Upon completion of cGMP manufacturing and IND submission, Notogen expects to initiate Phase I clinical trials for NTG-101 in 2020. About NTG-101 NTG-101 is protein-based biologic designed to mediate the progression of spinal disc degeneration disease (DDD) and induce a restorative effect.
Full Answer
Is there a treatment for NTG with high IOP?
Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for …
When is glaucoma filtering surgery the best treatment for NTG?
The Low-pressure Glaucoma Treatment Study (LoGTS) showed that patients with NTG treated with the alpha 2-adrenergic agonist Alphagan-P (brimonidine tartrate 0.2 percent) were less likely to have visual field progression than patients treated with the beta-adrenergic antagonist Istalol (timolol maleate 0.5 percent): The progression rates were 9 ...
Should beta-blockers be used in NTG patients with hypotension?
Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice.
Why did the cntgs program start with three Tests?
Sep 26, 2013 · When medications are unable to achieve adequate stability of visual field progression and optic nerve damage, glaucoma filtering surgery remains the most proven option in the treatment paradigm of NTG. Ideally, future treatment of NTG will target both IOP and IOP-independent risk factors.
When should glaucoma treatment start?
Abstract. The decision to start a glaucoma treatment in a newly diagnosed patient is easy when the disease is clearly identified with typical optic nerve cupping, visual field defect, and elevated intraocular pressure.
What is the treatment for normal-tension glaucoma?
Normal-tension glaucoma is treated in the same way as POAG by reducing the eye pressure using medications, laser treatment, and surgery. Blood flow to the optic nerve may play an important role in NTG but currently there is no treatment that can directly modify it.Oct 1, 2020
What are the management option for a patient has a normal or a low tension glaucoma do we require anti glaucoma medications?
Since so little is known about why normal eye pressure damages some eyes, most doctors treat normal tension glaucoma by reducing the eye pressure as low as possible using medications, laser treatments and conventional surgery.Jun 7, 2021
How quickly does normal-tension glaucoma progress?
Age was not a factor for progression, Dr. Anderson said. “Only half of the patients who present with normal-tension glaucoma will progress over a period of 5 to 7 years.Mar 31, 2012
What are the preventive measures and treatment for glaucoma?
PreventionGet regular dilated eye examinations. Regular comprehensive eye exams can help detect glaucoma in its early stages, before significant damage occurs. ... Know your family's eye health history. Glaucoma tends to run in families. ... Exercise safely. ... Take prescribed eyedrops regularly. ... Wear eye protection.Oct 23, 2020
What is SLT in ophthalmology?
Also known as Selective Laser Trabeculoplasty, SLT is a simple, yet highly effective laser procedure that reduces the intraocular pressure associated with glaucoma. It is performed in your ophthalmologist's office and typically takes no more than five minutes.
Is eye pressure of 15 high?
About 90 percent of people will fall between a pressure range of 10 and 21 with the average eye pressure being approximately 15 mm Hg. Eye pressure greater than 21 mm Hg is considered higher than normal, but even so, that does not mean eye pressure of 22 or higher is abnormal.Nov 18, 2021
What is NTG glaucoma?
Normal tension glaucoma (NTG) is a common form of primary open angle glaucoma (POAG) in which there is no measured elevation of the intraocular pressure (IOP).Apr 1, 2022
What is the difference between wide angle and narrow angle glaucoma?
In open-angle glaucoma, the iris is in the right position, and the uveoscleral drainage canals are clear. But the trabecular meshwork isn't draining properly. In closed-angle glaucoma, the iris is squeezed against the cornea, blocking the uveoscleral drains and the trabecular meshwork.
What is the prognosis for normal-tension glaucoma?
What Is the Prognosis for Normal-Tension Glaucoma? With early diagnosis and treatment, it's possible to prevent optic nerve damage and/or vision loss, if already present, may be slowed or stabilized. Keep in mind that once glaucomatous vision loss occurs, it is permanent and irreversible.
Which of the following can easily treat glaucoma in its early stages?
The treatment options for early glaucoma have expanded in recent years and fall into three categories: medications, laser, and incisional surgery. Medications or laser are both considered first-line treatments.Aug 23, 2021
What percentage of people with normal-tension glaucoma go blind?
“The 20-year incidence of blindness in normal tension glaucoma is 9.9% in 1 eye and 1.5% in both eyes,” he said. How can blindness be avoided? “Achieving a consistent IOP reduction of 20–30% is associated with a 93–96% probability of stable NTG without visual field progression over 15 years of treatment,” he explained.
How many visual fields are needed to detect and ascertain moderately fast progression?
DR. ANDERSON: On average, six visual fields over two years are required to detect and ascertain moderately fast progression. With fewer fields and less time, progression may appear to exist when not present—and true progression may be missed.
What is the target IOP range for a patient?
Of course, some patients will require medication. If further IOP lowering is needed, Dr. Moroi sets a target IOP range of 8 to 12 mmHg, which is at episcleral venous pressure. This can be achieved in some patients by maximally targeting outflow with prostaglandins and inflow with (in order of preference) beta-blockers, alpha 2 agonists, or carbonic anhydrase inhibitors (CAIs).
What are the factors that contribute to NTG?
The role of IOP in the pathogenesis of NTG is an area of controversy prompting research into a variety of IOP independent factors such as vascular dysregulation, hypotension, and lamina cribrosa abnormalities that may have some role to play in the development of this disease.
How often should IOP be monitored?
Once treatment is initiated, patients should be followed up 6-8 weeks later to ensure good adherence, minimal side effects, and adequate IOP lowering efficacy. Different medication classes, laser treatment or surgical therapy may be trialed until an appropriate treatment is found. Once treatment goals have been met, periodic measurement of IOP during medical therapy is recommended every 3-4 months to ensure maintenance of goal IOP and absence of progression. Patients should be monitored for signs of progression by periodic assessment of the optic nerve head (disc photos, HRT, OCT, etc.) and visual field testing every 6-12 months, with more frequent intervals in advanced or actively progressing disease. If progression is detected despite goal IOP, treatment goals should be lowered with advance of therapy to achieve them. (also see: Primary_Open-Angle_Glaucoma)
What is normal tension glaucoma?
Normal tension glaucoma (NTG) is a common form of primary open angle glaucoma (POAG) in which there is no measured elevation of the intraocular pressure (IOP). The clinical characteristics of NTG have many similarities to those in POAG, with a few notable distinctions. Like POAG, NTG is a chronic, progressive optic neuropathy that results in a characteristic optic nerve head cupping, retinal nerve fiber layer thinning and functional visual field loss. Careful and complete review of history, physical exam findings, and diagnostic testing are key to distinguishing NTG from other common forms of glaucomatous and non-glaucomatous optic neuropathy. The role of IOP in the pathogenesis of NTG is an area of controversy prompting research into a variety of IOP independent factors such as vascular dysregulation, hypotension, and lamina cribrosa abnormalities that may have some role to play in the development of this disease. Therefore, other proposed interventions in NTG have aimed at modification of blood pressure and optic nerve perfusion in addition to neuroprotection as a means of slowing disease progression independent of an IOP lowering mechanism. Despite the lack of an observed IOP elevation, the current medical and surgical treatment of NTG continues to be aimed at lowering IOP as in other forms of POAG.
Is selective laser trabeculoplasty invasive?
Selective Laser trabeculoplasty (SLT) may be a useful moderately invasive treatment with or without medical therapy. Indeed, there is some literature that supports an IOP lowering, and decreased IOP variability, effect of SLT in NTG patients.
Does NTG cause IOP to be higher?
Although always residing within the normal range for IOP, patients with NTG have been suggested to have higher-normal IOP levels. By contrast, prospective evaluation of patients in the Low-Pressure Glaucoma Treatment Study found no relation between IOP asymmetry and visual field asymmetry. Wide diurnal fluctuations in IOP and nocturnal IOP spikes have also been correlated with NTG .
When did tonometric means become available?
As reliable tonometric means became available in the mid 20th century, large population based studies of intraocular pressure were performed. Although the general distribution is skewed towards higher IOPs, these studies have established the means to calculate the estimated range of physiologic IOP.
Is open angle glaucoma asymptomatic?
As with all forms of open angle glaucoma, the condition is typically asymptomatic until very advanced. Patients may occasionally present with a subjective scotoma near fixation as these defects can occur early on in the disease process of NTG.