Résumé
Glaucoma is a progressive optic neuropathy that causes characteristic changes of the optic nerve and visual fi eld in relation to intraocular pressure (IOP). It is now known that glaucoma can occur at statistically normal IOPs and prevalence studies have shown that normal tension glaucoma (NTG) is more common than previously thought. While IOP is believed to be the predominant risk factor in primary open angle glaucoma (POAG), IOP-independent risk factors, such as vascular dysregulation, are believed to play an important part in the pathogenesis of NTG. Though certain distinguishing phenotypic features of NTG have been reported, such as an increased frequency of disc hemorrhages, acquired pits of the optic nerve and characteristic pa erns of disc cupping and visual fi eld loss, there is much overlap of the clinical fi ndings in NTG with POAG, suggesting that NTG is likely part of a continuum of open angle glaucomas. However, IOP modifi cation is still the mainstay of treatment in NTG. As in traditional POAG, reduction of IOP can be achieved with the use of medications, laser trabeculoplasty or surgery. Studies now show that the choice of medication may also be important in determining the outcomes of these patients. Though it is likely that future treatment of NTG will involve modifi cation of both IOP and IOP-independent risk factors, current eff orts to develop IOP-independent neuroprotective treatments have not yet proven to be eff ective in humans.