Neurologic evaluations in normal-tension glaucoma workups: Are they worth the effort?

Background: Normal-tension glaucoma is a chronic progressive optic neuropathy of unknown etiology. Neuro-imaging workup in these patients is controversial. Objectives: To determine the value of routine neurologic and neuro-ophthalmologic evaluations in patients with NTG. Methods: We conducted a retrospective review of all patients diagnosed with NTG in our institution between 2001 and 2006. Neurologic and neuro-ophthalmologic data were evaluated. Results: Sixty-eight patients were considered suitable for the study (35 males, 33 females; age range 43-90 years). Neurologic and neuro-ophthalmologic findings were normal in all of them. The computed tomography brain scan was normal in 88% and duplex carotid Doppler scan was normal in 92%. Conclusions: Pathologic findings in neurologic and neuro-ophthalmologic assessments were uncommon in NTG. Therefore, contrary to earlier suggestions, neurologic and neuro-ophthalmologic evaluations in typical normal-tension glaucoma patients appear to have no added value.