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Sample records for angle glaucoma oag

  1. Genetic architecture of open angle glaucoma and related determinants

    NARCIS (Netherlands)

    Ramdas, W.D.; Amin, N.; van Koolwijk, L.M.E.; Janssens, A.C.J.W.; Demirkan, A.; de Jong, P.T.V.M.; Aulchenko, Y.S.; Wolfs, R.C.W.; Hofman, A.; Rivadeneira, F.; Uitterlinden, A.G.; Oostra, B.A.; Lemij, H.G.; Klaver, C.C.W.; Vingerling, J.R.; Jansonius, N.M.; van Duijn, C.M.

    2011-01-01

    Background Although the vertical cup-disc ratio (VCDR) and intraocular pressure (IOP) are important determinants of open angle glaucoma (OAG), it is unclear to what extent the genetic origin of these traits overlap with those of OAG. We evaluated whether the same genes that determine VCDR and IOP al

  2. Glaucoma, Open-Angle

    Science.gov (United States)

    ... Programs Home > Statistics and Data > Glaucoma, Open-angle Glaucoma, Open-angle Open-angle Glaucoma Defined In open-angle glaucoma, the fluid passes ... 2010 2010 U.S. Age-Specific Prevalence Rates for Glaucoma by Age and Race/Ethnicity The prevalence of ...

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

    NARCIS (Netherlands)

    de Voogd, Simone; Ikram, M. Kamran; Wolfs, Roger C. W.; Jansonius, Nomdo M.; Witteman, Jacqueline C. M.; Hofman, Albert; de Jong, Paulus 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

  4. 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

  5. The additional yield of a periodic screening programme for open-angle glaucoma : a population-based comparison of incident glaucoma cases detected in regular ophthalmic care with cases detected during screening

    NARCIS (Netherlands)

    Stoutenbeek, R.; de Voogd, S.; Wolfs, R. C. W.; Hofman, A.; de Jong, P. T. V. M.; Jansonius, N. M.

    2008-01-01

    Aim: To study the additional yield of a periodic screening programme for open-angle glaucoma (OAG) by comparing, in a population-based setting, incident OAG (iOAG) cases detected in regular ophthalmic care with those detected during screening. Methods: Participants aged 55 and over from the populati

  6. Incidence of open-angle glaucoma in a general elderly population - The Rotterdam Study

    NARCIS (Netherlands)

    de Voogd, S; Ikram, MK; Wolfs, RCW; Jansonius, NM; Hofman, A; de Jong, PTVM

    2005-01-01

    Purpose: To determine the incidence of open-angle glaucoma (OAG) in a general elderly white population. Design: Population-based cohort study. Participants: Participants 55 years and older from the Rotterdam Study, The Netherlands. Methods: Participants at risk for incident OAG underwent at baseline

  7. Nutrient intake and risk of open-angle glaucoma : the Rotterdam Study

    NARCIS (Netherlands)

    Ramdas, Wishal D.; Wolfs, Roger C. W.; Kiefte-de Jong, Jessica C.; Hofman, Albert; de Jong, Paulus T. V. M.; Vingerling, Johannes R.; Jansonius, Nomdo M.

    2012-01-01

    Open-angle glaucoma (OAG) is the commonest cause of irreversible blindness worldwide. Apart from an increased intraocular pressure (IOP), oxidative stress and an impaired ocular blood flow are supposed to contribute to OAG. The aim of this study was to determine whether the dietary intake of nutrien

  8. Open-angle glaucoma : From epidemiology to molecular aspects and anatomical features

    NARCIS (Netherlands)

    H. Springelkamp (Henriët)

    2016-01-01

    markdownabstractOpen-angle glaucoma (OAG) is an important cause of irreversible blindness. In OAG, loss of retinal ganglion cells leads to damage of the optic nerve. This causes visual field loss and eventually blindness. Changes in the optic nerve head (ONH) can be examined with confocal scanning l

  9. Lifestyle and Risk of Developing Open-Angle Glaucoma The Rotterdam Study

    NARCIS (Netherlands)

    Ramdas, Wishal D.; Wolfs, Roger C. W.; Hofman, Albert; de Jong, Paulus T. V. M.; Vingerling, Johannes R.; Jansonius, Nomdo M.

    2011-01-01

    Objective: To determine whether lifestyle-related risk factors, such as socioeconomic status, smoking, alcohol consumption, and obesity, are associated with open-angle glaucoma (OAG). Methods: Participants from the Rotterdam Study, a prospective population-based cohort study, were considered eligibl

  10. Estrogen receptors alpha and beta and the risk of open-angle glaucoma

    NARCIS (Netherlands)

    de Voogd, Simone; Wolfs, Roger C. W.; Jansonius, Nomdo M.; Uitterlinden, Andre G.; Pols, Huibert A. P.; Hofman, Albert; de Jong, Paulus T. V. M.

    2008-01-01

    Objective: To investigate whether polymorphisms in the estrogen receptor alpha (ESR1) and beta (ESR2) genes were a risk factor for open-angle glaucoma (OAG). Methods: Participants 55 years and older from the population-based Rotterdam Study underwent, at baseline and at follow-up, the same ophthalmi

  11. Primary open-angle glaucoma genes

    OpenAIRE

    Fingert, J.H.

    2011-01-01

    A substantial fraction of glaucoma has a genetic basis. About 5% of primary open angle glaucoma (POAG) is currently attributed to single-gene or Mendelian forms of glaucoma (ie glaucoma caused by mutations in myocilinor optineurin). Mutations in these genes have a high likelihood of leading to glaucoma and are rarely seen in normal subjects. Other cases of POAG have a more complex genetic basis and are caused by the combined effects of many genetic and environmental risk factors, each of whic...

  12. Literature review and meta-analysis of translaminar pressure difference in open-angle glaucoma.

    Science.gov (United States)

    Siaudvytyte, L; Januleviciene, I; Daveckaite, A; Ragauskas, A; Bartusis, L; Kucinoviene, J; Siesky, B; Harris, A

    2015-10-01

    There is increasing evidence in the literature regarding translaminar pressure difference's (TPD) role in the pathophysiology of glaucoma. The optic nerve is exposed not only to intraocular pressure in the eye, but also to intracranial pressure (ICP), as it is surrounded by cerebrospinal fluid in the subarachnoid space. Although pilot studies have identified the potential importance of TPD in glaucoma, limited available data currently prevent a comprehensive description of the role that TPD may have in glaucomatous pathophysiology. In this review, we present all available qualified data from a systematic review of the literature of the role of TPD in open-angle glaucoma (OAG). PubMed (Medline), OVID Medline, ScienceDirect, SpringerLink, and all available library databases were reviewed and subsequent meta-analysis of pooled mean differences are presented where appropriate. Five papers including 396 patients met criteria for inclusion to the analysis. Importantly, we included all observational studies despite differences in ICP measurement methods, as there is no consensus regarding best-practice ICP measurements in glaucoma. Our results show that not only TPD is higher in glaucoma patients compared with healthy subjects, it is related to structural glaucomatous changes of the optic disc. Our analysis suggests further longitudinal prospective studies are needed to investigate the influence of TPD in OAG, with a goal of overcoming methodological weaknesses of previous studies.

  13. Acute angle closure glaucoma following ileostomy surgery

    Directory of Open Access Journals (Sweden)

    Mariana Meirelles Lopes

    2015-02-01

    Full Text Available Angle-closure glaucoma can be induced by drugs that may cause pupillary dilatation. We report a case of a patient that developed bilateral angle closure glaucoma after an ileostomy surgery because of systemic atropine injection. This case report highlights the importance of a fast ophthalmologic evaluation in diseases with ocular involvement in order to make accurate diagnoses and appropriate treatments.

  14. 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.

  15. Molecular mechanisms underlying primary open angle glaucoma

    NARCIS (Netherlands)

    Janssen, S.F.

    2014-01-01

    Primary open angle glaucoma (POAG) is a complex, multigenetic and heterogeneous optic neuropathy. It is an insidious disease that untreated leads to irreversible visual field loss and blindness. Worldwide, glaucoma causes around 12% of blindness. Although various risk factors have been established,

  16. The role of clinical parapapillary atrophy evaluation in the diagnosis of open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Joshua R Ehrlich

    2010-08-01

    Full Text Available Joshua R Ehrlich, Nathan M RadcliffeDepartment of Ophthalmology, Weill Cornell Medical College, New York, NY, USAPurpose: To determine if clinical evaluation of parapapillary atrophy (PPA significantly improves the ability to distinguish open-angle glaucoma (OAG patients from glaucoma suspects.Methods: Patients in this study were under evaluation for glaucoma and had open angles, at least one reliable 24-2 SITA-standard automatic perimetry, and digital stereophotographs of the optic disc. PPA was identified clinically as a parapapillary region of absent (βPPA or hyper/hypopigmented (αPPA retinal pigment epithelium. A single masked observer evaluated photos for: vertical cup-to-disc ratio (CDR, clock hours of total and βPPA, βPPA as percentage width of the optic disc, presence or absence of βPPA at each disc quadrant, and ordinal rating of total PPA. Generalized linear models were used to determine odds of an abnormal or borderline glaucoma hemifield test (GHT as a function of PPA variables and covariates; model fit was assessed using the log-likelihood ratio test.Results: Of 410 consecutive patients, 540 eyes (of 294 patients met inclusion criteria. Mean age was greater among patients with abnormal compared with normal GHT (P < 0.001, but sex and race/ethnicity did not differ between groups (P ≥ 0.22. Age, central corneal thickness (CCT and CDR (P ≤ 0.006, but not intraocular pressure (IOP (P = 0.71, were significant univariable predictors of the odds of an abnormal GHT. All PPA parameters significantly ­predicted GHT (P ≤ 0.03, except presence of temporal βPPA (P = 0.25. Adjustment for age, CCT, IOP, and CDR reduced the association between PPA and GHT, and model fit was not greatly improved by addition of PPA variables.Conclusions: Addition of most PPA parameters to a model already containing commonly assessed variables including age, CCT, IOP, and CDR does not significantly improve the ability to distinguish OAG patients from

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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.

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

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    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

  1. Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration

    Directory of Open Access Journals (Sweden)

    Rajjoub LZ

    2014-07-01

    Full Text Available Lamise Z Rajjoub, Nisha Chadha, David A Belyea Department of Ophthalmology, The George Washington University, Washington, DC, USA Abstract: This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. Keywords: angle closure glaucoma, plateau iris, topiramate, secondary glaucoma, drug-induced glaucoma

  2. Mechanism and Etiology of Primary Chronic Angle Closure Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    The ocular anatomic features, pupil-blocking force, status of angle synechiae closure and positivity of provocative tests were compared between the primary chronic angle closure glaucoma (PCACG) and primary a-cute angle closure glaucoma (PAACG) by using ultrasonic biometry, computerized anterior ocular segment image processing technique, gonioscopy and provocative tests. The studies showed that the anterior chamber depth of PAACG was shallower than that of PCACG; the pupil-blocking force of PAACG was st...

  3. Common genetic variants associated with open-angle glaucoma

    NARCIS (Netherlands)

    Ramdas, Wishal D.; van Koolwijk, Leonieke M. E.; Lemij, Hans G.; Pasutto, Francesca; Cree, Angela J.; Thorleifsson, Gudmar; Janssen, Sarah F.; Jacoline, Ten Brink; Amin, Najaf; Rivadeneira, Fernando; Wolfs, Roger C. W.; Walters, G. Bragi; Jonasson, Fridbert; Weisschuh, Nicole; Mardin, Christian Y.; Gibson, Jane; Zegers, Richard H. C.; Hofman, Albert; de Jong, Paulus T. V. M.; Uitterlinden, Andre G.; Oostra, Ben A.; Thorsteinsdottir, Unnur; Gramer, Eugen; Welgen-Luessen, Ulrich C.; Kirwan, James F.; Bergen, Arthur A. B.; Reis, Andre; Stefansson, Kari; Lotery, Andrew J.; Vingerling, Johannes R.; Jansonius, Nomdo M.; Klaver, Caroline C. W.; van Duijn, Cornelia M.

    2011-01-01

    Open-angle glaucoma (glaucoma) is a major eye disorder characterized by optic disc pathology. Recent genome-wide association studies identified new loci associated with clinically relevant optic disc parameters, such as the optic disc area and vertical cup-disc ratio (VCDR). We examined to what exte

  4. Canaloplasty versus Viscocanalostomy in Primary Open Angle Glaucoma

    Science.gov (United States)

    Wagdy, Faried Mohammed

    2017-01-01

    Introduction The purpose of this study was to compare the efficacy and safety of canaloplasty versus viscocanalostomy in management of uncontrolled primary open angle glaucoma (POAG) with medication. Methods Canaloplasty surgery was applied for thirty eyes of thirty patients (45–55 years) with a mean age of 48 years (Group A) and viscocanalostomy surgery was applied also for thirty eyes of thirty patients (43–54 years) with a mean age of 46 years (group B). All patients were with uncontrolled primary open angle glaucoma by maximally tolerated medical therapy. Results Intraocular pressure (IOP) in both surgeries was significantly reduced through follow up period (p glaucoma (POAG) with medication.

  5. OCULAR BIOMETRY IN ANGLE CLOSURE GLAUCOMA AND SENILE CATARACT

    Institute of Scientific and Technical Information of China (English)

    WANG Yu-lan; SHENG Yao-hua; YE Xiang-yu

    2008-01-01

    Objective To compare ocular biometric values in angle closure glaucoma and cataract in senile population.Methods Ocular biometry was performed in eyes classified to have angle closure glaucoma (29 eyes) and senile cataract (31 eyes). Ocular biometry readings between two groups were compared and analyzed statistically. Intraocular pressure was also recorded before and after lens extraction.Results Anterior chamber depth was shallower in patients with angle closure glaucoma group [(1.79±0.56) mm] compared with senile cataract group [(2.69±0.40) mm] (P<0.01). Lens thickness was greater in angle closure glaucoma group [(5.30±0.61) mm] than that in senile cataract group [(3.84±0.61) mm] (P<0.01). Phacoemusification was performed in 5 patients with persistent acute attack of angle closure glaucoma. IOPs were controlled in all five cases after lens extraction.Conclusion Eyes with angle closure glaucoma seems to have significantly shallow anterior chamber and greater lens thickness compared to senile cataract eyes in the same age. Lens extraction might be effective in those cases with such anatomy features.

  6. Association of known common genetic variants with primary open angle, primary angle closure, and pseudoexfoliation glaucoma in Pakistani cohorts

    NARCIS (Netherlands)

    Micheal, S.; Ayub, H.; Khan, M.I.; Bakker, B.; Schoenmaker-Koller, F.E.; Ali, M.; Akhtar, F.; Khan, W.A.; Qamar, R.; Hollander, A.I. den

    2014-01-01

    PURPOSE: Despite the different etiology of primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG), and pseudoexfoliative glaucoma (PEXG), several studies have suggested that these forms of glaucoma have overlapping genetic risk factors. Therefore, the aim of this study was to eval

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

    Directory of Open Access Journals (Sweden)

    Baek-Lok Oh

    Full Text Available 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.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.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.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.

  8. 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.

  9. Mitochondrial damage in the trabecular meshwork occurs only in primary open-angle glaucoma and in pseudoexfoliative glaucoma.

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    Alberto Izzotti

    Full Text Available BACKGROUND: Open-angle glaucoma appears to be induced by the malfunction of the trabecular meshwork cells due to injury induced by oxidative damage and mitochondrial impairment. Here, we report that, in fact, we have detected mitochondrial damage only in primary open-angle glaucoma and pseudo-exfoliation glaucoma, among several glaucoma types compared. METHODOLOGY/PRINCIPAL FINDINGS: Mitochondrial damage was evaluated by analyzing the common mitochondrial DNA deletion by real-time PCR in trabecular meshwork specimens collected at surgery from glaucomatous patients and controls. Glaucomatous patients included 38 patients affected by various glaucoma types: primary open-angle, pigmented, juvenile, congenital, pseudoexfoliative, acute, neovascular, and chronic closed-angle glaucoma. As control samples, we used 16 specimens collected from glaucoma-free corneal donors. Only primary open-angle glaucoma (3.0-fold and pseudoexfoliative glaucoma (6.3-fold showed significant increases in the amount of mitochondrial DNA deletion. In all other cases, deletion was similar to controls. CONCLUSIONS/SIGNIFICANCE: despite the fact that the trabecular meshwork is the most important tissue in the physiopathology of aqueous humor outflow in all glaucoma types, the present study provides new information regarding basic physiopathology of this tissue: only in primary open-angle and pseudoexfoliative glaucomas oxidative damage arising from mitochondrial failure play a role in the functional decay of trabecular meshwork.

  10. Angle closure glaucoma following a combined blepharoplasty and ectropion repair.

    Science.gov (United States)

    Gayton, J L; Ledford, J K

    1992-01-01

    This paper reports an occurrence of angle closure glaucoma following a combined blepharoplasty and ectropion repair. We are unaware of any previous reports of such an incident. Specific to this case was the coexistence of a cataract that contributed to the narrowing of the anterior chamber. This condition, along with pupil dilation secondary to the anesthetic, precipitated a phacomorphic angle closure glaucoma attack, necessitating emergency cataract surgery. Because other procedures involve pupillary dilation as a potential side effect, we recommend an increased awareness of this potential postoperative complication.

  11. Bilateral acute angle-closure glaucoma after dexfenfluramine treatment.

    Science.gov (United States)

    Denis, P; Charpentier, D; Berros, P; Touameur, S

    1995-01-01

    We report the case of a patient with narrow angles who had an attack of bilateral acute angle-closure glaucoma precipitated by dexfenfluramine, a serotoninergic drug developed for appetite suppression. Although the exact mechanism remains uncertain, the pupillary block observed in our case may be the result of the serotoninergic or indirect parasympatholytic properties of the drug on the iris sphincter muscle. Serotonergic psychoactive drugs should be prescribed cautiously in patients with known narrow angles and should be monitored by an ophthalmologist.

  12. 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...

  13. 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

  14. The genetic mechanisms of primary angle closure glaucoma.

    Science.gov (United States)

    Ahram, D F; Alward, W L; Kuehn, M H

    2015-10-01

    Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma affecting over 15 million individuals worldwide. Family history and ethnicity are strongly associated with the development of the disease, suggesting that one or more genetic factors contribute to PACG. Although strictly heritable disease-causing mutations have not been identified, a number of recent association studies have pointed out genetic factors that appear to contribute to an individual's risk to develop PACG. In addition, genetic factors have been identified that modify PACG endophenotypes for example, axial length. Herein we review the current literature on this important topic.

  15. Comparison between visual field defect in pigmentary glaucoma and primary open-angle glaucoma.

    Science.gov (United States)

    Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anisalsadat

    2016-10-01

    To compare visual field defect patterns between pigmentary glaucoma and primary open-angle glaucoma. Retrospective, comparative study. Patients with diagnosis of primary open-angle glaucoma (POAG) and pigmentary glaucoma (PG) in mild to moderate stages were enrolled in this study. Each of the 52 point locations in total and pattern deviation plot (excluding 2 points adjacent to blind spot) of 24-2 Humphrey visual field as well as six predetermined sectors were compared using SPSS software version 20. Comparisons between 2 groups were performed with the Student t test for continuous variables and the Chi-square test for categorical variables. Thirty-eight eyes of 24 patients with a mean age of 66.26 ± 11 years (range 48-81 years) in the POAG group and 36 eyes of 22 patients with a mean age of 50.52 ± 11 years (range 36-69 years) in the PG group were studied. (P = 0.00). More deviation was detected in points 1, 3, 4, and 32 in total deviation (P = 0.03, P = 0.015, P = 0.018, P = 0.023) and in points 3, 4, and 32 in pattern deviation (P = 0.015, P = 0.049, P = 0.030) in the POAG group, which are the temporal parts of the field. It seems that the temporal area of the visual field in primary open-angle glaucoma is more susceptible to damage in comparison with pigmentary glaucoma.

  16. Analysis of MYOC gene mutation in a Chinese glaucoma family with primary open-angle glaucoma and primary congenital glaucoma

    Institute of Scientific and Technical Information of China (English)

    ZHUO Ye-hong; WANG Mei; WEI Yan-tao; HUANG Ya-lin; GE Jian

    2006-01-01

    Background Glaucoma is one of the leading causes of blindness in the world. Primary open-angle glaucoma (POAG) and primary congenital glaucoma (PCG) are subtypes of glaucoma. Myocillin is the first gene identified to be involved in POAG. Recently, myocillin mutation has been found in PCG In this context, we reported a special glaucoma pedigree, which was composed of both PCG and POAG patients, and analyzed the mutation of myocillin in this pedigree.Methods The family was composed of the parents, a son and a daughter. All members of the family underwent the complete ophthalmologic examinations. All coding exons 1-3 and flanking introns of myocilin gene were screened for sequence alterations by polymerase chain reaction and direct DNA sequencing.Results The son was the proband, who was diagnosed as PCG in both eyes. The father was diagnosed as POAG in the right eye, the left eye was still normal. Both the sister and the mother of the proband had normal intraocular pressure without glaucomatous optic disc changes. The mutations in intron 2 of myocilin gene were detected in the family. While the proband and the father were homozygous, the mother and the sister were heterozygous for the mutation.Conclusions Homozygous mutation in intron 2 of myocilin gene is involved in both POAG and PCG. It is suggested that the pathogenesis might be overlapping in POAG and PCG.

  17. 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

  18. PRIMARY OPEN-ANGLE GLAUCOMA AND FARMACOECONOMICS - REVIEW

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    Sarenac Vulovic Tatjana

    2016-12-01

    Full Text Available Primary open-angle glaucoma (POAG is defined as a chronic and progressive disease. Date suggested that it is the second most common cause of the blindness in the world. Blindness, as global problem, is partially consequences of poor health insurance, low medical education, etc. The only modifiable risk factor for glaucoma is intraocular pressure. Cost of the antiglaucomatous treatment increased by prescribing and using wide spectrum of antiglaucomatous drugs. If an ophthalmologist is not satisfied with glaucomatous disease control, need for the laser or surgical treatment is appeared. Disease stadium also determines the cost of the treatment. The social and economic burden of glaucoma can be changed by increased life expectancy, older population age and higher per capita GDP. Unique opinion about cost effectiveness cannot be reached, due to nonconforming findings of many studies. Treatment approach must be individualized to every patient, according to the disease's stadium, availability of therapeutic modalities and approaches, life expectancy and the level of GDP. Efficacy, compliance and potential side-effects of prescribed medication also determine the proper treatment choice.

  19. 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

  20. Serous retinal detachment after trabeculectomy in angle recession glaucoma

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    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.

  1. Intraocular pressure fluctuation after water drinking test in primary angle-closure glaucoma and primary open-angle glaucoma

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    Yi-Chieh Poon

    2016-01-01

    Full Text Available Context: Only a few studies have assessed intraocular pressure (IOP changes during the water drinking test (WDT in patients with primary angle-closure glaucoma (PACG. Aims: The aim of this study is to investigate IOP changes during WDT in patients with PACG versus primary open-angle glaucoma (POAG. Settings and Design: This was a prospective and single tertiary center study. Materials and Methods: PACG and POAG patients (n = 15 each without prior glaucoma surgery were enrolled and subjected to WDT, wherein they consumed an amount of water proportional to their body weight within 10 min. IOP was measured at baseline and every 15 min for 1 h after water intake. Statistical Analysis Used: Intergroup comparisons were performed using Mann–Whitney U-test for continuous variables and Chi-square test for categorical variables. Wilcoxon signed-ranks test was used for comparisons of IOP before and after water intake in the two groups. Regression analysis was used to determine factors associated with IOP fluctuations during WDT. Results: IOP changes over 1 h after water intake showed no significant differences between groups. The mean maximum fluctuation from baseline was 3.61 ± 2.49 and 3.79 ± 1.91 mmHg, respectively, in the PACG and POAG groups. The mean peak IOP was 19.17 ± 4.32 and 19.87 ± 3.44 mmHg in the PACG and PAOG groups, respectively. The axial length and anterior chamber depth showed no correlations with IOP fluctuations. Conclusions: We found similar IOP fluctuation curves and peak IOP values in both PACG and POAG patients subjected to WDT. These findings suggest that WDT is a useful test to induce IOP peaks in both POAG and PACG patients.

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

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    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.

  3. MISTAKES IN THE DIAGNOSIS AND TREATMENT OF PRIMARY ANGLE-CLOSURE GLAUCOMA: CASE REPORT

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    Marić Vesna

    2016-07-01

    Full Text Available Primary angle-closure glaucoma (PACG is a leading cause of blindness globally. It is a condition that is responsible for nearly half of patients who have a bilateral blindness caused by glaucoma. PACG is highly prevalent in Asian countries, as compared with Primary open-angle glaucoma (POAG, which is reported as the predominant disease among Whites, but prevalence of PACG in Europe has been underestimated previously. Early detection by effective screening and appropriate prophylaxis and treatment may prevent blindness from angle-closure glaucoma. The purpose of this study was to present through the cases of 3 patients with PACG the importance of each phase of glaucoma: diagnosis, treatment and follow-up.

  4. Common Genetic Determinants of Intraocular Pressure and Primary Open-Angle Glaucoma

    NARCIS (Netherlands)

    van Koolwijk, Leonieke M. E.; Ramdas, Wishal D.; Ikram, M. Kamran; Jansonius, Nomdo M.; Pasutto, Francesca; Hysi, Pirro G.; Macgregor, Stuart; Janssen, Sarah F.; Hewitt, Alex W.; Viswanathan, Ananth C.; ten Brink, Jacoline B.; Hosseini, S. Mohsen; Amin, Najaf; Despriet, Dominiek D. G.; Willemse-Assink, Jacqueline J. M.; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S.; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y.; Gramer, Eugen; Welge-Luessen, Ulrich; Montgomery, Grant W.; Carbonaro, Francis; Young, Terri L.; Bellenguez, Celine; McGuffin, Peter; Foster, Paul J.; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y.; Czudowska, Monika A.; Hofman, Albert; Uitterlinden, Andre G.; Wolfs, Roger C. W.; de Jong, Paulus T. V. M.; Oostra, Ben A.; Paterson, Andrew D.; Mackey, David A.; Bergen, Arthur A. B.; Reis, Andre; Hammond, Christopher J.; Vingerling, Johannes R.; Lemij, Hans G.; Klaver, Caroline C. W.; van Duijn, Cornelia M.

    2012-01-01

    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 independen

  5. Note: A gel based imaging technique of the iridocorneal angle for evaluation of angle-closure glaucoma

    Science.gov (United States)

    Shinoj, V. K.; Murukeshan, V. M.; Baskaran, M.; Aung, T.

    2014-06-01

    Noninvasive medical imaging techniques have high potential in the field of ocular imaging research. Angle closure glaucoma is a major disease causing blindness and a possible way of detection is the examination of the anterior chamber angle in eyes. Here, a simple optical method for the evaluation of angle-closure glaucoma is proposed and illustrated. The light propagation from the region associated with the iridocorneal angle to the exterior of eye is considered analytically. The design of the gel assisted probe prototype is carried out and the imaging of iridocorneal angle is performed on an eye model.

  6. 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

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

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    Jacob, Soosan; Figus, Michele; Ashok Kumar, Dhivya; Agarwal, Ashvin; Agarwal, Amar; 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).

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

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    Soosan Jacob

    2016-01-01

    Full Text Available 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.

  9. What’s new in glaucoma treatment?

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    Richard Wormald

    2006-09-01

    Full Text Available Glaucoma treatment: the state of the evidenceInterventions for the treatment of different forms of glaucoma have been tried and tested for many years. The idea that lowering the pressure might be helpful was first proposed more than a hundred years ago. By the 1950s, it was established that raised intraocular pressure (IOP was glaucoma, and vice versa. However, in the mid 1960s, Fred Hollows and Peter Graham demolished that simple concept by revealing that there were many people in the population with raised IOP but no glaucoma, and people with glaucoma without raised IOP.1 Nevertheless, IOP remains an important risk factor (and the only one we can modify for a group of conditions characterised by a progressive atrophy of the optic nerve associated with typical structural and functional abnormalities.Only quite recently has robust evidence emerged regarding the effectiveness of treatment for open-angle glaucoma (OAG. There is still uncertainty about the best way to manage chronic angle closure. This discussion focuses only on the primary glaucomas in adults, open-angle and acute, and chronic angle closure.

  10. [From congenital glaucoma to chronic open angle glaucoma in adulthood: a clinical and genetic continuum].

    Science.gov (United States)

    Dufier, Jean-Louis; Rozet, Jean-Michel; Kaplan, Josseline; Roche, Olivier

    2013-01-01

    Congenital glaucoma, a true hydrocephalus of the eye, is defined by ocular hypertension resulting in buphthalmos in children up to three years old, the elasticity of the eye wall allowing its expansion. Juvenile glaucoma in teenagers and chronic glaucoma in adults do not alter the external aspect of the eye, as the eyeball has lost its elasticity. However, chronic ocular hypertension always causes ischemic excavation of the optic nerve head, leading to insidious amputation of the visual field and, potentially, blindness. Like most ophthalmological disorders, the different types of glaucoma have been shown to be genetically determined, and alterations in several genes have been identified. These altered genes can be expressed more or less early in life, suggesting a role of modifier genes. The role of CYP1B1 alterations in classic primary congenital glaucoma is well known, as is the role of PITX2, FOXC1, PAX6 and LOXC1 alterations in secondary congenital glaucoma due to iridogoniodysgenesis, and of MYOC alterations in the genesis of chronic glaucoma in adulthood. An outbred family carrying CYP1B1 mutations in the compound heterozygous state includes two sibs with primary congenital glaucoma and two others who developed chronic glaucoma in adulthood.

  11. Intraocular pressure lowering efficacy and safety of travoprost 0.004% as a replacement therapy in patients with open angle glaucoma or ocular hypertension

    Institute of Scientific and Technical Information of China (English)

    GE Jian; SUN Xing-huai; WANG Ning-li; ZHAO Jia-liang; WU Ling-ling; CHEN Xiao-ming; WANG Zhi-xin; Benny Li

    2010-01-01

    Background Travoprost has been widely used for the treatment of patients with open-angle glaucoma (OAG) or ocular hypertension (OH). The aim of this study was to evaluate the intraocular pressure (IOP) lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients.Methods This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy (due to either inadequate efficacy or safety issues) as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. In both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. IOP measurements were performed at the same time of day at the follow-up visits.Results For patients transitioned to travoprost, mean IOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were: latanoprost, (4.3±4.6) mmHg; β-blocker, (6.3±4.0) mmHg; a-agonist, (7.5±4.3) mmHg; topical carbonic anhydrase inhibitors, (8.0±4.9) mmHg. All mean IOP changes from baseline were statistically significant (P <0.001). No treatment-related serious adverse events were reported in this study.Conclusions In patients treated with other hypotensive medications or untreated, the IOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate IOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.

  12. Comparison of ocular response analyzer parameters in primary open angle glaucoma and exfoliative glaucoma patients

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    Emrullah Beyazyildiz

    2014-01-01

    Full Text Available Aim: We sought to identify differences in the following measures of the ocular response analyser (ORA between primary open angle glaucoma (POAG and exfoliative glaucoma (EXG patients: Corneal hysteresis (CH, corneal resistance factor (CRF, corneal-compensated intraocular pressure (IOPcc and Goldmann-correlated intraocular pressure (IOPg. We also sought to relate these ORA measures with central corneal thickness (CCT. Materials and Methods: This cross-sectional study was conducted on a total of 162 individuals (46 EXG patients, 66 POAG patients and 50 healthy subjects without any ocular and systemic disease. ORA measurements were performed, and a minimum of three readings were obtained from each test subject. Groups were compared according to their ORA parameters. Results: The mean CH levels of the EXG, POAG and healthy subjects were 7.6 ± 2.1, 9.1 ± 1.9 and 9.6 ± 1.7 mmHg, respectively. CH was significantly lower in the EXG patients compared to the other groups (P < 0.001.The mean CRF levels of the EXG, POAG and healthy subjects were 9.0 ± 2.0, 10.1 ± 1.7 and 9.8 ± 1.8mmHg, respectively. CRF levels in the eyes of the EXG patients were significantly lower compared to those of either the POAG patients (P = 0.005 or the healthy subjects (P = 0.03, but there was no significant difference in CRF levels between the POAG patients and the healthy subjects (P = 0.59. There was a significant positive correlation between CH and CCT in the EXG patients and healthy subjects (P < 0.001, but this correlation was not present in the POAG patients (P = 0.70. Conclusions: In this study, CH and CRF were found to be significantly reduced in the eyes of EXG patients compared to both the POAG patients and healthy subjects. Reduced CH in EXG patients might result in decreased support of peripapillary scleral structure and increased damage to the optic nerve during IOP increase.

  13. 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. ...

  14. Bilateral Angle-Closure Glaucoma in a Young Female Receiving Cabergoline: A Case Report

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    Hasan Razmjoo

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral acute angle-closure glaucoma after oral administration of cabergoline for the treatment of galactorrhea. Methods: A diagnosis of secondary drug-induced angle-closure glaucoma was made in a patient with elevated intraocular pressure (IOP and myopic refractive shift, which was confirmed by ultrasound biomicroscopy (UBM of the ciliary body and anterior segment, sonography, and optical coherence tomography. The treatment included the discontinuation of the culprit drug and the administration of topical anti-glaucoma drops. The treatment course was followed with serial measurements of the IOP and refraction, and with performing UBM. Results: Five hours after he received a single 0.5-mg oral cabergoline tablet, the patient suffered from acute secondary angle-closure glaucoma and myopic refractive error. UBM demonstrated both effusion of the ciliary body and an anterior rotation of the iris-ciliary body. IOP was reduced 8 h after cessation of the causative agent and administration of anti-glaucoma drops. Refractive errors returned to normal levels after 8 days. Conclusion: Secondary acute angle-closure glaucoma has been reported to occur after the administration of some drugs. In this report, an attempt has been made to describe this adverse reaction after oral cabergoline intake.

  15. Outcomes of trabeculectomy in juvenile open angle glaucoma

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    Daizy Pathania

    2014-01-01

    Full Text Available Purpose: This study was aimed at reporting the outcomes of trabeculectomy in primary juvenile open angle glaucoma (JOAG. Design: This study was a retrospective noncomparative case series. Materials and Methods: We included 60 eyes of 41 JOAG patients who underwent primary trabeculectomy without mitomycin-C (MMC between 1995 and 2007. The primary outcome was success, defined as complete, if intraocular pressure (IOP was >5 and ≤21 mmHg without medications or qualified if IOP was >5 and ≤21 mmHg with or without antiglaucoma medications. Secondary outcome measures were mean and percentage IOP reduction, complications, and risk factors for the failure of trabeculectomy. Results: The mean (±standard deviation age at presentation was 24.1 ± 6.8 years (range, 12-35. Mean follow-up was 67 ± 41 months (range, 12-156. At 1 year, the probability of complete success was 92% (n = 56, 95% CI: 81-96%, at 3 years it was 89% (n = 47, 95% CI: 78-95%, and at the end of 5 years, it was 80% (n = 34, 95% CI: 65-89%. The probability of qualified success was 100% (n = 60 at 1 year, 98% (n = 51, 95% CI: 87-100% at 3 years, and 96% (n = 36, 95% CI: 84-99% at the end of 5 years. The mean IOP reduced from 35 ± 10 to 13 ± 2.5 mmHg (P < 0.001 after trabeculectomy. There was no serious postoperative complication. Young age was the only significant risk factor associated with the failure (odds ratio = 0.89, P = 0.03. Conclusion: Primary trabeculectomy without MMC has good success rates in JOAG.

  16. 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.

  17. Anterior Chamber Angle Shape Analysis and Classification of Glaucoma in SS-OCT Images

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    Soe Ni Ni

    2014-01-01

    Full Text Available Optical coherence tomography is a high resolution, rapid, and noninvasive diagnostic tool for angle closure glaucoma. In this paper, we present a new strategy for the classification of the angle closure glaucoma using morphological shape analysis of the iridocorneal angle. The angle structure configuration is quantified by the following six features: (1 mean of the continuous measurement of the angle opening distance; (2 area of the trapezoidal profile of the iridocorneal angle centered at Schwalbe's line; (3 mean of the iris curvature from the extracted iris image; (4 complex shape descriptor, fractal dimension, to quantify the complexity, or changes of iridocorneal angle; (5 ellipticity moment shape descriptor; and (6 triangularity moment shape descriptor. Then, the fuzzy k nearest neighbor (fkNN classifier is utilized for classification of angle closure glaucoma. Two hundred and sixty-four swept source optical coherence tomography (SS-OCT images from 148 patients were analyzed in this study. From the experimental results, the fkNN reveals the best classification accuracy (99.11±0.76% and AUC (0.98±0.012 with the combination of fractal dimension and biometric parameters. It showed that the proposed approach has promising potential to become a computer aided diagnostic tool for angle closure glaucoma (ACG disease.

  18. Ultrastructural Observations of The Anterior Chamber Angle Tissues in Congenital Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Eighteen trabeculectomy specimens of congenital glaucoma were examined by light and transimssion electron microscopy. The results showed that the primary anomalies in congenital glaucoma included the developmental defects of trabecular meshwork, excessive collagen fibrils in the trabecular matrix, shifting forward of ciliary muscle fibres and persistent mesenchymal tissues in the anterior-chamber angle. The authors also pointed out the importance of the secondary lesions of the trabecular meshwork in th...

  19. 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...

  20. Bilateral acute angle closure glaucoma as a presentation of isolated microspherophakia in an adult: case report

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    2006-07-01

    Full Text Available Abstract Background Bilateral simultaneous angle closure glaucoma is a rare entity. To our knowledge this is the first reported case of bilateral acute angle-closure glaucoma secondary to isolated microspherophakia in an adult. Case presentation A 45-year-old woman presented with bilateral acute angle closure glaucoma, with a patent iridotomy in one eye. Prolonged miotic use prior to presentation had worsened the pupillary block. The diagnosis was not initially suspected, and the patient was subjected to pars-plana lensectomy and anterior vitrectomy for a presumed ciliary block glaucoma. The small spherical lens was detected intraoperatively, and spherophakia was diagnosed in retrospect. She had no systemic features of any of the known conditions associated with spherophakia. Pars-plana lensectomy both eyes controlled the intraocular pressure successfully. Conclusion This case demonstrates the importance of considering the diagnosis of isolated microspherophakia in any case of bilateral acute angle closure glaucoma. Lensectomy appears to be an effective first-line strategy for managing these patients.

  1. Association between CYP1A1m1 gene polymorphism and primary open-angle glaucoma.

    Science.gov (United States)

    Costa, N B; Silva, C T X; Frare, A B; Silva, R E; Moura, K K V O

    2014-12-04

    The CYP1A1 gene is related to the generation of secondary metabolites that are capable of inducing DNA damage. The CYP1A1m1 polymorphism has been examined in many studies, and is located in a region near loci that have been linked to glaucoma, including the locus GLC1I. As a result, this polymorphism has been related to several diseases that are influenced by exposure to xenobiotic as well as primary open-angle glaucoma. We compared the prevalence of the CYP1A1m1 polymorphism in 152 Brazilian patients, 100 patients with primary open-angle glaucoma, and 52 normal controls using restriction fragment length polymorphism analysis. The frequency of the homozygous wild-type (w1/w1) CYP1A1 gene among patients with primary open-angle glaucoma (N = 100) was 16%, for genotype w1/m1, the frequency was 77%, and for m1/m1 it was 7%. Among the control group (N = 52), the frequency of the homozygous wild-type (w1/w1) CYP1A1 gene was 54%, the frequency of w1/m1 was 46%, and the frequency of m1/m1 was 0%. The presence of the CYP1A1m1 polymorphism may interfere with xenobiotic metabolism and exacerbate direct or indirect damage to the optic nerve. These CYP1A1m1 polymorphisms may be risk factors for primary open-angle glaucoma.

  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. Variable clinical spectrum of the myocilin Gln368X mutation in a Dutch family with primary open angle glaucoma.

    NARCIS (Netherlands)

    Hogewind, B.F.T.; Mukhopadhyay, A.; Theelen, T.; Hollander, A.I. den; Hoyng, C.B.

    2010-01-01

    PURPOSE: To describe the clinical phenotype in a family with primary open angle glaucoma harboring a p.Gln368X mutation in MYOC. MATERIALS AND METHODS: We identified a proband with primary open angle glaucoma and the p.Gln368X MYOC mutation. She and her six siblings were examined clinically, includi

  4. Drug-Induced Ocular Hypertension and Angle-Closure Glaucoma.

    Science.gov (United States)

    Badhu, Badri P; Bhattarai, Balkrishna; Sangraula, Himal P

    2013-01-01

    The objective of this study was to review the available literature on the drugs causing ocular hypertension and glaucoma. Electronic literature search was carried out using the Web sites www.pubmed.gov and www.google.com published through the year 2011. The search words were "drug induced ocular hypertension" and "drug induced glaucoma" used in combination. The articles published or translated into English were studied. Quite a significant number of drugs commonly prescribed by various physicians of different specialties can induce ocular hypertension or glaucoma. A brief account of various drugs that can induce ocular hypertension has been given in this article. Those drugs are parasympatholytics; steroids; anticholinergics, adrenergics, and antidepressants; cholinomimetics; antineoplastic agents; antipsychotic and antiparkinsonism agents; H1 and H2 receptor blockers; botulinum toxin, cardiac agents, and anticoagulants; silicone oil; sulfa drugs; and anesthetic agents. Rational use of these drugs and knowledge of their potential adverse effects can help prevent the devastating complications resulting in loss of vision and compromised quality of life.

  5. Alzheimer's disease and primary open-angle glaucoma: is there a connection

    Directory of Open Access Journals (Sweden)

    Tsolaki F

    2011-06-01

    Full Text Available Fani Tsolaki1, Eleni Gogaki1, Sotiria Tiganita1, Christina Skatharoudi1, Chrysanthi Lopatatzidi1, Fotios Topouzis2, Magdalini Tsolaki31Ophthalmology Department, Hippokrateion General Hospital, Thessaloniki, Greece; 2Ophthalmology Department, Aristotle University of Thessaloniki, Greece; 3Neurology Department, Aristotle University of Thessaloniki, GreeceAim: To present, through a thorough literature research, current and older scientific efforts to investigate the putative association between Alzheimer's disease (AD and glaucoma, especially primary open-angle glaucoma (POAG.Methods: We included in our review article epidemiological, experimental and clinical laboratory studies.Results: While many authors support the existence of a strong correlation between the AD and POAG, based on epidemiological, genetic and immunohistochemical data, others present contradictory results, leaving the issue unresolved.Conclusion: Further research, probably targeted towards genetic parameters and based on large, multicenter studies has yet to be conducted. It is the authors' opinion however, that the existing data already justify the need for at least some degree of elevated clinical alertness for the occurrence of AD in patients with glaucoma and of glaucoma in patients with AD.Keywords: Alzheimer's disease, primary open-angle glaucoma, amyloid beta, apolipoprotein E, cerebrospinal fluid pressure, review article 

  6. Feasibility of laser trabeculoplasty in angle closure glaucoma: a review of favorable histopathological findings in narrow angles.

    Science.gov (United States)

    Matos, Alexis Galeno; Asrani, Sanjay G; Paula, Jayter Silva

    2017-02-28

    Selective laser trabeculoplasty (SLT) has been indicated as a safe and efficient treatment for primary open-angle glaucoma; however, recent studies have also shown positive results with the use of SLT in some clinical conditions related to primary angle-closure glaucoma (PACG). Despite the potential benefits of SLT in selected cases of PACG, the mechanisms underlying the modifications in the trabecular meshwork tissue of patients with PACG are poorly understood. This narrative review approached both the current, limited knowledge about the histological changes observed in different forms of PACG and the clinical results of SLT treatment for PACG. Favorable outcomes of SLT in patients with PACG, specifically in areas of non-occluded angle, need further substantiation through large controlled clinical trials. A deeper understanding of the biomolecular changes of those areas is essential to improve both laser technical details and the clinical efficacy of SLT therapy.

  7. Evaluation of Optineurin as a candidate gene in Indian patients with primary open angle glaucoma.

    NARCIS (Netherlands)

    Mukhopadhyay, A.; Komatireddy, S.; Acharya, M.; Bhattacharjee, A.; Mandal, A.K.; Thakur, S.K.D.; Chandrasekhar, G.; Banerjee, A.; Thomas, R.; Chakrabarti, S.; Ray, K.

    2005-01-01

    PURPOSE: To evaluate the role of the optineurin gene (OPTN) in Indian primary open angle glaucoma (POAG) patients from different parts of the country. METHODS: Two hundred patients with POAG and 200 ethnically matched normal controls were recruited from various parts of India for the study. The enti

  8. Goniosynechialysis for secondary angle closure glaucoma in a pseudophakic patient after vitrectomy and silicone oil injection

    Institute of Scientific and Technical Information of China (English)

    Jonghoon; Shin; Hyeshin; Jeon; Ik; Soo; Byon; Ji-Woong; Lee

    2014-01-01

    Dear Sir,Iam Jonghoon Shin,from the Department of Ophthalmology of Pusan National University Hospital,Busan,Korea.I write to present a patient with secondary angle closure glaucoma(SACG)after vitrectomy and silicone oil(SO)injection who was successfully treated by

  9. The long-term outcomes of four alternative treatment strategies for primary open-angle glaucoma

    NARCIS (Netherlands)

    van Gestel, Aukje; Webers, Carroll A.; Severens, Johan L.; Beckers, Henny J.; Jansonius, Nomdo M.; Hendrikse, Fred; Schouten, Jan S.

    2012-01-01

    Purpose: To evaluate the long-term effects and costs of four treatment strategies for primary open-angle glaucoma compared to usual care. Methods: Cost-effectiveness analyses with a lifelong horizon were made from a societal perspective. Data were generated with a patient-level model based on discre

  10. The vast complexity of primary open angle glaucoma : Disease genes, risks, molecular mechanisms and pathobiology

    NARCIS (Netherlands)

    Janssen, Sarah F.; Gorgels, Theo G. M. F.; Ramdas, Wishal D.; Klaver, Caroline C. W.; van Duijn, Cornelia M.; Jansonius, Nomdo M.; Bergen, Arthur A. B.

    2013-01-01

    Primary open angle glaucoma (POAG) is a complex progressive optic nerve neuropathy triggered by both environmental and genetic risk factors. Several ocular tissues, including the ciliary body, trabecular meshwork and optic nerve head, and perhaps even brain tissues, are involved in a chain of pathol

  11. Variants in the ASB10 Gene Are Associated with Primary Open Angle Glaucoma

    NARCIS (Netherlands)

    Micheal, S.; Ayub, H.; Islam, F.; Siddiqui, S.N.; Khan, W.A.; Akhtar, F.; Qamar, R.; Khan, M.I.; Hollander, A.I. den

    2015-01-01

    BACKGROUND: Recently nonsynonymous coding variants in the ankyrin repeats and suppressor of cytokine signaling box-containing protein 10 (ASB10) gene were found to be associated with primary open angle glaucoma (POAG) in cohorts from Oregon and Germany, but this finding was not confirmed in an indep

  12. Glaucoma

    Medline Plus

    Full Text Available ... Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and Aging Program Training and Jobs Fellowships NEI Summer Intern Program Diversity In Vision ...

  13. Glaucoma

    Medline Plus

    Full Text Available ... questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Dilated Exam Grants and Funding Extramural ... Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Glaucoma Embedded video ...

  14. Glaucoma

    Science.gov (United States)

    ... depositing them on the trabecular meshwork and causing intermittent pressure elevations. Because chronic forms of glaucoma can ... pressure or promote eye health. Eat a healthy diet. Eating a healthy diet can help you maintain ...

  15. Hypothesis-independent pathway analysis implicates GABA and acetyl-CoA metabolism in primary open-angle glaucoma and normal-pressure glaucoma.

    Science.gov (United States)

    Bailey, Jessica N Cooke; Yaspan, Brian L; Pasquale, Louis R; Hauser, Michael A; Kang, Jae H; Loomis, Stephanie J; Brilliant, Murray; Budenz, Donald L; Christen, William G; Fingert, John; Gaasterland, Douglas; Gaasterland, Terry; Kraft, Peter; Lee, Richard K; Lichter, Paul R; Liu, Yutao; McCarty, Catherine A; Moroi, Sayoko E; Richards, Julia E; Realini, Tony; Schuman, Joel S; Scott, William K; Singh, Kuldev; Sit, Arthur J; Vollrath, Douglas; Wollstein, Gadi; Zack, Donald J; Zhang, Kang; Pericak-Vance, Margaret A; Allingham, R Rand; Weinreb, Robert N; Haines, Jonathan L; Wiggs, Janey L

    2014-10-01

    Primary open-angle glaucoma (POAG) is a leading cause of blindness worldwide. Using genome-wide association single-nucleotide polymorphism data from the Glaucoma Genes and Environment study and National Eye Institute Glaucoma Human Genetics Collaboration comprising 3,108 cases and 3,430 controls, we assessed biologic pathways as annotated in the KEGG database for association with risk of POAG. After correction for genic overlap among pathways, we found 4 pathways, butanoate metabolism (hsa00650), hematopoietic cell lineage (hsa04640), lysine degradation (hsa00310) and basal transcription factors (hsa03022) related to POAG with permuted p glaucoma (NPG), the butanoate metabolism pathway was also significantly associated (p glaucoma pathogenesis, and suggest new potential therapeutic targets.

  16. Lamina depth and thickness correlate with glaucoma severity

    Directory of Open Access Journals (Sweden)

    Martha Kim

    2016-01-01

    Full Text Available Purpose: To evaluate the correlation between lamina cribrosa (LC morphology and glaucoma severity in patients with primary forms of open-angle glaucoma (OAG using enhanced depth imaging spectral-domain optical coherence tomography (SD-OCT and Humphrey visual field test (HVF. Subjects and Methods: Patients with OAG (n = 166, divided into normal-tension glaucoma (NTG and high-tension glaucoma (HTG groups (n = 66 and n = 100, were imaged using SD-OCT to obtain horizontal B-scan images of the optic nerve head (ONH. Laminar depth (LD and laminar thickness (LT were measured at the center of ONH. Results: The mean (±standard deviation values of LD, LT, and visual field mean deviation (MD were 555.4 ± 142.3 μm, 179.9 ± 49.7 μm, and − 5.7 ± 6.4 dB, respectively. In the multivariate linear regression analysis, LD, LT, and intraocular pressure (IOP were significantly correlated with MD (P = 0.007, P = 0.037, and P = 0.004, respectively. In the subgroup analyses, only LD was associated with MD in the NTG group (n = 66, whereas LT and IOP were correlated with MD in the HTG group (n = 100. Neither axial length nor central corneal thickness was associated with LD or LT. Conclusions: Glaucoma severity, as measured by HVF MD, shows significant correlations with LD and LT, with greater severity associated with increasing LD and decreasing LT. Normal- and high-tension OAG patients have different associations with LD and LT, which implies that the pathogenesis of these two entities might be different.

  17. Pit-like changes of the optic nerve head in open-angle glaucoma.

    Science.gov (United States)

    Radius, R. L.; Maumenee, A. E.; Green, W. R.

    1978-01-01

    Six patients with open-angle glaucoma and acquired pit-like changes in the optic nerve head are presented. In 1 patient evolution of the pit-like defect is documented. In all 6 patients progression of associated visual field deficits is described. It is suggested that such pit-like changes in selected patients with glaucoma may not represent congenital lesions but rather local, progressive nerve head disease, occurring particularly in response to raised intraocular pressure. The management of patients with optic nerve head pitting and the pathogenesis of glaucomatous optic neuropathy are discussed with respect to this observation. Images PMID:666988

  18. Ocular Adnexal Lymphoma Presenting as Refractory Unilateral Open-angle Glaucoma.

    Science.gov (United States)

    Sears, Nathaniel C; Singh, Annapurna; Singh, Arun D

    2016-08-01

    We report a single case of masquerade glaucoma caused by increased episcleral venous pressure from adnexal lymphoma. The patient presented as a referral for unilateral glaucoma with intraocular pressures (IOPs) consistently >40 mm Hg (right eye). We present data conclusively demonstrating extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in the involved eye, and provide an account of the treatment of the tumor with sustained regression and complete resolution of his elevated IOP. We conclude with a discussion of the proposed mechanism. This case serves as a reminder that unilateral open-angle glaucoma can be a sign of indolent ocular adnexal lymphoma. The case also provides a useful model for increased IOP with orbital lesions.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Mapping a gene for adult-onset primary open-angle glaucoma to chromosome 3q

    Energy Technology Data Exchange (ETDEWEB)

    Wirtz, M.K.; Samples, J.R.; Kramer, P.L. [Oregon Health Sciences Univ., Portland, OR (United States)] [and others

    1997-02-01

    Glaucoma is the third-leading cause of blindness in the world, affecting >13.5 million people. Adult-on-set primary open-angle glaucoma (POAG) is the most common form of glaucoma in the United States. We present a family in which adult-onset POAG is inherited as an autosomal dominant trait. Twelve affected family members were identified from 44 at-risk individuals. The disease-causing gene was mapped to chromosome 3q21-24, with analysis of recombinant haplotypes suggesting a total inclusion region of 11.1 cM between markers D3S3637 and D3S1744. This is the first report of mapping of an adult-onset POAG gene to chromosome 3q, gene symbol GLC1C. 57 refs., 3 figs., 3 tabs.

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

    Science.gov (United States)

    van Koolwijk, Leonieke M E; Ramdas, Wishal D; Ikram, M Kamran; Jansonius, Nomdo M; Pasutto, Francesca; Hysi, Pirro G; Macgregor, Stuart; Janssen, Sarah F; Hewitt, Alex W; Viswanathan, Ananth C; ten Brink, Jacoline B; Hosseini, S Mohsen; Amin, Najaf; Despriet, Dominiek D G; Willemse-Assink, Jacqueline J M; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y; Gramer, Eugen; Welge-Lüssen, Ulrich; Montgomery, Grant W; Carbonaro, Francis; Young, Terri L; Bellenguez, Céline; McGuffin, Peter; Foster, Paul J; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y; Czudowska, Monika A; Hofman, Albert; Uitterlinden, Andre G; Wolfs, Roger C W; de Jong, Paulus T V M; Oostra, Ben A; Paterson, Andrew D; Mackey, David A; Bergen, Arthur A B; Reis, André; Hammond, Christopher J; Vingerling, Johannes R; Lemij, Hans G; Klaver, Caroline C W; van Duijn, Cornelia M

    2012-01-01

    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.

  3. 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.

  4. Refractory topiramate-induced angle-closure glaucoma in a man: a case report

    Directory of Open Access Journals (Sweden)

    Edward Deepak P

    2011-01-01

    Full Text Available Abstract Introduction Topiramate is a sulphonamide derivative indicated in the treatment of epilepsy and migraine. A known adverse affect is an idiosyncratic reaction that results in angle-closure glaucoma. We describe a patient with bilateral glaucoma related to topiramate that showed some unusual clinical features. Case presentation A 39-year-old Caucasian man presented with acute angle-closure glaucoma; he initially presented with intractable headaches after being treated with an escalating dose of topiramate. Clinical signs included elevated intraocular pressure that was initially refractory to treatment, shallow anterior chambers, and extensive bilateral choroidal effusions. After treatment with intravenous methylprednisolone, in conjunction with conventional glaucoma treatment, there was rapid reduction of intraocular pressure, gradual delayed resolution of the choroidal effusion and induced myopic shift; and eventually a good outcome without optic nerve damage. Conclusion This case illustrates the importance of recognizing this entity in a non-ophthalmic setting and that intravenous methylprednisolone may be useful in the treatment of the condition when it is not responsive to conventional treatment. In addition, it is important to recognize that complete resolution of visual symptoms from the myopic shift may be delayed, despite normalization of intraocular pressure.

  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. Elevated Plasma Endothelin-1 Levels in Normal Tension Glaucoma and Primary Open-Angle Glaucoma: A Meta-Analysis

    Science.gov (United States)

    Li, Shengjie; Zhang, Aiping

    2016-01-01

    Purpose. The aim of this meta-analysis was to clarify the association between the plasma endothelin-1 level and the risks of normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). Methods. Relevant publications were collected from three databases including PubMed, EMBASE, and the Web of Science through December 31, 2015. In this study, the terms “(endothelin OR ET) AND glaucoma” were searched. Review Manager 5.2 was used to process the data. Results. Seven studies (212 cases, 164 controls) were included for the NTG analysis. The mean plasma endothelin-1 level in the NTG subjects was 0.60 pg/mL (p = 0.02, 95% CI: 0.17–1.04) higher than that of the healthy controls. Six studies (160 cases, 174 controls) were included for the POAG analysis, and the endothelin-1 level was 0.63 pg/mL (p = 0.007, 95% CI: 0.12–1.15) higher in the POAG subjects than in the healthy controls. Additionally, two studies influenced the meta-analysis results regarding the association of plasma endothelin-1 with POAG by sensitivity analysis, and the probability of publication bias was low. Conclusions. The observation that NTG and POAG subjects showed significantly elevated endothelin-1 plasma concentrations suggests that a higher plasma level of endothelin-1 might increase the risk of NTG and POAG development. PMID:27965889

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Cytokine biomarkers in tear film for primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Gupta D

    2017-02-01

    Full Text Available Divakar Gupta,1,* Joanne C Wen,2,* Janet L Huebner,3 Sandra Stinnett,1 Virginia B Kraus,3,4 Henry C Tseng,1 Molly Walsh1 1Department of Ophthalmology, Duke University Medical Center, Durham, NC, 2Department of Ophthalmology, University of Washington, Seattle, WA, 3Duke Molecular Physiology Institute, 4Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA *These authors contributed equally to this work Purpose: To determine the utility of tear film cytokines as biomarkers for early primary open-angle glaucoma (POAG. Methods: Patients without POAG and eye drop-naïve patients with newly diagnosed POAG were recruited from an academic hospital-based glaucoma practice. Tear films of recruited patients were obtained and analyzed using a multiplex, high-sensitivity electrochemiluminescent enzyme-linked immunosorbent assay for proinflammatory cytokines (IFNγ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNFα. Results: Mean concentrations of tear film cytokines were lower in the glaucoma group for 8 of 10 cytokines tested. IL-12p70 (3.94±2.19 pg/mL in control vs 2.31±1.156 pg/mL in POAG; P=0.035 was significantly lower in the tear film of patients with newly diagnosed POAG. Conclusion: Proinflammatory cytokines were lower in eye drop-naïve newly diagnosed glaucoma patients. Tear film cytokine profiles may be used as biomarkers of early POAG. Keywords: glaucoma, biomarkers, tear film, cytokines, glaucoma diagnosis, lower limit of detection

  9. A comparison of the circadian rhythm of intraocular pressure in primary phronic angle closure glaucoma, primary open angle glaucoma and normal eyes

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    Sihota Ramanjit

    2005-01-01

    Full Text Available Purpose: To evaluate the circadian rhythm of intraocular pressure (IOP in primary chronic angle closure glaucoma (PCACG, primary open angle glaucoma (POAG, and normal eyes. Methods: Cross-sectional study of newly diagnosed patients of POAG (60 eyes, PCACG following laser iridotomy (75 eyes, and age and sex matched normal controls (75 eyes. All subjects underwent applanation tonometry at 7 a.m., 10 a.m., 1 p.m., 4 p.m., 7 p.m., and 10 p.m. by a masked observer. Circadian rhythms were classified based upon the timing and presence of peak pressure. Results: Age and gender in all three groups were comparable. Diurnal IOP fluctuations were significantly higher in PCACG (7.69 + 3.03 mmHg and POAG (8.31 + 2.58 mmHg groups compared to normal controls (4.83 + 2.46 mmHg. PCACG eyes and controls had similarly timed circadian rhythms, with PCACG eyes having a consistently higher IOP. At 7 and 10 a.m., IOP peaked more often in POAG eyes compared to PCACG eyes. A plateau type of circadian rhythm was most common in normal eyes. The timing of peak IOP could be significantly correlated with the type of primary glaucoma examined. Conclusion: Afternoon peaks were more common in postiridotomy PCACG eyes, similar to the rhythm in normal eyes. Morning peaks were more frequent in POAG eyes. Diurnal fluctuation > 6 mmHg, associated with an IOP of 21 mmHg or more was never seen in a normal eye.

  10. [The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Macarie, S; Macarie, Daniela

    2013-01-01

    This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.

  11. 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

  12. Genes of the unfolded protein response pathway harbor risk alleles for primary open angle glaucoma.

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    Mary Anna Carbone

    Full Text Available The statistical power of genome-wide association (GWA studies to detect risk alleles for human diseases is limited by the unfavorable ratio of SNPs to study subjects. This multiple testing problem can be surmounted with very large population sizes when common alleles of large effects give rise to disease status. However, GWA approaches fall short when many rare alleles may give rise to a common disease, or when the number of subjects that can be recruited is limited. Here, we demonstrate that this multiple testing problem can be overcome by a comparative genomics approach in which an initial genome-wide screen in a genetically amenable model organism is used to identify human orthologues that may harbor risk alleles for adult-onset primary open angle glaucoma (POAG. Glaucoma is a major cause of blindness, which affects over 60 million people worldwide. Several genes have been associated with juvenile onset glaucoma, but genetic factors that predispose to adult onset primary open angle glaucoma (POAG remain largely unknown. Previous genome-wide analysis in a Drosophila ocular hypertension model identified transcripts with altered regulation and showed induction of the unfolded protein response (UPR upon overexpression of transgenic human glaucoma-associated myocilin (MYOC. We selected 16 orthologous genes with 62 polymorphic markers and identified in two independent human populations two genes of the UPR that harbor POAG risk alleles, BIRC6 and PDIA5. Thus, effectiveness of the UPR in response to accumulation of misfolded or aggregated proteins may contribute to the pathogenesis of POAG and provide targets for early therapeutic intervention.

  13. 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

  14. New drugs and preparations for open-angle glaucoma in adults.

    Science.gov (United States)

    2015-12-01

    Primary (or chronic) open-angle glaucoma (POAG or COAG) may be asymptomatic but causes progressive optic nerve damage with significant loss of visual field. Treatments aim to lower intraocular pressure (IOP) by reducing the production of aqueous humour and/or increasing its drainage. Here we update our previous articles to reflect new drugs, preservative-free preparations and fixed-dose drug combinations for POAG.

  15. 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.

  16. Effect of phacoemulsification, intraocular lens implantation, and trabeculectomy on angle-closure glaucoma merged with cataract

    Institute of Scientific and Technical Information of China (English)

    Qun Wu; Li-Li Hao; Wen-Xuan Tao; Chun-Xiang Liu

    2016-01-01

    Objective:To explore the clinical effect of phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract. Methods:A total of 80 patients with angle-closure glaucoma merged with cataract who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and randomized into the observation group and the control group. The patients in the control group were given phacoemulsification and intraocular lens implantation. On this basis, the patients in the observation group were given trabeculectomy. The vision, intraocular pressure, central anterior chamber depth, and visual field before operation, 1 week, 1 month, and 3 months after operation in the two groups were detected.Results: In the control group, 1 month after operation, while in the observation group, 1 week after operation, the vision was significantly improved, the intraocular pressure was significantly reduced, the central anterior chamber depth was significantly increased, and the average visual field defect value and average standard deviation value were significantly improved when compared with before operation (P<0.05); moreover, the improved degree in the observation group was significantly superior to that in the control group (P<0.05).Conclusions:Phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract can effectively increase the central anterior chamber depth, reduce the intraocular pressure, and improve the vision; therefore, it deserves to be widely recommended in the clinic.

  17. Subfoveal choroidal thickness and glaucoma. The Beijing Eye Study 2011.

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    Ya Xing Wang

    Full Text Available To examine subfoveal choroidal thickness (SFCT in eyes with glaucoma, using enhanced depth imaging spectral domain optical coherence tomography.The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years (range: 50-93 years. A detailed ophthalmic examination was performed including spectral-domain optical coherence tomography (SD-OCT with enhanced depth imaging for measurement of SFCT, and assessment of fundus photographs for presence of glaucoma. In addition, the group of patients with chronic angle-closure glaucoma (ACG from the Beijing Eye Study (n = 37 was merged with a group of patients with chronic ACG from the Tongren hospital (n = 52.Assessments of SFCT and glaucoma were available for 3232 (93.2% subjects. After adjusting for age, axial length, gender, anterior chamber and lens thickness, SFCT was not significantly associated with presence of glaucoma (P = 0.08; regression coefficient B:-15.7. As a corollary, in logistic regression analysis with adjustment for age, axial length and intraocular pressure, presence of glaucoma was not significantly associated with SFCT (P = 0.20. If only open-angle glaucoma was considered, multivariate analysis revealed no significant association between SFCT and presence of open-angle glaucoma (P = 0.44. As a corollary, in logistic regression analysis, open-angle glaucoma was not significantly associated with SFCT (P = 0.91. In a similar manner if only ACG was taken into account, SFCT was not significantly associated with the presence of ACG (P = 0.27 in multivariate analysis. As a corollary in binary regression analysis, presence of ACG was not significantly associated with SFCT (P = 0.27.In multivariate analysis with adjustment for age, axial length, gender, anterior chamber and lens thickness, neither OAG nor ACG was associated with an abnormal SFCT.

  18. Glaucoma

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    Geraldo Vicente de Almeida

    2007-05-01

    Full Text Available A palavra glaucoma é utilizada desde os tempos de Hipócrates, o qual, num de seus aforismas, proclama que nesta doença ocular “a pupila se torna cor do mar, a cegueira se instala e geralmente o outro olho também é afetado”. A formação da palavra encerra alguns mistérios.

  19. The influence of venous blood flow on the retinal ganglion cell complex in patients with primary open angle glaucoma

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    N. I. Kurysheva

    2014-07-01

    Full Text Available Purpose: To study the influence of venous blood flow on the ganglion cell complex (GCC in patients with preperimetric and perimetric open angle glaucoma.Methods: 74 patients were included in the research. 59 eyes and 62 eyes were diagnosed with preperimetric and perimetric open angle glaucoma respectively. The mean age was 56.5±10.5 years. 22 (12 female and 10 male healthy individuals constituted the control group. The ganglion cell complex and retinal nerve fibre layer were evaluated with the help of optical coherence tomography (RTVue-100 OCT, Optovue, Inc., Fremont, CA. Ocular blood flow was measured by Color Doppler Imaging (multifunctional VOLUSON 730 ProSystem. The statistical analysis included correlation between GCC and RNFL thickness in both glaucoma groups.Results: The results showed a statistically significant reduction of venous blood flow velocity in both glaucoma groups compared to the control group. No difference in venous blood flow parameters between two glaucoma groups was found, except resistance index, which was higher in perimetric group in comparison to preperimetric group. A correlation was also obtained between venous blood flow parameters and GCC and RNFL thickness in both glaucoma groups.Conclusion: Early GCC damage in glaucoma might occur due to venous blood flow reduction. This fact may be of great value in understanding glaucoma pathogenesis and search for novel treatment options.

  20. Prospective, randomized study of one, two, or three trabecular bypass stents in open-angle glaucoma subjects on topical hypotensive medication

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    Katz LJ

    2015-12-01

    Full Text Available L Jay Katz,1 Carl Erb,2 Amadeu Carceller Guillamet,3 Antonio M Fea,4 Lilit Voskanyan,5 Jeffrey M Wells,6 Jane Ellen Giamporcaro6 1Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA; 2Eye Clinic Wittenbergplatz, Berlin, Germany; 3Department of Ophthalmology, Hospital d’Hebron, Barcelona, Spain; 4University Eye Clinic of the University of Turin, Turin, Italy; 5SV Malayan Opthalmology Centre, Yerevan, Armenia; 6Glaukos Corporation, Laguna Hills, CA, USA Purpose: To assess the safety and efficacy of one, two, or three trabecular microbypass stents in eyes with primary open-angle glaucoma (OAG not controlled on ocular hypotensive medication. A total of 119 subjects were followed for 18 months postoperatively.Materials and methods: Subjects with medicated intraocular pressure (IOP 18–30 mmHg and postmedication-washout baseline IOP 22–38 mmHg were randomized to implantation of one, two, or three stents. Ocular hypotensive medication was to be used if postoperative IOP exceeded 18 mmHg.Results: A total of 38 subjects were implanted with one stent, 41 subjects with two stents, and 40 subjects with three stents. Both month 12 IOP reduction ≥20% without ocular hypotensive medication vs baseline unmedicated IOP and month 12 unmedicated IOP ≤18 mmHg were achieved by 89.2%, 90.2%, and 92.1% of one-, two-, and three-stent eyes, respectively. Furthermore, 64.9%, 85.4%, and 92.1% of the three respective groups achieved unmedicated IOP ≤15 mmHg. Over the 18-month follow-up period, medication was required in seven one-stent subjects, four two-stent subjects, and three three-stent subjects. At 18 months, mean unmedicated IOP was 15.9±0.9 mmHg in one-stent subjects, 14.1±1.0 mmHg in two-stent subjects, and 12.2±1.1 mmHg in three-stent subjects. Month 18 IOP reduction was significantly greater (P<0.001 with implantation of each additional stent, with mean differences in reduction of 1.84 mmHg (95% confidence interval 0.96

  1. 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...

  2. Efficacy and Tolerability of Travoprost 0.004%/Timolol 0.5% Fixed-Dose Combination for the Treatment of Primary Open-Angle Glaucoma or Ocular Hypertension Inadequately Controlled with Beta-Blocker Monotherapy

    Science.gov (United States)

    Park, Ki Ho; Hubatsch, Douglas A.; Erichev, Valeriy; Paczka, Jose A.; Roberts, Timothy V.

    2017-01-01

    Objective. To evaluate the efficacy and tolerability of travoprost 0.004%/timolol 0.5% fixed-dose combination (TTFC) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) inadequately controlled on beta-blocker monotherapy. Methods. In this phase IV, open-label study, 156 patients on beta-blocker monotherapy with mean intraocular pressure (IOP) between 18 and 32 mmHg were randomized (no washout period) to receive TTFC for 8 weeks (TTFC group) or to continue beta-blocker monotherapy for 4 weeks followed by TTFC for the remaining 4 weeks (beta-blocker group). Results. The mean IOP (±standard deviation) at baseline in the TTFC and beta-blocker groups was 22.5 ± 2.5 mmHg and 22.2 ± 2.3 mmHg, respectively, and at weeks 4 and 8, was 16.7 ± 3.1 mmHg and 16.1 ± 3.1 mmHg, respectively, in TTFC group and 21.1 ± 3.1 mmHg and 16.1 ± 2.8 mmHg, respectively, in the beta-blocker group. There was a significant least squares mean difference between TTFC and beta-blocker in 8 a.m. IOP at week 4 (−4.6 mmHg; one-sided 95% confidence interval [−inf, −3.9]; p < 0.0001 [primary endpoint]); the upper bound of the 95% confidence interval was within the prespecified limit (<0). Both treatments were well tolerated. Conclusion. Superior IOP control was achieved with TTFC in patients with OAG or OHT previously uncontrolled with beta-blockers. No new safety findings were identified. This trial is registered with ClinicalTrials.gov NCT02003391. PMID:28239491

  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. Validity and cost-effectiveness of methods for screening of primary open angle glaucoma

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    Fröschl, Barbara

    2007-02-01

    Full Text Available Health political background: About 950,000 people are affected by glaucoma in Germany, about 50% of which are undiagnosed. The German Ophthalmological Society and the German Association of Ophthalmologists recommend a screening for glaucoma according to their guidelines. The Federal Joint Committee disapproved a glaucoma-screening program on expense of the compulsory health insurance in 2004. Scientific background: Primary open angle glaucoma is diagnosed by evaluation of the optic disc, the retinal fibre layer and the visual field. The main examinations are ophthalmoscopy, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, retinal thickness analysis and optical coherence tomography. Scotomas are diagnosed by perimetry (standard automated perimetry, short wavelength automated perimetry and frequency doubling perimetry. The intraocular pressure is the most important treatable risk factor and is measured by (contact or non-contact tonometry. Research questions: The aim of this HTA-report is to investigate the diagnostic validity and cost effectiveness of diagnostic techniques or combinations of these methods with respect to the use in a screening setting in Germany. Methods: A systematic literature research was performed in 35 international databases and yielded 2602 articles. Overall 57 publications were included for assessment, according to predefined selection criteria. Results: The 55 medical articles deal mainly with frequency doubling perimetry, confocal scanning laser ophthalmoscopy and scanning laser polarimetry. Few articles cover short wavelength automated perimetry, tonometry and ophalmocopic evaluations by ophthalmologists. The quality of the papers is generally low, as far as the evidence in respect of screening is concerned. No single method exists with both, high sensitivity and high specificity for screening purpose. Data are also not sufficient to recommend combinations of methods. Only two economic models on cost

  5. Current concepts on primary open-angle glaucoma genetics: a contribution to disease pathophysiology and future treatment.

    Science.gov (United States)

    Gemenetzi, M; Yang, Y; Lotery, A J

    2012-03-01

    Glaucoma is a common, complex, heterogenous disease and it constitutes the major cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG) is the most common type of glaucoma in all populations. Most of the molecular mechanisms leading to POAG development are still unknown. Gene mutations in various populations have been identified by genetic studies and a genetic basis for glaucoma pathogenesis has been established. Linkage analysis and association studies are genetic approaches in the investigation of the genetic basis of POAG. Genome-wide association studies (GWAS) are more powerful compared with linkage analysis in discovering genes of small effect that might contribute to the development of the disease. POAG links to at least 20 genetic loci, but only 2 genes identified in these loci, myocilin and optineurin, are considered as well-established glaucoma-causing genes, whereas the role of other loci, genes, and variants implicated in the development of POAG remains controversial. Gene mutations associated with POAG result in retinal ganglion cell death, which is the common outcome of pathogenetic mechanisms in glaucoma. In future, if the sensitivity and specificity of genotyping increases, it may be possible to screen individuals routinely for disease susceptibility. This review is an update on the latest progress of genetic studies associated with POAG. It emphasizes the correlation of recent achievements in genetics with glaucoma pathophysiology, glaucoma treatment perspectives, and the possibility of future prevention of irreversible visual loss caused by the disease.

  6. BILATERAL ACUTE ANGLE CLOSURE GLAUCOMA AND MYOPIA INDUCED BY LOW DOSAGE TOPIRAMATE

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    Busra S. Arica

    2014-09-01

    Full Text Available Introduction: Topiramate, a sulfamate-substituted monosaccharide, has been shown to be effective in the treatment of epilepsy and migraine prophylaxis. However, acute secondary angle closure glaucoma and myopia has been shown to develop, especially during the first two weeks of treatment, in a small subset of patients. Case presentation: In the current case report, a 23 year old female patient developed acute myopia and angle closure glaucoma after one week topiramate treatment (25 mg/day for prophylaxis of migraine without aura. The patient was found to have significant conjunctival hyperemia, shallow anterior chamber, and bulging iris in both eyes. Grade 1 acute angle was detected in both eyes during gonioscopic examination. There was no pupillary block and intraocular pressure was 40 mmHg in both eyes. Refraction values were measured at -7.00 and -8.00 in the right and left eye, respectively. The patient and #8217;s visual acuity was at 0.1 to 0.2. Topiramate treatment was promptly discontinued, topical antiglaucomatous treatment was initiated, and laser peripheral iridotomy was performed on each eye. Intraocular pressure has declined to normal limits, refractive values were zero in both eyes and patient and #8217;s visual acuity has restored at follow-up period at 10 days after treatment. Conclusion: Side effects associated with topiramate treatments are known to disappear without long-term damage when the discontinuation of therapy and effective interventions are started early. Therefore, patients and their physicians should be alert for symptoms associated with acute secondary angle closure glaucoma and myopia; especially in the first weeks of topiramate treatment also with low dosage. [J Contemp Med 2014; 4(3.000: 168-171

  7. Analysis of COCH and TNFA Variants in East Indian Primary Open-Angle Glaucoma Patients

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    Subhadip Chakraborty

    2013-01-01

    Full Text Available Glaucoma represents a heterogeneous group of optic neuropathies with a complex genetic basis. It is the second-largest cause of blindness in the world that reduces vision without warning and often without symptoms. Among 3 major subtypes of glaucoma, primary open-angle glaucoma (POAG is the most common form. The focus of this study is to understand the molecular basis of the disease among Indian patients with respect to two genes, Cochlin (COCH and tumor necrosis factor alpha (TNFA, selected based on reports of possible association with POAG. The genes were screened in patients and controls by PCR and direct sequencing. Although two novel changes (–450 C/T and –79 G/G were identified in the 5′upstream region of COCH, no causal variant could be identified in either gene. –450 C/T was detected in 3 patients and 2 controls and –79 G/C in a single patient. Further, we did not observe significant association with the promoter SNPs of TNFA that had been previously reported to be associated with POAG pathogenesis. Thus, our study suggests lack of association of both COCH and TNFA with POAG pathogenesis.

  8. 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.

  9. Differential protein expression in tears of patients with primary open angle and pseudoexfoliative glaucoma.

    Science.gov (United States)

    Pieragostino, Damiana; Bucci, Sonia; Agnifili, Luca; Fasanella, Vincenzo; D'Aguanno, Simona; Mastropasqua, Alessandra; Ciancaglini, Marco; Mastropasqua, Leonardo; Di Ilio, Carmine; Sacchetta, Paolo; Urbani, Andrea; Del Boccio, Piero

    2012-04-01

    Primary open angle (POAG) and pseudoexfoliative glaucoma (PXG) are the most common primary and secondary forms of glaucoma, respectively. Even though the patho-physiology, aqueous humor composition, risk factors, clinical features, therapy and drug induced ocular surface changes in POAG and PXG have been widely studied, to date information concerning tear protein characterization is lacking. Tears are a source of nourishment for ocular surface tissues and a vehicle to remove local waste products, metabolized drugs and inflammatory mediators produced in several ophthalmic diseases. In glaucoma, the proteomic definition of tears may provide insights concerning patho-physiology of the disease and ocular surface modifications induced by topical therapy. Our study aimed at characterizing protein patterns in tears of patients with medically controlled POAG and PXG. A comparative tears proteomic analysis by label-free LC-MS(E) highlighted differences in the expression of several proteins in the two glaucoma sub-types and control subjects, highlighting inflammation pathways expressed in both diseases. Results were independently reconfirmed by SDS-PAGE and linear MALDI-TOF MS, validating altered levels of Lysozyme C, Lipocalin-1, Protein S100, Immunoglobulins and Prolactin Inducible Protein. Moreover, we found a differential pattern of phosphorylated Cystatin-S that distinguishes the two pathologies. The most relevant results suggest that in both pathologies there may be active inflammation pathways related to the disease and/or induced by therapy. We show, for the first time, tear protein patterns expressed under controlled intraocular pressure conditions in POAG and PXG subjects. These findings could help in the understanding of molecular machinery underlying these ophthalmologic diseases, resulting in early diagnosis and more specific therapy.

  10. 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...

  11. 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.

  12. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Glaucoma Symptoms, Treatment and Research Past Issues / Spring 2015 Table ... without any pain. Photo courtesy of NEI Glaucoma Symptoms At first, open-angle glaucoma has no symptoms. ...

  13. The Clinical Outcomes of Three Surgical Managements on Primary Angle-closure Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Xiulan; Zhang; Leilei; Teng; Ang; Li; Shaolin; Du; Yunyun; Zhu; Jian; Ge

    2007-01-01

    Purpose: To investigate the efficacy of trabeculectomy, phacotrabeculectomy and phacoemulsification in the management of primary angle closure glaucoma (PACG).Methods: A prospective observational study was performed in 88 chronic PACG patients (97 eyes) who were divided into three groups following defined indications to receive different surgical interventions. The indications and clinical outcomes were evaluated. The mean follow-up was (17.7±4.9) months.Results: Success rate in trabeculectomy, phacotrabeculectomy and phacoemulsification group was 81.08%, 78.57‰ and 81.25‰, respectively. The anterior chamber depth was deeper and the angle was wider postoperatively vs. preoperatively both in phacotrabeculectomy and phacoemulsification group. No obvious changes were seen in trabeculectomy group. The coefficient of outflow facility of aqueous humor (C values)significantly increased in three groups postoperatively (P<0.01 ). No severe intraoperative complications were found and the incidence of postoperative complications was low. Five eyes sustained hypotony 3± 1.87 months in trabeculectomy group and 1 eye happened malignant glaucoma in phacotrabeculectomy group. The visual acuity in patients with phacotrabeculectomy plus intraocular lens implantation and those only with phacoemulsification plus intraocular lens implantation were improved 78.57% and 93.74%, respectively. No significant improvement was found in trabeculectomy group (x2 = 47.10, P<0.001).Conclusion: Three surgical interventions were beneficial to manage PACG and with co-existing cataract. The indication choosing was suggested according to visual acuity,angle closure circumference, cataract, medication requirements and optic nerve damage.Phacotrabeculectomy was recommended for angle closed ≥180° circumference while phacoemulsification for angle closed < 180°.

  14. Efficacy of non-penetrating trabecular surgery for open angle glaucoma:a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    程金伟; 马晓晔; 魏锐

    2004-01-01

    Background Non-penetrating trabecular surgery is a new filtrating surgery without opening in ternal trabecular structures. This study was to estimate the overall efficacy of non-penetrating trabecular surgery for open angle glaucoma.Methods The published articles selected for this study were obtained by a computerised Medline and China Biological Medicine Disk search of the literature and a manual search of the bibliographies of relevant articles. Articles meeting the inclusion criteria were reviewed systematically, and the reported data were aggregated using the statistical techniques of meta-analysis.Results A total of 37 articles were included in the meta-analysis. The pooled complete success rates of non-penetrating trabecular surgery with different techniques were: deep sclerectomy single, 69.7% (95% CI: 58.5%-81.0%); deep sclerectomy with collagen implant, 59.4% (95% CI: 47.0%-71.8%); deep sclerectomy with reticulated hyaluronic acid implant, 71.1% (95% CI: 56.8%-85.3%); and viscocanalostomy, 72.0% (95% CI: 57.6%-86.4%). The overall weighted complete success rate of non-penetrating trabecular surgery was 67.8% (95% CI: 61.4%-74.3%).Conclusions Non-penetrating trabecular surgery is the best available therapy method for medically uncontrolled open angle glaucoma with a complete success rate of over 60%. But the different techniques cannot belie the complete success rate of non-penetrating trabecular surgery.

  15. 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.

  16. 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

  17. Topiramate-induced angle-closure glaucoma: cross-sensitivity with other sulphonamide derivatives causing anterior uveitis.

    Science.gov (United States)

    Kamal, Saurabh; Yadava, Usha; Kumar, Sushil; Goel, Ruchi

    2014-04-01

    Topiramate is a recognized cause of drug-induced acute angle-closure glaucoma. We describe a case presenting with bilateral acute angle-closure glaucoma caused by topiramate intake. Patient subsequently developed severe anterior uveitis caused by sulphonamide derivatives (acetazolamide and co-trimoxazole) due to cross-sensitivity, on two separate occasions. The present case also highlights the role of anterior segment optical tomography in diagnosis and follow-up. In a patient with known drug allergy to topiramate, other sulphonamide derivatives should be avoided to limit the ocular morbidity.

  18. 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.

  19. Myocilin polymorphisms and primary open-angle glaucoma: a systematic review and meta-analysis.

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    Jin-Wei Cheng

    Full Text Available BACKGROUND: Glaucoma is the leading cause of irreversible blindness in the world. Recent evidence indicates a role for genetic susceptibility to primary open-angle glaucoma (POAG. The relation between myocilin polymorphisms and POAG susceptibility has been studied in different populations. METHODS: A meta-analysis of 32 published genetic association case-control studies, which examined the relation between POAG and the R46X, R76K, Y347Y, T353I, and Q368X polymorphisms of the myocilin gene, was carried out. RESULTS: In meta-analysis, significant associations were observed between POAG risk and two myocilin polymorphisms with summarized odds ratio of 4.68 (95%CI, 2.02-10.85 for Q368X and 2.17 (95% CI, 1.32-3.57 for T353I. Both Q368X and T353I were significantly associated with high-tension glaucoma, with summarized odds ratio of 4.26 (1.69, 10.73 and 2.26 (1.37-3.72. In Westerners, significant association was observed for Q368X mutation (odds ratio, 5.17; 95% CI, 2.16-12.40. However, in Asians it was for T353I (odds ratio, 2.17; 95% CI, 1.32-3.57. CONCLUSIONS: There is strong evidence that myocilin polymorphisms are associated with POAG susceptibility, and the prevalence of myocilin mutations might be ethnicity-dependent in Caucasians for Q368X and in Asians for T353I.

  20. Graph theoretical analysis reveals the reorganization of the brain network pattern in primary open angle glaucoma patients

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    Wang, Jieqiong [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Li, Ting; Xian, Junfang [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); Wang, Ningli [Capital Medical University, Department of Ophthalmology, Beijing Tongren Hospital, Beijing (China); He, Huiguang [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Chinese Academy of Sciences, Research Center for Brain-Inspired Intelligence, Institute of Automation, Beijing (China)

    2016-11-15

    Most previous glaucoma studies with resting-state fMRI have focused on the neuronal activity in the individual structure of the brain, yet ignored the functional communication of anatomically separated structures. The purpose of this study is to investigate the efficiency of the functional communication change or not in glaucoma patients. We applied the resting-state fMRI data to construct the connectivity network of 25 normal controls and 25 age-gender-matched primary open angle glaucoma patients. Graph theoretical analysis was performed to assess brain network pattern differences between the two groups. No significant differences of the global network measures were found between the two groups. However, the local measures were radically reorganized in glaucoma patients. Comparing with the hub regions in normal controls' network, we found that six hub regions disappeared and nine hub regions appeared in the network of patients. In addition, the betweenness centralities of two altered hub regions, right fusiform gyrus and right lingual gyrus, were significantly correlated with the visual field mean deviation. Although the efficiency of functional communication is preserved in the brain network of the glaucoma at the global level, the efficiency of functional communication is altered in some specialized regions of the glaucoma. (orig.)

  1. Common variants on chromosome 9p21 are associated with normal tension glaucoma.

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    Mitsuko Takamoto

    Full Text Available Although intraocular pressure (IOP is the most definitive cause of glaucoma, a subtype of open angle glaucoma (OAG termed normal tension glaucoma (NTG, which occurs in spite of normal IOP, accounts for a large part of glaucoma cases, especially in Japan. To find common genetic variants contributing to NTG in Japanese patients, we conducted a genome-wide association study (GWAS. We performed the first screening for 531,009 autosomal SNPs with a discovery cohort of 286 cases and 557 controls, and then a second screening for the top 30 suggestive loci in an independent cohort of 183 cases and 514 controls. Our findings identified a significantly associated SNP; rs523096 [combined p-value = 7.40× 10(-8, odds ratio (OR= 2.00 with 95% confidence interval (CI 1.55-2.58] located 10 kbp upstream of CDKN2B on chromosome 9p21. Moreover, analysis of another independent case-control set successfully replicated the results of the screening studies (combined values of all 3 stages p = 4.96 × 10(-11, OR= 2.13 with 95% CI 1.69-2.68. The SNPs near rs523096 were recently reported to be associated with OAG associated with elevated IOP in primary open-angle glaucoma (POAG, the predominant subtype of glaucoma in Caucasian populations. Our results revealed that the 9p21 locus is also associated with NTG in Japanese. In addition, we identified SNPs more strongly associated with NTG.

  2. Prospective unmasked randomized evaluation of the iStent inject® versus two ocular hypotensive agents in patients with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fea AM

    2014-05-01

    Full Text Available Antonio M Fea,1 Jose I Belda,2 Marek Rękas,3 Anselm Jünemann,4 Lydia Chang,5 Luis Pablo,6 Lilit Voskanyan,7 L Jay Katz81Università degli Studi di Torino, Clinica Oculistica, Torino, Italy; 2Hospital Torrevieja Salud, UTE, Servicio de Oftalmologia, Alicante, Spain; 3Military Institute of Medicine, Department of Ophthalmology, Warsaw, Poland; 4Universitätsaugenklinik, Erlangen, Germany; 5Hinchingbrooke Hospital NHS Trust and Moorfields Bedford Hospital NHS Trust, United Kingdom; 6Hospital Universitario Miguel Servet, Servicio Oftalmologico, Zaragoza, Spain; 7SV Malayan Ophthalmological Center, Yerevan, Armenia; 8Wills Eye Institute, Jefferson Medical College, Philadelphia, PA, USAPurpose: The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG not controlled on one medication who underwent either implantation of two iStent inject® trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol.Patients and methods: Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject® devices in the treated eye and 98 to receive medical therapy.Results: At the month 12 visit, 94.7% of eyes (89/94 in the stent group reported an unmedicated intraocular pressure (IOP reduction of ≥20% versus baseline unmedicated IOP, and 91.8% of eyes (88/98 in the medical therapy group reported an IOP reduction ≥20% versus baseline unmedicated IOP. A 17.5% between-group treatment difference in favor of the iStent inject group was statistically significant (P=0.02 at the ≥50% level of IOP reduction. An IOP ≤18 mmHg was reported in 92.6% of eyes (87/94 in the iStent inject group and 89.8% of eyes (88/98 in the medical therapy group. Mean (standard deviation IOP decreases from screening of 8.1 (2.6 mmHg and 7.3 (2.2 mmHg were reported in the iStent inject and medical therapy groups, respectively. A high

  3. 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.

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

    Science.gov (United States)

    Mitra, Arijit; Ramakrishnan, R; Kader, Mohideen Abdul

    2014-08-01

    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.

  5. 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.

  6. Variants in the ASB10 Gene Are Associated with Primary Open Angle Glaucoma.

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    Shazia Micheal

    Full Text Available Recently nonsynonymous coding variants in the ankyrin repeats and suppressor of cytokine signaling box-containing protein 10 (ASB10 gene were found to be associated with primary open angle glaucoma (POAG in cohorts from Oregon and Germany, but this finding was not confirmed in an independent cohort from Iowa. The aim of the current study was to assess the role of ASB10 gene variants in Pakistani glaucoma patients.Sanger sequencing of the coding exons and splice junctions of the ASB10 gene was performed in 30 probands of multiplex POAG families, 208 sporadic POAG patients and 151 healthy controls from Pakistan. Genotypic associations of individual variants with POAG were analyzed with the Fisher's exact or Chi-square test.In total 24 variants were identified in POAG probands and sporadic patients, including 11 novel variants and 13 known variants. 13 of the variants were nonsynonymous, 6 were synonymous, and 5 were intronic. Three nonsynonymous variants (p.Arg49Cys, p.Arg237Gly, p.Arg453Cys identified in the probands were not segregating in the respective families. This is not surprising since glaucoma is a multifactorial disease, and multiple factors are likely to be involved in the disease manifestation in these families. However a nonsynonymous variant, p.Arg453Cys (rs3800791, was found in 6 sporadic POAG patients but not in controls, suggesting that it infers increased risk for the disease. In addition, one synonymous variant was found to be associated with sporadic POAG: p.Ala290Ala and the association of the variant with POAG remained significant after correction for multiple testing (uncorrected p-value 0.002, corrected p-value 0.047. The cumulative burden of rare, nonsynonymous variants was significantly higher in sporadic POAG patients compared to control individuals (p-value 0.000006.Variants in ASB10 were found to be significantly associated with sporadic POAG in the Pakistani population. This supports previous findings that sequence

  7. Myopia as a Risk Factor for Open-Angle Glaucoma : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Marcus, Michael W.; de Vries, Margriet M.; Montolio, Francisco G. Junoy; Jansonius, Nomdo M.

    2011-01-01

    Objective: To determine the association between myopia and open-angle glaucoma. Design: Systematic review and meta-analysis of observational studies. Participants: Thirteen studies involving 48 161 individuals. Methods: Articles published between 1994 and 2010 were identified in PubMed, Embase, and

  8. [Effects of nootropic agents on visual functions and lacrimal antioxidative activity in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Davydova, N G; Kuznetsova, T P; Borisova, S A; Abdulkadyrova, M Zh

    2006-01-01

    The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

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

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    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

  10. A comparison of betaxolol and timolol in open angle glaucoma and ocular hypertension.

    Science.gov (United States)

    Feghali, J G; Kaufman, P L; Radius, R L; Mandell, A I

    1988-04-01

    In a randomized, double-masked study, 41 patients with primary open-angle glaucoma or ocular hypertension were treated with betaxolol 0.5% or timolol 0.5% drops for 26 weeks. The average decrease in intraocular pressure (IOP) over the total study period was significant with both betaxolol (-6.3 mmHg) and timolol (-7.2 mmHg) in patients receiving no adjunctive therapy. There was no difference between betaxolol and timolol with respect to changes from baseline IOP. Significantly decreased mean brachial arterial pressure (MAP) was seen only with timolol, although the difference between the two groups was not significant. Pulse, pupil size, and basal tear secretion were unchanged in both groups. Burning upon instillation of the drops was more frequent with betaxolol.

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

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    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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Prospective unmasked randomized evaluation of the iStent inject® versus two ocular hypotensive agents in patients with primary open-angle glaucoma

    Science.gov (United States)

    Fea, Antonio M; Belda, Jose I; Rękas, Marek; Jünemann, Anselm; Chang, Lydia; Pablo, Luis; Voskanyan, Lilit; Katz, L Jay

    2014-01-01

    Purpose The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG) not controlled on one medication who underwent either implantation of two iStent inject® trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol. Patients and methods Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject® devices in the treated eye and 98 to receive medical therapy. Results At the month 12 visit, 94.7% of eyes (89/94) in the stent group reported an unmedicated intraocular pressure (IOP) reduction of ≥20% versus baseline unmedicated IOP, and 91.8% of eyes (88/98) in the medical therapy group reported an IOP reduction ≥20% versus baseline unmedicated IOP. A 17.5% between-group treatment difference in favor of the iStent inject group was statistically significant (P=0.02) at the ≥50% level of IOP reduction. An IOP ≤18 mmHg was reported in 92.6% of eyes (87/94) in the iStent inject group and 89.8% of eyes (88/98) in the medical therapy group. Mean (standard deviation) IOP decreases from screening of 8.1 (2.6) mmHg and 7.3 (2.2) mmHg were reported in the iStent inject and medical therapy groups, respectively. A high safety profile was also noted in this study in both the iStent inject and medical therapy groups, as measured by stable best corrected visual acuity, cup-to-disc ratio, and adverse events. Conclusion These data show that the use of iStent inject is at least as effective as two medications, with the clinical benefit of reducing medication burden and assuring continuous treatment with full compliance to implant therapy as well as having a highly favorable safety profile. PMID:24855336

  17. 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

  18. Influence of initial visual field sensitivity on visual field loss progression in open angle glaucoma

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    Hentova-Senćanić Paraskeva

    2012-01-01

    Full Text Available Introduction. It is important to know the risk factors for visual field defect progression in order to predict the future development of glaucoma. Objective. To investigate the influence of visual field initial sensitivity on the rate of visual field progression. Methods. A minimum of five visual fields were performed using computerized perimetry (Octopus over a mean follow- up 4-year period (48.85±17.84 months in 64 persons (114 eyes with primary open angle glaucoma. The rate of change of the whole central visual field and each of the seven regions of the field were measured by linear regression analysis of the mean sensitivity value versus time. Based on the slope of the regression line of visual field mean sensitivity over time the eyes were divided into two groups: the group with stable and the group with progressive visual field. The comparison of the mean sensitivity of the whole central visual field between the groups was performed using the Mann-Whitney U-test. The Spearman rang correlation coefficient and the Spearman probability p values were calculated to assess the mean sensitivity of the whole central visual field and of each visual field regions determined at the beginning of the study. Results. The initial mean sensitivity of the whole central visual field was lower in the group with progressive visual field (16.62±6.35 dB. Correlation between the initial mean sensitivity and the slope of the regression line was negative. The lowest mean sensitivity was in the group with progressive visual field in the upper temporal (13.73±7.35 dB, nasal (14.74±7.23 dB and upper nasal (15.03±7.75 dB regions. Conclusion. The lower mean sensitivity value of the visual field, especially in the nasal and upper nasal visual field regions, carries a greater risk for delayed progressive loss of the visual field in persons with glaucoma.

  19. Evaluation of Ex-PRESS implantation combined with phacoemulsification in primary angle-closure glaucoma

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    Liu, Bing; Guo, Da-Dong; Du, Xiu-Juan; Cong, Chen-Yang; Ma, Xiao-Hua

    2016-01-01

    Abstract To evaluate the safety and efficacy of Ex-PRESS (R50) implantation combined with phacoemulsification in primary angle-closure glaucoma (PACG) patients with cataract. Twenty-four eyes of 24 patients with unregulated PACG underwent combined cataract and glaucoma surgery. After phacoemulsification and intraocular lens implantation, the Ex-PRESS (R-50) was inserted into the anterior chamber under a scleral flap. The intraocular pressure (IOP), best corrected visual acuity (BCVA), number of medications, and complications were recorded preoperatively as well as postoperatively on day 7 and at 1, 3, 6, and 12 months. The mean follow-up was 16.4 ± 2.5 months (range 14–21 months) and the mean age of the patients was 64.7 ± 6.8 years (range 56–78 years). The mean IOP was 20.4 ± 5.4 mm Hg preoperatively and decreased to 10.2 ± 2.8, 13.1 ± 2.7, 14.9 ± 4.1, 14.3 ± 3.9, and 14.0 ± 3.6 mm Hg on day 7 and at 1, 3, 6, and 12 months after surgery (all P < 0.005). At 12 months, the mean BCVA was 0.62 ± 0.33 and the number of medications was 0.3 ± 0.6. Most of complications were resolved spontaneously and conservatively. The Ex-PRESS implantation combined with phacoemulsification cataract extraction is safe and effective for reducing IOP and antiglaucoma medications in PACG patients with cataract. PMID:27603352

  20. Soluble guanylate cyclase α1-deficient mice: a novel murine model for primary open angle glaucoma.

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    Emmanuel S Buys

    Full Text Available Primary open angle glaucoma (POAG is a leading cause of blindness worldwide. The molecular signaling involved in the pathogenesis of POAG remains unknown. Here, we report that mice lacking the α1 subunit of the nitric oxide receptor soluble guanylate cyclase represent a novel and translatable animal model of POAG, characterized by thinning of the retinal nerve fiber layer and loss of optic nerve axons in the context of an open iridocorneal angle. The optic neuropathy associated with soluble guanylate cyclase α1-deficiency was accompanied by modestly increased intraocular pressure and retinal vascular dysfunction. Moreover, data from a candidate gene association study suggests that a variant in the locus containing the genes encoding for the α1 and β1 subunits of soluble guanylate cyclase is associated with POAG in patients presenting with initial paracentral vision loss, a disease subtype thought to be associated with vascular dysregulation. These findings provide new insights into the pathogenesis and genetics of POAG and suggest new therapeutic strategies for POAG.

  1. [Administration of premedication with fexofenadine for paclitaxel-induced hypersensitive reactions in breast cancer patients complicated with closed-angle glaucoma].

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    Komatsubara, Kazuo; Miyoshi, Kyoko; Kogure, Yuuki; Matsuhisa, Tetsuaki; Eguchi, Hisae

    2010-01-01

    Paclitaxel (PTX) is one of the most important breast cancer treatment drugs. However, severe hypersensitivity reactions such as decreases in blood pressure and impaired breathing occur with high frequency. For the prevention of such hypersensitivity reactions, administration of a premedication composed of three components, diphenhydramine, ranitidine (or famotidine), and dexamethasone, has been advised in package insert information of medicine. Administration of diphenhydramine is difficult in breast cancer patients complicated with closed-angle glaucoma, because diphenhydramine has a weak anticholinergic adverse effect which can induce mydriasis and glaucoma attack. We studied the prevention of severe hypersensitivity reactions and of glaucoma attack in 2 breast cancer patients complicated with closed angle glaucoma at our hospital from April 2007 to March 2008. We switched from diphenhydramine to fexofenadine as the medicine to prevent hypersensitivity reactions. Hypersensitivity reactions were not observed throughout all courses in both patients, and no glaucoma attack was observed.

  2. 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

  3. Lamina cribrosa defects and optic disc morphology in primary open angle glaucoma with high myopia.

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    Yugo Kimura

    Full Text Available PURPOSE: To investigate whether lamina cribrosa (LC defects are associated with optic disc morphology in primary open angle glaucoma (POAG eyes with high myopia. METHODS: A total of 129 POAG patients and 55 age-matched control subjects with high myopia were evaluated. Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects. Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA lengths with and without Bruch's membrane (BM (temporal, nasal, superior, and inferior, tilt angle (vertical and horizontal, and disc diameter (transverse and longitudinal. Peripapillary intrachoroidal cavitations (PICCs, disc area, ovality index, and cyclotorsion of the optic disc were analyzed as well. RESULTS: LC defects were found in 70 of 129 (54.2% POAG eyes and 1 of 55 (1.8% control eyes (P < 0.001. Age, sex, spherical equivalent, axial length, intraocular pressure, and central corneal thickness were not significantly different among POAG eyes with LC defects, POAG eyes without LC defects, and control eyes. Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle. PICCs were detected more frequently in POAG eyes with LC defects than those without LC defects (P = 0.01 and control eyes (P = 0.02. POAG eyes with LC defects showed a smaller ovality index (P = 0.004, longer temporal PPA without BM (P < 0.001, and larger vertical/horizontal tilt angles (vertical, P < 0.001; horizontal, P = 0.01, and transverse diameter (P = 0.01. In multivariate analysis for the presence of LC defects, presence of POAG (P < 0.001 and vertical tilt angle (P < 0.001 were identified as significant. CONCLUSIONS: The presence of LC defects was associated with myopic optic disc morphology in POAG eyes with high

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

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    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

  5. Knowledge and attitude of eye hospital patients towards chronic open angle glaucoma in Onitsha

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    L O Onyekwe

    2009-01-01

    Conclusion:The study showed that knowledge of glaucoma is still very low in this environment. Fear of visual loss and cost are the major reasons for non-acceptance of surgery as a mode of treatment. The eye care providers should evolve a culture of useful health education and couseling regarding glaucoma, an irreversibly blindness disease.

  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

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

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    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.

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

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    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

    2016-05-31

    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.

  9. Genetic and environmental risk factors for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    范宝剑; 梁旭辉; 汪宁; 林顺潮; 刘瑶; 谭霭仙; 彭智培

    2004-01-01

    Background Primary open-angle glaucoma (POAG) is characterized by optic nerve damage and consists of a group of genetically heterogeneous disorders. This study was to investigate the associations of genetic and environmental factors with POAG in a hospital-based Chinese population.Methods Thirty-two adult onset POAG patients and 96 age-sex matched control subjects were studied by multivariable logistic regression analysis for the relationships between POAG and its risk factors including family history, diabetes, hypertension, cardiovascular diseases, cigarette smoking, alcohol consumption and polymorphisms of the myocilin and the optineurin genes.Results Univariate analysis showed that POAG was related to family history, cardiovascular disease, alcohol consumption and a myocilin sequence alteration (T353I) (P<0.04). Multivariable logistic regression analysis confirmed that POAG was significantly associated with family history (OR=20.2), hypertension (OR=3.58), cigarette smoking (OR=10.8), alcohol consumption (OR=0.028) and T353I (OR=6.03, all P<0.05).Conclusions Family history, hypertension, cigarette smoking and T353I in the myocilin gene are risk factors for POAG. Alcohol consumption, however, has a protective effect.

  10. Bimatoprost: a review of its use in open-angle glaucoma and ocular hypertension.

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    Curran, Monique P

    2009-01-01

    Bimatoprost (Lumigan) is a synthetic prostamide that reduces intraocular pressure (IOP) by increasing the outflow of aqueous humour. In patients with open-angle glaucoma or ocular hypertension, long-term treatment (for up to 48 months) with once-daily bimatoprost 0.03% ophthalmic solution was more effective than timolol twice daily in providing a sustained and stable reduction in IOP. Bimatoprost 0.03% ophthalmic solution demonstrated efficacy similar to, or greater than, the prostaglandin analogues latanoprost and travoprost in reducing IOP and achieving target IOP levels. Switching to bimatoprost was as effective in maintaining diurnal IOP control as switching to a fixed combination of latanoprost/timolol (in patients with IOP levels controlled with a nonfixed combination of latanoprost plus timolol), and similarly, or more, effective in lowering IOP and providing overall diurnal IOP control than switching to a combination of dorzolamide/timolol (in patients with IOP inadequately controlled with other antiglaucoma agents including timolol). Treatment with bimatoprost was generally well tolerated, with conjunctival hyperaemia (mostly mild), growth of eyelashes and ocular pruritus being commonly reported. Other adverse events included increases in the pigmentation of the iris, perorbital areas and eyelashes.

  11. Fascicular Visual Field Defects in Open-Angle Glaucoma: Evaluation with Microperimetry.

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    Arrico, Loredana; Giannotti, Rossella; Fratipietro, Manuela; Malagola, Romualdo

    2016-01-01

    Purpose. Use of microperimetry (Mp-1), correlating with Humphrey perimetry (30-2 program), in patients affected by primary open-angle glaucoma (POAG) with perimetric defects, in order to obtain an evaluation of the accuracy of the results obtained by Mp-1. Materials and Methods. In this study 40 eyes of 25 patients affected by POAG with perimetric defects were included. All patients underwent microperimetry test by Nidek Mp-1 (NAVIS software version 1.7.2, Nidek Technologies). Mean sensitivity values expressed in decibel (dB) of all tested dots and mean values for each quadrant obtained by microperimetric test were correlated with corresponding quadrants obtained by static perimetry analysis. Data were analyzed by Pearson's correlation and Bland-Altman analysis. Results. Interpolated data showed that mean sensitivity values in all spots tested by Mp-1 (11.98 dB, SD 4.31) may be significantly correlated with mean total values obtained by Humphrey 30-2 perimetry (17.95, SD 4.32), with correlation coefficient of 0.556. Conclusions. Topographic visualization of the perimetric alteration by microperimetry allows retesting areas with reduced sensitivity which are topographically visualized and displayable on the ocular fundus examination, avoiding worsening of the functional defect by better modulation of the antiglaucoma therapy and therefore it allows better monitoring of the pathologic functional damage.

  12. Association between primary open angle glaucoma and genetic polymorphisms GSTM1/GSTT1 in patients from Goiânia Central-West Region of Brazil.

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    Silva, C T X; Costa, N B; Silva, K S F; Silva, R E; Moura, K K V O

    2014-10-31

    In this study, we evaluated the genotype profile of GSTM1 and GSTT1 polymorphisms in patient carriers of primary open-angle glaucoma in the population of Goiânia, GO, Brazil. This case-control study included 100 Brazilian patients with glaucoma and 53 patients without glaucoma. Blood samples were genotyped for polymorphisms in GST genes using polymerase chain reaction-based methods. Polymorphism frequencies were compared using the X(2) test and odds ratio (α = 0.05). The GSTM1-present genotype was 40% in the glaucoma group and 71.6% in the control group, while the GSTM1 null genotype was 60 and 28.3% in the same groups, respectively. The GSTT1-present genotype was 52% in the primary open-angle glaucoma group and 66% in the control group; the null genotype was 48% in the case group and 34% in the control group. The GSTM1 null genotype was more frequent in the glaucoma group than in the control group (P = 0.0004; odds ratio = 6.7; 95% confidence interval = 2.7- 20.3). The combined GSTM1 null and GSTT1-present genotypes were more frequent in the primary open-angle glaucoma group compared to the control group (P = 0.02; odds ratio = 3.1; 95% confidence interval = 1.2-7.9).

  13. Mitochondrial sequence variation in African-American primary open-angle glaucoma patients.

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    David W Collins

    Full Text Available Primary open-angle glaucoma (POAG is a major cause of blindness and results from irreversible retinal ganglion cell damage and optic nerve degeneration. In the United States, POAG is most prevalent in African-Americans. Mitochondrial genetics and dysfunction have been implicated in POAG, and potentially pathogenic sequence variations, in particular novel transversional base substitutions, are reportedly common in mitochondrial genomes (mtDNA from POAG patient blood. The purpose of this study was to ascertain the spectrum of sequence variation in mtDNA from African-American POAG patients and determine whether novel nonsynonymous, transversional or other potentially pathogenic sequence variations are observed more commonly in POAG cases than controls. mtDNA from African-American POAG cases (n = 22 and age-matched controls (n = 22 was analyzed by deep sequencing of a single 16,487 base pair PCR amplicon by Ion Torrent, and candidate novel variants were validated by Sanger sequencing. Sequence variants were classified and interpreted using the MITOMAP compendium of polymorphisms. 99.8% of the observed variations had been previously reported. The ratio of novel variants to POAG cases was 7-fold lower than a prior estimate. Novel mtDNA variants were present in 3 of 22 cases, novel nonsynonymous changes in 1 of 22 cases and novel transversions in 0 of 22 cases; these proportions are significantly lower (p<.0005, p<.0004, p<.0001 than estimated previously for POAG, and did not differ significantly from controls. Although it is possible that mitochondrial genetics play a role in African-Americans' high susceptibility to POAG, it is unlikely that any mitochondrial respiratory dysfunction is due to an abnormally high incidence of novel mutations that can be detected in mtDNA from peripheral blood.

  14. Rehabilitation of vision disorder and improved quality of life in patients with primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; TIAN Zhen; ZHU Wen-hui; ZHUO YE-hong; LIAO Rui-duan

    2011-01-01

    Background Primary open angle glaucoma (POAG) is a common cause of irreversible blindness.The variable etiology of POAG poses significant challenges for treatment and rehabilitation.We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder,assess vision-related quality of life (VRQL),and to evaluate the efficacy of rehabilitative treatments.Methods We analyzed the visional disturbances in 500 POAG patients (890 eyes) by regular ophthalmic examination and visual field examination using Humphrey 30° perimetry.Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia,health education,counseling,and the fitting of typoscopes.VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire.Results Scores on the VRQL self-assessment were significantly lower compared to healthy controls.The primary cause of the vision disturbances was ametropia (97.99%),and 51.61% of the ametropia eyes had not received appropriate correction.The secondary causes of visual impairment were glaucomatous neurodegeneration (26.29%),complicated cataract,or other accompanying eye diseases.The causes of the clinical low vision (44 patients) were glaucomatous neurodegeneration (32 eyes),fundus diseases (23 eyes),keratopathy (11 eyes),and other eye diseases (10 eyes).The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia (P<0.01).Twenty-five patients with low vision were provided with typoscopes,and 21 (84%) experienced significant functional recovery,while the remaining low vision patients could see letter lines two or more levels lower (smaller) on visual charts in a near vision test.Conclusions Vision disorders in POAG patients are common and severe.Appropriate rehabilitation,especially the correction of ametropia,can significantly improve VRQL as revealed by the self-assessment of POAG patients.

  15. 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.

  16. Association of genetic variants with primary angle closure glaucoma in two different populations.

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    Mona S Awadalla

    Full Text Available PURPOSE: A recent large genome-wide association study (GWAS identified multiple variants associated with primary angle-closure glaucoma (PACG. The present study investigated the role of these variants in two cohorts with PACG recruited from Australia and Nepal. METHOD: Patients with PACG and appropriate controls were recruited from eye clinics in Australia (n = 232 cases and n = 288 controls and Nepal (n = 106 cases and 204 controls. Single nucleotide polymorphisms (SNPs rs3753841 (COL11A1, rs1015213 (located between PCMTD1 and ST18, rs11024102 (PLEKHA7, and rs3788317 (TXNRD2 were selected and genotyped on the Sequenom. Analyses were conducted using PLINK and METAL. RESULTS: After adjustment for age and sex, SNP rs3753841 was found to be significantly associated with PACG in the Australian cohort (p = 0.017; OR = 1.34. SNPs rs1015213 (p = 0.014; OR 2.35 and rs11024102 (p = 0.039; OR 1.43 were significantly associated with the disease development in the Nepalese cohort. None of these SNPs survived Bonferroni correction (p = 0.05/4 = 0.013. However, in the combined analysis, of both cohorts, rs3753841 and rs1015213 showed significant association with p-values of 0.009 and 0.004, respectively both surviving Bonferroni correction. SNP rs11024102 showed suggestive association with PACG (p-value 0.035 and no association was found with rs3788317. CONCLUSION: The present results support the initial GWAS findings, and confirm the SNP's contribution to PACG. This is the first study to investigate these loci in both Australian Caucasian and Nepalese populations.

  17. 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.

  18. The use of amniotic membrane in trabeculectomy for the treatment of primary open-angle glaucoma: a prospective study

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    Stavrakas P

    2012-02-01

    Full Text Available Panagiotis Stavrakas1, Gerasimos Georgopoulos1, Maria Milia1, Dimitris Papaconstantinou1, Maria Bafa2, Efthymios Stavrakas2, Mihalis Moschos11Department of Ophthalmology, University of Athens Medical School, General Hospital of Athens (Geniko Kratiko Hospital, Athens, Greece; 2Department of Ophthalmology, Thriassio General Hospital, Athens, GreeceBackground: To investigate the effectiveness of amniotic membrane transplantation (AMT on improving the outcomes of trabeculectomy in primary open-angle glaucoma (POAG.Methods: Fifty-nine eyes affected by primary open-angle glaucoma were enrolled in this prospective randomized study. Thirty-two eyes underwent amnion-shielded trabeculectomy (study group and 27 eyes underwent trabeculectomy without any antimetabolites (control group. Success was defined as intraocular pressure (IOP <21 mmHg without any medications at 24 months follow-up. The two groups were compared in terms of IOP, bleb morphology, bleb survival and risk of failure, glaucoma medications, and complications.Results: There was no statistically significant difference in terms of postoperative IOP between the two groups and at 24 months median IOP was 15.5 mmHg for the AMT group and 16 mmHg for the control group. IOP postoperative reduction was 8 mmHg for the AMT group versus 6 mmHg for the non AMT group (P = 0.276. Two patients from the study group developed IOP >21 mmHg in contrast to seven patients from the classic trabeculectomy group. The study group had 61.0% less risk of developing IOP >21 mmHg (P = 0.203. No major complications in the AMT group were observed. AMT blebs were diffuse with mild vascularization.Conclusion: In patients with POAG, AMT showed favorable effects on bleb survival, however data failed to provide firm evidence that AMT could be used as a routine procedure in trabeculectomy.Keywords: amniotic membrane, trabeculectomy, primary open-angle glaucoma, glaucoma filtering blebIn memory of Professor Mihalis Moschos. "We

  19. Low cerebrospinal fluid pressure in the pathogenesis of primary open-angle glaucoma: epiphenomenon or causal relationship? The Beijing Intracranial and Intraocular Pressure (iCOP) study.

    Science.gov (United States)

    Wang, Ningli; Yang, Diya; Jonas, Jost B

    2013-01-01

    Previous experimental and clinical investigations have suggested that some patients with primary open-angle glaucoma may have an abnormally low orbital cerebrospinal fluid pressure (CSFP). A meta-analysis of available clinical data showed a marked overlap in lumbar CSFP measurements between patients with normal-tension glaucoma and healthy subjects, so that the question arises as to which additional factors play a role in the pathogenesis of glaucomatous optic neuropathy.

  20. Cost of the medical management and prescription pattern for primary open angle glaucoma (POAG) in Ghana–a retrospective cross-sectional study from three referral facilities

    OpenAIRE

    Ocansey, Stephen; Kyei, Samuel; Diafo, Ama; Darfor, Kwabena Nkansah; Boadi-Kusi, Samuel Bert; Aglobitse, Peter B.

    2016-01-01

    Background Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana. Methods A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) c...

  1. Genome-wide linkage scan for primary open angle glaucoma: influences of ancestry and age at diagnosis.

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    Kristy R Crooks

    Full Text Available Primary open-angle glaucoma (POAG is the most common form of glaucoma and one of the leading causes of vision loss worldwide. The genetic etiology of POAG is complex and poorly understood. The purpose of this work is to identify genomic regions of interest linked to POAG. This study is the largest genetic linkage study of POAG performed to date: genomic DNA samples from 786 subjects (538 Caucasian ancestry, 248 African ancestry were genotyped using either the Illumina GoldenGate Linkage 4 Panel or the Illumina Infinium Human Linkage-12 Panel. A total of 5233 SNPs was analyzed in 134 multiplex POAG families (89 Caucasian ancestry, 45 African ancestry. Parametric and non-parametric linkage analyses were performed on the overall dataset and within race-specific datasets (Caucasian ancestry and African ancestry. Ordered subset analysis was used to stratify the data on the basis of age of glaucoma diagnosis. Novel linkage regions were identified on chromosomes 1 and 20, and two previously described loci-GLC1D on chromosome 8 and GLC1I on chromosome 15--were replicated. These data will prove valuable in the context of interpreting results from genome-wide association studies for POAG.

  2. Unilateral open-angle glaucoma associated with the ipsilateral nevus of ota.

    Science.gov (United States)

    Magarasevic, Lidija; Abazi, Zihret

    2013-01-01

    The nevus of Ota also known as "congenital melanosis bulbi" and "oculodermal melanocytosis" is a blue-gray hyperpigmentation that occurs on the face and eyes. The sclera is involved in two-thirds of cases (causing an increased risk of glaucoma). Women are nearly five times more likely to be affected than men. It is rare among Caucasian people. The nevus of Ota is congenital or acquired. Most cases of the nevus of Ota are unilateral (90%), although pigmentation is present bilaterally in 5%-10%. Ocular abnormalities included pigmentation of the sclera, cornea, retina, and optic disc and cavernous hemangiomas of the optic disc, elevated intraocular pressure, glaucoma, and ocular melanoma. We reported an appearance of unilateral glaucoma in a Caucasian female patient with the acquired, ipsilateral nevus of Ota.

  3. Unilateral Open-Angle Glaucoma Associated with the Ipsilateral Nevus of Ota

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    Lidija Magarasevic

    2013-01-01

    Full Text Available The nevus of Ota also known as “congenital melanosis bulbi” and “oculodermal melanocytosis” is a blue-gray hyperpigmentation that occurs on the face and eyes. The sclera is involved in two-thirds of cases (causing an increased risk of glaucoma. Women are nearly five times more likely to be affected than men. It is rare among Caucasian people. The nevus of Ota is congenital or acquired. Most cases of the nevus of Ota are unilateral (90%, although pigmentation is present bilaterally in 5%–10%. Ocular abnormalities included pigmentation of the sclera, cornea, retina, and optic disc and cavernous hemangiomas of the optic disc, elevated intraocular pressure, glaucoma, and ocular melanoma. We reported an appearance of unilateral glaucoma in a Caucasian female patient with the acquired, ipsilateral nevus of Ota.

  4. Predictive genetic testing in minors for Myocilin juvenile onset open angle glaucoma.

    Science.gov (United States)

    Souzeau, E; Glading, J; Ridge, B; Wechsler, D; Chehade, M; Dubowsky, A; Burdon, K P; Craig, J E

    2015-12-01

    Myocilin glaucoma is an autosomal dominant disorder leading to irreversible blindness, but early intervention can minimize vision loss and delay disease progression. The purpose of this study was to discuss the benefits of predictive genetic testing in minors for Myocilin mutations associated with childhood onset glaucoma. Three families with Myocilin mutations associated with an age of onset before 18 years and six unaffected at-risk children were identified. Predictive genetic testing was discussed with the parents and offered for at-risk minors. Parents opted for genetic testing in half of the cases. None carried the familial mutation. The age of disease onset in the family, the severity of the condition, and the age of the child are all factors that appear to influence the decision of the parent to test their children. Predictive genetic testing for early onset Myocilin glaucoma can facilitate early detection of disease or discharge from routine ophthalmic examinations.

  5. 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

  6. Association of Myopic Deformation of Optic Disc with Visual Field Progression in Paired Eyes with Open-Angle Glaucoma

    Science.gov (United States)

    Hangai, Masanori; Ishikawa, Makoto; Yoshitomi, Takeshi

    2017-01-01

    Purpose The influence of myopia on glaucoma progression remains unknown, possibly because of the multifactorial nature of glaucoma and difficulty in assessing a solo contribution of myopia. The purpose of this study is to investigate the association of myopia with visual field (VF) progression in glaucoma using a paired-eye design to minimize the influence of confounding systemic factors that are diverse among individuals. Methods This retrospective study evaluated 144 eyes of 72 subjects with open-angle glaucoma, with similar intra-ocular pressure between paired eyes, spherical equivalent (SE) ≤ -2 diopter (D), and axial length ≥ 24 mm. Paired eyes with faster and slower VF progression were grouped separately, according to the global VF progression rate assessed by automated pointwise linear regression analysis. The SE, axial length, tilt ratio and torsion angle of optic discs, Bruch’s membrane (BM) opening area, and gamma zone parapapillary atrophy (PPA) width were compared between the two groups. Factors associated with faster VF progression were determined by logistic regression analysis. Results The mean follow-up duration was 8.9 ± 4.4 years. The mean value of SE and axial length were -6.31 ± 1.88 D and 26.05 ± 1.12 mm, respectively. The mean global visual field progression rate was -0.32 ± 0.38 dB/y. Tilt ratio, BM opening area, and gamma zone PPA width were significantly greater in the eyes with faster VF progression than those with slower progression. In multivariate analysis, these factors were significantly associated with faster VF progression (all P < 0.05), while SE and axial length were not associated with it. Conclusion In myopic glaucoma subjects, tilt of the optic disc and temporal shifting and enlargement of the BM opening were associated with faster rate of VF progression between paired eyes. This suggests that myopia influences VF progression in glaucomatous eyes via optic disc deformations rather than via refractive error itself

  7. Clinical Analysis of Primary Angle Closure Glaucoma After Glaucoma Filtering Surgery%原发性闭角型青光眼滤过术后恶性青光眼的临床分析

    Institute of Scientific and Technical Information of China (English)

    张智伟

    2016-01-01

    Objective To investigate the risk factors and therapeutic effect of primary angle closure glaucoma after glaucoma filtering surgery.Methods 90 cases(90 eyes)with primary angle closure glaucoma in our hospital were selected,experimental group of 28 cases of malignant glaucoma after operation,there were no malignant glaucoma in 62 cases,the control group,the clinical data were retrospectively analyzed.Results Age,sex,preoperative intraocular pressure,lens thickness,axial length,type of glaucoma,and the structure of the angle of the room were the risk factors of postoperative malignant glaucoma. All patients were satisfied with the treatment effect.Conclusion Young patients with primary angle closure glaucoma with shorter axial length are prone to complications of malignant glaucoma after filtering surgery and need to be strengthened to prevent.%目的:探讨原发性闭角型青光眼滤过术后恶性青光眼的发病因素与治疗效果。方法选取我院收治的90例(90眼)原发性闭角型青光眼患者,术后恶性青光眼28例为实验组,术后未出现恶性青光眼62例为对照组,回顾性分析其临床资料。结果年龄、性别、术前眼压、晶体厚度、眼轴长度、青光眼类型、房角结构是引发术后恶性青光眼的危险因素;所有患者治疗效果比较满意。结论年轻的眼轴长度较短的原发性闭角型青光眼患者在滤过手术后容易出现恶性青光眼并发症,需要加强预防。

  8. 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.

  9. Correlation Between Humphrey Visual Field, Optical Coherence Tomography and Heidelberg Retina Tomograph Parameters in Primary Open-Angle Glaucoma, Normal-Tension Glaucoma and Ocular Hypertension

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    Ziya Ayhan

    2011-06-01

    Full Text Available Purpose: To evaluate the correlation of Humphrey visual field (VF parameters (MD and PSD with Heidelberg Retina Tomograph (HRT 3 and Stratus optical coherence tomography (OCT parameters in patients with primary open-angle glaucoma (POAG, normal-tension glaucoma (NTG and ocular hypertension (OHT. Material and Method: Fifty-five eyes of 29 POAG patients, 32 eyes of 16 OHT patients and 26 eyes of 13 NTG patients were enrolled in the study prospectively. Humphrey visual field test as well as optic nerve head and retinal nerve fiber layer (RNFL thickness analysis with HRT 3 and Stratus OCT were performed in all patients; the measurements were repeated every 6 months. Results: The mean age of the patients was 66.4±10.0 years and the mean follow-up time was 22±2.2 months. In POAG and NTG groups, MD and PSD correlated with all analyzed parameters in HRT, except for the height variation contour (HVC. In POAG group, MD and PSD values correlated with all analyzed parameters in OCT, except for the rim area (RA. In NTG group, correlation was found between MD values and all parameters in OCT. In NTG group, PSD correlated with all parameters in OCT, except for the RNFL thickness. In OHT group, no correlation was found between MD, PSD values and HRT parameters. In OHT group, only RA values in OCT correlated with MD and PSD. In all groups, there was no statistically significant difference between the first and last examinations for MD and PSD values and for the mean RNFL thickness measured with OCT and HRT. Discussion: In our study, it was found that in POAG and NTG patients, there was a general correlation of Humphrey VF parameters with HRT 3 and Stratus OCT parameters. (Turk J Ophthalmol 2011; 41: 143-50

  10. Hepatocyte growth factor genetic variations and primary angle-closure glaucoma in the Han Chinese population.

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    Zhengxuan Jiang

    Full Text Available PURPOSE: The aim of this study is to examine whether or not hepatocyte growth factor (HGF genetic variations are associated with susceptibility to primary angle-closure glaucoma (PACG in the Han Chinese population. METHODS: Three single-nucleotide polymorphisms (SNPs-rs5745718, rs17427817, and rs3735520-in the HGF gene were genotyped in 238 adult patients with PACG and 287 age-, sex-, and ethnically matched healthy controls by using a polymerase chain reaction restriction fragment length polymorphism assay. Data was analyzed by χ(2 analysis. RESULTS: The three tested analyzed polymorphisms in the HGF gene were in Hardy-Weinberg equilibrium, in all the subjects. The frequencies of the genotype and allele of rs5745718 and rs1742817 in the HGF gene were significantly different between the PACG patients and the controls. On one hand, the frequencies of the CC genotype and C allele of rs5745718 were significantly decreased in PACG patients compared with controls (Pc = 1.40×10(-3; Pc = 3.21×10(-4, respectively; however, on the other hand, significantly decreased frequencies of the GG genotype and the G allele of rs17427817 were observed in PACG patients compared with the controls (Pc = 0.006,; Pc = 6.06×10(-4, respectively. A comparison of the distributions of the genotypes and alleles of rs3735520 showed no statistically significant differences between the PACG patients and the controls (pc>0.05. The haplotype analysis results showed that the CGC haplotype frequency was significantly decreased in the patients with PACG compared with the controls (pc<0.001. No difference was detected between the patients and the controls with regard to the other haplotypes. CONCLUSIONS: Our study suggests that rs5745718 and rs17427817 are associated with a decreased risk of PACG in the Chinese Han population. The CGC haplotype was demonstrated to possibly play a protective role against PACG in this population.

  11. 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

  12. Apolipoprotein E gene ε4ε4 is associated with elevated risk of primary open angle glaucoma in Asians: a meta-analysis

    Science.gov (United States)

    2014-01-01

    Background Epidemiological studies have evaluated the association between Apolipoprotein E (APOE) gene ε2/ε3/ε4 polymorphism and glaucoma susceptibility. However, the published data are still inconclusive. The aim of the present study is to evaluate the impact of APOE gene ε2/ε3/ε4 polymorphism on glaucoma risk by using meta-analysis. Methods A comprehensive literature search of PubMed, EMBASE, Cochrane, Elsevier Science Direct and CNKI databases was conducted to identify relevant articles, with the last report up to January 5, 2014. Pooled odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of association by using the fixed or random effect model. Results Fifteen separate studies including 2,700 cases and 2,365 controls were included in the meta-analysis. We did not detect a significant association between APOE gene ε2/ε3/ε4 polymorphism and glaucoma in overall population (P > 0.0083). In Asians, we detected an association of the ε4ε4 genotype with elevated risk for glaucoma (OR = 5.22, 95% CI = 1.85-14.68, P = 0.002), mainly for primary open angle glaucoma (OR = 4.98, 95% CI = 1.75-14.20, P = 0.003). Conclusions The meta-analysis suggests that APOE gene ε4ε4 may be associated with elevated risk for primary open angle glaucoma in Asians. However, more epidemiologic studies based on larger sample size, case–control design and stratified by ethnicity as well as types of glaucoma are suggested to further clarify the relationship between APOE gene ε2/ε3/ε4 polymorphism and genetic predisposition to glaucoma. PMID:24885013

  13. [A challenge to primary open-angle glaucoma including normal-pressure. Clinical problems and their scientific solution].

    Science.gov (United States)

    Sugiyama, Kazuhisa

    2012-03-01

    Primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG), is reported by the Tajimi Study to afflict 3.9% of the total population, and this represents about 80% of all total glaucoma cases which, in total, afflict 5.0% of the population. We tried to analyze the clinical problems relating to POAG by looking at the pathogenesis, intraocular pressure (IOP), therapy, neuroprotection and surgery of the disease. To elucidate the pathogenesis of glaucoma progression, we measured retinal nerve fiber layer defect (RNFLD) angles', and divided the NTG cases into 2 groups, enlarged RNFLD and stable RNFLD. Disc hemorrhages were found to be significantly more frequent in the enlarged group than in the stable group. RNFLD was enlarged in the direction of disc hemorrhage in over 80% of the eyes. In the majority of the eyes of the enlarged group, the enlargement of RNFLD was toward the fovea. The enlargement of RNFLD in NTG was closely associated with disc hemorrhage and the deterioration of the visual field. We developed a simultaneous structure and function evaluation technique combining spectral-domain (SD) optical coherence tomography (OCT) and fundus-oriented perimeters for the detection of visual field abnormalities in the RNFLD area. We superimposed the ganglion cell complex map obtained by SD-OCT on the fundus-oriented perimeter image. We observed very early or preperimetric normal pressure glaucoma as well as disc hemorrhage adjacent to the borders of the RNFLD. The borderline of the RNFLD seemed to be the thinnest RNFL and had the lowest retinal sensitivity (Active site for RNFLD progression). To clarify the role of the circadian clock genes in the generation of a 24-hour IOP rhythm, we used the microneedle method to measure the IOP at eight time points daily, both in wild type mice and Cry-deficient (Cry 1-/-Cry 2-/-) mice. In the wild-type mice living in light-dark conditions, the pressure measured in the light phase was significantly lower than in

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

    Science.gov (United States)

    Cuchra, Magda; Markiewicz, Lukasz; Mucha, Bartosz; Pytel, Dariusz; Szymanek, Katarzyna; Szemraj, Janusz; Szaflik, Jerzy; Szaflik, Jacek P; Majsterek, Ireneusz

    2015-08-01

    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 399 Arg/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 399 Gln/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 148 Asp/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 324 Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might decrease the progression of POAG (OR 0.47; 95% CI 0.30-0.82 P = 0.005). We suggest that the 399 Arg/Gln polymorphism of the XRCC1 gene may serve as a predictive risk factor of POAG.

  15. 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.

  16. Diabetes Pathology and Risk of Primary Open-Angle Glaucoma: Evaluating Causal Mechanisms by Using Genetic Information.

    Science.gov (United States)

    Shen, Ling; Walter, Stefan; Melles, Ronald B; Glymour, M Maria; Jorgenson, Eric

    2016-01-15

    Although type 2 diabetes (T2D) predicts glaucoma, the potential for unmeasured confounding has hampered causal conclusions. We performed separate sample genetic instrumental variable analyses using the Genetic Epidemiology Research Study on Adult Health and Aging cohort (n = 69,685; 1995-2013) to estimate effects of T2D on primary open-angle glaucoma (POAG; 3,554 cases). Genetic instrumental variables for overall and mechanism-specific (i.e., linked to T2D via influences on adiposity, β-cell function, insulin regulation, or other metabolic processes) T2D risk were constructed by using 39 genetic polymorphisms established to predict T2D in other samples. Instrumental variable estimates indicated that T2D increased POAG risk (odds ratio = 2.53, 95% confidence interval: 1.04, 6.11). The instrumental variable for β-cell dysregulation also significantly predicted POAG (odds ratioβ-cell = 5.26, 95% confidence interval: 1.75, 15.85), even among individuals without diagnosed T2D, suggesting that metabolic dysregulation may increase POAG risk prior to T2D diagnosis. The T2D risk variant in the melatonin receptor 1B gene (MTNR1B) predicted risk of POAG independently of T2D status, indicating possible pleiotropic physiological functions of melatonin, but instrumental variable effect estimates were significant even excluding MTNR1B variants. To our knowledge, this is the first genetic instrumental variable study of T2D and glaucoma, providing a novel approach to evaluating this hypothesized relationship. Our findings substantially bolster observational evidence that T2D increases POAG risk.

  17. [Genetic variants of CYP1B1 and WDR36 in the patients with primary congenital glaucoma and primary open angle glaucoma from Saint-Petersburg].

    Science.gov (United States)

    Motushchuk, A E; Komarova, T Iu; Grudinina, N A; Rakhmanov, V V; Mandel'shtam, M Iu; Astakhov, Iu S; Vasil'ev, V B

    2009-12-01

    In 32 patients with primary congenital glaucoma (PCG), a search for mutations in the myocilin (MYOC), cytochrome P450B1 (CYP1B1), and WDR36 genes was performed. The Q368X mutation in myocilin gene, typical of the patients with adult-onset primary open-angle glaucoma (POAG), was not detected in the PCG patients. Screening of the CYP1B1 introns 2 and 3 for the presence of mutations in PCG patients revealed only six DNA polymorphisms, including IVS1-12ntT>C (g.3793 T>C), A119S (g.4160 G>T; GCC>TCC), G188G (g.4369 C>A; GGC>GGA), L432V (G.8131 C>G; CTG>GTG), D449D (g.8184 C>T; GAC>GAT), and N453S (g.8195 A>G; AAC>AGC) (nucleotide numbering is given in accordance with the GenBank sequence U56438). In the groups of PCG patients and donors without eye diseases, the frequencies of these variants were not statistically significantly different, pointing to the neutrality of these polymorphisms. Furthermore, the CYP1B1 polymorphism L432V, considered to be associated with POAG in some world populations, was not associated with this disease in the patients from St. Petersburg. DNA collections obtained from the POAG and PCG patients and from the control group were tested for the carriage of the worldwide distributed mutations of the WRD36 gene, D658G, R529Q, A449T, and N355S. D658G variant was found with equally low frequencies in the groups of POAG and PCG patients, as well as in the control group. Mutations A449T and R529Q were found only once each, while mutation N355S was not detected in any of the groups examined. Our results indicate that the WDR36 variants make no substantial contribution to the development of POAG and PCG in the patients from St. Petersburg and represent normal DNA polymorphism. It is likely that in most of the PCG patients from the population examined the disease is not associated with the CYP1B1 gene defects.

  18. A genome-wide association study for primary open angle glaucoma and macular degeneration reveals novel Loci.

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    Todd E Scheetz

    Full Text Available Glaucoma and age-related macular degeneration (AMD are the two leading causes of visual loss in the United States. We utilized a novel study design to perform a genome-wide association for both primary open angle glaucoma (POAG and AMD. This study design utilized a two-stage process for hypothesis generation and validation, in which each disease cohort was utilized as a control for the other. A total of 400 POAG patients and 400 AMD patients were ascertained and genotyped at 500,000 loci. This study identified a novel association of complement component 7 (C7 to POAG. Additionally, an association of central corneal thickness, a known risk factor for POAG, was found to be associated with ribophorin II (RPN2. Linked monogenic loci for POAG and AMD were also evaluated for evidence of association, none of which were found to be significantly associated. However, several yielded putative associations requiring validation. Our data suggest that POAG is more genetically complex than AMD, with no common risk alleles of large effect.

  19. 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.

  20. 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

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging.

    Science.gov (United States)

    Li, Gai-Yun; Al-Wesabi, Samer Abdo; Zhang, Hong

    2016-12-01

    The aim of this study was to determine whether differences exist in oxygen supply to the optic nerve head (ONH) from the retinal and choroidal vascular layers in patients with primary open angle glaucoma (POAG) using multispectral imaging (MSI).This ia an observational, cross-sectional study.Multispectral images were acquired from 38 eyes of 19 patients with POAG, and 42 healthy eyes from 21 matched volunteers with Annidis' RHA multispectral digital ophthalmoscopy. Superficial and deeper oxygen saturation of the optic disc was represented by the mean gray scale values on the retinal and choroidal oxy-deoxy maps, respectively. Statistical analysis was performed to detect differences in ONH oxygen saturation between the 2 groups. Oxygen saturation levels in the eyes of POAG patients with severe glaucoma were compared to those of fellow eyes from the same subjects. Linear correlation analysis was performed to assess the association between ONH oxygen saturation and systemic and ocular parameters.No statistical difference was found in retinal and choroidal oxygen saturation between the POAG and control groups. In the glaucoma patients, retinal oxygen saturation was lower for eyes with worse visual fields than in those with good visual fields (t = 4.009, P = 0.001). In POAG patients, retinal oxygen saturation was dependent on mean defect of visual field and retinal nerve fiber layer thickness (RNFLT) (r = 0.511, 0.504, P = 0.001, 0.001, respectively), whereas the choroid vasculature oxygen saturation was inversely related to RNFLT (r = -0.391, P = 0.015). An age-dependent increase in retinal oxygen saturation was found for both the POAG and control groups (r = 0.473, 0.410, P = 0.007, 0.003, respectively).MSI revealed a significant correlation between functional and structural impairments in glaucoma and retinal oxygen saturation. MSI could provide objective assessments of perfusion impairments of the glaucomatous ONH. This is a

  3. Examining Delay Intervals in the Diagnosis and Treatment of Primary Open Angle Glaucoma in an Egyptian Population and Its Impact on Lifestyle

    Science.gov (United States)

    Abu Hussein, Nahla B.; Habib, Ahmed E.; El Sayed, Yasmine M.

    2016-01-01

    Purpose. To examine causes as well as extent of delay in diagnosis and treatment of primary open angle glaucoma patients in a sample of Egyptians. Patients and Methods. 440 patients with primary open angle glaucoma were interviewed to evaluate delay in their diagnosis and treatment. The extent and cause of delay were investigated. The total delay interval, if any, was correlated with socioeconomic and other factors. Results. The median total delay was one year, with 50% of patients having a total delay of 1 year or less, of which 25% exhibited zero total delay. 25% of patients had a delay ranging from 1 to 3 years, and 25% had a total delay ranging from 3 to 27 years. Diagnostic delay accounted for 43.03% of cases. Longer delays were met in patients with certain socioeconomic factors. Patients with a positive family history of glaucoma displayed shorter delay periods. Conclusion. Significant delay in the diagnosis and treatment of glaucoma was found. Poor socioeconomic status seems to hinder timely diagnosis and treatment of POAG. Certain socioeconomic factors seem to correlate with the extent of delay. More effort is thus needed to subsidize the cost of investigations and treatment for glaucoma patients. PMID:28116140

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

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    N. I. Kurysheva

    2015-01-01

    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.

  5. New insights into the genetics of primary open-angle glaucoma based on meta-analyses of intraocular pressure and optic disc characteristics

    NARCIS (Netherlands)

    Springelkamp, Henriët; Iglesias, Adriana I; Mishra, Aniket; Höhn, René; Wojciechowski, Robert; Khawaja, Anthony P; Nag, Abhishek; Wang, Ya Xing; Wang, Jie Jin; Cuellar-Partida, Gabriel; Gibson, Jane; Cooke Bailey, Jessica N; Vithana, Eranga N; Gharahkhani, Puya; Boutin, Thibaud; Ramdas, Wishal D; Zeller, Tanja; Luben, Robert N; Yonova-Doing, Ekaterina; Viswanathan, Ananth C; Yazar, Seyhan; Cree, Angela J; Haines, Jonathan L; Koh, Jia Yu; Souzeau, Emmanuelle; Wilson, James F; Amin, Najaf; Müller, Christian; Venturini, Cristina; Kearns, Lisa S; Hee Kang, Jae; Consortium, Neighborhood; Tham, Yih Chung; Zhou, Tiger; van Leeuwen, Elisabeth M; Nickels, Stefan; Sanfilippo, Paul; Liao, Jiemin; Linde, Herma van der; Zhao, Wanting; van Koolwijk, Leonieke M E; Zheng, Li; Rivadeneira, Fernando; Baskaran, Mani; van der Lee, Sven J; Perera, Shamira; de Jong, Paulus T V M; Oostra, Ben A; Uitterlinden, André G; Fan, Qiao; Hofman, Albert; Shyong Tai, E-; Vingerling, Johannes R; Sim, Xueling; Wolfs, Roger C W; Teo, Yik Ying; Lemij, Hans G; Khor, Chiea Chuen; Willemsen, Rob; Lackner, Karl J; Aung, Tin; Jansonius, Nomdo M; Montgomery, Grant; Wild, Philipp S; Young, Terri L; Burdon, Kathryn P; Hysi, Pirro G; Pasquale, Louis R; Wong, Tien Yin; Klaver, Caroline C W; Hewitt, Alex W; Jonas, Jost B; Mitchell, Paul; Lotery, Andrew J; Foster, Paul J; Vitart, Veronique; Pfeiffer, Norbert; Craig, Jamie E; Mackey, David A; Hammond, Christopher J; Wiggs, Janey L; Cheng, Ching-Yu; van Duijn, Cornelia M; MacGregor, Stuart

    2017-01-01

    Primary open-angle glaucoma (POAG), the most common optic neuropathy, is a heritable disease. Siblings of POAG cases have a ten-fold increase risk of developing the disease. Intraocular pressure (IOP) and optic nerve head characteristics are used clinically to predict POAG risk. We conducted a genom

  6. New insights into the genetics of primary open-angle glaucoma based on meta-analyses of intraocular pressure and optic disc characteristics.

    NARCIS (Netherlands)

    Springelkamp, H. (Henriët); Iglesias, A.I. (Adriana); Mishra, A. (Aniket); Höhn, R. (René); Wojciechowski, R. (Robert); Khawaja, A.P. (Anthony); Nag, A. (Abhishek); Wang, Y.X. (Ya Xing); Wang, J.J. (Jie Jin); Cuellar-Partida, G. (Gabriel); Gibson, J. (Jane); Cooke Bailey, J.N. (Jessica); Vithana, E.N. (Eranga); Gharahkhani, P. (Puya); Boutin, T. (Thibaud); Ramdas, W.D. (Wishal); Zeller, T. (Tanja); Luben, R.N. (Robert); Yonova-Doing, E. (Ekaterina); Viswanathan, A.C. (Ananth); Yazar, S. (Seyhan); Cree, A.J. (Angela); Haines, J.L. (Jonathan); Koh, J.Y. (Jia Yu); Souzeau, E. (Emmanuelle); Wilson, J.F. (James); Amin, N. (Najaf); Müller, C. (Christian); Venturini, C. (Cristina); Kearns, L.S. (Lisa); Hee Kang, J. (Jae); Consortium, N. (Neighborhood); Tham, Y.C. (Yih Chung); Zhou, T. (Tiger); van Leeuwen, E.M. (Elisabeth); Nickels, S. (Stefan); Sanfilippo, P. (Paul); Liao, J. (Jiemin); Linde, H.V. (Herma van der); Zhao, W. (Wanting); van Koolwijk, L.M. (Leonieke); Zheng, L. (Li); Rivadeneira, F. (Fernando); Baskaran, M. (Mani); van der Lee, S.J. (Sven); Perera, S. (Shamira); de Jong, P.T. (Paulus); Oostra, B.A. (Ben); Uitterlinden, A.G. (André); Fan, Q. (Qiao); Hofman, A. (Albert); Shyong Tai, E. (E-); Vingerling, J.R. (Johannes); Sim, X. (Xueling); Wolfs, R.C. (Roger); Teo, Y.Y. (Yik Ying); Lemij, H.G. (Hans); Khor, C.C. (Chiea Chuen); Willemsen, R. (Rob); Lackner, K.J. (Karl); Aung, T. (Tin); Jansonius, N.M. (Nomdo); Montgomery, G. (Grant); Wild, P.S. (Philipp); Young, T.L. (Terri); Burdon, K.P. (Kathryn); Hysi, P.G. (Pirro); Pasquale, L.R. (Louis); Wong, T.Y. (Tien Yin); Klaver, C.C. (Caroline); Hewitt, A.W. (Alex); Jonas, J.B. (Jost); Mitchell, P. (Paul); Lotery, A.J. (Andrew); Foster, P.J. (Paul); Vitart, V. (Veronique); Pfeiffer, N. (Norbert); Craig, J.E. (Jamie); Mackey, D.A. (David); Hammond, C.J. (Christopher); Wiggs, J.L. (Janey); Cheng, C.Y. (Ching-Yu); van Duijn, C.M. (Cornelia); MacGregor, S. (Stuart)

    2017-01-01

    textabstractPrimary open-angle glaucoma (POAG), the most common optic neuropathy, is a heritable disease. Siblings of POAG cases have a ten-fold increase risk of developing the disease. Intraocular pressure (IOP) and optic nerve head characteristics are used clinically to predict POAG risk. We condu

  7. Contribution and significance of Heidelberg retinal tomography II in diagnostics of ocular hypertension and its conversion into primary open-angle glaucoma

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    Marković Vujica

    2009-01-01

    Full Text Available Background/Aim. A term 'ocular hypertension' is used when IOP is found to be > 21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II results that show very early, subtle changes in retinal neurofibre layers (RNFL in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio, but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. Methods. During a 5-year study period (2002-2007, 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT, central corneal thickness (CCT determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nervi optici (PNO examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D ratio, which was followed during the control examination by each segment, as well as PNO in global. Results. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413 comparing to the

  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

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    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. [The effect of parenteral citicoline on visual functions and life quality of patients with primary open-angle glaucoma].

    Science.gov (United States)

    Frolov, M A; Gonchar, P A; Barashkov, V I; Kumar, V; Morozova, N S; Frolov, A M; Kazakova, K A

    2011-01-01

    The effect of nootropic drug citicoline on visual functions, perimetric indexes of static automated perimetry, morphometric characteristics of retinal tomography and life quality of patients with primary open-angle glaucoma (POAG) stage I-III and normalized intraocular pressure (IOP) was studied. 40 patients aged 46-78 years old with POAG stage I-III and normalized IOP were treated with citicoline. Among them there were 24 female and 16 male. The patients were divided into 2 equal groups--experimental and control. Patients of both groups were treated with intravenous citicoline for 10 days. The dose of citicoline in experimental group was 1000 mg/day, in control--500 mg/day. After treatment in both groups visual functions, perimetric indexes of static automated perimetry, morphometric characteristics of retinal tomography and life quality showed improvement. Citicoline has significant neuroprotective effect preventing apoptosis.

  10. Multifocal VEP and OCT findings in patients with primary open angle glaucoma: A cross-sectional study

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    Moschos Marilita M

    2012-08-01

    Full Text Available Abstract Bakground To evaluate objectively the anatomical and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG by the joint use of optical coherence tomography (OCT and multifocal visual evoked potentials (mfVEP. Methods 29 eyes with open angle glaucoma and visual field defects, as well as 20 eyes of 10 age-matched control normal subjects were tested. All participants underwent a complete ophthalmological examination. Moreover, Humphrey visual field test, OCT examination and recording of mfVEP were performed. Amplitude and implicit time of mfVEP, as well as RNFL thickness were measured. Differences in density components of mfVEP and in RNFL thickness among POAG eyes and control eyes were examined using Student’s t-test. Results In glaucomatous eyes the mean Retinal Response Density (RRD was lower than normal in ring 1, 2 and 3 of mfVEP (p 2, 6.9 ± 4.8 nV/deg2 and 2.6 ± 1.6 nV/deg2 in rings 1, 2 and 3 respectively. In contrast the mean implicit time was similar to control eyes. In addition, the mean RNFL thickness in POAG eyes was estimated at 76.8 ± 26.6 μm in the superior area, 52.1 ± 16.3 μm in the temporal area, 75.9 ± 32.5 μm in the inferior area and 58.6 ± 19.4 μm in the nasal area. There was a statistically significant difference in RNFL thickness in all peripapillary areas (p  Conclusions Our study shows that, although Standard Automatic Perimetry is the gold standard to evaluate glaucomatous neuropathy, the joint use of mfVEP and OCT could be useful in better monitoring glaucoma progression.

  11. Comparison of vision-related quality of life in primary open-angle glaucoma and dry-type age-related macular degeneration.

    Science.gov (United States)

    Karadeniz Ugurlu, S; Kocakaya Altundal, A E; Altin Ekin, M

    2017-03-01

    PurposeTo compare quality of life (QoL) in patients with primary open-angle glaucoma (POAG) and dry-type age-related macular degeneration (AMD) with similar best-corrected visual acuity.MethodsAge-, sex-, and visual acuity-matched POAG and dry AMD patients were included in the study. Each patient performed 24-2 and 10-2 SITA standard visual field tests. Contrast sensitivity was evaluated with CSV-1000 HGT instrument. The 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was used to analyze QoL. Overall and subscale scores were converted to scores between 0 and 100, the higher scores indicating better vision-related QoL.ResultsOverall NEI-VFQ-25 scores were 86.44 and 84.66 in glaucoma and AMD groups, respectively (P=0.244). The highest scores were obtained in 'vision-related dependency' subgroup in glaucoma and 'color and peripheral vision' in AMD group, whereas the lowest scores were noted 'in peripheral vision' in both glaucoma and AMD patients. Glaucoma patients had significantly lower scores in ocular pain, color vision, and peripheral vision subgroups compared with the AMD group, whereas AMD patients had lower scores in near and distance vision activities, vision-related social activity, and dependency subgroups. Contrast sensitivity results and mean defect values showed correlation with NEI-VFQ-25 scores in both groups.ConclusionsGlaucoma and AMD patients with similar visual acuity experienced similar overall impairment in QoL. However, glaucoma patients described more difficulty with peripheral vision and ocular pain, whereas AMD patients complained more about near and distance vision and dependency items.

  12. Association of pattern reversal VEP parameters with the mean defect of Humphrey visual field in patients of primary open angle glaucoma.

    Science.gov (United States)

    Kothari, Ruchi; Singh, Ramji; Singh, Smita; Bokariya, Pradeep

    2013-01-01

    Glaucoma is a chronic, progressive bilateral optic neuropathy which disturbs the structural or functional integrity of the optic nerve that causes characteristic atrophic changes in it, which leads to specific visual field defects over time with loss of visual function. Primary open angle glaucoma (POAG) is the most common form of glaucoma in India and is fast emerging as a major cause of bilateral blindness. This rural hospital based study was conducted to evaluate whether glaucomatous visual field defects particularly the mean defect of Humphrey visual field could be related to VEP parameters of patients having POAG. Visual field by Humphrey perimeter and simultaneous recordings of pattern reversal visual evoked potential (PRVEP) were assessed in 100 patients with POAG. There was a significant (P VEP changes observed by us in POAG patients were consistent with the progressing mean defect quantitatively. Therefore, it can be concluded that the VEP parameters can be useful quantitative indices in the evaluation of glaucomatous visual function damage.

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

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    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. A COMPARATIVE STUDY TO ASSESS THE EFFICACY AND TOLERABILITY OF LATANOPROST, BIMATOPROST AND TRAVOPROST IN PATIENTS WITH OPEN ANGLE GLAUCOMA

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    Prempal

    2016-05-01

    Full Text Available Glaucoma is the leading cause of irreversible blindness in the world as it can remain asymptomatic until it causes severe visual loss. The target intraocular pressure with which progression is slowed sufficiently to avoid functional impairment should be achieved with the fewest medications and minimum adverse effects. The choice of medicine may be influenced by efficacy, cost, adverse effects, and dosing schedules. In general, prostaglandin analogues (PGA are the first-line of medical therapy. These drugs are administered once at night and have few systemic adverse effects. The study was conducted to compare the efficacy and safety of available PGAs. MATERIAL AND METHODS The study was conducted on sixty diagnosed cases of primary open angle glaucoma visiting the Outpatient Department of Regional Institute of Ophthalmology, Government Medical College, Amritsar. They were divided into three groups of twenty each. Each group was put on either of these anti-glaucoma topical drug (PGA - latanoprost 0.005%, travoprost 0.004% and bimatoprost 0.03% for three months duration. IOP at 9:00 AM ± 1 hr. and 4:00 PM ± 1 hr. were taken before and after 1 month and 3 months of treatment. The results of the reduction in mean IOP in each group were compared and analysed. OBSERVATIONS Mean baseline IOP at 8 AM in each group was similar (p value 0.772. Average decrease in IOP between the pretreatment (Baseline IOP and post-treatment levels (i.e. at 3 months was 31.90% in Group 1 (Bimatoprost Group, 32.97% in Group 2 (Latanoprost Group and 34.75% in Group 3 (Travoprost Group. When we applied paired t test, in each group, p value was <0.001, showing a statistically significant change. Once the efficacy of drugs was seen, we compared the efficacy of 3 groups with each other by applying ANOVA, P value was 0.108 which is not statistically significant. CONCLUSIONS Individually Bimatoprost, Latanoprost and Travoprost significantly lowered the intraocular pressure but

  15. Effect of high myopia on 24-hour intraocular pressure in patients with primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    YANG Ying-xin; WANG Ning-li; WU Lie; ZHEN Yi; WANG Tao; REN Cai-xia; PENG Xiao-xia; HAO Jie; XIA Yan-ting

    2012-01-01

    Background As intraocular pressure (lOP) and lOP fluctuation are known risk factors for glaucoma,it is important to understand the effects of high myopia on these ocular parameters.The aim of this study was to investigate if primary open-angle glaucoma (POAG) patients with high myopia exhibit higher lOP and greater lOP fluctuations at resting conditions over 24 hours.@@Methods We designed a prospective control clinical study.Eighty-two eyes of 82 high-tension Chinese POAG patients only on prostaglandin analogue locally were divided into 3 groups according to various myopic grades (<-6.0 D,n=27 and between -0.76 and -5.99 D,n=33) or without myopia (-0.75 to 0.75 D,n=22).Single time lOP at 10 am,mean corrected 24-hour lOP,mean corrected night lOP,24-hour lOP fluctuation and lOPs of 10 am,2 pm,6 pm,10 pm,2 am,6 am and 8 am were measured.@@Results The lOP was higher in POAG patients with high myopia over those POAG alone in three ways:the elevated lOP value was 0.65 mmHg measured in single time lOP at 10 am,0.84 mmHg in mean corrected 24-hour lOP,0.97 mmHg in mean corrected night lOP.The 24-hour lOP fluctuation was lower in the two myopia groups than in non-myopia group.Further,using repeated measurement analysis of variance,there was no statistical significance among groups regarding the lOPs at the seven time points (P=0.77) and there was no interaction between groups and time points (P=0.71),but the difference of lOPs at the seven time points in same group was statistically significant (P=0.01).@@Conclusion High-tension POAG patients with high myopia,even on pharmacological glaucoma therapy,still have higher lOp,but 24-hour lOP fluctuation at resting conditions was lower in these patients.

  16. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy.

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    Nicole J Van Bergen

    Full Text Available Primary Open Angle Glaucoma (POAG is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs. Aging and increased intraocular pressure (IOP are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower. Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function.

  17. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy.

    Science.gov (United States)

    Van Bergen, Nicole J; Crowston, Jonathan G; Craig, Jamie E; Burdon, Kathryn P; Kearns, Lisa S; Sharma, Shiwani; Hewitt, Alex W; Mackey, David A; Trounce, Ian A

    2015-01-01

    Primary Open Angle Glaucoma (POAG) is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs). Aging and increased intraocular pressure (IOP) are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS) complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON) patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower). Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function.

  18. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy

    Science.gov (United States)

    Van Bergen, Nicole J; Crowston, Jonathan G.; Craig, Jamie E.; Burdon, Kathryn P.; Kearns, Lisa S.; Sharma, Shiwani; Hewitt, Alex W.; Mackey, David A.; Trounce, Ian A.

    2015-01-01

    Primary Open Angle Glaucoma (POAG) is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs). Aging and increased intraocular pressure (IOP) are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS) complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON) patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower). Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function. PMID:26496696

  19. 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

  20. ABCC5, a gene that influences the anterior chamber depth, is associated with primary angle closure glaucoma.

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    Monisha E Nongpiur

    2014-03-01

    Full Text Available Anterior chamber depth (ACD is a key anatomical risk factor for primary angle closure glaucoma (PACG. We conducted a genome-wide association study (GWAS on ACD to discover novel genes for PACG on a total of 5,308 population-based individuals of Asian descent. Genome-wide significant association was observed at a sequence variant within ABCC5 (rs1401999; per-allele effect size =  -0.045 mm, P = 8.17 × 10(-9. This locus was associated with an increase in risk of PACG in a separate case-control study of 4,276 PACG cases and 18,801 controls (per-allele OR = 1.13 [95% CI: 1.06-1.22], P = 0.00046. The association was strengthened when a sub-group of controls with open angles were included in the analysis (per-allele OR = 1.30, P = 7.45 × 10(-9; 3,458 cases vs. 3,831 controls. Our findings suggest that the increase in PACG risk could in part be mediated by genetic sequence variants influencing anterior chamber dimensions.

  1. Efficacy of bimatoprost 0.03% in reducing intraocular pressure in patients with 360° synechial angle-closure glaucoma: A preliminary study

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    Vyas Prateep

    2011-01-01

    Full Text Available Context: Peripheral anterior synechiae (PAS; synechiae anterior to functional trabecular meshwork formation in primary angle-closure glaucoma (PACG hampers access to uveoscleral outflow. Thus, the role of bimatoprost in such patients with 360° synechiae was evaluated. Aims: To assess efficacy and safety profile of bimatoprost 0.03% in lowering intraocular pressure (IOP in 360° synechial angle-closure glaucoma patients. Settings and Design: This was a prospective, non-randomized, non-comparative, selective analysis, single-center pilot study. Materials and Methods: A total of 23 eyes of 20 Indian chronic angle-closure glaucoma (CACG patients with IOP greater than 21 mmHg, 360° PAS and no visual potential in the study eye underwent detailed eye examination. Baseline IOP was measured and YAG peripheral iridotomy was performed for complete angle-closure reconfirmation. Bimatoprost 0.03% was administered for 8 weeks as once-daily evening dose. IOP reduction within treatment group was determined with "paired t-test." Results: The mean reduction in IOP from baseline to 8 weeks of bimatoprost therapy was 15.3 ± 9.5 mmHg (P < 0.001. The most commonly observed adverse event was conjunctival hyperemia (35%. Bimatoprost was well tolerated in the study. Conclusions: In this study, exclusively involving patients with 360° synechial angle-closure glaucoma and no visual potential, bimatoprost 0.03% treatment demonstrated a statistically significant IOP reduction. Hence, it can be inferred that bimatoprost 0.03% is an efficacious treatment modality in this subgroup of patients for reducing IOP.

  2. Pengaruh Lamanya Pemberian Citicoline dalam Memperbaiki Retinal Nerve Fiber Layer (Rnfl dan Lapang Pandangan pada Primary Open Angle Glaucoma (Poag

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    Kemala Sayuti

    2014-01-01

    Full Text Available AbstrakTujuan penelitian ini adalah untuk menilai pengaruh lamanya pemberian citicoline dalam memperbaiki kualitas RNFL dan lapang pandangan pada POAG. Penelitian ini dilakukan pada pasien POAG yang datang dari bulan September 2010 – Januari 2011 dengan tehnik consecutive sampling. Semua subjek penelitian yang sudah diskrining dilakukan pemeriksaan OCT dan perimetri segera sebelum pemberian citicoline, pemeriksaan ulangan dilakukan setelah 10 hari pertama, 10 hari kedua, dan 10 hari ketiga pemberian citicoline. Dari penelitian ini didapatkan perbaikan ketebalan RNFL dengan pemeriksaan OCT lebih banyak terjadi pada pemberian citicoline selama 10 hari III (45.7% dibandingkan dengan pemberian 10 hari I (25,7% dan 10 hari II (42,9%. Perbaikan mean sensitivity lapang pandangan dengan pemeriksaan perimetri lebih banyak terjadi pada pemberian citicoline selama 10 hari III (51,4% dibandingkan dengan pemberian 10 hari I (32.4% dan 10 hari II (37.2%. Lama pemberian citicoline sangat berpengaruh meningkatkan ketebalan RNFL dengan pemeriksaan OCT dan mean sensitivity lapang pandangan dengan pemeriksaan perimetri pada pasien POAG dan bermakna secara statistik dengan p=0.000 dan p=0.001Kata kunci: Primary Open Angle Glaucoma, Retinal Nerve Fiber Layer, CiticolineAbstractThe objective of this study was to assessing the influence of duration of citicoline administration in improve the quality of RNFL and visual field in POAG. The study was conducted in patients with POAG who take place in September 2010 - January 2011 with consecutive sampling technique. After screening examination, subjects underwent OCT examination and early perimetry after the administration of citicoline, re-examination were in first 10 days, second 10 days, and third 10 days. RNFL thickness by OCT examination were much more going in citicoline administered for the third 10 days (45.7% compared with the provision of first 10 days (25.7% and second 10 day (42.9%. Mean sensitivity

  3. 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.

  4. 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.

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

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    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

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

    OpenAIRE

    2015-01-01

    Abdullah Kaya,1 Yakup Aksoy,2 Mehmet Koray Sevinç,3 Oktay Diner41Department of Ophthalmology, Anittepe Military Dispansery, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, Cyprus; 3Department of Ophthalmology, Beytepe Military Hospital, Ankara, 4Department of Ophthalmology, Erzurum Military Hospital, Erzurum, TurkeyWe read the current study “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma&rdqu...

  7. A Study of CYP1B1 Gene Prevalent Mutations in Patients With Primary Open-Angle Glaucoma in Sistan and Baluchestan Province, Iran

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    Narooie-Nejad

    2016-03-01

    Full Text Available Background Glaucoma is the second leading cause of blindness worldwide, and it is associated with increased intraocular pressure and visual field loss. The most common type of glaucoma, primary open-angle glaucoma (POAG, involves progressive optic nerve damage and the death of ganglion cells in adults. Despite the unknown etiology, genetic predisposition plays a significant role in the development of the disease. Objectives In order to identify the genetic basis of POAG in Zahedan, Iran, three common mutations of the CYP1B1 gene (G61E, R390H, and R469W were evaluated in this study. Patients and Methods Forty patients with POAG were recruited from the ophthalmic divisions of Alzahra hospital, which is associated with Zahedan University of Medical Sciences. The CYP1B1 prevalent mutations of p.G61E, p.R390H, and p.R469W were identified in DNA extracted from the blood samples of patients using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP technique. Results We identified no mutations in these patients in the three screened positions. Conclusions To ensure that these genes play no role in the disease, evaluation of the non-coding regions of both the CYP1B1 and MYOC genes is strongly recommended, since other genes are involved in the pathogenesis of glaucoma.

  8. Safety and efficacy of bimatoprost/timolol fixed combination in Chinese patients with open-angle glaucoma or ocular hypertension

    Institute of Scientific and Technical Information of China (English)

    Ling Zhihong; Zhang Mingchang; Hu Yizhen; Yin Zhengqin; Xing Yiqiao; Fang Aiwu; Ye Jian

    2014-01-01

    Background Lowering intraocular pressure (lOP) is currently the only therapeutic approach in primary open-angle glaucoma.and the fixed-combination medications are needed to achieve sufficiently low target lOP.A multicenter prospective study in the Chinese population was needed to confirm the safety and efficacy of Bimatoprost/Timolol Fixed Combination Eye Drop in China.In this study,we evaluated the safety and efficacy of Bimatoprost/Timolol Fixed Combination with concurrent administration of its components in Chinese patients with open-angle glaucoma or ocular hypertension.Methods In this multicenter,randomized,double-masked,parallel controlled study,patients with open-angle glaucoma or ocular hypertension who were insufficiently responsive to monotherapy with either topical β-blockers or prostaglandin analogues were randomized to one of two active treatment groups in a 1:1 ratio at 11 Chinese ophthalmic departments.Bimatoprost/timolol fixed combination treatment was a fixed combination of 0.03% bimatoprost and 0.5% timolol (followed by vehicle for masking) once daily at 19:00 P.M.and concurrent treatment was 0.03% bimatoprost followed by 0.5% timolol once daily at 19:00 P.M.The primary efficacy variable was change from baseline in mean diurnal intraocular pressure (IOP) at week 4 visit in the intent-to-treat (ITr) population.Primary analysis evaluated the non-inferiority of bimatoprost/timolol fixed combination to concurrent with respect to the primary variable using a confidence interval (CI) approach.Bimatoprost/timolol fixed combination was to be considered non-inferior to concurrent if the upper limit of the 95% CI for the between-treatment (bimatoprost/timolol fixed combination minus concurrent) difference was-≤1.5 mmHg.Adverse events were collected and slit-lamp examinations were performed to assess safety.Between-group comparisons of the incidence of adverse events were performed using the Pearson chi-square test or Fisher's exact test

  9. Association of Common Variants in eNOS Gene with Primary Open Angle Glaucoma: A Meta-Analysis

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    Yang Xiang

    2016-01-01

    Full Text Available Purpose. To clarify the association of endothelial nitric oxide synthase (eNOS polymorphisms and primary open angle glaucoma (POAG. Methods. After a systematic literature search in the MEDLINE, EMBASE, and ISI Web of Science databases, all relevant studies evaluating the association between the polymorphisms (rs2070744 and rs1799983 of eNOS gene and POAG were screened and included. The pooled odds ratios (ORs and the 95% confidence interval (CI of each single-nucleotide polymorphism (SNP in five genetic models were estimated using fixed-effect model if I2<50% in the test for heterogeneity; otherwise the random-effects model was used. Results. Thirty-one records were obtained, with five being suitable for meta-analysis. The overall results showed that both TT genotype in rs2070744 and GG genotype in rs1799983 are associated with decreased risk of POAG susceptibility. Stratified analysis based on ethnicity showed that the association of rs2070744 with POAG remained only in Caucasians. Results of subgroup analysis by sex indicated association between both polymorphisms and POAG in female group, but not in male group. Conclusions. TT genotype and/or T-allele in rs2070744, as well as GG genotype and/or G-allele in rs1799983, was associated with decreased risk for POAG overall and in female group.

  10. 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

    2014-05-30

    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 (IOPgenetic association of INK4 locus with POAG in East Indian population which needs to be replicated in larger studies in diverse world populations.

  11. Fluctuation in systolic blood pressure is a major systemic risk factor for development of primary open-angle glaucoma

    Science.gov (United States)

    Lee, Na Young; Jung, Younhea; Han, Kyungdo; Park, Chan Kee

    2017-01-01

    We evaluated the risk of development of primary open-angle glaucoma (POAG) in terms of variability in BP using a nationwide, population-based, 11-year longitudinal study using the Korean National Health Insurance Research Database. We included patients who underwent health care examinations more than twice between January 2002 and December 2006. We divided all subjects by the quartiles of variability in systolic blood pressure (SBP), diastolic blood pressure (DBP), and the difference between SBP and DBP. Of the total of 80,021 included subjects, 910 were diagnosed with POAG between January 2007 and December 2013. Both the Kaplan-Meier survival curves and log-rank test data indicated that patients with higher-level BP variability developed POAG significantly more frequently than did patients with lower-level variability (P < 0.001). On multivariate Cox’s regression modeling including gender, age, sex, household income, smoking status, level of alcohol intake, extent of exercise, diabetes mellitus status, dyslipidemia status, SBP, and DBP; the hazard ratios among the highest and lowest quartiles of SD SBP and CV SBP were 1.256 and 1.238, respectively. Our findings suggest that subjects in the highest quartile of SBP variability were significantly more likely to develop POAG in our population-based sample of Korean adults. PMID:28262703

  12. Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma

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    Marjanović Ivan

    2013-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. Objective. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP in women and men with primary open angle glaucoma. Methods. The study included 60 patients (33 males and 27 females older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, >25 mm Hg. They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Results. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end- diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. Conclusion. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure. The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

  13. Benzalkonium chloride and glaucoma.

    Science.gov (United States)

    Rasmussen, Carol A; Kaufman, Paul L; Kiland, Julie A

    2014-01-01

    Glaucoma patients routinely take multiple medications, with multiple daily doses, for years or even decades. Benzalkonium chloride (BAK) is the most common preservative in glaucoma medications. BAK has been detected in the trabecular meshwork (TM), corneal endothelium, lens, and retina after topical drop installation and may accumulate in those tissues. There is evidence that BAK causes corneal and conjunctival toxicity, including cell loss, disruption of tight junctions, apoptosis and preapoptosis, cytoskeleton changes, and immunoinflammatory reactions. These same effects have been reported in cultured human TM cells exposed to concentrations of BAK found in common glaucoma drugs and in the TM of primary open-angle glaucoma donor eyes. It is possible that a relationship exists between chronic exposure to BAK and glaucoma. The hypothesis that BAK causes/worsens glaucoma is being tested experimentally in an animal model that closely reflects human physiology.

  14. 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

  15. Epidemiology of Glaucoma in Asia-Pacific

    Institute of Scientific and Technical Information of China (English)

    P.Siva; Reddy

    1992-01-01

    Primary open angle glaucoma is the second most important cause of permanent blindness in the Asia Pacific region. Thus it is very important to identify epidemiological and other risk factore which are associated with open angle glaucoma. The risk for glaucoma optic nerve damage increases with the age and with the level of the intraocular pressure. In this paper, I will highlight our study of several risk factors for development of the open angle glaucoma like (1) elevated intraocular pressure, (2) myopi...

  16. Expression profile of the matricellular protein osteopontin in primary open-angle glaucoma and the normal human eye.

    Science.gov (United States)

    Chowdhury, Uttio Roy; Jea, Seung-Youn; Oh, Dong-Jin; Rhee, Douglas J; Fautsch, Michael P

    2011-08-16

    PURPOSE. To characterize the role of osteopontin (OPN) in primary open-angle glaucoma (POAG) and normal eyes. METHODS. OPN quantification was performed by enzyme-linked immunosorbent assay in aqueous humor (AH) obtained from human donor eyes (POAG and normal) and surgical samples (POAG and elective cataract removal). OPN expression and localization in whole eye tissue sections and primary normal human trabecular meshwork (NTM) cells were studied by Western blot and immunohistochemistry. Latanoprost-free acid (LFA)-treated NTM cells were analyzed for OPN gene and protein expression. Intraocular pressure was measured by tonometry, and central corneal thickness was measured by optical coherence tomography in young OPN(-/-) and wild-type mice. RESULTS. OPN levels were significantly reduced in donor POAG AH compared with normal AH (0.54 ± 0.18 ng/μg [n = 8] vs. 0.77 ± 0.23 ng/μg [n = 9]; P = 0.039). A similar trend was observed in surgical AH (1.05 ± 0.31 ng/μg [n = 20] vs. 1.43 ± 0.88 ng/μg [n = 20]; P = 0.083). OPN was present in the trabecular meshwork, corneal epithelium and endothelium, iris, ciliary body, retina, vitreous humor, and optic nerve. LFA increased OPN gene expression, but minimal change in OPN protein expression was observed. No difference in intraocular pressure (17.5 ± 2.0 mm Hg [n = 56] vs. 17.3 ± 1.9 mm Hg [n = 68]) but thinner central corneal thickness (91.7 ± 3.6 μm [n = 50] vs. 99.2 ± 5.5 μm [n = 70]) was noted between OPN(-/-) and wild-type mice. CONCLUSIONS. OPN is widely distributed in the human eye and was found in lower concentrations in POAG AH. Reduction of OPN in young mice does not affect IOP.

  17. 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.

  18. Clinical relevance of the glucocorticoid receptor gene polymorphisms in glucocorticoid-induced ocular hypertension and primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    Xiu-Qing; Wang; Zhao-Xia; Duan; Xiang-Ge; He; Xi-Yuan; Zhou

    2015-01-01

    AIM: To avoid the side effects of ocular hypertension of glucocorticoid(GC) usage in eye, we must identify susceptible individuals, which exists in about one-third of all population. Further, the majority of all primary open angle glaucoma(POAG) patients show this phenotype.Glucocorticoid receptor(GR) regulates C responsiveness in trabecular meshwork(TM) cells. In this study, single nucleotide polymorphism(SNP) genotyping was used to determine whether there are differences in the Bcl I(rs41423247) and N363S(rs6195) polymorphisms of the GR gene in healthy and POAG patients, and glucocorticoid-induced ocular hypertension(GIOH)populations.METHODS: Three hundred and twenty-seven unrelated Chinese adults, including 111 normal controls, 117 GIOH subjects and 99 POAG patients, were recruited. DNA samples were prepared and the Bcl I and N363 S polymorphisms were screened using real-time polymerase chain reaction(RT-PCR)-restriction fragment length polymorphism(RFLP) analysis. Frequencies of the Bcl I and N363 S polymorphisms were determined and compared using Fisher’s exact test and the Chi-squared test.RESULTS: Only the Bcl I polymorphism was identified in the Chinese Han population. The frequency of the G allele was 21.6 % in normal controls, 18.3% in GIOH patients, and 13.64% in the POAG patients. There was no significant difference in polymorphism or allele frequency in the 3 groups. Furthermore, no N363 S polymorphism was found in the study subjects.CONCLUSION: The Bcl I polymorphisms in GR gene had no association with GIOH and POAG patients, and N363 S polymorphism might not exist in the Chinese Han population. Therefore, the Bcl I polymorphism might not be responsible for the development of GC-induced ocular hypertension or POAG.

  19. Variants in Nebulin (NEB Are Linked to the Development of Familial Primary Angle Closure Glaucoma in Basset Hounds.

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    Dina F Ahram

    Full Text Available Several dog breeds are susceptible to developing primary angle closure glaucoma (PACG, which suggests a genetic basis for the disease. We have identified a four-generation Basset Hound pedigree with characteristic autosomal recessive PACG that closely recapitulates PACG in humans. Our aim is to utilize gene mapping and whole exome sequencing approaches to identify PACG-causing sequence variants in the Basset. Extensive clinical phenotyping of all pedigree members was conducted. SNP-chip genotyping was carried out in 9 affected and 15 unaffected pedigree members. Two-point and multipoint linkage analyses of genome-wide SNP data were performed using Superlink-Online SNP-1.1 and a locus was mapped to chromosome 19q with a maximum LOD score of 3.24. The locus contains 12 Ensemble predicted canine genes and is syntenic to a region on chromosome 2 in the human genome. Using exome-sequencing analysis, a possibly damaging, non-synonymous variant in the gene Nebulin (NEB was found to segregate with PACG which alters a phylogenetically conserved Lysine residue. The association of this variants with PACG was confirmed in a secondary cohort of unrelated Basset Hounds (p = 3.4 × 10-4, OR = 15.3 for homozygosity. Nebulin, a protein that promotes the contractile function of sarcomeres, was found to be prominently expressed in the ciliary muscles of the anterior segment. Our findings may provide insight into the molecular mechanisms that underlie PACG. The phenotypic similarities of disease presentation in dogs and humans may enable the translation of findings made in this study to patients with PACG.

  20. Bimatoprost/timolol fixed combination (BTFC) in patients with primary open angle glaucoma or ocular hypertension in Greece

    Science.gov (United States)

    Rotsos, Tryfon G.; Kliafa, Vasso G.; Asher, Kevin J.; Papaconstantinou, Dimitrios

    2016-01-01

    AIM To evaluate the efficacy and tolerability of the fixed combination of bimatoprost 0.03% and timolol 0.5% (BTFC) in patients in Greece with primary open angle glaucoma (POAG) or ocular hypertension (OHT) whose previous therapy provided insufficient lowering of intraocular pressure (IOP). METHODS A multicenter, prospective, open-label, non-interventional, observational study of the use of BTFC in clinical practice was conducted at 41 sites in Greece. The primary endpoint was the reduction in IOP from baseline at study end, approximately 12wk after initiation of BTFC therapy. RESULTS A total of 785 eligible patients were enrolled in the study and 97.6% completed the study. The mean±SD IOP reduction from baseline at 12wk after initiation of BTFC was 6.3±2.8 mm Hg (n=764; P<0.001). In patients (n=680) who replaced their previous IOP-lowering monotherapy (a single drug, or a fixed combination of 2 drugs in a single ophthalmic drop) with once-daily BTFC, the mean±SD IOP reduction from baseline at 12wk was 6.2±2.8 mm Hg (P<0.001). IOP was reduced from baseline in 99.2% of patients, and 58.0% of patients reached or exceeded their target IOP. Substantial mean IOP reductions were observed regardless of the previous therapy. BTFC was well tolerated, with 96.0% of patients who completed the study rating the tolerability of BTFC as “good” or “very good.” Adverse events were reported in 8.3% of patients; only 0.6% of patients discontinued the study due to adverse events. CONCLUSION In clinical practice in Greece, BTFC is well tolerated and effectively lower the IOP in patients with POAG or OHT who requires additional IOP lowering on their previous therapy. PMID:26949613

  1. Efficacy and safety of benzalkonium chloride-free fixed-dose combination of latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension

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    Bhagat P

    2014-06-01

    Full Text Available Purvi Bhagat,1 Kalyani Sodimalla,2 Chandrima Paul,3 Surinder S Pandav,4 Ganesh V Raman,5 Rengappa Ramakrishnan,6 Abhijeet Joshi,7 Atul Raut7 1Glaucoma Clinic, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India; 2Glaucoma Department, PBMA’s H.V. Desai Eye Hospital, Maharashtra, India; 3Glaucoma Service, B B Eye Foundation, Kolkata, India; 4Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India; 5Glaucoma Clinic, Aravind Eye Hospital, Coimbatore, Tamilnadu, India; 6Glaucoma Clinic, Aravind Eye Hospital, Tirunelveli, Tamilnadu, India; 7Clinical Research Department, Sun Pharma Advanced Research Company Ltd, Mumbai, Maharashtra, India Background: Benzalkonium chloride (BAK is a common preservative in topical ocular preparations; however, prolonged use may lead to deleterious effects on the ocular surface, affecting quality of life and reducing adherence to treatment and overall outcomes. This study compared the intraocular pressure (IOP-lowering efficacy and safety of a novel once-daily, BAK-free, fixed-dose combination of latanoprost plus timolol with latanoprost or timolol administered as monotherapy or concomitantly. Methods: This was a 6-week, randomized, open-label, parallel-group, active-controlled study in patients aged ≥18 years with open-angle glaucoma or ocular hypertension. A total of 227 patients were randomized to either a once-daily, BAK-free, fixed-dose combination of latanoprost 0.005%/timolol 0.5% ophthalmic solution or concomitant administration of once-daily latanoprost 0.005% plus twice-daily timolol 0.5% or once-daily latanoprost 0.005% monotherapy, or twice-daily timolol 0.5% monotherapy. Efficacy end points were assessed at three time points on visits at weeks 1, 2, 4, and 6 versus baseline. Results: The IOP-lowering efficacy of the fixed-dose combination of latanoprost/timolol was similar to that of latanoprost plus timolol administered

  2. Selective Laser Trabeculoplasty for Glaucoma Secondary to Emulsified Silicone Oil after Pars Plana Vitrectomy: A Pilot Study

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    Zeynep Alkin

    2014-01-01

    Full Text Available Background. To investigate the efficacy of selective laser trabeculoplasty (SLT for lowering intraocular pressure (IOP in patients with open angle glaucoma (OAG secondary to emulsified silicone oil (SO. Methodology/Principal Findings. Prospective, interventional, consecutive case series of 11 eyes with sustained elevation of IOP after SO removal. The mean IOP at baseline, week 1, month 1, month 3, and month 6 was evaluated. The mean baseline IOP was significantly decreased from 25 ± 2.7 mmHg to 18.4 ± 5.5 mmHg at week 1 (P=0.01, 17.9 ± 3.1 mmHg at month 1 (P=0.008, 15.8 ± 3.9 mmHg at month 3 (P=0.003, and 16.2 ± 4.7 mmHg at month 6 (P=0.004. IOP < 21 mmHg was achieved in 91% of the eyes without a significant complication at month 6. Conclusion/Significance. SLT may be successful for lowering IOP in patients with OAG secondary to emulsified SO which was not controlled with maximum antiglaucomatous medical treatment.

  3. Network Centrality of Resting-State fMRI in Primary Angle-Closure Glaucoma Before and After Surgery.

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    Fengqin Cai

    Full Text Available Using voxel-wise degree centrality (DC, as measured by resting-state fMRI, we aimed to study alterations in the brain functional networks in patients with primary angle-closure glaucoma (PACG and to reveal the plastic trajectories of surgery.A total of 23 preoperative PACG patients (49.48 ± 14.37 years old were recruited to undergo a resting-state fMRI scan, and 9 of them were rescanned 3 months after surgery. All PACG patients underwent a complete ophthalmologic examination, including intraocular pressure (IOP, retinal nerve fiber layer (RNFL thickness, vertical cup to disc ratio (V C/D, and average cup to disc ratio (A C/D. Another 23 gender- and age-matched healthy controls (48.18 ± 9.40 years old underwent scanning once for comparison. The group difference in DC was calculated in each voxel, and the correlations between the DC value and each of the clinical variables were analyzed in the PACG patients.Preoperative PACG (pre-PACG patients showed significantly decreased DC in the bilateral visual cortices but increased DC in the left anterior cingulate cortex (ACC and caudate (p < 0.05, corrected compared with the controls. Statistical analysis showed a significantly negative correlation between DC in the bilateral visual cortices and the IOP score and between DC in the anterior cingulate cortex (ACC and both the A C/D and V C/D scores in the pre-PACG patients. Three months after surgery, these postoperative PACG (post-PACG patients showed a significantly increased DC in both the bilateral visual cortices and the left precentral gyrus compared with the pre-PACG patients.Our results suggest that PACG may contribute to decreased functional centrality in the visual system and to increased degree centrality in cognition-emotional processing regions. Alterations in visual areas seem to parallel the cup to disc ratio, but not the duration of angle closure. The changes of functional centrality in PACG patients after operation may reveal the

  4. [Glaucoma and retinal surgery].

    Science.gov (United States)

    Müller, M; Geerling, G; Zierhut, M; Klink, T

    2010-05-01

    In the therapeutic approach to complex glaucomas different initial situations were considered: pre-existing glaucoma, induction of glaucoma after vitreoretinal surgery and antiglaucomatous procedures. In pre-existing glaucoma and after filtering surgery maintenance of the filtering bleb requires a vitreoretinal approach for conjunctiva preservation with techniques such as pneumatic retinopexy or small gauge vitrectomy. After vitreoretinal surgery an increase in intraocular pressure (IOP) is common. Secondary glaucoma may occur after scleral buckling and after vitrectomy with or without gas or silicone oil tamponade as well as after application of steroids. Angle closure glaucoma after scleral buckling develops because of congestion and anterior rotation of the ciliary body. Vitreous tamponades with expansive or saturated gases may cause angle-closure glaucoma with or without pupillary blockage and may critically shorten ocular perfusion. Postoperative checks, immediate action and a ban on boarding aircraft over the period of intraocular gas tamponade prevent permanent damage to the eye. The majority of secondary glaucomas can effectively be controlled by topical medication and adequate postoperative posture of the patient. Besides the temporary use of systemic antiglaucomatous medication or laser therapy, very rarely in cases of massive swelling or overfill, a direct intervention, such as partial gas or silicone oil removal is required. A prophylactic inferior peripheral iridectomy prevents pupillary blockage in aphakic eyes with intraocular tamponade. In cases of heavy silicone oil use, the peripheral iridectomy is placed in the superior position. Nd:YAG laser application will regulate IOP in cases of occlusion. Secondary glaucoma due to silicone oil emulsification overload is treated by trabecular meshwork aspiration and lavage. In refractory glaucoma repetitive cyclophotocoagulation and drainage implants represent an approved method for long-term IOP regulation

  5. Glaucoma Foundation

    Science.gov (United States)

    ... IMPORTANT RESEARCH FINDING First Cellular Model of Exfoliation Glaucoma Research is advancing in the quest to find ... cure for exfoliation syndrome and its associated exfoliation glaucoma, the current focus of The Glaucoma Foundation. Exfoliation ...

  6. Mechanism Research on the Primary Open-angle Glaucoma%原发性开角型青光眼发病机制的研究

    Institute of Scientific and Technical Information of China (English)

    张永梅; 于蒙; 莫日根

    2016-01-01

    青光眼是现今主要的致盲疾病之一,是一组以特征性视神经损害和视野缺损为共同特征的疾病.原发性开角型青光眼是青光眼的重要类型,发病机制尚未阐明,其临床特点是起病隐匿,多数患者眼内压升高,特征性视盘改变,进行性视神经损害,最终导致不可逆的视野缺损乃至失明.青光眼造成的视功能损伤是不可逆的,后果极为严重.在长期的医学实践中,人们发现很多青光眼有明显的遗传倾向.但是,遗传因素并不能完全解释原发性开角型青光眼的发病,同时还伴随着很多危险因素.本文对原发性开角型青光眼的危险因素和致病基因进行了概述.%Primary open-angle glaucoma (POAG) is a kind of irreversible blindness with the feature of optic nerve damage and visual field defect.POAG is an important type of glaucoma,and the mechanism is unknown.The clincial characteristic of POAG are high intraocular pressure,a characteristic change of the optic disc,and progressive optic nerve damage.The results were irreversible visual field defects and even blindness.Visual function damage of glaucoma is irreversible and had serious consequences.People find that glaucoma was significant genetic predisposition in long time medical practices.However,genetic factors do not explain the pathogenesis of primary open-angle glaucoma completely,and by a lot of risk factors were accompanied with POAG.The risk factors and disease genes of POAG are summarized.

  7. No association of genetic polymorphisms in CYP1B1 with primary open-angle glaucoma: a meta- and gene-based analysis

    OpenAIRE

    Dong, Shuqian; Yang, Jingyun; Yu, Weihong; Kota, Pravina; Xia, Xiaobo; Xu, Huizhuo

    2012-01-01

    Purpose To examine the effects of genetic polymorphisms in cytochrome P450, subfamily 1, polypeptide 1 (C1P1B1) on primary open-angle glaucoma (POAG). Methods A systematic literature search was performed, and random-effects meta-analyses were used to evaluate genetic polymorphisms in CYP1B1 with POAG. A gene-based analysis was conducted to investigate the cumulative effects of genetic polymorphisms in CYP1B1. Results A total of six studies from published papers were included in our analysis. ...

  8. [Interactive, multimedia learning system for the study of primary open angle glaucoma--system description from the viewpoint of the computer scientist].

    Science.gov (United States)

    Zenz, H; Maresch, H; Faulborn, J

    1994-01-01

    For use on an Apple Macintosh PC, a software packet was developed with the aid of which medical students can learn all about primary open-angle glaucoma; at the same time, it is also highly suitable for supplementing lectures. The subject is subdivided into the three sections anatomy, pathology and clinical picture. All the possibilities of computer technology, for example controllable animation, video sequences and special graphic effects are utilized. A special lexicon, a complex of questions and all the possible cross-references combine to make the learning system a very flexible and highly effective learning tool.

  9. [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.

  10. Flat Anterior Chamber after Trabeculectomy in Secondary Angle-Closure Glaucoma with BEST1 Gene Mutation: Case Series

    Science.gov (United States)

    Xiao, Hui; Luo, Jingyi; Zuo, Chengguo; Huang, Xiaobo; Huang, Jingjing; Mi, Lan; Zhang, Qingjiong; Liu, Xing

    2017-01-01

    Purpose Trabeculectomy has been regarded as a mainstay of initial treatment in eyes of angle closure glaucoma (ACG) with peripheral anterior synechia > 180° in the Chinese population while its efficacy in secondary ACG with BEST1 gene mutation remains unclear. We set out to investigate the treatment outcome of trabeculectomy for secondary ACG in a group of patients with autosomal recessive bestrophinopathy (ARB). Methods In this retrospective case series study, 8 secondary ACG patients with ARB and their 4 recruited family members underwent a thorough ophthalmic examination including best-corrected visual acuity, Goldmann applanation tonometry, gonioscopy, and fundus examinations. Ultrasound biomicroscopy, optical coherence tomography (OCT), ultrasound A-scan, B-scan, electro-oculography (EOG), Humphrey perimetry, fundus photography, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were also performed. Blood samples were obtained in the patients and their available family members to analyze the variants of the BEST1 gene. Trabeculectomy was performed in the 8 patients (15 eyes). Results The age of onset varied from 13 to 38 years. The average axial length (AL) of the affected eyes was 21.82 ± 0.92 mm and the average anterior chamber depth (ACD) was 2.19 ± 0.29 mm. There was marked axial shallowing of the anterior chamber in all 15 eyes after trabeculectomy, and was not improved with potent mydriatics. The IOP was elevated in 3 eyes. Variable degree of yellowish subretinal deposits was observed in the posterior retina. The FFA showed punctuate or patched hyperfluorescence suggesting retinal pigment epithelium impairment. The ICGA demonstrated dilatation of choroidal vessels. The OCT revealed diffused neuroretinal detachment in the posterior and midperipheral retina, with intraretinal fluid collections, and hyperreflective subretinal accumulations. The average subfoveal choroidal thickness of the patients was 382.36 ± 80.09 μm. All

  11. Comparison of the Efficacy of Latanoprost, Bimatoprost, and Travoprost in Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

    Directory of Open Access Journals (Sweden)

    Nur Çolak

    2014-05-01

    Full Text Available Objectives: The aim of this prospective study was to compare the efficacy of latanoprost, bimatoprost, and travoprost in lowering intraocular pressure (IOP and in preventing or delaying visual field loss in patients with primary open-angle glaucoma (POAG and ocular hypertension (OH. Materials and Methods: The study included 124 eyes of 73 patients who were diagnosed in our clinic as having POAG or OH. All of the patients had IOP values of 22-34 mmHg, an early diagnosis of POAG or OH, without any previous treatment. The patients were randomly divided into 3 Groups: Group 1; 42 eyes treated with latanoprost (0.005%, Group 2; 40 eyes treated with bimatoprost (0.03%, and Group 3; 42 eyes treated with travoprost (0.004%. The visual field has been evaluated via the Humprey visual field evaluation of statistical program Statpac mean deviation (MD and pattern standard deviation (PSD. The IOP, MD, and PSD values have been measured initially and at the end of the first year of treatment. Results: In comparison to the baseline, the mean changes of IOP values after one year of treatment were 6.99, 6.79 and 5.87 mmHg for the 3 Groups, respectively. The decrease in the IOP was statistically significant for each of the treatment groups (p0.05. Comparison of the MD and PSD values revealed no significant differences among the treatment groups both initially and at the end of the first year (p>0.05. The mean changes in MD and PSD values at the end of the first year were similar among the treatment groups (p>0.05. Conclusion: In patients with POAG and OH, treatment with latanoprost, bimatoprost, and travoprost decrease the IOP effectively. After a one-year treatment, no significant difference has been found between the efficacy of the 3 drugs in lowering IOP and in preventing or delaying visual field loss. (Turk J Ophthalmol 2014; 44: 170-4

  12. Efficacy of Monotherapy with Either Bimatoprost or Travoprost in Patients with Primary Open-Angle Glaucoma Resistant to Latanoprost Therapy

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    Yusuf Koçluk

    2011-10-01

    Full Text Available Pur po se: This prospective study aimed to evaluate the efficacy of monotherapy with either bimatoprost or travoprost in patients with primary open-angle glaucoma (POAG resistant to latanoprost therapy. Patients and Methods: Forty patients with POAG who received therapy with topical latanoprost at Gaziantep University Hospital, Department of Ophthalmology between March 2009 and March 2010 were chosen to participate in this study. The decision to stop latanoprost therapy in these patients was made either due to the fact that they were resistant to therapy or due to the necessity to further decrease the intraocular pressure (IOP; 20 subjects were chosen to receive monotherapy with bimatoprost and 20 were chosen to receive monotherapy with travoprost. The patients were observed for 6 months with follow-up visits at 1 week, 1 month, 3 months and 6 months. Results: For the group of patients receiving therapy with bimatoprost, the average decrease in IOP was measured to be 2.05 mmHg at 1 week, 2.25 mmHg at 1 month, 1.90 mmHg at 3 months and 2.40 mmHg at 6 months. For the group of patients receiving therapy with travoprost, the average decrease in IOP was measured to be 1.47 mmHg at 1 week, 1.75 mmHg at 1 month, 1.42 mmHg at 3 months and 1.27 mmHg at 6 months. At the end of 6 months, there were no significant changes observed in the mean deviation and central corneal thickness in both therapy groups. Conjunctival hyperemia and ocular irritation were the most common side effects observed in both groups, with the bimatoprost therapy group showing higher values than the travoprost group. Discussion: For patients resistant to latanoprost therapy, prior to any adjuvant therapy, monotherapy with either bimatoprost, which is a prostamide, or travoprost, a prostaglandin analogue, has been shown to be effective at lowering IOP. (Turk J Ophthalmol 2011; 41: 295-8

  13. [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.

  14. 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

    Directory of Open Access Journals (Sweden)

    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

  15. Polymorphisms in matrix metalloproteinases MMP1 and MMP9 are associated with primary open-angle and angle closure glaucoma in a Pakistani population

    NARCIS (Netherlands)

    Micheal, S.; Yousaf, S.; Khan, M.I.; Akhtar, F.; Islam, F.; Khan, W.A.; Hollander, A.I. den; Qamar, R.; Ahmed, A.

    2013-01-01

    PURPOSE: Matrix metalloproteinases (MMPs) play an important role in remodeling of the extracellular matrix during development and growth of various tissues including the eye. Various functional polymorphisms in MMPs have been implicated in the pathogenesis of different types of glaucoma. The aim of

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

    Directory of Open Access Journals (Sweden)

    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

  17. 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...

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

    Directory of Open Access Journals (Sweden)

    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. Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Rong-Feng Liao; Zi-Lin Zhong; Min-Jie Ye; Li-Yun Han; Dong-Qing Ye; Jian-Jun Chen

    2016-01-01

    Background:Glaucoma is a major cause of irreversible blindness worldwide.There is evidence showing that a subset of the disease is genetically determined.In this study,we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG).Methods:A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations.In addition,200 unrelated healthy Chinese controls were also recruited as normal control.GLC1A gene was amplified by polymerase chain reaction,and DNA sequencing was performed to screen for mutations.Results:Six members were diagnosed as POAG,with severe clinical manifestations,and history of high intraocular pressures.The mean age of disease onset was 26.3 years.However,the others were asymptomatic.In six affected and three asymptomatic members,gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC).Furthermore,we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members,which was not reported previously in POAG patients.The two newly identified variants were absent in other family members as well as controls.Conclusion:The mutations c.1456C<T (p.L486F) in MYOC and c.322G<A (p.V108I) in B4GALT3 are likely responsible for the pathogenesis of POAG in this family.

  20. Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma

    Science.gov (United States)

    Liao, Rong-Feng; Zhong, Zi-Lin; Ye, Min-Jie; Han, Li-Yun; Ye, Dong-Qing; Chen, Jian-Jun

    2016-01-01

    Background: Glaucoma is a major cause of irreversible blindness worldwide. There is evidence showing that a subset of the disease is genetically determined. In this study, we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG). Methods: A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations. In addition, 200 unrelated healthy Chinese controls were also recruited as normal control. GLC1A gene was amplified by polymerase chain reaction, and DNA sequencing was performed to screen for mutations. Results: Six members were diagnosed as POAG, with severe clinical manifestations, and history of high intraocular pressures. The mean age of disease onset was 26.3 years. However, the others were asymptomatic. In six affected and three asymptomatic members, gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC). Furthermore, we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members, which was not reported previously in POAG patients. The two newly identified variants were absent in other family members as well as controls. Conclusion: The mutations c.1456C

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

    Directory of Open Access Journals (Sweden)

    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

  2. 原发性闭角型青光眼视野损害的特点%Charactistics of visual field defects in primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    韩芳; 袁援生

    2009-01-01

    Objective To determine the difference of visual field defects between acute angle-closure glaucoma (AACG) and chronic angle-closure glaucoma (CACG) and to analyze the difference in the changes of visual field between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). Methods This retrospective case series study consisted of 53 patients with CACG,42 with AACG, and 42 with POAG. Visual field tests were examined using the 30-2 threshold program of the Humphrey Visual Field Analyzer. All cases with eligible visual fields were scored from 1 to 11 with the modified criterion used by Advanced Glaneoma Intervention Study (AGIS seures, mild groups: 1-5 and moderate groups: 6-11). An upper hemifields, lower hemifields, nasal area and overall field, mean defect (MD) and pattern standard deviation (PSD) were calculated and compared among the three glaucoma groups. The differenee in central 10°(12 points) of visual field damage, the nasal area, and the most defect quadrant of static visual field in each groups were evaluated. All analyses were performed with SAS 9.1 software. The factor analysis was used to analyze significant differences in mean defect (MD), pattern standard deviation (PSD), VF scores of nasal area and overal field among the three glaucoma groups. Analysis of variance were assessed differences between VF scores of the superior hemifield and the inferior hemifield. The differences in central 10° of visual field damage,the nasal area and the most defect quadrant of static visual field in each groups were examined using a chi-square test. P<0.05 were considered to be statistically significant. Results (1) VF scores with inferior hemifieid in POAG were lower than in CACG (t=4.24, P=0.0000) and in AACC(t=3.28, P=0.0013); There were no significant differences of VF seores between the superior hemifieid and the inferior hemifield in CACG (t=1.35, P=0.1808) and AACG (t=0.55, P=0.5824). There was found a significant differences of VF scores

  3. New approach of surgical treatment for open-angle glaucoma%开角型青光眼手术治疗最新进展

    Institute of Scientific and Technical Information of China (English)

    王晓蕾; 张秀兰

    2011-01-01

    The treatments for open-angle glaucoma include medication, laser and surgery.Trabeculectomy is still the first choice for its efficacy in controlling intraocular pressure. Good nonfiltering bleb surgeries have been developed recently, and the new surgeries include canaloplasty,trabecular bypass devices, the Glaukos iStent trabecular micro-bypass stent, Eyepass glaucoma implant, Gold Micro-Shunt implant, Trabectome, and excimer laser trabeculotomy ab interno. Other new alternatives such as the Ex-PRESS glaucoma shunt and pneumatic rabeculoplasty have also been developed. This article briefly reviews these new techniques.%开角型青光眼的治疗包括药物、激光和手术。小梁切除术因其降低眼压迅速、有效、成功率高,目前仍然是首选的滤过性手术。近年来,新型的治疗开角型青光眼的手术方式有了很大发展,其中以无滤过泡的(非滤过泡依赖的)滤过性手术为主,包括Schlemm管成形术、内引流iStent植入术、外引流Eyepass植入术、前房-脉络膜上腔分流装置Gold Micro-Shunt植入术、内路小梁切开术、内路准分子激光小梁切除术,这些都属于眼内引流手术;其他如Ex-PRESS青光眼微型引流钉植入术和真空小梁成形术等都显示出各自的特点。本综述将对这些最新手术的进展作一简要概述。

  4. Ultra-high resolution profiles of macular intra-retinal layer thicknesses and associations with visual field defects in primary open angle glaucoma

    Science.gov (United States)

    Chen, Qi; Huang, Shenghai; Ma, Qingkai; Lin, Huiling; Pan, Mengmeng; Liu, Xinting; Lu, Fan; Shen, Meixiao

    2017-01-01

    The structural characteristics of the outer retinal layers in primary open angle glaucoma (POAG) are still controversial, and these changes, along with those in the inner retinal layers, could have clinical and/or pathophysiological significance. A custom-built ultra-high resolution optical coherence tomography (UHR-OCT) combined with an automated segmentation algorithm can image and measure the eight intra-retinal layers. The purpose of this study is to determine the thickness characteristics of the macular intra-retinal layers, especially the outer layers, in POAG patients. Thirty-four POAG patients (56 eyes) and 33 normal subjects (63 eyes) were enrolled. Thickness profiles of the eight intra-retinal layers along a 6-mm length centred on the fovea at the horizontal and vertical meridians were obtained and the regional thicknesses were compared between two groups. The associations between the thicknesses of each intra-retinal layer and the macular visual field (VF) sensitivity were then analysed. POAG affected not only the inner retinal layers but also the photoreceptor layers and retinal pigment epithelium of the outer retina. However, the VF loss was correlated mainly with the damage of the inner retinal layers. UHR-OCT with automated algorithm is a useful tool in detecting microstructural changes of macula with respect to the progression of glaucoma. PMID:28169283

  5. Ultrasonic Emulsification Cataract and Glaucoma Combined Surgical Treatment Effect of Angle-closure Glaucoma with Cataract%超声乳化及青光眼白内障联合手术治疗合并白内障的闭角型青光眼效果研究

    Institute of Scientific and Technical Information of China (English)

    叶东升

    2016-01-01

    ObjectiveTo study the combined cataract ultrasonic emulsification cataract and glaucoma angle-closure glaucoma patients combined clinical effect of surgical treatment.Methods Selection of 36 cases with cataract in recent years angle-closure glaucoma patients admitted in our hospital, were divided into research group and the control group randomly. The control group was treated with glaucoma and cataract surgery.The research group was treated with phacoemulsification and chamber angle separation.Results After operation, the indicators of the research group were significantly better than that of control group, with statistical significance (P<0.05).Conclusion The combined cataract ultrasonic emulsification cataract and glaucoma angle-closure glaucoma patients joint surgery clinical effect is remarkable.%目的:研究对合并白内障闭角型青光眼患者行超声乳化及青光眼白内障联合手术治疗的临床效果。方法选取我院近年收治的36例合并白内障闭角型青光眼患者,将其按照随机数字表法分为研究组与对照组。对照组行青光眼白内障联合手术治疗,研究组行白内障超声乳化吸除联合房角分离术治疗。结果研究组术后各项指标均显著性优于对照组,有统计学意义(P<0.05)。结论对合并白内障闭角型青光眼患者行超声乳化及青光眼白内障联合手术治疗临床效果显著。

  6. Experience in the Treatment of 31 Cases of Acute Angle Closure Glaucoma%31例急性闭角型青光眼患者的治疗体会

    Institute of Scientific and Technical Information of China (English)

    李宏宇

    2016-01-01

    目的:探讨急性闭角型青光眼患者的治疗方法。方法对我院2013年3月~2015年6月收治的31例急性闭角型青光眼患者的临床治疗进行观察分析。结果本组31例急性闭角型青光眼患者治疗后均康复出院,治疗有效率为100%。结论及时明确急性闭角型青光眼患者的临床分期,并行对症治疗,大部分患者均可康复出院。%Objective To investigate the treatment of patients with acute angle closure glaucoma.Methods Clinical observation and analysis of 31 cases of acute angle closure glaucoma treated in our hospital from March 2013 to June 2015 were conducted.ResultsIn this group, 31 cases of patients with acute angle closure glaucoma patients were discharged from hospital after treatment, the effective rate was 100%.Conclusion The clinical staging of patients with acute angle closure glaucoma is in a timely manner, and the patients can be discharged from hospital.

  7. Whole exome sequencing implicates eye development, the unfolded protein response and plasma membrane homeostasis in primary open-angle glaucoma

    Science.gov (United States)

    Souzeau, Emmanuelle; Sharma, Shiwani; Landers, John; Mills, Richard; Goldberg, Ivan; Healey, Paul R.; Graham, Stuart; Hewitt, Alex W.; Mackey, David A.; Galanopoulos, Anna; Casson, Robert J.; Ruddle, Jonathan B.; Ellis, Jonathan; Leo, Paul; Brown, Matthew A.; MacGregor, Stuart; Lynn, David J.; Burdon, Kathryn P.; Craig, Jamie E.

    2017-01-01

    Purpose To identify biological processes associated with POAG and its subtypes, high-tension (HTG) and normal-tension glaucoma (NTG), by analyzing rare potentially damaging genetic variants. Methods A total of 122 and 65 unrelated HTG and NTG participants, respectively, with early onset advanced POAG, 103 non-glaucoma controls and 993 unscreened ethnicity-matched controls were included in this study. Study participants without myocilin disease-causing variants and non-glaucoma controls were subjected to whole exome sequencing on an Illumina HiSeq2000. Exomes of participants were sequenced on an Illumina HiSeq2000. Qualifying variants were rare in the general population (MAF < 0.001) and potentially functionally damaging (nonsense, frameshift, splice or predicted pathogenic using SIFT or Polyphen2 software). Genes showing enrichment of qualifying variants in cases were selected for pathway and network analysis using InnateDB. Results POAG cases showed enrichment of rare variants in camera-type eye development genes (p = 1.40×10–7, corrected p = 3.28×10–4). Implicated eye development genes were related to neuronal or retinal development. HTG cases were significantly enriched for key regulators in the unfolded protein response (UPR) (p = 7.72×10–5, corrected p = 0.013). The UPR is known to be involved in myocilin-related glaucoma; our results suggest the UPR has a role in non-myocilin causes of HTG. NTG cases showed enrichment in ion channel transport processes (p = 1.05×10–4, corrected p = 0.027) including calcium, chloride and phospholipid transporters involved in plasma membrane homeostasis. Network analysis also revealed enrichment of the MHC Class I antigen presentation pathway in HTG, and the EGFR1 and cell-cycle pathways in both HTG and NTG. Conclusion This study suggests that mutations in eye development genes are enriched in POAG. HTG can result from aberrant responses to protein misfolding which may be amenable to molecular chaperone therapy. NTG

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. Glaucoma Symptoms

    Science.gov (United States)

    ... Next Normal-Tension Glaucoma Share this: Facebook Twitter Google Plus Email Print this page Don't miss ... and Glaucoma: What You Should Know Driving a car is for some synonymous with independence and is ...

  10. 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 ...

  11. 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

  12. Glaucoma in developing countries

    Directory of Open Access Journals (Sweden)

    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

  13. Role of apoptosis in the рathogenesis of glaucomatous optic nerve damage during primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    M. A. Frolov

    2014-07-01

    Full Text Available This work is devoted to the study of the molecular mechanisms of programmed cell death or apoptosis in primary open-angleglaucoma. As one of the main factors in the pathogenesis of this disease appears the loss of retinal ganglion cells. Their death occursby apoptosis — programmed suicide mechanism. We consider two major apoptotic pathways, which are described in the literature —Fas-mediated and Bcl-2-dependent or mitochondrial. The existence of these paths and their regulators in many organs and tissues isdescribed, including the retina and optic nerve. Based on the analysis of domestic and foreign literature is presented modern view ofthe stages of this process in glaucoma. A thorough understanding of the mechanisms of apoptosis and their regulation may contribute to the development of new pharmacological methods of prevention and treatment of eye diseases

  14. Role of apoptosis in the рathogenesis of glaucomatous optic nerve damage during primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    M. A. Frolov

    2013-01-01

    Full Text Available This work is devoted to the study of the molecular mechanisms of programmed cell death or apoptosis in primary open-angleglaucoma. As one of the main factors in the pathogenesis of this disease appears the loss of retinal ganglion cells. Their death occursby apoptosis — programmed suicide mechanism. We consider two major apoptotic pathways, which are described in the literature —Fas-mediated and Bcl-2-dependent or mitochondrial. The existence of these paths and their regulators in many organs and tissues isdescribed, including the retina and optic nerve. Based on the analysis of domestic and foreign literature is presented modern view ofthe stages of this process in glaucoma. A thorough understanding of the mechanisms of apoptosis and their regulation may contribute to the development of new pharmacological methods of prevention and treatment of eye diseases

  15. c.194 A>C (Q65P) mutation in the LMX1B gene in patients with nail-patella syndrome associated with glaucoma

    Science.gov (United States)

    Romero, Pablo; Sanhueza, Felipe; Lopez, Pamela; Reyes, Loreto

    2011-01-01

    Purpose To report the clinical, ophthalmic, extraophthalmic, and genetic characteristics of nail-patella syndrome (NPS) in a Chilean family and to investigate the expressivity of open angle glaucoma (OAG) and ocular hypertension (OHT) in the family members. Methods Five family members affected with NPS and two unaffected members underwent a complete ophthalmologic examination, including computerized visual field, optical coherence tomography (OCT) of the optic disc and ultrasound pachymetry. Renal function was assessed by urinalysis and blood tests. Orthopedic evaluations were also performed, including radiological studies of the wrist, elbow and hip joints. Genomic DNA was extracted from peripheral leukocytes of the five affected and two unaffected family members. Exons 2–6 of the LIM homeobox transcription factor 1-beta (LMX1B) gene were screened for mutations by DNA sequencing of the proband. We also screened for mutations in exon 2 by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the other participants and 91 blood donors. Results Five living family members from three generations were positively diagnosed with NPS, three of them with varying degrees of OAG and one with OHT. Retinal nerve fiber layer (RNFL) thickness measured by spectral domain OCT was below normal values in three individuals. All subjects evaluated had normal nephrologic function. Orthopedic, clinical, and radiological alterations were compatible with NPS. Screening for mutations in exons 2- 6 of LMX1B showed a heterozygous missense mutation c.194 A>C changing glutamine to proline within exon 2 in codon 65 (Q65P) of the coding sequence. This mutation was present in all NPS subjects and absent in the unaffected family members and in 91 Chilean blood donors. Conclusions This is the first report of c.194 A>C mutation in LMX1B in a Chilean family with NPS and the second worldwide. The phenotype associated with this mutation is variable within the family

  16. [Corneal endothelium in glaucoma].

    Science.gov (United States)

    Stefan, C; Nicolae, Miruna; Pop, Adina

    2012-01-01

    It is a clinical, observational, retrospective, randomised study, performed on 34 eyes with hipertensive primary open angle glaucoma (POAG) drug equilibrated and 18 eyes with normotensive POAG. We have evaluated the endothelial cells number variation in the hypertensive POAG and normotensive POAG.

  17. Efficacy and safety of benzalkonium chloride-free fixed-dose combination of latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension

    OpenAIRE

    2014-01-01

    Purvi Bhagat,1 Kalyani Sodimalla,2 Chandrima Paul,3 Surinder S Pandav,4 Ganesh V Raman,5 Rengappa Ramakrishnan,6 Abhijeet Joshi,7 Atul Raut7 1Glaucoma Clinic, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India; 2Glaucoma Department, PBMA’s H.V. Desai Eye Hospital, Maharashtra, India; 3Glaucoma Service, B B Eye Foundation, Kolkata, India; 4Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Indi...

  18. Comparison of Goldmann applanation and dynamic contour tonometry in a population of Mexican open-angle glaucoma patients.

    Science.gov (United States)

    Jimenez-Roman, J; Gil-Carrasco, F; Martinez, A; Albis-Donado, O; De la Torre-Tovar, J D

    2013-06-01

    To compare intraocular pressure (IOP) measurements obtained with Goldmann applanation (GAT) and dynamic contour tonometry (DCT) in a Mexican population. 40 glaucoma patients were included in this cross-sectional observational cohort study. IOP measurements were performed in the following order: DCT, ultrasonic pachymetry and GAT, with a 5-minute difference between each measurement, between 8 am and 2 pm. Only DCT measurements of good quality (Q ≤ 3) were accepted. GAT measurements were made three times with the same Goldmann tonometer, previously checked for calibration errors, and the mean was used for statistical purposes. The IOP (mean [standard deviation], 95 % confidence interval [CI]) measured with the Goldmann tonometer (13.2 [2.4], 12.4-14.0 mmHg) was significantly lower than that obtained with the DCT (18.4 [3.3], 17.0-19.2 mmHg), p DCT were (r = 0.24, 95 % CI = 0.07-0.52, p = 0.133) and (r = 0.13, 95 % CI = -0.19 to 0.43, p = 0.412), respectively. The concordance correlation coefficient between GAT and DCT was r c = 0.3, 95 % CI = 0.17-0.41). DCT seems to overestimate the IOP as compared to GAT. Additionally, although there was a good correlation between the IOP measurements assessed with either GAT or DCT, the agreement was poor.

  19. Selective laser trabeculoplasty compared with medical treatment for the initial management of open angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Efraín Pérez

    2016-11-01

    Full Text Available La trabeculoplastía láser selectiva es una alternativa terapéutica relativamente reciente para el manejo del glaucoma de ángulo abierto y la hipertensión ocular. Por otro lado, el tratamiento médico es de efectividad probada, e incluso ha mejorado en las últimas décadas con la introducción de los análogos de prostaglandinas. Buscamos la evidencia que compara ambos tratamientos utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos. Identificamos cuatro revisiones sistemáticas que en conjunto incluyen cuatro estudios aleatorizados y un estudio no aleatorizado y realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la trabeculoplastía láser selectiva produce una reducción absoluta de presión intraocular de menor magnitud que el tratamiento médico. Sin embargo, no está claro si existen diferencias en la tasa de éxito del tratamiento o la necesidad de intervenciones antiglaucomatosas adicionales porque la certeza de la evidencia es muy baja.

  20. 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

  1. A retrospective survey of childhood glaucoma prevalence according to Childhood Glaucoma Research Network classification

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    Ambika Hoguet

    2016-01-01

    Full Text Available Purpose: To evaluate the Childhood Glaucoma Research Network (CGRN classification system and describe the prevalence of each subtype according to this classification. Materials and Methods: Retrospectively, the medical records of 205 consecutive childhood glaucoma and glaucoma suspect patients at an urban tertiary care center were reviewed. The initial diagnosis and new diagnosis according to CGRN classification were recorded. Results: All patients fit one of the seven categories of the new classification. Seventy-one percent of diagnoses were changed upon reclassification. Twenty-three percent of patients had primary glaucoma (juvenile open-angle glaucoma and primary congenital glaucoma [PCG]; 36% had secondary glaucoma (glaucoma associated with nonacquired ocular anomalies; glaucoma associated with nonacquired systemic disease or syndrome; glaucoma associated with acquired condition; and glaucoma following cataract surgery; and 39% were glaucoma suspect. Of the patients diagnosed with glaucoma, PCG was the most common diagnosis, seen in 32% of patients. Conclusion: The CGRN classification provides a useful method of classifying childhood glaucoma.

  2. Preservative-free bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension in clinical practice

    Science.gov (United States)

    Pillunat, Lutz E; Eschstruth, Peter; Häsemeyer, Stefan; Thelen, Ulrich; Foja, Christian; Leaback, Richard; Pfennigsdorf, Stefan

    2016-01-01

    Background Intraocular pressure (IOP)-lowering medications for primary open-angle glaucoma and ocular hypertension commonly contain preservatives that can cause ocular surface damage in many patients. The purpose of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF) bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension (IOP ≥18 mmHg) in a clinical practice setting. Methods This open-label study observed patients who were switched to PF bimatoprost 0.03% for medical reasons. IOP was measured at baseline and ~12 weeks later at the final visit, and the change in IOP was calculated. Tolerability and continuation of therapy were assessed at two follow-up visits. Results A total of 1,830 patients were included in the study, and complete IOP data were available for 1,543 patients. Mean IOP was reduced by 23% from 21.64 mmHg to 16.59 mmHg (P<0.0001). In subgroup analyses, the mean IOP was significantly reduced compared with baseline, regardless of prior therapy, including those previously treated with PF monotherapy. A total of 85.7% of physicians reported the IOP-lowering efficacy of PF bimatoprost 0.03% to be as expected or better than expected. Adverse events (AEs) were experienced by 5.7% of patients, and there were no serious AEs reported. The most common AEs were eye irritation (1.7%) and hyperemia (1.4%). Physician-reported treatment compliance was reported as better than (48.7%) or equal to (43.6%) prior treatment in most patients. Most patients (82%) were expected to continue PF bimatoprost 0.03% after the end of the study. Conclusion This observational study showed that, in clinical practice, switching to PF bimatoprost 0.03% was associated with a significant IOP reduction from baseline. There was a low AE rate. PF bimatoprost 0.03% may, therefore, be an effective treatment option for patients who are intolerant of preservatives or have an inadequate response to prior IOP

  3. Preservative-free bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension in clinical practice

    Directory of Open Access Journals (Sweden)

    Pillunat LE

    2016-09-01

    Full Text Available Lutz E Pillunat,1 Peter Eschstruth,2 Stefan Häsemeyer,3 Ulrich Thelen,4 Christian Foja,5 Richard Leaback,6 Stefan Pfennigsdorf7 1Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, 2Ophthalmology Practice, Kiel, 3Eye Center Kraichgau, Wiesloch, 4Department of Ophthalmology, University of Münster, Münster, 5Ophthalmology Practice, Leipzig, Germany; 6Allergan Holdings Ltd., Marlow, UK; 7Ophthalmology Practice, Polch, Germany Background: Intraocular pressure (IOP-lowering medications for primary open-angle glaucoma and ocular hypertension commonly contain preservatives that can cause ocular surface damage in many patients. The purpose of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension (IOP ≥18 mmHg in a clinical practice setting. Methods: This open-label study observed patients who were switched to PF bimatoprost 0.03% for medical reasons. IOP was measured at baseline and ~12 weeks later at the final visit, and the change in IOP was calculated. Tolerability and continuation of therapy were assessed at two follow-up visits. Results: A total of 1,830 patients were included in the study, and complete IOP data were available for 1,543 patients. Mean IOP was reduced by 23% from 21.64 mmHg to 16.59 mmHg (P<0.0001. In subgroup analyses, the mean IOP was significantly reduced compared with baseline, regardless of prior therapy, including those previously treated with PF monotherapy. A total of 85.7% of physicians reported the IOP-lowering efficacy of PF bimatoprost 0.03% to be as expected or better than expected. Adverse events (AEs were experienced by 5.7% of patients, and there were no serious AEs reported. The most common AEs were eye irritation (1.7% and hyperemia (1.4%. Physician-reported treatment compliance was reported as better than (48.7% or equal to (43.6% prior treatment in

  4. Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial

    Science.gov (United States)

    Javanbakht, Mehdi; Azuara-Blanco, Augusto; Burr, Jennifer M; Ramsay, Craig; Cooper, David; Cochran, Claire; Norrie, John; Scotland, Graham

    2017-01-01

    Objective To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon. Setting 22 hospital eye services in the UK. Population Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions Lens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care. Results The mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67–89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. Trial registration number ISRCTN44464607; Results. PMID:28087548

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

    Directory of Open Access Journals (Sweden)

    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

  6. 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

  7. [Neovascular glaucoma--etipathogeny and diagnosis].

    Science.gov (United States)

    Călugăru, D; Călugăru, M

    2012-01-01

    Neovascular glaucoma is defined as an iris and/or anterior chamber angle neovascularization associated with increased intraocular presure. It is a secondary glaucoma most frequently determined by a severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion and ocular ischemic syndrome; the uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and probably predominant agent in the pathogenesis of both intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis as well as neovacular glaucoma is divided into four grades that is prerubeotic, preglaucomatous, open-angle and angle closure glaucoma stages.

  8. 重视原发性闭角型青光眼诊断与治疗方法的新转变%Progress in the diagnosis and treatment of primary angle closur e glaucoma

    Institute of Scientific and Technical Information of China (English)

    吕爱国; 郭黎霞; 范肃洁

    2016-01-01

    Glaucoma is the largest cause of irreversible blindness around the world .With the acceleration of population aging process , the incidence of glaucoma also gradually increases .Once the patient′s visual function is damaged , it will not be recoverable .What′s more, it will give obstacle to patient′s life and bring great economic burden .China is one of the high incidence areas on primary angle closure glaucoma.Therefore, to decrease the patient′s visual function damage down to minimum , early detection and early intervention become the primary goal of prevention and treatment of blindness of glaucoma in China.In this paper, the author reviews the new changes and development trend of the diagnosis and treatment of angle closure glaucoma in recent years .%青光眼是世界上第一大不可逆性致盲眼病。随着人口老龄化进程的加快,青光眼的发病率也在逐步提高,而这部分病人的视功能一旦受到损伤就不可恢复,这必然会给病人的生活造成障碍并带来一定的经济负担。我国是原发性闭角型青光眼( PACG)的高发区,故早期发现、早期干预,将患者的视功能损害程度降到最低成为我国青光眼防盲工作的首要目标。本文中笔者对近年来有关闭角型青光眼诊断和治疗方法的新转变与发展趋势进行评述。

  9. Multicenter, prospective, open-label, observational study of bimatoprost 0.01% in patients with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Laube T

    2012-05-01

    Full Text Available Stefan Pfennigsdorf,1 Osman Ramez,2 Gerrit von Kistowski,3 Birgit Mäder,4 Peter Eschstruth,5 Michael Froböse,6 Ulrich Thelen,7 Christoph Spraul,8 Dietmar Schnober,9 Hazel Cooper,10 Thomas Laube111Polch Ophthalmology Practice, Polch, 2Buxtehude Ophthalmology Practice, Buxtehude, 3Nürnberg Ophthalmology Practice, Nürnberg, 4Weißwasser Ophthalmology Practice, Weißwasser, 5Ophthalmology Practice, Kiel, 6Ophthalmology Practice, Bielefeld, 7Group Practice, Münster, 8Group Practice, Ulm, 9Ophthalmology Practice, Werdohl, Germany; 10Allergan, Marlow, UK, 11Group Practice, Düsseldorf, GermanyBackground: Bimatoprost 0.01% was developed for improved tolerability over bimatoprost 0.03%, while maintaining efficacy in lowering intraocular pressure (IOP. This multicenter, prospective, open-label, observational study was designed to investigate the efficacy and tolerability of bimatoprost 0.01% in routine clinical practice.Methods: Data were collected from 10,337 patients with primary open-angle glaucoma or ocular hypertension attending 1334 centers in Germany. The primary efficacy outcome was mean change in IOP in each eye from baseline to 10–14 weeks after initiation of bimatoprost 0.01%. Target IOP, prior therapies, additional treatments, and adverse events were also assessed. All treatment decisions were at the physicians’ discretion.Results: Bimatoprost 0.01% significantly lowered mean IOP from baseline by –4.1 mmHg (P < 0.0001 in all patients after a mean of 10.45 weeks. In patients without previous treatment, bimatoprost 0.01% reduced mean IOP from baseline by –6.5 mmHg (P < 0.0001. Bimatoprost 0.01% also significantly reduced IOP in patients previously treated with monotherapy of β-blockers, prostaglandin analogs, carbonic anhydrase inhibitors or bimatoprost 0.03%. No adverse events were reported by 93.9% of patients during treatment with bimatoprost 0.01%; the most commonly reported adverse events were eye irritation (2.0%, ocular

  10. 前房穿刺治疗急性闭角型青光眼的临床观察%Clinical observation of anterior chamber puncture in the treatment of acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈秀华

    2015-01-01

    Objective:To explore the clinical effect of anterior chamber puncture in the treatment of acute angle closure glaucoma. Methods:30 patients with acute angle closure glaucoma(33 eyes) were selected.They were given anterior chamber puncture treatment.The curative effects of patients were observed.Results:The intraocular pressure and vision of patients after treatment were significantly better than those before treatment(P<0.05).Conclusion:The curative effect of anterior chamber puncture in the treatment acute angle closure glaucoma is significant.%目的:探讨前房穿刺治疗急性闭角型青光眼的临床效果。方法:收治急性闭角型青光眼患者30例(33眼),给予前房穿刺术治疗,观察患者的疗效。结果:治疗后患者眼压和视力明显优于治疗前(P<0.05)。结论:前房穿刺术治疗急性闭角型青光眼疗效显著。

  11. 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.

  12. 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.

  13. Structural and functional brain changes in early- and mid-stage primary open-angle glaucoma using voxel-based morphometry and functional magnetic resonance imaging.

    Science.gov (United States)

    Jiang, Ming-Ming; Zhou, Qing; Liu, Xiao-Yong; Shi, Chang-Zheng; Chen, Jian; Huang, Xiang-He

    2017-03-01

    To investigate structural and functional brain changes in patients with primary open-angle glaucoma (POAG) by using voxel-based morphometry based on diffeomorphic anatomical registration through exponentiated Lie algebra (VBM-DARTEL) and blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI), respectively.Thirteen patients diagnosed with POAG and 13 age- and sex-matched healthy controls were enrolled in the study. For each participant, high-resolution structural brain imaging and blood flow imaging were acquired on a 3.0-Tesla magnetic resonance imaging (MRI) scanner. Structural and functional changes between the POAG and control groups were analyzed. An analysis was carried out to identify correlations between structural and functional changes acquired in the previous analysis and the retinal nerve fiber layer (RNFL).Patients in the POAG group showed a significant (P superior frontal gyrus, left inferior parietal lobule, left cuneus, and left midcingulate area; many of these regions had high correlations with the RNFL.Patients with POAG undergo widespread and complex changes in cortical brain structure and blood flow. (ClinicalTrials.gov number: NCT02570867).

  14. Association of glutathione S-transferase polymorphisms (GSTM1 and GSTT1) with primary open-angle glaucoma: an evidence-based meta-analysis.

    Science.gov (United States)

    Huang, Wenbin; Wang, Wei; Zhou, Minwen; Chen, Shida; Zhang, Xiulan

    2013-09-10

    Studies investigating the associations between glutathione S-transferase (GST) genetic polymorphisms and primary open-angle glaucoma (POAG) have reported controversial results. Therefore, a meta-analysis was performed to clarify the effects of GSTM1 and GSTT1 polymorphisms on POAG risk. Published literatures from PubMed, EMBASE, ISI Web of Science and CBM databases were retrieved. All studies evaluating the association between GSTM1/GSTT1 polymorphisms and POAG were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed- or random-effects model. Eleven studies on GSTM1 (1339 cases and 1412 controls) and seven studies on GSTT1 (958 cases, 1003 controls) were included. Overall analysis showed that the association between GSTM1 and GSTT1 null genotype and POAG risk is not statistically significant. Subgroup analyses showed that the null genotype of GSTM1 increased the risk of POAG in Asians. In GSTM1-GSTT1 interaction analysis, individuals with dual null genotype were associated with a significantly increased risk of POAG when compared with the dual present genotype. In conclusion, the present meta-analysis suggested that GSTM1 null genotypes are associated with increased POAG risk in Asian populations but not in Caucasian and mixed populations. Dual null genotype of GSTM1/GSTT1 is associated with increased risk of POAG. Given the limited sample size, the finding on GST polymorphisms needs further investigation.

  15. Role of the APOE ε2/ε3/ε4 polymorphism in the development of primary open-angle glaucoma: evidence from a comprehensive meta-analysis.

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    Qinglu Song

    Full Text Available Primary open-angle glaucoma (POAG is one of the leading causes of blindness worldwide. The association between the APOE ε2/ε3/ε4 polymorphism and the risk of POAG has been widely reported, but the results of previous studies remain controversial. To comprehensively evaluate the APOE ε2/ε3/ε4 polymorphism on the genetic risk for POAG, we performed a systematic review and meta-analysis of previously published studies. The PubMed and Web of Science databases were systematically searched to identify relevant studies. Data were extracted from these studies and odds ratios with corresponding 95% confidence intervals were computed to estimate the strength of the association. Stratified analyses according to ethnicity and sensitivity analyses were also conducted for further confirmation. A total of nine studies were eligible for the meta-analysis, and these studies included data on 1928 POAG cases and 1793 unrelated match controls. The combined results showed that there were no associations between the APOE ε2/ε3/ε4 polymorphism and POAG risk in any of the 10 comparison models. The analysis that was stratified by ethnicity subgroups also failed to reveal a significant association. The sensitivity analysis confirmed the stability and reliability of the findings. There was no risk of publication bias. Our meta-analysis provides strong evidence that the APOE ε2/ε3/ε4 polymorphism is not associated with POAG susceptibility in any populations.

  16. Association between the p53 codon 72 polymorphism and primary open-angle glaucoma risk: Meta-analysis based on 11 case–control studies

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    Mohsen Gohari

    2016-01-01

    Full Text Available The TP53 is important in functions of cell cycle control, apoptosis, and maintenance of DNA integrity. Studies on the association between p53 codon 72 polymorphism and primary open-angle glaucoma (POAG risk have yielded conflicting results. Published literature from PubMed and Web of Science databases was retrieved. All studies evaluating the association between p53 codon 72 polymorphisms and POAG were included. Pooled odds ratio (OR and 95% confidence interval (CI were calculated. Eleven separate studies including 2541 cases and 1844 controls were pooled in the meta-analysis. We did not detect a significant association between POAG risk and p53 codon 72 polymorphism overall population except allele genetic model (C vs. G: OR = 0.961, 95% CI = 0.961–0.820, P = 0.622. In the stratified analysis for Asians and Caucasians, there was an association between p53 codon 72 polymorphism and POAG. In the dominant model in the overall population and by ethnicity subgroups, the highest elevated POAG risk was presented. In summary, these results indicate that p53 codon 72 polymorphism is likely an important genetic factor contributing to susceptibility of POAG. However, more case–controls studies based on larger sample size and stratified by ethnicity are suggested to further clarify the relationship between p53 codon 72 polymorphism and POAG.

  17. Age at natural menopause genetic risk score in relation to age at natural menopause and primary open-angle glaucoma in a US-based sample

    Science.gov (United States)

    Pasquale, Louis R.; Aschard, Hugues; Kang, Jae H.; Bailey, Jessica N. Cooke; Lindström, Sara; Chasman, Daniel I.; Christen, William G.; Allingham, R. Rand; Ashley-Koch, Allison; Lee, Richard K.; Moroi, Sayoko E.; Brilliant, Murray H.; Wollstein, Gadi; Schuman, Joel S.; Fingert, John; Budenz, Donald L.; Realini, Tony; Gaasterland, Terry; Gaasterland, Douglas; Scott, William K.; Singh, Kuldev; Sit, Arthur J.; Igo, Robert P.; Song, Yeunjoo E.; Hark, Lisa; Ritch, Robert; Rhee, Douglas J.; Gulati, Vikas; Havens, Shane; Vollrath, Douglas; Zack, Donald J.; Medeiros, Felipe; Weinreb, Robert N.; Pericak-Vance, Margaret A.; Liu, Yutao; Kraft, Peter; Richards, Julia E.; Rosner, Bernard A.; Hauser, Michael A.; Haines, Jonathan L.; Wiggs, Janey L.

    2017-01-01

    Abstract Objective: Several attributes of female reproductive history, including age at natural menopause (ANM), have been related to primary open-angle glaucoma (POAG). We assembled 18 previously reported common genetic variants that predict ANM to determine their association with ANM or POAG. Methods: Using data from the Nurses’ Health Study (7,143 women), we validated the ANM weighted genetic risk score in relation to self-reported ANM. Subsequently, to assess the relation with POAG, we used data from 2,160 female POAG cases and 29,110 controls in the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database (NEIGHBORHOOD), which consists of 8 datasets with imputed genotypes to 5.6+ million markers. Associations with POAG were assessed in each dataset, and site-specific results were meta-analyzed using the inverse weighted variance method. Results: The genetic risk score was associated with self-reported ANM (P = 2.2 × 10–77) and predicted 4.8% of the variance in ANM. The ANM genetic risk score was not associated with POAG (Odds Ratio (OR) = 1.002; 95% Confidence Interval (CI): 0.998, 1.007; P = 0.28). No single genetic variant in the panel achieved nominal association with POAG (P ≥0.20). Compared to the middle 80 percent, there was also no association with the lowest 10th percentile or highest 90th percentile of genetic risk score with POAG (OR = 0.75; 95% CI: 0.47, 1.21; P = 0.23 and OR = 1.10; 95% CI: 0.72, 1.69; P = 0.65, respectively). Conclusions: A genetic risk score predicting 4.8% of ANM variation was not related to POAG; thus, genetic determinants of ANM are unlikely to explain the previously reported association between the two phenotypes. PMID:27760082

  18. Factors Influencing the Placebo Effect in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: An Analysis of Two Randomized Clinical Trials.

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    Taichi Kawamura

    Full Text Available To explore factors related to the placebo effect in patients with primary open-angle glaucoma (POAG or ocular hypertension (OH.This was a retrospective cohort study of patients with POAG and patients with OH who were treated with placebo. The patients' data were extracted from two randomized, double-masked, parallel, multicenter clinical trials (trial 1 and trial 2 in Japan. We explored the baseline factors that were associated with the intraocular pressure (IOP-lowering effect of placebo ophthalmic solution after 4 weeks of instillation treatment at two time points by using multivariable models. The time points were Hour 0 (between 08:30 and 10:30 before instillation and Hour 2 (within 1.5 to 2.5 h after instillation and by 12:30 at the baseline date and after 4 weeks. The changes in IOP from baseline to 4 weeks at the two time points were evaluated for the IOP-lowering effect induced by placebo instillation.Of the 330 patients included in the two trials, 89 patients were eligible for the analysis. The results of the multivariable analysis for Hour 0 indicated a high IOP at the baseline date (coefficient: 0.24, 95% confidence interval (CI: 0.02 to 0.46, P = 0.03, and the magnitude of the IOP fluctuation at the baseline date (coefficient: 0.57, 95% CI: 0.24 to 0.90, P = 0.001 was associated with the IOP-lowering effect after 4 weeks. With respect to Hour 2, the trial type was associated with the IOP-lowering effect (coefficient: -1.15, 95% CI: -2.14 to -0.16, P = 0.02.A large fluctuation in IOP during the day is associated with the IOP-lowering effect induced by placebo in patients with POAG or OH. This finding would be helpful to researchers when designing studies related to glaucoma in the early stages of clinical development of drugs.

  19. An observational study of bimatoprost 0.01% in treatment-naïve patients with primary open angle glaucoma or ocular hypertension: the CLEAR trial

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    Nixon DR

    2012-12-01

    Full Text Available Donald R Nixon,1 Susan Simonyi,2 Meetu Bhogal,2 Christopher S Sigouin,3 Andrew C Crichton,4 Marino Discepola,5 Cindy ML Hutnik,6 David B Yan71Private Practice, Barrie, ON, 2Allergan Inc, Markham, ON, 3CLINWest Research, Burlington, ON, 4University of Calgary, Calgary, AB, 5McGill University, Montreal, QC, 6London Health Sciences Centre, London, ON, 7University of Toronto, Toronto, ON, CanadaBackground: This study was designed to evaluate the occurrence and severity of ocular hyperemia in subjects with elevated intraocular pressure (IOP due to primary open angle glaucoma (POAG or ocular hypertension (OHT following treatment with bimatoprost 0.01% in a real-world clinical setting.Methods: This was an open-label, observational study conducted at 67 centers in Canada. Subjects with elevated IOP due to POAG or OHT instilled bimatoprost 0.01% topically as monotherapy once daily. Ocular hyperemia was graded by the investigator at baseline and weeks 6 and 12 using a photographic five-point grading scale. Change in IOP from baseline was also evaluated at these time points. This analysis includes only the subgroup of 522 subjects who were naïve to IOP-lowering medication prior to the study.Results: After 12 weeks of treatment with bimatoprost 0.01%, hyperemia was graded as none-to-mild (grades 0, +0.5, or +1 for 93.3% of subjects and as moderate-to-severe (grades +2 or +3 for 6.7%. At weeks 6 and 12, most subjects (93.2% and 93.5% had no change in hyperemia grade from baseline. IOP was reduced by 7.4 mmHg (29.8% at week 6 and 7.7 mmHg (30.9% at week 12 from baseline.Conclusion: This real-world, observational study found that bimatoprost 0.01% instilled once daily reduced IOP by a mean of 30% from baseline without moderate or severe ocular hyperemia in 93% of treatment-naïve subjects with POAG or OHT.Keywords: glaucoma, intraocular pressure, hyperemia, bimatoprost

  20. Using Genetic Mouse Models to Gain Insight into Glaucoma: Past Results and Future Possibilities

    OpenAIRE

    Fernandes, Kimberly A; Harder, Jeffrey M.; Williams, Pete A.; Rausch, Rebecca L.; Kiernan, Amy E.; Nair, K. Saidas; Anderson, Michael G; John, Simon W.; Howell, Gareth R.; Libby, Richard T.

    2015-01-01

    While all forms of glaucoma are characterized by a specific pattern of retinal ganglion cell death, they are clinically divided into several distinct subclasses, including normal tension glaucoma, primary open angle glaucoma, congenital glaucoma, and secondary glaucoma. For each type of glaucoma there are likely numerous molecular pathways that control susceptibility to the disease. Given this complexity, a single animal model will never precisely model all aspects of all the different types ...

  1. Nursing research of patients with acute angle-closure glaucoma at acute exacerbation%急性闭角型青光眼患者急性发作期的护理研究

    Institute of Scientific and Technical Information of China (English)

    王燕

    2016-01-01

    ABSTRACT:Objective to analyze the acute phase of the nursing intervention in patients with acute angle-closure glaucoma. Methods to choose in September 2011 - February 2014 in our hospital to receive a total of 35 patients with acute angle-closure glaucoma, the corresponding nursing measures, the nursing effect was analyzed. Results 35 patients after clinical care, an average of 30 minutes symptoms began to ease, 3 days later to intraocular pressure value to glaucoma surgery. Conclusion in patients with acute angle-closure glaucoma acute phase to take corresponding nursing intervention, can relieve patients' pain, reduce the blindness rate obviously, has clinical value.%目的:分析研究急性闭角型青光眼患者急性发作期的护理干预效果。方法选取2011年9月至2014年2月在我院接收的急性闭角型青光眼患者一共有35例,对其采取相对应的护理措施,对其护理效果给予分析。结果35例患者经过临床护理以后,平均30分钟症状开始缓解,3天以后降至到青光眼手术眼压值。结论在急性闭角型青光眼患者急性发作期采取针对性护理干预,可以使病人痛苦减轻,使其致盲率明显降低,具有临床推广价值。

  2. In vivo proton magnetic resonance spectroscopy (1H-MRS) evaluation of the metabolite concentration of optic radiation in primary open angle glaucoma

    Energy Technology Data Exchange (ETDEWEB)

    Sidek, Sabrilhakim [University of Malaya, Department of Biomedical Imaging, University Malaya Research Imaging Centre (UMRIC), Kuala Lumpur (Malaysia); Universiti Teknologi MARA, Medical Imaging Unit, Faculty of Medicine, Sg Buloh, Selangor (Malaysia); Ramli, Norlisah; Rahmat, Kartini; Kuo, Tan Li [University of Malaya, Department of Biomedical Imaging, University Malaya Research Imaging Centre (UMRIC), Kuala Lumpur (Malaysia); Ramli, Norlina Mohd; Abdulrahman, Fadzlina [University of Malaya, Department of Ophthalmology, Faculty of Medicine, Kuala Lumpur (Malaysia)

    2016-12-15

    To compare the metabolite concentration of optic radiation in glaucoma patients with that of healthy subjects using Proton Magnetic Resonance Spectroscopy (1H-MRS). 1H-MRS utilising the Single-Voxel Spectroscopy (SVS) technique was performed using a 3.0Tesla MRI on 45 optic radiations (15 from healthy subjects, 15 from mild glaucoma patients, and 15 from severe glaucoma patients). A standardised Volume of Interest (VOI) of 20 x 20 x 20 mm was placed in the region of optic radiation. Mild and severe glaucoma patients were categorised based on the Hodapp-Parrish-Anderson (HPA) classification. Mean and multiple group comparisons for metabolite concentration and metabolite concentration ratio between glaucoma grades and healthy subjects were obtained using one-way ANOVA. The metabolite concentration and metabolite concentration ratio between the optic radiations of glaucoma patients and healthy subjects did not demonstrate any significant difference (p > 0.05). Our findings show no significant alteration of metabolite concentration associated with neurodegeneration that could be measured by single-voxel 1H-MRS in optic radiation among glaucoma patients. (orig.)

  3. Effects of preservative-free tafluprost on tear film osmolarity, tolerability, and intraocular pressure in previously treated patients with open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Janulevičienė I

    2012-01-01

    Full Text Available Ingrida Januleviciene, Irmante Derkac, Lina Grybauskiene, Ruta Paulauskaite, Ruta Gromnickaite, Loreta KuzmieneEye Clinic of Kaunas Medical Academy of Lithuanian University of Health Sciences, Kaunas, LithuaniaPurpose: To compare the effects on tolerability, tear osmolarity, and intraocular pressure (IOP-lowering effect of switching from benzalkonium chloride (BAK containing prostaglandin analog (PGA latanoprost to preservative-free tafluprost.Patients and methods: Thirty patients with open-angle glaucoma (N = 60 eyes, 26 women (87% and four men (13% aged 64.1 (SD 14.1 years, showing abnormal values of tear osmolarity, corneal fluorescein staining, tear film break-up time (TBUT, or subjective discomfort with current latanoprost treatment were included. After tear osmolarity (TearLab™ Osmolarity System, TBUT, corneal fluorescein staining, and baseline IOP (Goldmann tonometer measurements and the completion of Ocular Surface Disease Index and Ocular Surface Symptoms in Glaucoma Scale questionnaires, patients were assigned to preservative-free tafluprost treatment. Measurements were repeated 2, 6 and 12 weeks after change of medication.Results: No statistically significant differences in IOP were observed 2, 6, and 12 weeks after switching to preservative-free tafluprost. Mean IOP at baseline was 16.4 mmHg (SD 2.9, after 2 weeks 16.2 mmHg (2.8, after 6 weeks 16.2 (2.6, and after 12 weeks 16.3 mmHg (2.3. Mean tear osmolarity decreased significantly from 315.7 mOsm/L (SD 15.1 at baseline to 308.0 ± 14.4 mOsm/L (P = 0.002, 301.7 ± 14.5 mOsm/L (P < 0.001, and 302.0 ± 9.9 mOsm/L (P < 0.001 2, 6, and 12 weeks after changing medication to preservative-free tafluprost, respectively. Tear osmolarity was lower in 37 eyes (61.7% after 2 weeks, in 46 eyes (76.7% after 6 weeks, and in 49 eyes (81.7% after 12 weeks (P < 0.005; t-test. At baseline corneal fluorescein staining was observed in 43 eyes (71.7%, after 2 weeks in 34 eyes (56.7%, after 6 weeks

  4. Pediatric glaucoma: current perspectives

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    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

  5. Glaucoma Research Foundation

    Science.gov (United States)

    ... born with glaucoma. Read her story » Learn About Glaucoma Glaucoma is a complicated disease in which damage ... Booklet Vision Loss Progression healthy advanced Tips for Glaucoma Care We've worked with patients, researchers, and ...

  6. Malignant glaucoma

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    Sebastião Cronemberger

    2012-10-01

    Full Text Available The aim of this review is to discuss current knowledge about pathophysiology and clinical, therapeutic and prophylactic approaches for malignant glaucoma. This type of glaucoma can occur after different surgical procedures. It can also occur in aphakic, phakic and pseudophakic eyes and develop spontaneously in individuals with no ocular surgical history, or associated with topical miotics. Currently, the ultrasound biomicroscopy has provided many interesting and useful findings for diagnosis and monitoring the treatment of malignant glaucoma. It occurs more often in short eyes in which pre operative measurements of the anterior chamber depth and axial length are extremely important for its prophylaxis and diagnosis.

  7. Feline Glaucoma.

    Science.gov (United States)

    McLellan, Gillian J; Teixeira, Leandro B C

    2015-11-01

    Feline glaucoma is often insidious in onset and slowly progressive with very subtle clinical signs. As a consequence, it is likely that the disease in cats is underdiagnosed. As cats typically present late in the course of disease, prognosis for long-term maintenance of vision is poor. Patient and owner compliance with frequent application of topical medications can be a limiting factor, and represents a serious clinical challenge. This review outlines the clinical features, classification, and pathophysiology of the feline glaucomas and provides current evidence on which to base the selection of appropriate treatment strategies for cats with glaucoma.

  8. Fixed combination of travoprost and timolol maleate reduces intraocular pressure in Japanese patients with primary open-angle glaucoma or ocular hypertension: analysis by prostaglandin analogue

    Science.gov (United States)

    Nakano, Tadashi; Mizoue, Shiro; Fuse, Nobuo; Iwase, Aiko; Matsumoto, Shun; Yoshikawa, Keiji

    2017-01-01

    Background We have shown a decrease in mean intraocular pressure (IOP) by switching to travoprost/timolol fixed combination (TTFC) in subjects receiving prostaglandin analogue (PGA) monotherapy and requiring additional medication in a previous report. For analyzing factors affecting IOP reduction, baseline IOP and preceding PGA were selected as statistically and clinically significant factors. In this report, we examine IOP-lowering effect and adverse drug reactions by preceding PGA. Methods Patients with primary open angle glaucoma or ocular hypertension who received monotherapy with one of four PGAs (travoprost, latanoprost, tafluprost, or bimatoprost) for at least 3 months at 26 institutions and were determined to require additional medication by their primary physician were included. IOP reduction and adverse events were examined at 4, 8, and 12 weeks for each of four PGAs after switching to TTFC. Results In total, 157 patients who could be followed up for at least 4 weeks after switching to TTFC were included in the efficacy analysis. Multiple regression analysis was performed, and baseline IOP and PGA were found to be significant factors to IOP reduction. IOP reduction at week 12, adjusted with the regression model, was −3.5, −1.8, and −1.4 mmHg in the tafluprost, latanoprost, and travoprost groups, whereas it was −0.5 mmHg in the bimatoprost group. Along with differences in baseline IOP between groups, an IOP-lowering effect of >1 mmHg was noted in the tafluprost, latanoprost, and travoprost groups after the switch. IOP was maintained at 13.8–14.8 mmHg throughout the follow-up period. No serious adverse events or noteworthy issues were observed in any group after the switch. Conclusion Clinically significant IOP-reducing effects of TTFC were observed in the latanoprost, travoprost, and tafluprost groups when switching from each PGA monotherapy, while there were some differences in effects between groups, with minimal safety concerns. PMID:28053501

  9. Association of single nucleotide polymorphisms in the CYP1B1 gene with the risk of primary open-angle glaucoma: a meta-analysis.

    Science.gov (United States)

    Wang, Z; Li, M; Li, L; Sun, H; Lin, X Y

    2015-12-17

    Mutations in the CYP1B1 gene were detected in primary open-angle glaucoma (POAG) patients. However, the association between these mutations and the incidence of POAG remains to be elucidated. Here, we have conducted a meta-analysis to analyze this correlation, using relevant studies obtained from an extensive search of various electronic databases, including EMBase, Web of Science, and PubMed. The extracted studies were selected for the meta-analysis based on the inclusion and exclusion criteria. The quality of each included study was assessed by the Newcastle-Ottawa scale (NOS), and the I2 value was calculated to evaluate the heterogeneity between studies. The combined effect size was presented as the odds ratio (OR), and confidence intervals (CI) were used to assess the association between POAG and CYP1B1 mutations. Eight studies, each with a high NOS score, were included in the analysis. Compared to the mutant allele, the wild-type allele of the rs180040 polymorphism in POAG patients showed a 12% decrease in OR (OR = 0.88, 95%CI = 0.76- 1.00); also, the wild-type allele of rs1056827 showed a 23% decrease in OR of the incidence of POAG (OR = 0.77, 95%CI = 0.60-0.99). However, the latter result was controversial. Polymorphisms at rs1056836, rs10012, and rs1056837 were not correlated with the incidence of POAG (using any evaluation model). In conclusion, three of the tested SNPs in the CYP1B1 gene were correlated with POAG; however, the SNPs rs180040 and rs1056827 showed an association with risk of POAG. These results must be further validated with larger-scale evaluations.

  10. Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

    Science.gov (United States)

    Tomić, Martina; Kaštelan, Snježana; Metež Soldo, Kata; Salopek-Rabatić, Jasminka

    2013-01-01

    Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; P < 0.001). Mean TBUT decreased from 11.70 ± 1.86 seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P < 0.001). Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface. PMID:23971041

  11. Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Martina Tomić

    2013-01-01

    Full Text Available Purpose. Primary open-angle glaucoma (POAG, a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP, tear break-up time (TBUT, and ocular surface disease index (OSDI were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; P<0.001. Mean TBUT decreased from 11.70±1.86 seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001. Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P<0.001. Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

  12. 高度近视与原发性开角型青光眼%Relationship between high myopia and primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    王平; 姜德咏

    2004-01-01

    目的:从流行病学、临床特征及诊断、遗传学说及机制等方面对高度近视与原发性开角型青光眼的关系及研究进展进行综述.方法:仔细分析了28篇原文,总结出高度近视与原发性开角型青光眼的可能机理.结果:高度近视与原发性开角型青光眼密切相关,其可能的机制有:①升压基因学说.②胶原基因学说.结论:高度近视与原发性开角型青光眼密切相关,根据TIGR基因理论和胶原基因理论,高度近视与原发性开角型青光眼都与TIGR基因突变和胶原疾病有关.%AIM: To review the relationship between high myopia (HM) and primary open angle glaucoma (POAG) from the aspects of epidemiological features, clinic features, diagnosis, as well as genetic and molecular mechanism.METHODS: Twenty-eight original articles related to thisissue were selected. These articles were carefully reviewed to find out the possible mechanism of the relationship between HM and POAG.RESULTS: CONCLUSIONS: HM and POAG are closely related toHM is a genetically-associated disease and isclosely related with POAG. According to the TIGR gene theory and the collagen gene theory, HM and POAG are both associated with the mutations of TIGR and collagenous lesions.each other in that their mechanisms are both related to hypertension gene and collagen gene.

  13. The impact of chronic use of prostaglandin analogues on the biomechanical properties of the cornea in patients with primary open-angle glaucoma

    Science.gov (United States)

    Meda, Roman; Wang, Qianqian; Paoloni, David; Harasymowycz, Paul; Brunette, Isabelle

    2017-01-01

    Aims To determine the influence of prostaglandin analogues (PGAs) on corneal biomechanical properties in patients undergoing chronic treatment for primary open-angle glaucoma (POAG). Methods Prospective, interventional case–control study. 70 eyes from 35 patients with POAG on chronic PGA therapy were recruited. One eye per patient underwent PGA cessation for 6 weeks while the contralateral eye continued to receive the treatment. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOP) (IOPcc), central corneal thickness (CCT) and Goldmann tonometry (Haag-Streit AG, Koeniz, Switzerland) IOP (IOPGAT) were measured at baseline (visit 1), 6 weeks after PGA cessation (visit 2) and 6 weeks after PGAs reinitiation (visit 3) and were analysed using a linear mixed-effect model. The discrepancy between IOPcc and IOPGAT was defined as IOP bias (IOPcc—IOPGAT). Results Baseline characteristics were comparable between the two groups. In the study eyes, significant increases (p<0.0001) were detected at visit 2 in CH (9.0±1.8 vs 10.3±1.7 mm Hg), CRF (10.5±2.1 vs 11.7±2.1 mm Hg), CCT (541.8±43.2 vs 551.9±41.9 μm) and IOPGAT (15.4±3.0 vs 18.4±3.8 mm Hg). IOP bias in this group was significantly lowered at visit 2 (p<0.0001). These effects were reversed at visit 3. The control eyes did not demonstrate any significant changes over the study period. Conclusion Topical PGAs induce reversible reduction in CH, CRF and CCT in patients with POAG. These changes contribute to underestimation of the IOP measured by Goldmann applanation tonometry and warrant caution when assessing response to treatment. Trial registration number NCT02388360, Results. PMID:27162226

  14. Comparative efficacy and safety of the fixed versus unfixed combination of latanoprost and timolol in Chinese patients with open-angle glaucoma or ocular hypertension

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    Sun Nai-Xue

    2011-08-01

    Full Text Available Abstract Background A noninferiority trial was conducted to evaluate the efficacy of a single evening dose of fixed-combination latanoprost 50 μg/mL and timolol 0.5 mg/mL (Xalacom®; LTFC, in Chinese patients with primary open-angle glaucoma (POAG or ocular hypertension (OH who were insufficiently controlled on β-blocker monotherapy or β-blocker-based dual therapy. Methods This 8-week, randomized, open-label, parallel-group, noninferiority study compared once-daily evening dosing of LTFC with the unfixed combination of latanoprost, one drop in the evening, and timolol, one drop in the morning (LTuFC. The primary efficacy endpoint was the mean change from baseline to week 8 in diurnal intraocular pressure (IOP; mean of 8 AM, 10 AM, 2 PM, 4 PM IOPs. LTFC was considered noninferior to LTuFC if the upper limit of the 95% confidence interval (CI of the difference was Results Baseline characteristics were similar for LTFC (N = 125; POAG, 70%; mean IOP, 25.8 mmHg and LTuFC (N = 125; POAG, 69%; mean IOP, 26.0 mmHg. Mean diurnal IOP changes from baseline to week 8 were -8.6 mmHg with LTFC and -8.9 mmHg with LTuFC (between-treatment difference: 0.3 mmHg; 95%-CI, -0.3 to 1.0. Both treatments were well tolerated. Conclusions A single evening dose of LTFC was at least as effective as the unfixed combination of latanoprost in the PM and timolol in the AM in reducing IOP in Chinese subjects with POAG or OH whose IOP was insufficiently reduced with β-blocker monotherapy or β-blocker-based dual therapy. LTFC is an effective and well tolerated once-daily treatment for POAG and OH. Trial registration Clinicaltrials.gov registration: NCT00219596

  15. Altered aquaporin expression in glaucoma eyes.

    Science.gov (United States)

    Tran, Thuy Linh; Bek, Toke; la Cour, Morten; Nielsen, Søren; Prause, Jan Ulrik; Hamann, Steffen; Heegaard, Steffen

    2014-09-01

    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, 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 without glaucoma were used as control. Immunohistochemistry was performed using antibodies against AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9. For each specimen, optical densities of immunoprecipitates were measured using Photoshop and the staining intensities were calculated. Immunostaining showed labelling of AQP7 and AQP9 in the nonpigmented ciliary epithelium and the staining intensities were significantly decreased in glaucoma eyes (p = 0.003; p = 0.018). AQP7 expression in the Müller cell endfeet was increased (p = 0.046), and AQP9 labelling of the retinal ganglion cells (RGC) showed decreased 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 in the Müller cell endfeet. In the ciliary body of glaucoma eyes, the expression of AQP7 and AQP9 was reduced. Therefore, the expression of AQPs seems to play a role in glaucoma.

  16. 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.

  17. What should be done in glaucoma research in China

    Institute of Scientific and Technical Information of China (English)

    GE Jian

    2007-01-01

    @@ Glaucoma research in China has been booming in recent years. The research involves from gene mapping and functional assessment to surgical treatment using phaco alone, trabeculectomy or phacotrabeculectomy in angle closure glaucoma.1,2 The Panel of Glaucoma of the Chinese Ophthalmological Society has established the diagnosis and classification system for glaucoma with reference to the Preferred Practice Pattern (PPP) introduced by the American Academy of Ophthalmology in 2005.

  18. Glaucoma in Costa Rica. Initial approaches

    OpenAIRE

    Chavarría-Soley, Gabriela; Rautenstrauss, Bernd; Azofeifa, Jorge

    2014-01-01

    Glaucoma is the second most frequent cause of irreversible blindness worldwide. Genetic factors havebeen implicated in the development of the disease. So far six loci (GLC1A-GLC1F) and two genes(TIGR/MYOC and OPTN) are involved in the development of juvenile (JOAG) and adult onset or chronic primaryopen angle glaucoma (COAG), while two loci (GLC3A,GLC3B) and one gene (CYP1B1) are known forprimary congenital glaucoma (PCG). Here we summarize the results of the first genetic studies of glaucoma...

  19. 原发性开角型青光眼的基因学研究进展%Advances in molecular genetic study of primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    王德贵

    2013-01-01

    原发性开角型青光眼(POAG)是一组威胁和损害视神经视觉功能,与病理性眼压升高有关的临床眼病,其全球范围内的致盲率仅次于白内障.近几年来,遗传学的研究方法在眼科基础研究中应用较多,主要有家系连锁分析、全基因组关联分析、病例对照相关研究等,通过这些方法已发现多个相关基因.目前已发现报道超过20个染色体位点与POAG相关,较为公认的有MYOC、OPTN、WDR36.然而这3个基因的突变能解释的POAG仅占不到10%.只有一小部分POAG病例遵循孟德尔遗传规律,更多的是由多个基因共同作用所导致.就目前较为明确的POAG相关基因位点,尤其是已确认的MYOC、OPTN、WDR36,以及最新发现的CAVI/CAV24个相关致病基因的定位、结构、功能和突变等方面进行综述,希望能揭示研究相关的一些规律,为POAG进一步的遗传研究提供理论参考.%Primary open angle glaucoma (POAG) is a group of disorders characterized by loss of retinal ganglion cells (RGCs) associated with optic nerve degeneration and visual field damage.With the application of molecular biology in ophthalmology,at least 20 chromosome loci have been identified to be linked to POAG.Only 3 causative genes were identified from these loci,i.e.myocilin (MYOC),optineurin (OPTN) and WD repeat domain 36 (WDR36),which altogether account for less than 10% of POAG.Only a portion of POAG Complies with Mendelian inheritance,and a considerable fraction results from a large number of variants in multiple genes,each contributing less effects.The main technological approaches include family linkage analysis,genome-wide scan,casecontrol association study,etc.Association studies found at least 16 genes to be related to POAG,but reports on glaucoma-causing effects of these genes are conflicting.In this article,we reviewed the POAG related genes,especially the four well known causative genes of MYOC,OPTN,WDR36,and CA V1/CA V2,in terms of

  20. 原发性开角型青光眼致病基因研究进展及研究策略%Research progress and strategies on identification of disease-caused genes in primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    顾明亮

    2012-01-01

    Glaucoma is an optic nerve disease characterized by optic nerve damage and visual impairment.Its characteristics are progressive,irreversible and with genetic heterogeneity.It is the second most common causes,after cataract,of the blindness.Primary open angle glaucoma (POAG) is the most common type.In this review,we will provide a brief overview of glaucoma,including classical genetics research strategies,research progre.ss,and current research strategies,challenges and countermeasures in identification of causative genes by whole-exome sequencing.%青光眼是一种以视神经损伤和相应视功能损害为特征的视神经疾病,具有渐进性、不可逆性和遗传异质性的特点,是位居第二的致盲性疾病,其中原发性开角型青光眼则最为常见.此文对青光眼经典的遗传学研究策略及主要的研究进展进行简要的概述;对采取全外显子组测序(whole-exome sequencing)鉴定致病基因的策略、面临的挑战及采取的对策进行系统的阐述.

  1. 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.

  2. Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

    Science.gov (United States)

    Martinez-de-la-Casa, Jose Maria; Diaz-Valle, David; Morales-Fernandez, Laura; Fernandez-Perez, Cristina; Garcia-Feijoo, Julian

    2016-01-01

    Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was 47.4 ± 18.46 months. Mean baseline IOP was 19.95 ± 3.71 mmHg with medication and 26 ± 3.11 mmHg after washout. Mean end-follow-up IOP was 16.25 ± 1.99 mmHg, representing an IOP decrease of 36.92%, 9.74 ± 3.14 mmHg (P < 0.001), from baseline washout IOP. The mean number of medications was significantly reduced from 1.3 ± 0.66 to 0.75 ± 0.79 (P = 0.017). 45% of patients were medication-free by the end of follow-up. Mean log⁡MAR BCVA improved significantly from 0.42 ± 0.16 to 0.18 ± 0.16 (P < 0.001). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract. PMID:27882243

  3. Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

    Directory of Open Access Journals (Sweden)

    Pedro Arriola-Villalobos

    2016-01-01

    Full Text Available Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT. Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP, topical hypotensive medications required, and best-corrected visual acuity (BCVA. Results. 20 patients were enrolled. Mean follow-up was 47.4±18.46 months. Mean baseline IOP was 19.95±3.71 mmHg with medication and 26±3.11 mmHg after washout. Mean end-follow-up IOP was 16.25±1.99 mmHg, representing an IOP decrease of 36.92%, 9.74±3.14 mmHg (P<0.001, from baseline washout IOP. The mean number of medications was significantly reduced from 1.3±0.66 to 0.75±0.79 (P=0.017. 45% of patients were medication-free by the end of follow-up. Mean log⁡MAR BCVA improved significantly from 0.42±0.16 to 0.18±0.16 (P<0.001. No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT and cataract.

  4. 青少年开角型青光眼临床表型及遗传学特征%Clinical and genetic characteristics of primary juvenile-onset open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    刘铁城

    2014-01-01

    青少年开角型青光眼(juvenile-onset open-angle glaucoma,JOAG)是常染色体显性遗传性疾病,具有发病年龄早、眼压高和进展快等特点.本文回顾了JOAG的临床表型、相关基因及功能,为建立基因型和表型之间的联系,为探讨青光眼的发病机制提供帮助.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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

  8. Fixed combination of latanoprost and timolol vs the individual components for primary open angle glaucoma and ocular hypertension: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yi; Xing; Fa-Gang; Jiang; Teng; Li

    2014-01-01

    AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After searched PubMed, EMBASE, the Cochrane Library and SCI, all randomized controlled clinical trials(RCTs) and cross-over studies were included. The control groups were the monotherapy or the concomitant therapy of latanoprost and timolol. The outcomes were visual field defect, optic atrophy, mean intraocular pressure(IOP) and IOP fluctuation. The analysis was carried out in RevMan version 5.1 software.RESULTS:Thepost-interventionmeanIOPofFCLTwas significantly lower compared to timolol [mean difference(MD)-2.92, 95%CI-3.28 to-2.55, P <0.00001] and latanoprost(MD-1.11, 95%CI-1.51 to-0.72, P <0.00001). The postintervention IOP fluctuation was also significantly lower compared to timolol(MD-0.88, 95%CI-1.23 to-0.53, P <0. 00001) and latanoprost( MD- 0. 63, 95 % CI- 1. 04to-0.22, P =0.002). The mean IOP was higher in FCLT morning dose group than the one in unfixed combination of 0.005% latanoprost and 0.5% timolol(UFCLT)(MD1.10, 95% CI 0.81 to 1.39, P <0.00001). Otherwise, there was no difference between FCLT evening dose group and UFCLT(MD 0.34, 95% CI-0.01 to 0.69, P =0.06).There was no statistical difference for the incidence ofvisual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.visual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect

  9. 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.

  10. Ultrasound biomicroscopy measurement of primary angle-closure glaucoma%原发性闭角型青光眼的超声生物测量研究

    Institute of Scientific and Technical Information of China (English)

    宋金鑫; 孙乃学

    2013-01-01

    目的 应用A型眼科超声和超声生物显微镜(ultrasound biomicroscope,UBM)研究原发性闭角型青光眼(primary angle-closure glaucoma,PACG)不同瞳孔直径下眼前节和后房结构的解剖特征.方法 正常对照组24例(48眼)及PACG组24例(48眼)按照检查时瞳孔直径(d)分为以下3组:d <2.5 mm组,2.5 mm≤d≤4.0 mm组,d>4.0 mm组,进行眼轴测量和UBM检查.眼轴长度采用STORZ-A型眼科超声诊断仪测量,眼前节各项参数采用Zeiss-Humphrey-840型UBM检查.结果 PACG眼较正常眼前房浅,眼轴短,小梁网虹膜夹角变小,房角开放距离缩短,睫状突高度减小,巩膜外侧面与虹膜长轴的夹角、与睫状突夹角减小.PACG眼的角膜厚度较正常眼增厚,分别为(584.208±78.210) μm、(577.583±39.681)μm,但差异无统计学意义(P>0.05).反映瞳孔阻滞的参数虹膜晶状体接触距离差异无统计学意义(P>0.05).PACG眼与具有正常瞳孔直径的眼相比,瞳孔直径越大,小梁网虹膜夹角越小,根部虹膜越厚,虹膜晶状体接触距离越小,而正常眼的根部虹膜厚度、小梁网虹膜夹角、虹膜晶状体接触距离与瞳孔直径无相关性.结论 PACG眼与正常眼解剖结构在任何瞳孔直径下均不同.PACG眼随瞳孔直径增大,眼前节更为拥挤,睫状体旋前增加房角关闭可能.%Objective To study the characteristics in anatomy of PACG at different pupil diameters by standardized A scan and Ultrasound biomicroscope. Methods Normal group had 24 cases(48 eyes)and PACG group had 24 cases(48 eyes) ,and they were respectively divided into three groups according to the pupil diameter (d 4. 0 mm). The axial length was measured by STORZ-A, and the anterior chamber was checked by Zeiss-Humphrey-840 type UMB. Results Central anterior chamber depth, axial length, trabecular-iris angle, angle-opening distance at 500 μm,trabecular ciliary process distance,iris-ciliary process distance and ciliary process thickness were

  11. 预测及筛查原发性闭角型青光眼高危人群的研究进展%Research advances of predicting and screening for the primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    吴若欣; 李金瑛

    2013-01-01

    If the high-risk groups of primary angle closure glaucoma can be screened before acute angle closure attacks or peripheral anterior synechia formation among anatomically narrow angle eyes,and proper prophylactic treatment can be performed in time,subsequent glaucomatous optic neuropathy can be prevented.Each of those methods,such as gonioscopy,ultrasound biomicroscopy,anterior segment optical coherence tomography and Scheimpflug photograph,has advantages and drawbacks.Latest research shows predicting and screening for PACG involved with fairly wide range of biometric measurements,including the parameters on anterior chamber,angle opening degree,iris,lens,volume change of iris,and uveal effusion as well.This article briefly reviews research advances in predicting and screening methods for high risk cases of the primary angle closure glaucoma.%危险窄房角者若能在急性房角关闭及周边虹膜前粘连形成之前筛查出高度可疑前房角关闭者,可早期阻断发病环节,对防止演变成原发性闭角型青光眼(primary angle closure glaucoma,PACG)具有重要意义.PACG的预测及筛查方法中,前房角镜检查、超声生物显微镜、眼前段相干光断层扫描、Scheimpflug照相技术有各自的优缺点.预测及筛查PACG涉及众多的眼球生物学参数测量,最新的研究进展涉及静态参数与动态参数.前者包括前房深度、宽度、体积、面积,房角开放程度参数,虹膜厚度、体积、曲率,晶状体厚度、相对位置、拱高等;后者包括虹膜容积变化测量及葡萄膜渗漏检查等.

  12. The research progress of the iris choroid mechanism in angle-closure glaucoma%虹膜脉络膜在闭角型青光眼中的作用机制研究进展

    Institute of Scientific and Technical Information of China (English)

    张莹; 吴作红

    2016-01-01

    PACG是一种常见的不可逆的致盲性疾病.以往认为其特征性房角关闭的危险因素包括浅前房、短眼轴、厚晶状体等静态解剖因素,还包括虹膜动态变化,脉络膜膨胀等房角动态因素.随着各项眼科影像学技术的发展,人们能更细致地观察到眼球各解剖结构在房角关闭中的作用.其中,虹膜及脉络膜在闭角型青光眼中起到的作用已越来越为人们所重视,借助眼前节OCT(AS-OCT)等各种眼科影像学技术,我们对前房角关闭的机制有了新的认识,可进一步深入阐明虹膜脉络膜与房角关闭之间的联系,为闭角型青光眼早期诊断和个体化治疗做出指导.%Primary angle closure glaucoma (PACG) is a kind of common disease causing irreversible blindness.The traditional risk factors of the characteristic features of angle closure glaucoma include not only some static anatomical factors such as:shallower anterior chamber,shorter axial length and thicker lens,but also some dynamic factors including iris dynamic change,choroidal expansion.With the development of the technology of Ophthalmological iconography,more anatomical structures in the closure angle can be observed more carefully.Among them,the iris and choroid,which play important roles in PACG should be paid more attention.With the new techniques such as AS-OCT (anterior segment optical coherence tomographyanterior segment optical coherence tomography),we can summarize some new comprehension of the mechanism of angle closure,in order to clarify the relation between iris,choroid and angle closure,thus to make better guidance for early diagnosis and personalized treatment of angle closure glaucoma.

  13. Localização e freqüência das alterações de campo visual no glaucoma primário de ângulo aberto na estratégia SITA (Swedish Interactive Threshold Algorithm Location and frequency of visual field defects as measured by SITA (Swedish Interactive Threshold Algorithm strategy in primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Vanessa Cristina Ruegger Nascimento

    2005-10-01

    Full Text Available OBJETIVO: Caracterizar os defeitos de campo visual nos exames realizados com o perímetro Humphrey®, estratégia SITA - Swedish Interactive Threshold Algorithm - segundo sua freqüência e localização em pacientes com glaucoma primário de ângulo aberto (GPAA. MÉTODOS: Realizamos análise retrospectiva de 6.200 prontuários. Avaliamos o exame de campo visual dos pacientes que preenchiam os critérios de inclusão e os dividimos em glaucoma leve, moderado e grave de acordo com a classificação de Hodapp. Definimos os seguintes defeitos glaucomatosos: degrau nasal, escotoma paracentral, escotoma arqueado, escotoma Seidel, defeito temporal em cunha, diminuição generalizada de sensibilidade, escotoma anular e campo tubular. Utilizamos diagrama que correlaciona os pontos do campo visual com as regiões do disco óptico e avaliamos as regiões mais acometidas de acordo com a densidade de pontos comprometidos. A análise estatística foi realizada aplicando-se o teste t de Student. RESULTADOS: Selecionamos 152 pacientes com idade média de 66,5±9,6%, sendo 59,9% do sexo feminino. No glaucoma leve o defeito campimétrico mais freqüente foi o degrau nasal superior, seguido respectivamente pelo escotoma paracentral e degrau nasal inferior. A diminuição generalizada de sensibilidade, apesar de rara, ocorreu em 7,8% desses pacientes. A região superior foi mais acometida que a inferior. CONCLUSÃO: O degrau nasal superior e o escotoma paracentral foram os defeitos mais freqüentemente observados no glaucoma primário de ângulo aberto em fase inicial pela estratégia SITA, e o hemicampo superior foi a região mais acometida. A diminuição generalizada de sensibilidade foi defeito glaucomatoso precoce.PURPOSE: To evaluate the frequency, location and pattern of visual field defects as measured by SITA strategy in primary open angle glaucoma (POAG. METHODS: Six thousand and two-hundred charts were reviewed. One hundred and fifty two patients who

  14. 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

    Science.gov (United States)

    Stevens, Annemie; Iliev, Milko E; de Jong, Leo; Grobeiu, Ioana; Hommer, Anton

    2016-01-01

    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 (Pbimatoprost 0.01% monotherapy from previous monotherapy reduced mean IOP by a further 3.2±3.6 mmHg (17.2%, Pbimatoprost 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 Pbimatoprost 0.01% lowered IOP effectively in treatment-naïve and previously treated ocular hypertension and primary open-angle glaucoma patients, and was associated with good tolerability and patient adherence over 12 weeks. PMID:27103783

  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. An analysis of glaucoma patients seen at the General Hospital Kuala Lumpur over a five year period: 1986 to 1990.

    Science.gov (United States)

    Selvarajah, S

    1998-03-01

    The records of all the glaucoma patients seen at the General Hospital Kuala Lumpur over a five year period were analysed. The racial, age and sex distribution of patients with primary open angle glaucoma and primary angle closure glaucoma was determined. The causes of secondary glaucoma were analysed. As no previous records of glaucoma statistics are available in Malaysia, it is hoped that these findings will form an initial mosaic to build on in the future.

  17. Glaucoma Genetics: Recent Advances and Future Directions.

    Science.gov (United States)

    Aung, Tin; Khor, Chiea Chuen

    2016-01-01

    Once considered primarily a disease of aging caused by unknown environmental influences, the notion that heritable factors could significantly contribute to the pathogenesis of sporadic glaucoma has rapidly gained traction. In part, this is due to the rapid and definitive identification of genes with strong effects on familial, earlier onset forms of glaucoma. Although the endpoint of glaucoma is irreversible optic nerve damage accompanied by blindness, the initial inciting trigger could differ. To this end, well-powered genome-wide association studies have each been conducted for primary open-angle glaucoma, primary angle-closure glaucoma, along with exfoliation syndrome and glaucoma. Each of these studies has revealed sets of significantly associated genetic loci implicating biological pathways that do not overlap between the forms of glaucoma. Although substantial biological insight has been gained from their identification, much further work remains to definitively link the implicated genetic variants with glaucoma causation. It is also hoped that the genetic findings could point us to potential routes of therapy beyond that of intraocular pressure-lowering medications or surgery.

  18. 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. ...

  19. The Study of Relationships between the Damage of Visual Function and Hemorrheology, Ocular Rheography, as well as Other Related Factors in Patients with Primary Open Angle Glaucoma (POAG)

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocular pressure (IOP) is not the only factor to induce visual impairment. POAG patients are shown to have markedly reduced diastolic purfussion pressure in ophthalmic artery, besides prolonged filling time of the retinal artery and vein, diminished erythrocyte deformability and increased platele...

  20. Incident Open-Angle Glaucoma and Blood Pressure%开角型青光眼患病率与血压水平的关系

    Institute of Scientific and Technical Information of China (English)

    M. Cristina Leske,MD ,MPH; Suh- Yuh Wu ,MA; Barbara Nemesure , PhD; Anselm Henais ,MRCP (UK) ,PhD

    2003-01-01

    背景:开角型青光眼(OAG)的发病危险性与相对于眼压的低血压、即与低灌注压(PP)有关.此外,全身高血压可能增加OAG的发病危险性.目的:在一黑人人群中,对作为OAG发病危险因素的高血压和PP(PP=血压-眼压)进行评估,以澄清它们可能存在的相互关系.设计:以人群为基础的队列研究(参加率85%),对西印度群岛巴巴多斯的年龄≥40岁的居民进行单纯随机抽样.参加者:具有发病危险的黑人2 989例,4年以后67人发生OAG(发病率2.2%).主要观察指标:根据逻辑回归分析,计算OAG的校正相对危险度(RR).结果:4年危险度随基线眼压而明显增加.当眼压≤17mm Hg(1kPa=7.5mm Hg)时,发病率为0.7%;当眼压>25mm Hg时,发病率达到18.3%,RR增加25倍.然而,OAG在整个眼压范围内均可发生,并且2/3新发病例的基线眼压<25mm Hg.基线高血压与OAG的RR的半量相关[RR为0.49;95%可信限(CI)为0.29~0.85],RR也趋于随收缩期血压增加而降低(P=0.07).与上述发现相一致,基线灌注压较低使RR增加(收缩期PP<101mm Hg,RR为2.6,95%CI为1.3~4.9;舒张期PP<55mm Hg,RR为3.2,95%CI为1.6~6.6;平均灌注压<42mm Hg,RR为3.1,95%CI为1.6~6.0).结论:随基线眼压升高,OAG的发病危险性大幅度增加.与其相比,基础状态下全身高血压患者的RR却只有其一半,这提示:高血压不增加(而且可能降低)OAG的4年发病危险度.较低的基线PP增加RR大约3倍,这一结果与OAG发病机制的血管假说相一致.

  1. Influence of lifestyle on primary open angle glaucoma patients%生活方式对原发性开角型青光眼患者的影响

    Institute of Scientific and Technical Information of China (English)

    潘英姿; 方圆

    2016-01-01

    原发性开角型青光眼(POAG)患者应遵守医生制定的治疗方案进行治疗,定期复查,并坚持目前普遍认同的健康生活方式如拒绝吸烟、适量运动、多吃水果蔬菜等.根据现有的研究结果,POAG患者应尽量避免可能升高眼压的活动如某些瑜伽动作、长时间吹奏管乐器、过量饮用咖啡等,以最大限度降低青光眼进展的风险,保护视神经.%Primary open angle glaucoma (POAG) patients should comply with medical therapy and follow-up recommendations by doctors provided.Doctors also suggest POAG patients advocating for activities consistent with overall good health such as avoidance of smoking,moderate exercise and a diet high in fruits and vegetables.According to the existing research results,POAG patients should avoid some activities that could elevate intraocular pressure such as certain yoga positions,playing high wind instruments for long periods of time,and drinking large amounts of caffeinated coffee,to reduce the risk of glaucoma progression and protect optic nerve.

  2. 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.

  3. 激光周边虹膜切开术在急性闭角型青光眼的临床应用%Clinical application of laser peripheral iridotomy in acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    林延; 王玮

    2011-01-01

    目的 观察激光周边虹膜切开术在治疗急性闭角型青光眼临床前期及间歇期的效果,探讨其作用机制.方法 49例78只眼闭角型青光眼行激光周边虹膜切开术,采用倍频532 nm激光烧灼、ND:YAG激光击穿周边虹膜,术后观察前房反应、眼压,随访3~12个月.结果 所有眼术后均出现了虹膜炎性反应,1 d后消退;一过性眼压升高3眼(22~30 mmHg),经处理后降至正常;前房出血2眼,1 d后吸收;角膜内皮损伤混浊2眼,3 d后消退.结论 激光周边虹膜切开术并发症少,不影响降压效果,适合于急性闭角型青光眼临床前期及间歇期的治疗.%Objective To observe the therapeutic effects of laser peripheral iridotomy on angle closure glaucoma at early and interim period. Methods Forty-nine patients (78 eyes) with diagnosed angle closure glaucoma were received laser peripheral iridotomy . The laser with frequency of 532 nm and Nd: YAG (neodymium-doped yttrium aluminium garnet) was employed to perform on the middle of iris periphery. The intraocular pressure (IOP) and condition of the anterior chamber were observed after operation. The follow-up went for 3 ~ 12 months. Results Iris inflammation was found in all patients after operation; transient rising of IOP( 22 ~30 mmHg)in 3 eyes; anterior chamber bleeding in 2 eyes and epithelial damage in the cornea in 2 eyes were also observed. All the complications disappeared within 1 ~ 3 days. Conclusion Laser peripheral iridotomy is safe and effective to treat angle closure glaucoma, especially for patients at early and interim stage since it is with few complications and do not have adverse effect on reducing IOP

  4. Combined surgery for acute angle-closure glaucoma surgery%联合手术治疗急性闭角型青光眼合并白内障

    Institute of Scientific and Technical Information of China (English)

    郝黎

    2013-01-01

    Objective To observe the efficacy of the phacoemulsification and intraocular lens implantation with trabeculectomy for acute angle-closure glaucoma with cataract.Methods 38 patients (50eyes) of acute angle-closure glaucoma with cataract had received phacoemulsification and intraocular lens implantation combined with trabeculectomy.The follow-up ranged from 6 to 12 months.Results Visual acuity was increased after operation.The postoperative best corrected visual acuity was ≤ 0.2 in 9 eyes (18.00%),> 0.2 in 41 eyes (82.00%).Postoperative intraocular pressure was controlled in normal range in 48 eyes (96.00%).Postoperative functional filtering bleb was obtained in 48 eyes (96.00%).No severe complication occurred.Conclusion The phacoemulsification and intraocular lens implantation combined with trabeculectomy is valuable for acute angle-closure glaucoma with cataract.%目的 观察联合手术治疗急性闭角型青光眼合并白内障的临床效果.方法 38例(50眼)急性闭角型青光眼合并白内障行超声乳化人工晶状体植人联合小梁切除术,随访6 ~12个月.结果 手术后视力均较术前有不同程度提高.术后最佳矫正视力≤0.2者9眼(18.00%),>0.2者41眼(82.00%).术后眼压控制在正常范围内者48眼(96.00%).术后功能性滤过泡为48眼(96.00%).无严重并发症发生.结论 联合手术治疗急性闭角型青光眼合并白内障是有效的.

  5. 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.

  6. 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

    Directory of Open Access Journals (Sweden)

    Mark A. Babizhayev

    2016-12-01

    Mitochondrial targeting of compounds with universal types of antioxidant activity represents a promising approach for treating a number of ROS-related ocular diseases of the aging eye and can be implicated in the management of cataracts and primary open-angle glaucoma.

  7. Uveitis and glaucoma: new insights in the pathogenesis and treatment.

    Science.gov (United States)

    Sng, Chelvin C A; Ang, Marcus; Barton, Keith

    2015-01-01

    Glaucoma is a potentially blinding complication of uveitis, where intraocular inflammation, secondary corticosteroid response, and varying types and degrees of angle abnormalities contribute to its pathogenesis. Management of uveitic glaucoma remains challenging. Treatment is targeted at reducing the inflammation and lowering the intraocular pressure. Recent studies have highlighted the role of viruses, such as cytomegalovirus, herpes simplex virus, and more recently Ebola virus, in the pathogenesis of uveitic glaucoma. Antiviral therapy may be beneficial in eyes with detectable viral DNA. The success of glaucoma surgery is decreased in eyes with uveitic glaucoma, and surgical interventions are associated with a higher incidence of postoperative complications. Novel glaucoma surgical and laser treatments may improve the predictability of surgery for uveitic glaucoma, but these require further evaluation.

  8. Altered aquaporin expression in glaucoma eyes

    DEFF Research Database (Denmark)

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

    2014-01-01

    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......, 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...... of AQP7 and AQP9 in the nonpigmented ciliary epithelium and the staining intensities were significantly decreased in glaucoma eyes (p = 0.003; p = 0.018). AQP7 expression in the Müller cell endfeet was increased (p = 0.046), and AQP9 labelling of the retinal ganglion cells (RGC) showed decreased...

  9. Research progress on related genes for primary open angle glaucoma%原发性开角型青光眼的相关基因研究进展

    Institute of Scientific and Technical Information of China (English)

    艾力江·艾尔肯; 具尔提·哈第尔

    2014-01-01

    原发性开角型青光眼( POAG )是以视野缺损和视神经损害为特征的致盲性眼病。最近几年越来越多学者的研究结果表明基因的变异及遗传在原发性开角型青光眼的发生发展中起非常重要的作用。现在已知的原发性开角型青光眼致病基因有20余种,现在就目前较为确定的原发性开角型青光眼的相关基因,尤其是已确认的MYOC、OPTN、WDR36及CAV1/CAV2基因的定位、结构及相关研究等方面进行综述,为在原发性开角型青光眼的遗传基因研究方面提供一点参考。%Primary open angle glaucoma ( POAG ) is the main cause of blindness with visual field damage and optic nerve degeneration.In recent years, a lot of researches have been done, showing that genetic factors and gene mutation play an important role in POAG.There are more than 20 related POAG genes. Now we will review the related genes of POAG, especially the well known causative genes of MYOC, OPTN, WDR36, and CAV1/CAV2, in terms of their locations, structures, research progress, et al, and provide a reference for genetic research in primary open-angle glaucoma.

  10. Unusual Presentation of Phacolytic Glaucoma: Simulating Microbial Keratitis

    Directory of Open Access Journals (Sweden)

    Srikant Kumar Sahu

    2011-01-01

    Full Text Available The differential diagnoses for phacolytic glaucoma are acute angle closure glaucoma, open angle glaucoma with uveitis, neovascular glaucoma, and glaucoma secondary to trauma. We report an unusual case where the dislocated cataractous lens firmly adherent to the corneal endothelium evoked a cellular reaction similar to phacolytic glaucoma but clinically appeared like a deep corneal abscess. The 73-year-old lady presented with severe photophobia, pain, and redness in the left eye for two months despite being on antibiotics and antifungals. Anterior chamber wash revealed a cataractous lens buried within the infiltrate, which was removed and sent for histopathological examination. Postoperatively she was treated with topical ofloxacin, homatropine, dorzolamide, timolol, and tapering dose of steroids. Histological confirmation of inflammation, histiocytic response, and giant cells around the lens material confirmed the ongoing phacolytic process. Photophobia, pain, and redness subsided following removal of the lens and surrounding cellular reaction. At her last visit, four months after surgery, she was comfortable.

  11. Late-stage, primary open-angle glaucoma in Europe: social and health care maintenance costs and quality of life of patients from 4 countries

    DEFF Research Database (Denmark)

    Thygesen, J.; Aagren, M.; Arnavielle, S.

    2008-01-01

    OBJECTIVE: The purpose of this study was to estimate costs and quality of life (QoL) of late-stage glaucoma patients in 4 European countries. METHODS: Retrospective review of medical charts of patients with POAG who were followed in a low-vision or vision rehabilitation center in one of 4 countries...... for at least 1 year was used to determine patient characteristics, health status, and health care resource use. Visual impairment was measured by best-corrected visual acuity (Snellen score). Patients were also interviewed over the telephone in order to assess their health-related QoL (using EuroQol EQ-5D......) and use of resources including: the number of visits to rehabilitation centers, visits to hospital and non-hospital specialists, the use of low-vision devices, medication, tests, and the use of hired home help. The costs associated with resource use were calculated from the perspective of a third...

  12. Relation between Glaucoma and Sensorineural Hearing Loss

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    A Mollasadeghi

    2008-01-01

    Full Text Available Introduction: Glaucoma is one of the leading causes of blindness throughout the world. Some studies have suggested a relationship between glaucoma and sensorineural hearing loss, while others have found no evidence of an association. We performed a study to determine whether there is a significant difference in hearing of patients with glaucoma and a match control population. Methods: In this cross-sectional study, from February, 2005 till April, 2006, 44 patients with glaucoma were studied. The age range was between 15 to 60 years. After taking a complete medical history, those suffering from presbycusis, history of exposure to ototoxic drugs and substances and history of ear surgery were excluded from the study. All of the patients were cases of open-angle glaucoma, and were surveyed separately for normal-pressure glaucoma. Then complete audiometric tests (PTA, SDS, SRT, Impedance were conducted for all of them, and the results compared with a control group. Results: There was no statistically significant difference between the case group and control group in PTA, SDS, and SRT, except for Normal Tension Glaucoma (NTG. There wasn't any statistically significant difference between two groups with respect to age, gender, and history of diseases. In the NTG group, significant difference was seen only in high frequencies. Conclusion: As mentioned, there was a statistically significant difference between NTG group and control group. It is therefore recommended to conduct complete audiometric tests and histopathologic examinations in this group for early detection of hearing loss and application of rehabilitative measures.

  13. Complex genetic mechanisms in glaucoma: An overview

    Directory of Open Access Journals (Sweden)

    Rao Kollu

    2011-12-01

    Full Text Available Glaucomas comprise a group of hereditary optic neuropathies characterized by progressive and irreversible visual field loss and damage to the optic nerve head. It is a complex disease with multiple molecular mechanisms underlying its pathogenesis. Genetic heterogeneity is the hallmark of all glaucomas and multiple chromosomal loci have been linked to the disease, but only a few genes have been characterized, viz. myocilin (MYOC, optineurin (OPTN, WDR36 and neurotrophin-4 (NTF4 in primary open angle glaucoma (POAG and CYP1B1 and LTBP2 in congenital and developmental glaucomas. Case-control-based association studies on candidate genes involved in different stages of glaucoma pathophysiology have indicated a very limited involvement. The complex mechanisms leading to glaucoma pathogenesis indicate that it could be attributed to multiple genes with varying magnitudes of effect. In this review, we provide an appraisal of the various efforts in unraveling the molecular mystery in glaucoma and also some future directions based on the available scientific knowledge and technological developments.

  14. Complex genetic mechanisms in glaucoma: an overview.

    Science.gov (United States)

    Rao, Kollu N; Nagireddy, Srujana; Chakrabarti, Subhabrata

    2011-01-01

    Glaucomas comprise a group of hereditary optic neuropathies characterized by progressive and irreversible visual field loss and damage to the optic nerve head. It is a complex disease with multiple molecular mechanisms underlying its pathogenesis. Genetic heterogeneity is the hallmark of all glaucomas and multiple chromosomal loci have been linked to the disease, but only a few genes have been characterized, viz. myocilin (MYOC), optineurin (OPTN), WDR36 and neurotrophin-4 (NTF4) in primary open angle glaucoma (POAG) and CYP1B1 and LTBP2 in congenital and developmental glaucomas. Case-control-based association studies on candidate genes involved in different stages of glaucoma pathophysiology have indicated a very limited involvement. The complex mechanisms leading to glaucoma pathogenesis indicate that it could be attributed to multiple genes with varying magnitudes of effect. In this review, we provide an appraisal of the various efforts in unraveling the molecular mystery in glaucoma and also some future directions based on the available scientific knowledge and technological developments.

  15. 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.

  16. Epidemiology of primary angle-closure glaucoma in a rural population in Shaanxi Province of China%中国陕西省农村原发性闭角型青光眼流行病学调查

    Institute of Scientific and Technical Information of China (English)

    白芝兰; 任百超; 杨建刚; 何媛; 陈莉; 孙乃学

    2005-01-01

    目的:调查陕西省农村≥40岁人群原发性闭角型青光眼的患病率及影响因素.方法:2003-07/12,采用按比例随机整群抽样的方法在陕南、陕北及关中3个地区农村调查8 500人,其中≥40岁人群3 500人,所有受检人员均进行标准问卷调查,包括询问青光眼确诊史、家族史、发作史及手术史,并进行了相关的眼科检查,包括视力、外眼、Van Herick周边前房深度评估、眼底检查.≥50岁人群及怀疑有高眼压者对其应用压平式眼压计测量眼压.对可疑青光眼者进行进一步检查,包括复查眼压、前房角镜检查、暗室试验、视野检查.结果:8 500人中有6 815人完成了青光眼的相关检查,总受检率为80.18%,其中≥40岁人群3 500人中有2 835人完成了青光眼的相关检查,受检率为81.00%.Van Herick周边前房深度分级:2级、1级和0级分别占10.4%、3.0%和0.2%.≥40岁人群原发性闭角型青光眼患者有31例,其患病率为1.09%,通过多因素logistic回归分析显示随着年龄的增长患病率显著增加(P=0.008).虽然女性较男性多见(0R:1.77,95%CI为O.77~4.10),文盲较非文盲多见(OR:1.71,95%CI为0.76~3.87),但其差异无统计学意义(P不同性别=0.180,P不同文化程度=0.199).事前未被诊断为青光眼的患者占67.74%(21例),在另外1 0例有确诊史的青光眼患者中只有6例(60%)曾作过虹膜根切术.48.39%(15例)原发性闭角型青光眼患者存在不同程度的视力损伤,其中盲目占29.03%.70.97%(22例)为慢性闭角型青光眼.结论:陕西省农村≥40岁人群的窄房角比例高于亚洲其他国家人群.原发性闭角型青光眼的患病率与国内其他报道相近,且随着年龄的增长而增加.大部分患者无青光眼确诊史.%· AIM: To assess the prevalence and related risk factors for primary angle-closure glaucoma in a rural population for 40 years of age or older in Shaanxi Province.· METHODS: By using a stratified, cluster

  17. 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.

  18. Management of exfoliative glaucoma: challenges and solutions.

    Science.gov (United States)

    Holló, Gábor; Katsanos, Andreas; Konstas, Anastasios Gp

    2015-01-01

    Exfoliative glaucoma is the most common type of secondary open-angle glaucoma worldwide. It is characterized by high intraocular pressure (IOP) and worse 24-hour IOP characteristics. In order to minimize progression, treatment of exfoliative glaucoma has to provide a low long-term mean IOP and good 24-hour IOP control. To achieve these goals, fixed-dose combination eye drops, argon and selective laser trabeculoplasty, and various forms of surgery (trabeculectomy, deep sclerectomy, viscocanalostomy, ab interno trabeculotomy, trabecular aspiration, and cataract surgery) all need to be considered during the long-term management of the disease. Since exfoliative glaucoma is a disease of the elderly, and is frequently associated with systemic vascular disease, interdisciplinary consultations are of great clinical importance. These management aspects and the current medical, laser, and surgical results are covered in this review, with a special focus on the needs of the general ophthalmologist.

  19. Glaucoma Treatments and Drugs

    Science.gov (United States)

    ... Navigation Previous Secondary Glaucoma Share this: Facebook Twitter Google Plus Email Print this page Don't miss ... and Glaucoma: What You Should Know Driving a car is for some synonymous with independence and is ...

  20. 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 ...

  1. African Americans and Glaucoma

    Science.gov (United States)

    ... Us Donate In This Section African Americans and Glaucoma email Send this article to a friend by ... and eventually, in developing more effective treatments. Does glaucoma treatment differ? Although treatment varies for all individuals, ...

  2. 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 ...

  3. Screening for Glaucoma

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Glaucoma The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Glaucoma . This final recommendation statement ...

  4. Bimatoprost/timolol fixed combination versus latanoprost in treatment-naïve glaucoma patients at high risk of progression: a pilot study

    Directory of Open Access Journals (Sweden)

    Gutierrez-Diaz E

    2014-04-01

    Full Text Available Esperanza Gutierrez-Diaz,1 Jose Silva Cotta,2 Francisco J Muñoz-Negrete,3 Consuelo Gutierrez-Ortiz,4 Robert J Morgan-Warren,5 John Maltman5 On behalf of the GIFT study group1Department of Ophthalmology, Hospital Doce de Octubre, Universidad Complutense, Madrid, Spain; 2Department of Ophthalmology, Hospital de São João, Porto, Portugal; 3Department of Ophthalmology, Hospital Ramón y Cajal, IRYCIS, Universidad Alcalá, Madrid, Spain; 4Department of Ophthalmology, Hospital Universitario Príncipe de Asturias, Madrid, Spain; 5Medical Affairs, Allergan Holdings Ltd, Marlow, UKObjective: To compare a fixed combination of 0.03% bimatoprost and 0.5% timolol (BTFC with latanoprost monotherapy (LM in treatment-naïve patients with open-angle glaucoma (OAG and risk factors for glaucomatous progression.Methods: Patients were enrolled at 15 sites in Spain and Portugal, and were randomized 1:1 to BTFC or LM. Patients instilled one drop of medication once per day at 8 pm for 12 weeks. The primary outcome was change in intraocular pressure (IOP at 12 weeks.Results: Of 81 patients enrolled, 43 were randomized to BTFC and 38 to LM. Mean (SD change in IOP from baseline to 12 weeks was significantly greater for BTFC than for LM: -13.5 mmHg (4.48 versus -11.4 mmHg (3.19, respectively (P=0.003. Similarly, at 12 weeks, significantly more BTFC patients than LM patients had IOP reductions of ≥40% (74.4% versus 47.4%, P=0.015 or ≥50% (46.5% versus 15.8%, P=0.003. Adverse events were more frequent with BTFC than with LM (33 versus 13 events, but most were mild in severity. The only serious adverse event (colon cancer was adjudged unrelated to the study medication.Conclusion: BTFC was effective and well tolerated in treatment-naïve patients with OAG at high risk of progression.Keywords: open-angle, fixed combinations

  5. 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.

  6. Analysis of the Expression and Polymorphism of APOE, HSP, BDNF, and GRIN2B Genes Associated with the Neurodegeneration Process in the Pathogenesis of Primary Open Angle Glaucoma

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    Alicja Nowak

    2015-01-01

    Full Text Available Glaucoma is characterized by optic neuropathy of the RGC or retinal nerve fiber. The aim of this study was to evaluate a relationship between the neurodegenerative genes’ polymorphisms of the APOE (rs449647, BDNF (rs2030324, GRIN2B (rs3764028, and HSP70-1 (rs1043618 and the occurrence risk of POAG and to investigate its effect on allele-specific gene expression. Genomic DNA was extracted from peripheral blood. Analysis of the genes’ polymorphisms was performed using PCR-RFLP. The level of mRNA expression was determined by QRT-PCR. We showed a statistically significant association of BDNF and APOE genes’ polymorphisms with a risk of POAG occurrence. There was a statistically significant association of the rs2030324 polymorphism with progression of POAG based on cup disc ratio value and rs1043618 polymorphism based on nerve fiber index and rim area. Furthermore, we found that mean HSP70-1 mRNA expression was significantly lower in the case of individuals with the G/G genotype than in the case of minor allele carriers, that is, G/C and C/C. We also found that BDNF and HSP70-1 expression level are associated with the progression of POAG based on rim area value. In conclusion, our results suggest that BDNF, APOE, and HSP70-1 genes might be associated with a risk of POAG occurrence in the Polish population.

  7. Analysis of the expression and polymorphism of APOE, HSP, BDNF, and GRIN2B genes associated with the neurodegeneration process in the pathogenesis of primary open angle glaucoma.

    Science.gov (United States)

    Nowak, Alicja; Majsterek, Ireneusz; Przybyłowska-Sygut, Karolina; Pytel, Dariusz; Szymanek, Katarzyna; Szaflik, Jerzy; Szaflik, Jacek P

    2015-01-01

    Glaucoma is characterized by optic neuropathy of the RGC or retinal nerve fiber. The aim of this study was to evaluate a relationship between the neurodegenerative genes' polymorphisms of the APOE (rs449647), BDNF (rs2030324), GRIN2B (rs3764028), and HSP70-1 (rs1043618) and the occurrence risk of POAG and to investigate its effect on allele-specific gene expression. Genomic DNA was extracted from peripheral blood. Analysis of the genes' polymorphisms was performed using PCR-RFLP. The level of mRNA expression was determined by QRT-PCR. We showed a statistically significant association of BDNF and APOE genes' polymorphisms with a risk of POAG occurrence. There was a statistically significant association of the rs2030324 polymorphism with progression of POAG based on cup disc ratio value and rs1043618 polymorphism based on nerve fiber index and rim area. Furthermore, we found that mean HSP70-1 mRNA expression was significantly lower in the case of individuals with the G/G genotype than in the case of minor allele carriers, that is, G/C and C/C. We also found that BDNF and HSP70-1 expression level are associated with the progression of POAG based on rim area value. In conclusion, our results suggest that BDNF, APOE, and HSP70-1 genes might be associated with a risk of POAG occurrence in the Polish population.

  8. 原发性闭角型青光眼易感基因位点统计模型预测分析研究%Statistical model analysis of primary angle closure glaucoma associated genes and SNP

    Institute of Scientific and Technical Information of China (English)

    桑景荭; 张业武; 王宁利

    2015-01-01

    目的 评价相关易感基因位点检测对PACG患者的诊断效力.方法 实验研究.通过统计反演算和统计模拟的演算,对已知4个相关易感单核苷酸多态性(SNP)位点rs11024102(PLEKHA7)、rs3753841 (COL11A1)、rs1015213(PCMTD1-ST18)及rs1401999(ABCC5)检测的敏感性、特异性和阳性预测值进行评价.结果 在对单一SNP位点的统计模拟中,rs11024102(PLEKHA7)对PACG患者诊断的敏感性为55.88%,特异性为51.31%;rs3753841(COL11A1)诊断的敏感性为54.47%,特异性为51.00%;rs1015213(PCNTD1-ST18)诊断的敏感性为59.93%,特异性为45.32%;rs1401999(ABCC5)诊断的敏感性为52.97%,特异性为50.00%.4个SNP位点的阳性预测值曲线均贴近无效参考值.4个位点的联合作用在提高敏感度场景的统计模拟中,获得的ROC曲线下面积为0.51.在提高特异度的场景中,ROC曲线下面积为0.52.4个位点自由组合的统计模拟结果发现单一SNP位点和多个SNP位点组合的诊断效力均较差.结论 4个已知相关易感基因位点检测对PACG诊断效力差,尚不能作为单独的诊断试验用于临床筛查.%Objective To evaluate GWAS significant associated SNP for primary angle closure glaucoma.Methods Experimental study.Taking advantage of different statistical models,the usefulness was evaluated by sensitivity,specificity and the area under the receiver-operating characteristic curve (ROC),which indicates the accuracy of genetic profiling in discriminating between primary angle closure glaucoma patients and normal controls.Results rs11024102 (PLEKHA7)had a sensitivity of 55.88% with a specificity of 51.31% ; the sensitivity and specificity of rs3753841 (COL1 1 A1) was 54.47% and 51.00% respectively.The sensitivity of rs1015213 (PCNTD1-ST18) and rs1401999 (ABCC5) were 59.93% and 52.97%.The specificity of these two SNP were 45.32% and 50.00%.The positive predictive value curves of these four SNP were nearly reference line.The area

  9. 体位改变对开角型青光眼小梁切除术后眼压波动的影响%Effect of postural change on intraocular pressure fluctuation in open angle glaucoma patients after trabeculectomy

    Institute of Scientific and Technical Information of China (English)

    李伟

    2015-01-01

    To study the effect of postural change on intraocular pressure ( lOP ) fluctuation in open angle glaucoma patients after trabeculectomy, and to discuss the value of this investigation on prognosis.METHODS:Fifty-one cases (62 eyes) of primary open angle glaucoma were selected as the research object. Perkins ophthalmotonometer was used to test lOP at the time when patient seat ( first seat ) . The patients were asked to lie supine for 25min, detected lOP, and the patients seated again (final seat), sustaining for 15min, detected lOP. According to whether the lOP range was more than 5mmHg, they were divided into high volatility fluctuation group and low volatility fluctuation group. We recorded their visual field progression ( with AGlS score) , HPA staging, in order to evaluate the correlation of lOP range with them. Reviews were made 3mo a time, and lasted for 1a, in order to evaluate the relation between lOP range and AGlS scores.RESULTS: The lOP of first seat was 18. 1+2. 2mmHg. There was no significant difference in the same position (P>0. 05 ). The lOP range was 4. 1 ± 1. 5mmHg. Low volatility fluctuation group was more likely to have low AGlS score and to be early vision HPA ( P0.05),眼压极差4.1±1.5mmHg;低波动组AGIS视野稳定者及HPA早期者显著多于高波动组( P<0.001;P<0.05),眼压极差与 AGIS 显著正相关( r=0.412,P<0.001);随时间延长,视野进展人数上升,眼压极差上升,且任意时刻两者间均呈显著正相关(P<0.01)。结论:小梁切除术后患者体位改变下眼压波动与视野进展程度有关,可通过检测眼压波动简单预测患者预后,从而调整眼压控制方案。

  10. 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

  11. 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

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    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

  12. INTRAOCULAR PRESSURE ASYMMETRY: AN INDICATOR FOR GLAUCOMA DIAGNOSIS

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    Rekha R.

    2016-05-01

    Full Text Available AIM To investigate the amount of intraocular pressure asymmetry between fellow eyes in patients with and without primary open angle glaucoma. MATERIALS AND METHODS This was a retrospective case control study conducted at a tertiary care hospital of Central India. A single pre-treatment IOP of the primary open angle glaucoma patients was recorded from the Glaucoma Clinic data from Jan 2013 to Dec 2013. The inter-eye IOP asymmetry of these cases was compared with normal subjects without primary open angle glaucoma (POAG. RESULTS There were 84 (POAG glaucoma patients and 168 control subjects in the study. It was observed that 23.8% patients suffering from glaucoma had an asymmetry of 2 mmHg while 20.23% had no asymmetry. Asymmetry as high as >20 mmHg was also seen in glaucomatous patients. Intraocular pressure asymmetry was a significant factor for having glaucoma (Odds ratio, 18.89%; P<0.001. CONCLUSION Inter-eye asymmetry of IOP is a common finding in patients with POAG. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma.

  13. SCREENING FOR GLAUCOMA IN RURAL POPULATION: A HOSPITAL BASED STUDY

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    Rhutuja A

    2015-12-01

    Full Text Available AIM To estimate the prevalence of blindness due to glaucoma in patients aged 40 years and above attending Tertiary Care Hospital. MATERIAL AND METHODS The study was conducted in the Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences, Sevagram. Visual acuity, anterior segment examination and anterior chamber depth assessment by slit lamp, digital tension, non-contact tonometry, confrontation field test, fundus examination, direct ophthalmoscopy and fundus imaging was done. Gonioscopy and automated perimetry was done in glaucoma suspects. RESULTS 7600 eyes of 3800 patients were examined, 108 eyes were diagnosed to have glaucoma. Based on the best corrected visual acuity, 15(13.8% eyes and 8(0.22% persons had visual impairment and 33(30.5% eyes and 20(31.7% persons were blind. The prevalence of glaucoma in eyes was 1.42%. The prevalence of blindness due to glaucoma in eyes was 0.43% and person was 0.52%. The prevalence of Primary Open Angle Glaucoma in eyes was 1%, Primary Angle Closure Glaucoma in eyes was 0.15%, Neovascular glaucoma in eyes was 0.07%, Lens Induced Glaucoma in eyes was 0.17% and Pseudoexfoliative Glaucoma in eyes was 0.03%. IOP>20mmHg was present in 50(36.1% glaucomatous eyes, majority of the eyes being in Open Angle Glaucoma 24(31.5% eyes; 58(53.7% glaucomatous eyes had IOP in the range 11-20mmHg, among them 38 eyes were on treatment and 20 eyes were operated. CONCLUSION Being an irreversible disease if diagnosed early, blindness can be avoided. So screening is very important for early diagnosis and their proper management thereon.

  14. EX-PRESS Glaucoma Filtration Device: efficacy, safety, and predictability.

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    Chan, Jessica E; Netland, Peter A

    2015-01-01

    Trabeculectomy has been the traditional primary surgical therapy for open-angle glaucoma. While trabeculectomy is effective in lowering intraocular pressure, complications associated with the procedure have motivated the development of alternative techniques and devices, including the EX-PRESS Glaucoma Filtration Device. This review describes the efficacy, safety, complication rates, and potential advantages and disadvantages of the EX-PRESS Glaucoma Filtration Device. EX-PRESS implantation is technically simpler compared with that of trabeculectomy, with fewer surgical steps. Vision recovery has been more rapid after EX-PRESS implantation compared with trabeculectomy. Intraocular pressure variation is lower during the early postoperative period, indicating a more predictable procedure. While efficacy of the EX-PRESS implant has been comparable to trabeculectomy, postoperative complications appear less common after EX-PRESS implantation compared with trabeculectomy. The EX-PRESS Glaucoma Filtration Device appears to be safe and effective in the surgical management of open-angle glaucoma.

  15. 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

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    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

  16. 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.

  17. Neovascular glaucoma treatment with extraction of anterior chamber fibrovascular tissue.

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    Nadal, Jeroni; Carreras, Elisa; Kudsieh, Bachar; Canut, Maribel

    2013-08-01

    The use of antibody to vascular endothelial growth factor to treat neovascular glaucoma yields good anatomic results in most cases. However, this type of glaucoma can cause angle closure with decompensation of intraocular pressure secondary to fibrovascular tissue contraction in the anterior chamber. Our surgical technique treats the cause by removing the anterior chamber fibrous complex after administration of antibody to vascular endothelial growth factor, thus restoring the chamber angle.

  18. Efficacy of complex treatment of glaucoma optical neuropathy by Cortexin

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    Shcherbinina I.V.

    2010-12-01

    Full Text Available The comparative analysis of efficacy of intranasal and intramuscular application of cortexin in combination with transcranial magnetotherapy in patients with primary open-angle glaucoma was conducted. 102 patients (182 eyes took part in research with primary open-angle glaucoma of I, II, III stages. The most considerable improvement of visual functions resulted from intramuscular and endonasal introductions of cortexin in combination with transcranial magnetotherapy; and longer stabilization of functional indicators was marked in this group

  19. Schlemm管切开加黏弹剂扩张术治疗开角型青光眼的临床研究现状%Recent advances in viscocanalostomy for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    宗媛; 袁志兰

    2013-01-01

    Viscocanalostomy is used as the surgical intervention for open angle glaucoma.It has advantage of creating gradual filtration through the thin trabeculo-descemet membrane to reduce markedly the postoperative complications.Lately,many surgeons modified VCO,like combined it with phacoemulsification,or use the implant.Many to lower IOP to a greater degree and enhance success rates.This article reviewed the history of VCO,specially on the point of the surgical methods,effect,development,progress and tendency of VCO.%Schlemm管切开加黏弹剂扩张术(VCO)是一种治疗开角型青光眼的手术.它通过手术后遗留下的小梁网-后弹力层窗实现缓慢滤过,从而避免了眼压骤降,大大减少了术后的并发症.近来,许多术者对VCO手术不断地改进,如联合超声乳化白内障吸除术,术中使用植入物等.这些方法增强了VCO术降眼压的力度,使得术后成功率明显提高.本文对VCO手术的历史进行了回顾,着重阐述了VCO手术的方式、效果、创新发展及未来趋势.

  20. 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

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    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.

  1. PREVALENCE OF GLAUCOMA IN PATIENTS UNDERGOING CATARACT SURGERY IN RURAL SET UP IN SOUTHERN INDIA

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    Bharathi

    2015-05-01

    Full Text Available PURPOSE: To determine the prevalence and types of glaucoma in rural patients posted for cataract surgery under eye camps at a tertiary care hospital . BACKGROUND: Glaucoma is the second leading cause of blindness in the adult pop ulation in India. The global prevalence of glaucoma for population aged 40 to 80 years is estimated to be 3.54% and the projected number of people with glaucoma worldwide will increase to 111.8 million in 2040. This creates a need for early diagnosis and p rompt management of glaucomas especially in the underprivileged rural areas that lack awareness and facilities. METHODOLOGY: A cross - sectional study was conducted at a regional ophthalmic center for all the patients posted for cataract surgery under eye ca mps. Study was carried out for duration of one year and included 1400 patients. The patients underwent detailed workup to detect the presence of glaucomas and were treated accordingly if the disease was detected. RESULTS: The overall prevalence of glaucoma in our study population was 2.14%. Amongst them, 0.78% had primary open angle glaucoma, 0.14% had primary angle closure glaucoma and 1.21% of them had pseudoexfoliative glaucoma. The prevalence of glaucomas increased with increasing age. CONCLUSION: With increasing life expectancy the number of glaucoma patients is constantly growing large in our country. Early case detection rate is of utmost importance to reduce the disease burden in the rural population where awareness in terms of routine eye screening is very low

  2. Glaucoma associated with the management of rhegmatogenous retinal detachment

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    Mangouritsas G

    2013-04-01

    Full Text Available George Mangouritsas, Spyridon Mourtzoukos, Dimitra M Portaliou, Vassilios I Georgopoulos, Anastasia Dimopoulou, Elias Feretis Eye Clinic, General Hospital "Hellenic Red Cross", Athens, Greece Abstract: Transient or permanent elevation of intraocular pressure (IOP is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. An exacerbation of preexisting open-angle glaucoma or a steroid-induced elevation of IOP should also be considered. Scleral buckling may be complicated by congestion and anterior rotation of the ciliary body resulting in secondary angle closure, which can usually resolve with medical therapy. The use of intravitreal gases may also induce secondary angle-closure with or without pupillary block. Aspiration of a quantity of the intraocular gas may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified silicone oil in the anterior chamber and obstruction of the aqueous outflow pathway. In most eyes medical therapy is successful in controlling IOP; however, silicone oil removal with or without concurrent glaucoma surgery may also be required. Diode laser transscleral cyclophotocoagulation and glaucoma drainage devices constitute useful treatment modalities for long-term IOP control. Cooperation between vitreoretinal and glaucoma specialists is necessary to achieve successful management. Keywords: retinal detachment, intraocular pressure elevation, glaucoma, vitrectomy, intravitreal gas, silicone oil

  3. Using genetic mouse models to gain insight into glaucoma: Past results and future possibilities.

    Science.gov (United States)

    Fernandes, Kimberly A; Harder, Jeffrey M; Williams, Pete A; Rausch, Rebecca L; Kiernan, Amy E; Nair, K Saidas; Anderson, Michael G; John, Simon W M; Howell, Gareth R; Libby, Richard T

    2015-12-01

    While all forms of glaucoma are characterized by a specific pattern of retinal ganglion cell death, they are clinically divided into several distinct subclasses, including normal tension glaucoma, primary open angle glaucoma, congenital glaucoma, and secondary glaucoma. For each type of glaucoma there are likely numerous molecular pathways that control susceptibility to the disease. Given this complexity, a single animal model will never precisely model all aspects of all the different types of human glaucoma. Therefore, multiple animal models have been utilized to study glaucoma but more are needed. Because of the powerful genetic tools available to use in the laboratory mouse, it has proven to be a highly useful mammalian system for studying the pathophysiology of human disease. The similarity between human and mouse eyes coupled with the ability to use a combination of advanced cell biological and genetic tools in mice have led to a large increase in the number of studies using mice to model specific glaucoma phenotypes. Over the last decade, numerous new mouse models and genetic tools have emerged, providing important insight into the cell biology and genetics of glaucoma. In this review, we describe available mouse genetic models that can be used to study glaucoma-relevant disease/pathobiology. Furthermore, we discuss how these models have been used to gain insights into ocular hypertension (a major risk factor for glaucoma) and glaucomatous retinal ganglion cell death. Finally, the potential for developing new mouse models and using advanced genetic tools and resources for studying glaucoma are discussed.

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

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

    2016-01-01

    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

  5. ASSOCIATION BETWEEN GLAUCOMA AND BLOOD GROUPS

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    F. Ghannadi R. Varmazyar

    2006-09-01

    Full Text Available There are reports from different countries that some types of glaucoma are associated with blood groups. This cross-sectional study was performed on 400 glaucomatous patients [100 patients in each group of Primary open angle glaucoma (POAG, chronic angle closure glaucoma (CACG, pseudoexfoliative glaucoma (PEXG and primary congenital glaucoma (PCG] and 400 blood donors as control group to assess the association between blood groups and glaucoma. All patients underwent ABO and Rh blood group testing. The prevalence of blood group A was 30% in the control group, 27% in POAG, 33% in CACA, 38% in PEXG and 36% in PCG. The prevalence of blood group B was 24% in the control group, 19% in POAG, 20% in CACG, 15% in PEXG and 34% in PCG (P < 0.025. The prevalence of blood group AB was 8% in the control group, 9% in POAG, 5% in CACG, 12% in PEXG, and 8% in PCG. The prevalence of blood group O was 38% in the control group, 45% in POAC, 42% in CACG, 35% in PEXG and 22% in PCG (P < 0.001. The prevalence of Rh+ was 88% in the control group, 84% in POAG, 87% in CACG, 86% in PEXG and 87% in PCG. Compared to control group, blood group B was more prevalent and blood group O was less prevalent in PCG. There was no association between other types of blood groups (ABO and Rh and PCG. There was no association between blood groups (ABO and Rh and other types of glaucoma.

  6. Effect of fundus image devices for early diagnosis of primary open angle glaucoma%眼底图像分析系统在原发性开角型青光眼早期诊断中的作用

    Institute of Scientific and Technical Information of China (English)

    潘英姿

    2009-01-01

    眼底图像分析技术的迅速发展使视神经损害的直接定量检测成为可能,同时因其检测手段客观、结果可靠而日益受到重视.但由于临床医师对眼底图像分析技术如海德堡视网膜断层扫描、相干光断层扫描等在青光眼早期诊断中的意义仍存在认识上的分歧,因此有必要就此问题进行论述.有多数研究结果表明,现有的检测设备不仅在分辨率和重复性方面已经达到临床要求,而且能够较好地区分正常人和青光眼的眼底改变,但现阶段利用视神经结构定量指标来实现对青光眼的早期诊断,其敏感性和特异性尚不尽如人意.其原因是多方面的,如结构指标个体差异较大,缺乏完善的正常人数据库,缺乏达成共识的敏感而特异的诊断指标等.尽管如此,现有的研究趋势表明,利用图像分析技术测量青光眼性视神经损害已显示出令人鼓舞的临床应用前景,临床医师若能充分了解各种图像分析手段的优缺点,这些新的检测技术将成为早期诊断原发性开角型青光眼的有益补充手段.%Evaluation of the optic disc and retinal nerve fiber layer measurements (RNFL) with sterephotography is the current "gold standard" for the diagnosis of early primary open angle glaucoma (POAG), but it is still subjective and is dependent too much upon an experienced observer.Substantial variability exists in the interpretation of optic disc change over time.There are consistent evidences that image analysis devices such as optical coherence tomography (OCT) and Heidelberg retina tomograph (HRT-Ⅱ) can detect early to moderate glaucoma as well as expert assessment of stereoscopic optic disc and RNFL photographs.Optic disc and RNFL defect can be quantitatively measured by these devices.But the sensitivity and specificity of the measurements obtained with these devices are not good enough for the early diagnosis of POAG at this time due to several reasons, such as

  7. Update on normal tension glaucoma

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    Jyotiranjan Mallick

    2016-01-01

    Full Text Available Normal tension glaucoma (NTG is labelled when typical glaucomatous disc changes, visual field defects and open anterior chamber angles are associated with intraocular pressure (IOP constantly below 21 mmHg. Chronic low vascular perfusion, Raynaud's phenomenon, migraine, nocturnal systemic hypotension and over-treated systemic hypertension are the main causes of normal tension glaucoma. Goldmann applanation tonometry, gonioscopy, slit lamp biomicroscopy, optical coherence tomography and visual field analysis are the main tools of investigation for the diagnosis of NTG. Management follows the same principles of treatment for other chronic glaucomas: To reduce IOP by a substantial amount, sufficient to prevent disabling visual loss. Treatment is generally aimed to lower IOP by 30% from pre-existing levels to 12-14 mmHg. Betaxolol, brimonidine, prostaglandin analogues, trabeculectomy (in refractory cases, systemic calcium channel blockers (such as nifedipine and 24-hour monitoring of blood pressure are considered in the management of NTG. The present review summarises risk factors, causes, pathogenesis, diagnosis and management of NTG.

  8. Maladaptive coping strategies and glaucoma progression.

    Science.gov (United States)

    Freeman, Ellen E; Lesk, Mark R; Harasymowycz, Paul; Desjardins, Daniel; Flores, Veronica; Kamga, Hortence; Li, Gisèle

    2016-08-01

    The identification of modifiable risk factors for glaucoma progression is needed. Our objective was to determine whether maladaptive coping styles are associated with recent glaucoma progression or worse visual field mean deviation.A hospital-based case-control study was conducted in the Glaucoma Service of Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients with primary open angle glaucoma or normal tension glaucoma with ≥4 years of follow-up and ≥5 Humphrey visual fields were included. Cases had recent visual field progression as defined according to the Early Manifest Glaucoma Trial pattern change probability maps. Controls had stable visual fields. The Brief Cope questionnaire, a 28-item questionnaire about 14 different ways of coping with the stress of a chronic disease, was asked. Questions were also asked about demographic and medical factors, and the medical chart was examined. Outcomes included glaucoma progression (yes, no) and visual field mean deviation. Logistic and linear regressions were used.A total of 180 patients were included (82 progressors and 98 nonprogressors). Although none of the 14 coping scales were associated with glaucoma progression (P > 0.05), higher denial was correlated with worse visual field mean deviation (r = -0.173, P = 0.024). In a linear regression model including age, sex, education, depression, intraocular pressure, and family history of glaucoma, greater levels of denial (β = -1.37, 95% confidence interval [CI] -2.32, -0.41), Haitian ethnicity (β = -7.78, 95% CI -12.52, -3.04), and the number of glaucoma medications (β = -1.20, 95% CI -2.00, -0.38) were statistically significantly associated with visual field mean deviation.The maladaptive coping mechanism of denial was a risk factor for worse visual field mean deviation. Further prospective research will be required to verify the pathways by which denial may exert an effect on glaucomatous visual field loss.

  9. Genetic association of SNPs near ATOH7, CARD10, CDKN2B, CDC7 and SIX1/SIX6 with the endophenotypes of primary open angle glaucoma in Indian population.

    Directory of Open Access Journals (Sweden)

    Ferdinamarie Sharmila Philomenadin

    Full Text Available Primary open angle glaucoma (POAG belonging to a group of optic neuropathies, result from interaction between genetic and environmental factors. Study of associations with quantitative traits (QTs is one of the successful strategies to understand the complex genetics of POAG. The current study attempts to explore the association of variations near/in genes like ATOH7, SIX1/SIX6 complex, CDKN2B, CARD10, and CDC7 with POAG and its QTs including vertical cup to disc ratio (VCDR, central corneal thickness (CCT, intra ocular pressure (IOP, and axial length (AL. Case-control study design was carried out in a sample size of 97 POAG cases and 371 controls from South India. Model-based (additive, recessive, dominant association of the genotypes and their interaction was carried out between cases and controls using chi-square, linear and logistic regression methods. Nominal significance (P<0.05 was observed for QTs like i VCDR with SNPs rs1900004 (ATOH7; rs1192415 (CDC7; rs10483727 (SIX1/SIX6, rs9607469 (CARD10; ii CCT with rs1192415; iii IOP with rs1900004 and iv AL with rs1900004 and rs1063192 (CDKN2B. We were able to replicate previously known interactions between ATOH7-SIX6 and SIX6-CDKN2B along with few novel interactions between ATOH7-CDC7 and SIX6 with genes including CARD10 and CDC7. In summary, our results suggest that a probable interaction among the candidate genes for QTs, play a major role in determining the individual's susceptibility to POAG.

  10. A novel mutation in the myocilin gene identified in a Chinese primary open angle glaucoma family%原发性开角型青光眼家系一新的myocilin基因突变

    Institute of Scientific and Technical Information of China (English)

    田强; 李海云; 李富华; 赵堪兴; 王立; 单晓艳; 庞玉英; 李祎馨; 吴梅筠; 邱枫

    2007-01-01

    目的 探讨一个中国人原发性开角型青光眼(primary open angle glaucoma,POAG)家系的myocilin基因缺陷.方法 对一个5代POAG大家系进行全面的临床检查后,用聚合酶链反应扩增家系成员myocilin基因的所有外显子以及相邻部分内含子,对其产物直接测序.结果 家系的遗传方式符合常染色体显性遗传.确诊年龄在26~59岁之间.在所有青光眼患者,可疑者以及4例尚未出现明显青光眼体征的家系成员发现携带myocilin基因T455K突变.无该突变的家系成员中无POAG患者及可疑者.突变位于myocilin蛋白C-末端非常保守的氨基酸残基.结论 T455K突变是中国人所特有的新的致病性myocilin基因突变.突变的临床表型为混合发病年龄型POAG且具有很高的外显率.这个新基因突变的发现证实中国人的致病性myocilin基因突变类型与其他种族不同.

  11. 原发性开角型青光眼患者Myocilin基因的单核苷酸多态性%Single nucleotide polymorphisms of the myocilin gene in primary open-angle glaucoma patients

    Institute of Scientific and Technical Information of China (English)

    范宝剑; 梁旭辉; 彭智培; Larry Baum; 谭霭仙; 汪宁; 林顺潮

    2004-01-01

    目的探讨Myocilin(MYOC)基因的单核苷酸多态性(single nucleotide polymorphisms, SNPs) 及其与原发性开角型青光眼(primary open-angle glaucoma, POAG)发病的关系.方法应用高通量构象敏感性凝胶电泳和荧光标记自动测序法筛选和鉴定香港157例POAG散发患者和155名对照MYOC基因的SNPs.结果在MYOC基因所有3个外显子及邻近的非编码区共检出17种SNPs:1-83G→A、G12R、P16L、A17S、R46X、R76K、R91X、T123T、D208E、L215P、730+35A→G、A260A、I288I、E300K、T353I、Y471C和1515+73G→C.其中,R91X、E300K和Y471C仅在POAG患者中检测到.此外,1515+73G→C各基因型在POAG患者与对照人群中的分布差异具有显著意义,POAG患者中CG型频率为0.6%,低于对照组的4.5%(P=0.036).其余16种SNPs各基因型在两组人群中的分布差异均无显著意义.结论 MYOC基因多态性可能与中国人POAG发病有关,提示MYOC基因是POAG的相关基因.

  12. Clinical characteristics and current treatment of glaucoma.

    Science.gov (United States)

    Cohen, Laura P; Pasquale, Louis R

    2014-06-02

    Glaucoma is a neurodegenerative disorder in which degenerating retinal ganglion cells (RGC) produce significant visual disability. Clinically, glaucoma refers to an array of conditions associated with variably elevated intraocular pressure (IOP) that contributes to RGC loss via mechanical stress, vascular abnormalities, and other mechanisms, such as immune phenomena. The clinical diagnosis of glaucoma requires assessment of the ocular anterior segment with slit lamp biomicroscopy, which allows the clinician to recognize signs of conditions that can produce elevated IOP. After measurement of IOP, a specialized prismatic lens called a gonioscope is used to determine whether the angle is physically open or closed. The structural manifestation of RGC loss is optic nerve head atrophy and excavation of the neuroretinal rim tissue. Treatment is guided by addressing secondary causes for elevated IOP (such as inflammation, infection, and ischemia) whenever possible. Subsequently, a variety of medical, laser, and surgical options are used to achieve a target IOP.

  13. 原发性开角型青光眼家系的MYOC基因突变研究%Analysis on the gene mutations of MYOC in primary open angle glaucoma pedigree

    Institute of Scientific and Technical Information of China (English)

    谢小兵; 周新; 田艳丽; 曲喜英; 匡多秀; 朱惠斌; 喻京生; 宁兴旺

    2009-01-01

    目的 对来自重庆地区的1个原发性开角型青光眼(POAG)家系进行MYOC基因突变筛查,研究POAG与MYOC基因突变的相关性,探讨MYOC基因突变在中国人POAG发病中的作用.方法 1个4代共39例的青光眼家系,8例为已确诊患者,健康对照者100名.用单链构象多态性分析(SSCP)、PCR.限制性片段长度多态性(RFLP)和基因测序的方法筛选MYOC基因的突变(包括G34C、C136T、G144T、G227A、C624G、G736A、C1009G、A1036G、C1081T、G1099A、G1138A、A1139C、T1430A、C1441A和C1442T等),同时对检测到的突变结果进行生物信息学分析.结果 在该家系中,发现1个G227A(Arg76Lys)突变,该突变存在2例已确诊的POAG患者和1例家系表型正常者中,健康对照者中未榆出.发现1个缺失突变(C1009del),该突变存在于家系中所有发病患者和1例4岁的子代亲属,健康对照者中未检出.未发现其他突变.由于C1009del突变是首次发现,据此我们申请了GenBank号,已发表的GenBank序列号为FJ237047,对应的蛋白序列号为ACI62293.结论 G227A(Arg76Lys)突变为已报道的多态性位点,与该家系青光眼的发病无相关性.移码突变C1009del突变与青光眼的发病密切相关,也可由此推测青光眼患者亲属的发病率较正常人高.%Objective To screen the mutations of MYOC gene in a Chinese primary open angle glaucoma (POAG) family from Cbengqing and investigate the relationship between the mutations in MYOC/TIGR gene and POAG.Methods In a large 4-generation glaucoma family, myocilin gene (MYOC) was screened in 39 family members, 8 of which were confirmed patients. Normal controls included 100 normal Chinese subjects.The known mutations of MYOC gene ( including G34C, C136T, G144T, G227A, C624G,G736A, C1009G, A1036G, C1081T, G1099A, G1138A, A1139C, T1430A, C1441A and C1442T) were detected by single strand conformation polymorphism(SSCP) , po]ymerase chain reaction restriction fragment length polymorphism (PCR

  14. 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

  15. 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

  16. Genetic Epidemiology of Glaucoma

    NARCIS (Netherlands)

    L.M.E. van Koolwijk (Leonieke)

    2011-01-01

    textabstractGlaucoma is a heterogeneous group of optic neuropathies that have in common an accelerated degeneration of retinal ganglion cells and their axons, a subsequent typical excavation of the optic disc and a concomitant pattern of irreversible visual field loss. Glaucoma affects approximately

  17. Painless Treatment for Glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈宏

    1995-01-01

    People with glaucoma may soon have a safe, painless alternative to surgery,say researchers at the Weizmann Institute of Science in Rehovot, Israel. The researchers are using an enzyme to treat the condition. In patients with glaucoma,the duct that normally drains excess fluid from inside the eyeball is blocked,and pressure within the eye slowly increas-

  18. 眼前节相干光断层扫描在原发性闭角型青光眼诊治中的应用%Anterior segment optical coherence tomography for the evaluation of primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    刘杏; 李媚

    2013-01-01

    眼前节相干光断层扫描(AS-OCT)是继超声生物显微镜(UBM)后又一种眼前段成像检测手段,其为无创性、非接触性,分辨率较UBM高.可测量包括角膜、前房、前房角、虹膜、晶状体等多个眼前段结构参数.本文评价了AS-OCT在原发性闭角型青光眼(PACG)诊治中利用AS-OCT了解PACG和正常人眼前段生物学参数的差异,了解周边虹膜切开(或切除)术后、小梁切除术后、白内障手术后PACG的眼前段结构性参数的变化,以及对小梁切除术后滤过泡功能进行评估等,强调AS-OCT在PACG的诊断、发病机制、治疗观察中具有重要的临床应用价值.%Anterior segment optical coherence tomography (AS-OCT) is an imaging instrument developped after ultrasound biomi-croscopy (UBM). Moreover, AS-OCT is a non-invasive and non-contact instrument with a higher resolution than UBM. AS-OCT offers anterior segment images of the cornea, anterior chamber, anterior chamber angle, iris and lens. In this article, the value of AS-OCT is e-valuated in the diagnosis and treatment of primary angle closure glaucoma (PACG), including the application of AS-OCT in observing the differences between PACG and normal controls, the changes in anterior segment configuration after peripheral iridectomy/trabeculec-tomy/ cataract surgery in PACG, and the morphology of filtering blebs after trabeculectomy. The present study showed that AS-OCT would play an important role in the diagnosis, treatment choice and pathogenesis study of PACG.

  19. Glaucoma Genes and Mechanisms.

    Science.gov (United States)

    Wiggs, Janey L

    2015-01-01

    Genetic studies have yielded important genes contributing to both early-onset and adult-onset forms of glaucoma. The proteins encoded by the current collection of glaucoma genes participate in a broad range of cellular processes and biological systems. Approximately half the glaucoma-related genes function in the extracellular matrix, however proteins involved in cytokine signaling, lipid metabolism, membrane biology, regulation of cell division, autophagy, and ocular development also contribute to the disease pathogenesis. While the function of these proteins in health and disease are not completely understood, recent studies are providing insight into underlying disease mechanisms, a critical step toward the development of gene-based therapies. In this review, genes known to cause early-onset glaucoma or contribute to adult-onset glaucoma are organized according to the cell processes or biological systems that are impacted by the function of the disease-related protein product.

  20. Glaucoma progression associated with Leber's hereditary optic neuropathy.

    Science.gov (United States)

    Nucci, Carlo; Martucci, Alessio; Mancino, Raffaele; Cerulli, Luciano

    2013-02-01

    The purpose of this article is to describe a case of open-angle glaucoma progression associated with Leber's hereditary optic neuropathy. Single case analysis method is used. A 53-year-old woman with a previous diagnosis of glaucoma presented with progressive visual field loss. Complete ophthalmological examination and blood tests were negative for other concomitant diseases. Genetic counseling revealed mitochondrial DNA mutation compatible with the diagnosis of Leber's hereditary optic neuropathy. In conclusion, the case describes the concomitant occurrence of open-angle glaucoma and Leber's optic neuropathy. We hypothesize that the two diseases may have a cumulative effect on oxidative stress and retinal ganglion cell death with the consequent rapid progression of visual impairment. Screening for mitochondrial DNA mutations may be requested in patients with glaucoma who, despite pharmacologically controlled intraocular pressure, show rapid progression of the disease.

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

    Directory of Open Access Journals (Sweden)

    Cheng CS

    2016-07-01

    Full Text Available Clarissa Shu Ming Cheng,1,2 Yi Fang Lee,2 Charles Ong,3 Zhu Li Yap,2 Andrew Tsai,2 Aditi Mohla,2 Monisha E Nongpiur,4 Tin Aung,2,4 Shamira A Perera2,4 1Department of Ophthalmology, Tan Tock Seng Hospital, 2Department of Ophthalmology, Singapore National Eye Centre, 3Yong Loo Lin School of Medicine, National University of Singapore, 4Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 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

  2. Comparison of macular choroidal thickness between primary open angle glaucoma and normal subjects%原发性开角型青光眼患者与正常人黄斑区脉络膜厚度的比较

    Institute of Scientific and Technical Information of China (English)

    张苗苗; 王建荣; 刘伟

    2015-01-01

    目的:研究原发性开角型青光眼(POAG)患者黄斑区脉络膜厚度与正常人之间的差异。方法应用增强深部成像的相干光断层扫描(EDI-OCT)仪测量60例(60只眼)POAG 患者(POAG 组)和60例(60只眼)正常人(对照组)黄斑区脉络膜厚度。组内相关系数(ICC)表示检测者内和检测者间信度分析。结果检测者内的 ICC 值为0.994~0.999(P <0.001),检测者间的 ICC 值为0.995~0.998(P <0.001)。黄斑区脉络膜厚度特征为黄斑中心凹下方最厚,鼻侧最薄。POAG 组黄斑区各象限脉络膜厚度均明显厚于对照组(t =3.114~4.456,P <0.05)。POAG 组和对照组黄斑区象限脉络膜厚度均随年龄增加及眼轴增长而变薄(r =-0.456~-0.520,-0.445~-0.491;P <0.05)。结论POAG 患者的黄斑区脉络膜厚度比正常人厚;POAG 患者黄斑区脉络膜增厚与青光眼的发病机制相关。%Objective To compare the macular choroidal thickness between primary open angle glaucoma (POAG)and normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT).Methods Scans were per-formed by EDI-OCT in eyes of 60 POAG patients and 60 age-and sex-matched normal subjects.The reliability analysis of intra-and inter-observer was tested using intraclass correlation coefficient (ICC).Results The intra-and inter-ob-server ICC values ranged from 0.994 to 0.999 and 0.995 to 0.998 respectively (both P <0.001).In the COPD pa-tients and controls,the choroidal thickness beneath the fovea was thickest and the nasal choroidal thickness was thin-nest.Each quadrant of choroidal thickness in POAG patients were thicker than that of the controls (t =3.114 to 4.456, P <0.05).For both subjects investigated,the choroidal thickness showed a negative correlation with age and axial length (r =-0.456 to -0.520,-0.445 to -0.491;P <0.05).Conclusion The choroidal thickness of POAG pa

  3. Application of "one to one" nursing intervention in the treatment of patients with acute angle closure glaucoma%“一对一”护理干预在急性闭角型青光眼患者治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    金福子

    2015-01-01

    Glaucoma is a common clinical disease,which seriously affects the patient's vision,it will cause blindness with the sustainable development of the illness,it has a serious impact on the health and life of patients.Effective nursing intervention plays a key role in the treatment of glaucoma,this article briefly describes the application of "one to one" nursing intervention in the treatment of patients with acute angle closure glaucoma,to provide discuss for clinic.%目的:青光眼是一种临床常见疾病,严重影响患者的视力,病情持续发展则会致盲,给患者的健康和生活产生严重的影响。有效的护理干预在青光眼的治疗中起着关键的作用,本文简要介绍“一对一”护理干预在急性闭角型青光眼患者治疗中的应用,为临床提供探讨。

  4. 超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼的临床疗效%Clinical efficacy of phacoemulsification combined with intraocular lens implantation for angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    李辉

    2014-01-01

    目的:探讨超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼的临床疗效。方法回顾性分析闭角性青光眼38例(43眼)的临床资料,所有患者采用超声乳化白内障吸除术联合后房型折叠式人工晶状体植入术治疗。分析患者临床疗效。结果术后患者眼压显著下降,前房深度显著提高(P<0.01)。与术前比较,术后患者矫正视力得到显著提高(P<0.01)。结论超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼能够显著降低眼压,改善患者视力,值得临床推广。%Objective To discuss clinical efficacy of phacoemulsification combined with intraocular lens implantation for angle-closure glaucoma. Methods Selected 38 cases(43 eyes) with angle-closure glaucoma were retrospectively analyzed. All cases were treated by phacoemulsification combined with intraocular lens implantation. Clinical efficacy was analyzed. Results Intraocular pressure after operation was decreased apparently compared with that of before operation(P<0.01). Corrected visual acuity after operation was increased apparently compared with that of before operation(P<0.01). Conclusion Phacoemulsification combined with intraocular lens implantation for angle-closure glaucoma can decrease intraocular pressure and increase corrected visual acuity, worthy of clinical application.

  5. 小梁切除术联合丝裂霉素应用治疗16例急性闭角型青光眼疗效分析%The Effcacy Analysis of 16 Cases of Acute Angle-closure Glaucoma in Trabeculectomy With Mitomycin Application Therapy

    Institute of Scientific and Technical Information of China (English)

    王海菊

    2016-01-01

    Objective To analyse the treatment of acute angle-closure glaucoma trabeculectomy combined mitomycin the curative effect. Methods According to the principle of random, in our hospital from February 2015 to February 2016, 31 cases of acute angle closure glaucoma patients were divided into two groups, 15 patients in control group only with trabeculectomy, 16 cases of the observation group were treated by trabeculectomy combined with mitomycin treatment.Results Observation group effect of surgery and postoperative intraocular pressure to improve the effect was better than the control group, comparing the two groups was statistically significant difference (P<0.05).ConclusionTrabeculectomy combined mitomycin method applied in treatment of acute angle-closure glaucoma, had a higher success rate of surgery.%目的:分析小梁切除术联合丝裂霉素治疗急性闭角型青光眼的疗效。方法按照随机原则,将我院2015年2月~2016年2月收治的31例急性闭角型青光眼患者分为两组,15例对照组患者单独采用小梁切除术,16例观察组患者采用小梁切除术联合丝裂霉素进行治疗。结果观察组的手术效果及术后眼压改善效果均优于对照组,两组比较差异有统计学意义(P<0.05)。结论使用小梁切除术联合丝裂霉素的方法应用治疗急性闭角型青光眼,手术成功率较高。

  6. 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.

  7. CYP1B1基因突变与原发性开角型青光眼发病关系的研究进展%Study progress in the relationship of CYP1B1 gene mutation with primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    黄一鸿

    2014-01-01

    原发性青光眼包括原发性开角型青光眼(POAG)、原发性闭角型青光眼(PACG)及原发性婴幼儿青光眼(PCG).目前认为原发性青光眼的发病是遗传因素、环境因素、生活习惯等多种因素综合作用的结果,其中遗传因素,尤其是基因突变,在青光眼的发病过程中起着重要作用.自1997年发现CYP1B1基因为PCG的致病基因以来,关于CYP1B1基因突变与青光眼发病关系的研究成为青光眼遗传和基因研究的热点.随着研究的逐渐深入,许多学者认为CYP1B1基因也是POAG致病基因的候选基因.本研究对近十余年来对CYP1 B1基因的结构和功能以及CYP1B1基因突变与POAG发病及进展关系的研究进展进行总结.%Primary glaucoma is a group of blinding eye diseases,including of primary open angle glaucoma (POAG),primary angle-closure glaucoma (PACG) and primary congenital glaucoma (PCG).It is thought that the pathogenesis of primary glaucoma is a comprehensive action of genetic factor,environment factor and life style,and the genetic factor plays an important role.CYP1B1 gene was firstly identified as a causal gene for PCG in 1997.After that,thousands of reports on the pathogenesis of POAG focused on CYP1B1 gene mutation.With the developing of research,researches found that CYP1B1 gene to be one of the candidate genes of POAG.The structure and function of CYP1B1 gene,the relationship between CYP1B1 and POAG were reviewed.

  8. 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

  9. Anatomy parameters in attack eye of primary acute angle-closure glaucoma patients compared to that of contralateral eye%急性闭角型青光眼发作眼与对侧眼解剖参数的比较

    Institute of Scientific and Technical Information of China (English)

    王华; 梁远波; 唐炘; 范肃洁; 孙霞; 王涛; 孙兰萍; 王宁利

    2011-01-01

    Objective To campare the central corneal thickness (CCT) between the attack eye and contralateral eye in primary acute angle-closure glaucoma(AACG) patients. Methods About 75 primary acute angle-closure glaucoma patients was observed. We measured the CCT of the both eyes in primary acute angle-closure glaucoma by A scan. Also the ACD, thickness of lens and axis were measured when the IOP was reduced. And paired t test was used to compare the difference. Results The mean CCT of the attacked eye of AACG is (576.97 ±50.93) μm while the mean CCT of the contralateral eye is (544.68 ±33.53)(μm. There is significance in CCT between the attacked eye and the contralateral eye(P 0.05). Conclusions CCT was increased in acute angle-closure glaucoma after the attack compared to the contralateral eye which should be considered during the treatment of the AACG patients.%目的 对照研究急性闭角型青光眼发作眼和对侧眼的角膜中央厚度和前房深度,晶状体厚度和眼轴长度.方法 共观察了急性闭角型青光眼75例.眼压控制后每个患者双眼接受A超检查,检查项目包括角膜中央厚度、前房深度、晶状体厚度和眼轴长度.统计分析采用配对t检验.结果 急性闭角型青光眼发作眼的平均角膜中央厚度是(576.97±50.93)μm,对侧眼的平均角膜中央厚度为(544.68±33.53)μm(P0.05).结论 与对侧眼相比,急性闭角型青光眼的角膜中央厚度较厚,可能是发作后遗留的损害.其它眼解剖参数无统计学差异,因此对侧眼也应进行预防治疗.

  10. 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 ...

  11. 视网膜静脉阻塞患者中原发性开角型青光眼发病比例的研究%Percentage of primary open angle glaucoma in retinal vein occlusion patients

    Institute of Scientific and Technical Information of China (English)

    许珂; 吴玲玲; 马志中; 刘瑜玲; 钱芳

    2016-01-01

    背景 有研究表明,高加索人视网膜静脉阻塞(RVO)与原发性开角型青光眼(POAG)的产生存在关联,但目前鲜见关于亚洲人群RVO患者中POAG发病比例的报道. 目的 观察以医院人群为基础的RVO患者中POAG的发病比例.方法 采用横断面观察性研究设计,连续纳入2011年10月至2013年5月在北京大学第三医院眼科确诊且病程在1年以内的RVO患者375例,患者均接受房角镜检查,POAG的诊断参照国际地域性和流行病学眼科学学会的青光眼诊断标准.根据眼底彩色照片和FFA将RVO分为视网膜中央静脉阻塞(CRVO)型、半侧视网膜静脉阻塞(HRVO)型和视网膜分支静脉阻塞(BRVO)型;按照静脉阻塞的部位分为动静脉交叉RVO(AV-RVO)型、视盘RVO(OC-RVO)型、无视盘水肿的视神经RVO(NONHS-RVO)型及有视盘水肿的视神经RVO(ONHS-RVO)型.分别统计不同RVO类型患者中POAG的发病比例.结果 共317例患者纳入青光眼筛查并完成各检查项目,应答率为84.5%.POAG在RVO患者中的发病比例为8.2%,其中在CRVO型中的比例为7.1%,在HRVO型中为23.5%,在BRVO型中为6.2%.OC-RVO型患者和NONHS-RVO型患者中POAG的发病比例分别为27.9%和13.2%,明显高于AV-RVO和ONHS-RVO中的4.7%和1.3%,差异均有统计学意义(均P<0.05). 结论 中国RVO患者中POAG的发病比例是正常人群的3~4倍;OC-RVO型和NONHS-RVO型患者中POAG的发病比例较高,提示RVO的发病可能与POAG的视盘结构改变密切相关.%Background Researches determined that the pathogenesis of retinal vein occlusion (RVO) is associated with primary open angle glaucoma (POAG) in Caucasian population.However,the relationship between RVO and POAG in Asian population is unclear.Objective This study was to survey the percentage of POAG in RVO patients in China.Methods A prospective cross-sectional observational study based on hospital was performed.Three hundred and seventy five patients with newly

  12. 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.

  13. The clinical effect of Ex-Press glaucoma drainage device implantation combined with phacoemulsification for primary acute angle-closure glaucoma with cataract and persistent ocular hypertension%持续高眼压下白内障青光眼联合手术中青光眼引流器的应用

    Institute of Scientific and Technical Information of China (English)

    刘杰

    2015-01-01

    目的 探讨Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者的临床效果和安全性.方法 回顾性分析26例(30只眼)行Ex-Press青光眼引流器植入联合超声乳化手术治疗的合并白内障的急性闭角型青光眼持续性高眼压患者术前及术后各时间段的视力、眼压及并发症发生情况.结果 所有患者均随访至1年,完全成功率为76.67%(23只眼),部分成功率23.33%(7只眼),总成功率100.00%.术前平均眼压为(32.19±9.12) mmHg(1 mmHg=0.133kPa).术后1周,1、2、3、6及12个月的平均眼压分别为(10.30±5.07) mmHg、(10.28±4.93) mmHg、(10.87±4.22) mmHg、(11.32±6.11) mmHg、(12.12 ±6.07)mmHg、(13.05±5.26)mmHg,手术后眼压均较术前低,差异有统计学意义(P<0.05).术后1周视力较术前提高,差异有统计学意义(Z=-4.19,P=0.000).30只眼中2只眼出现少量前房积血,分别于术后4~7d吸收;4只眼出现一过性低眼压,8~10 d后眼压>6 mmHg;1只眼出现渗出性脉络膜脱离,于术后14 d复位.所有患者均未出现其他并发症.结论 Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术是治疗合并白内障的急性闭角型青光眼持续性高眼压的一种安全而有效的方法.%Objective To investigate the clinical effects and safety of Ex-Press glaucoma drainage device implantation combined with phacoemulsification (E-P P) for primary acute angle-closure glaucoma (PAACG) with cataract and persistent ocular hypertension.Methods The data of 30 eyes of 26 patients of PAACG with cataract and persistent ocular hypertension were retrospectively analyzed, who received E-P P surgery.The visual acuity,intraocular pressure (IOP) and complications were observed.Results All patients were followed up for 1 year.The complete success rate was 76.67% (23 eyes), the partial success rate was 23.33% (7 eyes), and the total success rate was 100

  14. 原发性开角型青光眼房水外流通路改变的研究进展%The progress of aqueous humor outflow pathway in open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    安琳; 季健

    2011-01-01

    原发性开角型青光眼(POAG)是一种以视神经轴索及相关视网膜神经节细胞丢失为特征的视神经病变.眼压升高是POAG最重要的危险因素.大多数POAG患者眼压升高主要是房水外流阻力异常增高所致.小梁网是产生房水排出阻力的主要部位.目前多数研究者认为POAG患者小梁网功能不良与致炎因子表达、细胞老化、氧化应激损伤及细胞质成分减少等因素有关.小梁网细胞本身及细胞外基质的变化均可以引起房水外流阻力的改变,进而导致眼内压的升高.为了进一步开展对POAG发病机制的研究,有必要就目前有关POAG患者房水外流通路改变的研究进展予以综述,旨在为POAG的深入研究提供参考依据.%Primary open angle glaucoma (POAG) is defined as an optic neuropathy characterized by loss of optic nerve axons and retinal ganglion cells.Increase of intraocular pressure (IOP) is a major risk factor for POAG,which is partially due to an abnormally high aqueous humor outflow resistance in trabecular meshwork ( TM ).Trabecular outflow pathway is a key element in drainage of aqueous humor.Malfunction of TM in POAG is associated with over expression of inflammatory markers,cellular senescence,oxidative stress,and decrease of cellularity.The biological changes of TM cell and extracellular matrix compromise trabecular pathway drainage resulting in an increased IOP.This article reviewed the progression in research on aqueous humor outflow pathway emphasizing the alteration of trabecular pathway.

  15. 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.

  16. Surgical outcomes of mitomycin C combined with adjustable suture trabeculectomy for primary angle-closure glaucoma%丝裂霉素C联合可拆除缝线在小梁切除术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    杨红艳

    2016-01-01

    目的:观察丝裂霉素 C 联合可拆除缝线在青光眼小梁切除术中的效果。方法对30例(35眼)青光眼患者进行丝裂霉素联合可拆除缝线的小梁切除术,术后随诊观察视力、眼压和滤过泡状况。结果手术后第1周眼压为(12.49±1.68) mmHg,第1个月眼压为(14.28±2.22)mmHg,第1年眼压为(17.29±2.87)mmHg 与手术前眼压相比较差异有统计学意义(P <0.05);术后1年功能型滤过泡35眼(82.86%)。结论丝裂霉素 C 联合可拆除缝线在小梁切除术中能有效降低眼压,减少术后并发症,提高手术成功率。%Objective To investigate the safety and efficacy of mitomycin C combined with adjustable suture trabeculectomyin treating primary angle-closure glaucoma.Methods This study included 30 patients(35 eyes)who underwent adjustable suture trabeculectomy combined with mitomycin C.Visual acuity,intraocular pressure and filtering blebs were measured.Results Mean postoperative intraoc-ular pressures were (12.49 ±1.68)mmHg at 1 week,(14.28 ±2.22)mmHg at 1 month and (17.29 ±2.87)mmHg at 1 year,re-spectively.There was significant difference between preoperation and postoperation(P <0.05).The rate of effective filtering bleb was 82.86% at 1 year.Conclusions Mitomycin C combined with adjustable suture trabeculectomy is a safe and effective surgical proce-dure to decrease intraocular pressure,reduce postoperative complications and raise success rate of the surgery.

  17. GWAS for susceptibility genes of primary open-angle glaucoma%原发性开角型青光眼易感基因研究中 GWAS 的应用

    Institute of Scientific and Technical Information of China (English)

    唐冰花; 曹文俊

    2016-01-01

    Primary open-angle glaucoma(PoaG)is a kind of complex diseases caused by interaction between multiple genes and environmental factors,and genetic factors play important roles in PoaG development. Genome-wide association study(GWas)is widely applied into genetic research for PoaG,and it has obtained a series of research results. this method can analyze candidate susceptibility genes in PoaG patients,and quantitatively analyze related genes of endophenotypes. Vertical cup-disc ratio(VCDr),intraocular pressure(IoP),central corneal thickness(CCt)and optic disc area(oDa)can also be analyzed. these abnormal phenotype-related genes are crucial in the development of PoaG. this article reviews the findings of GWas for PoaG.%原发性开角型青光眼(PoaG)是由多个基因及环境因素相互作用所致的复杂疾病,遗传因素在其发生发展中起重要作用。全基因组关联研究(GWas)方法被广泛应用到该病的遗传学研究中,并取得了一系列研究成果。该方法除可分析 PoaG 患者的候选易感基因外,还可定量分析 PoaG 内在表型有关基因,包括垂直杯盘比(VCDr)、眼内压(IoP)、中央角膜厚度(CCt)和视神经盘区(oDa),这些异常表型的相关基因在PoaG 的发展中是至关重要的。文章归纳了 GWas 在 PoaG 易感基因研究中的应用。

  18. 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

  19. BaFAlSi and BaFAlGe: First transition metal-free LaOAgS-type fluoride tetrelides

    Energy Technology Data Exchange (ETDEWEB)

    Charkin, Dmitri O., E-mail: charkin@inorg.chem.msu.ru; Plokhikh, Igor V.; Kuznetsov, Alexey N.; Kazakov, Sergey M.

    2015-04-05

    Highlights: • Two first tetrelide fluorides with the LaOAgS structure have been prepared. • They are also the first transition metal-free representatives of the structure type. • Contrary to pnictides, hydride tetrelides are predicted to have different structures. - Abstract: Studies of the LaOAgS-type compounds among alkaline earth – Al (Ga) fluoride tetrelides revealed the existence of two new compounds BaFAlSi and BaFAlGe which are the first representatives of fluoride tetrelides; they also are the first representatives of the structure type not involving transition metals. No compound of the structure type is formed for strontium and gallium. Quantum chemical calculations indicate that only these two compounds are thermodynamically stable; the structure is probably stabilized by ionic interactions in the FeSe-like anionic slabs, which are relatively weak for bonds formed between triels and tetrels that are close in electronegativity.

  20. Glaucoma and cigarette smoking: a review of narrative reviews

    Directory of Open Access Journals (Sweden)

    Francesca Di Murro

    2016-12-01

    Full Text Available Background: Glaucoma is an optic neuropathy associated with visual field changes for which high intra-ocular pressure is a major risk factor. Emerging research indicates that modifiable factors, among which the cigarette smoke, besides IOP may be associated with the presence of glaucoma. Objective: The objective of the study was to perform a review of narrative reviews to examine on the relationship between cigarette smoking and glaucoma. Methods: The results of all narrative reviews in the scientific literature about glaucoma and tobacco smoking were analyzed. A quality assessment was performed according to an easy and convenient tool for the quality assessment of narrative reviews for systematic reviews (International Narrative Systematic assessment the INSA tool. Literature searches were performed using PubMed. Results: 20 studies about relation between glaucoma and smoke were collected, no restriction language was applied. 15 of these studies have been excluded. We selected among them 5 reviews. With the INSA tool we measured the quality of the 5 selected narrative reviews. Studies that had a highest score with the INSA tool were two: A. Coleman et al. “Risk Factors for Glaucoma Needing More Attention” and R. Salowe et al. “Primary Open-Angle Glaucoma in Individuals of African Descent: A Review of Risk Factors”. Conclusion: The narrative reviews analyzed underline that there is no definitive association between cigarette smoking.

  1. Benzalkonium Chloride and Glaucoma

    OpenAIRE

    Rasmussen, Carol A.; Kaufman, Paul L.; Kiland, Julie A.

    2014-01-01

    Glaucoma patients routinely take multiple medications, with multiple daily doses, for years or even decades. Benzalkonium chloride (BAK) is the most common preservative in glaucoma medications. BAK has been detected in the trabecular meshwork (TM), corneal endothelium, lens, and retina after topical drop installation and may accumulate in those tissues. There is evidence that BAK causes corneal and conjunctival toxicity, including cell loss, disruption of tight junctions, apoptosis and preapo...

  2. 超声乳化联合人工晶体植入术治疗闭角型青光眼合并白内障临床观察%Cataract extraction combined with intraocular lens implantation for the treatment of angle closure glaucoma with cataract clinical observation

    Institute of Scientific and Technical Information of China (English)

    胡开东

    2012-01-01

    Objective Observation of cataract extraction with intraocular lens implantation forangle closure glaucoma patients with cataract treatment. Methods A retrospective analysis from June 2008 to April 2010 54 cases of angle-closure glaucoma and cataract patients, the implementation of cataract surgery and intraocular lens implantation (phacoemulsification in 31 cases, a small incision extracapsular cataract extraction 23 cases). Follow-up period of 1 month to 1 year. Results Postoperative visual acuity improved to varying degrees, intraocular pressure control in 11 ~20mmHg. Anterior chamber deepened, widened to varying degreesangle. Conclusion Cataract surgery and intraocular lens implantation can be effective in treating angle-closure glaucoma and cataract patients.%目的 观察白内障摘除联合人工晶体植入术治疗闭角型青光眼合并白内障的患者的疗效.方法 回顾性分析2008年6月~2010年4月54例闭角型青光眼合并白内障患者,实施白内障摘除术联合人工晶体植入术(超声乳化术31例,小切口囊外摘除术23例)的疗效.结果 术后视力不同程度提高,眼压控制在11~20mmHg,前房加深,房角不同程度增宽.结论 白内障摘除术联合人工晶体植入术可有效治疗闲角型青光眼合并白内障的患者.

  3. 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

  4. 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.

  5. Analysis the Curative Effect of 20 Cases Neovascular Glaucoma With Anterior Chamber Angle Closure by Combined Surgey%20例闭角型期新生血管性青光眼联合手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    庞彦利

    2016-01-01

    Objective To analyse the therapeutic effect of neovascular glaucoma (NVG) with anterior chamber angle closure.MethodsTotally 20 patients with NVG from April 2014 to August 2015 in our hospital, which the angle closure period, 5 patients with light perception ang 15 patients without light perception. According to the thickness of ball conjunctiva, they were divided to two groups (A,B). group A were with thin conjunctiva, underwent the cyclocryotherapy combined with peripheral retinal cryotherapy. 15 cases in group B underwent combined trabeculectomy with panretinal photocoagulation or peripheral retinal cryotherapy. according to their refractive status 0.25 mg/ml mitomycin C was applicatied for 3 to 5 minutes, and after operation 0.3 ml 5-FU was subconjunctived to reduce the scarring of the ifltering bleb. The patients were followed up for 3 months to observe the intraocular pressure, complications and the relief of pain in the eyes.Results In group A, preoperative intraocular pressure (IOP) was (50.12±6.20) mm Hg, and in group B it was (51.03±6.13) mm Hg, There was no signiifcant difference. On the 3rd postoperative day, IOP in group A was (28.63±5.74) mm Hg, in group B was (40±6.25) mm Hg, both were lowered signiifcantly. At 1 week after operations,the IOP were (21.63±5.86) mm Hg and (13±4.42) mm Hg, still lower than the preoperative. At one months after operations,the IOP were (25.31±4.72) mm Hg and (17±2.17) mm Hg, still lower than the preoperative. In group A ,the foreign body sensation, pain and anterior chamber exudation were significantly higher than that in B group, and in group B the incidence of anterior chamber hemorrhage was higher.Conclusion Correct choice of individuated surgical procedures in neovascular glaucoma can effectively lower the IOP, and relieve the pain of them.%目的:观察闭角期新生血管青光眼的治疗效果。方法回顾性分析2014年4月~2015年8月我院20例新生血管青光眼的临床资料,均为新生

  6. Updates on the Surgical Management of Pediatric Glaucoma.

    Science.gov (United States)

    Tan, Yar-Li; Chua, Jocelyn; Ho, Ching-Lin

    2016-01-01

    Childhood glaucoma is known to be one of the most challenging conditions to manage. Surgical management is more complicated than in adults because of differences in anatomy from adults along with variations in anatomy caused by congenital and developmental anomalies, wide-ranging pathogenetic mechanisms, a more aggressive healing response, and a less predictable postoperative course. Challenges in postoperative examination and management in less cooperative children and the longer life expectancies preempting the need for future surgeries and reinterventions are also contributing factors. Angle surgery is usually the first-line treatment in the surgical management of primary congenital glaucoma because it has a relatively good success rate with a low complication rate. After failed angle surgery or in cases of secondary pediatric glaucoma, options such as trabeculectomy, glaucoma drainage devices, or cyclodestructive procedures can be considered, depending on several factors such as the type of glaucoma, age of the patient, and the severity and prognosis of the disease. Various combinations of these techniques have also been studied, in particular combined trabeculotomy-trabeculectomy, which has been shown to be successful in patients with moderate-to-advanced disease. Newer nonpenetrating techniques, such as viscocanalostomy and deep sclerectomy, have been reported in some studies with variable results. Further studies are needed to evaluate these newer surgical techniques, including the use of modern minimally invasive glaucoma surgeries, in this special and diverse group of young patients.

  7. Peripheral iridotomy for pigmentary glaucoma

    Science.gov (United States)

    Michelessi, Manuele; Lindsley, Kristina

    2016-01-01

    Background Glaucoma is a chronic optic neuropathy characterized by retinal ganglion cell death resulting in damage to the optic nerve head and the retinal nerve fiber layer. Pigment dispersion syndrome is characterized by a structural disturbance in the iris pigment epithelium (the densely pigmented posterior surface of the iris) that leads to dispersion of the pigment and its deposition on various structures within the eye. Pigmentary glaucoma is a specific form of open-angle glaucoma found in patients with pigment dispersion syndrome. Topcial medical therapy is usually the first-line treatment; however, peripheral laser iridotomy has been proposed as an alternate treatment. Peripheral laser iridotomy involves creating an opening in the iris tissue to allow drainage of fluid from the posterior chamber to the anterior chamber and vice versa. Equalizing the pressure within the eye may help to alleviate the friction that leads to pigment dispersion and prevent visual field deterioration. However, the effectiveness of peripheral laser iridotomy in reducing the development or progression of pigmentary glaucoma is unknown. Objectives The objective of this review was to assess the effects of peripheral laser iridotomy compared with other interventions, including medication, trabeculoplasty, and trabeculectomy, or no treatment, for pigment dispersion syndrome and pigmentary glaucoma. Search methods We searched a number of electronic databases including CENTRAL, MEDLINE and EMBASE and clinical trials websites such as (mRCT) and ClinicalTrials.gov. We last searched the electronic databases on 2 November 2015. Selection criteria We included randomized controlled trials (RCTs) that had compared peripheral laser iridotomy versus no treatment or other treatments for pigment dispersion syndrome and pigmentary glaucoma. Data collection and analysis We used standard methodological procedures for systematic reviews. Two review authors independently screened articles for eligibility

  8. New Tool to Predict Glaucoma

    Science.gov (United States)

    ... News About Us Donate In This Section A New Tool to Predict Glaucoma email Send this article ... determine if a patient has glaucoma. Recently, a new tool has become available to eye care specialists ...

  9. Does Marijuana Help Treat Glaucoma?

    Science.gov (United States)

    ... Glaucoma Infographic Leer en Español: La Marihuana y el Glaucoma Find an Ophthalmologist Advanced Search Ask an ... Number: * Email: * Enter code: * Message: Thank you Your feedback has been sent.

  10. 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 ...

  11. 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.

  12. A Comparative study of dermatoglyphic patterns in patients with primary glaucoma and control group

    Directory of Open Access Journals (Sweden)

    Sharmila Pal

    2013-08-01

    Full Text Available Dermatoglyphics are the dermal ridge configurations on the digits, palms and soles. They are permanent and inherited. A comparative study of the Dermatoglyphic patterns of patients with primary glaucoma and general healthy population was made to ascertain the value of Dermatoglyphics as a diagnostic tool for primary glaucoma. Fifty-seven primary glaucoma patients (24 males, 33 females and fifty normal healthy persons (25 males, 25 females participated in this study. In the present study primary glaucoma subjects were examined in terms of dermatoglyphic characteristics and compared with that of controls. Frequency of loops was decreased in primary glaucoma but in case of whorls and arch increased numbers.Deviation is also observed in a-b ridge count and atd angle. In general tfrc and afrc also increased. These can be considered as useful as a supportive investigation and to some extent knowing the prediction for primary glaucoma

  13. Layer-by-layer analysis of retinal thickness in primary open-angle glaucoma using optical coherence tomography%POAG患者视网膜各层厚度的OCT分析

    Institute of Scientific and Technical Information of China (English)

    张萌; 章畅; 王玉宏; 吕帆

    2014-01-01

    Objective To analysis each layer of retinal thickness,especially the ganglion cell layer (GCL) in the macular area,in patients with primary open-angle glaucoma (POAG) using an RTVue OCT; to assess its value in the diagnosis of glaucoma.Methods In this prospective case-control study,76 patients (91 eyes) with POAG (30 patients [30 eyes] in the early stage,25 patients [29 eyes] in the middle stage and 21 patients [32 eyes] in late stage) and 32 healthy age-and gender-matched controls (32 eyes) were recruited.The macular area was scanned with an RTVue OCT,and the retina was divided into nine layers with self-programming retinal image processing software.The thickness of each layer and the total retinal thickness were calculated and an LSD-t test was used to compare the average thickness of the macular area in each retinal layer for early,middle and late POAG patients and the control group.Results In the early stage of POAG,the mean thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were 31.6±9.2 μm and 33.9±5.0 μm,respectively,becoming thinner (P<0.05) than healthy controls.In the middle stage,the mean thicknesses of the RNFL and GCL were 31.2±3.4 μm and 34.1±3.9 μm,respectively,which was thinner than the control group (P<0.05).In the late stage,the mean thicknesses of the RNFL,GCL,inner plexiform layer (IPL),inner segment of the photoreceptor (IS),and total retina (TR) were 18.8±7.6 μm,24.2±7.9 μm,38.0±6.4 μm,22.8±4.4 μm and 299.5±15.1 μm,respectively,and all measurements were thinner than the controls (P<0.05).The mean thickness of the inner nuclear layer (INL) was 39.1±6.6 μm,which was thicker than the controls (P<0.05).Conclusion The mean thickness of the retinal macular area of POAG patients became obviously thinner.The GCL was especially affected by early POAG.GCL combined with clinical observations can be used as an early diagnostic indicator of POAG.%目的 利用RTVue OCT对POAG患者黄斑区视网

  14. 急性闭角型青光眼对侧眼与可疑原发房角关闭眼的前节参数比较%Comparison of anterior segment parameters between fellow eyes of unilateral acute angle closure glaucoma and primary angle closure suspects

    Institute of Scientific and Technical Information of China (English)

    郭竞敏; 许小兰; 张虹; 王军明

    2015-01-01

    目的:探讨原发闭角型青光眼单侧急性发作( acute angle closure glaucoma,AACG)的对侧眼、可疑原发房角关闭眼(primary angle closure suspects,PACS)和正常眼的前节生物学参数差异。  方法:采用光学相干断层扫描( optical coherence tomography,OCT)和 Pentacam 三维眼前节分析诊断系统(pentacam scheimpflug system,Pentacam)完成26例26眼AACG对侧眼及与之年龄、性别匹配的28例28眼PACS和34例34眼正常眼的前节扫描。采用Pentacam获得以下参数:中央角膜厚度( CCT)、角膜容积( CV)、瞳孔直径( PD)、中央前房深度( CACD)、周边前房深度( PACD)、前房容积( CV )和房角度数( ACA )。应用图像处理软件和OCT测量虹膜厚度(IT750,IT2000),面积(IS)、体积(IV)和房角开放距离500( AOD500)进行。  结果:角膜参数(CCT,CV),PD、虹膜参数(IT750,IT2000, IS,IV)无统计学差异( P>0.05)。与 AACG 对侧眼和PACS比较,正常人CACD和PACD更深, ACV更大, ACA和AOD500更宽敞( P0.05)。以AACG对侧眼作为房角关闭好发的诊断标准,上述前房参数的受试者工作特征曲线下面积均小于0.7。  结论:AACG对侧眼和PACS的前节生物学参数无显著差异,以此作为房角关闭好发的诊断精准度较低。%AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma ( AACG ) , primary angle-closure suspects ( PACS) and normal group. METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography ( OCT) and pentacam scheimpflug system ( Pentacam ) . Anatomical parameters including central corneal thickness ( CCT ) , corneal volume ( CV ) , pupillary diameter ( PD ) , central anterior chamber depth ( CACD ) , peripheral anterior chamber depth ( PACD ) , anterior chamber volume ( ACV ) and anterior chamber angle

  15. 激光周边虹膜成形及切除术治疗药物难控制的急性闭角型青光眼%Laser peripheral iridoplasty combined with iridectomy for the unmanageable acute angle-closure glaucoma by medication

    Institute of Scientific and Technical Information of China (English)

    刘国颖; 刘斐

    2014-01-01

    AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication. METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery. RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.%目的:探讨激光周边虹膜成形联合周边虹膜切除术,治疗药物难控制的急性闭角型青光眼的效果和安全性。  方法:选取药物治疗24 h后眼压仍高于21 mmHg的原发性急性闭角型青光眼15例17眼和白内障膨胀期继发的急性闭角型青光眼4例4眼,共19例21眼,采用激光周边虹膜成形联合周边虹膜切除术,术后24 h观察视力、眼压、角膜、周边前房深度、房角及并发症。  结果:所有患者激光术后24 h眼压均有大幅度的下降,术前眼压53.09±11.01mmHg,术后24h眼压下降至14.98±4.21mmHg,治疗前后差异有统计学意义( P  结论:激光周边虹膜切除联合周边虹膜成形术,是降低药物难控制的急性闭角型青光眼眼压的一种安全有效的方法。

  16. 中国人近视与原发性开角型青光眼相关性的 Meta 分析%Meta-analysis of association between myopia and primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    项勇刚; 夏凌云; 张勇; 曾宪涛; 许玲

    2014-01-01

    Objective To explore the association between myopia and primary open angle glaucoma ( POAG) by Meta-analysis.Methods Relevant studies, published up to July 20, 2013, were searched from CNKI and VIP databases . After data extraction, a meta-analysis was performed using CMA (comprehensive meta analysis) v2.2 software.Results Five studies were finally recruited , including 3 studies that reported the association between myopia and POAG independ-ently.The results of meta-analysis showed that myopia evidently increases the risk of POAG by 3.07 times ( OR=3.07, 95%CI=1.90~4.96), and high myopia obviously increases the risk of POAG by 7.15 times (OR=7.15, 95% CI=4.01~12.75).Sensitivity analysis showed that the results were robust .The publication bias analysis was not conducted . Conclusion Based on the current evidence , myopia is probably an independent and significant risk factor for POAG , and the high myopia persons were with higher risk for POAG .%采用Meta分析的方法探讨中国人近视与原发性开角型青光眼( POAG)的相关性。方法检索CNKI和VIP数据库中自建库至2013年7月20日之间公开发表的文献,对符合纳入标准的研究进行数据提取之后,采用Comprehensive Meta Analysis ( CMA) v2.2软件进行 Meta分析。结果最终纳入5个研究,其中3个研究将高度近视作为暴露因素单独列出来。 Meta分析结果显示,暴露于近视的人群罹患POAG的风险增加3.07倍(OR =3.07,95%CI =1.90~4.96;P <0.01);暴露于高度近视者(屈光度数>-6.0 D),罹患POAG的风险增加7.15倍(OR =7.15,95%CI =4.01~12.75;P <0.01)。敏感性分析显示结果稳健性好,未行发表偏倚分析。结论当前证据表明近视很可能是开角型青光眼的一个独立的、有意义的危险因素,并且高度近视者罹患POAG的风险高。

  17. 深层巩膜切除术联合透明质酸片植入治疗原发性开角型青光眼%Deep sclerectomy with hyaluronate implant for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    姜发纲; Klaus W.Ruprecht

    2004-01-01

    目的:探讨深层巩膜切除联合透明质酸片植入(DSHI)治疗原发性开角型青光眼(POAG)的临床疗效.方法:回顾性总结在Saarland大学眼科医院行DSHI治疗的POAG.结果:符合条件并入选的有216患者的377只POAG.平均随诊31(5~51)mo.术前平均眼压(28.3±8.4)mmHg(1mmHg=O.133kPa),术后1wk,6mo,1、2、3、4a眼压分别为(9.7±3.6)、(12.4+5.3)、(15.5±8.7)、(15.4±6.8)、(16.1±6.7)、(17.4±7.5)mmHg.术前平均视力为0.65,术后1wk,6mo,1、2、3、4a视力分别为0.63、O.68、0.72、0.71、0.76、0.70.术后la显效(不加抗青光眼药物且眼压≤21mmHg)率为89%,有效(加抗青光眼药物时眼压≤21mmHg)率为9%.术后4a时,显效率为45%,有效率48%.并发症包括切口渗漏、前房出血、脉络膜脱离等.结论:DSHI对POAG治疗效果良好,并发症少且轻微.%AIM: To explore the clinical effects of deep sclerectomy with hyaluronate implant (DSHI) for primary open-angle glaucoma (POAG).METHODS: A retrospective investigation was made in patients with POAG treated with DSHI in Saarland University.RESULTS: A tolal of 377 eyes in 216 patients with POAG were selected. The average follow-up was 31months (5-51 months). The mean intraocular pressure (IOP) was 28.3+8.4 mmHg (1mmHg=0.133kPa) before surgery, and9.7+3.6, 12.4+5.3, 15.5+8.7, 15.4+6.8,16.1+6.7 and 17.4+7.5 mmHg respectively at 1 week, 6months, 1 year, 2 years, 3 years and 4 years after surgery. The mean visual acuity was 0.65 before surgery,and 0.63, 0.68, 0.72, 0.71, 0.76, 0.70 respectively at 1week, 6 months, 1 year, 2 years, 3 years and 4 years after surgery. Complete success rate (IOP≤21 mmHg without antiglaucoma medication) was 89% and qualified success rate (IOP≤21mmHg with antiglaucoma medication) was 9% at 1 year after surgery. They were 45%and 48% at 4 years after surgery respectively. Complications included wound leak, hyphema and choroidal detachment, etc.CONCLUSION: DSHI is efficacious for POAG. Complications following

  18. Advances in molecular genetic study on primary angle-closure glaucoma%原发性闭角型青光眼的基因学研究进展

    Institute of Scientific and Technical Information of China (English)

    段觉昵

    2015-01-01

    原发性闭角型青光眼(PACG)是具有很强遗传倾向的复杂眼病,在全球范围内PACG患者中以亚洲人居多,且女性占大多数.目前PACG发病的分子生物学机制研究已引起关注,研究方法多采用关联分析或全基因组关联研究(GWAS),但迄今为止其发病机制仍未清晰阐明,PACG的遗传学研究还面临许多挑战.目前已有个别可疑候选基因和最新报道的3个易感基因位点被证实与PACG发病有关,已发表的相关基因研究报道也很少.但是,研究发现一些与POAG有关的基因与PACG发病具有相关性;另一方面,因为PACG患者眼部具有特殊的解剖生物学特征,因此一些参与眼球发育或与眼轴改变调控的基因也陆续被报道,并在部分特定人群中发现了基质金属蛋白酶(MMPs)、肝细胞生长因子(HGF)等与PACG之间的关联.此外,应用GWAS技术对PACG患者进行的分子遗传学研究也有望取得新的突破.%Primary angle-closure glaucoma (PACG) is a group of complex ophthalmic disorders with genetic heterogeneity.PACG appears to be more frequently occurred in Asian population and females worldwide.Recently,some studies tried to find the possible pathogenesis of PACG from biomolecular level,some association analysis and genome-wide association study (GWAS) technique have been used to illustrate the mechanism of PACG.But so far its pathogenesis still is not yet elucidated,there are much more puzzles in molecular genetic study on PACG.Up to now,only a few uncertain genes and three new susceptibility loci were reported to be associated with PACG and only 40 literature were published.However,some genes referred to POAG display a close association with PACG.As eyes with PACG tend to share certain anatomic biometric characteristics,the associations between PACG and several genes,such as matrix metalloproteinases (MMPs) and hepatocyte growth factor (HGF),which involve in the modulation of eye growth.Besides,GWAS shows us another

  19. [Dyslipidaemia and glaucoma].

    Science.gov (United States)

    Jünemann, A G; Huchzermeyer, C; Rejdak, R; Hohberger, B

    2014-12-01

    Endothelial dysfunction and vascular dysregulation play a role in the multifactorial pathogenesis of glaucomatous optic nerve atrophy. Dyslipidaemia as a risk factor for endothelial dysfunction is associated with glaucoma and cardiovascular morbidity and mortality. In additional to a genetic disposition, a potential mechanism for the pathogenesis of endothelial dysfunction could be an additive effect of several risk factors, like dyslipidaemia, smoking, arterial hypertension, diabetes and hyperhomocysteinaemia. This paper reviews the literature concerning the association between dyslipidaemia and glaucomatous disease and explains the possible role of dyslipidaemia for the pathogenesis and progression of glaucoma. The role of exogeneous modifiable risk factors for prevention and therapy of glaucoma and their neutralisation by changing life style like weight reduction, modifications of nutrition and physical activity, are discussed.

  20. 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)

  1. [Congenital glaucoma and trabeculodysgenesis. Clinical and genetic aspects].

    Science.gov (United States)

    Dureau, P

    2006-02-01

    Congenital glaucoma is generally related to an iridocorneal angle malformation, with an obstacle to aqueous humor outflow. This spectrum of diseases can involve the angle, the iris and the cornea. The diagnosis relies on characteristic signs and is confirmed by an examination under general anaesthesia and paraclinical examinations (especially echography). An early diagnosis is essential for beginning surgical treatment. Several filtering surgery techniques with equivalent intraocular pressure results are available, but visual function must be protected in all cases. In many cases, genetic counseling relies on a careful clinical analysis and sometimes on a molecular analysis. A number of ocular and/or general abnormalities can be accompanied by glaucoma in infants and children. They must be screened in case of associated signs, but the existence of these abnormalities leads to suspicion of associated glaucoma.

  2. Incorporating corneal pachymetry into the management of glaucoma.

    Science.gov (United States)

    Iester, Michele; Mete, Maurizio; Figus, Michele; Frezzotti, Paolo

    2009-09-01

    Intraocular pressure (IOP) results from a dynamic balance between aqueous humor formation and outflow. The simplest technique to measure IOP is indentation tonometry. Another technique is applanation. These methods are related to the elasticity of the eye, which mainly depends on its thickness and hysteresis. For several decades, Goldmann applanation tonometry has been the most accepted method of measuring IOP; the Goldmann tonometer is still used in all important trials. The relationship between IOP values and central corneal thickness (CCT) is well known; Goldmann stated that this relationship only holds for an average corneal thickness of 520 microm measured by optical pachymetry. The Ocular Hypertension Treatment Study (OHTS) showed that CCT is an important risk factor for a change from ocular hypertension to primary open-angle glaucoma. In a multivariate model that included IOP, CCT was the most powerful component of the predictive model. In the Early Manifest Glaucoma Trial (EMGT) with an 11-year follow-up, CCT was a significant predictive factor for glaucoma progression in patients with higher baseline IOP but not in those with lower baseline IOP. Clinical trials such as the OHTS and EMGT cannot prove that CCT is linked to a risk for glaucoma on a biological level. Thus, in eyes with glaucoma, IOP must be treated because it has a significant influence on progression of glaucoma, regardless of the baseline IOP and CCT.

  3. 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.

  4. Lensectomy, vitrectomy, and transvitreal ciliary body photocoagulation as primary treatment for glaucoma in microspherophakia.

    Science.gov (United States)

    Goel, Neha; Sharma, Ravi; Sawhney, Amrita; Mandal, Madhullika; Choudhry, Reena M

    2015-08-01

    Microspherophakia is a rare, bilateral developmental anomaly of the crystalline lens. It can occur in isolation or as a component of a familial disorder. It has been associated with the Weill-Marchesani syndrome and Marfan syndrome. Angle clousure glaucoma can occur in microspherophakia and is the primary cause of visual loss. We describe the management of 2 sisters with bilateral microspherophakia and advanced angle closure glaucoma.

  5. The Ahmed Glaucoma Valve in Neovascular Glaucoma (An AOS Thesis)

    Science.gov (United States)

    Netland, Peter A.

    2009-01-01

    Purpose: To evaluate the results of Ahmed glaucoma valve surgery in neovascular glaucoma and control patients. Methods: In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, without further glaucoma surgery, and without loss of light perception. Results: Average follow-up for control and neovascular glaucoma patients was 18.4 and 17.4 months, respectively (P = .550). At last follow-up, mean IOP was 16.2 ± 5.2 mm Hg and 15.5 ± 12.5 mm Hg (P = .115) in control and neovascular glaucoma patients, respectively. Life-table analysis showed a significantly lower success for neovascular glaucoma patients compared with controls (P = .0096), with success at 1 year of 89.2% and 73.1%, at 2 years of 81.8% and 61.9%, and at 5 years of 81.8% and 20.6% for control and neovascular glaucoma eyes, respectively. Cox proportional hazards regression analysis showed neovascular glaucoma as a risk factor for surgical failure (odds ratio, 5.384, 95% CI, 1.22–23.84, P = .027). Although IOP control and complications were comparable between the two groups, visual outcomes were worse in neovascular glaucoma patients, with 9 eyes (23.7%) with neovascular glaucoma compared with no controls losing light perception vision (P = .002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period. Conclusion: Neovascular glaucoma patients have greater risk of surgical failure after Ahmed glaucoma valve surgery compared with controls. Despite improved mean IOP with drainage implants, visual outcomes may be poor, possibly due to progression of underlying disease. PMID:20126506

  6. 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.

  7. A novel missense mutation in ADAMTS10 in Norwegian Elkhound primary glaucoma.

    Science.gov (United States)

    Ahonen, Saija J; Kaukonen, Maria; Nussdorfer, Forrest D; Harman, Christine D; Komáromy, András M; Lohi, Hannes

    2014-01-01

    Primary glaucoma is one of the most common causes of irreversible blindness both in humans and in dogs. Glaucoma is an optic neuropathy affecting the retinal ganglion cells and optic nerve, and elevated intraocular pressure is commonly associated with the disease. Glaucoma is broadly classified into primary open angle (POAG), primary closed angle (PCAG) and primary congenital glaucoma (PCG). Human glaucomas are genetically heterogeneous and multiple loci have been identified. Glaucoma affects several dog breeds but only three loci and one gene have been implicated so far. We have investigated the genetics of primary glaucoma in the Norwegian Elkhound (NE). We established a small pedigree around the affected NEs collected from Finland, US and UK and performed a genome-wide association study with 9 cases and 8 controls to map the glaucoma gene to 750 kb region on canine chromosome 20 (praw = 4.93×10-6, pgenome = 0.025). The associated region contains a previously identified glaucoma gene, ADAMTS10, which was subjected to mutation screening in the coding regions. A fully segregating missense mutation (p.A387T) in exon 9 was found in 14 cases and 572 unaffected NEs (pFisher = 3.5×10-27) with a high carrier frequency (25.3%). The mutation interrupts a highly conserved residue in the metalloprotease domain of ADAMTS10, likely affecting its functional capacity. Our study identifies the genetic cause of primary glaucoma in NEs and enables the development of a genetic test for breeding purposes. This study establishes also a new spontaneous canine model for glaucoma research to study the ADAMTS10 biology in optical neuropathy.

  8. A novel missense mutation in ADAMTS10 in Norwegian Elkhound primary glaucoma.

    Directory of Open Access Journals (Sweden)

    Saija J Ahonen

    Full Text Available Primary glaucoma is one of the most common causes of irreversible blindness both in humans and in dogs. Glaucoma is an optic neuropathy affecting the retinal ganglion cells and optic nerve, and elevated intraocular pressure is commonly associated with the disease. Glaucoma is broadly classified into primary open angle (POAG, primary closed angle (PCAG and primary congenital glaucoma (PCG. Human glaucomas are genetically heterogeneous and multiple loci have been identified. Glaucoma affects several dog breeds but only three loci and one gene have been implicated so far. We have investigated the genetics of primary glaucoma in the Norwegian Elkhound (NE. We established a small pedigree around the affected NEs collected from Finland, US and UK and performed a genome-wide association study with 9 cases and 8 controls to map the glaucoma gene to 750 kb region on canine chromosome 20 (praw = 4.93×10-6, pgenome = 0.025. The associated region contains a previously identified glaucoma gene, ADAMTS10, which was subjected to mutation screening in the coding regions. A fully segregating missense mutation (p.A387T in exon 9 was found in 14 cases and 572 unaffected NEs (pFisher = 3.5×10-27 with a high carrier frequency (25.3%. The mutation interrupts a highly conserved residue in the metalloprotease domain of ADAMTS10, likely affecting its functional capacity. Our study identifies the genetic cause of primary glaucoma in NEs and enables the development of a genetic test for breeding purposes. This study establishes also a new spontaneous canine model for glaucoma research to study the ADAMTS10 biology in optical neuropathy.

  9. Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

    Science.gov (United States)

    Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

    2016-01-01

    Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

  10. Genetics Home Reference: early-onset glaucoma

    Science.gov (United States)

    ... Home Health Conditions early-onset glaucoma early-onset glaucoma Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Glaucoma is a group of eye disorders in which ...

  11. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... 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 ...

  12. 选择性激光小梁成形术治疗原发性开角型青光眼%Selective laser trabeculoplasty in the treatment for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    于爱萍; 王瑞夫

    2011-01-01

    目的 评价选择性小梁激光成形术(SLT)治疗各类原发性开角性青光眼(POAG)的疗效观察.方法 79例(93眼)根据种族的不同(小梁Seheie色素分级)、年龄及眼压情况分为3组,采用国通公司倍频Q-开关.532 nm ND:YAG激光器,单脉冲,时间为3 ns,波长532 nm,光斑直径400μm,脉冲能量设置0.4~1.6 mJ.术前在盐酸奥布卡因表麻下放置前房角镜,瞄准功能小梁网,选择相应的脉冲能量、象限范围和激光点数进行治疗或重复治疗.术后随访眼压(1 h、1 d、1周、1个月、3个月、6个月、1年)、眼底及视野.结果 3个组79例(93眼)术前1年平均眼压依次为(23.1±6.3)mmHg、(26.52±6.1)mmHg和(29.52±6.1)mmHg;术后1年眼压依次为(12.52±4.3)mmHg、(15.58±4.7)mmHg和(16.65±4.5)mmHg.术前与术后眼压相比有显著下降(P<0.01).3个组眼底C/D比,术前为0.50~0.70±0.15~0.13;术后为0.57~0.68±0.16~0.42.视力:术前0.85~0.57±0.32~0.29;术后0.91~0.58±0.30~0.27,两者比较其差异均无统计学意义.结论 SLT对各类POAG均有显著降压作用.%Objective To evaluate selective laser trabeculoplasty(SLT) in treating primary open angle glaucoma(POAG) and observation on the therapeutic effect. Methods 79 patients, 93 eyes were divided into 3 groups acording to the different races, medical history, age, IOP. The ELLEX Laser distributed by GT-Medical Company,with double frequency, 532 nm, Nd:YAG, single pulse, pulse width 3ns, spot size 400 μm, pulse energy 0.4-1. 6mJ was used. Pre-op: Oxybuprocaine HCI for topical anesthesia, a gonioscope, aiming at functional trabecular meshwork, selected different pulse energy, quadrant, different spots, and/or retreatment. Post-op: IOP follow-up at 1 hour, 1 day, 1 week, 1 month, 3 months,6 months.1 year, retina, visual field, visual acuity. Results comparison on pre-op and post-op IOP, the three groups of 79 patients and 93 eyes, pre-op average IOP was (23. 134±6.34)mmHg, (26.524±6.11)mmHg and

  13. Dogs and humans share a common susceptibility gene SRBD1 for glaucoma risk.

    Directory of Open Access Journals (Sweden)

    Nobuyuki Kanemaki

    Full Text Available Glaucoma is a degenerative optic neuropathy that is associated with elevated intraocular pressure. Primary open angle glaucoma is the most common type of glaucoma in canines, and its highest incidence among dog breeds has been reported in Shiba-Inus, followed by Shih-Tzus. These breeds are known to have an abnormal iridocorneal angle and dysplastic prectinate ligament. However, the hereditary and genetic backgrounds of these dogs have not yet been clarified. In this study, we investigated the association between polymorphisms of the glaucoma candidate genes, SRBD1, ELOVL5, and ADAMTS10, and glaucoma in Shiba-Inus and Shih-Tzus. We analyzed 11 polymorphisms in these three genes using direct DNA sequencing. Three SRBD1 SNPs, rs8655283, rs22018514 and rs22018513 were significantly associated with glaucoma in Shiba-Inus, while rs22018513, a synonymous SNP in exon 4, showed the strongest association (P = 0.00039, OR = 3.03. Conditional analysis revealed that rs22018513 could account for most of the association of these SNPs with glaucoma in Shiba-Inus. In Shih-Tzus, only rs9172407 in the SRBD1 intron 1 was significantly associated with glaucoma (P = 0.0014, OR = 5.25. There were no significant associations between the ELOVL5 or ADAMTS10 polymorphisms and glaucoma in Shiba-Inus and Shih-Tzus. The results showed that SRBD1 polymorphisms play an important role in glaucoma pathology in both Shiba-Inus and Shih-Tzus. SRBD1 polymorphisms have also been associated with normal- and high-tension glaucomas in humans. Therefore, SRBD1 may be a common susceptibility gene for glaucoma in humans and dogs. We anticipate that the nucleotide sequencing data from this study can be used in genetic testing to determine for the first time, the genetic status and susceptibility of glaucoma in dogs, with high precision. Moreover, canine glaucoma resulting from SRBD1 polymorphisms could be a useful animal model to study human glaucoma.

  14. VAV2 and VAV3 as candidate disease genes for spontaneous glaucoma in mice and humans.

    Directory of Open Access Journals (Sweden)

    Keiko Fujikawa

    Full Text Available BACKGROUND: Glaucoma is a leading cause of blindness worldwide. Nonetheless, the mechanism of its pathogenesis has not been well-elucidated, particularly at the molecular level, because of insufficient availability of experimental genetic animal models. METHODOLOGY/PRINCIPAL FINDINGS: Here we demonstrate that deficiency of Vav2 and Vav3, guanine nucleotides exchange factors for Rho guanosine triphosphatases, leads to an ocular phenotype similar to human glaucoma. Vav2/Vav3-deficient mice, and to a lesser degree Vav2-deficient mice, show early onset of iridocorneal angle changes and elevated intraocular pressure, with subsequent selective loss of retinal ganglion cells and optic nerve head cupping, which are the hallmarks of glaucoma. The expression of Vav2 and Vav3 tissues was demonstrated in the iridocorneal angle and retina in both mouse and human eyes. In addition, a genome-wide association study screening glaucoma susceptibility loci using single nucleotide polymorphisms analysis identified VAV2 and VAV3 as candidates for associated genes in Japanese open-angle glaucoma patients. CONCLUSIONS/SIGNIFICANCE: Vav2/Vav3-deficient mice should serve not only as a useful murine model of spontaneous glaucoma, but may also provide a valuable tool in understanding of the pathogenesis of glaucoma in humans, particularly the determinants of altered aqueous outflow and subsequent elevated intraocular pressure.

  15. Transscleral laser cyclocoagulation in treatment of noncompensated glaucoma

    Science.gov (United States)

    Bakutkin, Valery V.; Karimov, Ravil N.; Tcherviakova, Olga V.

    2001-05-01

    The object of the present study is to estimate the impact of transscleral laser cyclocoagulation as a treatment for patients with non-compensated glaucoma and low visual functions. The effectiveness of the given treatment is estimated by the use of multiple statistical methods, including correlation, multiple regression and discriminant analysis. The results meaningfully confirm the effectiveness of laser surgery in non-compensated open-angle (stage III) glaucoma treatment, whilst the developed mathematical model of correlation between intra-eye liquid production and key operation parameters can be successfully used to control the process of liquid production.

  16. Incidence of and Risk Factors for Postoperative Glaucoma and Its Treatment in Paediatric Cataract Surgery.

    Science.gov (United States)

    Mataftsi, Asimina

    2016-01-01

    Postoperative glaucoma is perhaps the most feared complication after paediatric cataract surgery, as it is difficult to control. Paediatric glaucoma is also challenging to diagnose, and different definitions of glaucoma have led to a rather big range of reported incidences of this disease. It can occur soon after surgery, in which case it is usually closed-angle glaucoma, or it can have a late onset, even more than a decade after surgery, and its aetiopathogenesis remains unclear to this day. There is significant controversy as to what the risk factors are for developing it, especially regarding intraocular lens implantation. The vast majority of studies show that an earlier age at surgery confers a higher risk. Medical and surgical treatment of aphakic/pseudophakic glaucoma can be successful; however, management often requires repeated procedures with or without multiple medications, and the prognosis is guarded. The visual outcome depends on sufficient intraocular pressure control and management of concurrent amblyopia.

  17. MEMS glaucoma monitoring device

    Science.gov (United States)

    Shankar, Smitha; Austin, Michael

    2007-04-01

    Glaucoma is a serious disease, affecting millions of people worldwide requiring continuous monitoring of Intra Ocular Pressure (IOP) to avoid the risk of blindness. Current laboratory measurements are infrequent, intrusive and do not indicate the progression of the disease. The paper reports on the development of an implantable Glaucoma monitoring system that can monitor IOP in the eye to indicate any elevation in risk to the patient. A mathematical model of the anterior chamber of the eye was used to analyze the complex fluid flow and pressure balance in the eye. This was done in order to determine the performance requirements of the actuator, sensor and transmission electronics that could be integrated on a single microchip using microelectromechanical systems (MEMS) technology, to carry out the testing internally. The accuracy of the system was theoretically tested against results from external medical tests. The results were found to be comparable.

  18. 细胞外基质重塑在原发性开角型青光眼的作用及研究进展%Effect and current reseaches of extracellular matrix remodeling on primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    庞宇; 余玲

    2016-01-01

    青光眼是一组以特征性视神经萎缩和视野缺损为共同特征的疾病,病理性眼压增高是其主要危险因素。视网膜神经节细胞( retinal ganglion cells, RGCs)凋亡及其轴突丢失是青光眼的主要病理特征。细胞外基质( extracellular matrix, ECM)含量和成分的变化对小梁网构型、视乳头筛板结构、RGCs凋亡起着决定性作用。青光眼患者小梁网及房水中转化生长因子-β2( transforming growth factor-β2,TGF-β2)增加,引起ECM分泌增加和堆积导致眼压升高;高眼压引起视神经乳头ECM成分的改变,引起神经营养因子剥夺,导致RGCs凋亡;同时,高眼压引起视网膜基质金属蛋白酶类-9(matrix metalloproteinase-9,MMPs-9)活性增加,层连黏蛋白的减少又将导致 RGCs 凋亡的增加。因此,研究ECM和青光眼的关系至关重要,可能为原发性开角型青光眼发病机制及治疗提供新的方向。%Glaucoma is characterized by optic atrophy and visual field defect. The pathological elevated intraocular pressure is the leading risk factor for glaucoma. The pathological characteristic of glaucoma is apoptosis of retinal ganglion cells ( RGCs ) and their axon loss. Changes of the amounts and compositions of the extracellular matrix ( ECM ) play a crucial role in the structure of trabecular meshwork, lamina cribrose of opitic nerve head and the apoptosis of RGCs. The expression of transforming growth factor-β2 ( TGF-β2 ) increases in trabecular meshwork and aqueous humor for glaucomatic patients, which leads to elevated intraocular pressure by secretion and accumulation of ECM. Elevated intraocular pressure causes changes in ECM of optic nerve head and retina, resulting in blocked transport of neurotrophins, the high level of matrix metalloproteinase ( MMPs)-9 and low level of laminin respectively, which eventually lead to the apoptosis of RGCs. Therefore, it is important to understand the relationship between ECM and glaucoma, which

  19. [Hearing disorders with glaucoma].

    Science.gov (United States)

    Kremmer, S; Anastassiou, G; Selbach, J M

    2014-02-01

    One of the most common sensory impairments of elderly people is hearing loss. Glaucoma is one of the leading causes of blindness worldwide. Hearing and vision loss typically increase with older age. There is scientific evidence that the coincidence of hearing and vision loss is more frequent than expected by the prevalence of individual disorders. With regards to demographic changes and an aging population, in future, it is probable that the incidence of combined hearing and vision impairments will increase, representing a particular challenge not only for doctors and nurses but also a high burden for the private environment of the patients. Therefore, it is of particular importance to diagnose and to treat hearing and vision loss (dual sensory loss) as early as possible. The treatment of hearing disorders and glaucoma as well as possibly underlying systemic diseases such as circulatory disturbances is as important as responsible rehabilitation measures and the supply of hearing and low vision aids. During the last years, knowledge about the molecular biological background of hearing loss and glaucoma has continuously increased but it is currently still at the level of laboratory and animal experiments. Therefore, it remains to be seen whether and to what extent a real therapy for the underlying genetic, immunological and in particular mitochondrial disorders may be accessible in the future.

  20. 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.

  1. Prevalence of comorbid retinal disease in patients with glaucoma at an academic medical center

    Directory of Open Access Journals (Sweden)

    Griffith JF

    2015-07-01

    Full Text Available Joseph F Griffith,1 Jeffrey L Goldberg2 1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2Shiley Eye Center, University of California San Diego, La Jolla, CA, USA Background: Patients with various retinal diseases and patients who have undergone retinal procedures and surgeries have an increased risk of developing ocular hypertension and glaucoma. Little is known about the epidemiology of comorbid retinal diseases in glaucoma patients. This study evaluated the prevalence of retinal comorbidities in a population of patients with five types of glaucoma.Methods: A longitudinal, retrospective study was conducted using International Classification of Disease (ICD-9 billing records from 2003 to 2010 at an academic medical center. Patients were classified as having primary open-angle glaucoma (POAG, low tension open-angle glaucoma (NTG, pigmentary open-angle glaucoma, chronic-angle closure glaucoma (CACG, or pseudoexfoliation glaucoma (PXG if they had at least three clinic visits with the same ICD-9 code. Patients were classified as having a retinal comorbidity if they had two visits with the same code. Variables were analyzed with the independent t-test, χ2 test, analysis of variance, or Fisher’s exact test.Results: A total of 5,154 patients had glaucoma, and 14.8% of these had a retinal comorbidity. The prevalence of comorbid retinal disease was higher in patients with POAG (15.7% than in those with NTG (10.7%, PXG (10.1%, or pigmentary open-angle glaucoma (3.7%; P<0.05. Two hundred and two patients had diabetic retinopathy, with POAG patients (4.5% having a higher prevalence than those with CACG (1.4% or PXG (0.6%; P<0.001. There were 297 patients who had macular degeneration and both POAG (2.0% and PXG patients (2.9% had a higher prevalence of nonexudative macular degeneration than those with CACG (0%; P<0.01. Patients with comorbid retinal disease had a higher prevalence of blindness and low vision than those without comorbid

  2. 中国原发性开角型青光眼一家系MYOC基因的突变分析%Analysis of MYOC gene mutation in a primary open angle glaucoma family from China

    Institute of Scientific and Technical Information of China (English)

    王凤云; 李杨; 兰兰; 李博; 陆晓和

    2014-01-01

    Background Primary open angle glaucoma (POAG) is one of the frequent glaucomatous types,and genetic factor participates in pathogenesis and development of the disease.Recently,MYOC mutation was found to be associated with POAG.Objective This study was to describe the clinical and genetic findings in a POAG family from Luoyang,China.Methods This study protocol was approved by Ethic Committee of Affiliated First Hospital of Henan University of Science and Technology.The study adhered to Declaration of Helsinki.A POAG family with 29 members of 5 generations was surveyed and followed-up for 5-year duration.The mode of inheritance was determined by the pedigree analysis.The periphery blood sample was collected form 12 families and 100 health controls for the extraction of genomic DNA under the informed consent.The third exon and its flanking introns of MYOC were amplified,and quantitative real time PCR products were sequenced,and the structure and function of mutated gene were examined by restriction fragment length polymorphism analysis.The predicted effects of the detected variants on the secondary structure of MYOC protein were evaluated using Garnier-Osguthorpe-Robson (GOR) method,and homology analysis of protein was carried out by Blast software provided by National Center for Biotechnology Information (NCBI).Results This POAG family included 29 members of 5 generations,and the clinical data were not clear in 11 family members.Three individuals from 3 generations were determined POAG,another one was ocular hypertension,and 2 were carriers.Pedigree analysis appeared an autosomal dominant inheritance.In 12 subjects included 6 members genetically affected and 6 members with normal phenotype,the heterozygous mutation was found in the third exon of MYOC gene in 6 genetically affected members,which revealed a T→C transition at position 1021 (p.S341P),resulting in a switch of serine (Ser) to proline (Pro).It was a missense mutation abolished a CviKI-1 restriction site

  3. Glaucoma and Cytochrome P4501B1 Gene Mutations

    Directory of Open Access Journals (Sweden)

    Mukesh Tanwar

    2010-01-01

    Full Text Available Developmental anomalies of the ocular anterior chamber angle may lead to an incomplete development of the structures that form the conventional aqueous outflow pathway. Thus, disorders that present with such dysfunction tend to be associated with glaucoma. Among them, Axenfeld-Rieger (ARS malformation is a rare clinical entity with an estimated prevalence of one in every 200,000 individuals. The changes in eye morphogenesis in ARS are highly penetrant and are associated with 50% risk of development of glaucoma. Mutations in the cytochrome P4501B1 (CYP1B1 gene have been reported to be associated with primary congenital glaucoma and other forms of glaucoma and mutations in pituitary homeobox 2 (PITX2 gene have been identified in ARS in various studies. This case was negative for PITX2 mutations and compound heterozygote for CYP1B1 mutations. Clinical manifestations of this patient include bilateral elevated intraocular pressure (>40 mmHg with increased corneal diameter (>14 mm and corneal opacity. Patient also had iridocorneal adhesions, anteriorly displaced Schwalbe line, anterior insertion of iris, broad nasal bridge and protruding umbilicus. This is the first study from north India reporting CYP1B1 mutations in Axenfeld-Rieger syndrome with bilateral buphthalmos and early onset glaucoma. Result of this study supports the role of CYP1B1 as a causative gene in ASD disorders and its role in oculogenesis.

  4. Comparison of Intraocular Pressure, Blood Pressure, Ocular Perfusion Pressure and Blood Flow Fluctuations During Dorzolamide Versus Timolol Add-On Therapy in Prostaglandin Analogue Treated Glaucoma Subjects

    Directory of Open Access Journals (Sweden)

    Ruta Barsauskaite

    2012-03-01

    Full Text Available Objective: To compare the effects of dorzolamide and timolol add-on therapy in open-angle glaucoma (OAG patients previously treated with prostaglandin analogue (Pg, by evaluating fluctuations in the intraocular (IOP, blood (BP, ocular perfusion pressures (OPP and retrobulbar blood flow (RBF parameters. Methods: 35 OAG patients (35 eyes, 31 women (88.6% age 63.3 (8.9 years were evaluated in a 3 month randomized, cross-over, single-masked study. During the experiments BP, heart rate, IOP and OPP were assessed 4 times per day (8–12–16–20 h. RBF was measured twice per day (8–20 h using Color Doppler imaging in the ophthalmic (OA, central retinal (CRA, nasal (nSPCA and temporal (tSPCA posterior ciliary arteries. In each vessel, peak systolic velocity (PSV and end-diastolic velocity (EDV were assessed and vascular resistance (RI calculated. Results: Both add-on therapies lowered IOP in a statistically significant manner from 15.7 ± 2.4 mmHg at latanoprost baseline to 14.9 ± 2.2 mmHg using dorzolamide (p < 0.001 and 14.2 ± 1.9 mmHg using timolol (p < 0.001. The IOP lowering effect was statistically significant at 20 h, favoring timolol as compared to dorzolamide (1.4 ± 2.4 vs. 0.2 ± 2.1 mmHg, (p < 0.05. Dorzolamide add-on therapy showed smaller IOP (2.0 ± 1.4, SPP (13.3 ± 7.9, systolic BP (13.5 ± 8.7 and diastolic BP (8.4 ± 5.4 fluctuations as compared to both latanoprost baseline or timolol add-on therapies. Higher difference between morning and evening BP was correlated to decreased evening CRA EDV in the timolol group (c = −0.41; p = 0.01. With increased MAP in the morning or evening hours, we found increased evening OA RI in timolol add-on group (c = 0.400, p = 0.02; c = 0.513, p = 0.002 accordingly. Higher MAP fluctuations were related to impaired RBF parameters during evening hours-decreased CRA EDV (c = −0.408; p = 0.01, increased CRA RI (c = 0.576; p < 0.001 and tSPCA RI (c = 0.356; p = 0.04 in the dorzolamide group and

  5. 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.

  6. The future of glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Arsham Sheybani

    2015-01-01

    Full Text Available Glaucoma surgery is ripe for innovation. In the last few years, there has been a substantial increase in the number of devices approaching commercialization. While not all that is new is necessarily good, the role of these devices in changing glaucoma surgery is equally important in terms of both success and failure. Trabeculectomy, the most commonly performed incisional filtration surgery for glaucoma, is subjective by nature and certainly has risks. As devices aim to standardize glaucoma surgery, specifically subconjunctival filtration surgery, predictability and in turn safety should theoretically improve. This may allow the glaucoma surgeon to intervene earlier in the disease process, prevent more advanced vision loss and potentially decrease the burden of medications.

  7. Anterior lamina cribrosa surface position in idiopathic intracranial hypertension and glaucoma

    DEFF Research Database (Denmark)

    Villarruel, Jenni Martinez; Li, Xiao; Bach-Holm, Daniella;

    2017-01-01

    PURPOSE: To compare the anterior lamina cribrosa (LC) surface position in patients with idiopathic intracranial hypertension (IIH), primary open-angle glaucoma (high-tension glaucoma [HTG] and normal-tension glaucoma [NTG]), and healthy controls using enhanced depth imaging spectral-domain optical...... the Bruch membrane opening plane to the anterior LC surface, was manually measured on selected B-scans covering the central three-quarters of the optic nerve head in each eye. RESULTS: Mean LC depth in patients with IIH (325.2 ± 92.1 µm) was significantly (p<0.01) decreased compared to control subjects...

  8. Applying Transpalpebral Rheoophthalmography to Monitor Effectiveness of the Treatment of Patients with Glaucoma

    Directory of Open Access Journals (Sweden)

    Dmitry M. Shamaev

    2016-12-01

    Full Text Available Assessment of ocular hemodynamics is an important element in diagnosis of all forms of glaucoma. Existing methods, unlike the transpalpebral rheoophthalmography (TP-ROG, evaluate only the posterior eye segment. This study evaluates the opportunities of new TP-ROG technology to assess the effectiveness of the glaucoma treatment. The proposed TP-ROG method is characterized by ease of use and the lack of direct contact between the surface of the eyeball and the electrodes; this method is highly informative and quite accurate, which allows us to objectively assess the state of ocular hemodynamics in patients with primary open-angle glaucoma.

  9. 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.

  10. Relationship of carbonic anhydrase Ⅱgene polymorphism with primary open angle glaucoma genetic susceptibility%碳酸酐酶Ⅱ基因多态性与原发性开角型青光眼遗传易感性的关系

    Institute of Scientific and Technical Information of China (English)

    吴安黛; 叶锌铭; 高和香; 李俊; 赵晨

    2016-01-01

    Abstract•AIM:To analyze the relationship of carbonic anhydraseⅡ gene polymorphism with primary open angle glaucoma genetic susceptibility.•METHODS:From January 2012 to December 2014, 50 cases in our hospital for treatment of primary open angle glaucoma ( study group ) and 50 cases in outpatient department of our hospital for health examination ( control group ) were tested. The conventional elbow venous blood was taken.The use of polymerase chain reaction ( PCR ) and restriction fragment length polymorphism test were used to detect the characteristics of carbonic anhydraseⅡgene polymorphism.•RESULTS:The locus site of rs3758078 and rs10504813 of the two groups were in line with Hardy -Weinberg equilibrium law ( Hardy -Weinberg equilibrium ) .The results displayed in rs10504813 site, the difference of genotype frequencies between the two groups was not statistically significant ( P>0.05 ) .But the difference in allele frequencies between the two groups was statistical significance (P0.05 ) .After the carbonic anhydrase Ⅱ polymorphism haplotype analysis in the two groups, TAC ( Tracking area code of cell served by neighbor Enb) haplotype carriers appeared lawer risk of primary open-angle glaucoma.•CONCLUSION:There is certain relation between the polymorphism and the risk of carbonic anhydrase primary open -angle glaucoma, and rs3758078 locus balance may be the main reason for low risk; TAC haplotype carriers appear lower risk of primary open angle glaucoma.%目的:分析碳酸酐酶Ⅱ基因多态性与原发性开角型青光眼遗传易感性的关系。方法:选取2012-01/2014-12在丽水市人民医院进行诊治的原发性开角型青光眼患者(观察组)50例与在丽水市人民医院门诊部体检的健康人(对照组)50例进行试验观察,常规肘静脉取血,使用聚合酶链反应和限制性片段长度多态性技术测试碳酸酐酶Ⅱ基因多态性的特点。结果:两组患者在和rs10504813位

  11. Gene therapy in glaucoma-3: Therapeutic approaches

    OpenAIRE

    Mohamed Abdel-Monem Soliman Mahdy

    2010-01-01

    Despite new and improving diagnostic and therapeutic options for glaucoma, blindness from glaucoma is increasing and glaucoma remains a major public health problem. The role of heredity in ocular disease including glaucoma is attracting greater attention as the knowledge and recent advances of Human Genome Project and the HapMap Project have made genetic analysis of many human disorders possible. Glaucoma offers a variety of potential targets for gene therapy. All risk factors for glaucom...

  12. 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

  13. 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.

  14. Attributes Associated with Adherence to Glaucoma Medical Therapy and its Effects on Glaucoma Outcomes: An Evidence-Based Review and Potential Strategies to Improve Adherence.

    Science.gov (United States)

    Joseph, Arun; Pasquale, Louis R

    2017-01-01

    The treatment paradigm in glaucoma classically starts with exhausting all medical therapy prior to proceeding with laser or incisional surgery, although laser-first and surgery-first strategies have been explored in randomized clinical trials. Although glaucoma drops are proven to work well to lower intraocular pressure, slow the conversion from ocular hypertension, and slow the progression of disease in early open angle glaucoma, adherence to treatment is likely optimum in the randomized clinical trials that support these claims. In real-world scenarios, medical therapy often fails and practitioners are forced to proceed with more invasive treatment modalities to slow the progression of this blinding disease. This review aims to take an evidence-based approach to study the risk factors for poor adherence in glaucoma patients, to determine whether poor adherence is, in fact, associated with worse outcomes, and to seek potential strategies to improve adherence in these patients.

  15. Combined surgery for neovascular angle-closure glaucoma secondary to proliferative diabetic retinopathy%联合手术治疗增殖性糖尿病视网膜病变的继发性新生血管性闭角型青光眼

    Institute of Scientific and Technical Information of China (English)

    李丽; 关新辉; 易湘龙

    2016-01-01

    AlM:To explore the efficacy and safety of combined surgery for neovascular angle - closure glaucoma secondary to proliferative diabetic retinopathy ( PDR) . METHODS:A prospective nonrandomized clinical study was performed. All enrolled patients were initially treated with intravitreal injection of ranibizumab at the dose of 0. 5mg (0. 05mL). After new vessels (NV) on the iris and the angle of anterior chamber regressed completely, all patients received phacoemulsification ( PHACO ) , intraocular lens implantation ( lOL ) , trabeculectomy ( TRAB ) , pars plana vitrectomy ( PPV ) and endophotocoagulation ( EPC ) . The changes of best corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , NV and complications were observed, and followed up for 6mo. RESULTS: Nineteen eyes of 19 patients with neovascular glaucoma ( NVG ) were involved in this study. After followed up for 6mo, postoperative BCVA of all was improved. Mean lOP was decreased significantly (P CONCLUSlON: Combined surgery of intravitreal injection of ranibizumab as adjunctive treatment for PHACO+lOL+TRAB+PPV+EPC could be safe and effect for neovascular angle-closure glaucoma secondary to PDR.%目的:探讨联合手术治疗增殖性糖尿病视网膜病变的继发性新生血管性闭角型青光眼的临床疗效。  方法:前瞻性非随机临床研究。所有入选患者先行玻璃体腔注射ranibizulab 0.5lg(0.05lL),待虹膜和房角新生血管完全消退,再行白内障超声乳化吸除术+人工晶状体植入术+小梁切除术+经睫状体平坦部玻璃体切除术+眼内激光术。术后随访6lo,观察最好矫正视力( best corrected visual acuity,BCVA)、眼压( IOP)、虹膜新生血管( NV)及并发症的变化情况。  结果:入选患者19例19眼,随访6 lo所有患者术后视力均有提高。平均IOP显著降低,差异有统计学意义( P  结论:玻璃体腔注射ranibizulab辅助白内障超声乳化吸除术+人工晶状体植入术+小梁

  16. LOXL1基因多态性与四川地区原发性开角型青光眼的关联研究%Association between LOXL1 gene polymorphisms and primary open angle glaucoma in Sichuan population

    Institute of Scientific and Technical Information of China (English)

    龚波; 李秀兰; 李宁; 郝芳; 陈蓉; 曾光群; 张丁丁

    2015-01-01

    Objective To investigate association between the lysyl oxidase-like 1 (LOXL1)gene single nucleotide polymorphism(SNP) and primary open-angle glaucoma (POAG) in Sichuan population.Methods In this study,416 subjects with primary open-angle glaucoma and 997 normal controls were recruited.Three reported LOXL1 tag SNPs (rs1048661,rs3825942 and rs2165241)were genotyped by SNaPshot method.Results The study showed that the genotypes of LOXL1 rs1048661,rs3825942 and rs2165241 between POAG and control groups were not statistically significant (OR=1.085,95%CI 0.92-1.28,P=0.578 for rs1048661 ;OR=1.059,95%CI 0.82-1.37,P=0.846 for rs3825942; OR=1.006,95%CI 0.77-1.32,P=0.966 for rs2165241,respectively).There were no significant difference in allele frequency distribution ofLOXL1 rs1048661、rs3825942 and rs2165241 between POAG and normal controls (P=0.322,P=0.660,P=0.965).Conclusion The results from the present study do not indicate the association of LOXL1 SNPs (rs1048661,rs3825942 and rs2165241)with POAG in Sichuan population.%目的 探讨四川地区原发性开角型青光眼(primary open angle glaucoma,POAG)与LOXL1基因单核苷酸多态性(single nucleotide polymorphism,SNPs)位点rs1048661、rs3825942和rs2165241的关联性.方法 选取416例POAG患者及997名正常对照,采用病例-对照关联研究设计方法,用单碱基延伸(SNaPshot)法对已报道的LOXL1基因的3个标签SNPs位点(rs1048661、rs3825942和rs2165241)进行基因分型.结果 LOXL1基因的3个标签SNPs位点rs1048661、rs3825942和rs2165241的基因型频率在四川地区POAG病例组和对照组间差异无统计学意义(P=0.578、P=0.846、P=0.966),其相应的OR值(95%CI)分别是1.085 (0.92~1.28)、1.059 (0.82~1.37)和1.006(0.77~1.32).这3个位点的等位基因频率在POAG病例组和正常对照组间的差异也均无统计学意义(P=0.322、P=0.660、P=0.965).结论 LOXL1基因SNPs位点rs1048661、rs3825942和rs2165241与四川地区POAG无关联性.

  17. Effects comparison of tree prostaglandin eyedrops in reducing open-angle glaucoma intraocular pressure%不同种类前列腺素类滴眼液治疗原发性开角型青光眼的降眼压效果对比

    Institute of Scientific and Technical Information of China (English)

    杨洪涛

    2014-01-01

    Objective To compare the effect of latanoprost, travoprost and bimatoprost on the 24 h intraocular pressure (IOP) curve in open-angle glaucoma patients. Methods 78 patients with open-angle glaucoma were randomly divided into 3 groups according to different kinds of administration methods, with 26 cases in each group. GroupⅠ, groupIIand group Ⅲ were treated once daily with latanoprost, travoprost and bimatoprost eyedrops for four weeks,respectively. Be-fore and 4 weeks after the treatment, IOP was measured and compared at 4 time opints in 24 hours. Results There was no difference of IOP before the treatment among the three groups (P > 0.05), but IOP became lower at various time points among the three groups 4 weeks after the treatment, the differences were statistically significant (P0.05). There was no significant difference of IOP a-mong the three groups after 4 weeks' treatment (P>0.05). Conclusion The method is quite obvious by using latanoprost, travoprost and bimatoprost on the IOP in open-angle glaucoma patients.%目的:比较拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼患者6周后的降眼压的效果.方法选取2012年10月~2013年10月于承德市中心医院门诊就诊的原发性开角型青光眼患者78例(141只眼).将其按照给药方法分为三组,每组均为26例,其中玉组给予拉坦前列素滴眼液(47只眼);域组给予曲伏前列素滴眼液(47只眼);芋组给予贝美前列素滴眼液(47只眼),三组均每日不同时间点滴眼1次,疗程为4周,测量比较三组用药前后的24 h内、不同时间点的眼压以及用药前后4周内眼压.结果三组治疗前眼压比较,差异无统计学意义(P>0.05);三组治疗后24 h内各时间点眼压均明显下降,差异有统计学意义(P0.05);三组用药后4周眼压比较,差异无统计学意义(P>0.05).结论采用拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原

  18. A novel P/Ag/Ag2O/Ag3PO4/TiO2 composite film for water purification and antibacterial application under solar light irradiation.

    Science.gov (United States)

    Zhu, Qi; Hu, Xiaohong; Stanislaus, Mishma S; Zhang, Nan; Xiao, Ruida; Liu, Na; Yang, Yingnan

    2017-01-15

    TiO2-based thin films have been intensively studied in recent years to develop efficient photocatalyst films to degrade refractory organics and inactivate bacteria for wastewater treatment. In the present work, P/Ag/Ag2O/Ag3PO4/TiO2 composite films on the inner-surface of glass tube were successfully prepared via sol-gel approach. P/Ag/Ag2O/Ag3PO4/TiO2 composite films with 3 coating layers, synthesized at 400°C for 2h, showed the optimal photocatalytic performance for rhodamine B (Rh B) degradation. The results indicated that degradation ratio of Rh B by P/Ag/Ag2O/Ag3PO4/TiO2 composite film reached 99.9% after 60min under simulated solar light, while just 67.9% of Rh B was degraded by pure TiO2 film. Moreover, repeatability experiments indicated that even after five recycling runs, the photodegradation ratio of Rh B over composite film maintained at 99.9%, demonstrating its high stability. Photocatalytic inactivation of E. coli with initial concentration of 10(7)CFU/mL also showed around 100% of sterilization ratio under simulated solar light irradiation in 5min by the composite film. The radical trapping experiments implied that the major active species of P/Ag/Ag2O/Ag3PO4/TiO2 composite films were photo-generated holes and O2(-) radicals. The proposed photocatalytic mechanism shows that the transfer of photo-induced electrons and holes may reduce the recombination efficiency of electron-hole pairs and potential photodecomposition of composite film, resulting in enhanced photocatalytic ability of P/Ag/Ag2O/Ag3PO4/TiO2 composite films.

  19. 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 ...

  20. Clinical Observation on Evidence-based Nursing Applied to the Patients Suffering from Primary Angle-closure Glaucoma%循证护理应用于原发性闭角型青光眼患者的效果观察

    Institute of Scientific and Technical Information of China (English)

    夏湘君; 曹亚; 徐玲亚; 王燕萍

    2014-01-01

    Objective:To explore the effects of evidence-based nursing (EBN) administered to the patients undergoing the surgery of primary angle-closure glaucoma. Methods:Fifty patients who underwent trabeculectomy under retrobulbar anaesthesia were randomized into the experiment group and the control group equally. Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), self-rating scale of sleep (SRSS) and social support revalued scale (SSRS) of both groups were compared. Results:The experiment group was lower than the control group remarkably in SAS, SDS and SRSS after nursing (P<0.05), while higher than the control group remarkably in SSRS (P<0.05). Conclusion:EBN could improve negative emotion of the patients undergoing the surgery of primary angle-closure glaucoma, raise sleep quality and social support.%目的:探讨循证护理在原发性闭角型青光眼手术患者中的应用效果。方法:将50例球后麻醉下行小梁切除术的原发性闭角型青光眼手术患者随机分为研究组和对照组各25例。比较2组Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、改良睡眠状况自评量表(SRSS)和社会支持评定量表(SSRS)评分变化。结果:SAS、SDS和SRSS评分护理后研究组明显低于对照组(P<0.05),而SSRS各维度评分研究组显著高于对照组(P<0.05)。结论:循证护理可改善原发性闭角型青光眼手术患者的负性情绪,提高睡眠质量和社会支持。

  1. 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.

  2. 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.

  3. Molecular genetics of the glaucomas: Mapping of the first five {open_quotes}GLC{close_quotes} loci

    Energy Technology Data Exchange (ETDEWEB)

    Raymond, V.

    1997-02-01

    Glaucoma encompasses a complex of ocular-disease entities characterized by an optic neuropathy in which degeneration of retinal ganglion cells leads to a characteristic excavation of the head of the optic nerve. Such damage causes progressive narrowing of the visual fields and, when uncontrolled, blindness. Affected people often have ocular hypertension defined as intraocular pressures consistently >21 mm Hg in both eyes. Although ocular hypertension is no longer an obligatory diagnostic criterion for glaucoma, it is still recognized as one of the most important risk factors. A diagnosis of glaucoma is made after observation of the characteristic atrophy of the optic nerve, which is associated with typical visual field defects. In 1992, the World Health Organization estimated that, in the global population, 5.2 million people were blind as a result of glaucoma, making it the third leading cause of blindness worldwide. The most common form is adult-onset primary open-angle glaucoma, which represents {ge}50% of all cases of glaucoma. Among Caucasians, this form of the disorder affects {approximately}2% of the population >45 years old. In African Americans, prevalence of adult-onset open-angle glaucoma is three to four times higher than that observed in White Americans. More than 15 million North Americans may have some form of glaucoma, but at least half of them may not be aware of it. 43 refs., 1 tab.

  4. Correlation between genotype and phenotype in primary open angle glaucoma of Brazilian families with mutations in exon 3 of the TIGR/MYOC gene Correlação entre genótipo-fenótipo em famílias brasileiras com glaucoma primário de ângulo aberto determinada por mutações no exon 3 do gene TIGR/MYOC

    Directory of Open Access Journals (Sweden)

    Cristine Araújo Povoa

    2006-06-01

    Full Text Available PURPOSE: To investigate the phenotype of primary open-angle glaucoma (POAG in Brazilian families with mutation in exon 3 of TIGR/MYOC. METHODS: Seventy-eight POAG patients with a positive family history and eighteen unrelated patients with POAG were screen