To investigate the relationship between trans-lamina cribrosa pressure difference (TLCPD) and morphologic parameters of optic disc (OD) in normal tension glaucoma (NTG) patients.

Data from 31 NTG patients (31 eyes) and 29 controls (29 eyes) were analyzed retrospectively. Their cerebrospinal fluid pressure was estimated using diastolic pressure (DBP), body mass index (BMI) and age. TLCPD was defined as the difference of intraocular pressure (IOP) and the estimated cerebrospinal fluid pressure (ECSFP). Measurements of the rim area (RA), disc area (DA), average and vertical cup/disc (C/D) ratio, retinal nerve fiber layer thickness (RNFLT) and cup volume (CV) were taken for all patients using optical coherence tomography. The correlation between TLCPD and morphologic parameters of OD were assessed.

There were no significant differences between the two groups in terms of age, DBP, IOP and spherical equivalent (SE) and BMI. The mean ECSFP was significantly higher in the controls (10.7 ± 2.8 vs. 12.2 ± 2.2 mm Hg, p = 0.031) and TLCPD was significantly higher in patients (2.4 ± 2.1 vs. 4.9 ± 3.7 mm Hg, p = 0.002). In the NTG group, there was a negative correlation between TLCPD and RA (r = -0.595) and positive correlations between TLCPD and the average C/D ratio (r = 0.504), vertical C/D ratio (r = 0.434) and CV (r = 0.420). Average RNLFT was also significantly correlated with TLCPD (r = -0.500) and RNFLT for four quadrants, except the nasal quadrant, in NTG patients.

NTG patients had higher TLCPD. A higher TLCPD was associated with a narrower RA, larger C/D ratio, and thinner RNFLT.