ArticleCureus2026
Early-Onset Normal-Tension Glaucoma in Patients Under 40 Years of Age: Risk Factors for Progression.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the clinical characteristics of normal-tension glaucoma (NTG) in patients under 40 years of age, aiming to identify distinct patterns and risk factors associated with progression in early-onset NTG.
methodsA retrospective study was conducted on NTG patients under 40 years of age seen at a tertiary eye care center from 2006 to 2023. Details that were retrieved included visual field indices, intraocular pressure at baseline, central corneal thickness, refractive error, optical coherence tomography (OCT) & OCT angiography (OCT-A) parameters, ocular and systemic associations, and visual field progression on glaucoma progression analysis. Data were statistically analyzed using multivariate regression for predictors of progression.
resultsA total of 41 eyes from 26 NTG patients under 40 years (mean age = 32 ± 5.1 years; 22.5% female) were studied. Twelve had bilateral NTG, while 14 were unilateral (seven showing pre-perimetric changes and seven being normal or disc suspects). Affected eyes had significantly worse mean deviation (MD) (-10 ± 8.1 dB) and visual field index (VFI) (78 ± 25.9%) compared to unaffected eyes (-1 ± 1.1 dB and 92 ± 7.8%, p = 0.02). Low-to-moderate myopia was observed in 72%, while high myopia (>6 dioptres) was present in six eyes (three patients). Progression occurred in nine eyes (rate of progression = -3 ± 1.9 dB, including five eyes with high myopia), with high myopia and reduced macular VD being significant predictors (β = -0.6, p = 0.03; β = 0.3, p = 0.002).
conclusionNTG in individuals under 40 years of age is characterized by significant changes in macular vessel density. High myopia and reduced macular vessel density on OCT-A may be risk factors for the progression of NTG in young patients.
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