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Visual and structural prognosis of the untreated fellow eyes of unilateral normal tension glaucoma patients

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the visual and structural prognosis of untreated initial non-glaucomatous fellow eyes of unilateral normal tension glaucoma (NTG) patients.

Methods

In this retrospective observational cohort study, 50 NTG patients with unilateral visual field (VF) loss and no VF defect, retinal nerve fiber layer (RNFL) defect or neuroretinal rim (NRR) notching in the fellow eyes, and those who had initial non-glaucomatous fellow eyes untreated were included. For the fellow eyes, the development of VF defect, RNFL defect, and NRR notching was inspected retrospectively by two observers. Baseline clinical characteristics including initial intraocular pressure (IOP), central corneal thickness, and spherical equivalent (SE) were compared between glaucomatous and fellow eyes.

Results

During the mean follow-up period of 8.77 ± 2.92 years, five patients (10 %) developed RNFL defect and four patients (8 %) developed NRR notching in the fellow eye. Among six patients (12 %) who had developed either RNFL defect or NRR notching, only three patients (6 %) developed VF loss in 1.81, 3.09, and 9.27 years respectively. The initial IOP was significantly higher (p = 0.031), SE was more myopic (p = 0.025), and the occurrence of disc hemorrhage (p = 0.049) was significantly higher in glaucomatous eyes than that in fellow eyes.

Conclusions

The incidence of glaucoma development in the fellow eye is rather low. Therefore, the initial non-glaucomatous fellow eye of the unilateral NTG patient may be observed without treatment until glaucoma develops.

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Acknowledgments

The authors’ specific contributions to the work described herein are: design of the study (C.K.); conduct of the study (H.C., W.S., C.K.); data collection and management, analysis and interpretation of the data (H.C., W.S., C.K.); preparation, review, and approval of the manuscript (H.C., C.K.). The present study was approved by the Institutional Review Board of Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. An exemption from informed consent for research was granted because this was a retrospective research study.

Declaration of interest

The authors indicate no financial support or financial conflict of interest.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Sungmo Eye Hospital, Busan, Republic of Korea

    Hyun-Kyung Cho

  2. Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, University of Hallym, Hwaseong, Republic of Korea

    Wool Suh

  3. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea

    Changwon Kee

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  1. Hyun-Kyung Cho
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  2. Wool Suh
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Correspondence to Changwon Kee.

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Cho, HK., Suh, W. & Kee, C. Visual and structural prognosis of the untreated fellow eyes of unilateral normal tension glaucoma patients. Graefes Arch Clin Exp Ophthalmol 253, 1547–1555 (2015). https://doi.org/10.1007/s00417-015-3081-4

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  • DOI: https://doi.org/10.1007/s00417-015-3081-4

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