Article Text

Download PDFPDF
Long-term clinical course of normotensive preperimetric glaucoma
  1. Akira Sawada1,
  2. Yusuke Manabe1,
  3. Tetsuya Yamamoto1,
  4. Chisato Nagata2
  1. 1 Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
  2. 2 Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
  1. Correspondence to Dr Akira Sawada, Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan; sawadaa-gif{at}


Aims To evaluate the long-term clinical course of normotensive preperimetric glaucoma (PPG).

Methods We retrospectively analysed 130 eyes of 130 patients initially diagnosed as having preperimetric normal tension glaucoma and followed these cases for at least 5 years with reliable visual field (VF) examinations by standard automated perimetry. When the VF defect (VFD) met Anderson-Patella’s criteria on three or more consecutive examinations, and consistently met the criteria on subsequent examinations, we concluded that a glaucomatous VFD was present. Predictive factors for developing a VFD were assessed.

Results Seventy-one eyes (54.6%) developed a glaucomatous VFD during the follow-up period. The mean deviation slope varied from −0.90 to 0.41 dB/year. A Cox proportional hazard model showed that having a greater initial pattern SD (p=0.005), the presence of optic disc haemorrhage (p=0.022) and higher mean intraocular pressure (IOP) prior to developing a VFD (p=0.039) were related to developing a VFD.

Conclusions Our findings confirmed that the mean IOP, but not the IOP fluctuation, is strongly associated with the development of a VFD in cases of PPG.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors AS: conception, design, data acquisition, analysis, drafting, interpretation, critical revision. YM: data acquisition. TY: interpretation, critical revision. CN: analysis. All authors: final approval and accountability for all aspects of the work.

  • Competing interests None declared.

  • Patient consent The information of the patients in our article can be sufficiently anonymised.

  • Ethics approval The Institutional Review Board of Gifu University Graduate School of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.