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Sample records for angle closure glaucoma

  1. Primary angle-closure glaucoma: an update.

    Science.gov (United States)

    Wright, Carrie; Tawfik, Mohammed A; Waisbourd, Michael; Katz, Leslie J

    2016-05-01

    Primary angle-closure glaucoma is potentially a devastating disease, responsible for half of glaucoma-related blindness worldwide. Angle closure is characterized by appositional approximation or contact between the iris and trabecular meshwork. It tends to develop in eyes with shallow anterior chambers, anteriorly positioned or pushed lenses, and angle crowding. Risk of primary angle-closure glaucoma is high among women, the elderly and the hyperopic, and it is most prevalent in Asia. Investigation into genetic mechanisms of glaucoma inheritance is underway. Diagnosis relies on gonioscopy and may be aided by anterior segment optical coherence tomography and ultrasound biomicroscopy. Treatment is designed to control intraocular pressure while monitoring changes to the angle and optic nerve head. Treatment typically begins with medical management through pressure-reducing topical medications. Peripheral iridotomy is often performed to alleviate pupillary block, while laser iridoplasty has been found effective for mechanisms of closure other than pupillary block, such as plateau iris syndrome. Phacoemulsification, with or without goniosynechialysis, both in eyes with existing cataracts and in those with clear lenses, is thus far a viable treatment alternative. Long-term research currently underway will examine its efficacy in cases of angle closure in early stages of the disease. Endoscopic cyclophotocoagulation is another treatment option, which can be combined with cataract surgery. Trabeculectomy remains effective therapy for more advanced cases. PMID:26119516

  2. Citalopram associated with acute angle-closure glaucoma: case report

    OpenAIRE

    Hassan Sabit; Thirumalai Srinivasa; Croos Robert; Davis Jane

    2005-01-01

    Abstract Background Acute angle-closure glaucoma is a rare complication in patients receiving anti-depressant treatment. In the following case, we report the development of acute angle closure glaucoma in a patient who overdosed on Citalopram, an antidepressant, and discuss the possible etiological mechanisms for the condition. Case presentation We report a 54 year old, Caucasian lady, with depression and alcohol dependence syndrome, who developed acute angle-closure glaucoma after an overdos...

  3. Citalopram associated with acute angle-closure glaucoma: case report

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    Hassan Sabit

    2005-10-01

    Full Text Available Abstract Background Acute angle-closure glaucoma is a rare complication in patients receiving anti-depressant treatment. In the following case, we report the development of acute angle closure glaucoma in a patient who overdosed on Citalopram, an antidepressant, and discuss the possible etiological mechanisms for the condition. Case presentation We report a 54 year old, Caucasian lady, with depression and alcohol dependence syndrome, who developed acute angle-closure glaucoma after an overdose of Citalopram, along with alcohol. She was treated with medications and had bilateral Yag laser iridotomies to correct the glaucoma and has made complete recovery. In this case, the underlying cause for glaucoma appears to be related to the ingestion of Citalopram. Conclusion The patho-physiological basis for acute angle closure glaucoma in relation to antidepressant medications remains unclear. The authors suggest Citalopram may have a direct action on the Iris or Ciliary body muscle through serotonergic or anti-cholinergic mechanisms or both. This case highlights the importance of the awareness of the underlying risks, which may predispose an individual to develop acute angle-closure glaucoma, and reminds the clinicians the significance of history taking and examination of the eye before and after starting anti-depressants. This area needs to be further researched.

  4. Geleophysic dysplasia associated with bilateral angle closure glaucoma

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    Murat Sinan Saricaoglu

    2013-01-01

    Full Text Available In this case report, we present occurrence of bilateral angle closure glaucoma in a 9-year-old girl with geleophysic dysplasia. Bilateral YAG laser iridotomy was applied, but intraocular pressure (IOP remained at high levels, necessitating bilateral trabeculectomy with mitomycin C. On her follow-up examinations for 3 years, IOP remained in the mid-20s with no need for further intervention or antiglaucoma medication. There are few reports describing the ocular findings of geleophysic dysplasia in literature. To our knowledge, this is the first case report describing an application of glaucoma surgery and its results at geleophysic dysplasia.

  5. An Indian perspective on primary angle closure and glaucoma

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    Sihota Ramanjit

    2011-12-01

    Full Text Available Aim: To provide a synopsis of primary angle closure disease in India, and Indian studies on the same. Results: Primary angle closure glaucoma forms almost half of all adult primary glaucomas seen in a hospital setting in India. Anatomically, corneal diameters and anterior chamber depths were least in acute and chronic PACG eyes as compared to subacute eyes and controls. Besides relative pupillary block, a Valsalva maneuver during activities of daily living may be responsible for intermittent angle closure and raised IOP in predisposed eyes. Iridotomy alone, controlled the intraocular pressure in 66.7% of subacute eyes and 12.9% of the acute. Medical therapy was additionally required for 35.5% of the acute eyes, 12.1% of the subacute and 30.0% of the chronic cases. There was a greater mean and peak IOP reduction, achieved with 0.005% latanoprost once daily, 8.2 ± 2.0 mm Hg, compared with 0.5% timolol twice daily, 6.1 ± 1.7 mm Hg2. A progression of PACS to PAC was seen in 22%, PAC to PAC OHT in 38.7% and PAC OHT to PACG in 30.7% over 5 years. Conclusions: Primary angle closure disease is common in India, and can be managed well with iridotomy, followed by an appropriate control of IOP.

  6. Bilateral Acute Angle-Closure Glaucoma Induced By Escitalopram

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    Dilbade Yıldız Ekinci

    2014-10-01

    Full Text Available Escitalopram is an antidepressant of the selective serotonin reuptake inhibitor(SSRI class. In this manuscript, we report the case of a female patient who developed bilateral acute angle-closure glaucoma induced by escitalopram. A 46-year-old female patient was admitted to our ophthalmology clinic with complaints of severe pain around the both eyes, headache, nausea, and vomiting for two days. In her past medical history, she was using escitalopram for depression for two years. Visual acuity was at hand movement level in both eyes. Anterior segment examination showed bilateral diffuse conjunctival hyperemia, corneal edema, shallow anterior chamber, and fixed dilated pupils. Intraocular pressure was 47 mmHg in the right and 68 mmHg in the left eye. The diagnosis was acute angle-closure glaucoma, and the escitalopram medication was discontinued. She was treated with topical and systemic antiglaucomatous medication. After the cornea become clear, bilateral peripheral laser iridotomy was done. In the following year, she did not begin escitalopram medication again and no other acute angle-closure attack was seen. (Turk J Ophthalmol 2014; 44:396-9

  7. Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula

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    Thinda Sumeer

    2012-07-01

    Full Text Available Abstract Background Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the external or internal carotid arteries. Although rare, closure of carotid cavernous fistulas can lead to immediate ocular complications. To our knowledge, our case represents the first report of worsening angle closure glaucoma and choroidal detachments over an extended period of two months subsequent to closure of a carotid cavernous fistula. Case presentation A 70-year-old female with a history of primary angle closure glaucoma presented with 4 mm of proptosis, resistance to retropulsion, tortuous corkscrew blood vessels and an orbital bruit of the right eye. Diagnostic cerebral angiogram showed a small indirect Barrow type D right carotid cavernous fistula. Transarterial embolization was planned but repeat cerebral angiography prior to the procedure demonstrated spontaneous partial closure of the carotid cavernous fistula and the procedure was aborted. One month later, our patient was noted to have worsening vision and choroidal detachments of the right eye. She declined further testing and was thus started on self-administered manual carotid jugular compressions. One month later, she developed progressive worsening of her choroidal detachments and angle closure. She eventually opted for surgical intervention but repeat cerebral angiography showed significant thrombosis of the carotid cavernous fistula and no intervention was warranted. Examination two months later showed complete resolution of the choroidal detachments and open angles of both eyes. Conclusions Our patient demonstrated worsening angle closure glaucoma and choroidal detachments after spontaneous closure of her carotid cavernous fistula had been noted. Ocular complications, including acute angle closure, have been reported to occur immediately after closure of carotid cavernous fistulas, but not over months as in our patient. It is imperative that individuals who have

  8. Mefenamic acid-induced bilateral transient myopia, secondary angle closure glaucoma and choroidal detachment

    OpenAIRE

    Vishwakarma Parag; Raman Ganesh; Sathyan P

    2009-01-01

    Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.

  9. Cataract Surgery in Eyes with Filtered Primary Angle Closure Glaucoma

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    Sasan Moghimi

    2013-01-01

    Full Text Available Purpose: To evaluate the effect of cataract surgery on intraocular pressure (IOP in filtered eyes with primary angle closure glaucoma (PACG. Methods: In this prospective interventional case series, 37 previously filtered eyes from 37 PACG patients with mean age of 62.1±10.4 years were consecutively enrolled. All patients had visually significant cataracts and phacoemulsification was performed at least 12 months after trabeculectomy. Visual acuity, IOP and the number of glaucoma medications were recorded preoperatively, and 1, 3, 6 and 12 months after surgery. Anterior chamber (AC depth was measured preoperatively and 3 months after cataract surgery with A-scan ultrasonography. The main outcome measure was IOP at 12 months. Results: IOP was decreased significantly from 18.16±5.91 mmHg at baseline to 15.37±2.90 mmHg at final follow-up (P<0.01. The mean number of glaucoma medications was significantly decreased from 1.81±0.24 to 0.86±1.00 (P=0.001 at 1 year postoperatively. At final follow up, 36 (97.2% eyes and 32 (86.4% eyes had IOP≤21 and IOP≤18 mmHg, respectively; 14 (37.8% eyes and 9 (24.3% eyes had IOP≤21 and IOP≤18 mmHg without medications, respectively. The magnitude of IOP reduction was correlated with higher preoperative IOP (r=0.85, P<0.001, shallower preoperative AC depth (r=-0.38, P=0.01 and greater changes in AC depth (r=-0.39, P=0.01. Conclusion: Cataract surgery reduces IOP and the number of glaucoma medications in previously filtered PACG eyes. This reduction seems to be greater in patients with higher preoperative IOP and shallower anterior chambers.

  10. Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma

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    Qing G

    2012-10-01

    Full Text Available Guoping Qing,1,2 Ningli Wang,1 Dapeng Mu11Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China; 2State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, ChinaPurpose: To evaluate the intraocular pressure (IOP-lowering efficacy of goniosynechialysis (GSL for advanced chronic angle-closure glaucoma (CACG using a simplified slit-lamp technique.Patients and methods: Patients with CACG with one severely affected eye with best-corrected visual acuity below 20/200 and a mildly or functionally unaffected fellow eye were enrolled in this study. All patients underwent ophthalmologic examinations including measurement of visual acuity, best-corrected visual acuity, and IOP; biomicroscopy; specular microscopy; fundus examination; and gonioscopy followed by anterior chamber paracentesis and GSL for nasal peripheral anterior synechiae in the eye with severe CACG.Results: Thirty patients (18 men, 12 women were identified as having CACG with an initial mean IOP of 47.1 ± 6.7 mmHg (range 39–61 mmHg in the severely affected eye. One week after GSL, the mean IOP of the treated eyes decreased to 19.3 ± 2.8 mmHg (range 14–26 mmHg without antiglaucoma medication (average decrease 27.7 ± 6.5 mmHg; range 16–41 mmHg, which was significant (P < 0.00001 compared with baseline. After an average follow-up period of 36.6 ± 1.0 months (range 35–38 months, the mean IOP stabilized at 17.4 ± 2.2 mmHg (range 12–21 mmHg. The nasal angle recess did not close again in any one of the patients during the follow-up period. The average significant (P < 0.00001 decrease in corneal endothelial cell density in the treated eyes was 260 ± 183 cells/mm2 (range 191–328 cells/mm2.Conclusions: Anterior chamber paracentesis and GSL lowers IOP in advanced CACG, though it may lead to mild corneal endothelial cell loss

  11. Acute angle-closure glaucoma following botulinum toxin injection for blepharospasm.

    OpenAIRE

    Corridan, P.; Nightingale, S; Mashoudi, N.; Williams, A C

    1990-01-01

    Botulinum toxin inhibits acetylcholine release and therefore could cause mydriasis. We report a case of acute angle-closure glaucoma which occurred shortly after a series of injections of botulinum toxin round the eyelids for blepharospasm.

  12. New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Jian Ge; Yan Guo; Yizhi Liu; Mingkai Lin; Yehong Zhuo; Bing Chen; Xiuqi Chen

    2000-01-01

    Objective: To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation. Design: Retrospective, noncontrolled interventional case series.Participants: In 36 eyes with angle-closure glaucoma (ACG), there were 18 eyes with primary acute angle-closure glaucoma (PACG), 14 eyes with primary chronic angle-closure glaucoma (PCCG), 3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle-closure glaucoma (SCCG).Intervention: Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures: Postoperative visual acuity, IOP, axial anterior chamber depth.Results: After a mean postoperative follow-up time of 8.81 ± 7.45 months, intraocular pressure was reduced from a preoperative mean of 23.81 ± 17.84 mmHg to a postoperative mean of 12.54 ± 4. 73 mmHg ( P = 0. 001 ). Mean anterior chamber depth was 1.75 ± 0.48 mm preoperatively and 2.29 ± 0.38 mm postoperatively ( P = 0. 000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0. 01 to 0. 7 (20/200 to 20/30) postoperatively, which was better than preoperative VA ranging from hand movement to 0.4 (20/50) ( P= 0. 000).Conclusion: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma. Eye Science 2000; 16:22 ~ 28.

  13. Unilateral Angle-Closure Glaucoma with Ciliochoroidal Effusion after the Consumption of Cannabis: A Case Report

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    Rana Hanna

    2014-12-01

    Full Text Available A 35-year-old male patient, diagnosed with acute angle-closure glaucoma, did not improve despite intensive treatment with antiglaucoma medications. Ultrasound biomicroscopy revealed a ciliochoroidal effusion. Due to his past history of drug abuse, a urine test was analyzed and found to be positive for cannabis. After topical cycloplegia and oral steroid therapy, his symptoms improved substantially. The present case highlights the role of ultrasound biomicroscopy in evaluating patients with acute angle-closure glaucoma and the role of cannabis abuse in the development of ciliochoroidal effusion.

  14. Unilateral angle-closure glaucoma with ciliochoroidal effusion after the consumption of cannabis: a case report.

    Science.gov (United States)

    Hanna, Rana; Tiosano, Beatrice; Dbayat, Noora; Gaton, Dan

    2014-01-01

    A 35-year-old male patient, diagnosed with acute angle-closure glaucoma, did not improve despite intensive treatment with antiglaucoma medications. Ultrasound biomicroscopy revealed a ciliochoroidal effusion. Due to his past history of drug abuse, a urine test was analyzed and found to be positive for cannabis. After topical cycloplegia and oral steroid therapy, his symptoms improved substantially. The present case highlights the role of ultrasound biomicroscopy in evaluating patients with acute angle-closure glaucoma and the role of cannabis abuse in the development of ciliochoroidal effusion. PMID:25606036

  15. Phacoemulsification Alone versus Phacoemulsification Combined with Trabeculectomy for Primary Angle-Closure Glaucoma

    OpenAIRE

    Rhiu, Soolienah; Hong, Samin; Seong, Gong Je; Kim, Chan Yun

    2010-01-01

    Surgical outcomes of phacoemulsification only and phacoemulsification combined with trabeculectomy were compared in patients with primary angle-closure glaucoma (PACG). Clinical records of 41 consecutive patients were retrospectively reviewed, and there was no difference in best-corrected visual acuity and intraocular pressure preoperatively and at the final follow-up in both study groups. Regarding the number of anti-glaucoma medications, it was higher in the phacoemulsification combined wit...

  16. Angle-closure glaucoma in a patient with the nanophthalmos-ocular cystinosis-foveoschisis-pigmentary retinal dystrophy complex

    OpenAIRE

    Sonmez Kenan; Ozcan Pehmen Y

    2012-01-01

    Abstract Background To report clinical features of bilateral angle-closure glaucoma in a patient with nanophthalmic eyes associated with ocular cystinosis, foveoschisis and pigmentary retinal dystrophy. This is probably the first published report of the possible association of all these five entities in the same patient. Case presentation A 50-year-old white male was referred for uncontrolled glaucoma in both eyes. He was previously diagnosed with angle-closure glaucoma in association with oc...

  17. Bilateral nanophthalmos, pigmentary retinal dystrophy, and angle closure glaucoma--a new syndrome?

    OpenAIRE

    Ghose, S.; Sachdev, M S; Kumar, H.

    1985-01-01

    An unusual case of bilateral nanophthalmos with pigmentary retinal dystrophy and angle closure glaucoma is presented. This is probably the first published report of the established association of all these three entities in the same patient. The aetiological possibilities and clinical significance are discussed.

  18. A CASE OF ANGLE - CLOSURE GLAUCOMA SECONDARY TO CHRONIC ANTERIOR UVEITIS

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    Pandu

    2015-05-01

    Full Text Available Elevation of intraocular pressure secondary to intraocular inflammation frequently presents a diagnostic & therapeutic challenge. Secondary glaucoma is more common in chronic anterior uveitis. We present a case of the same, a 25 years old female presented with headache and redness in right eye. She gives history of gradual loss of vision in both eyes 15 years back. On examination there was no perception of light in both eyes and pupillary reactions were absent in both eyes. Anterior segment of right eye showed circumciliary congestion, corneal edema, peripheral anterior synechiae, Aqueous flare of grade 1+, annular posterior synechiae with complicated cataract. Anterior segment of left eye showed shallow anterior chamber with closed angles and complicated cataract. A clinical diagnosis of secondary angle closure glaucoma was made. Once IOP was under control she underwent synechotomy and lens extraction in right eye and lens extraction in left eye. Post operatively corneal edema and congestion resolved. Fundus examination revealed glaucomatous optic atrophy. Thus, prompt and early treatment of anterior uveitis is needed to prevent secondary angle closure glaucoma. We report a case of secondary angle closure glaucoma in a young female patient.

  19. Bilateral acute angle closure glaucoma caused by fluoxetine: a case report

    OpenAIRE

    Pina, S; Silva, F.; Alves, S; Azevedo, A.; Santos, MJ; Vaz, F.; Kaku, P; Esperancinha, F

    2011-01-01

    Background: Acute angle closure glaucoma (ACG) occurs in patients with narrow iridocorneal angle, being more prevalent in elderly, hyperopic and asian. Mydriasis, induced by factors such as darkness, stress or drugs, may be a triggering factor of this disease. Methods: Case report of a 55 years old patient, female, black, with history of depressive mood that one month after initiation of oral fluoxetine therapy, appears in the emergency department with bilateral condition of intense eye pa...

  20. Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

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    Osman Okan Olcaysu

    2015-01-01

    Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

  1. Primary Chronic Angle-closure Glaucoma in Chinese——A Clinical Exploration of Its Pathogenesis And Natural Course

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Fourty-three cases (86 eyes) of primary chronic angle-closure glaucoma were randomly selected. An additional 44 cases (77 eyes) of primary acute angle-closure glaucoma and 30 normal subjects (34 eyes) were also randomly enrolled as control groups for comparison in the clinical study. Ultrasonic biometric measurements of the anterior chamber depth, lens thickness and axial length of the eyeball were performed. Using an potic microgauge attached to the slit-lamp, the entrance of anterior chamber angle was...

  2. Topiramate-induced bilateral acute angle closure glaucoma and myopic shift

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    Rajnish Raj

    2014-06-01

    Full Text Available Topiramate (TPM shows idiosyncratic adverse reaction of peripheral ciliochoroidal effusion leading to acute angle closure glaucoma (AACG, which should be diagnosed and managed at the earliest to prevent irreversible visual loss. We report, a case of TPM-induced bilateral AACG and myopic shift, which was reversed by omitting TPM and administering antiglaucoma medications. [Int J Basic Clin Pharmacol 2014; 3(3.000: 562-565

  3. Association of Matrix Metalloproteinase-9 (MMP9) Variants with Primary Angle Closure and Primary Angle Closure Glaucoma

    Science.gov (United States)

    Wiggs, Janey L.; Pasquale, Louis R.; Sun, Xinghuai; Fan, Bao Jian

    2016-01-01

    Shorter axial length observed in patients with primary angle closure glaucoma (PACG) might be due to altered matrix metalloproteinase-9 (MMP9) activity resulting in ECM remodeling during eye growth and development. This study aimed to evaluate common variants in MMP9 for association with PACG. Six tag SNPs of MMP9 were genotyped in a Chinese sample of 1,030 cases, including 572 PACG and 458 primary angle closure (PAC), and 499 controls. None of 6 SNPs were significantly associated with overall PAC/PACG (P > 0.07) or with PAC/PACG subgroups (Pc > 0.18). Meta-analysis of two non-Chinese studies revealed significant association between rs17576 and PACG (ORs = 0.56, P 0.47). The largest association study to date did not find significant association between MMP9 and PAC/PACG in Chinese; meta-analysis with other Chinese datasets did not produce significant association. In most instances combination with non-Chinese datasets was not possible except for one variant showing nominally significant association. More work is needed to define the role of MMP9 variants in PACG. PMID:27272641

  4. Association of Matrix Metalloproteinase-9 (MMP9 Variants with Primary Angle Closure and Primary Angle Closure Glaucoma.

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    Xueli Chen

    Full Text Available Shorter axial length observed in patients with primary angle closure glaucoma (PACG might be due to altered matrix metalloproteinase-9 (MMP9 activity resulting in ECM remodeling during eye growth and development. This study aimed to evaluate common variants in MMP9 for association with PACG. Six tag SNPs of MMP9 were genotyped in a Chinese sample of 1,030 cases, including 572 PACG and 458 primary angle closure (PAC, and 499 controls. None of 6 SNPs were significantly associated with overall PAC/PACG (P > 0.07 or with PAC/PACG subgroups (Pc > 0.18. Meta-analysis of two non-Chinese studies revealed significant association between rs17576 and PACG (ORs = 0.56, P 0.47. The largest association study to date did not find significant association between MMP9 and PAC/PACG in Chinese; meta-analysis with other Chinese datasets did not produce significant association. In most instances combination with non-Chinese datasets was not possible except for one variant showing nominally significant association. More work is needed to define the role of MMP9 variants in PACG.

  5. Argon laser iridoplasty : A primary mode of therapy in primary angle closure glaucoma

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    Agarwal H

    1991-01-01

    Full Text Available Argon laser iridoplasty was performed in 40 eyes of 33 patients of primary angle closure glaucoma. There were 12 male and 21 female patients. The mean ages of the male and female patients were 51 years and 48.4 years respectively. Forty eyes were divided into two groups. Group I consisted of ten eyes of subacute angle closure glaucoma and group II included thirty eyes of chronic angle closure glaucoma. Argon laser iridoplasty was performed with Coherent 9000 model using laser settings of spot size 200 micron, duration 0.2 second and power 0.7 watt. A total of 80 spots were applied over 360 degree circumference. The intraocular pressure control (below 22 mm Hg was achieved after iridoplasty in all the eyes (100% in group I, where as in group II the intraocular pressure was controlled in 70% eyes. The follow up period varied from 3 months to one year with a mean of eight months. The success rate with iridoplasty was directly related to the extent of peripheral anterior synechiae, optic disc cupping and presence of visual field changes.

  6. Topiramate-induced Myopic Shift and Bilateral Secondary Angle-closure Glaucoma

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    Özgür Örüm

    2012-03-01

    Full Text Available In this case report, we discuss a 24-year-old female patient with diagnosis of epilepsy who developed myopia and acute bilateral angleclosure glaucoma after 7 days of treatment with topiramate. The patient had also been taking duloxetine daily for six months with diagnosis of depression. Both topiramate and duloxetine have been related to the increase of intraocular pressure and the development of glaucoma. This case report highlights the need for being suspicious about acute bilateral angle-closure glaucoma, which is reversible by supportive treatment in patients using topiramate. We recommend that particular attention should be paid in prescribing topiramate to patients who are already under treatment with duloxetine or other antidepressants with a similar mechanism of action and that patients should be informed about possible side effects. (Turk J Oph thal mol 2012; 42: 154-6

  7. Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma

    OpenAIRE

    Khor, CC; Do, T.; Jia, H; Nakano, M; George, R.; Abu-Amero, K; Duvesh, R; Chen, LJ; Z. Li; Nongpiur, ME; Perera, SA; Qiao, C.; Wong, H-T; Sakai, H.; de Melo, MB

    2016-01-01

    Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = ...

  8. Ultrasonic Evaluation of the Lens Thickness to Axial Length Factor in Primary Closure Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    Ultrasonic biometry was done in 232 normal eyes and 138 eyes with primary angle closure glaucoma (ACG), using Ultrascan Digital B System IV (10 MHz). The ratio between the lens thickness and the axial length (lens thickness to axial length factor, LAF) was evaluated as a biometric index for assessing the eye with primary ACG in Chinese. LAF of 2.00 was found to be ideal point of demarcation between ACG and normal eyes (i.e., lens thickness equals to 1/5 of axial length). It appears that LAF is helpful i...

  9. The effect of lens parameters on the development of the primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    Zhaohui Feng; Naixue Sun; Aiyi Zhou; Donggang Han; Yun Long; Zhao Wang; Xiaohua Wang

    2007-01-01

    Objective:To investigate the role the lens dimensions played on the pathogenesis of primary angle-closure glaucoma.Methods:38 eyes of 20 patients with primary angle-closure glaucoma (PACG) and 35 eyes of 22 normal individuals without ocular abnormalities were examined. The anatomical parameters of the lens and other structures of the anterior segment were calculated using B ultrasound, computer image processing and ultrasound biomicroscopy (UBM). The parameters were compared between the patients and normal subjects. Correlation analysis was used to determine the relationship between the radii of curvature of the anterior lens surface (RCALS) and the other parameters of the anterior segment. Results:Compared with the normal eyes, the eyes of PACG had thicker lens, steeper curvature of anterior lens surface, decreased depth of the anterior chamber, narrower chamber angle, and more anterior position of the ciliary bodies and lens. All these differences were significant(P < 0.05 or P < 0.01). In the PACG group, the RCALS had significantly negative correlation with the central and peripheral lens thickness (P < 0.01 and P < 0.05 respectively), and had positive correlation with relative lens position, anterior chamber depth (ACD), angle-open distance at 500 um(AOD500), trabecular iris angle(TIA) and trabecular ciliary processes distance(TCPD, P < 0.05 or P < 0.01 ). Conclusion:The occurrence of PACG is relevant to the abnormal anatomical structures of the anterior segment. Among all factors, the lens parameters play an important role in the pathogenesis. Increased lens thickness, relative more anterior position of lens, especially steepened curvature of anterior lens surface are predisposing factors of the pathologic phenomenon in PACG including pupillary blockage, shallow anterior chamber, secondary closure of chamber angle and elevation of intraocular pressure.

  10. Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

    Science.gov (United States)

    Kim, Kyoung Nam; Lim, Hyung Bin; Lee, Jong Joo

    2016-01-01

    Purpose To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. Methods In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. Results In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). Conclusions In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic). PMID:27478355

  11. Topiramate-associated acute, bilateral, angle-closure glaucoma: case report

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    Lucas Barasnevicius Quagliato

    2013-02-01

    Full Text Available This paper describes a topiramate induced acute bilateral angle-closure glaucoma. This rare adverse effect is an idiosyncratic reaction characterized by uveal effusion and lens forward displacement, leading to increased intraocular pressure and vision loss. We describe a 55 year-old white woman with migraine, spasmodic torticollis and essential tremor, who developed bilateral acute angle-closure glaucoma, one week after starting topiramate 25 mg/day. She was seen at the Ophthalmology Emergency Department of the Fundação João Penido Burnier (Campinas, SP, Brazil with a 4 hours history of blurry vision, ocular pain and bright flashes vision. Slit lamp examination revealed moderate conjunctival injection and corneal edema, and shallow anterior chambers. Intraocular pressure was 48 mmHg in both eyes. Fundoscopic examination findings were normal. She was treated with timolol, brimonidine, dorzolamide, pilocarpine, prednisone acetate eye drops and acetazolamide. One hour after those measures, as the intraocular pressure was 30 mmHg, she received a manitol intravenous injection and the intraocular pressure normalized. After 24 hours an iridotomy with Yag laser was performed. Topiramate was discontinued and she was totally recovered after one week.

  12. Do we really need to panic in all acute vision loss in ICU? Acute angle-closure glaucoma.

    Science.gov (United States)

    Akal, Ali; Kucuk, Ahmet; Yalcin, Funda; Yalcin, Saban

    2014-08-01

    Acute angle closure glaucoma is a sight-threatening situation characterized by a sudden and marked rise in intraocular pressure (IOP) due to obstruction of aqueous humour outflow. Many local (ocular drops, nasal and nebulized agents) and systemic drugs (e.g. atropine, adrenaline, ephedrine, some psychoactive and antiepileptic drugs) that are widely used in intensive care units have the potential to precipitate such an acute attack. In this case report, we describe progressive visual loss due to acute angle-closure glaucoma (AACG) in a 59 year old female patient followed in the ICU due to a massive pulmonary embolism. PMID:25252529

  13. Reduction of intraocular pressure and improvement of vision after cataract surgeries in angle closure glaucoma with concomitant cataract patients

    OpenAIRE

    Zhang, Zong-Mei; Niu, Qing; Nie, Yan; Zhang, Jin

    2015-01-01

    Objective: This study is to compare the efficacy of three different cataract surgeries in eyes with angle closure glaucoma (ACG) with concomitant cataract. Methods: A retrospective comparative analysis of 106 ACG patients (112 eyes) with concomitant cataract was conducted between February, 2012 and February, 2014. Clinical outcomes of ACG patients with concomitant cataract underwent phacoemulsification and intraocular lens implantation (group A, n = 34, 36 eyes, angle closure < 180°); combine...

  14. Management of intermittent angle closure glaucoma with Nd: yag laser iridotomy as a primary procedure

    International Nuclear Information System (INIS)

    To assess the efficacy and complications of Nd: YAG laser iridotomy in patients with intermittent (sub-acute) angle closure glaucoma. Twenty-five eyes of twenty-three patients with periodic (intermittent) angle closure, selected in outpatient department, were kept on pilocarpine until YAG laser iridotomy was performed. After YAG laser iridotomy oral acetazolamide and topical dexamethasone was used to control post laser rise of IOP and inflammation respectively. Patency of iridotomy was confirmed and intra-ocular pressure was measured one hour after the procedure. Immediate complication, if any, was noted. Follow-up was done for six months. Prophylactic laser iridotomy was done in fellow eye with occludable angle. Levene's test for equality of variance and t-test for equality of means were used for statistical analysis. This study revealed a significant difference in IOP before and after YAG laser iridotomy (p = .002). Complete follow-up of 6 months was possible in 25 eyes of 23 subjects. After YAG Laser iridotomy, 21 (84%) eyes showed negative provocative test, intraocular pressure below 19mm Hg without medication and anterior chamber angle no more occludable and were labeled successful. Iridotomy remained patent in 96% of eyes. Iridotomy failed to reduce IOP in 4 (16%) eyes. The complications were minimal and transient. (author)

  15. Oseltamivir (Tamiflu-induced bilateral acute angle closure glaucoma and transient myopia

    Directory of Open Access Journals (Sweden)

    Ji Woong Lee

    2014-01-01

    Full Text Available A 27-year-old woman developed bilateral acute angle closure glaucoma (AACG and transient myopia after taking oseltamivir for four days. On the fourth day, she received systemic and topical intraocular pressure (IOP-lowering agents, and IOP decreased in both eyes. However, her visual acuity was unchanged. A myopic shift of -5.25 D OD and -5.0 D OS was estimated to have occurred in the acute phase. A-scan ultrasonography and Pentacam showed markedly shallow anterior chambers and increased lens thickness. Ultrasound biomicroscopy revealed an annular ciliochoroidal effusion with forward displacement of the lens-iris diaphragm. Ciliochoroidal effusion and transient myopia were resolved after discontinuation of oseltamivir.

  16. Angle-closure glaucoma in a patient with the nanophthalmos-ocular cystinosis-foveoschisis-pigmentary retinal dystrophy complex

    Directory of Open Access Journals (Sweden)

    Sonmez Kenan

    2012-07-01

    Full Text Available Abstract Background To report clinical features of bilateral angle-closure glaucoma in a patient with nanophthalmic eyes associated with ocular cystinosis, foveoschisis and pigmentary retinal dystrophy. This is probably the first published report of the possible association of all these five entities in the same patient. Case presentation A 50-year-old white male was referred for uncontrolled glaucoma in both eyes. He was previously diagnosed with angle-closure glaucoma in association with ocular cystinosis. Ocular examination revealed high hyperopia (+13.5 OD and +14 OS diopters with reduced axial length (16.27 mm OD and 15.93 mm OS. Despite being on 3 topical medications, his IOP measured 37 mmHg OD and 35 mm Hg OS. Slit-lamp biomicroscopy showed refractile, polychromatic crystalline deposits throughout the cornea and conjunctiva in both eyes. Gonioscopy revealed an extremely narrow angle with peripheral anterior synechiae (PAS. Anterior chamber depths were shallow. Fundus examination disclosed punctate hypopigmentation of the retinal pigment epithelium mainly at the posterior pole. Optical coherence tomography showed foveal schisis appearing as small retinal cysts. The patient did not display any systemic abnormalities. Conclusions This case brings into discussion a new clinical entity of angle closure glaucoma in nanophthalmos accompanied by ocular cystinosis-foveoschisis-pigmentary retinal dystrophy complex.

  17. Impact of Phacoemulsification Surgery on Intraocular Pressure in Primary Angle-Closure Glaucoma

    Directory of Open Access Journals (Sweden)

    Volkan Dayanır

    2012-12-01

    Full Text Available Pur po se: To investigate whether primary phacoemulsification in acute primary angle closure glaucoma (APACG and chronic primary angle closure glaucoma (CPACG will lower intraocular pressure (IOP or not. Ma te ri al and Met hod: This retrospective, non-comparative, consecutive, interventional case series includes 22 eyes of 20 patients with APACG and 31 eyes of 23 patients with CPACG. All eyes had undergone phacoemulsification surgery without any reference to the presence of cataract. Data about IOP, number of antiglaucoma medications and best corrected visual acuity (BCVA were collected. Re sults: In APACG mean IOP (95% CI, number of antiglaucoma medications and Snellen visual acuity changed at last preoperative evaluation from 30.9±15.6 mmHg (23.0-38.0, 2.6±1.4 boxes and 0.4±0.2 lines to 15.5±3.9 mm Hg (p<0.000, 13.8-17.0, 0.6±0.9 boxes (p<0.000 and 0.6±0.3 lines (p=0.001 at last follow-up. Same parameters in CPACG changed from 18.0±7.8 mmHg (15.1- 20.8, 1.6±1.1 boxes and 0.5±0.2 lines at last preoperative evaluation to 14.7±3.6 mmHg (p<0.023, 13.4-16.0, 0.5±0.8 boxes (p<0.000 and 0.6±0.3 lines (p=0.007 at last follow-up. Mean follow-up (95% CI for APACG and CPACG were 554±646 (268-841 and 747±820 (438-1041 days respectively. In APACG and CPACG groups 19 eyes (86% and 16 eyes (52% had lower IOP respectively at last follow-up. 59% of the eyes with APACG and 61% of the eyes with CPACG were classified as complete success when it was defined as IOP ≤18mmHg without any antiglaucoma medications. Dis cus si on: Primary phacoemulsification without any reference to cataract is a safe and effective procedure in terms of IOP control and reducing the number of antiglaucoma drops in APACG and CPACG. (Turk J Ophthalmol 2012; 42: 438-42

  18. [Chronic angle-closure glaucoma in a pseudophakic eye with Soemmering's ring and plateau iris: case report].

    Science.gov (United States)

    Esmenjaud, E; Rebollo, O

    2013-05-01

    We present a case of a pseudophakic woman with chronic angle-closure glaucoma. She had undergone uncomplicated bilateral phacoemulsification in 1994 with 21-diopter implants in the capsular bag. Fourteen years later, the right eye developed progressive angle closure with ocular hypertension, disc cupping and visual field defect. We observed a shallow anterior chamber, myopic shift, and closed angle, not openable on indentation gonioscopy. UBM revealed anteroposition of the ciliary body and a Soemmering's ring, with both appearing to contribute to the angle closure. After two incomplete iridotomies and one complete but blocked by the Soemmering's ring, a final UBM-guided iridotomy afforded a partial reopening of the angle, and satisfactory IOP control. The appearance and development of a Soemmering's ring after phacoemulsification are not always appreciated. It is common but usually asymptomatic. However, in some cases, when it is thick and/or located anteriorly, in the case of an anteroposition of the ciliary body (as in our case), it seems to cause direct pressure on the iris and pupillary block. Angle-closure glaucoma in pseudophakic eyes remains uncommon, the use of UBM is recommended, the role of a Soemmering's ring should be investigated, iridotomies must often be repeated, and long-term monitoring of pseudophakic patients remains necessary. PMID:23618736

  19. Bilateral acute angle closure glaucoma in a patient with dengue fever: case report Glaucoma agudo bilateral em um paciente com dengue: relato de caso

    OpenAIRE

    Paulo de Tarso Ponte Pierre Filho; Jurandir Pontes Carvalho Filho; Érika Teles Linhares Pierre

    2008-01-01

    Ocular complications in dengue fever are uncommon but may result in visual loss. The authors report the first documented case of a patient with dengue fever who presented with simultaneous bilateral acute angle closure glaucoma. The disease was confirmed by specific serological tests. Despite the treatment, severe visual impairment occurred in this case.Complicações oculares são incomuns na dengue, mas podem resultar em perda visual. Os autores relatam o primeiro caso de um paciente com dengu...

  20. Susceptibility to primary angle closure glaucoma in Saudi Arabia: the possible role of mitochondrial DNA ancestry informative haplogroups

    OpenAIRE

    Abu-Amero, Khaled K; González, Ana M; Osman, Essam A.; Larruga, José M; Cabrera, Vicente M; Al-Obeidan, Saleh A.

    2011-01-01

    Purpose In a previous preliminary analysis we reported that mitochondrial DNA (mtDNA) haplogroup R0a was significantly more frequent in primary angle closure glaucoma (PACG) Saudi patients than in healthy Saudi controls. This result prompted us to extend our work using a significant larger Saudi PACG cohort and more healthy controls. Methods We sequenced the mtDNA regulatory hypervariable region-I (HVS-I) and coding regions, comprising haplogroup diagnostic polymorphisms, in 227 PACG Saudi pa...

  1. Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma.

    Science.gov (United States)

    Khor, Chiea Chuen; Do, Tan; Jia, Hongyan; Nakano, Masakazu; George, Ronnie; Abu-Amero, Khaled; Duvesh, Roopam; Chen, Li Jia; Li, Zheng; Nongpiur, Monisha E; Perera, Shamira A; Qiao, Chunyan; Wong, Hon-Tym; Sakai, Hiroshi; Barbosa de Melo, Mônica; Lee, Mei-Chin; Chan, Anita S; Azhany, Yaakub; Dao, Thi Lam Huong; Ikeda, Yoko; Perez-Grossmann, Rodolfo A; Zarnowski, Tomasz; Day, Alexander C; Jonas, Jost B; Tam, Pancy O S; Tran, Tuan Anh; Ayub, Humaira; Akhtar, Farah; Micheal, Shazia; Chew, Paul T K; Aljasim, Leyla A; Dada, Tanuj; Luu, Tam Thi; Awadalla, Mona S; Kitnarong, Naris; Wanichwecharungruang, Boonsong; Aung, Yee Yee; Mohamed-Noor, Jelinar; Vijayan, Saravanan; Sarangapani, Sripriya; Husain, Rahat; Jap, Aliza; Baskaran, Mani; Goh, David; Su, Daniel H; Wang, Huaizhou; Yong, Vernon K; Yip, Leonard W; Trinh, Tuyet Bach; Makornwattana, Manchima; Nguyen, Thanh Thu; Leuenberger, Edgar U; Park, Ki-Ho; Wiyogo, Widya Artini; Kumar, Rajesh S; Tello, Celso; Kurimoto, Yasuo; Thapa, Suman S; Pathanapitoon, Kessara; Salmon, John F; Sohn, Yong Ho; Fea, Antonio; Ozaki, Mineo; Lai, Jimmy S M; Tantisevi, Visanee; Khaing, Chaw Chaw; Mizoguchi, Takanori; Nakano, Satoko; Kim, Chan-Yun; Tang, Guangxian; Fan, Sujie; Wu, Renyi; Meng, Hailin; Nguyen, Thi Thuy Giang; Tran, Tien Dat; Ueno, Morio; Martinez, Jose Maria; Ramli, Norlina; Aung, Yin Mon; Reyes, Rigo Daniel; Vernon, Stephen A; Fang, Seng Kheong; Xie, Zhicheng; Chen, Xiao Yin; Foo, Jia Nee; Sim, Kar Seng; Wong, Tina T; Quek, Desmond T; Venkatesh, Rengaraj; Kavitha, Srinivasan; Krishnadas, Subbiah R; Soumittra, Nagaswamy; Shantha, Balekudaru; Lim, Boon-Ang; Ogle, Jeanne; de Vasconcellos, José P C; Costa, Vital P; Abe, Ricardo Y; de Souza, Bruno B; Sng, Chelvin C; Aquino, Maria C; Kosior-Jarecka, Ewa; Fong, Guillermo Barreto; Tamanaja, Vania Castro; Fujita, Ricardo; Jiang, Yuzhen; Waseem, Naushin; Low, Sancy; Pham, Huan Nguyen; Al-Shahwan, Sami; Craven, E Randy; Khan, Muhammad Imran; Dada, Rrima; Mohanty, Kuldeep; Faiq, Muneeb A; Hewitt, Alex W; Burdon, Kathryn P; Gan, Eng Hui; Prutthipongsit, Anuwat; Patthanathamrongkasem, Thipnapa; Catacutan, Mary Ann T; Felarca, Irene R; Liao, Chona S; Rusmayani, Emma; Istiantoro, Vira Wardhana; Consolandi, Giulia; Pignata, Giulia; Lavia, Carlo; Rojanapongpun, Prin; Mangkornkanokpong, Lerprat; Chansangpetch, Sunee; Chan, Jonathan C H; Choy, Bonnie N K; Shum, Jennifer W H; Than, Hlaing May; Oo, Khin Thida; Han, Aye Thi; Yong, Victor H; Ng, Xiao-Yu; Goh, Shuang Ru; Chong, Yaan Fun; Hibberd, Martin L; Seielstad, Mark; Png, Eileen; Dunstan, Sarah J; Chau, Nguyen Van Vinh; Bei, Jinxin; Zeng, Yi Xin; Karkey, Abhilasha; Basnyat, Buddha; Pasutto, Francesca; Paoli, Daniela; Frezzotti, Paolo; Wang, Jie Jin; Mitchell, Paul; Fingert, John H; Allingham, R Rand; Hauser, Michael A; Lim, Soon Thye; Chew, Soo Hong; Ebstein, Richard P; Sakuntabhai, Anavaj; Park, Kyu Hyung; Ahn, Jeeyun; Boland, Greet; Snippe, Harm; Stead, Richard; Quino, Raquel; Zaw, Su Nyunt; Lukasik, Urszula; Shetty, Rohit; Zahari, Mimiwati; Bae, Hyoung Won; Oo, Nay Lin; Kubota, Toshiaki; Manassakorn, Anita; Ho, Wing Lau; Dallorto, Laura; Hwang, Young Hoon; Kiire, Christine A; Kuroda, Masako; Djamal, Zeiras Eka; Peregrino, Jovell Ian M; Ghosh, Arkasubhra; Jeoung, Jin Wook; Hoan, Tung S; Srisamran, Nuttamon; Sandragasu, Thayanithi; Set, Saw Htoo; Doan, Vi Huyen; Bhattacharya, Shomi S; Ho, Ching-Lin; Tan, Donald T; Sihota, Ramanjit; Loon, Seng-Chee; Mori, Kazuhiko; Kinoshita, Shigeru; Hollander, Anneke I den; Qamar, Raheel; Wang, Ya-Xing; Teo, Yik Y; Tai, E-Shyong; Hartleben-Matkin, Curt; Lozano-Giral, David; Saw, Seang Mei; Cheng, Ching-Yu; Zenteno, Juan C; Pang, Chi Pui; Bui, Huong T T; Hee, Owen; Craig, Jamie E; Edward, Deepak P; Yonahara, Michiko; Neto, Jamil Miguel; Guevara-Fujita, Maria L; Xu, Liang; Ritch, Robert; Liza-Sharmini, Ahmad Tajudin; Wong, Tien Y; Al-Obeidan, Saleh; Do, Nhu Hon; Sundaresan, Periasamy; Tham, Clement C; Foster, Paul J; Vijaya, Lingam; Tashiro, Kei; Vithana, Eranga N; Wang, Ningli; Aung, Tin

    2016-05-01

    Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG. PMID:27064256

  2. A CLINICAL STUDY OF PRIMARY ANGLE CLOSURE GLAUCOMA AND ITS MANAGEMENT WITH Nd.YAG LASER IRIDOTOMY

    Directory of Open Access Journals (Sweden)

    Rajashree

    2016-02-01

    Full Text Available BACKGROUND Sixty million people are affected with glaucoma worldwide and more than 20 million have PACG. Of these, more than 5 million with PACG are blind, which is twice more than POAG. Early detection and timely treatment with Nd.YAG laser iridotomy and associated complications determine visual outcome. OBJECTIVES To study efficacy of Nd.YAG laser iridotomy in controlling intraocular pressure in primary angle closure glaucoma patients. To study role of prophylactic Nd.YAG laser iridotomy in the fellow eyes of primary angle closure glaucoma patients. To study anatomical changes in the angle of anterior chamber following peripheral iridotomy and complications of Nd.YAG laser iridotomy. METHODS A prospective study of 100 cases of primary angle closure glaucoma was conducted in Basaveshwar Teaching and General Hospital (Attached to M.R. Medical College, Kalaburagi. A detailed ophthalmic examination was performed. IOP was measured by Goldmann applanation tonometry. Gonioscopy was done by Goldmann 3 mirror lens. Nd.YAG laser was performed on all affected eyes and 82 fellow eyes of 100 patients and followed up for six months. RESULTS Among the patients included in the study 73 (73% patients were females and 27 (27% were males. In our study most of the patients were 40 to 60 years of age group. Our study included 57 (57% with PAC, 28 (28% with PACG and 15 (15% PACS. There was improvement of 2 Shaffer’s grades in 65%, 1 Shaffer’s grades in 25% of patients. In my study 53 (92.2% of 57 PAC (Acute and sub-acute patients had improved with stable visual acuities and good control of IOP at followup visits; 20 (71.4% of 28 PACG (Chronic patients had good control of IOP at followup visits with improvement of stable visual acuities. All the PACS eyes and the fellow eyes with prophylactic laser iridotomy were with good IOP control and visual acuities; 6 (3.4% eyes out of 172 eyes which underwent iridotomies were found closed at follow-up visits with shallow

  3. Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    WANG Mei; GE Jian; FANG Min; BAI Yu-jing; ZHANG Wei-zhong; LIN Ming-kai; LIU Bing-qian; HAO Yuan-tao; LING Yun-lan; ZHUO Ye-hong

    2012-01-01

    Background Trabeculectomy has become a mainstream treatment in intraocular pressure (IOP) reduction for primary angle-closure glaucoma (PACG); combined trabeculectomy and cataract surgery was reported to reduce lOP and simultaneously improve vision for patients with PACG and coexisting cataract.This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract.Methods This is a comparative case series study.Thirty-one patients (31 eyes) with PACG and coexisting cataract were enrolled.Of these,17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone.lOP,filtering blebs,and complications were compared at the final follow-up.Complete success was defined as a final lOP less than 21 mmHg without lOP-lowering medication.Results After 10 months of postoperative follow-up,the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding IOP reduction ((20.59±7.94) vs.(24.85±14.39) mmHg,P=0.614),complete success rate (88% vs.71%,P=0.370),formation rate of functioning blebs (65% (11/17) vs.93% (13/14),P=0.094),and complications (41% (7/17) vs.57% (8/14),P=0.380).lOP-lowering medication was not required for most of the patients in both groups.Additional surgery interventions,including anterior chamber reformation and phacoemulsification,were needed in the trabeculectomy group,whereas no surgery was needed postoperatively in the phacotrabeculectomy group.Conclusion Phacotrabeculectomy and trabeculectomy treatments exhibit similar IOP reduction,successful rates,and complications when it comes to treating PACG patients with coexisting cataract,although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.

  4. MR diffusion tensor imaging of optic nerve in patients with primary chronic angle-closure glaucoma

    International Nuclear Information System (INIS)

    Objective: To investigate the value of MR diffusion tensor imaging (DTI) of optic nerve in the estimation of optic nerve changes of primary chronic angle-closure glaucoma (PCACG). Methods: Twenty-five patients with PCACG including monocular involvement in 4 patients and binocular involvement in 21 patients and involving 46 eyes in which 24 right eyes and 22 1eft eyes, and 20 normal volunteers were enrolled.Conventional MRI and DTI were performed on all subjects using Magnetom Tim 3.0 T MRI. Fractional anisotropy(FA), mean diffusivity (MD), axial diffusivities (λ ∥) and radial diffusivities (λ ⊥) were measured and then compared between patients group and control group and between left eyes and right eyes. Two independent samples t-test and paired t-test were used. Results: On conventional MRI, thinner optic nerve with vaginal cavity widened slightly was found in 8 optic nerves of 6 patients.The value of FA, λ∥, λ⊥ and MD of 24 right optic nerves in patient group was(0.27 ± 0.09) × 10-3, (2.30 ±0.26) × 10-3, (1.55 ± 0.35) × 10-3, and (1.80 ± 0.31) × 10-3 mm2/s respectively and that of 22 left optic nerves was (0.24 ± 0.09) × 10-3,(2.25 ± 0.41) × 10-3,(1.61 ± 0.46) × 10-3, and (1.82 ±0.47) × 10-3 mm2/s respectively. The FA of optic nerve in patient group was lower than that of control group (P<0.05), while the mean λ∥, λ ⊥ and MD values was obviously higher than control group (P<0.05). There was no significant difference between right and left optic nerves in patient group (P>0.05). Conclusions: DTI could detect abnormality and provide information about the pathological process of optic nerve in patients with PCACG. (authors)

  5. The reduction of intraocular pressure after instillation of travoprost compared with timolol in chronic primary angle-closure glaucoma

    Directory of Open Access Journals (Sweden)

    Edi S. Affandi

    2006-12-01

    Full Text Available The objective of this study is to compare the reduction of intraocular pressure (IOP after instillation of Travoprost compared with timolol in chronic primary angle-closure glaucoma. A prospective randomized, crossover study was conducted from April 2005 to July 2005 at Department of Ophthalmology, National Central General Hospital (RSCM Jakarta on subjects with chronic primary angle-closure glaucoma. Subjects were randomly divided into 2 groups: those taking Travoprost once daily and those taking timolol twice daily. Two weeks after treatment with the first drug, the second drug was substituted. Intraocular pressure was recorded before therapy, at day 1, day 7, and day 14. There was a wash out period of three weeks prior to initial treatment and after the cross over. Sixteen subjects (32 eyes met the inclusion criteria and were included in this study. The mean baseline IOP in the Travoprost group was 25.38 ± 3.01 mmHg, while in the timolol group it was 25.88 ± 2.55 mmHg (p=0.354. At day 7, the IOP were consecutively 16.75 + 1.92 mmHg and 21.25 + 3.09 mmHg (p=0.001 and at day 14 IOP were 13.94 + 2.02 mmHg and 19.25 + 2.18 mmHg (p=000. This showed that Travoprost decreased the IOP faster and greater than timolol. The mean baseline IOP was 25.38 ± 3.01 mmHg was decreased to 11.44 ± 1.90 mmHg with Travoprost. In the timolol group, the mean baseline IOP of 25.88 ± 2.55 mmHg was decreased to 6.63 ± 2.25 mmHg. Statistically, Travoprost significantly reduced the IOP faster and greater than timolol (p<0.05. Travoprost eye drops reduced the IOP faster and greater than timolol. (Med J Indones 2006; 15:242-5Keywords: chronic primary angle closure glaucoma, intraocular pressure, Travoprost, timolol.

  6. Miopia aguda e glaucoma de ângulo fechado associados ao uso de topiramato em paciente jovem: relato de caso Acute myopia and angle closure glaucoma associated with topiramate use in a young patient: case report

    Directory of Open Access Journals (Sweden)

    Mariana Neves Brandão

    2009-02-01

    Full Text Available O glaucoma agudo de ângulo fechado pode ser secundário, dentre outras causas, ao uso de medicações sistêmicas, como o anticonvulsivante topiramato. Esse trabalho descreve o caso de uma paciente jovem com quadro agudo bilateral de miopia e glaucoma de ângulo fechado induzidos por terapia com topiramato para prevenção de crises de enxaqueca, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica referentes à entidade.Acute angle-closure glaucoma may be induced, among other causes, by therapy with systemic drugs, such as the anticonvulsant topiramate. This paper reports the case of an young patient with acute myopia and angle-closure glaucoma associated with migraine prevention with topiramate. We make a link with similar cases described in medical journals and in a bibliographic review related to this entity.

  7. Miopia aguda e glaucoma de ângulo fechado associados ao uso de topiramato em paciente jovem: relato de caso Acute myopia and angle closure glaucoma associated with topiramate use in a young patient: case report

    OpenAIRE

    Mariana Neves Brandão; Ivana Coutinho Fernandes; Flávia Fernanda Oliveira Barradas; Juliana Franca Machado; Mariane Tavares de Oliveira

    2009-01-01

    O glaucoma agudo de ângulo fechado pode ser secundário, dentre outras causas, ao uso de medicações sistêmicas, como o anticonvulsivante topiramato. Esse trabalho descreve o caso de uma paciente jovem com quadro agudo bilateral de miopia e glaucoma de ângulo fechado induzidos por terapia com topiramato para prevenção de crises de enxaqueca, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica referentes à entidade.Acute angle-closure glaucoma may be induced, am...

  8. Comparison of phacotrabeculectomy and sequential surgery in the treatment of chronic angle-closure glaucoma coexisted with cataract

    Science.gov (United States)

    Li, Hai-Jun; Xuan, Jie; Zhu, Xiao-Min; Xie, Lin

    2016-01-01

    AIM To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma (CACG) with coexisting cataract. METHODS One hundred and sixty-two CACG patients (162 eyes) were retrospectively analyzed. Of them, 87 patients (87 eyes) in group A had underwent phacotrabeculectomy with intraocular lens (IOL) implantation, and 75 patients (75 eyes) in group B had underwent sequential surgery with IOL implanted. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), complications and anterior chamber angle (ACA) were measured. RESULTS Demographic characteristics of the two groups were similar. A mean follow-up period was 15±6mo (range 13 to 24mo), a mean IOP of 16.61±6.43 mm Hg in group A and 15.80±5.35 mm Hg in group B (P=0.84) at the last follow up. The Kaplan-Meier analysis revealed that the cumulative probability of success in both groups was similar (P=0.61). Anterior uveitis and hypotony were the most common complications in group A, whereas group B experienced shallow anterior chamber with trabeculectomy. With the exception of anterior uveitis, no complications occurred to 11 trabeculectomized eyes. All postoperative measurements of anterior chamber showed statistically significant differences in each group according to the preoperative data (Psurgery exhibit similar IOP reduction, visual recovery, and complications when treating CACG patients with cataract. However, for a wider ACA, phacotrabeculectomy has demonstrated higher effectiveness than sequential surgery. PMID:27275422

  9. Anterior chamber depth and primary angle-closure glaucoma. II. A genetic study.

    Science.gov (United States)

    Alsbirk, P H

    1975-06-01

    The genetics of primary angle-closure glaucome (a.c.g.) was studied: a) through the prevalence in sibs and children of a.c.g. probands, and b) through the family distribution of the closely correlated axial anterior chamber depth (ACD). The material emerged from an epidemiologic study in Greeland Eskimos. a) Compared with the general population, the observed prevalence of a.c.g. was increased in sibs of a.c.g. probands and the estimated, future prevalence was found to be the same in sibs and children. Age influence prevented a proper Mendelian analysis, but no simple monogenic inheritance seems probable. b) The biometric study showed a relatively shallow chamber in sibs, children, nephews, nieces and grandchildren of a.c.g. probands. Regression analyses revealed a corresponding pattern, also in control families of probands with shallow chambers and in general population families. A heritability of 70% was found, indicating that about two thirds of the age and sex independent variation in ACD seems to be genetic. PMID:1174403

  10. Incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo Incidence of primary angle-closure glaucoma in the Glaucoma Service of the São Geraldo Hospital

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    Rafael Vidal Mérula

    2008-06-01

    Full Text Available OBJETIVOS: Determinar a incidência do glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo; estabelecer o perfil destes pacientes e identificar possíveis fatores de risco. MÉTODOS: Estudo transversal. Período de análise: setembro/2005 a agosto/2006. Inclusão: diagnóstico de glaucoma agudo primário. Exclusão: presença de catarata que acarrete baixa acuidade visual ou miopização, glaucomas secundários, íris em platô. Foram avaliados: número de atendimentos, incidência de glaucoma agudo primário, idade, sexo, raça, história familiar de glaucoma, ceratometria, e dados biométricos. RESULTADOS: Dentre 879 pacientes atendidos, 20 (2,3% tiveram o diagnóstico de glaucoma agudo primário, desse modo, a incidência de glaucoma agudo primário foi de 22,7 por 1000 atendimentos. Dos pacientes com glaucoma agudo primário: 6 (30,0% eram do sexo masculino e 14 (70,0% feminino; a idade variou de 40 a 73 anos (média: 60,4 ± 8,1 anos; 12 (60,0% eram leucodérmicos e 8 (40,0% feodérmicos; 5 (25,0% com história familiar positiva para glaucoma. O risco relativo para o sexo feminino foi de 1,44 (IC 95%. Onze (55,0% pacientes tiveram glaucoma agudo primário no olho direito e 9 (45,0% no esquerdo. Não houve diferença estatisticamente significativa na comparação dos parâmetros biométricos e ceratometria entre os olhos afetados e os contralaterais. CONCLUSÕES: A incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo foi de 22,7 por 1000 atendimentos, sendo mais freqüente em mulheres, leucodérmicas, com história familiar negativa para glaucoma e média de idade de 60,4 anos. Os olhos afetados e olhos contralaterais foram semelhantes nos parâmetros biométricos.PURPOSE: To determine the incidence of the primary angle-closure glaucoma at the Glaucoma Service of São Geraldo Hospital, to establish the profile of these patients and to identify the possible risk factors. METHODS

  11. Anterior chamber depth and lens thickness in primary angle-closure glaucoma : A case-control study

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    Saxena Sandeep

    1993-01-01

    Full Text Available Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma (PACG. In a tertiary care centre-based case-control study, 70 patients and equal number of controls were investigated to analyse the strength of association and predictability of anterior chamber depth (ACD and lens thickness (LT in the disease. Mean (+/- S.D. ACD and LT in the cases and the controls were found to be 2.28 +/- 0.19, 2.87 +/- 0.10; 4.57 +/- 0.34 and 4.13 +/- 0.19 mm respectively. Two sample t test demonstrated statistically significant difference in the ACD and LT between the cases and the controls (Difference being -0.59, 0.44; 95% confidence interval of the difference: -0.64, -0.53 and 0.34, 0.53 respectively, P < 0.01. Logistic regression analysis demonstrated statistically significant protective effect of ACD over PACG (P < 0.01. The odds ratio corresponding to an increase of 0.01 mm in ACD and LT were computed as 0.83 and 1.11 respectively

  12. The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE: study protocol for a randomized controlled trial

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    Chew Paul

    2011-05-01

    Full Text Available Abstract Background Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle and medical treatment (to reduce intraocular pressure. If these treatments fail, glaucoma surgery (eg, trabeculectomy is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care. EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. Methods/Design EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible. The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy, costs to the health services and patients, and adverse events. A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat. 400 participants (200 in each group will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05

  13. Glaucoma bilateral por fechamento angular induzido por sulfametoxazol-trimetoprima: relato de caso Bilateral angle-closure glaucoma induced by trimetoprim and sulfamethoxazole combination: case report

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    Viviane Souto Spadoni

    2007-06-01

    Full Text Available Sulfametoxazol e trimetoprima (cotrimoxazol é uma combinação de drogas amplamente usada no tratamento e profilaxia de inúmeras infecções sistêmicas. Esta droga e outras derivadas da sulfa podem causar uma síndrome ocular rara caracterizada por efusão coroidal supracililar com miopização transitória e glaucoma por fechamento angular. A maioria dos autores atribui o glaucoma ao edema do corpo ciliar que leva ao deslocamento anterior do diafragma irido-cristaliniano causando fechamento do ângulo camerular. Este trabalho descreve um caso raro no qual a síndrome ocorreu após o uso desta combinação de drogas e evoluiu para um desfecho desfavorável. Paciente de 49 anos, sexo masculino, branco com diagnóstico de síndrome da imunodeficiência adquirida iniciou tratamento profilático para Pneumocystis carinii com cotrimoxazol. Quatro dias após, apresentou quadro de dor ocular, hiperemia e quemose conjuntival, glaucoma agudo por fechamento angular com pressões intra-oculares maiores que 50 mmHg e efusão coroidal 360º, com os achados presentes nos dois olhos. Nesse mesmo dia, a medicação foi suspensa com diminuição da pressão intra-ocular após quatro dias. O paciente evoluiu com catarata total e phthisis bulbi bilateral nos dois meses subseqüentes. Os casos já descritos mencionam a melhora clínica completa do quadro ocular após a suspensão da medicação. Este seria o primeiro caso na literatura no qual a evolução foi desfavorável apesar do diagnóstico e da suspensão precoce da medicação causadora.Sulfamethoxazole-trimethoprim (cotrimoxazole is an antibiotic combination widely used for infections treatment and prophylaxis. These and others sulfonamides have been implicated in a rare syndrome of choroidal effusion with transient myopia and angle-closure glaucoma. Previous cases reported in literature evolved to complete resolution after drug withdrawal. In contrast, we describe a rare case in which a patient

  14. Phacoemulsification versus combined phacotrabeculectomy in the treatment of primary angle-closure glaucoma with cataract: a Meta-analysis

    Science.gov (United States)

    Wang, Fang; Wu, Zhi-Hong

    2016-01-01

    AIM To compare the efficacy and safety of phacoemulsification (Phaco) against combined phacotrabeculectomy (Phacotrabe) in primary angle-closure glaucoma (PACG) with coexisting cataract. METHODS By searching electronically the PubMed, EMBASE, Scientific Citation Index and Cochrane Library published up from inception to January 2014, all randomized controlled trials that matched the predefined criteria were included. The quality of included trials was evaluated according to the guidelines developed by the cochrane collaboration. And the outcomes estimating efficacy and safety of two different surgical treatments were measured and synthesised by RevMan 5.0. RESULTS Five randomized controlled trials were selected and included in Meta-analysis with a total of 468 patients (468 eyes) with both PACG and cataract. We found that Phacotrabe had a greater intraocular pressure (IOP) lowing effect [preoperative IOP: weighted mean difference (WMD)=0.58, 95% confidence intervals (95% CI, -0.53 to 1.69), P=0.31; postoperative IOP: WMD=1.37, 95% CI (0.45 to 2.28), P=0.003], a lower number of anti-glaucoma medications [ risk ratio (RR) =0.05, 95% CI (0.02 to 0.18), P<0.00001] needed postoperatively and less serious damage of optic nerve [risk ratio (RR)=0.48, 95% CI (0.21 to 1.07), P=0.07], but a higher risk of complications [odds ratio (OR) =0.04, 95% CI (0.01 to 0.16), P<0.00001] compared with Phaco. The rest studies indicated that there had no significantly difference between the two surgical methods for postoperative best-corrected visual acuity (BCVA) [WMD=-0.05, 95% CI (-0.14 to 0.05), P=0.32] and loss of visual field [OR=1.06, 95% CI (0.61 to 1.83), P=0.83]. CONCLUSION Phaco alone compared with Phacotrabe had a better effect in IOP reduction, whereas the security decline. Considering the number of sample size, our results remains to be further studied. PMID:27162736

  15. Glaucoma, Open-Angle

    Science.gov (United States)

    ... Prevalent Cases of Glaucoma (in thousands) by Age, Gender, and Race/Ethnicity Because of their longer life ... Prevalent Cases of Glaucoma (in thousands) by Age, Gender, and Race/Ethnicity Projections for Glaucoma (2010-2030- ...

  16. Glaucoma agudo bilateral em paciente jovem secundário ao uso de topiramato: relato de caso Bilateral acute angle closure glaucoma in a young patient receiving oral topiramate: case report

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    Fausto Stangler

    2007-02-01

    Full Text Available Topiramato é droga derivada das sulfas e utilizada sistemicamente como anticonvulsivante. Pode produzir efusão uveal e causar glaucoma agudo por fechamento angular pelo deslocamento da íris e do cristalino anteriormente, com miopização transitória. O processo cede com a suspensão da droga, se identificado precocemente. Os autores relatam, pela primeira vez na literatura científica nacional, um caso no qual a efusão uveal ocorreu após a administração de topiramato para tratamento de enxaqueca. Paciente branca de 40 anos foi examinada no setor de emergência do Hospital Banco de Olhos de Porto Alegre apresentando cefaléia intensa, dor ocular e diminuição da visão em ambos os olhos. Referia uso de topiramato desde dez dias antes do início dos sintomas. O exame biomicroscópico mostrava injeção conjuntival, quemose e câmara anterior rasa nos dois olhos. A pressão intra-ocular era de 40 mmHg no olho direito e 38 mmHg no olho esquerdo. Os achados fundoscópicos estavam normais nos dois olhos. A ultra-sonografia ocular mostrou efusão uveal e descolamento de coróide bilateral nos dois olhos. Foi realizado o diagnóstico de efusão uveal relacionada com o uso de topiramato. A medicação foi suspensa com melhora do quadro clínico e da acuidade visual três dias após a apresentação inicial. A efusão uveal induzida por drogas ocorre raramente. O topiramato pode causar edema do corpo ciliar e relaxamento da zônula, com conseqüente deslocamento anterior do diafragma irido-cristaliniano, causando miopização aguda e fechamento angular. Como o mecanismo de fechamento angular não envolve bloqueio pupilar, iridectomias periféricas e o uso de mióticos tópicos não são efetivos nesses casos. Houve regressão completa do quadro após a suspensão da medicação.This paper reports a clinical case of uveal effusion in both eyes causing bilateral acute angle closure glaucoma in a young patient after oral administration of topiramate

  17. Disturbed spontaneous brain activity pattern in patients with primary angle-closure glaucoma using amplitude of low-frequency fluctuation: a fMRI study

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    Huang X

    2015-07-01

    Full Text Available Xin Huang,1,* Yu-Lin Zhong,1,* Xian-Jun Zeng,2 Fuqing Zhou,2 Xin-Hua Liu,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Yi Shao,1 Xi-Jian Dai21Department of Ophthalmology, 2Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China*These authors contributed equally to this workObjective: The aim of this study is to use amplitude of low-frequency fluctuation (ALFF as a method to explore the local features of spontaneous brain activity in patients with primary angle -closure glaucoma (PACG and ALFFs relationship with the behavioral performances.Methods: A total of twenty one patients with PACG (eight males and 13 females, and twenty one healthy subjects (nine males and twelve females closely matched in age, sex, and education, each underwent a resting-state functional magnetic resonance imaging scan. The ALFF method was used to assess the local features of spontaneous brain activity. The correlation analysis was used to explore the relationships between the observed mean ALFF signal values of the different areas in PACG patients and the thickness of the retinal nerve fiber layer (RNFL. Results: Compared with the healthy subjects, patients with PACG had significant lower ALFF areas in the left precentral gyrus, bilateral middle frontal gyrus, bilateral superior frontal gyrus, right precuneus, and right angular gyrus, and higher areas in the right precentral gyrus. In the PACG group, there were significant negative correlations between the mean ALFF signal value of the right middle frontal gyrus and the left mean RNFL thickness (r=-0.487, P=0.033, and between the mean ALFF signal value of the left middle frontal gyrus and the right mean RNFL thickness (r=-0.504, P=0.020. Conclusion: PACG mainly involved in the dysfunction in the frontal lobe, which may reflect the underlying pathologic mechanism of PACG.Keywords: angle-closure glaucoma, amplitude of low-frequency fluctuation, functional

  18. Ocular Biometry in Angle Closure

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    Mohammad Reza Razeghinejad

    2013-01-01

    Full Text Available Purpose: To compare ocular biometric parameters in primary angle closure suspects (PACS, primary angle closure glaucoma (PACG and acute primary angle closure (APAC. Methods: This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT, axial length (AL, anterior chamber depth (ACD and lens thickness (LT were measured with an ultrasonic biometer. Lens-axial length factor (LAF, relative lens position, corrected ACD (CACD and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. Results: No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons. However, eyes with APAC had thicker cornea (P=0.001, thicker lens (P<0.0001, shallower ACD (P=0.009, shallower CACD (P=0.003 and larger LAF (P<0.0001. Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001 and CCT (P=0.001 were significant risk factors. Conclusion: This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC.

  19. A birth order effect study on primary-angle closure glaucoma%原发性闭角型青光眼的出生顺序分析

    Institute of Scientific and Technical Information of China (English)

    严新凤; 郭文毅; 孟炜; 江峰; 孙兴怀

    2006-01-01

    目的分析原发性闭角型青光眼(primary angle closure glaucoma,PACG)患者的出生顺序效应,探讨环境因素及遗传因素与PACG的关系.方法应用Greenwood-Yule和Haldane-Smith的出生顺序方法,对来自复旦大学附属眼耳鼻喉科医院的200例PACG患者以及18例同胞患者进行出生顺序研究.结果Greenwood法分析结果显示,出生顺序为1~3的子代中PACG患者实际分布大于期望分布,而出生较晚的子代中则实际分布小于期望分布,提示PACG多发生于出生较早的子代.Haldane法结果显示,∑6A实际值为3 310,∑6A期望值为3 610,两者相差两个标准差(S=121.91)以上,且有统计学差异,进一步提示PACG同出生顺序有关,且出生顺序越早越容易发生PACG.结论PACG的发生与出生顺序有关,好发于出生顺序较早的个体.

  20. Análise morfométrica comparativa entre olhos com glaucoma agudo primário e olhos contralaterais Comparative morphometric assessment between eyes with acute primary angle-closure glaucoma and contralateral eyes

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    Rafael Vidal Mérula

    2008-06-01

    üência os seios camerulares fechados quando comparados com os OCLs. Os olhos com GAP apresentaram: K médio de 45,21 ± 1,96 D, ECC média de 534,46 ± 34,15 mm, PCCA média de 2,43 ± 0,28 mm; AXL médio de 21,68 ± 0,96 mm, CR média de 4,85 ± 0,32 mm, e a relação CR/AXL de 2,24 ± 0,16. Os OCLs apresentaram: K médio de 44,92 ± 1,86 D, ECC média de 533,18 ± 31,41 mm, PCCA média de 2,51 ± 0,29 mm; AXL médio de 21,82 ± 0,92 mm, CR média de 4,85 ± 0,36 mm, e a relação CR/AXL de 2,23 ± 0,18. Houve diferença estatisticamente significativa apenas na comparação de K e PCCA, entre os olhos que tiveram GAP e os OCLs. CONCLUSÕES: A incidência de GAP foi de 20,8/1000, sendo mais freqüente em mulheres, leucodérmicas, com história familiar negativa para glaucoma e média de idade de 59,6 anos. Os olhos com GAP apresentaram, de modo estatisticamente significativo, pior acuidade visual, menor equivalente esférico hipermetrópico, maior escavação do disco óptico, maior K médio e menor PCCA que os OCLs.PURPOSE: To establish the profile of patients with acute primary angle-closure glaucoma (APACG and to assess comparatively clinical and morphometric parameters between eyes with APACG and contralateral eyes (CLEs. METHODS: Prospective study including patients attended from September 2005 to March 2007. Inclusion criteria: diagnosis of APACG. Exclusion criteria: presence of cataract (except for "glaukomflecken" that may cause low visual acuity or myopization, secondary glaucoma, previous APAGC or surgical procedure in the (CLE, no possibility to control the acute crisis of glaucoma clinically, plateau iris. The following were evaluated: incidence of APACG, age, gender, race, family history of glaucoma, corrected visual acuity (CVA and uncorrected visual acuity (UVA, spherical equivalent (SE, cup/disc ratio (C/D, gonioscopy, keratometry (K, central corneal thickness (CCT, and echobiometric data [anterior central chamber depth (ACCD, axial length (AL, lens

  1. 急性闭角型青光眼合并糖尿病患者的围手术期护理%Perioperative Nursing for Acute Angle-Closure Glaucoma Patients With Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    赵淼; 于红雨; 温春娟

    2016-01-01

    临床上,急性闭角型青光眼属于房角关闭,因房水排出手足,导致眼压急剧升高,出现许多病理变化的眼病,临床表现为恶心、头痛、眼痛等症状,属于眼科急症。若得不到有效治疗、处理,可导致失明。目前,随着人们生活条件逐渐提高,糖尿病病发率逐年提升,并发急性闭角型青光眼病例也逐渐增加,因高血糖症状,创口愈合延迟,增加了术后感染率和手术危险性。针对急性闭角型青光眼伴随糖尿病,必须加强围术期护理。%Clinical acute angle-closure glaucoma is closed, corner because of aqueous humor from brothers, lead to a dramatic increase in intraocular pressure, appear many pathological changes of eye disease, clinical symptoms such as nausea, headache, eye pain symptom, belongs to the ophthalmic emergency. If can not get effective treatment, the processing, can lead to blindness. At present, as people living conditions gradually improve, diabetes disease rate increase year by year, and acute angle-closure glaucoma cases also gradually increased, the symptoms of hyperglycemia and wound healing delay, increased risk of postoperative infection and surgery[1]. For acute angle-closure glaucoma associated with diabetes, it is necessary to strengthen perioperative nursing care.

  2. New Management of Angle-closure Glaucoma by Phacoemulsification with Folable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    JianGE; YanGuo; 等

    2002-01-01

    Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOIL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In 36 eyes with angle -closure glaucoma(ACG).there were 18eyes with primary acute angle-closure glaucoma(PACG),14 eyes with primary chonic angle -closure glaucoma(PCCG),3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle -closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow -time of 8.81±7.45 months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84 mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior chamber depth was 1.75±0.48 mm preoiperatively and 2.29±0.38mm postoperatively(P-0.000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0.01 to 0.7(20/200 to 20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma.Eye Science2000;16:22-28.

  3. YAG激光配合钩藤汤治疗闭角型青光眼探讨%Study on YAG laser combined with Uncaria Decoction treating angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    汪新芳

    2016-01-01

    目的:分析YAG激光虹膜根部造孔术配合中药钩藤汤治疗闭角型青光眼的疗效。方法选取2015年1月至2015年12月在本院进行闭角型青光眼治疗的40例患者,行虹膜根部YAG激光造孔配合钩藤汤治疗,2个月为一个疗程,观察患者治疗效果。结果所有40例患者(62只眼)皆完成治疗,治疗总有效率高达88.7%,仅5例患者(7只眼)并未治愈,无效率为11.3%。结论 YAG激光配合钩藤汤治疗闭角型青光眼可有效控制青光眼眼压,值得临床推广。%Objective To analyze the effect of YAG laser iris root pore surgery coordinate Chinese medicine Uncaria soup to treat Angle-closure glaucoma.Methods The 40 patients that had Angle-closure glaucoma and treated in our hospital during January 2015 to December 2015 had been chosen.All patients were YAG laser iris root pore surgery coordinate Chinese medicine Uncaria soup to treat with,two months for a course of treatment.Then the treatment effect was observed.Results All 40 patients (62 eyes) are completed treatment,the total efficiency of up to 95.2%,only 2 patients (3 eyes) is not a cure, invalid was 4.8%.Conclusion Using YAG laser with Uncaria decoction angle-closure glaucoma can effectively control the intraocular pressure of glaucoma,be worth to be promoted in clinical.

  4. 选择性激光小梁成形术治疗原发性青光眼%Selective laser trabeculoplasty on primary open-angle glaucoma and primary angle-closure glaucoma with previous iridotomy

    Institute of Scientific and Technical Information of China (English)

    邹燕红; 李静贞

    2006-01-01

    目的评价选择性激光小梁成形术治疗原发性开角型青光眼(primary open-angle glaucome,POAG)及原发性闭角型青光眼(prionary angle-closure glaucome,PACG)虹膜周切术后残余青光眼的疗效和安全性.方法前瞻性、非随机性选择局部用药眼压不能控制的原发性开角型青光眼患者(13例16眼),或已行周边虹膜切除或激光虹膜打孔术,房角大部开放而眼压高的原发性闭角型青光眼患者(22例32眼).应用选择性激光小梁成形术治疗.观察患者术后6个月眼压的变化.结果两组患者的眼压在激光治疗后均有显著下降:POAG组由术前的(25.3±3.9)mmHg降低至术后6个月的(18.0±4.2)mmHg;PACG组由术前的(23.9±3.0)mmHg,降低至术后6个月的(18.8±3.8)mmHg(1 kPa=7.5mmHg).术后暂时的眼压升高为最常见的并发症.结论选择性激光小梁成形术不仅可用于原发性开角型青光眼的治疗,也可以作为治疗残余闲角型青光眼的一种安全有效的方法.

  5. Clinical observation of uveitis secondary angle-closure glaucoma therapy%葡萄膜炎继发闭角型青光眼治疗的临床观察

    Institute of Scientific and Technical Information of China (English)

    侯习武; 杨茹

    2014-01-01

    目的:虹膜激光切除术治疗葡萄膜炎继发闭角型青光眼的临床效果。方法回顾性分析23例32眼葡萄膜炎继发闭角型青光眼给予虹膜激光切除术后临床资料,通过视力、眼压观察治疗情况。结果术前眼压25~40 mmHg(1 mmHg=0.133 kPa),术后终末眼压为12~21 mmHg,随访期间31眼(96.88%)眼压在正常范围内;术后视力≥0.5者14眼(43.74%),较术前视力≥0.5者3眼(9.38%)明显提高。结论虹膜激光切除术治疗葡萄膜炎继发性闭角型青光眼是一种安全有效的方法。%Objective Clinical effect of iris laser resection in the treatment of uveitis secondary angle-closure glaucoma. Methods A retrospective analysis of 23 patients (32 eyes) with uveitis secondary angle-closure glaucoma were performed iris laser resection, and observation of treatment by vision and intraocular pressure. Results The preoperative intraocular pressure was 25~40 mmHg (1 mmHg=0.133 kPa) which decreased to postoperative intraocular pressure of 12~21 mmHg. 31 eyes(96.88%)was normal after follow 6 months.3 eyes(9.38%) had a vision of≥0.5 of preoperative, 14 eyes (43.74%) had a vision of≥0.5 of postoperative, the vision of postoperative was increased obviously. Conclusion Iris laser resection in the treatment of uveitis secondary angle-closure glaucoma is a safe and effective method.

  6. Molecular Genetics in Glaucoma

    OpenAIRE

    Liu, Yutao; Allingham, R. Rand

    2011-01-01

    Glaucoma is a family of diseases whose pathology is defined by the progressive loss of retinal ganglion cells. Clinically, glaucoma presents as a distinctive optic neuropathy with associated visual field loss. Primary open-angle glaucoma (POAG), chronic angle closure glaucoma (ACG), and exfoliation glaucoma (XFG) are the most prevalent forms of glaucoma globally and are the most common causes of glaucoma-related blindness worldwide. A host of genetic and environmental factors contribute to gl...

  7. Cluster headache or narrow angle glaucoma?

    Directory of Open Access Journals (Sweden)

    Prasad Palimar

    1991-01-01

    Full Text Available A 47 year old man with episodes of attacks of pain, redness and mild blurring of vision was investigated for narrow angle glaucoma in view of shallow anterior chambers and a cupped optic disc. The history was reviewed following a spontaneous attack in hospital, which had features other than acute glaucoma. A diagnosis of cluster headache was made on the basis of tests. Cluster headache has been defined as unilateral intense pain, involving the eye and head on one side, usually associated with flushing, nasal congestion and lacrimation; the attacks recurring one or more times daily and lasting 20 - 120 minutes. Such attacks commonly continue for weeks or months and are separated by an asymptomatic period of months to years. This episodic nature, together with unilaterality and tendency to occur at night, closely mimics narrow angle glaucoma. Further, if patients have shallow anterior chambers and disc cupping, the differentiation becomes more difficult yet critical. Resource to provocative tests is often the only answer as the following case report demonstrates.

  8. Modern Technologies of Open-Angle Glaucoma Surgery

    OpenAIRE

    2014-01-01

    Currently, glaucoma surgery has become a major technique. Surgery is a method of choice in open-angle glaucoma, especially in those cases when conservative and laser treatments have no effect, as well as if glaucoma is inaccessible or a patient has low treatment compliance. In this review the authors give the information about the development of main glaucoma surgery directions, such as removal of pupillary block, the anterior chamber fistulization, the reduction of intraocular fluid producti...

  9. Prevalence of open angle glaucoma in accompanying first degree relatives of patients with glaucoma

    Directory of Open Access Journals (Sweden)

    Franciele Vegini

    2008-01-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the prevalence of open angle glaucoma in first-degree relatives accompanying POAG patients during routine examination in a reference hospital. METHOD: First-degree relatives of primary open angle glaucoma patients who accompanied their relatives to the glaucoma service of a reference hospital were screened for glaucoma. RESULTS: One-hundred and one first-degree relatives were examined, of which 56.4% had never had their intraocular pressure measured. 10.9% had previously been diagnosed with glaucoma, and 5.9% were newly diagnosed during this study. CONCLUSIONS: The eye examination of first-degree relatives identified a significant percentage of individuals with glaucoma. Despite being first-degree relatives of glaucoma patients, 56.4% of the companions had never had their eye pressure measured, demonstrating a lack of awareness about this disease.

  10. Incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo Incidence of primary angle-closure glaucoma in the Glaucoma Service of the São Geraldo Hospital

    OpenAIRE

    Rafael Vidal Mérula; Sebastião Cronemberger; Nassim Calixto

    2008-01-01

    OBJETIVOS: Determinar a incidência do glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo; estabelecer o perfil destes pacientes e identificar possíveis fatores de risco. MÉTODOS: Estudo transversal. Período de análise: setembro/2005 a agosto/2006. Inclusão: diagnóstico de glaucoma agudo primário. Exclusão: presença de catarata que acarrete baixa acuidade visual ou miopização, glaucomas secundários, íris em platô. Foram avaliados: número de atendimentos, incidência de glauc...

  11. Epidemiological characterization of primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Leonor Rosario Díaz Alfonso

    2010-11-01

    Full Text Available Background: The primary open-angle glaucoma is a problem for public health all over the world. It is a silent and slowly progressive disease leading to blindness. In most patients this can be prevented if the risk factors leading to the disease are detected in time. Objective: To describe some epidemiological factors of patients with primary open-angle glaucoma. Methods: Clinical, epidemiological, prospective and longitudinal study in patients with primary open-angle glaucoma who attended the glaucoma consultation of the Provincial General University Hospital "Dr. Gustavo Aldereguía Lima" of Cienfuegos, from January to February 2009. The following variables were analyzed: age, sex, family and personal medical history, toxic habits and time of diagnosis of the disease. Results: There was prevalence of primary open-angle glaucoma (87, 5% mostly in females (53, 6% and patients over 61 years old as well as in white skinned patients (52 and 62% respectively. Hypertension was the leading entity referred to as pathological personal and family antecedent (62 and 42% respectively. Glaucoma and myopia predominated as previous eye history. The most frequent toxic habits were the consumption of more than 2 cups of coffee a day (53% and smoking (32%. The largest amount of patients had more than 5 years evolution of the disease. Conclusions: Primary open-angle glaucoma occurred mainly in female patients and those with a history

  12. The causes and preventive measures of misdiagnosis on primary acute angle closure glaucoma%原发性急性闭角型青光眼误诊原因及对策

    Institute of Scientific and Technical Information of China (English)

    唐秀武

    2013-01-01

    Objective To explore the causes and preventive measures for misdiagnosed primary acute angle closure glaucoma(PAACG).Methods In this retrospective analyses,the causes of 38 cases of misdiagnosed PAACG were analyzed who first visited other departments and were diagnosed as other diseases.The preventive measures of misdiagnosis were concluded.Results Of 38 cases,misdiagnoses included hypertensive encephalopathy in 13 cases,lacunar infarction in 11 cases,migraine in 5 cases,nerveous headache in 7 cases and gastrointestinal diseases in 2 cases.All cases were transferred to ophthalmology department after consultation and underwent antiglaucoma surgeries.After treatment,the patients' visual acuities were at non-light perception in 4 eyes,light perception in 3 eyes,counting fingers in 7 eyes,O.05 ~0.08 in 8 eyes,0.1 ~ 0.2 in 11 eyes and 0.3 ~ 0.5 in 5 eyes.The longer misdiagnoses lasted,the severer visual impairment became.Conclusion PAACG without systemic symptoms and first visit other department except ophthalmology department will easily to be misdiagnosed.To avoid misdiagnosis,it is glaucoma specialist' s responsibility to promote PAACG education for doctors and patients.%目的 探讨原发性急性闭角型青光眼误诊原因及防止误诊的对策.方法 回顾性研究,对首诊于其他科室的原发性急性闭角型青光眼误诊为其他疾病的38例(38眼)原因进行分析,研究防止类似情况发生的对策.结果 38眼中误诊为高血压脑病13例,腔隙性脑梗死11例,偏头痛5例,神经性头痛7例,胃肠疾病2例.经眼科会诊确诊后转眼科,行抗青光眼手术治疗.治疗后视力:无光感4眼,光感3眼,数指者7眼,0.05~0.08者8眼,0.1~0.2者11眼,0.3 ~0.5者5眼.误诊时间越长,视力受损害严重.结论 首诊于其他科室的急性闭角型青光眼患者,而且合并有全身症状的,容易误诊.青光眼医师有责任为各科医师及患者普及原发性急性闭角型青光眼知识,以减少误诊.

  13. A case-control study of factors associated with primary angle-closure glaucoma%原发性闭角型青光眼相关因素的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    庄勋; 朱蓉嵘; 管怀进; 黄春华; 施文平; 姜声扬

    2008-01-01

    Objective To understand the risk factors of primary angle-closure glaucoma. Methods One to one matched case-control study was conducted in this study. One hundred and ninety two PACG cases and 192 controls, matched by age and gender, were collected from Department of Ophthalmology, Affiliated Hospital of Nantong University. All of the participants were investigated for their demographic information,behavioral habits, disease history, glaucoma family history and received clinical ocular examinations. The difference between these two groups was analyzed. Results Several factors, including hypertension ( OR =2.004,P =0.009), glaucoma family history (OR = 6.726,P =0.003), presbyopia (OR =3.192,P =0.031 ), shallow anterior chamber ( OR = 12.804, P = 0. 000) and high cup-to-disc ratio ( OR = 9.401, P =0.007 ) were associated with PACG by multiply Logistic regression. The results did not support that smoking, drinking, myopia, diabetes mellitus and blood style were related to PACG. Conclusion Follow up the populations with glaucoma family history, shallow anterior chamber or high cup-to-disc ratio are the main procedures for the decrease of incidence of PACG.%目的 探讨原发性闭角型青光眼(PACG)的危险因素.方法 采用1:1配对病例对照研究设计.收集2004年2月至2005年6月在南通大学附属医院眼科诊治的192例原发性闭角型青光眼患者,以年龄、性别作为匹配条件,选择有其他眼部疾患的192例患者作为对照组,通过χ2检验比较PACG病例组与对照组在人群特征、生活行为习惯、既往病史、青光眼家族史及眼底、屈光、眼压、A超等方面的差异.结果 单因素分析提示,居住农村(OR=2.40,P=0.000)、高文化程度(OR=0.21,P=0.000)、高经济收入(OR=0.34,P=0.000)、高血压(OR=3.05,P=0.000)、青光眼阳性家族史(OR=5.59,P=0.001)、浅前房(OR=11.25,P:0.000)、大杯盘比(OR:8.81,P=0.000)、近视眼(OR=0.31,P=0.000)、近距离看电视(OR=0.47,P=0.001)是PACG

  14. 原发性闭角型青光眼易感性与GSTM1和GSTT1基因多态性的关系%Relationship of susceptibility of primary angle-closure glaucoma with glutathione S-transferase T1 and M1 polymorphisms

    Institute of Scientific and Technical Information of China (English)

    罗丽丹

    2015-01-01

    目的:研究原发性闭角型青光眼易感性与谷胱甘肽硫转移酶T1( GSTT1)与谷胱甘肽硫转移酶M1( GSTM1)的关系。  方法:将300例原发性闭角型青光眼患者作为观察对象,同时随机选择300例健康志愿者的血液标本作为对照,并将观察组患者分为慢性、急性两亚组,采用PCR技术检测GSTM1和GSTT1基因多态性。  结果:GSTT1缺失基因型在观察组中的分布频率为54.3%,在对照组的分布频率为54.0%,两组差异无统计学意义(χ2=0.053, P>0.05);观察组中慢性组GSTT1缺失基因型分布频率为54.9%,急性组GSTT1缺失基因型分布频率为48.6%,急性组与对照组相比,差异无统计学意义(χ2=0.064,P>0.05),慢性组与对照组差异无统计学意义(χ2=0.037,P>0.05);观察组GSTM1缺失基因型分布频率为59.0%,对照组为55.7%,两组差别无统计学意义(χ2=0.013, P>0.05);GSTM1缺失基因型在观察组急性和慢性两亚组的分布频率分别为62.3%和58.1%,慢性组与对照组差异无统计学意义(χ2=0.047,P>0.05),急性组与对照组差异无统计学意义(χ2=0.005,P>0.05)。  结论:原发性闭角型青光眼易感性与GSTM1和GSTT1基因多态性间不存在明显相关性。%•AlM:To investigate the relationship of susceptibility of primary angle- closure glaucoma with glutathione S-transferase T1 ( GSTT1 ) and M1 ( GSTM1 ) polymorphisms. • METHODS: Totally, 300 cases were collected from primary angle-closure glaucoma patients and 300 health volunteers were served as control group. The observation group were divided into chronic and acute primary angle-closure glaucoma groups, then multiplex PCR technology was used to detect the genetic polymorphisms of GSTM1 and GSTT1. •RESULTS:The distribution frequencies of GSTT1-null genotype were 54. 3%, while it was 54. 0% in the control group, statistically no significance between control group and observation group (χ2 = 0. 053, P > 0. 05 ) ; The frequency GSTT

  15. Vascular risk factors in primary open angle glaucoma

    OpenAIRE

    Belzunce, A. (Arnaldo); M. Casellas

    2004-01-01

    To determine whether cardiovascular risk factors distribution differ between primary open-angle glaucoma (POAG) and control subjects. To assess the strength of this association in POAG. To analyze the most frequent pathology in this group of patients for a better selection of medical treatment. METHODS: Observational cross-sectional study in patients with a diagnosis of POAG. Fifty glaucoma patients were selected with consecutive sampling between t...

  16. Association of Open-Angle Glaucoma Loci With Incident Glaucoma in the Blue Mountains Eye Study

    OpenAIRE

    Kathryn P Burdon; Mitchell, Paul; Lee, Anne; Healey, Paul R.; White, Andrew J R; Rochtchina, Elena; Thomas, Peter B.M.; Wang, Jie Jin; Craig, Jamie E

    2015-01-01

    Purpose To determine if open-angle glaucoma (OAG)-associated single nucleotide polymorphisms (SNPs) are associated with incident glaucoma and if such genetic information is useful in OAG risk prediction. Design Case-control from within a population-based longitudinal study. Methods study population : Individuals aged over 49 years of age living in the Blue Mountains region west of Sydney and enrolled in the Blue Mountains Eye Study. observation : Cases for this sub-study (n = 67) developed in...

  17. Molecular complexity of primary open angle glaucoma: current concepts

    Indian Academy of Sciences (India)

    Kunal Ray; Suddhasil Mookherjee

    2009-12-01

    Glaucoma is a group of heterogeneous optic neuropathies with complex genetic basis. Among the three principle subtypes of glaucoma, primary open angle glaucoma (POAG) occurs most frequently. Till date, 25 loci have been found to be linked to POAG. However, only three underlying genes (Myocilin, Optineurin and WDR36) have been identified. In addition, at least 30 other genes have been reported to be associated with POAG. Despite strong genetic influence in POAG pathogenesis, only a small part of the disease can be explained in terms of genetic aberration. Current concepts of glaucoma pathogenesis suggest it to be a neurodegenerative disorder which is triggered by different factors including mechanical stress due to intra-ocular pressure, reduced blood flow to retina, reperfusion injury, oxidative stress, glutamate excitotoxicity, and aberrant immune response. Here we present a mechanistic overview of potential pathways and crosstalk between them operating in POAG pathogenesis.

  18. Eye Conditions in Older Adults: Open-Angle Glaucoma.

    Science.gov (United States)

    Iroku-Malize, Tochi; Kirsch, Scott

    2016-06-01

    Glaucoma is the leading cause of irreversible vision loss in the United States, affecting 1.9% of individuals older than 40 years. The prevalence of the most common form, open-angle glaucoma, increases with age and is higher in non-Hispanic minorities. The progressive loss of peripheral vision in glaucoma often leads to difficulty with driving, particularly at night, and can increase the risk of falls and subsequent fractures. Although glaucoma usually is characterized by chronically elevated intraocular pressure, it is more accurately defined as an optic neuropathy. Typically, there are no warning signs or symptoms, and extensive and permanent optic nerve damage can occur before the patient is aware of visual field loss. A cup to disc ratio greater than 0.6 on ophthalmoscopy is suspicious for glaucoma, and visual field testing results show a characteristic peripheral loss. Medical and surgical treatments are aimed at decreasing intraocular pressure by decreasing production of aqueous humor and increasing its outflow. Drugs for glaucoma treatment include prostaglandin analogs, beta blockers, alpha2-adrenergic agonists, and carbonic anhydrase inhibitors. Surgical or laser treatment is indicated if medical management is unsuccessful. Alternative therapies are less effective and have more adverse effects than standard treatments. PMID:27348527

  19. Modern Technologies of Open-Angle Glaucoma Surgery

    Directory of Open Access Journals (Sweden)

    Svetozarskiy S.N.

    2014-03-01

    Full Text Available Currently, glaucoma surgery has become a major technique. Surgery is a method of choice in open-angle glaucoma, especially in those cases when conservative and laser treatments have no effect, as well as if glaucoma is inaccessible or a patient has low treatment compliance. In this review the authors give the information about the development of main glaucoma surgery directions, such as removal of pupillary block, the anterior chamber fistulization, the reduction of intraocular fluid production. Drainage surgery, its history and modern technical devices have been characterized in detail. The design of drainage devices has been improved towards their size reduction, extension of filtration area and the development of valve mechanisms. Indications for their implementation in open-angle glaucoma treatment, and the factors contributing to a successful treatment have been discussed. There have described early and late complications of microdrainage and paid particular attention to obliteration of developed outflow pathways, being the main problem as they reduce the effect of filtering and draining operations. The authors have presented a number of advanced micro-invasive technologies, both used in clinical practice (Ex-PRESS™ mini-shunt, Trabectome™, iStent, canaloplasty and viscocanalostomy, and those being under clinical study — SOLX Gold Micro-Shunt, CyPass, Hydrus™ Microstent a canalicular scaffold, AqueSys Microfistula Implant. There has been presented the information on design and technology of these devices with their detailed classification based on the differences in their mechanism of action, operative approach type and material used.

  20. Systemic antihypertensive medication and incident open-angle glaucoma

    NARCIS (Netherlands)

    Muskens, Rogier P. H. M.; de Voogd, Simone; Wolfs, Roger C. W.; Witteman, Jacqueline C. M.; Hofman, Albert; de Jong, Paulus T. V. M.; Stricker, Bruno H. C.; Jansonius, Nomdo M.

    2007-01-01

    Purpose: To determine the association between systemic anti hypertensive medication and incident open-angle glaucoma. Design: Prospective population-based cohort study. Participants: The study population consisted of a subset of 3842 participants of the Rotterdam Study for whom data from identical o

  1. 急性闭角型青光眼治疗方法的循证评价%An evldence-based appraisal of interventions for acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    孙霞; 梁远波; 李思珍; 乔春艳; 詹思延; 王宁利

    2008-01-01

    目的 从循证医学的角度对有关急性闭角型青光眼发作眼和对侧眼的治疗方法进行文献回顾和证据评价,并对今后的研究工作提出建议.方法 系统综述,检索MEDLINE、EMBASE、Cochrane组织(1966年至2006年12月)所有相关英文文献以及中国期刊全文数据库收录的中文核心刊物发表的相关文献(1979年至2006年12月),纳入文献包括随机对照临床研究(RCT)、非随机对照研究、前瞻性病例分析和病例数大于50例的回顾性病例分析,并对相关综述和入选文献的参考文献进行手工检索.入选文献按照治疗性医学文献证据级别的判定标准进行证据分级和评价.结果 共23篇英文文献和5篇中文文献入选.英文、中文文献中分别有5项和3项RCT,其余证据来自非随机临床对照研究和病例分析,涉及的治疗方法包括药物、激光和手术三大类.结论 目前已有较为有力证据的治疗方法:急性发作时即刻行激光周边虹膜成形术较传统的药物治疗方案降眼压作用起效快;急性发作缓解后行激光周边虹膜切开术(LPI)以及对侧眼的预防性LPI,具有解除瞳孔阻滞、控制眼压和预防急性发作再发或新发的效果;LPI和周边虹膜切除手术(SPI)治疗效果相当.白内障摘除术等治疗方法缺乏足够的高级别研究证据和远期随访结果证明其效果和安全性.%Objective To give an evidence-based appraisal to the interventions to treat acute angle closure glaucoma (AACG) in the affected or contralateral eye,and provide some suggestions to further clinical research.Methods Systematic review.Studies published in the English language were identified (1966 to December 2006) from MEDLINE,PubMed,EMBASE,and the Cochrane Collaborations,as well as studies published in the Chinese language from core journals of Chinese Periodical Fulltext Database (1979 to December 2006).Randomized clinical trials (RCTs),prospecfive controlled clinical

  2. Choroidal physiology and primary angle closure disease.

    Science.gov (United States)

    Zhang, Xiulan; Wang, Wei; Aung, Tin; Jonas, Jost B; Wang, Ningli

    2015-01-01

    Primary angle closure disease (PACD), prevalent in Asian countries, is generally associated with a shallower anterior chamber, a shorter axial length, thicker lens, hyperopia, and female sex. Other physiologic factors, however, may be important, especially with regard to triggering acute primary angle closure. Thickening of the choroid has been demonstrated in untreated and treated, acute and chronic PACD eyes. Recently, there has been growing interest in studying the role of the choroid in the pathophysiology of PACD. The emergence of new imaging technology such as the enhanced depth imaging mode of spectral-domain optical coherence tomography and swept-source optical coherence tomography has contributed to understanding PACD pathologies. We summarize the functions of the choroid and choroidal changes in the pathogenesis of PACD, and discuss potential future developments. PMID:26164737

  3. Latanoprost ophthalmic solution in the treatment of open angle glaucoma or raised intraocular pressure: a review

    Directory of Open Access Journals (Sweden)

    Andrea Russo

    2009-01-01

    Full Text Available Andrea Russo, Ivano Riva, Teodoro Pizzolante, Federico Noto, Luciano QuarantaCattedra di Malattie dell’Apparato Visivo, Università degli studi di Brescia, USVD “Centro per lo studio del Glaucoma” Spedali Civili di BresciaAbstract: Latanoprost is a prostaglandin F2-alpha isopropyl ester prodrug which is rapidly hydrolyzed by esterases in the cornea to the biologically active latanoprost acid. When latanoprost is topically administered into the eye, the cornea seems to act like as a slow-release depot to the anterior segment. One hour after administration maximum concentration is found in the iris, followed by the anterior chamber and the ciliary body. Despite extensive research, controversy remains about the real mechanism of action of this drug. Immunohistochemical data have shown that the intraocular pressure (IOP reduction with topical prostaglandin F2-alpha is associated with a reduction of collagens within the uveoscleral outflow pathway. Evidence from several experimental and clinical studies suggests that latanoprost is a valuable addition first-line treatment alternatives for glaucoma, ocular hypertension and even angle-closure glaucoma. Strong points are its efficacy, which is demonstrated to be higher than that of brimonidine, dorzolamide and timolol with fewer systemic adverse effects; a convenient administration schedule; and the IOP-controlling pattern, which is relatively flat compared with timolol and dorzolamide, and enables better control in glaucoma progression, since large fluctuations may be associated with the risk of developing glaucoma in untreated ocular hypertensive subjects.Keywords: latanoprost, intraocular pressure, glaucoma, ocular hypertension

  4. Early diagnosis and research of high myopia with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Yan Guo

    2014-04-01

    Full Text Available People with high myopia are high risk populations to have primary open angle glaucoma. Clinically, we found that patients with primary open angle glaucoma and high myopia is closely related. So to understand the clinical features of high myopia with primary open angle glaucoma and the importance of early diagnosis, to avoiding missed diagnosis or lower misdiagnosed rate, can help to improve the vigilance and level of early diagnosis of the clinicians. In this paper, high myopia with clinical features of primary open angle glaucoma, and the research progress on the main points of early diagnosis were reviewed.

  5. Impaired Saccadic Eye Movement in Primary Open-angle Glaucoma

    DEFF Research Database (Denmark)

    Lamirel, Cédric; Milea, Dan; Cochereau, Isabelle;

    2013-01-01

    PURPOSE:: Our study aimed at investigating the extent to which saccadic eye movements are disrupted in patients with primary open-angle glaucoma (POAG). This approach followed upon the discovery of differences in the eye-movement behavior of POAG patients during the exploration of complex visual...... scenes. METHODS:: The eye movements of 8 POAG patients and 4 healthy age-matched controls were recorded. Four of the patients had documented visual field scotoma, and 4 had no identifiable scotoma on visual field testing. The eye movements were monitored as the observers watched static and kinetic...

  6. Corneal thickness in glaucoma.

    Science.gov (United States)

    De Cevallos, E; Dohlman, C H; Reinhart, W J

    1976-02-01

    The central corneal stromal thickness of patients with open angle glaucoma, secondary glaucoma (the majority aphakic), or a history of unilateral acute angle closure glaucoma were measured and compared with the stromal thickness of a group of normal patients. In open angle glaucoma, there was a small but significant increase in the average stromal thickness. This thickness increase was, in all likelihood, due to an abnormal function of the endothelium in this disease since the level of the intraocular pressure did not seem to be a factor. There was no correlation between stromal thickness and duration of the glaucoma or type of anti-glaucomatous medication. Most cases of secondary glaucome, controlled medically or not, had markedly increased corneal thickness, again, most likely, due to endothelial damage rather than to level of intraocular pressure. After an angle closure attack, permanent damage to the cornea was found to be rare. PMID:1247273

  7. Modern Capabilities of Surgical Management of Patients with Open-Angle Glaucoma Combined with Cataract

    OpenAIRE

    2014-01-01

    Cataract and glaucoma affecting mainly elderly people sometimes are associated; therefore the problem of their combined treatment is urgent. The aim of the investigation was to assess the efficiency of modern surgery in patients with combined cataract and open-angle glaucoma. Materials and Methods. The present open prospective study is based on the examination and surgery findings of patients with associated cataract and different stages of open-angle glaucoma (200 eyes). Depending on...

  8. Serous retinal detachment after trabeculectomy in angle recession glaucoma

    Directory of Open Access Journals (Sweden)

    Roy, Avik Kumar

    2015-12-01

    Full Text Available An 18-year-old male with 360 degree angle recession after blunt trauma in his right eye developed uncontrolled intraocular pressure (IOP despite four antiglaucoma medications (AGM with advancing disc damage. He underwent trabeculectomy with intraoperative mitomycin-c (MMC application. There was an intraoperative vitreous prolapse which was managed accordingly. On post-surgery day 1, he had shallow choroidal detachment superiorly with non-recordable IOP. This was deteriorated 1 week postoperatively as choroidal detachment proceeded to serous retinal detachment. He was started with systemic steroid in addition to topical route. The serous effusions subsided within 2 weeks time. At the last follow up at 3 months, he was enjoying good visual acuity, deep anterior chamber, diffuse bleb, an IOP in low teens off any AGM and attached retina. This case highlights the rare occurrence of serous retinal detachment after surgical management of angle recession glaucoma.

  9. Glaucoma in aphakia and pseudophakia after congenital cataract surgery.

    OpenAIRE

    Mandal Anil; Netland Peter

    2004-01-01

    Glaucoma is one of the most common causes of visual loss despite successful congenital cataract surgery. The overall incidence does not appear to have decreased with modern microsurgical techniques. The onset of glaucoma may be acute or insidious and notoriously refractory to treatment. Angle closure glaucoma may occur in the early postoperative period; but the most common type of glaucoma to develop after congenital cataract surgery is open angle glaucoma. Several risk factors have been iden...

  10. Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria

    Directory of Open Access Journals (Sweden)

    Lawan Abdu

    2013-01-01

    Full Text Available Background. Primary open angle glaucoma (POAG is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria. Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking. Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG by applying test(s which can be applied rapidly. Such test(s should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management. Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser. Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life. Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.

  11. The Role of Systemic Arterial Stiffness in Open-Angle Glaucoma with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Seong Hee Shim

    2015-01-01

    Full Text Available Purpose. To investigate the role of systemic arterial stiffness in glaucoma patients with diabetes mellitus (DM. Design. Retrospective, cross-sectional study. Participants. DM subjects who underwent brachial-ankle pulse wave velocity (baPWV were recruited. Methods. Glaucoma patients (n=75 and age-matched control subjects (n=92 were enrolled. Systemic examination including BaPWV and detailed eye examination were performed. The glaucoma group was divided into subgroups of normal tension glaucoma (NTG, n=55 and primary open-angle glaucoma (POAG based on an IOP of 21 mmHg. BaPWV was used to stratify the population into 4 groups based on the rate. Stepwise multiple logistic regression analysis by baPWV quartiles was used to compare the glaucoma group with the control group. Main Outcome Measures. BaPWV in glaucoma with DM patients. Results. Faster baPWV was positively associated with glaucoma (odds ratio: 3.74; 95% CI: 1.03–13.56, stepwise multiple logistic regression analysis in patients with DM. Increasing baPWV was also positively associated with glaucoma (p for trend = 0.036. The NTG subgroup showed similar results to those of the glaucoma group. Conclusions. In this study, increased arterial stiffness was shown to be associated with glaucoma and may contribute to the pathogenesis of glaucoma in DM patients.

  12. Relationship of disc damage likelihood scale nomogram and optical coherence tomogram for primary chronic angle-closure glaucoma: report of 73 eyes%视盘分级法评估原发性慢性闭角型青光眼视神经损害与OCT视神经纤维检查的相关性

    Institute of Scientific and Technical Information of China (English)

    李海军; 谢琳; 贺翔鸽; 乐莉; 王原

    2011-01-01

    目的 用视盘损害分级(disc damage likelihood scale,DDLS)方法 评估原发性慢性闭角型青光眼(primary chronic angle-closure glaucoma,PCACG)视神经损害,探讨其与光学断层相干扫描仪(optical coherence tomography,OCT)检测视神经纤维厚度参数的相关性.方法 收集2009年10月至2010年8月我院眼科PCACG患者共38例(73眼),通过双面Volk 90D前置镜在裂隙灯下对视盘直径及其盘沿最窄处宽度测量,按DDLS分级标准进行分级;Stratus OCT 3000成像仪、RNFL3.4程序获取象限位、钟点位及自选参数的视网膜神经纤维(retina nerve fiber layer,RNFL)厚度.运用SPSS 15.0统计软件分析DDLS分级与OCT视盘周围3.4 mm处RNFL检测参数的相关性.结果 共38例(73眼)中大直径视盘17眼(占23.3%),中等直径视盘41眼(占56.2%),小直径视盘15眼(占20.6%);上方、下方、颞侧象限RNFL厚度均值与DDLS分级评分相关(r=-0.673,P=0.0001;r=-0.605,P=0.0001,r=-0.499,P=0.0014),鼻侧方象限RNFL厚度均值与DDLS分级评分不相关(r=-0.352,P=0.0602);11、7、6、10、12钟点位RNFL厚度与DDLS分级评分具有相关性(r=-0.673,P=0.0001; r=-0.605,P=0.0001; r=-0.531,P=0.0006;r=-0.525,P=0.0007;r=-0.520,P=0.0008),而3、2、8点位无统计学意义(r=-0.320,P=0.0501;r=-0.320,P=0.0510;r=-0.297,P=0.0702);DDLS分级评分与OCT检查自选参数Avg、Smax、Imax的RNFL厚度也呈中度相关(r=-0.582,P=0.0001;r=-0.504,P=0.0012;r=-0.478,P=0.0024).结论 DDLS分级方法 对PCACG视神经损害的评估与OCT视网膜神经纤维厚度主要检查参数检查具有相关性,DDLS分级方法 适用于PCACG视神经损害的评估.%Objective To evaluate relationships between the results of disc damage likelihood scale (DDLS) and the parameters of optical coherence tomography (OCT) for primary chronic angle-closure glaucoma. Methods Thirty-eight primary chronic angle-closure glaucoma patients (73 eyes) who admited in our department from October 2009 to August 2010 were

  13. Long-term outcomes of laser peripheral iridectomy for primary angle closure glaucoma%激光周边虹膜切除术治疗原发性闭角型青光眼的远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    卞爱玲; 赵家良; 周崎; 张扬; 刘小力; 毛进

    2009-01-01

    Objective To explore the long-term efficacy and safety of laser peripheral iridectomy for primary angle closure glaucoma (PACG).Methods It was a retrospective case series study.Data were collected from those patients who received laser peripheral iridectomy (LPI) for acute or chronic PACG from April 1992 through October 2002 at the Peking Union Medical College Hospital.Ordy patients who were followed for at least 5 years were included in this study.The control of intraocular pressure (IOP),visual acuity and managements after LPI were analyzed.All of the studied eyes were re-classified into three categories according to the status of anterior chamber angle,optic nerve head and visual field before LPI:primary angle closure suspect (PACS),primary angle closure (PAC) and primary angle closure glaucoma (PACG).Satisfactory control of IOP was defined as the IOP was less than 21 mm Hg (1 mm Hg=0.133 kPa) without any medications after LPI.No satisfactory control of IOP was defined as the IOP was greater than 21 mm Hg after LPI,yet could be controlled below 21 mm Hg by anti-glaucoma medications.A failure in IOP control was defined as an acute attack of angle closure developed or filtering surgery was required to control IOP after LPI.Chi-square analysis was used for comparison of IOP control in different groups.Results One hundred and thirty one patients (251 eyes) with PACG were eligible for this study.The mean follow-up period was (9.2±3.7) years.Of the 251 eyes,18 eyes (7.2%) were identified as PACS,98 eyes (39.0%) PAC,129 eyes (51.4%) PACG,and 6 eyes (2.4%) could not be classified owing to the lack of the information on the optic nerve head and visual field before LPI.The rates of satisfactory control of IOP were 27.1% in all eyes,and 88.9% (16/18),38.8% (38/98) and 10.9% (14/129) in PACS,PAC and PACG eyes respectively.The rates of no satisfactory control of IOP were 59.8% in all eyes,and 5.6% (1/18),48.0% (47/98) and 75.2% (97/129) in PACS,PAC and PACG eyes

  14. Primary open-angle glaucoma: everyone’s business

    Directory of Open Access Journals (Sweden)

    Hannah Faal

    2012-01-01

    Full Text Available Primary open-angle glaucoma (POAG is sometimes called the ‘thief of sight’. There is no pain or discomfort, and vision loss is so gradual that people often do not notice it.POAG cannot be cured: it requires ongoing treatment for the remainder of a patient’s life. Blindness from POAG also cannot be reversed, but it can be prevented if the disease is diagnosed early and treated. Effectively addressing POAG therefore requires the careful involvement of many different people, including health workers, the patient, non-clinical staff, and health planners.As eye care practitioners, we must do more than merely diagnose and treat people with POAG; we must gain the trust of patients and show them that we are there to help.

  15. The ocular hypotensive effect of saffron extract in primary open angle glaucoma: a pilot study

    OpenAIRE

    Jabbarpoor Bonyadi, Mohammad Hossein; yazdani, Shahin; Saadat, Saeed

    2014-01-01

    Background The progressive nature of glaucoma and its growing incidence make its therapy an important target for research. The role of oxidative damage in the pathogenesis of glaucoma makes antioxidants such as saffron extract an attractive target for potential clinical use. Herein, we evaluate the effect of aqueous saffron extract on intraocular pressure (IOP) in eyes with primary open-angle glaucoma (POAG). Methods Thirty-four eyes of 34 clinically stable POAG patients receiving treatment w...

  16. [Current trends in neovascular glaucoma treatment].

    Science.gov (United States)

    Vancea, P P; Abu-Taleb, A

    2005-01-01

    Neovascular glaucoma is divided in three clinical stages: rubeosis iridis, secondary open-angle glaucoma, and synechia of the angle-closure glaucoma. 36% of neovascular glaucomas occurs after central retinal vein occlusion, 32% after diabetic proliferative retinopathy, and 13% occurs after carotid artery obstructive. The key of success in the treatment of neovascular glaucoma is the early and rightly diagnosis, the treatment is aimed mainly at relieving pain, as the prognosis for maintaining visual function is extremely poor. The most important surgical procedures are trabeculectomy, artificial drainage shunts and cyclo-distraction by trans-scleral diode laser. This essay presents a synthesis of modern principle data concerning neovascular glaucoma. PMID:16607783

  17. Single-step primary open-angle glaucoma and complicated cataract surgery using modified technique of stainless steel Glaucoma Filtration Device implantation

    OpenAIRE

    I. L. Bessonov; J. A. Gusev; V. N. Trubilin; S. M. Makkaeva

    2014-01-01

    Purpose: To analyze the efficacy of novel technique of primary open-angle glaucoma (POAG) and complicated cataract surgery that combines phacoemulsification and modified stainless steel Glaucoma Filtration Device implantation.Methods: 34 patients (38 eyes) with POAG and complicated cataract were included in the study. Phacoemulsification with Glaucoma Filtration Device implantation using improved technique (i.e., with additional collagen glaucoma drainage implantation and posterior scleral im...

  18. Glaucoma Symptoms

    Science.gov (United States)

    ... up You can help find a cure for glaucoma Give now Signs & Symptoms The most common types ... have completely different symptoms. Symptoms of Open-Angle Glaucoma Most people who develop open-angle glaucoma don’ ...

  19. Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

    Science.gov (United States)

    Jacob, Soosan; Figus, Michele; Ashok Kumar, Dhivya; Areeckal Incy, Saijimol

    2016-01-01

    Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS), for primary open angle glaucoma (POAG). Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects). After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5–1 mm into cornea and anterior chamber (AC) was entered. Kelly Descemet's punch (1 mm) was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured. Results. Mean preoperative IOP was 27.41 ± 5.54 mmHg and mean postoperative IOP was 16.47 ± 4.81 mmHg (n = 17). Mean reduction in IOP was 38.81 ± 16.55%. There was significant reduction of IOP (p < 0.000). 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered. Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18 ± 1.88 months). PMID:27144015

  20. Open angle glaucoma as a manifestation of Waardenburg′s syndrome.

    OpenAIRE

    Gupta Viney; Aggarwal Harish

    2000-01-01

    Waardenburg′s syndrome is a rare, autosomal dominant disorder, with several clinical signs, each with variable penetrance. We report this case of Waardenburg′s syndrome with bilateral open-angle glaucoma with unique gonioscopic findings.

  1. Open angle glaucoma as a manifestation of Waardenburg′s syndrome.

    Directory of Open Access Journals (Sweden)

    Gupta Viney

    2000-01-01

    Full Text Available Waardenburg′s syndrome is a rare, autosomal dominant disorder, with several clinical signs, each with variable penetrance. We report this case of Waardenburg′s syndrome with bilateral open-angle glaucoma with unique gonioscopic findings.

  2. Association of primary open-angle glaucoma with mitochondrial variants and haplogroups common in African Americans

    OpenAIRE

    Collins, David W.; Gudiseva, Harini V.; Trachtman, Benjamin; Bowman, Anita S; Sagaser, Anna; Sankar, Prithvi; Miller-Ellis, Eydie; Lehman, Amanda; Addis, Victoria; O'Brien, Joan M.

    2016-01-01

    Purpose To estimate the population frequencies of all common mitochondrial variants and ancestral haplogroups among 1,999 subjects recruited for the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study, including 1,217 primary open-angle glaucoma (POAG) cases and 782 controls, and to identify ancestral subpopulations and mitochondrial mutations as potential risk factors for POAG susceptibility. Methods Subject classification by characteristic glaucomatous optic nerve findings ...

  3. Selective Laser Trabeculoplasty as Primary Treatment for Open-Angle Glaucoma.

    Science.gov (United States)

    Kadasi, Laith M; Wagdi, Safa; Miller, Kimberly V

    2016-01-01

    Open-angle glaucoma is a silent, chronic disorder which results in progressive and permanent vision loss. Designing the optimal treatment regimen can be particularly challenging in the management of high-risk patients with frequent loss to follow-up or a longstanding history of medication noncompliance. In this article we aim to review fundamental techniques in glaucoma diagnosis and treatment with emphasis on the strengths and weaknesses of selective laser trabeculoplasty, a technique in modern therapy which may mold the future of primary treatment in open angle glaucoma management. [Full article available at http://rimed.org/rimedicaljournal-2016-06.asp, free with no login]. PMID:27247968

  4. Argon laser trabeculoplasty as primary therapy in open angle glaucoma

    International Nuclear Information System (INIS)

    To determine the effect of Argon Laser Trabeculoplasty (ALT) as a primary mode of therapy in reducing the intraocular Pressure (IOP) of patients diagnosed with Primary Open Angle Glaucoma (POAG). A total of 35 eyes of 35 patients with the gender distribution of 27 men and 8 women who were newly diagnosed with POAG, were included in this study. Mean age of the patients was 55.2 years with the range of 32 to 76 years. All of them were treated with argon laser trabeculoplasty as a primary mode of therapy. Intra ocular pressure was measured objectively using Goldman applanation tonometer, pre-and-post laser therapy. The pre-laser mean IOP was 27.63 mmHg (range 21-40 mmHg). The post-laser mean IOP measured at 6 months follow up was 15.5 mmHg (range 11 - 33 mmHg) with mean decrease of 12.1 mmHg. The decrease in IOP was seen in 32 eyes (95%) with no change observed in 3 (5%) eyes. The result shows a marked decline in IOP in patients with POAG who underwent ALT as a primary mode of treatment. Further studies with large sample size and longer follow-up will help in making future recommendations. (author)

  5. Current primary open-angle glaucoma treatments and future directions

    Directory of Open Access Journals (Sweden)

    Beidoe G

    2012-10-01

    Full Text Available Gabriel Beidoe, Shaker A MousaPharmaceutical Research Institute at Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USAAbstract: Primary open-angle glaucoma (POAG is a leading cause of blindness with no known cure. Management of the disease focuses on lowering intraocular pressure (IOP with current classes of drugs like prostaglandin analogs, beta-blockers, alpha-agonists, and carbonic anhydrase inhibitors. These treatments have not helped all patients. Some patients continue to experience deterioration in the optic nerve even though their IOPs are within the normal range. New views have surfaced about other pathophysiological processes (such as oxidative stress, vascular dysfunction, and retinal cell apoptosis being involved in POAG progression, and adjunctive treatments with drugs like memantine, bis(7-tacrine, nimodipine, and mirtogenol are advocated. This review examines the current and proposed treatments for POAG. Some of the proposed drugs (bis(7-tacrine, nimodipine, vitamin E, and others have shown good promise, mostly as monotherapy in various clinical trials. It is recommended that both the current and proposed drugs be put through further robust trials in concurrent administration and evaluated.Keywords: bis(7-tacrine, betaxolol, memantine, mirtogenol, POAG, timolol, travoprost

  6. Altered aquaporin expression in glaucoma eyes

    DEFF Research Database (Denmark)

    Tran, Thuy Linh; Bek, Toke; la Cour, Morten;

    2014-01-01

    , AQP7 and AQP9 in human glaucoma eyes compared with normal eyes. Nine glaucoma eyes were examined. Of these, three eyes were diagnosed with primary open angle glaucoma; three eyes had neovascular glaucoma; and three eyes had chronic angle-closure glaucoma. Six eyes with normal intraocular pressure and...... intensity (p = 0.037). No difference in AQP1, AQP4 and AQP9 expression was found in the optic nerve fibres. This study is the first investigating AQPs in human glaucoma eyes. We found a reduced expression of AQP9 in the retinal ganglion cells of glaucoma eyes. Glaucoma also induced increased AQP7 expression......Aquaporins (AQP) are channels in the cell membrane that mainly facilitate a passive transport of water. In the eye, AQPs are expressed in the ciliary body and retina and may contribute to the pathogenesis of glaucoma and optic neuropathy. We investigated the expression of AQP1, AQP3, AQP4, AQP5...

  7. Anti-neurotrophic effects from autoantibodies in adult diabetes having primary open angle glaucoma or dementia

    Directory of Open Access Journals (Sweden)

    Mark B Zimering

    2013-05-01

    Full Text Available Aims: To test for anti-endothelial and anti-neurotrophic effects from autoantibodies in subsets of diabetes having open- angle glaucoma, dementia or control subjects.Methods: Protein-A eluates from plasma of 20 diabetic subjects having glaucoma or suspects and 34 age-matched controls were tested for effects on neurite outgrowth in rat pheochromocytoma PC12 cells or endothelial cell survival. The mechanism of the diabetic glaucoma autoantibodies' neurite inhibitory effect was investigated in coincubations with the selective Rho kinase inhibitor Y27632 or the sulfated proteoglycan synthesis inhibitor sodium chlorate. Stored protein-A eluates from certain diabetic glaucoma or dementia subjects which contained long-lasting, highly stable cell inhibitory substances were characterized using mass spectrometry and amino acid sequencing.Results: Diabetic primary open angle glaucoma or suspects (n=20 or diabetic dementia (n=3 autoantibodies caused significantly greater mean inhibition of neurite outgrowth in PC12 cells (p < .0001 compared to autoantibodies in control diabetic (n=24 or nondiabetic (n=10 subjects without glaucoma (p < .01. Neurite inhibition by the diabetic glaucoma autoantibodies was completely abolished by 10 µM concentrations of Y27632 (n=4. It was substantially reduced by 30 mM concentrations of sodium chlorate (n=4. Peak, long-lasting activity survived storage x 5 years at 0-4 deg C and was associated with a restricted subtype of Ig kappa light chain. Diabetic glaucoma or dementia autoantibodies (n=5 caused contraction and process retraction in quiescent cerebral cortical astrocytes effects which were blocked by 5 µM concentrations of Y27632. Conclusion: These data suggest that autoantibodies in adult diabetes having primary open angle glaucoma (glaucoma suspects and/or dementia inhibit neurite outgrowth and promote a reactive astrocyte morphology by a mechanism which may involve activation of the RhoA/p160 ROCK signaling pathway.

  8. Modern Capabilities of Surgical Management of Patients with Open-Angle Glaucoma Combined with Cataract

    Directory of Open Access Journals (Sweden)

    Mantseva J.Y.

    2014-03-01

    Full Text Available Cataract and glaucoma affecting mainly elderly people sometimes are associated; therefore the problem of their combined treatment is urgent. The aim of the investigation was to assess the efficiency of modern surgery in patients with combined cataract and open-angle glaucoma. Materials and Methods. The present open prospective study is based on the examination and surgery findings of patients with associated cataract and different stages of open-angle glaucoma (200 eyes. Depending on surgery type patients were divided into three groups. Group 1 included 81 patients (100 eyes with combined cataract and glaucoma stabilized by medical treatment, who underwent phacoemulsification with intraocular lens implantation. Group 2 consisted of 44 patients (50 eyes with cataract associated with open-angle glaucoma, who underwent phacoemulsification with intraocular lens implantation in combination with sinusotomy with viscocanalodilatation. 44 patients (50 eyes with associated cataract and glaucoma, in whom phacotrabeculectomy was performed, composed group 3. Most patients had developed and advanced stages of glaucoma (81%. In addition, in the majority of patients the pseudoexfoliation syndrome (71.5% was found. Results. Phacotrabeculectomy and phacoemulsification with viscocanalodilatation were found to have a marked hypotensive effect in significant improvement of visual function in patients with associated cataract and glaucoma, regardless of glaucoma stage and pseudoexfoliation syndrome presence. Moreover, phacoemulsification with sinusotomy and viscocanalodilatation provides earlier visual acuity recovery with less early postoperative complications compared to phacotrabeculectomy, and hypotensive effect is comparable to phacotrabeculectomy after additional laser goniopuncture which was required postoperatively in 58% cases. Phacoemulsification, being a less traumatic procedure, causes less postoperative complications in patients with associated cataract

  9. 原发性闭角型青光眼单侧急性发作对侧眼激光虹膜周边切除术后随访研究%Follow-up of laser peripheral iridotomy in fellow eyes with unilateral acute attack of primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    张海涛; 杨华; 徐英英

    2011-01-01

    Background Laser peripheral iridotomy(LPI) is used as the primary therapy for the eyes at risk of angle closure.But there are still 28% eyes with primary angle closure suspect occur angle closure within 2 years after LPI.It is necessary to explore the associated factors of the efficacy of LPI.Objective The aim of this study was to explore the changes of intraocular pressure(IOP) and anterior chamber angle in the fellow eyes of patients with unilateral acute attack of primary angle closure glaucoma (PACG) and analyze the relevant factors influencing the successful rate of LPI.Methods Eighty-seven fellow eyes received LPI from 87 patients with unilateral acute attack of PACG were included in this study and retrospectively analyzed.The IOP and gonioscopy were performed before and 1 week,3,6,9,12 months after LPI.Successful signs of LPI were defined as an IOP 6-21mmHg without any anti-glaucoma medication,none of glaucomatous neuropathy and the coincident visual field loss,and no need of additional glaucomatous medication or surgery.This study was approved by Ethic Committee of the First Hospital of Xinxiang Medical College,and written informed consent was obtained from each patient.Results Seventy-nine eyes of 79 cases finished the medical visit throughout the follow-up duration with the age 61.4±0.4 years and 33(41.8%) males and 46(58.2%) females.The mean IOP was lowed in various time points after LPI in comparison with before operation with the general difference among different time visiting groups(F=4.056,P<0.01).Shaffer grade was increased in superior,temporal and nasal quadrants and significant differences were found between 1 week group,3 months group or 6 months group and before operation group (P<0.05).LPI lessened the range of appositional angle closure (AAC) in postoperative 1 week group and 3 months group compared with pre-operative group (P<0.05),but no statistically significant reduce was seen in range of AAC from 6 months through 12 months after

  10. Glaucoma

    Science.gov (United States)

    Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading ... no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. ...

  11. Glaucoma

    Medline Plus

    Full Text Available ... Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Glaucoma NEI ...

  12. OCT对急性闭角型青光眼治疗前后角结膜结构的改变%Clinical observation of OCT on detecting the structural change of cornea and conjunctiva in patients with acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    赵黎; 李青松; 张兴儒

    2015-01-01

    Abstract•AlM:To observe thickness and morphological changes of cornea and bulbar conjunctiva pre- and post acute angle closure glaucoma ( AACG ) therapy by optical coherence tomography ( OCT) .•METHODS: Twenty - five patients with AACG were recruited. lntraocular pressure ( lOP ) and morphological characteristic of cornea and conjunctiva were measured at their first visit, 1, 2 and 3d after they began the treatments.•RESULTS:The corneal epithelium thickness and corneal thickness of patients with acute attack of angle closure glaucoma were 72. 76±11. 95μm and 589. 40±66. 91μm; the conjunctival epithelial layer thickness was 58. 88±12. 87μm;the thickness of conjunctive stroma was 299. 76±94. 86μm;the conjunctival full thickness was 358. 64±102. 55μm. The corneal epithelium thickness and corneal thickness at the first day of the treatment were 69. 28±12. 65μm and 579. 04± 67. 88μm;the conjunctival epithelial layer thickness was 57. 04 ± 12. 05μm;the thickness of conjunctive stroma was 282. 44±91. 47μm;the conjunctival full thickness was 339. 48± 100. 28μm. the corneal epithelium thickness and corneal thickness at the second day of treatment were 66. 76 ± 11. 42μm and 563. 32 ± 63. 87μm;the conjunctival epithelial layer thickness was 54. 76 ± 11. 01μm;the thickness of conjunctive stroma was 267. 00 ± 98. 54μm;the conjunctival full thickness was 322. 16 ± 106. 12μm. the corneal epithelium thickness and corneal thickness of the third day treatment are 65. 16 ± 12. 25μm and 550. 36 ± 71. 48μm; the conjunctival epithelial layer thickness was measured 53. 36± 10. 29μm;the thickness of conjunctive stroma was 252. 76± 99. 32μm;the conjunctival full thickness was 306. 52 ± 107. 31μm. The difference of lOP, corneal epithelial thickness, corneal thickness, conjunctival epithelial layer thickness, conjunctival stroma thickness and conjunvtival full thickness had statistically significant(P<0. 05).•CONCLUSlON:The corneal and

  13. Effects of trabeculectomy with biological amniotic membrane transplantation in the treatment of primary chronic angle closure glaucoma%小梁切除联合生物羊膜移植术治疗原发性慢性闭角型青光眼效果分析

    Institute of Scientific and Technical Information of China (English)

    高阳; 刘洁梅; 张良

    2015-01-01

    目的:探讨小梁切除联合生物羊膜移植术对原发性慢性闭角型青光眼患者的临床治疗效果。方法将2009年7月到2013年7月于我院接受治疗的60例(72只眼)原发性慢性闭角型青光眼患者作为研究对象,随机将其分为观察组35例(42只眼)与对照组25例(30只眼),观察组患者采用小梁切除联合生物羊膜移植术,对照组患者采用小梁切除术,对比两组患者的临床治疗效果。结果完全成功:观察组34只眼(80.95%),对照组16只眼(53.33%)( P =0.012),术后视力提高患眼数:观察组26只眼(61.90%),对照组11只眼(36.67)( P =0.035),术后需加用抗青光眼药物的患眼:观察组1只眼(2.38%),对照组6只眼(20.00%)( P =0.018),术后出现并发症的患眼:观察组2只眼(4.76%),对照组7只眼(23.33%)( P =0.029),术后眼压:观察组(16.7±1.5)mm-Hg,对照组(18.9±2.5)mmHg( P =0.036)。结论小梁切除联合生物羊膜移植术能提高原发性慢性闭角型青光眼的手术成功率,减少术后并发症。%Objective To analysis the clinical effect of trabeculectomy combined with biological amniotic mem-brane transplantation on primary chronic angle closure glaucoma.Methods This study included 60 patients (72 eyes) treated in our hospital from 2009 July to 2013 July.Patients were randomly divided into observation group (35 patients, 42 eyes) and control group (25 patients, 30 eyes) .Observation group received trabeculectomy combined with biological amni-otic membrane transplantation, and control group received trabeculectomy alone.Results The successful rate was signifi-cantly higher in observation group (34 eyes, 80.95%) compared to that in control group (16 eyes, 53.33%, P =0. 012).Visual acuity improved in more patients in observation group (26 eyes, 61.90%) than in control group ( P

  14. iStent trabecular micro-bypass stent for open-angle glaucoma

    OpenAIRE

    Saheb, Hady

    2014-01-01

    Kim Le, Hady Saheb Department of Ophthalmology, McGill University, Montreal, QC, Canada Abstract: Trabecular micro-bypass stents, commonly known as iStents, are micro-invasive glaucoma surgery (MIGS) devices used to treat open-angle glaucoma. Like other MIGS procedures that enhance trabecular outflow, the iStent lowers intraocular pressure (IOP) by creating a direct channel between the anterior chamber and Schlemm’s canal. iStents are typically implanted at the time of phacoemulsif...

  15. iStent trabecular micro-bypass stent for open-angle glaucoma

    OpenAIRE

    Le K; Saheb H

    2014-01-01

    Kim Le, Hady Saheb Department of Ophthalmology, McGill University, Montreal, QC, Canada Abstract: Trabecular micro-bypass stents, commonly known as iStents, are micro-invasive glaucoma surgery (MIGS) devices used to treat open-angle glaucoma. Like other MIGS procedures that enhance trabecular outflow, the iStent lowers intraocular pressure (IOP) by creating a direct channel between the anterior chamber and Schlemm’s canal. iStents are typically implanted at the time of phacoemulsificat...

  16. Prevalence of Primary Open Angle Glaucoma in Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Mohammad Raza Besharati; Masoud Reza Manaviat; Ali Reza Azarpeikan

    2014-01-01

    Background: Obstructive sleep apnea (OSA) is partial or complete recurrent upper airway obstructions during sleep. Reduction in blood flow of the optic nerve head is an important causative factor in glaucoma. The objective of this study is to determine the prevalence of primary open angle glaucoma (POAG) in OSA patients. Materials and Methods: From September 2009 to January 2010 in this descriptive-analytic cross sectional study, 90 cases of patients with OSA referred to Yazd Shah...

  17. Short-term effect of latanoprost and timolol eye drops on tear fluid and the ocular surface in patients with primary open-angle glaucoma and ocular hypertension

    DEFF Research Database (Denmark)

    Thygesen, John; Aaen, Kim; Theodorsen, F.;

    2000-01-01

    ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology......ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology...

  18. Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    Elton; Lik; Tong; Tay; Vernon; Khet; Yau; Yong; Boon; Ang; Lim; Stelson; Sia; Elizabeth; Poh; Ying; Wong; Leonard; Wei; Leon; Yip

    2015-01-01

    AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography(AS-OCT), as well as gonioscopy and spectral domain OCT(SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT assessments.METHODS: Seventeen consecutive subjects(33 eyes)were recruited from the study hospital’s Glaucoma clinic.Gonioscopy was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other’s analyses of OCT images.RESULTS: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively(P <0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k =0.31(95% confidence interval, CI: 0.03-0.59) and k =0.35(95%CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k =0.21(95% CI: 0.07-0.49) and slight at k =0.17(95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51(95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18(95% CI: 0.08-0.45).CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively.

  19. Glaucoma

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  20. Epidemiology and clinical characteristics of patients with glaucoma: An analysis of hospital data between 2003 and 2012

    OpenAIRE

    Yang Zhao; Jia-Li Fu; Yu-Li Li; Ping Li; Feng-Lan Lou

    2015-01-01

    Purpose: To assess demographic and clinical characteristics of glaucoma patients in an Ophthalmologic Hospital of Jinan, China from 2003 to 2012. Materials and Methods: Medical charts of patients with primary open-angle glaucoma (POAG), primary angle closure glaucoma (PACG), and secondary glaucoma (SG) were reviewed. The main outcome measures of patients with glaucoma included basic demographic data (age at presentation, gender, and residence), clinical characteristics (admission date, intrao...

  1. HLA class I haplotypes and progression of primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fábio Zenha

    2011-04-01

    Full Text Available PURPOSE: To verify if patients with primary open-angle glaucoma with HLA class I haplotypes (A9-B12, A2-B40, A1-B8 associated with this disease may have a greater rate of progression than patients who do not present these haplotypes. METHODS: Anatomical and functional glaucoma evaluation (cup-to-disc ratio and visual field of 25 patients (six of them with one of the haplotypes associated with glaucoma followed at the Glaucoma Outpatient Clinic of the University Hospital, Ribeirão Preto School of Medicine, São Paulo University (HCFMRP-USP for ten years after typing of their HLA antigens in order to compare with their previous condition. RESULTS: A greater increase of the cup-to-disc ratio was observed in patients with HLA haplotypes associated with primary open-angle glaucoma predisposition. However, no significant differences in functional damage progression or in retinal nerve fibers loss were detected between them and other patients with glaucoma. CONCLUSION: The present results indicate an association of class I HLA haplotypes with progression of anatomic alterations of the optic nerve head in glaucomatous patients.

  2. 急性原发性闭角型青光眼%Acute Primary Closed Angle Glaucoma(Abstract)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Acute primary closed angle glaucoma is fast becoming one of the most important causes of blindness in the 21 st Century. World bhnding statistics show that there are 60 million people suffering from glaucoma. Of these,approximately 6 million are blind and 1.5 million (25%) are due to acute closed angle glaucoma. With the aging population, the number of patients blind from glaucoma will continue to increase.Attacks from acute primary closed angle glaucoma can lead to irreversible blindness to the affected eye.Blindness can be effectively prevented in acute primary closed angle glaucoma because the severity of symptoms will draw the attention of the patient who will then seek for medical care. Therefore, it is essential to educate the public,doctors and healthcare workers about the danger and symptoms of acute glaucoma. With early diagnosis and treatment to the affected eye and laser iridotomy to the fellow eye-bilateral blindness from acute glaucoma can be prevented.This paper highlights important clinical advances in the management of acute primary closed angle glaucoma and also poses several questions for discussion.(1) What evidence is there to suggest that bilateral blindness from acute primary closed angle glaucom is preventable?(2) In what way is Ultrasonic Biomicroscopy (UBM) useful in clinical research in glaucoma?(3) Will UBM be important in clinical diagnosis in primary closed angle glaucoma?(4) What is the scientific basis of treatment in acute primary closed angle glaucoma?(5) What are the essential procedures to preserve vision in chronic primary closed angle glaucoma?(6) What are the reasons for blindness after laser iridotomy?(7) What is the mechanism of laser iridoplasty?(8) What are the reasons why laser iridoplasty should be combined with laser iridotomy?(9) Why there is an intraocular pressure increase in 50% of eyes within 3 months after laser iridoplasty?(10) Can UBM explain the changes in the angle after lens removal in primary closed angle

  3. 前房穿刺术联合激光周边虹膜切除术治疗急性原发性闭角型青光眼%Clinical effect of anterior chamber paracentesis combined with laser peripheral iridotomy on acute primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    李松峰; 常海敏

    2013-01-01

    目的 评价前房穿刺术联合激光周边虹膜切除术(laser peripheral iridotomy,LPI)治疗急性原发性闭角型青光眼(primary angle-closure glaucoma,PACG)的效果.方法 回顾性分析北京同仁医院2007年11月至2009年5月就诊的急性PACG患者16例(16眼),就诊时眼压≥50 mmHg(1 kPa =7.5 mmHg),均及时行前房穿刺术,并于术后12h内行LPI.用压平眼压计测量并记录前房穿刺术前、术后30 min、2h,LPI术前、术后24 h、7d、1个月、6个月和1 a的眼压,同时记录患者术后角膜水肿及瞳孔情况.结果 16例PACG患者随诊1 a,前房穿刺术后眼压由术前(63.13±7.94) mmHg降至术后30 min(15.47±7.67)mmHg,LPI术前眼压为(15.56±6.93) mmHg,LPI术后24 h眼压为(18.81±7.24) mmHg,其中14例患者术后1 a眼压为(12.79±1.72) mmHg,另2例患者因高眼压控制不良再行小梁切除术.LPI术后患者角膜水肿明显减轻,LPI术前瞳孔明显缩小,为(1.94±1.09)mm,有利于LPI的进行.结论 作为一种可行治疗方法,前房穿刺术联合LPI可安全有效地降低急性PACG患者眼压.%Objective To evaluate the clinical effects of anterior chamber paracentesis combined with laser peripheral iridotomy(LPI) on acute primary angle-closure glaucoma(PACG).Methods A total of 16 cases (16 eyes) with acute PACG and intraocular pressure(IOP) ≥50 mmHg(1 kPa =7.5 mmHg) in Beijing Tongren Hospital from November,2007 to May,2009 were retrospectively analyzed.They were all treated by anterior chamber paracentesis immediately and then LPI was performed on them within 12 hours after operation.The IOP was measured by applanation tonometry before paracentesis and 30 minutes and 2 hours after paracentesis,and before LPI and 24 hours,7 days,1 month,0.5 year,1 year after LPI.Results All patiens were followed up for 1 year.The IOP reduced from (63.13 ± 7.94) mmHg before paracentesis to (15.47 ± 7.67) mmHg 30 minutes after paracentesis,and then to (15.56 ± 6.93) mmHg before LPI and(18.81

  4. Glaucoma

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  5. Glaucoma

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  6. [Iris examination in transformed light in primary open-angle glaucoma].

    Science.gov (United States)

    Vodovozov, A M; Rybnikov, A A

    1991-01-01

    The iris was examined in transformed light by iridochromoscopy, iridochromophotography, biomicroscopy in polarized light, transillumination in red light, and fluorescent iridoangiography in 83 eyes of patients with primary open-angle glaucoma and 117 eyes of normal reference subjects. The examinations have shown the prevalence of trophic and vascular shifts in the iris of all glaucoma patients as against the reference patients (R 0.05). The major iris changes revealed in primary open-angle glaucoma were stromal atrophy with the predominant involvement of the pupil segment, destruction of the pupil pigmented border, exogenic pigmentation of the pupil and ciliary segments, thickening of the anterior border layer, pseudoexfoliation of the pupil edge, defects of the posterior pigmented lamina disseminated in the pupil segment, hypoperfusion of the iris vessels combined with their impaired permeability and micro-neovascularization in the iris edge and ciliary agea. PMID:2035203

  7. Glaucoma

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  8. Glaucoma

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  9. Glaucoma

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  10. Glaucoma

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  11. Glaucoma

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  12. Glaucoma

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  13. Glaucoma

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  14. Glaucoma

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  15. Is diabetes mellitus a risk factor for open-angle glaucoma? The Rotterdam Study

    NARCIS (Netherlands)

    S. de Voogd; M.K. Ikram; R.C.W. Wolfs; N.M. Jansonius; J.C.M. Witteman; A. Hofman; P.T.V.M. de Jong

    2006-01-01

    Purpose: To investigate whether diabetes mellitus is a risk factor for open-angle glaucoma (OAG). Design: Prospective population-based cohort study. Participants: Participants ages >= 55 years from the Rotterdam Study, The Netherlands. Methods: Participants at risk for incident OAG (iOAG) underwent

  16. Is Diabetes Mellitus a Risk Factor for Open-Angle Glaucoma? The Rotterdam Study

    NARCIS (Netherlands)

    Voogd, S. de; Ikram, M.K.; Wolfs. R.C.W., [No Value; Jansonius, N.M.; Witteman, J.C.M.; Hofman, A.; de Jong, P.T.V.M.

    2006-01-01

    Purpose: To investigate whether diabetes mellitus is a risk factor for open-angle glaucoma (OAG). Design: Prospective population-based cohort study. Participants: Participants ages =55 years from the Rotterdam Study, The Netherlands. Methods: Participants at risk for incident OAG (iOAG) underwent at

  17. Corticosteroids and Open-Angle Glaucoma in the Elderly A Population-Based Cohort Study

    NARCIS (Netherlands)

    Marcus, Michael W.; Muskens, Rogier P. H. M.; Ramdas, Wishal D.; Wolfs, Roger C. W.; De Jong, Paulus T. V. M.; Vingerling, Johannes R.; Hofman, Albert; Stricker, Bruno H. C.; Jansonius, Nomdo M.

    2012-01-01

    Background It is largely unknown if corticosteroid-induced open-angle glaucoma (OAG) is an entity that is limited to a few susceptible individuals or whether it contributes significantly to the overall population burden of OAG. Objective The aim of this study was to determine whether there is an ass

  18. Levels of circulating homocysteine, vitamin B6, vitamin B12, and folate in different types of open-angle glaucoma

    OpenAIRE

    Turgut, Burak; KAYA, Murat; ARSLAN, Sermal; Demir, Tamer; Güler, Mete; Kaya, Mehmet Kaan

    2010-01-01

    Objective: To compare the levels of plasma homocysteine (Hcy), vitamin B6 (vit-B6), serum vitamin B12 (vit-B12), and folate in healthy individuals and in patients with normal tension glaucoma (NTG), pseudoexfoliative glaucoma (PXG), or primary open-angle glaucoma (POAG). Study design: A prospective controlled trial. Participants and methods: Forty healthy subjects, 48 patients with NTG, 38 patients with PXG, and 34 patients with POAG were included in the study. Those who used vitamin suppleme...

  19. Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients

    OpenAIRE

    Chen, Hsin-Yi; Hsu, Sheng-Yao; Chang, Yue-Cune; Lin, Che-Chen; Sung, Fung-Chang; Chen, Wen-Chi; Kao, Chia-Huang

    2015-01-01

    Abstract The aim of the study was to investigate the association between statin use and open-angle glaucoma (OAG) risk in hyperlipidemia patients. We used the research database of the Taiwan National Health Insurance program to conduct a population-based case-control study. A total of 1276 patients with newly diagnosed OAG were identified from 2004 to 2011. Controls comprised of 12,760 patients without glaucoma and were frequency-matched for age, sex, history of diabetes mellitus, and year of...

  20. Common genetic determinants of intraocular pressure and primary open-angle glaucoma.

    Directory of Open Access Journals (Sweden)

    Leonieke M E van Koolwijk

    Full Text Available Intraocular pressure (IOP is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4 independent population-based studies in The Netherlands. We replicated our findings in 7,482 participants from 4 additional cohorts from the UK, Australia, Canada, and the Wellcome Trust Case-Control Consortium 2/Blue Mountains Eye Study. IOP was significantly associated with rs11656696, located in GAS7 at 17p13.1 (p=1.4×10(-8, and with rs7555523, located in TMCO1 at 1q24.1 (p=1.6×10(-8. In a meta-analysis of 4 case-control studies (total N = 1,432 glaucoma cases, both variants also showed evidence for association with glaucoma (p=2.4×10(-2 for rs11656696 and p=9.1×10(-4 for rs7555523. GAS7 and TMCO1 are highly expressed in the ciliary body and trabecular meshwork as well as in the lamina cribrosa, optic nerve, and retina. Both genes functionally interact with known glaucoma disease genes. These data suggest that we have identified two clinically relevant genes involved in IOP regulation.

  1. Topiramate-induced angle closure with acute myopia, macular striae

    Directory of Open Access Journals (Sweden)

    S Natesh

    2010-01-01

    Full Text Available Topiramate is a sulfamate-substituted monosaccharide used in the treatment of seizures, and prophylaxis of migraine. A number of ocular side-effects have been described with use of topiramate, like bilateral angle closure, acute myopia and macular striae. Ultrasound biomicroscopy (UBM clinches the diagnosis after ruling out other causes of shallow anterior chamber. Previous studies have not demonstrated internal limiting membrane folds presenting as macular striae. We report a case of topiramate-induced acute myopia with angle closure and macular striae in a young adult. This is the first report wherein striae formation after low doses of topiramate and their resolution have been documented by Optical Coherence Tomography (OCT.

  2. Early phacoemulsification in patients with acute primary angle closure

    OpenAIRE

    Moghimi, Sasan; Hashemian, Hesam; Chen, Rebecca; Johari, Mohammadkarim; Mohammadi, Massood; Lin, Shan C.

    2016-01-01

    Purpose To compare long term efficacy of phacoemulsification in the early management of acute primary angle closure (APAC) after aborting an acute attack and performing laser peripheral iridotomy (LPI). Methods In this nonrandomized comparative prospective study, we included 35 subjects presenting with APAC who had responded to medical treatment and LPI with intraocular pressure (IOP) less than 25 mmHg. Twenty patients with visually significant cataract with visual acuity of 21 mmHg with or w...

  3. Topiramate-induced angle closure with acute myopia, macular striae

    OpenAIRE

    Natesh, S.; Rajashekhara, S. K.; Rao, A. S. D.; B Shetty

    2010-01-01

    Topiramate is a sulfamate-substituted monosaccharide used in the treatment of seizures, and prophylaxis of migraine. A number of ocular side-effects have been described with use of topiramate, like bilateral angle closure, acute myopia and macular striae. Ultrasound biomicroscopy (UBM) clinches the diagnosis after ruling out other causes of shallow anterior chamber. Previous studies have not demonstrated internal limiting membrane folds presenting as macular striae. We report a case of topira...

  4. iStent trabecular micro-bypass stent for open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Le K

    2014-09-01

    Full Text Available Kim Le, Hady Saheb Department of Ophthalmology, McGill University, Montreal, QC, Canada Abstract: Trabecular micro-bypass stents, commonly known as iStents, are micro-invasive glaucoma surgery (MIGS devices used to treat open-angle glaucoma. Like other MIGS procedures that enhance trabecular outflow, the iStent lowers intraocular pressure (IOP by creating a direct channel between the anterior chamber and Schlemm’s canal. iStents are typically implanted at the time of phacoemulsification for patients with open-angle glaucoma and visually significant cataracts. This review summarizes the published data regarding the efficacy, safety, and cost considerations of trabecular micro-bypass stents. Most studies found statistically significant reductions in mean IOP and ocular medication use after combined phacoemulsification with single or double iStent implantation. The devices were found to be very safe, with a safety profile similar to that of cataract surgery. Complications were infrequent, with the most common complications being temporary stent obstruction or malposition, which resolved with observation or secondary procedures. Future studies are needed to evaluate long-term outcomes, patient satisfaction, cost effectiveness, and expanded indications. Keywords: iStent, trabecular micro-bypass, glaucoma, MIGS, ab interno, surgery

  5. Tafluprost once daily for treatment of elevated intraocular pressure in patients with open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Liu Y

    2012-12-01

    Full Text Available Yang Liu, Weiming MaoDepartment of Cell Biology and Anatomy, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TXAbstract: Glaucoma is a leading cause of visual loss worldwide. Current antiglaucoma therapy focuses on lowering intraocular pressure to a safe level. In recent years, prostaglandin analogs have become the first-line agents for treating open angle glaucoma. Tafluprost, which was first reported in 2003, is a novel prostaglandin analog, and has been shown to be a potent ocular hypotensive agent in a number of preclinical and clinical studies. Also, its unique preservative-free formulation helps to decrease preservative-associated ocular disorders and improve patient compliance. In this review, studies from 2003 to 2012 focusing on the structure, metabolism, efficacy, and safety of tafluprost are summarized. These studies suggested that application of tafluprost once daily is a safe and effective treatment for patients with open angle glaucoma.Keywords: tafluprost, prostaglandin analog, glaucoma, intraocular pressure, preservative-free formulation

  6. Glaucoma

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  7. Glaucoma

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  8. Glaucoma

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  9. Glaucoma

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  10. Glaucoma

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  11. Glaucoma

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  12. The effect of different criteria on the number of patients blind from open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Heijl Anders

    2011-11-01

    Full Text Available Abstract Background The prevalence of blindness and visual impairment from glaucoma is influenced by the criteria used to define these entities, which differ between countries and regions, as well as among published reports. The objective of the present study was to ascertain the extent to which different criteria of blindness and visual impairment influence estimates of the number of patients classified as blind or visually impaired by glaucoma in a clinic-based population. Methods We conducted a retrospective chart review of 914 patients with open-angle glaucoma to compare numbers of patients identified as visually impaired with and without considering visual field status. We also compared proportions classified using World Health Organisation (WHO and United States (US blindness criteria, and applying a new US Social Security Administration (SSA disability criterion: perimetric mean deviation (MD ≤ -22 dB. Results Forty patients (4.4% were bilaterally blind from glaucoma by the WHO criteria. Fifty-two (5.7% were blind by the the US criterion. Assessing only visual acuity, 14 (1.5% patients were blind by the WHO criteria and 24 (2.6% by the US definition. Eighty-five (9.3% met the US SSA disability criterion. Among those, 52 were impaired also by the WHO definition. No patients impaired according to the WHO criteria had MD values better than -22 dB. Conclusions Excluding visual field status will seriously underestimate the prevalence of glaucoma blindness. In our patient population, 30% more patients were classified as blind by the US than by the WHO definition. Also, 60% more were identified as visually impaired by the US SSA criterion than by the WHO criteria. Visual field assessment is vital to determine visual impairment caused by glaucoma.

  13. Evaluation of blotchy pigments in the anterior chamber angle as a sign of angle closure

    Directory of Open Access Journals (Sweden)

    Harsha L Rao

    2012-01-01

    Full Text Available Background: Blotchy pigments in the anterior chamber (AC angle are considered diagnostic of primary angle closure (PAC. But there are no reports either on the prevalence of blotchy pigments in AC angles or the validity of this sign. Aims: To determine the prevalence of blotchy pigments in AC angles and to evaluate their relationship with glaucomatous optic neuropathy (GON in eyes with occludable angles. Setting and Design: Cross-sectional, comparative study. Materials and Methods: Gonioscopy was performed in 1001 eyes of 526 subjects (245 eyes of 148 consecutive, occludable angle subjects and 756 eyes of 378 non-consecutive, open angle subjects, above 35 years of age. Quadrant-wise location of blotchy pigments was documented. Statistical Analysis: Odds of blotchy pigments in occludable angles against that in open angles were evaluated. Relationship of GON with blotchy pigments in occludable angle eyes was evaluated using a multivariate model. Results: Prevalence of blotchy pigments in occludable angles was 28.6% (95% CI, 22.9-34.3 and in open angles was 4.7% (95% CI, 3.2-6.3. Blotchy pigments were more frequently seen in inferior (16% and superior quadrants (15% of occludable angles, and inferior quadrant of open angles (4%. Odds of superior quadrant blotchy pigments in occludable angles were 33 times that in open angles. GON was seen in 107 occludable angle eyes. Blotchy pigments were not significantly associated with GON (odds ratio = 0.5; P = 0.1. Conclusions: Blotchy pigments were seen in 28.6% of occludable angle eyes and 4.7% of open angles eyes. Presence of blotchy pigments in the superior quadrant is more common in occludable angles. Presence of GON in occludable angle eyes was not associated with blotchy pigments.

  14. Epidemiological characterization of primary open-angle glaucoma Caracterización epidemiológica del glaucoma primario de ángulo abierto

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    Armando Rafael Milanés Armengol

    2010-11-01

    Full Text Available Background: The primary open-angle glaucoma is a problem for public health all over the world. It is a silent and slowly progressive disease leading to blindness. In most patients this can be prevented if the risk factors leading to the disease are detected in time. Objective: To describe some epidemiological factors of patients with primary open-angle glaucoma. Methods: Clinical, epidemiological, prospective and longitudinal study in patients with primary open-angle glaucoma who attended the glaucoma consultation of the Provincial General University Hospital "Dr. Gustavo Aldereguía Lima" of Cienfuegos, from January to February 2009. The following variables were analyzed: age, sex, family and personal medical history, toxic habits and time of diagnosis of the disease. Results: There was prevalence of primary open-angle glaucoma (87, 5% mostly in females (53, 6% and patients over 61 years old as well as in white skinned patients (52 and 62% respectively. Hypertension was the leading entity referred to as pathological personal and family antecedent (62 and 42% respectively. Glaucoma and myopia predominated as previous eye history. The most frequent toxic habits were the consumption of more than 2 cups of coffee a day (53% and smoking (32%. The largest amount of patients had more than 5 years evolution of the disease. Conclusions: Primary open-angle glaucoma occurred mainly in female patients and those with a historyFundamento: el glaucoma primario de ángulo abierto constituye un problema de salud pública a nivel mundial, es una enfermedad silente y lentamente progresiva que conduce a la ceguera; en la mayoría de los enfermos esto puede prevenirse si son detectados tempranamente los factores de riesgo que pueden llevar a esta enfermedad. Objetivo: describir algunos factores epidemiológicos de pacientes portadores de glaucoma

  15. The efficacy of NHIS-listed anti-glaucoma drugs in the manage-ment of primary open-angle glaucoma

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    Koffuor, G. A.

    2012-04-01

    Full Text Available Ghana is the most affected country in Africa as far as glaucoma is concerned. This study therefore aims at determining the efficacy of the National Health Insurance Scheme listed anti-glaucoma drugs in the management of primary open-angle glaucoma in Ghana. This retrospective survey was carried out at the Golden Jubilee Eye Centre of St Michael’s Catholic Hospital, Pramso in the Bosomtwi Atwima Kwanwoma District of the Ashanti Region of Ghana from January 2008 to De-cember 2010. By random and purposive sampling, 141 patient folders (35.25% of total folders stud-ied were selected and data on drugs and intra-ocular pressure measurements for eight consecutive visits to the centre were recorded and analyzed appropriately. The outcome of primary open-angle glaucoma in the study was not gender sensitive but increased with age (majority 70 – 79 years. While Timolol, in monotherapy, reduced but not significantly (p > 0.05 the initial mean intra-ocular pressure measurements, Latanoprost reduced the initial mean intra-ocular pressure very significantly (p ≤ 0.001. Combination therapies involving Latanoprost and listed anti-glaucoma drugs reduced intra-ocular pressure significantly than combination therapies involving NHIS-listed drugs only (p ≤ 0.01. Though the National Health Insurance Scheme listed anti-glaucoma drug show intra-ocular pressure reduction in mono- and combination therapies, reduction by Lat-anoprost and combination of Latanoprost with the NHIS-listed drugs is very much significant. An addition of Latanoprost to the National Health Insurance Scheme list of anti-glaucoma medica-tions would therefore be very beneficial to glaucoma patients in Ghana.

  16. Features of ophthalmoneuroprotection in patients with open-angle glaucoma in combination with diabetic retinopathy

    OpenAIRE

    O. I. Borzunov

    2014-01-01

    Aim: of this study is to evaluate ophthalmoneuroprotectional treatment of patients with POAG and diabetes mellitus type II in a specialized hospital.Material and methods: We have performed retro — and prospective analysis of the combined treatment of 130 patients (248 eyes) with a combination of primary open-angle glaucoma and diabetic retinopathy. Evaluation of the effectiveness of treatment was conducted on the following criteria: the severity of the hypotensive effect, the degreeof improve...

  17. Risk Factors for Primary Open-Angle Glaucoma in Western Turkey

    OpenAIRE

    Güliz Fatma Yavaş; Tuncay Küsbeci; Mustafa Şanlı; Dilek Toprak; Sıtkı Samet Ermiş; Ümit Übeyt İnan; Faruk Öztürk

    2013-01-01

    Pur po se: To evaluate the prevalence of primary open-angle glaucoma (POAG) in subjects aged over 40 years in Western Turkey and to quantify its association with several systemic risk factors. Ma te ri al and Met hod: The research was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. A total of 1533 subjects aged 40 years or more were included in the study. Diabetes mellitus, hypertension, atherosclerotic cardiac disease, obesity, smoki...

  18. Comparison of Central Corneal Thickness Measurements by Ultrasonic Pachymetry, Orbscan II, and SP3000P in Eyes with Glaucoma or Glaucoma Suspect

    OpenAIRE

    Mei-Ching Teng; Ing-Chou Lai; Tsung-Ho Ou

    2012-01-01

    Background: Intraocular pressure (IOP) measurements are affected by the central cornea thickness (CCT). The conventional method for CCT measurement is ultrasonic pachymetry. However, noncontact procedures lower the risk of infection and corneal damage. In this study, we compared the CCT measured by Orbscan II, SP3000P, and ultrasonic pachymetry in patients with glaucoma or glaucoma suspect.Methods: The CCT of 208 eyes (46 eyes with glaucoma suspect, 42 with primary angle-closure glaucoma, and...

  19. Retrobulbar hemodynamic parameters in men and women with open angle glaucoma

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    Marjanović Ivan

    2014-01-01

    Full Text Available Background/Aim. Several factors may have influence on systemic circulation. Additionally, peripheral circulation also demonstrates sex differences, in young women presenting significantly lower finger blood flow in comparison to men of the same age, a finding that disappears in women after menopause. The aim of this study was to compare the retrobulbar hemodynamic parameters measured by means of color Doppler imaging in women and men with open-angle glaucoma and elevated intraocular pressure. Methods. A total of 52 eyes from 52 open-angle glaucoma (OAG patients, with elevated intraocular pressure (IOP, were included in this cross-sectional study. Peak-systolic velocity (PSV, end-diastolic velocity (EDV, and Pourcelot resistivity index (RI were assessed in the ophtalmic artery (OA, central retinal artery (CRA, and posterior cilliary arteries (PCA. IOP was measured both with Goldmann Applanation tonometer (GAT and with the dynamic contour tonometer (DCT, three times respectively. Ocular pulse amplitude (OPA appeared during the DCT measurement. Results. The retrobulbar hemodynamic parameters did not show any difference between men and post-menopausal women. Conclusion. The results of our study did not find any difference between sexes in patients with open-angle glaucoma and elevated intraocular pressure.

  20. Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital

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    Arvind Kumar Yadav

    2013-01-01

    Full Text Available Objective: To study drug use pattern in patients of primary open angle glaucoma (POAG and to analyze the cost of different anti-glaucoma medications. Materials and Methods: This prospective study was carried in the glaucoma clinic of a tertiary care teaching hospital over a period of 9 months. The data collected for patients with POAG included the patient′s demographic details and the drugs prescribed. Data were analyzed for drug use pattern and cost drugs used. Results: In a total 180 prescriptions (297 drugs analyzed, most drugs (83.83% were prescribed by topical route as eye drops. β blockers (93.88% were found to be the most frequently prescribed for POAG. Timolol (82.22% was the most frequently prescribed drug and timolol with acetazolamide (17.22% was the most commonly prescribed drug combination. Fixed dose combinations constituted 26.66% of prescriptions. β blockers were found to be cheaper than other anti-glaucoma drugs while prostaglandins analogs were the costliest. Instructions about the route, frequency and duration of treatment were present in all prescriptions. However, instructions regarding instillation of eye drops were missing in all prescriptions.

  1. Prevalence of Primary Open Angle Glaucoma in Obstructive Sleep Apnea Syndrome

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    Mohammad Raza Besharati

    2014-01-01

    Full Text Available Background: Obstructive sleep apnea (OSA is partial or complete recurrent upper airway obstructions during sleep. Reduction in blood flow of the optic nerve head is an important causative factor in glaucoma. The objective of this study is to determine the prevalence of primary open angle glaucoma (POAG in OSA patients. Materials and Methods: From September 2009 to January 2010 in this descriptive-analytic cross sectional study, 90 cases of patients with OSA referred to Yazd Shahid Sadoughi hospital were collected and studied by polysomnography, blood gas analysis and ocular examination including measurement of intra ocular pressure, gonioscopy, fondoscopy and automated perimetry. Statistical analysis was performed by SPSS software6T. Results: Thirty-one patients had mild OSA, 30 patients had moderate OSA and 29 patients had severe OSA. The prevalence of POAG in this group of patients was 10% (95% CI: 4-16. It is higher than the general population in the same age group (p=0.017. There was no significant correlation between the presence of glaucoma and apnea hypopnea index (AHI, mean saturation arterial OR2R (MSaOR2R, body mass index (BMI, sex and age. A significant correlation between AHI with IOP and cup/disc ratio was not documented6T. Conclusion: According to our founding, the prevalence of POAG in OSA patients was higher than the general population in the same age group. Thus we recommend screening of glaucoma in OSA patients. This Study suggests that AHI, MSaOR2R, BMI, sex or age are not important risk factors for glaucoma in OSA patients6T

  2. The Biometric Values of Affected and Fellow Eyes in Patients with Acute Attack of Primary Angle Closure

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    Mohammad Reza Razeghinejad

    2009-12-01

    Full Text Available Background: It has been estimated that 67 million peopleworldwide are affected with a primary glaucoma and that onethirdhave primary angle closure glaucoma. We aimed to determinethe biometric differences between the eyes of patientswith acute attack of primary angle closure and their noninvolvedfellow eyes.Methods: Twenty eight patients with acute attack of primary angleclosure were recruited in this prospective study. Three weeksafter laser iridotomy and resolution of corneal edema, all patientshad a complete ocular examination including slit lamp biomicroscopy,pachymetry, keratometry, and ocular biometry. The followingA-scan parameters were measured: anterior chamberdepth, lens thickness, axial length, lens– axial length factor, relativelens position, and corrected anterior chamber depth.Results: There were 22 (78.5% women and six (21.5% menwith mean age of 52.82±9.25 years. There were no statisticallysignificant differences in the biometric figures between theaffected and fellow eyes [anterior chamber depth (P=0.4, lensthickness (P=0.4, axial length (P=0.7, lens-axial length factor(P=0.6, relative lens position (P=0.7, and corrected anteriorchamber depth (P=0.8]. The mean ± standard deviation ofcentral corneal thickness in the affected and fellow eyes were560.12±41.93 and 557.727±18.53, respectively (P=0.806.There was no statistically significant difference between theboth eyes in the mean keratometric diopters in the affected andin the fellow eyes (45.05±2.02 v 44.91±1.73; P=0.78.Conclusion: The present study did not reveal any statisticallysignificant differences regarding the ocular biometricparameters between the affected and fellow eyes in patientswith acute primary angle closure. The biometric parameterswere similar between male and female patients as well.

  3. The Association between Primary Open-Angle Glaucoma and Blood Pressure: Two Aspects of Hypertension and Hypotension

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    Hye Jin Chung

    2015-01-01

    Full Text Available Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG is not fully understood, elevated intraocular pressure (IOP is considered the most important risk factor. Several vascular factors have also been identified as risk factors and can lead to hypoperfusion of the optic nerve head and thus may play an important role in the pathogenesis and progression of POAG. The results of the present study suggest that both high and low blood pressure (BP are associated with an increased risk of POAG based on a comprehensive literature review. Elevated BP is associated with elevated IOP, leading to increased risk of glaucoma, but excessive BP lowering in glaucoma patients may cause a drop in ocular perfusion pressure (OPP and subsequent ischemic injury. The relationship between IOP, OPP, and BP suggests that the relationship between BP and glaucoma progression is U-shaped.

  4. Pentacam对原发性闭角型青光眼激光周边虹膜切开术前后前房形态和参数的评估%The morphologic and quantitative evaluation of ocular anterior chamber parameters after laser peripheral iridotomy in primary angle-closure glaucoma eyes

    Institute of Scientific and Technical Information of China (English)

    刘晓丽; 刘丹岩; 张斌; 郭从容; 杜颖华; 段佳良

    2016-01-01

    in the quantitative evaluation of ocular anterior segment in primary angle-closure glaucoma (PACG) eyes than slit lamp microscope and ultrasound biomicroscope (UBM).However,its accuracy in the earlier stage of PACG before and after YAG laser peripheral iridotomy (LPI) is not fully elucidated.Objective This study was to assess the effect of YAG LPI in PACG patients with Pentacam.Methods A prospective self-controlled study was performed.Thirtyfive fellow eyes (pre-clinical stage of PACG) of acute PACG and 35 fellow eyes of chronic PACG were included in the Second Hospital of Hebei Medical University from July,2012 to December,2013.YAG LPI was performed on the eyes,and the parameters of ocular anterior segment including central anterior chamber depth (ACD),anterior chamber volume (ACV) and peripheral anterior chamber angle (ACA) were measured and compared by Pentacam before and 1 day,7 days,28 days after operation.This study was approved by the Ethic Committee of the Second Hospital of Hebei Medical University and informed consent was obtained from all subjects.Results In pre-clinical stage of PACG eyes,the postoperative ACD and ACV values were increased in comparison with preoperation,showing significant differences among various time points (ACD:F =6.783,P =0.004;ACV:F =19.090,P =0.000),and no significant difference was found in ACA among different time points (F =0.153,P =0.928).In the fellow eyes of chronic PACG,the postoperative ACD and ACV values were larger than those of preoperation,with significant differences among various time points (ACD:F =21.576,P =0.000;ACV:F =47.506,P =0.000),and no significant difference was found in ACA among different time points (F=0.581,P=0.629).The change values of ACD and ACV were (0.064±0.022) mm and (27.840±4.963) mm3 in the eyes of pre-clinical stage of PACG,and those in the fellow eyes of chronic PACG were (0.047-± 0.020) mm and (21.000 ± 3.278) mm3,showing significant differences between the two groups (ACD:t=2.783,P=0

  5. Association Between Peripheral Vascular Endothelial Function and Progression of Open-Angle Glaucoma.

    Science.gov (United States)

    Liu, Chun-Hsiu; Su, Wei-Wen; Shie, Shian-Sen; Cheng, Shih-Tsung; Su, Cheng-Wen; Ho, Wang-Jing

    2016-03-01

    The aim of the study is to evaluate the relationship between Humphrey visual field progression and peripheral vascular endothelial function in patients with open-angle glaucoma (OAG), assessed by noninvasive endothelium-dependent flow-mediated vasodilation (FMD).Forty OAG patients, among which 22 had normal-tension glaucoma (NTG) and 18 had primary open-angle glaucoma (POAG) were enrolled. Each enrolled patient underwent a thorough ophthalmological examination including the Humphrey visual field test and measurement of FMD via high-resolution 2-dimensional ultrasonographic imaging of the brachial artery. Blood samples were evaluated for biochemistry and lipid profiles as well as levels of high-sensitivity C-reactive protein (hsCRP). The annual change of threshold sensitivity of the visual field in each test location were analyzed with pointwise linear regression. The correlation between long-term visual field progression and FMD was evaluated.A mean follow-up of 7.47 ± 1.84 years revealed a faster progression rate over the superior visual field in all 40 OAG patients (superior field -0.24 ± 0.67 dB/y, inferior field -0.10 ± 0.59 dB/y, P = 0.37). However, only the annual sensitivity change of the inferior peripheral field showed correlation with baseline FMD. There was no significant difference in the change slope of visual field between NTG and POAG patients.A correlation between baseline brachial artery FMD and visual field progression was observed in the inferior peripheral field in patients with NTG and POAG. This result suggests that peripheral vascular endothelial dysfunction may be related to glaucoma progression. PMID:26962832

  6. Longitudinal Changes of Angle Configuration in Primary Angle-Closure Suspects

    Science.gov (United States)

    Jiang, Yuzhen; Chang, Dolly S.; Zhu, Haogang; Khawaja, Anthony P.; Aung, Tin; Huang, Shengsong; Chen, Qianyun; Munoz, Beatriz; Grossi, Carlota M.

    2015-01-01

    Objective To determine longitudinal changes in angle configuration in the eyes of primary angle-closure suspects (PACS) treated by laser peripheral iridotomy (LPI) and in untreated fellow eyes. Design Longitudinal cohort study. Participants Primary angle-closure suspects aged 50 to 70 years were enrolled in a randomized, controlled clinical trial. Methods Each participant was treated by LPI in 1 randomly selected eye, with the fellow eye serving as a control. Angle width was assessed in a masked fashion using gonioscopy and anterior segment optical coherence tomography (AS-OCT) before and at 2 weeks, 6 months, and 18 months after LPI. Main Outcome Measures Angle width in degrees was calculated from Shaffer grades assessed under static gonioscopy. Angle configuration was also evaluated using angle opening distance (AOD250, AOD500, AOD750), trabecular-iris space area (TISA500, TISA750), and angle recess area (ARA) measured in AS-OCT images. Results No significant difference was found in baseline measures of angle configuration between treated and untreated eyes. At 2 weeks after LPI, the drainage angle on gonioscopy widened from a mean of 13.5° at baseline to a mean of 25.7° in treated eyes, which was also confirmed by significant increases in all AS-OCT angle width measures (P<0.001 for all variables). Between 2 weeks and 18 months after LPI, a significant decrease in angle width was observed over time in treated eyes (P<0.001 for all variables), although the change over the first 5.5 months was not statistically significant for angle width measured under gonioscopy (P = 0.18), AOD250 (P = 0.167) and ARA (P = 0.83). In untreated eyes, angle width consistently decreased across all follow-up visits after LPI, with a more rapid longitudinal decrease compared with treated eyes (P values for all variables ≤0.003). The annual rate of change in angle width was equivalent to 1.2°/year (95% confidence interval [CI], 0.8–1.6) in treated eyes and 1.6°/year (95% CI, 1

  7. Non-pupillary block angle-closure mechanisms: a comprehensive analysis of their prevalence and treatment outcomes

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    Daniela L. M. Junqueira

    2014-12-01

    Full Text Available Purpose: To assess the prevalence and treatment outcomes of angle-closure mechanisms other than pupillary block in a population of Brazilian patients. Methods: A retrospective chart review was conducted to evaluate patients who had undergone laser peripheral iridotomy (LPI due to occludable angles at a single institution between July 2009 and April 2012. An occludable angle was defined as an eye in which the posterior trabecular meshwork was not visible for ≥180° on dark-room gonioscopy. Key exclusion criteria were any form of secondary glaucoma and the presence of >90° of peripheral anterior synechiae. Collected data were age, race, gender, angle-closure mechanism (based on indentation goniocopy and ultrasound biomicroscopy, intraocular pressure (IOP, number of antiglaucoma medications and subsequent management during follow-up. If both eyes were eligible, the right eye was arbitrarily selected for analysis. Results: A total of 196 eyes of 196 consecutive patients (mean age 58.3 ± 11.6 years who underwent LPI were included. In most of the patients [86% (169 patients; 133 women and 36 men], LPI sucessfully opened the angle. Mean IOP was reduced from 18.3 ± 6.4 mmHg to 15.4 ± 4.5 mmHg after LPI (p<0.01. Among the 27 patients with persistent occludable angles, the most common underlying mechanisms were plateau iris (56% and lens-induced component (34%. Most of these patients (85% were treated with argon laser peripheral iridoplasty (ALPI; approximately 90% showed non-occludable angles following the laser procedure (mean IOP reduction of 18.9%, with no significant differences between patients with plateau iris and lens-induced components (p=0.34; mean follow-up of 11.4 ± 3.6 months. Conclusion: Our findings suggest that, in this population of Brazilian patients, several eyes with angle closure were not completely treated with LPI. In the present large case series involving middle-age patients, plateau iris was the leading cause of

  8. Levels of circulating homocysteine, vitamin B6, vitamin B12, and folate in different types of open-angle glaucoma

    OpenAIRE

    Burak Turgut; Murat Kaya; Sermal Arslan; et al

    2010-01-01

    Burak Turgut, Murat Kaya, Sermal Arslan, Tamer Demir, Mete Güler, Mehmet Kaan KayaFırat University School of Medicine, Department of Ophthalmology, Elazıg, TurkeyObjective: To compare the levels of plasma homocysteine (Hcy), vitamin B6 (vit-B6), serum vitamin B12 (vit-B12), and folate in healthy individuals and in patients with normal tension glaucoma (NTG), pseudoexfoliative glaucoma (PXG), or primary open-angle glaucoma (POAG).Study design: A prospective controlled trial.Participan...

  9. Levels of circulating homocysteine, vitamin B6, vitamin B12, and folate in different types of open-angle glaucoma

    OpenAIRE

    Turgut, Burak

    2010-01-01

    Burak Turgut, Murat Kaya, Sermal Arslan, Tamer Demir, Mete Güler, Mehmet Kaan KayaFırat University School of Medicine, Department of Ophthalmology, Elazıg, TurkeyObjective: To compare the levels of plasma homocysteine (Hcy), vitamin B6 (vit-B6), serum vitamin B12 (vit-B12), and folate in healthy individuals and in patients with normal tension glaucoma (NTG), pseudoexfoliative glaucoma (PXG), or primary open-angle glaucoma (POAG).Study design: A prospective controlled trial.Particip...

  10. Five-year extension of a clinical trial comparing the EX-PRESS glaucoma filtration device and trabeculectomy in primary open-angle glaucoma

    OpenAIRE

    de Jong L; Lafuma A; Aguadé A-S; Berdeaux G

    2011-01-01

    Leo de Jong1, Antoine Lafuma2, Anne-Sophie Aguadé2, Gilles Berdeaux3,41Academic Medical Centre, Ophthalmology Department, Amsterdam, The Netherlands, 2Cemka-Eval, Bourg la Reine, Paris, France, 3Alcon France, Rueil-Malmaison, Paris, France, 4Conservatoire National des Arts et Métiers, Paris, FranceBackground: This study compared the efficacy of the EX-PRESS® glaucoma filtration device and trabeculectomy in primary open-angle glaucoma up to five years after surger...

  11. Monitoring dynamics of aqueous humor in glaucoma

    International Nuclear Information System (INIS)

    Aqueous humor dynamics was observed in patients treated for glaucoma. Aqueous flow was measured using the radionuclide method of contact application of 22NaCl and the detection of gamma radiation with external detectors. The sample of 184 eyes was divided into three groups: open-angle glaucoma with therapy, open-angle glaucoma without therapy and angle-closure glaucoma 47 eyes were used as controls. Changes were observed in 22Na outflow half-time in dependence on the duration of the disease, therapy, intraocular pressUre and changes in the perimeter. The new technique has been fully proven in practice, is a contribution to the diagnosis of glaucoma and an indicator of the compensation of the disease. (author)

  12. Avaliação dos tipos de glaucoma no serviço de oftalmologia da UNICAMP Evaluation of glaucoma types at the sector of ophthalmology - UNICAMP

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    Andréia Peltier Urbano

    2003-01-01

    treatment were analyzed. RESULTS: There were 329 patients examined at the Glaucoma Service: 132 (40.1% were referred to the service as glaucoma suspects and 197 (59.9% as glaucoma patients. Ninety of the 132 glaucoma suspects had glaucoma (68.2% and 42 are still under investigation (31.8%. Among the 329 patients, 283 (86% had glaucoma, 42 (12.8% were glaucoma suspects, 2 (0.6% had ocular hypertension and 2 (0.6% did not have glaucoma. There were 530 eyes with glaucoma: 298 (56.2% with primary open angle glaucoma, 108 (20.4% with chronic angle closure glaucoma, 21 (4% with glaucoma following cataract surgery, 19 (3.6% congenital glaucoma and 16 (3% with low-tension glaucoma. All patients received initial clinical treatment with IOP-lowering medication. After a mean follow up of 10.5 months, 89 (16.8% underwent laser therapy: 72 (13.6% iridotomy, 7 (1.3% trabeculoplasty and 10 (1.9% panphotocoagulation. A hundred and seventy nine (33% eyes required surgical treatment. CONCLUSION: The most frequent types of glaucoma were primary open angle and angle closure glaucoma. Low tension glaucoma and glaucoma associated with exfoliation syndrome were uncommon in this population.

  13. [Surgery in the treatment of primary advanced open-angle glaucoma].

    Science.gov (United States)

    Chiseliţă, D; Vancea, P P

    1995-01-01

    A series of 25 cases of advanced open-angle primitive glaucoma (C/D higher than 0.8, visual field stages C, D, E according to Greve's classification), operated upon by extended and adapted trabeculectomy, surgery being the initial step in the treatment of this affection, was reviewed. After a 18.5-month follow up, the progression of glaucoma was arrested in 60% of the cases, and a regression of papilloperimetric alterations was found in 8% of the cases. There was a significant correlation between the obtained IOP level and glaucoma course (in the cases with a favourable course postoperative IOP was of 15.5 mmHg, while in those evolving unfavorably IOP was of 18 mmHg). Our experience suggests that antiglaucoma surgery may be recommended as an initial treatment in those patients in whom a short-term drug trial (topic administration of 3 drugs for few days) induces a lowering of IOP to less than 15.5 mmHg, and life expectancy is not short. PMID:7766591

  14. Association between systemic oxidative stress and visual field damage in open-angle glaucoma.

    Science.gov (United States)

    Tanito, Masaki; Kaidzu, Sachiko; Takai, Yasuyuki; Ohira, Akihiro

    2016-01-01

    Local and systemic oxidative stress in intraocular pressure (IOP) elevation and optic nerve damage may be involved in the pathogenesis of glaucoma. We reported previously that a lower level of systemic antioxidative capacity is associated with IOP elevation in open-angle glaucoma (OAG). We assessed the correlation between the visual field sensitivity value, i.e., mean deviation (MD), and systemic levels of prooxidants and antioxidants by analyzing the blood biochemistry in 202 patients with glaucoma. Serum levels of lipid peroxides, ferric-reducing activity, and thiol antioxidant activity were measured using the diacron reactive oxygen metabolite (dROM), biological antioxidant potential (BAP), and sulfhydryl (SH) tests, respectively, using a free-radical analyzer. Univariate and multivariate analyses suggested a positive correlation between MD and BAP (R = 0.005 and P = 0.0442 by a multiple regression model adjusted for seven demographic parameters), but no significant associations between the MD and the dROM (R = 0.002 and P = 0.8556) and SH tests (R = -0.001 and P = 0.8280). Use of more antiglaucoma medication and primary OAG rather than normal tension glaucoma also were associated significantly with worse visual field damage. This large and comprehensive assessment of the association between systemic redox status and visual field damage in OAG suggests that lower systemic antioxidant capacity measured by ferric-reducing activity is associated with more severe visual field damage in OAG that partly explained its roles in IOP elevation. PMID:27165400

  15. The efficacy of viscocanalostomy for uncontrollable primary open-angle glaucoma in a developing country

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    Khodadad Moradian

    2013-01-01

    Full Text Available Purpose: To evaluate the safety and efficacy of viscocanalostomy in the management of medically uncontrollable primary open-angle glaucoma (POAG in a developing country. Materials and Methods: This is a prospective, non-randomized case series of 14 consecutive eyes with medically uncontrollable POAG, all subjected to viscocanalostomy. The main outcome measure was success rate based on the intraocular pressure (IOP level achieved post-operatively. The procedure was considered a complete success if IOP was less than 21 mmHg without any anti-glaucoma medication. Qualified success was defined as IOP of less than 21 mmHg with anti-glaucoma medication. All patients had a regular follow-up of at least 12 months. Results: IOP was reduced from a mean baseline value of 27.9 ± 7.3 mmHg (range: 21-40 mmHg to a mean final value of 16.0 ± 2.7 mmHg (range: 13-22 mmHg, which was statistically highly significant (P < 0.005. The mean number of pre-operative anti-glaucoma medications was 3.0 ± 0.4 (range: 2-4, which was reduced significantly (P < 0.0001 to 0.3 ± 0.6 (range: 0-2 at the last follow-up visit. One year post-operatively, complete success was achieved in 71% and qualified success was observed in 21.4% of patients, summing up to an overall success rate of 92.4%. There were no major complications in any of the patients. Conclusion: Viscocanalostomy could be performed effectively and safely for control of POAG in developing countries.

  16. Association between systemic oxidative stress and visual field damage in open-angle glaucoma

    Science.gov (United States)

    Tanito, Masaki; Kaidzu, Sachiko; Takai, Yasuyuki; Ohira, Akihiro

    2016-01-01

    Local and systemic oxidative stress in intraocular pressure (IOP) elevation and optic nerve damage may be involved in the pathogenesis of glaucoma. We reported previously that a lower level of systemic antioxidative capacity is associated with IOP elevation in open-angle glaucoma (OAG). We assessed the correlation between the visual field sensitivity value, i.e., mean deviation (MD), and systemic levels of prooxidants and antioxidants by analyzing the blood biochemistry in 202 patients with glaucoma. Serum levels of lipid peroxides, ferric-reducing activity, and thiol antioxidant activity were measured using the diacron reactive oxygen metabolite (dROM), biological antioxidant potential (BAP), and sulfhydryl (SH) tests, respectively, using a free-radical analyzer. Univariate and multivariate analyses suggested a positive correlation between MD and BAP (R = 0.005 and P = 0.0442 by a multiple regression model adjusted for seven demographic parameters), but no significant associations between the MD and the dROM (R = 0.002 and P = 0.8556) and SH tests (R = −0.001 and P = 0.8280). Use of more antiglaucoma medication and primary OAG rather than normal tension glaucoma also were associated significantly with worse visual field damage. This large and comprehensive assessment of the association between systemic redox status and visual field damage in OAG suggests that lower systemic antioxidant capacity measured by ferric-reducing activity is associated with more severe visual field damage in OAG that partly explained its roles in IOP elevation. PMID:27165400

  17. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

    Science.gov (United States)

    Cham, Abdourahman; Bansal, Mayank; Banda, Himanshu K; Kwon, Young; Tlucek, Paul S; Bassuk, Alexander G; Tsang, Stephen H; Sobol, Warren M; Folk, James C; Yeh, Steven; Mahajan, Vinit B

    2016-01-01

    Objective The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), a hereditary autoimmune uveitis due to mutations in CAPN5. Patients and methods A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP), visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT) were also analyzed. Results Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA) implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5) required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser peripheral iridotomy. Patient 4 had both hypotony and elevated IOP that required periodic antiglaucoma medication in the FA-implanted eye. Patient 3 did not develop steroid-response glaucoma in either eye. Optic disk examinations were obscured by fibrosis and better assessed with OCT. Conclusion ADNIV patients show combined mechanism secondary glaucoma best assessed by OCT of the optic disk. The FA implants have reduced uveitic and neovascular glaucoma. Nevertheless, IOP management remains complex due to steroid-response glaucoma, angle closure glaucoma, and hypotony. PMID:27390515

  18. Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma

    OpenAIRE

    Qiu, Chen; Qian, Shaohong; Sun, Xinghuai; Zhou, Chuandi; Meng, Fanrong

    2015-01-01

    Purpose To identify whether myopia was associated with the visual field (VF) progression of primary open-angle glaucoma (POAG). Methods A total of 270 eyes of 270 POAG followed up for more than 3 years with ≥9 reliable VFs by Octopus perimetry were retrospectively reviewed. Myopia was divided into: mild myopia (-2.99 diopter [D], 0), moderate myopia (-5.99, 3.00 D), marked myopia (-9.00, -6.00 D) and non-myopia (0 D or more). An annual change in the mean defect (MD) slope >0.22 dB/y and 0.30 ...

  19. Glaucoma in developing countries

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    Ravi Thomas

    2012-01-01

    Full Text Available Objective: To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries. Materials and Methods: Extrapolation of existing data and experience in eye care delivery and teaching models in an unequally developed country (India are used to make recommendations. Results: Parameters like population attributable risk percentage indicate that glaucoma is a public health problem but lack of simple diagnostic techniques and therapeutic interventions are barriers to any effective plan. Case detection rather than population-based screening is the recommended strategy for detection. Population awareness of the disease is low and most patients attending eye clinics do not receive a routine comprehensive eye examination that is required to detect glaucoma (and other potentially blinding eye diseases. Such a routine is not taught or practiced by the majority of training institutions either. Angle closure can be detected clinically and relatively simple interventions (including well performed cataract surgery can prevent blindness from this condition. The strategy for open angle glaucoma should focus on those with established functional loss. Outcomes of this proposed strategy are not yet available. Conclusions: Glaucoma cannot be managed in isolation. The objective should be to detect and manage all potential causes of blindness and prevention of blindness from glaucoma should be integrated into existing programs. The original pyramidal model of eye care delivery incorporates this principle and provides an initial starting point. The routine of comprehensive eye examination in every clinic and its teaching (and use in residency programs is mandatory for the detection and management of potentially preventable blinding pathology from any cause, including glaucoma. Programs for detection of glaucoma should not be initiated unless adequate facilities for diagnosis and surgical intervention are in place and

  20. Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma

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    Bertelmann T

    2015-10-01

    Full Text Available Thomas Bertelmann, Ilse Strempel Department of Ophthalmology, Philipps-University Marburg, Baldingerstraβe, Marburg, Germany Purpose: To evaluate whether additive relaxation music (RM has an adjuvant short-term effect on physiological and psychological parameters in patients with primary open-angle glaucoma.Methods: Prospective, randomized clinical trial. Patients in the therapy group (TG received a 30-minute RM via headphones, whereas members of the control group (CG did not. Best corrected visual acuity, intraocular pressure, visual field testing, short- and long-term mental states, and blood levels of different stress hormones were analyzed and compared.Results: A total of 25 (61%/16 (39% patients were assigned to the TG/CG. Best corrected visual acuity, daily intraocular pressure, and short-term mental state (KAB development were significantly better in the TG in comparison to controls. Visual field testing, long-term mental well-being (profile of mood states, and adrenalin, cortisol, and endothelin-I blood levels did not differ significantly between both groups.Conclusion: Additive RM applied on a daily basis can positively impact various physiological and psychological parameters in the short term. Keywords: primary open angle glaucoma, POAG, music therapy, intraocular pressure, IOP, mental health

  1. Relationship between progression of visual field defect and intraocular pressure in primary open-angle glaucoma

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    Naito T

    2015-07-01

    Full Text Available Tomoko Naito,1 Keiji Yoshikawa,2 Shiro Mizoue,3 Mami Nanno,4 Tairo Kimura,5 Hirotaka Suzumura,6 Fumio Shiraga1 1Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan; 2Yoshikawa Eye Clinic, Tokyo, Japan; 3Department of Ophthalmology, Ehime University Graduate School of Medicine, Ehime, Japan; 4Kagurazaka Minamino Eye Clinic, 5Ueno Eye Clinic, 6Suzumura Eye Clinic, Tokyo, Japan Purpose: To analyze the relationship between intraocular pressure (IOP and the progression of visual field defects in Japanese primary open-angle glaucoma (POAG and normal-tension glaucoma (NTG patients.Patients and methods: The subjects of the study were patients undergoing treatment for POAG or NTG who had performed visual field tests at least ten times with a Humphrey field analyzer (Swedish interactive thresholding algorithm standard, C30-2 program. The progression of visual field defects was defined by a significantly negative value of the mean deviation slope at the final visual field test during the follow-up period. The relationships between the progression of visual field defects and IOP, as well as other clinical factors, were retrospectively analyzed.Results: A total of 156 eyes of 156 patients were included in the analysis. Significant progression of visual field defects was observed in 70 eyes of 70 patients (44.9%, while no significant progression was evident in 86 eyes of 86 patients (55.1%. The eyes with visual field defect progression had significantly lower baseline IOP (P<0.05, as well as significantly lower IOP reduction rate (P<0.01. The standard deviation of IOP values during follow-up was significantly greater in the eyes with visual field defect progression than in eyes without (P<0.05.Conclusion: Reducing IOP is thought to be useful for Japanese POAG or NTG patients to suppress the progression of visual field defects. In NTG, IOP management should take into account not only achieving the target IOP, but also

  2. Discovery and functional annotation of SIX6 variants in primary open-angle glaucoma.

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    Megan Ulmer Carnes

    Full Text Available Glaucoma is a leading cause of blindness worldwide. Primary open-angle glaucoma (POAG is the most common subtype and is a complex trait with multigenic inheritance. Genome-wide association studies have previously identified a significant association between POAG and the SIX6 locus (rs10483727, odds ratio (OR = 1.32, p = 3.87×10(-11. SIX6 plays a role in ocular development and has been associated with the morphology of the optic nerve. We sequenced the SIX6 coding and regulatory regions in 262 POAG cases and 256 controls and identified six nonsynonymous coding variants, including five rare and one common variant, Asn141His (rs33912345, which was associated significantly with POAG (OR = 1.27, p = 4.2×10(-10 in the NEIGHBOR/GLAUGEN datasets. These variants were tested in an in vivo Danio rerio (zebrafish complementation assay to evaluate ocular metrics such as eye size and optic nerve structure. Five variants, found primarily in POAG cases, were hypomorphic or null, while the sixth variant, found only in controls, was benign. One variant in the SIX6 enhancer increased expression of SIX6 and disrupted its regulation. Finally, to our knowledge for the first time, we have identified a clinical feature in POAG patients that appears to be dependent upon SIX6 genotype: patients who are homozygous for the SIX6 risk allele (His141 have a statistically thinner retinal nerve fiber layer than patients homozygous for the SIX6 non-risk allele (Asn141. Our results, in combination with previous SIX6 work, lead us to hypothesize that SIX6 risk variants disrupt the development of the neural retina, leading to a reduced number of retinal ganglion cells, thereby increasing the risk of glaucoma-associated vision loss.

  3. Aqueous humor level of sCD44 in patients with degenerative myopia and primary open-angle glaucoma

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    Akdogan Muberra

    2009-11-01

    Full Text Available Abstract Background The transmembrane glycoprotein CD44 is a major hyaluronan cell surface receptor widely distributed in eye tissues and fluids. The shed ectodomain of CD44 is termed soluble CD44 and is toxic to human retinal ganglion cells in cell culture. The purpose of this study was to investigate the concentration of sCD44 in the aqueous humor (AH of normal subjects, patients with primary open-angle glaucoma, and patients with degenerative myopia but without glaucoma, to determine if the molecule might serve as a protein marker of glaucoma. Findings In this case-control study, AH samples were collected from controls (n = 16, patients with primary open-angle glaucoma (n = 11, and patients with degenerative myopia (n = 11 who underwent phacoemulsification surgery to treat mature or immature cataracts. The sCD44 concentration in AH was measured using a commercial ELISA kit. In normal AH samples the sCD44 concentration was 5.40 ± 1.21 ng/mL, whereas in degenerative myopia patients the sCD44 concentration was 5.76 ± 1.15 ng/mL. There was thus no statistically significant difference between these two groups (p > 0.05. The aqueous sCD44 concentration in patients with primary open-angle glaucoma (12.2 ± 10.1 ng/mL was higher than that of the control group (p Conclusion sCD44 may be a protein marker of primary open-angle glaucoma.

  4. Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies.

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    Nicole A Restrepo

    Full Text Available Electronic medical records (EMRs are being widely implemented for use in genetic and genomic studies. As a phenotypic rich resource, EMRs provide researchers with the opportunity to identify disease cohorts and perform genotype-phenotype association studies. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE study, as part of the Population Architecture using Genomics and Epidemiology (PAGE I study, has genotyped more than 15,000 individuals of diverse genetic ancestry in BioVU, the Vanderbilt University Medical Center's biorepository linked to a de-identified version of the EMR (EAGLE BioVU. Here we develop and deploy an algorithm utilizing data mining techniques to identify primary open-angle glaucoma (POAG in African Americans from EAGLE BioVU for genetic association studies. The algorithm described here was designed using a combination of diagnostic codes, current procedural terminology billing codes, and free text searches to identify POAG status in situations where gold-standard digital photography cannot be accessed. The case algorithm identified 267 potential POAG subjects but underperformed after manual review with a positive predictive value of 51.6% and an accuracy of 76.3%. The control algorithm identified controls with a negative predictive value of 98.3%. Although the case algorithm requires more downstream manual review for use in large-scale studies, it provides a basis by which to extract a specific clinical subtype of glaucoma from EMRs in the absence of digital photographs.

  5. Open angle glaucoma in a case of Type IV Ehler Danlos syndrome: A rarely reported association

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    Arijit Mitra

    2014-01-01

    Full Text Available A 26-year-old male presented to us with defective vision in the left eye. He had best corrected visual acuity (BCVA of hand movement (HM in right eye and 6/9 in left eye. He had ptosis with ectropion in both eyes and relative afferent pupillary defect (RAPD in right eye. Intraocular pressure (IOP was 46 and 44 mmHg in right and left eye, respectively. Fundus showed glaucomatous optic atrophy (GOA in right eye and cup disc ratio (CDR of 0.75 with bipolar rim thinning in left eye. Systemic examination showed hyperextensible skin and joints, acrogeria, hypodontia, high arched palate, and varicose veins. He gave history of easy bruising and tendency to fall and history of intestinal rupture 5 years ago for which he had undergone surgery. He was diagnosed as a case of Type IV Ehler-Danlos syndrome (EDS with open angle glaucoma. He underwent trabeculectomy in both eyes. This is a rare case that shows glaucoma in a patient of EDS Type IV. Very few such cases have been reported in literature.

  6. Laser Applications on Iris for Treatment of Glaucoma

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    Ahmet Özkök

    2013-06-01

    Full Text Available Laser applications on iris for the treatment of glaucoma include laser iridotomy (LI and laser peripheral iridoplasty (LPI. LI is a simple and effective modality for treatment of closed-angle glaucoma with pupillary block. LPI is an easy and effective treatment for closed angle in situations in which LI either cannot be performed or does not repair the appositional angle closure because mechanisms other than pupillary block are present. The aim of this review is to summarize the indications, technique details, and complications of laser applications on iris for the treatment of glaucoma. (Turk J Ophthalmol 2013; 43: 190-4

  7. Incidence and risk factors of open-angle glaucoma : the Rotterdam study

    NARCIS (Netherlands)

    S. de Voogd (Simone); A. Hofman (Albert)

    2006-01-01

    markdownabstract__Abstract__ Glaucoma is one of the poorest understood and defined eye diseases among those known since our era. Despite two millennia of writing about glaucoma, a straightforward and clear-cut definition is not available worldwide. In essence, glaucoma is an eye disease characteriz

  8. Clinical evidence in concurrence of retinitis pigmentosa and glaucoma

    Institute of Scientific and Technical Information of China (English)

    WANG Mei; LIN Hao-tian; BAI Yu-jing; GE Jian; ZHUO Ye-hong

    2011-01-01

    Glaucoma is rarely complicated by retinitis pigmentosa (RP). To provide clinical evidences for this rare situation, we report the concurrence of these two diseases in two children of a Chinese family. In the present two-child Chinese family without positive history, the older sister presented with bilateral sector RP and coexisting chronic angle-closure glaucoma,and the brother with bilateral whole RP but without coexisting glaucoma. Clinical evidences in concurrence of variants of RP and glaucoma because of possible different gene mutations from the same genetic background represent a rare situation, which may provide clues for future researches in molecular pathogenesis of these rare diseases.

  9. The Analysis of Pedigree GZ (Guangzhou) . 1with Primary Open Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Yehong Zhuo; Jian Ge; Mci Wang; Haiquan Liu; Minkai Lin

    2000-01-01

    Purpose: To analyze the hereditary modality of primary open-angle glaucoma in China.Methods: The genetic form of Pedigree GZ. 1 was analyzed using Mandalian hereditary rules.Results: Pedigree GZ. 1 had following characteristics: 1) The pedigree had four generations, and there existed POAG patients in each generation; 2) Each patient had a parent with POAG. If the parents didn't suffer from the disease, their children would not. 3) The incidence of POAG in the relatives of the patients was 1/2. In addition,The age of onset, intraocular pressure, fundus and prognosis was different from each other in the patients.Conclusions: 1 ) Pedigree GZ. 1 is inherited as an autosomal dominant trait. 2) There exists individual differences of clinical manifestations in POAG patients. Eye Science 2000; 16: 53~ 55.

  10. The Analysis of Pedigree GZ(Guangzhou).1 with Primary Open Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    YehongZhuo; MeiWang; 等

    2002-01-01

    Purpose:To analyze the hereditary modality of primary open-angle glaucoma in China.Methods:The genetic form of Pedigree GZ.1 was analyzed using Mandalian hereditary rules.Results:Pedigree GZ.1 had following characteristics:1)The pedigree had four gene-rations,and there existed POAG patients in each generation;2) Each patient had a parent with POAG.If the parents didn't suffer from the disease,their children would not.3)The incidence of POAG in the relatives of the patients was 1/2 .In addition,The age of onset,intraocular pressure,fundus and prognosis was different from each other in the patients.Conclusions:1)Pedigree GZ.1 is inherited as an autosomal dominant trait.2) There exists individual differences of clinical manifestations in POAG patients.Eye Science 2000;16:53-55.

  11. [Toward a high quality glaucoma care].

    Science.gov (United States)

    Kashiwagi, Kenji

    2012-03-01

    The following studies were performed to solve current problems in glaucoma care and to pursue quality glaucoma care. Using a scanning peripheral anterior chamber depth analyzer that we developed, we: 1) conducted cross-sectional screening for eyes with angle closure; 2) examined longitudinal changes in anterior chamber depth and occurrence rates of primary angle closure in local senior residents; 3) investigated the significance of the anterior chamber and the angle of eyes with open angle glaucoma; and 4) looked into possible applications of anterior chamber depth and the angle in routine examinations. We investigated the effects of retinal glial cells and optic nerve astrocytes on retinal ganglion cell (RGC) survival and neurite growth using a culture system. We also identified candidate genies of retinal glial cells and optic nerve astrocytes affecting RGC survival and neurite growth using microarray and siRNA systems. SRC, a membrane-associated 60-kDa tyrosine kinase, is reported to be involved in neuron death and neurite growth. We developed two types of gene-targeted mice in which we modified the status of SRC phosphorylation. We compared RGC survival and neurite growth by conducting in vivo and in vitro experiments. Adherence is currently a very important issue in the field of glaucoma. We developed a nm thick and composed of 21.5 chitosan-sodium alginate pairs. IOP reduction and its duration, as well as adverse effects, were investigated. In addition, we established and evaluated a support system for glaucoma care in an effort to promote participation of glaucoma patients in glaucoma care using information and communication technology. This system improved the literacy of glaucoma patients as well as glaucoma medical therapy. At the same time, in order to ably provide glaucoma care given the increase in the number of glaucoma patients and the shortage of glaucoma specialists, a tele-medicine system for ophthalmology was developed, in which ophthalmologists

  12. Risk Factors for Primary Open-Angle Glaucoma in Western Turkey

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    Güliz Fatma Yavaş

    2013-04-01

    Full Text Available Pur po se: To evaluate the prevalence of primary open-angle glaucoma (POAG in subjects aged over 40 years in Western Turkey and to quantify its association with several systemic risk factors. Ma te ri al and Met hod: The research was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. A total of 1533 subjects aged 40 years or more were included in the study. Diabetes mellitus, hypertension, atherosclerotic cardiac disease, obesity, smoking, alcohol consumption, and dietary habitus (meat, chicken, and fish consumption were asked. Level of blood glucose, serum total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, very-low-density lipoprotein, Vitamin B12, and thyroid-stimulating-hormone were determined. Ophthalmic examination was performed, and intraocular pressure was measured by tonopen. Subjects with an IOP of 21 mmHg or more and/or with a cupping/disc ratio of 0.3 or more were told to come to the clinic for visual field analysis and gonioscopy. Subjects with a typical glaucomatous visual field defect and an open angle were recorded as POAG. Risk factors for POAG were determined by chi-square test. Re sults: Prevalence of POAG was found to be 2% (30 subjects and the only associated risk factor was age (p=0.05. Dietary habitus was also not associated with glaucoma (p>0.05. Dis cus si on: This study provides a population-based data about the prevalence and risk factors of POAG in Turkey. (Turk J Ophthalmol 2013; 43: 87-90

  13. Short-Term Effects of Acupuncture on Open-Angle Glaucoma in Retrobulbar Circulation: Additional Therapy to Standard Medication

    OpenAIRE

    Takayama, Shin; Seki, Takashi; Nakazawa, Toru; Aizawa, Naoko; Takahashi, Seri; WATANABE, Masashi; Izumi, Masayuki; Kaneko, Soichiro; Kamiya, Tetsuharu; Matsuda, Ayane; Kikuchi, Akiko; Yambe, Tomoyuki; Yoshizawa, Makoto; Nitta, Shin-Ichi; Yaegashi, Nobuo

    2011-01-01

    Background. The relation between glaucoma and retrobulbar circulation in the prognosis has been indicated. Purpose. To investigate the effects of acupuncture on retrobulbar circulation in open-angle glaucoma (OAG) patients. Methods. Eleven OAG patients (20 eyes with OAG) who were treated by topical antiglaucoma medications for at least 3 months were enrolled. Acupuncture was performed once at acupoints BL2, M-HN9, ST2, ST36, SP6, KI3, LR3, GB20, BL18, and BL23 bilaterally. Retrobulbar circula...

  14. Short-Term Effects of Acupuncture on Open-Angle Glaucoma in Retrobulbar Circulation: Additional Therapy to Standard Medication

    OpenAIRE

    Shin Takayama; Takashi Seki; Toru Nakazawa; Naoko Aizawa; Seri Takahashi; Masashi Watanabe; Masayuki Izumi; Soichiro Kaneko; Tetsuharu Kamiya; Ayane Matsuda; Akiko Kikuchi; Tomoyuki Yambe; Makoto Yoshizawa; Shin-ichi Nitta; Nobuo Yaegashi

    2011-01-01

    Background. The relation between glaucoma and retrobulbar circulation in the prognosis has been indicated. Purpose. To investigate the effects of acupuncture on retrobulbar circulation in open-angle glaucoma (OAG) patients. Methods. Eleven OAG patients (20 eyes with OAG) who were treated by topical antiglaucoma medications for at least 3 months were enrolled. Acupuncture was performed once at acupoints BL2, M-HN9, ST2, ST36, SP6, KI3, LR3, GB20, BL18, and BL23 bilaterally. Retrobulbar c...

  15. Novel therapeutic approaches to correct retinal metabolic abnormalities in primary open-angle glaucoma and age-related macular degeneration

    OpenAIRE

    K. A. Mirzabekova

    2015-01-01

    Common pathogenic aspects of age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), i.e., the role of free radicals inducing oxidative damage of the retina and optic nerve, are discussed. Factors that activate free radical reactions as well as multilevel antioxidant protection system are reviewed. Data derived from studies on current antioxidants that are used to treat and prevent dry AMD and glaucomatous optic nerve damage are compared. Neuroprotection for glaucoma wi...

  16. Risk factors for open-angle glaucoma in Nigeria: results from the Nigeria National Blindness and Visual Impairment Survey.

    OpenAIRE

    Kyari, F; Abdull, MM; Wormald, R; Evans, Jr., Daw-Nay N. R.; Nolan, W; Murthy, GV; Gilbert, CE; Nigeria National Blindness and Visual Impairment Study Group; , COLLABORATORS; Imam, A.; Abiose, A; Ezelum, C; Entekume, G; Faal, H; Rabiu, M.

    2016-01-01

    The glaucoma-specific blindness prevalence in Nigeria (0.7 %, 95 % CI 0.6-0.9 %) among those aged ≥40 years is one of the highest ever reported. This study determined the risk factors for open-angle glaucoma (OAG) in adults examined in the Nigeria National Blindness and Visual Impairment Survey. A nationally representative sample of 13,591 people aged ≥40 years in 305 clusters in Nigeria were examined (response rate 90.4 %) between January 2005 to June 2007. Everyone had logMAR visual a...

  17. Risk factors for open-angle glaucoma in Nigeria: results from the Nigeria National Blindness and Visual Impairment Survey

    OpenAIRE

    Kyari, Fatima; Mohammed M Abdull; Wormald, Richard; Evans, Jennifer R.; Nolan, Winifred; Murthy, Gudlavelleti V. S.; Clare E Gilbert; ,; Imam, Abdullahi; Abiose, Adenike; Ezelum, Christian; Entekume, Gabriel; Faal, Hannah; Rabiu, Mansur M.; Bankole, Olufunmilayo O.

    2016-01-01

    Background The glaucoma-specific blindness prevalence in Nigeria (0.7 %, 95 % CI 0.6–0.9 %) among those aged ≥40 years is one of the highest ever reported. This study determined the risk factors for open-angle glaucoma (OAG) in adults examined in the Nigeria National Blindness and Visual Impairment Survey. Methods A nationally representative sample of 13,591 people aged ≥40 years in 305 clusters in Nigeria were examined (response rate 90.4 %) between January 2005 to June 2007. Everyone had lo...

  18. Non-compliance with Drug Therapy in Patients with Primary Open-angle Glaucoma No cumplimiento del tratamiento farmacológico en pacientes con glaucoma primario de ángulo abierto

    OpenAIRE

    Ariana Fernández García; Idalia Triana Casado; Rosa Maria Lam Díaz; Rosendo Villar Valdés

    2012-01-01

    Background: Early treatment and patient’s compliance with this treatment are the most effective ways of preventing glaucoma related blindness. Objectives: To identify the behavior of patients` compliance or non compliance with the treatment in cases of primary open-angle glaucoma. Methods: A descriptive and cross sectional study was conducted including 106 patients with confirmed primary open-angle...

  19. Association of primary open-angle glaucoma with mitochondrial variants and haplogroups common in African Americans

    Science.gov (United States)

    Gudiseva, Harini V.; Trachtman, Benjamin; Bowman, Anita S.; Sagaser, Anna; Sankar, Prithvi; Miller-Ellis, Eydie; Lehman, Amanda; Addis, Victoria; O'Brien, Joan M.

    2016-01-01

    Purpose To estimate the population frequencies of all common mitochondrial variants and ancestral haplogroups among 1,999 subjects recruited for the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study, including 1,217 primary open-angle glaucoma (POAG) cases and 782 controls, and to identify ancestral subpopulations and mitochondrial mutations as potential risk factors for POAG susceptibility. Methods Subject classification by characteristic glaucomatous optic nerve findings and corresponding visual field defects, as defined by enrolling glaucoma specialists, stereo disc photography, phlebotomy, extraction of total DNA from peripheral blood or saliva, DNA quantification and normalization, PCR amplification of whole mitochondrial genomes, Ion Torrent deep semiconductor DNA sequencing on DNA pools (“Pool-seq”), Sanger sequencing of 3,479 individual mitochondrial DNAs, and bioinformatic analysis. Results The distribution of common African haplogroups within the POAAGG study population was broadly similar to prior surveys of African Americans. However, the POAG case population was found to be enriched in L1c2 haplogroups, which are defined in part by missense mutations m.6150G>A (Val83Ile, odds ratio [OR] 1.8, p=0.01), m.6253C>T (Met117Thr, rs200165736, OR 1.6, p=0.04), and m.6480G>A (Val193Ile, rs199476128, OR 4.6, p=0.04) in the cytochrome c oxidase subunit 1 (MT-CO1) gene and by a variant, m.2220A>G (OR 2.0, p=0.01), in MT-RNR2, which encodes the mitochondrial ribosomal 16s RNA gene. L2 haplogroups were predicted to be overrepresented in the POAG case population by Pool-seq, and the difference was confirmed to be significant with Sanger sequencing, that targeted the L2-associated variants m.2416T>C (rs28358580, OR 1.2, p=0.02) and m.2332C>T (OR 1.2, p=.02) in MT-RNR2. Another variant within MT-RNR2, m.3010G>A (rs3928306), previously implicated in sensitivity to the optic neuropathy-associated antibiotic linezolid, and arising on D4 and J1

  20. The Role of Systemic Arterial Stiffness in Open-Angle Glaucoma with Diabetes Mellitus

    OpenAIRE

    Seong Hee Shim; Chan Yun Kim; Joon Mo Kim; Da Yeong Kim; Yang Jae Kim; Jeong Hun Bae; Ki Chul Sung

    2015-01-01

    Purpose. To investigate the role of systemic arterial stiffness in glaucoma patients with diabetes mellitus (DM). Design. Retrospective, cross-sectional study. Participants. DM subjects who underwent brachial-ankle pulse wave velocity (baPWV) were recruited. Methods. Glaucoma patients (n = 75) and age-matched control subjects (n = 92) were enrolled. Systemic examination including BaPWV and detailed eye examination were performed. The glaucoma group was divided into subgroups of normal tension...

  1. Glaucoma in atomic bomb survivors.

    Science.gov (United States)

    Kiuchi, Yoshiaki; Yokoyama, Tomoko; Takamatsu, Michiya; Tsuiki, Eiko; Uematsu, Masafumi; Kinoshita, Hirofumi; Kumagami, Takeshi; Kitaoka, Takashi; Minamoto, Atsushi; Neriishi, Kazuo; Nakashima, Eiji; Khattree, Ravindra; Hida, Ayumi; Fujiwara, Saeko; Akahoshi, Masazumi

    2013-10-01

    Radiation has been associated with increases in noncancerous diseases. An effect of low-dose radiation on the prevalence of clinically detected glaucoma has not been previously reported. We therefore investigated the prevalence of glaucoma in A-bomb survivors and its possible association with radiation dose. A total of 1,589 people who participated in the clinical examination program for A-bomb survivors at the Radiation Effects Research Foundation (RERF) between October 2006 and September 2008 and who had reconstructed radiation doses, were recruited into this cross-sectional screening study. The prevalence of glaucoma and its dose-response relationship to A-bomb radiation were measured. Each subject underwent an initial screening consisting of an interview and ophthalmological examination. Questionable cases with any indication of ocular disease, including glaucoma, were referred to local hospitals for more comprehensive evaluation. A diagnosis of glaucoma was made based on specific optic disc appearance, perimetric results and other ocular findings. Of 1,589 eligible people, we detected 284 (17.9%) cases of glaucoma overall, including 36 (2.3%) cases of primary open-angle glaucoma with intraocular pressure levels greater than 21 mmHg, 226 (14.2%) cases of normal-tension glaucoma and 25 (1.6%) cases of primary angle-closure glaucoma. Seven glaucoma risk factors were examined as potential confounders but only two needed to be included in the final model. Binary regression using a generalized estimating equation method, with adjustment for gender, age, city, cataract surgery or diabetes mellitus, revealed an odds ratio at 1 Gy of 1.31 (95% confidence interval 1.11-1.53, P = 0.001) in the case of normal-tension glaucoma, but no association for other types of glaucoma. The prevalence of normal-tension glaucoma may increase with A-bomb radiation dose, but uncertainties associated with nonparticipation (59% participation) suggest caution in the interpretation of these

  2. Effects of Laser Peripheral Iridotomy in Subgroups of Primary Angle Closure Based on Iris Insertion

    OpenAIRE

    Sung-Cheol Yun; Ji Wook Hong; Kyung Rim Sung; Jin Young Lee

    2015-01-01

    Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration. Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, ir...

  3. LEARNING FROM ERRORS -TOPIRAMATE INDUCED BILATERAL ANGLE CLOSURE WITH ACUTE ONSET MYOPIA

    OpenAIRE

    Nayana; Sarita; Vishnu; Pratima B

    2014-01-01

    : Topiramate is an oral sulfamate medication used primarily for seizure treatment and has also demonstrated efficacy in the treatment of bipolar disorders and migraine. The mechanism of causation of angle closure and acute myopia is not clearly understood and several theories have been proposed of which the uveal effusion theory is widely accepted. We report a case of topiramate induced acute myopia with bilateral acute angle closure. With the increase in the frequency of ...

  4. The association between primary open-angle glaucoma and fall: an observational study

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    Tanabe S

    2012-03-01

    Full Text Available Sachiko Tanabe1,2*, Kenya Yuki1*, Naoki Ozeki1, Daisuke Shiba1, Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Tokyo, Japan; 2Tanabe Eye Clinic, Kai City, Yamanashi, Japan*These authors contributed equally to this workPurpose: Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG who were more than 45 years old, compared with comparably aged healthy subjects.Methods: This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye.Results: The self-reported prevalence of injurious fall was 0.9% (1/117 in the control group and 6.9% (7/101 in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test. Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with

  5. Diabetes Mellitus as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis

    OpenAIRE

    Minwen Zhou; Wei Wang; Wenbin Huang; Xiulan Zhang

    2014-01-01

    Objective To determine the association between diabetes mellitus (DM) and primary open-angle glaucoma (POAG). Methods This is a systematic review and meta-analysis of case-control and cohort studies. The literature search included two databases (PubMed and Embase) and the reference lists of the retrieved studies. Separate meta-analyses for case-control studies and cohort studies were conducted using random-effects models, with results reported as adjusted odds ratios (ORs) and relative risks ...

  6. Mitochondrial DNA lineages of African origin confer susceptibility to primary open-angle glaucoma in Saudi patients

    OpenAIRE

    Abu-Amero, Khaled K; González, Ana M; Osman, Essam A.; Larruga, José M; Cabrera, Vicente M; Al-Obeidan, Saleh A.

    2011-01-01

    Purpose We previously reported that certain mitochondrial DNA (mtDNA) polymorphisms in the coding region may be involved in the pathogenesis for primary open-angle-glaucoma (POAG). This encouraged us to extend our work and assess whether mtDNA diagnostic polymorphisms, defining geographically structured haplogroups, could be associated with the development of POAG. Methods We sequenced the mtDNA regulatory hypervariable region-I (HVS-I) region and coding regions, comprising haplogroup diagnos...

  7. Randomized Trial of Brinzolamide/Brimonidine Versus Brinzolamide Plus Brimonidine for Open-Angle Glaucoma or Ocular Hypertension

    OpenAIRE

    Gandolfi, Stefano A.; Lim, John; Sanseau, Ana Cristina; Parra Restrepo, Juan Camilo; Hamacher, Thomas

    2014-01-01

    Introduction Fixed-combination intraocular pressure (IOP)—lowering medications simplify treatment regimens for patients requiring 2 ocular hypotensive agents to maintain sufficiently low IOP. The aim of this study was to evaluate the safety and efficacy of fixed-combination brinzolamide 1%/brimonidine 0.2% (BBFC) versus concomitant administration of brinzolamide 1% plus brimonidine 0.2% (BRINZ + BRIM) in patients with open-angle glaucoma or ocular hypertension. Methods This was a prospective,...

  8. Prevalence and risk factors of primary open-angle glaucoma in a city of Eastern China: a population-based study in Pudong New District, Shanghai

    OpenAIRE

    He, Jiangnan; Zou, Haidong; Lee, Richard K.; Tong, Xiaowei; Tang, Wenli; Zhang, Yi; Zhao, Rong; Ge, Ling

    2015-01-01

    Background The aim of the present study was to investigate the prevalence and characteristics of primary open-angle glaucoma among the urban population of Pudong New District, Shanghai. Methods Three residents’ committees were randomly selected from Pudong New District, and residents aged 50 and older were screened for primary open-angle glaucoma (POAG) from March to April 2011. In remote screening, the tests on visual acuity, refraction, intraocular pressure (IOP), and the photographs of ant...

  9. Changes of fundus blood flow state of patients with open-angle glaucoma before and after the treatment

    Institute of Scientific and Technical Information of China (English)

    Huai-Jie Huang; Mei-Min Niu; Yi Yang; Ke-Qin Li

    2016-01-01

    Objective:To To study and observe the change situation of fundus blood flow state of patients with open-angle glaucoma before and after the treatment.Methods:A total of 60 patients with open-angle glaucoma treated in our hospital from October 2013 to May 2015 were selected as the observation group, and 60 healthy persons with physical examination at the same period were the control group, then the RI, PI, PSV, EDV and VM levels of ocular artery, central retinal artery and posterior ciliary artery of observation group before the treatment and at 2th, 4th, 8th and 12th week after the treatment and control group were compared.Results:The RI and PI levels of ocular artery, central retinal artery and posterior ciliary artery of observation group before the treatment and at 2th, 4th and 8th week after the treatment were higher than those of control group, while the PSV, EDV and VM levels of ocular artery, central retinal artery and posterior ciliary artery were lower than those of control group. The detection results of observation group at different time after the treatment were better than those before the treatment, and there were significant differences (P0.05).Conclusions:The changes of fundus blood flow state of patients with open-angle glaucoma before and after the treatment are great, and the various artery blood flow presents continuous improvement.

  10. Decreased keratocyte density and central corneal thickness in primary open-angle glaucoma patients undergoing treatment with topical prostaglandin analogues

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    Sibel Kocabeyoglu

    2015-01-01

    Full Text Available Purpose: To evaluate whether prostaglandin (PG analogue use is associated with alterations in keratocyte density and central corneal thickness (CCT in subjects with primary open-angle glaucoma (POAG. Materials and Methods: Thirty-five POAG patients treated with PG analogues for >2 years and 35 control subjects without glaucoma were included in this cross-sectional study. All subjects were underwent CCT measurements using ultrasound pachymetry. Keratocyte densities of each stromal layer were determined by in vivo confocal microscopy. Student′s t-test and Chi-square test were used for statistical evaluations. Correlations between keratocyte densities and CCT were analyzed using Pearson′s correlation analysis. Results: Keratocyte densities in each stromal layer were significantly lower in glaucoma patients receiving PG analogues as compared to those of controls (P < 0.001. The mean CCT was also lower in glaucoma patients (515.2 ± 18.8 μ than control subjects (549.6 ± 21.1 μ, P < 0.001. A positive correlation between keratocyte densities in each stromal layer and CCT was observed in POAG patients. Conclusions: Long-term administration of topical PG analogues may adversely influence keratocyte densities and CCT. Further prospective studies are required clarify the relationship between PG analogues and their effects on the cornea.

  11. Features of ophthalmoneuroprotection in patients with open-angle glaucoma in combination with diabetic retinopathy

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    O. I. Borzunov

    2014-01-01

    Full Text Available Aim: of this study is to evaluate ophthalmoneuroprotectional treatment of patients with POAG and diabetes mellitus type II in a specialized hospital.Material and methods: We have performed retro — and prospective analysis of the combined treatment of 130 patients (248 eyes with a combination of primary open-angle glaucoma and diabetic retinopathy. Evaluation of the effectiveness of treatment was conducted on the following criteria: the severity of the hypotensive effect, the degreeof improvement and duration of remission of major ophthalmic indicators. The patients were divided into four clinical — homogeneous groups: primary — 40 people (77 eyes, the comparison group I — 37 persons (71 eyes, the comparison group II — 33 people (60 eyes, the control group — 20 people (40 eyes.Results: Combination of different treatment strategy of laser and conservative treatment was tested. The result has been designed for optimal balance improving performance and reducing ocular side effects. Retinalamin ® 5 mg parabulbare number 10, Tanakan 1 tablet 3 times a day — 3 months. The optimal timing of re-treatment (at least 1time in 9 months, in the case of significant progression of glaucomatous optic neuropathy — the timing is solved individually.

  12. Features of ophthalmoneuroprotection in patients with open-angle glaucoma in combination with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    O. I. Borzunov

    2014-07-01

    Full Text Available Aim: of this study is to evaluate ophthalmoneuroprotectional treatment of patients with POAG and diabetes mellitus type II in a specialized hospital.Material and methods: We have performed retro — and prospective analysis of the combined treatment of 130 patients (248 eyes with a combination of primary open-angle glaucoma and diabetic retinopathy. Evaluation of the effectiveness of treatment was conducted on the following criteria: the severity of the hypotensive effect, the degreeof improvement and duration of remission of major ophthalmic indicators. The patients were divided into four clinical — homogeneous groups: primary — 40 people (77 eyes, the comparison group I — 37 persons (71 eyes, the comparison group II — 33 people (60 eyes, the control group — 20 people (40 eyes.Results: Combination of different treatment strategy of laser and conservative treatment was tested. The result has been designed for optimal balance improving performance and reducing ocular side effects. Retinalamin ® 5 mg parabulbare number 10, Tanakan 1 tablet 3 times a day — 3 months. The optimal timing of re-treatment (at least 1time in 9 months, in the case of significant progression of glaucomatous optic neuropathy — the timing is solved individually.

  13. Assessment of polygenic effects links primary open-angle glaucoma and age-related macular degeneration.

    Science.gov (United States)

    Cuellar-Partida, Gabriel; Craig, Jamie E; Burdon, Kathryn P; Wang, Jie Jin; Vote, Brendan J; Souzeau, Emmanuelle; McAllister, Ian L; Isaacs, Timothy; Lake, Stewart; Mackey, David A; Constable, Ian J; Mitchell, Paul; Hewitt, Alex W; MacGregor, Stuart

    2016-01-01

    Primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD) are leading causes of irreversible blindness. Several loci have been mapped using genome-wide association studies. Until very recently, there was no recognized overlap in the genetic contribution to AMD and POAG. At genome-wide significance level, only ABCA1 harbors associations to both diseases. Here, we investigated the genetic architecture of POAG and AMD using genome-wide array data. We estimated the heritability for POAG (h(2)g = 0.42 ± 0.09) and AMD (h(2)g = 0.71 ± 0.08). Removing known loci for POAG and AMD decreased the h(2)g estimates to 0.36 and 0.24, respectively. There was evidence for a positive genetic correlation between POAG and AMD (rg = 0.47 ± 0.25) which remained after removing known loci (rg = 0.64 ± 0.31). We also found that the genetic correlation between sexes for POAG was likely to be less than 1 (rg = 0.33 ± 0.24), suggesting that differences of prevalence among genders may be partly due to heritable factors. PMID:27241461

  14. Assessment of polygenic effects links primary open-angle glaucoma and age-related macular degeneration

    Science.gov (United States)

    Cuellar-Partida, Gabriel; Craig, Jamie E.; Burdon, Kathryn P.; Wang, Jie Jin; Vote, Brendan J.; Souzeau, Emmanuelle; McAllister, Ian L.; Isaacs, Timothy; Lake, Stewart; Mackey, David A.; Constable, Ian J.; Mitchell, Paul; Hewitt, Alex W.; MacGregor, Stuart

    2016-01-01

    Primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD) are leading causes of irreversible blindness. Several loci have been mapped using genome-wide association studies. Until very recently, there was no recognized overlap in the genetic contribution to AMD and POAG. At genome-wide significance level, only ABCA1 harbors associations to both diseases. Here, we investigated the genetic architecture of POAG and AMD using genome-wide array data. We estimated the heritability for POAG (h2g = 0.42 ± 0.09) and AMD (h2g = 0.71 ± 0.08). Removing known loci for POAG and AMD decreased the h2g estimates to 0.36 and 0.24, respectively. There was evidence for a positive genetic correlation between POAG and AMD (rg = 0.47 ± 0.25) which remained after removing known loci (rg = 0.64 ± 0.31). We also found that the genetic correlation between sexes for POAG was likely to be less than 1 (rg = 0.33 ± 0.24), suggesting that differences of prevalence among genders may be partly due to heritable factors. PMID:27241461

  15. Cholesterol-lowering drugs and incident open-angle glaucoma: a population-based cohort study.

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    Michael W Marcus

    Full Text Available BACKGROUND: Open-angle glaucoma (OAG is a progressive neurodegenerative disease that may lead to blindness. An elevated intraocular pressure (IOP is its major risk factor. OAG treatment is currently exclusively directed towards the lowering of the IOP. IOP lowering does not prevent disease progression in all patients and thus other treatment modalities are needed. Earlier studies reported cholesterol-lowering drugs to have neuroprotective properties. The aim of this study was to determine the associations between the use of cholesterol-lowering drugs and incident OAG. METHODOLOGY/PRINCIPAL FINDINGS: Participants in a prospective population-based cohort study underwent ophthalmic examinations, including IOP measurements and perimetry, at baseline and follow-up. The use of statins and non-statin cholesterol-lowering drugs was monitored continuously during the study. Associations between the use of cholesterol-lowering drugs and incident OAG were analyzed with Cox regression; associations between cholesterol-lowering drugs and IOP at follow-up were analyzed with multiple linear regression. During a mean follow-up of 9.8 years, 108 of 3939 eligible participants (2.7% developed OAG. The hazard ratio for statin use was 0.54 (95% confidence interval 0.31-0.96; P = 0.034 and for non-statin cholesterol-lowering drugs 2.07 (0.81-5.33; P = 0.13. The effect of statins was more pronounced with prolonged use (hazard ratio 0.89 [0.41-1.94; P = 0.77] for use two years or less; 0.46 [0.23-0.94; P = 0.033] for use more than two years; P-value for trend 0.10. The analyzes were adjusted for age and gender, baseline IOP and IOP-lowering treatment, the family history of glaucoma, and myopia. There was no effect of statins on the IOP. CONCLUSIONS/SIGNIFICANCE: Long-term use of statins appears to be associated with a reduced risk of OAG. The observed effect was independent of the IOP. These findings are in line with the idea that statins have

  16. [Surgical results of dissection of the superficial temporal artery in patients with preglaucoma and initial open-angle glaucoma].

    Science.gov (United States)

    Shilkin, G A; Iartseva, N S; Mironova, E M; Oreshkina, R M; Mikhaĭlova, G D

    1989-01-01

    Results of superficial temporal artery dissection performed in 42 patients (44 eyes) with preglaucoma and initial open-angle glaucoma have shown no impairement of visual field, visual acuity, optic disc in the period from 0.5 to 1.5 years after it. The increased linear rate of bloodflow after the operation remained stable in 17 eyes of patients with preglaucoma and in 14 eyes of patients with glaucoma. Intraocular pressure became normalized in 20 and 19 eyes as well as intraocular fluid outflow in 14 and 13 eyes, respectively. In both groups there was a tendency to normalization of retinal functions and hydrodynamics of the eye. Thus, the operation produces improvement of regional bloodflow, tonographic and electrophysiologic indices. Its usage is considered to be reasonable, but, when determining indications to it, an individual approach is necessary. PMID:2755669

  17. Levels of circulating homocysteine, vitamin B6, vitamin B12, and folate in different types of open-angle glaucoma

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    Burak Turgut

    2010-04-01

    Full Text Available Burak Turgut, Murat Kaya, Sermal Arslan, Tamer Demir, Mete Güler, Mehmet Kaan KayaFırat University School of Medicine, Department of Ophthalmology, Elazıg, TurkeyObjective: To compare the levels of plasma homocysteine (Hcy, vitamin B6 (vit-B6, serum vitamin B12 (vit-B12, and folate in healthy individuals and in patients with normal tension glaucoma (NTG, pseudoexfoliative glaucoma (PXG, or primary open-angle glaucoma (POAG.Study design: A prospective controlled trial.Participants and methods: Forty healthy subjects, 48 patients with NTG, 38 patients with PXG, and 34 patients with POAG were included in the study. Those who used vitamin supplements or medications affecting Hcy and vitamin levels were excluded from the study. The levels of Hcy and vit-B6 were measured by High Performance Liquid Chromatography (HPLC. The levels of serum vit-B12 and folic acid were measured by competitive chemiluminescent enzyme immunoassay (CEI. One-way analysis if variance (ANOVA, analysis of covariance (ANCOVA, and the Tukey honestly significant difference test were used for statistical analysis.Results: The mean Hcy level of the PXG group was 15.46 ± 9.27 μmol/L which was significantly higher (P = 0.03 than that of the control group. There were no statistical differences in serum vit-B12 and folate levels among control subjects and NTG, PXG and POAG groups (P > 0.05. It was found that the mean plasma vit-B6 level was significantly higher in subjects with NTG (P = 0.03 and POAG (P = 0.025 versus controls. Mean vit-B6 levels in NTG and POAG were 30.50 ± 11.29 μg/L and 30 ± 12.15 μg/L, respectively.Conclusions: The plasma level of Hcy was found to be increased only in PXG patients and the plasma levels of vit-B6 were found to increase in the NTG and POAG sample groups. Using homocysteine and vit-B6 levels as the determinants of hyperhomocysteinemia still needs further research.Keywords: normal tension glaucoma, pseudoexfoliative glaucoma, primary open-angle

  18. Risk factors for progression to blindness in high tension primary open angle glaucoma: Comparison of blind and nonblind subjects

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    Karanjit S Kooner

    2008-08-01

    Full Text Available Karanjit S Kooner1, Mohannad AlBdoor1, Byung J Cho3, Beverley Adams-Huet21Department of Ophthalmology, 2Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA; 3Konkuk University Hospital, Seoul, KoreaAims: To determine which risk factors for blindness were most critical in patients diagnosed with high tension primary open angle glaucoma (POAG in a large ethnically diverse population managed with a uniform treatment strategy.Methods: A longitudinal observational study was designed to follow 487 patients (974 eyes with POAG for an average of 5.5 ± 3.6 years. Detailed ocular and systemic information was collected on each patient and updated every six months. For this study, blindness was defined as visual acuity of 20/200 or worse and/or visual field less than 20° in either eye. Known risk factors were compared between patients with blindness in at least one eye versus nonblind patients.Results: The patients with blindness had on average: higher intraocular pressure (IOP, mmHg: (24.2 ± 11.2 vs. 22.1 ± 7.7, p = 0.03, wide variation of IOP in the follow-up period (5.9 vs. 4.1 mmHg, p = 0.031, late detection (p = 0.006, poor control of IOP (p < 0.0001, and noncompliance (p < 0.0003. Other known risk factors such as race, age, myopia, family history of glaucoma, history of ocular trauma, hypertension, diabetes, vascular disease, smoking, alcohol abuse, dysthyoidism, and steroid use were not significant.Conclusions: The most critical factors associated with the development of blindness among our patients were: elevated initial IOP, wide variations and poor control of IOP, late detection of glaucoma, and noncompliance with therapy.Keywords: primary open angle glaucoma, blindness, intraocular pressure, risk factors, and noncompliance

  19. Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma.

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    Chen Qiu

    Full Text Available To identify whether myopia was associated with the visual field (VF progression of primary open-angle glaucoma (POAG.A total of 270 eyes of 270 POAG followed up for more than 3 years with ≥9 reliable VFs by Octopus perimetry were retrospectively reviewed. Myopia was divided into: mild myopia (-2.99 diopter [D], 0, moderate myopia (-5.99, 3.00 D, marked myopia (-9.00, -6.00 D and non-myopia (0 D or more. An annual change in the mean defect (MD slope >0.22 dB/y and 0.30 dB/y was defined as fast progression, respectively. Logistic regression was performed to determine prognostic factors for VF progression.For the cutoff threshold at 0.22 dB/y, logistic regression showed that vertical cup-to-disk ratio (VCDR; p = 0.004 and the extent of myopia (p = 0.002 were statistically significant. When logistic regression was repeated after excluding the extent of myopia, axial length (AL; p = 0.008, odds ratio [OR] = 0.796 reached significance, as did VCDR (p = 0.001. Compared to eyes with AL≤23 mm, the OR values were 0.334 (p = 0.059, 0.309 (p = 0.044, 0.266 (p = 0.019, 0.260 (p = 0.018, respectively, for 23 26 mm. The significance of vertical cup-to-disk ratio of (p = 0.004 and the extent of myopia (p = 0.008 did not change for the cutoff threshold at 0.30dB/y.VCDR and myopia were associated with VF prognosis of POAG. Axial myopia may be a protective factor against VF progression.

  20. Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? Insights from a case–control study in Nepal

    OpenAIRE

    Krettek, Alexandra; Shakya-Vaidya, Suraj; Aryal, Umesh Raj; Upadhyay, Madan

    2013-01-01

    Background: Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepales...

  1. Changes in the retrobulbar arterial circulation after decrease of elevated intraocular pressure in patients with primary open angle glaucoma

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    Knežević Miroslav

    2011-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. Objective. To evaluate changes of haemodynamic parameters in the retrobulbar arterial circulation after a decrease of elevated intraocular pressure (IOP in patients with primary open angle glaucoma (POAG. Methods. Twenty-six patients were examined, 14 men and 12 women, 21 up to 50 years old and 5 below, all with previously diagnosed and treated POAG, and all examined at the Eye Clinic, Clinical Centre of Serbia. IOP was measured both with a Goldmann aplanation tonometer and dynamic contour tonometer. Central corneal thickness was measured with ultrasound pachymeter. Imaging of the retrobulbar arterial circulation by colour Doppler was performed at the Neurology Clinic, Clinical Centre of Serbia. It involved measuring of haemodynamic parameters of the ophthalmic artery, central retinal artery, and posterior ciliary arteries. Peak systolic velocity (PSV and end-diastolic velocity (EDV were measured, and resistive index (RI and pulsatility index (PI were calculated. Results. Haemodynamic arterial parameters PSV and EDV in the ophthalmic and central retinal artery after decrease of IOP were lower, while RI and PI were higher. In the posterior ciliary arteries PSV, EDV and PI were lower, and RI was higher. Conclusion. Changes of the retrobulbar arterial circulation after elevated IOP in POAG patients are important for approach and treatment, while the role of vascular factors in the supplement of the optic disc neuroretinal rim could be a key for progression backlash of glaucoma and the radix of neuroprotection.

  2. Factores de riesgo vascular en el glaucoma primario de ángulo abierto Vascular risk factors in primary open angle glaucoma

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    A. Belzunce

    2004-12-01

    enfermedad pulmonar obstructiva crónica (EPOC es el GRD más frecuente (6%. El factor de riesgo vascular más frecuente en ambos grupos es la hipertensión arterial (54 frente a un 40% seguido del accidente cerebrovascular (26 frente al 12% del grupo control. El tratamiento médico más utilizado en estos pacientes son los betabloqueantes solos (24,3% o en asociación (18,9% Conclusiones. El GPAA está asociado con la enfermedad cerebrovascular y las variaciones de la presión arterial (hiper/hipotensión. Las enfermedades del sistema respiratorio (neumonía y EPOC, circulatorio (insuficiencia cardiaca congestiva-ICC- y cardiopatía isquémica son la causa de morbilidad más prevalente en este grupo. El tratamiento médico del glaucoma más utilizado son los betabloqueantes que están contraindicados en pacientes con EPOC e ICC.Purpose. To determine whether cardiovascular risk factors distribution differ between primary open-angle glaucoma (POAG and control subjects. To assess the strength of this association in POAG. To analyze the most frequent patology in this group of patients for a better selection of medical treatment. Methods. Observational cross-sectional study in patients with a diagnosis of POAG. Fifty glaucoma patients were selected with consecutive sampling between those who had been admitted to an terciary hospital by any reason and compared with fifty admitted to the same hospital patients without POAG diagnosis in the same period of time. The variables age, sex, the reason for admission to hospital clasificated by diagnosis related group (DRG and diagnostic mayor criteria (DMC, treatment for glaucoma, stroke, diabetes mellitus, high blood pressure, ischaemic cardiopathy, Raynaud phenomenon, low blood pressure, hypercholesterolemia and tobacco were investigated. Results. An association was found between POAG and stroke (prevalence ratio=2.16;CI al 95%=1.01-2.20; p=0.074*, low blood pressure (prevalence ratio=5; CI=1.14-2.63; p=0.092* and high blood pressure

  3. Pattern of intraocular pressure reduction following laser trabeculoplasty in open-angle glaucoma patients: comparison between selective and nonselective treatment

    Directory of Open Access Journals (Sweden)

    Almeida Jr ED

    2011-07-01

    Full Text Available Eglailson Dantas Almeida Júnior1, Luciano Moreira Pinto1,2, Rodrigo Antonio Brant Fernandes1,2, Tiago Santos Prata1,31Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; 2Cerpo Oftalmologia, São Paulo, Brazil; 3Hospital Medicina dos Olhos, São Paulo, BrazilObjective: To compare the pattern of intraocular pressure (IOP reduction following selective laser trabeculoplasty (SLT versus argon laser trabeculoplasty (ALT in open-angle glaucoma (OAG patients, and to investigate the ability of initial IOP reduction to predict mid-term success.Methods: A prospective, nonrandomized, interventional case series was carried out. Consecutive uncontrolled OAG glaucoma patients underwent SLT or ALT; the same preoperative medical regimen was maintained during follow-up. Data collected included age, type of OAG, pre- and postoperative IOP, number of glaucoma medications, and surgical complications. Post-treatment assessments were scheduled at day 1 and 7 and months 1, 3, and 6.Results: A total of 45 patients (45 eyes were enrolled [SLT group (n = 25; ALT group (n = 20]. Groups were similar for age, baseline IOP, and number of glaucoma medications (P ≥ 0.12. We found no significant differences in mean IOP reduction between SLT (5.1 ± 2.5 mmHg; 26.6% and ALT (4.4 ± 2.8 mmHg; 22.8% groups at month 6 (P = 0.38. Success rates (IOP ≤ 16 mmHg and IOP reduction ≥25% at last follow-up visit were similar for SLT (72% and ALT (65% groups (P = 0.36. Comparing the pattern of IOP reduction (% of IOP reduction at each visit between groups, we found a greater effect following SLT compared with ALT at day 7 (23.7% ± 13.7% vs 8.1% ± 9.5%; P < 0.001. No significant differences were observed at other time points (P ≥ 0.32. Additionally, the percentage of IOP reduction at day 7 and at month 6 were significantly correlated in the SLT group (R2 = 0.36; P < 0.01, but not in the ALT group (P = 0.89. Early postoperative success predicted late

  4. Comparison of fixed topical combination glaucoma drugs in patients with open-angle glaucomsa or ocular hypertension

    OpenAIRE

    BAKHRITDINOVA FAZILAT ARIFOVNA; KARIMOV ULUGBEK RASULOVICH; MIRRAKHIMOVA SAIDA SH.; AKSHEY KHERA

    2016-01-01

    The purpose of study was to compare the intraocular pressure lowering efficacy, safety and cost-efficiency of fixed combinations travoprost 0.004 %/timolol 0.5 % (tim + tarv), brimonidine 0.2 %/timolo0.5 % (tim + brim), brinzolamide 1 %/timolol 0.5 % (tim + brinz) and pilocarpin 2 %/timolol 0.5 % (tim + pil) in patients with ocular hypertension or open-angle glaucoma. In this prospective, randomized clinical trial included 80 qualifying patients (4 groups) during six month. It was found that ...

  5. Comparison of the diagnostic ability of Moorfield′s regression analysis and glaucoma probability score using Heidelberg retinal tomograph III in eyes with primary open angle glaucoma

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    Jindal Shveta

    2010-01-01

    Full Text Available Purpose: To compare the diagnostic performance of the Heidelberg retinal tomograph (HRT glaucoma probability score (GPS with that of Moorfield′s regression analysis (MRA. Materials and Methods: The study included 50 eyes of normal subjects and 50 eyes of subjects with early-to-moderate primary open angle glaucoma. Images were obtained by using HRT version 3.0. Results: The agreement coefficient (weighted k for the overall MRA and GPS classification was 0.216 (95% CI: 0.119 - 0.315. The sensitivity and specificity were evaluated using the most specific (borderline results included as test negatives and least specific criteria (borderline results included as test positives. The MRA sensitivity and specificity were 30.61 and 98% (most specific and 57.14 and 98% (least specific. The GPS sensitivity and specificity were 81.63 and 73.47% (most specific and 95.92 and 34.69% (least specific. The MRA gave a higher positive likelihood ratio (28.57 vs. 3.08 and the GPS gave a higher negative likelihood ratio (0.25 vs. 0.44.The sensitivity increased with increasing disc size for both MRA and GPS. Conclusions: There was a poor agreement between the overall MRA and GPS classifications. GPS tended to have higher sensitivities, lower specificities, and lower likelihood ratios than the MRA. The disc size should be taken into consideration when interpreting the results of HRT, as both the GPS and MRA showed decreased sensitivity for smaller discs and the GPS showed decreased specificity for larger discs.

  6. Diagnostic capability of Fourier-Domain optical coherence tomography in early primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    FANG Yuan; PAN Ying-zi; LI Mei; QIAO Rong-hua; CAI Yu

    2010-01-01

    Background Optical coherence tomography (OCT) is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure.This study was designed to evaluate the diagnostic capability of parameters of the optic disc, retinal nerve fiber layer thickness, and ganglion cell complex (GCC) using a new technology called Fourier-domain OCT (FD-OCT) for early primary open angle glaucoma (POAG) patients.Methods Two groups of patients, early perimetric damage POAG and normal subjects were included in this observational cross-sectional study.All patients underwent FD-OCT and visual field examination in addition to full ophthalmic examinations.Receiver operating characteristic curves (ROC) were studied for all parameters.The sensitivity and specificity for distinguishing between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves (AROC) and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters using arbitrary cutoffs.Results Thirty-four eyes of 34 early POAG patients and 42 eyes of 42 normal subjects were analyzed.Cup/disc (C/D)vertical ratio presented the best sensitivity and positive likelihood ratio for selected specificities (95% and 85%) which were 79.4% and 88.2%, 33.4 and 7.4, respectively.Among all single parameters, the C/D vertical ratio demonstrated the highest AROC which was at 0.930.The average thickness of circumpapillary RNFL on 3.45 mm showed the highest AROC among all of the peripapillary RNFL parameters.The sensitivity at selected specificity and AROC of GCC were not as high as C/D vertical ratio and RNFL AT on 3.45 mm.When the C/D vertical ratio, RNFL AT on 3.45 mm, and rim area were combined using a logistical diagnostic model, the AROC was raised to 0.949 but not significantly different from the top single parameter, C/D vertical ratio.Conclusions The key parameters obtained by FD-OCT were able to show the

  7. Determination of Serum Ceruloplasmin Concentration in Patients with Primary Open Angle Glaucoma with Cataract and Patients with Cataract Only: A Pilot Study

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    Sarnat-Kucharczyk, Monika; Rokicki, Wojciech; Zalejska-Fiolka, Jolanta; Pojda-Wilczek, Dorota; Mrukwa-Kominek, Ewa

    2016-01-01

    Background The aim of this article was to describe the role of ceruloplasmin and to report preliminary results of ceruloplasmin concentrations in patients with primary open-angle glaucoma (POAG) with cataract and in patients with only cataract. Glaucoma, a neurodegenerative disease, is a heterogeneous group of conditions characterized by loss of retinal ganglion cells (RGC), their axons, progressive optic nerve damage, and visual field deterioration. Material/Methods The POAG group included 30 patients and the cataract group included 25 patients. Results Ceruloplasmin plays an essential role in iron metabolism and inactivating free radicals. In the presented pilot study, serum ceruloplasmin level was lower in the POAG group in comparison to the group with only cataract. Conclusions In treating persistent inflammation in the course of glaucoma, antiglaucoma drugs may increase the permeability of the blood-ocular barrier, which may be connected with the lower concentration of serum ceruloplasmin in the glaucoma patients group. PMID:27109647

  8. Brinzolamide/brimonidine: a review of its use in patients with open-angle glaucoma or ocular hypertension.

    Science.gov (United States)

    Greig, Sarah L; Deeks, Emma D

    2015-03-01

    Brinzolamide 1 %/brimonidine 0.2 % ophthalmic suspension (Simbrinza(®)) is a fixed-combination of a carbonic anhydrase inhibitor and an α2-adrenergic receptor agonist that is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension in both the USA and EU (with the EU indication restricted to patients for whom monotherapy provides insufficient IOP reduction). In phase III randomized trials, both three-times-daily and twice-daily administration of brinzolamide/brimonidine provided significantly greater IOP-lowering efficacy over 3-6 months than either of its individual components alone, and twice-daily brinzolamide/brimonidine was noninferior to concomitant administration of brinzolamide plus brimonidine over 6 months in this regard. Brinzolamide/brimonidine was generally well tolerated, with a tolerability profile that was consistent with its individual components and with no unexpected safety findings. Therefore, brinzolamide/brimonidine is an effective treatment option for patients with open-angle glaucoma or ocular hypertension, providing a convenient alternative for those patients who require multiple IOP-lowering medications. Brinzolamide/brimonidine is the first available fixed-combination that does not contain timolol, and maybe particularly suited to patients with comorbidities that restrict treatment with β-adrenergic receptor antagonists. PMID:25732405

  9. Correlação entre a espessura corneana central e o comprimento axial ocular nos portadores de glaucoma e em olhos normais Correlation between central corneal thickness and axial length in patients with glaucoma and normal eyes

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    Paula Resende Aquino de Assis Pereira Mello

    2009-08-01

    Full Text Available OBJETIVO: Correlacionar a espessura corneana central com o comprimento axial ocular nos portadores de glaucoma primário de ângulo aberto, com glaucoma primário de fechamento angular e indivíduos com olhos normais. MÉTODOS: A amostra foi constituída de 94 olhos de 94 pacientes, divididos em três grupos compostos por 33 olhos de 33 pacientes portadores de glaucoma primário de ângulo aberto, 30 olhos de 30 pacientes com glaucoma primário de fechamento angular e 31 olhos normais de 31 indivíduos. A espessura corneana e o comprimento axial do olho foram obtidos pela paquimetria ultrassônica e ecobiometria, respectivamente. RESULTADOS: A média da espessura corneana central foi de 535,1 mm no glaucoma primário de fechamento angular; 520,6 mm no glaucoma primário de ângulo aberto e 519,2 mm nos olhos normais (p=0,18. A média do comprimento axial do globo ocular nos portadores de glaucoma primário de fechamento angular foi de 22,16 mm e nos grupos com glaucoma primário de ângulo aberto e olhos normais foram de 22,68 mm e 22,64 mm, respectivamente (p=0,13. Não houve correlação significativa entre a espessura corneana central e comprimento axial do globo ocular nos grupos com glaucoma primário de fechamento angular (r=-0,085; p=0,65, glaucoma primário de ângulo aberto (r=-0,070; p=0,69 e olhos normais (r=-0,120; p=0,52. CONCLUSÃO: Os resultados deste trabalho sugerem não haver correlação entre a espessura corneana central e o comprimento axial do globo ocular nos portadores de glaucoma e indivíduos com olhos normais.PURPOSE: To evaluate and to correlate the central corneal thickness with the ocular axial length in patients with primary open-angle glaucoma, primary angle-closure glaucoma and individuals with normal eyes. METHODS: The sample was composed of 94 patients' eyes, divided into three groups constituted of 33 eyes of 33 primary open-angle glaucoma patients, 30 eyes of 30 primary angle-closure glaucoma patients and 31

  10. Relationship between consecutive deterioration of mean deviation value and progression of visual field defect in open-angle glaucoma

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    Naito T

    2015-11-01

    Full Text Available Tomoko Naito,1 Keiji Yoshikawa,2 Shiro Mizoue,3 Mami Nanno,4 Tairo Kimura,5 Hirotaka Suzumura,6 Ryuji Takeda,7 Fumio Shiraga1 1Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, 2Yoshikawa Eye Clinic, Tokyo, 3Department of Ophthalmology, Ehime University Graduate School of Medicine, Ehime, 4Kagurazaka Minamino Eye Clinic, 5Ueno Eye Clinic, 6Suzumura Eye Clinic, Tokyo, 7Department of Agriculture, Kinki University, Nara, Japan Purpose: To analyze the relationship between consecutive deterioration of mean deviation (MD value and glaucomatous visual field (VF progression in open-angle glaucoma (OAG, including primary OAG and normal tension glaucoma.Patients and methods: The subjects of the study were patients undergoing treatment for OAG who had performed VF tests at least 10 times with a Humphrey field analyzer (SITA standard, C30-2 program. The VF progression was defined by a significantly negative MD slope (MD slope worsening at the final VF test during the follow-up period. The relationship between the MD slope worsening and the consecutive deterioration of MD value were retrospectively analyzed.Results: A total of 165 eyes of 165 patients were included in the analysis. Significant progression of VF defects was observed in 72 eyes of 72 patients (43.6%, while no significant progression was evident in 93 eyes of 93 patients (56.4%. There was significant relationship between the frequency of consecutive deterioration of MD value and MD slope worsening (P<0.0001, Cochran–Armitage trend test. A significant association was observed for MD slope worsening in the eyes with three (odds ratio: 2.1, P=0.0224 and four (odds ratio: 3.6, P=0.0008 consecutive deterioration of MD value in multiple logistic regression analysis, but no significant association in the eyes with two consecutive deterioration (odds ratio: 1.1, P=0.8282. The eyes with VF progression had significantly lower intraocular pressure reduction rate (P<0

  11. Discovery of the ROCK inhibitor netarsudil for the treatment of open-angle glaucoma.

    Science.gov (United States)

    Sturdivant, Jill M; Royalty, Susan M; Lin, Cheng-Wen; Moore, Lori A; Yingling, Jeffrey D; Laethem, Carmen L; Sherman, Bryan; Heintzelman, Geoffrey R; Kopczynski, Casey C; deLong, Mitchell A

    2016-05-15

    Inhibition of Rho kinase (ROCK) to improve fluid outflow through the trabecular meshwork and lower intraocular pressure is a strategy for the development of new anti-glaucoma agents. Alpha-aryl-beta-amino isoquinoline analogs were identified as potent ROCK inhibitors. Compounds that provided a longer duration of intraocular pressure reduction in Dutch Belted rabbits also inhibited norepinephrine transporter. Ester 60 improved bioavailability of its parent ROCK inhibitor, 29 (Ki=0.2nM) and demonstrated an effective and sustained IOP reduction for 24h after dosing. From these studies, netarsudil (a.k.a. AR-13324) was discovered and is currently in clinical trials for the treatment of glaucoma and ocular hypertension. PMID:27072905

  12. Pro- and Anti-inflammatory Aspects of the Pathogenesis of Open Angle Glaucoma

    OpenAIRE

    Hammer, Christian Manfred

    2010-01-01

    In this study, morphological alterations were investigated that prevailed in the trabecular meshwork (TM) of steroid-treated bovine eyes and in trabeculectomy specimens derived from uveitic glaucoma patients. Porcine anterior eye perfusion was performed to examine the effect of pro- and anti-inflammatory cytokines on the intraocular pressure (IOP) and on the expression of the endothelial leukocyte adhesion molecule-1 (ELAM-1) in the TM. 4 steroid-treated bovine eyes were examined histological...

  13. Effects of Laser Peripheral Iridotomy in Subgroups of Primary Angle Closure Based on Iris Insertion

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    Sung-Cheol Yun

    2015-01-01

    Full Text Available Purpose. To investigate the effect of laser peripheral iridotomy (LPI in subgroups of primary angle closure based on iris insertion configuration. Methods. Anterior segment optical coherence tomography (AS-OCT images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG and nonbasal insertion group (NBG was performed. Anterior chamber depth (ACD, lens vault (LV, iris curvature, iris area, iris thickness (IT750, and angle opening distance (AOD750 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750 before and after LPI. Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes or BG (53 eyes. The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750 was affected by ACD (p<0.001, p=0.044 before LPI. AOD750 was affected by LV (p=0.012 in NBG, but by ACD (p<0.001 and IT750 (p=0.039 in BG after LPI. Conclusions. The outcomes of LPI are not significantly different between angle closure subgroups with different iris insertions. However, factors affecting AOD750 show differences between two subgroups after LPI.

  14. [Late postcontusion secondary glaucoma].

    Science.gov (United States)

    Chiseliţă, D; Vancea, P; Filiman, O; Brănişteanu, D; Bredetean, M; Poiata, I

    1995-01-01

    The investigation of 33 patients with late postcontusional glaucoma subjected to surgery and followed up for 25 +/- 8.24 months has revealed: the interval accident-surgery is shorter in the close-angle combined forms; the essential mechanisms responsible for glaucoma occurrence are: the alteration of trabecular meshwork (for open-angle glaucoma) and pupillary block (for close angle glaucoma); simple cases required antiglaucoma surgery (trabeculectomy, peripheral iridectomy) and the mixed ones required combined (trabeculectomy, lens extraction, lens implant) or sequential surgeries (antiglaucoma surgery, vitrectomy etc); the glaucomatous process was stopped in 83.4% of the open-angle glaucoma cases and progressed in 23.5% of the close-angle glaucoma cases; the functional improvements post antiglaucoma surgery combined with removal of opacities are lessened by the higher frequency of severe per- and post-operative complication. PMID:7654676

  15. Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography

    Science.gov (United States)

    Wen, Joanne C.; Zhang, Qinqin; Xin, Chen; Gupta, Divakar; Mudumbai, Raghu C.; Johnstone, Murray A.; Wang, Ruikang K.; Chen, Philip P.

    2016-01-01

    Purpose To investigate optic disc perfusion differences in normal, primary open-angle glaucoma (POAG), and normal tension glaucoma (NTG) eyes using optical microangiography (OMAG) based optical coherence tomography (OCT) angiography technique. Design Cross-sectional, observational study. Subjects Twenty-eight normal, 30 POAG, and 31 NTG subjects. Methods One eye from each subject was scanned with a 68 kHz Cirrus HD-OCT 5,000-based OMAG prototype system centered at the optic nerve head (ONH) (Carl Zeiss Meditec Inc, Dublin, CA). Microvascular images were generated from the OMAG dataset by detecting the differences in OCT signal between consecutive B-scans. The pre-laminar layer (preLC) was isolated by a semi-automatic segmentation program. Main Outcome Measures Optic disc perfusion, quantified as flux, vessel area density, and normalized flux (flux normalized by the vessel area) within the ONH. Results Glaucomatous eyes had significantly lower optic disc perfusion in preLC in all three perfusion metrics (p<0.0001) compared to normal eyes. The visual field (VF) mean deviation (MD) and pattern standard deviation (PSD) were similar between the POAG and NTG groups, and no differences in optic disc perfusion were observed between POAG and NTG. Univariate analysis revealed significant correlation between optic disc perfusion and VF MD, VF PSD, and rim area in both POAG and NTG groups (p≤0.0288). However, normalized optic disc perfusion was correlated with some structural measures (retinal nerve fiber layer thickness and ONH cup/disc ratio) only in POAG eyes. Conclusions Optic disc perfusion detected with OMAG was significantly reduced in POAG and NTG groups compared to normal controls, but no difference was seen between POAG and NTG groups with similar levels of VF damage. Disc perfusion was significantly correlated with VF MD, VF PSD, and rim area in glaucomatous eyes. Vascular changes at the optic disc as measured using OMAG may provide useful information for

  16. Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography.

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    Karine D Bojikian

    Full Text Available To investigate optic disc perfusion differences in normal, primary open-angle glaucoma (POAG, and normal tension glaucoma (NTG eyes using optical microangiography (OMAG based optical coherence tomography (OCT angiography technique.Cross-sectional, observational study.Twenty-eight normal, 30 POAG, and 31 NTG subjects.One eye from each subject was scanned with a 68 kHz Cirrus HD-OCT 5,000-based OMAG prototype system centered at the optic nerve head (ONH (Carl Zeiss Meditec Inc, Dublin, CA. Microvascular images were generated from the OMAG dataset by detecting the differences in OCT signal between consecutive B-scans. The pre-laminar layer (preLC was isolated by a semi-automatic segmentation program.Optic disc perfusion, quantified as flux, vessel area density, and normalized flux (flux normalized by the vessel area within the ONH.Glaucomatous eyes had significantly lower optic disc perfusion in preLC in all three perfusion metrics (p<0.0001 compared to normal eyes. The visual field (VF mean deviation (MD and pattern standard deviation (PSD were similar between the POAG and NTG groups, and no differences in optic disc perfusion were observed between POAG and NTG. Univariate analysis revealed significant correlation between optic disc perfusion and VF MD, VF PSD, and rim area in both POAG and NTG groups (p≤0.0288. However, normalized optic disc perfusion was correlated with some structural measures (retinal nerve fiber layer thickness and ONH cup/disc ratio only in POAG eyes.Optic disc perfusion detected with OMAG was significantly reduced in POAG and NTG groups compared to normal controls, but no difference was seen between POAG and NTG groups with similar levels of VF damage. Disc perfusion was significantly correlated with VF MD, VF PSD, and rim area in glaucomatous eyes. Vascular changes at the optic disc as measured using OMAG may provide useful information for diagnosis and monitoring of glaucoma.

  17. Does Helicobacter pylori Eradication Reduce the Risk of Open Angle Glaucoma in Patients With Peptic Ulcer Disease?

    Science.gov (United States)

    Chen, Hsin-Yi; Lin, Cheng-Li; Chen, Wen-Chi; Kao, Chia-Hung

    2015-09-01

    To investigate whether Helicobacter pylori (H pylori) eradication would influence the risk of primary open angle glaucoma (POAG) in patients with peptic ulcer disease. From the Longitudinal Health Insurance Database 2000, 6061 patients with peptic ulcer and receiving H pylori eradication therapy were recruited. The study cohort was subdivided into early (within 1 year) and late (after 1 year) eradication cohorts. The 24,244 control cohort subjects were those who without peptic ulcer and without receiving H pylori eradication therapy and were frequency-matched with the H pylori eradication cohort by age, sex, and the year of receiving H pylori eradication therapy. The higher incidence of POAG was observed in late H pylori eradication cohort and in early H pylori eradication cohort than in control cohort (1.57, 1.32, and 0.95, per 1000 person-year, respectively). However, overall risk of glaucoma was not significantly higher in the late eradication than in the early eradication (adjusted hazard ratio = 0.85, 95% confidence interval = 0.48-1.53). The POAG incidence was greater in the late H pylori eradication cohort when follow-up duration ≤ 5 years (1.59, per 1000 person-years). However, when follow-up duration >5 years, the incidence of POAG was greater in the early H pylori eradication cohort (1.68, per 1000 person-years). These relationships were not associated with a significantly increased or decreased risk of POAG in multivariable analyses. Either early or late H pylori eradication does not significantly reduce the risk of glaucoma in patients with peptic ulcer disease compared with normal control. PMID:26426633

  18. Age-based analysis of choroidal thickness and choroidal vessel diameter in primary open-angle glaucoma.

    Science.gov (United States)

    Toprak, Ibrahim; Yaylalı, Volkan; Yildirim, Cem

    2016-04-01

    We aimed to assess choroidal thickness and vessel diameter in patients with primary open-angle glaucoma (POAG) using enhanced depth imaging (EDI) optical coherence tomography (OCT) with age-based analysis. Fifty-four patients with a confirmed diagnosis of POAG and 44 age-sex matched healthy subjects were included into the study. A masked physician performed measurements of largest choroidal vessel diameter and choroidal thicknesses (subfoveal, nasal, and temporal) using EDI OCT. Subgroup analyses were performed to compare choroidal measurements based on age (with a cut point of 70 years). The study cohort comprised 54 patients with POAG (mean age of 63.2 ± 8.8 years) and 44 healthy control subjects (mean age of 62.9 ± 8.5 years) (P = 0.870). We found no significant differences in terms of choroidal measurements (P > 0.05) between the glaucoma and control groups. However, in the glaucoma group, patients with an age ≥70 years had significantly thinner subfoveal and nasal choroid compared to those of the patients with  0.05). Choroidal thickness and vessel caliber seem not to differ between patients with POAG and healthy controls. However, an age ≥70 years might be associated with thinning in subfoveal and nasal choroid in patients with POAG. Further studies are needed to elucidate whether choroidal thinning is a cause or result in POAG. PMID:26077882

  19. Clinical effectiveness of brinzolamide 1%-brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension.

    Science.gov (United States)

    Sharma, Sourabh; Trikha, Sameer; Perera, Shamira A; Aung, Tin

    2015-01-01

    The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol) are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC) for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide), and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste sensation, oral dryness, fatigue, somnolence, and decreased alertness. BBFC seems to be a promising new fixed combination for use in glaucoma patients. However, long-term effects of BBFC on IOP, treatment adherence, and safety need to be determined. PMID:26648686

  20. LEARNING FROM ERRORS -TOPIRAMATE INDUCED BILATERAL ANGLE CLOSURE WITH ACUTE ONSET MYOPIA

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    Nayana

    2014-12-01

    Full Text Available : Topiramate is an oral sulfamate medication used primarily for seizure treatment and has also demonstrated efficacy in the treatment of bipolar disorders and migraine. The mechanism of causation of angle closure and acute myopia is not clearly understood and several theories have been proposed of which the uveal effusion theory is widely accepted. We report a case of topiramate induced acute myopia with bilateral acute angle closure. With the increase in the frequency of prescribing topiramate for migraine prophylaxis it is important that the prescribing physicians should be aware of these complications. It is also important to educate the patients regarding the possible symptoms so that they can report at the earliest.

  1. Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: additional therapy to standard medication.

    Science.gov (United States)

    Takayama, Shin; Seki, Takashi; Nakazawa, Toru; Aizawa, Naoko; Takahashi, Seri; Watanabe, Masashi; Izumi, Masayuki; Kaneko, Soichiro; Kamiya, Tetsuharu; Matsuda, Ayane; Kikuchi, Akiko; Yambe, Tomoyuki; Yoshizawa, Makoto; Nitta, Shin-Ichi; Yaegashi, Nobuo

    2011-01-01

    Background. The relation between glaucoma and retrobulbar circulation in the prognosis has been indicated. Purpose. To investigate the effects of acupuncture on retrobulbar circulation in open-angle glaucoma (OAG) patients. Methods. Eleven OAG patients (20 eyes with OAG) who were treated by topical antiglaucoma medications for at least 3 months were enrolled. Acupuncture was performed once at acupoints BL2, M-HN9, ST2, ST36, SP6, KI3, LR3, GB20, BL18, and BL23 bilaterally. Retrobulbar circulation was measured with color Doppler imaging, and intraocular pressure (IOP) was also measured at rest and one hour after rest or before and after acupuncture. Results. The Δ value of the resistive index in the short posterior ciliary artery (P < .01) and the Δ value of IOP (P < .01) were decreased significantly by acupuncture compared with no acupuncture treatment. Conclusions. Acupuncture can improve the retrobulbar circulation and IOP, which may indicate the efficacy of acupuncture for OAG. PMID:21437193

  2. Goldmann applanation tonometry compared with corneal-compensated intraocular pressure in the evaluation of primary open-angle Glaucoma

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    Ehrlich Joshua R

    2012-09-01

    Full Text Available Abstract Background To better understand the role of corneal properties and intraocular pressure (IOP in the evaluation of primary open-angle glaucoma (POAG; and to determine the feasibility of identifying glaucomatous optic neuropathy (GON using IOP corrected and uncorrected for corneal biomechanics. Methods Records from 1,875 eyes of consecutively evaluated new patients were reviewed. Eyes were excluded if central corneal thickness (CCT or Ocular Response Analyzer (ORA measurements were unavailable. Presence or absence of GON was determined based on morphology of the optic disc, rim and retinal nerve fiber layer at the time of clinical examination, fundus photography and Heidelberg Retinal Tomography. Goldmann-applanation tonometry (GAT in the untreated state was recorded and Goldmann-correlated (IOPg and corneal-compensated IOP (IOPcc were obtained using the ORA. Glaucomatous eyes were classified as normal or high-tension (NTG, HTG using the conventional cutoff of 21 mm Hg. One eligible eye was randomly selected from each patient for inclusion. Results A total of 357 normal, 155 HTG and 102 NTG eyes were included. Among NTG eyes, IOPcc was greater than GAT (19.8 and 14.4 mm Hg; p  Conclusions IOPcc may account for measurement error induced by corneal biomechanics. Compared to GAT, IOPcc may be a superior test in the evaluation of glaucoma but is unlikely to represent an effective diagnostic test.

  3. Novel therapeutic approaches to correct retinal metabolic abnormalities in primary open-angle glaucoma and age-related macular degeneration

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    K. A. Mirzabekova

    2015-01-01

    Full Text Available Common pathogenic aspects of age-related macular degeneration (AMD and primary open-angle glaucoma (POAG, i.e., the role of free radicals inducing oxidative damage of the retina and optic nerve, are discussed. Factors that activate free radical reactions as well as multilevel antioxidant protection system are reviewed. Data derived from studies on current antioxidants that are used to treat and prevent dry AMD and glaucomatous optic nerve damage are compared. Neuroprotection for glaucoma will be considered soon as a basis for its treatment. B vitamins are generally included into therapeutic algorithms for glaucomatous optic neuropathy. While being metabolic therapeutics, they stimulate adaptive compensatory mechanisms and reduce the severity of various pathological processes, e.g., hypoxia, lipid peroxidation etc. Neurotrophic, antioxidant, and regenerative effects of B vitamins as wells as their involvement in metabolism, myelinsynthesis and other processes are of special importance for ophthalmologists. Currently, several vitamin and mineral supplements that differ in composition, dosage, and schedule are approved in Russia. SuperOptic, a biologically activeadditive, contains more free lutein (10 mg and zeaxanthin (500 μg as well as potent antioxidants (vitamin E and vitamin C, microelements (zinc and copper, and balanced vitamin B complex. These components play an important role in ocular health. SuperOptic can be recommended for the prevention and treatment of AMD and glaucomatous optic nerve damage.

  4. Laser Peripheral Iridotomy with Iridoplasty in Primary Angle Closure Suspect: Anterior Chamber Analysis by Pentacam

    OpenAIRE

    Lee, Jong Rak; Choi, Jin Young; Kim, Yeon-Deok; Choi, Jaewan

    2011-01-01

    Purpose To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam. Methods Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iri...

  5. Primary Phacoemulsification and Intraocular Lens Implantation for Acute Primary Angle-Closure

    OpenAIRE

    Su, Wei-Wen; Chen, Phil Yeong-Fung; Hsiao, Ching-Hsi; Chen, Henry Shen-Lih

    2011-01-01

    Background To investigate the effect of primary phacoemulsification on intraocular pressure (IOP) in patients with acute primary angle-closure (PAC) and coexisting cataract. Methodology Sixteen eyes of 14 patients with acute PAC received phacoemulsification and intraocular lens implantation as initial management for medically uncontrolled IOP in a retrospective chart review. The effects on IOP, vision, anterior chamber depth (ACD), and number of antiglaucoma medications were evaluated. Princi...

  6. Violation of the vascular platelet hemostasis as a risk factor of primary open-angle glaucoma progression

    Directory of Open Access Journals (Sweden)

    N. I. Kurysheva

    2015-10-01

    Full Text Available Purpose: to study the vascular platelet hemostasis parameters in primary open-angle glaucoma (POAG.Patients and methods: ophthalmic examination, plasma level of spontaneous and induced platelet aggregation and von Willebrand factor (vWF were performed in 67 patients with high pressure glaucoma (HPG, 41 patients had normal tension glaucoma (NTG and 38 were in control group. Period of study was 36 months. The statistical analysis included standard methods of variation statistics. The threshold P value for statistical significance was 0.05.Results: platelet aggregation was increased in glaucoma (adrenalin-induced aggregation in HPG was 63,34 %±20,42 %, р = 0,043, in NTG 62,35 %±11,53 %, р = 0,047, in comparison with control group — 49,71 %±15,96 %; ristocetin-induced aggregation in HPG was 79,45 %±28,63 %, р = 0,015, in NTG 68,98 %±12,42 %, р = 0,022, and in control group 53,56 %±8,80 % accordingly; the mean level of vWF was increased in HPG (113,25 %±24,31 %, р = 0,009 and NTG (106,85 %±21,02 %, р = 0,012 in comparisonwith control group (93,86 %±17,13 %. Patients with normal level of vWF did not have a progression of glaucoma optical neuropathy. Patients with normalized level of vWF under treatment had significant improvement of MD in 6 months (from –4,916±5,121 to –4,103±4,658, р = 0,037 and were stable in the further follow up period. Patients with increased level of vWF had deterioration of MD in 36 months (from –4,616dB±8,426 dB to –5,974dB±8,852 dB, р = 0,042, increase of cup / disk ratio (from 0,59±0,21 to 0,66±0,24, р = 0,041 and thinning of average RNFL according to HRT and OCT (from 0,21±0,09 μm to 0,17±0,08 μm, р = 0,04; from 74,37±15,34 μm to 69,44±15,12 μm, р = 0,04.Conclusion. The obtained results indicate the importance of the vascular platelet hemostasis in POAG pathogenesis and the perspectives of its correction in glaucoma treatment.

  7. A comparative study on safety and efficacy of travoprost and brimonidine/timolol fixed combination in patients of primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Rekha Mehani

    2015-10-01

    Conclusions: The fixed combination brimonidine/timolol twice daily demonstrated superior mean IOP lowering efficacy compared to travoprost 0.004% in patients with open-angle glaucoma. [Int J Basic Clin Pharmacol 2015; 4(5.000: 976-980

  8. Non-compliance with Drug Therapy in Patients with Primary Open-angle Glaucoma No cumplimiento del tratamiento farmacológico en pacientes con glaucoma primario de ángulo abierto

    Directory of Open Access Journals (Sweden)

    Ariana Fernández García

    2012-06-01

    Full Text Available

    Background: Early treatment and patient’s compliance with this treatment are the most effective ways of preventing glaucoma related blindness. Objectives: To identify the behavior of patients` compliance or non compliance with the treatment in cases of primary open-angle glaucoma. Methods: A descriptive and cross sectional study was conducted including 106 patients with confirmed primary open-angle glaucoma who were treated at the Glaucoma Service of the Dr. Salvador Allende Hospital in Havana during the first quarter of 2011. We analyzed the following variables: age, sex, educational level, personal pathological antecedents and family history of glaucoma, treatment and treatment compliance and self-reported general health condition and vision. Results: Average age among patients was 60.7 years old, 72.7% were women and 51.9% did not comply with drug treatment. 91, 6% of patients used monotherapy and 73.6% used timolol alone or in combination with another drug. 68, 9% had a family history of glaucoma. Hypertension (51, 1% was the most commonly reported chronic disease. The most referred self-assessment of general health and vision was that of regular (42, 5% and 49, 1% respectively. Conclusions: More than half of patients did not comply with drug therapy as indicated for the control of the disease. This behavior was associated with age in the cases included in this study.


    Fundamento: el tratamiento precoz y su cumplimiento, por parte del paciente, son las formas más efectivas de prevenir la ceguera por glaucoma. Objetivos: identificar el cumplimiento o no cumplimiento del tratamiento en pacientes con glaucoma primario de ángulo abierto. Métodos: estudio descriptivo,  transversal en 106 pacientes con glaucoma primario de ángulo abierto confirmado, atendidos en el

  9. Family studies in glaucoma.

    OpenAIRE

    Rosenthal, A R; Perkins, E S

    1985-01-01

    Two groups of patients with a family history of chronic open-angle glaucoma were compared with a normal population of 5919 individuals studied during the Bedford Glaucoma Survey. The mean screening intraocular pressure was significantly raised in both groups with a family history of chronic open-angle glaucoma. The prevalence rate of a raised intraocular pressure was 3.81 times that found in the normal population. This relationship was maintained when age-dependent prevalence rates were evalu...

  10. Mechanisms of angle closure in primary angle closure%原发性前房角关闭的发病机制

    Institute of Scientific and Technical Information of China (English)

    江兵; 叶雷; 田祥; 张英; 潘乐

    2013-01-01

    Objective To investigate the mechanisms of angle closure through observing changes of anterior segment morphology after laser peripheral iridotomy (LPI) in eyes with primary angle closure (PAC).Methods A prospective intervention observational case series.Forty-eight eyes with PAC,which were examined by ultrasound biomicroscopy (UBM) in darkness,were divided into three groups:The group A,simple pupillary block group; the group B,multi-mechanism group,the group C (0),simple pure non-pupillary block group.Ultrasound biomicroscopy examination was carried out before and 2 weeks after LPI treatment was preformed on PAC.UBM parameters included AOD,TIA,IT1,TCPD,ILA,ILCD,SS-IR.Results 1.Composition of the PAC was:simple pupillary block group (9 eyes,18.75%); multiple mechanism group (39 eyes,81.25%); simple pure non-pupillary block group (0 eye,0%).In multiple mechanism group (39 eyes,81.25%),there were 14.6% (7 eyes) in pupillary blocking coexisting a anterior positioned ciliary body; 12.5% (6 eyes) in pupillary blocking coexisting a thicker iris; 54.2% (26 eyes) in pupillary blocking coexisting a thicker iris and a anterior positioned ciliary body.2.The rate of angle open after LPI was 100% (9/9) in simple pupillary block group,and 41.0% (16/39) in multiple mechanism group (P =0.001).3.The preoperative peripheral iris thickness of group B (0.4029±0.0466mm) was thicker than that of group A (0.3248±0.0520mm) (P <0.05).Angle opening degree after LPI in group A were significantly increased (AOD500,TIA) compared with group B (P <0.05).There were no significant differences in iris bombe degree (ILCD,ILA) between group A and group B after LPI (P >0.05).After LPI,SS-IR in angle closure points were significantly shorter than in angle opening points (P <0.05).Conclusions The mechanism of primary angle closure is main multiple mechanism.Both a thicker iris and an anterior positioned ciliary body played a key role in the pathogenesis of angle closure after

  11. The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis

    OpenAIRE

    Gao Feng; Miller J; Miglior Stefano; Beiser Julia A; Torri Valter; Kass Michael A; Gordon Mae O

    2012-01-01

    Abstract Background Primary open-angle glaucoma (POAG) is one of the leading causes of blindness in the United States and worldwide. While lowering intraocular pressure (IOP) has been proven to be effective in delaying or preventing the onset of POAG in many large-scale prospective studies, one of the recent hot topics in glaucoma research is the effect of IOP fluctuation (IOP lability) on the risk of developing POAG in treated and untreated subjects. Method In this paper, we analyzed data fr...

  12. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Cham A

    2016-06-01

    Full Text Available Abdourahman Cham,1,2 Mayank Bansal,3 Himanshu K Banda,4 Young Kwon,1 Paul S Tlucek,1 Alexander G Bassuk,5 Stephen H Tsang,6,7 Warren M Sobol,8 James C Folk,1 Steven Yeh,4 Vinit B Mahajan1,2 1Department of Ophthalmology and Visual Sciences, 2Omics Laboratory, University of Iowa, Iowa City, IA, USA; 3Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 4Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, 5Department of Pediatrics, University of Iowa, Iowa City, IA, 6Barbara and Donald Jonas Laboratory of Stem Cells and Regenerative Medicine and Bernard and Shirlee Brown Glaucoma Laboratory, Department of Pathology and Cell Biology, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, 7Edward S Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, 8Retina Physicians & Surgeons, Inc., Dayton, OH, USA Objective: The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV, a hereditary autoimmune uveitis due to mutations in CAPN5. Patients and methods: A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP, visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT were also analyzed. Results: Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5 required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser

  13. The role of base excision repair in the development of primary open angle glaucoma in the Polish population

    Energy Technology Data Exchange (ETDEWEB)

    Cuchra, Magda; Markiewicz, Lukasz; Mucha, Bartosz [Department of Clinical Chemistry and Biochemistry, Medical University of Lodz (Poland); Pytel, Dariusz [The Abramson Family Cancer Research Institute, Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 (United States); Department of Biochemistry and Molecular Biology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425 (United States); Szymanek, Katarzyna [Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw (Poland); Szemraj, Janusz [Department of Medical Biochemistry, Medical University of Lodz, Lodz (Poland); Szaflik, Jerzy; Szaflik, Jacek P. [Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw (Poland); Majsterek, Ireneusz, E-mail: ireneusz.majsterek@umed.lodz.pl [Department of Clinical Chemistry and Biochemistry, Medical University of Lodz (Poland)

    2015-08-15

    Highlights: • We suggested the association of XRCC1 gene with the increase risk of POAG development. • We indicated the association of clinical factor and XRCC1, MUTYH, ADPRT and APE1 genes with POAG progression. • We postulated the increase level of oxidative DNA damage in group of patients with POAG in relation to healthy controls. • We suggested the slightly decrease ability to repair of oxidative DNA damage. • This is the first data that showed the role of BER mechanism in POAG pathogenesis. - Abstract: Glaucoma is a leading cause of irreversible blindness in developing countries. Previous data have shown that progressive loss of human TM cells may be connected with chronic exposure to oxidative stress. This hypothesis may suggest a role of the base excision repair (BER) pathway of oxidative DNA damage in primary open angle glaucoma (POAG) patients. The aim of our study was to evaluate an association of BER gene polymorphism with a risk of POAG. Moreover, an association of clinical parameters was examined including cup disk ratio (c/d), rim area (RA) and retinal nerve fiber layer (RNFL) with glaucoma progression according to BER gene polymorphisms. Our research included 412 patients with POAG and 454 healthy controls. Gene polymorphisms were analyzed by PCR-RFLP. Heidelberg Retinal Tomography (HRT) clinical parameters were also analyzed. The 399Arg/Gln genotype of the XRCC1 gene (OR 1.38; 95% CI 1.02–1.89 p = 0.03) was associated with an increased risk of POAG occurrence. It was indicated that the 399Gln/Gln XRCC1 genotype might increase the risk of POAG progression according to the c/d ratio (OR 1.67; 95% CI 1.07–2.61 P = 0.02) clinical parameter. Moreover, the association of VF factor with 148Asp/Glu of APE1 genotype distribution and POAG progression (OR 2.25; 95% CI 1.30–3.89) was also found. Additionally, the analysis of the 324Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might

  14. Functional alterations of V1 cortex in patients with primary open angle glaucoma using functional MRI retinotopic mapping

    International Nuclear Information System (INIS)

    Objective: To evaluate the functional changes of visual cortex (V1) in patients with primary open angle glaucoma (POAG) by fMRI retinotopic mapping technology. Methods: Fifteen POAG patients and 15 healthy volunteers underwent stimulations with fMRI retinotopic mapping stimulus and contrast-reversing checkerboard patterns stimulus on a Siemens Trio 3.0 T MRI whole-body scanner for functional data collection. Comparisons of V1 fMRI responses between the glaucomatous eyes and the healthy eyes of the patients were carried out using paired samples t-test, while independent samples t-test was used to compare V1 fMRI responses and activations between the healthy eyes of patients and the age-, gender- and side- matched eyes of normal people. Differences of V1 cortical functions and visual functions were analyzed by linear correlation analysis when the glaucomatous and the healthy eyes were simulated individually., Results: (1) V1 fMRI responses of the individually stimulated glaucomatous eyes [(1.24±0.72)%] were weaker than those of the healthy eyes [(2.18±0.93)%] (t=4.757, P0.05). (2) Differences of V1 cortical functions were negatively correlated with those of visual functions in the individually stimulated glaucomatous and healthy eyes (r=-0.887, P< 0.01). (3) The activated area indexes of V1 cortexes in the healthy eyes from patients (0.72±0.12) were lower than those in the matched eyes of normal people (0.85±0.09) (t=-3.801, P<0.01) . Conclusion: Cortical function impairment was in accordance with visual function impairment in glaucoma. Located and quantified measurement with fMRI retinotopic mapping was a useful method for clinical follow-up and evaluation of functional alteration of glaucomatous visual cortex, and a potentially useful means of studying trans-synaptic degeneration of visual pathways of in vivo glaucoma. (authors)

  15. The role of base excision repair in the development of primary open angle glaucoma in the Polish population

    International Nuclear Information System (INIS)

    Highlights: • We suggested the association of XRCC1 gene with the increase risk of POAG development. • We indicated the association of clinical factor and XRCC1, MUTYH, ADPRT and APE1 genes with POAG progression. • We postulated the increase level of oxidative DNA damage in group of patients with POAG in relation to healthy controls. • We suggested the slightly decrease ability to repair of oxidative DNA damage. • This is the first data that showed the role of BER mechanism in POAG pathogenesis. - Abstract: Glaucoma is a leading cause of irreversible blindness in developing countries. Previous data have shown that progressive loss of human TM cells may be connected with chronic exposure to oxidative stress. This hypothesis may suggest a role of the base excision repair (BER) pathway of oxidative DNA damage in primary open angle glaucoma (POAG) patients. The aim of our study was to evaluate an association of BER gene polymorphism with a risk of POAG. Moreover, an association of clinical parameters was examined including cup disk ratio (c/d), rim area (RA) and retinal nerve fiber layer (RNFL) with glaucoma progression according to BER gene polymorphisms. Our research included 412 patients with POAG and 454 healthy controls. Gene polymorphisms were analyzed by PCR-RFLP. Heidelberg Retinal Tomography (HRT) clinical parameters were also analyzed. The 399Arg/Gln genotype of the XRCC1 gene (OR 1.38; 95% CI 1.02–1.89 p = 0.03) was associated with an increased risk of POAG occurrence. It was indicated that the 399Gln/Gln XRCC1 genotype might increase the risk of POAG progression according to the c/d ratio (OR 1.67; 95% CI 1.07–2.61 P = 0.02) clinical parameter. Moreover, the association of VF factor with 148Asp/Glu of APE1 genotype distribution and POAG progression (OR 2.25; 95% CI 1.30–3.89) was also found. Additionally, the analysis of the 324Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might

  16. Brinzolamide ophthalmic suspension: a review of its pharmacology and use in the treatment of open angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Michele Iester

    2008-10-01

    Full Text Available Michele IesterClinica Oculistica, University of Genoa, ItalyAbstract: Brinzolamide is a white powder commercially formulated as a 1% ophthalmic suspension to reduce intraocular pressure (IOP. Pharmacologically, brinzolamide is a highly specific, non-competitive, reversible, and effective inhibitor of carbonic anhydrase II (CA-II, able to suppress formation of aqueous humor in the eye and thus to decrease IOP. Several clinical trials have evaluated its safety and the most commonly ocular adverse events are blurred vision (3%–8%, ocular discomfort (1.8%–5.9%, and eye pain (0.7%–4.0%. Brinzolamide has been introduced to treat ocular hypertension and primary open-angle glaucoma. In some clinical studies it has been estimated that brinzolamide reduced IOP by was about 18%. Brinzolamide can be added to beta-blockers and prostaglandins. In the latter combination, because prostaglandin derivatives improve the uveoscleral outflow but also increase the activity of CA in ciliary epithelium with a secondary increase in aqueous humor secretion, and slightly reduce the efficacy of prostaglandin analogues, theoretically topical CA inhibitors (CAI decrease IOP by inhibiting CA-II, thus improving prostaglandin efficacy as well as lowering IOP. Brinzolamide could have a secondary possible effect on ocular flow too. Some clinical studies showed a mild improvement of ocular blood flow. Theoretically, CAI could give rise to metabolic acidosis, with secondary vasodilatation and improvement of blood flow. Systemic acidosis can occur in the setting of oral CAI therapy, and local acidosis within ocular tissues is theoretically possible with topical CAI therapy, with the potential for a local increase in ocular blood flow. In conclusion, topical CAI treatment has efficacy in IOP-lowering ranging from 15% to 20%. From published data, brinzolamide can be used as first-line medication, even if other medications have a higher efficacy, with few side effects and it is a

  17. Correlation between peripapillary retinal nerve fiber layer thickness and fundus autofluorescence in primary open-angle glaucoma

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    Reznicek L

    2013-09-01

    Full Text Available Lukas Reznicek,* Florian Seidensticker,* Thomas Mann, Irene Hübert, Alexandra Buerger, Christos Haritoglou, Aljoscha S Neubauer, Anselm Kampik, Christoph Hirneiss, Marcus Kernt Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany *These authors contributed equally to this work Purpose: To investigate the relationship between retinal nerve fiber layer (RNFL thickness and retinal pigment epithelium alterations in patients with advanced glaucomatous visual field defects. Methods: A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma and advanced glaucomatous visual field defects were included in this study. All study participants underwent a full ophthalmic examination followed by visual field testing with standard automated perimetry as well as spectral-domain optical coherence tomography (SD-OCT for peripapillary RNFL thickness and Optos wide-field fundus autofluorescence (FAF images. A pattern grid with corresponding locations between functional visual field sectors and structural peripapillary RNFL thickness was aligned to the FAF images at corresponding location. Mean FAF intensity (range: 0 = black and 255 = white of each evaluated sector (superotemporal, temporal, inferotemporal, inferonasal, nasal, superonasal was correlated with the corresponding peripapillary RNFL thickness obtained with SD-OCT. Results: Correlation analyses between sectoral RNFL thickness and standardized FAF intensity in the corresponding topographic retina segments revealed partly significant correlations with correlation coefficients ranging between 0.004 and 0.376 and were statistically significant in the temporal inferior central field (r = 0.324, P = 0.036 and the nasal field (r = 0.376, P = 0.014. Conclusion: Retinal pigment epithelium abnormalities correlate with corresponding peripapillary RNFL damage, especially in the temporal inferior sector of patients with advanced glaucomatous visual field defects. A

  18. Genetic bases for glaucoma.

    Science.gov (United States)

    Fuse, Nobuo

    2010-05-01

    Glaucoma is the leading cause of visual impairment and blindness throughout the world. Primary open angle glaucoma (POAG; MIM 137760) is the main type of glaucoma in most populations, and more than 20 genetic loci for POAG have been reported. Only three causative genes have been identified in these loci, viz. myocilin (MYOC), optineurin (OPTN), and WD repeat domain 36 (WDR36). However, mutations in these genes account for only a small percentage of the patients with POAG. Some of these glaucoma cases have a Mendelian inheritance pattern, and a considerable fraction of the cases result from a large number of variants in several genes each contributing small effects. Glaucoma is considered to be a common disease such as diabetes mellitus, coronary disease, Crohn disease, and several( )common cancers. The main technological approaches used to identify the genes associated with glaucoma are the candidate gene approach, linkage analysis, case-control association study, and genome-wide association study. Association studies have found about 27 genes related to POAG, but the glaucoma-causing effects of these genes need to be investigated in more detail. The current trend is to use case-control association studies or genome-wide association studies to map the genes associated with glaucoma. Such studies are expected to greatly advance our understanding of the genetic basis of glaucoma, and to provide information on the effectiveness of glaucoma therapy. This review gives an overview on the genetic aspects of glaucoma. PMID:20431268

  19. Pediatric Glaucoma: Pharmacotherapeutic Options.

    Science.gov (United States)

    Samant, Monica; Medsinge, Anagha; Nischal, Ken K

    2016-06-01

    Childhood glaucoma is a major therapeutic challenge for pediatric ophthalmologists and glaucoma specialists worldwide. Management depends on the etiology and age at presentation. A variety of drugs are available for the control of intraocular pressure in children; however, none of these drugs have been licensed by the regulatory agencies for use in children. Furthermore, evidence gained from randomized controlled trials in the pediatric population is sparse, and little is known regarding the use of newer anti-glaucoma preparations. This evidence-based review aims to discuss the available pharmacotherapeutic options for glaucoma in children. Topical adrenoceptor blockers, topical and systemic carbonic anhydrase inhibitors, prostaglandin (PG) analogs, adrenoceptor agonists, parasympathomimetics, and combined preparations are available for use in children, but usually as an off-label indication. Therefore, it is important to recognize that serious side effects have been reported, even with topical drops, and measures to reduce systemic absorption should be taken. Most drugs have been shown to have comparable ocular hypotensive effects, with the lowest occurrence of systemic side effects with PG analogs. Whereas a newly introduced prostaglandin analog, tafluprost, and some other preservative-free preparations have shown promising results in adult glaucoma patients, no pediatric reports are available as yet. Future studies may describe their role in treating pediatric glaucoma. This review also shares some suggested treatment pathways for primary congenital glaucoma (PCG), juvenile open angle glaucoma (JOAG), developmental glaucoma, aphakic/pseudophakic glaucoma, and uveitic glaucoma. PMID:27093864

  20. Development of Dorzolamide Loaded 6-O-Carboxymethyl Chitosan Nanoparticles for Open Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Ujwala Shinde

    2013-01-01

    Full Text Available Chitosan (CS is a biodegradable, biocompatible, and mucoadhesive natural polymer soluble in acidic pH only and can be irritating to the eye. Objective of the study was to synthesize water soluble 6-O-carboxymethyl (OCM-CS derivative of CS, and to develop CS and OCM-CS nanoparticles (NPs loaded with dorzolamide hydrochloride (DRZ. CS was reacted with monochloroacetic acid (MCA for OCM-CS synthesis and was characterized by FT-IR, DSC, and 13C NMR. CS and OCM-CS NPs were prepared by ionic gelation method. Ocular irritation potential were evaluated and therapeutic efficacy was measured by reduction in intraocular pressure (IOP in normotensive rabbits. Maximum yield was obtained when the ratio of water/isopropyl alcohol was 1/4 at 55°C. The FT-IR, DSC and 13C NMR confirmed the formation of an ether linkage between hydroxyl groups of CS and MCA. The particle size and zeta potential of optimised CSNPs was 250.3 ± 2.62 nm and +33.47 ± 0.723 mV, whereas those for OCM-CSNPs were 187.1 ± 2.72 nm and 30.87 ± 0.86 mV. The entrapment efficiency was significantly improved for OCM-CSNPs, compared to CSNPs. OCM-CSNPs had tailored drug release and improved bioavailability with reduction in pulse entry as compared to CSNPs. Hence, it can be concluded that DRZ loaded OCM-CSNPs would be better alternative option to available eye drops for glaucoma treatment.

  1. A new futuristic glaucoma therapeutic management paradigm

    Directory of Open Access Journals (Sweden)

    Anusuya Gehlot

    2015-04-01

    Full Text Available Glaucoma is a group of diseases, characterized by a progressive form of optic nerve damage. Current studies indicate more selective pathophysiological involvement, thereby targeted therapies are warranted. Although both the prostaglandin analogs and beta blockers are still, most commonly used drugs for glaucoma, due to their efficacy, lack of adverse effects. In addition, a stepped care approach is the corner stone for its management. In addition, attempts have been made to enhance patient compliance and ocular delivery of already available anti-glaucoma drugs such as pilocarpine and timolol maleate. Notable among futuristic treatment options are; novel delivery systems, benzalkonium chloride-free drugs, various glaucoma drainage devices, new targeted therapies and prompt diagnosis plus aggressive treatment, in patients with primary angle closure glaucoma. Promising new focus on vision sparing, greater patient safety and tolerability will provide improved treatment options and long-term preservation of vision and quality of life. [Int J Basic Clin Pharmacol 2015; 4(2.000: 195-197

  2. The Path to Open-Angle Glaucoma Gene Discovery: Endophenotypic Status of Intraocular Pressure, Cup-to-Disc Ratio, and Central Corneal Thickness

    OpenAIRE

    Charlesworth, Jac; Kramer, Patricia L.; Dyer, Tom; Diego, Victor; Samples, John R.; Craig, Jamie E; Mackey, David A.; Hewitt, Alex W; Blangero, John; Wirtz, Mary K.

    2010-01-01

    The primary open-angle glaucoma (POAG) risk factors intraocular pressure, vertical cup-to-disc ratio, and central corneal thickness are shown to be highly heritable in 22 large POAG families from Australia and the Northwest Pacific region of the United States. Furthermore, bivariate genetic analysis reveals that both intraocular pressure and vertical cup-to-disc ratio represent potentially useful endophenotypes for the genetic dissection of POAG risk.

  3. A randomised, controlled comparison of latanoprostene bunod and latanoprost 0.005% in the treatment of ocular hypertension and open angle glaucoma: The VOYAGER study

    OpenAIRE

    Weinreb, RN; Ong, T.; Sforzolini, BS; Vittitow, JL; Singh, K.; Kaufman, PL; Ackerman, S.; Branch, J; Cottingham, A; Day, D.; Depenbusch, M; El-Hazari, S; Firozvi, A; Jorizzo, P; Ou, R

    2015-01-01

    Aim To assess the efficacy and safety of latanoprostene bunod (LBN) compared with latanoprost 0.005%, and to determine the optimum drug concentration(s) of LBN in reducing intraocular pressure (IOP) in subjects with open angle glaucoma or ocular hypertension. Methods Randomised, investigator-masked, parallelgroup, dose-ranging study. Subjects instilled one drop of study medication in the study eye once daily each evening for 28 days and completed five study visits. The primary efficacy endpoi...

  4. Cost-Minimisation Study of Dorzolamide versus Brinzolamide in the Treatment of Ocular Hypertension and Primary Open-Angle Glaucoma: In Four European Countries

    OpenAIRE

    Jeanfrancois Rouland; Claude Lepen; Carlos Gouveiapinto; Patrizia Berto; Gilles Berdeaux

    2003-01-01

    Objective: Cost is an issue when prescribing two drugs with equivalent efficacy. We compared the direct medical costs of topical brinzolamide 1% (twice a day or three times daily) with topical dorzolamide 2% (twice a day or three times daily) in France, Italy, Portugal and Spain in patients with ocular hypertension or primary open-angle glaucoma. Design and setting: Three double-blind, controlled, randomised trials (with a study duration of 3 months) compared the response rate of brinzolamide...

  5. Effects of brinzolamide vs timolol as an adjunctive medication to latanoprost on circadian intraocular pressure control in primary open-angle glaucoma Japanese patients

    OpenAIRE

    Ishikawa, Makoto

    2009-01-01

    Makoto Ishikawa1,2, Takeshi Yoshitomi11Department of Ophthalmology, Akita University Faculty of Medicine, Akita, Japan; 2Department of Ophthalmology, Ogachi Central Hospital, Akita, JapanPurpose: To study the effect of the concomitant use of brinzolamide and latanoprost on the 24-hour variation in intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients first treated with timolol and latanoprost.Methods: We studied 30 eyes from 30 POAG patients previously treated with latanop...

  6. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension [Erratum

    OpenAIRE

    Yoshikawa K; Kozaki J; Maeda H

    2014-01-01

     Yoshikawa K, Kozaki J, Maeda H. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension. Clin Ophthalmol. 2014;8:389–399.The Acknowledgments on page 397 contains an error: "Hidehito Kawabata (Kusakari Eye Clinic, Chiba, Japan)" should be "Hidehito Kawabata (Kawabata Eye Clinic, Chiba, Japan)".Read the original article

  7. Role of fixed-combination brinzolamide 1%/timolol 0.5% in the treatment of elevated intraocular pressure in open-angle glaucoma and ocular hypertension

    OpenAIRE

    Beckers, Henny

    2009-01-01

    Henny JM Beckers, Jan SAG Schouten, Carroll AB WebersUniversity Eye Clinic, Maastricht, The NetherlandsAbstract: Brinzolamide 1%/timolol 0.5% is a new fixed-combination for the treatment of open-angle glaucoma or ocular hypertension. Brinzolamide/timolol has a favorable safety profile, with an incidence of ocular burning and stinging <5%. Published data show that brinzolamide 1%/timolol 0.5% and dorzolamide 2%/timolol 0.5% have similar efficacies for lowering intraocular pressure (IOP)...

  8. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension [Erratum

    Directory of Open Access Journals (Sweden)

    Yoshikawa K

    2014-05-01

    Full Text Available  Yoshikawa K, Kozaki J, Maeda H. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension. Clin Ophthalmol. 2014;8:389–399.The Acknowledgments on page 397 contains an error: "Hidehito Kawabata (Kusakari Eye Clinic, Chiba, Japan" should be "Hidehito Kawabata (Kawabata Eye Clinic, Chiba, Japan".Read the original article

  9. Diagnostic accuracy of the parameters from ganglion cell complex map, evaluated with SD-OCT in primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    B. Anguelov

    2014-10-01

    Full Text Available Purpose: To evaluate the sensitivity and specificity of ganglion cell complex (GCC parameters, obtained with optical coherence tomography (OCT and to determine their accuracy and ability to differentiate healthy from primary open-angle glaucoma patients. Patients and methods. 84 eyes of primary open-angle glaucoma patients and 40 eyes of healthy individuals were enrolled in the study. All of them underwent complete eye examination, including standard automated perimetry (HFA II and OCT (RTVue-100. Avg. GCC (average GCC, Sup. GCC (superior GCC, Inf. GCC (inferior GCC, GLV (globаl loss volume, FLV (focal loss volume and RNFL (retinal nerve fiber layer — ONH map were measured. ROC curveswere created and sensitivity and specificity were calculated for each of these parameters.Results.The highest sensitivity and specificity was found for GLV and the lowest for Sup. GCC. Area under the ROC curves (AUC for GLV was found to be the largest and the smallest for Sup. GCC.Conclusion. Parameters from GCC map have high sensitivity and specificity. Their diagnostic capability is similar, even slightly better than the one of RNFL. GLV has the highest diagnostic accuracy for primary open-angle glaucoma detection in this study.

  10. Comparative analysis of the results of various physical therapy techniques in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Lazarev М.S.

    2012-06-01

    Full Text Available

    Aim of the study: to evaluate the effectiveness of the techniques of dynamic simultaneous transcranial magnetic therapy and resonance, and electrical stimulation, transcranial magnetic therapy and dynamic laser stimulation, magnetic simpatokorrektsii in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia. Techniques. We observed 184 patients diagnosed with primary open-angle glaucoma who received different physical therapy techniques. Results. Patients treated with transcranial magnetic therapy and electrical stimulation or laser stimulation, in addition to improving visual function and improve the bioelectrical activity of the visual cortex, more pronounced than in other groups also observed the activation of the intraocular blood fow. Application of magnetic simpatokorrektsii allows for improvement of basic functional, electrophysiological and hemodynamic performance by reducing the activity of the sympathetic nervous system and reduce the vasopressor effect. Conclusion. Transcranial magnetic therapy in combination with electrical stimulation or laser stimulation is effective in the treatment of patients with POAG. In patients with primary open-angle glaucoma with chronic cerebral ischemia technique of magnetic sim-patokorrektsii compared with traditional methods of vasoactive therapy is more effective, which is manifested not only increase the visual functions, but also a decrease in cognitive impairment.

  11. Macular Pigment Optical Density in Chinese Primary Open Angle Glaucoma Using the One-Wavelength Reflectometry Method

    Science.gov (United States)

    Ji, Yuying; Zuo, Chengguo; Lin, Mingkai; Zhang, Xiongze; Li, Miaoling; Mi, Lan; Liu, Bing; Wen, Feng

    2016-01-01

    Purpose. To investigate macular pigment optical density (MPOD) and its relationship with retinal thickness in primary open angle glaucoma (POAG) patients using the one-wavelength reflectometry method. Methods. A total of 30 eyes from 30 POAG patients (18 males and 12 females, mean age 47.27 ± 16.93) and 52 eyes from 52 controls (27 males and 25 females, mean age 49.54 ± 19.15) were included in this prospective, observational, case-control study. MPOD was measured in a 7-degree area using one-wavelength reflectometry method. Two parameters, max and mean optical density (OD), were used for analyses. Spectral-domain-optical coherence tomography was used to measure retinal thickness, including central retinal thickness (CRT), the macular ganglion cell complex (GCC), and the circumpapillary retinal nerve fiber layer (RNFL). Results. Both maxOD and meanOD were significantly reduced in POAG patients compared with normal subjects (P < 0.001). GCC, CRT, and RNFL thicknesses were also significantly reduced in POAG patients (P < 0.001). GCC thickness had a positive relationship with MPOD. Conclusions. MPOD within the 7-degree area was significantly lower in Chinese POAG patients than in control subjects, and GCC thickness was significantly and positively associated with MPOD. Whether the observed lower MPOD in POAG contributes to the disease process or is secondary to pathological changes caused by the disease (such as loss of ganglion cells) warrants further and longitudinal study. PMID:27144013

  12. Evaluation of genetic association of the INK4 locus with primary open angle glaucoma in East Indian population.

    Science.gov (United States)

    Vishal, Mansi; Sharma, Anchal; Kaurani, Lalit; Chakraborty, Subhadip; Ray, Jharna; Sen, Abhijit; Mukhopadhyay, Arijit; Ray, Kunal

    2014-01-01

    INK4 locus at chromosome 9p21 has been reported to be associated with primary open angle glaucoma (POAG) and its subtypes along with the associated optic disc parameters across the populations of European, Japanese and African ancestries. The locus encodes three tumor suppressor genes namely CDKN2A, ARF, CDKN2B and a long non-coding RNA CDKN2B-AS1 (also known as ANRIL). Here, we report association study of 34 SNPs from INK4 locus with POAG in a population of Indo-European ancestry from the eastern part of India (350 patients and 354 controls). With 81% power to detect genetic association we observed only nominal association of rs1011970 (uncorrected p = 0.048) with POAG and rs10120688 (uncorrected p = 0.048) in patients without a high intra-ocular pressure (IOP<21 mm of Hg) compared to controls. This study, in contrast to the previous reports, suggests lack of significant genetic association of INK4 locus with POAG in East Indian population which needs to be replicated in larger studies in diverse world populations. PMID:24875940

  13. Diabetes mellitus as a risk factor for open-angle glaucoma: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Minwen Zhou

    Full Text Available To determine the association between diabetes mellitus (DM and primary open-angle glaucoma (POAG.This is a systematic review and meta-analysis of case-control and cohort studies. The literature search included two databases (PubMed and Embase and the reference lists of the retrieved studies. Separate meta-analyses for case-control studies and cohort studies were conducted using random-effects models, with results reported as adjusted odds ratios (ORs and relative risks (RRs, respectively.Thirteen studies--seven case-control studies and six population-based cohort studies--were included in this meta-analysis. The pooled RR of the association between DM and POAG based on the risk estimates of the six cohort studies was 1.40 (95% CI, 1.25-1.57. The pooled OR of the association between DM and POAG based on the risk estimates of the seven case-control studies was 1.49 (95% CI, 1.17-1.88. There was considerable heterogeneity among the case-control studies that reported an association between DM mellitus and POAG (P<0.001 and no significant heterogeneity among the cohort studies (P = 0.377. After omitting the case-control study that contributed significantly to the heterogeneity, the pooled OR for the association between DM and POAG was 1.35 (95% CI, 1.06-1.74.Individuals with DM have an increased risk of developing POAG.

  14. Comparison of Newly Diagnosed Ocular Hypertension and Open-Angle Glaucoma: Ocular Variables, Risk Factors, and Disease Severity

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    Yvonne M. Buys

    2012-01-01

    Full Text Available Purpose. To describe the distribution of ocular variables, risk factors, and disease severity in newly diagnosed ocular hypertension (OH or open-angle glaucoma (OAG. Methods. Eligible subjects underwent a complete history and examination. Adjusted odds ratios (ORs and 95% confidence intervals (CIs obtained from multiple logistic regression models were used to compare OAG to OH and advanced to early/moderate OAG. Results. 405 subjects were enrolled: 292 (72.1% with OAG and 113 (27.9% with OH. 51.7% had early, 27.1% moderate, and 20.9% advanced OAG. The OR for OAG versus OH was 8.19 (P<0.0001 for disc notch, 5.36 (P<0.0001 for abnormal visual field, 1.45 (P=0.001 for worsening mean deviation, 1.91 (P<0.0001 for increased cupping, 1.03 for increased age (P=0.030, and 0.36 (P=0.010 for smoking. Conclusions. Increased age was a risk for OAG, and smoking decreased the risk of OAG compared to OH. Almost half of the OAG subjects had moderate/advanced disease at diagnosis.

  15. Epidemiology and clinical characteristics of patients with glaucoma: An analysis of hospital data between 2003 and 2012

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    Yang Zhao

    2015-01-01

    Full Text Available Purpose: To assess demographic and clinical characteristics of glaucoma patients in an Ophthalmologic Hospital of Jinan, China from 2003 to 2012. Materials and Methods: Medical charts of patients with primary open-angle glaucoma (POAG, primary angle closure glaucoma (PACG, and secondary glaucoma (SG were reviewed. The main outcome measures of patients with glaucoma included basic demographic data (age at presentation, gender, and residence, clinical characteristics (admission date, intraocular pressure, and naked vision, and previous history (injury, cardiovascular disease, diabetes mellitus, hypertension, smoking, and alcohol consumption. Results: Data from 1458 glaucoma patients were reviewed, of which PACG and SG patients accounted for 45.40% and 47.19%, respectively. The average age of all patients with glaucoma increased from 56.05 years in 2003 to 57.83 years in 2012, and the proportion of patients from rural areas rose from 46.43% to 59.13% during 10-year period. Female gender, cardiovascular disease, and hypertension were associated with PACG. POAG was related to smoking and alcohol consumption. There was positive correlation between SG and history of injury and diabetes mellitus. Conclusion: PACG and SG are the major types of glaucoma. Gender, injury, diabetes mellitus, cardiovascular disease, hypertension, smoking, and alcohol consumption were associated with different types of glaucoma.

  16. Glaucoma in Iran and contributions of studies in Iran to the understanding of the etiology of glaucoma

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    Fatemeh Suri

    2015-01-01

    Full Text Available Epidemiologic and genetic/molecular research on glaucoma in Iran started within the past decade. A population-based study on the epidemiology of glaucoma in Yazd, a city in central Iran, revealed that 4.4% of studied individuals were affected with glaucoma: 1.6% with high tension primary open angle glaucoma (POAG, 1.6% with normal tension POAG, and 0.4% each with primary angle closure glaucoma (PACG and pseudoexfoliation glaucoma (PEXG, and other types of secondary glaucoma. Two notable observations were the relatively high frequency of normal tension glaucoma cases (1.6% and the large fraction of glaucoma affected individuals (nearly 90% who were unaware of their condition. The first and most subsequent genetic studies on glaucoma in Iran were focused on primary congenital glaucoma (PCG showing that cytochrome P450 1B1 (CYP1B1 is the cause of PCG in the majority of Iranian patients, many different CYP1B1 mutations are present among Iranian patients but only four mutations constitute the vast majority, and the origins of most mutations in the Iranians are identical by descent (IBD with the same mutations in other populations. Furthermore, most of the PCG patients are from the northern and northwestern provinces of Iran. A statistically significant male predominance of PCG was observed only among patients without CYP1B1 mutations. Clinical investigations on family members of PCG patients revealed that CYP1B1 mutations exhibit variable expressivity, but almost complete penetrance. A great number of individuals harboring CYP1B1 mutations become affected with juvenile onset POAG. Screening of JOAG patients showed that an approximately equal fraction of the patients harbor CYP1B1 and (myocilin MYOC mutations; MYOC is a well-known adult onset glaucoma causing gene. Presence of CYP1B1 mutations in JOAG patients suggests that in some cases, the two conditions may share a common etiology. Further genetic analysis of Iranian PCG patients led to

  17. Safety and efficacy of a fixed versus unfixed brinzolamide/timolol combination in Japanese patients with open-angle glaucoma or ocular hypertension

    OpenAIRE

    Nagayama M; Nakajima T; Ono J

    2014-01-01

    Mikio Nagayama1, Toru Nakajima2, Junji Ono3 1Nagayama Eye Clinic, Okayama, 2Nakajima Eye Clinic, Shizuoka, 3Ono Ophthalmic Clinic, Shizuoka, Japan Background: The purpose of this study was to assess the safety and efficacy of fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC) compared with concomitant brinzolamide 1% and timolol 0.5% (BRINZ + TIM) in Japanese patients with open-angle glaucoma (primary open-angle, exfoliation, pigmentary) or ocular hypertension. Methods: This rando...

  18. Phase III safety and efficacy study of long-term brinzolamide/timolol fixed combination in Japanese patients with open-angle glaucoma or ocular hypertension

    OpenAIRE

    Nakajima M; Iwasaki N; Adachi M.

    2013-01-01

    Masayuki Nakajima,1 Naoki Iwasaki,2 Masaki Adachi31Nakajima Eye Clinic, Kyoto, 2Iwasaki Eye Clinic, 3Adachi Eye Clinic, Osaka, JapanBackground: The purpose of this study was to evaluate the safety and efficacy of a long-term, twice-daily brinzolamide 1%/timolol 0.5% fixed combination ophthalmic suspension (BRINZ/TIM-FC) in Japanese patients with open-angle glaucoma (primary open-angle, normal-tension, exfoliation, or pigmentary) or ocular hypertension.Methods: This was a prospective, nonrando...

  19. Posterior internal auditory canal closure following the retrosigmoid approach to the cerebellopontine angle.

    Science.gov (United States)

    Leonetti, J P; Anderson, D E; Newell, D J; Smith, P G

    1993-01-01

    The retrosigmoid approach is utilized in a variety of cerebellopontine angle and internal auditory canal procedures. Drill curettage of the posterior internal auditory canal enhances lateral exposure, however, this step may also increase the patient's risk for postoperative cerebrospinal fluid (CSF) otorrhea. Obliteration of perilabyrinthine air cells is technically difficult and muscle graft displacement frequently occurs. A technique for posterior petrous dural flap stabilization of a temporalis muscle plug has proved successful in decreasing the risk of postoperative CSF fistula following retrosigmoid surgery. Temporal bone air-cell anatomy, as it relates to retrosigmoid, posterior internal auditory canal surgery is reviewed. Our technique for internal auditory canal closure, with bone wax, bone paté, muscle grafts, and petrous ridge dural flaps is outlined. PMID:8424473

  20. Inter-eye comparison of retinal oximetry and vessel caliber between eyes with asymmetrical glaucoma severity in different glaucoma subtypes

    Science.gov (United States)

    Cheng, Clarissa Shu Ming; Lee, Yi Fang; Ong, Charles; Yap, Zhu Li; Tsai, Andrew; Mohla, Aditi; Nongpiur, Monisha E; Aung, Tin; Perera, Shamira A

    2016-01-01

    Background To compare retinal vessel oxygenation and vessel caliber in primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and normal controls, as well as between eyes of asymmetrical glaucoma severity. Methods This was a prospective, cross-sectional study. The 159 subjects (PACG, n=39; POAG, n=41; NTG, n=41; normal controls, n=38) underwent retinal oxygen saturation measurements using the Oxymap T1 Retinal Oximeter, optical coherence tomography, and Humphrey visual field testing. Retinal oxygen saturation and vessel diameter were compared between the glaucoma groups and normal controls, as well as between eyes of asymmetrical glaucoma severity. Kruskal–Wallis test was performed for comparison among different subtypes of glaucoma. Wilcoxon signed-rank test was used to compare the inter-eye differences. Results Compared to normal controls, arteriolar oxygen saturation was increased in PACG eyes (P=0.048) but not in POAG or NTG eyes. There were no significant differences in oxygen saturation in venules or arteriovenous (AV) difference in all three glaucoma groups. Venular diameter was significantly reduced in all glaucoma groups compared to normal controls (P<0.001), but no such change was observed in arteriolar diameter (P=0.10). When comparing between eyes of asymmetrical glaucoma severity, arteriolar oxygen saturation (P=0.03) and AV difference (P=0.04) were significantly higher, while arteriolar diameter was significantly lower (P=0.001) in the worse eye in PACG group. There were no significant differences in oximetric parameters or vessel calibers between the worse and the better eyes in POAG and NTG groups. Conclusion Eyes with PACG showed increased arteriolar oxygen saturation and increased AV difference. This was not observed in POAG and NTG eyes. Arteriolar diameter in PACG and venular diameter in all three glaucoma groups were reduced. The difference observed in PACG eyes may be due to an increased

  1. Safety and tolerability of tafluprost in treatment of elevated intraocular pressure in open-angle glaucoma and ocular hypertension

    OpenAIRE

    Dorota Pozarowska

    2010-01-01

    Dorota PozarowskaDepartment of Ophthalmology, Medical University, Lublin, PolandAbstract: Glaucoma is one of the most common neuropathies of the optic nerve. An elevated intraocular pressure (IOP) is a well documented risk factor for the development and progression of this disease. Until now, IOP reduction is the only well documented successful method of glaucoma treatment. Among the many hypotensive drugs, prostaglandin analogs are proved to be the most potent antiglaucoma agents, with very ...

  2. Comparative studies of RNFL thickness measured by OCT with global index of visual fields in patients with ocular hypertension and early open angle glaucoma

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    Sergios Taliantzis

    2009-06-01

    Full Text Available Sergios Taliantzis, Dimitris Papaconstantinou, Chrysanthi Koutsandrea, Michalis Moschos, Michalis Apostolopoulos, Gerasimos GeorgopoulosAthens University Medical School, Department of Ophthalmology, Athens, GreecePurpose: To compare the functional changes in visual fields with optical coherence tomography (OCT findings in patients with ocular hypertension, open angle glaucoma, and suspected glaucoma. In addition, our purpose is to evaluate the correlation of global indices with the structural glaucomatous defect, to assess their statistical importance in all the groups of our study, and to estimate their validity to the clinical practice.Methods: One hundred sixty nine eyes (140 patients were enrolled. The patients were classified in three groups. Group 1 consisted of 54 eyes with ocular hypertension, group 2 of 42 eyes with preperimetric glaucoma, and group 3 of 73 eyes with chronic open angle glaucoma. All of them underwent ophthalmic examination according to a prefixed protocol, OCT exam (Stratus 3000 for retinal nerve fiber layer (RNFL thickness measurement with fast RNFL thickness protocol and visual fields (VF examination with Octopus perimeter (G2 program, central 30–2 threshold strategy. Pearson correlation was calculated between RNFL thickness and global index of VF.Results: A moderate correlation between RNFL thickness and indices mean sensitivity (MS, mean defect (MD and loss variance (LV of VF (0.547, -0.582, -0.527, respectively; P < 0.001 was observed for all patients. Correlations of the ocular hypertension and preperimetric groups are weak. Correlation of RNFL thickness with global indices becomes stronger as the structural alterations become deeper in OCT exam. Correlation of RNFL thickness with the global index of VF, in respective segments around optic disk was also calculated and was found significant in the nasal, inferior, superior, and temporal segments.Conclusion: RNFL average thickness is not a reliable index for early

  3. Factores de riesgo vascular en el glaucoma primario de ángulo abierto Vascular risk factors in primary open angle glaucoma

    OpenAIRE

    Belzunce, A. (Arnaldo); M. Casellas

    2004-01-01

    Fundamentos. Conocer si los factores de riesgo cardiovascular se distribuyen de modo distinto en pacientes con glaucoma primario de ángulo abierto (GPAA) o en pacientes controles. Cuantificar la prevalencia de estos factores en el GPAA. Analizar la patología concomitante más prevalente en este grupo de pacientes y analizar sus implicaciones en el tratamiento médico del GPAA. Material y Métodos. Estudio observacional transversal sobre población hospitalaria con diagnóstico de GPAA. Se seleccio...

  4. GALC deletions increase the risk of primary open-angle glaucoma: the role of Mendelian variants in complex disease.

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    Yutao Liu

    Full Text Available DNA copy number variants (CNVs have been reported in many human diseases including autism and schizophrenia. Primary Open Angle Glaucoma (POAG is a complex adult-onset disorder characterized by progressive optic neuropathy and vision loss. Previous studies have identified rare CNVs in POAG; however, their low frequencies prevented formal association testing. We present here the association between POAG risk and a heterozygous deletion in the galactosylceramidase gene (GALC. This CNV was initially identified in a dataset containing 71 Caucasian POAG cases and 478 ethnically matched controls obtained from dbGAP (study accession phs000126.v1.p1. (p = 0.017, fisher's exact test. It was validated with array comparative genomic hybridization (arrayCGH and realtime PCR, and replicated in an independent POAG dataset containing 959 cases and 1852 controls (p = 0.021, OR (odds ratio = 3.5, 95% CI -1.1-12.0. Evidence for association was strengthened when the discovery and replication datasets were combined (p = 0.002; OR = 5.0, 95% CI 1.6-16.4. Several deletions with different endpoints were identified by array CGH of POAG patients. Homozygous deletions that eliminate GALC enzymatic activity cause Krabbe disease, a recessive Mendelian disorder of childhood displaying bilateral optic neuropathy and vision loss. Our findings suggest that heterozygous deletions that reduce GALC activity are a novel mechanism increasing risk of POAG. This is the first report of a statistically-significant association of a CNV with POAG risk, contributing to a growing body of evidence that CNVs play an important role in complex, inherited disorders. Our findings suggest an attractive biomarker and potential therapeutic target for patients with this form of POAG.

  5. Anterior Lamina Cribrosa Surface Depth in Open-Angle Glaucoma: Relationship with the Position of the Central Retinal Vessel Trunk

    Science.gov (United States)

    Oh, Baek-Lok; Kim, Hyunjoong; Girard, Michaël J. A.; Mari, Jean Martial; Kim, Tae-Woo

    2016-01-01

    Purpose To determine the factors influencing the anterior lamina cribrosa (LC) surface depth (LCD) in patients with open-angle glaucoma (OAG), focusing on the association between LCD and the position of the central retinal vessel trunk (CRVT) at the anterior LC surface. Methods Optic nerve heads of 205 OAG eyes were scanned using swept-source optical coherence tomography (SS-OCT). After processing the images using adaptive compensation, the LCD was determined from 11 horizontal B-scan images that divided the optic disc vertically into 12 equal parts. Eyes were divided into two groups (central or peripheral) according to where the CRVT exits from the anterior LC surface. The influence of CRVT position on LCD was evaluated, taking into account age, gender, untreated intraocular pressure (IOP), IOP at optic-disc scanning, retinal nerve fiber layer (RNFL) thickness, visual-field mean deviation, central corneal thickness, and axial length. Results Patients in the peripheral CRVT group were younger and more myopic, and had a larger mean LCD and thinner global RNFL than those in the central CRVT group (all P≤0.023). On multivariate analysis, the peripheral CRVT location was significantly associated with a larger LCD (P = 0.002), together with the significant association of younger age (P<0.001), higher untreated IOP (P = 0.010), and thinner RNFL (P = 0.003) on the larger LCD. Conclusion In OAG, CRVT location was an independent factor influencing the LCD, together with age, untreated IOP, and global RNFL thickness. The data indicate that the CRVT may contribute to the resistance of the LC against deformation. A longitudinal prospective observation is required to clarify this relationship. PMID:27355646

  6. Comparison of intraocular pressure lowering effect of latanoprost and timolol combination versus latanoprost alone in primary open angle glaucoma

    International Nuclear Information System (INIS)

    To compare the intraocular pressure (IOP) lowering effect of topical drug combination (Latanoprost and Timolol) with Latanoprost alone in patients of Primary Open Angle Glaucoma (POAG). Study Design: Randomized controlled Trials (RCT). Place and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi from December 2009 to May 2011. Patients and Methods: A total of 240 eyes of 120 patients (68 males and 52 females) were included in the study. The patients were randomized into two groups of 60 each using random numbers table. Group A (60 patients, 120 eyes) were put on topical drug combination of Latanoprost and Timolol eye drops and Group B (60 patients, 120 eyes) were treated with topical Latanoprost eye drops alone. IOP assessments were done at baseline, 2 weeks, 4 weeks and 8 weeks intervals after initiation of treatment. Results: Both the groups were age matched with mean age in Group A was 56.39 ± 8.50 years and in Group B was 55.61 ± 8.95 years (p=0.09). Both groups showed significant IOP decrease from the baseline at each follow up interval. However after 8 weeks of start of treatment, pressure lowering effect in group A (14.73 ± 2.50 mmHg) was significantly more as compared to Group B (9.10 ± 2.51 mmHg) (p<0.001). Conclusion: Combination therapy of Latanoprost and Timolol is more effective as compared to monotherapy with Latanoprost in lowering IOP of patients with POAG. (author)

  7. Glaucoma Treatments and Drugs

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    ... This procedure is usually used to treat more aggressive or advanced open-angle glaucoma that has not ... to your inbox Sign Up About Research Programs Leadership Partners Accountability Careers Research Research We Fund Alzheimer’s ...

  8. Phase III safety and efficacy study of long-term brinzolamide/timolol fixed combination in Japanese patients with open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Nakajima M

    2013-12-01

    Full Text Available Masayuki Nakajima,1 Naoki Iwasaki,2 Masaki Adachi31Nakajima Eye Clinic, Kyoto, 2Iwasaki Eye Clinic, 3Adachi Eye Clinic, Osaka, JapanBackground: The purpose of this study was to evaluate the safety and efficacy of a long-term, twice-daily brinzolamide 1%/timolol 0.5% fixed combination ophthalmic suspension (BRINZ/TIM-FC in Japanese patients with open-angle glaucoma (primary open-angle, normal-tension, exfoliation, or pigmentary or ocular hypertension.Methods: This was a prospective, nonrandomized, multicenter, open-label, Phase III study of Japanese patients aged ≥20 years with diagnoses of open-angle glaucoma or ocular hypertension. Patients were treated with topical BRINZ/TIM-FC twice daily for 52 weeks. The primary endpoint was mean reduction from baseline in intraocular pressure. Data were analyzed using repeated-measures analysis of variance and t-tests. Adverse events and ophthalmic, physiologic, and laboratory parameters were measured throughout the study as safety endpoints. A total of 126 patients (mean ± SD age, 63±12 years were enrolled, and 125 received BRINZ/TIM-FC.Results: Mean intraocular pressure was significantly reduced from baseline at weeks 4 through 52, with changes ranging from –4.1 mmHg to –5.7 mmHg (P<0.0001, all time points. Adverse events related to BRINZ/TIM-FC treatment were observed in 22% of patients. No substantial changes from baseline were observed in ophthalmic, physiologic, or laboratory variables.Conclusion: Long-term, twice-daily BRINZ/TIM-FC therapy produced and maintained significant intraocular pressure reductions and was generally well tolerated in Japanese patients with open-angle glaucoma or ocular hypertension.Keywords: clinical trial, intraocular pressure, long-term safety, Japan

  9. Glaucoma agudo bilateral secundário al uso de topiramato como tratamiento para la perdida de peso

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    Cristina Nieto Gómez

    2015-08-01

    Full Text Available Topiramate is a drug used in the treatment of epilepsy, migraine, bulimia and other pathologies. We report a case of a 40-years-old woman, presented to the emergency department of ophthalmology with blurred vision in both eyes and bilateral acute angle closure. Her medications included topiramate started 6 days before Secondary angle closure glaucoma due to topiramate was diagnosed. The medication was discontinued and she was treated with topical antiglaucoma medications, intravenous mannitol and cyclopegics. At the 5-days follow-up visit, vision, intraocular pressure, and angle anatomy had returned to normal. The acute angle-closure glaucoma occurs due to edema of the ciliary body and uveal effusion that produces an anterior motion of the iris-lens diaphragm , with ocular hypertension and acute myopia .

  10. The Management of Secondary Glaucoma in Nanophthalmic Patients

    Institute of Scientific and Technical Information of China (English)

    Shengsong Huang; Minbin Yu; Changyu Qiu; Tiancai Ye

    2002-01-01

    Purpose: To investigate the clinical characteristcs, management of secondary glaucoma in nanophthalmos, and the prevention of its complications.Methods: Retrospectively, 9 cases (17 eyes) with nanophthalmic glaucoma were studied.Results: The axial length of the eyes ranged (14.36 ~ 19.33) mm; All of the cases combined with hyperopia ranged (+7.00~+16.00)D. All 17 eyes had the manifestation like angle-closure glaucoma.The glaucoma was controlled in 9 of 17 eyes at the early stage, which underwent laser iridotomy (4 of 9 eyes also underwent laser iridoplasty). 1 eye underwent ciliary photocoagulation because its visual acuity was lost and the patient complained of pain. The other 7 eyes underwent filtration surgery and 3 of them had permanent loss of vision caused by disastrous complications after the surgery.Conclusions: Management of secondary glaucoma in nanophthalmos is complicated. The laser iris surgery is safe and effective in glaucoma at the early stage. Vortex vein decompression, sclerotectomy or anterior sclerotomy may be performed to reduce disastrous complications.

  11. Paracentesis as an initial intervention in Malay Indonesian eyes with acute primary angle closure

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    Widya Artini

    2012-05-01

    Full Text Available Background: Acute primary angle closure (APAC is one of the causes of blindness in Department of Ophthalmology Cipto Mangunkusumo General Hospital. Management of APAC is still controversial. Laser peripheral iridotomy is difficult to be done due to corneal edema as a result of persistent high intraocular pressure (IOP. It is believe that paracentesis will lower IOP immediately. The objective of the study was to assess outcome of paracentesis as the initial management in Malay Indonesian eyes with APAC.Methods: This intervention study was conducted at the Eye Clinic of Cipto Mangunkusumo Hospital and Jakarta Eye Center commencing in January 2005 until December 2007. Malay Indonesian eyes with APAC were included in this study in accordance with the new Asia Pacific consensus. All APAC eyes underwent paracentesis to lower IOP. The presenting and post-paracentesis IOP and peripheral anterior synechiae were noted. The outcome was termed as good when IOP was ≤ 21 mmHg and poor when IOP was > 21 mmHg.Results: A total of 45 APAC eyes were recruited. Thirty-eight of these belonged to women; mean age was 54.6 ± 1.56 years. Meanwhile, average duration of symptoms was 13.15 ± 7.4 days and mean of extent of peripheral anterior synechiae (PAS was 7.7 ± 3.1 hours. There was a strong correlation regarding duration of symptoms to the formation of PAS (r = 0.672; p < 0.001. The mean presenting IOP was 55 ± 13.37 mmHg and mean post-paracentesis IOP was 27 ± 12.78 mmHg. A decrease of 49% in IOP ( p < 0.001 was observed after paracentesis with good outcome in 19 eyes and poor outcome in 26 eyes.Conclusion: Paracentesis as an initial intervention in APAC eyes reduces the IOP immediately, but only as a temporary response. (Med J Indones. 2012;21:113-7Keywords: Acute primary angle closure (APAC, intraocular pressure (IOP, paracentesis, peripheral anterior synechiae (PAS

  12. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension

    OpenAIRE

    Yoshikawa K; Kozaki J; Maeda H

    2014-01-01

    Keiji Yoshikawa,1 Jun Kozaki,2 Hidetaka Maeda31Yoshikawa Eye Clinic, Tokyo, Japan; 2Kozaki Eye Clinic, Osaka, Japan; 3Maeda Eye Clinic, Osaka, JapanPurpose: To evaluate the efficacy and safety of brinzolamide 1%/timolol 0.5% fixed-combination (BRINZ/TIM-FC) therapy compared with timolol 0.5% (TIM) monotherapy in Japanese patients with open-angle glaucoma or ocular hypertension.Methods: This randomized, double-masked, multicenter study included Japanese patients aged ≥20 years. Patients...

  13. Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract

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    George Kitsos

    2010-06-01

    Full Text Available George Kitsos1, Miltiades Aspiotis1, Yannis Alamanos2, Konstantinos Psilas11Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece; 2Department of Hygiene and Epidemiology, Medical School, University of Patras, Patras, GreecePurpose: To present the technique of a modified deep sclerectomy, which we will call “reversed” deep sclerectomy (RDS and the results and our observations of its use in patients with open angle glaucoma (OAG and with or without cataract extraction (phacoemulsification.Materials and methods: This prospective study included 132 eyes which underwent RDS: 37 eyes (group A with uncontrolled OAG and 95 eyes (group B with OAG and visually significant cataract. Mean pressure preoperatively for group A was 24.48 ± 4.92 mmHg and for group B was 22.99 ± 3.00. The mean number of antiglaucoma drugs received was 2.97 ± 0.69 and 2.56 ± 0.73 for groups A and B respectively. The RDS was performed where the deep scleral stroma is prepared in 2 parts, folded and inserted under the lateral sides of the sclerectomy, and the Schlemm’s canal is opened prior to deep scleral stroma preparation. Cataract was extracted by phacoemulsification through the same scleral opening. The follow-up for group A was 22.23 ± 10.18 months and for group B, 25.36 ± 10.12 months. Results: Postoperative intraocular pressure (IOP ≤ 21 mmHg was achieved for group A in 40.5% without antiglaucoma drugs and 94.6% with antiglaucoma drugs, and for group B in 66.3% and in 94.7% respectively. Mean IOP reduction was 7.02 ± 6.35 mmHg (28.67%, P < 0.05 for group A and 5.26 ± 3.72 mmHg (25.06%, P ≤ 0.05 for group B, while mean drug reduction was 1.97 ± 1.09 (P < 0.01 and 2.14 ± 0.95 (P ≤ 0.01 respectively. 5-Fluorouracil was used in 8 eyes of group A and in 5 eyes of group B.Conclusion: In the follow-up time during which the two groups were under study, the RDS was effective with a few complications, similar to the classic deep

  14. Changes in the retrobulbar hemodynamic parameters after decreasing the elevated intraocular pressure in primary open-angle glaucoma patients

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    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Ocular blood flow (OBF disturbances could be involved both in the pathogenesis and in progression of glaucomatous damage. Objective. The aim of the study was to compare the retrobulbar hemodynamic parameters in the ophthalmic artery (OA, central retinal artery (CRA and short posterior cilliary arteries (SPCA after decreasing the elevated intraocular pressure (IOP in primary open-angle glaucoma (POAG patients by using color Doppler imaging (CDI. Methods. We examined 60 patients (21 male and 39 female with diagnosed and treated POAG. Thirtynine patients had increased IOP (>25 mm Hg. Peak-systolic velocity (PSV, end-diastolic velocity (EDV, Pourcelot resistance index (RI, and pulsatility index (PI were assessed in the OA, CRA, and SPCA. IOP was measured both with the Goldmann Applanation tonometer (GAT and with the Dynamic Contour tonometer (DCT, three times respectively. Ocular pulse amplitude (OPA was measured using DCT. Results. The retrobulbar parameters between the baseline and after IOP reduction showed no difference in measurements. After Bonferroni correction (p≤0.0056, alpha/9 statistical significance was recorded only in the following retrobulbar hemodynamic parameters; DCT (29.8±6.2 vs. 15.5±5.0, GAT (33.8±9.0 vs. 15.0±6.6 and OPA measurements (4.3±1.0 vs. 3.0±1.6, as compared to the baseline. There was no correlation between the changes in IOP measured with either DCT or GAT and changes in the hemodynamic parameters (p>0.05 for all. Pearson correlation coefficient (95% CI showed very good correlation for IOP measurements between DCT and GAT: at baseline 0.83 (0.71 to 0.90 and at the end 0.71 (0.55 to 0.83; p0.05. Conclusion. There was a lack of correlation between the changes in IOP measured with either DCT or GAT and the changes in the hemodynamic parameters.

  15. EFFECT OF SYSTEMIC ADMINISTRATION OF HMG Co A REDUCTASE INHIBITOR ATORVASTATIN ON CENTRAL RETINAL ARTERY FLOW DYNAMICS, INTRA OCULAR PRESSURE AND VISUAL FIELD CHANGES IN PRIMARY OPEN ANGLE GLAUCOMA AND NORMAL TENSION GLAUCOMA PATIENTS

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    Deepak Kumar

    2015-12-01

    Full Text Available PURPOSE To study the effect of systemic administration of HMG CoA reductase inhibitor Atorvastatin on Central Retinal Artery (CRA flow dynamics, Intraocular Pressure (IOP and Visual Field (VF changes in Primary Open Angle Glaucoma (POAG and Normal Tension Glaucoma (NTG patients. MATERIALS AND METHODS Prospective randomized placebo controlled double blind parallel group study consisting of 80 eyes of 40 patients suffering from POAG and NTG was conducted. After baseline clinical evaluation and Color Doppler Imaging (CDI of CRA subjects were randomized to receive 40mg/day of Atorvastatin (Tonact or matching Placebo for 3 months and followed at two weeks, one month and three months. Main outcome measures were Peak Systolic Velocity (PSV, End Diastolic Velocity (EDV, Resistive Index (RI, IOP and Mean Deviation (MD in VF. RESULTS Atorvastatin group showed decrease in IOP (P=0.0009 in right eye and P=0.0049 in left eye and in RI (P=0.0005 in right eye and P=0.0008 in left eye, while there was increase in RI in the placebo group (P=0.0006 in right eye and P=0.0007 in left eye after 3 months. No significant change in MD of VF was noticed in both groups. CONCLUSION Atorvastatin has favorable effect in POAG and NTG patients causing decrease in IOP and resistance of CRA with increase in CRA flow dynamics.

  16. [Vascular factors in glaucoma].

    Science.gov (United States)

    Mottet, B; Aptel, F; Geiser, M; Romanet, J P; Chiquet, C

    2015-12-01

    The exact pathophysiology of glaucoma is not fully understood. Understanding of the vascular pathophysiology of glaucoma requires: knowing the techniques for measuring ocular blood flow and characterizing the topography of vascular disease and the mechanisms involved in this neuropathy. A decreased mean ocular perfusion pressure and a loss of vascular autoregulation are implicated in glaucomatous disease. Early decrease in ocular blood flow has been identified in primary open-angle glaucoma and normal pressure glaucoma, contributing to the progression of optic neuropathy. The vascular damage associated with glaucoma is present in various vascular territories within the eye (from the ophthalmic artery to the retina) and is characterized by a decrease in basal blood flow associated with a dysfunction of vasoregulation. PMID:26597554

  17. Update and optimal use of a brinzolamide-timolol fixed combination in open-angle glaucoma and ocular hypertension

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    Syed MF

    2011-09-01

    Full Text Available Misha F Syed, Emma KR LoucksDepartment of Ophthalmology and Visual Sciences, The University of Texas Medical Branch, Galveston, TX, USAAbstract: Glaucoma encompasses a wide clinical spectrum of disease, with the common pathophysiology of progressive optic neuropathy leading to visual field loss. Elevated intraocular pressure (IOP is a key risk factor in disease progression. Treatment is aimed at reduction of IOP to minimize continued optic nerve head damage. Pharmacologic treatment with various classes of IOP-lowering medications is generally employed before more aggressive surgical interventions. Monotherapy is generally accepted as initial therapy for glaucoma, but at least half of patients may require more than one IOP-lowering medication. One option is the fixed combination of brinzolamide 1% and timolol maleate 0.5%, which is commercially available in some countries as Azarga® for treatment of glaucoma not adequately responsive to monotherapy. These agents may also be used in an unfixed fashion, but fixed combination therapy is generally more convenient for patients, which may result in improved compliance, a reduction of the "washout effect" from instilling multiple drops, and a potential reduction in the side effects related to multiple doses of preservatives.Keywords: brinzolamide, timolol, glaucoma, fixed combination therapy, ocular hypertension

  18. Fixed combination of bimatoprost and timolol in patients with primary open-angle glaucoma or ocular hypertension with inadequate IOP adjustment

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    Gerrett Brief

    2010-09-01

    Full Text Available Gerrett Brief1, Tobias Lammich2, Edgar Nagel3, Sabine Pfennigsdorf4, Christoph W Spraul5, Selwyn Ho61Facharzt für Augenheilkunde, Dortmund, Germany; 2Neubrandenburg, Germany; 3Augenarztpraxis Rudolstadt, Germany; 4Polch, Germany; 5Geiselhart, Ulm, Germany; 6Allergan Europe, Marlow, UKObjective: To assess the efficacy and tolerability of a fixed combination of bimatoprost and timolol (BTFC in a large patient sample in a clinical setting.Methods: In this multicenter, observational, noncontrolled, open-label study, patients (n = 1862 with primary open-angle glaucoma or ocular hypertension were treated with BTFC. Assessments were made at baseline, six weeks, and three months.Results: Prior to starting BTFC, 92.3% of patients were taking other ocular hypotensive medications. In the overall group at three months, mean intraocular pressure was reduced from baseline (21.7 ± 4.5 mmHg and 21.8 ± 4.9 mmHg for the right and left eye, respectively to 16.1 ± 3.0 mmHg for each eye (P < 0.0001. The majority of patients (92% reported no adverse events. The most commonly reported adverse events (in >1% of patients were eye irritation, and ocular and conjunctival hyperemia. Adherence to treatment was generally better than (35.4% or the same as (57.5% with prior therapy. BTFC tolerability was rated as excellent or good by 92.3% of physicians and 85.8% of patients.Conclusions: In a large group of patients with primary open-angle glaucoma or ocular hypertension, treatment with BTFC was associated with consistent reductions in IOP, improved adherence to treatment, and good tolerability.Keywords: bimatoprost, timolol, intraocular pressure, fixed combination, glaucoma

  19. Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

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    Sharma S

    2015-11-01

    Full Text Available Sourabh Sharma,1 Sameer Trikha,1 Shamira A Perera,1 Tin Aung1,2 1Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, 2Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide, and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste

  20. First-line latanoprost therapy in ocular hypertension or open-angle glaucoma patients: a 3-month efficacy analysis stratified by initial intraocular pressure

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    Rouland Jean

    2010-02-01

    Full Text Available Abstract Background Prospective, multicenter, randomized, double-masked trials have shown latanoprost instilled once daily to be at least as effective as and generally superior to timolol administered twice daily and to be as effective as other frequently prescribed prostaglandin analogues. This study prospectively assessed the efficacy of latanoprost monotherapy in a large cohort of treatment-naive patients with a broad range of baseline intraocular pressure (IOP levels treated in actual clinical practice settings. Methods This prospective, open-label, multicenter, uncontrolled, phase IV study included treatment-naive ocular hypertension or open-angle glaucoma subjects initiating latanoprost once daily (evening. IOP levels were measured at baseline and after 1 and 3 months. The primary efficacy outcome was mean change in IOP from baseline to month 3. Analyses were stratified by baseline IOP: ≥ 20 and vs ≥ 24 mmHg. Results Efficacy analyses (intent to treat included 572 subjects: 20 to vs -9.2 ± 3.7 mmHg, respectively; -28.0 ± 10.6% vs -34.1 ± 11.9%, respectively. An IOP reduction of ≥ 30% from baseline to month 3 was noted in 48.4% and 65.6% of subjects, respectively (p Conclusions This "real world" study found once-daily latanoprost to be effective and safe in treatment-naive ocular hypertension or open-angle glaucoma patients. Patients with baseline IOP levels of 20 to Trial Registration Trial Registration Number: NCT00647101

  1. Comparison of Central Corneal Thickness Measurements by Ultrasonic Pachymetry, Orbscan II, and SP3000P in Eyes with Glaucoma or Glaucoma Suspect

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    Mei-Ching Teng

    2012-06-01

    Full Text Available Background: Intraocular pressure (IOP measurements are affected by the central cornea thickness (CCT. The conventional method for CCT measurement is ultrasonic pachymetry. However, noncontact procedures lower the risk of infection and corneal damage. In this study, we compared the CCT measured by Orbscan II, SP3000P, and ultrasonic pachymetry in patients with glaucoma or glaucoma suspect.Methods: The CCT of 208 eyes (46 eyes with glaucoma suspect, 42 with primary angle-closure glaucoma, and 120 with primary open-angle glaucoma was measured using Orbscan II, SP3000P, and ultrasonic pachymetry. We compared the linear correlation of the CCT between each mode.Results: The mean CCT measured by Orbscan II (563.63 Ų 35.867 µm was larger than with the other two devices. There were significant linear correlations between measurements with ultrasonic pachymetry and Orbscan II (Pearson correlation coefficient (r = 0.793, p 500 µm to ≤ 578 µm, and > 578 µm. There was no significant linear correlation between ultrasonic pachymetry and Orbscan II in the thin group. But, in the intermediate and thick CCT groups, there were significant linear correlations between each of the three devices.Conclusion: We showed good linear correlations of CCT measurements between each of 3 devices, especially in the intermediate and thickest CCTs. These results will be helpful in predicting the relationship between IOP and CCT for the diagnosis and screening of glaucoma; even we used optic systems.

  2. Update and optimal use of a brinzolamide-timolol fixed combination in open-angle glaucoma and ocular hypertension

    OpenAIRE

    Syed MF; Loucks EKR

    2011-01-01

    Misha F Syed, Emma KR LoucksDepartment of Ophthalmology and Visual Sciences, The University of Texas Medical Branch, Galveston, TX, USAAbstract: Glaucoma encompasses a wide clinical spectrum of disease, with the common pathophysiology of progressive optic neuropathy leading to visual field loss. Elevated intraocular pressure (IOP) is a key risk factor in disease progression. Treatment is aimed at reduction of IOP to minimize continued optic nerve head damage. Pharmacologic treatment with vari...

  3. Safety and efficacy of a fixed versus unfixed brinzolamide/timolol combination in Japanese patients with open-angle glaucoma or ocular hypertension

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    Nagayama M

    2014-01-01

    Full Text Available Mikio Nagayama1, Toru Nakajima2, Junji Ono3 1Nagayama Eye Clinic, Okayama, 2Nakajima Eye Clinic, Shizuoka, 3Ono Ophthalmic Clinic, Shizuoka, Japan Background: The purpose of this study was to assess the safety and efficacy of fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC compared with concomitant brinzolamide 1% and timolol 0.5% (BRINZ + TIM in Japanese patients with open-angle glaucoma (primary open-angle, exfoliation, pigmentary or ocular hypertension. Methods: This randomized, double-masked, multicenter, parallel-group, positive-control, Phase III study was conducted in Japan and included patients aged ≥20 years. Baseline intraocular pressure was assessed after 4 weeks of treatment with timolol 0.5%. Patients were randomized to twice-daily BRINZ/TIM-FC or BRINZ + TIM for 8 weeks (treatment phase. The primary endpoint was mean intraocular pressure reduction from baseline to week 8 at 11 am, at which time noninferiority of BRINZ/TIM-FC versus BRINZ + TIM was evaluated. Data were analyzed using repeated-measures analysis of covariance and t-tests. Adverse events and ophthalmic/physiologic variables were assessed. Results: In total, 319 patients of mean age 64±12 years were enrolled in the treatment phase. BRINZ/TIM-FC and BRINZ + TIM were associated with reductions in mean intraocular pressure from baseline throughout the study (ranges -2.5 to -3.4 mmHg and -2.7 to -3.3 mmHg, respectively. Mean between-group differences in intraocular pressure reduction ranged from 0 to -0.3 mmHg; the upper limit of the 97.5% confidence interval for week 8 at 11 am was <1.1 mmHg, indicating noninferiority of BRINZ/TIM-FC. Treatment-related adverse events were observed in 3% and 12% of patients receiving BRINZ/TIM-FC and BRINZ + TIM, respectively. No substantial changes in other safety parameters were reported. Conclusion: Twice-daily BRINZ/TIM-FC reduced intraocular pressure by levels similar to concomitant BRINZ + TIM in Japanese patients with

  4. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma

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    Donnenfeld ED

    2015-11-01

    Full Text Available Eric D Donnenfeld,1 Kerry D Solomon,2 Lilit Voskanyan,3 David F Chang,4 Thomas W Samuelson,5 Iqbal Ike K Ahmed,6 L Jay Katz7 1Ophthalmic Consultants of Long Island, Rockville Centre, NY, 2Carolina Eyecare Physicians, Mt Pleasant, SC, USA; 3S.V. Malayan Ophthalmology Centre, Yerevan, Armenia; 4Altos Eye Physicians, Los Altos, CA, 5Minnesota Eye Consultants, Minneapolis, MN, USA; 6University of Toronto, Toronto, ON, Canada; 7Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA Purpose: To evaluate 3-year safety and intraocular pressure (IOP following two trabecular microbypass stents in phakic and pseudophakic subjects with open-angle glaucoma (OAG not controlled on preoperative medication. Patients and methods: In this prospective pilot study, phakic or pseudophakic subjects with OAG and IOP between 18 mmHg and 30 mmHg on one preoperative topical ocular hypotensive medication underwent medication washout. Thirty-nine qualified subjects with preoperative unmedicated IOP ≥22 mmHg and ≤38 mmHg received two stents. Postoperative examinations were scheduled at Day 1, Week 1, Months 1, 3, 6, and 12, and semiannually through Month 60. Ocular hypotensive medication was considered if postoperative IOP exceeded 21 mmHg. IOP, medication use, and safety were assessed at each visit. Subject follow-up through Month 36 was completed. Results: Thirty-six eyes (92.3%; 95% confidence interval [CI] 79.1%, 98.4% achieved the primary efficacy end point of Month 12 reduction in IOP ≥20% from baseline (unmedicated IOP without ocular hypotensive medication. Four subjects required medication during the Month 36 follow-up period. Mean IOP at 36 months for subjects not taking medication was 15.2 mmHg. At 36 months, subjects sustained mean IOP decrease of 9.1±2.7 mmHg (95% CI 8.0 mmHg, 10.14 mmHg, or 37% IOP reduction, from unmedicated baseline IOP. Compared to preoperative medicated IOP, subjects had mean reduction at Month 36 of 5.5±2

  5. Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? Insights from a case–control study in Nepal

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    Alexandra Krettek

    2013-11-01

    Full Text Available Background: Non-communicable diseases (NCDs such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG. POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepalese population. Methods: To explore the history of systemic illness, our hospital-based case–control study used non-random consecutive sampling in the general eye clinics in three hospitals across Nepal to enroll patients newly diagnosed with POAG and controls without POAG. The study protocol included history taking, ocular examination, and interviews with 173 POAG cases and 510 controls. Data analysis comprised descriptive and inferential statistics. Descriptive statistics computed the percentage, mean, and standard deviation (SD; inferential statistics used McNemar's test to measure associations between diseases. Results: POAG affected males more frequently than females. The odds of members of the Gurung ethnic group having POAG were 2.05 times higher than for other ethnic groups. Hypertension and diabetes were strongly associated with POAG. The overall odds of POAG increased 2.72-fold among hypertensive and 3.50-fold among diabetic patients. Conclusion: POAG associates significantly with hypertension and diabetes in Nepal. Thus, periodic glaucoma screening for hypertension and diabetes patients in addition to opportunistic screening at eye clinics may aid in detecting more POAG cases at an early stage and hence in reducing avoidable blindness.

  6. The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis

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    Gao Feng

    2012-10-01

    Full Text Available Abstract Background Primary open-angle glaucoma (POAG is one of the leading causes of blindness in the United States and worldwide. While lowering intraocular pressure (IOP has been proven to be effective in delaying or preventing the onset of POAG in many large-scale prospective studies, one of the recent hot topics in glaucoma research is the effect of IOP fluctuation (IOP lability on the risk of developing POAG in treated and untreated subjects. Method In this paper, we analyzed data from the Ocular Hypertension Treatment Study (OHTS and the European Glaucoma Prevention Study (EGPS for subjects who had at least 2 IOP measurements after randomization prior to POAG diagnosis. We assessed the interrelationships among the baseline covariates, the changes of post-randomization IOP over time, and the risk of developing POAG, using a latent class analysis (LCA which allows us to identify distinct patterns (latent classes of IOP trajectories. Result The IOP change in OHTS was best described by 6 latent classes differentiated primarily by the mean IOP levels during follow-up. Subjects with high post-randomization mean IOP level and/or large variability were more likely to develop POAG. Five baseline factors were found to be significantly predictive of the IOP classification in OHTS: treatment assignment, baseline IOP, gender, race, and history of hypertension. In separate analyses of EGPS, LCA identified different patterns of IOP change from those in OHTS, but confirmed that subjects with high mean level and large variability were at high risk to develop POAG. Conclusion LCA provides a useful tool to assess the impact of post-randomization IOP level and fluctuation on the risk of developing POAG in patients with ocular hypertension. The incorporation of post-randomization IOP can improve the overall predictive ability of the original model that included only baseline risk factors.

  7. Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

    Science.gov (United States)

    Sharma, Sourabh; Trikha, Sameer; Perera, Shamira A; Aung, Tin

    2015-01-01

    The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol) are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC) for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide), and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste sensation, oral dryness, fatigue, somnolence, and decreased alertness. BBFC seems to be a promising new fixed combination for use in glaucoma patients. However, long-term effects of BBFC on IOP, treatment adherence, and safety need to be determined. PMID:26648686

  8. Developing the specifications of an Open Angle Glaucoma screening intervention in the United Kingdom: a Delphi approach

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    Campbell Susan E

    2012-12-01

    Full Text Available Abstract Background Glaucoma is a leading cause of blindness. Early detection is advocated but there is insufficient evidence from randomized controlled trials (RCTs to inform health policy on population screening. Primarily, there is no agreed screening intervention. For a screening programme, agreement is required on the screening tests to be used, either individually or in combination, the person to deliver the test and the location where testing should take place. This study aimed to use ophthalmologists (who were experienced glaucoma subspecialists, optometrists, ophthalmic nurses and patients to develop a reduced set of potential screening tests and testing arrangements that could then be explored in depth in a further study of their feasibility for evaluation in a glaucoma screening RCT. Methods A two-round Delphi survey involving 38 participants was conducted. Materials were developed from a prior evidence synthesis. For round one, after some initial priming questions in four domains, specialists were asked to nominate three screening interventions, the intervention being a combination of the four domains; target population, (age and higher risk groups, site, screening test and test operator (provider. More than 250 screening interventions were identified. For round two, responses were condensed into 72 interventions and each was rated by participants on a 0-10 scale in terms of feasibility. Results Using a cut-off of a median rating of feasibility of ≥5.5 as evidence of agreement of intervention feasibility, six interventions were identified from round 2. These were initiating screening at age 50, with a combination of two or three screening tests (varying combinations of tonometry/measures of visual function/optic nerve damage organized in a community setting with an ophthalmic trained technical assistant delivering the tests. An alternative intervention was a ‘glaucoma risk score’ ascertained by questionnaire. The advisory panel

  9. Apolipoprotein E–Promoter Single-Nucleotide Polymorphisms Affect the Phenotype of Primary Open-Angle Glaucoma and Demonstrate Interaction with the Myocilin Gene

    Science.gov (United States)

    Copin, Bruno; Brézin, Antoine P.; Valtot, Françoise; Dascotte, Jean-Claude; Béchetoille, Alain; Garchon, Henri-Jean

    2002-01-01

    Primary open-angle glaucoma (POAG) is an optic neuropathy that has a high worldwide prevalence and that shows strong evidence of complex inheritance. The myocilin (MYOC) gene is the only one that has thus far been shown to have mutations in patients with POAG. Apolipoprotein E (APOE) plays an essential role in lipid metabolism, and the APOE gene has been involved in neuronal degeneration that occurs in Alzheimer disease (AD). Here, we report that two APOE-promoter single-nucleotide polymorphisms (SNPs) previously associated with AD also modify the POAG phenotype. APOE(−219G) is associated with increased optic nerve damage, as reflected by increased cup:disk ratio and visual field alteration. In addition, APOE(−491T), interacting at a highly significant level with an SNP in the MYOC promoter, MYOC(−1000G), is associated with increased intraocular pressure (IOP) and with limited effectiveness of IOP-lowering treatments in patients with POAG. Together, these findings establish APOE as a potent modifier for POAG, which could explain the linkage to chromosome 19q previously observed by use of a genome scan for this condition and an increased frequency of glaucoma in patients with AD. The findings also shed new light on potential mechanisms of optic nerve damage and of IOP regulation in POAG. PMID:11992263

  10. Diode laser trans - scleral cyclo - ablation as a primary surgical treatment for primary open - angle glaucoma after maximum tolerated medical therapy

    International Nuclear Information System (INIS)

    The incidence rate and prevalence of glaucoma in Pakistan is similar to that of other dark - colored population countries. Primary trabeculectomy is still a preferred surgical approach. Diode laser is widely accepted as the therapy of choice in severe glaucoma cases. The purpose of this study was to deter-mine the role of Diode Laser Transscleral Cyclo-ablation as a primary surgical treatment option in Primary Open Angle Glaucoma after maximum tolerated medical therapy. This quasi - experimental study was con-ducted at Layton Rahmatullah Benevolent Trust Free Eye Care and Cancer Hospital, Lahore. Sixty patients fulfilling the inclusion criteria were selected from the Glaucoma unit for this study. 25 - 30 burns of Diode Laser were applied to 270 degrees avoiding 3 and 9 O clock positions, 1.5 mm posterior to the limbus. Laser was set at duration of 1 second and power between 1000 and 1500 mw. Patients were followed up for a period of one year. Results: Out of a total of 60 eyes with mean age 52.73 +- 7.40 years, 36 (60%) were male and 24 (40%) were female. The mean pre-operative Intra Ocular Pressure IOP was 41.0 +- 7.0 mmHg (The pre-operative IOP ranged from 28 mmHg to 60 mmHg). The mean post-operative IOP was 18.97 mmHg on day one, 16.75 mmHg at 1 week, 15.68 mmHg at 1 month, 15.00 mmHg at 6 months and by the end of a year it was about 14.15 mmHg (The post-operative IOP ranged from 6 mmHg to 52 mmHg). There was a significant drop of more than 50% of post-operative IOP as compared to pre-operative IOP. Conclusion: Diode Laser Transscleral Cycloablation is a practical, rapid, well - tolerated procedure that provides a significant lowering of intraocular pressure with few complications and can considered as alternative treatment in POAG if medical therapy fails. (author)

  11. Effects of Cataract Surgery on Intraocular Pressure in Patients with and without Glaucoma

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    Tülin İsmi

    2013-06-01

    Full Text Available Pur po se: To evaluate the effects of phacoemulsification surgery with primary intraocular lens (IOL implantation on intraocular pressure (IOP in various types of glaucoma patients with visually significant cataract and to compare these results with cataract patients without glaucoma. Ma te ri al and Met hod: This retrospective study included consecutive cases of 21 primary open-angle glaucoma patients, 13 primary angle-closure glaucoma (PACG patients, 11 pseudoexfoliation glaucoma patients, and 21 control eyes without any type of glaucoma; all patients had co-existing cataract. Visual acuities, IOP, number of glaucoma medications used, anterior chamber depth (ACD, and gonioscopic evaluations were noted both pre- and postoperatively. Phacoemulsification and IOL implantations were performed via clear corneal incisions in the whole study group. Study group was followed-up for six months. Re sults: Postoperative visits at the 1st, 3rd, and 6th months were noted. After surgery, visual acuities improved significantly (p=0.001 in all groups. Intraocular pressures decreased in all groups postoperatively, but the change was statistically significant in the PACG group (p=0.013. Increase in ACD was significant in PACG group (p=0.001. Widening of iridocorneal angle and decrease in the number of antiglaucoma drugs were observed in all groups, but these were significant in the PACG group (p=0.001 and p<0.05, respectively. Dis cus si on: In glaucoma patients with co-existing cataract, phacoemulsification surgery allows both the visual rehabilitation and IOP control. This IOP lowering effect is seen most markedly in the PACG group. (Turk J Ophthalmol 2013; 43: 167-72

  12. A European perspective on costs and cost effectiveness of ophthalmic combinations in the treatment of open-angle glaucoma

    DEFF Research Database (Denmark)

    Hommer, A.; Thygesen, J.; Ferreras, A.;

    2008-01-01

    PURPOSE: Efficacy, safety, and cost implications are important considerations when choosing an ophthalmic treatment. Fixed-combination glaucoma medications containing brimonidine 0.2% and timolol 0.5%, or dorzolamide 2% and timolol 0.5%, were compared with brimonidine 0.2% and dorzolamide 2% that...... therapy. Modelled cost-minimization and cost-effectiveness analyses were performed to investigate the economic consequences of ophthalmic therapy with brimonidine, dorzolamide, and timolol from a societal perspective. RESULTS: The literature review found that brimonidine and dorzolamide used as fixed...

  13. [Results of a double-blind medium-term study comparing effects of timolol maleate and epinephrine in 120 patients with chronic open-angle glaucoma].

    Science.gov (United States)

    Demailly, P; Lehner, M A; Etienne, R; Trepsat, C; Haut, J; Raynaud, G; Massin, M; Tatry, C

    1978-12-01

    A double-blind medium term study of the activity of timolol in chronic open-angle glaucoma was conducted in four French ophthalmological centers, using the same protocol. A total of 119 patients were treated: --60 with timolol; --59 with épinéphrine, for comparison. Results showed a significantly superior efficacy for timolol over épinéphrine, after in weeks of treatment. Good tonometric control was obtained in 81.6% of the patients treated with timolol, against 52.5% of those receiving épinéphrine. In 68% of the glaucomatons patients treated with timolol, good tonometric control was obtained with the lowest dose preparation containing 0.1%. No side-effects were noted during the study, either locally or generally (particularly blood pressure changes). PMID:155097

  14. Role of fixed-combination brinzolamide 1%/timolol 0.5% in the treatment of elevated intraocular pressure in open-angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Henny JM Beckers

    2009-10-01

    Full Text Available Henny JM Beckers, Jan SAG Schouten, Carroll AB WebersUniversity Eye Clinic, Maastricht, The NetherlandsAbstract: Brinzolamide 1%/timolol 0.5% is a new fixed-combination for the treatment of open-angle glaucoma or ocular hypertension. Brinzolamide/timolol has a favorable safety profile, with an incidence of ocular burning and stinging <5%. Published data show that brinzolamide 1%/timolol 0.5% and dorzolamide 2%/timolol 0.5% have similar efficacies for lowering intraocular pressure (IOP. There is some evidence that brinzolamide/timolol may be more comfortable. Although patients receiving brinzolamide/timolol may experience more blurred vision on instillation, some data show a preference for brinzolamide/timolol over dorzolamide/timolol. Although available data to assess the role of brinzolamide/timolol in daily clinical practice are still limited, these first results suggest the agent to be a reasonable alternative for patients who do not reach target IOP with monotherapy.

  15. Glaucoma (image)

    Science.gov (United States)

    Glaucoma is a condition of increased fluid pressure inside the eye. The increased pressure causes compression of ... nerve which can eventually lead to nerve damage. Glaucoma can cause partial vision loss, with blindness as ...

  16. Glaucoma Foundation

    Science.gov (United States)

    ... Options: SIZE CONTRAST Search Home About TGF About Glaucoma About Exfoliation Syndrome Research Center Contact Us Get ... be allergy season. For those who live with glaucoma, it’s especially important to manage the symptoms. Seasonal ...

  17. Preliminary results following the use of a fixed combination of timolol–brimonidine in patients with ocular hypertension and primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Dimitris Papaconstantinou

    2009-03-01

    Full Text Available Dimitris Papaconstantinou1, Ilias Georgalas2, Nikolaos Kourtis1, Christos Pitsas1, Efthimios Karmiris1, Chrysanthi Koutsandrea1, Ioannis Ladas1, Gerasimos Georgopoulos11Department of Ophthalmology, “G Gennimatas” Hospital of Athens, University of Athens, Athens, Greece; 2Department of Ophthalmology, “G Gennimatas” Hospital of Athens, NHS, Athens, Greece Purpose: The purpose of this prospective study was to evaluate the efficacy in intraocular pressure (IOP control and the tolerance of a topically administered fixed combination of timolol–brimonidine in 50 patients with ocular hypertension and primary open-angle glaucoma.Methods: After determining a baseline IOP, the fixed combination timolol–brimonidine was used twice daily for two months, while IOP, ophthalmic signs, and/or symptoms were monitored.Results: The mean IOP value was decreased from 23.09 mm Hg (±1.98 SD to 17.46 mm Hg (±1.47 SD during the 1st month (paired Student’s t test = 9.88 και p < 0.001, and to 17.51 mm Hg (±1.43 SD in the 2nd month. Between the 1st and 2nd month, no statistical difference was observed (paired Student’s t test = 0.02 και p < 0.1. In 8% of the patients during the 1st month and 10% of patients in the 2nd month, some ophthalmic signs were observed, while only mild ophthalmic symptoms were reported in 6% and 8% of the patients, respectively.Conclusions: In conclusion, the fixed combination of timolol–brimonidine has a satisfactory IOP-lowering effect without any serious side effects due to the topical use. Keywords: fixed combination 0.2% brimonidine–0.5% timolol, ocular hypertension, primary open-angle glaucoma

  18. Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension

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    Yoshikawa K

    2014-02-01

    Full Text Available Keiji Yoshikawa,1 Jun Kozaki,2 Hidetaka Maeda3 1Yoshikawa Eye Clinic, Tokyo, Japan; 2Kozaki Eye Clinic, Osaka, Japan; 3Maeda Eye Clinic, Osaka, Japan Purpose: To evaluate the efficacy and safety of brinzolamide 1%/timolol 0.5% fixed-combination (BRINZ/TIM-FC therapy compared with timolol 0.5% (TIM monotherapy in Japanese patients with open-angle glaucoma or ocular hypertension. Methods: This randomized, double-masked, multicenter study included Japanese patients aged ≥20 years. Patients were treated during a 4-week observation period with TIM monotherapy in advance of randomization to treatment with topical BRINZ/TIM-FC or TIM monotherapy twice daily for 8 weeks. The primary endpoint was mean reduction in intraocular pressure (IOP from baseline to week 8 at 2 hours postinstillation. Adverse events (AEs were recorded at each visit. Results: A total of 301 patients (BRINZ/TIM-FC, n=150; TIM, n=151; age [mean ± standard deviation], 61±13 years were enrolled. Mean IOP reductions from baseline were greater with BRINZ/TIM-FC than with TIM at weeks 4 and 8 at 0 and 2 hours postinstillation (all P≤0.0001, with mean reductions of -3.2 mmHg with BRINZ/TIM-FC and -1.4 mmHg with TIM at week 8, 2 hours postinstillation. Although AEs were observed in 19% of all patients (BRINZ/TIM-FC, 20%; TIM, 19%, all AEs were mild or moderate. Conclusion: BRINZ/TIM-FC therapy was associated with significantly greater reductions in IOP compared with TIM, and it was well tolerated in Japanese patients with open-angle glaucoma or ocular hypertension. Keywords: Azarga, intraocular pressure, carbonic anhydrase inhibitor, beta blocker

  19. A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results

    Directory of Open Access Journals (Sweden)

    Lee JWY

    2014-09-01

    Full Text Available Jacky WY Lee,1,2 Catherine WS Chan,2 Mandy OM Wong,3 Jonathan CH Chan,3 Qing Li,2 Jimmy SM Lai2 1The Department of Ophthalmology, Caritas Medical Centre, 2The Department of Ophthalmology, The University of Hong Kong, 3The Department of Ophthalmology, Queen Mary Hospital, Hong Kong Background: The objective of this study was to investigate the effects of adjuvant selective laser trabeculoplasty (SLT versus medication alone on intraocular pressure (IOP control, medication use, and quality of life in patients with primary open-angle glaucoma.Methods: This prospective, randomized control study recruited 41 consecutive primary open-angle glaucoma subjects with medically-controlled IOP ≤21 mmHg. The SLT group (n=22 received a single 360-degree SLT treatment. The medication-only group (n=19 continued with their usual treatment regimen. In both groups, medication was titrated to maintain a target IOP defined as a 25% reduction from baseline IOP without medication, or <18 mmHg, whichever was lower. Outcomes, which were measured at baseline and at 6 months, included the Glaucoma Quality of Life-15 (GQL-15 and Comparison of Ophthalmic Medications for Tolerability (COMTOL survey scores, IOP, and the number of antiglaucoma medicines. Results: The baseline IOP was 15.8±2.7 mmHg and 14.5±2.5 mmHg in the SLT and medication-only groups, respectively (P=0.04. Both groups had a comparable number of baseline medication (P=0.2, GQL-15 (P=0.3 and COMTOL scores (P=0.7. At 6 months, the SLT group had a lower IOP (P=0.03 and required fewer medications compared with both baseline (P<0.0001 and with the medication-only group (P=0.02. There was no statistically significant difference in the 6-month GQL-15 or COMTOL score as compared to baseline (P≥0.4 or between the two treatment groups (P≥0.2.Conclusion: A single session of adjuvant SLT provided further reductions in IOP and medication without substantial changes in quality of life or medication tolerability at 6

  20. Comparison between the EX-PRESS P-50 implant and trabeculectomy in patients with open-angle glaucoma

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    Mendoza-Mendieta ME

    2016-02-01

    Full Text Available María Elena Mendoza-Mendieta,1 Ana Paola López-Venegas,2 Gerardo Valdés-Casas3 1Department of Anterior Segment, Dr Luis Sánchez Bulnes Hospital, Association to Prevent Blindness, Mexico City, Mexico; 2Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico; 3Department of General Ophthalmology, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico Purpose: To evaluate the EX-PRESS P-50 implant compared to standard trabeculectomy (TBC. Methods: Single-center prospective randomized study; 20 eyes of 20 patients were treated with the EX-PRESS P-50 implant, and 20 eyes of 20 patients with TBC, over a 19-month period. Records of all patients were reviewed and compared. Success was defined as intraocular pressure (IOP <21 and >5 mmHg or a decrease of 30% of IOP. Failure was defined as >21 mmHg or decline in visual acuity. Statistical analysis was made with Student’s t-test and χ2 test analyzed with SPSS version 13.0. Results: The average follow-up was 8.6 months (±4.9 months for the EX-PRESS P-50 group and 9.6 months (±5.3 months for the TBC group. The postoperative visual acuity and IOP were not significantly different. We report more complications in the EX-PRESS P-50 group. At 3, 6, and 12 months follow-up, the control group was found to be free of complications, whereas multiple complications were observed in the EX-PRESS P-50 group at 3 and 6 months follow-up. We found no differences in either group with respect to success. Conclusion: Both procedures are equally effective for the treatment of glaucoma, with 80% success in the EX-PRESS P-50 group and 72.7% in the control group. Keywords: glaucoma, IOP, EX-PRESS, trabeculectomy

  1. Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM and trabeculectomy with antimetabolite (MMC in the treatment of primary open angle glaucoma

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    Saeed AM

    2012-10-01

    Full Text Available Ahmed M SaeedOphthalmology Department, Benha University, Benha, EgyptBackground: Various methods have been investigated to avoid postoperative scarring of the filtering bleb in modern glaucoma surgery. Most deal with the application of antimetabolic drugs such as mitomycin C (MMC. 2’,7’-bis-(2-carboxyethyl-5-(and-6-carboxyfluorescein, acetoxymethyl ester (BCECF-AM is a locally acting intracellular photosensitizer which could control and decrease postoperative fibrosis at the trabeculectomy site.Purpose: To compare the effect of photodynamic therapy in combination with trabeculectomy to the effect of MMC combined with the same procedure in controlling postoperative intraocular pressure (IOP in patients with medically uncontrolled primary open angle glaucoma (1ry OAG.Methods: A randomized controlled clinical trial was conducted on 76 eyes of 76 patients divided into three groups undergoing trabeculectomy, trabeculectomy with BCECF-AM (group A, trabeculectomy with MMC (group B, and trabeculectomy only as a control group (group C. Patients were reviewed postoperatively for clinical evaluation and photo documentation of the blebs with a fundus camera and ultrasonic biomicroscopy (UBM. The desirable effect of the adjunctive material was evaluated according to the clinical efficacy, tolerability, and safety by comparison with the control group.Setting: Benha University Hospital, Benha, Egypt.Results: After a mean follow-up of 24 months, all procedures succeeded in lowering IOP. The cumulative probability of complete success at the 24 month follow-up was 91% for group B, compared to 82% and 81.5% for group A and group C, respectively. The percentage of complete success was highest for group B, second highest for group A, and lowest for group C over the follow-up period; however, these differences were not statistically significant (P > 0.05. Regarding the bleb morphology and UBM reflectivity, the differences were not statistically significant (P > 0

  2. A characteristic optic disc appearance associated with myopia in subjects with Graves' ophthalmopathy and in subjects with primary open-angle glaucoma

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    Yamazaki S

    2013-01-01

    Full Text Available Sei Yamazaki,1 Rishu Inoue,2 Toshikazu Tsuboi,3 Ai Kozaki,2 Toshu Inoue,2 Toyoko Inoue,2 Yoichi Inoue21Yamazaki Eye Clinic, Shinagawa-ku, Tokyo, Japan; 2Olympia Eye Hospital, Shibuya-ku, Tokyo, Japan; 3Tsuboi Eye Clinic, Edogawa-ku, Tokyo, JapanPurpose: To determine if qualitatively defining the appearance of optic disc change was a valid characteristic of myopia in subjects with Graves' ophthalmopathy (GO or primary open-angle glaucoma (POAG.Methods: We defined typical tilt appearance as the simultaneous presence of the following: an elliptical optic disc, a crescent, unequal sharpness of the cupping margin (horizontally, and nasally displaced vessels in the optic cup. Ninety-two eyes from 92 subjects each with GO or with POAG and no severe complications were included in the study after matching for spherical refractive errors. Using our definition of tilt appearance, two independent observers subjectively judged optic disc photographs. One observer repeated judgments in 70 randomly selected eyes and judgment reproducibility was assessed using kappa statistics. Tilt ratio was used as a quantitative parameter.Results: The numbers of eyes judged as having a typical tilt appearance in the GO group and in the POAG group were 25 (27.2% and 39 (42.4%, respectively, by one observer (P = 0.0297, and 12 (13% and 44 (47.8%, respectively, by another observer (P < 0.0001. Intra- and interobserver reproducibility of tilt judgment were very good (kappa = 0.93 and good (kappa = 0.65, respectively. Tilt ratio did not significantly differ between the two groups. Analytical results including background factors were essentially the same for the two observers: multivariate logistic regression for one observer's judgment showed that the presence of the typical tilt appearance was associated with belonging to the glaucoma group (odds ratio [OR], 6.25; P = 0.0054, tilt ratio (OR per 0.01, 0.77; P < 0.0001, and spherical refractive error (OR per diopter, 0.80; P < 0

  3. Brinzolamide 1%/timolol versus dorzolamide 2%/timolol in the treatment of open-angle glaucoma or ocular hypertension: prospective randomized patient-preference study

    Directory of Open Access Journals (Sweden)

    Altafini R

    2015-12-01

    Full Text Available Romeo Altafini,1 Maria-Luise Scherzer,2 Douglas A Hubatsch,3 Paolo Frezzotti4 1Glaucoma Segment Unit, “San Bortolo” Hospital, Vicenza, Italy; 2Private Practice, Regenstauf, Germany; 3Alcon Laboratories, Inc., Fort Worth, TX, USA; 4Ophthalmic Unit, University of Siena, Siena, Italy Purpose: The objective of this study was to assess preference for fixed-combination brinzolamide 1%/timolol 0.5% (BTFC versus fixed-combination dorzolamide 2%/timolol 0.5% (DTFC in patients with open-angle glaucoma or ocular hypertension.Methods: In this prospective, single-masked crossover study, patients were randomized 1:1 to BTFC-DTFC or DTFC-BTFC treatment sequences. Patients self-administered each medication for 7 days, with a 48-hour washout period between treatments, and rated ocular discomfort after each treatment period. Medication preferences based on ocular comfort (primary endpoint and anticipated adherence were assessed. Safety outcomes included adverse events and intraocular pressure. Between-group differences in treatment preference and ocular discomfort scores were analyzed using chi-square and Wilcoxon–Mann–Whitney tests, respectively. Adherence, intraocular pressure, and adverse events were summarized descriptively.Results: In total, 112 patients were enrolled (mean ± SD age, 66±11 years, and 109 patients completed the study. Numerically, more patients in the intent-to-treat dataset preferred BTFC versus DTFC (59.3% versus 40.7%; however, this result was not statistically significant (treatment difference, 18.6%; P=0.0670. Mean ocular discomfort scores (range, 0–9 were statistically significantly lower with BTFC versus DTFC (2.6 versus 3.7; P=0.0002, Wilcoxon–Mann–Whitney test. More patients who preferred BTFC over DTFC were confident that they would adhere to their preferred medication. Treatment-related adverse events included blurred vision with BTFC and eye irritation or eye pain with DTFC.Conclusion: BTFC and DTFC were preferred

  4. Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

    OpenAIRE

    Kang, Kui Dong; Yim, Hye Bin; Biglan, Albert W.

    2006-01-01

    Purpose To investigate the causes and characteristics of glaucoma in children following cataract surgery. Methods Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in ...

  5. Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients: A Taiwanese Population-based Case-control Study.

    Science.gov (United States)

    Chen, Hsin-Yi; Hsu, Sheng-Yao; Chang, Yue-Cune; Lin, Che-Chen; Sung, Fung-Chang; Chen, Wen-Chi; Kao, Chia-Huang

    2015-11-01

    The aim of the study was to investigate the association between statin use and open-angle glaucoma (OAG) risk in hyperlipidemia patients.We used the research database of the Taiwan National Health Insurance program to conduct a population-based case-control study. A total of 1276 patients with newly diagnosed OAG were identified from 2004 to 2011. Controls comprised of 12,760 patients without glaucoma and were frequency-matched for age, sex, history of diabetes mellitus, and year of hyperlipidemia diagnosis at a 1:10 ratio. Accumulated defined daily doses (DDDs) of statins prescribed during follow-up were calculated. Average statin use was calculated as the sum of DDDs divided by the duration from the initial statin prescription date to the index date (per year), and was subdivided into 3 levels: <30, 30 to 119, and ≥120 DDDs. Comorbidity, including hypertension, depression, and the Charlson comorbidity index, the frequency of eye care visits, and the use of nonstatin cholesterol-lowering drugs, were all considered as confounding factors.For the group with statin use, the adjusted odds ratio of OAG was 1.02 (95% confidence interval 0.90-1.15) when compared with the group without statin use. Subanalysis showed that a high dosage of statin use (≥120 DDD/y) resulted in a1.24-fold increased risk of OAG (odds ratio 1.24, 95% confidence interval 1.03-1.49). The incidence of OAG was increased with the increase of the dosage of statin use (P for trend = 0.0458).Clinicians should be cautious of hyperlipidemia patients with a high dosage of statin use because it might be associated with an increased risk of OAG. Ophthalmologist consultation is necessary for this high-risk group. PMID:26559301

  6. Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Oghenowede Eyawo

    2009-07-01

    Full Text Available Oghenowede Eyawo1, Jean Nachega2,3, Pierre Lefebvre4, David Meyer5, Beth Rachlis6, Chia-Wen Lee7, Steven Kelly7, Edward Mills81Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; 2Division of Clinical Pharmacology and Medicine, University of Cape Town, Cape Town, South Africa; 3Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; 4Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; 5Department of Ophthalmology, Stellenbosch University, Cape Town, South Africa; 6Department of Public Health, University of Toronto, Toronto, Canada; 7Outcome Research and Evidence Based Medicine, Pfizer Ltd UK. Tadworth, UK; 8Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, CanadaBackground: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed.Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins.Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], –0.24 mmHg, 95% CI, –0.87 to 0.38, P = 0.45, I2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01. Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02. And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1

  7. Assessment of Open-Angle Glaucoma Peripapillary and Macular Choroidal Thickness Using Swept-Source Optical Coherence Tomography (SS-OCT.

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    Yong Ju Song

    Full Text Available To compare peripapillary and macular choroidal thickness (PCT and MCT between open-angle glaucoma (OAG and normal controls using swept-source optical coherence tomography (SS-OCT, and to evaluate global and localized relationships between choroidal thickness and various factors in OAG, also using SS-OCT.In this cross-sectional comparative study, 134 OAG patients and 73 normal controls were examined. PCT (global, 12 clock-hour sectors, MCT (global, six sectors were measured by SS-OCT. The difference in choroidal thickness between the OAG patients and the normal controls was analyzed. The relationships between choroidal thickness and various factors including age, sex, spherical equivalent (SE, axial length (AXL, central corneal thickness (CCT, intraocular pressure (IOP, peripapillary retinal nerve fiber layer thickness (pRNFLT, visual field mean deviation (MD, ganglion cell-inner plexiform layer thickness (GCIPLT, and disc area were analyzed by univariate and multivariate linear regression. Global and regional analyses were performed in 12 segments of the peripapillary circle and in six sectors of the macula.There were significant differences in global PCT and MCT between the OAG patients and the normal controls (115.22±41.17 vs. 138.89±44.70, P<0.001, (184.36±57.15 vs. 209.25±61.11, P = 0.004. The difference in global PCT remained, both after adjusting for age, AXL (117.08±3.45 vs. 135.47±4.70, P = 0.002 and also after adjusting for age, AXL, disc area (117.46±3.46 vs. 135.67±4.67, P = 0.002. But the difference in global MCT did not remain after adjusting for age, AXL, SE (188.18±4.46 vs. 202.25±6.08, P = 0.066. PCT showed significant differences between the groups in all of the 12 clock-hour sectors. These differences remained after adjusting for age, AXL and for age, AXL, disc area, with the exception of the 10 o'clock (o/c sector. MCT in six sectors showed differences between the two groups, but they did not remain after adjusting

  8. Association of ABO blood groups with glaucoma in the Pakistani population.

    NARCIS (Netherlands)

    Khan, M.I.; Micheal, S.; Akhtar, F.; Naveed, A.; Ahmed, A.; Qamar, R.

    2009-01-01

    OBJECTIVE: To study the association of blood groups with different types of glaucoma including primary open-angle glaucoma (POAG), primary closed-angle glaucoma (PCAG), and pseudoexfoliative glaucoma (PEXG) in the Pakistani population. STUDY DESIGN: The present study was a prospective case control s

  9. [Contrast sensitivity in glaucoma].

    Science.gov (United States)

    Bartos, D

    1989-05-01

    Author reports on results of the contrast sensitivity examinations using the Cambridge low-contrast lattice test supplied by Clement Clarke International LTD, in patients with open-angle glaucoma and ocular hypertension. In glaucoma patients there was observed statistically significant decrease of the contrast sensitivity. In patients with ocular hypertension decrease of the contrast sensitivity was in patients affected by corresponding changes of the visual field and of the optical disc. The main advantages of the Cambridge low-contrast lattice test were simplicity, rapidity and precision of its performance. PMID:2743444

  10. Comparison of timolol 0.5% + brimonidine 0.2% + dorzolamide 2% versus timolol 0.5% + brimonidine 0.2% in a Mexican population with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Baiza-Durán LM

    2012-07-01

    Full Text Available Leopoldo Martín Baiza-Durán, Juan Francisco Llamas-Moreno, Clotilde Ayala-BarajasClinical Research Department, Laboratorios Sophia, SA de CV Guadalajara, Jalisco, MéxicoBackground: The purpose of this study was to evaluate the efficacy and safety of two fixed combinations, ie, timolol 0.5% + brimonidine 0.2% + dorzolamide 2% (TBD versus timolol 0.5% + brimonidine 0.2% (TB in patients with primary open-angle glaucoma or ocular hypertension.Methods: We performed a 3-month, randomized, double-blind study in patients with primary open-angle glaucoma or ocular hypertension and an intraocular pressure of 21–30 mmHg. Patients were randomly assigned to receive one drop of TBD or TB twice a day. The primary efficacy endpoint was change in intraocular pressure after 3 months of treatment. Safety measures were assessed by the presence of adverse events.Results: Mean baseline intraocular pressure was similar at 8 am and 4 pm in the treatment groups (TBD 22.3 ± 0.9 mmHg, TB 22.4 ± 1.8 mmHg, P = 0.558; TBD 19.02 ± 1.3, TB 19.08 ± 1.2, P = 0.536, respectively. At the end of the study, the mean intraocular pressure was significantly lower in the TBD group at both 8 am (16.19 ± 2.0 mmHg versus 18.35 ± 1.4 mmHg, P = 0.000 and 4 pm (14.74 ± 2.4 mmHg versus 16.77 ± 1.4 mmHg, P = 0.000.Conclusion: Fixed-combination TBD was more effective than fixed-combination TB for reducing IOP in patients with primary open-angle glaucoma.Keywords: primary open-angle glaucoma, ocular hypertension, intraocular pressure, fixed combination

  11. Fixed-combination brinzolamide 1%/brimonidine 0.2% vs monotherapy with brinzolamide or brimonidine in patients with open-angle glaucoma or ocular hypertension: results of a pooled analysis of two phase 3 studies

    OpenAIRE

    Realini, T; Nguyen, Q H; Katz, G.; DuBiner, H

    2013-01-01

    Purpose To describe pooled efficacy and safety data from two phase 3 studies comparing brinzolamide 1%/brimonidine 0.2% fixed combination (BBFC) with its component medications, brinzolamide and brimonidine, in patients with open-angle glaucoma or ocular hypertension. Methods Data were pooled from two nearly identical clinical trials comparing BBFC with its component medications, each given three times daily. The 3-month efficacy outcome was mean intraocular pressure (IOP) at 0800, 1000, 1500,...

  12. Efficacy and safety of combination therapy with latanoprost after a change in therapeutic regimen from timolol to brinzolamide in Japanese adult patients with primary open-angle glaucoma and ocular hypertension: open, non-randomized 12-week study

    OpenAIRE

    Ishikawa, Shusaku

    2008-01-01

    Shusaku Ishikawa1, Yoshimi Nakamura1, Yuko Nakamura1, Hiroshi Sakai1, Shoichi Sawaguchi1, Kazuo Terashima2, Makoto Kanno2, Hidetoshi Yamashita21Department of Ophthalmology, University of the Ryukyus Faculty of Medicine, Okinawa, Japan; 2Department of Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, Yamagata, JapanPurpose: To compare the efficacy of brinzolamide in Japanese patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH) after a change fro...

  13. Mapping of the disease locus and identification of ADAMTS10 as a candidate gene in a canine model of primary open angle glaucoma.

    Directory of Open Access Journals (Sweden)

    John Kuchtey

    2011-02-01

    Full Text Available Primary open angle glaucoma (POAG is a leading cause of blindness worldwide, with elevated intraocular pressure as an important risk factor. Increased resistance to outflow of aqueous humor through the trabecular meshwork causes elevated intraocular pressure, but the specific mechanisms are unknown. In this study, we used genome-wide SNP arrays to map the disease gene in a colony of Beagle dogs with inherited POAG to within a single 4 Mb locus on canine chromosome 20. The Beagle POAG locus is syntenic to a previously mapped human quantitative trait locus for intraocular pressure on human chromosome 19. Sequence capture and next-generation sequencing of the entire canine POAG locus revealed a total of 2,692 SNPs segregating with disease. Of the disease-segregating SNPs, 54 were within exons, 8 of which result in amino acid substitutions. The strongest candidate variant causes a glycine to arginine substitution in a highly conserved region of the metalloproteinase ADAMTS10. Western blotting revealed ADAMTS10 protein is preferentially expressed in the trabecular meshwork, supporting an effect of the variant specific to aqueous humor outflow. The Gly661Arg variant in ADAMTS10 found in the POAG Beagles suggests that altered processing of extracellular matrix and/or defects in microfibril structure or function may be involved in raising intraocular pressure, offering specific biochemical targets for future research and treatment strategies.

  14. Exome Sequencing Identifies a Missense Variant in EFEMP1 Co-Segregating in a Family with Autosomal Dominant Primary Open-Angle Glaucoma.

    Directory of Open Access Journals (Sweden)

    Donna S Mackay

    Full Text Available Primary open-angle glaucoma (POAG is a clinically important and genetically heterogeneous cause of progressive vision loss as a result of retinal ganglion cell death. Here we have utilized trio-based, whole-exome sequencing to identify the genetic defect underlying an autosomal dominant form of adult-onset POAG segregating in an African-American family. Exome sequencing identified a novel missense variant (c.418C>T, p.Arg140Trp in exon-5 of the gene coding for epidermal growth factor (EGF containing fibulin-like extracellular matrix protein 1 (EFEMP1 that co-segregated with disease in the family. Linkage and haplotype analyses with microsatellite markers indicated that the disease interval overlapped a known POAG locus (GLC1H on chromosome 2p. The p.Arg140Trp substitution was predicted in silico to have damaging effects on protein function and transient expression studies in cultured cells revealed that the Trp140-mutant protein exhibited increased intracellular accumulation compared with wild-type EFEMP1. In situ hybridization of the mouse eye with oligonucleotide probes detected the highest levels of EFEMP1 transcripts in the ciliary body, cornea, inner nuclear layer of the retina, and the optic nerve head. The recent finding that a common variant near EFEMP1 was associated with optic nerve-head morphology supports the possibility that the EFEMP1 variant identified in this POAG family may be pathogenic.

  15. Global variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis.

    Science.gov (United States)

    Kapetanakis, Venediktos V; Chan, Michelle P Y; Foster, Paul J; Cook, Derek G; Owen, Christopher G; Rudnicka, Alicja R

    2016-01-01

    Systematic review of published population based surveys to examine the relationship between primary open angle glaucoma (POAG) prevalence and demographic factors. A literature search identified population-based studies with quantitative estimates of POAG prevalence (to October 2014). Multilevel binomial logistic regression of log-odds of POAG was used to examine the effect of age and gender among populations of different geographical and ethnic origins, adjusting for study design factors. Eighty-one studies were included (37 countries, 216 214 participants, 5266 POAG cases). Black populations showed highest POAG prevalence, with 5.2% (95% credible interval (CrI) 3.7%, 7.2%) at 60 years, rising to 12.2% (95% CrI 8.9% to 16.6%) at 80 years. Increase in POAG prevalence per decade of age was greatest among Hispanics (2.31, 95% CrI 2.12, 2.52) and White populations (1.99, 95% CrI 1.86, 2.12), and lowest in East and South Asians (1.48, 95% CrI 1.39, 1.57; 1.56, 95% CrI 1.31, 1.88, respectively). Men were more likely to have POAG than women (1.30, 95% CrI 1.22, 1.41). Older studies had lower POAG prevalence, which was related to the inclusion of intraocular pressure in the glaucoma definition. Studies with visual field data on all participants had a higher POAG prevalence than those with visual field data on a subset. Globally 57.5 million people (95% CI 46.4 to 73.1 million) were affected by POAG in 2015, rising to 65.5 million (95% CrI 52.8, 83.2 million) by 2020. This systematic review provides the most precise estimates of POAG prevalence and shows omitting routine visual field assessment in population surveys may have affected case ascertainment. Our findings will be useful to future studies and healthcare planning. PMID:26286821

  16. Association Between Baseline Iris Thickness and Prophylactic Laser Peripheral Iridotomy Outcomes in Primary Angle Closure Suspects

    Science.gov (United States)

    Lee, Roland Y.; Kasuga, Toshimitsu; Cui, Qi N.; Porco, Travis C.; Huang, Guofu; He, Mingguang; Lin, Shan C.

    2014-01-01

    Objective To evaluate the association between baseline measurements of iris thickness at three positions and change in anterior segment biometric parameters after prophylactic laser peripheral iridotomy (LPI). Design Prospective clinical cohort study. Participants Fifty-two eyes of 52 nonglaucomatous subjects with anatomically narrow angles. Methods Anterior segment optical coherence tomography images captured before and after LPI were analyzed using customized software, the Zhongshan Angle Assessment Program. Differences in preoperative and postoperative measurements for anterior segment biometric parameters were compared by paired Student’s t-tests. Multivariate linear regression models, adjusted for age, sex, ethnicity, and preoperative pupil diameter, were used to examine the association between the baseline measurements of iris thickness at three positions and the change in anterior segment biometric parameters after LPI. Main Outcome Measures Baseline iris thickness measured at 750μm (IT750) and 2000μm (IT2000) from the scleral spur and maximal iris thickness (ITM). Changes in iris curvature (ICURV) and trabecular–iris space area at 500μm (TISA500) and 750μm (TISA750) from the scleral spur after LPI. Results ICURV significantly decreased, while TISA500 and TISA750 significantly increased following LPI (all PTISA500 and TISA750 (both PTISA500 and TISA750 after LPI. This suggests that eyes with thinner irides undergoing LPI were more likely to exhibit greater magnitude of change in terms of flattening of the iris convexity (i.e., ICURV) and widening of the anterior chamber angle (i.e., TISA500 and TISA750). PMID:24534754

  17. Pediatric glaucoma: current perspectives

    Directory of Open Access Journals (Sweden)

    Marchini G

    2014-05-01

    Full Text Available Giorgio Marchini, Marco Toscani, Francesca Chemello Eye Clinic, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy Abstract: “Childhood glaucoma” is a heterogeneous group of severe pediatric conditions often associated with significant visual loss and characterized by elevated intraocular pressure (IOP and optic-disk cupping. Successful IOP control is crucial but challenging and most often achieved surgically, with medical therapy playing a supportive role. There are many classifications of childhood glaucoma, but they can simply be divided into primary, in which a developmental abnormality of the anterior chamber angle only exists, and secondary, in which aqueous outflow is reduced due to independent mechanisms that secondarily impair the function of the filtration angle. The worldwide prevalence of childhood blindness ranges from 0.03% in high-income countries to 0.12% in undeveloped countries. The majority of cases do not have an identified genetic mutation and, where the mutation is known, the genes often account for only a small proportion of cases. Several pathogenetic mechanisms are known to contribute to the development of childhood glaucoma. Whatever the cause, it results in a reduced aqueous outflow at the level of the trabecular meshwork. Age of onset and magnitude of the elevated IOP largely determine the clinical manifestation the high variability of clinical manifestations. Glaucoma from any cause in a neonate and infant is characterized by the classic triad of epiphora, photophobia, and blepharospasm, and could be associated with eye enlargement (buphthalmos and Haab striae. The eye examination, usually performed under general anesthesia, includes: tonometry, anterior-segment examination, gonioscopy, corneal diameter and axial length measurement, dilated fundoscopy with optic-nerve-head evaluation. Medical therapy, considering the high frequency of side effects, is generally used as

  18. Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

    OpenAIRE

    Aung, Tin

    2015-01-01

    Sourabh Sharma,1 Sameer Trikha,1 Shamira A Perera,1 Tin Aung1,2 1Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, 2Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination t...

  19. Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

    OpenAIRE

    Sharma S; Trikha S; Perera SA; Aung T

    2015-01-01

    Sourabh Sharma,1 Sameer Trikha,1 Shamira A Perera,1 Tin Aung1,2 1Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, 2Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination t...

  20. Safety and efficacy of fixed-combination travoprost/timolol in patients with open-angle glaucoma or ocular hypertension not controlled with timolol monotherapy

    Directory of Open Access Journals (Sweden)

    Jordão MLS

    2014-08-01

    Full Text Available Marcelo Lopes da Silva Jordão,1 Marcelo Hatanaka,2 Abayomi Ogundele,3 Maria Rosa Bet de Moraes Silva,4 Roberto Murad Vessani5 1Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil; 2University of São Paulo School of Medicine, São Paulo, Brazil; 3Global Medical Affairs, Alcon Laboratories, Inc., Fort Worth, TX, USA; 4Faculty of Medicine of Botucatu, Universidade Estadual Paulista (UNESP, São Paulo, Brazil; 5General Hospital of Itapecerica da Serra, Serviço Social da Construção Civil do Estado de São Paulo (SECONCI-SP São Paulo, Brazil Objective: To assess the intraocular pressure (IOP-lowering effect of travoprost 0.004%/timolol 0.5% fixed-dose combination (TRAV/TIM–FC in patients not achieving the target IOP of ≤18 mmHg while on timolol 0.5% (TIM monotherapy. Methods: A multicenter, prospective, open-label study (NCT01336569 was conducted in patients with open-angle glaucoma or ocular hypertension. Eligible patients were receiving TIM monotherapy with a screening/baseline IOP of 19–35 mmHg in ≥1 eye. TIM was discontinued on the baseline visit day (no washout period and TRAV/TIM–FC was initiated and administered once daily at 8 pm for 4–6 weeks. The primary efficacy variable was mean change in IOP from TIM-treated baseline to study end, measured by Goldmann applanation tonometry. Results were analyzed by analysis of variance and paired samples t-test (5% significance. Results: A total of 49 patients were enrolled (mean age, 63 [range, 42–82] years; 55.1% White; 73.5% women, and 45 were included in the intent-to-treat (ITT population. Mean duration of treatment with TRAV/TIM–FC was 31 days. Mean ± standard deviation IOP reduction from baseline (TIM to the follow-up visit (TRAV/TIM–FC was -5.0±3.6 mmHg. IOP decreased significantly (P<0.0001 from baseline (22.1±2.6 mmHg to study end (17.1±3.9 mmHg in the ITT population, with a mean IOP reduction of 22.3%. Most patients (n=33/45; 73

  1. Effects of brinzolamide vs timolol as an adjunctive medication to latanoprost on circadian intraocular pressure control in primary open-angle glaucoma Japanese patients

    Directory of Open Access Journals (Sweden)

    Makoto Ishikawa

    2009-09-01

    Full Text Available Makoto Ishikawa1,2, Takeshi Yoshitomi11Department of Ophthalmology, Akita University Faculty of Medicine, Akita, Japan; 2Department of Ophthalmology, Ogachi Central Hospital, Akita, JapanPurpose: To study the effect of the concomitant use of brinzolamide and latanoprost on the 24-hour variation in intraocular pressure (IOP in primary open-angle glaucoma (POAG patients first treated with timolol and latanoprost.Methods: We studied 30 eyes from 30 POAG patients previously treated with latanoprost monotherapy. After a washout of four weeks in both eyes, all patients were treated with 0.5% timolol and latanoprost. Three months after the initiation of treatment with timolol and latanoprost, the 24-hour IOP variation was measured. Thereafter, all patients were treated with concomitant 1% brinzolamide and latanoprost. Three months after changing the therapeutic regimen, the 24-hour IOP variation was measured a second time. Latanoprost was administered once a day, and timolol and brinzolamide were twice a day. IOP was measured with a noncontact tomometer.Results: On treatment with brinzolamide and latanoprost, a significant decrease in IOP compared to timolol and latanoprost was observed at all time points except at 3 PM and 6 PM. As a group, the patients had a significantly lower diurnal mean IOP and nocturnal mean IOP during treatment with brinzolamide and latanoprost than with timolol and latanoprost.Conclusions: Treatment of POAG with a combination of brinzolamide and latanoprost demonstrated improved hypotensive effects compared with timolol and latanoprost during a 24-hour period.Keywords: circadian intraocular pressure, adverse effects, timolol, brinzolamide

  2. Glaucoma medications.

    Science.gov (United States)

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi

    2013-01-01

    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates. PMID:23505792

  3. Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

    Directory of Open Access Journals (Sweden)

    Nabanita Barua

    2016-01-01

    Full Text Available Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD optical coherence tomography (OCT among primary open angle glaucoma (POAG and ocular hypertension (OHT versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group. After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson′s coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P 0.5 when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715. Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable.

  4. Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

    Science.gov (United States)

    Barua, Nabanita; Sitaraman, Chitra; Goel, Sonu; Chakraborti, Chandana; Mukherjee, Sonai; Parashar, Hemandra

    2016-01-01

    Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL) in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD) optical coherence tomography (OCT) among primary open angle glaucoma (POAG) and ocular hypertension (OHT) versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group). After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC) parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson's coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P 0.5) when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715). Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable. PMID:27221682

  5. A patient preference comparison of Azarga™ (brinzolamide/timolol fixed combination vs Cosopt® (dorzolamide/timolol fixed combination in patients with open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Thomas K Mundorf

    2008-10-01

    Full Text Available Thomas K Mundorf1, Steven H Rauchman2, Robert D Williams3, Ricardo Notivol4, Brinzolamide/Timolol Preference Study Group51Mundorf Eye Center, Charlotte, NC, USA; 2North Valley Eye Medical Group, Mission Hills, CA, USA; 3Taustine Eye Center, Louisville, KY, USA; 4Alcon, Barcelona, Spain; 5Ophthalmology Clinics, USAPurpose: To determine patient preference of and ocular discomfort with fixed combination brinzolamide/timolol compared with fixed combination dorzolamide/timolol.Methods: In a prospective, double-masked, randomized, active-controlled, crossover, multicenter study, patients received 1 drop of brinzolamide/timolol and dorzolamide/timolol in both eyes on consecutive days in random order. Ocular discomfort was rated 1 minute after instillation of each medication, and preference was noted on Day 2. Adverse events, if any, were solicited at each visit.Results: 127 subjects with ocular hypertension or open-angle glaucoma were included in the intent-to-treat analysis. Of the 106 subjects who expressed a drug preference, 79.2% preferred brinzolamide/timolol (p < 0.0001. Ocular discomfort scores were significantly higher with dorzolamide/timolol than brinzolamide/timolol (2.9 vs 1.4, respectively; p < 0.0001. Significantly more patients reported ocular pain and discomfort after dorzolamide/timolol instillation and transient blurred vision after brinzolamide/timolol instillation.Conclusions: Patients with ocular hypertension or open-angle glaucoma preferred the brinzolamide/timolol fixed combination over the dorzolamide/timolol fixed combination. This is likely due to the greater ocular discomfort associated with dorzolamide/timolol. The differences in preference, discomfort, and adverse events are likely attributable to formulation differences given the similarities of the active ingredients. Stronger patient preference for brinzolamide/timolol may lead to better therapeutic compliance.Keywords: brinzolamide/timolol, dorzolamide

  6. A Joint Model for Prognostic Effect of Biomarker Variability on Outcomes: long-term intraocular pressure (IOP) fluctuation on the risk of developing primary open-angle glaucoma (POAG)

    OpenAIRE

    Gao, Feng; Miller, J Philip; Miglior, Stefano; Beiser, Julia A.; Torri, Valter; Kass, Michael A; Gordon, Mae O.

    2011-01-01

    Primary open-angle glaucoma (POAG) is among the leading causes of blindness in the United States and worldwide. While numerous prospective clinical trials have convincingly shown that elevated intraocular pressure (IOP) is a leading risk factor for the development of POAG, an increasingly debated issue in recent years is the effect of IOP fluctuation on the risk of developing POAG. In many applications, this question is addressed via a “naïve” two-step approach where some sample-based estimat...

  7. Efficacy and safety of combination therapy with latanoprost after a change in therapeutic regimen from timolol to brinzolamide in Japanese adult patients with primary open-angle glaucoma and ocular hypertension: open, non-randomized 12-week study

    OpenAIRE

    Ishikawa, Shusaku; Nakamura, Yoshimi; Nakamura, Yuko; Sakai, Hiroshi; Sawaguchi, Shoichi; Terashima, Kazuo; Kanno, Makoto; Yamashita, Hidetoshi

    2008-01-01

    Purpose To compare the efficacy of brinzolamide in Japanese patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH) after a change from timolol in combination therapy with latanoprost. Methods A 12-week, prospective, open-label, comparative study was performed in 20 patients [11 males and 9 females, mean age of 64.5 ± 11.0 (SD)y] with POAG or OH treated with both latanoprost once daily and timolol 0.5% twice daily. During the study brinzolamide was substituted for timolol...

  8. Two Independent Mutations in ADAMTS17 Are Associated with Primary Open Angle Glaucoma in the Basset Hound and Basset Fauve de Bretagne Breeds of Dog

    Science.gov (United States)

    Oliver, James A. C.; Forman, Oliver P.; Pettitt, Louise; Mellersh, Cathryn S.

    2015-01-01

    Purpose Mutations in ADAMTS10 (CFA20) have previously been associated with primary open angle glaucoma (POAG) in the Beagle and Norwegian Elkhound. The closely related gene, ADAMTS17, has also been associated with several different ocular phenotypes in multiple breeds of dog, including primary lens luxation and POAG. We investigated ADAMTS17 as a candidate gene for POAG in the Basset Hound and Basset Fauve de Bretagne dog breeds. Methods We performed ADAMTS17 exon resequencing in three Basset Hounds and three Basset Fauve de Bretagne dogs with POAG. Identified variants were genotyped in additional sample cohorts of both breeds and dogs of other breeds to confirm their association with disease. Results All affected Basset Hounds were homozygous for a 19 bp deletion in exon 2 that alters the reading frame and is predicted to lead to a truncated protein. Fifty clinically unaffected Basset Hounds were genotyped for this mutation and all were either heterozygous or homozygous for the wild type allele. Genotyping of 223 Basset Hounds recruited for a different study revealed a mutation frequency of 0.081 and predicted frequency of affected dogs in the population to be 0.007. Based on the entire genotyping dataset the association statistic for the POAG-associated deletion was p = 1.26 x 10−10. All affected Basset Fauve de Bretagne dogs were homozygous for a missense mutation in exon 11 causing a glycine to serine amino acid substitution (G519S) in the disintegrin-like domain of ADAMTS17 which is predicted to alter protein function. Unaffected Basset Fauve de Bretagne dogs were either heterozygous for the mutation (5/24) or homozygous for the wild type allele (19/24). Based on the entire genotyping dataset the association statistic for the POAG-associated deletion was p = 2.80 x 10−7. Genotyping of 85 dogs of unrelated breeds and 90 dogs of related breeds for this variant was negative. Conclusion This report documents strong associations between two independent ADAMTS17

  9. Retinal nerve fiber layer in primary open-angle glaucoma with high myopia determined by optical coherence tomography and scanning laser polarimetry

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-en; WANG Xiao-yu; GU Yang-shun; HUANG Zhu

    2013-01-01

    Background Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG).This study aim to determine the characteristics of RNFL thickness changes in patients with both POAG and HM and compare these to changes in patients with only HM.The diagnostic capabilities of both OCT and GDxVCC in this subset of patients are also evaluated.Methods Twenty-two eyes with POAG and HM (spherical equivalent (SE) between-6.0 and-12.0 D) were evaluated,and 22 eyes with HM were used for comparison.Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC),and the diagnostic capabilities of these imaging modalities were compared.RNFL parameters evaluated included superior average (Savg-GDx),inferior average (lavg-GDx),temporal-superior-nasal-inferior-temporal (TSNIT) average,and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT),inferior average (lavg-OCT),nasal average (Navg-OCT),temporal average (Tavg-OCT),and average thickness (AvgThick-OCT) on OCT (fast RNFL scan).Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD).Results The RNFL parameters (P <0.05) significantly different between groups included Savg-GDx,lavg-GDx,TSNIT average,NFI,Savg-OCT,lavg-OCT,Tavg-OCT,and AvgThick-OCT.Significant correlations existed between TSNIT average and AvgThick-OCT (r=0.778),TSNIT average and MD (r=0.749),AvgThick-OCT and MD (r=0.647),TSNIT average and PSD (r=-0.756),and AvgThick-OCT and PSD (r=-0.784).The area under the receiver operating characteristic curve (AUROC) values of TSNIT average,Savg-GDx,lavg-GDx,NFI,Savg-OCT,lavg-OCT,Navg-OCT,Tavg-OCT,and AvgThick-OCT were 0.947,0.962,0.973,0.994,0.909,0.917,0.511,0.906,and 0.913,respectively.The NFI AUROC was the highest value.Conclusions RNFL

  10. Comparison of the efficacy and safety of fixed combination travoprost/timolol and dorzolamide/timolol in patients with primary open-angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Babić Nikola

    2013-01-01

    Full Text Available Introduction. Combining two medications in one bottle may improve compliance by reducing the time required to administer drops and the frequency of the total number of medication bottles. Objective. To compare the efficacy of reduced intraocular pressure (IOP and safety of fixed combination travoprost 0.004%/timolol 0.5% vs. fixed combination dorzolamide 2%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension. Methods. Prospective randomized clinical study included 60 patients divided into 2 groups. Follow-up was done at day 14 and 45 and month 3. IOP measurements were taken at each follow-up examination at 8 am, 10 am and 4 pm. Results. Both fixed combinations reduced IOP significantly compared to initial values at all follow-ups (p<0.001. Mean pooled IOP at all visits and time points was slightly lower in the travoprost/timolol group compared with the dorzolamide/timolol group (16.13 mmHg vs. 16.15 mmHg. Mean IOP reduction from baseline ranged from -7.46 mmHg to -9.92 mmHg in the travoprost/timolol group and from -6.93 mmHg to -8.93 mmHg for the dorzolamide/timolol group. Mean (±standard error of the mean reduction in diurnal IOP from baseline to 3rd month was 8.96±2.79 in the travoprost/timolol group versus 8.07±2.91 in patients receiving dorzolamide/timolol fixed combination (p=0.196. The most frequent treatment-related adverse events were conjunctival hyperemia in the travoprost/timolol group, and dry eye and foreign body sensation in the dorzolamide/timolol group. Conclusion. Travoprost/timolol fixed combination was slightly more effective than dorzolamide/timolol fixed combination in reducing mean diurnal IOP. Travoprost/timolol group resulted in an IOP reduction for up to 1.07 mmHg higher than dorzolamide/timolol group. Both fixed combinations were well tolerated and safe.

  11. Preference for a fixed combination of brinzolamide/timolol versus dorzolamide/ timolol among patients with open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Sanseau A

    2013-02-01

    Full Text Available Ana Sanseau,1 Juan Sampaolesi,2 Emilio Rintaro Suzuki Jr,3 Joao Franca Lopes,4 Hector Borel51Instituto de la Visión, Ciudad de Buenos Aires, Argentina; 2Consultorio Oftalmologico Sampaolesi, Ciudad de Buenos Aires, Argentina; 3Oftalmoclinica Curitiba, Curitiba, Brazil; 4Hospital El Salvador, Providencia, Chile; 5Fundacion Oftalmologica Los Andes, Vitacura Santiago, ChileObjective: To assess ocular discomfort upon instillation and patient preference for brinzolamide/timolol relative to dorzolamide/timolol, in patients with open-angle glaucoma or ocular hypertension.Methods: This was a multicenter, prospective, patient-masked, randomized, crossover study. On day 0, patients received one drop of brinzolamide/timolol in one eye and one drop of dorzolamide/timolol in the contralateral eye. On day 1, patients were randomly assigned to receive one drop of either brinzolamide/timolol or dorzolamide/timolol in both eyes; on day 2, patients received one drop of the alternate treatment in both eyes. Measures included a patient preference question on day 2 (primary and mean ocular discomfort scale scores on days 1 and 2 (secondary. Safety assessments included adverse events, visual acuity, and slit-lamp examinations.Results: Of 120 patients who enrolled, 115 completed the study. Of these, 112 patients instilled both medications and expressed a study medication preference on day 2. A significantly greater percentage preferred brinzolamide/timolol to dorzolamide/timolol (67.0% versus 30.4%; P < 0.001. The ocular discomfort (expressed as mean [standard deviation] with brinzolamide/timolol was significantly lower than with dorzolamide/timolol (day 2: 1.9 [2.3] versus 3.7 [2.8], respectively [P = 0.0003]; both days combined: 2.1 [2.5] versus 3.5 [2.9], respectively [P = 0.00014]. On day 1, five patients receiving brinzolamide/timolol reported five nonserious adverse events (AEs: flu (n = 1, bitter taste (n = 2, and headache (n = 2. Four events, bitter taste

  12. Changes in choroidal thickness after prophylactic iridectomy in primary angle closure suspect eyes using enhanced depth imaging optical coherence tomography

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    Wei Wang

    2015-01-01

    Full Text Available Purpose: The aim of the present study was to evaluate the effect of surgical peripheral iridectomy (SPI on choroidal thickness in primary angle-closure suspect (PACS eyes. Materials and Methods: This was a prospective observational case series of 30 subjects with PACS. Ocular biometry was performed before SPI (baseline and then 1 week later. Choroid was imaged by enhanced depth imaging optical coherence tomography (EDI-OCT. The choroidal thickness of the subfoveal area at 1 and 3 mm diameter around the fovea was determined. Central anterior chamber depth (ACD, lens thickness (LT, vitreous chamber depth (VCD, and axial length (AL were measured by A-scan ultrasound. Parameters were compared before SPI (baseline and 1 week later. Results: Thirty eyes of 30 patients with mean age of 61.53 ± 7.98 years were studied. There was no significant difference in the choroidal thickness at all macular locations before and after SPI (all P > 0.05. Mean subfoveal choroidal thickness was 279.61 μm ± 65.50 μm before and 274.54 μm ± 63.36 μm after SPI (P = 0.308. There was also no significant change in central ACD, LT, VCD, and LT after SPI (all P > 0.05. Conclusions: SPI does not appear to alter choroidal thickness in PACS eyes, as assessed using EDI-OCT. Long-term follow-up of PACS eyes treated with SPI may provide further insight into the effects of this treatment modality on the choroid.

  13. Animal models of glucocorticoid-induced glaucoma.

    Science.gov (United States)

    Overby, Darryl R; Clark, Abbot F

    2015-12-01

    Glucocorticoid (GC) therapy is widely used to treat a variety of inflammatory diseases and conditions. While unmatched in their anti-inflammatory and immunosuppressive activities, GC therapy is often associated with the significant ocular side effect of GC-induced ocular hypertension (OHT) and iatrogenic open-angle glaucoma. Investigators have generated GC-induced OHT and glaucoma in at least 8 different species besides man. These models mimic many features of this condition in man and provide morphologic and molecular insights into the pathogenesis of GC-OHT. In addition, there are many clinical, morphological, and molecular similarities between GC-induced glaucoma and primary open-angle glaucoma (POAG), making animals models of GC-induced OHT and glaucoma attractive models in which to study specific aspects of POAG. PMID:26051991

  14. Glaucoma and Diabetic Retinopathy in patients with diabetes mellitus type 2. Review.

    OpenAIRE

    Vorobyeva, I. V.; E. V. Shherbakova

    2014-01-01

    Glaucoma and diabetic retinopathy (DR) are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics ...

  15. Efeitos da leitura, exercício e exercício sob leitura na pressão intra-ocular de portadores de glaucoma primário de ângulo aberto ou hipertensão ocular controlados clinicamente com medicação tópica Effects of reading, exercise and exercise combined with reading on intraocular pressure for patients sustaining primary glaucoma (open angle or ocular hypertension, both clinically controlled with topic medication

    Directory of Open Access Journals (Sweden)

    Alice Maria Corrêa Medina

    2007-02-01

    Full Text Available OBJETIVO: Verificar a pressão intra-ocular (Po em indivíduos usuários de análogos de prostaglandina, prostamida ou beta-bloqueador em portadores de glaucoma primário de ângulo aberto ou hipertensão ocular após leitura, exercício e exercício sob leitura. MÉTODOS: Quarenta indivíduos (79 olhos, subdivididos em 5 grupos: G1 (portadores de hipertensão arterial e glaucoma ou hipertensão ocular usando análogos de prostaglandinas ou prostamidas; G2 (portadores de hipertensão arterial e glaucoma ou hipertensão ocular usando beta-bloqueador; G3 (indivíduos sem hipertensão arterial e portadores de glaucoma ou hipertensão ocular em uso de análogos de prostaglandinas ou prostamidas; G4 (indivíduos sem hipertensão arterial e portadores de glaucoma ou hipertensão ocular em uso de beta-bloqueador e G5 (indivíduos sem hipertensão arterial e sem glaucoma ou hipertensão ocular, tiveram a pressão intra-ocular verificada antes e após realizarem leitura, exercício e exercício sob leitura. Cada teste foi realizado em dia distinto e sempre no período vespertino. RESULTADOS: Não houve diferença estatisticamente significante na média da pressão intra-ocular inicial e final nos diferentes grupos do estudo quando submetidos à leitura, exercício e exercício sob leitura. CONCLUSÃO: Ler e fazer exercícios individualmente ou concomitantemente, não representa fator de agravo da pressão intra-ocular em portadores de glaucoma primário de ângulo aberto ou hipertensão ocular em usuários de análogos de prostaglandinas ou prostamidas ou beta-bloqueador.PURPOSE: To check intraocular pressure (IOP in individuals using prostaglandin, prostamide or beta-blocker analogues, who sustain either primary open angle glaucoma or ocular hypertension after reading, exercise or exercise combined with reading. METHODS: 40 individuals (79 eyes, subdivided in to five groups: G1 (with arterial hypertension and either glaucoma or ocular hypertension, all

  16. African Americans and Glaucoma

    Science.gov (United States)

    ... Involved News About Us Donate In This Section African Americans and Glaucoma email Send this article to ... glaucoma is the leading cause of blindness in African Americans. Half of those with glaucoma don't ...

  17. Get Tested for Glaucoma!

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Get Tested for Glaucoma! Past Issues / Fall 2009 Table of Contents Taylor ... aoa.org/ When were you finally diagnosed with glaucoma? Not until 1969, after a game of basketball. ...

  18. Comparing the efficacy of the monocular trial treatment paradigm with multiple measurements of intraocular pressure before and after treatment initiation in primary open-angle glaucoma

    OpenAIRE

    Koulen, Peter

    2012-01-01

    Rohit Krishna, Peter W DeBry, Corey W Waldman, Peter KoulenVision Research Center, Department of Ophthalmology, University of Missouri-Kansas City School of Medicine, MO, USAAbstract: The monocular trial has been proposed as a test to help control for diurnal fluctuations in eye pressure when assessing medication effectiveness. We undertook a prospective study to determine the sensitivity and specificity of the monocular trial as a test for determining the effectiveness of a glaucoma medicati...

  19. Brinzolamide 1%/timolol versus dorzolamide 2%/timolol in the treatment of open-angle glaucoma or ocular hypertension: prospective randomized patient-preference study

    OpenAIRE

    Altafini R; Scherzer ML; Hubatsch DA; Frezzotti P

    2015-01-01

    Romeo Altafini,1 Maria-Luise Scherzer,2 Douglas A Hubatsch,3 Paolo Frezzotti4 1Glaucoma Segment Unit, “San Bortolo” Hospital, Vicenza, Italy; 2Private Practice, Regenstauf, Germany; 3Alcon Laboratories, Inc., Fort Worth, TX, USA; 4Ophthalmic Unit, University of Siena, Siena, Italy Purpose: The objective of this study was to assess preference for fixed-combination brinzolamide 1%/timolol 0.5% (BTFC) versus fixed-combination dorzolamide 2%/timolol 0.5% (DTFC) in patients w...

  20. Traumatic glaucoma with features of unilateral pigment dispersion.

    Science.gov (United States)

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

    We report a patient with traumatic glaucoma with features of unilateral pigment dispersion. This rare form of secondary glaucoma has only been reported twice previously, with both patients demonstrating angle recession, indicating associated damage to the trabecular meshwork. To our knowledge, this is the first such case reported in which angle recession was absent. PMID:25097455

  1. Chinical Analysis of Steroid Glaucoma

    Institute of Scientific and Technical Information of China (English)

    LingxunKong; ChengZhang

    1995-01-01

    Purpose:The authors accumulated 15cases(26eyes)of steroid glaucoma due to topical administration of dexamethasone or prednisolone.Methods:From1970to 1990,26eyesin 15cases were observed(Bilateral11cas-es,unilateral4cases)including 12right eyes and 14left eyes.10cases were male and 5cases female with age ranging from14to52years averaging 28years.25eyes had the manifestation of chronic open angle glaucoma in the clinical coures,and 1eye simulated an acute glaucoma attack.Results:All patents had taken antiglaucoma medication before coming to our ohs-pital,but theIOPwas over6.7kPa in9eyes.TheC/Dration was equal to or over0.6in 9cases(16eyes).and the values were inconsistent between both eyes in 55%of the patients.Treatment for glaucoma was immediate discontinuation of the steroids with antiglaucoma medication if necessary.Three eyes received filter-ing operations and 2eyes had the removal of subconjunctival residual steroid.Normal IOPwas restored in monyths up to a year.Conclusion:Dexamethasone of prednisolone were the easiest to induce steroid glaucoma when the patients had long0term use of steroid eyedrops.

  2. Efficacy and safety of combination therapy with latanoprost after a change in therapeutic regimen from timolol to brinzolamide in Japanese adult patients with primary open-angle glaucoma and ocular hypertension: open, non-randomized 12-week study

    Directory of Open Access Journals (Sweden)

    Shusaku Ishikawa

    2008-09-01

    Full Text Available Shusaku Ishikawa1, Yoshimi Nakamura1, Yuko Nakamura1, Hiroshi Sakai1, Shoichi Sawaguchi1, Kazuo Terashima2, Makoto Kanno2, Hidetoshi Yamashita21Department of Ophthalmology, University of the Ryukyus Faculty of Medicine, Okinawa, Japan; 2Department of Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, Yamagata, JapanPurpose: To compare the efficacy of brinzolamide in Japanese patients with primary open-angle glaucoma (POAG or ocular hypertension (OH after a change from timolol in combination therapy with latanoprost.Methods: A 12-week, prospective, open-label, comparative study was performed in 20 patients [11 males and 9 females, mean age of 64.5 ± 11.0 (SDy] with POAG or OH treated with both latanoprost once daily and timolol 0.5% twice daily. During the study brinzolamide was substituted for timolol. Intraocular pressure (IOP was measured at baseline, 4, 8, and 12 weeks. Blood pressure (BP, pulse rate (PR, and adverse events were also recorded.Results: IOPs at baseline, 4, 8, and 12 weeks were 18.6 ± 2.1 mmHg, 17.8 ± 2.6 mmHg, 17.4 ± 2.5 mmHg, and 17.3 ± 3.5 mmHg, respectively. IOP reduction at 4 and 8 weeks was statistically significant (p < 0.05. The PR was significantly increased at 12 weeks (p < 0.01, but BP was not significantly affected. Four ocular adverse events were noted, but all were mild and transient.Conclusions: Substituting brinzolamide 1% for timolol 0.5% in combination therapy with latanoprost 0.005% demonstrated significant IOP reduction with improvement in PR with POAG or OH. Combination therapy using latanoprost and brinzolamide may be recommended for better IOP control with fewer systemic adverse events.Keywords: open-angle glaucoma, brinzolamide/latanprost combination therapy, timolol/latanoprost combination therapy, intraocular pressure

  3. The pedigree of a patient with juvenile glaucoma

    OpenAIRE

    DİLSİZ, Dr. Serdal ÇELEBİ Dr. Orhan AYDEMİR : D

    1999-01-01

    Purpose: The pedigree of nine year old patient diagnosed with juvenile glaucoma has been evaluated. Materials and Methods: The pedigree of seven members (close relatives of proband's from three generations) was investigated and then clinical examinations were performed. Their blood samp/es were analysed for chromosomes. Resu/ts: From this pedigree, it was found that, two cases had juvenile glaucoma, two cases had primary open angle glaucoma and two cases were suspected to have...

  4. Vascular Considerations in Glaucoma Patients of African and European Descent

    OpenAIRE

    Huck, Andrew; Harris, Alon; Siesky, Brent; Kim, Nathaniel; Muchnik, Michael; Kanakamedala, Priyanka; Amireskandari, Annahita; Tobe, Leslie Abrams

    2014-01-01

    Glaucoma is the leading cause of blindness in individuals of African descent (AD). While open angle glaucoma (OAG) disproportionately affects individuals of AD compared to persons of European descent (ED); the physiological mechanisms behind this disparity are largely unknown. The more rapid progression and greater severity of the disease in persons of AD further raises the concern for identifying these underlying differences in disease pathophysiology between AD and ED glaucoma patients. Ocu...

  5. Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

    Directory of Open Access Journals (Sweden)

    Yoshino Hideaki

    2012-03-01

    Full Text Available Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block. Conclusion This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.

  6. A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Bozzani Fiammetta Maria

    2012-08-01

    Full Text Available Abstract Background Economic viability of treatments for primary open-angle glaucoma (POAG should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified. Methods A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25 were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods. Results Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08 whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively. The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001; most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D. Conclusions The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages.

  7. The Prevalence of Glaucoma in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Heydar Amini

    2008-11-01

    Full Text Available

    PURPOSE: To determine the prevalence of glaucoma in adults 40 years of age or older in Tehran, Iran. METHODS: This stratified random-sampling cross-sectional population survey was performed on residents of Tehran, the capital of Iran, aged 40 years and older in the year 2001. Refraction, best-corrected visual acuity, slitlamp biomicroscopy, Goldmann applanation tonometry, funduscopy, and gonioscopy were performed in all subjects. Automated perimetry was performed in selected cases. RESULTS: Out of 4418 sampled subjects, 2184 individuals (49.4% participated in the survey. Eventually data from 2160 individuals including 814 (38% male and 1346 (62% female subjects with mean age of 55.1±10.2 (range 40-92 years were analyzed. The overall prevalence of glaucoma was 1.44% (95% confidence interval, 0.94-1.94 including primary open angle glaucoma 0.46%, chronic angle closure glaucoma 0.33%, normal tension glaucoma 0.28%, pseudoexfoliation glaucoma 0.23%, and other types of glaucoma 0.14%. More than 80% of affected subjects were unaware of their condition. CONCLUSION: The prevalence of glaucoma in adults 40 years of age or older in Tehran is 1.44%, which is in the lower range

  8. Localised wedge shaped defects of the retinal nerve fibre layer in glaucoma.

    OpenAIRE

    Jonas, J. B.; Schiro, D

    1994-01-01

    Glaucoma can be associated with a diffuse or localised loss of the retinal nerve fibre layer (RNFL). This study evaluated the wedge shaped localised RNFL defects. Red free wide angle RNFL photographs of 421 patients with glaucoma and 193 normal subjects were examined. Localised RNFL defects were described for one eye of the normal group and for 20% of the patients with glaucoma. They were usually located in the inferior temporal and superior temporal fundus regions. Within the glaucoma group,...

  9. Get Tested for Glaucoma!

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Glaucoma Get Tested for Glaucoma! Past Issues / Fall 2009 Table of ... and why it is so important to get tested. To Find Out More MedlinePlus: www.medlineplus.gov ...

  10. Glaucoma in Asian Populations

    Science.gov (United States)

    ... Us Donate In This Section Glaucoma In Asian Populations email Send this article to a friend by ... an even more serious problem as the world population and longevity increases. The other major glaucoma type ...

  11. Daily Life with Glaucoma

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  12. Coping with Glaucoma

    Medline Plus

    Full Text Available ... told me. Doctor: I told Ben he had glaucoma. I told him we could treat it. But ... me when he did because left untreated his glaucoma might well have cost him his eyesight. In ...

  13. Five Common Glaucoma Tests

    Science.gov (United States)

    ... About Us Donate In This Section Five Common Glaucoma Tests en Español email Send this article to ... year or two after age 35. A Comprehensive Glaucoma Exam To be safe and accurate, five factors ...

  14. Screening for Glaucoma

    Science.gov (United States)

    ... t know which people with early signs of disease will develop serious vision problems or blindness. There are two major ... for advice about glaucoma screening. Glaucoma is a serious disease that affects the health and quality of life ...

  15. Alternative therapy in glaucoma management: Is there any role?

    Directory of Open Access Journals (Sweden)

    Parikh Rajul

    2011-12-01

    Full Text Available Glaucoma is one of the leading causes of blindness worldwide. Various randomized controlled clinical trials have shown that lowering intraocular pressure (IOP does reduce progression of primary open-angle glaucoma. However, there is lots of interest in nonpharmacological options that includes lifestyle adjustment and alternative and complementary therapy (ACT. At least 5% glaucoma population uses ACT. Various lifestyle activities like exercise and alcohol can reduce IOP by 1 to 2 mm Hg but would have small effect on glaucoma. The psychological stress can increase IOP. Hypothetically and few studies do show neuroprotective effect (or effect on ocular blood flow of alcohol, Gingko biloba, bilberry, but the current evidence is weak for its routine use. We must also remember the side effects of ′medications′ (e.g., marijuana, alcohol before promoting as remedy for glaucoma. In current armamentarium of glaucoma management, ACT cannot substitute the conventional treatment available to lower IOP.

  16. EX-PRESS glaucoma shunt for the treatment of open-angle glaucom%EX-PRESS 引流钉植入术治疗开角型青光眼的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李维娜; 李学喜; 林小兰; 赖钟祺

    2016-01-01

    Objective To evaluate the therapeutic effects of EX-PRESS glaucoma shunt in open-angle glaucoma . Methods A retrospective case analysis.Twenty-two subjects (30 eyes) were enrolled, among which 12 cases (17 eyes) were confirmed to be primary open-angle glaucoma (POAG) and the rest 10 cases (13 eyes) were secondary open-angle glaucoma (SOAG).Follow-up time ranged from 6 to 21 months.Visual acuity, intraocular pressure before admission, at 1 week, 1 month and 3 months after surgery, and at final follow-up were recorded.The amount of pressure-lowering agents used at final follow-up and surgical related complications were also analyzed .Results There was no significant difference in visual acuity among different time-points.IOPs were 38.69 ±12.23 mmHg, 11.03 ±5.46 mmHg, 14.62 ±8.04 mm-Hg, 15.59 ±7.87 mmHg, 18.89 ±9.06 mmHg before admission and at 1 week, 1 month and 3 months after surgery , and at final follow-up respectively.The IOPs after surgery were significantly lower than that prior to admission ( P 21 mmHg (20%) in 6 patients.In these cases, 4 patients were not using any drops while two patients were on 2 different drops.The position of EXPRESS was too posterior in 5 cases and touched iris in 3 patients .In 1 patient it located too anteriorly but did not touch the cornea .Seven patients suffered from grade II shallow anterior chamber , but only minimal hyphema was found in 1 patient and it resolved rapidly after treatment .One patient experienced choroid detachment and was cured with steroid administration .Conclusions EX-PRESS is effective to lower IOP in open-angle glaucoma and has little impact on visual acuity.However, it should raise physician’s concern that EX-PRESS could lead to some unique complications .%目的:评价EX-PRESS引流钉植入术治疗开角型青光眼的疗效。方法采用回顾性病例分析。收集2013年9月至2015年3月在本院眼科确诊为开角型青光眼的患者22例(30只眼),其中

  17. Clinical observation and nursing intervention of primary open angle glaucoma medications%原发性开角型青光眼药物治疗的临床观察及护理干预

    Institute of Scientific and Technical Information of China (English)

    余长青

    2015-01-01

    目的:研究和分析原发性开角型青光眼患者进行药物治疗时的临床观察要点及有效的护理干预措施。方法:收集原发性开角型青光眼患者共85例(162只眼),随机分为观察组与对照组,各81只眼,对照组患者使用曲伏前列素进行治疗,观察组患者在此基础上接受噻吗洛尔、布林佐胺的联合治疗,并随机抽取两组共45名患者进行护理干预,将两组患者的临床效果进行观察和对比。结果:观察组患者治疗半年后的眼压达标率明显高于对照组,观察组患者治疗1年后的眼压达标率显著高于对照组患者,观察组患者实施护理干预半年和1年后的眼压达标率均明显高于对照组,(P均<0.05)。结论:在原发性开角型青光眼患者的治疗过程中,使用曲伏前列素、噻吗洛尔和布林佐胺的联合治疗,能够有效提高治疗的效果,而患者在接受了护理干预之后,药物治疗的效果得到了有效提高,值得推广应用。%Objective: To study clinical observation points and analysis of patients with primary open angle glaucoma eye drug treatment and effective nursing intervention measures. Methods: to collect the primary open angle glaucoma patients with a total of 85 cases(162 eyes), were randomly divided into observation group and control group, each 81 cases, patients in the control group were treated with travoprost, patients in the observation group received timolol, brinzolamide combined treatment, and nursing intervention randomly selected two groups of a total of 45 patients, the clinical effect of the two groups were observed and compared. Results: the observation group of patients with intraocular pressure after six months treatment compliance rate was significantly higher than the control group , patients in the observation group treatment compliance rate of intraocular pressure after 1 years was significantly higher than that in control group

  18. Glaucoma Research Foundation

    Science.gov (United States)

    ... and research. Subscribe Browse the Gleams Archive » Glaucoma Research Foundation www.glaucoma.org 251 Post Street, Suite 600 San Francisco , CA 94108 (415) 986-3162 (800) 826-6693 question@ glaucoma.org ... Progress Get Involved News About Us Donate Informacion ...

  19. A combined analysis of five observational studies evaluating the efficacy and tolerability of bimatoprost/timolol fixed combination in patients with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Pfennigsdorf S

    2013-06-01

    Full Text Available Stefan Pfennigsdorf,1 Leo de Jong,2 Stefan Makk,3 Yvette Fournichot,4 Alain Bron,5 Robert J Morgan-Warren,6 John Maltman6 1Ophthalmology Practice, Polch, Germany; 2Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; 3Ophthalmology Practice, Graz, Austria; 4Ophthalmology Practice, Schlieren, Switzerland; 5Department of Ophthalmology, University Hospital, Dijon, France; 6Allergan Ltd, Marlow, UK Objective: The aim of this study was to evaluate the safety and efficacy of a fixed combination of bimatoprost 0.03% and timolol (BTFC in a clinical setting, in a large sample of patients with primary open-angle glaucoma or ocular hypertension and insufficient intraocular pressure (IOP lowering on prior therapy. Methods: Patient data were combined (n = 5556 from five multicenter, observational, non-controlled, open-label studies throughout Europe. Patients were identified from 830 sites in Austria, France, Germany, The Netherlands, and Switzerland. Assessments were made at baseline, 6 weeks (in Austrian, German and Swiss centers, and 12 weeks in all centers. Results: BTFC lowered mean IOP from baseline by 5.4 mmHg over the 12-week duration of the studies (P < 0.0001. At study entry, 92.9% of patients were receiving another ocular hypotensive medication. In patients with no previous treatment (n = 311, BTFC reduced IOP by -9.1 mmHg, corresponding to a reduction from baseline of 36.4% (P < 0.0001. In patients receiving prior therapy of a prostaglandin analog, a ß-blocker, or a fixed combination, BTFC reduced IOP by a further 24.5%, 25.9%, and 21.4%, respectively. The majority of patients (90.3% reported no adverse events. The most common adverse events were conjunctival hyperemia (3.2% and eye irritation (2.8%. BTFC was rated as "good" or "very good" by 92.5% of physicians and 88.0% of patients. Most patients (96.3% were equally or more compliant with BTFC than with their previous treatment. Conclusion: In routine clinical practice

  20. Effects of Latanoprost 0.005%/Timolol Maleate 0.5% and Dorzolamide 2%/Timolol Maleate 0.5% Fixed Combinations on 24-hour Intraocular Pressure in Patients with Primary Open-Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Berna Yüce

    2012-01-01

    Full Text Available Pur po se: To evaluate the effects of latanoprost/timolol maleate and dorzolamid/timolol maleate fixed combinations on-24 hours intraocular pressure in patients with open-angle glaucoma. Ma te ri als and Met hod: Forty-eight eyes of 24 patients with open-angle glaucoma were enrolled in the study. They were randomized to receive fixed combinations of either latanoprost/timolol maleate (Group 1 - 24 eyes of 12 patients or dorzolamid/timolol maleate (Group 2 - 24 eyes of 12 patients. Patients who achieved intraocular pressure of ≤ 21 mmHg 3 weeks after combined therapy were hospitalized and intraocular pressure was monitored at hour 06:00, 10:00, 14:00, 18:00, 22:00 and 02:00 for 24 hours. Diurnal and nocturnal fluctuations were determined by measurements done between 06:00 and 18:00 hours and between 22:00 and 02:00, respectively. Mean intraocular pressure and fluctuations of intraocular pressure between the two groups were compared. Re sults: There was no difference between the groups in terms of age, sex, visual acuity and cup/disc ratio (p>0.05. Three weeks after combined therapy, all patients achieved target intraocular pressure of ≤ 21 mmHg. There was no statistically significant difference between the two groups with regard to mean intraocular pressure over 24 hours (17.1±2.3 mmHg and 17.27±2.3 mmHg for Group 1 and Group 2, respectively; p>0.05. Diurnal fluctuations were 3.6 mmHg for Group 1 and 4.7 mmHg for Group 2; nocturnal fluctuations were 4.3 mmHg for Group 1 and 2.3 mmHg for Group 2. Diurnal fluctuations in Group 1 were lower than in Group 2, while nocturnal fluctuations were lower in Group 2 than in Group 1 (p<0.05. Dis cus si on: Both latanoprost/timolol maleate and dorzolamid/timolol maleate fixed combinations are effective for 24-hour intraocular pressure control. Latanoprost/timolol maleate fixed combination is superior to dorzolamid/timolol maleate in controlling diurnal fluctuations, while dorzolamid/timolol maleate is

  1. A combined analysis of four observational studies evaluating the intraocular pressure-lowering ability and tolerability of bimatoprost 0.01% in patients with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Stevens A

    2016-04-01

    Full Text Available Annemie Stevens,1 Milko E Iliev,2 Leo de Jong,3 Ioana Grobeiu,4 Anton Hommer5 1Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium; 2Department of Ophthalmology, University of Bern, Bern, Switzerland; 3Department of Ophthalmology, Academic Medical Centre, Amsterdam, the Netherlands; 4Allergan Holdings Ltd, Marlow, UK; 5Private Office, Vienna, Austria Objective: Combine and evaluate data from four clinical practice studies investigating the intraocular pressure (IOP-lowering ability, tolerability of and patient adherence to bimatoprost 0.01% therapy in patients with primary open-angle glaucoma or ocular hypertension. Methods: Data were combined from four multicenter, prospective, observational studies. Patients (n=2,593 were recruited from 328 sites in Austria, Belgium, Switzerland, and the Netherlands. Assessments were at study entry (baseline and after 10–14 weeks. Results: Bimatoprost 0.01% lowered mean IOP by 5.0 mmHg from baseline to final visit (P<0.0001. Individual IOP goals were achieved in 75.5% of patients. Results were similar in right and left eyes; right-eye data are presented here for brevity. The greatest mean IOP reduction was 6.7±4.7 mmHg (28.8% reduction from baseline to final visit, P<0.0001 in treatment-naïve patients. Switching to bimatoprost 0.01% monotherapy from previous monotherapy reduced mean IOP by a further 3.2±3.6 mmHg (17.2%, P<0.0001. Switching to bimatoprost 0.01% from previous prostaglandin monotherapy reduced mean IOP by 2.9±3.5 mmHg (15.5%, including by 3.1±3.4 mmHg (15.8% and 3.3±4.1 mmHg (16.9% for previous latanoprost and travoprost treatment, respectively (all P<0.0001. IOP reduction in patients previously treated with a fixed combination was 2.7±4.0 mmHg (14.2%, P<0.0001. The most commonly reported adverse events were conjunctival hyperemia (5.2% and eye irritation (4.7%. Tolerability was rated as “very good” or “good” by 90.1% of patients. Adherence was rated by

  2. The role of matricellular proteins in glaucoma.

    LENUS (Irish Health Repository)

    Wallace, Deborah M

    2014-07-01

    Glaucoma is an optic neuropathy affecting approximately 60million people worldwide and is the second most common cause of irreversible blindness. Elevated intraocular pressure (IOP) is the main risk factor for developing glaucoma and is caused by impaired aqueous humor drainage through the trabecular meshwork (TM) and Schlemm\\'s canal (SC). In primary open angle glaucoma (POAG), this elevation in IOP in turn leads to deformation at the optic nerve head (ONH) specifically at the lamina cribrosa (LC) region where there is also a deposition of extracellular matrix (ECM) molecules such as collagen and fibronectin. Matricellular proteins are non-structural secreted glycoproteins that help cells communicate with their surrounding ECM. This family of proteins includes connective tissue growth factor (CTGF), also known as CCN2, thrombospondins (TSPs), secreted protein acidic and rich in cysteine (SPARC), periostin, osteonectin, and Tenascin-C and -X and other ECM proteins. All members appear to play a role in fibrosis and increased ECM deposition. Most are widely expressed in tissues particularly in the TM and ONH and deficiency of TSP1 and SPARC have been shown to lower IOP in mouse models of glaucoma through enhanced outflow facility. The role of these proteins in glaucoma is emerging as some have an association with the pathophysiology of the TM and LC regions and might therefore be potential targets for therapeutic intervention in glaucoma.

  3. Size of the Optic Nerve Head and Its Relationship with the Thickness of the Macular Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer in Patients with Primary Open Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Nobuko Enomoto

    2015-01-01

    Full Text Available Purpose. To evaluate the relationships among the optic nerve head (ONH area, macular ganglion cell complex (mGCC thickness, circumpapillary retinal nerve fiber layer (cpRNFL thickness, and visual field defects in patients with primary open angle glaucoma (POAG. Methods. This retrospective study included 90 eyes of 90 patients with POAG. The ONH area, rim area, mGCC thickness, and cpRNFL thickness were measured using optical coherence tomography. Mean deviation (MD was measured using standard automated perimetry. The relationships among clinical factors including age, refraction, the ONH area, the rim area, the mGCC thickness, the cpRNFL thickness, and MD were evaluated using correlation coefficients and multiple regression analyses. Results. The significant correlation of the ONH area with refraction (r=0.362, P<0.001, the mGCC thickness (r=0.225, P=0.033, and the cpRNFL thickness (r=0.253, P=0.016 was found. Multiple regression analysis showed that the ONH area, rim area, and MD were selected as significant contributing factors to explain the mGCC thickness and cpRNFL thickness. No factor was selected to explain MD. Conclusions. The ONH area, in other words, the disc size itself may affect the mGCC thickness and cpRNFL thickness in POAG patients.

  4. Primary lens extraction for glaucoma management: A review article

    OpenAIRE

    Eid, Tarek M.

    2011-01-01

    Recently, primary lens extraction alone gained more acceptance as an alternative surgical approach for glaucoma management. This view was supported by the advances in phacoemulsification and intraocular lenses with greater safety and visual recovery, in addition to a substantial reduction of intraocular pressure and deepening of the anterior chamber and filtration angle. The decrease in IOP after cataract surgery in primary open-angle glaucoma (POAG) is mild, less predictable, related to base...

  5. Glaucoma Surgery in Pregnancy: A Case Series and Literature Review.

    Science.gov (United States)

    Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S; Moster, Marlene R

    2016-09-01

    Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon's lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594

  6. Selective Laser Trabeculoplasty on Early Primary Open Angle Glaucoma : a Clinical Research%选择性激光小梁成形术治疗早期开角型青光眼的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨云东; 贾洪强; 杨立东; 徐深

    2011-01-01

    Objective To evaluate the efficacy and safety of selective laser trabeculoplasty (SLT) angioplasty for the treatment of early primary open angle glaucoma (POAG) .Methods Eighty-one eyes with early POAG were included in this study, their intraocular pressure (IOP) was not controlled effectively simply by drugs, to observe the fluctuation of IOP within 12 months after SLT treatment.Results The mean preoperative IOP was (29.93 ±4.57) mmHg. At the 2 h,24 h,1 week,1 month, 3 months, 6 months and 12 months of the follow-up period, the mean IOP was (24.01 ± 5.13 ), ( 19.86 ± 5.19), ( 17.57 ± 3.43 ), ( 14.21 ± 3.09), ( 13.64 ±2.95), ( 13.96 ± 3.18) and ( 14.10 ± 3.17 ) mmHg, respectively. Compared with the mean preoperative IOP, after seven times measurements the postoperative mean IOP was obviously dropped, with statistically significant differences, P < 0.01.Conclusions SLT could effectively and safely reduce the IOP of early POAG, with mild injury and repeatability, which is a safe and effective way to the treatment of glaucoma.%目的 评价选择性激光小梁成形术(selective laser trabeculoplasty angioplasty,SLT)治疗早期原发性开角型青光眼(primary openangle glaucom,POAG)的有效性和安全性.方法 选择局部单纯用药眼压控制效果不理想的早期POAG42例81只眼.观察SLT治疗后12个月的眼压变化.结果 术前、术后2,24 h,1周及1、3,6和12个月平均眼压分别为(29.93±4.57)、(24.01±5.13)、(19.86±5.19)、(17.57±3.43)、(14.21±3.09)、(13.64±2.95)、(13.96±3.18)和(14.10±3.17)mmHg.结论 SLT可以安全有效地降低POAG的眼压,具有损伤小和可重复的优点,可用于治疗早期开角型青光眼.

  7. Is Estrogen a Therapeutic Target for Glaucoma?

    Science.gov (United States)

    Dewundara, Samantha S; Wiggs, Janey L; Sullivan, David A; Pasquale, Louis R

    2016-01-01

    This article's objective is to provide an overview of the association between estrogen and glaucoma. A literature synthesis was conducted of articles published in peer-reviewed journals screened through May 5, 2015, using the PubMed database. Keywords used were "estrogen and glaucoma," "reproductive factors and glaucoma," and "estrogen, nitric oxide and eye." Forty-three journal articles were included. Results indicated that markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open-angle glaucoma (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses' Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 years had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk), while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma-related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of postmenopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in

  8. Does Marijuana Help Treat Glaucoma?

    Science.gov (United States)

    ... that it does not recommend marijuana or other cannabis products for the treatment of glaucoma . Speak with ... Marijuana for Glaucoma Infographic Leer en Español: La Marihuana y el Glaucoma Find an Ophthalmologist Advanced Search ...

  9. The Assessment of Sleep Apnoea as a Risk Factor in Glaucoma

    OpenAIRE

    Khandgave, Tejaswini Prashant; Puthran, Neelam; Ingole, Avinash B.; Nicholson, Anjali D.

    2013-01-01

    Background: The risk of developing open angle glaucoma increases in the presence of associated disorders such as hypertension, Diabetes mellitus and migraine. In recent years, sleep apnoea is also being investigated as a risk factor in the development of open angle glaucoma.

  10. [The retinal nerve fiber layer in normal and glaucoma eyes].

    Science.gov (United States)

    Jonas, J B; Schiro, D; Naumann, G O

    1993-12-01

    Glaucoma leads to changes of the retinal nerve fiber layer (RNFL). This study was performed to evaluate glaucomatous alterations of the RNFL and to correlate them with other parameters of glaucomatous optic nerve damage. The study included red-free wide-angle fundus photographs of the RNFL of 453 normal eyes and 609 eyes with glaucoma. We evaluated the visibility of the RNFL in different fundus regions and the occurrence of localized RNFL defects. In the glaucoma eyes, including those with "early" glaucomatous optic nerve damage, the visibility of RNFL was significantly lower than in the normal eyes. The degree of RNFL visibility correlated with other morphological and perimetric parameters. Localized RNFL defects were detected in 20% of the glaucoma eyes. Their frequency increased significantly (P diffuse RNFL loss, the varying frequency of localized RNFL defects in different types of glaucoma and the association between localized RNFL defects and optic disk hemorrhages are diagnostically and pathogenetically important. PMID:8124022

  11. Correlação e correspondência topográfica entre espessura da camada de fibras nervosas da retina e campo visual no glaucoma primário de ângulo aberto Correlation and topographic match between nerve fiber layer thickness and visual field in primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Paula Boturão de Almeida

    2001-04-01

    classificados como discretos: SF e SN. Nos olhos classificados como moderados: SF e SI. Nos olhos classificados como graves: MD e SN; MD e EM; MD e S; CPSD e EM. 4- DN t e TD t; DN s e TD ni; DN i e TD ns. 5- Encontramos correspondência positiva (+ em 36 olhos (51,43% dos casos e correspondência negativa (- em 34 olhos (48,57% dos casos. Conclusões: Concluiu-se que houve poucas correlações significantes entre esses dois exames, e que as existentes foram muito fracas. Conclui-se, também, que houve correspondência topográfica, na análise dos setores mais comprometidos, em 51,43% dos casos.Purpose: To determine the relationship between nerve fiber layer thickness detected by scanning laser polarimetry (GDx and visual field function measured by automated conventional white-on-white perimetry. Methods: 82 eyes of 48 open angle glaucoma patients were studied. The following correlations were inves-tigated: 1- Correlation between mean sensitivity of 4 quadrants plus the fixation point, in dBs, and the mean of the nerve fiber layer thickness of the correspondent retina, in micra. 2- Correlation between mean sensitivity of 4 quadrants plus the fixation point, in dBs, and the mean of the nerve fiber layer thickness of the correspondent retina, in micra, in the patients classified according to the amount of visual field loss. 3- Correlation between the global indices of visual field and the numeric indices of GDx. 4- Correlation between the mean of "total deviation" of visual field and the "deviation from normal" of GDx. 5- Topographic match between visual field and retinal nerve fiber layer thickness changes. Statistical analysis was performed using the Spearmann coeficient correlation test. Results: We observed a very poor correlation regarding: 1- total GDx and VF total; superior GDx and nasal inferior VF; inferior GDx and nasal superior VF; nasal GDx and temporal VF; superior GDx and inferior VF; inferior GDx and superior VF. 2- inferior GDx and nasal superior VF (severe eyes

  12. Nanotechnology Applications for Glaucoma.

    Science.gov (United States)

    Cetinel, Sibel; Montemagno, Carlo

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide, and the antiglaucoma treatments currently available suffer from various complications. Nanotechnology-based treatments show a great deal of promise in overcoming these complications and form the basis for next-generation glaucoma treatment strategies, with the help of applications such as controlled release, targeted delivery, increased bioavailability, diffusion limitations, and biocompatibility. Significant progress has been made in nanomedicine in the efficiency of antiglaucoma medications, nanofabrication systems such as microelectromechanical systems that remove the limitations of nanodevices, and tissue regeneration vesicles for developing glaucoma treatments not based on intraocular pressure. With the use of these advanced technologies, the prevention of glaucoma-induced blindness will be possible in the near future. Herein, we reviewed the recent advances in nanotechnology-based treatment strategies for glaucoma. PMID:26693592

  13. Estudo comparativo entre o tonômetro de aplanação de Goldmann e o tonômetro de contorno dinâmico de Pascal no glaucoma primário de ângulo aberto e olhos normais Dynamic contour tonometry (DCT versus Goldmann applanation tonometry (GAT in open-angle glaucoma and normal eyes: a comparative study

    Directory of Open Access Journals (Sweden)

    Sergio Henrique Sampaio Meirelles

    2008-12-01

    Full Text Available OBJETIVO: Comparar as medidas da pressão intra-ocular (PIO obtidas com o tonômetro de aplanação de Goldmann (TAG e o tonômetro de contorno dinâmico (TCD e correlacioná-las com a espessura central da córnea (ECC. MÉTODOS: Estudo transversal, com os pacientes divididos em dois grupos: glaucoma primário de ângulo aberto (GPAA e olhos normais (ON. As medidas da PIO foram obtidas em todos os pacientes com o TAG e o TCD. Um examinador realizou as tonometrias com o TAG e outro examinador com o TCD. A ECC foi obtida pelo paquímetro ultrassônico. Os resultados foram avaliados através do teste Z para amostras independentes, teste t de Student para amostras relacionadas, teste de correlação linear de Pearson e gráfico de Bland-Altman. RESULTADOS: Foram incluídos 134 olhos de 71 pacientes. O grupo GPAA foi constituído por 85 olhos de 45 pacientes e o grupo ON por 49 olhos de 26 indivíduos com olhos normais. Não houve diferença significativa da ECC entre os dois grupos em ambos os olhos (p= 0,54 OD; p= 0,71 OE. As tonometrias realizadas com o TCD foram maiores nos dois grupos (GPAA: pPURPOSE: To compare intraocular pressure (IOP readings of Goldmann applanation tonometry (GAT and dynamic contour tonometry (DCT, and to correlate central corneal thickness (CCT with these readings. METHODS: This transversal study included patients in two groups: open-angle glaucoma (OAG and normal eyes (NE. IOP measurements were obtained in all patients using GAT and DCT. The same examiner made all GAT measurements. Another examiner, who was masked to the GAT readings, made DCT measurements. CCT was determined by ultrasound pachimetry. RESULTS: The study included 134 eyes of 71 subjects. The groups were composed of 85 eyes from 45 patients with OAG and 49 eyes from 26 subjects with NE. There was no statically significant difference between CCT in the two groups (p = 0,54, right eye; p = 0,71, left eye. DCT readings consistently were higher than GAT

  14. Atypical Intrapapillary Hemorrhage in a Patient with Glaucoma

    Directory of Open Access Journals (Sweden)

    Sirel Gür Güngör

    2015-04-01

    Full Text Available A 73-year-old man presented for routine follow-up. There were primary open-angle glaucoma, diabetes mellitus, and usage of acetylsalicylic acid in patient’s history. Dilated fundus examination demonstrated cup hemorrhage in the right eye. Because of the progression of the superotemporal retinal nerve fiber layer defect in the last seven months, we think that the disk hemorrhage could be associated with glaucoma. (Turk J Ophthalmol 2015; 45: 77-8

  15. Atypical Intrapapillary Hemorrhage in a Patient with Glaucoma

    OpenAIRE

    Sirel Gür Güngör; Gülce Gökgöz Özışık; Ahmet Akman; Leyla Asena

    2015-01-01

    A 73-year-old man presented for routine follow-up. There were primary open-angle glaucoma, diabetes mellitus, and usage of acetylsalicylic acid in patient’s history. Dilated fundus examination demonstrated cup hemorrhage in the right eye. Because of the progression of the superotemporal retinal nerve fiber layer defect in the last seven months, we think that the disk hemorrhage could be associated with glaucoma. (Turk J Ophthalmol 2015; 45: 77-8)

  16. Compliance with topical glaucoma medications in Owo, Nigeria.

    OpenAIRE

    BO OMOLASE; OA ADEOSUN; AK AKINWALERE; OA SOTILOYE; OT OGUNLEYE; CO OMOLASE

    2013-01-01

    Introduction: Poor compliance with medications is a major challenge in the management of primary open angle glaucoma as it can lead to deterioration of eyesight. This study assessed the compliance with glaucoma medications among patients attending an Eye Clinic in Nigeria. We also assessed the problems encountered during the applications of topical medications. Materials and Methods: This study was conducted over a period of one year (October 2011 to October 2012) at the Eye Clinic of the Fed...

  17. Mitochondrial haplogroup U is associated with a reduced risk to develop exfoliation glaucoma in the German population

    Directory of Open Access Journals (Sweden)

    Wissinger Bernd

    2010-01-01

    Full Text Available Abstract Background Various lines of evidence demonstrate the involvement of mitochondrial dysfunction in the pathogenesis of glaucoma. Therefore, mitochondrial DNA is a promising candidate for genetic susceptibility studies on glaucoma. To test the hypothesis that mitochondrial haplogroups influence the risk to develop glaucoma, we genotyped 12 single-nucleotide polymorphisms that define the European mitochondrial DNA haplogroups in healthy controls and two German patient cohorts with either exfoliation glaucoma or the normal tension subgroup of primary open angle glaucoma. Results Mitochondrial haplogroup U was significantly under-represented in patients with exfoliation glaucoma (8.3% compared with 18.9% in controls; p = 0.004. Conclusions People with haplogroup U have a lower risk to develop exfoliation glaucoma. Our results substantiate the suggestion that mitochondrial alterations have an impact on the etiology of glaucoma.

  18. Glaucoma incidence in an unselected cohort of diabetic patients: is diabetes mellitus a risk factor for glaucoma?

    OpenAIRE

    Ellis, J.; Evans, J.; Ruta, D; Baines, P.; Leese, G; MacDonald, T; Morris, A

    2000-01-01

    AIMS—To evaluate whether diabetes mellitus is a risk factor for the development of primary open angle glaucoma or ocular hypertension (OHT).
METHODS—A historical cohort study of an unselected population comprising all residents of the Tayside region of Scotland was performed using record linkage techniques followed by case note review. Ascertainment of prevalent diabetes was achieved using the Diabetes Audit and Research in Tayside Study (DARTS) validated regional diabetes register. Glaucoma ...

  19. Glaucoma: Screening Can Save Your Sight!

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Screening Can Save Your Sight! Past Issues / Fall 2009 Table of Contents People with glaucoma see the world through a tunnel. Glaucoma is ...

  20. Posttranslational Modifications, Localization, and Protein Interactions of Optineurin, the Product of a Glaucoma Gene

    OpenAIRE

    Hongyu Ying; Xiang Shen; BumChan Park; Beatrice Y J T Yue

    2010-01-01

    BACKGROUND: Glaucoma is a major blinding disease. The most common form of this disease, primary open angle glaucoma (POAG), is genetically heterogeneous. One of the candidate genes, optineurin, is linked principally to normal tension glaucoma, a subtype of POAG. The present study was undertaken to illustrate the basic characteristics of optineurin. METHODOLOGY/PRINCIPAL FINDINGS: Lysates from rat retinal ganglion RGC5 cells were subjected to N- or O-deglycosylation or membrane protein extract...

  1. ACUPUNCTURE AND GLAUCOMA

    Institute of Scientific and Technical Information of China (English)

    WANG Ying; HU Shi-xing; BAI Peng

    2006-01-01

    It is to recognize glaucoma in view of Chinese medicine and synthesize the treatments and mechanisms of acupuncture on glaucoma in the paper. It is indicated in the results that acupuncture plays the importance in lowering ocular tension, improving ocular circulation and protecting optic nerve. Additionally,acupuncture inhibits probably the cellular apoptosis of optic ganglion and provides definite actions on psychological factors of glaucoma. Acupuncture cannot replace operation and medicinal therapy in lowing ocular tension, but their coordinated and auxiliary effects are quite clear and definite.

  2. 单侧性原发性开角型青光眼 与双侧性青光眼睫状体炎综合征%Unilatteral Primaly Open Angle Glaucoma and Bilatteral Glaucom atocyclitic Crisis

    Institute of Scientific and Technical Information of China (English)

    周和政; 王柏川; 周雄; 黄震

    2001-01-01

    目的 探讨单侧性原发性开角型青光眼(POAG)与双侧性青光眼睫状体炎综合征(PSS)的关系。方法 对临床拟诊的22例单侧性POAG和17例双侧性PSS进行视野及眼压等项追踪观察,并以同期观察的99例双侧性POAG和109例单侧性PSS作参照。结果 ①22例单侧性POAG中,15例并非POAG,其中9例为PSS;②17例双侧性PSS中,15例有青光眼性视盘或/和视野损害(其中9例为中、晚期),较单侧性PSS显著地多而重;③15例中,9例的损害原因已查明;5例为单纯的PSS,4例系合并POAG。结论 单侧性POAG的诊断必须十分慎重,尤其要警惕PSS,双侧性PSS则与POAG有更紧密的联系。%Objective To evaluate the relationship between u ni latteralprimaly open angle glaucoma(POAG) and bilatteral glaucomatocyclitic cri sis(Posner-Schlossman's Symdrome,PSS).Methods 22 cases of unil atteral POAG and 17 cases of bilatteral PSS inicially diagnosed were followed up with perimeter and tonometer,99 cases of bilatteral POAG and 109 cases of unila tteral PSS were taken as a control group.Results ①15 of the 22 cases of unilatteral POAG were comfirmed not to be POAG,9 of them had been prov ed to be PSS.②Glaucomatous damage of optic disc and/or visual field were found in 15 of the 17 cases of bilatteral PSS,the damage in 9 cases were of middle or late stage.There was more frequent and serious than that in unilatteral PSS.③Th e factors leading to the damage had been determined in 9 of the 15 cases;5 cases were due to purely PSS,4 cases were complicated with POAG.Conclusions Enough caution should be payed when making a diagnosed of unilatteral PO AG,especial alertion should be aimed to PSS;bilatteral PSS had a closer connecti on with POAG.

  3. A pharmacoeconomic analysis to determine the relative cost-effectiveness of bimatoprost 0.03% eye drops and brimonidine 0.2% eye drops in patients of primary open-angle glaucoma/ocular hypertension

    Directory of Open Access Journals (Sweden)

    Navreet Kaur Natt

    2014-01-01

    Full Text Available Aims: The aim was to compare efficacy and cost-effectiveness of bimatoprost 0.03% and brimonidine 0.2% in primary open-angle glaucoma (POAG/ocular hypertension (OHT. Settings and Design: Open, randomized, cross-over, comparative study. Materials and Methods: Forty patients of POAG or OHT with intraocular pressure (IOP <30 mm Hg were included in the study after a written informed consent. The patients were divided randomly into two groups of 20 patients each. Patients of group A were administered bimatoprost 0.03% eye drops once daily, and those of group B brimonidine 0.2% eye drops twice daily for a period of 4 weeks. After a washout period of 4 weeks, the patients were crossed over that is, group A was administered brimonidine 0.2% and group B bimatoprost 0.03%. Fall in IOP at 4 weeks was recorded. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost-effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Independent samples t-test was used to compare the efficacy of both drugs. Results: IOP lowering with bimatoprost (8.9 ± 1.598 mm Hg was significantly (P < 0.0001 higher than brimonidine (6.55 ± 1.26 mm Hg. The number of drops/ml were 33.43 ± 0.52 and 25.49 ± 0.26, respectively, for bimatoprost and brimonidine. Treatment with bimatoprost was costlier than brimonidine with daily costs/eye Rs. 4.02 ± 0.06 and 3.14 ± 0.03, yearly costs/eye Rs. 1467.46 ± 20.74 and 1147.75 ± 11.15, respectively. Bimatoprost was more cost-effective than brimonidine with the cost-effectiveness ratio (CER respectively Rs. 13.10 ± 2.61/mm Hg and Rs. 13.96 ± 2.86/mm Hg. Incremental CER Rs. 10.43/mm Hg implies lower costs/mm Hg extra IOP lowering by bimatoprost than Rs. 13.96 for brimonidine. Conclusion: In spite of being costlier, bimatoprost is more efficacious and cost-effective than brimonidine.

  4. Coping with Glaucoma

    Medline Plus

    Full Text Available ... opthalmologistor optometrist. The exam may include a painless test that measures pressure within the eye and sometimes ... detect glaucoma is with a painless and easy test in which the doctor, using drops to dilate ...

  5. Coping with Glaucoma

    Medline Plus

    Full Text Available ... no way I was prepared for what the doctor told me. Doctor: I told Ben he had glaucoma. I told ... a painless and easy test in which the doctor, using drops to dilate or enlarge the pupil, ...

  6. Coping with Glaucoma

    Medline Plus

    Full Text Available ... comprehensive eye examination performed by a qualified eye care professional such as an opthalmologistor optometrist. The exam ... at-risk individuals -- that's the recommendation of eye care professionals, and that's the way to stop glaucoma ...

  7. [The denominations cataract and glaucoma].

    Science.gov (United States)

    Tornquist, R

    1997-01-01

    Since ancient times a grey or white pupil in an nearly blind eye was thought to be caused by a mucous substance in front of the lens. It was called "hypochysis" or "hypochyma" in Greece and "suffusio" in Rome. Later the term "cataract" (=waterfall) was the most popular denomination. A surgical method was tried very early with usually good effect, when with a thin needle, introduced into the eye, the opaque material was removed from the pupillary area. In the middle of the 17th century more careful investigations showed that there was no membrane in front of the lens, but the lens itself was opaque. The final proof was delivered when an extraction of the lens was performed with good effect. In ancient times incurable blindness, which was called glaucoma, was thought to be located to the lens, which probably had a very important role in the seeing process. The name (of Greek orgin) is translated "green" or "blue-green", which was sometimes notified to be the color of the lens, seen through the pupil, in these cases. A period of great confusion followed when the removal of this very important part of the eye did not lead to blindness but rather an improved vision. As there were significant difficulties in identifying the specific color of the pupil the name glaucoma seemed to be very inadequate. In the beginning of the 19th century a disease entity (which is to-day called acute closed-angle glaucoma) seemed to eventually fullfill the demand of a greenlooking pupil. The most characteristic symptoms are pain and a high intraocular pressure causing a corneal edema and a change of the blackness of the pupil to hazy grey (and maybe a little green?). PMID:11625470

  8. Post-keratoplasty glaucoma

    OpenAIRE

    S. A. Malozhen; S. V. Trufanov; S. Yu. Petrov

    2015-01-01

    Post-keratoplasty glaucoma (PKG) remains one of the leading causes of blindness due to the loss of optic nerve fibers and irreversible graft opacification. PKG is a challenge due to diagnostic and therapeutic difficulties and recalcitrant course. This paper reviews main pre-operative PKG risk factors such as pre-existing glaucoma, corneal disorders for which keratoplasty is performed, and lens status. Intraoperative errors that caused by ocular hypertension (tight suturing, larger trephine si...

  9. Neuroprotection in glaucoma

    Directory of Open Access Journals (Sweden)

    Azadeh Doozandeh

    2016-01-01

    Full Text Available Glaucoma is a degenerative optic neuropathy characterized by retinal ganglion cell (RGC loss and visual field defects. It is known that in some glaucoma patients, death of RGCs continues despite intraocular pressure (IOP reduction. Neuroprotection in the field of glaucoma is defined as any treatment, independent of IOP reduction, which prevents RGC death. Glutamate antagonists, ginkgo biloba extract, neurotrophic factors, antioxidants, calcium channel blockers, brimonidine, glaucoma medications with blood regulatory effect and nitric oxide synthase inhibitors are among compounds with possible neuroprotective activity in preclinical studies. A few agents (such as brimonidine or memantine with neuroprotective effects in experimental studies have advanced to clinical trials; however the results of clinical trials for these agents have not been conclusive. Nevertheless, lack of compelling clinical evidence has not prevented the off-label use of some of these compounds in glaucoma practice. Stem cell transplantation has been reported to halt experimental neurodegenerative disease processes in the absence of cell replacement. It has been hypothesized that transplantation of some types of stem cells activates multiple neuroprotective pathways via secretion of various factors. The advantage of this approach is a prolonged and targeted effect. Important concerns in this field include the secretion of unwanted harmful mediators, graft survival issues and tumorigenesis. Neuroprotection in glaucoma, pharmacologically or by stem cell transplantation, is an interesting subject waiting for broad and multidisciplinary collaborative studies to better clarify its role in clinical practice.

  10. Efficacy, safety and tolerability of combination therapy with timolol and dorzolamide in glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Parul Ichhpujani

    2010-05-01

    Full Text Available Parul Ichhpujani1,2, L Jay Katz11William and Anna Goldberg Glaucoma Service, 1Wills Eye Institute, Philadelphia, PA, USA; 2Department of Ophthalmology, Government Medical College and Hospital, Chandigrah, IndiaAbstract: Combination pharmacotherapy has simplified and improved glaucoma medication regimens. This update focuses on the previous and recent studies on efficacy and tolerability profile of dorzolamide–timolol in adult ocular hypertension and open angle glaucoma patients. Dorzolamide–timolol has been shown to be efficacious and well tolerated in clinical trials and the adverse effects reflect those of the individual components.Keywords: glaucoma, ocular hypertension, dorzolamide, timolol

  11. Improving Glaucoma Detection and Management

    Science.gov (United States)

    2015-12-09

    Glaucoma; Glaucoma Suspect; Diabetic Retinopathy; Ocular Hypertension; Cataract; Branch Retinal Vein Occlusion; Branch Retinal Arterial Occlusion; Central Retinal Vein Occlusion; Central Retinal Artery Occlusion; Epi-retinal Membrane; Macular Degeneration; Drusen; Loss of Vision

  12. New Tool to Predict Glaucoma

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  13. Does Your Child Have Glaucoma?

    Science.gov (United States)

    ... Donate In This Section Does Your Child Have Glaucoma? email Send this article to a friend by ... a pediatric ophthalmologist. Signs and Symptoms of Childhood Glaucoma What to watch for in children under the ...

  14. Epidemiology of glaucoma in Sub-Saharan Africa: Prevalence, incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Fatima Kyari

    2013-01-01

    Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL were searched using the full text, Medical Subject Headings (MeSH terms, author(s and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Results: Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Conclusion: Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.

  15. Efficacy and Tolerability of Fixed-Combination Brinzolamide/Timolol in Latin American Patients with Open-Angle Glaucoma or Ocular Hypertension Previously on Brimonidine/Timolol Fixed Combination

    OpenAIRE

    Alezzandrini, Arturo; Hubatsch, Douglas; Alfaro, Rene

    2014-01-01

    Introduction Fixed-combination glaucoma medications are commonly used to achieve target intraocular pressure (IOP) reduction in patients uncontrolled with monotherapy; however, ocular discomfort associated with eye drops can decrease adherence. This study assessed the efficacy and tolerability of twice-daily fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC) in Latin American patients transitioned from fixed-combination brimonidine 0.2%/timolol 0.5% (BRIM/TIM-FC) because of insuffi...

  16. Post-keratoplasty glaucoma

    Directory of Open Access Journals (Sweden)

    S. A. Malozhen

    2015-10-01

    Full Text Available Post-keratoplasty glaucoma (PKG remains one of the leading causes of blindness due to the loss of optic nerve fibers and irreversible graft opacification. PKG is a challenge due to diagnostic and therapeutic difficulties and recalcitrant course. This paper reviews main pre-operative PKG risk factors such as pre-existing glaucoma, corneal disorders for which keratoplasty is performed, and lens status. Intraoperative errors that caused by ocular hypertension (tight suturing, larger trephine sizes, long bites of individual sutures, increased peripheral corneal thickness and graft-host disparity are evaluated. Peripheral anterior synechiae, steroid use, and tonometry errors after deep anterior lamellar keraplasty are amongst post-operative causes of PKG. Partial transparency optical media, high post-operative astigmatism and graft edema make standard tonometry unreliable. Various tonometers and measurement reliability after keratoplasty are discussed. Currently, multiple treatment options including medications, laser and filtering surgery, glaucoma drainage devices and cyclodestructive procedures are available. In most cases of PKG, medications are initially prescribed. Evolution of approaches to PKG treatment as well as current therapy schedules, their advantages and ophthalmic complications are discussed. In cases non-responsive to medications, laser trabeculoplasty is performed. If laser procedures cannot be performed of their hypotensive effect is insufficient, glaucoma surgery is advised. A number of specialists prefer trabeculectomy with intra- or post-operative cytostatic adjunct. Glaucoma surgery with various drainage device implantation prevails. Ineffective surgery can be enhanced with transscleral laser cyclophotocoagulation.

  17. Investigation of the association between glaucoma and Helicobacter pylori infection using the {sup 14}C-urea breath test

    Energy Technology Data Exchange (ETDEWEB)

    Tuzcu, Esra Ayhan; Aydogan, Fusun; Motor, Vicdan Koksaldi; Ilhan, Ozgur; Daglioglu, Mutlu Cihan; Coskun, Mesut; Parlakfikirer, Nihan; Keskin, Ugurcan, E-mail: drayhant@hotmail.com [Medical Faculty, Mustafa Kemal University, Hatay (Turkey)

    2015-07-01

    Purpose: to investigate the association between glaucoma and Helicobacter pylori infection by evaluating for the presence of H. pylori infection in patients with glaucoma using the 14C-urea breath test (14C-UBT). Methods: Using 14C-UBT, H. pylori infection positivity was compared between a group of patients with primary open-angle glaucoma and a control group with normal intraocular pressure and a normal optic disc or normal perimetry. Results: the 14C-UBT was positive in 18 (51.42%) out of 35 patients in the glaucoma group and in 15 (42.85%) out of 35 patients in the control group. H. pylori infection positivity rates were similar between the glaucoma and control groups (p>0.05). Conclusion: according to the 14C-UBT, there is no association between primary open-angle glaucoma and H. pylori infection. (author)

  18. Investigation of the association between glaucoma and Helicobacter pylori infection using the 14C-urea breath test

    International Nuclear Information System (INIS)

    Purpose: to investigate the association between glaucoma and Helicobacter pylori infection by evaluating for the presence of H. pylori infection in patients with glaucoma using the 14C-urea breath test (14C-UBT). Methods: Using 14C-UBT, H. pylori infection positivity was compared between a group of patients with primary open-angle glaucoma and a control group with normal intraocular pressure and a normal optic disc or normal perimetry. Results: the 14C-UBT was positive in 18 (51.42%) out of 35 patients in the glaucoma group and in 15 (42.85%) out of 35 patients in the control group. H. pylori infection positivity rates were similar between the glaucoma and control groups (p>0.05). Conclusion: according to the 14C-UBT, there is no association between primary open-angle glaucoma and H. pylori infection. (author)

  19. Vascular considerations in glaucoma patients of African and European descent.

    Science.gov (United States)

    Huck, Andrew; Harris, Alon; Siesky, Brent; Kim, Nathaniel; Muchnik, Michael; Kanakamedala, Priyanka; Amireskandari, Annahita; Abrams-Tobe, Leslie

    2014-08-01

    Glaucoma is the leading cause of blindness in individuals of African descent (AD). While open-angle glaucoma (OAG) disproportionately affects individuals of AD compared with persons of European descent (ED), the physiological mechanisms behind this disparity are largely unknown. The more rapid progression and greater severity of the disease in persons of AD further raise the concern for identifying these underlying differences in disease pathophysiology between AD and ED glaucoma patients. Ocular structural differences between AD and ED patients, including larger optic disc area, cup:disc ratio and thinner corneas, have been found. AD individuals are also disproportionately affected by systemic vascular diseases, including hypertension, cardiovascular disease, stroke and diabetes mellitus. Abnormal ocular blood flow has been implicated as a risk factor for glaucoma, and pilot research is beginning to identify localized ocular vascular differences between AD and ED OAG patients. Given the known systemic vascular deficits and the relationship between glaucoma and ocular blood flow, exploring these concepts in terms of glaucoma risk factors may have a significant impact in elucidating the mechanisms behind the disease disparity in the AD population. PMID:24460758

  20. Biomarkers and special features of oxidative stress in the anterior segment of the eye linked to lens cataract and the trabecular meshwork injury in primary open-angle glaucoma: challenges of dual combination therapy with N-acetylcarnosine lubricant eye drops and oral formulation of nonhydrolyzed carnosine.

    Science.gov (United States)

    Babizhayev, Mark A

    2012-02-01

    The implication of oxidative stress associated with increased oxidant production in mammalian and human cells characterized by the release of free radicals, resulting in cellular degeneration, is involved in many ocular diseases, such as age-related macular degeneration, retinopathy of prematurity, retinal light damage, primary open-angle glaucoma (POAG), and cataract. Cataract is the leading cause of blindness, accounting for 50% of blindness worldwide. Glaucoma, the leading cause of irreversible blindness, is considered as a progressive optic neuropathy often caused by elevated intraocular pressure (IOP) consequent to abnormally high resistance to aqueous humor (AH) drainage via the trabecular meshwork (TM) and Schlemm's canal. Morphological and biochemical analyses of the TM of patients with POAG revealed the loss of cells, increased accumulation of extracellular matrix proteins (ECM), changes in the cytoskeleton, cellular senescence, and the process of subclinical inflammation. The TM is the target tissue of glaucoma in the anterior chamber, and the development and progression of glaucoma are accompanied by the accumulation of oxidative damage in this tissue. The separate studies were conducted to comparatively evaluate the sensitivity to oxidative stress and lipid peroxidation (LPO) of anterior chamber tissues including TM. Accumulation of the primary, secondary, and end products of LPO (diene and triene conjugates, Schiff's bases) was noted in the studied extracts. Significant differences in the levels of all mentioned LPO products in comparison with the control were observed. The data may be considered as an evidence of LPO participation in the destruction of the trabecule and Schlemm's canal in POAG. Treatment of TM cells with oxidative stress induced POAG-typical changes such as ECM accumulation, cell death, disarrangement of the cytoskeleton, advanced senescence, and the release of inflammatory markers. By pretreatment with antioxidants, prostaglandin

  1. Prevalence and Spatial Concordance of Visual Field Deterioration in Fellow Eyes of Glaucoma Patients

    OpenAIRE

    Kim, Min Kyo; Lee, Jun Mo; Morales, Esteban; Caprioli, Joseph

    2014-01-01

    Purpose To examine the prevalence of visual field deterioration in contralateral eyes of patients with worsening open-angle glaucoma and to evaluate the spatial concordance of visual field deterioration between both eyes. Methods One hundred sixteen open-angle glaucoma patients who underwent 8 or more visual field examinations over ≥6 years of follow-up were included. The rates of the fast and slow components of visual field decay for each of 52 visual field test locations were calculated wit...

  2. Comparison between the efficacy and side effects of intravitreal versus anterior chamber Bevacizumab injection in neovascular glaucoma patients

    OpenAIRE

    Ungureanu, E; Geamanu, A; Popescu, V; Dinu, I; Grecescu, M; Gradinaru, S

    2014-01-01

    Rationale. Neovascular glaucoma is the type of glaucoma most refractory to treatment. The most frequent causes are those associated with retinal hypoxia, which promotes the upregulation of the VEGF synthesis and produces fibrovascular membranes over the anterior chamber angle. Because the administration of anti VEGF products is still off label for neovascular glaucoma, there is not a single accepted way of treatment. There are differences between the site of administration (vitreal or anterio...

  3. Neuroprotection in glaucoma.

    Directory of Open Access Journals (Sweden)

    Kaushik S

    2003-01-01

    Full Text Available Currently, glaucoma is recognised as an optic neuropathy. Selective death of retinal ganglion cells (RGC is the hallmark of glaucoma, which is also associated with structural changes in the optic nerve head. The process of RGC death is thought to be biphasic: a primary injury responsible for initiation of damage that is followed by a slower secondary degeneration related to noxious environment surrounding the degenerating cells. For example, retinal ishaemia may establish a cascade of changes that ultimately result in cell death: hypoxia leads to excitotoxic levels of glutamate, which cause a rise in intra-cellular calcium, which in turn, leads to neuronal death due to apoptosis or necrosis. Neuroprotection is a process that attempts to preserve the cells that were spared during the initial insult, but are still vulnerable to damage. Although not yet available, a neuroprotective agent would be of great use in arresting the progression of glaucoma. There is evidence that neuroprotection can be achieved both pharmacologically and immunologically. Pharmacological intervention aims at neutralising some of the effects of the nerve-derived toxic factors, thereby increasing the ability of the spared neurons to cope with stressful conditions. On the other hand, immunological interventions boost the body′s own repair mechanisms for counteracting the toxic effects of various chemicals generated during the cascade. This review, based on a literature search using MEDLINE, focuses on diverse cellular events associated with glaucomatous neurodegeneration, and discusses some pharmacological agents believed to have a neuroprotective role in glaucoma.

  4. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... inside this specially designed contact lens. In laboratory experiments, the lens, which can also correct vision, releases ... eye rapidly and inconsistently. During testing in an animal model, the new ... multi-institution research team has found that glaucoma appears to result ...

  5. OCT Imaging in Glaucoma

    Science.gov (United States)

    Nevins, Jessica E.; Wollstein, Gadi; Schuman, Joel S.

    The precise micron scale quantification of ocular structures provided by OCT turn this technology to be a valuable tool in clinical evaluation of glaucoma patients. This chapter describes the clinical utility of OCT from choosing the scan pattern and scan location to the interpretation of the test outcome.

  6. Dual-illumination mode, wide-field probe imaging scheme for imaging irido-corneal angle region inside eye

    Science.gov (United States)

    Shinoj, V. K.; Murukeshan, V. M.; Hong, Jesmond; Baskaran, M.; Aung, Tin

    2015-07-01

    Noninvasive medical imaging techniques have generated great interest and high potential in the research and development of ocular imaging and follow up procedures. It is well known that angle closure glaucoma is one of the major ocular diseases/ conditions that causes blindness. The identification and treatment of this disease are related primarily to angle assessment techniques. In this paper, we illustrate a probe-based imaging approach to obtain the images of the angle region in eye. The proposed probe consists of a micro CCD camera and LED/NIR laser light sources and they are configured at the distal end to enable imaging of iridocorneal region inside eye. With this proposed dualmodal probe, imaging is performed in light (white visible LED ON) and dark (NIR laser light source alone) conditions and the angle region is noticeable in both cases. The imaging using NIR sources have major significance in anterior chamber imaging since it evades pupil constriction due to the bright light and thereby the artificial altering of anterior chamber angle. The proposed methodology and developed scheme are expected to find potential application in glaucoma disease detection and diagnosis.

  7. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

  8. Normal-tension glaucoma (Low-tension glaucoma)

    OpenAIRE

    Anderson Douglas

    2011-01-01

    Glaucoma is now considered an abnormal physiology in the optic nerve head that interacts with the level of intraocular pressure (IOP), with the degree and rate of damage depending on the IOP and presumably the degree of abnormal physiology. Diagnosis of normal-tension glaucoma (NTG), defined as glaucoma without a clearly abnormal IOP, depends on recognizing symptoms and signs associated with optic nerve vulnerability, in addition to absence of other explanations for disc abnormality and visua...

  9. Impact of a Glaucoma Severity Index on Results of Trabectome Surgery: Larger Pressure Reduction in More Severe Glaucoma

    Science.gov (United States)

    Loewen, Ralitsa T.; Roy, Pritha; Parikh, Hardik A.; Dang, Yalong; Schuman, Joel S.; Loewen, Nils A.

    2016-01-01

    Purpose To stratify outcomes of trabectome-mediated ab interno trabeculectomy (AIT) by glaucoma severity using a simple and clinically useful glaucoma index. Based on prior data of trabectome after failed trabeculectomy, we hypothesized that more severe glaucoma might have a relatively more reduced facility compared to mild glaucoma and respond with a larger IOP reduction to trabecular meshwork ablation. Methods Patients with primary open angle glaucoma who had undergone AIT without any other same session surgery and without any second eye surgery during the following 12 months were analyzed. Eyes of patients that had less than 12 months follow up or were diagnosed with neovascular glaucoma were excluded. A glaucoma index (GI) was created to capture glaucoma severity based on visual field, number of preoperative medications, and preoperative IOP. Visual field (VF) was separated into 3 categories: mild, moderate, and advanced (assigned 1, 2, and 3 points, respectively). Preoperative number of medications (meds) was divided into 4 categories: ≤1, 2, 3 or ≥4, and assigned with a value of 1 to 4. Baseline IOP (IOP) was divided into 3 categories: 12–18 (Group 3) and >18 (Group 4). Linear regression was used to determine if there was an association between GI group and IOP reduction after one year or age, gender, race, diagnosis, cup to disc (C/D) ratio, and Shaffer grade. Results Out of 1340 patients, 843 were included in the analysis. The GI group distribution was GI1 = 164, GI2 = 202, GI3 = 260, and GI4 = 216. Mean IOP reduction after one year was 4.0±5.4, 6.4±5.8, 9.0±7.6, 12.0±8.0 mmHg for GI groups 1 to 4, respectively. Linear regression showed that IOP reduction was associated with GI group after adjusting for age, gender, race, diagnosis, cup to disc ratio, and Shaffer grade. Each GI group increase of 1 was associated with incremental IOP reductions of 2.95±0.29 mmHg. Success rate at 12 months was 90%, 77%, 77%, and 71% for GI groups 1 to 4. The log

  10. Glaucoma and Corneal Transplant Procedures

    Directory of Open Access Journals (Sweden)

    Ammar M. Al-Mahmood

    2012-01-01

    Full Text Available Glaucoma after corneal transplantation is a leading cause of ocular morbidity after penetrating keratoplasty. The incidence reported is highly variable and a number of etiologic factors have been identified. A number of treatment options are available; surgical intervention for IOP control is associated with a high incidence of graft failure. IOP elevation is less frequently seen following deep anterior lamellar keratoplasty. Descemet's striping-automated endothelial keratoplasty is also associated with postprocedure intraocular pressure elevation and secondary glaucoma and presents unique surgical challenges in patients with preexisting glaucoma surgeries. Glaucoma exists in up to three-quarters of patients who undergo keratoprosthesis surgery and the management if often challenging. The aim of this paper is to highlight the incidence, etiology, and management of glaucoma following different corneal transplant procedures. It also focuses on the challenges in the diagnosis of glaucoma and intraocular pressure monitoring in this group of patients.

  11. Glaucoma in patients with uveitis.

    OpenAIRE

    Panek, W C; Holland, G N; Lee, D A; Christensen, R E

    1990-01-01

    The records of 100 patients (161 eyes) with uveitis were reviewed retrospectively to determine the prevalence of increased intraocular pressure, the forms of uveitis most commonly associated with glaucoma, and the forms that require specific glaucoma therapy. Secondary glaucoma was present in 23 patients (31 eyes): three of 24 patients with acute uveitis (three eyes, 12% of acute uveitis patients) and 20 of 76 patients with chronic uveitis (28 eyes, 26% of chronic uveitis patients). Eighteen ...

  12. The management of complicated glaucoma

    Directory of Open Access Journals (Sweden)

    Clement C

    2011-12-01

    Full Text Available Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management.

  13. Neuroprotective therapies for glaucoma

    Directory of Open Access Journals (Sweden)

    Song W

    2015-03-01

    Full Text Available Wei Song, Ping Huang, Chun Zhang Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China Abstract: Glaucoma is the second leading cause for blindness worldwide. It is mainly caused by glaucomatous optic neuropathy (GON characterized by retinal ganglion cell loss, which leads to visual field defect and blindness. Up to now, the main purpose of antiglaucomatous therapies has been to lower intraocular pressure (IOP through surgeries and medications. However, it has been found that progressive GON is still present in some patients with effective IOP decrease. Therefore, risk factors other than IOP elevation, like neurotrophin deprivation and excitotoxicity, contribute to progressive GON. Novel approaches of neuroprotection may be more effective for preserving the function of the optic nerve. Keywords: glaucoma, glaucomatous optic neuropathy, retinal ganglion cells, neuro­protection

  14. Ceratoplastia penetrante e glaucoma Penetrating keratoplasty and glaucoma

    Directory of Open Access Journals (Sweden)

    Márcio Eulálio Barreto Soares

    2007-08-01

    Full Text Available O objetivo deste artigo é discutir os conhecimentos atuais sobre a abordagem clínica e terapêutica da ceratoplastia penetrante e do glaucoma a ela associado.The aim of this article is to make a review about glaucoma associated with penetrating keratoplasty, describing since its incidence and risk factors until the different options for treatment.

  15. Intravitreal Bevacizumab (Avastin Injection for Neovascular Glaucoma

    Directory of Open Access Journals (Sweden)

    Shahin Yazdani

    2008-12-01

    Full Text Available

    PURPOSE: To report two cases with neovascular glaucoma secondary to ischemic central retinal vein occlusion (CRVO who were treated with intravitreal bevacizumab. CASE REPORT: Two patients were referred for neovascular glaucoma following CRVO. Visual acuity was light perception. Both eyes had extensive iris neovascularization (NVI, synechial angle closure and high intraocular pressure (IOP in spite of anti-glaucoma medications. After obtaining informed consent, both eye received an intravitreal injection of 2.5 mg (0.1 ml bevacizumab (Avastin. Both eyes demonstrated dramatic IOP reduction together with decreased severity and extent of NVI during 4 weeks of follow up. Visual acuity remained unchanged. CONCLUSION: Despite the dramatic short-term response in terms of IOP reduction and regression of neovascularization, due to limited clinical experience, one should consider this novel indication for bevacizumab cautiously.

  1. 重庆市永川地区50岁以上人群中青光眼患病率调查%Prevalence of glaucoma among adults aged 50 years or above in Yongchuan district of Chongqing

    Institute of Scientific and Technical Information of China (English)

    宋胜仿; 邬羽飞; 李华; 张永烨; 贺翔鸽; 刘世纯; 李崇金; 李春华; 缪李丽; 李革; 徐霁

    2009-01-01

    examination and the other examinations included peripheral depth of the anterior chamber (Van Heriek' s Method), intraocluar pressure(IOP)measure-ment with a portable mechanical applanation tonometer (Perkins tonometer), clinical assessment of the optic disk (including the cup-disc ratio、cup/disc asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages)which was performed with direct ophthalmoscopy.Results The examinations about glau-coma were finished in 5938 individuals.The reponse rate was 86.77%.In this population,the prevalence of glau-coma was 3.55%.The prevalence of the primary angle closure glaucoma was 2.49%, which increased with age significantly and was significantly higher in female population than male population.The prevalence of the pri-mary angle closure glaucoma was compared in different educational level, the lower the educational level, the higher the prevalence, there was significant difference.The prevalence of the primary open angle glaucoma and the secondary glaucoma was 0.86% and 0.20% respectively.There were only two subjects whose visual acuity was no less than 0.3 in this population.The visual function was damaged in 209 glaucoma patients, 8 were de-tected as low vision, 4 bilateral low vision, 168 unilateral blindness and 29 bilateral blindness cases.Conclu-sions The prevalence was higher in Yongchuan district of Chongqing than Shunyi district of Beijing in 1996, and the primary angle closure glaucoma was the main type of glaucoma in this district.The large proportion of enucleation of eyeball and blindness in the subjects of Yongchuan district was related to the social factors such as economy, culture, educational level and so on.The blincless cases of glaucoma patients will be reduced if we can follow-up closely and manage early through glaucoma screening programs for the subjects whose peripher-al depth of the anterior chamber are≤1/4 corneal thickness.

  2. [Glaucoma in dogs and cats. Review and retrospective evaluation of 421 patients. I. Pathobiological background, classification and breed predisposition].

    Science.gov (United States)

    Boevé, M H; Stades, F C

    1985-03-15

    Glaucoma is diagnosed frequently in dogs and cats. A review of case records at the University of Utrecht Small Animal Clinic revealed that during a 4-year period glaucoma accounted for 8.6% of all ophthalmological diagnoses. Glaucoma is defined as an increased intraocular pressure, which sooner or later leads to loss of function of the eye. Primary and secondary types can be distinguished. In primary glaucoma an increased intraocular pressure exists in the absence of other primary eye disorders. By gonioscopy a discrimination can be made between open and narrow or closed anterior chamber angle forms of primary glaucoma. This requires a clear distinction between the definitions of chamber angle and filtration angle. In the Netherlands primary glaucoma is seen especially in the American Cocker Spaniel, Bouvier and Basset breeds. In secondary glaucoma an increased intraocular pressure occurs as a consequence of another primary eye disorder. Dislocation of the lens is the main cause for secondary glaucoma. Several-mainly small-terrier breeds are predisposed to this entity. PMID:3873120

  3. The early history of glaucoma: the glaucous eye (800 BC to 1050 AD

    Directory of Open Access Journals (Sweden)

    Leffler CT

    2015-02-01

    Full Text Available Christopher T Leffler,1 Stephen G Schwartz,2 Tamer M Hadi,3 Ali Salman,1 Vivek Vasuki1 1Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA; 2Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL, USA; 3Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, TN, USA Abstract: To the ancient Greeks, glaukos occasionally described diseased eyes, but more typically described healthy irides, which were glaucous (light blue, gray, or green. During the Hippocratic period, a pathologic glaukos pupil indicated a media opacity that was not dark. Although not emphasized by present-day ophthalmologists, the pupil in acute angle closure may appear somewhat green, as the mid-dilated pupil exposes the cataractous lens. The ancient Greeks would probably have described a (normal green iris or (diseased green pupil as glaukos. During the early Common Era, eye pain, a glaucous hue, pupil irregularities, and absence of light perception indicated a poor prognosis with couching. Galen associated the glaucous hue with a large, anterior, or hard crystalline lens. Medieval Arabic authors translated glaukos as zarqaa, which also commonly described light irides. Ibn Sina (otherwise known as Avicenna wrote that the zarqaa hue could occur due to anterior prominence of the lens and could occur in an acquired manner. The disease defined by the glaucous pupil in antiquity is ultimately indeterminate, as the complete syndrome of acute angle closure was not described. Nonetheless, it is intriguing that the glaucous pupil connoted a poor prognosis, and came to be associated with a large, anterior, or hard crystalline lens. Keywords: glaucoma, history of ophthalmology, couching

  4. Risk factors for progression of visual field defects in medically treated patients with glaucoma.

    Science.gov (United States)

    Richler, M; Werner, E B; Thomas, D

    1982-12-01

    A multivariate discriminant analysis of potential risk factors for the progression of visual field defects was performed in 70 patients with chronic open-angle or low-tension glaucoma. Male sex, low diastolic blood pressure and diabetes mellitus were found to be significant risk factors. When the patients with low-tension glaucoma were excluded, a high mean intraocular pressure was identified as a risk factor. It was concluded that there is no reliable way to predict future visual field loss in patients with glaucoma. PMID:7165838

  5. Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma

    Directory of Open Access Journals (Sweden)

    Raj V Azad

    2014-01-01

    Full Text Available Purpose: To compare clarity, exposure and quality of anterior chamber angle visualization in congenital glaucoma patients, using RetCam and indirect gonioscopy images. Design: Cross-sectional study Participants. Congenital glaucoma patients over age of 5 years. Materials and Methods: A prospective consecutive pilot study was done in congenital glaucoma patients who were older than 5 years. Methods used are indirect gonioscopy and RetCam imaging. Clarity of the image, extent of angle visible and details of angle structures seen were graded for both methods, on digitally recorded images, in each eye, by two masked observers. Outcome Measures: Image clarity, interobserver agreement. Results: 40 eyes of 25 congenital glaucoma patients were studied. RetCam image had excellent clarity in 77.5% of patients versus 47.5% by gonioscopy. The extent of angle seen was similar by both methods. Agreement between RetCam and gonioscopy images regarding details of angle structures was 72.50% by observer 1 and 65.00% by observer 2. Conclusions: There was good agreement between RetCam and indirect gonioscopy images in detecting angle structures of congenital glaucoma patients. However, RetCam provided greater clarity, with better quality, and higher magnification images. RetCam can be a useful alternative to gonioscopy in infants and small children without the need for general anesthesia.

  6. Clinical effect of laser peripheral iridectomy for the treatment of early angle-closure glaucoma%激光虹膜周切术治疗早期闭角型青光眼临床观察

    Institute of Scientific and Technical Information of China (English)

    丁琼; 谭荣强; 郑春昌; 吴林彬; 周家承; 郑诚

    2012-01-01

    目的:观察早期闭角型青光眼患者激光虹膜周边切除术(laser peripheral iridectomy,LPI)的近、远期临床疗效.方法:对急性闭角型青光眼临床前期21例21眼和慢性闭角型青光眼早期15例15眼患者行LPI,随访1a,观察中央前房深度,房角宽度及眼压等情况.结果:急性闭角型青光眼临床前期和慢性闭角型青光眼早期LPI术后中央前房深度加深,房角增宽,眼压下降,但随访1a后慢性闭角型青光眼早期患者中央前房深度有所变浅、眼压回升,其中3例需药物控制眼压,1例药物控制眼压失败需行滤过性减压手术.结论:LPI治疗急性闭角型青光眼临床前期效果满意,慢性闭角型青光眼早期患者应注意LPI适应证的选择,对所有LPI患者,应密切随诊,以防止视功能进一步损害.

  7. Glaucoma: role of neuroprotective agents

    Directory of Open Access Journals (Sweden)

    Achyut N. Pandey

    2014-10-01

    Full Text Available Glaucoma is an optic neuropathy, considered as the second leading cause of blindness worldwide. Glaucoma is characterized by selective death of retinal ganglion cells (RGC and a progressive loss of vision. Elevated intraocular pressure (IOP is one of the most important risk factors for developing glaucoma and hence we mainly focus on lowering IOP to arrest the progression of glaucoma. However, many patients continue to demonstrate a clinically downhill course despite the control of initially raised IOP. In fact, some patients develop what is called normal tension glaucoma, not associated to an increased IOP. This emphasizes that several pressure-independent mechanisms are responsible for the development and progression of glaucomatous neuropathy and that high IOP and vascular insufficiency in the optic nerve head are only risk factors for the development of glaucoma, and are not the only target for the treatment of glaucoma. The reason is that the process of RGC death is thought to be biphasic, and the primary injury is followed by a slower secondary degeneration related to a noxious environment surrounding the apoptotic cells. This environment is characterized by changes in the extra-cellular ionic concentrations, increased amounts of free radicals, neurotrophins (NT depletion and increased glutamate-induced excitotoxicity due to high extra-cellular glutamate levels, which binds to N-methyl-D-aspartate (NMDA receptors leading to an abnormally high intracellular Ca2+ concentration. Neuroprotection is a process that attempts to preserve the remaining cells that are still vulnerable to damage, and the main aim of neuroprotective therapy is to employ pharmacologic or other means to attenuate the hostility of the environment surrounding the degenerating cells, or to supply the cells with the tools to deal with this aggression, providing resilience to the insult. Several agents have been reported neuroprotective in glaucoma, both in clinical assays

  8. Advanced glaucoma: Management pearls

    Directory of Open Access Journals (Sweden)

    Girum W Gessesse

    2013-01-01

    Full Text Available A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient′s perspective. The physician may also feel that they are in a difficult position managing the patient′s disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ′biopsychosociospiritual′ (BPSS profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health, psychological considerations (e.g., fear, depression, socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite, and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life.

  9. Macular Thickness and Volume Parameters Measured Using Optical Coherence Tomography (OCT) for Evaluation of Glaucoma Patients

    OpenAIRE

    Barišić, Freja; Jurin Sičaja, Ana; Malenica Ravlić, Maja; Novak-Lauš, Katia; Iveković, Renata; Mandić, Zdravko

    2012-01-01

    The aim of this study was to evaluate macular thickness parameters in glaucoma patients and to compare them to normal subjects using Optical Coherence Tomography (OCT). This prospective, observational study included 20 primary open angle glaucoma patients (POAG) and 20 healthy subjects in control group. Exclusion criteria were diabetes and other macular pathology, like age-related macular degeneration, macular oedema, central serous retinopathy and high myopia >4.00 dsph. OCT imag...

  10. Neovascular Glaucoma at King Khaled Eye Specialist Hospital – Etiologic Considerations

    OpenAIRE

    Al-Shamsi Hanan; Dueker David; Nowilaty Sawsan; Al-Shahwan Sami

    2009-01-01

    Background: Neovascular glaucoma (NVG) is a severe form of secondary glaucoma caused by the growth of new vessels over the trabecular meshwork. The principal causes are associated with retinal ischemia. Ablative treatment of the retina can prevent, halt, and even reverse the growth of new vessels on the iris and angle. It is an essential part of the management in most cases. Aims: To determine the causes of NVG among Saudi patients, presented at the King Khaled Eye Specialist Hospital. Me...

  11. Identification of noncompliant glaucoma patients using Bayesian networks and the Eye-Drop Satisfaction Questionnaire

    OpenAIRE

    Nordmann, Jean-Philippe; Baudouin, Christian; Renard, Jean-Paul; Denis, Philippe; Regnault, Antoine; Berdeaux, Gilles

    2010-01-01

    Objective: To identify poorly compliant glaucoma patients, using the Eye-Drop Satisfaction Questionnaire (EDSQ). Methods: This was an observational cross-sectional study with compliance data collected by an electronic monitoring device. Patients with primary open-angle glaucoma or ocular hypertension completed the EDSQ, a six-dimension self-reported questionnaire addressing “treatment concern”, “disease concern”, “patient–clinician relationship”, “positive beliefs”, “treatment convenience”, a...

  12. Laser trabeculoplasty as the primary therapy in simple and capsular glaucoma

    International Nuclear Information System (INIS)

    Very little is known about the efficacy of Argon laser trabeculoplasty as an initial therapy in early glaucomatous eyes. Owing to the favourable results gained with laser trabeculoplasty in the treatment of advanced stages of glaucoma and the low rate of complications reported, laser trabeculoplasty was accepted as an alternative to conventional medical therapy in early open angle glaucoma. In this paper, a retrospective study of 54 treated patients, the therapy is reported to be highly effective. (Auth.)

  13. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    OpenAIRE

    Betsy Sleath; Blalock, Susan J; Carpenter, Delesha M.; Kelly W. Muir; Robyn Sayner; Scott Lawrence; Giangiacomo, Annette L.; Mary Elizabeth Hartnett; Gail Tudor; Jason Goldsmith; Robin, Alan L.

    2014-01-01

    Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at s...

  14. 布林佐胺联合曲伏前列素治疗开角型青光眼的临床疗效及安全性%Brinzolamide Combined with Travoprost in Treating Open Angle Glaucoma and Its Safety

    Institute of Scientific and Technical Information of China (English)

    刘艳琼

    2015-01-01

    目的 探讨布林佐胺联合曲伏前列素治疗开角型青光眼的临床疗效及安全性.方法 选取2014年1月至2015年1月医院收治的开角型青光眼患者64例(112眼),随机分成对照组和观察组,各32例(56眼).药物洗脱期后,对照组给予曲伏前列素每日1次滴眼治疗,观察组加用布林佐胺每日2次滴眼治疗.结果 观察组总有效率为90. 62%,显著高于对照组的76. 67%( P0. 05 ).观察组不良反应发生率为12. 50%,与对照组的15. 62%比较无明显差异( P>0. 05 ).结论 布林佐胺联合曲伏前列素治疗开角型青光眼可有效改善患者眼压情况,临床疗效佳,但可导致患者泪膜稳定性下降,泪液分泌减少,对结膜、角膜有一定损伤,对眼表的影响与单一用药相当.%Objective To evaluate the clinical efficacy of brinzolamide combined with travoprost in treating open-angle glaucoma and its safety. Methods 64 patients with open angle glaucoma ( 112 eyes ) from January 2015 to January 2014 were randomly divided into control group and observation group, 32 cases ( 56 eyes ) in each group. After a washout period, the control group was treated with travo-prost eye drops ( 1 time/d ) , the observation group was added with brinzolamide eye drops ( 2 times/d ) on the basis of the contro, group. Results After treatment, the total effective rate of the observation group was 90. 62% , which was significantly higher than 76. 67% of the control group ( P 0. 05 ) . The incidence rate of adverse reactions in the observation group was 12. 50%, which had no significantly difference between the control group ( P > 0. 05 ) . Conclusion Brinzolamide combined with travoprost in treating open angle glaucoma can effectively improve the IOP with good clinical efficacy. But it can also lead to a decrease in tear film stability and tear secretion, and has some damage on conjunctiva and cornea;its influence on the ocular surface is equal with the single drug use.

  15. Watch Out for Glaucoma | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Glaucoma Watch Out for Glaucoma Past Issues / Spring 2015 Table of Contents A ... used to check eye pressure for signs of glaucoma. Photo courtesy of NEI Glaucoma is a group ...

  16. Glaucoma after Congenital Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Mahmoodreza Panahi Bazaz

    2014-05-01

    Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.

  17. Evaluation of a glaucoma patient

    Directory of Open Access Journals (Sweden)

    Thomas Ravi

    2011-12-01

    Full Text Available The diagnosis of glaucoma is usually made clinically and requires a comprehensive eye examination, including slit lamp, applanation tonometry, gonioscopy and dilated stereoscopic evaluation of the optic disc and retina. Automated perimetry is obtained if glaucoma is suspected. This establishes the presence of functional damage and provides a baseline for follow-up. Imaging techniques are not essential for the diagnosis but may have a role to play in the follow-up. We recommend a comprehensive eye examination for every clinic patient with the objective of detecting all potentially sight-threatening diseases, including glaucoma.

  18. Long-term results of non-valved Glaucoma drainage implant surgery and glaucoma drainage implant combined with trabeculectomy

    Directory of Open Access Journals (Sweden)

    Teruhiko Hamanaka

    2014-01-01

    Full Text Available Purpose: The purpose was to investigate the efficacy and complications of nonvalved glaucoma drainage implant (GDI surgery and GDI combined with trabeculectomy. Subjects and Methods: Serial Japanese patients who received GDI were retrospectively investigated. The survival rate of eyes was analyzed using the Kaplan-Meier method, defining death as: (1 Intraocular pressure (IOP <6 mmHg, or ≥22 mmHg, and <20% reduction of preoperative IOP, (2 additional glaucoma surgery, (3 loss of light perception. Prognostic factors of age, sex, previous surgery, type of glaucoma, synechial closure, preoperative IOP, type of GDI (single-, double-plate Molteno, Baerveldt 350 and GDI combined with trabeculectomy were investigated employing proportional hazards analysis. Results: One hundred and twenty-four eyes of 109 patients aged 53.3 ± 7.8 years old were analyzed. Types of GDI were single-plate (15.3%, double-plate Molteno (71.8%, and Baerveldt 350 (12.9%. The results of survival rate analysis were 86.1, 71.1, 71.1, and 64.6% for 1, 3, 5, and 10 years respectively. Thirty-four eyes (27.4% died because of uncontrolled IOP (19.4%, loss of light perception (5.6%, and additional glaucoma surgery (2.4%. Single-plate Molteno was the only risk factor for failure. Persistent unphysiological hypotony (0.8% and bullous keratopathy (5.6% were observed. Conclusion: Nonvalved GDI surgery and GDI combined with trabeculectomy using nonabsorbable tube ligature proved to be an excellent device for any type of glaucoma in Japanese patients. Hypotony and corneal endothelial loss are the most serious complication in the long-term results of our patients.

  19. Clinical findings following Ahmed Glaucoma Valve™ implantation in pediatric glaucoma

    OpenAIRE

    Pirouzian, Amir; Demer, Joseph L.

    2008-01-01

    Purpose To describe clinical findings after Ahmed valve drainage implantation in children. Design All records in one practice were reviewed to identify and describe clinical findings in all children who had undergone Ahmed Glaucoma Valve™ S2 model insertion for uncontrolled primary or secondary glaucoma. Results A total of 6 patients were identified, ranging in age from 2–15 years. Mean follow-up time averaged from 2–5 years from the time of tube insertion. Three patients exhibited pupillary ...

  20. Cerebrospinal Fluid Pressure and Glaucoma

    OpenAIRE

    Jonas, Jost B; Ningli Wang

    2013-01-01

    Eyes with normal-pressure glaucoma and those with high-pressure glaucoma can show a similar optic nerve head appearance, while eyes with vascular optic neuropathies show a markedly different optic disc appearance. Factors in addition to intraocular pressure (IOP) may thus play a role in the pathogenesis of glaucomatous optic neuropathy. Clinical and experimental studies showed that (1) physiologic associations between cerebrospinal fluid (CSF) pressure, systemic arterial blood pressure, IOP a...

  1. Double anterior chamber in a patient with glaucoma and microspherophakia

    Directory of Open Access Journals (Sweden)

    Hamid Khakshoor

    2011-01-01

    Full Text Available We report the case of a 16-year-old woman with microspherophakia and secondary open angle glaucoma. The patient presented with a membrane dividing the anterior chamber into two segments without edema or Descemet′s membrane detachment. Slit lamp biomicroscopy, Pentacam, and specular microscopy images were obtained. Double anterior chamber is primarily found in patients with anterior chamber anomalies when there is no history of surgery or trauma.

  2. Economic burden of glaucoma in Rivers State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adio AO

    2012-12-01

    Full Text Available Adedayo O Adio,1 Alfred A Onua21University Of Port Harcourt Teaching Hospital, 2Braithwaite Memorial Specialist Hospital, Port Harcourt, Rivers State, NigeriaBackground: Primary open angle glaucoma is reported to blind 150,000 people in the Nigerian population and over 7000 in Rivers State, and requires constant follow-up. Compliance is a challenge, given that most inhabitants live below the poverty line. This study was performed to determine how Nigerian patients are affected economically by the disease.Methods: Consecutive adult patients attending the eye clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, with a diagnosis of primary open angle glaucoma and on outpatient antiglaucoma treatment in the first 6 months of 2006, were recruited for the study. The lowest paid government worker was on USD50 (N7500.00 per month and the gross domestic product per capita was USD1150 for the period under review.Results: We enrolled 120 consecutive patients of mean age 52.7 ± 10.4 years, with a male to female ratio of 2:3. The most common occupations were in the civil service (n = 56, 46.7%. All participants were on topical antiglaucoma treatment. The average cost of medical antiglaucoma medication was N6000 (USD40 per month. Computed to include indirect costs, including medical laboratory tests, transportation, and care by patient escorts, an average sum of USD105.4 (N15,810 was spent by each patient per month. Most of the patients (73.3% were responsible for their own treatment costs. No patient accepted the cheaper option of surgery (USD275.4, N41,310. Eighty of the patients (66.7% visited our eye clinic monthly. Direct and indirect loss to the economy was USD3,064587 per annum from those already blind. This was in addition to the USD 4.1 million being spent yearly on medical treatment by those who were visually impaired by glaucoma.Conclusion: Middle-income earners spent over 50% of their monthly income and low

  3. Current concepts in the diagnosis and management of developmental glaucomas

    Directory of Open Access Journals (Sweden)

    Mandal Anil

    1993-01-01

    Full Text Available Developmental glaucoma is a global problem and has a broad range of ocular manifestations and is sometimes associated with systemic disorders and syndromes. It poses a major diagnostic and management problem to the ophthalmologists. A proper diagnostic evaluation under general anesthesia is advisable for all children who do not cooperate for an office examination. Surgery remains the principal therapeutic modality in the management of developmental glaucoma and medical therapy is limited to a supplemental role while the child is being prepared for surgery. Conventional angle incision surgery (goniotomy and trabeculotomy ab externo is uniquely valuable in the management of primary developmental glaucoma, while combined trabeculotomy cum trabeculectomy offers the best hope of success in advanced cases. In recent years, artificial drainage devices such as the Molteno implant seem to be promising for safe and effective pressure control in children with refractory developmental glaucoma. Visual rehabilitation involves correction of refractive errors, removal of opacities in media (i.e. cataract or corneal scarring and aggressive amblyopia therapy. Early diagnosis, prompt institution of therapy combined with commitment from the family for postoperative follow-up care are critical for the restoration of good visual function.

  4. Evaluation of the Ex-PRESS® P-50 implant under scleral flap in combined cataract and glaucoma surgery

    Science.gov (United States)

    Huerva, Valentín; Soldevila, Jordi; Ascaso, Francisco J.; Lavilla, Laura; Muniesa, M. Jesús; Sánchez, M. Carmen

    2016-01-01

    AIM To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS® P-50 for combined cataract surgery and glaucoma. METHODS Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS® P-50 model placed under scleral flap was performed. RESULTS Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, Pphacoemulsification with ExPRESS® P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation. PMID:27162726

  5. A study of the safety and efficacy of travoprost 0.004%/timolol 0.5% ophthalmic solution compared to latanoprost 0.005% and timolol 0.5% dosed concomitantly in patients with open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Douglas J Rhee

    2008-06-01

    Full Text Available Douglas J Rhee1, James H Peace2, Sushanta Mallick3, Theresa A Landry3, Michael VW Bergamini3, and the Study Group*1Massachusetts Eye and Ear Infirmary, Harvard University, Boston, MA, USA; 2Diabetic Eye Medical Clinic, Inglewood, CA, USA; 3Alcon Laboratories, Inc., Ft. Worth, TX, USA; *Study Group members listed in AppendixBackground/Aims: To compare the intraocular pressure (IOP-lowering efficacy of travoprost 0.004%/timolol 0.5% in fixed combination with the unfixed combination of latanoprost 0.005% and timolol 0.5% in open-angle glaucoma or ocular hypertension patients with IOP levels below 18 mmHg on the unfixed combination of latanoprost 0.005% and timolol 0.5%.Methods: Following a 30-day open-label run-in with latanoprost QD PM and timolol QD AM, subjects with intraocular pressure below 18 mmHg were randomized to continue concomitant latanoprost QD PM and timolol QD AM or switch to travoprost 0.004%/timolol 0.5% QD AM and vehicle QD PM in masked fashion and were followed for 3 months. The primary efficacy endpoint was mean IOP reduction from baseline.Results: There were no clinically relevant or statistically significant differences in mean IOP, mean IOP change from baseline, or percentage IOP change from baseline between the two treatment groups. Between-group differences in mean IOP were within ±0.3 mmHg at all time points (p ≥ 0.384, and between-group differences in mean IOP change from baseline were within ±0.4 mmHg at all time points. Overall, 88% of patients whose IOP was less than 18 mmHg on the unfixed combination of latanoprost and timolol remained well controlled on the same regimen in the masked portion of the study, compared with 92% who remained well controlled after switching to travoprost/timolol.Conclusion: Travoprost 0.004%/timolol 0.5% administered once daily and concomitant administration of timolol 0.5% and latanoprost 0.005% produce similar maintenance of IOP-lowering effect in patients who were previously well

  6. Dry Eyes and Glaucoma: Double Trouble

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  7. Association Between Diabetes Mellitus And Glaucoma

    OpenAIRE

    Oshitari T

    2014-01-01

    It has not been determined definitively whether there is a significant association between diabetes mellitus (DM) and glaucoma. Some population-based studies have shown a positive association between diabetes and glaucoma, and others have shown negative association between diabetes and glaucoma. However in many studies that showed a lack of a significant association between diabetes and glaucoma, the diagnosis of DM was made by self-presentation.

  8. YBR/EiJ mice: a new model of glaucoma caused by genes on chromosomes 4 and 17

    Science.gov (United States)

    Nair, K. Saidas; Cosma, Mihai; Raghupathy, Narayanan; Sellarole, Michael A.; Tolman, Nicholas G.; de Vries, Wilhelmine; Smith, Richard S.

    2016-01-01

    ABSTRACT A variety of inherited animal models with different genetic causes and distinct genetic backgrounds are needed to help dissect the complex genetic etiology of glaucoma. The scarcity of such animal models has hampered progress in glaucoma research. Here, we introduce a new inherited glaucoma model: the inbred mouse strain YBR/EiJ (YBR). YBR mice develop a form of pigmentary glaucoma. They exhibit a progressive age-related pigment-dispersing iris disease characterized by iris stromal atrophy. Subsequently, these mice develop elevated intraocular pressure (IOP) and glaucoma. Genetic mapping studies utilizing YBR as a glaucoma-susceptible strain and C57BL/6J as a glaucoma-resistant strain were performed to identify genetic loci responsible for the iris disease and high IOP. A recessive locus linked to Tyrp1b on chromosome 4 contributes to iris stromal atrophy and high IOP. However, this is not the only important locus. A recessive locus on YBR chromosome 17 causes high IOP independent of the iris stromal atrophy. In specific eyes with high IOP caused by YBR chromosome 17, the drainage angle (through which ocular fluid leaves the eye) is largely open. The YBR alleles of genes on chromosomes 4 and 17 underlie the development of high IOP and glaucoma but do so through independent mechanisms. Together, these two loci act in an additive manner to increase the susceptibility of YBR mice to the development of high IOP. The chromosome 17 locus is important not only because it causes IOP elevation in mice with largely open drainage angles but also because it exacerbates IOP elevation and glaucoma induced by pigment dispersion. Therefore, YBR mice are a valuable resource for studying the genetic etiology of IOP elevation and glaucoma, as well as for testing new treatments. PMID:27483353

  9. YBR/EiJ mice: a new model of glaucoma caused by genes on chromosomes 4 and 17.

    Science.gov (United States)

    Nair, K Saidas; Cosma, Mihai; Raghupathy, Narayanan; Sellarole, Michael A; Tolman, Nicholas G; de Vries, Wilhelmine; Smith, Richard S; John, Simon W M

    2016-08-01

    A variety of inherited animal models with different genetic causes and distinct genetic backgrounds are needed to help dissect the complex genetic etiology of glaucoma. The scarcity of such animal models has hampered progress in glaucoma research. Here, we introduce a new inherited glaucoma model: the inbred mouse strain YBR/EiJ (YBR). YBR mice develop a form of pigmentary glaucoma. They exhibit a progressive age-related pigment-dispersing iris disease characterized by iris stromal atrophy. Subsequently, these mice develop elevated intraocular pressure (IOP) and glaucoma. Genetic mapping studies utilizing YBR as a glaucoma-susceptible strain and C57BL/6J as a glaucoma-resistant strain were performed to identify genetic loci responsible for the iris disease and high IOP. A recessive locus linked to Tyrp1(b) on chromosome 4 contributes to iris stromal atrophy and high IOP. However, this is not the only important locus. A recessive locus on YBR chromosome 17 causes high IOP independent of the iris stromal atrophy. In specific eyes with high IOP caused by YBR chromosome 17, the drainage angle (through which ocular fluid leaves the eye) is largely open. The YBR alleles of genes on chromosomes 4 and 17 underlie the development of high IOP and glaucoma but do so through independent mechanisms. Together, these two loci act in an additive manner to increase the susceptibility of YBR mice to the development of high IOP. The chromosome 17 locus is important not only because it causes IOP elevation in mice with largely open drainage angles but also because it exacerbates IOP elevation and glaucoma induced by pigment dispersion. Therefore, YBR mice are a valuable resource for studying the genetic etiology of IOP elevation and glaucoma, as well as for testing new treatments. PMID:27483353

  10. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath

    2014-01-01

    Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

  11. View How Glaucoma May Affect Vision

    Science.gov (United States)

    ... inbox. Sign up View How Glaucoma May Affect Vision Normal Vision This is an example of normal vision. This is also an example of how someone ... gradual and often imperceptible failing of side (peripheral) vision. Intermediate Glaucoma As glaucoma progresses, the center of ...

  12. Restaurant closures

    CERN Multimedia

    Novae Restauration

    2012-01-01

    Christmas Restaurant closures Please note that the Restaurant 1 and Restaurant 3 will be closed from Friday, 21 December at 5 p.m. to Sunday, 6 January, inclusive. They will reopen on Monday, 7 January 2013.   Restaurant 2 closure for renovation To meet greater demand and to modernize its infrastructure, Restaurant 2 will be closed from Monday, 17 December. On Monday, 14 January 2013, Sophie Vuetaz’s team will welcome you to a renovated self-service area on the 1st floor. The selections on the ground floor will also be expanded to include pasta and pizza, as well as snacks to eat in or take away. To ensure a continuity of service, we suggest you take your break at Restaurant 1 or Restaurant 3 (Prévessin).

  13. The observation of anterior segment morphological changes in eyes with primary angle closure after LPI by using UBM%原发性前房角关闭行LPI后眼前节形态学的UBM观察

    Institute of Scientific and Technical Information of China (English)

    吴杨杨; 宋胜仿; 刘世纯; 李春华; 张永烨; 吕莎

    2014-01-01

    观察原发性前房角关闭(primary angle closure, PAC)行YAG激光周边虹膜切除术(laser peripheral iridotomy, LPI)后眼前节形态学的变化。方法:选择2012年3月至2013年3月在我院诊断为PAC并行LPI的患者28例(48眼)为研究对象,应用超声生物显微镜(ultrasound biomicroscopy, UBM),观察LPI术前及术后1天、1周、1个月及3个月各时间点颞上、正上、正下、颞侧、鼻侧共5个位点的房角开放距离(angle opening distance, AOD500)、小梁虹膜夹角(trabecu-lar-iris angle, TIA)、小梁睫状体距离(trabecular ciliary process distance, TCPD)、虹膜睫状体距离(iris ciliary process distance , ICPD)、虹膜晶体夹角(iris lens angle, ILA)、虹膜晶体接触距离(iris lens process distance, ILCD)、虹膜厚度1(iris thickness, ITl)、IT2、IT3以及中央前房深度(cental depth distance, ACD)的变化。结果:AOD500、TIA:术后较术前均增大(P<0.05);术后1周大于术后其余时间点(P>0.05)。TCPD:除个别位点较术前增加(P>0.05),其余时间点相应位点较术前增加(P<0.05);术后1周大于术后其余时间点(P>0.05)。ILA:术后较术前均减小(P<0.05);术后1天至术后3个月逐渐增大(P>0.05)。ILCD:术后较术前均增大(P<0.05),术后1天至术后3个月逐渐减小(P>0.05);IT1、IT2、IT3:术后较术前均减小(P<0.05);术后各时间点间比较(P>0.05)。ACD:术后较术前增加(P>0.05)。 LPI术前及术后各时间点平均ILA与平均ILCD的相关性显示二者呈高度负相关。结论:PAC患者行LPI术后周边前房明显加深,虹膜膨隆和瞳孔阻力减轻,但术后3个月内眼前节形态并不稳定,个别参考值有不同程度的回退,LPI术后有必要进行长期随访观察。%Objective To evaluate the changes in the anterior segment morphology by using ultrasound biomicroscopy (UBM) after YAG laser

  14. 原发性前房角关闭激光周边虹膜切除术后前房角的改变%Evaluation of changes in anterior segment morphology of primary angle closure after laser peripheral iridotomy

    Institute of Scientific and Technical Information of China (English)

    张英; 田祥; 潘乐

    2012-01-01

    Objective To discover primary angle closure (PAC) in eyes of anatomic narrow angle (ANA),evaluate quantify changes of the PAC in anterior segment morphology after laser iridotomy using ultrasound biomicroscopy (UBM) and explore the therapy of primary angle closure.Methods Prospective interventive observational case series.Twenty-eight eyes of patients presented PAC in the Department of Ophthalmology at Zunyi Medical College Hospital.PAC was presented on iris contacting with trabecular meshwork temporally in one UBM image.The PAC eyes were examined again by UBM in the both same light conditions and items at two weeks after laser peripheral iridotomy (LPI).Results The rate of PAC was significantly decreased after LPI in the same condition,the rate of PAC was 96.43% before LPI in dark condition,and it was significantly dropped down to 32.14% after LPI (x2 =14.45,P <0.05).In light condition,it was cut down from 67.86% to 7.14% after LPI (x2 =15.06,P <0.05).The AOD500 and TIA were increased after LPI (P <0.001),it indicated that the angle of PAC was widened after LPI.The ILCD of PAC was also added after LPI,but the ILA was decreased after LPI (P <0.001).This phenomenon suggested that the pupillary block was relieved after care of LPI.The IT1 was thinner in laser site quadrant in dark condition after LPI which combined Nd-YAG and green laser (P <0.05).There were no significant changes of the ACD (P >0.05).The ICPD was reduced in dark after LPI (t =2.519,P =0.012).The pupillary block was relieved; it leaded to iris caving backward.But the TCPD was added in light after LPI (t =-2.967,P =0.003).It suggested that the ciliary body removed towards the back after LPI.Conclusions LPI produces a significant widening of the peripheral anterior chamber angle and reducing the power of pupillary block for major PAC eyes,which have not peripheral anterior synechia,but not deeping the central anterior chamber distance.LPI can prevent most PAC from developing to PACG

  15. DNA sequence variants in the LOXL1 gene are associated with pseudoexfoliation glaucoma in a U.S. clinic-based population with broad ethnic diversity

    Directory of Open Access Journals (Sweden)

    Miller Joan W

    2008-02-01

    Full Text Available Abstract Background Pseudoexfoliation syndrome is a major risk factor for glaucoma in many populations throughout the world. Using a U.S. clinic-based case control sample with broad ethnic diversity, we show that three common SNPs in LOXL1 previously associated with pseudoexfoliation in Nordic populations are significantly associated with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Methods Three LOXL1 SNPs were genotyped in a patient sample (206 pseudoexfoliation, 331 primary open angle glaucoma, and 88 controls from the Glaucoma Consultation Service at the Massachusetts Eye and Ear Infirmary. The SNPs were evaluation for association with pseudeoexfoliation syndrome, pseudoexfoliation glaucoma, and primary open angle glaucoma. Results The strongest association was found for the G allele of marker rs3825942 (G153D with a frequency of 99% in pseudoexfoliation patients (with and without glaucoma compared with 79% in controls (p = 1.6 × 10-15; OR = 20.93, 95%CI: 8.06, 54.39. The homozygous GG genotype is also associated with pseudoexfoliation when compared to controls (p = 1.2 × 10-12; OR = 23.57, 95%CI: 7.95, 69.85. None of the SNPs were significantly associated with primary open angle glaucoma. Conclusion The pseudoexfoliation syndrome is a common cause of glaucoma. These results indicate that the G153D LOXL1 variant is significantly associated with an increased risk of pseudoexfoliation and pseudoexfoliation glaucoma in an ethnically diverse patient population from the Northeastern United States. Given the high prevalence of pseudooexfoliation in this geographic region, these results also indicate that the G153D LOXL1 variant is a significant risk factor for adult-onset glaucoma in this clinic based population.

  16. The current research status of normal tension glaucoma

    Directory of Open Access Journals (Sweden)

    Mi XS

    2014-09-01

    Full Text Available Xue-Song Mi,1,2 Ti-Fei Yuan,3,4 Kwok-Fai So2,4,5 1Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China; 2Department of Anatomy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China; 3School of Psychology, Nanjing Normal University, Nanjing, People’s Republic of China; 4Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China; 5GHM Institute of CNS Regeneration, Jinan University, Guangzhou, People’s Republic of China Abstract: Normal tension glaucoma (NTG is a progressive optic neuropathy that mimics primary open-angle glaucoma, but lacks the findings of elevated intraocular pressure or other mitigating factors that can lead to optic neuropathy. The present review summarized the causes, genetics, and mechanisms underlying NTG in both animal models and human patients. We also proposed that the neurovascular unit is a therapeutic target for NTG management. Keywords: aging, genetics, neurovascular unit, primary open-angle glaucoma, treatment

  17. Generation of reactive oxygen species in the anterior eye segment. Synergistic codrugs of N-acetylcarnosine lubricant eye drops and mitochondria-targeted antioxidant act as a powerful therapeutic platform for the treatment of cataracts and primary open-angle glaucoma.

    Science.gov (United States)

    Babizhayev, Mark A

    2016-12-01

    Senile cataract is a clouding of the lens in the aging eye leading to a decrease in vision. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide. Cataracts result from the deposition of aggregated proteins in the eye lens and lens fiber cells plasma membrane damage which causes clouding of the lens, light scattering, and obstruction of vision. ROS induced damage in the lens cell may consist of oxidation of proteins, DNA damage and/or lipid peroxidation, all of which have been implicated in cataractogenesis. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can't drain out of the eye. With primary open-angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs further inside the drainage canals, similar to a clogged pipe below the drain in a sink. The excessive oxidative damage is a major factor of the ocular diseases because the mitochondrial respiratory chain in mitochondria of the vital cells is a significant source of the damaging reactive oxygen species superoxide and hydrogen peroxide. However, despite the clinical importance of mitochondrial oxidative damage, antioxidants have been of limited therapeutic success. This may be because the antioxidants are not selectively taken up by mitochondria, but instead are dispersed throughout the body, ocular tissues and fluids' moieties. This work is an attempt to integrate how mitochondrial reactive oxygen species (ROS) are altered in the aging eye, along with those protective and repair therapeutic systems believed to regulate ROS levels in ocular tissues and how damage to these systems contributes to age-onset eye disease and cataract formation. Mitochondria

  18. Susceptibility to glaucoma: differential comparison of the astrocyte transcriptome from glaucomatous African American and Caucasian American donors

    OpenAIRE

    Lukas, Thomas J.; Miao, Haixi; Chen, Lin; Sean M Riordan; Li, Wenjun; Crabb, Andrea M.; Wise, Alexandria; Du, Pan; Lin, Simon M; Hernandez, M Rosario

    2008-01-01

    Background Epidemiological and genetic studies indicate that ethnic/genetic background plays an important role in susceptibility to primary open angle glaucoma (POAG). POAG is more prevalent among the African-descent population compared to the Caucasian population. Damage in POAG occurs at the level of the optic nerve head (ONH) and is mediated by astrocytes. Here we investigated differences in gene expression in primary cultures of ONH astrocytes obtained from age-matched normal and glaucoma...

  19. Interface Fluid Syndrome Induced by Uncontrolled Intraocular Pressure Without Triggering Factors After LASIK in a Glaucoma Patient

    OpenAIRE

    Shoji, Nobuyuki; Ishida, Akira; Haruki, Takahiro; Matsumura, Kazuhiro; Kasahara, Masayuki; Shimizu, Kimiya

    2015-01-01

    Abstract This study sought to describe a glaucoma patient with interface fluid syndrome (IFS) induced by uncontrolled intraocular pressure (IOP) without triggering factors after laser in situ keratomileusis (LASIK). Case report and review of the literature. A 23-year-old man with open-angle glaucoma underwent bilateral LASIK for myopia in 2009. Two years later, the patient reported sudden vision loss. The IOP in the right eye was not measurable using Goldmann applanation tonometry (GAT), but ...

  20. Clinical findings following Ahmed Glaucoma Valve™ implantation in pediatric glaucoma

    Directory of Open Access Journals (Sweden)

    Amir Pirouzian

    2008-03-01

    Full Text Available Amir Pirouzian1, Joseph L Demer21Department of Ophthalmology, San Diego Children’s Hospital, San Diego, UCSD, San Diego, CA, USA; 2Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USAPurpose: To describe clinical findings after Ahmed valve drainage implantation in children.Design: All records in one practice were reviewed to identify and describe clinical findings in all children who had undergone Ahmed Glaucoma ValveTM S2 model insertion for uncontrolled primary or secondary glaucoma.Results: A total of 6 patients were identified, ranging in age from 2–15 years. Mean follow-up time averaged from 2–5 years from the time of tube insertion. Three patients exhibited pupillary peaking towards the tube of the valve. All patients required additional surgery or additional medications to control intraocular pressure. Lenticular opacification near the tube site developed in one patient. Gradual tube extrusion was also noted in another two patients.Conclusion: Multiple clinical events follow the Ahmed valve insertion in children. Pupillary irregularity is the most commonly noted event in this series. To avoid or reduce the risk of this complication, additional or modification of surgical procedures could be considered. The mechanism of such occurrence will further be discussed.Keywords: Ahmed Glaucoma Valve, children, pediatric glaucoma

  1. 海德堡视网膜断层扫描仪在开角型青光眼诊断中的价值%The evaluation signifcance of Heidelberg retina tomography in primary open angl glaucoma

    Institute of Scientific and Technical Information of China (English)

    李海燕; 张翠荣; 方秀荣; 万晓钢

    2011-01-01

    目的 评价海德堡视网膜断层扫描仪 (Heidelberg retina tomograph,HRT)在开角型青光眼(primary open angl glaucom,POAG)诊断中的应用价值.方法 对照组98例(98眼)和POAG组36例(36眼)分别行HRT检查,比较各组间视盘结构参数的差异,并用ROC曲线下面积分析不同参数的诊断灵敏度和特异度.结果 对照组与POAG组间杯盘面积比、视杯容积、盘沿容积、视杯形态测量指数及平均视网膜神经纤维层厚度差异均有统计学意义(P<0.05).ROC曲线下面积分析特异度最高的为视杯形态测量指数,灵敏度最高的为平均视网膜神经纤维层厚度.结论 HRT检查对开角型青光眼的诊断有很大帮助.

  2. Relationship between systemic hypertension, perfusion pressure and glaucoma: A comparative study in an adult Indian population

    Directory of Open Access Journals (Sweden)

    Amit K Deb

    2014-01-01

    Full Text Available Aims: To study the relationship between blood pressure (BP, intraocular pressure (IOP, mean ocular perfusion pressure (MOPP and primary open angle glaucoma (POAG in patients with hypertension and compare it to a control group of normotensives. Design: Cross-sectional observational study. Materials and Methods: A total of 108 subjects with primary hypertension and 100 age-matched controls without hypertension were enrolled for the study. IOP measurement using Noncontact Tonometer and dilated fundus evaluation using + 90 D lens were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey′s central visual fields, optical coherence tomography and pachymetry were done for all subjects with IOP > 21 mm Hg or C: D ratio ≥ 0.5 or asymmetry of > 0.2. Statistical Analysis: Univariate and multivariate multinomial regression models were used to determine the association between covariates and risk of glaucoma or glaucoma suspect. Results: There was no difference in the glaucoma status between subjects with and without hypertension. Subjects on antihypertensive medications were 1΍ times more likely to have suspicious glaucoma (odds ratio [OR] =1.56] and nearly twice as likely to have POAG (OR = 1.85. In addition, we found a 31% and 12% reduction in risk of having POAG (95% confidence interval [CI] =13-45%, P = 0.001 and glaucoma suspect (95% CI = 2-21%, P = 0.03 respectively with every 1 mm Hg increment in MOPP. Conclusion: Subjects on antihypertensive medications are more likely to have either glaucoma or glaucoma suspect, and higher ocular perfusion pressure offers relative protection from glaucomatous damage.

  3. Correlation between optic disc parameters detected by OCT3 and visual field defect in primary open angle glaucoma%OCT3检测视盘参数与视野的相关性研究

    Institute of Scientific and Technical Information of China (English)

    成云翠; 段宣初

    2008-01-01

    目的:研究第三代光学相干断层扫描仪(stratus optical co-herence tomography 3000,OCT3)检测原发性开角型青光眼(primary open angle glaucom,POAG)视盘参数与视野平均缺损(mean defect,MD)的相关性,评估OCT3检测视盘参数在POAG早期诊断中的价值.方法:正常人43例(43眼)、48例原发性可疑型青光眼(SOAG)、55例(55眼)原发性开角型青光眼(POAG).采用OCULUS Easyflied视野计和OCT3分别进行视野和视盘形态检测.比较OCT3检测三组间视盘参数的差异,分析青光眼组视野检测的视野平均缺损(MD)与OCT3视盘参数的关系.结果:OCT3检测三组间的视盘参数均存在显著性差异(P<0.01).在原发性开角型青光眼组,RA与MD相关性最好(P<0.05).结论:OCT3能够检测到青光眼的早期视盘结构的改变,且与MD有基本一致的较好相关性.OCT3检测视盘参数可用于POAG的早期诊断.

  4. Glaucoma and optic nerve repair.

    Science.gov (United States)

    Diekmann, Heike; Fischer, Dietmar

    2013-08-01

    Glaucoma is a leading cause of irreversible blindness worldwide and causes progressive visual impairment attributable to the dysfunction and death of retinal ganglion cells (RGCs). Progression of visual field damage is slow and typically painless. Thus, glaucoma is often diagnosed after a substantial percentage of RGCs has been damaged. To date, clinical interventions are mainly restricted to the reduction of intraocular pressure (IOP), one of the major risk factors for this disease. However, the lowering of IOP is often insufficient to halt or reverse the progress of visual loss, underlining the need for the development of alternative treatment strategies. Several lines of evidence suggest that axonal damage of RGCs occurs primary at the optic nerve head, where axons appear to be most vulnerable. Axonal injury leads to the functional loss of RGCs and subsequently induces the death of the neurons. However, the detailed molecular mechanism(s) underlying IOP-induced optic nerve injury remain poorly understood. Moreover, whether glaucoma pathophysiology is primarily axonal, glial, or vascular remains unclear. Therefore, protective strategies to prevent further axonal and subsequent soma degeneration are of great importance to limit the progression of sight loss. In addition, strategies that stimulate injured RGCs to regenerate and reconnect axons with their central targets are necessary for functional restoration. The present review provides an overview of the context of glaucoma pathogenesis and surveys recent findings regarding potential strategies for axonal regeneration of RGCs and optic nerve repair, focusing on the role of cytokines and their downstream signaling pathways. PMID:23512141

  5. Panophthalmitis with orbital cellulitis following glaucoma drainage implant surgery in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Bruno L. B. Esporcatte

    2016-04-01

    Full Text Available ABSTRACT Here we report a case of childhood glaucoma refractory to angle and trabeculectomy surgery. The patient was treated with an Ahmed™ drainage implant that was subsequently complicated by rapid-onset panophthalmitis and orbital cellulitis. Intravenous and intravitreal antibiotic therapy was initiated and the drainage tube was removed. The infectious process resolved within 3 weeks; however, phthisis bulbi developed subsequently.

  6. Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients

    OpenAIRE

    WALDOCK, A; Snape, J; Graham, C

    2000-01-01

    AIMS—To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients.
METHODS—141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for ana...

  7. Purtscher's retinopathy followed by neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Kuroda M

    2013-11-01

    Full Text Available Masasko Kuroda,1 Akihiro Nishida,1 Masashi Kikuchi,2 Yasuo Kurimoto11Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; 2Kikuchi Eye Clinic, Kobe, Hyogo, JapanAbstract: We report the case of a 66-year-old Japanese man who developed neovascular glaucoma secondary to Purtscher's retinopathy following a head injury. The patient presented at our hospital with blurred vision and a visual field abnormality in his left eye 1 month after suffering from a head injury. Upon initial presentation, his best-corrected visual acuity on a decimal chart was 1.5 oculus dexter and 0.6 oculus sinister. The intraocular pressure (IOP was 12 mmHg in both eyes. Fundus examination of the left eye revealed multiple white lesions in the posterior pole. Optical coherence tomography demonstrated retinal edema, particularly in the inner retina. On the basis of these findings, a diagnosis of Purtscher's retinopathy was made. One month after the initial examination, the visual acuity in the left eye deteriorated to 0.01 in decimal chart, and the IOP increased to 37 mmHg. Gonioscopy showed angle neovascularization. The patient received an intravitreal bevacizumab injection and panretinal photocoagulation. Subsequently, the IOP normalized and the angle neovascularization regressed.Keywords: blurred vision, visual field, retinal edema, head injury, head trauma

  8. Glaucoma Alters the Circadian Timing System

    OpenAIRE

    Drouyer, Elise; Dkhissi-Benyahya, Ouria; Chiquet, Christophe; WoldeMussie, Elizabeth; Ruiz, Guadalupe; Wheeler, Larry A.; Denis, Philippe; Cooper, Howard M.

    2008-01-01

    Glaucoma is a widespread ocular disease and major cause of blindness characterized by progressive, irreversible damage of the optic nerve. Although the degenerative loss of retinal ganglion cells (RGC) and visual deficits associated with glaucoma have been extensively studied, we hypothesize that glaucoma will also lead to alteration of the circadian timing system. Circadian and non-visual responses to light are mediated by a specialized subset of melanopsin expressing RGCs that provide photi...

  9. NOVELTIES IN MEDICAL TREATMENT OF GLAUCOMA.

    Science.gov (United States)

    Cornel, Stefan; Mihaela, Timaru Cristina; Adriana, Iliescu Daniela; Mehdi, Batras; Algerino, De Simone

    2015-01-01

    The purpose of this study is to review the current medical treatment and the new and better alternatives for patients with glaucoma. Glaucoma refers to a group of related eye disorders that have in common an optic neuropathy associated with visual function loss. It is one of the leading causes of irreversible blindness worldwide. Glaucoma can damage vision gradually so it may not be noticed until the disease is at an advanced stage. Early diagnosis and treatment can minimize or prevent optic nerve damage and limit glaucoma-related vision loss. Nowadays, research continues for the improvement of current medical treatment. PMID:26978866

  10. Use of electroconvulsive therapy in the presence of GLAUCOMA: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jitender Aneja

    2013-01-01

    Full Text Available Limited data is available with respect to use of Electroconvulsive therapy (ECT in the presence of glaucoma. We present a case of severe depression with psychotic symptoms who did not respond to various antidepressant trials and required ECT. His medical history showed that he was diagnosed to have open angle glaucoma and cataract in both the eyes. He had undergone bilateral trabeculectomy and cataract surgery for his ophthalmological aliments. He was safely treated with bilateral ECT, with which he achieved remission.

  11. The comparative study of selective laser trabeculoplasty effectiveness in phacic and pseudophacic patients with glaucoma

    OpenAIRE

    N. I. Kurysheva; V. N. Trubilin; P. K. Ryzhkov; T. A. Shaimova

    2014-01-01

    Purpose: To compare the effect of selective laser trabeculoplasty (SLT) in phacic and pseudophacic patients with glaucoma.Methods: A retrospective chart review was performed on 148 eyes of 139 patients with moderate primary open angle glaucoma (POAG). In the first group (pseudophacic group) 50 patients (50 eyes) underwent SLT at the period of 6 months and more after uneventful phacoemulsification cataract surgery, in the second (phacic group: 9 patients, 98 eyes) — 2‑3 months prior it. The po...

  12. 25-Gauge pars plana vitrectomy for ciliary block (malignant) glaucoma.

    Science.gov (United States)

    Meng, Li; Wei, Wenbin; Li, Yanlong; Hui, Xiaoying; Han, Xiaodong; Shi, Xiaobo

    2015-08-01

    To evaluate the efficacy of 25-ga pars plana vitrectomy (PPV) and 25-ga PPV combined with phacoemulsification surgery for managing ciliary block (malignant) glaucoma. The medical records of 11 eyes, in nine consecutive patients with malignant glaucoma were retrospectively reviewed to determine the efficacy of 25-ga PPV for alleviating this disease. All phakic eyes underwent phacoemulsification surgery during vitrectomy. Control of intraocular pressure (IOP), pre- and postoperative best-corrected visual acuity (BCVA), and development of intra- and postoperative complications were evaluated during follow-up. Malignant glaucoma was promptly resolved, and recurrence was not observed during a mean follow-up period of 12.7 ± 3.2 (range 6-18) months. The mean IOP decreased from 35.9 ± 2.9 mmHg, preoperatively, to 16.0 ± 1.4 mmHg, measured at last visit (P = 0.013). Although IOP control was achieved in all eyes after surgery, two eyes required long-term topical antiglaucoma medication. The mean logarithm of the minimum angle of resolution BCVA improved from +0.69 ± 0.11, preoperatively, to +0.29 ± 0.07, postoperatively (P = 0.027). No severe intraoperative complications were observed. Postoperative complications mostly occurred during the first week after surgery, including transient corneal edema and Descemet's membrane folds in three eyes, fibrotic exudation in 2, local iris posterior synechia in 1, and transient hypotony in 1, which were resolved spontaneously or with medication. The 25-ga PPV procedure seems to be safe and effective for treating malignant glaucoma. Combined vitrectomy with phacoemulsification surgery and a staged surgical approach may improve the success rate. PMID:25062710

  13. Radiotherapy of glaucoma absolutum dolorosum

    International Nuclear Information System (INIS)

    During the period 1980-1982 the authors applied X-ray therapy to 47 patients with painful glaucoma, unaffected by drug treatment. X-ray therapy was generated at 100 KV and half-decreasing 3 mm aluminium. Surface dose from 0,50 to 0,70 Gy was applied at 2-3 day intervals, total 4-6 times. All patients were followed up over a period from 1 to 3 years. The inflammatory changes disappeared in all patients, and pain was not relieved in only one patient. Ocular tension remained elevated in 15 patients and in 32 was reduced to a different degree. No radiation injury, occuring during the observation period, was recorded. The results justify X-ray therapy in patients with painful glaucoma

  14. 曲伏前列素与布林佐胺治疗开角型青光眼或高眼压症的临床研究%Clinical research on treatment of travoprost combined with brinzolamide for primary open angle glaucoma or ocular hypertension

    Institute of Scientific and Technical Information of China (English)

    王建萍; 张德秀; 马勇; 车选义

    2009-01-01

    目的:研究曲伏前列素与布林佐胺联合治疗原发性开角型青光眼(primary open angle glaucoma,POAG)、高眼压症(ocular hypertension,OHT)及抗青光眼术后高眼压的降眼压疗效及安全性.方法:将48例52眼POAG,OHT,抗青光眼术后高眼压的患者纳入为期2mo的前瞻性、单向性、开放性研究.经药物洗脱期测量眼压基线值.用药后2,4,8,12wk测量眼压、视力、视野,观察眼部症状、体征及全身副作用.计算12wk时眼压≤17mmHg患者百分比.结果:患者基线眼压28.08±2.50mmHg,4次随访眼压(17.12±1.42, 16.71±1.55, 16.13±1.52,16.12±1.49)mmHg,眼压下降均值10.35mmHg,最大下降率45%.用药后眼压与基线眼压比较差值有非常显著意义(P<0.01),用药12wk时,眼压≤17mmHg的患者占64%.常见的不良反应是结膜充血,偶见轻微烧灼感,轻度味觉异常等,对角膜、泪膜、视力、视野、血压、心率均未影响.结论:曲伏前列素与布林佐胺联合应用降眼压的效果明显,安全性好.联合用药,眼压≤17mmHg患者所占百分比显著.

  15. 马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症临床研究%Clinical comparative study of timolol maleate and brinzolamide in treatment of open-angle glaucoma and ocular hypertension combined with travoprost

    Institute of Scientific and Technical Information of China (English)

    杨涛; 项振扬; 郑玥

    2014-01-01

    目的:对比评价马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症的临床疗效。方法将我院使用曲伏前列素单药治疗效果不佳的开角型青光眼与高眼压的76例患者分为S组和B组,S组38例(38眼)患者在曲伏前列素基础上合用马来酸噻吗洛尔治疗,B组38例(38眼)患者则合用布林佐胺治疗,于2周和1、3、6个月随访。对比观察两组治疗前后的平均眼压、昼夜眼压差、心率、血压和不良反应发生情况。结果两组患者在联合用药后2周和1、3、6个月平均眼压下降,与治疗前比较差异均有统计学意义(P0.05);S组联合用药后6个月昼夜眼压差较B组大,两组差异有统计学意义(P0.05);B组患者心率在联合用药前后无明显变化(P>0.05),S组患者心率则在随访6个月时出现明显心脏抑制(P0. 05). The difference of diurnal IOP was significant between the two groups after 6 months of combination therapy(P0. 05). The heart rate did not change significantly,and the patients of group S showed significant cardiac depression after 6 months follow-up (P<0. 05). No serious adverse events occurred in both groups. Conclusion The clinical efficacy would significant when it is trea-ted for open-angle glaucoma and ocular hypertension,either timolol maleate or brinzolamide combined travopros,and the clinical efficacy would be stable and safe when brinzolamide is applied than timolol maleate.

  16. Glaucoma and Diabetic Retinopathy in patients with diabetes mellitus type 2. Review.

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyeva

    2014-10-01

    Full Text Available Glaucoma and diabetic retinopathy (DR are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics are optical coherence tomography and Heidelberg retina tomography. They give an opportunity to estimate the dynamics of pathological process and the efficiency of surgical and pharmacological treatment. Optical scanning of an optic disk and peripapillary retina gives a chance to estimate up to 20 morphometric parameters. Determination of retinal nerve fiber layer (RNFL thickness in peripapillary zone reflects a condition of nerve fibers and extent of their defeat. It is shown that in glaucoma there is a thinning of RNFL and a neuroretinal rim. In early diagnostics of glaucoma the parameters of optic disk characterizing neuroretinal rim are considered the most informative. OCT considerably expands diagnostic research possibilities of structural and morphological retinal changes in a macular zone in patients with DR and DME. Measurement of retinal thickness in macular area is a key point in diagnostics and tactics of treatment. The standard method of DR therapy is retinal laser coagulation. However, laser photocoagulation as monotherapy is not effective enough in patients with diffuse and cystoid macular edema. It is more reasonable to use retinal laser photocoagulation in combination with antiangiogenic therapy for treatment of the diabetic macular edema (DME and DR. The special emphasis is put on development of treatment algorithm of combination of glaucoma and diabetic retinopathy. Therapy of neovascular glaucoma in patients with diabetes

  17. Glaucoma and Diabetic Retinopathy in patients with diabetes mellitus type 2. Review.

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyeva

    2014-01-01

    Full Text Available Glaucoma and diabetic retinopathy (DR are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics are optical coherence tomography and Heidelberg retina tomography. They give an opportunity to estimate the dynamics of pathological process and the efficiency of surgical and pharmacological treatment. Optical scanning of an optic disk and peripapillary retina gives a chance to estimate up to 20 morphometric parameters. Determination of retinal nerve fiber layer (RNFL thickness in peripapillary zone reflects a condition of nerve fibers and extent of their defeat. It is shown that in glaucoma there is a thinning of RNFL and a neuroretinal rim. In early diagnostics of glaucoma the parameters of optic disk characterizing neuroretinal rim are considered the most informative. OCT considerably expands diagnostic research possibilities of structural and morphological retinal changes in a macular zone in patients with DR and DME. Measurement of retinal thickness in macular area is a key point in diagnostics and tactics of treatment. The standard method of DR therapy is retinal laser coagulation. However, laser photocoagulation as monotherapy is not effective enough in patients with diffuse and cystoid macular edema. It is more reasonable to use retinal laser photocoagulation in combination with antiangiogenic therapy for treatment of the diabetic macular edema (DME and DR. The special emphasis is put on development of treatment algorithm of combination of glaucoma and diabetic retinopathy. Therapy of neovascular glaucoma in patients with diabetes

  18. Staging operation in the treatment of refractory glaucoma%青光眼顽固性高眼压的分期手术治疗

    Institute of Scientific and Technical Information of China (English)

    高郁玮; 张舒心; 孙丽; 张馨方

    2016-01-01

    • AIM: To analyze the clinical results of cyclophotocoagulation followed by other anti-glaucoma surgeries in the treatment of refractory glaucoma.•METHODS:The clinical data of 30 patients ( 30 eyes ) with refractory glaucoma were retrospectively analyzed from January 2013 to July 2014 in Beijing Huade Hospital, including 12 females and 18 males, with an average age of 56 years.Among the 30 eyes, there were 2 eyes with acute angle-closure glaucoma, 4 eyes with over mature cataract, 6 eye with intumescent cataract, 5 eyes with neovascular glaucoma, 9 eyes with hard-to-controlled glaucoma even after surgeries, 4 eyes with secondary glaucoma after vitrectomy. Diode laser transscleral cyclophotocoagulation was applied to all patients as the primary choice.If the intraocular pressure ( IOP) was not well controlled, a secondary anti-glaucoma surgery was applied.•RESULTS:During the follow-up period, all of the 30 eyes had satisfactory results, with no complications during or after the operations. The average pre -operative IOP was 62.79 ±5.59mmHg, which dropped to 32.84 ±8.16mmHg at 1wk after cyclophotocoagulation. Six of 30 eyes had totally normal IOP, the rest 24 cases underwent another anti-glaucoma operation, after which the IOP decreased to a normal range and in which no complication occurred.•CONCLUSION:In the treatment of refractory glaucoma, applying cyclophotocoagulation first to control the IOP can greatly reduce risk of complications during the secondary surgeries. According to their original categories, further anti-glaucoma surgery can reduce the IOP to a safe and effective range.%目的:分析青光眼顽固性高眼压状态下,先行睫状体光凝术降低部分眼压,Ⅱ期行进一步抗青光眼手术治疗的临床疗效观察。方法:回顾性分析北京华德眼科医院2013-01/2014-07收治的青光眼顽固性高眼压患者临床资料,共30例30眼,其中女12例,男18例,平均年龄56岁。这30眼中,急性

  19. Glaucoma and dry eye disease: the role of preservatives in glaucoma medications

    Directory of Open Access Journals (Sweden)

    Ratna Sitompul

    2011-11-01

    Full Text Available Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC-containing eye drop  used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patients’ compliance and   decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5Keywords: benzalkonium chloride, dry eye, glaucoma

  20. Normal tension glaucoma and Alzheimer disease

    DEFF Research Database (Denmark)

    Bach-Holm, Daniella; Kessing, Svend Vedel; Mogensen, Ulla;

    2012-01-01

    PURPOSE: To investigate whether normal tension glaucoma (NTG) is associated with increased risk of developing dementia/Alzheimer disease (AD). METHODS: A total of 69 patients with NTG were identified in the case note files in the Glaucoma Clinic, University Hospital of Copenhagen (Rigshospitalet...