Observational Study of the Long-term Effect of Latanoprost in Normal Tension Glaucoma

Primary outcomes

1. Change From Baseline in Raw Intraocular Pressure (IOP) by Visit

   Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

   Mean IOP values measured by applanation tonometry or noncontact method; valid range: 8-40 millimeters of mercury (mmHg). Only the IOP reading for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed. Last visit = last post-baseline visit at which participant provides a value of IOP.

2. Number of Participants With a 24-Hour Intraocular Pressure (IOP) Profile: Month 12

   Time frame: Month 12

   Response: Yes = had an IOP 24-hour profile; No = did not have an IOP 24-hour profile.

3. Number of Participants With a 24-Hour Intraocular Pressure (IOP) Profile: Month 24

   Time frame: Month 24

   Response: Yes = had an IOP 24-hour profile; No = did not have an IOP 24-hour profile.

4. Number of Participants Per Visit With Intraocular Pressure (IOP) 24-Hour Pressure Peaks: Month 12

   Time frame: Month 12

   Response: Yes = had IOP 24-hour pressure peak; No = did not have IOP 24-hour pressure peak.

5. Number of Participants Per Visit With Intraocular Pressure (IOP) 24-Hour Pressure Peaks: Month 24

   Time frame: Month 24

   Response: Yes = had IOP 24-hour pressure peak; No = did not have IOP 24-hour pressure peak.

6. Percentage of Participants Who Achieved Intraocular Pressure (IOP) Target at Last Visit

   Time frame: Month 24, (or last visit)

   Percentage of participants who achieved their IOP target set at baseline. Response: Yes = achieved IOP target at last vist; No = did not achieve IOP target at last visit.

7. Change From Baseline by Visit in Optic Disc Excavation: Horizontal Cup to Disc Ratio

   Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

   Mean horizontal cup to disc (cup/disc or C/D) ratio measured by slit lamp examination to assess progression of glaucoma; calculated as the ratio of the diameter of the depression (cup) to that of the optical nerve head (disc). Valid range: 0.1-1.0. Only data for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

8. Change From Baseline by Visit in Optic Disc Excavation: Vertical Cup to Disc Ratio

   Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

   Mean vertical cup to disc (cup/disc or C/D) ratio measured by slit lamp examination to assess progression of glaucoma; calculated as the ratio of the diameter of the depression (cup) to that of the optical nerve head (disc). Valid range: 0.1-1.0; a high cup/disc ratio may imply glaucoma. Only data for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

9. Number of Participants With Optic Disc Hemorrhage by Visit: Month 6

   Time frame: Month 6

   Presence of optic disc hemorrhages assessed by slip lamp examination. Only data for eye were treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

10. Number of Participants With Optic Disc Hemorrhage by Visit: Month 12

    Time frame: Month 12

    Presence of optic disc hemorrhages assessed by slip lamp examination. Only data for eye were treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

11. Number of Participants With Optic Disc Hemorrhage by Visit: Month 18

    Time frame: Month 18

    Presence of optic disc hemorrhages assessed by slip lamp examination. Only data for eye were treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

12. Number of Participants With Optic Disc Hemorrhage by Visit: Month 24

    Time frame: Month 24

    Presence of optic disc hemorrhages assessed by slip lamp examination. Only data for eye were treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

13. Change From Baseline in Heidelberg Retina Tomograph (HRT) Parameters: Rim Area

    Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

    Rim area (millimeter [mm]2) right and left eye assessed by HRT imaging. Valid range: 0.500 to 1.900 mm2. Only the rim area for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

14. Change From Baseline in Heidelberg Retina Tomograph (HRT) Parameters: Rim Volume

    Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

    Rim volume (mm3) right and left eye assessed by HRT imaging. Valid range: 0.080 to 0.700 mm3. Only the rim volume for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

15. Change From Baseline in Heidelberg Retina Tomograph Parameters: Cup Shape Measure

    Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

    Cup shape measure right and left eye assessed by HRT imaging . Valid range: -0.400 to -0.010. Only the cup shape measure for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

16. Change From Baseline in Heidelberg Retina Tomograph (HRT) Parameters: Mean RNFL Thickness

    Time frame: Baseline, Month 6, Month 12, Month 18, Month 24, Last Visit

    Mean retinal nerve fiber layer (RNFL) thickness in millimeters (mm) right and left eye assessed by HRT imaging. Valid range: 0.100 to 0.400 mm. Only the RNFL for the eye treated with Xalatan® was used; if both eyes were treated, the value of the right eye was analyzed.

17. Number of Participants With Change From Baseline to Month 24 in Aulhorn Stages

    Time frame: Baseline, Month 24

    Values of change in Aulhorn Stage measured by Humphrey Visual Field Analyzer. Aulhorn stages: no scotoma, Stage I (relative scotomas only), Stage II (absolute scotomas without connection to blind spot), Stage III (absolute scotomas with connection to blind spot), Stage IV (absolute scotomas more than 1 quadrant affected), and Stage V (temporal residual visual field only). If both eyes were treated with Xalantan® the value of right eye was analyzed; otherwise, only the assessment for the eye treated with study medication was used.

18. Number of Participants With Change From Baseline to Month 24 in Visual Field Defect

    Time frame: Baseline, Month 24

    Change in mean defect right and left eye; valid range: -30 - + 30 decibels (dB). Visual field defect categories: preperimetric glaucoma: ≥ -2 dB; mild damage: < -2 dB and ≥ -3.3 dB; moderate damage: < -3.3 dB and ≥ -4.6 dB; and severe damage: < -4.6 dB. If both eyes were treated with Xalatan® , the value for the right eye was used; otherwise, only the mean defect value for the eye treated with study medication was used.

19. Number of Participants With Investigator Assessments of Efficacy at Month 24

    Time frame: Month 24

    Number of participants with Investigator assessments of the efficacy of Xalatan® treatment rated as: 1=very good, 2=good, 3=moderate, 4=insufficient. If study medication was stopped before 24 months, assessment was performed at the time of early termination.

20. Number of Participants With Individual Progression of Glaucoma Damage: Horizontal Cup to Disc Ratio and/or Vertical Cup to Disc Ratio

    Time frame: Month 24 (or last visit)

    Increase in Horizontal Cup to Disc Ratio and/or Vertical Cup to Disc Ratio by at least 0.2 (Last Visit minus Baseline).

21. Number of Participants With Individual Progression of Glaucoma Damage: Optic Disc Hemorrhage

    Time frame: Month 24 (or last visit)

    Participants with at least one post-baseline optic disc hemorrhage.

22. Number of Participants With Individual Progression of Glaucoma Damage: Rim Area, Rim Volume, or Mean Retinal Nerve Fiber Layer (RNFL) Thickness

    Time frame: Month 24 (or last visit)

    Decrease in at least one Heidelberg Retina Tomograph (HRT) parameter by: Rim Area 0.2 millimeter (mm)2, Rim Volume 0.1 mm3, or mean retinal nerve fiber layer (RNFL) Thickness 0.1 mm, (Last Visit minus Baseline).

23. Number of Participants With Individual Progression of Glaucoma Damage: Visual Field Defect-Deterioration

    Time frame: Month 24 (or last visit)

    Visual Field Deterioration rated as progressive by physician on at least one post-baseline visit; range: 1= improved 2= stable 3= progressive. If both eyes were treated with Xalatan® the value for the right eye was used; otherwise, only the assessment for the eye treated with study medication was used.

24. Number of Participants With Individual Progression of Glaucoma Damage: Aulhorn Stage

    Time frame: Month 24 (or last visit)

    Increase in Aulhorn Stage by at least one stage (last visit minus baseline). Three different visual field defect categories defined using Aulhorn stage values 1-5: Aulhorn stage 1 = mild damage, Aulhorn stages 2, 3 = moderate damage, Aulhorn stages 4, 5 =severe damage.

25. Number of Participants With Individual Progression of Glaucoma Damage: Mean Defect

    Time frame: Month 24 (or last visit)

    Decrease in mean defect by at least 2.5 decibels (dB) (Last Visit minus Baseline).

26. Percentage of Participants With Overall Progression of Glaucoma Damage

    Time frame: Month 24 (or last visit)

    Overall progression defined as at least 1 of the 6 individual progression of glaucoma damage measures met: increase in horizontal cup to disc ratio and/or vertical cup to disc ratio by at least 0.2; at least 1 post Baseline (BL) optic-disc hemorrhage; decreased rim area (0.2 mm2), rim volume (0.1 mm3), mean retinal nerve fiber layer (RNFL)(0.1 mm), progressive visual field deterioration, increase in Aulhorn stage (by at least 1 stage), and/or decrease in mean defect by at least 2.5 decibels [dB])

27. Percentage of Participants With Progression of Optic Disc Excavation

    Time frame: Month 24 (or last visit)

    Progression (Last Visit minus Baseline) defined as increase in horizontal cup to disc ratio and/or vertical cup to disc ratio by at least 0.2, and/or decrease in at least 1 of Heidelberg Retina Tomograph (HRT) parameters (deterioration of rim area 0.2 mm2; deterioration of rim volume 0.1 mm3 deterioration or mean retinal nerve fiber layer (RNFL) thickness 0.1 mm).

28. Percentage of Participants With Progression of Visual Field

    Time frame: Month 24 (or last visit)

    Progression defined as visual field deterioration rated progressive by physician on at least 1 post-baseline visit, and increase in Aulhorn stage (by at least 1 stage) and/or decrease in mean defect by at least 2.5 dB (Last Visit minus Baseline).