chamber angle in ACG patients because it can assess the structures of the anterior chamber angle objectively.
Anterior Chamber* ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Microscopy, Acoustic* ; Ultrasonography*

PURPOSE: To compare the parameters measured with the ocular response analyzer (ORA; Reichert Inc., Depew, NY, USA) between normal control subjects and patients with normal tension glaucoma (NTG) and to investigate clinical usefulness of ORA. METHODS: Intraocular pressure (IOP) and central corneal thickness (CCT) were measured using the Goldmann applanation tonometer (GAT) in 100 eyes of 100 normal subjects and 100 eyes of 100 NTG patients. Four types of ORA parameters, corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were also measured. RESULTS: The mean CH values were 11.2 mm Hg and 10.3 mm Hg and the mean CRF values were 10.8 mm Hg and 9.9 mm Hg in the normal subjects group and the NTG group, respectively. Mean CH and CRF were significantly lower in NTG patients (p < 0.001) and the IOPcc were higher than normal subjects (p = 0.004). IOPg was in agreement with the GAT IOP (ICC = 0.811) and IOPcc was not correlated with CCT. The cut-off value of 'IOPcc - IOPg' as the diagnostic standard parameter was -0.05 mm Hg (sensitivity; 76%, specificity; 55%). CONCLUSIONS: IOPg measurements were similar to GAT IOP, and other ORA parameters (CH, CRF, IOPcc) were significantly different between normal subjects and NTG patients. Consequently, the difference of IOPcc and IOPg could be a useful parameter in NTG diagnosis.
Diagnosis ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Sensitivity and Specificity

PURPOSE: To compare the intraocular pressure (IOP)-lowering effect and safety between superior 180 degree and inferior 180 degree selective laser trabeculoplasty (SLT). METHODS: Forty patients with primary open-angle glaucoma and normal tension glaucoma were treated with superior 180-degree SLT, and 28 patients with the same diagnosis were treated with inferior 180-degree SLT. IOP was checked at 1 day, and 1, 2, 3, and 6 months after SLT. Anterior chamber reaction and ocular pain was evaluated at postoperative 1 day. Peripheral anterior synechia was examined at 6 months postoperatively. RESULTS: At the postoperative 6-month follow-up, the superior treatment group had a mean IOP of 15.53 +/- 3.49 mm Hg with a mean reduction of 24.6%, while the inferior treatment group had a mean IOP of 17.18 +/- 3.29 mm Hg with a mean reduction of 21.9%. There were no significant differences in IOP reduction between the 2 groups. There was a slightly higher anterior chamber reaction rate in the inferior treatment group. CONCLUSIONS: The site of SLT application is not important for IOP reduction. Both superior 180 degree and inferior 180 degree SLT are safe and effective procedures for glaucoma treatment because of successful IOP reduction and low complication risks.
Anterior Chamber ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Low Tension Glaucoma ; Trabeculectomy

PURPOSE: To assess the effectiveness and safety of Pattern Laser Trabeculoplasty (PLT) in patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). METHODS: Twenty-six eyes in patients with POAG and 14 eyes in patients with NTG were targeted in this study. The intraocular pressure (IOP) for each patient needed to be reduced within proper ranges. The clinical outcome was assessed by IOP at 1 week, 1 month, 3 months, 6 months and 9 months after PLT. RESULTS: The mean (+/- standard deviation) IOP in the POAG group was 20.7 +/- 4.1 mm Hg before treatment. After PLT, the IOPs in POAG group were 16.4 +/- 3.1 mm Hg, 16.9 +/- 3.8 mm Hg, and 16.5 +/- 5.2 mm Hg at 1, 6 and 9 months, respectively, and the pressure remained stabled over 9 months of post-procedural follow-up. However, no statistical difference in IOP reduction was observed in the NTG group before and after treatment. CONCLUSIONS: PLT provides a possibility to decrease additional medical therapy in patients with POAG. In addition, PLT can be considered as an auxiliary therapy for POAG patients who tolerate maximal medical therapy prior to undergoing surgical treatment.
Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure* ; Low Tension Glaucoma ; Trabeculectomy*

PURPOSE: To analyze the clinical effectiveness of tafluprost used in the treatment of glaucoma, using ocular pulse amplitude (OPA) measurements with dynamic contour tonometry (DCT). METHODS: Sixty patients (119 eyes) with normal tension glaucoma (NTG) or primary open angle glaucoma (POAG) treated with tafluprost or other eyedrops were investigated in the present study. Intraocular pressure (IOP) was measured with Goldmann applanation tonometry (GAT), and OPA was measured with DCT, before and after treatment, retrospectively. RESULTS: In 20 patients treated with tafluprost, IOP decreased from 17.1 mm Hg before treatment to 13.0 mm Hg 3 months after treatment (24.0% descent rate), and OPA decreased from 2.35 to 1.57 (33.2% descent rate). For 20 patients who switched from another monotherapy to tafluprost, IOP decreased from 15.7 mm Hg to 13.2 mm Hg from 15.7 mm Hg (15.3%) and OPA from 2.38 to 1.69 (27.7%). CONCLUSIONS: Tafluprost used to treat glaucoma has a large OPA and IOP lowering effect and, therefore can be applied to patients who have a large OPA with glaucoma progression in spite of well controlled IOP.
Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Low Tension Glaucoma ; Manometry ; Ophthalmic Solutions ; Prostaglandins F