Pushing IOP Into Single Digits May Lower Normal-Tension Glaucoma Progression
A recent meta-analysis published in Acta Ophthalmologica explores whether aggressively lowering intraocular pressure (IOP) into the single digits can help normal-tension glaucoma (NTG) patients who continue to experience visual field loss despite conventional treatment. Key Takeaways The Study: Researchers reviewed nine observational studies involving 266 patients (270 eyes) who underwent trabeculectomy to achieve substantial IOP reduction, followed for an average of seven years. Slowing Progression: On average, IOP dropped from 14.8mm Hg down to 9.8mm Hg. Consequently, the rate of visual field loss slowed significantly from -0.91 dB/year to -0.25 dB/year (an average improvement of 0.59 dB/year). Mixed Individual Results: While some studies showed dramatic benefits—such as 91.7% of single-digit IOP eyes experiencing a positive shift in mean deviation slope—others noted mixed or statistically insignificant differences at strict single-digit cutoffs. Risks & Complications: ...