Glaucoma Registry: Deep Dive Into The Glaucoma Landscape In Asia

This session will focus on the characteristics and management of normal tension glaucoma (NTG), a condition prevalent in Asia.

NTG falls within the broader category of open-angle glaucomas, characterized by a distinct loss of the neuroretinal rim and an enlargement and deepening of the optic cup. Additionally, there is an enlargement or development of the parapapillary beta zone, setting it apart from optic neuropathy induced solely by vascular factors.

Investigating whether the heightened prevalence of NTG in Asian populations is influenced by genetics or environment requires further exploration. Epidemiologic and genetic studies suggest that patients with NTG possess a unique set of predisposing risk factors compared to patients with high-tension primary open-angle glaucoma (POAG). In theory, an abnormally high trans-lamina cribrosa pressure difference (TLCPD) due to low cerebrospinal fluid pressure (CSFP), particularly when coupled with low arterial blood pressure, could contribute to the onset of NTG. This aligns with the established fact that reducing IOP (and consequently indirectly reducing TLCPD) remains the validated approach in managing NTG.

The Asian Glaucoma Registry was established as a multi-center collaboration across 11 Asian countries with the goal of understanding the various types of glaucoma, the risk factors contributing to its progression, and the practice patterns of glaucoma management in Asia. The data gleaned from the initial pilot phase will be shared in this presentation. Our findings revealed that patients diagnosed with normal tension glaucoma exhibited a more rapid decline in visual field sensitivity compared to those with primary open angle glaucoma or primary angle closure glaucoma.