A CLINICAL STUDY ON THE PROPORTION OF SYSTEMIC RISK FACTORS FOR NORMAL TENSION GLAUCOMA
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Keywords
Normal tension glaucoma, hypertension, diabetes mellitus, migraine, risk factors.
Abstract
Background: Glaucoma is a progressive optic neuropathy associated with a specific pattern of optic disc changes and irreversible visual field changes for which intraocular pressure ( IOP) is considered the most common risk factor. Glaucomatous disc damage in individuals with normal IOP is attributed to many systemic risk factors, all causing hypo perfusion of the optic nerve head. The present study was undertaken to determine the proportion of risk factors in such patients.
Purpose: To determine the proportion of systemic risk factors in patients with Normal Tension Glaucoma
Method: This was a hospital based cross sectional study of 31 patients. NTG Patients attending the Eye department from October 2019 to November 2021 were recruited. After obtaining informed consent, relevant data like age, sex, h/o smoking, h/o diabetes mellitus and its duration, h/o systemic hypertension, Cerebrovascular accident, migraine, Raynaud’s phenomenon, sleep apnea, family history of glaucoma etc. were obtained. A complete ocular examination including IOP and clinical evaluation of optic disc was then performed. Visual fields by automated perimetry and Optical Coherence Tomography of the optic disc and nerve fibre layer were done wherever necessary. Data was entered in MS excel and SPSS version 19.0 was used for statistical analysis.
Results: 53% of patients were in the age group of 50 to 70 years. Female to male ratio was 2:1. 40% of the patients had type 2 DM, 33% had systemic hypertension and 36.7% had dyslipidemia. 20% gave a history of ischemic heart disease. Migraine headache was reported by 26.7% patients. 3% had Raynaud phenomenon. Moderate loss of visual field was noted in 60% of male and 95% of female patients. Field loss was more significant in patients with multiple risk factors.
Conclusion: Normal tension glaucoma was more common in older females. Type 2 Diabetes Mellitus was the most common risk factor followed by hypertension and dyslipidemia. There was no significant association with smoking or family history of glaucoma. Presence of multiple risk factors had more impact on field loss.
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Dr. Hari Ramakrishnan
Associate Professor, Department of Ophthalmology, Dr. SMCSI Medical College, Karakonam, Trivandrum, Kerala, India.
Dr. Anuroop Patra
Senior Resident, Department of Ophthalmology, Dr. SMCSI Medical College, Karakonam, Trivandrum, Kerala, India.