NORMAL-TENSION GLAUCOMA - A DIAGNOSTIC CH ALLENGE

Purpose Normal-tension glaucoma (NTG) is a frequently discussed optic neuropathy. The purpose of this retrospective study was to evaluate th e final diagnosis of patients with presumed NTG and to select the best distinguishing examination methods. Patients All patients with presum ed 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 presume d NTG the final diagnosis had to be changed, mainly because the diurna l IOP curve showed a dysregulation; often only the early-morning IOP i n supine position was elevated. Conclusions We suggest that early-morn ing IOP spikes are one of the important pathogenetic factors in patien ts with glaucomatous changes without other pathology. Early morning IO P measurement in supine position before rising should therefore be a m andatory part of diurnal IOP curves in patients with presumed NTG.