Advance in the pathogenesis and treatment of normal-tension glaucoma

Normal-tension glaucoma (NTG) is a multifactorial disease where
mechanical stresses and vascular alterations to the optic nerve head
probably represent the key pathogenic moments. Although
intraocular pressure (IOP) plays a crucial role in the retinal ganglion
cell loss, the IOP reduction does not necessarily reduces the disease
progression. Therefore, several IOP-independent factors such as
glutamate toxicity, oxidative stress, autoimmunity, and vascular
dysregulation have been considered in the pathogenesis of NTG.
Numerous evidences documented an impairment of the ocular blood
flow, involved both in the onset and progression of the disease. The
IOP reduction remains the main strategy to reduce the damage
progression in NTG. Recently, new treatment strategies have been
proposed to improve the control of the disease. Neuroprotection is a
rapidly expanding area of research, which represents a promising
tool. In the present review, we summarize the recent scientific
advancements in the pathogenesis and treatment of NTG.