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Purpose   To investigate factors related to a right-left difference in visual field defect in untreated normal tension glaucoma (NTG).Methods   The medical records of 92 patients with untreated NTG were reviewed. Ocular blood flow was evaluated with laser speckle flowgraphy, and the mean blur rate (MBR) at the optic nerve head was analyzed. Relationships between right-left differences in mean deviation (MD), intraocular pressure, MBR, spherical equivalent, central corneal thickness, and mean ocular perfusion pressure were evaluated using Spearman's rank correlation coefficient. Multiple regression analysis was used to detect factors contributing to a right-left difference in MD.Results   The right-left difference in MD was correlated with differences in intraocular pressure ( r  = −0.263,  P  = 0.011), MBR ( r  = 0.417,  P  < 0.001), and spherical equivalent ( r  = 0.213,  P  = 0.042), but not with central corneal thickness or mean ocular perfusion pressure. Multiple regression analysis showed that a difference in MBR was the only significant contributor to a right-left difference in MD (slope 0.047, 95% confidence interval 0.025–0.069;  P  < 0.001).Conclusion   In untreated NTG, a difference in blood flow at the optic nerve head was a significant contributor to a right-left difference in visual field defect.

Factors Related to a Right-Left Difference in Visual Field Defect in the Eyes with Untreated Normal Tension Glaucoma