Glaucoma maligno en paciente con cirugía previa de catarata traumática e implante valvular: reporte de caso

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Juan Carlos Serna-Ojeda

2015-07-01

Full Text Available El glaucoma maligno es un glaucoma secundario asociado con un bloqueo ciliar y dirección equivocada del flujo del humor acuoso. Se presenta el caso de un paciente masculino de 19 años con antecedente de explosión de filtro metálico en ojo derecho. Se encuentra con una presión intraocular de 52 mmHg y cristalino luxado a cámara anterior. Se inicia terapia máxima para glaucoma y se realiza facoemulsificación con posterior colocación de válvula de Ahmed, y 3 semanas después de la cirugía presenta hallazgos clínicos compatibles con glaucoma maligno. Se presenta el seguimiento del paciente y los estudios de imagen indicados

Hipoadrenocorticismo primario canino: reporte de caso

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J. L. Granados

2011-06-01

Full Text Available Un canino macho Cocker Spaniel de 6 meses de edad fue presentado a la Clínica para Pequeños Animales de la Universidad Nacional de Colombia, con historia de vómito y diarrea de una semana de duración. El paciente presentaba hiperkalemia, y los electrocardiogramas realizados fueron compatibles con este hallazgo. El diagnóstico de hipoadrenocorticismo primario fue confirmado mediante la realización de una prueba de estimulación con ACTH. Posteriormente a la muerte súbita del paciente, el examen microscópico de las glándulas adrenales reveló cambios histológicos compatibles con laenfermedad de Addison. El hipoadrenocorticismo primario es un desorden endocrinopoco común que afecta principalmente pacientes caninos; está caracterizado por ladestrucción inmunomediada de las cortezas adrenales, lo cual conduce a deficienciade glucocorticoides, mineralocorticoides y hormonas sexuales adrenales. La historia delos pacientes afectados es variable y los signos clínicos son usualmente inespecíficos; laspruebas de laboratorio, por lo general, revelan hiperkalemia e hiponatremia, resultantesde la pérdida de la secreción de aldosterona. La historia, el examen clínico, la ecografíaabdominal y los hallazgos de laboratorio pueden indicar enfermedad de Addison, sinembargo, la prueba de estimulación con hormona adrenocorticotrópica (ACTH esconsiderada como la prueba de oro para el diagnóstico definitivo de la entidad. La enfermedadde Addison no tiene cura, pero puede ser manejada con terapia médica parareemplazar las deficiencias de mineralocorticoides y glucocorticoides.

Trabeculoplastia selectiva con láser en glaucoma Selective laser trabeculoplasy in the treatment of glaucoma

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Ailen Garcés Fernández

2009-12-01

Full Text Available Se realiza una breve revisión bibliográfica sobre la trabeculoplastia selectiva con Nd YAG Láser de frecuencia doblada en la enfermedad glaucomatosa. El equipo Laserex Tango LT 5106-T Nd: YAG Láser (Ellex Medical Pty Ltd para trabeculoplastia selectiva se encuentra en nuestro instituto desde marzo de 2006, única institución del país que dispone de este equipo hasta este momento. La alta esperanza de vida de nuestra población, que conlleva a un incremento en la incidencia de glaucoma y cataratas, induce a ser consecuentes con todo aquello que contribuya a mejorar la calidad de vida de los pacientes: esta circunstancia motivó esta revisión. Se presentan sus indicaciones, parámetros más utilizados, efectividad y complicaciones.A brief literature review on selective trabeculoplasty with doubled frequency Nd:YAG laser in the treatment of glaucoma was made. Laserex Tango LT 5106-T Nd: YAG Laser (Ellex Medical Pty Ltd equipment for selective trabeculoplasty is available in our institute since March 2006 (the only center having this equipment in our country up to the present. The high life expectancy of our population, with an increase of glaucoma and cataract incidence, prompts us to be consistent with everything that supports the improved quality of life of patients; this was the reason for this review. Indications, most used parameters, effectiveness and complications were presented.

Osteosarcoma primario del corazón

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Benito Serrano Gomez

1986-07-01

Full Text Available Se informa un caso de osteosarcoma primario del corazón localizado en el ventrículo derecho con metástasis al sistema nervioso central, pulmón derecho y a la serosa del fleon. Este es el único tumor maligno primario del corazón en nuestro archivo de 12.230 autopsias realizadas en el Hospital San Juan de Dios en Bogotá entre 1954 y 1986. Se subraya el hecho de que las manifestaciones clínicas puedan obedecer, como ocurrió en este caso, a las metástasis y no a la alteración funcional del órgano afectado par la neoplasia primitiva. Se hace una electiva revisión del tema.

Hipoadrenocorticismo primario canino: reporte de caso

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J. L. Granados

2011-01-01

Full Text Available Un canino macho Cocker Spaniel de 6 meses de edad fue presentado a la Clínica para Pequeños Animales de la Universidad Nacional de Colombia, con historia de vómito y diarrea de una semana de duración. El paciente presentaba hiperkalemia, y los electrocardiogramas realizados fueron compatibles con este hallazgo. El diagnóstico de hipoadrenocorticismo primario fue confirmado mediante la realización de una prueba de estimulación con ACTH. Posteriormente a la muerte súbita del paciente, el examen microscópico de las glándulas adrenales reveló cambios histológicos compatibles con la enfermedad de Addison. El hipoadrenocorticismo primario es un desorden endocrino poco común que afecta principalmente pacientes caninos; está caracterizado por la destrucción inmunomediada de las cortezas adrenales, lo cual conduce a deficiencia de glucocorticoides, mineralocorticoides y hormonas sexuales adrenales. La historia de los pacientes afectados es variable y los signos clínicos son usualmente inespecíficos; las pruebas de laboratorio, por lo general, revelan hiperkalemia e hiponatremia, resultantes de la pérdida de la secreción de aldosterona. La historia, el examen clínico, la ecografía abdominal y los hallazgos de laboratorio pueden indicar enfermedad de Addison, sin embargo, la prueba de estimulación con hormona adrenocorticotrópica (ACTH es considerada como la prueba de oro para el diagnóstico definitivo de la entidad. La enfermedad de Addison no tiene cura, pero puede ser manejada con terapia médica para reemplazar las deficiencias de mineralocorticoides y glucocorticoides.

La disfunción del cilio primario y su relación con las ciliopatías. Bases moleculares y celulares

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Zulema Ramírez Carmenate

2017-01-01

Full Text Available bjetivo: explicar la relación estructural y funcional de la disfunción del cilio primario en enfermedades genéticas denominadas ciliopatías. Desarrollo: las disfunciones ciliares están estrechamente vinculadas con un amplio espectro de enfermedades denominadas ciliopatías, que se definen como un grupo de síndromes clínica y genéticamente heterogéneos. Son causadas por defectos en la formación o función de algunas variedades de cilios. Diversos estudios se enfocan en el esclarecimiento de cómo la disfunción ciliar puede desarrollar estas enfermedades que incluyen rasgos fenotípicos comunes tales como, los riñones poliquísticos, el retraso mental y la obesidad; también involucran malformaciones en el sistema esquelético y defectos en el desarrollo de órganos del sistema nervioso central. En la actualidad, la identificación de los componentes que participan en la generación y función de estos organelos así como, la relación estructura-función, se considera como un paso clave en el entendimiento de la biología ciliar y la etiología de las ciliopatías. La amplia distribución de las variedades de cilios y las funciones orgánicas fundamentalmente del cilio primario, permite que sus disfunciones se relacionen con las ciliopatías y abren un campo de explicaciones a numerosas enfermedades cuya causa estructural-molecular eran totalmente desconocidas. Conclusiones: los defectos en la formación y función de los cilios primarios son la base fundamental de las ciliopatías, que afectan el desarrollo y funciones de varios sistemas de órganos. El espectro de la función ciliar en los procesos celulares fundamentales, destaca la importancia de dilucidar las proteínas relacionadas con las ciliopatías a fin de encontrar nuevas terapias potenciales.

Síndrome de Waardenburg. Presentación de un caso con glaucoma pigmentario

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Sol Inés Parapar Tena

2017-11-01

Caso clínico: Paciente femenina de 30 años de edad que acude con diagnóstico de síndrome de Waardenburg tipo ii subtipo B, con heterocromía del iris, huso de Krukenberg, hipermetropía, hiperpigmentación de la malla trabecular del ángulo iridocorneal y presión ocular ligeramente elevada que nos hicieron pensar en un glaucoma pigmentario.

Linfoma de Burkitt primario de la cavidad oral en una paciente con sida. Reporte de un caso y revisión de la literatura

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Marcelo Corti

2015-01-01

Full Text Available Los linfomas no Hodgkin (LNH son un grupo heterogéneo de enfermedades linfoproliferativas con elevada prevalencia en pacientes infectados por el virus de la inmunodeficiencia humana (VIH. La inmunodeficiencia asociada al sida predispone al desarrollo de LNH, incluyendo el linfoma de Burkitt (LB. El LB es un subtipo infrecuente y agresivo de LNH con elevada frecuencia en pacientes con sida. Se asocia a una alta tasa de replicación celular (determinada por el índice Ki67 y con alta frecuencia de compromiso extranodal como forma de presentación clínica de la neoplasia. Se presenta una paciente con sida que desarrolló un LB primario de la cavidad oral y se realiza una revisión de la literatura sobre el tema.

Influencia del uso de la tierra con cultivos de cacao, chakras y bosque primario, sobre la diversidad, almacenamiento de carbono y productividad en la Reserva de la Biosfera Sumaco, Ecuador.

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Jadán Maza, Ángel Oswaldo

2013-01-01

La investigación se realizó en la Reserva de la Biosfera Sumaco, en la provincia del Napo, Republica del Ecuador. Se estudiaron siete sistemas de uso de la tierra: Chakras con y sin sombra, cultivos de cacao propagados por semilla con y sin sombra, cacao injertado con y sin sombra y bosque primario. Se evaluaron tres variables de respuesta: diversidad arbórea y arbustiva, almacenamiento-acumulación de carbono (C) y productividad, en los diferentes sistemas de usos de la tierra.

Evaluación estética de seis tipos de coronas para dientes primarios

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Héctor Alejandro Ramírez Peña

2017-03-01

Full Text Available Objetivo: Evaluar las preferencias estéticas en relación con el color y la forma de coronas primarias utilizadas para dientes incisivos superiores primarios, mediante la realización de una encuesta a miembros de la Academia Mexicana de Odontología Pediatrica (AMOP. Material y Métodos: Se establecieron seis grupos de estudio con seis coronas diferentes: grupo 1, coronas de zirconia EZ-Pedo; grupo 2, coronas de zirconia NuSmile Zr; grupo 3, coronas estéticas hechas en el consultorio; grupo 4, coronas de fundas de celuloide; grupo 5, coronas estéticas prefabricadas NuSmile signature; y grupo 6, coronas estéticas fenestradas. Se llevaron a cabo encuestas con la finalidad de conocer las preferencias estéticas de estas diferentes coronas, con la finalidad de conocer cuál es la mejor opción para su uso en el consultorio dental. Resultados: Noventa miembros de la AMOP realizaron una encuesta válida, y se determinó que el grupo 4 fue el mejor evaluado, seguido de los grupos 2, 5, 1, 6 y 3. Se identificaron diferencias significativas entre los diferentes grupos. Conclusiones: Las coronas de fundas de celuloide fueron seleccionadas como mejor alternativa de uso en los dientes primarios anteriores, por parte de los miembros de la AMOP; asimismo, se consideró a las coronas de zirconia como una buena opción terapéutica. Es recomendable que se implemente el tratamiento estético en dientes primarios, para realizar un tratamiento integral.

Estudio de cultivos celulares primarios de Psorophora confinnis (Díptera: Culicidae)

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Felio J. Bello; Jaime A. Rodríguez; Alberto Morales; Víctor A. Olano

1999-01-01

Con el propósito de obtener una línea celular de Psorophora confinnis (Arribalzaga, 1891) para estudios de susceptibilidad a infecciones con arbovirus, se iniciaron los cultivos primarios de esta especie, vectora del virus de la encefalitis equina venezolana, tipo epidemo-epizoótico. A partir de huevos embrionados, larvas de primer estadio recién eclosionadas y ovarios de hembras adultas, se realizaron explantes por separado de tejidos embrionarios en diversos medios de cultivos, suplementado...

Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico

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C. N. Pisoni

2003-06-01

Full Text Available Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difuso. Se inició radioterapia, no completó el tratamiento por complicaciones y falleció. Son muy pocos los casos publicados de linfoma primario del sistema nervioso central asociado a lupus eritematoso sistémico.A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

La iridotomía periférica con Nd YAG láser en el síndrome de dispersión pigmentaria/glaucoma pigmentario Nd YAG laser peripheral iridotomy in the pigment dispersion syndrome/pigmentary glaucoma

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Francisco García González

2002-06-01

Full Text Available En 13 ojos con diagnóstico de síndrome de dispersión pigmentaria y 5 con glaucoma pigmentario, inicialmente se evaluaron la presión intraocular, los signos de dispersión pigmentaria, la relación excavación-papila y las alteraciones del campo visual; se realizó iridotomía periférica Nd YAG láser en los ojos con este síndrome y trabeculectomía a los que presentaban glaucoma pigmentario. Se chequearon cada 4 meses hasta 24 meses. Once ojos con iris cóncavo mostraron aplanamiento del iris y 2 con iris convexos no variaron con la iridotomía láser; en los 18 ojos disminuyeron evidentemente los signos de dispersión pigmentaria y la presión intraocular permaneció estable, la cual mejoró en los tratados con la trabeculectomía. En el síndrome de dispersión pigmentaria es muy frecuente la configuración cóncava del iris; la iridotomía lo aplana y evita el roce iridozonular, disminuyendo la dispersión y deposición de pigmento que prevendría el aumento de la presión intraocular y el glaucoma pigmentario.The intraocular pressure, the signs of pigment dispersion, the excavation-papilla relation and the alterations of the visual field were initially evaluated in 13 eyes with diagnosis of pigment dispersion syndrome and 5 with pigmentary glaucoma. Nd YAG laser perypheral iridotomy was performed in patients with this syndrome, whereas those who presented pigmentary glaucoma underwent trabeculectomy. They were checked every 4 months up to 24 months. 11 eyes with concave iris showed flattening of the iris and 2 with convex iris did not vary with laser iridotomy. An evident reduction of the signs of pigment dispersion was observed in the 18 eyes. The intraocular pressure remained stable and it improved in those treated with trabeculectomy. In the pigment dispersion syndrome it is very frequent the concave configuration of the iris; the iridotomy flattens it and avoids the iridozonular friction, reducing the dispersion and deposition of

Hiperparatiroidismo primario: Evolución postoperatoria a largo plazo

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Francisco R. Spivacow

2010-10-01

Full Text Available Presentamos la evolución postoperatoria a largo plazo de 87 pacientes con hiperparatiroidismo primario. Del total, 78 mujeres y 9 varones, relación: 8.7:1. Edad media 55.3 ± 10.2 años. Antes de la cirugía el 44% presentó litiasis renal, el 70% osteopenia u osteoporosis y un 71.2% tuvo hipercalciuria. Se encontró disminución del filtrado glomerular en el 12.6%. Del total, 72 pacientes presentaron un adenoma único, dos un doble adenoma, dos hiperplasia, cuatro histología normal y en siete no se pudo disponer del resultado. El calcio sérico, el calcio iónico, el fósforo y la parathormona intacta se normalizaron en todos los pacientes postcirugía. La densitometría ósea aumentó un 6.9% en columna lumbar y un 3% en cuello de fémur. Los marcadores del remodelado óseo se normalizaron y persistieron normales a los 23 meses del seguimiento, coincidiendo con la parathormona intacta. Lo mismo sucedió con los valores de 25 OH D. Cuando se compararon pacientes con hipercalciuria inicial vs. aquellos con normocalciuria, no se encontraron diferencias en los valores basales y postcirugía en ambos grupos. En 11 pacientes con filtrado glomerular previo < 60 ml/min, encontramos una parathormona intacta más elevada que el resto y menor densidad mineral ósea. El filtrado glomerular no cambió en forma significativa luego de la cirugía. En conclusión, el hiperparatiroidismo primario operado por cirujanos especializados tiene una excelente evolución a largo plazo, con normalización de todos los parámetros del metabolismo fosfocálcico y del remodelado óseo y mejoría significativa en la densidad mineral ósea. Los efectos adversos son escasos y de resolución espontánea.

Prevalencia de glaucoma primario de ángulo abierto en pacientes mayores de 40 años de edad en un simulacro de campaña diagnóstica

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Carlos Alberto Romo Arpio

2017-11-01

Conclusiones: Existen escasos datos sobre la prevalencia de glaucoma de ángulo abierto en México. Los resultados de nuestro estudio coinciden con la bibliografía preexistente a nivel internacional. La evaluación completa y el diagnóstico de un gran número potencial de pacientes que presentan glaucoma son un trabajo muy complejo en términos de logística e impacto socioeconómico, es por eso que es imprescindible elaborar un método de tamizaje eficaz para posteriormente elegir qué pacientes necesitan un estudio completo.

Linfoma primario cutáneo difuso de células B grandes, tipo pierna (LPCDCBG-TP), localizado en cuero cabelludo

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Felipe Fereira, Oristel I; Leonardo, Eugenio; Hernández Vázquez, Juan

2010-01-01

Los linfomas primarios cutáneos de células B se consideran actualmente como categoría distintiva de los linfomas primarios cutáneos y se reconocen subtipos característicos dentro de ellos. Se presenta un caso de linfoma primario cutáneo difuso de células B grandes, tipo pierna, con localización en el cuero cabelludo, donde se pudo disponer de estudios inmunohistoquímicos para su tipificación, que mostraron positividad para los marcadores CD20, bcl-2 y MUM-1, y negatividad para CD3 y bcl-6. Es...

Metodología para el tratamiento de la reafirmación profesional en la especialidad Maestros Primarios

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Yuderkys Bell-Speck

2017-11-01

Full Text Available El trabajo metodológico dirigido al tratamiento de la reafirmación profesional en la especialidad Maestros Primarios de la Escuela Pedagógica se fundamenta en la exigencia social de formar maestros primarios con una sólida preparación, capaces de dirigir el proceso de educación y desarrollo de los escolares primarios. En el artículo se analiza cómo perfeccionar dicho proceso en el primer año de la mencionada especialidad desde el trabajo metodológico y se propone una metodología para su tratamiento dirigida por el claustrillo. La valoración de los resultados y la implementación en la práctica demuestra su pertinencia y viabilidad.

Is device-modified trabeculectomy better than classic surgery for treatment of glaucoma?

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Eduardo Pimente

2017-08-01

Full Text Available Resumen En los últimos años, diversas técnicas han surgido como complemento o reemplazo para la trabeculectomía, cirugía estándar en el manejo del glaucoma. La trabeculectomía modificada con dispositivo es una técnica reciente cuyos resultados en comparación con la técnica clásica aún no han sido del todo definidos. Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Identificamos ocho revisiones sistemáticas que en conjunto incluyen 34 estudios aleatorizados. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la trabeculectomía modificada con dispositivo probablemente se asocia a un mayor éxito completo y que podría disminuir la presión intraocular más que la cirugía clásica. Además, está técnica probablemente tendría un mejor perfil de seguridad que la terapia estándar.

La construcción discursiva en la formación del maestro primario

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Cristina Savón-Leyva

2017-11-01

Full Text Available En el proceso docente- educativo de la disciplina Estudios Lingüísticos en la formación inicial del maestro primario se presentan insuficiencias en las relaciones entre los contenidos de la lengua y su didáctica que limitan la construcción discursivo profesional. En este artículo se propone un método para el proceso de enseñanza-aprendizaje de la disciplina, resultado de una tesis doctoral, contentivo de las relaciones esenciales entre el dominio lingüístico, el uso, la situación, los factores socioculturales con enfoque cognitivo, comunicativo, sociocultural y profesional que contribuya de manera más efectiva a la formación de los maestros primarios.

LINFOMA CUTÁNEO PRIMARIO DE CÉLULAS B, DEL TIPO DE LA PIERNA

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BONILLA JARAMILLO, LINA MARÍA; CALDERÓN, JORGE ENRIQUE; JUAN GUILLERMO, CHALELA; GONZÁLEZ, MARÍA ISABEL

2012-01-01

El linfoma de células B del tipo de la pierna, es una neoplasia rara y agresiva, con características clínicas, morfológicas e inmunofenotípicas distintivas. Está clasificada dentro del grupo de linfomas cutáneos primarios de células B y se presenta en edades avanzadas, con predominio en mujeres y altas tasas de recurrencia. Presentamos el caso de una mujer de 63 años de edad, con diagnóstico clínico e inmunofenotípico de linfoma cutáneo de células B del tipo de la pierna. Primary cutaneous...

Pesquisaje de glaucoma

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Aldo Sigler Villanueva

1996-06-01

Full Text Available Se efectuó un pesquisaje de glaucoma mediante un chequeo masivo al 92,1 % (210 pacientes de la población mayor de 40 años de edad atendida en un consultorio del médico de la familia del municipio Morón. Se encontró que el 9,6 % (20 pacientes presentaban cifras de tensión ocular por encima de los valores normales, así como 3 pacientes que tenían tensión ocular normal, pero con excavaciones de papilas sospechosas y 2 pacientes con antecedentes familiares de glaucoma, los cuales se enviaron a la consulta especializada del Hospital General Provincial Docente de Moron para confirmar o no el diagnóstico.The 92,1 % (210 patients of the population over 40 years treated at a family physician's office in Morón municipality took part in a glaucoma mass screening. It was found that 9,6 % (20 patients showed figures of ocular tension exceeding normal values and that 3 patients had normal ocular tension but presented suspicious excavation of the optic disc. Two patients having glaucoma family history were referred to the specialist at the Provincial General Teaching Hospital of Moron in order to confirm the diagnosis.

Quimioembolización intraarterial hepática supraselectiva transitoria en pacientes con hepatocarcinoma o metástasis a hígado con primario controlado

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Madelaine Lucia Bracho

2008-07-01

Full Text Available Antecedentes: No existe tratamiento estándar parapacientes con carcinoma hepatocelular o metástasishepática no erradicable con primario controlado pero quehan fallado al tratamiento sistémico. Se presenta laexperiencia del tratamiento con quimioembolizaciónintraarterial hepática supraselectiva (QEIAHS realizado enla Unidad de Oncología del Hospital Universitario deSantander, Bucaramanga, Colombia. Metodología: Serevisaron las historias clínicas de los pacientes atendidosentre marzo de 2000 a marzo de 2007. Resultados: Serealizaron doce procedimientos de QEIAHS en seispacientes (entre uno y cuatro ciclos por paciente. Cuatrotenían patología maligna propia del tejido hepático(hepatocarcinoma o colangiocarcinoma y dos a metástasis(tumor carcinoide y adenocarcinoma de sigmoidesconfinadas al hígado. El tamaño basal de las masastumorales dominantes estaban entre 5 y 12 cm; el síntomapredominante en todos los casos fue dolor abdominal grado2. El estado funcional al inicio era igual o mejor a 1. Larespuesta se evaluó cuatro semanas después de laaplicación de cada ciclo de QEIAHS. En una paciente elprocedimiento fue fallido por aterosclerosis. Las mejoresrespuestas paliativas alcanzadas estuvieron entre 50 y93%, aunque en un paciente se dio progresión. Los eventos adversos fueron mínimos, transitorios y de fácil manejomédico, sin presencia de efectos hematológicos. Solo unpaciente presentó síndrome postquimioembolización. Eltiempo medio de de seguimiento fue de 11.2 meses, conmediana de sobrevida de 16 meses y sobrevida a 2 años de27%. En todos los pacientes desapareció el dolor,mantuvieron estado funcional grado 0 y 1, permaneciendoactivos y con buenos niveles de autocuidado durante elperiodo de sobrevida, estando generalmente asintomáticos.Conclusiones: La QEIAHS de la(s arteria(s nutricia(s porangiografía del tronco celiaco es una alternativa paliativapara el tratamiento de pacientes con tumores primarioshepáticos o

Caracterización clínicoepidemiológica de pacientes con retinosis pigmentaria y glaucoma Clinical and epidemiological characterization of patients with retinitis pigmentosa and glaucoma

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Idalia Triana Casado

2011-05-01

Full Text Available Introducción: La coincidencia clínica de retinosis pigmentaria y glaucoma es bastante frecuente. Objetivo: Determinar la asociación entre ambas enfermedades por medio de variables clinicoepidemiológicas. Métodos: Se realizó un estudio descriptivo y transversal de 85 pacientes dispensarizados en el Centro Nacional de Referencia de Retinosis Pigmentaria de La Habana, durante el primer semestre de 2010, que además padecían alguna de las formas de glaucoma. En la casuística se utilizó la Clasificación de la Escuela Cubana de Retinosis Pigmentaria. Resultados: Las 2 entidades clínicas concomitaron en 85 pacientes (9,37 % y tasa de 0,09, sobre todo en aquellos de 41-60 años (47,05 %, sexo femenino (57,64 %, con glaucoma crónico simple (54,11 %, antecedente familiar de glaucoma (14,11 %, retinosis pigmentaria típica de grado IV (40,0 % y entre 10-20 años de evolución del proceso morboso. Conclusiones: La común asociación de ambas enfermedades provoca gran invalidez visual por superposición de sus efectos individuales.Introduction: The clinical coincidence of retinitis pigmentosa and glaucoma is very frequent. Objective: To determine the association between both diseases by means of clinical and epidemiological variables. Methods: A descriptive and cross-sectional study in 85 patients classified at the National Reference Center of Retinitis Pigmentosa in Havana, during the first semester of 2010, who also suffered from some forms of glaucoma. In our cases the Classification of the Cuban School of Retinitis Pigmentosa was used. Results: These 2 concomitant clinical entities were found in 85 patients (9,37 % and rate of 0,09, mainly in those of 41-60 years (47,05 %, female sex (57,64 %, with simple chronic glaucoma (54,11 %, and family history of glaucoma (14,11 %, retinitis pigmentosa typical of grade IV (40,0 % and a course of the disease between 10 and 20 years. Conclusions: The common association of both diseases causes severe

Efecto de la pérdida prematura de molares primarios sobre la relación horizontal incisiva

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Yérica M García

2011-01-01

Full Text Available La pérdida prematura de molares primarios predispone a maloclusiones incluyendo apiñamiento, impactación de dientes permanentes y alteración de la relación molar y canina. El objetivo del presente estudio es determinar el efecto de las pérdidas prematuras de molares primarios sobre la relación incisiva horizontal. El estudio es documental, retrospectivo y observacional. Se evaluaron los registros ortodóncicos (historias clínicas, fotografías y radiografías de 209 pacientes con edades entre 4 a 15 años. La relación incisiva horizontal se consideró normal (grupo 1 cuando hubo contacto entre en borde incisal del incisivo inferior con la cara palatina del superior, aumentada (grupo 2 cuando había distancia positiva entre ellos y negativa (grupo 3 cuando los bordes incisales se encontraban a tope o en mordida cruzada. Los datos se analizaron utilizando coeficiente Pearson (p≤0,001. El 22% (45 pacientes presentó pérdidas prematuras. La prevalencia de pérdidas prematuras no tuvo diferencia significativa entre géneros y fue mayor en el grupo de 7 a 9 años. De los pacientes con pérdidas prematuras, 6 (13,3% se clasificó en el grupo 1; 12 (26,7% en el grupo 2 y 27 (60% en el grupo 3. Hubo asociación positiva entre el número de molares perdidos y la presencia de mordida cruzada anterior, siendo la media de molares perdidos mayor (4, 7 en el grupo 3. Se demostró que las pérdidas prematuras de molares primarios tienen una relación estadísticamente significativa con la mordida cruzada anterior, siendo posible que la falta de soporte oclusal posterior favorezca el desplazamiento protrusivo de la mandíbula.

Linfoma no Hodgkin primario de sistema nervioso central en un paciente pediátrico sin inmunodeficiencia relacionada

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Rocío Cárdenas-Cardos

2015-10-01

Full Text Available El linfoma no Hodgkin primario de sistema nervioso central es una afección poco frecuente en la población pediátrica. No existen (o son pocas las recomendaciones o estudios clínicos que sean útiles para definir la mejor opción terapéutica. El objetivo de este trabajo es describir el caso de una niña con linfoma primario de sistema nervioso central, sin ninguna inmunodeficiencia asociada, y realizar de una revisión cualitativa de la literatura especializada sobre esta enfermedad en niños. Se ha postulado la posibilidad de cambios citogenéticos que pudieran explicar la heterogeneidad en el comportamiento de esta enfermedad pues se ha visto que es distinto al de otros linfomas en presentaciones habituales. La experiencia de tratamiento en niños con linfoma se basa en resultados de tratamientos obtenidos en pacientes adultos, con regímenes basados principalmente en antimetabolitos como metotrexato y citarabina. Aún es controvertida la utilidad de la radioterapia craneal, la cual sólo se recomienda en casos específicos.

Carcinoma primario intraóseo

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Susana Szlabi

2013-12-01

Full Text Available El carcinoma primario intraóseo (PIOC es un tumor poco frecuente, definido como carcinoma escamoso que se desarrolla en huesos maxilares, no teniendo conexión inicial con mucosa ni piel adyacente. Es localmente agresivo, con una incidencia de metástasis en ganglios regionales del 28% y en pulmón del 5%, en el momento del diagnóstico. Su origen puede ser de novo o a partir de otros tumores odontogénicos. Los huesos maxilares son los únicos que tienen en su interior tejidos epiteliales, por lo cual esta neoplasia se localiza exclusivamente en este sitio, predominantemente en la mandíbula. Los criterios diagnósticos del PIOC incluyen: histopatología de carcinoma escamocelular, ausencia de compromiso de mucosa oral y senos paranasales, descartando metástasis de un sitio distante en base a estudios clínicos y métodos complementarios. El tratamiento de elección consiste, siempre que sea posible, en la exéresis con criterios oncológicos, y radio y/o quimioterapia adicional. Se requiere además, cirugía reconstructiva con injerto y/o prótesis con fines estéticos y funcionales. Presentamos el caso de un varón de 72 años, que consultó por molestias en maxilar inferior tres meses después de la extracción de un molar. Se efectuó biopsia por curetaje y luego se resecó el maxilar inferior con vaciamiento ganglionar. El estudio histopatológico mostró un carcinoma escamoso pobremente diferenciado, infiltrante en hueso maxilar, con hallazgos morfológicos que lo vinculaban a quiste odontogénico residual, y metástasis en 15 de 48 ganglios aislados. Se realizó radioterapia postquirúrgica, falleciendo a los 30 meses del diagnóstico por deterioro progresivo.

Factores biológicos asociados al retardo primario del lenguaje en niños menores de cinco años

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Ileana Valdivia Álvarez

Full Text Available Introducción: el retardo primario del lenguaje está presente entre 6 y 10 % de niños menores de 6 años, y constituye un frecuente motivo de consulta pediátrica, sobre el que se puede actuar, una vez conocidos los factores de riesgo. Objetivos: identificar factores biológicos o personales asociados al retardo primario del lenguaje, en niños entre 18 meses y 5 años de edad. Metodos: estudio analítico caso-control, en niños entre 18 meses y 5 años, atendidos en la Consulta de Neuropediatría del Hospital Pediátrico "Juan Manuel Márquez", por retardo del lenguaje, entre enero de 2010 y julio de 2011, en relación con un grupo control de niños sanos. Resultados: el retardo primario del lenguaje es más frecuente en varones a razón de 1:4,6, que son diagnosticados a una edad media de 3,05 (+0,95 años, con antecedentes familiares de retardo de lenguaje (p= 0,001 y enfermedades neuropsiquiátricas (p= 0,012. Presentaron más antecedentes de malformaciones, traumas y distermia al nacer (p= 0,007, y también mayor retardo en el desarrollo de la lateralidad (p= 0,025. Conclusiones: se consideran factores de riesgo para el retardo primario del lenguaje, el género masculino, los antecedentes familiares de trastornos del lenguaje y enfermedades neuropsiquiátricas, la lateralidad demorada y los eventos posnatales patológicos.

LINFOMA CUTÁNEO DE CÉLULAS B TIPO CENTRO FOLICULAR CON INFILTRACIÓN A MÉDULA ÓSEA: REPORTE DE UN CASO

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ARENAS SOTO, CLAUDIA MARCELA; MARIÑO ÁLVAREZ, MARÍA LILIANA; CALDERÓN GÓMEZ, JORGE ENRIQUE; GONZÁLEZ C, MARÍA ISABEL; ROBAYO, MARTHA PATRICIA

2012-01-01

Los linfomas cutáneos primarios de células B constituyen cerca del 2025% de todos los linfomas. El linfoma cutáneo primario de células B tipo centro folicular es el subtipo más frecuente y se manifiesta principalmente en pacientes adultos con una edad media de 58 años (1), la diseminación extracutánea es muy rara y se presenta con nódulos, tumores o placas solitarios o en grupo usualmente localizados en cabeza o tronco. Presentamos el caso de una paciente con un linfoma primario cutáneo tipo ...

Dinámica de la biomasa aérea en bosques primarios de Colombia y su relación con la precipitación y la altitud

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Quinto Mosquera, Harley

2010-01-01

El estudio de la biomasa aérea (BA) de los bosques tropicales es fundamental para entender el balance del C global en el contexto del cambio climático. La BA se cuantificó en un bosque primario de Salero (Chocó Biogeográfico), mediante ecuaciones diseñadas para bosques húmedos tropicales, a partir de datos de densidad de madera, diámetro (DAP) y altura de árboles (con DAP ≥ 10 cm) medidos en dos sub-parcelas permanentes (“E” y “U”) de 1 hectárea, las cuales se monitorearon en los años 1998, 2...

Efecto de la ingesta de un preparado lácteo con fibra dietética sobre el estreñimiento crónico primario idiopático The effect of a fibre enriched dietary milk product in chronic primary idiopatic constipation

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J. López Román; A. B. Martínez Gonzálvez; A. Luque; J. A. Pons Miñano; A. Vargas Acosta; J. R. Iglesias; M. Hernández

2008-01-01

Objetivo: Determinar si la administración de un preparado lácteo enriquecido con un suplemento de fibra soluble (Naturfibra)®[inulina y maltodextrina resistente a la digestión (Fibersol 2®)], afecta a la sintomatología en el estreñimiento crónico primario idiopático. Ámbito: Sujetos de ambos sexos con estreñimiento según los criterios de Roma II. Sujetos: Se trata de un ensayo clínico doble ciego aleatorizado de intervención dietética realizado en 32 individuos con estreñimiento de ambos sexo...

Tratamiento ortodóntico interceptivo para paciente pediátrico con problema periodontal ocasionado por trauma oclusal primario. Reporte de caso

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Johana Maldonado-Villamizar

2016-07-01

Full Text Available El diagnóstico correcto puede evitar la evolución de patologías que lleven al paciente pediátrico a padecer de problemas graves en el futuro. Este diagnóstico junto con un tratamiento interceptivo a tiempo, puede ayudar a resolver problemas de tipo periodontal causado por el inadecuado posicionamiento dental o injurias oclusales. El objetivo de este artículo es realizar el reporte de caso de un paciente pediátrico que presenta una maloclusion dental tipo mordida cruzada anterior acompañada por un trauma oclusal primario, el cual causo un problema periodontal localizado, a su vez, describir la terapéutica interceptiva basada en el correcto diagnóstico odontopediátrico, ortodóntico y periodontal. Concluyendo que al seleccionar la aparatología adecuada se puede solventar diversos problemas dentales que puedan ocasionar un daño mayor a las estructuras comprometidas.

Diagnóstico y tratamiento de pacientes con linfomas primarios del sistema nervioso central (LPSN y sindrome de inmunodeficiencia adquirida (SIDA

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Luis E Raez

1999-07-01

Full Text Available La incidencia del linfoma primario del sistema nervioso central (LPSNC ha crecido rápidamente. El LPSNC as una complicación letal en pacientes con SIDA. Objetivo: Nuestro objetivo fue estudiar la historia natural, métodos diagnósticos, al tratamiento y los factores pronósticos para la sobrevida de 75 pacientes con LPSNC y SIDA seguidos en el Jackson Memorial Hospital/Universidad de Miami. Resultados: La edad media fue de 37 años. El 84% de los pacientes eran hombres y el 55% hispanos. Factores de riesgo más comunes para SIDA fueron homosexualidad y múltiples compañeros sexuales. La cuenta promedio de CD4 fue de 15/ul y al promedio de LDH fue 1.5 veces al normal. La tomografía computarizada del cerebro mostraba lesiones múltiples en el 44% de los pacientes. Gammagrafia computarizada de emisión de fotones con talio-201 (SPECT del cerebro se realizó en 2/3 de los pacientes. Las histologías más comunes en las biopsias fueron: linfoma inmunoblástico y linfoma de células grandes. La radiación craneana fue ineficiente en el 50% de los pacientes tratados. La sobrevida promedio del grupo fue de 2.2 meses. Análisis univariado y multivariado mostraron que la mayor sobrevida se asociaba con una buena capacidad funcional (ECOG=1-2 vs 3-4. La presencia previa de infecciones oportunistas, la presencia de factores de riesgo de SIDA, las cuentas de CD4, niveles de LDH y raza no mostraron influencia en la sobrevida. Conclusiones: LPSNC es una neoplasia con pronóstico muy pobre y corta sobrevida aun con radioterapia del SNC. La capacidad funcional parece ser al factor de sobrevida más importante. No se encontraron diferencias en la presentación clínica ni el resultado entre pacientes hispanos y no hispanos. ( Rev Med Hered 1999; 10:96-104 .

Efecto de un tratamiento intensivo con insulina sobre la reactividad plaquetaria en pacientes con hiperglucemia que ingresan con un síndrome coronario agudo

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Vivas Balcones, Luis David

2011-01-01

El objetivo primario de este trabajo ha sido la valoración del efecto que produce el control estricto de la glucemia mediante un tratamiento intensivo y precoz con insulina sobre la reactividad plaquetaria durante la fase hospitalaria en pacientes que ingresan en una unidad de cuidados intensivos cardiológicos con un síndrome coronario agudo e hiperglucemia, respecto a un tratamiento convencional.

Linfoma primario del sistema nervioso central en un paciente inmunocompetente

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José Málaga-Zenteno

2012-07-01

Full Text Available El linfoma primario del sistema nervioso central (LPSNC constituye el 2% de los linfomas extranodales y entre 0,3% y 1,5% de todas las neoplasias intracraneales en pacientes inmunocompetentes, siendo más frecuente a partir de los 60 años. Reportamos el caso de un paciente varón de 76 años, sin antecedentes médicos de importancia, que inició su enfermedad con inestabilidad en la marcha, dificultad para mover el hemicuerpo izquierdo, a predominio braquial, cefalea holocraneal y mareos. Ingresó a emergencia despierto, parcialmente desorientado, Glasgow 14 y ptosis palpebral derecha; además, hemiparesia e hipoestesia izquierda, a predominio crural. Por tomografía computarizada cerebral se evidenció imagen captadora de contraste en región frontoparietal derecha, intra y extra craneal, edema cerebral y desplazamiento de la línea media. Se realizó craneotomía y biopsia del tumor, diagnosticándose linfoma difuso de células grandes B del sistema nervioso central. Fue VIH negativo. Se descartó otro tumor primario y metástasis. Recibió esquema CHOD/BVAM y radioterapia. Evolucionó favorablemente. Según resonancia magnética cerebral postratamiento, desapareció el tumor.

Desarrollo de aceros reforzados con carburos primarios vía metalurgia líquida

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Agote, I.

2005-12-01

Full Text Available The steel reinforcement by means of the addition of primary carbides via liquid metallurgy needs to fulfill two essential requirements to be technically viable: the development of a solid reinforcing product which is appropriate to be mixed with the steel and the optimization of the metallurgic addition of these reinforcing particles into the liquid steel. Besides, the improvement of the reinforced alloy characteristics is directly related to the particles' nature of reinforcing particles, their homogeneous and uniform distribution in the matrix and their size and morphology. The manufacture of these carbides by SHS ('Self propagating High temperature Synthesis' and their addition before steel is poured into moulds allows achieving the above-mentioned conditions.

Para que el reforzamiento de los aceros con carburos primarios vía metalurgia líquida sea técnicamente viable se requiere del desarrollo de un tipo de producto reforzante sólido, adecuado para su incorporación al acero, así como de la optimización de dicha vía metalúrgica de adición del producto reforzante al material base en estado líquido. Además, la mejora de características de la aleación reforzada es función directa de la naturaleza de las partículas, de su homogénea y uniforme distribución en la matriz y del tamaño y morfología regular de las mismas. Estas condiciones se consiguen cuando las partículas de carburo se elaboran previamente mediante la técnica SHS (selfpropagating high temperature synthesis y se añaden al baño de acero líquido previo a su colada en moldes o lingoteras.

Estudio de cultivos celulares primarios de Psorophora confinnis (Díptera: Culicidae

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Felio J. Bello

1999-06-01

Full Text Available Con el propósito de obtener una línea celular de Psorophora confinnis (Arribalzaga, 1891 para estudios de susceptibilidad a infecciones con arbovirus, se iniciaron los cultivos primarios de esta especie, vectora del virus de la encefalitis equina venezolana, tipo epidemo-epizoótico. A partir de huevos embrionados, larvas de primer estadio recién eclosionadas y ovarios de hembras adultas, se realizaron explantes por separado de tejidos embrionarios en diversos medios de cultivos, suplementados con 20% de suero fetal bovino y una mezcla de antibióticos y antimicóticos al 1%. La esterilización del material biológico se efectuó mediante la inmersión de éste en diversas sustancias, tales como: hipoclorito de sodio al 1,6%, etanol al 70% y una solución de 0,25% de cloruro de mercurio disuelto en 70% de etanol. El crecimiento celular se inició sólo en el medio MMNPl2 en un tiempo promedio de 62 días después de efectuadas las siembras, mediante la proliferación de colonias aisladas procedentes de tejidos embrionarios, y también a partir de las terminaciones de los fragmentos larvales. La evolución del crecimiento celular hasta la formación de la monocapa confluente fue supremamente lenta y sólo se alcanzó a los 8 meses post-explante, presentando ésta una morfología celular predominantemente epitelioide. No fue exitoso el crecimiento celular a partir de los tejidos ováricos de hembras adultas. La iniciación del crecimiento celular en esta especie presentó tiempos diferentes comparados con los empleados en los cultivos celulares de otros mosquitos, lo cual indica que a pesar de utilizarse una metodología similar en el proceso para obtener cultivos primarios, las adaptaciones celulares a las condiciones físicas, ambientales y nutricionales son diferentes en cada una de las especies. Este es el primer informe de cultivos celulares de una especie de mosquito perteneciente al género Psorophora.

COMPORTAMIENTO NO LINEAL EN SERIES DE PRODUCTOS PRIMARIOS

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Christian Espinosa Méndez

2013-01-01

Full Text Available En este artículo se emplea la prueba de Hinich para detectar ventanas de no lineali-dad sobre las series de rendimientos diarios de los productos primarios cobre, oro, paladio, petróleo Brent, plata, platino y petróleo WTI. Además, se utiliza la teoría de wavelets para estudiar la escala o las escalas temporales en que se produce o acumula el proceso de no linealidad.En cuanto a la prueba de Hinich los resultados obtenidos son compatibles con los encontrados en investigaciones anteriores, lo que confirma el fenómeno de com-portamiento no lineal en series de activos financieros. Sin embargo, al descompo-ner la serie completa usando wavelets se encontró evidencia que existen periodos de no linealidad que se producen con anterioridad a la ventana no lineal detectada por la prueba de Hinich. Además, encontramos pruebas de que después de una ventana no lineal el fenómeno de no linealidad no se disipa por completo sino que sigue en ventanas del próximo periodo a escalas distintas de tiempo. Los resultados indican que no se pueden construir modelos lineales predictivos de precios, con lo ual podría hacer aconsejable gestionar el riesgo financiero, tanto para empresas pertenecientes al sector privado como aquellas en manos del Estado, de una manera distinta.

Carcinoma escamoso metastásico primario de origen desconocido. Presentación de un caso Primary Metastatic Squamous Cell Carcinoma of Unknown Origin. A Case Report

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Miguel Ángel Serra Valdés

2012-12-01

Full Text Available El cáncer primario oculto representa según varias series del 0,5 al 7 % de todos los cánceres que se diagnostican y la edad media de presentación es 60 años. Se presenta un caso de metástasis ganglionar de carcinoma primario de células escamosas no identificado, de una paciente de 58 años de edad, de color de piel blanca, con antecedentes de salud, ama de casa, que fumaba desde joven e ingería alcohol frecuentemente. Ingresó con aumento de volumen de los ganglios del cuello. Se diagnosticó por biopsia metástasis de carcinoma escamoso. No pudo identificarse el primario en vida ni en la necropsia. El cáncer metastásico primario de origen desconocido sigue siendo un reto para la práctica clínica.Occult primary cancer represents, according to several series, from 0,5 % to 7 % of all diagnosed cancers, the average onset age being 60 years old. We report the case of nodal metastasis of unidentified primary squamous cell carcinoma in a 58 years old patient with white skin and a history of good health. The patient was a housekeeper who smoked from early age and frequently consumed alcohol. She was admitted with an enlargement of the neck glands. Metastases of squamous cell carcinoma were diagnosed through biopsy. Primary cancer was not identified neither while still alive or at necropsy. Primary metastatic cancers of unknown origin remain a challenge for clinical practice.

Glaucoma, una enfermedad ocular que trasciende la frontera de los aspectos médicos Glaucoma, an ocular disease transcending medical aspects

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Eglis Esteban García Alcolea

2009-04-01

Full Text Available El glaucoma constituye una de las principales causas de ceguera a nivel mundial y en nuestro país representa la primera. Muchas veces pasa inadvertido siendo un excelente simulador, pero por lo general sus síntomas son evidentes. Se realizó un estudio exploratorio acerca de los aspectos sociales, económicos y psicológicos relacionados con el glaucoma, con el objetivo de realizar un análisis integral del tema que permita comprenderlo en toda su amplitud y elevar la calidad de vida de los pacientes. Toda la información fue obtenida a través de la literatura disponible hasta el año 2008.Glaucoma is one of the most important causes of blindness around the world, being the first one in Cuba. Although it regularly goes unnoticed being an excellent simulator, symptoms are generally evident. An exploratory study on the economic, psychological, and social aspects related to glaucoma was conducted, aiming at analyzing this topic to fully understand it and increase patients' quality of life. Information was obtained from bibliography available up to 2008.

Caracterización del glaucoma juvenil

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Silvia Roche Caso

2011-03-01

Full Text Available INTRODUCCIÓN. El glaucoma no es frecuente en los niños, pero cuando ocurre sus síntomas son poco perceptibles y produce graves consecuencias para la salud visual. El objetivo de este estudio fue caracterizar, desde las aristas clínica y epidemiológica, a los pacientes con glaucoma juvenil atendidos en los servicios de oftalmología de los Hospitales Pediátricos del Cerro y «Pedro Borrás», en Ciudad de La Habana, en el período comprendido entre enero de 2008 y diciembre de 2009. MÉTODOS. Se realizó un estudio epidemiológico longitudinal y prospectivo, cuyo universo estuvo constituido por 176 pacientes entre 5 y 18 años de edad, con presunto glaucoma. La muestra, después de aplicados los criterios de inclusión y exclusión, quedó conformada por 38 casos. Se analizaron las variables: edad al momento del diagnóstico, sexo, color de la piel, antecedentes familiares según grado de parentesco, agudeza visual máxima corregida, tipo de defecto refractivo, características del ángulo camerular, espesor corneal central, valor de la presión intraocular, alteraciones fundoscópicas y campimétricas. RESULTADOS. En la mayoría de los pacientes el diagnóstico de glaucoma juvenil constituyó un hallazgo. La mediana de edad al momento del diagnóstico fue de 12,5 años, con ligero predominio de varones y de la piel no blanca. Fue más frecuente el antecedente de glaucoma en familiares de segundo grado de consanguinidad. La mayoría de los casos tenía visión óptima, algún grado de miopía y ángulo abierto sin alteraciones evidentes del ángulo camerular, entre las cuales la más frecuente fue la presencia de procesos iridianos prominentes. CONCLUSIONES. Predominaron la disminución moderada del espesor corneal y valores medios de presión intraocular de 26,91 mm Hg. La alteración fundoscópica encontrada con mayor frecuencia fue la excavación papilar moderada (entre 0,4 y 0,5 y como lesión campimétrica, el aumento de la mancha

Obtención de Acido Poli Láctico a partir de lactosuero para la fabricación de empaque primarios.

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Cuichán Guanoluisa, Remigio Ismael

2015-01-01

En la Provincia de Chimborazo, Cantón Riobamba, se evaluó la obtención de ácido poliláctico (APL), a partir de lactosuero para la fabricación de empaques primarios, teniendo un total de 16 unidades experimentales, distribuidas en 4 tratamientos (4 niveles de plastificante 1.5, 2.0, 2.5 y 3.0 %) y 4 repeticiones en cada uno. Los resultados experimentales fueron analizados mediante el análisis de varianza y la separación de medias con la prueba de Tuckey, con la finalidad de dete...

Prevalencia y factores asociados al síndrome de sobrecarga del cuidador primario de ancianos*

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Doris Cardona A; Ángela M. Segura C; Dedsy Y. Berbesí F; María A. Agudelo M

2013-01-01

El síndrome de sobrecarga del cuidador de los adultos mayores es un estado de angustia que amenaza la salud física y mental por la dificultad persistente de cuidar a un familiar. Objetivo: identificar la prevalencia y factores asociados a sobrecarga en el cuidador primario de ancianos. Metodología: estudio descriptivo transversal, con 310 cuidadores principales de adultos mayores de 65 años y más de edad, seleccionados por muestreo aleatorio simple y entrevistados telefónicamente. Se calculó ...

Prevalencia y factores asociados al síndrome de sobrecarga del cuidador primario de ancianos

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Cardona A., Doris; Segura C., Ángela M.; Berbesí F., Dedsy Y.; Agudelo M., María A.

2013-01-01

El síndrome de sobrecarga del cuidador de los adultos mayores es un estado de angustia que amenaza la salud física y mental por la dificultad persistente de cuidar a un familiar. OBJETIVOS: identificar la prevalencia y factores asociados a sobrecarga en el cuidador primario de ancianos. METODOLOGIA:estudio descriptivo transversal, con 310 cuidadores principales de adultos mayores de 65 años y más de edad, seleccionados por muestreo aleatorio simple y entrevistados telefónicamente. Se calculó ...

123. Intervención quirúrgica urgente en paciente varón joven con angiosarcoma primario cardíaco con diagnóstico de tromboembolismo pulmonar agudo

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N. Miranda

2012-04-01

Conclusiones: Son infrecuentes los casos de sarcoma cardíaco primario publicados en la bibliografía y muy pocos los que han cursado como tromboembolismo pulmonar agudo. Este caso ilustra la enorme dificultad que presentan para un diagnóstico y tratamiento precoz que ofrezca unas mínimas expectativas de vida a medio plazo.

Competencia cognitiva en penados primarios y reincidentes: implicaciones para la reeducación

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Ramón Arce

2014-01-01

Full Text Available La probabilidad de reincidencia delictiva es aproximadamente tres veces mayor para los penados reincidentes que para los primarios. En esta línea, se sugiere una relación entre el grado de comportamiento antisocial y delictivo, y el nivel de desarrollo de la competencia cognitiva. Así, se prevé que los penados reincidentes presenten un menor desarrollo de la competencia cognitiva que los primarios. Para comprobar esta hipótesis, 104 penados, 54 primarios y 50 reincidentes, que no habían sido previamente objeto de un tratamiento penitenciario, fueron evaluados en atribución de la responsabilidad, autoconcepto, afrontamiento e inteligencia emocional. Los resultados mostraron que los penados reincidentes tenían menos desarrollado el autoconcepto y la inteligencia emocional que los primarios. Además, se observó una mayor tendencia en los reincidentes a afrontar las situaciones estresantes y de riesgo a través de estrategias no adaptativas (v.gr., centradas en las emociones, evitativas. Sin embargo, primarios y reincidentes se atribuyen por igual la responsabilidad. En suma, los penados reincidentes son menos competentes cognitivamente que los primarios. Se discuten las implicaciones de los resultados para la reeducación, resocialización y reinserción social de los penados.

ESTRUCTURA POBLACIONAL DE Ocotea puberula EN UN BOSQUE SECUNDARIO Y PRIMARIO DE LA SELVA MIXTA MISIONERA

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Silvana Lucia Caldato

2002-12-01

Full Text Available El objetivo de este trabajo fue estudiar la estructura de la población de Ocotea puberula (Nees et Mart. Nees (Lauraceae, en bosques de sucesión secundaria y primaria en el Nordeste de Misiones en Argentina, a 26º 15´S y 54º 15´W. Dos parcelas permanentes de muestreo de 3 hectáreas cada una fueron instaladas en el bosque secundario y primario, respectivamente. Cada parcela fue dividida en 75 subparcelas de 20 x 20 m, donde todos los individuos de Ocotea puberula de tamaño igual o superior a 20 centímetros de altura fueron registrados. Se estudió la estructura de tamaño y la distribución espacial. Ocotea puberula mostró ser una especie secundaria con un número abundante de individuos en la fase de regeneración natural en el bosque secundario, y solamente árboles adultos en el bosque primario. La especie presentó en ambos bosques un patrón agrupado de distribución espacial.

Tumores cardíacos primarios

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Rosa Eugenia Díaz Garriga

2013-10-01

Full Text Available Introducción: los tumores cardíacos primarios son aquellos que se originan en Miocardio o Pericardio. El 90% son benignos, no son invasivos, pero debido a su localización pueden provocar alteraciones hemodinámicas graves y arrítmias. Presentación del caso: dos casos portadores de tumores cardíacos diagnosticados en la etapa prenatal, una gestante de 32 años, portadora de una Neurofribromatosis que en la ecocardiografía fetal de su hijo, se identifican dos tipos de tumores cardíacos, un mixoma auricular y un fibroma, y un niño que desde la etapa prenatal se diagnosticó un rabdomioma, lo cual se confirmó al nacimiento y que regresó espontáneamente. Conclusiones: a ecocardiografía fetal permite cada vez con más frecuencia, el diagnóstico intraútero de tumores cardíacos. Los rabdomiomas regresan en más del 50% de los casos, pero pueden ser un marcador de Esclerosis Tuberosa. Los tumores cardiacos se asocian a otras afecciones congénitas y requieren de tratamiento quirúrgico. Aspectos todos a tener en consideración para realizar el asesoramiento genético a la familia.

Tuberculosis congénita asociada con tuberculosis materna miliar diseminada

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Luis Miguel Sosa

2007-12-01

Se presenta el caso de una mujer primigestante con tuberculosis miliar diseminada, con inicio de las manifestaciones en el puerperio inmediato, diagnóstico en el segundo mes del puerperio y desenlace fatal. Además, se presenta el caso de su hijo prematuro con manifestaciones desde el nacimiento, evidencia de complejo pulmonar primario, atelectasia persistente por obstrucción bronquial por las adenopatías e infección por citomegalovirus; recibió tratamiento estándar con mejoría.

Mercado primario de valores negociables

OpenAIRE

Alonso Espinosa, Francisco José

1994-01-01

Estudio del régimen del mercado primario de valores según la Ley 24/1988, del Mercado de Valores y el RD 291/1992, de 27 de marzo. Caracterización de los valores negociables y estudio del régimen de la oferta pública de suscripción de valores negociables.

Glaucoma facomórfico y ultrabiomicroscopia

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María Cristina González González

2015-01-01

Conclusiones: La ultrabiomicroscopia es un herramienta útil ya que permite una valoración completa del segmento anterior, aun en presencia de medios opacos y ayuda a determinar la relación del cristalino con las estructuras adyacentes y el probable mecanismo del glaucoma.

Espesor corneal y variables epidemiológicas y fisiológicas en población de riesgo de glaucoma Corneal thickness and the epidemiological and physiological variables seen in the glaucoma risk population

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Idalia Triana Casado

2012-12-01

Full Text Available Objetivo: caracterizar el espesor corneal central en pacientes con factores de riesgo de glaucoma crónico simple. Métodos: se realizó un estudio epidemiológico, observacional, descriptivo y longitudinal prospectivo, en el Servicio de Glaucoma del Hospital "Dr. Salvador Allende" durante el año 2010. El universo estuvo constituido por 1 238 pacientes que acudieron a la consulta de oftalmología por síntomas astenópicos. La muestra, aplicados los criterios de inclusión y exclusión, quedó conformada por 656 pacientes con factores de riesgo de la enfermedad, de estos se desecharon 19 por una diferencia entre los ojos de 10 µm o más de espesor corneal. Las variables analizadas fueron: espesor corneal, edad, sexo, color de la piel y presión intraocular. Resultados: de los pacientes con factores de riesgo de glaucoma, predominaron aquellos entre 50 y 59 años de edad (22,76 %, masculinos (60,28 % y de piel no blanca (57,29 %. El espesor corneal estuvo disminuido (61,85 % y la presión intraocular aumentada (55,41 %, aún con ajuste (46,93 %. Conclusiones: la disminución del espesor corneal estuvo relacionada con la edad, el sexo femenino, la piel no blanca y el aumento de la presión intraocular en aquellos pacientes sospechosos de glaucoma.Objective: to characterize the central corneal thickness seen in patients with simple chronic glaucoma risk factors. Methods: a prospective longitudinal, descriptive, observational, and epidemiological study was conducted in the Glaucoma Service of “Dr. Salvador Allende” hospital during 2010. The universe of study was made up of 1 238 patients that went to the ophthalmological service due to asthenopic symptoms. Taking the inclusion and exclusion criteria into account, the final sample was composed by 656 patients with glaucoma risk factors, 19 of whom were excluded because of 10 µm and over difference in the corneal thickness between the eyes. The analyzed variables were corneal thickness, age

ANÁLISIS PROTEÓMICO DE CULTIVOS PRIMARIOS DE TIROIDES

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Nancy Echeverry

2011-01-01

Full Text Available En el presente estudio se identificaron proteínas de expresión constitutiva, como vimentina, actina, tubulina, proteína de choque térmico de 60 kDa, peroxirredoxina y la ATP sintasa mitocondrial, en cultivos primarios de tiroides normales y de carcinoma papilar de tiroides. Se establecieron las condiciones de extracción, solubilización, análisis cuantitativo y cualitativo de dichas proteínas, y se buscaron las mejores condiciones de isoelectroenfoque (IEF en la electroforesis en dos dimensiones (2D. En la extracción y solubilización de las proteínas se evaluó la presencia o ausencia de anfolitos y sales, se obtuvo un mejor resultado empleando en el amortiguador de extracción sales como Tris-HCl y acetato de magnesio que incrementan la solubilidad de las proteínas. Para la cuantificación se recomienda el uso conjunto de técnicas colorimétricas con la electroforesis SDS-PAGE tiñendo con azul de Coomassie y corroborando los resultados mediante western blot, lo cual permite, además, verificar la integridad de las proteínas. Respecto a la electroforesis en dos dimensiones, se obtuvieron geles con un mayor número de manchas (spots, resueltos, enfocados y reproducibles empleando en el IEF gradientes inmovilizados de pH de 4-7 y voltaje final de 8.000 V. Las proteínas se identificaron mediante el análisis bioinformático de los geles 2D con el programa PDQuest (PDQuest 7.2, Bio-Rad® y MALDI-TOF.

Fisiología trabecular y glaucoma de ángulo abierto Trabecular physiology and open angle glaucoma

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Yoanner Martín Perera

2012-01-01

Full Text Available El glaucoma constituye una de las enfermedades oculares más frecuentes en el mundo. Su etiología es variada, pero el problema radica generalmente en la evacuación del humor acuoso a nivel de la red trabecular y del canal de Schlemm. Se realizó una revisión bibliográfica sobre los principales mecanismos envueltos en la función trabecular: capacidad fagocítica de las células trabeculares, regulación de la composición de la matriz extracelular, contracción-relajación de las células trabeculares y los cambios en su volumen y forma. Un mayor conocimiento de la fisiología trabecular y su relación con la fisiopatología del glaucoma permitirá un mejor manejo de la enfermedad, así como el desarrollo de nuevos fármacos que tengan como diana la vía trabecular de manera selectiva y que permitan evitar los efectos secundarios relacionados con el empleo de medicamentos poco específicos.Glaucoma is one of the most common eye diseases worldwide, but usually the problem lies in the evacuation of aqueous humor at the trabecular meshwork and Schlemm's canal. A literature review was made about the main mechanisms involved in the trabecular function: the phagocytic capacity of trabecular cells, the regulation of the extracellular matrix composition, the contraction-relaxation of trabecular cells and the changes in their volume and shape. A better understanding of the trabecular physiology and the pathophysiology of glaucoma will allow better disease management and development of new drugs that have as their target the trabecular pathway in a selective way and that avoid the side effects associated with the use of nonspecific drugs.

Glaucoma Medication Preferences among Glaucoma Specialists in Mexico

OpenAIRE

Lazcano-Gomez, Gabriel; Alvarez-Ascencio, Daniela; Haro-Zuno, Cindy; Turati-Acosta, Mauricio; Garcia-Huerta, Magdalena; Jimenez-Arroyo, Jesus; Castañeda-Diez, Rafael; Castillejos-Chevez, Armando; Gonzalez-Salinas, Roberto; Dominguez-Dueñas, Francisca; Jimenez-Roman, Jesus

2017-01-01

Aim To determine the glaucoma specialists’ preferences for the different brands of topical glaucoma medications available in Mexico. Materials and methods A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. Results Data from 111 (74%) glaucoma s...

Pautas para el trabajo metodológico que fomenten las competencias docentes de los maestros primarios

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MSc. Juan Carlos Pérez Castillo

2016-03-01

Full Text Available El desarrollo de las competencias docentes, es un reto en el proceso de formación de los maestros primarios noveles; con el propósito de satisfacer estas demandas, se diseñaron pautas para un trabajo metodológico pertinente, al tener presente las características de la institución educativa, a partir de la introducción de resultados científicos con el método: investigación acción participativa. La dinámica de trabajo que se utilizó fue la gestión y circulación del conocimiento, se corrobora su eficacia e impacto social. Se logró cambios en el proceder de los maestros principalmente en las competencias de planificación y dirección del proceso de enseñanza y aprendizaje.

Glaucoma

Medline Plus

Full Text Available ... Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Glaucoma Embedded video for NEI YouTube Videos: Glaucoma Embedded video for NEI YouTube Videos: Glaucoma NEI ...

Degeneración de los terminales aferentes primarios de rata luego de lesión extensa por avulsión del plexo braquial

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Vilma Muñetón-Gómez

2004-06-01

Full Text Available El uso de las neuronas sensoriales primarias ha aportado avances en el entendimiento de las razones por las cuales falla la regeneración cuando el sistema nervioso central (SNC es dañado. La rizotomía dorsal se puede usar como un modelo experimental de las lesiones por avulsión del plexo braquial, una lesión en la cual son desprendidas, en su punto de entrada en la médula espinal, las ramas centrales de los aferentes primarios causando una disfunción motora y sensorial grave e irreversible del miembro superior. En el presente trabajo, se examinó la organización central de los aferentes primarios en ratas Wistar adultas. Éstas fueron divididas en controles normales no lesionados y en animales rizotomizados entre los niveles cervical 3 y torácico 3 (C3-T3. Se estudió la deaferentación de los subtipos de axones sensoriales utilizando anticuerpos específicos contra el péptido relacionado con el gen de la calcitonina (CGRP, el receptor purinérgico (P2X3, el receptor de baja afinidad p75 para el factor de crecimiento nervioso (NGF y contra la subunidad ? de la toxina de cólera (TC?. Otro subtipo fue marcado con la lectina Griffonia simplicifolia IB4. La inmunohistoquímica y la microscopía óptica de alta resolución demostraron que el modelo animal de rizotomía completa del plexo braquial reproduce diversos déficit observados en las lesiones humanas. Esta lesión produce diferentes grados de degeneración terminal entre los diversos tipos de aferentes primarios que definen subpoblaciones de neuronas sensoriales. En los niveles de la médula espinal estudiados (entre C6 y C8, la deaferentación fue parcial para las fibras peptidérgicas GCRP-positivas, en contraste con la eliminación de las fibras no peptidérgicas y las mielinizadas. La rizotomía dorsal es un modelo experimental apropiado para estudiar las alteraciones sensoriales como el dolor agudo y la alodinia, así como los factores que podrían afectar la regeneración en

Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.

Science.gov (United States)

Lazcano-Gomez, Gabriel; Alvarez-Ascencio, Daniela; Haro-Zuno, Cindy; Turati-Acosta, Mauricio; Garcia-Huerta, Magdalena; Jimenez-Arroyo, Jesus; Castañeda-Diez, Rafael; Castillejos-Chevez, Armando; Gonzalez-Salinas, Roberto; Dominguez-Dueñas, Francisca; Jimenez-Roman, Jesus

2017-01-01

To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition. How to cite this article: Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez

Glaucoma

Science.gov (United States)

... glaucoma Images Eye Slit-lamp exam Visual field test Glaucoma References Anderson DR. The optic nerve in glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013 . Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 48. Giaconi JA, ...

Facts about Glaucoma

Science.gov (United States)

... Information » Glaucoma » Facts About Glaucoma Listen Facts About Glaucoma This information was developed by the National Eye ... is the best person to answer specific questions. Glaucoma Defined What is Glaucoma? Glaucoma is a group ...

What Is Glaucoma?

Science.gov (United States)

... Stories Español Eye Health / Eye Health A-Z Glaucoma Sections What Is Glaucoma? What Are the Symptoms ... Diagnosis Glaucoma Treatment Glaucoma Vision Simulator What Is Glaucoma? Leer en Español: ¿Qué es el glaucoma? Written ...

Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

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Betsy Sleath

2014-01-01

Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

Estrés y depresión en cuidadores informales de pacientes con trastorno afectivo bipolar

OpenAIRE

Palacios-Espinosa, Ximena; Jiménez-Solanilla, Karim-Offir

2009-01-01

El presente estudio tiene como objetivo establecer la prevalencia del estrés y la depresión en cuidadores primarios informales de pacientes con trastorno afectivo bipolar (TAB) de la Clínica de Nuestra Señora de La Paz (Bogotá, Colombia). La muestra fue de 40 cuidadores primarios informales, a quienes se les aplicaron varios instrumentos: una encuesta filtro, una ficha sociodemográfica, el Inventario de Depresión de Beck (BDI) y el Cuestionario de Estrés Diario. Los resultados indican que hay...

Trastorno Somatosensorial en niños con Trastornos por Déficit de Atención con Hiperactividad.

OpenAIRE

Romero Ayuso, Dulce María

2016-01-01

Introducción: El estudio de los trastornos por déficit de atención (ADHD) se ha centrado en la falta de control inhibitorio como déficit primario, aunque su fisiopatología también se ha relacionado con la corteza somatosensorial. El objetivo de este trabajo fue conocer si existe un trastorno para la discriminación sensorial táctil y praxis en los niños con ADHD y si éste es similar en los subtipos inatento (ADHD-I) y combinado (ADHD-C). Método: los participantes fueron 74 niños entre 7 y 11 a...

Glaucoma Research Foundation

Science.gov (United States)

... born with glaucoma. Read her story » Learn About Glaucoma Glaucoma is a complicated disease in which damage ... Christopher doesn't ever want to go blind » Glaucoma 360 Glaucoma 360 — three days of events uniting ...

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

Science.gov (United States)

Shen, Christopher C; Salim, Sarwat; Du, Haiming; Netland, Peter A

2011-01-01

Purpose: To compare surgical outcomes in neovascular glaucoma patients who underwent trabeculectomy with mitomycin C versus Ahmed Glaucoma Valve implantation. Patients and methods: This was a retrospective comparative case series. We reviewed 40 eyes of 39 patients with underlying diagnosis of neovascular glaucoma, divided into two groups: Ahmed Glaucoma Valve (N = 20) and trabeculectomy with mitomycin C (N = 20). Surgical success was defined as 6 mm Hg ≤ intraocular pressure ≤21 mm Hg, with or without the use of glaucoma medications, with no further glaucoma surgery, and light perception or better vision. Early postoperative hypotony was defined as intraocular pressure Ahmed Glaucoma Valve group and 25 months (6–77 months) for the trabeculectomy group. Although the mean number of postoperative intraocular pressure-lowering medications was significantly higher in the trabeculectomy group compared with the Ahmed Glaucoma Valve group at 3 and 6 month time points, there was no statistically significant difference at any other time point. There was no statistically significant difference between both groups in postoperative visual acuity and intraocular pressure. Success was 70% and 65% at 1 year and 60% and 55% at 2 years after Ahmed Glaucoma Valve and trabeculectomy, respectively. Kaplan–Meier survival curve analysis showed no significant difference in success between the two groups (P = 0.815). Hyphema was the most common complication in both groups. Conclusion: We found similar results after trabeculectomy with mitomycin C and Ahmed Glaucoma Valve implantation in eyes with neovascular glaucoma. PMID:21468334

Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma.

Science.gov (United States)

Pakravan, Mohammad; Esfandiari, Hamed; Yazdani, Shahin; Doozandeh, Azadeh; Dastborhan, Zahra; Gerami, Ebrahim; Kheiri, Bahareh; Pakravan, Parastou; Yaseri, Mehdi; Hassanpour, Kiana

2018-03-01

To evaluate the outcomes of Ahmed glaucoma valve implantation in refractory primary congenital glaucoma as well as primary procedure in aphakic glaucoma. In this retrospective study, medical records of patients who underwent Ahmed glaucoma valve implantation for refractory glaucoma and aphakic glaucoma were reviewed. Primary outcome measures were the surgical success defined as intraocular pressure ≤21 mm Hg and decreased ≥20% and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity, and intraocular pressure. A total of 62 eyes of refractory primary congenital glaucoma patients (group 1) and 33 eyes of aphakic glaucoma patients (group 2) were included in our study. Mean follow-up was 51 ± 33 months in group 1 and 49 ± 41 months in group 2 (p = 0.82). The cumulative probability of success was 90% in both groups at the first year; however, the success rate was 52.5% in group 1 and 71.5% in group 2 at 5 years' follow-up visit. In group 1, the mean intraocular pressure ± standard deviation was 33.1 ± 8.6 mm Hg at the baseline and decreased to 17.1 ± 5.3 mm Hg at 1 year and 18.5 ± 6.4 at 3 years postoperatively (all p's glaucoma medications was 3 ± 0.7 that decreased to 2 ± 0.8 at final follow-up (p = 0.02). Ahmed glaucoma valve implantation has a moderate success rate in the management of refractory primary congenital glaucoma with an increased chance of tube-related complications. The surgical success rate is higher in case of primary Ahmed glaucoma valve implant for aphakic glaucoma with acceptable safety profile.

Glaucoma, Open-Angle

Science.gov (United States)

... Home » Statistics and Data » Glaucoma, Open-angle Listen 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 ...

Equine Glaucoma.

Science.gov (United States)

Michau, Tammy Miller

2017-12-01

Glaucoma is a multifactorial neurodegenerative ocular disease leading to progressive loss of retinal ganglion cells and their axons that form the optic nerve, causing blindness. Knowledge of the pathogenesis and development of equine glaucoma is in its infancy compared with human glaucoma. Glaucoma occurs most commonly secondary to uveitis and may be underdiagnosed or misdiagnosed in horses suffering from uveitis. Recognition and clinical diagnosis of glaucoma in the horse is improved with clinician awareness and the availability of handheld tonometers. Therapy for glaucoma is aimed at decreasing aqueous humor production through medical and surgical means. Even with therapy, long-term prognosis for vision is poor. Copyright © 2017 Elsevier Inc. All rights reserved.

Absceso primario del músculo psoas: Presentación de 1 caso y revisión de la literatura

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Rafael Pila Pérez

2001-06-01

Full Text Available El absceso primario del psoas es una entidad infrecuente que afecta principalmente a adultos jóvenes y adolescentes. Se describe un caso de absceso primario del psoas en un paciente de 77 años de edad. Los síntomas predominantes fueron fiebre, dolor abdominal y deterioro progresivo del estado general. El diagnóstico se realizó mediante tomografía axial computadorizada. El tratamiento consistió en antibioticoterapia y drenaje percutáneo, con éxito. Se revisó la literatura medica; se señaló la patogenia, la clínica, el diagnóstico y el tratamiento de esta enfermedadPrimary psoas abscess is an uncommon entity affecting mainly young adults and adolescents. A case of primary psoas abscess in a patient aged 77 is described. Prevailing symptoms were: fever, abdominal pain and progressive deterioration of the general state. The diagnosis was made using computerized axial tomography (CAT. The treatment with antibiotic therapy and percutaneous drainage was successful. Medical literature was reviewed and the pathogeny, clinic, diagnosis and treatment of this disease were stressed

Exposición a televisión y retardo primario del lenguaje en menores de 5 años

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Ileana Valdivia Álvarez

Full Text Available Introducción: además del impacto en los hallazgos genéticos planteados en la actualidad, en estudios recientes se enfatiza en 2 factores de impacto ambiental: la interacción verbal padre-hijo y la exposición del niño a medios electrónicos (televisión, videos, computadoras con interesantes implicaciones en el desarrollo del lenguaje. Objetivo: evaluar la exposición a la televisión como factor de riesgo en el desarrollo del lenguaje, en niños entre 18 meses y 5 años de edad. Métodos: estudio analítico caso-control, en niños entre 18 meses y 5 años, atendidos en la consulta de Neuropediatría del Hospital Pediátrico "Juan Manuel Márquez" por retardo del lenguaje, entre enero de 2010 y julio de 2011, en relación con un grupo control de niños sanos. Resultados: el retardo primario del lenguaje es más frecuente en niños procedentes de familias de nivel universitario en más del 80 %, que presentan una exposición más prolongada (p= 0,0001 y precoz (p= 0,001 a la televisión. Conclusiones: se consideran factores de riesgo para el retardo primario del lenguaje, la exposición a la televisión antes de los 2 años de edad y por más de 2 horas al día.

"JUEGO HISTÓRICO INTERACTIVO FÍSICO: COSMOVISIÓN MOCHE EN LA IDENTIDAD CULTURAL DE ESTUDIANTES DEL NIVEL PRIMARIO.”

OpenAIRE

Saldarriaga Vera, Marilyn

2016-01-01

La creación de un juego físico teniendo como base principal la Cosmovisión Moche, puede ser entendida como el modo de concepción e interpretación del entorno y realidad de esta cultura, para mejorar la identidad cultural en niños de nivel primario. La propuesta de juego es concebida como complemento para promover la educación primaria de los/as niños/as con fines de optimizar el conocimiento de la Historia peruana de manera didáctica; en una etapa real del aprendizaje (como lo es la niñez), p...

Glaucoma: Symptoms and Causes

Science.gov (United States)

... types of glaucoma include the following: Open-angle glaucoma Open-angle glaucoma is the most common form ... re even aware of a problem. Angle-closure glaucoma Angle-closure glaucoma, also called closed-angle glaucoma, ...

Glaucoma Symptoms

Science.gov (United States)

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

Implante ExPRESS-P en el glaucoma traumático

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Francisco Fumero González

Full Text Available Se presenta un paciente masculino, blanco, de 32 años de edad, con antecedentes de trauma contuso en el ojo izquierdo a los 8 años de edad. El examen oftalmológico del ojo izquierdo reveló agudeza visual mejor corregida 60 VAR; presión intraocular 42 mmHg con terapia hipotensora máxima; catarata corticonuclear traumática y daño glaucomatoso avanzado. Como opción de tratamiento se realizó la cirugía combinada (facoemulsificación e implante de dispositivo ExPRESS, modelo P-50, asociado al uso de mitomicina C 0,2 %. Se obtuvo agudeza visual mejor corregida 97 VAR y presión intraocular 17 mmHg a los 3 meses posoperatorio. Este caso evidencia la necesidad del seguimiento de por vida luego de un trauma ocular, y fundamentalmente cuando existe un receso angular traumático, con la finalidad de diagnosticar precozmente la hipertensión ocular y prevenir la pérdida visual irreversible por glaucoma. La facoemulsificación combinada con el implante ExPRESS resulta una opción favorable para el tratamiento de casos complejos que presentan glaucoma y catarata.

Quemaduras accidentales en niños y niñas remitidos del nivel primario de atención

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Raúl Ricardo Rizo González

2015-01-01

Full Text Available Se realizó un estudio descriptivo y transversal de 58 pacientes con quemaduras, ingresados en el Servicio de Caumatología del Hospital Infantil Norte Docente "Juan de la Cruz Martínez Maceira" de Santiago de Cuba, remitidos del nivel primario de atención, desde enero de 2009 hasta diciembre de 2010, con el objetivo de investigar los factores más frecuentes que ocasionaron estos accidentes. En la serie predominaron el sexo masculino, los líquidos hirvientes como agente causal más frecuente, además de la baja percepción del riesgo, las malas condiciones de vida y la procedencia rural como factores socioeconómicos desfavorables. La atención médica se consideró satisfactoria ya que más de 50 % de los pacientes ingresaron entre graves y críticos extremos y solo dos 2 fallecieron

Auditoría con Informática a Sistemas Contables.

OpenAIRE

Yeiniel Alfonso Martínez; Briseida Blanco Alfonso; Liuba Loy Marichal

2012-01-01

En la actualidad existe un gran avance de la Tecnología de la información y con éste un nuevo concepto: Auditoria con informática. Las auditorias financieras no solo se deben limitar en la realización de comprobaciones de la actividad económica y financiera mediante documentos primarios, también se debe incluir herramientas informáticas que estén en los sistemas contables de una entidad, surgiendo la necesidad de un auditor informático que apoye laactividad de Auditoria.

Tratamiento con estatinas en pacientes pediátricos con síndrome nefrótico resistente a esteroides. Reporte de dos casos

OpenAIRE

C Sánchez-García; A A Bailón-Ortega; S Zaltzman-Girshevich

2017-01-01

El síndrome nefrótico se define por la asociación de proteinuria, hipoalbuminemia, hiperlipidemia y edema. El 80% de los pacientes pediátricos con síndrome nefrótico primario responde a la terapia con esteroides; el 20% restante requiere asociar otros medicamentos para alcanzar la remisión (ciclofosfamida, ciclosporina). La hiperlipidemia en el síndrome nefrótico es debida tanto a un incremento en la síntesis acompañada de disminución en la eliminación de los lípidos de la sangre; siendo la c...

Eficacia de la melatonina en insomnio primario en el adulto mayor: revisión sistemática de la literatura

OpenAIRE

Gaitán Quintero, Lina María; Rondón Rueda, Paola Andrea

2015-01-01

Introducción: La melatonina, una sustancia cronobiótica endógena, es cada vez más empleada para el manejo de los problemas del sueño en adultos mayores por su aparente eficacia y buen perfil de eventos adversos. En este sentido, se intentó evaluar la eficacia de la melatonina en el tratamiento del insomnio primario en el adulto mayor (≥55 años) comparado con benzodiacepinas, zopiclona y placebo a la luz de la evidencia disponible en los últimos cinco años. Métodos: Revisión sistemática de la ...

Glaucoma de ángulo abierto posterior a la vitrectomía pars plana

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Kenia Galindo Reymond

Full Text Available Con este trabajo nos proponemos revisar las evidencias científicas relacionadas con la aparición del glaucoma de ángulo abierto posterior a la vitrectomía pars plana. Se revisaron las evidencias científicas relacionadas con la aparición del glaucoma de ángulo abierto posterior a la cirugía de vitrectomía pars plana. Para la investigación documental se examinaron los artículos de la temática indexados en las bases de datos Pubmed, Pubmed Central y Scielo, que correspondieron a los descriptores DeCs-MeSH: glaucoma de ángulo abierto y vitrectomía pars plana. En la búsqueda de avanzada se utilizó el booleano AND y la restricción de tiempo entre los años 2004 y 2014. De los 38 artículos identificados, se desecharon 16 por no tenerse acceso íntegro al documento. El tratamiento de los datos se realizó mediante el análisis de contenido de tipo directo. Los mecanismos patológicos que causan glaucoma de ángulo abierto posterior a la vitrectomía pars plana son múltiples y complejos. La hipótesis del daño por estrés oxidativo en las celdas de la malla trabecular y su repercusión en la salida del humor acuoso, tiene un sustento científico en su patogenia que la hace plausible. El tratamiento para controlar la hipertensión ocular en estos pacientes después de la vitrectomía es individualizado; puede transitar desde el tratamiento médico y hasta el uso de técnicas quirúrgicas simples o complejas en algunos casos. Aún no se han esclarecido los mecanismos fisiopatológicos del glaucoma de ángulo abierto posterior a la vitrectomía pars plana, por lo que son necesarias nuevas investigaciones sobre el tema.

Diabetes mellitus e hipertensión: Estudio en el nivel primario de salud

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Nelson Crespo Mojena

2002-10-01

Full Text Available Se revisaron 11 estudios en pacientes diabéticos del nivel primario de salud para conocer la prevalencia de hipertensión arterial en dicha serie entre los años 1986- 2000, registrándose un total de 1 126 pacientes diabéticos con una prevalencia de hipertensión arterial del 53,2 %. Es importante señalar como factor predictor de daño renal el estudio de la presencia de microalbuminuria en 60 pacientes diabéticos del nivel primario de salud y 60 pacientes diabéticos del nivel secundario, lo que demuestra la relación existente entre la hipertensión arterial y la presencia de microalbuminuria en una fase aún reversible de daño renal. Se discuten los fundamentos del tratamiento antihipertensivo en pacientes diabéticos y se recomienda el uso de los inhibidores del sistema renina angiotensina (SRA. El objetivo del tratamiento es lograr la reducción de la tensión arterial por debajo de 140/90, con un ideal de 120/80 para así reducir la morbimortalidad por enfermedad cardiovascular, cerebrovascular y renal.Diabetes mellitus and hypertension. Study at the primary health care level Eleven studies conducted among diabetic patients at the primary health care level were reviewed to know the prevalence of arterial hypertension in this series from 1986 to 2000. A total of 1 126 diabetic patients with a prevalence of arterial hypertension of 53.2 % were registered. It is important to stress the presence of albuminuria as a predictive factor of renal damage in 60 diabetic patients at the primary health care level and in 60 diabetic patients at the secondary level, which shows the relation existing between arterial hypertension and the presence of albuminuria at a still reversible stage of renal damage. The foundations of the antihypertensive treatment in diabetic patients are discussed and the use of renin-angiotensin system (RAS inhibitors is recommended. The treatment is aimed at reducing arterial hypertension to values under 140 x 90 with an

RENDIMIENTO ACADÉMICO: SU RELACION CON LA MEMORIA DE TRABAJO

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Magdalena López

2013-01-01

Full Text Available Este artículo tiene como objetivo estudiar la relación de los componentes de la memoria de trabajo con el desempeño académico en lengua y matemática de estudiantes de 8 y 9 años de edad, escolarizados en 3o año de nivel primario. Para evaluar cada una de las variables investigadas, se aplicaron, a 54 estudiantes pruebas que tendían a evaluar de forma independiente cada componente de la memoria de trabajo por medio de dos sub pruebas del test WISC III: dígitos en orden directo e inverso y el test de figuras complejas de Rey. El desempeño académico se obtuvo de las notas finales de los tres trimestres, una vez finalizado el año lectivo. Los resultados muestran que el componente ejecutivo central es el predictor significativo del desempeño en lengua (R2= .21; p = .000 y en matemáticas (R2= .27; p = .000 en los estudiantes que culminan el 3o año de nivel primario. Dichos datos se discuten en relación con una mayor comprensión del rendimiento académico y con la generación de nuevas propuestas que ayuden a revertir la problemática del fracaso escolar.

Infarto agudo del miocardio como primera manifestación del síndrome antifosfolípido primario en un paciente de veinticuatro años Acute myocardial infarction as first manifestation of primary antiphospholipid syndrome in a twenty-four years old patient

Directory of Open Access Journals (Sweden)

Carlos E Uribe

2005-09-01

Full Text Available El síndrome antifosfolípido primario usualmente se manifiesta como trombosis venosa profunda, tromboembolismo pulmonar y como evento cerebrovascular en la circulación arterial. Se presenta el caso de un paciente joven previamente sano, con infarto agudo del miocardio como primera manifestación del síndrome antifosfolípido primario.Primary antiphospholipid syndrome is usually manifested with deep venous thrombosis, pulmonary thromboembolism and arterial thrombosis, including cerebrovascular accidents. We report the case of a previously healthy young patient who suffered an acute myocardial infarction as the first manifestation of a primary antiphospholipid syndrome.

The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences in Southwest Ethiopia.

Science.gov (United States)

Gessesse, Girum W

2015-07-01

The management of refractory glaucoma is a challenging task for any glaucoma surgeon. This study is aimed to evaluate the efficacy of Ahmed Glaucoma Valve implantation in refractory glaucomas in South-West Ethiopia. A retrospective review was conducted on the charts of consecutive patients treated with Ahmed glaucoma valve implantation at Jimma University Specialized Hospital between August 2012 and August 2014. Success was defined as Intraocular Pressure (IOP) less than 22 mm Hg and greater than 5mm Hg at 6 months, with at least 30% reduction from baseline, without medical therapy (complete success) or either with or without medication (qualified successes). A total of 12 eyes of 11 patients were included. The mean age of patients was 40.7 (SD= 19.0) years; 63.6% of them were males. The main types of glaucoma were pseudoexfoliative (3 eyes), uveitic (2 eyes), chronic angle closure (2 eyes) and Juvenile Open Angle (JOAG) (2 eyes). The mean IOP was reduced from preoperative level (32.75±7.14 mmHg) to (15.75 ±4.35 mmHg) at six postoperative months, (PAhmed glaucoma valve implant appears to be effective and relatively safe for treating complicated glaucomas with success rate comparable with those reported from other studies. Ahmed glaucoma valve, refractory glaucoma, complications, Ethiopia.

Glaucoma

Medline Plus

Full Text Available ... YouTube Videos: Glaucoma Embedded video for NEI YouTube Videos: Glaucoma ... *PDF files require the free Adobe® Reader® software for viewing. This website is maintained by the ...

DOCENTES, TAREAS Y ALUMNOS EN LA DEFINICIÓN DEL COMPROMISO: INVESTIGANDO EL AULA DE NIVEL PRIMARIO DE EDUCACIÓN

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Daiana Yamila Rigo

Full Text Available RESUMEN: El artículo presenta resultados preliminares de una investigación desarrollada con alumnos y docentes de nivel primario en el área de las Ciencias Sociales. El propósito fue describir, explorar y explicar cómo el compromiso de los estudiantes se relaciona e interrelaciona con factores contextuales y la configuración de la clase. Se entiende por implicación la intensidad y la emoción con las cuales los estudiantes se involucran en el contexto de enseñanza para iniciar y llevar a cabo actividades de aprendizaje. Para la recolección de datos, se usaron cuestionarios y protocolos de observación. Los resultados muestran que la configuración de la clase se define como factor clave para atender al compromiso, asimismo, las principales conclusiones permiten apreciar que el compromiso se contagia; y el contexto de aprendizaje y el diseño de la clase son fundamentales en la implicación que los alumnos muestran hacia el aprendizaje en el área de las Ciencias Sociales.

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. ...

Glaucoma

Medline Plus

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

Glaucoma

Medline Plus

Full Text Available ... Diabetic Eye Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and ... Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish ...

Glaucoma

Medline Plus

Full Text Available ... Diabetic Eye Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and Aging ... Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos ...

Tratamiento de la mordida cruzada anterior con plano inclinado anterior. Efecto sobre los arcos dentales

OpenAIRE

Carolina Rodríguez Manjarrés; Jesús Alberto Hernández Silva

2017-01-01

Objetivo: Evaluar los cambios dimensionales de los arcos dentales primarios tratados con plano inclinado anterior como método de corrección de la mordida cruzada anterior. Métodos: Se trataron 10 pacientes con edades entre 3 y 5 años afectados con mordida cruzada anterior completa, se colocó un plano inclinado anterior elaborado en acrílico, que estuvo en posición en promedio 8.5 semanas. Se obtuvieron modelos de estudio en 3 momentos T0: antes del tratamiento; T1: 6 meses después de iniciado...

Hipertensos primarios. Evolución de la remodelación cardiaca según tratamiento

OpenAIRE

González Núñez, Honey; García López, Vivian; Medina, Ángel; Herrera Cruz, Niria

2009-01-01

Fundamento: La hipertensión arterial es un problema prioritario de salud a nivel mundial que afecta eminentemente a las sociedades desarrolladas y es extraordinariamente prevalente. Objetivo: Valorar, después del tratamiento farmacológico, la evolución de la remodelación cardiaca en pacientes hipertensos primarios. Método: Se realizó un estudio observacional, analítico transversal en tres áreas de salud del municipio Camagüey a 178 pacientes hipertensos primarios, mayores de 18 años, diagnost...

Glaucoma

Medline Plus

Full Text Available ... YouTube Videos » NEI YouTube Videos: Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration ... Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Glaucoma Embedded video for NEI YouTube Videos: ...

Módulo para solicitudes de gammagrafía ósea en pacientes con cáncer

OpenAIRE

Morales, Rosanna; Vásquez, Edinson; Cano, Roque; Díaz, Pepe; Vásquez, Mario; Vásquez, María; Rojas, Peter

2014-01-01

Se reporta la aplicación de un software que permite registrar con datos completos y pertinentes del paciente, la solicitud para la realización de los exámenes de gammagrafía ósea, con la finalidad que cada información sea consultada adecuadamente y el paciente sea atendido con eficiencia en los servicios de medicina nuclear. La gammagrafía ósea es un estudio de uso frecuente que permite diagnosticar la existencia de un cáncer primario, dirigir un estudio para biopsia o reportar la diseminació...

Glaucoma and dry eye disease: the role of preservatives in glaucoma medications

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Ratna Sitompul

2011-11-01

Full Text Available Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC-containing eye drop  used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patients’ compliance and   decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5Keywords: benzalkonium chloride, dry eye, glaucoma

Glaucoma Monitoring in a Clinical Setting Glaucoma Progression Analysis vs Nonparametric Progression Analysis in the Groningen Longitudinal Glaucoma Study

NARCIS (Netherlands)

Wesselink, Christiaan; Heeg, Govert P.; Jansonius, Nomdo M.

Objective: To compare prospectively 2 perimetric progression detection algorithms for glaucoma, the Early Manifest Glaucoma Trial algorithm (glaucoma progression analysis [GPA]) and a nonparametric algorithm applied to the mean deviation (MD) (nonparametric progression analysis [NPA]). Methods:

Normal-tension glaucoma (Low-tension glaucoma)

Science.gov (United States)

Anderson, Douglas R

2011-01-01

Glaucoma is now considered an abnormal physiology in the optic nerve head that interacts with the level of intraocular pressure (IOP), with the degree and rate of damage depending on the IOP and presumably the degree of abnormal physiology. Diagnosis of normal-tension glaucoma (NTG), defined as glaucoma without a clearly abnormal IOP, depends on recognizing symptoms and signs associated with optic nerve vulnerability, in addition to absence of other explanations for disc abnormality and visual field loss. Among the findings are a halo or crescent of absence of retinal pigment epithelium around the disc, bilateral pre-chiasmal visual field defects, splinter hemorrhages at the disc margin, vascular dysregulation (low blood pressure, cold hands and feet, migraine headache with aura, and the like), or a family history of glaucoma. Possibly relevant, is a history of hemodynamic crisis, arterial obstructive disease, or sleep apnea. Neurological evaluation with imaging is needed only for atypical cases or ones that progress unexpectedly. Management follows the same principle of other chronic glaucomas, to lower the IOP by a substantial amount, enough to prevent disabling visual loss. However, many NTG cases are non-progressive. Therefore, it may often be wisein mild cases to determine whether the case is progressive and the rate of progression before deciding on how aggressivene to be with therapy. Efforts at neuroprotection and improvement in blood flow have not yet been shown effective. PMID:21150042

Normal-tension glaucoma (Low-tension glaucoma

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Anderson Douglas

2011-12-01

Full Text Available Glaucoma is now considered an abnormal physiology in the optic nerve head that interacts with the level of intraocular pressure (IOP, with the degree and rate of damage depending on the IOP and presumably the degree of abnormal physiology. Diagnosis of normal-tension glaucoma (NTG, defined as glaucoma without a clearly abnormal IOP, depends on recognizing symptoms and signs associated with optic nerve vulnerability, in addition to absence of other explanations for disc abnormality and visual field loss. Among the findings are a halo or crescent of absence of retinal pigment epithelium around the disc, bilateral pre-chiasmal visual field defects, splinter hemorrhages at the disc margin, vascular dysregulation (low blood pressure, cold hands and feet, migraine headache with aura, and the like, or a family history of glaucoma. Possibly relevant, is a history of hemodynamic crisis, arterial obstructive disease, or sleep apnea. Neurological evaluation with imaging is needed only for atypical cases or ones that progress unexpectedly. Management follows the same principle of other chronic glaucomas, to lower the IOP by a substantial amount, enough to prevent disabling visual loss. However, many NTG cases are non-progressive. Therefore, it may often be wisein mild cases to determine whether the case is progressive and the rate of progression before deciding on how aggressivene to be with therapy. Efforts at neuroprotection and improvement in blood flow have not yet been shown effective.

Effects of change in primary forest cover on armadillo (Cingulata, Mammalia burrow use in the Central Amazon Efectos del cambio en la cobertura de bosque primario sobre el uso de las madrigueras por los armadillos (Cingulata, Mammalia en la Amazonia Central

Directory of Open Access Journals (Sweden)

María Clara Arteaga

2012-03-01

Full Text Available Transformation of primary forest to other vegetation types alters the availability and distribution of resources, and thus affects their use by species that inhabit the forest. Although armadillos are important earthmover mammals in the Amazon forest, and their burrows play an important physical and ecological role in the ecosystem, the impact of loss of primary forest cover on these organisms has been poorly understood. In order to evaluate the effects of change in the primary forest cover on burrow use by armadillos, we performed 2 censuses in 33 plots within 12 sites of different vegetation cover characteristics, and recorded burrow density and current use. A total of 109 armadillo burrows were found; the sites with higher percentages of primary forest cover showed a larger number of active burrows, although burrow density and the probability of establishing new burrows remained unaffected by this variable. Our results show that areas with higher quantities of primary forest habitat show more intense use by armadillos, probably due to the permanence time of individuals. These findings suggest that the viability of armadillo populations, as well as the role that these animals play within the ecosystem, may be affected in disturbed areas.La transformación del bosque primario a otro tipo de vegetación cambia la disponibilidad y distribución de los recursos, afectando su uso por especies que habitan el bosque. Los armadillos son el principal grupo de mamíferos escavadores del Amazonas y sus madrigueras cumplen un papel físico y ecológico en el ecosistema. Sin embargo, no se conoce el impacto de la pérdida del bosque sobre estos organismos. Con el fin de evaluar el efecto de los cambios en la cobertura de bosque primario sobre el uso de sus madrigueras, realizamos 2 censos en 33 parcelas dentro de 12 localidades con diferentes coberturas vegetales y reportamos la densidad y el estado de uso de las madrigueras. Encontramos 109 madrigueras y

Opciones de tratamiento en un paciente con pérdida prematura de segundos molares primarios: zapato distal modificado / Treatment Options in a Patient with Primary Second Molar Premature Loss: Modified Distal Shoe Space Maintainer

OpenAIRE

Cardoso, María Lorena; Universidad Nacional del Nordeste. Corrientes, Argentina; Falcón, Diana Emilia; Universidad Nacional del Nordeste. Corrientes, Argentina; Galiana, Andrea Verónica; Universidad Nacional del Nordeste. Corrientes, Argentina

2017-01-01

RESUMEN. Antecedentes: La pérdida prematura de un molar primario conlleva a malposición de los dientes contiguos y del sucesor permanente. El efecto depende de las fuerzas que actúan sobre el diente, que están condicionadas a su vez por el estado de erupción del primer molar permanente. Propósito: Describir una opción de tratamiento para la pérdida prematura de segundos molares primarios hasta la erupción de los primeros molares permanentes. Descripción del caso: El caso clínico presentado in...

Trabeculoplastia selectiva láser en pacientes glaucomatosos Selective laser trabeculoplasty in glaucomatose patients

Directory of Open Access Journals (Sweden)

Marerneda Domínguez Randulfe

2010-01-01

Full Text Available OBJETIVO: Evaluar la efectividad y la seguridad de la trabeculoplastia selectiva láser en pacientes afectados por glaucoma primario de ángulo abierto, en el Instituto Cubano de Oftalmología «Ramón Pando Ferrer». MÉTODOS: Se realizó un estudio descriptivo, prospectivo de corte longitudinal con 30 pacientes para un total de 36 ojos, en el período de noviembre de 2006 a abril de 2007. Se caracterizó la muestra de estudio y se les realizaron pruebas estadísticas a las variables. RESULTADOS: Las enfermedades vasculares y el factor hereditario fueron los antecedentes de mayor importancia. Se logró disminuir la medicación en la mayoría de los ojos tratados. Se obtuvo una reducción media final de la presión intraocular a los 6 meses de seguimiento a 7 mmHg, y la hipertensión ocular fue la complicación más frecuente. CONCLUSIONES: La trabeculoplastia selectiva láser se perfila como una opción terapéutica eficaz y segura para mejorar la calidad de vida del paciente con glaucoma primario de ángulo abierto.OBJECTIVE: To evaluate the effectiveness and the safety of the selective laser trabeculoplasty in patients affected by open angle primary glaucoma, in "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: A longitudinal, prospective and descriptive study was performed in 30 patients for a total number of 36 eyes, in the period of November 2006 to April 2007. The study sample was characterized and the variables were processed by statistical tests. RESULTS: The vascular diseases and the hereditary factor were the most important antecedents. It was possible to reduce the drug treatment in most of the treated eyes. There was final mean reduction in the intraocular pressure of 7 mmHg after 6-month follow-up and the ocular hypertension was the most frequent complication. CONCLUSIONS: The selective laser trabeculoplasty seems to be an effective and safe therapeutic option to improve the quality of life of the patients with open

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

OpenAIRE

Netland, Peter; Shen,Chris; Salim,Sarwat; Du,Haiming

2011-01-01

Christopher C Shen1, Sarwat Salim2, Haiming Du2, Peter A Netland31Glaucoma Consultants Northwest, Seattle, WA, USA; 2University of Tennessee Health Science Center, Memphis, TN, USA; 3University of Virginia School of Medicine, Charlottesville, VA, USAPurpose: To compare surgical outcomes in neovascular glaucoma patients who underwent trabeculectomy with mitomycin C versus Ahmed Glaucoma Valve implantation. Patients and methods: This was a retrospective comparative case series. We reviewed 40 e...

High prevalence of narrow angles among Chinese-American glaucoma and glaucoma suspect patients.

Science.gov (United States)

Seider, Michael I; Pekmezci, Melike; Han, Ying; Sandhu, Simi; Kwok, Shiu Y; Lee, Roland Y; Lin, Shan C

2009-01-01

To evaluate the prevalence of gonioscopically narrow angles in a Chinese-American population with glaucoma or glaucoma suspicion. Charts from all Chinese-American patients seen in a comprehensive ophthalmology clinic in the Chinatown district of San Francisco in 2002 were reviewed. One eye from each patient with glaucoma or glaucoma suspicion that met inclusion criteria was included (n=108). Data were collected for sex, age, race (self-declared), refraction (spherical equivalent), intraocular pressure, gonioscopy, and vertical cup-to-disk ratio. Sixty percent (n=65) of Chinese-American eyes with glaucoma or glaucoma suspicion had gonioscopically narrow angles (Shaffer grade or = 0.071). In a multivariate model including age, sex, and refraction as predictors of angle grade (open or narrow), only age was a significant predictor of angle grade (P=0.004). A large proportion of Chinese-Americans in our study population with glaucoma or glaucoma suspicion had gonioscopically narrow angles. In multivariate analysis, patients with narrow angles were older than those with open angles but did not differ from them in terms of sex or refraction. Continued evaluation of angle closure glaucoma risk among Chinese-Americans is needed.

The use of Ahmed glaucoma valve in the management of pediatric glaucoma.

Science.gov (United States)

Balekudaru, Shantha; Vadalkar, Juhie; George, Ronnie; Vijaya, Lingam

2014-08-01

To assess the intraocular pressure control (IOP), changes in visual acuity, complications, reoperation rates and risk factors for failure following Ahmed glaucoma valve implantation in pediatric eyes with glaucoma. The medical records of consecutive patients with glaucoma who underwent Ahmed glaucoma valve implantation from January 2000 to December 2009) were retrospectively reviewed. Only one eye of each patient was included. Subgroup analysis was performed in three groups; group 1 included phakic eyes with primary congenital glaucoma, juvenile open-angle glaucoma, or glaucoma associated with ocular anomalies; group 2 included eyes with glaucoma in aphakia or pseudophakia; group 3 included eyes with other diagnoses. A successful outcome was defined as final IOP between 6 mm Hg and 18 mm Hg without loss of light perception or reoperation for glaucoma. A total of 71 eyes in 71 patients: 15 (21%) in group 1, 47 (66%) in group 2, and 9 (13%) in group 3 were included Successful IOP control was achieved in 44 eyes of 44 patients (62%). Cumulative probabilities of success by Kaplan-Meier analysis at 12 and 24 months was 97% and 80% for the entire group, 100% and 82% for group 1, 95% and 86% for group 2, and 90% and 42% for group 3. Reoperation was necessary for 18 patients (25%), either for tube-related complications or for IOP control. The only significant risk factor for failure was the category of diagnosis (P = 0.029). Ahmed glaucoma valve implantation is an option in the management of pediatric glaucoma; however, reoperations for tube related complications or for persistent elevated IOP is frequently needed. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Desempeño docente y satisfacción/insatisfacción laboral del profesorado de nivel primario de la I.E. Alfredo Bonifaz Fonseca - 2015

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Ramírez Silva, Dante Alexander.

2015-01-01

El objetivo de la presente investigación fue determinar de qué manera se relaciona el desempeño docente con la satisfacción/insatisfacción laboral de los profesores del nivel primario de la LE. "Alfredo Bonifaz Fonseca". El enfoque fue de una investigación cuantitativa, de tipo descriptivo correlacional, de diseño no experimental. La población estuvo compuesta por sesenta y cuatro (64) docentes, de los cuales se tomó una muestra de cincuenta y cinco (55) participantes, obtenidos por muestreo ...

[Music and Glaucoma].

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Plange, N

2017-02-01

Music may have multiple influences on the human organism. A possible therapeutic effect for patients with glaucoma has been postulated, aside from the known impact of music on the cardiovascular system, psychogenic effects and a short-term improvement in mental performance (Mozart effect). The higher level of mental stress in patients with glaucoma and type-A personality behaviour may be related to higher intraocular pressure in patients with glaucoma. Relaxing music may have a positive impact in these patients, related to a reduction in intraocular pressure or its fluctuations. However, only limited data exist on the effects of music on intraocular pressure. No clinical studies have yet been performed to investigate the effect of music or music therapy on glaucoma progression. The music of Mozart may influence visual field examinations, possibly due to a positive short term effect on mental performance. This factor needs to be addressed in studies dealing with the effect of music in glaucoma. The relevance of intraocular pressure increases in professional wind instrument players is controversial. An increased level of care might be advisable in patients with advanced glaucoma. The influences of music on humans, altered personality profiles in patients with glaucoma and the studies showing some effect of stress on intraocular pressure stress the relevance of psychological support for glaucoma patients, who are confronted with a disease with a high longterm risk of blindness. Georg Thieme Verlag KG Stuttgart · New York.

Alteraciones psíquicas y conductuales en escolares primarios hijos de padres divorciados

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Reynerio Camejo Lluch

2015-05-01

Full Text Available Se realizó un estudio observacional y descriptivo, con el objetivo de caracterizar las alteraciones psíquicas y conductuales de los niños que son hijos de padres divorciados, pertenecientes a un área de salud del policlínico “Manuel Fajardo Rivero”, del municipio de Las Tunas, Cuba; en el período comprendido entre septiembre de 2014 y febrero de 2015. El universo estuvo constituido por 135 escolares primarios, que asistieron a la consulta de psicología infantil en el tiempo que se efectuó la investigación, de ellos se tomó una muestra de 30 niños de padres divorciados, aplicándole a padres y maestros cuestionarios para investigar la apreciación que tienen sobre los educandos, desde el punto de vista psíquico y conductual. A los alumnos se les realizó estudio psicométrico con la colaboración de los psicometristas del equipo de salud mental, para diagnosticar las posibles alteraciones psicológicas. Se llegó a la conclusión de que existen alteraciones psíquicas en la esfera cognitiva, específicamente trastornos del lenguaje y de la memoria; y en la esfera afectiva, la ansiedad y la depresión. En el área conativa se observó la hiperactividad y la agresividad

Crecimiento anual de cuatro especies arbóreas con yemas desnudas nativas de los bosques templados húmedos de Patagonia

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Sosa, Claudia M; Puntieri, Javier G

2016-01-01

Las especies vegetales que habitan en regiones con bajo nivel de estacionalidad en el clima suelen presentar rasgos morfo-arquitecturales que ocurren con menor frecuencia en especies de regiones con clima estacional. El objetivo de este estudio fue evaluar el crecimiento primario en vivero de cuatro especies leñosas típicas de los bosques templados húmedos de Patagonia, conocidos como selva valdiviana, donde el grado de estacionalidad es menos marcado que en otros bosques patagónicos. Las esp...

Glaucoma (image)

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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 ...

Glaucoma Foundation

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... Options: SIZE CONTRAST Search Home About TGF About Glaucoma About Exfoliation Syndrome Research Center Contact Us Get ... tear glands, and a common preservative in many glaucoma medications can worsen the symptoms. The main treatment ...

Evaluation of Ahmed valve in the glaucoma of poor surgical prognosis

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García González, Francisco; Novoa Sánchez, Ester; San Martín Geisse, Raúl

2001-01-01

Se intervinieron 8 pacientes con glaucoma de mal pronóstico quirúrgico a los que se les implantaron una válvula de Ahmed con la técnica quirúrgica convencional. Se logró controlar la presión intraocular (PIO). Las complicaciones fueron: hipotonía (75 %), desprendimiento coroideo (37,5 %), hifema (25,0 %), contacto tubo iridiano (25, 0 %), hipotalamia (12,5 %) y congestión en el área del implante (12,5 %). No hubo complicaciones intraoperatorias. Se obtuvieron resultados satisfactorios a media...

[Long-term outcomes of Ahmed glaucoma valve implantation for treating refractory glaucoma].

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Xu, Yumei; Hong, Tao; Li, Wanming

2015-02-10

To explore the efficacies and complications of Ahmed glaucoma valve implantation for treating refractory glaucoma. A retrospective study of case series was conducted for 24 patients (26 eyes) with refractory glaucoma from February 2001 to July 2008 at our hospital. Ahmed glaucoma valve implantation was performed. Pre- and post-operative best spectacle-corrected visual acuity (BSCVA), intraocular pressure (IOP), number of medications and complications were recorded and analyzed. The follow-up period was 58-159 months. The post-operative values of IOP were 13.02+/-6.79, 11.43+/-5.24 and 18.56+/-6.43 mmHg at 1 day, 1 month and the last follow-up respectively. There were significant difference when compared with pre-operative IOP (37.59+/-10.76 mmHg, P glaucoma drugs after glaucoma valve implantation and the average number of medication was 1.72+/-0.98. There was significant difference with the pre-operative medication number 2.7 ± 0.7 (P = 0.001). The surgical success rate was 73.1%. And the causes of failure were endophthalmitis, corneal endothelial decompensation, persistent conjunctival wound non-healing, glaucoma valve exposure and loss of light perception.Early postoperative complications were ocular hypotony, shallow anterior chamber, hyphema, transient high IOP and tube occlusion. And long-term complications included encapsulated cyst formation, tube exposure, corneal endothelial decompensation and endophthalmitis. Ahmed glaucoma valve implantation is efficacious for refractory glaucoma.However, clinicians should pay attention to the prevention and treatment of complications.

ALMACÉN DE CARBONO EN SISTEMAS AGROFORESTALES CON CAFÉ

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William Espinoza-Domínguez

2012-01-01

Full Text Available El presente estudio se realizó con el objetivo de estimar el almacén de carbono en sistemas agroforestales (SAF con base en café en la región de Huatusco, zona de mayor producción de café (Coffea arabiga L. en el estado de Veracruz, México, a fin de obtener información cuantitativa sobre el potencial de mitigación de carbono en los SAF de la región. Para ello, se estimaron los reservorios de carbono en biomasa vegetal y la materia orgánica edáfica existentes en sistemas agroforestales de café-plátano, café-macadamia, café-cedro rosado, café-ganado ovino y café-chalahuite, y como referencia de una condición no agroforestal se incluyeron un bosque primario y un potrero con pradera natural. La recolección de muestras se hizo en parcelas de 4 x 25 m (100 m2, donde se colectó biomasa de vegetación herbácea y mantillo, y para el suelo la profundidad de muestreo fue de 0 a 30 cm. El sistema agroforestal que presentó la mayor cantidad de carbono aéreo, estimado con modelos alelométricos, fue café-cedro rosado (Ca + Ce, con 114 Mg C·ha-1, seguido de los sistemas café - macadamia (Ca + Ma, con 34 Mg C·ha-1; café-chalahuite (Ca + Ch, con 29 Mg C·ha-1; café-plátano velillo (Ca + Pl, con 27 Mg C·ha-1; y por último el sistema silvopastoril (Sp, con 2 Mg C·ha-1. Para el caso del carbono orgánico del suelo, el tratamiento (Ca + Ce fue el que presentó mayor contenido de carbono fácilmente oxidable en el suelo, con 58 Mg C·ha-1, y el menor fue el tratamiento potrero (P, con 50 Mg C·ha-1. Del carbono orgánico total entre los SAF el tratamiento Ca + Ce fue el que tuvo el mayor valor, con 172 Mg C·ha-1, y el tratamiento silvopastoril (Sp presentó el menor, con 65 Mg C·ha-1. De los sistemas evaluados se concluye que, en promedio, los SAF almacenan 102 Mg C·ha-1, mientras que el potrero almacena 52 t C·ha-1, y el bosque primario es el sistema que más almacena carbono total, con un valor de 355 Mg C·ha-1.

Cultivos celulares primarios de Lutzomyia shannoni (Diptera: psychodidae y estudio cariologico preliminar de la especie

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Felio J. Bello

1997-03-01

Full Text Available Con el propósito de obtener una línea celular de Lutzomyia shannoni (Dyar para estudios de susceptibilidad viral y mantenimiento de parásitos, se iniciaron cultivos celulares primarios de esta especie, vectora del virus de la estomatitis vesicular en los Estados Unidos y vectora sospechosa de leishmaniasis cutánea en las Américas. A partir de embriones y larvas neonatas del flebotomineo, se realizaron explantes de tejidos embrionarios en el medio MMIVP12, suplementado con 20% de suero fetal bovino y una mezcla de antibiótico y antimicótico, los cuales fueron incubados a una temperatura promedio de 2VC, sin atmósfera de CO,. El crecimiento celular comenzó en un periodo de 85 a 88 días después de efectuadas las siembras, mediante la presencia de vesículas compuestas de células epitelioides, flotando en el medio o adheridas a pequeños fragmentos de tejidos con células en división. Previa estimulación mecánica de los cultivos, se incrementó la proliferación celular a la semana siguiente de efectuado el procedimiento; sin embargo, el proceso mitótico de las células fue lento, similar al desarrollado con Lu. longipalpis, pero diferente a los cultivos celulares derivados de mosquitos. La formación de colonias individuales, dispersas en la superficie del frasco de cultivo, se observó a los 90 días de incubación, las cuales posteriormente evolucionaron a una monocapa semiconfluente. La morfología celular fue heterogénea con predominio de tipos epitelioides. Mediante la técnica de squash, se obtuvo el cariotipo de la especie, cuyo número diploide de cromosomas fue de 8, derivados de tejidos cerebrales de larvas de IV estadio.

Glaucoma: Symptoms, Diagnosis & Treatment

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

Cannabinoides y su posible uso en el glaucoma Cannabinoids and their possible use in the treatment of glaucoma

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Beatriz Zozaya Aldana

2011-09-01

Full Text Available Aunque la planta Cannabis sativa ha sido empleada desde la más remota antigüedad con fines medicinales, uno de sus derivados, la marihuana, se ha convertido en la droga de uso ilegal más consumida en el mundo. Asimismo tanto el Cannabis como sus cannabinoides se emplean como terapéutico en pocas enfermedades generalmente neurológicas. Se realizó una revisión bibliográfica para exponer el posible uso de los cannabinoides en la terapéutica del glaucoma. Para ello se tuvo en cuenta la literatura disponible sobre el tema, durante el período enero a septiembre de 2010. Se ha comprobado el efecto hipotensor ocular de los cannabinoides al disminuir la producción de humor acuoso, y aumentar la excreción de humor acuoso a través de la malla trabecular y la vía uveoescleral, efecto compatible con el hallazgo de elevadas concentraciones de receptores de cannabinoides rCB1 y rCB2; además, el tetrahidrocannabinol ha demostrado disminuir el efecto neurodegenerativo en modelos de isquemia cerebral en ratas y se evidenció también el efecto beneficioso de los cannabinoides al disminuir la degeneración secundaria asociada al glaucoma mediada por la excitotoxicidad del glutamato. Estos hallazgos sobre el efecto beneficioso de los cannabinoides como hipotensores oculares y por su efecto neuroprotector, transmiten un mensaje esperanzador sobre la función que estos podrían desempeñar en el campo del glaucoma, aunque para mayor seguridad y eficacia serían necesarios ensayos clínicos encaminados a valorar su aplicabilidad en la práctica clínica diaria.Although the Cannabis Sativa plant has been used since the most remote ancient times for medicinal purposes, one of its derivatives, marijuana, has become the most commonly used illegal drug in the world. Similarly, both Cannabis and the cannabinoids are used therapeutically in a small number of general neurological pathologies. Literature review was made to set forth the possible use of

Get Tested for Glaucoma!

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... 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. ...

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

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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.

Evaluación de la válvula de Ahmed en el glaucoma de mal pronóstico quirúrgico Evaluation of Ahmed valve in the glaucoma of poor surgical prognosis

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Francisco García González

2001-12-01

Full Text Available Se intervinieron 8 pacientes con glaucoma de mal pronóstico quirúrgico a los que se les implantaron una válvula de Ahmed con la técnica quirúrgica convencional. Se logró controlar la presión intraocular (PIO. Las complicaciones fueron: hipotonía (75 %, desprendimiento coroideo (37,5 %, hifema (25,0 %, contacto tubo iridiano (25, 0 %, hipotalamia (12,5 % y congestión en el área del implante (12,5 %. No hubo complicaciones intraoperatorias. Se obtuvieron resultados satisfactorios a mediano plazo.8 patients with glaucoma of poor surgical prognosis were implanted an Ahmed valve by using the conventional surgical technique. It was possible to control the intraocular pressure (IOP. The complications were: hypotony (75 %, choroidal detachment (37.5 %, hyphaemia (25.0 %, contact with the iridian tube (25.0 %, hypothalamia (12.5 % and congestion in the area of the implantation (12.5 %. There were no intraoperative complications. Medium term results were satisfactory.

Glaucoma as a Metabolic Optic Neuropathy: Making the Case for Nicotinamide Treatment in Glaucoma.

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Williams, Pete A; Harder, Jeffrey M; John, Simon W M

2017-12-01

Mitochondrial dysfunction may be an important, if not essential, component of human glaucoma. Using transcriptomics followed by molecular and neurobiological techniques, we have recently demonstrated that mitochondrial dysfunction within retinal ganglion cells is an early feature in the DBA/2J mouse model of inherited glaucoma. Guided by these findings, we discovered that the retinal level of nicotinamide adenine dinucleotide (NAD, a key molecule for mitochondrial health) declines in an age-dependent manner. We hypothesized that this decline in NAD renders retinal ganglion cells susceptible to damage during periods of elevated intraocular pressure. To replete NAD levels in this glaucoma, we administered nicotinamide (the amide of vitamin B3). At the lowest dose tested, nicotinamide robustly protected from glaucoma (~70% of eyes had no detectable glaucomatous neurodegeneration). At this dose, nicotinamide had no influence on intraocular pressure and so its effect was neuroprotective. At the highest dose tested, 93% of eyes had no detectable glaucoma. This represents a ~10-fold decrease in the risk of developing glaucoma. At this dose, intraocular pressure still became elevated but there was a reduction in the degree of elevation showing an additional benefit. Thus, nicotinamide is unexpectedly potent at preventing this glaucoma and is an attractive option for glaucoma therapeutics. Our findings demonstrate the promise for both preventing and treating glaucoma by interventions that bolster metabolism during increasing age and during periods of elevated intraocular pressure. Nicotinamide prevents age-related declines in NAD (a decline that occurs in different genetic contexts and species). NAD precursors are reported to protect from a variety of neurodegenerative conditions. Thus, nicotinamide may provide a much needed neuroprotective treatment against human glaucoma. This manuscript summarizes human data implicating mitochondria in glaucoma, and argues for studies to

High Prevalence of Narrow Angles among Chinese-American Glaucoma and Glaucoma Suspect Patients

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Seider, Michael I; Pekmezci, Melike; Han, Ying; Sandhu, Simi; Kwok, Shiu Y; Lee, Roland Y; Lin, Shan C

2009-01-01

Purpose To evaluate the prevalence of gonioscopically narrow angles in a Chinese-American population with glaucoma or glaucoma suspicion. Patients and Methods Charts from all Chinese-American patients seen in a comprehensive ophthalmology clinic in the Chinatown district of San Francisco in 2002 were reviewed. One eye from each patient with glaucoma or glaucoma suspicion that met inclusion criteria was included (n=108). Data was collected for gender, age, race (self-declared), refraction (spherical equivalent), intraocular pressure (IOP), gonioscopy and vertical cup-to-disk ratio (CDR). Results Sixty percent (n=65) of Chinese-American eyes with glaucoma or glaucoma suspicion had gonioscopically narrow angles (Shaffer grade ≤2 in three or more quadrants). Those with narrow angles were significantly older (P=0.004) than their open angle counterparts, but the two groups did not differ in terms of gender, refraction, IOP or CDR (all, P≥0.071). In a multivariate model including age, gender and refraction as predictors of angle grade (open or narrow), only age was a significant predictor of angle grade (P=0.004). Conclusions A large proportion of Chinese-Americans in our study population with glaucoma or glaucoma suspicion had gonioscopically narrow angles. In multivariate analysis, patients with narrow angles were older than those with open angles but did not differ from them in terms of gender or refraction. Continued evaluation of angle closure glaucoma risk among Chinese-Americans is needed. PMID:19826385

Rabdomioma cardiaco tratado quirúrgicamente con éxito y revisión de la literatura

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Cigarroa López,Ángel; García Jiménez,Yoloxóchitl; Yáñez Gutiérrez,Lucelly; Jiménez Arteaga,Santiago; Martínez Sánchez,Arturo; Ortegón Cardeña,José; David Gómez,Felipe; Sánchez Soberanes,Agustín; López Gallegos,Diana; Riera-Kinkel,Carlos; Alva Espinosa,Carlos

2005-01-01

Los tumores cardiacos primarios son raros, con incidencia variable en todas las edades del 0.005 al 0.05%. En pacientes pediátricos, la incidencia es del 0.27%. Los tumores más frecuentes durante la infancia son los rabdomiomas cardiacos, considerados como benignos. Aunque la expresión clínica es amplia, en la mayoría de los casos son asintomáticos y se detectan por la presencia de soplos. En la etapa prenatal se manifiestan con arritmias o hydrops fetalis. En algunos neonatos y lactantes se ...

Glaucoma: Hot Topics in Pharmacology.

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Balendra, Shiama I; Shah, Parth Arvind; Jain, Mishank; Grzybowski, Andrzej; Cordeiro, Maria F

2017-01-01

Glaucoma comprises a group of neurodegenerative diseases resulting in retinal ganglion cell death within the optic nerve head. It is projected to affect almost 80 million people worldwide by 2020. The condition's asymptomatic nature translates to over half of glaucoma sufferers being unaware of their condition. By the time of diagnosis, irreversible blindness is likely to have occurred. Prime areas of glaucoma research therefore include identification and optimization of risk factors for the disease, accurate and early diagnostic tools and novel therapeutic methods. The goal of this review was to summarize main areas of latest glaucoma research into risk factors of glaucoma, diagnostic tools and treatments. PubMed was used to search for terms including glaucoma risk factors, glaucoma diagnostics, glaucoma treatment, glaucoma drug delivery and glaucoma IOP. The evidence for risk factors of low CSF pressure, IOP, smoking, vascular risk factors and light toxicity is described. Latest diagnostic and monitoring techniques for glaucoma include SD-OCT, DARC and IOP telemetry. Current and emerging medical and surgical treatments in glaucoma are discussed. Rho kinase inhibitors have the potential to both lower IOP and also provide neuroprotection, several of which are in clinical trials. Several other new medical treatments such as calcium channel blockers and neurotrophic agents also have the capacity to provide neuroprotection. Minimally Invasive Glaucoma Surgery (MIGS) devices provide an improved safety profile compared to traditional trabeculectomy; the latest ab interno and ab externo devices are described. Novel drug delivery methods, including punctual plugs and contact lenses, help overcome the challenges with patient adherence. The ultimate goals are to reduce the individual patient risk factors associated with glaucoma, diagnose the condition early and to find treatments that not only reduce IOP but also reverse neurodegeneration of RGCs. The usage of combinations

Efecto de las neurotrofinas en cultivos primarios de ganglio espinal, normales e infectados con virus de la rabia

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Hernán Hurtado

2000-02-01

Full Text Available

Los cultivos de ganglio espinal son utilizados para estudiar la interacción entre el virus de la rabia y las neuronas sensoriales presentes en ellos. Se conoce que in vivo, el virus utiliza estas neuronas como una de las puertas de entrada al Sistema Nervioso Central en donde posteriormente se produce una encefalopatía letal. La patología producida por el virus es debida a su marcado tropismo hacia las neuronas, que depende a su vez de la unión entre el virus y receptores específicos en la membrana neuronal. Entre las moléculas que se han reportado como posibles receptores virales están el Receptor Nicotínico de Acetilcolina (RNACh, la Molécula de Adhesión Celular Neuronal (NCAM y el receptor de baja afinidad para las neurotrofinas (p75NTR. Se sabe que en cultivos de neuronas sensoriales adultas, las neurotrofinas pueden promover la regeneración neurítica y mantener los fenotipos neuronales. Además existe evidencia de que en líneas celulares el Nerve Growth Factor (NGF modifica la calidad y cantidad de RNACh y NCAM expresados, así en estos cultivos primarios (que expresan toda clase de receptores para neurotrofinas se pudieran estar presentando también tales cambios, que conlleven a modificaciones en la infección por el virus de rabia. De esta manera, el objetivo de este estudio, fue evaluar el efecto de las neurotrofinas sobre la regeneración neurítica y la supervivencia neuronal (en cultivos no infectados y sobre la proporción de células infectadas por virus de rabia. Para ello, los cultivos se trataron desde el inicio con NGF, Brain-Derived Neurotrophic Factor (BDNF y Neurotrophin-3 (NT-3 a tres diferentes concentraciones y algunos de ellos fueron infectados con virus de la rabia, cepa CVS (Challenge Virus Standard obtenido en cerebro de ratón. A los

OBTENCIÓN DE BIOETANOL PRIMARIO A PARTIR DE LA BIOMASA LIGNOCELULÓSICA DEL MATE (Crescentía cujete

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Ely Fernando Sacón Vera

2013-12-01

Full Text Available El objetivo de esta investigación fue obtener bioetanol a partir de la biomasa lignocelulósica del mate (Crescentía cujete. Se empleó un Diseño Completamente al Azar en arreglo bifactorial AxB con tres réplicas por cada tratamiento. Se manipularon los factores de estudio: A. Concentración de ácido sulfúrico (2.5%, 5% y 7.5% y B. Cantidad de levadura Saccharomyces cerevisiae (2 y 5 mL. Se evaluaron las variables: acidez, °Brix, Grado Gay Lussac, Azucares totales y reductores. Los resultados encontrados demostraron que la hidrólisis ácida permitió desdoblar la lignocelulosa ya que incrementaron los azúcares reductores fue de 13.82% en comparación con los encontrados en la pulpa 6.46%; de la misma forma se obtuvo mayor contenido de alcohol (20.70 GL en el tratamiento a2b2 (5% de ácido sulfúrico + 5 mL de levadura S. cerevisiae, el cual presentó menor contenido de acidez con 0.643%, los °Brix fue de 18.47, mientras que el tratamiento a2b2 presentó mayor contenido de acidez con 0.893%, el a2b1 obtuvo menor contenido de °Brix con 15.00, y el a1b1 presentó menor contenido de Grado Gay Lussac con 8.33. De esta forma se concluye que es posible obtener un alcohol primario a partir de la biomasa del mate sometido a una hidrólisis ácida al 5% y fermentación con S. cerevisiae al 2% en relación al peso de la pulpa del mate.

Ceratoplastia penetrante e glaucoma Penetrating keratoplasty and glaucoma

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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.

Mesotelioma pericárdico primario manifestado como derrame pericárdico severo

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Viviana Quintero

2015-01-01

Conclusiones: El derrame pericárdico severo y recurrente puede ser la primera manifestación de un mesotelioma primario pericárdico y deberá considerarse como diagnóstico diferencial en esta presentación clínica.

Screening for Glaucoma

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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 ...

Novel surgical procedures in glaucoma: advances in penetrating glaucoma surgery.

Science.gov (United States)

Filippopoulos, Theodoros; Rhee, Douglas J

2008-03-01

Despite late modifications and enhancements, traditional penetrating glaucoma surgery is not without complications and is reserved for patients in whom pharmacologic treatment and/or laser trabeculoplasty do not suffice to control the intraocular pressure. This article critically reviews recent advances in penetrating glaucoma surgery with particular attention paid to two novel surgical approaches: ab interno trabeculectomy with the Trabectome and implantation of the Ex-PRESS shunt. Ab interno trabeculectomy (Trabectome) achieves a sustained 30% reduction in intraocular pressure by focally ablating and cauterizing the trabecular meshwork/inner wall of Schlemm's canal. It has a remarkable safety profile with respect to early hypotonous or infectious complications as it does not generate a bleb, but it can be associated with early postoperative intraocular pressure spikes that may necessitate additional glaucoma surgery. The Ex-PRESS shunt is more commonly implanted under a partial thickness scleral flap, and appears to have similar efficacy to standard trabeculectomy offering some advantages with respect to the rate of early complications related to hypotony. Penetrating glaucoma surgery will continue to evolve. As prospective randomized clinical trials become available, we will determine the exact role of these surgical techniques in the glaucoma surgical armamentarium.

Perfil de micro ARNs exosomales asociados a daño glomerular en pacientes hipertensos con microalbuminuria

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Pérez Hernández, Javier

2018-01-01

Introducción: La hipertensión arterial esencial (HTA) es la enfermedad crónica con mayor prevalencia a nivel mundial y constituye uno de los factores de riesgo cardiovascular primario. Pese al control de la presión arterial con antihipertensivos, la aparición de daño renal en la HTA es frecuente y se mide clínicamente como un aumento en la excreción urinaria de albúmina (EUA). Este daño incipiente se define como microalbuminuria, puede progresar a macroalbuminuria y proteinuria durante el cur...

Tumores malignos primarios del hígado

OpenAIRE

Jaime de la Hoz de la Hoz; Jorge Brieva M.; José J. Arias A.; Pedro E. Morales M.

1986-01-01

Treinta y seis tumores malignos primarios del hígado fueron seleccionados de protocolos de patología en un periodo de 20 años, Los hepatomas continúan siendo bastante raros en el mundo occidental. Existen regiones del África y Asia en que es endémico. Aunque en la mayoría de los pacientes la consulta es debida a dolor y masa abdominal por crecimiento del tumor, gracias a los adelantos recientes en los métodos diagnósticos, pequeños tumores están siendo cada vez mas diagnosticados. La detec...

Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

Science.gov (United States)

Yarmohammadi, Adeleh; Zangwill, Linda M.; Diniz-Filho, Alberto; Suh, Min Hee; Manalastas, Patricia Isabel; Fatehee, Naeem; Yousefi, Siamak; Belghith, Akram; Saunders, Luke J.; Medeiros, Felipe A.; Huang, David; Weinreb, Robert N.

2016-01-01

Purpose The purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients. Methods Two hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy. Results Age-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65). Conclusions Optical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG. PMID:27409505

Glaucoma: Screening Can Save Your Sight!

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... 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 ...

The glaucoma research foundation patient survey: patient understanding of glaucoma and its treatment.

Science.gov (United States)

Herndon, Leon W; Brunner, Thomas M; Rollins, Jane Neff

2006-01-01

Determine patients' understanding of glaucoma and its treatment, their sources of information about glaucoma, their preferences for treatment, their experience with medication side effects, and their reasons for changing eye doctors. Prospective, nonrandomized patient survey study. A questionnaire was developed and sent to the 22,000 subscribers of the Gleams newsletter who have glaucoma. Questionnaires were returned by 4310 glaucoma patients. Most respondents received glaucoma information from their eye doctor. Only 28% of respondents reported having changed eye doctors for reasons related to their glaucoma. Of those who had, 60% cited poor communication as the reason. When queried about specific side effects associated with their medication, over 85% of responding patients were never or rarely bothered by headaches and eyelid darkening. Most respondents (67% and 55%, respectively) were rarely or never disturbed by red eye or burning and stinging. Most respondents understood the importance of intraocular pressure (IOP) lowering in glaucoma, and of those patients who expressed a preference, 92% reported that they would prefer the medication that lowers IOP the most, even if it caused red eye for a few weeks, over a medication that caused no red eye but did not get IOP as low. Patients who subscribe to Gleams and responded to the survey rely most on their doctors for information about glaucoma and its treatment. Most understand the importance of maintaining low IOP to decrease the risk of vision loss, and most will tolerate temporary ocular side effects to achieve low IOP.

Nanotechnology Applications for Glaucoma.

Science.gov (United States)

Cetinel, Sibel; Montemagno, Carlo

2016-01-01

Glaucoma is the second leading cause of blindness worldwide, and the antiglaucoma treatments currently available suffer from various complications. Nanotechnology-based treatments show a great deal of promise in overcoming these complications and form the basis for next-generation glaucoma treatment strategies, with the help of applications such as controlled release, targeted delivery, increased bioavailability, diffusion limitations, and biocompatibility. Significant progress has been made in nanomedicine in the efficiency of antiglaucoma medications, nanofabrication systems such as microelectromechanical systems that remove the limitations of nanodevices, and tissue regeneration vesicles for developing glaucoma treatments not based on intraocular pressure. With the use of these advanced technologies, the prevention of glaucoma-induced blindness will be possible in the near future. Herein, we reviewed the recent advances in nanotechnology-based treatment strategies for glaucoma.

Advances in the diagnosis of substations primary equipment by means of high sensitivity techniques; Avances en el diagnostico de equipo primario de subestaciones mediante tecnicas de alta sensibilidad

Energy Technology Data Exchange (ETDEWEB)

Garcia Colon H, V. Rodolfo; Nava G, J. Armando; Azcarraga R, Carlos G [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)

2005-07-01

In an electrical system, the substations primary equipment is integrated by the power transformers, the instrument transformers, the breakers and the interconnection circuits (energy cables). At the present time, the described primary equipment has been integrated in an arrangement denominated encapsulated substation that presents dimensional and aesthetic advantages in the conventional substations. Nevertheless, the isolation involved in this type of substations means new challenges when carrying out its diagnosis in a planned way or after the appearance of a fault. In this sense, the insulating and electromechanical system of the primary equipment of substations must be evaluated in a programmed way or be constantly monitored. This with the final purpose of detecting incipient problems that could evolve towards a fault or to the diminution of the electrical system reliability. [Spanish] En un sistema electrico, el equipo primario de subestaciones esta integrado por los transformadores de potencia, los transformadores de instrumento, los interruptores y los circuitos de interconexion (cables de energia). En la actualidad, el equipo primario descrito se ha integrado en un arreglo denominado subestacion encapsulada que presenta ventajas dimensionales y esteticas sobre las subestaciones convencionales. Sin embargo, el aislamiento involucrado en este tipo de subestaciones significa nuevos retos al efectuar su diagnostico de manera planeada o despues de presentarse una falla. En este sentido, el sistema aislante y electromecanico del equipo primario de subestaciones debe ser evaluado de manera programada o monitoreado constantemente. Ello con la finalidad de detectar problemas incipientes que pudieran evolucionar hacia una falla o la disminucion de la confiabilidad del sistema electrico.

Anti-glaucoma potential of Heliotropium indicum Linn in experimentally-induced glaucoma

OpenAIRE

Kyei, Samuel; Koffuor, George Asumeng; Ramkissoon, Paul; Owusu-Afriyie, Osei

2015-01-01

Background Heliotropium indicum is used as a traditional remedy for hypertension in Ghana. The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H. indicum to manage experimentally-induced glaucoma. Methods The percentage change in intraocular pressure (IOP), after inducing acute glaucoma (15 mLkg?1 of 5?% dextrose, i.v.), in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract (HIE) (30?300 mgkg?1), acetazolamide (5 mg...

A prospective comparative study on neovascular glaucoma and non-neovascular refractory glaucoma following Ahmed glaucoma valve implantation.

Science.gov (United States)

Li, Zheng; Zhou, Minwen; Wang, Wei; Huang, Wenbin; Chen, Shida; Li, Xingyi; Gao, Xinbo; Zhang, Xiulan

2014-01-01

Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients. This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups. All of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.

Efficacy of intravitreal ranibizumab combined with Ahmed glaucoma valve implantation for the treatment of neovascular glaucoma.

Science.gov (United States)

Tang, Min; Fu, Yang; Wang, Ying; Zheng, Zhi; Fan, Ying; Sun, Xiaodong; Xu, Xun

2016-01-09

Neovascular glaucoma is a refractive glaucoma. Recently, anti-VEGF factors have been used alone or in combination for the treatment of neovascular glaucoma. However, the medium- and long-term efficacy of such drugs remains to be evaluated. This study was to determine the efficacy of intravitreal ranibizumab combined with Ahmed glaucoma valve implantation for the treatment of neovascular glaucoma. In this prospective non-randomized study, 43 neovascular glaucoma patients (43 eyes) were assigned to receive either 0.5 mg intravitreal ranibizumab for three to 14 days before Ahmed glaucoma valve implantation (injection group, n = 21) or Ahmed glaucoma valve implantation alone (control group, n = 22). The patients were followed up for six to 12 months. Differences in surgical success rate, intraocular pressure, best corrected visual acuity, anti-glaucoma medications and postoperative complications were compared between the two groups. Surgical success was defined as IOP > = 6 mm Hg and glaucoma medications, and without severe complications or reoperation. Of the 43 patients, 40 completed the 6-month follow-up and 37 completed the 1-year follow-up. Success rate was 73.7% vs. 71.4% at six months and 72.2% vs. 68.4% at 12 months in the injection group and the control group respectively. No significant difference was noted between the two groups (six months: P = 0.87, 12 months: P = 1.00). There were no significant differences in the two groups with respect to intraocular pressure, best corrected visual acuity, anti-glaucoma medications or postoperative complications at six months or 12 months. Single intravitreal ranibizumab (0.5 mg) before surgery has no significant effect on the medium- or long-term outcomes of neovascular glaucoma treated with Ahmed glaucoma valve implantation. Chinese Clinical Trial Registry ( ChiCTR-OOC-14005709, Trial registration date: 2014-12-01).

Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma

OpenAIRE

Angmo, Dewang; Sharma, Reetika; Temkar, Shreyas; Dada, Tanuj

2015-01-01

ExPress glaucoma filtration device (GFD) has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs) not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medicat...

Modelado del sistema de enfriamiento primario en máquinas de colada de acero con cristalizador curvo//Modelling of continuos casting steel during first cooling system with curve mold

Directory of Open Access Journals (Sweden)

Yusdel Díaz‐Hernández

2014-01-01

Full Text Available En el proceso de enfriamiento primario durante la colada continua de aceros sucede una serie de transformaciones físicas que inciden directamente en la calidad final del producto. Los modelos matemáticos que explican este fenómeno no pueden ser tratados indistintamente para una instalación u otra debido a las disímiles variables implicadas en el proceso. En esta investigación se obtuvo un modelo físico- estadístico mediante regresiones múltiples sucesivas para el caudal necesario de agua en máquinas de colada continua de aceros con cristalizador curvo. Para el modelado se tuvo en cuenta las variables de operación del enfriamiento en cristalizadores curvos así como la validación estadística encondiciones de explotación en tiempo real. El modelo obtenido permitió estimar el comportamiento de las variables de control del proceso con suficiente precisión.Palabras claves: enfriamiento, solidificación, colada continua, modelado, aceración.______________________________________________________________________________AbstractIn the process of primary cooling in the continuous casting of Steel there are physical transformations that affect directly the quality of the final product. The mathematical models that explain this phenomenon cannot be applied to different installations because the variables involved in the process are different. Inthis research, a physical-statistical model was obtained through multiple and successive regression for the flow of water which is necessary in this complex process. For the modeling the variables of operations in the cured cooling systems were taken into account as well as the statistical validation in conditions ofexploitation in real time. The model permitted to predict the behavior of the variables with sufficient precision.Key words: cooling, solidifications, continuous casting, modeling, steelmaking.

Experience with the Ahmed Glaucoma Valve

African Journals Online (AJOL)

Design:Aprospective study of three glaucoma patients who had the Ahmed glaucoma valve implant at the. University of Benin ... Key words: glaucoma, glaucoma valve implant, ... introduced the micro-trephination with a diameter of. 0.6mm in ...

[Secondary glaucoma in Paraguay. Etiology and incidence].

Science.gov (United States)

Strohl, A; Pozzi, S; Wattiez, R; Roesen, B; Miño de Kaspar, H; Klauss, V

1999-06-01

Glaucoma is the third-most-frequent cause of blindness in the world, with a total of 5.2 million blind people as a result of this disease; 80% live in developing countries. In Paraguay, after cataract it is the second-most-frequent-cause. Early detection of the risk factors and groups can help to avoid progress of this disease. Trauma, cataract and infectious uveitis represent special risks for developing secondary glaucoma, which is a more frequent cause of blindness in third-world countries than in industrialized nations. Until now there has been little data regarding the causes, disease course, and options for therapy. Therefore, secondary glaucoma was examined in Paraguay to obtain information on the situation in Latin America. The aim of the study was to explore the causes of secondary glaucoma for programs concerning prevention and therapy. From November 1996 to February 1997 patients with secondary glaucoma were examined at the University Hospital of Asunción, Paraguay. After the clinical examination the secondary glaucomas were classified. Patients with primary glaucoma were included in the same period of time as well in order to get the rate of secondary glaucoma. Altogether 293 patients were examined: 61 with secondary and 232 with primary glaucoma. The causes of secondary glaucoma in 73 eyes were: 20 (27%) with pseudoexfoliation glaucoma, 19 (26%) with post-traumatic glaucoma, 16 (22%) with neovascular glaucoma, 4 (5%) with lens-related glaucoma, 3 (4%) with glaucoma associated with ocular surgery, 2 (3%) with pigmentary and 2 (3%) with corticoid-induced glaucoma. A ratio of 4:1 primary glaucomas to secondary glaucomas was found. The development of special measures for prevention and early therapy is only possible if the causes of this severe disease are explored. The results of this study represent basic information and could help to introduce of prevention programs.

Variantes quirúrgicas para el tratamiento del linfedema primario de pene y escroto

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Orestes Díaz Hernández

2000-12-01

Full Text Available Se presentan 2 variantes técnicas del tratamiento quirúrgico del linfedema primario de pene y escroto en 2 pacientes con características clínicas diferentes. Una de las técnicas quirúrgicas empleadas consistió en 2 incisiones laterales en las bolsas escrotales con resección del tejido linfedematoso y la otra con una incisión única en la bolsa y reimplantación de la base del pene con resección de todo el tejido linfedematoso. En ambos casos antes de intentar la resección del tejido linfedematoso se extrajeron de su lecho el cordón espermático y los testículos para facilitar la operación, minimizar el tiempo quirúrgico y producir menos complicaciones. La propia piel del cuello de la bolsa escrotal se emplea en su reconstrucción e incluso para acomodar los testículos. No se hizo necesario, con estas técnicas, realizar injerto libre ni pediculado de piel. Los pacientes recuperaron la capacidad funcional del pene, tuvieron mejoría estética y desapareció la angustia que esta enfermedad les ocasionabaTwo technical variants of the surgical treatment of primary penile and scrotal lymphoedema used in 2 patients with different clinical characteristics are presented. One of the surgical techniques used consisted in 2 lateral incisions in the scrotal bursae with resection of the lymphoedematous tissue and the other in a single incision in the bursa and reimplantation of the basis of the penis with resection of all the lymphoedematous tissue. In both cases, before attempting the resection of the lymphoedematous tissue the spermatic cord and the testes were removed from their bed to facilitate the operation, to reduce the surgical time and to cause less complications. The own skin of the neck of the scrotal bursa is used in its reconstruction and even to accomodate the testes. By using these techniques, it was not necessary to make a free or pediculate skin graft. Patients recovered the functional capacity of the penis, had an aesthetic

Evaluación de la co-digestión anaerobia de lodos de aguas residuales municipales con residuos de alimentos

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Ileana Consuelo Julio Guerrero

2016-06-01

Full Text Available La digestión anaerobia es un proceso ampliamente utilizado para el tratamiento de los lodos producidos en las plantas de tratamiento de agua residual, debido a sus ventajas técnicas y económicas. Este artículo presenta un estudio en el que se evaluó la co-digestión de lodos de aguas residuales con residuos de alimentos (RA como una estrategia para optimizar la digestión de los lodos. Se realizaron mono-digestiones y co-digestiones de los sustratos en condiciones mesofílicas (35°C usando reactores por lotes. Los lodos utilizados fueron: lodo primario (LP, lodo secundario espesado (LSE y una mezcla de LP con LSE en la proporción 60:40 con base en sólidos totales (LP:LSE. Las co-digestiones se realizaron usando distintas proporciones de mezclas de los sustratos con base en sólidos volátiles totales: LP:RA=30:70, LP:RA=50:50, LP:RA=70:30 y (LP+LSE:RA=70:30. La máxima producción de metano, 0,25LCH4/gSVadicionado, se obtuvo para la mezcla LP:RA=30:70, presentando una producción 32% mayor que la obtenida en la mono-digestión del lodo primario.

Neuroprotection in glaucoma

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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.

Safety and efficacy of a low-cost glaucoma drainage device for refractory childhood glaucoma.

Science.gov (United States)

Kaushik, Sushmita; Kataria, Pankaj; Raj, Srishti; Pandav, Surinder Singh; Ram, Jagat

2017-12-01

To evaluate the safety and efficacy of a low-cost glaucoma drainage device (GDD), Aurolab aqueous drainage implant (AADI), similar in design to the Baerveldt glaucoma implant (BGI), in refractory childhood glaucoma. This prospective interventional study was conducted in a tertiary care postgraduate teaching institute. Children aged glaucoma valve implant in children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Uveitic Secondary Glaucoma].

Science.gov (United States)

Lommatzsch, Claudia; Heinz, Carsten

2018-05-01

An intraocular pressure increase with development of glaucomatous damage is a common complication of uveitis. The prevalence has a wide range depending on various factors such as the underlying uveitis type and the duration of the disease. Pathogenetically, a distinction must be made between a secondary angle closure component and the more frequently occurring open-angle glaucoma. In diagnostics, in addition to the clinical optic nerve head assessment, perimetry and tonometry, the use of imaging examination equipment, such as OCT and HRT, are recommended. In the context of uveitic glaucoma, it must be considered in the evaluation, because the glaucoma-typical changes are generally less pronounced or can be concealed by retinal swelling in comparison with other forms of glaucoma. Therapeutically, drug therapy in the form of eye drops continues to be a first-line recommendation, with the use of topical carbonic anhydrase inhibitors or beta-blockers primarily preferred, depending on the contraindications. An operative therapy follows after unsuccessful or inadequate conservative therapy: the adequate surgical technique depends on the respective finding and includes actually techniques such as filtering procedures and glaucoma drainage devices. Georg Thieme Verlag KG Stuttgart · New York.

Cambridge community Optometry Glaucoma Scheme.

Science.gov (United States)

Keenan, Jonathan; Shahid, Humma; Bourne, Rupert R; White, Andrew J; Martin, Keith R

2015-04-01

With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom. The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma. 1733 patients were evaluated by this scheme between 2010 and 2013. Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist. The number of false positive referrals from initial referral into the scheme. Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit. The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

Glaucoma treatment trends: a review.

Science.gov (United States)

Conlon, Ronan; Saheb, Hady; Ahmed, Iqbal Ike K

2017-02-01

Glaucoma is one of the most common causes of blindness worldwide, and its prevalence is increasing. The aim of the present review is to describe the current medical and surgical treatment trends in the management of open-angle glaucoma. There has been an increase in the availability of glaucoma medications and the use of laser trabeculoplasty over the past decade, with a subsequent decrease in invasive incisional surgery. In addition, a new class of glaucoma procedures, termed microinvasive glaucoma surgery, has emerged, which aims to fill the gap between conservative medical management and more invasive surgery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients

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Salim S

2012-06-01

Full Text Available Sarwat Salim, Haiming Du, Sumalee Boonyaleephan, Jim WanUniversity of Tennessee Health Science Center, Memphis, TN, USAPurpose: To compare the surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients.Design: Retrospective comparative case series.Methods: This was a comparative case series of 36 eyes of 36 African Americans and 43 eyes of 43 whites that underwent placement of the Ex-PRESS glaucoma filtration device under a partial-thickness scleral flap for uncontrolled glaucoma. All eyes received intraoperative mitomycin C. The primary outcome measures were intraocular pressure (IOP, number of postoperative glaucoma medications, and surgical success. Surgical success was defined as IOP between 5 and 18 mm Hg, with or without glaucoma medications, without further glaucoma surgery, or loss of light perception vision. Results: Average follow-up was 31.9 ± 9.8 (range, 14.6–47 months for African Americans and 30.7 ± 8.6 (range, 14.3–47 months for whites. At 33 months, surgical success was 80.0% in the African American group and 83.3% in the white group (P = 1.00. Reasons for surgical failure included increased IOP (3 eyes, 3.8%, persistent hypotony with maculopathy (1 eye, 1.3%, and further surgery (4 eyes, 5.06%. Compared with preoperative values, the mean postoperative IOP and number of glaucoma medications were significantly reduced in both groups, and no statistical difference was observed between the two groups at 33 months. Postoperative complications were similar in the two groups.Conclusions: Similar surgical outcomes were observed in African American and white glaucoma patients after implantation of the Ex-PRESS glaucoma filtration device. This latest modification of glaucoma filtration surgery may be a better surgical option for African Americans given its potential advantages of no tissue removal, predictable outcomes related to consistent lumen size and controlled flow, fewer

[OCT and neovascular glaucoma].

Science.gov (United States)

Bellotti, A; Labbé, A; Fayol, N; El Mahtoufi, A; Baudouin, C

2007-06-01

Neovascular glaucoma is a chronic and sight-threatening disease. Four different grades have been described. Anterior chamber optical coherence tomography (OCT) is a new imaging technique allowing the visualization of the anterior segment. The purpose of our study was to describe the appearance of the different neovascular glaucoma grades with the OCT in order to refine the clinical analysis of this disease. Eleven patients (nine men and two women) with different grades of neovascular glaucoma were analyzed in this study. Neovascular glaucoma complicated central retinal vein occlusion in seven patients and diabetic retinopathy in four patients. All patients had bilateral biomicroscopical examination and OCT analysis. OCT images and clinical examination were then compared. No modifications could be observed using OCT in patients with grade 1 neovascular glaucoma. For grade 2, a slightly hyper-reflective linear iris secondary to neovascularization was observed. For grade 3, OCT images showed a thickened hyper-reflective iridocorneal angle with possible iridocorneal synechiae. For grade 4, the iridocorneal angle was closed and associated with iris contraction and uveae ectropion. OCT is a new promising technique for the precise analysis of different grades of neovascular glaucoma. It certainly helps in the management of such cases.

Glaucoma: a brief update for 2017

African Journals Online (AJOL)

glaucoma. Predictions are that glaucoma will affect almost ... Abstract. Glaucoma is a complex condition of the eye and the second leading cause of blindness around the globe. ..... a stinging sensation upon instilling the drops into the eyes, as well as dry eyes .... Dimitriou C, Broadway D. Pathophysiology of glaucoma.

Short term outcome of Ahmed glaucoma valve implantation in management of refractory glaucoma in a tertiary hospital in Oman

Science.gov (United States)

Shah, Manali R.; Khandekar, Rajiv B.; Zutshi, Rajiv; Mahrooqi, Rahima

2013-01-01

Background: We present outcomes of Ahmed Glaucoma Valve (AGV) implantation in treating refractory glaucoma in a tertiary hospital in Oman. Refractory glaucoma was defined as previously failed conventional glaucoma surgery and an uncontrolled intraocular pressure (IOP) of more than 21 mm Hg despite treatment with three topical and/or oral therapy. Materials and Methods: This historical cohort study was conducted in 2010. Details of medical and surgical treatment were recorded. Ophthalmologists examined eyes and performed glaucoma surgeries using AGV. The best corrected distant vision, IOP, and glaucoma medications were prospectively reviewed on 1st day, 1st, 6th, 12th week postoperatively, and at the last follow up. Result: Glaucoma specialists examined and treated 40 eyes with refractory glaucoma of 39 patients (20 males + 19 females). Neo-vascular glaucoma was present in 23 eyes. Vision before surgery was glaucoma medications (2.38; SD 1.1) was reduced compared to the mean number of postoperative medications (1.92; SD 0.9) at 12 weeks. Conclusion: We succeeded in reducing visual disabilities and the number of anti-glaucoma medications used to treat refractory glaucoma by AGV surgery. PMID:23772122

Interocular asymmetry of the visual field defects in newly diagnosed normal-tension glaucoma, primary open-angle glaucoma, and chronic angle-closure glaucoma.

Science.gov (United States)

Huang, Ping; Shi, Yan; Wang, Xin; Liu, Mugen; Zhang, Chun

2014-09-01

To compare the interocular asymmetry of visual field loss in newly diagnosed normal-tension glaucoma (NTG), primary open-angle glaucoma (POAG), and chronic angle-closure glaucoma (CACG) patients. Visual field results of 117 newly diagnosed, treatment-naive glaucoma patients (42 NTG, 38 POAG, and 37 CACG) were studied retrospectively. The following 3 visual field defect parameters were used to evaluate the interocular asymmetry: (1) global indices; (2) local mean deviations (MDs) of 6 predefined visual field areas; and (3) stage designated by glaucoma staging system 2. The differences of the above parameters between the trial eye (the eye with greater MDs) and the fellow eye in each subject were defined as interocular asymmetry scores. Interocular asymmetry of visual field loss was presented in all the 3 groups (all P0.05). Interocular asymmetry scores of glaucoma staging system 2 had no significant difference among the 3 groups (P=0.068). All CACG, POAG, and NTG groups presented with interocular asymmetric visual field loss at the time of diagnosis. CACG had greater interocular asymmetry compared with NTG and POAG. No significant interocular asymmetry difference was observed between NTG and POAG.

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.

Angle closure glaucoma in congenital ectropion uvea

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Grace M. Wang

2018-06-01

Full Text Available Purpose: Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Observations: Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months and required additional surgery (cycloablation or trabeculectomy. Conclusions and importance: Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control. Keywords: Congenital ectropion uvea, Juvenile glaucoma, Angle-closure glaucoma, Glaucoma drainage device

Actualización sobre el Síndrome de Dispersión Pigmentaria y el Glaucoma Pigmentario

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Yaima Mayo González

2015-03-01

Full Text Available El síndrome de dispersión pigmentaria se da por la liberación de pigmento del epitelio pigmentado del iris y depósito de gránulos de este en el iris y en las estructuras del segmento anterior, incluyendo el endotelio corneal y la malla trabecular, con posterior aumento de la presión intraocular y glaucoma. El glaucoma pigmentario (GP es un glaucoma de ángulo abierto, secundario a un síndrome de dispersión pigmentaria, que consiste en el acúmulo de pigmento a nivel de la malla trabecular, aumentando la resistencia a la salida del humor acuoso, ocasionando así un deterioro progresivo e irreversible de las estructuras oculares, llevando a la pérdida visual. El glaucoma pigmentario es el más frecuente de los glaucomas secundarios. Se presenta en pacientes jóvenes durante la tercera o cuarta década de la vida y el diagnóstico se realiza en una etapa de daño glaucomatoso avanzado, por lo que genera un gran impacto social. El propósito de este artículo es revisar la fisiopatología, clínica, tratamiento del GP y proporcionarles recomendaciones según lo estudiado

La preparacion en ciencia de los candidatos a maestros del nivel elemental primario segun la reforma de la educacion cientifica en Puerto Rico: Una propuesta de secuencia curricular

Science.gov (United States)

Rodriguez Plaza, Evelyn

El proposito de esta investigacion fue identificar los componentes de la preparacion en ciencia que deben recibir los estudiantes del Bachillerato en Artes en Educacion Elemental, Nivel Primario, de acuerdo a los documentos que dirigen la reforma de la educacion cientifica en Puerto Rico. Tambien, se identificaron los componentes de los cursos que forman parte de la preparacion en ciencia de estos estudiantes. Se compararon los componentes de la preparacion en ciencia y los componentes de los cursos para determinar congruencias y discrepancias. Con los datos recopilados se identificaron los componentes de los cursos de una secuencia curricular para la preparacion en ciencia de los candidatos a maestros del nivel elemental primario. La secuencia curricular que se propone en esta investigacion incluye cursos de contenido cientifico y de metodologia en la ensenanza de la ciencia disenados para satisfacer las necesidades de los candidatos. Se recomienda que en los procesos para el diseno, la implantacion y la evaluacion de estos cursos participen profesores de ciencia, profesores de educacion y maestros del nivel elemental primario. Todos los cursos de la secuencia curricular deben tener un enfoque constructivista. Las experiencias educativas que se incluyan en los cursos deben aspirar a desarrollar en los candidatos los atributos de la cultura cientifica y actitudes positivas hacia la ciencia y hacia la ensenanza de esta disciplina. El modelaje por parte de los profesores que ensenen los cursos de la secuencia curricular es fundamental en el desarrollo profesional de los candidatos. Se recomienda que en los cursos de contenido cientifico se estudien los conceptos y los conocimientos cientificos que forman parte del curriculo de Kindergarten a tercer grado de forma integrada y con una profundidad universitaria. Estos cursos deben tener un enfoque interdisciplinario e incluir el estudio de la naturaleza de la ciencia y un componente de laboratorio para desarrollar los

Glaucoma in developing countries

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Ravi Thomas

2012-01-01

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

Comportamiento de la visión de color en pacientes sospechosos de glaucoma y glaucomatosos como daño precoz de las células ganglionares de la retina Colour vision of patients suspected of and diagnosed with glaucoma as an early damage of ganglionary cells of the retina

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José Alberto Cabrera Martínez

2007-06-01

Full Text Available Se realizó un estudio descriptivo y analítico en 60 pacientes (sospechosos de glaucoma y con diagnóstico de glaucoma crónico simple estadio inicial que concurrieron a la consulta de Oftalmología del Hospital Militar Central "Dr. Carlos J. Finlay" en el período comprendido entre los años 2003 y 2006. La muestra se conformó con 30 pacientes con sospecha de glaucoma y 30 con diagnóstico de glaucoma que cumplieron los requisitos de inclusión y exclusión. Los primeros 30 pacientes de cada grupo que fueron atendidos durante ese período fueron los seleccionados. Se les aplicaron diferentes test para evaluar la visión de colores, como daño precoz de las células ganglionares de la retina. Se consideró sospechoso de glaucoma todo paciente que tuviese al menos tres de los más importantes factores de riesgos (HTO, edad mayor de 40 años, raza negra y antecedentes familiares de primer grado que padezcan la enfermedad. Se diagnosticó como glaucomatoso aquel paciente que presentó síntomas y signos de la enfermedad y alteraciones incipientes del campo visual (aumento mancha ciega, escalón nasal o escotoma Seidel. También se utilizó en el estudio una muestra de 31 sujetos supuestamente sanos de la investigación realizada en el Hospital "Hermanos Ameijeiras" bajo las mismas condiciones de exploración como grupo control -que se tituló "Estudio de la visión cromática en una población sana". El método de evaluación de los pacientes consistió en un examen inicial oftalmológico donde se recogieron sus datos generales paciente, síntomas y signos clínicos hallados, así como factores de riesgo de la enfermedad. Se constató que los sujetos sanos no presentaban alteraciones en relación con los colores y que los sospechosos y glaucomatosos sí las presentaron en un índice significativoA descriptive analytical study of 60 patients suspected of glaucoma and diagnosed with simple chronic glaucoma at initial stage, who went to the

Progress of inflammatory cytokines in glaucoma

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Ping Hu

2015-12-01

Full Text Available Glaucomais a group of diseases characterized by optic nerve damage and visual field defect, and pathological high intraocular pressure is a risk factor for glaucoma. Glaucoma is affected by the interaction of multiple genes and environmental factors, and inflammation may be involved in the pathogenesis of glaucoma. A great deal of studies have confirmed that high expression of connective tissue growth factor(CTGF, tumor necrosis factor-α(TNF-α, interleukins(ILs, nuclear factor-kappa B(NF-κBand various cytokines in the aqueous humor of patients with glaucoma, which have a close correlation with pathogenesis of glaucoma.This article reviews the progress of inflammatory cytokines and their relationship with glaucoma.

Clinical Metabolomics and Glaucoma.

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Barbosa-Breda, João; Himmelreich, Uwe; Ghesquière, Bart; Rocha-Sousa, Amândio; Stalmans, Ingeborg

2018-01-01

Glaucoma is one of the leading causes of irreversible blindness worldwide. However, there are no biomarkers that accurately help clinicians perform an early diagnosis or detect patients with a high risk of progression. Metabolomics is the study of all metabolites in an organism, and it has the potential to provide a biomarker. This review summarizes the findings of metabolomics in glaucoma patients and explains why this field is promising for new research. We identified published studies that focused on metabolomics and ophthalmology. After providing an overview of metabolomics in ophthalmology, we focused on human glaucoma studies. Five studies have been conducted in glaucoma patients and all compared patients to healthy controls. Using mass spectrometry, significant differences were found in blood plasma in the metabolic pathways that involve palmitoylcarnitine, sphingolipids, vitamin D-related compounds, and steroid precursors. For nuclear magnetic resonance spectroscopy, a high glutamine-glutamate/creatine ratio was found in the vitreous and lateral geniculate body; no differences were detected in the optic radiations, and a lower N-acetylaspartate/choline ratio was observed in the geniculocalcarine and striate areas. Metabolomics can move glaucoma care towards a personalized approach and provide new knowledge concerning the pathophysiology of glaucoma, which can lead to new therapeutic options. © 2017 S. Karger AG, Basel.

Anti-glaucoma potential of Heliotropium indicum Linn in experimentally-induced glaucoma.

Science.gov (United States)

Kyei, Samuel; Koffuor, George Asumeng; Ramkissoon, Paul; Owusu-Afriyie, Osei

2015-01-01

Heliotropium indicum is used as a traditional remedy for hypertension in Ghana. The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H. indicum to manage experimentally-induced glaucoma. The percentage change in intraocular pressure (IOP), after inducing acute glaucoma (15 mLkg(-1) of 5 % dextrose, i.v.), in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract (HIE) (30-300 mgkg(-1)), acetazolamide (5 mgkg(-1)), and normal saline (10 mLkg(-1)) per os were measured. IOPs were also monitored in chronic glaucoma in rabbits (induced by 1 % prednisolone acetate drops, 12 hourly for 21 days) after treatments with the same doses of HIE, acetazolamide, and normal saline for 2 weeks. The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour. Glutamate concentration in the vitreous humour was also determined using ELISA technique. Histopathological assessment of the ciliary bodies was made. The extract significantly reduced intraocular pressure (p ≤ 0.05-0.001) in acute and chronic glaucoma, preserved glutathione levels and glutamate concentration (p ≤ 0.01-0.001). Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group. The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive, anti-oxidant and possible neuro-protective effects, which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.

ANÁLISIS PROTEÓMICO DE CULTIVOS PRIMARIOS DE TIROIDES

OpenAIRE

Nancy Echeverry; Blanca Laura Ortíz; Jorge Caminos

2011-01-01

En el presente estudio se identificaron proteínas de expresión constitutiva, como vimentina, actina, tubulina, proteína de choque térmico de 60 kDa, peroxirredoxina y la ATP sintasa mitocondrial, en cultivos primarios de tiroides normales y de carcinoma papilar de tiroides. Se establecieron las condiciones de extracción, solubilización, análisis cuantitativo y cualitativo de dichas proteínas, y se buscaron las mejores condiciones de isoelectroenfoque (IEF) en ...

Ahmed Glaucoma Valve Implantation for Uveitic Glaucoma Secondary to Behçet Disease.

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Satana, Banu; Yalvac, Ilgaz S; Sungur, Gulten; Eksioglu, Umit; Basarir, Berna; Altan, Cigdem; Duman, Sunay

2015-01-01

To evaluate outcomes of patients with uveitic glaucoma secondary to Behçet disease (BD) who underwent Ahmed glaucoma valve (AGV) implantation. A retrospective chart review of 14 eyes of 10 patients with uveitic glaucoma associated with BD who underwent AGV implantation at a tertiary referral center. Treatment success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg with or without antiglaucoma medication, without further additional glaucoma surgery or loss of light perception. The main outcome measures were IOP, best-corrected visual acuity measured with Snellen charts, and number of glaucoma medications. Mean duration of postoperative follow-up was 18.2±6.6 months (range, 6 to 31 mo). Of the 14 eyes, 10 (71.4%) were pseudophakic and 5 (35.7%) had primary AGV implantation without a history of previous glaucoma surgery. At the most recent follow-up visit, 13 of the 14 eyes had an IOP between 6 and 21 mm Hg. Mean IOP was significantly reduced during follow-up, as compared with preoperative values (P≤0.005). The cumulative probability of surgical success rate was 90.9% at 18 months based on Kaplan-Meier survival analysis. The mean number of antiglaucoma medications required to achieve the desired IOP decreased from 3.4±0.5 preoperatively to 1.0±1.1 postoperatively (P≤0.05). Visual acuity loss of >2 lines occurred in 4 eyes (28.5%) due to optic atrophy associated with retinal vasculitis. Temporary hypotony developed during follow-up in 4 eyes (28.5%) at first postoperative week. For the management of uveitic glaucoma associated with BD, AGV implantation is a successful method for glaucoma control but requires additional surgical interventions for high early hypotony rates.

Contexto carcelario: un estudio de los estresores y las respuestas de afrontamiento en detenidos primarios y reincidentes Prison context: a study on primary offenders and recidivists stressors and coping responses

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Isabel María Mikulic

2005-12-01

Full Text Available El presente trabajo se propone presentar los resultados preliminares obtenidos en la investigación llevada a cabo con sujetos en situación de privación de libertad, primarios y reincidentes. El objetivo de este estudio ha sido evaluar las respuestas de afrontamiento implementadas por los mismos ante situaciones percibidas como estresantes, desde el enfoque de los factores de riesgo y protección, especialmente considerando las características del contexto carcelario. Se realizó un estudio de campo exploratorio-descriptivo, comparandose dos muestras intencionales: 35 detenidos primarios en Comisarías, y 35 reincidentes en Penitenciarias. Los resultados obtenidos indican un predominio de respuestas de afrontamiento evitativas por sobre las de aproximación al problema en todos los evaluados, siendo las principales situaciones estresantes mencionadas la privación de libertad, el distanciamiento familiar y la ruptura con la pareja. Este predominio ha sido asociado por múltiples autores, con estados de indefensión que impiden al sujeto lograr bienestar y control sobre sus propias vidas, y desarrollar caracterìsticas resilientesThis study shows preliminary results obtained in actual research on primary offenders and repeat offenders. Its objective has been to assess offenders coping responses when perceiving stressing events. Coping responses have been analyzed from a risk perception and protective factors approach, specially taking into consideration context characteristics in prison environment. An exploratory-descriptive field study allowed us to compare two intentional samples, 35 primary offenders and 35 repeat offenders. Results show avoidance predominance within coping strategies both in primary offenders and repeat offenders responses. Main reported stressing events were: lack of freedom, family distance and spouse separation. Avoidance responses are associated with a state of helplessness which weakens offenders posibilities of well

Clinical observation on Ahmed glaucoma valve implantation for teenagers with refractory glaucoma

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Dong-Dao Song

2016-06-01

Full Text Available AIM:To observe the clinical effect of Ahmed glaucoma valve(AGVimplantation for teenagers with refractory glaucoma. METHODS: Twenty-seven patients(27 eyeswith refractory glaucoma were treated with AGV implantation in our hospital from October 2012 to October 2014. The patients were followed up for 12mo. The success rate of the operation, postoperative intraocular pressure, the best corrected visual acuity, as well as complications were recorded. RESULTS: The success rate of the operation was 85%. The intraocular pressure of the 27 patients decreased from 48.3±8.3mmHg before operations to 21.4±8.1mmHg(PPCONCLUSION: AGV implantation is characterized by a high success rate, simple operation, less complications and is an effective treatment for refractory glaucoma in adolescents.

Altered aquaporin expression in glaucoma eyes

DEFF Research Database (Denmark)

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

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...... 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...

Late-Onset Endophthalmitis Secondary to Exposed Glaucoma Tube Implant in a Rare Case of Paediatric Glaucoma

OpenAIRE

Ranganath, Akshatha; Hashim, Adnan

2011-01-01

Glaucoma drainage implants (GDIs) are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP) control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae...

The effect of an Ahmed glaucoma valve implant on corneal endothelial cell density in children with glaucoma secondary to uveitis.

Science.gov (United States)

Kalinina Ayuso, Viera; Scheerlinck, Laura M; de Boer, Joke H

2013-03-01

To assess the effect of Ahmed glaucoma valve implants on corneal endothelial cell density (ECD) in children with uveitic glaucoma. Cross-sectional study. setting: Institutional. patientpopulation: Eighty eyes from 42 patients diagnosed with uveitis before the age of 16. Twenty-eight eyes had an Ahmed glaucoma valve implant because of secondary glaucoma. Fifty-two eyes without an implant served as controls. intervention orobservationprocedure(s): Corneal ECD was examined cross-sectionally using a noncontact specular microscope. Univariate and multivariate generalized estimating equations analyses with correction for paired eyes were performed. mainoutcomemeasure(s): Correlation of ECD with the presence of an Ahmed glaucoma valve implant and with the time following implantation. ECD was significantly lower in the Ahmed glaucoma valve group than in controls (2359 and 3088 cells/mm(2), respectively; P Ahmed glaucoma valve implantation. Presence of an Ahmed glaucoma valve implant, previous intraocular surgery, age, duration of uveitis, and history of corneal touch by the implant tube were all significantly associated with decreased ECD. Following a multivariate analysis, presence of an Ahmed glaucoma valve implant (B = -340; adjusted P Ahmed glaucoma valve implantation was highly correlated with decreased ECD (B = -558, P Ahmed glaucoma valve implants in children with uveitic glaucoma are independently associated with decreased ECD, and this effect is associated with the time interval following Ahmed glaucoma valve implantation. Copyright © 2013 Elsevier Inc. All rights reserved.

Genetics Home Reference: early-onset glaucoma

Science.gov (United States)

... called a syndrome. If glaucoma appears before the age of 5 without other associated abnormalities, it is called primary congenital glaucoma. Other individuals experience early onset of primary open-angle glaucoma, the most ...

Graft failure: III. Glaucoma escalation after penetrating keratoplasty.

Science.gov (United States)

Greenlee, Emily C; Kwon, Young H

2008-06-01

Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period. Early postoperative causes of glaucoma include pre-existing glaucoma, retained viscoelastic, hyphema, inflammation, pupillary block, aqueous misdirection, or suprachoroidal hemorrhage. Late causes include pre-existing glaucoma, angle-closure glaucoma, ghost cell glaucoma, suprachoroidal hemorrhage, and steroid-induced glaucoma. Determining the cause of IOP elevation can help guide therapeutic intervention. Treatments for refractory glaucoma include topical anti-glaucoma medications such as beta-adrenergic blockers. Topical carbonic anhydrase inhibitors, miotic agents, adrenergic agonists, and prostaglandin analogs should be used with caution in the post-keratoplasty patient, because of the possibility of corneal decompensation, cystoid macular edema, or persistent inflammation. Various glaucoma surgical treatments have reported success in post-keratoplasty glaucoma. Trabeculectomy with mitomycin C can be successful in controlling IOP without the corneal toxicity noted with 5-fluorouracil. Glaucoma drainage devices have successfully controlled intraocular pressure in postkeratoplasty glaucoma; this is, however, associated with increased risk of graft failure. Placement of the tube through the pars plana may improve graft success compared with implantation within the anterior chamber. In addition, cyclophotocoagulation remains a useful procedure for eyes that have refractory glaucoma despite multiple surgical interventions.

Arguments Against Funding Glaucoma Treatment and Rebuttal

African Journals Online (AJOL)

2018-03-01

Mar 1, 2018 ... for the treatment of glaucoma at no cost to IWG at the point of delivery toward reducing glaucoma,s harmful impact on the .... and logistic reasons. Nigeria doesn .... cataract unlike from glaucoma can be reversed. This does not.

Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: A systematic review and meta-analysis.

Science.gov (United States)

Lavia, Carlo; Dallorto, Laura; Maule, Milena; Ceccarelli, Manuela; Fea, Antonio Maria

2017-01-01

MIGS have been developed as a surgical alternative for glaucomatous patients. To analyze the change in intraocular pressure (IOP) and glaucoma medications using different MIGS devices (Trabectome, iStent, Excimer Laser Trabeculotomy (ELT), iStent Supra, CyPass, XEN, Hydrus, Fugo Blade, Ab interno canaloplasty, Goniscopy-assisted transluminal trabeculotomy) as a solo procedure or in association with phacoemulsification. Randomized control trials (RCT) and non-RCT (non randomized comparative studies, NRS, and before-after studies) were included. Studies with at least one year of follow-up in patients affected by primary open angle glaucoma, pseudoexfoliative glaucoma or pigmentary glaucoma were considered. Risk of Bias assessment was performed using the Cochrane Risk of Bias and the ROBINS-I tools. The main outcome was the effect of MIGS devices compared to medical therapy, cataract surgery, other glaucoma surgeries and other MIGS on both IOP and use of glaucoma medications 12 months after surgery. Outcomes measures were the mean difference in the change of IOP and glaucoma medication compared to baseline at one and two years and all ocular adverse events. The current meta-analysis is registered on PROSPERO (reference n° CRD42016037280). Over a total of 3,069 studies, nine RCT and 21 case series with a total of 2.928 eyes were included. Main concerns about risk of bias in RCTs were lack of blinding, allocation concealment and attrition bias while in non-RCTs they were represented by patients' selection, masking of participants and co-intervention management. Limited evidence was found based on both RCTs and non RCTs that compared MIGS surgery with medical therapy or other MIGS. In before-after series, MIGS surgery seemed effective in lowering both IOP and glaucoma drug use. MIGS showed a good safety profile: IOP spikes were the most frequent complications and no cases of infection or BCVA loss due to glaucoma were reported. Although MIGS seem efficient in the

The Philadelphia Glaucoma Detection and Treatment Project

Science.gov (United States)

Waisbourd, Michael; Pruzan, Noelle L.; Johnson, Deiana; Ugorets, Angela; Crews, John E.; Saaddine, Jinan B.; Henderer, Jeffery D.; Hark, Lisa A.; Katz, L. Jay

2016-01-01

Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT

Glaucoma in Asian Populations

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... Involved News About Us Donate In This Section Glaucoma In Asian Populations email Send this article to ... lower than in their Asian counterparts. Normal Tension Glaucoma affects Japanese Japanese populations, however, have a substantially ...

African Americans and Glaucoma

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... 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, ...

Costs of a community-based glaucoma detection programme: analysis of the Philadelphia Glaucoma Detection and Treatment Project.

Science.gov (United States)

Pizzi, Laura T; Waisbourd, Michael; Hark, Lisa; Sembhi, Harjeet; Lee, Paul; Crews, John E; Saaddine, Jinan B; Steele, Deon; Katz, L Jay

2018-02-01

Glaucoma is the foremost cause of irreversible blindness, and more than 50% of cases remain undiagnosed. Our objective was to report the costs of a glaucoma detection programme operationalised through Philadelphia community centres. The analysis was performed using a healthcare system perspective in 2013 US dollars. Costs of examination and educational workshops were captured. Measures were total programme costs, cost/case of glaucoma detected and cost/case of any ocular disease detected (including glaucoma). Diagnoses are reported at the individual level (therefore representing a diagnosis made in one or both eyes). Staff time was captured during site visits to 15 of 43 sites and included time to deliver examinations and workshops, supervision, training and travel. Staff time was converted to costs by applying wage and fringe benefit costs from the US Bureau of Labor Statistics. Non-staff costs (equipment and mileage) were collected using study logs. Participants with previously diagnosed glaucoma were excluded. 1649 participants were examined. Mean total per-participant examination time was 56 min (SD 4). Mean total examination cost/participant was $139. The cost/case of glaucoma newly identified (open-angle glaucoma, angle-closure glaucoma, glaucoma suspect, or primary angle closure) was $420 and cost/case for any ocular disease identified was $273. Glaucoma examinations delivered through this programme provided significant health benefit to hard-to-reach communities. On a per-person basis, examinations were fairly low cost, though opportunities exist to improve efficiency. Findings serve as an important benchmark for planning future community-based glaucoma examination programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma.

Science.gov (United States)

Angmo, Dewang; Sharma, Reetika; Temkar, Shreyas; Dada, Tanuj

2015-05-01

ExPress glaucoma filtration device (GFD) has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs) not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications) was achieved in eight cases (66.7%) and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications) in two cases (16.7%) at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37). ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma's, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.

Displasia oculoauriculovertebral o síndrome de Goldenhar: Estudio multidisciplinario de un caso clínico Oculoauriculovertebral displasia or Goldehar syndrome: Multidisciplinary study of a clinical case

Directory of Open Access Journals (Sweden)

Marina de La Barca Lleonart

2001-06-01

Full Text Available Presentamos un caso clínico de displasia oculoauriculovertebral o síndrome de Goldenhar en una paciente femenina de 26 años con múltiples anomalías congénitas y la presencia de quiste branquial y glaucoma primario de ángulo abierto. Mediante un estudio multidisciplinario, clínico, genético, imagenológico y con pruebas psicofísicas, se ponen en evidencia diversas anomalías craneofaciales, óseas y de vísceras toracoabdominales presentes en una misma paciente. Se señalan las diferentes deformidades que conforman actualmente un amplio espectro de anomalías, según la literatura revisada, así como las características clínicas, tratamiento y su evolución. El quiste branquial resulta un hallazgo novedoso que bien puede explicarse en este tipo de alteraciones morfogenéticas, sin embargo, el glaucoma parece ser una entidad casual. Se descartan otras anomalías oculares propias del Goldenhar que pueden ocasionar glaucoma. Se comenta la importancia del diagnóstico y tratamiento multidisciplinario, así como el riesgo quirúrgico de estos enfermos.We present a clinical case of oculoauriculovertebral displasia or Goldenhar syndrome in a 26-year-old female patient with multiple congenital abnormalities, branchial cyst and primary open-angle glaucoma. A multidisciplinary, clinical, genetic and imaging study is made in conjunction with psycophysical tests that show that the patient suffers from diverse craniofacial and osteal abnormalities and from abnormalities of the thoraco-abdominal viscera. The different deformities that are part at present of a wide spectrum of abnormalities, according to the literature reviewed by us, as well as the clinical characteristics, treatment and evolution are stressed. The branchial cyst is a novel finding that may be well explained in this type of morphogenetic alterations; however, glaucoma seems to be a causal entity. Other eye abnormalities inherent to Goldenhar syndrome that may cause glaucoma are

Supra-Tenon Capsule Implantation of the Ahmed Glaucoma Valve in Refractory Pediatric Glaucoma.

Science.gov (United States)

Elhefney, Eman M; Al-Sharkawy, Hossam T; Kishk, Hanem M

2016-09-01

To evaluate the efficacy of supra-Tenon capsule implantation of an Ahmed glaucoma valve (AGV) as a measure to decrease the fibrotic potential of the Tenon capsule on bleb formation and its subsequent effect on intraocular pressure (IOP) control in children with refractory glaucoma. Mansoura Ophthalmic Centre, Faculty of Medicine, Mansoura University, Egypt. A prospective interventional study. Twenty-two eyes of 12 children with refractory glaucoma underwent supra-Tenon capsule implantation of AGV. Ophthalmic examinations under general anesthesia including measurement of the corneal diameter and the IOP with Perkin's tonometer were performed preoperatively, on the first postoperative day, the first postoperative week, weekly for the first month, 2-weekly for the following 3 months, and monthly for at least 18 months. Postoperative complications and the number of glaucoma medications used preoperatively and postoperatively were recorded. The paired Student t test was used to compare preoperative and postoperative data. There were 12 eyes (54.6%) with refractory congenital glaucoma, 7 eyes (31.8%) with refractory pseudophakic glaucoma, and 3 eyes (13.6%) with refractory aphakic glaucoma. Patients included 10 male (83.3%) and 2 female (16.7%) children with a mean age of 16.3±9.7 months. The mean follow-up duration was 24.1±4.3 months. There was a statistically significant difference between the mean preoperative IOP (30.7±2.88 mm Hg) and the mean postoperative IOP (16.1±3.60 mm Hg) (t=16.22 and P=0.000, with a mean decrease in the IOP by 47.6%). The difference between the mean number of antiglaucoma medications before surgery (1.86±0.4) and after surgery (1.0±0.9) was also statistically significant (t=4.31 and P=0.000). Total success was achieved in 18 eyes (81.9%). Postoperative complications included tube exposure and slippage (10%), hypotony (10%), and hyphema (5%). Supra-Tenon capsule implantation of the AGV was successful in controlling the IOP with few

Niveles de GLP-1 tras el test de sobrecarga oral de glucosa en mujeres con antecedentes de diabetes mellitus gestacional

OpenAIRE

Maraver Selfa, Silvia María

2017-01-01

Se ha descrito una reducción significativa del efecto incretina en pacientes con DM2 que puede deberse a la secreción alterada de las hormonas incretinas y/o a una acción insulinotrópica defectuosa de las mismas. Podría plantearse que este efecto incretina deteriorado en pacientes con trastornos del metabolismo hidrocarbonado, fuese un defecto primario precoz que preceda al desarrollo de la DM2, o secundario a la propia hiperglucemia. Objetivos. Estudiar el patrón de secreción de GLP-1 ...

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 ...

Angle closure glaucoma in congenital ectropion uvea.

Science.gov (United States)

Wang, Grace M; Thuente, Daniel; Bohnsack, Brenda L

2018-06-01

Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months) and required additional surgery (cycloablation or trabeculectomy). Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control.

Oculoplastic technique of connecting a glaucoma valve shunt to extraorbital locations in cases of severe glaucoma.

Science.gov (United States)

Rubin, Peter A D; Chang, Eli; Bernardino, Carlo Roberto; Hatton, Mark P; Dohlman, Claes H

2004-09-01

To describe a technique for inserting glaucoma shunts to the sinuses or the lacrimal sac as a means of lowering intraocular pressure in patients with refractory glaucoma associated with severe ocular surface disease. Nineteen patients with severe ocular surface disease necessitating a keratoprosthesis and with intractable glaucoma underwent placement of a modified Ahmed shunt to direct aqueous in the maxillary or ethmoid sinus or lacrimal sac. Intraocular pressure is presently well controlled without glaucoma medications in two thirds of patients. None of the patients had endophthalmitis. Established oculoplastic surgery techniques may be used to redirect aqueous to extraorbital locations and effectively lower intraocular pressure in patients with severe ocular surface disease and refractory glaucoma. This procedure has not been associated with endophthalmitis.

Glaucoma and clinical characteristics in Vietnamese Americans.

Science.gov (United States)

Peng, Pai-Huei; Manivanh, Richard; Nguyen, Ngoc; Weinreb, Robert N; Lin, Shan C

2011-08-01

To assess the proportions of glaucoma types and clinical characteristics in Vietnamese Americans in a single-center, retrospective study. Medical charts of Vietnamese-American patients who visited a single private practice in Northern California from 1998-2007 were reviewed. The main outcome measures included the distribution and characteristics of glaucoma types, and clinical parameters associated with the presence of various glaucomas. Data from 2247 patients aged 18-98 years were reviewed. Glaucoma was determined for 305 patients (13.6%). Among this group, 54.8% had primary open-angle glaucoma (POAG), 26.9% had primary angle-closure glaucoma (PACG), 13.4% had mixed mechanism glaucoma (MMG), and 4.9% had secondary glaucoma. In the MMG group (41 patients), 27 patients who initially had open angles developed narrow angles and underwent laser peripheral iridotomy (LPI) with a mean follow up of 6.4 years from the time of iridotomy. The other 13 patients had glaucoma progression with open angles after LPI. One POAG patient had neovascular glaucoma due to retinal vein occlusion several years later. Compared to the PACG group, the MMG group had significantly lower baseline intraocular pressure (25.0 vs. 20.2 mmHg, p = 0.007) but with no difference in biometry. POAG is the major type of glaucoma in this clinic-based Vietnamese population. However, Vietnamese appear to have a relatively higher proportion of PACG than Caucasians and those of African descent. It is recommended that gonioscopy be part of the regular eye check-up for adult Vietnamese patients.

Glaucoma

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Full Text Available ... Eye Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and Aging Program African American Program Training and ...

Pediatric glaucoma: current perspectives

Directory of Open Access Journals (Sweden)

Marchini G

2014-05-01

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

The impact of available anti-glaucoma therapy on the volume and age profile of patients undergoing glaucoma filtration surgery.

LENUS (Irish Health Repository)

Keane, P A

2012-02-01

PURPOSE: To investigate whether new classes of glaucoma medication have influenced glaucoma filtration surgery over a 20-year period in the southeast region of Ireland. METHODS: All patients undergoing glaucoma filtration surgery between January 1986 and December 2005 in Waterford Regional Hospital were identified. The following data were recorded for each patient: age; sex; and type of filtration procedure. RESULTS: Over the 20-year study period two consultant ophthalmic surgeons performed a total of 760 glaucoma filtration procedures on patients aged over 20 years. The annual average number of glaucoma surgeries declined steadily, defined by availability of different topical anti-glaucoma medications, from an average of 23.75 surgeries per surgeon per year in the subperiod 1986-1995, to 21 in 1996, 20 in 1997, and 12.69 surgeries per surgeon per year in 1998-2005, these differences being statistically significant (general linear model, P<0.001). The age profile of patients did not change significantly over the course of the study period. CONCLUSIONS: The volume of patients requiring glaucoma filtration surgery under the care of two consultant ophthalmic surgeons decreased over the 20-year study period, an era in which three classes of anti-glaucoma medications were made available. However, an increase in the age profile of patients undergoing glaucoma filtration surgery during the same period was not observed. Further study is required to resolve whether introduction of the new topical anti-glaucoma medications has led to a real reduction in the demand for glaucoma filtration surgery, or has just led to the deferral of such a demand.

GENDER AND AGE FEATURES OF GLAUCOMA

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O. V. Makarenk

2014-02-01

Full Text Available Today, the definition “glaucoma” combines a number of eye pathologies that lead to irreversible blindness, and therefore is difficult disabling disease. Glaucoma occurs in people of working age, so this problem is not only medical, but also social, because it causes disability in substantial economic costs not only for individual patients, but also for the whole country – patients become unable to work. Gender features of glaucoma are also contradictory. In European literature the basic idea is that men are more likely to suffer from glaucoma than women. Such studies have not been conducted in the Podillya region of Ukraine, that makes impossible to design a reliable global data to estimate the prevalence of glaucoma in different age groups for persons living in Vinnitsa region. Therefore, the aim of the study was a retrospective analysis of medical records of patients in Eye Microsurgery Department of Vinnitsa Regional Clinical Hospital for the period 2008-2012 years for determining the gender and age characteristics. Materials and methods 1418 patients with primary open-angle glaucoma (841 men and 577 women aged 14 to 92 years (mean age 67,12 ± 7,64, which were treated in the Eye Microsurgery Department, took part in the study. For the purpose of the study they were divided into two groups: I – male patients with glaucoma, II – female patients with glaucoma. Each group was divided into 7 subgroups according to the ontogenesis scheme: A – teens, B – youth, C – I adulthood age, D – II adulthood age, E – elderly age, F – senily age and G – centenarians. Thus was allocated 12 research groups. Results The structure of the incidence of glaucoma is 59.31% in men and 40.69% in women. Incidence of glaucoma is highest in the IE group and is 34.98%. The group IIE incidence is lower – 35.32%. In the group D the incidence of glaucoma among men and women was very different (13.89% and 2.89%, respectively. It should also be noted

Estudio comparativo de 2 técnicas quirúrgicas para la cirugía del pterigión primario Comparative study of 2 surgical techniques for the operation of primary Pterygium

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Leonor R Díaz Alfonso

2000-12-01

Full Text Available Realizamos un estudio comparativo de 2 técnicas quirúrgicas para la cirugía del Pterigión Primario. Nuestra muestra estuvo conformada por 100 pacientes portadores del Pterigión Primario Grado II, que fueron enviados a una consulta creada al efecto, según los criterios de inclusión y exclusión establecidos. Les fue llenada una encuesta. Según el método de muestreo aleatorio por conglomerados en el tiempo del Programa ALE de la Facultad de Ciencias Médicas de Cienfuegos. A 50 de estos pacientes se les realizó la autoplastia conjuntival y al resto la exéresis simple; estos pacientes se siguieron en consulta evolutivamente durante 6 meses. Comparamos los resultados obtenidos con la utilización de las 2 técnicas y encontramos que la autoplastia conjuntival resultó ser más eficaz; pues la frecuencia de complicaciones fue solamente del 6,0 %; mientras que con la técnica convencional la recidiva es del 20,0 %; por lo que esperamos resultados alentadores en cuanto al tratamiento del Pterigión PrimarioA comparative study of 2 surgical techniques used in the operation of primary Pterygium was conducted. Our sample was composed of 100 patients carriers of primary Pterygium degree II that were referred to to the consulting room created to this end according to the established criteria of inclusion and exclusion. Patients were surveyed according to the method of randomized sampling by clusters at the time of the implementation of the ALE Program in the Faculty of Medical Sciences of Cienfuegos. 50 of these patients underwent Conjunctival Autoplasty and the rest Simple Exeresis. The evolution of these patients was followed-up at the consulting room during 6 months. The results obtained on using both techiques were compared and we found that the Conjunctival Autoplasty was more efficient, since the frequence of complications was just 6.0%, whereas with the conventional technique the relapse was 20.0%. We hope to attain encouraging results in

Clinical findings following Ahmed Glaucoma Valve™ implantation in pediatric glaucoma

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Amir Pirouzian

2008-03-01

Full Text Available Amir Pirouzian1, Joseph L Demer21Department of Ophthalmology, San Diego Children’s Hospital, San Diego, UCSD, San Diego, CA, USA; 2Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USAPurpose: To describe clinical findings after Ahmed valve drainage implantation in children.Design: All records in one practice were reviewed to identify and describe clinical findings in all children who had undergone Ahmed Glaucoma ValveTM S2 model insertion for uncontrolled primary or secondary glaucoma.Results: A total of 6 patients were identified, ranging in age from 2–15 years. Mean follow-up time averaged from 2–5 years from the time of tube insertion. Three patients exhibited pupillary peaking towards the tube of the valve. All patients required additional surgery or additional medications to control intraocular pressure. Lenticular opacification near the tube site developed in one patient. Gradual tube extrusion was also noted in another two patients.Conclusion: Multiple clinical events follow the Ahmed valve insertion in children. Pupillary irregularity is the most commonly noted event in this series. To avoid or reduce the risk of this complication, additional or modification of surgical procedures could be considered. The mechanism of such occurrence will further be discussed.Keywords: Ahmed Glaucoma Valve, children, pediatric glaucoma

Level of agreement among Latin American glaucoma subspecialists on the diagnosis and treatment of glaucoma: results of an online survey.

Science.gov (United States)

Grigera, Daniel E; Mello, Paulo Augusto Arruda; Barbosa, Wilma Lelis; Casiraghi, Javier Fernando; Grossmann, Rodolfo Perez; Peyret, Alejo

2013-01-01

The aim of this research was to assess the level of agreement among glaucoma experts in Latin America on key practices related to treatment and diagnosis of glaucoma. An online questionnaire was sent to a multinational panel of glaucoma experts. The questionnaire contained 107 statements on the medical treatment (Part 1) and diagnosis (Part 2) of glaucoma, and was developed in Spanish and translated into English. Agreement was defined as >70% of respondents. Fifty participants from 14 countries completed the questionnaire. For the medical treatment of glaucoma, nearly all respondents (98% or greater) confirmed that medical treatment as first-line therapy is preferred to surgery, prostaglandin analogs are the medication of first choice for primary open-angle glaucoma (POAG), longitudinal monitoring of efficacy should include intraocular pressure, structural and functional status, as well as if patients' quality of life is impaired by the high cost of medication. For the diagnosis of glaucoma section, all respondents confirmed that, after initial examination, gonioscopy should be repeated over time, standard automated perimetry is the most important functional examination for diagnosis and monitoring of primary open-angle glaucoma, central corneal thickness is important in assessment of glaucoma, and computerized imaging tests help in clinical evaluation of optic disc. This survey shows a high level of agreement on most aspects of glaucoma diagnosis and treatment among Latin American glaucoma experts. Areas of disagreement highlight the need for further evidence or education. These findings will be useful for guiding future efforts to optimize glaucoma practice by clinicians in Latin America.

Level of agreement among Latin American glaucoma subspecialists on the diagnosis and treatment of glaucoma: results of an online survey

Directory of Open Access Journals (Sweden)

Daniel E. Grigera

2013-06-01

Full Text Available PURPOSE: The aim of this research was to assess the level of agreement among glaucoma experts in Latin America on key practices related to treatment and diagnosis of glaucoma. METHODS: An online questionnaire was sent to a multinational panel of glaucoma experts. The questionnaire contained 107 statements on the medical treatment (Part 1 and diagnosis (Part 2 of glaucoma, and was developed in Spanish and translated into English. Agreement was defined as >70% of respondents. RESULTS: Fifty participants from 14 countries completed the questionnaire. For the medical treatment of glaucoma, nearly all respondents (98% or greater confirmed that medical treatment as first-line therapy is preferred to surgery, prostaglandin analogs are the medication of first choice for primary open-angle glaucoma (POAG, longitudinal monitoring of efficacy should include intraocular pressure, structural and functional status, as well as if patients' quality of life is impaired by the high cost of medication. For the diagnosis of glaucoma section, all respondents confirmed that, after initial examination, gonioscopy should be repeated over time, standard automated perimetry is the most important functional examination for diagnosis and monitoring of primary open-angle glaucoma, central corneal thickness is important in assessment of glaucoma, and computerized imaging tests help in clinical evaluation of optic disc. CONCLUSIONS: This survey shows a high level of agreement on most aspects of glaucoma diagnosis and treatment among Latin American glaucoma experts. Areas of disagreement highlight the need for further evidence or education. These findings will be useful for guiding future efforts to optimize glaucoma practice by clinicians in Latin America.

Prevención y tratamiento actual del glaucoma

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DR. P. José Manuel Díaz

2010-11-01

Full Text Available El glaucoma es la principal causa de ceguera no reversible en el mundo, afectando al 2% de la población. Actualmente se considera una neuropatía óptica, donde la presión intraocular juega un rol fundamental en la patogenia y las características del daño óptico producido. Con el tratamiento actual, se busca prevenir el daño en la estructura del nervio óptico, para preservar el campo visual, persiguiendo mantener la calidad de vida del paciente. Existen nuevos métodos imaginológicos que junto al examen clínico y campo visual, predicen daño y avance de enfermedad. Se incluyen en la comprensión de la patología la apoptosis y el concepto de neuroprotección. Nuevos fármacos buscan mantener una adecuada reducción en la presión intraocular sin fluctuaciones, evitando efectos adversos y mejorando la adherencia al tratamiento. Nuevas herramientas terapéuticas como la trabeculoplastía selectiva láser y nuevas cirugías como el implante de tubos de drenaje, aumentan las posibilidades de evitar la ceguera por glaucoma.

THE TREATMENT OF OPEN- AND NARROW-ANGLE GLAUCOMA

African Journals Online (AJOL)

1971-04-10

Apr 10, 1971 ... glaucoma will be considered: narrow-angle glaucoma. (acute glaucoma) and ... emotional or a physical crisis. The pain is in the distribu- .... ness, not increased pressure, haunts people suffering from glaucoma'.' The saga of ...

Update on pigment dispersion syndrome and pigmentary glaucoma.

Science.gov (United States)

Okafor, Kingsley; Vinod, Kateki; Gedde, Steven J

2017-03-01

The present article reviews the clinical features and pathogenesis of pigment dispersion syndrome and pigmentary glaucoma and provides an update regarding their diagnosis and management. Newer imaging modalities including ultrasound biomicroscopy and anterior segment optical coherence tomography facilitate visualization of the iris concavity characteristic of eyes with pigment dispersion syndrome and pigmentary glaucoma. Patients with pigmentary glaucoma may be distinguished from those with other glaucoma types by the presence of typical symptoms, personality type, and patterns of diurnal intraocular pressure fluctuation. Although laser iridotomy has been shown to alter iris anatomy in pigmentary glaucoma, it is not proven to slow visual field progression. Multiple trials have validated the safety and efficacy of filtering surgery in treating pigmentary glaucoma, with fewer studies published on the role of micro-invasive glaucoma surgery. Literature from the review period has further defined the unique clinical characteristics of pigment dispersion syndrome and pigmentary glaucoma. Laser surgery has a limited role in the management of these entities, whereas trabeculectomy remains an acceptable first-line surgical treatment. Further studies are needed to define the potential application of the newer micro-invasive glaucoma procedures in pigmentary glaucoma.

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.

Glaucoma

Medline Plus

Full Text Available ... Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino ... To search for current job openings visit HHS USAJobs Home » NEI YouTube ...

Scanning the macula for detecting glaucoma

Directory of Open Access Journals (Sweden)

Viquar U Begum

2014-01-01

Full Text Available Background: With the advent of spectral domain optical coherence tomography (SDOCT, there has been a renewed interest in macular region for detection of glaucoma. However, most macular SDOCT parameters currently are thickness parameters which evaluate thinning of the macular layers but do not quantify the extent of area over which the thinning has occurred. We therefore calculated a new macular parameter, "ganglion cell complex surface abnormality ratio (GCC SAR" that represented the surface area over which the macular thickness was decreased. Purpose: To evaluate the ability of SAR in detecting perimetric and preperimetric glaucoma. Design: Retrospective image analysis. Materials and Methods: 68 eyes with perimetric glaucoma, 62 eyes with preperimetric glaucoma and 165 control eyes underwent GCC imaging with SDOCT. SAR was calculated as the ratio of the abnormal to total area on the GCC significance map. Statistical Analysis: Diagnostic ability of SAR in glaucoma was compared against that of the standard parameters generated by the SDOCT software using area under receiver operating characteristic curves (AUC and sensitivities at fixed specificities. Results: AUC of SAR (0.91 was statistically significantly better than that of GCC average thickness (0.86, P = 0.001 and GCC global loss volume (GLV; 0.88, P = 0.01 in differentiating perimetric glaucoma from control eyes. In differentiating preperimetric glaucoma from control eyes, AUC of SAR (0.72 was comparable to that of GCC average thickness (0.70, P > 0.05 and GLV (0.72, P > 0.05. Sensitivities at specificities of 80% and 95% of SAR were comparable (P > 0.05 for all comparisons to that of GCC average thickness and GLV in diagnosing perimetric and preperimetric glaucoma. Conclusion: GCC SAR had a better ability to diagnose perimetric glaucoma compared to the SDOCT software provided global GCC parameters. However, in diagnosing preperimetric glaucoma, the ability of SAR was similar to that of

Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy

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Zhi-Qin Wu

2016-07-01

Full Text Available AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy. METHODS: Thirty-six patients(36 eyeswith prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure(IOP, best corrected visual acuity(BCVAand complications were ovserved and all the patients were followed up at least for 12mo. RESULTS: Mean preoperative IOP was 35.20±7.28mmHg and reduced to 10.15±3.34, 11.23±3.56, 15.63±5.72, 17.17±5.47, 17.73±6.23,19.76±5.43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level(t=12.643, 11.837, 10.324, 8.839, 8.462, 8.046, all PZ=-0.420, P>0.05. At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient. CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

Nanotechnology and glaucoma: a review of the potential implications of glaucoma nanomedicine.

Science.gov (United States)

Kim, Nathaniel J; Harris, Alon; Gerber, Austin; Tobe, Leslie Abrams; Amireskandari, Annahita; Huck, Andrew; Siesky, Brent

2014-04-01

The purpose of this review is to discuss the evolution of nanotechnology and its potential diagnostic and therapeutic applications in the field of ophthalmology, particularly as it pertains to glaucoma. We reviewed literature using MEDLINE and PubMed databases with the following search terms: glaucoma, nanotechnology, nanomedicine, nanoparticles, ophthalmology and liposomes. We also reviewed pertinent references from articles found in this search. A brief history of nanotechnology and nanomedicine will be covered, followed by a discussion of the advantages and concerns of using this technology in the field of glaucoma. We will look at various studies concerning the development of nanomedicine, its potential applications in ocular drug delivery, diagnostic and imaging modalities and, surgical techniques. In particular, the challenges of assuring safety and efficacy of nanomedicine will be examined. We conclude that nanotechnology offers a novel approach to expanding diagnostic, imaging and surgical modalities in glaucoma and may contribute to the knowledge of disease pathogenesis at a molecular level. However, more research is needed to better elucidate the mechanism of cellular entry, the potential for nanoparticle cytotoxicity and the assurance of clinical efficacy.

Glaucoma evolution in patients with diabetes.

Science.gov (United States)

Apreutesei, Nicoleta Anton; Chiselita, D; Motas, O I

2014-01-01

Glaucoma and diabetes are two chronic diseases with a long suspected pathogenic relationship. Screening for glaucoma in patients with diabetes. A retrospective study on 92 eyes from 46 patients with primitive open angle glaucoma (POAG) (normal and hypertensive) and intraocular hypertension (OHT) receiving medication and/or surgery associated with diabetes mellitus (DM) (type I, type II, mixed) is presented. Participants were divided into two groups as following: 16 eyes with glaucoma and diabetic retinopathy changes (group 1) and 76 eyes with glaucoma and without diabetic retinopathy changes (group 2). The following parameters were analysed: ocular pressure (Goldmann aplanotonometry), perimeter development (computerized perimetry) and fundus condition (absence, presence or progression of diabetic retinopathy). In patients with glaucoma and diabetic retinopathy (8 patients) we found a mean difference between treated intraocular pressure (IOP) and IOP last untreated control of 4.95 mmHg; a depreciation of the MD by 4.18 dB and an average number of glaucoma medications used of 0.889 +/- 1.054. Predominant changes in proliferative diabetic retinopathy were mild. In patients with glaucoma in the absence of diabetic retinopathy, the average difference between untreated IOP and IOP under treatment at the last check-up was 1.63 mmHg, the MD depreciation was by 0.65 dB and the average number of glaucoma medications used was 0.795 +/- 0.978. No statistically significant differences in terms of initial and final pressure were found. No statistically significant differences in the evolution of changes in perimeter between the two groups were observed. The presence of non-proliferating diabetic retinopathy influenced (only marginally statistically) the glaucomatous disease progression. Large comparative prospective studies are needed for the long-term follow up.

Glaucoma in patients with uveitis.

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Panek, W C; Holland, G N; Lee, D A; Christensen, R E

1990-01-01

The records of 100 patients (161 eyes) with uveitis were reviewed retrospectively to determine the prevalence of increased intraocular pressure, the forms of uveitis most commonly associated with glaucoma, and the forms that require specific glaucoma therapy. Secondary glaucoma was present in 23 patients (31 eyes): three of 24 patients with acute uveitis (three eyes, 12% of acute uveitis patients) and 20 of 76 patients with chronic uveitis (28 eyes, 26% of chronic uveitis patients). Eighteen ...

Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

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... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing Ahmed glaucoma valve implantation: 2-year follow-up.

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Arcieri, Enyr S; Paula, Jayter S; Jorge, Rodrigo; Barella, Kleyton A; Arcieri, Rafael S; Secches, Danilo J; Costa, Vital P

2015-02-01

To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation. This was a multicentre, prospective, randomized clinical trial that enrolled 40 patients with uncontrolled neovascular glaucoma that had undergone panretinal photocoagulation and required glaucoma drainage device implantation. Patients were randomized to receive IVB (1.25 mg) or not during Ahmed valve implant surgery. Injections were administered intra-operatively, and 4 and 8 weeks after surgery. After a mean follow-up of 2.25 ± 0.67 years (range 1.5-3 years), both groups showed a significant decrease in IOP (p glaucoma undergoing Ahmed glaucoma valve implantation. There is a trend to slightly lower IOPs and number of medications with IVB use during AGV implantation for neovascular glaucoma. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Childhood glaucoma surgery in the 21st Century

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Papadopoulos, M; Edmunds, B; Fenerty, C; Khaw, P T

2014-01-01

Most children with glaucoma will require surgery in their lifetime, often in their childhood years. The surgical management of childhood glaucoma is however challenging, largely because of its greater potential for failure and complications as compared with surgery in adults. The available surgical repertoire for childhood glaucoma has remained relatively unchanged for many years with most progress owing to modifications to existing surgery. Although the surgical approach to childhood glaucoma varies around the world, angle surgery remains the preferred initial surgery for primary congenital glaucoma and a major advance has been the concept of incising the whole of the angle (circumferential trabeculotomy). Simple modifications to the trabeculectomy technique have been shown to considerably minimise complications. Glaucoma drainage devices maintain a vital role for certain types of glaucoma including those refractory to other surgery. Cyclodestruction continues to have a role mainly for patients following failed drainage/filtering surgery. Although the prognosis for childhood glaucoma has improved significantly since the introduction of angle surgery, there is still considerable progress to be made to ensure a sighted lifetime for children with glaucoma all over the world. Collaborative approaches to researching and delivering this care are required, and this paper highlights the need for more high-quality prospective surgical trials in the management of the childhood glaucoma. PMID:24924446

The East London glaucoma prediction score: web-based validation of glaucoma risk screening tool

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Stephen, Cook; Benjamin, Longo-Mbenza

2013-01-01

AIM It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHOD The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described: Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed: Sensitivity = 88%; Positive predictive value = 97%; Specificity = 75%. CONCLUSION Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables. PMID:23550097

GLAUCOMA IN PSEUDOEXFOLIATION- CLINICAL PROSPECTIVE STUDY

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Balasubramanian M. Manickavelu

2018-01-01

Full Text Available BACKGROUND Pseudoexfoliation is one of the common cause of secondary open-angle glaucoma worldwide with a mean progression rate higher than primary open-angle glaucoma. In India, prevalence rate of pseudoexfoliation is around 2% (Hiller et al. In South India, the prevalence rate is 6% in >40 years of age as per Krishnadas et al in 2003. The aim of the study is to study the demographic aspects of pseudoexfoliation, the frequency of glaucoma in patients with pseudoexfoliation syndrome and to assess the treatment response in pseudoexfoliation syndrome. MATERIALS AND METHODS The study was conducted among 96 patients with pseudoexfoliation who attended OP Department of Ophthalmology, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, from January 2017 to June 2017. Complete ocular examination with visual acuity, anterior segment examination, intraocular pressure, gonioscopy, fundus examination, central corneal thickness, visual field, ultrasound B scan and ultrasound biomicroscopy was done. RESULTS Incidence of glaucoma is more common in pseudoexfoliation and most of them have open angles. All patients with pseudoexfoliation should undergo complete glaucoma evaluation for early detection. Further ophthalmologist should focus on detection of pseudoexfoliation, since it is related to high risk of operative complication. CONCLUSION Incidence of glaucoma is more in pseudoexfoliation with most common bilateral presentation with open angles with recalcitrant intraocular pressure. Severity of optic nerve damage and with progression of field defects appeared to be more compared to primary open-angle glaucoma. Better response to combination drug therapy and surgical therapy than primary open-angle glaucoma.

Cannabinoids and their possible use in the treatment of glaucoma

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Zozaya Aldana, Beatriz; Medina Rodríguez, Isabel; Tamayo Pineda, Nirma

2011-01-01

Aunque la planta Cannabis sativa ha sido empleada desde la más remota antigüedad con fines medicinales, uno de sus derivados, la marihuana, se ha convertido en la droga de uso ilegal más consumida en el mundo. Asimismo tanto el Cannabis como sus cannabinoides se emplean como terapéutico en pocas enfermedades generalmente neurológicas. Se realizó una revisión bibliográfica para exponer el posible uso de los cannabinoides en la terapéutica del glaucoma. Para ello se tuvo en cuenta la literatura...

Determinants of glaucoma awareness and knowledge in urban Chennai

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Sathyamangalam Ramesh

2009-01-01

Full Text Available Aim: To assess the awareness and knowledge levels about glaucoma and its determinants in an urban population of Chennai in south India. Materials and Methods: Chennai glaucoma study (CGS was a population based prevalence study to estimate the prevalence of glaucoma in a rural and urban south Indian population. A total of 3850 subjects aged 40 years or above participated in the urban arm of CGS. A systematic random sample of 1926 (50.0% subjects completed a questionnaire that assesses their awareness and knowledge level of glaucoma. Respondents "having heard of glaucoma" even before they were contacted/recruited for the study were defined as "aware" and respondents having some understanding of the eye disease were defined as "knowledgeable". Results: Overall 13.5% were aware of glaucoma, the age-gender adjusted rate for awareness was 13.3% (95% CI: 11.57 to 15.03. Two clinicians graded knowledge on glaucoma, based on the subject′s knowledge of risk factors, definitions and treatment aspects of glaucoma. Overall 8.7% had some knowledge about glaucoma. Among those who had knowledge 0.5% had good knowledge about glaucoma, 4% had fair knowledge and 4.2% had poor knowledge. We observed a very good agreement between the clinicians in grading knowledge (k =0.92. Determinants of glaucoma awareness and knowledge were higher levels of education, females, age, religion and family history of glaucoma. Conclusion: Awareness and knowledge about glaucoma was very low among the urban population of Chennai. We have found that younger subjects and men were less aware of glaucoma. Subjects with lower levels of education were less aware and knew less about glaucoma than their counterparts. The study findings stress the need for health education for effective prevention of blindness due to glaucoma.

Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: A critically evaluated prospective clinical study

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Panda, Anita; Prakash, Vadivelu Jaya; Dada, Tanuj; Gupta, Anoop Kishore; Khokhar, Sudarshan; Vanathi, Murugesan

2011-01-01

Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV) in post-penetrating-keratoplasty glaucoma (PKPG). Materials and Methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP) >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7) implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up. PMID:21586837

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

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Andréia Peltier Urbano

2003-01-01

Full Text Available OBJETIVO: Avaliar a freqüência dos tipos de glaucoma no Setor de Glaucoma do Hospital das Clínicas da Universidade Estadual de Campinas. MÉTODOS: Estudo transversal de 329 pacientes atendidos no Setor de Glaucoma da Universidade Estadual de Campinas entre 1 de outubro e 20 de dezembro de 2000, com avaliação dos tipos de glaucoma e conduta terapêutica. RESULTADOS: De 329 pacientes atendidos no Ambulatório de Glaucoma, 132 foram encaminhados ao ambulatório por suspeita de glaucoma (40,1% e 197 como glaucoma diagnosticado (59,9%. Dos 132 suspeitos de glaucoma, 90 (68,2% foram confirmados como tendo glaucoma e 42 (31,8% encontram-se em acompanhamento. Dos 329 pacientes avaliados, 283 (86% tinham glaucoma, 42 (12,8% suspeita de glaucoma, 2 (0,6% diagnóstico de glaucoma excluído e 2 (0,6% hipertensão ocular. Dos 530 olhos glaucomatosos, havia 298 (56,2% glaucomas primários de ângulo aberto, 108 (20,4% glaucomas primários de ângulo estreito, 21 (4% glaucomas pós-facectomia, 19 (3,6% glaucomas congênitos e 16 (3% glaucomas de pressão normal. A conduta terapêutica adotada foi inicialmente clínica em todos os casos. Após seguimento médio de 10,5 meses, 89 (16,8% olhos necessitaram tratamento com laser: 72 (13,6% iridotomias, 7 (1,3% trabeculoplastias e 10 (1,9% panfotocoagulações. Cento e setenta e cinco olhos (33% foram submetidos a tratamento cirúrgico. CONCLUSÃO: O tipo mais freqüente de glaucoma observado foi o glaucoma primário de ângulo aberto, seguido por glaucoma primário de ângulo estreito. Glaucomas como o de pressão normal e o pseudo-exfoliativo foram pouco freqüentes na população estudada.PURPOSE: To evaluate the frequency of different types of glaucoma at the Hospital das Clínicas of Campinas State University. METHODS: Cross-sectional study of 329 patients followed at the Glaucoma Service of Campinas State University from October 1 to December 20, 2000. The frequency of each type of glaucoma and the

Polímeros espumados con base de polietileno y copolímero etileno acetato de vinilo: generalidades y estructura celular

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Almanza Montero, O. A.

2012-01-01

Se presenta una caracterización térmica por calorimetría difereriva de los términos griegos "poli" y "meros", que significan mucho y partes respectivamente. Un polímero es una sustancia compuesta de macromoléculas con largas secuencias de una o más especies de átomos o grupos de ellos, enlazados unos con otros por enlaces primarios, usualment covalentes. El énfasis sobre la palabra sustancia en esta definición, es para resaltar que aunque la palabra polímero y macro molécula son usadas indist...

New pharmacotherapy for the treatment of glaucoma.

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Schehlein, Emily M; Novack, Gary; Robin, Alan L

2017-12-01

Glaucoma is the second leading cause of blindness in the world and current pharmacotherapies for glaucoma have remained relatively unchanged (with the exception of fixed combinations of previously available medications) since the mid-1990s with the development of prostaglandin analogues. Now, with both new formulations and new classes of medications with novel mechanisms of action, the medical therapy of glaucoma may be heralding a new dawn in medical management. Areas covered: This review outlines new topical therapies for intraocular pressure (IOP) lowering treatment, in addition to new formulations, preservative-free options, and advances in glaucoma medical therapy delivery. We performed a comprehensive search for published studies for glaucoma medical therapy using the electronic database PubMed. A manual search for each therapy or delivery system was also performed. Expert commentary: These advances in glaucoma therapy have the potential to overcome many barriers to glaucoma's medical care, particularly in terms of adherence. However, both time and research are needed to prove the relative efficacy and safety of these new pharmacotherapies and products, helping us decide their role in the treatment of elevated intraocular pressure. We are hopeful that these new developments in therapy may bring more options for glaucoma medical therapy.

Cambios de la presión intraocular en pacientes con hipertensión arterial

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G. Tenorio-Guajardo

2014-07-01

Conclusiones: En este estudio se encontró correlación entre presión intraocular y la presión arterial diastólica, pero no se encontró correlación entre la sistólica. Es recomendable vigilar la presión intraocular en pacientes hipertensos, especialmente en aquellos con hipertensión diastólica persistente y con antecedentes familiares de glaucoma.

Combined Phacoemulsification and Ahmed Glaucoma Drainage Implant Surgery for Patients With Refractory Glaucoma and Cataract.

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Valenzuela, Felipe; Browne, Andrew; Srur, Miguel; Nieme, Carlos; Zanolli, Mario; López-Solís, Remigio; Traipe, Leonidas

2016-02-01

To examine the indications, safety, efficacy, and complications of combined phacoemulsification and Ahmed glaucoma drainage implant surgery. A retrospective case review of 35 eyes (31 patients) subjected to combined phacoemulsification and Ahmed glaucoma drainage implant surgery. Demographic characteristics of the study population, indications for combined surgery, and operative and postoperative complications were recorded. Visual acuity, intraocular pressure (IOP), and number of glaucoma medications were evaluated preoperatively and postoperatively. Complete success was defined as IOP ≤ 21 mm Hg without medication, qualified success if IOP ≤ 21 mm Hg with ≥ 1 medications, and failure if IOP>21 mm Hg or ≤ 5 mm Hg on ≥ 2 consecutive visits. Mean follow-up was 29.5 months (range, 6 to 87 mo). The most common indication for combined surgery was a history of prior failed trabeculectomy (60%). Postoperative visual acuity improved in 30 of 35 eyes (85%) (PAhmed glaucoma drainage implant surgery seems to be a safe and effective surgical option, providing good visual rehabilitation and control of IOP for patients with refractory glaucoma and cataract.

A case of WAGR syndrome in association with developmental glaucoma requiring bilateral Baerveldt glaucoma implants and subsequent tube repositioning

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Akagi T

2015-06-01

Full Text Available Tadamichi Akagi, Munemitsu Yoshikawa, Hideo Nakanishi, Nagahisa Yoshimura Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan Abstract: Glaucoma drainage device implantation is efficacious for the treatment of pediatric glaucoma patients when multiple angle surgeries fail. However, tube touching of the corneal endothelium is one of the major postoperative complications to deal with. A 15-month-old male patient with Wilms’ tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR syndrome was diagnosed with bilateral developmental glaucoma. He underwent Baerveldt glaucoma implant (BGI surgeries in both eyes after multiple failed trabeculotomies. The tube in his right eye was touching the cornea 15 months after BGI surgery. To avoid corneal endothelium damage, BGI tube repositioning with scleral fixation was performed without serious complications. The bilateral BGI surgeries achieved successful intraocular pressure reduction for over 2 years and tube repositioning with scleral fixation of BGI tube was successful for BGI tube malposition. Although careful attention to intraocular pressure and tube malposition is essential after glaucoma drainage device implantation, especially in pediatric cases, BGI surgery is effective in the management of developmental glaucoma following unsuccessful angle surgeries. Keywords: Baerveldt glaucoma implant, developmental glaucoma, WAGR syndrome, tube repositioning, glaucoma drainage device

New Tool to Predict Glaucoma

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... In This Section A New Tool to Predict Glaucoma email Send this article to a friend by ... Close Send Thanks for emailing that article! Tweet Glaucoma can be difficult to detect and diagnose. Measurement ...

Does Your Child Have Glaucoma?

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... 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 ...

Does Marijuana Help Treat Glaucoma?

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... time, reducing side vision. It sometimes leads to blindness. One cause of optic nerve damage in glaucoma ... high doses, can cause problems with short-term memory and concentration. As scientists learn more about glaucoma, ...

Propionibacterium acnes endophthalmitis in Ahmed glaucoma valve.

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Gutiérrez-Díaz, E; Montero-Rodríguez, M; Mencía-Gutiérrez, E; Fernández-González, M C; Pérez-Blázquez, E

2001-01-01

To report a case of Propionibacterium acnes endophthalmitis in a patient with an Ahmed glaucoma valve. A nine-year-old boy with bilateral congenital glaucoma, with an Ahmed glaucoma valve implanted in the left eye, had recurrent conjunctival dehiscence and endophthalmitis. Vitreous cultures demonstrated the presence of Propionibacterium acnes. This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.

Late-onset endophthalmitis secondary to exposed glaucoma tube implant in a rare case of paediatric glaucoma.

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Ranganath, Akshatha; Hashim, Adnan

2011-01-01

Glaucoma drainage implants (GDIs) are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP) control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae. The glaucoma tube was exposed due to erosion of the overlying conjunctiva with no visible pericardial graft. After control of active infection, he underwent tube revision surgery whereby the exposed tube was retained and repatched with a double-thickness pericardial patch graft. He did well following surgery with good control of IOP and restoration of vision. Conjunctival dehiscence with graft melting over the GDI tube presented a major risk factor for endophthalmitis. Prompt surgical revision of an exposed tube is highly recommended to avoid ocular morbidity.

Late-Onset Endophthalmitis Secondary to Exposed Glaucoma Tube Implant in a Rare Case of Paediatric Glaucoma

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Akshatha Ranganath

2011-01-01

Full Text Available Glaucoma drainage implants (GDIs are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae. The glaucoma tube was exposed due to erosion of the overlying conjunctiva with no visible pericardial graft. After control of active infection, he underwent tube revision surgery whereby the exposed tube was retained and repatched with a double-thickness pericardial patch graft. He did well following surgery with good control of IOP and restoration of vision. Conjunctival dehiscence with graft melting over the GDI tube presented a major risk factor for endophthalmitis. Prompt surgical revision of an exposed tube is highly recommended to avoid ocular morbidity.

Glaucoma

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Full Text Available ... Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity ...

Resource Planning in Glaucoma: A Tool to Evaluate Glaucoma Service Capacity.

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Batra, Ruchika; Sharma, Hannah E; Elaraoud, Ibrahim; Mohamed, Shabbir

2017-12-28

The National Patient Safety Agency (2009) publication advising timely follow-up of patients with established glaucoma followed several reported instances of visual loss due to postponed appointments and patients lost to follow-up. The Royal College of Ophthalmologists Quality Standards Development Group stated that all hospital appointments should occur within 15% of the intended follow-up period. To determine whether: 1. Glaucoma follow-up appointments at a teaching hospital occur within the requested time 2. Appointments are requested at appropriate intervals based on the NICE Guidelines 3. The capacity of the glaucoma service is adequate Methods: A two-part audit was undertaken of 98 and 99 consecutive patients respectively attending specialist glaucoma clinics. In the first part, the reasons for delayed appointments were recorded. In the second part the requested follow-up was compared with NICE guidelines where applicable. Based on the findings, changes were implemented and a re-audit of 100 patients was carried out. The initial audit found that although clinical decisions regarding follow-up intervals were 100% compliant with NICE guidelines where applicable, 24% of appointments were delayed beyond 15% of the requested period, due to administrative errors and inadequate capacity, leading to significant clinical deterioration in two patients. Following the introduction of an electronic appointment tracker and increased clinical capacity created by extra clinics and clinicians, the re-audit found a marked decrease in the percentage of appointments being delayed (9%). This audit is a useful tool to evaluate glaucoma service provision, assist in resource planning for the service and bring about change in a non-confrontational way. It can be widely applied and adapted for use in other medical specialities.

Rentabilidad diagnóstica de la perimetría pulsar y la polarimetría láser en pacientes hipertensos oculares con perimetría blanco-blanco (TOP G1) normal

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Besil Rodríguez, María Milagros

2016-01-01

El glaucoma es una enfermedad neurodegenerativa, un grupo de trastornos crónicos y progresivos, con una base causal multifactorial y compleja. Es un espectro, cuyo “continumm” depende del estadio en que se le identifique. Es la segunda causa de ceguera legal en el mundo y la primera de ceguera irreversible con una alta prevalencia global. En el paciente con hipertensión ocular (HTO), como sospechoso de glaucoma, el reto para el oftalmólogo es mayor y conocer la magnitud de la existencia de fa...

Tratamiento con estatinas en pacientes pediátricos con síndrome nefrótico resistente a esteroides. Reporte de dos casos

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C Sánchez-García

2017-01-01

Full Text Available El síndrome nefrótico se define por la asociación de proteinuria, hipoalbuminemia, hiperlipidemia y edema. El 80% de los pacientes pediátricos con síndrome nefrótico primario responde a la terapia con esteroides; el 20% restante requiere asociar otros medicamentos para alcanzar la remisión (ciclofosfamida, ciclosporina. La hiperlipidemia en el síndrome nefrótico es debida tanto a un incremento en la síntesis acompañada de disminución en la eliminación de los lípidos de la sangre; siendo la causa directa de esto la proteinuria. La hiperlipidemia incrementa el riesgo cardiovascular, así como el daño glomerular. Con base en esto, la hiperlipidemia persistente en el síndrome nefrótico resistente a esteroides debe ser tratada. Los inhibidores de la 3-hidroxi-3-metilglutaril-coenzima A (HMG-CoA reductasa han demostrado efecto antiinflamatorio, inmunomodulador y antiproliferativo. Por ello el papel de las estatinas en el síndrome nefrótico va más allá de su efecto hipolipemiante. Presentamos dos casos de pacientes pediátricos con diagnóstico de síndrome nefrótico resistente a esteroides y su evolución durante el tratamiento con ciclosporina y estatinas.

Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma

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Dewang Angmo

2015-01-01

Full Text Available ExPress glaucoma filtration device (GFD has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications was achieved in eight cases (66.7% and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications in two cases (16.7% at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37. ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma′s, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.

Evaluation of Ocular Surface Disease in Patients with Glaucoma

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Mathews, Priya M.; Ramulu, Pradeep Y.; Friedman, David S.; Utine, Canan A.; Akpek, Esen K.

2013-01-01

Purpose To evaluate the subjective and objective measures of ocular surface disease in patients with glaucoma. Design Cross-sectional study. Participants Sixty-four glaucoma subjects with bilateral visual field (VF) loss and 59 glaucoma suspects with normal VFs. Methods Consecutive patients were recruited prospectively from the Wilmer Eye Institute Glaucoma Clinic. Main Outcome Measures Tear film breakup time (TBUT), corneal staining score (0–15), and Schirmer’s test results were included as objective metrics, whereas the Ocular Surface Disease Index (OSDI) questionnaire was administered to assess symptoms. Total OSDI score, vision-related subscore (derived from questions about vision and task performance), and discomfort-related subscore (derived from questions about ocular surface discomfort) were calculated for each subject. Results Seventy-five percent (48/64) of glaucoma subjects and 41% (24/59) of glaucoma suspects were receiving topical medications. The corneal staining grade was greater in glaucoma subjects than in glaucoma suspects (6.4 vs. 4.1; P0.20 for both). Multivariate regression models showed that topical glaucoma therapy burden was associated with a significantly higher total corneal staining grade (β, +0.9 for each additional glaucoma drop; 95% confidence interval [CI], 0.5–1.3; P0.20 for both). Glaucoma subjects had significantly higher total OSDI scores than glaucoma suspects (16.7 vs. 7.9; Pglaucoma group (11.1 vs. 3.3; Pglaucoma therapy burden was not associated with higher total OSDI score or vision- or discomfort-related subscore (P>0.20 for all). Conclusions Glaucoma is associated with significant ocular surface disease, and topical glaucoma therapy burden seems predictive of corneal staining severity. However, OSDI is a poor metric for capturing ocular surface disease in glaucoma because symptoms seem to be related largely to VF loss. PMID:23714318

Driving patterns in older adults with glaucoma.

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van Landingham, Suzanne W; Hochberg, Chad; Massof, Robert W; Chan, Emilie; Friedman, David S; Ramulu, Pradeep Y

2013-02-21

The ability to drive is important for ensuring quality of life for many older adults. Glaucoma is prevalent in this age group and may affect driving. The purpose of this study is to determine if glaucoma and glaucomatous visual field (VF) loss are associated with driving cessation, limitations, and deference to another driver in older adults. Cross-sectional study. Eighty-one glaucoma subjects and 58 glaucoma suspect controls between age 60 and 80 reported if they had ceased driving, limited their driving in various ways, or preferred another to drive. Twenty-three percent of glaucoma subjects and 6.9% of suspects had ceased driving (p = 0.01). Glaucoma subjects also had more driving limitations than suspects (2.0 vs. 1.1, p = 0.007). In multivariable models, driving cessation was more likely for glaucoma subjects as compared to suspects (OR = 4.0; 95% CI = 1.1-14.7; p = 0.03). The odds of driving cessation doubled with each 5 decibel (dB) decrement in the better-eye VF mean deviation (MD) (OR = 2.0; 95% CI = 1.4-2.9; p driving limitations (OR = 4.7; 95% CI = 1.3-16.8; p = 0.02). The likelihood of reporting more limitations increased with the VF loss severity (OR = 1.6 per 5 dB decrement in the better-eye VF MD; 95% CI = 1.1-2.4; p = 0.02). Neither glaucoma nor VF MD was associated with other driver preference (p > 0.1 for both). Glaucoma and glaucomatous VF loss are associated with greater likelihood of driving cessation and greater limitation of driving in the elderly. Further prospective study is merited to assess when and why people with glaucoma change their driving habits, and to determine if their observed self-regulation of driving is adequate to ensure safety.

Stage of visual field loss and age at diagnosis in 1988 patients with different glaucomas: implications for glaucoma screening and driving ability.

Science.gov (United States)

Gramer, Gwendolyn; Gramer, Eugen

2018-04-01

To compare stage of visual field loss (VFL) and age at diagnosis between patients with different types of glaucoma with regard to glaucoma screening and driving ability. In a cross-sectional study of 1988 consecutive patients with different types of glaucoma VFL at diagnosis and age at diagnosis were assessed. Patients with binocular advanced or severe VFL were classified unable, patients with no VFL in one eye and VFL I-V (Aulhorn classification) in the other eye able, all other constellations questionably able to drive. There were significant differences in age at diagnosis between different glaucomas and between patients with different stages of VFL at diagnosis. Age-related assessment of VFL at diagnosis in normal tension glaucoma (NTG) compared to primary open-angle glaucoma (POAG) showed that NTG is not a disease of the elderly but a disease with late diagnosis at severe VFL. In POAG a solely age-related glaucoma screening, e.g. from the age of 50 years, does not sufficiently lead to diagnosis at an early stage of the disease. In POAG solely based on binocular VFL 11.5% of patients were judged unable, 29.2% questionably able to drive, in NTG 19.6%/43.1%, pigmentary glaucoma 16%/22%, pseudoexfoliation glaucoma 9.1%/16.7%, and in primary angle-closure glaucoma 14.6%/30%. Depending on type of glaucoma more than 50% of patients require counselling regarding safe driving as part of clinical care. A disease-specific, age-related perimetric examination considering additional risk factors like family history of glaucoma is essential for early detection of glaucoma and road safety.

Glaucoma Drainage Device Erosion Following Ptosis Surgery.

Science.gov (United States)

Bae, Steven S; Campbell, Robert J

2017-09-01

To highlight the potential risk of glaucoma drainage device erosion following ptosis surgery. Case report. A 71-year-old man underwent uncomplicated superotemporal Ahmed glaucoma valve implantation in the left eye in 2008. Approximately 8 years later, the patient underwent bilateral ptosis repair, which successfully raised the upper eyelid position. Three months postoperatively, the patient's glaucoma drainage implant tube eroded through the corneal graft tissue and overlying conjunctiva to become exposed. A graft revision surgery was successfully performed with no further complications. Caution and conservative lid elevation may be warranted when performing ptosis repair in patients with a glaucoma drainage implant, and patients with a glaucoma implant undergoing ptosis surgery should be followed closely for signs of tube erosion.

Monitoring dynamics of aqueous humor in glaucoma

International Nuclear Information System (INIS)

Vyborny, P.; Hornova, J.

1985-01-01

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

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

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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

Determinants of glaucoma awareness in urban punjab

International Nuclear Information System (INIS)

Farooq, S.; Jaffar, S.; Kausar, A.

2015-01-01

To assess the awareness about glaucoma and the factors affecting it in urban Punjab population. Study Design: Cross-sectional study. Place and Duration of Study: Study was conducted in March-April 2011 in Rawalpindi District Punjab, Pakistan. Material and Methods: Glaucoma awareness study was conducted on urban population of Rawalpindi, Islamabad, Lahore and Taxila. Individuals belonging to medical profession (doctors, nurses and paramedics etc) were not included. Demographic details and educational status of all participants were documented. A brief structured close-ended study questionnaire was used to collect information about their awareness of risk factors, treatment aspects and complication of glaucoma. Results: There were 729 participants in the study. Majority were females (60.1%) and adults (76.1%). Literacy level of 40.2% was up to matriculate level. The study indicated that the awareness level about glaucoma was low especially about the recognition of high-risk groups and symptoms. Only one-third of respondents i.e. 32.6% had an idea about the symptoms of the disease and 27.4% participants had awareness of glaucoma as a blinding eye disease. Determinants of glaucoma awareness amongst study participants were gender, age, education level and occupation. Conclusion: Awareness of glaucoma was quite low among the urban population in Punjab. There is need of increased public health education to reduce glaucoma associated blindness and its burden on society. (author)

Asociación entre manifestaciones respiratorias atópicas y contaminantes primarios de la atmósfera

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Roberto Álvarez Sintes

1997-06-01

Full Text Available Se realizó un estudio prospectivo en 94 pacientes asmáticos atendidos en el consultorio del médico de la familia No. 43 perteneciente al Policlínico Docente "Antonio Maceo" del municipio Cerro de Ciudad de La Habana. Durante un año (12 meses consecutivos relacionamos las eventualidades diarias de su estado de salud con los siguientes contaminantes primarios de la atmósfera: dióxido de nitrógeno, dióxido de azufre y hollín. Las muestras fueron analizadas en el Laboratorio de Higiene del Aire del Instituto Nacional de Higiene y Epidemiología del Ministerio de Salud Pública de Cuba. El análisis estadístico se realizó utilizando el entrecruzamiento de variables, regresión múltiple, el método de paso a paso del paquete estadístico SPSS/PC Plus. Se realizó la matriz de correlación lineal paramétrica. Se obtuvo una correlación directa significativa entre la coriza, la tos, las crisis de asma y los contaminantes primarios de la atmósfera.A prospective study of 94 asthmatic patients receiving attention at the family physician's office No. 43 from the "Antonio Maceo" Teaching Polyclinic in Cerro municipality, Havana City, was conducted. During a year (12 months in a row we related their daily health status to the following primary air pollutants: nitrogen dioxide, sulphur dioxide, and soot. The samples were analyzed at the Air Hygiene Laboratory of the National Institute of Hygiene and Epidemiology, Ministry of Public Health. The statistical analysis was made by using the intercrossing of variables, the multiple regression, and the step by step method of the SPSS/PC Plus statistical package. The parametric lineal correlation matrix was also calculated. There was a significant direct correlation among coryza, cough, asthma crises, and the primary air pollutants.

Tumores primarios de la pared torácica Primary tumors of the thorax wall

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Bárbaro Agustín Armas Pérez

2011-09-01

Full Text Available Introducción: se revisan aspectos teóricos en los tumores primarios de la pared torácica, sobre todo en la clasificación y en aspectos clínicos, diagnósticos y terapéuticos, con el propósito de conocer los resultados del tratamiento en el centro. Métodos: se realizó un estudio retrospectivo descriptivo para analizar los resultados del tratamiento quirúrgico en 22 pacientes (muestra con tumores primarios de la pared torácica, en un período de 15 años (enero de 1993 a diciembre de 2008, en los servicios de cirugía general y ortopedia del Hospital "Amalia Simoni" de Camagüey. Resultados: hubo ligero predominio del sexo femenino y del grupo de edad entre 17 a 44 años (media 39,4, la comorbilidad que predominó fue la hipertensión arterial, el hemitórax derecho fue el más afectado, y las costillas de la 1 a la 4 las más lesionadas, y predominaron las afecciones benignas, entre ellas, el osteocondroma. El tratamiento más utilizado fue la resección quirúrgica, y la complicación posoperatoria que predominó fue la bronconeumonía. El índice de recidiva tumoral fue alto, no siempre por cáncer. Hubo 4 fallecidos por enfermedad maligna avanzada, y no se presentaron muertes perioperatorias. Conclusiones: fueron comparados los resultados con los de otros reportes y se hallaron puntos de coincidencia en diversos aspectos, pero también discrepantes, se trata de unificar criterios para mejorar el diagnóstico y los resultados del tratamiento en estos enfermos. La mayoría de los pacientes no presentaron complicaciones, y la recidiva tumoral estuvo por encima de lo esperado. La resección tumoral siempre debe ser amplia. El resultado global fue satisfactorio.Introduction: the theoretical features in the primary tumors of the thorax wall, especially in the classification and clinical, diagnostic y therapeutical features were reviewed to know the results of treatment in our institution. Methods: a descriptive and retrospective study was

Evaluation of a glaucoma patient

Science.gov (United States)

Thomas, Ravi; Loibl, Klaus; Parikh, Rajul

2011-01-01

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. PMID:21150033

Management of Blood Pressure in Patients with Glaucoma.

Science.gov (United States)

Levine, Russell M; Yang, Alina; Brahma, Venkatesh; Martone, James F

2017-09-19

Ocular perfusion pressure (OPP) is defined as the difference between BP and intraocular pressure (IOP). With low BP comes low OPP and resultant ischemic damage to the optic nerve, leading to glaucoma progression. The purpose of this article is to review the literature on BP as it relates to glaucoma and to create a forum of discussion between ophthalmologists and internal medicine specialists. Both high and low BP has been linked glaucoma. Low BP is particularly associated with glaucoma progression in normal-tension glaucoma (NTG) patients. Patients who have low nighttime BP readings are at highest risk of progression of their glaucoma. Internal medicine specialists and ophthalmologists should consider the relationship between BP and glaucoma when treating patients with concomitant disease. Too-low nighttime BP should be avoided. Ambulatory blood pressure monitoring is a useful tool to identify patients at greatest risk for progression.

Linfoma no Hodgkin primario de mama, revisión de la literatura y presentación de un caso

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Caridad Verdecia Cañizares

2011-06-01

Full Text Available El linfoma no Hodgkin primario de la mama es una entidad poco frecuente en pediatría y representa el 0,4 al 0,5 % de todos los tumores mamarios malignos. Debido a que carecen de características propias, tanto clínicas, citológicas como ecográficas, resulta muy difícil establecer el diagnóstico preoperatorio. Se presenta el caso de un linfoma no Hodgkin primario de la mama en una paciente de 3 años que llegó en estadio avanzado de la enfermedad, y se subraya la importancia del tratamiento en un equipo multidisciplinario.

Ahmed glaucoma valve implant: surgical technique and complications

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Riva I

2017-02-01

Full Text Available Ivano Riva,1 Gloria Roberti,1 Francesco Oddone,1 Anastasios GP Konstas,2 Luciano Quaranta3 1IRCCS “Fondazione GB Bietti per l’Oftalmologia”, Rome, Italy; 21st University Department of Ophthalmology, Glaucoma Unit, AHEPA Hospital, Thessaloniki, Greece; 3Department of Medical and Surgical Specialties, Section of Ophthalmology, University of Brescia, Brescia, Italy Abstract: Implantation of Ahmed glaucoma valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed glaucoma valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the valve mechanism embedded in the Ahmed glaucoma valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed glaucoma valve implantation and to report related complications. Keywords: glaucoma, surgical technique, glaucoma drainage devices, Ahmed glaucoma valve, complications

Goniodysgenesis in familial primary open-angle glaucoma

NARCIS (Netherlands)

Verbraak, F. D.; vd Berg, W.; Delleman, J. W.; Greve, E. L.

1994-01-01

Results of a pilot study to evaluate goniodysgenesis as a cause of familial open-angle glaucoma are reported. Patients with a familial high tension open-angle glaucoma and a goniodysgenetic chamber angle (n = 11), a number of their relatives with glaucoma (n = 12), and their relatives without

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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 ...

Análisis proteómico de cultivos primarios de tiroides

OpenAIRE

Echeverry, Nancy; Ortíz, Blanca Laura; Caminos, Jorge

2011-01-01

En el presente estudio se identificaron proteínas de expresión constitutiva, como vimentina, actina, tubulina, proteína de choque térmico de 60 kDa, peroxirredoxina y la ATP sintasa mitocondrial, en cultivos primarios de tiroides normales y de carcinoma papilar de tiroides. Se establecieron las condiciones de extracción, solubilización, análisis cuantitativo y cualitativo de dichas proteínas, y se buscaron las mejores condiciones de isoelectroenfoque (IEF) en ...

Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

Science.gov (United States)

Wright, Heathcote R; Diamond, Jeremy P

2015-03-01

To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Análisis económico del eslabón primario de la cadena ganadera argentina

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Marianela De Batista

2013-12-01

Full Text Available Los cambios en el contexto nacional e internacional evidencian la necesidad de reconvertir el negocio de la ganadería bovina, una de las principales actividades de la economía argentina. En este sentido, el presente trabajo presenta un análisis económico del eslabón primario de la cadena ganadera, desde una óptica sistémica y multidisciplinaria. La metodología se inicia con un estudio de la zona bajo análisis de modo de caracterizar los sistemas productivos. Sobre la base del estudio de la relación costo-volumen-utilidad se determina la estructura de costos e ingresos, considerando: sistema productivo; tamaño del establecimiento; parámetros técnico-productivos y canal de venta. Los resultados, demuestran que a pesar de la importancia de la ganadería en la economía nacional, esta no es capaz de generar un aporte positivo a los resultados económicos de las explotaciones. Generándose el desafío de construir ventajas competitivas sostenibles, basadas en el incremento de la productividad y el desarrollo de una estructura de costos eficiente.

Scanning laser polarimetry in glaucoma.

Science.gov (United States)

Dada, Tanuj; Sharma, Reetika; Angmo, Dewang; Sinha, Gautam; Bhartiya, Shibal; Mishra, Sanjay K; Panda, Anita; Sihota, Ramanjit

2014-11-01

Glaucoma is an acquired progressive optic neuropathy which is characterized by changes in the optic nerve head and retinal nerve fiber layer (RNFL). White-on-white perimetry is the gold standard for the diagnosis of glaucoma. However, it can detect defects in the visual field only after the loss of as many as 40% of the ganglion cells. Hence, the measurement of RNFL thickness has come up. Optical coherence tomography and scanning laser polarimetry (SLP) are the techniques that utilize the evaluation of RNFL for the evaluation of glaucoma. SLP provides RNFL thickness measurements based upon the birefringence of the retinal ganglion cell axons. We have reviewed the published literature on the use of SLP in glaucoma. This review elucidates the technological principles, recent developments and the role of SLP in the diagnosis and monitoring of glaucomatous optic neuropathy, in the light of scientific evidence so far.

Nivel de consumo diario de frutas y verduras en escolares con sobrepeso y obesidad del primer y segundo grado de primaria de la Institución Educativa Particular San Andrés. Lima. Mayo 2011

OpenAIRE

Alfaro, katherine

2013-01-01

Objetivos: Determinar el nivel de consumo diario de frutas y verduras en escolares con sobrepeso y obesidad de primer y segundo grado de nivel primario de la IEP San Andrés. Diseño: Estudio descriptivo, transversal, observacional y prospectivo. Institución: Institución Educativa Particular San Andrés. Participantes: Veintisiete escolares con sobrepeso y 33 con obesidad, de primer y segundo grado de nivel primaria. Intervenciones: Aplicación de formato de frecuencia de consumo de frutas y verd...

Potential applications of optical coherence tomography angiography in glaucoma.

Science.gov (United States)

Dastiridou, Anna; Chopra, Vikas

2018-05-01

Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging modality that allows assessment of the retinal and choroidal vasculature. The scope of this review is to summarize recent studies using OCTA in glaucoma and highlight potential applications of this new technology in the field of glaucoma. OCTA studies have shown that retinal vascular changes may not develop solely as a result of advanced glaucoma damage. OCTA-derived measurements have provided evidence for lower retinal vascular densities at the optic nerve head, peripapillary and macula in preperimetric-glaucoma and early-glaucoma, as well as, in more advanced glaucoma, in comparison to with normal eyes. OCTA is a novel imaging modality that has already started to expand our knowledge base regarding the role of ocular blood flow in glaucoma. Future studies will better elucidate the role of OCTA-derived measurements in clinical practice, research, and clinical trials in glaucoma.

Cultivos primarios de células endoteliales aisladas de cordón umbilical humano: un modelo biológico para el estudio de los mecanismos de infección por enterococos.

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Carlos Andrés Chiriboga

2004-12-01

Full Text Available Aunque las especies de enterococos son flora normal del tracto gastrointestinal humano, se encuentran entre los tres agentes patógenos microbianos que más se asocian con infecciones intrahospitalarias. Tradicionalmente, los enterococos se han considerado bacterias extracelulares. Sin embargo, es creciente la información que reporta su ingreso a través de líneas celulares epiteliales o macrófagos. A pesar de que estos microorganismos constituyen el tercer grupo de aislamientos obtenido de pacientes con bacteriemia o endocarditis, su interacción con la célula endotelial no se ha descrito completamente. En el presente trabajo evaluamos si el aislamiento intrahospitalario de Enterococcus faecalis (Ef2880 podía penetrar en células endoteliales de la vena de cordón umbilical humano (HUVEC cultivadas in vitro. Nuestros resultados indican que los cultivos primarios HUVEC después de ser inoculados con Ef2890, incubados y tratados con antibióticos bactericidas para las bacterias extracelulares y adheridas a la cara externa de la membrana celular, exhiben bacterias intracelulares que pueden ser recuperadas vivas cuatro horas después de la inoculación. El modelo biológico desarrollado se puede constituir en una herramienta útil para el estudio de las interacciones que establecen los enterococos con el endotelio.

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Effects of polymorphisms in vitamin E-, vitamin C-, and glutathione peroxidase-related genes on serum biomarkers and associations with glaucoma

Science.gov (United States)

To study the association of selected polymorphism in genes related to vitamin E, vitamin C, and glutathione peroxidase with these biomarkers and primary open-angle glaucoma (POAG) risk. A case-control study matched for age, sex, and bodyweight was undertaken. Two hundred fifty POAG cases and 250 con...

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.

Comparison of axial lengths in occludable angle and angle-closure glaucoma-The Bhaktapur Glaucoma Study

NARCIS (Netherlands)

Thapa, S.S.; Paudyal, I.; Khanal, S.; Paudel, N.; van Rens, G.H.M.B.

2011-01-01

Purpose. To compare the anterior chamber depth (ACD) and axial length of eyes in a population-based sample among normal, occludable angle, and primary angle-closure glaucoma (PACG) groups. Methods. Totally, 3979 subjects from a population-based glaucoma prevalence study underwent complete ocular

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.

Profile of glaucoma in a major eye hospital in North India

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Das Jayachandra

2001-01-01

Full Text Available Purpose: To study the clinical profile and distribution of various subtypes of glaucoma in a referral practice in North India. Method: A retrospective analysis was done of 2425 patients who attended the glaucoma clinic in a tertiary eye-care centre for five years from Januaryl995 to December 1999. A detailed history was obtained and a thorough examination was performed, including gonioscopy, disc assessment, applanation tonometry and automated perimetry. Diurnal variation of IOP and provocative tests for glaucoma were done where applicable. Result: Primary angle closure glaucoma (PACG was the most common glaucoma subtype. The primary open angle glaucoma (POAG to the PACG ratio was 37:63. Chronic angle closure glaucoma (CACG was the most common PACG subtype. The majority of CACG cases were relatively asymptomatic. Male dominance was seen for POAG, juvenile open angle glaucoma (JOAG, CACG, normal tension glaucoma (NTG and secondary glaucomas. Female dominance was seen for ocular hypertension (OHT, acute or intermittent ACG and developmental glaucomas. The mean age in years at presentation was POAG: 60.54 years (males 61.54 years, females 59.01 years and PACG: 55.13 years (males 57.25 years, females 53.60. The three common secondary glaucomas were: glaucoma secondary to adherent leucoma, aphakic and pseudophakic glaucomas and traumatic glaucomas. Advanced glaucoma was detected in 42 to 53% of patients and bilateral blindness in 8 to 14% of patients in various subtypes. Conclusion: Compared to Caucasians, glaucoma patients in North India seem to present nearly a decade earlier and the disease is more advanced at presentation. While PACG is the most commonly encountered glaucoma, NTG and exfoliative glaucoma are relatively rare.

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Glaucoma

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... considerably, providing more precise visual assessment tests and biologic markers for the disease. NIH-sponsored research led to the development of prostaglandins, a new class of drugs that offers excellent IOP control with fewer side effects. The Early Manifest Glaucoma ...

Level of agreement among Latin American glaucoma subspecialists on the diagnosis and treatment of glaucoma: results of an online survey

OpenAIRE

Daniel E. Grigera; Paulo Augusto Arruda Mello; Wilma Lelis Barbosa; Javier Fernando Casiraghi; Rodolfo Perez Grossmann; Alejo Peyret

2013-01-01

PURPOSE: The aim of this research was to assess the level of agreement among glaucoma experts in Latin America on key practices related to treatment and diagnosis of glaucoma. METHODS: An online questionnaire was sent to a multinational panel of glaucoma experts. The questionnaire contained 107 statements on the medical treatment (Part 1) and diagnosis (Part 2) of glaucoma, and was developed in Spanish and translated into English. Agreement was defined as >70% of respondents. RESULTS: Fifty p...

Ocular hemodynamics and glaucoma: the role of mathematical modeling.

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Harris, Alon; Guidoboni, Giovanna; Arciero, Julia C; Amireskandari, Annahita; Tobe, Leslie A; Siesky, Brent A

2013-01-01

To discuss the role of mathematical modeling in studying ocular hemodynamics, with a focus on glaucoma. We reviewed recent literature on glaucoma, ocular blood flow, autoregulation, the optic nerve head, and the use of mathematical modeling in ocular circulation. Many studies suggest that alterations in ocular hemodynamics play a significant role in the development, progression, and incidence of glaucoma. Although there is currently a limited number of studies involving mathematical modeling of ocular blood flow, regulation, and diseases (such as glaucoma), preliminary modeling work shows the potential of mathematical models to elucidate the mechanisms that contribute most significantly to glaucoma progression. Mathematical modeling is a useful tool when used synergistically with clinical and laboratory data in the study of ocular blood flow and glaucoma. The development of models to investigate the relationship between ocular hemodynamic alterations and glaucoma progression will provide a unique and useful method for studying the pathophysiology of glaucoma.

Prevalence of glaucoma in a Nigerian hospital | Usifoh | Journal of ...

African Journals Online (AJOL)

Primary Open Angle Glaucoma (POAG) was the most common type of glaucoma (91.24%), followed by Normal Tension Glaucoma (NTG) with a prevalence of 3.23%. No significant association was found between age or sex and types of glaucoma. PACG and Juvenile glaucoma remains relatively rare accounting for only ...

Long-term Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma at Farabi Eye Hospital, Tehran, Iran.

Science.gov (United States)

Zarei, Reza; Amini, Heidar; Daneshvar, Ramin; Nabi, Fahimeh Naderi; Moghimi, Sasan; Fakhraee, Ghasem; Eslami, Yadollah; Mohammadi, Masoud; Amini, Nima

2016-01-01

To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran. This retrospective cohort study evaluated patient records of all subjects with refractory glaucoma who had undergone AGV implantation up to January 2013. The main outcome measure was the surgical success rate. Complete success was defined as intraocular pressure (IOP) glaucoma medications or additional surgery. Qualified success was IOP glaucoma medications. In all cases, loss of vision (no light perception) was considered an independent indicator of failure. Data were also collected on intraoperative and postoperative complications. Twenty-eight eyes were included in the study. With a mean follow-up of 48.2 ± 31.7 months (median: 40.50 months; range: 3-124 months), the IOP decreased from a mean preoperative value of 30.8 ± 5.6 mmHg to 20.0 ± 6.4 mmHg at last visit. The number of medications decreased from 3.7 ± 0.4 preoperatively to 2.5 ± 1.1 postoperatively. Cumulative qualified success was achieved in 69% of eyes. Mean time to failure according to qualified success criteria was 92.3 ± 9.4 months. Postoperative complications were recorded in 16 (57.1%) eyes. The most common complication was focal endothelial corneal decompensation at the site of tube-cornea touch. AGV implantation with adjunctive topical anti-glaucoma drops controlled IOP in approximately 70% of eyes with refractory glaucoma with a median of 40.5 months of follow-up. However, complication rates were higher.

Aqueous shunt implantation in glaucoma

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Jing Wang

2017-01-01

Full Text Available Aqueous shunts or glaucoma drainage devices are increasingly utilized in the management of refractory glaucoma. The general design of the most commonly-used shunts is based on the principles of the Molteno implant: ie. a permanent sclerostomy (tube, a predetermined bleb area (plate and diversion of aqueous humour to the equatorial region and away from the limbal subconjunctival space. These three factors make aqueous shunts more resistant to scarring as compared to trabeculectomy. The two most commonly used shunts are the Ahmed Glaucoma Valve, which contains a flow-restrictor, and the non-valved Baervedlt Glaucoma Implant. While the valved implants have a lower tendency to hypotony and related complications, the non-valved implants with larger, more-biocompatible end plate design, achieve lower intraocular pressures with less encapsulation. Non-valved implants require additional suturing techniques to prevent early hypotony and a number of these methods will be described. Although serious shunt-related infection is rare, corneal decompensation and diplopia are small but significant risks.

The role of inflammation in the pathogenesis of glaucoma

DEFF Research Database (Denmark)

Vohra, Rupali; Tsai, James C; Kolko, Miriam

2013-01-01

Glaucoma is an ocular disorder characterized by the progressive loss of retinal ganglion cells (RGC) and their axons. There are various hypotheses concerning the cause of RGC death. Previously, glaucoma was defined by high intraocular pressure (IOP); during the past decade, however, glaucoma...... specialists have acknowledged that elevated IOP is the most important risk factor for glaucoma, but does not define the disease. Other factors such as genetics, blood flow, and excitotoxicity are suggested as potential causal factors for progressive RGC death observed in glaucoma. We review recent studies...... elucidating a possible role of low-grade inflammation as a causal factor in the pathogenesis of glaucoma....

Childhood glaucoma profile in Dakahelia, Egypt: a retrospective study

Directory of Open Access Journals (Sweden)

Tharwat H. Mokbel

2018-04-01

Full Text Available AIM: To analyze childhood glaucoma regarding its demographics, presentations, different causes and surgical modalities used among patients in Dakahelia and to apply the Childhood Glaucoma Research Network (CGRN classification retrospectively to evaluate its convenience. METHODS: A retrospective study in which the medical files of all glaucoma patients <16 years old presented to Mansoura Ophthalmic Center, Mansoura University from 2014 to 2017, were retrieved and analyzed. Collected data included: age, gender, laterality, visual acuity (VA, refraction, intraocular pressure (IOP, corneal diameter, cup-disc ratio, types and number of surgeries and antiglaucomatous drugs (AGD at the first and last visit. Prevalence of different subtypes was calculated and means of clinical features were compared. RESULTS: A total of 305 eyes of 207 patients were included classified into 6 groups: primary congenital glaucoma (PCG, juvenile open angle glaucoma (JOAG, glaucoma associated with systemic disease, glaucoma associated with ocular anomalies, acquired glaucoma and glaucoma following cataract surgery. PCG was the predominant type (55.1% followed by acquired glaucoma (29.5%. Males represented 63.8% of the whole studied patients. Glaucoma associated with ocular anomaly group showed the youngest age at diagnosis (21.9±30.0mo. The shortest corneal diameter was recorded in post cataract group (10.4±0.5 mm. Highest cup-disc ratio was found in the PCG group (P<0.0005. Glaucoma associated with systemic disease presented with the highest baseline IOP (34.5±5.0 mm Hg. All the cases with PCG were treated surgically with 21.8% required more than one surgery. The majority of the patients (74.2% in the acquired group were treated medically. Combined trabeculotomy-trabeculectomy was the most frequent operation done, accounting for 34.5% of all primary surgeries. Ahmed valve implantation comprised 87% of the secondary surgeries. Acquired glaucoma group had the highest

Glaucoma

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Full Text Available ... Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube ...

Digital versus film stereo-photography for assessment of the optic nerve head in glaucoma and glaucoma suspect patients.

Science.gov (United States)

Hasanreisoglu, Murat; Priel, Ethan; Naveh, Lili; Lusky, Moshe; Weinberger, Dov; Benjamini, Yoav; Gaton, Dan D

2013-03-01

One of the leading methods for optic nerve head assessment in glaucoma remains stereoscopic photography. This study compared conventional film and digital stereoscopy in the quantitative and qualitative assessment of the optic nerve head in glaucoma and glaucoma suspect patients. Fifty patients with glaucoma or suspected glaucoma underwent stereoscopic photography of the optic nerve head with a 35-mm color slide film and a digital camera. Photographs/images were presented in random order to 3 glaucoma specialists for independent analysis using a standardized assessment form. Findings for the following parameters were compared among assessors and between techniques: cup/disc (C/D) ratio, state of the optic rim, presence of peripapillary atrophy and appearance of the retinal nerve fiber layer, blood vessels, and lamina cribrosa. The film-based and image-based diagnoses (glaucoma yes/no) were compared as well. Despite high level of agreement across graders using the same method for the horizontal and vertical C/D ratio, (intraclass correlations 0.80 to 0.83), the agreement across graders was much lower for the other parameters using the same method. Similarly the agreement between the findings of the same grader using either method was high for horizontal and vertical C/D ratio, but low for the other parameters. The latter differences were reflected in the disagreement regarding the final diagnosis: The diagnoses differed by technique for each grader in 18% to 46% of eyes, resulting in 38.5% of eyes diagnosed with glaucoma by film photography that "lost" their diagnosis on the digital images, whereas 18.7% of eyes diagnosed as nonglaucomatous by film photography were considered to have glaucoma on the digital images. Although there is consistency between 35-mm film stereoscopy and digital stereoscopy in determining the cup/disc (C/D) ratio, in all other parameters large differences exist, leading to differences in diagnosis. Differences in capturing images between

Trabecular Meshwork Height in Primary Open-Angle Glaucoma Versus Primary Angle-Closure Glaucoma.

Science.gov (United States)

Masis, Marisse; Chen, Rebecca; Porco, Travis; Lin, Shan C

2017-11-01

To determine if trabecular meshwork (TM) height differs between primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) eyes. Prospective, cross-sectional clinical study. Adult patients were consecutively recruited from glaucoma clinics at the University of California, San Francisco, from January 2012 to July 2015. Images were obtained from spectral-domain optical coherence tomography (Cirrus OCT; Carl Zeiss Meditec, Inc, Dublin, California, USA). Univariate and multivariate linear mixed models comparing TM height and glaucoma type were performed to assess the relationship between TM height and glaucoma subtype. Mixed-effects regression was used to adjust for the use of both eyes in some subjects. The study included 260 eyes from 161 subjects, composed of 61 men and 100 women. Mean age was 70 years (SD 11.77). There were 199 eyes (123 patients) in the POAG group and 61 eyes (38 patients) in the PACG group. Mean TM heights in the POAG and PACG groups were 812 ± 13 μm and 732 ± 27 μm, respectively, and the difference was significant in univariate analysis (P = .004) and in multivariate analysis (β = -88.7 [24.05-153.5]; P = .008). In this clinic-based population, trabecular meshwork height is shorter in PACG patients compared to POAG patients. This finding may provide insight into the pathophysiology of angle closure and provide assistance in future diagnosis, prevention, and management of the angle-closure spectrum of disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

Glaucoma Blindness at a Tertiary Eye Care Center.

Science.gov (United States)

Stone, Jordan S; Muir, Kelly W; Stinnett, Sandra S; Rosdahl, Jullia A

2015-01-01

Glaucoma is an important cause of irreversible blindness. This study describes the characteristics of a large, diverse group of glaucoma patients and evaluates associations between demographic and clinical characteristics and blindness. Data were gathered via retrospective chart review of patients (N = 1,454) who were seen between July 2007 and July 2010 by glaucoma service providers at Duke Eye Center. Visual acuity and visual field criteria were used to determine whether patients met the criteria for legal blindness. Descriptive and comparative statistical analyses were performed on the glaucoma patients who were not blind (n = 1,258) and those who were blind (n = 196). A subgroup analysis of only those patients with primary open-angle glaucoma was also performed. In this tertiary care population, 13% (n = 196) of glaucoma patients met criteria for legal blindness, nearly one-half of whom (n = 94) were blind from glaucoma, and another one-third of whom (n = 69) had glaucoma-related blindness. The most common glaucoma diagnosis at all levels of vision was primary open-angle glaucoma. A larger proportion of black patients compared with white patients demonstrated vision loss; the odds ratio (OR) for blindness was 2.25 (95% CI, 1.6-3.2) for black patients compared with white patients. The use of systemic antihypertensive medications was higher among patients who were blind compared with patients who were not blind (OR = 2.1; 95% CI, 1.4-3.1). A subgroup analysis including only patients with primary open-angle glaucoma showed similar results for both black race and use of systemic antihypertensive medications. The relationship between use of systemic antihypertensive medications and blindness was not different between black patients and white patients (interaction P = .268). Data were based on chart review, and associations may be confounded by unmeasured factors. Treated systemic hypertension may be correlated with blindness, and the cause cannot be explained solely

The Ex-PRESS glaucoma shunt versus trabeculectomy in open-angle glaucoma: a prospective randomized study

NARCIS (Netherlands)

de Jong, Leo A. M. S.

2009-01-01

The purpose of this study was to establish the efficacy and safety of the Ex-PRESS (Optonol Ltd., Neve Ilan, Israel) mini glaucoma shunt in open-angle glaucoma. This was a prospective, randomized trial. Eyes from enrolled patients were randomly assigned to either Ex-PRESS implantation under a

Glaucoma screening during regular optician visits : can the population at risk of developing glaucoma be reached?

NARCIS (Netherlands)

Stoutenbeek, R.; Jansonius, N. M.

2006-01-01

Aim: To determine the percentage of the population at risk of developing glaucoma, which can potentially be reached by conducting glaucoma screening during regular optician visits. Methods: 1200 inhabitants aged > 40 years were randomly selected from Dutch community population databases. A

The interrelation between hypothyroidism and glaucoma

DEFF Research Database (Denmark)

Thvilum, Marianne; Hjelm Brandt Kristensen, Frans; Brix, Thomas Heiberg

2017-01-01

Data on the association between hypothyroidism and glaucoma are conflicting. We sought to shed light on this by conducting a critical review and meta-analyses. The meta-analyses were conducted in adherence with the widely accepted MOOSE guidelines. Using the Medical Subject Heading (MeSH) terms......: hypothyroidism, myxoedema and glaucoma or intraocular pressure, case-control studies, cohort studies and cross-sectional studies were identified (PubMed) and reviewed. Using meta-analysis, the relative risk (RR) of coexistence of glaucoma and hypothyroidism was calculated. Based on the literature search......, thirteen studies fulfilled the inclusion criteria and could be categorized into two groups based on the exposure. The designs of the studies varied considerably, and there was heterogeneity related to lack of power, weak phenotype classifications and length of follow-up. Eight studies had glaucoma (5757...

Modelo integral para la administración de información escolar en escuelas primarias públicas en México con un sistema de información

OpenAIRE

Israel Patiño Galván; Martín Verduzco Rodríguez

2014-01-01

El presente trabajo es el resultado de investigaciones científicas y tecnológicas realizadas en sector educativo primario público, cuyo objetivo es crear un modelo integral para la administración de información escolar con Criptografía de datos, mediante un sistema de información. El cual permitirá colaborar con alternativas tecnologías integrales, para sistematizar los procesos operativos y administrativos en dicho sector. Para el desarrollo y culminación de esta investigación se emplearon m...

Gestión del talento humano y compromiso organizacional de los docentes del nivel primario en las instituciones educativas del Cercado de Huaral, 2014

OpenAIRE

Huapalla Paredes, Javier Mitchel

2015-01-01

El presente estudio se centra en describir cómo se relaciona Gestión del talento humano y compromiso organizacional de los docentes del nivel primario en las Instituciones Educativas del Cercado de Huaral, 2014. El nivel de la presente investigación es cuantitativo de tipo descriptivo correlacional. La muestra es probabilística de 125 docentes del nivel primario de las Instituciones Educativas del Cercado de Huaral. Los instrumentos utilizados para observar y recabar inform...

Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project.

Science.gov (United States)

Hark, Lisa; Waisbourd, Michael; Myers, Jonathan S; Henderer, Jeffrey; Crews, John E; Saaddine, Jinan B; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L; Katz, L Jay

2016-01-01

The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4-6 weeks and 4-6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program.

Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

Directory of Open Access Journals (Sweden)

Huang J

2015-06-01

Full Text Available Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries.Patients and methods: Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1 intraocular pressure (IOP ≥6 and ≤21 mmHg; 2 IOP reduction of at least 30% relative to preoperative values; and 3 without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications.Results: Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80 mm, corneal diameter was 14.71±1.07 (13.0–16.0 mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0, and IOP was 39.5±5.7 (30–55 mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18 months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001 postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan–Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28

Dry eye, sleep quality, and mood status in glaucoma patients receiving prostaglandin monotherapy were comparable with those in non-glaucoma subjects.

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Shugyoku Ra

Full Text Available Prior studies suggested that glaucoma patients suffer worse dry eye and mood and sleep disorders than non-glaucoma subjects. Prostaglandin analogues are first-line therapy for glaucoma, inducing few instillation problems and sufficient pressure-reduction effects. This study compared dry eye, sleep quality, and mood status between glaucoma patients receiving prostaglandin monotherapy and non-glaucoma subjects.This cross-sectional study evaluated 1520 patients (579 males and 941 females for glaucoma status and dry eye-related symptoms (dryness, eye fatigue, photophobia, pain, blurring and signs (Schirmer test, tear break-up time, corneal staining scores. Of the total cohort, 93 patients were also evaluated by Pittsburgh sleep quality index (PSQI and hospital anxiety and depression score (HADS. Inclusion criteria were consecutive patients ≥ 51 years of age and best-corrected visual acuity ≥ 20/25. Glaucoma patients included those treated with prostaglandin or a fixed combination including prostaglandin. Exclusion criteria were history of ocular surgery within one month. Data were analyzed using the chi-square or Mann-Whitney U tests, at 5% significance.There were no significant differences in dry eye-related signs and symptoms between the control (n = 1431, mean age of 66.9 years and glaucoma groups (n = 89, 67.9 years. The psychiatric sub-analysis of the control (n = 61, 66.2 years and glaucoma groups (n = 32, 67.3 years revealed mean scores of 5.02 ± 3.10 and 5.16 ± 3.46 for PSQI (normal range ≤ 5, 9.47 ± 5.61 and 9.42 ± 7.36 for HADS (normal range ≤ 10, 4.84 ± 3.22 and 4.71 ± 3.45 for anxiety (normal range ≤ 5, and 4.63 ± 3.05 and 4.71 ± 4.40 for depression (normal range ≤ 5, respectively, without statistical significance.Our results were comparable between glaucoma patients on prostaglandin monotherapy and non-glaucoma subjects for dry eye-related clinical manifestations, sleep quality, and mood status.

Importance of intraocular pressure in glaucoma

Science.gov (United States)

Joos, Karen M.

1999-06-01

Glaucoma results in permanent vision loss and affects the peripheral vision initially. It is presented in 22.5 million people worldwide and is the 3rd cause of blindness. Present tonometers are not ideal for intraocular pressure measurements in all eyes. Of concern, PRK and LASIK may result in lower intraocular pressure readings. A challenges now exists for the development of a tonometer which can easily compensate for corneas with many parameters to avoid a future increase in normal-tension glaucoma or glaucoma which is advanced.

Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity.

Science.gov (United States)

Kwon, Hye Jin; Kong, Yu Xiang George; Tao, Lingwei William; Lim, Lyndell L; Martin, Keith R; Green, Catherine; Ruddle, Jonathan; Crowston, Jonathan G

2017-07-01

This study provides ophthalmologists who manage uveitic glaucoma with important information on factors that can affect the success of surgical management of this challenging disease. This study examines surgical outcomes of trabeculectomy and glaucoma device implant (GDI) surgery for uveitic glaucoma, in particular the effect of uveitis activity on surgical outcomes. Retrospective chart review at a tertiary institution. Eighty-two cases with uveitic glaucoma (54 trabeculectomies and 28 (GDI) surgeries) performed between 1 December 2006 and 30 November 2014. Associations of factors with surgical outcomes were examined using univariate and multivariate analysis. Surgical outcomes as defined in Guidelines from World Glaucoma Association. Average follow up was 26.4 ± 21.5 months. Overall qualified success rate of the trabeculectomies was not statistically different from GDI, being 67% and 75%, respectively (P = 0.60). Primary and secondary GDI operations showed similar success rates. The most common postoperative complication was hypotony (~30%). Active uveitis at the time of operation was higher in trabeculectomy compared with GDI group (35% vs. 14%). Active uveitis at the time of surgery did not significantly increase risk of failure for trabeculectomies. Recurrence of uveitis was significantly associated with surgical failure in trabeculectomy group (odds ratio 4.8, P = 0.02) but not in GDI group. Surgical success rate of GDI was not significantly different from trabeculectomy for uveitic glaucoma in this study. Regular monitoring, early and prolonged intensive treatment of ocular inflammation is important for surgical success particularly following trabeculectomy. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma

Directory of Open Access Journals (Sweden)

Jesus Jimenez-Roman

2017-09-01

Full Text Available AIM: To compare the effect of phacoemulsification on intraocular pressure (IOP in patients with primary open angle glaucoma (POAG and pseudoexfoliation glaucoma (PXG. METHODS: A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico. The study enrolled consecutive patients having phacoemulsification with intraocular lens (IOL implantation and a diagnosis of POAG or PXG. Data about IOP values and number of glaucoma medications used was collected at baseline, 1, 3, 6 and 12mo postoperatively. RESULTS: The study enrolled 88 patients (88 eyes. After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients (P<0.001. In the POAG group, a 20% decrease in IOP values was evidenced, and a 56.5% reduction in the number of medications used at the one-year follow-up. The PXG group showed a 20.39%, and a 34.46% decrease in IOP and number of medications used, respectively. A significant difference in the mean ΔIOP (postoperative changes in IOP was evidenced between groups (P=0.005. The reduction of the postsurgical IOP mean values in both groups, the POAG group showed a greater reduction in IOP values compared to the PXG group. CONCLUSION: In both types of glaucoma, phacoemulsification cataract surgery can result in a significant IOP reduction (20% over a 12mo follow-up period. The number of medications used is also significantly reduced up to 12mo after surgery, especially in the PXG group.

Macular thickness after glaucoma filtration surgery.

Science.gov (United States)

Sesar, Antonio; Cavar, Ivan; Sesar, Anita Pusić; Geber, Mia Zorić; Sesar, Irena; Laus, Katia Novak; Vatavuk, Zoran; Mandić, Zdravko

2013-09-01

The aim of present study was to analyze early postoperative changes in the macular area using optical coherence tomography (OCT) after uncomplicated glaucoma filtration surgery. This prospective study included 32 patients (34 eyes) with open-angle glaucoma, which underwent trabeculectomy with or without use of mitomycin C. Exclusion criteria were macular edema, uveitis, age-related macular degeneration, blurred optical media, secondary glaucoma and angle-closure glaucoma. All standard clinical examinations were made before surgery, at the 2nd day, 1 week and 1 month after surgery. Tomography of the macula was performed during every examination using Cirrus HD OCT for the analysis of central subfield thickness. Results show that thickening of the macula was slightly higher 1 week and 1 month after operation in comparison with baseline end 2nd day postoperativelly. There was no significant difference in the change of macular thickness in patients who have used topical prostaglandins compared with those who have used other topical medications. Also, there was no difference in macular changes between patients treated with or without mitomycin C. In conclusion, we found a slight subclinical increase in macular thickness after uncomplicated trabeculectomy, for which we considered that was the result in reduction of intraocular pressure after glaucoma surgery. Macular thickening after glaucoma filtering surgery could be a physiological reaction to the stress of the retina caused by a sudden reduction of intraocular pressure and it is the consequence of altered relationship between capillary pressure and interstitial fluid pressure.

SQSTM1 Mutations and Glaucoma.

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Todd E Scheetz

Full Text Available Glaucoma is the most common cause of irreversible blindness worldwide. One subset of glaucoma, normal tension glaucoma (NTG occurs in the absence of high intraocular pressure. Mutations in two genes, optineurin (OPTN and TANK binding kinase 1 (TBK1, cause familial NTG and have known roles in the catabolic cellular process autophagy. TKB1 encodes a kinase that phosphorylates OPTN, an autophagy receptor, which ultimately activates autophagy. The sequestosome (SQSTM1 gene also encodes an autophagy receptor and also is a target of TBK1 phosphorylation. Consequently, we hypothesized that mutations in SQSTM1 may also cause NTG. We tested this hypothesis by searching for glaucoma-causing mutations in a cohort of NTG patients (n = 308 and matched controls (n = 157 using Sanger sequencing. An additional 1098 population control samples were also analyzed using whole exome sequencing. A total of 17 non-synonymous mutations were detected which were not significantly skewed between cases and controls when analyzed separately, or as a group (p > 0.05. These data suggest that SQSTM1 mutations are not a common cause of NTG.

Understanding practice patterns of glaucoma sub-specialists in India

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Nikhil S. Choudhari

2017-10-01

Full Text Available AIM: To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS: Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS: The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57% had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%. Goldmann applanation tonometry was preferred by 103 (72% specialists whilst n=25 (17.4% used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66% whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively. Nearly three quarter specialists (n=96; 72% preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93% and medical management (prostaglandin analogue, n=104; 78%, respectively. Approximately only a third of the specialists surveyed (n=37; 28% were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47% were not operating on congenital glaucoma at all. CONCLUSION: This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies.

The medical management of glaucoma | Marais | South African ...

African Journals Online (AJOL)

Glaucoma is one of the leading causes of blindness worldwide. The main characteristic features include optic disc cupping, visual field loss, and in most instances a raised intraocular pressure. Primary open angle glaucoma accounts for nearly two thirds of all cases, while angle closure glaucoma contributes the majority of ...

Enfermedad periodontal en pacientes con discapacidad en custodia versus pacientes con discapacidad independientes

Directory of Open Access Journals (Sweden)

Fermín-Guerrero-Del Ángel

2012-01-01

Full Text Available Objetivo: Identificar el estado de salud periodontal en pacientes con discapacidad en custodia versus pacientes independientes en su higiene oral. Material y métodos: Se examinaron pacientes con discapacidad, ambos sexos, 3 a 19 años que acuden al Servicio de Odontopediatría del Centro de Rehabilitación Infantil Teletón (CRIT Tamaulipas mediante revisión de cavidad oral y aplicación del Índice de Higiene Oral Simplificado (IHOS, Índice Periodontal Comunitario de la Necesidad de Tratamiento (IPCNT y entrevista con su cuidador primario. Se agruparon en dos categorías: Independientes y de Custodia. Resultados: En el total de la muestra la Media y Desviación estándar (D.E. de IPCNT fue de 0.89±0.54, así como el IHOS de 1.88±0.77. El IPCNT en pacientes con discapacidad de Custodia fue 0.91±0.57 e Independientes de 0.86±0.49 (p=0.70, IHOS en pacientes de Custodia 1.89±0.78 e Independientes 1.87±.0.74 (p=.93. IPCNT en géneros masculino 1.03±0.54 y femenino 0.75±0.51 (p=.009. IHOS en pacientes que habitan área rural 2.41±1.25 y área urbana 1.83±0.68 (p=.02. Relación entre la edad y la necesidad de tratamiento periodontal (p=0.001. Frecuencia del cepillado del grupo Independientes 2.03±0.56 y de Custodia 2.00±0.75 (p=.84. Conclusiones: No existe diferencia en el estado de salud periodontal y el grado de higiene oral entre pacientes con discapacidad Independientes y de Custodia. La mayoría de los pacientes Independientes y de Custodia tienen una necesidad de tratamiento de Instrucción de Higiene Oral (TN1 y tienen Higiene Oral Regular.

Anticlotting agents and the surgical management of glaucoma.

Science.gov (United States)

Sozeri, Yasemin; Salim, Sarwat

2018-03-01

A large subset of patients with glaucoma uses anticlotting agents. No standardized guidelines currently exist for managing these agents in the specific perioperative setting of glaucoma surgery. The present review focuses on currently available anticlotting agents, their influence on hemorrhagic complications following glaucoma surgery, and management strategies for their use in the perioperative period RECENT FINDINGS: Anticlotting agents increase the risk of perioperative hemorrhagic complications following glaucoma surgery. Other factors that increase that risk have been identified as well, including the type of glaucoma surgery, preoperative intraocular pressure, postoperative hypotony, previous ocular surgeries, and race. Although general guidelines in the perioperative management of blood thinning agents exist, the best way to apply these guidelines specifically to glaucoma surgery remains unclear. Blood thinners are widely used and can increase the risk of hemorrhagic complications in patients undergoing glaucoma surgery. Managing these agents in the perioperative setting is challenging and should be done in collaboration with the patient's primary care provider, hematologist, or cardiologist. Management strategies should be tailored to each individual's risk of hemorrhage versus thromboembolism. Additionally, surgical plans can be modified to help minimize hemorrhagic outcomes, especially in patients who are deemed to be at high risk for perioperative bleeding.

Involvement of genetic variants associated with primary open-angle glaucoma in pathogenic mechanisms and family history of glaucoma.

Science.gov (United States)

Mabuchi, Fumihiko; Sakurada, Yoichi; Kashiwagi, Kenji; Yamagata, Zentaro; Iijima, Hiroyuki; Tsukahara, Shigeo

2015-03-01

To investigate the associations between the non-intraocular pressure (IOP)-related genetic variants (genetic variants associated with vulnerability of the optic nerve independent of IOP) and primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG) and high-tension glaucoma (HTG), and between the non-IOP-related genetic variants and a family history of glaucoma. Case-control study. Japanese patients with NTG (n = 213) and HTG (n = 212) and 191 control subjects were genotyped for 5 non-IOP-related genetic variants predisposing to POAG near the SRBD1, ELOVL5, CDKN2B/CDKN2B-AS1, SIX1/SIX6, and ATOH7 genes. The load of these genetic variants was compared between the control subjects and patients with NTG or HTG and between the POAG patients with and without a family history of glaucoma. The total number of POAG risk alleles and the product of the odds ratios (POAG risk) of these genetic variants were significantly larger (P product of the odds ratios increased (P = .012 and P = .047, respectively). Non-IOP-related genetic variants contribute to the pathogenesis of HTG as well as NTG. A positive family history of glaucoma in cases of POAG is thought to reflect the influence of genetic variants predisposing to POAG. Copyright © 2015 Elsevier Inc. All rights reserved.

Caracterización de pacientes con neoplasias primarias del segmento hepatobiliopancreático

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Danilo Romaguera Barroso

2015-02-01

Full Text Available Se realizó un estudio observacional, descriptivo y longitudinal de 60 pacientes con cáncer primario del segmento hepatobiliopancreático, operados y egresados vivos del Servicio de Cirugía General del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde el 2005 hasta el 2011, con vistas a caracterizarles según variables seleccionadas. Entre las localizaciones más frecuentes figuraron: páncreas, hígado, vesícula y vías biliares extrahepáticas, en pacientes de la sexta década de la vida del sexo masculino; aunque el tumor de vesícula biliar prevaleció en las féminas. La estadificación clínica de la mayoría correspondió a las etapas más avanzadas, limitada al tratamiento quirúrgico paliativo. Los pacientes con factores de riesgo deben ser dispensarizados en las áreas de atención primaria de salud para que acudan al nivel secundario en etapas iniciales de la enfermedad, y puedan recibir el tratamiento quirúrgico con intención curativa, lo cual mejora su pronóstico y calidad de vida

Tumor pardo maxilar: Elemento diagnóstico de hiperparatiroidismo primario Maxillary brown tumor: A diagnostic tool for primary hyperparathyroidism

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S. Gallana Álvarez

2005-08-01

Full Text Available El hiperparatiroidismo primario es un transtorno generalizado del metabolismo óseo producido por un aumento de la secreción de hormona paratiroidea (PTH. La etiología de este transtorno es múltiple; en la forma primaria la causa de la hipersecreción de la hormona es la propia glándula, y el motivo más frecuente el adenoma paratiroideo. Los tumores pardos son lesiones óseas focales secundarias a hiperparatiroidismo. El tratamiento de elección de los tumores pardos es la extirpación del adenoma de paratiroides, ya que la normalización de la función paratiroidea debería provocar una reducción del tamaño o desaparición del tumor. Presentamos un caso de tumor pardo mandibular en un paciente con hiperparatiroidismo primario, en el cual el tumor recidivó después de la extirpación del adenoma paratiroideo. La finalidad de la presentación de este caso es recordar el interés que para el cirujano oral y maxilofacial representan las manifestaciones orales de la patología sistémica.The primary hyperparathyroidism is a generalized disorder of the osseous metabolism, caused by hypersecretion of PTH. Hyperparathyroidism has a multiple etiology. In its primary form, the hypersecretion of the hormone is caused by the gland itself, the commonest reason being parathyroid adenoma. The treatment of first choice for brown tumor is the parathyroidectomy because the normalization of parathyroid function should lead to a reduction in size or disappearance of the tumor. We present a case of the brown tumor in the mandible and primary hyperparathyroidism in whom the tumor enlarged after removal of parathyroid adenoma. Upon presentation of this report, our aim is to bring forward the significance oral manifestations of systemic pathology has for oral and maxillofacial surgeons.

Normal tension glaucoma and Alzheimer disease

DEFF Research Database (Denmark)

Bach-Holm, Daniella; Kessing, Svend Vedel; Mogensen, Ulla Brasch

2012-01-01

Purpose: To investigate whether normal tension glaucoma (NTG) is associated with increased risk of developing dementia/Alzheimer disease (AD). Methods: A total of 69 patients with NTG were identified in the case note files in the Glaucoma Clinic, University Hospital of Copenhagen (Rigshospitalet...

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.

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.

Ahmed glaucoma valve implant: surgical technique and complications.

Science.gov (United States)

Riva, Ivano; Roberti, Gloria; Oddone, Francesco; Konstas, Anastasios Gp; Quaranta, Luciano

2017-01-01

Implantation of Ahmed glaucoma valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed glaucoma valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the valve mechanism embedded in the Ahmed glaucoma valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed glaucoma valve implantation and to report related complications.

Morphological and functional diversity of primary producers group in savannas; Diversidad morfologica y funcional del grupo de productores primarios en sabanas

Energy Technology Data Exchange (ETDEWEB)

Medina, E [Instituto Venezolano de Investigaciones Cientificas (IVIC). Centro de Ecologia. Laboratorio de Ecofisiologia Vegetal, Altos de Pipe (Venezuela)

1996-07-01

(mutual symbiosis) affect the availability of nutritious, and in consequence the productive capacity of savannas. Although there is a theoretical mark to explain the mechanisms that allow the coexistence of similar species in tropical savannas, the specific echo-physiologic properties are still ignored, even for the most dominant species. The advance in the diversity-function study of tropical savannas requires ambitious programs in order to characterize the way how the different primary producer species make use of the available environmental resources. [Spanish] El significado de la diversidad biologica para el funcionamiento y estabilidad de los ecosistemas naturales es materia de gran interes teorico y practico. La aparicion y permanencia de una especie en un ambiente dado indica su capacidad de competir con otras especies de habito y requerimientos similares y acumular los recursos que le permiten reproducirse. Por otra parte, la coexistencia de especies similares en un mismo ecosistema permite preguntarse si existe 'redundancia biologica', es decir, si coexisten varias especies con una misma funcion dentro del ecosistema, de manera que la desaparicion de una de ellas no tendria consecuencias biologicas significativas. Una estrategia para simplificar el analisis de las relaciones entre biodiversidad y funcionamiento de ecosistemas es la agrupacion de especies de funcion similar, los llamados grupos funcionales. En este trabajo se analiza el grupo funcional de los productores primarios, esencialmente plantas superiores, en ecosistemas de sabanas. El analisis establece que el grupo de los productores primarios es heterogeneo y complejo, tanto morfologica como funcionalmente: 1) La complejidad estructural y diversidad de formas de vida en un ecosistema de sabanas estan asociadas con la explotacion estratificada de recursos por encima (luz) debajo del suelo (nutrientes y agua). Cambios de diversidad que afecten la estructura del sistema muy probablemente afectaran su

Glaucoma after corneal replacement.

Science.gov (United States)

Baltaziak, Monika; Chew, Hall F; Podbielski, Dominik W; Ahmed, Iqbal Ike K

Glaucoma is a well-known complication after corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty, has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with penetrating keratoplasty. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser, or surgical therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia — Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project

Science.gov (United States)

Myers, Jonathan S.; Henderer, Jeffrey; Crews, John E.; Saaddine, Jinan B.; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L.; Katz, L. Jay

2016-01-01

Purpose The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. Methods The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4–6 weeks and 4–6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. Results This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. Conclusions The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program. PMID:26950056

Glaucoma progression detection with frequency doubling technology (FDT) compared to standard automated perimetry (SAP) in the Groningen Longitudinal Glaucoma Study.

Science.gov (United States)

Wesselink, Christiaan; Jansonius, Nomdo M

2017-09-01

To determine the usefulness of frequency doubling perimetry (FDT) for progression detection in glaucoma, compared to standard automated perimetry (SAP). Data were used from 150 eyes of 150 glaucoma patients from the Groningen Longitudinal Glaucoma Study. After baseline, SAP was performed approximately yearly; FDT every other year. First and last visit had to contain both tests. Using linear regression, progression velocities were calculated for SAP (Humphrey Field Analyzer) mean deviation (MD) and FDT MD and the number of test locations with a total deviation probability below p glaucoma progression in patients who cannot perform SAP reliably. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Design of low cost glaucoma screening

NARCIS (Netherlands)

Niessen, A. G.; Langerhorst, C. T.; Geijssen, H. C.; Greve, E. L.

1997-01-01

In 1991 the Netherlands Glaucoma Patient Association organized a glaucoma screening survey. This survey was designed to evaluate the effectiveness of a low cost screening setting. During a screening period of 8 days, 1259 subjects over the age of 49 years were examined by a team of

Revisión con agujas y uso de mitomicina C en bulas de filtración encapsuladas Needle revision and use of Mitomycin-C to manage encapsulated filtering blebs

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Francisco Fumero González

2012-01-01

Full Text Available La trabeculectomía es uno de los tratamientos de elección en los pacientes con glaucoma. La causa más común de fallo de esta cirugía en su primer trimestre es la bula de filtración encapsulada. Usualmente es resultado de la proliferación fibrótica subconjuntival que lleva a fallo de la bula, como por ejemplo en los glaucomas traumáticos. La revisión con agujas y la mitomicina C constituyen una opción efectiva y relativamente segura para restaurar la función de la cirugía de filtración. Se presenta un paciente donde se restableció el flujo de humor acuso con este proceder.Trabeculectomy is the surgical treatment of choice for many patients with glaucoma. The most common cause of failure during the first trimester after trabeculectomy is encapsulated bleb. Generally, that results from scarring in the subconjunctival space with a resultant intrableb fibrosis and the development of a failed bleb, for example in traumatic glaucoma. Needling bleb revision with mitomycin-C appears to be an effective and relatively safe way to revive the function of the filtration surgery. This was the case report of a patient whose aqueous humor flow was reestablished with this treatment.

Retinal oxygen saturation before and after glaucoma surgery.

Science.gov (United States)

Nitta, Eri; Hirooka, Kazuyuki; Shimazaki, Takeru; Sato, Shino; Ukegawa, Kaori; Nakano, Yuki; Tsujikawa, Akitaka

2017-08-01

This study compared retinal vessel oxygen saturation before and after glaucoma surgery. Retinal oxygen saturation in glaucoma patients was measured using a non-invasive spectrophotometric retinal oximeter. Adequate image quality was found in 49 of the 108 consecutive glaucoma patients recruited, with 30 undergoing trabeculectomy, 11 EX-PRESS and eight trabeculotomy. Retinal oxygen saturation measurements in the retinal arterioles and venules were performed at 1 day prior to and at approximately 10 days after surgery. Statistical analysis was performed using a Student's t-test. After glaucoma surgery, intraocular pressure (IOP) decreased from 19.8 ± 7.7 mmHg to 9.0 ± 5.7 mmHg (p glaucoma surgery had an effect on the retinal venous oxygen saturation. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Methylphenidate (Ritalin-associated Cataract and Glaucoma

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Chao-Kung Lu

2006-12-01

Full Text Available Methylphenidate hydrochloride (Ritalin is the drug of choice for attention deficit hyperactivity disorder (ADHD. However, an association of Ritalin with glaucoma has been reported. We report a case of Ritalin-associated cataract and glaucoma. A 10-year-old boy was diagnosed with ADHD and had received methylphenidate hydrochloride, 60 mg/day for 2 years. He presented with blurred vision. Best-corrected visual acuity was 6/60 in both eyes. Ocular examinations revealed intraocular pressure (IOP of 30 mmHg under medication, dense posterior subcapsular opacity of lens, pale disc with advanced cupping, and marked constriction of visual field. Despite maximal anti-glaucomatous medication, IOP still could not be controlled. The patient then received combined cataract and glaucoma surgery. Visual acuity improved and IOP was within normal limits in both eyes postoperatively. Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate.

Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

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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

Método de las invariantes en la conducta a seguir ante un paciente con abdomen agudo quirúrgico en el nivel primario de atención

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Esteban Regalado García

2003-08-01

Full Text Available El médico que hoy formamos tiene una visión más integral de los problemas de salud del ser humano. En nuestro sistema de salud, el nivel primario constituye, en gran medida, su puerta de entrada. Los profesionales que laboran en este nivel deben estar preparados para resolver los problemas de salud propios de su especialidad e identificar aquellas entidades que deben ser resueltas en los otros niveles del sistema. El abdomen agudo quirúrgico es de los problemas de salud que deben ser atendidos oportunamente para evitar complicaciones, incluso fatales, en nuestros pacientes. Un método pedagógico para aprender los conocimientos necesarios, con calidad y que orienta la conducta correcta ante cada paciente, es el método de las invariantes. El concepto de invariante contempla la identificación de aquellas cuestiones fundamentales, esenciales y necesarias para poder sospechar un diagnóstico. Cuando el Médico General Integral conoce las invariantes de una entidad, puede tomar decisiones con un elevado margen de seguridad. Un abdomen agudo quirúrgico puede ser producido por cientos de enfermedades y estudiarlas una por una sería interminable; dada su gravedad, cualquier error que se cometa en su manejo puede ser fatal. Hemos identificado 7 signos invariantes en el abdomen agudo quirúrgico, estos signos que presentamos en este trabajo, pueden ser reconocidos en 9 de cada 10 pacientes que consultan con un dolor abdominal agudo. Existen dificultades para su identificación en un pequeño número de pacientes, a lo que hemos llamado "Situaciones Especiales".The physicians that we are preparing today have more comprehensive vision of the health problems of the human being. In our health care system, the primary health care level constitutes, in a greater extent, an entry door. Health professionals working at this level should be ready to solve health problems inherent to their specialty and to identify those entities that should be resolved at

DETERMINACIÓN DEL INDICADOR DE RIESGOS INDUSTRIALES DE PLANTAS REDUCTORAS DE ALUMINIO PRIMARIO EN VENEZUELA METODOLOGÍA SATPRO

Directory of Open Access Journals (Sweden)

Liliana Manduca Alvarado

2004-11-01

Full Text Available

En el trabajo se determina el indicador de riesgos industriales en el sector productor de aluminio, del área de Reducción de Aluminio Primario en la zona de Guayana, Venezuela. Se utilizó la metodología SATPRO, en primer lugar porque permite reducir los accidentes de trabajo y las enfermedades profesionales y por ende, sus costos; en segundo lugar permite integrar la política de prevención de riesgos en las restantes políticas de la empresa y en su estrategia empresarial; y en tercer lugar, porque se evitarán las sanciones administrativas, apoyando a la gestión administrativa de la empresa y les permitiría realizar estrategias operacionales en la productividad, logrando utilidades sustanciales y cumplir con la nueva Ley de Prestaciones e Indemnizaciones por Accidentes de Trabajo y Enfermedades Ocupacionales, actualmente en discusión en el país donde se exigirá el pago de impuestos, por parte de la empresa evaluada, al gobierno, dependiendo del riesgo detectado.

Hiperparatiroidismo primario: Evolución postoperatoria a largo plazo Primary hyperparathyrodism: Postoperative long-term evolution

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Francisco R. Spivacow

2010-10-01

Full Text Available Presentamos la evolución postoperatoria a largo plazo de 87 pacientes con hiperparatiroidismo primario. Del total, 78 mujeres y 9 varones, relación: 8.7:1. Edad media 55.3 ± 10.2 años. Antes de la cirugía el 44% presentó litiasis renal, el 70% osteopenia u osteoporosis y un 71.2% tuvo hipercalciuria. Se encontró disminución del filtrado glomerular en el 12.6%. Del total, 72 pacientes presentaron un adenoma único, dos un doble adenoma, dos hiperplasia, cuatro histología normal y en siete no se pudo disponer del resultado. El calcio sérico, el calcio iónico, el fósforo y la parathormona intacta se normalizaron en todos los pacientes postcirugía. La densitometría ósea aumentó un 6.9% en columna lumbar y un 3% en cuello de fémur. Los marcadores del remodelado óseo se normalizaron y persistieron normales a los 23 meses del seguimiento, coincidiendo con la parathormona intacta. Lo mismo sucedió con los valores de 25 OH D. Cuando se compararon pacientes con hipercalciuria inicial vs. aquellos con normocalciuria, no se encontraron diferencias en los valores basales y postcirugía en ambos grupos. En 11 pacientes con filtrado glomerular previo The long-term postoperative outcome of 87 patients with primary hyperparathyrodism is here presented. Of the total 78 were females and 9 males, ratio: 8.7:1. Mean age 55.3 ± 10.2 years. Before surgery, 44% had kidney stones, 70% had osteopenia or osteoporosis and 71.2% had hypercalciuria. Decrease renal glomerular filtration was found in 12.6%. Of the total, 72 patients had a single adenoma, two double adenoma, two hyperplasia, four had normal histology and seven could not dispose of the result. Serum calcium, ionized calcium, phosphorus and intact parathyroid hormone were normalized in all post surgery patients. Bone mineral density increased by 6.9% in lumbar spine and 3% in femoral neck. Markers of bone remodeling were normalized and persisted normal 23 months of follow-up, coinciding with

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.

Glaucoma and Driving: On-Road Driving Characteristics

Science.gov (United States)

Wood, Joanne M.; Black, Alex A.; Mallon, Kerry; Thomas, Ravi; Owsley, Cynthia

2016-01-01

Purpose To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment. Methods Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years) with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB) and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years). On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire. Results Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability. Conclusions Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness. PMID:27472221

Demographic features of subjects with congenital glaucoma

Science.gov (United States)

Tamçelik, Nevbahar; Atalay, Eray; Bolukbasi, Selim; Çapar, Olgu; Ozkok, Ahmet

2014-01-01

Context: Congenital glaucoma is a potentially blinding ocular disease of the childhood. Identification of the possible associated risk factors and may be helpful for prevention or early detection of this public health problem. Aims: To demonstrate the demographic features of congenital glaucoma subjects. Setting and Design: The charts of congenital glaucoma patients referred to Tamcelik Glaucoma Center were retrospectively reviewed through the dates of 2000 and 2013. Materials and Methods: Analyzed data included diagnosis, age at first presentation, symptoms at first presentation, laterality of the disease, sex, presence of consanguinity, family history of congenital glaucoma, maturity of the fetus at delivery, and maternal age at conception. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) version 19.0 by IBM (SPSS Inc, Chicago, Illinois, USA) was used to compare the mean of continuous variables with Student's t-test and analysis of variance (ANOVA) and χ2 test was used to test differences in proportions of categorical variables. Results: The data of 600 eyes of 311 patients were analyzed. The distribution of primary and secondary congenital glaucoma among the patients were 63.3% (n = 197) and 36.7% (n = 114), respectively. Of the 311 patients, 57.2% (n = 178) were male and 42.8% (n = 133) were female. The overall frequency of bilateral disease was 92.3% (n = 287). Overall rate of consanguinity and positive family history was 45.3% (n = 141) and 21.2% (n = 66), respectively. Conclusions: Bilateral disease in this study was more common than previously reported studies. Positive family history was more frequent in primary congenital glaucoma although not statistically significant. PMID:24881602

Glaucoma and Driving: On-Road Driving Characteristics.

Directory of Open Access Journals (Sweden)

Joanne M Wood

Full Text Available To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment.Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire.Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability.Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness.

Glaucoma and Driving: On-Road Driving Characteristics.

Science.gov (United States)

Wood, Joanne M; Black, Alex A; Mallon, Kerry; Thomas, Ravi; Owsley, Cynthia

2016-01-01

To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment. Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years) with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB) and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years). On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire. Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability. Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness.

Combined Glaucoma Tube Shunt (Ahmed) and Fluocinolone Acetonide (Retisert™) Implantation Compared to Ahmed Alone in Uveitic Glaucoma.

Science.gov (United States)

Zivney, Mark; Lin, Phoebe; Edmunds, Beth; Parikh, Mansi; Takusagawa, Hana; Tehrani, Shandiz

2016-12-01

Glaucoma is a known complication of uveitis, and may require glaucoma tube shunt implantation for intraocular pressure (IOP) control. The success of glaucoma tube shunt implantation in the setting of a local ocular steroid depot in uveitic glaucoma remains unknown. The purpose of this study was to determine whether patients who underwent combined glaucoma tube shunt (Ahmed) and fluocinolone acetonide (Retisert™, Bausch + Lomb, Bridgewater, NJ, USA) implantation have superior outcomes compared to patients with Ahmed implants only in the setting of uveitic glaucoma. All participants were studied retrospectively and underwent Ahmed implantation alone or with existing/concurrent Retisert implantation (combined group) at a single academic institution. The main outcome measures were IOP, visual acuity (VA), number of IOP-lowering medications, and adverse events at 6 months after Ahmed implantation. Secondary outcome measures included adverse events and surgical success at 6 months after Ahmed implantation. Mean IOP at 6 months after Ahmed implantation was 15.3 ± 4.8 and 15.1 ± 4.9 mm Hg in the Ahmed only group (n = 17) and the combined group (n = 17), respectively (p = 0.89). The mean number of IOP-lowering medications at 6 months after Ahmed implantation was 1.7 ± 1.0 and 1.8 ± 1.0 in the Ahmed only group and the combined group, respectively (p = 0.86). Mean VA at 6 months after Ahmed implantation was 0.35 ± 0.29 and 0.42 ± 0.33 log mean angle of resolution in the Ahmed only group and the combined group, respectively (p = 0.50). No significant differences in surgical success or adverse events were noted between the two groups. At 6 months, no significant differences in mean IOP, mean number of IOP-lowering medications, VA, surgical success, or adverse events were noted between Ahmed implantation alone or combined Ahmed and Retisert implantation in patients with uveitic glaucoma.

Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure.

Science.gov (United States)

Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

2015-01-01

The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56-30.80) mm, corneal diameter was 14.71±1.07 (13.0-16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9-1.0), and IOP was 39.5±5.7 (30-55) mmHg. The mean follow-up time was 18.29±10.96 (5-44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pvalve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases. AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications.

Antihypertensive medication postpones the onset of glaucoma

DEFF Research Database (Denmark)

Horwitz, Anna; Klemp, Marc; Jeppesen, Jørgen

2017-01-01

The aim was to investigate the impact of antihypertensive medication on the onset of glaucoma. Data from the complete Danish population between 40 and 95 years of age were used in the period from 1996 to 2012, covering >2.6 million individuals. The National Danish Registry of Medicinal Products...... Statistics was used to identify all claimed prescriptions for glaucoma medication and antihypertensive drugs. We first investigated basic correlations in the data and found that patients treated with antihypertensive medication, at any time during the study period, had a significantly higher overall relative...... risk (RR) of glaucoma, even when controlling for age and sex (with a RR of 1.31 and Pglaucoma. To investigate the causal effect of antihypertensive treatment on the onset of treatment for glaucoma, we used...

Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

Science.gov (United States)

Coleman, Anne L; Yu, Fei; Evans, Stacy J

2006-12-01

The American Academy of Ophthalmology Preferred Practice Patterns for angle closure and open-angle glaucoma (OAG) patients recommends performing bilateral gonioscopy upon initial presentation to evaluate the possibility of narrow angle or angle-closure glaucoma (ACG) and then repeating the examination at least every 5 years. This study aims to assess how commonly eye care providers perform gonioscopy before planned glaucoma surgery in OAG, anatomic narrow angle, and ACG in the Medicare population. Data obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States in 1999 were retrospectively reviewed. The proportion of patients with evidence of at least one gonioscopic examination before glaucoma surgery was determined for the period of 1995 to 1999. Demographic and clinical factors potentially influencing the decision to perform gonioscopy were also examined. Overall, gonioscopy is apparently performed in 49% of Medicare beneficiaries during the 4 to 5 years preceding glaucoma surgery. This rate was significantly lower (P gonioscopy rates (P Gonioscopy examination before glaucoma surgery in Medicare beneficiaries is underused, undercoded, and/or miscoded, given current recommendations. Underuse is of particular concern in patients undergoing laser iridotomy as it is the diagnostic test of choice in ACG.

Central corneal thickness among glaucoma patients attending ...

African Journals Online (AJOL)

AAU_CHS

ocular pressure measurement and is different among different ethnic population and subtypes of glaucoma. The central corneal thickness of different subtypes of glaucoma at Menelik II Hospital ... Intraocular pressure is a key element in the.

Glaucoma and cataract surgery: two roads merging into one.

Science.gov (United States)

Shah, Manjool; Law, Geoffrey; Ahmed, Iqbal Ike K

2016-01-01

To discuss the increasing utilization of cataract extraction in the management of glaucoma and to highlight advances in surgical care that can promote synergistic treatment of these comorbid conditions. Recent years have demonstrated significant advances in the management of glaucoma through the use of novel microinvasive glaucoma devices. Furthermore, an increased understanding of the role of cataract surgery in the treatment of various glaucomas warrants review. Nevertheless, cataract surgery in the glaucoma patient warrants specific preoperative, intraoperative, and postoperative planning to optimize visual function and quality of life while mitigating potential risk factors for adverse events. Although the challenges of performing cataract extraction on glaucoma patients exist, the potential benefit to these patients is substantial. With attention to pre- and perioperative surgical planning and intraoperative technique, as well as with awareness and potential utilization of novel devices and treatment strategies, cataract extraction offers a unique platform for anatomical and functional improvement in this increasingly common cohort of patients.

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.

Prevalence and determinants of glaucoma : an epidemiologic approach (The Rotterdam Study)

NARCIS (Netherlands)

I. Dielemans (Ida)

1995-01-01

textabstractGlaucoma is an eye disease characterized by damage to the optic nerve head and related visual field defects, often accompanied by elevated intraocular pressure. Glaucoma is an important cause of blindness, particularly in the elderly. One may divide glaucoma in primary glaucoma without

Glaucoma Surgery in Pregnancy: A Case Series and Literature Review

Directory of Open Access Journals (Sweden)

Mohammad Reza Razeghinejad

2016-09-01

Full Text Available 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.

Dolor, calidad de vida y estado anímico relacionados con la salud de pacientes ancianos hospitalizados

Directory of Open Access Journals (Sweden)

Juan Máximo Molina Linde

2013-01-01

el cuestionario Perfil de Salud de Nottingham (PSN y la Escala Verbal Simple (EVS. Resultados. En general, se observó que, en la medida en que el dolor aumentaba, empeoraban las áreas de calidad de vida evaluadas con el PSN, así como los niveles de ansiedad y depresión. Conclusión. Ante el deterioro de la calidad de vida y su relación con las respuestas emocionales asociadas a ansiedad y depresión, conforme la intensidad del dolor, se deben realizar intervenciones de nivel primario y secundario que permitan el control del dolor, con el fin de reducir el impacto en la salud mental de los adultos mayores, a partir de estrategias integradas entre lo farmacológico y psicológico. Del mismo modo, se sugiere la creación de programas intrahospitalarios que incorporen terapias integrales que, a su vez, atiendan la dimensión emocional y afectiva de los pacientes ancianos hospitalizados, con el propósito de mejorar su calidad de vida.

Relationship between retinal lattice degeneration and open angle glaucoma.

Science.gov (United States)

Rahimi, Mansour

2005-01-01

Patients with retinal disorders may develop glaucoma of both a primary and secondary type. Pigment may contribute to trabecular obstruction in some patients with open-angle glaucoma. Lattice degeneration of the retina in its typical form is a sharply demarcated, circumferentially oriented, degenerative process with significant alterations of retinal pigmentation. The association between myopia, open angle glaucoma and pigment dispersion is striking. Therefore, it could be postulated that there is significant prevalence of open angle glaucoma in patients with retinal lattice degeneration, especially in combination with myopia.

Willingness to Use Mobile Health in Glaucoma Patients.

Science.gov (United States)

Dai, Miaomiao; Xu, Jianan; Lin, Jialiu; Wang, Zhonghao; Huang, Wenmin; Huang, Jingjing

2017-10-01

Development of mobile health (m-health) in China carries tremendous potential, especially for glaucoma, one of the major chronic ophthalmic diseases afflicting millions of people. However, little research has been undertaken to investigate the willingness of glaucoma patients to use m-health and the factors influencing their decisions. This was a cross-sectional study. A self-administered or face-to-face interview survey was performed on 1,487 patients with glaucoma at the outpatient glaucoma service, Zhongshan Ophthalmic Center, Sun Yat-sen University. Questionnaires captured patients' demographic data, WeChat access, and willingness to receive m-health. The data were analyzed by single factor chi-square test. Multiple logistic regression revealed the motivators and barriers to accept m-health adoption. One thousand ninety-seven valid questionnaires were obtained. Seven hundred twenty-five respondents (66.1%) were willing to participate in m-health programs. 65.4% were younger than 60 years old. 40.9% had travel time from home to hospital of >3 h. 63.6% had more than four follow-up visits for glaucoma. 86.5% experienced trouble events during clinic visits. The overall WeChat usage rate was 61.7%. Age, travel time, number of visits, trouble events in clinic, and WeChat access in patients with glaucoma were related to the willingness to use m-health (p < 0.05). Most patients with glaucoma were willing to participate in m-health programs, which are essential to increasing and improving access to care.

Atención neonatal y materno con enfoque de riesgo

Directory of Open Access Journals (Sweden)

Ruiz de Cárdenas Carmen Helena

1991-12-01

Full Text Available

En los últimos años el enfoque de la atención en salud ha estado orientado hacia la atención primaria ejercida dentro de una comunidad determinada y vinculada a los organismos de nivel primario. Este enfoque que de por sí es una estrategia muy importante para el progreso de las comunidades, no ha permitido el desarrollo de acciones desde los niveles de atención secundaria y terciaria hacia la comunidad y los organismos de primer nivel. En el presente trabajo se pretende desarrollar un programa docente asistencial coordinado por una enfermera, con la participación de las facultades de Enfermería y Medicina de la Universidad Nacional y el Instituto Materno Infantil e implementar algunas estrategias de atención primaria con la participación de otros profesionales y la coordinación inter- institucional, en un organismo de tercer nivel como es el Instituto Materno Infantil y proyectarlos hacia la comunidad y los centros de salud correspondientes al área de influencia de la institución.

Shared Care in Monitoring Stable Glaucoma Patients: A Randomized Controlled Trial

NARCIS (Netherlands)

Holtzer-Goor, Kim M.; van Vliet, Ellen J.; van Sprundel, Esther; Plochg, Thomas; Koopmanschap, Marc A.; Klazinga, Niek S.; Lemij, Hans G.

2016-01-01

Comparing the quality of care provided by a hospital-based shared care glaucoma follow-up unit with care as usual. This randomized controlled trial included stable glaucoma patients and patients at risk for developing glaucoma. Patients in the Usual Care group (n=410) were seen by glaucoma

Optineurin, a multifunctional protein involved in glaucoma

Indian Academy of Sciences (India)

MADHU

Glaucomas are a heterogeneous group of neurodegenerative eye diseases that ... with normal tension glaucoma (a sub-type of adult onset primary open angle .... identifies variants at CSF1, OPTN and TNFRSF11A as genetic risk factors for.

Visual disability in Newly Diagnosed Primary open Angle Glaucoma ...

African Journals Online (AJOL)

Background: Glaucoma remains the second leading cause of blindness worldwide and the highest cause of irreversible blindness worldwide. In Nigeria, Glaucoma accounts for 16% of blindness and primary open angle glaucoma is the most prevalent clinical type. Aim: The aim of this study is to assess the visual disability ...

[Influence of Luxury Foodstuffs on Glaucoma].

Science.gov (United States)

Huber-van der Velden, K K

2017-02-01

The term "luxury foodstuffs" refers to foods which are not consumed because of their nutritional value. Classic modern luxury foodstuffs are alcohol, caffeine-containing drinks, cocoa, sugar and tobacco. The following review article examines some of these modern luxury foodstuffs in detail, as well as their influence on glaucoma. Thus, small quantities of alcohol lower high intraocular pressure and have a positive influence on the blood circulation of the optic nerve. In addition, red wine polyphenols exert vasoprotective effects. In general, however, alcohol consumption appears to have no significant effect on the prevalence of glaucoma. The most important source of caffeine intake is coffee consumption. In some studies, coffee consumption caused no changes in intraocular pressure, while others reported a rise. A large study showed a connection between heavy coffee consumption and the risk of pseudoexfoliation glaucoma. Green and black teas are rich sources of flavonoids with antioxidant activity. In addition, a slight trend for lowering the intraocular pressure has been measured. As regards chocolate, flavonoid-rich dark chocolate should be favoured, due to its antioxidant activity. It lowers blood pressure and improves endothelium-dependent vascular relaxation. Excessive sugar consumption over many years can lead to increased body mass index (BMI) and type 2 diabetes. Many studies show a positive relationship between BMI and intraocular pressure. Some studies have identified significant correlations between type 2 diabetes and the risk of glaucoma. Smoking is a very widespread stimulant; it narrows the blood vessels and thus reduces the blood circulation of the optic nerve. Otherwise, studies on the role of smoking as a risk factor for glaucoma have been very inconsistent. Luxury foodstuffs may effect glaucoma and should be included in the medical history. Georg Thieme Verlag KG Stuttgart · New York.

Glaucoma in Asia: regional prevalence variations and future projections.

Science.gov (United States)

Chan, Errol Wei'en; Li, Xiang; Tham, Yih-Chung; Liao, Jiemin; Wong, Tien Yin; Aung, Tin; Cheng, Ching-Yu

2016-01-01

To evaluate glaucoma prevalence and disease burden across Asian subregions from 2013 to 2040. We conducted a systematic review and meta-analysis of 23 population-based studies of 1318 primary open angle glaucoma (POAG) cases in 66,800 individuals and 691 primary angle closure glaucoma (PACG) cases in 72,767 individuals in Asia. Regions in Asia were defined based on United Nations' (UN) classification of macro-geographic regions. PubMed, Medline and Web of Science databases were searched for population-based glaucoma prevalence studies using standardised criteria published to 31 December 2013. Pooled glaucoma prevalence for individuals aged 40-80 years was calculated using hierarchical Bayesian approaches. Prevalence differences by geographic subregion, subtype and habitation were examined with random effects meta-regression models. Estimates of individuals with glaucoma from 2013 to 2040 were based on the UN World Population Prospects. In 2013, pooled overall glaucoma prevalence was 3.54% (95% credible interval (CrI) 1.83 to 6.28). POAG (2.34%, 95% CrI 0.96 to 4.55) predominated over PACG (0.73%, 95% CrI 0.18 to 1.96). With age and gender adjustment, PACG prevalence was higher in East than South East Asia (OR 5.55, 95% CrI 1.52 to 14.73), and POAG prevalence was higher in urban than rural populations (OR 2.11, 95% CrI 1.57 to 2.38). From 2013 to 2040, South Central Asia will record the steepest increase in number of glaucoma individuals from 17.06 million to 32.90 million compared with other Asian subregions. In 2040, South-Central Asia is also projected to overtake East Asia for highest overall glaucoma and POAG burden, while PACG burden remains highest in East Asia. Across the Asian subregions, there was greater glaucoma burden in South-Central and East Asia. Sustainable public health strategies to combat glaucoma in Asia are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Presentation of Primary Open Angle Glaucoma (POAG) at Lions ...

African Journals Online (AJOL)

Objective Primary open angle glaucoma (POAG) is the most common type of glaucoma in Africa. We carried out a study to determine the clinical presentation pattern of patients with primary open angle glaucoma (POAG) at a tertiary hospital in Malawi. Design A cross-sectional study. Setting Lions Sight First Eye Hospital—a ...

Trabectome surgery for primary and secondary open angle glaucomas.

Science.gov (United States)

Jordan, Jens F; Wecker, Thomas; van Oterendorp, Christian; Anton, Alexandra; Reinhard, Thomas; Boehringer, Daniel; Neuburger, Matthias

2013-12-01

In most forms of open angle glaucoma, the trabecular meshwork is the main barrier for aqueous humor outflow, causing elevated intraocular pressure (IOP). The Trabectome is a minimal invasive device for the surgical treatment of open angle glaucoma, particularly eliminating the juxtacanalicular meshwork. This study was conducted to compare the effectiveness and complication profile among different glaucoma subgroups. Single center prospective observational study. There were 557 consecutive eyes of 487 patients included in this study. Trabectome surgery was performed either alone or in combination with cataract surgery. Intraoperative and postoperative complications were documented systematically. Main outcome measures were IOP reduction over time and the preoperative and postoperative number of IOP-lowering medications. Due to subgroup sizes, only data from eyes with primary open angle glaucoma and pseudoexfoliation glaucoma were processed for statistical analysis. For the 261 eyes classified as primary open angle glaucoma, preoperative IOP was 24 ± 5.5 mmHg (mean ± SD) under 2.1 ± 1.3 IOP-lowering medications. After a mean follow-up of 204 ± 238 days, IOP was reduced to 18 ± 6.1 mmHg, and medication was reduced to 1.2 ± 1.1. For the 173 eyes classified as pseudoexfoliation glaucoma, after a mean follow-up of 200 ± 278 days, IOP was reduced from 25 ± 5.9 mmHg to 18 ± 8.2 mmHg, and medication was reduced from 2.0 ± 1.2 to 1.1 ± 1.1. A Cox proportional hazards model hinted forward superiority of the combined surgery cases (Trabectome + Phaco + intraocular lens) in comparison to Trabectome surgery only in phakic or pseudophakic eyes. No serious complications were observed. Minimal invasive glaucoma surgery with the Trabectome seems to be safe and effective. The subgroup analysis of different kinds of open angle glaucomas presented in this study may help in first-line patient selection. The lack of ocular surface alterations makes it a valuable addition to

Visual disability and quality of life in glaucoma patients.

Science.gov (United States)

Cesareo, Massimo; Ciuffoletti, Elena; Ricci, Federico; Missiroli, Filippo; Giuliano, Mario Alberto; Mancino, Raffaele; Nucci, Carlo

2015-01-01

Glaucoma is an optic neuropathy that can result in progressive and irreversible vision loss, thereby affecting quality of life (QoL) of patients. Several studies have shown a strong correlation between visual field damage and visual disability in patients with glaucoma, even in the early stages of the disease. Visual impairment due to glaucoma affects normal daily activities required for independent living, such as driving, walking, and reading. There is no generally accepted instrument for assessing quality of life in glaucoma patients; different factors involved in visual disability from the disease are difficult to quantify and not easily standardized. This chapter summarizes recent works from clinical and epidemiological studies, which describe how glaucoma affects the performance of important vision-related activities and QoL. © 2015 Elsevier B.V. All rights reserved.

Comparison of polypropylene and silicone Ahmed® glaucoma valves in the treatment of neovascular glaucoma: A 2-year follow-up.

Science.gov (United States)

Lubiński, Wojciech; Krzystolik, Karol; Gosławski, Wojciech; Kuprjanowicz, Leszek; Mularczyk, Maciej

2018-01-01

Inflammation associated with biomaterials of Ahmed® glaucoma drainage devices may cause the formation of a capsule around the device and can thus have a significant influence on the level of intraocular pressure reduction. The objective of this study was to compare the clinical outcomes after the implantation of a polypropylene or silicone Ahmed® glaucoma valve in patients with neovascular glaucoma. In the study, 27 eyes with neovascular glaucoma (group 1) received silicon Ahmed® valves and 23 eyes (group 2) received polypropylene valves. The best corrected distance visual acuity (BCDVA), intraocular pressure (IOP) and number of anti-glaucomatous drugs were recorded preoperatively and during a follow-up period of 24 months after surgery. Success was defined by the following criteria: 1) intraocular pressure in the rage of 6-21 mm Hg; 2) IOP reduction of at least 30% relative to preoperative values. All complications were registered. One month postoperatively, the mean BCDVA increased significantly in both groups compared to preoperative values (p glaucoma, the implantation of a silicone valve is associated with a significantly higher probability of long-term reduction of IOP below 21 mm Hg and with a lower risk of valve encapsulation in comparison to polypropylene valves. The obtained results suggest that silicone Ahmed® valves are more effective in the treatment of patients with neovascular glaucoma.

Evaluación del espesor corneal central y su influencia en la presión intraocular en pacientes del Hospital "Dr. Miguel Enríquez" Evaluation of the central corneal thickness and its impact on the intraocular pressure of patients in "Dr. Miguel Enriquez" hospital

Directory of Open Access Journals (Sweden)

María Teresa Arrronte Alarcón

2012-01-01

Full Text Available Objetivo: evaluar el espesor corneal central en sujetos sanos, hipertensos oculares, sospechosos de glaucoma y glaucomatosos, y su influencia en la presión intraocular. Métodos: se realizó un estudio descriptivo y transversal que incluyó 708 ojos de 356 sujetos que acudieron al servicio de oftalmología del Hospital Universitario "Dr. Miguel Enríquez" entre enero y diciembre de 2010. A los pacientes se les midió el espesor corneal central con paquimetría ultrasónica (paquímetro US 4000. El resto de la información se obtuvo a partir de las historias clínicas de los pacientes. Resultados: Los hipertensos oculares presentaron córneas gruesas (p=0,07; el mayor número de casos que tenían diagnóstico de sospecha de glaucoma y de glaucoma primario de ángulo abierto presentaron un grosor corneal delgado (p=0,62 y p=0,08 respectivamente. Si no se hubiese tenido en cuenta el factor de corrección para evaluar la presión intraocular se encontraría 48,1 % de los glaucomatosos y 31,5 % de los hipertensos oculares con diagnóstico inadecuado (pObjective: to evaluate the central corneal thickness in healthy individuals, in persons with ocular hypertension, and in suspected glaucoma and glaucomatous people, and its influence in intraocular pressure. Methods: a cross-sectional and descriptive study was performed in 708 eyes from 356 people who had been seen at ophthalmology service of “Dr. Miguel Enríquez”, university hospital from January to December, 2010. Their central corneal thickness was measured with ultrasonic pachymetry (pachymeter US 4000. The rest of the information came from the clinical histories of the patients. Results: Most of the ocular hypertensives presented thick corneas (p=0,07; a high number of cases that had diagnosis of glaucoma suspicion and primary open-angle glaucoma showed thin corneas (p=0,62 and (p=0,08 respectively. If the correction factor to evaluate the IOP had not been considered, then 48,1 % of the

Glaucoma detection with damato multifixation campimetry online

DEFF Research Database (Denmark)

Olsen, Ane Sophie; Alberti, M.; Serup, L.

2016-01-01

to define abnormality, and these were evaluated using the Glaucoma Staging System as gold standard. Receiver operating characteristic (ROC) curves and area under the ROC (AUC) were calculated. Results AUCs from 15 algorithms ranged from 0.79 to 0.90. The most promising algorithm combined results from two...... successive DMCO STANDARD tests. The sensitivity was highly dependent on the severity of glaucoma. Hence, for eyes with mild, moderate, advanced, and severe glaucoma, the DMCO test demonstrated a sensitivity of 11.8, 71.4, 100, and 100%, respectively. The specificity was as high as 98.1%. Median duration per...... eye to complete the DMCO STANDARD test was 86 s for the control group and 125 s in participants with glaucoma. Conclusions DMCO shows promise as a free-of-charge online tool to identify glaucomatous visual field defects in a preselected population. Ongoing studies are evaluating the use of DMCO...

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.

What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome?

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Siddiqui, Yasmin; Ten Hulzen, Richard D; Cameron, J Douglas; Hodge, David O; Johnson, Douglas H

2003-06-01

To determine the probability of converting from pigment dispersion syndrome to pigmentary glaucoma. Retrospective community-based study of all newly diagnosed cases of pigment dispersion syndrome or pigmentary glaucoma. Subjects were patients newly diagnosed with pigment dispersion syndrome or pigmentary glaucoma from 1976 to 1999 in Olmsted County, Minnesota. Criteria for pigment dispersion syndrome were two of three signs: midperipheral, radial iris transillumination defects; Krukenberg spindle; heavy trabecular meshwork pigmentation. Criteria for pigmentary glaucoma were pigment dispersion syndrome and two of three findings: intraocular pressure (IOP) greater than 21 mm, optic nerve damage, or visual field loss. Kaplan-Meier survival curves were used to determine the probability of conversion to pigmentary glaucoma. A total of 113 patients were newly diagnosed with pigment dispersion syndrome over the 24-year period. Of these, 9 persons developed pigmentary glaucoma or elevated IOP requiring therapy. The probability of converting to pigmentary glaucoma was 10% at 5 years and 15% at 15 years. An additional 23 patients were found to have pigmentary glaucoma at their initial examination. The mean age at diagnosis of pigmentary glaucoma was 42 +/- 12 years; 78% of patients were male, whereas 58% of patients with pigmentary dispersion syndrome glaucoma were male. The most significant risk factor for conversion to pigmentary glaucoma was an IOP greater than 21 mm Hg at initial examination, whereas age, refractive error, and family history of glaucoma were not correlated with conversion. The risk of developing pigmentary glaucoma from pigment dispersion syndrome was 10% at 5 years and 15% at 15 years. Young, myopic men were most likely to have pigmentary glaucoma. An IOP greater than 21 mm Hg at initial examination was associated with an increased risk of conversion.

Pigment dispersion syndrome and pigmentary glaucoma--a major review.

Science.gov (United States)

Niyadurupola, Nuwan; Broadway, David C

2008-12-01

Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.

Acupuncture for glaucoma.

Science.gov (United States)

Law, Simon K; Li, Tianjing

2013-05-31

Glaucoma is a multifactorial optic neuropathy characterized by an acquired loss of retinal ganglion cells at levels beyond normal age-related loss and corresponding atrophy of the optic nerve. Although many treatments are available to manage glaucoma, glaucoma is a chronic condition. Some patients may seek complementary or alternative medicine approaches such as acupuncture to supplement their regular treatment. The underlying plausibility of acupuncture is that disorders related to the flow of Chi (the traditional Chinese concept translated as vital force or energy) can be prevented or treated by stimulating relevant points on the body surface. The objective of this review was to assess the effectiveness and safety of acupuncture in people with glaucoma. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2013), EMBASE (January 1980 to January 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2013), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to January 2013), ZETOC (January 1993 to January 2013), Allied and Complementary Medicine Database (AMED) (January 1985 to January 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the National Center for Complementary and Alternative Medicine web site (NCCAM) (http://nccam.nih.gov). We did not use any language or date restrictions in the search for trials. We last searched the electronic databases on 8 January 2013 with the exception of NCCAM which was last searched on 14 July 2010. We also handsearched Chinese

24-h Efficacy of Glaucoma Treatment Options.

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Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

2016-04-01

Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

Epidemiology of glaucoma in sub-saharan Africa: prevalence, incidence and risk factors.

Science.gov (United States)

Kyari, Fatima; Abdull, Mohammed M; Bastawrous, Andrew; Gilbert, Clare E; Faal, Hannah

2013-01-01

The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. 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. 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. 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.

EVOLUTION THE CONCEPTS OF ROLE OF INTRAOCULAR PRESSURE IN GLAUCOMA PROGRESSION (REVIEW

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N. I. Kurysheva

2016-01-01

Full Text Available The role of elevated intraocular pressure (IOP in the progression of glaucoma optical neuropathy has emphasized repeatedly. The question about the role of elevated IOP as the underlying cause of glaucoma arose in the early 1960s. However, epidemiological studies have questioned the role of IOP as a diagnostic criterion for glaucoma, due to the relatively rare detection the disease among those with ocular hypertension and frequent detection of glaucoma with normal IOP. Multicenter studies determining the role of antihypertensive therapy in the treatment of glaucoma, have shown the importance of reducing IOP: decricing IOP at 1 mm Hg reduced the risk of developing glaucoma on 10-19%. In addition, it was found that the rate of glaucoma progression is very variable. It depends not only on the form of glaucoma, but also on other factors such as the stage of disease and therapy. Swedish study shown normal-tension glaucoma often progressed among the patients with more aggressive treatment such as argon laser trabeculoplasty or trabeculectomies. According to the study’s data, age is the most important risk factor for the progression of normal-tension glaucoma. Such questions as fluctuations in IOP, reduction of retrobulbar blood flow, antihypertensive treatment on the progression of glaucoma are still discussed. Despite the fact that the latter UKGTS multicenter study (2014 showed a decrease in the rate of progression of glaucoma in patients treated with latanoprost, a high percentage of non-treated patients didn’t have disease’s progression. In this regard, the role of IOP as main starting factor in glaucoma pathogenesis is still open.

Traumatic glaucoma due to paintball injuries: A case series

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Kelly M. Lee

2017-12-01

Full Text Available Purpose: To study the management and outcomes of patients with paintball injuries resulting in traumatic glaucoma. Methods: A retrospective review was performed, identifying four patients with a confirmed diagnosis of traumatic glaucoma secondary to paintball sports. Results: Four male patients with paintball gun injuries presented with a mean follow-up time of 51 months after the date of injury. The mean age was 23.5 ± 18.6 years. Three patients presented with blunt trauma, while one patient had a ruptured globe. Presenting visual acuity (VA was hand motions in three of the patients and no light perception in the fourth patient. All patients were diagnosed with traumatic glaucoma and treated with glaucoma medications during their follow-up. Two patients received tube shunts to control intraocular pressures (IOPs. At the time of most recent follow-up, three patients had elevated IOPs and were not on any medications. VA at the last follow-up was 20/400 or worse. Conclusions: Traumatic glaucoma can be managed with surgical and medical interventions, while VA usually does not return to baseline levels prior to the injury. Prognostic predictors can be used to guide treatment and identify patients who should be closely followed. Because the presentation and onset is widely variable, follow-up and screening is crucial even years after the injury. Keywords: Paintball, Ocular trauma, Glaucoma, Secondary glaucoma

Clinical Outcomes of FP-7/8 Ahmed Glaucoma Valves in the Management of Refractory Glaucoma in the Mainland Chinese Population.

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Yingting Zhu

Full Text Available To evaluate the efficacy and safety of the Ahmed glaucoma valve (AGV and the risk factors associated with AGV implantation failure in a population of Chinese patients with refractory glaucoma.In total, 79 eyes with refractory glaucoma from 79 patients treated in our institution from November 2007 to November 2010 were enrolled in this retrospective study. The demographic data, preoperative and postoperative intraocular pressures (IOPs, best corrected visual acuity (BCVA, number of anti-glaucoma medications used, completed and qualified surgery success rates and postoperative complications were recorded to evaluate the outcomes of AGV implantation. Factors that were associated with implant failure were determined using Cox proportional hazard regression model analysis and multiple linear regression analysis.The average follow-up time was 12.7±5.8 months (mean±SD. We observed a significant reduction in the mean IOP from 39.9±12.6 mm Hg before surgery to 19.3±9.6 mm Hg at the final follow-up. The complete success rate was 59.5%, and the qualified success rate was 83.5%. The number of previous surgeries was negatively correlated with qualified success rate (P<0.05, OR=0.736, 95% CI 0.547-0.99. Patients with previous trabeculectomy were more likely to use multiple anti-glaucoma drugs to control IOP (P<0.01. The primary complication was determined to be a flat anterior chamber (AC.AGV implantation was safe and effective for the management of refractory glaucoma. Patients with a greater number of previous surgeries were more likely to experience surgical failure, and patients with previous trabeculectomy were more likely to use multiple anti-glaucoma drugs to control postoperative IOP.

Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study

Science.gov (United States)

2017-05-02

Glaucoma; Glaucoma Suspect; Diabetic Retinopathy; Ocular Hypertension; Cataract; Branch Retinal Vein Occlusion; Branch Retinal Arterial Occlusion; Central Retinal Vein Occlusion; Central Retinal Artery Occlusion; Epi-retinal Membrane; Macular Degeneration; Drusen; Loss of Vision

Socioeconomics of long-term glaucoma therapy in India

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Bhagabat Nayak

2015-01-01

Full Text Available Purpose: To determine the socioeconomic impact of long-term glaucoma therapy. Materials and Methods: One hundred and fifty consecutive glaucoma patients on medical therapy, following up at our glaucoma service for at least 6 months were recruited. A questionnaire regarding monthly income, cost of glaucoma medications prescribed, availability of medications, travel time, time spent in review clinics, compliance, education status, medical insurance and systemic or local side-effects was administered. Results: The patients seen at the tertiary government hospital had an average monthly income of Rs. 10,912/- (range: Rs. 500/- to Rs. 50,000/- with approximately 56% of the patients having an income of less than Rs. 5000/month. The expenditure on anti-glaucoma medications ranged from 0.3% in high income group to 123% of their monthly gross income in low income group (P < 0.0001. The total expenditure including travel, stay, and loss of wages of patients and accompanying persons ranged from 1.6% in high income group to 137% of the monthly income in low income group (P < 0.0001. Mean time required for a glaucoma clinic visit was 15.66 h, (range: 6-96 h/month. About 2.7% experienced systemic side-effects and 21.3% had complaints of ocular adverse effects. About 90% of the patients were compliant. 92% were not covered by any insurance plan/government reimbursement for their treatment. Conclusions: Medical therapy for glaucoma is an economic burden to many patients and should be individualized, according to the socioeconomic status, availability of drugs and the required distance to travel to reach the specialist clinics.

Cyclo-photocoagulation in the management of aphakic glaucoma

International Nuclear Information System (INIS)

Lee, P.-F.

1984-01-01

Transpupillary argon laser photocoagulation of the ciliary processes (TALC) through a widely dilated pupil, with or without cerebral depression, has been used in the management of glaucoma in aphakic eyes for a number of years. 58% of glaucoma in aphakics treated with TALC showed sustained and meaningful intraocular pressure reduction 2 months to 5 years after the procedure. Clinically, the TALC procedure is a relatively safe, effective, and an useful alternative approach in the management of selected cases of glaucoma in aphakics. (Auth.)

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

Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

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Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

2015-01-01

Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pglaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

Structure-Function Correlation Using Confocal Laser Ophthalmoscope in Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma.

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Pappas, Theofanis; Founti, Panayiota; Yin, Xiang Jun; Koskosas, Archimidis; Anastasopoulos, Eleftherios; Salonikiou, Angeliki; Kilintzis, Vasilios; Antoniadis, Antonios; Ziakas, Nikolaos; Topouzis, Fotis

2016-04-01

To compare Heidelberg Retina Tomograph (HRT) optic disc parameters and structure-function correlation between primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). Prospective, observation case series. A total of 54 POAG and 33 PEXG cases, consecutively recruited from a University Glaucoma Service, underwent a comprehensive ophthalmic examination, including HRT optic disc imaging. Glaucoma definition required the presence of both structural and functional damage. One eye per subject was included in the analysis. T test, Mann-Whitney U test, and analysis of covariance were used to compare HRT parameters between POAG and PEXG, adjusting for age, mean deviation (MD) in the visual field, intraocular pressure, and disc area. The correlation between HRT and MD was assessed in each group. Cup area (P=0.048), height variation contour (P=0.016), and cup/disc area ratio (P=0.023) were higher in POAG, whereas the mean retinal nerve fiber layer thickness (P=0.048), retinal nerve fiber layer cross-section area (P=0.044), and rim area (P=0.048) were lower in POAG, compared with PEXG. The correlation of HRT parameters with MD was significant only in the POAG group. At a similar level of functional damage, POAG subjects presented with more pronounced structural damage than PEXG subjects. The correlation between HRT and visual field parameters was more evident in POAG, compared with PEXG.

Experimental Contact Lens to Prevent Glaucoma-Induced Blindness

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... An Experimental Contact Lens to Prevent Glaucoma-Induced Blindness By Sharon Reynolds Posted January 23, 2014 An ... group of conditions that can result in irreversible blindness. This vision loss can be reduced if glaucoma ...

Marijuana for Glaucoma: A Recipe for Disaster or Treatment?

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Sun, Xiaoshen; Xu, Chaoying S; Chadha, Nisha; Chen, Allshine; Liu, Ji

2015-09-01

Marijuana has been shown to lower intraocular pressure (IOP) but with limited duration of action and numerous adverse effects. Use of marijuana to lower IOP as a means of glaucoma treatment would require frequent use throughout the day, leading to significant adverse effects, possible progression toward Cannabis Use Disorder (CUD), and/or withdrawal symptoms. The treatment of glaucoma based on the cannabis plant or drugs based on the cannabinoid molecule should be considered carefully before being prescribed. Considerations should include the adverse physical and psychological adverse effects, including substance abuse. Currently, the deleterious effects of marijuana outweigh the benefits of its IOP-lowering capacity in most glaucoma patients. Under extremely rare circumstances, a few categories of glaucoma patients may be potential candidates for treatment with medical marijuana. Further studies on alternate routes and more focused means of cannabinoid molecule delivery to the eye for glaucoma treatment are needed.

Epidemiology of Glaucoma in Sub-Saharan Africa: Prevalence, Incidence and Risk Factors

Science.gov (United States)

Kyari, Fatima; Abdull, Mohammed M.; Bastawrous, Andrew; Gilbert, Clare E.; Faal, Hannah

2013-01-01

Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. 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. PMID:23741130

Poblaciones linfocitarias, células dendríticas y perfil de citoquinas en ratones con melanoma tratados con Uncaria tomentosa

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Iván Lozada-Requena

Full Text Available Objetivos. Evaluar el efecto inmunomodulador sobre poblaciones linfocitarias, células dendríticas (DC, citoquinas Th1/Th2/Th17 (T-helper e inflamatorias en el ámbito sistémico y/o en el microambiente tumoral de ratones con o sin melanoma. Materiales y métodos. Se obtuvieron muestras de sangre periférica y/o de tumores primarios de ratones con melanoma B16 tratados o no con un extracto hidroalcohólico de Uncaria tomentosa (UT con 5,03% de alcaloides oxindólicos pentacíclicos (UT-POA obtenido de la corteza de la planta. Todos los ensayos de medición de células y citoquinas fueron realizados por citometría de flujo. Resultados. UT-POA a nivel sistémico incrementa la relación CD4/CD8a (Cluster of Differenciation, mientras que la activación celular es inversamente proporcional; incrementa la proporción de DCm (DC mieloides; induce un perfil Th1 proinflamatorio y reduce la respuesta Th17. TNF-a (tumor necrosis factor alpha y IL-17A (interleuquina correlacionan positiva y negativamente con la relación CD4/CD8a. Conclusiones. El incremento de Th1 (TNF-a puede tener como consecuencia el incremento de linfocitos CD4 o la activación de macrófagos M1. Aunque UT-POA muestra un incremento de DCm, este no es dosis-dependiente. La disminución de Th17 (IL-17A puede favorecer el funcionamiento de los linfocitos CD8a. UT-POA muestra mejores efectos inmunomoduladores en el ámbito sistémico que intratumoral

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.

Areas and factors associated with patients’ dissatisfaction with glaucoma care

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Foo VH

2017-10-01

Full Text Available Valencia Hui Xian Foo,1 Sarah En Mei Tan,2 David Ziyou Chen,3 Shamira A Perera,1,4 Charumathi Sabayanagam,4,5 Eva Katie Fenwick,4,5 Tina T Wong,1,4,5 Ecosse L Lamoureux4–6 1Singapore National Eye Centre, Singapore; 2Tan Tock Seng Hospital, Singapore; 3Department of Ophthalmology, National University of Singapore and National University Health System, Singapore; 4Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 5Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; 6Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia Objective: The aim of this study was to evaluate patients’ dissatisfaction with overall and specific aspects of a tertiary glaucoma service and to determine their independent factors, including intraocular pressure (IOP and visual acuity (VA. Methods: Patients, aged ≥21 years, from a specialist glaucoma service in a tertiary eye hospital in Singapore for at least 6 months, were recruited for this cross-sectional study between March and June 2014. All consenting patients completed a 7-area glaucoma-specific satisfaction questionnaire and one item related to satisfaction with overall glaucoma care. We determined the top three areas of dissatisfaction and overall dissatisfaction with the glaucoma service. We also explored the independent factors associated with overall and specific areas of patients’ dissatisfaction with their glaucoma care, including VA and IOP by using logistic regression models. Results: Of the 518 patients recruited, 438 (84.6% patients completed the study. Patients’ dissatisfaction with the overall glaucoma service was 7.5%. The three areas of glaucoma service with the highest dissatisfaction rates were as follows: 1 explanation of test results (24.8%; 2 explanation of glaucoma complications (23.7%; and 3 advice on managing glaucoma (23.5%. Patients who were dissatisfied with the overall service had a worse mean VA compared with

The optic nerve head in glaucoma

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Rupert RA Bourne

2006-09-01

Full Text Available ll types of glaucoma involve glaucomatous optic neuropathy. The key to detection and management of glaucoma is understanding how to examine the optic nerve head (ONH. This pictorial glossary addresses the following issues: how to examine the ONH; normal characteristics of the ONH; characteristics of a glaucomatous ONH; how to tell if the glaucomatous optic neuropathy is getting worse;‘pitfalls and pearls’.

Glaucoma: Eye-to-Eye with Dr. Rachel Bishop

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... of this page please turn JavaScript on. Feature: Glaucoma Eye-to-Eye with Dr. Rachel Bishop Past ... nerves are pale and cupped—signs of advanced glaucoma. Yet the patient wasn't aware of any ...

Intracameral air injection during Ahmed glaucoma valve implantation in neovascular glaucoma for the prevention of tube obstruction with blood clot: Case Report.

Science.gov (United States)

Hwang, Sung Ha; Yoo, Chungkwon; Kim, Yong Yeon; Lee, Dae Young; Nam, Dong Heun; Lee, Jong Yeon

2017-12-01

Glaucoma drainage implant surgery is a treatment option for the management of neovascular glaucoma. However, tube obstruction by blood clot after Ahmed glaucoma valve (AGV) implantation is an unpredictable clinically challenging situation. We report 4 cases using intracameral air injection for the prevention of the tube obstruction of AGV by blood clot. The first case was a 57-year-old female suffering from ocular pain because of a tube obstruction with blood clot after AGV implantation in neovascular glaucoma. Surgical blood clot removal was performed. However, intractable bleeding was noted during the removal of the blood clot, and so intracameral air injection was performed to prevent a recurrent tube obstruction. After the procedure, although blood clots formed around the tube, the tube opening where air could touch remained patent. In 3 cases of neovascular glaucoma with preoperative severe intraocular hemorrhages, intracameral air injection and AGV implantation were performed simultaneously. In all 3 cases, tube openings were patent. It appears that air impeded the blood clots formation in front of the tube opening. Intracameral air injection could be a feasible option to prevent tube obstruction of AGV implant with a blood clot in neovascular glaucoma with high risk of tube obstruction. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Undetected angle closure in patients with a diagnosis of open-angle glaucoma.

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Varma, Devesh K; Simpson, Sarah M; Rai, Amandeep S; Ahmed, Iqbal Ike K

2017-08-01

The aim of this study was to identify the proportion of patients referred to a tertiary glaucoma centre with a diagnosis of open-angle glaucoma (OAG) who were found to have angle closure glaucoma. Retrospective chart review. Consecutive new patients referred for glaucoma management to a tertiary centre between July 2010 and December 2011 were reviewed. Patients whose referrals for glaucoma assessment specified angle status as "open" were included. The data collected included glaucoma specialist's angle assessment, diagnosis, and glaucoma severity. The status of those with 180 degrees or more Shaffer angle grading of 0 was classified as "closed." From 1234 glaucoma referrals, 179 cases were specified to have a diagnosis of OAG or when angles were known to be open. Of these, 16 (8.9%) were found on examination by the glaucoma specialist to have angle closure. Pseudoexfoliation was present in 4 of 16 patients (25%) in the missed angle-closure glaucoma (ACG) group and 22 of 108 patients (13.5%) in the remaining OAG group. There was no difference found in demographic or ocular biometric parameters between those with confirmed OAG versus those with missed ACG. Almost 1 in 11 patients referred by ophthalmologists to a tertiary glaucoma centre with a diagnosis of OAG were in fact found to have angle closure. Given the different treatment approaches for ACG versus OAG, this study suggests a need to strengthen angle evaluations. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Neuroprotection in glaucoma

Science.gov (United States)

Vasudevan, Sushil K; Gupta, Viney; Crowston, Jonathan G

2011-01-01

Glaucoma is a neurodegenerative disease characterized by loss of retinal ganglion cells and their axons. Recent evidence suggests that intraocular pressure (IOP) is only one of the many risk factors for this disease. Current treatment options for this disease have been limited to the reduction of IOP; however, it is clear now that the disease progression continues in many patients despite effective lowering of IOP. In the search for newer modalities in treating this disease, much data have emerged from experimental research the world over, suggesting various pathological processes involved in this disease and newer possible strategies to treat it. This review article looks into the current understanding of the pathophysiology of glaucoma, the importance of neuroprotection, the various possible pharmacological approaches for neuroprotection and evidence of current available medications. PMID:21150020

Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

OpenAIRE

Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

2015-01-01

Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve...

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

Ganglion cell complex scan in the early prediction of glaucoma.

Science.gov (United States)

Ganekal, S

2012-01-01

To compare the macular ganglion cell complex (GCC) with peripapillary retinal fiber layer (RNFL) thickness map in glaucoma suspects and patients. Forty participants (20 glaucoma suspects and 20 glaucoma patients) were enrolled. Macular GCC and RNFL thickness maps were performed in both eyes of each participant in the same visit. The sensitivity and specificity of a color code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Standard Automated Perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. The statistical analysis was performed with the SPSS 10.1 (SPSS Inc. Chicago, IL, EUA). Results were expressed as mean +/- standard deviation and a p value of 0.05 or less was considered significant. Provide absolute numbers of these findings with their units of measurement. There was a statistically significant difference in average RNFL thickness (p=0.004), superior RNFL thickness (p=0.006), inferior RNFL thickness (p=0.0005) and average GCC (p=0.03) between the suspects and glaucoma patients. There was no difference in optic disc area (p=0.35) and vertical cup/disc ratio (p=0.234) in both groups. While 38% eyes had an abnormal GCC and 13% had an abnormal RNFL thickness in the glaucoma suspect group, 98% had an abnormal GCC and 90% had an abnormal RNFL thickness in the glaucoma group. The ability to diagnose glaucoma with macular GCC thickness is comparable to that with peripapillary RNFL thickness . Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma. © NEPjOPH.

Outcomes of glaucoma reoperations in the Tube Versus Trabeculectomy (TVT) Study.

Science.gov (United States)

Saheb, Hady; Gedde, Steven J; Schiffman, Joyce C; Feuer, William J

2014-06-01

To describe the incidence and outcomes of reoperations for glaucoma in the Tube Versus Trabeculectomy (TVT) Study. Cohort study of patients in a multicenter randomized clinical trial. The TVT Study enrolled 212 patients with medically uncontrolled glaucoma who had previous cataract and/or glaucoma surgery. Randomization assigned 107 patients to surgery with a tube shunt (350 mm(2) Baerveldt glaucoma implant) and 105 patients to trabeculectomy with mitomycin C (0.4 mg/mL for 4 minutes). Data were analyzed from patients who failed their assigned treatment and had additional glaucoma surgery. Outcome measures included intraocular pressure (IOP), use of glaucoma medications, visual acuity, surgical complications, and failure (IOP >21 mm Hg or not reduced by 20%, IOP ≤5 mm Hg, additional glaucoma surgery, or loss of light perception vision). Additional glaucoma surgery was performed in 8 patients in the tube group and 18 patients in the trabeculectomy group in the TVT Study, and the 5-year cumulative reoperation rate was 9% in the tube group and 29% in the trabeculectomy group (P = .025). Follow-up (mean ± SD) after additional glaucoma surgery was 28.0 ± 16.0 months in the tube group and 30.5 ± 20.4 months in the trabeculectomy group (P = .76). At 2 years after a glaucoma reoperation, IOP (mean ± SD) was 15.0 ± 5.5 mm Hg in the tube group and 14.4 ± 6.6 mm Hg in the trabeculectomy group (P = .84). The number of glaucoma medications (mean ± SD) after 2 years of follow-up was 1.1 ± 1.3 in the tube group and 1.4 ± 1.4 in the trabeculectomy group (P = .71). The cumulative probability of failure at 1, 2, 3, and 4 years after additional glaucoma surgery was 0%, 43%, 43%, and 43%, respectively, in the tube group, and 0%, 9%, 20%, and 47% in the trabeculectomy group (P = .28). Reoperations to manage complications were required in 1 patient in the tube group and 5 patients in the trabeculectomy group (P = .63). The rate of reoperation for glaucoma was higher following

Coincidence of retinitis pigmentosa and pseudoexfoliative glaucoma

Directory of Open Access Journals (Sweden)

Božić Marija

2017-01-01

Full Text Available Introduction. This is an observational case report presenting retinitis pigmentosa associated with pseudoexfoliative glaucoma. Case outline. A 69-year-old man presented with retinitis pigmentosa. On examination, pseudoexfoliative material was detected on anterior segment structures, and intraocular pressure was 26 mmHg in the right and 24 mmHg in the left eye. The patient was commenced on topical antiglaucomatous therapy (timolol + dorzolamide twice daily, latanoprost once in the evening to both eyes. Conclusion. To the best of our knowledge, this is the first reported case of retinitis pigmentosa associated with pseudoexfoliative glaucoma. Although rare, retinitis pigmentosa and glaucoma can occur in the same eye.

Los trastornos de la lectura y la escritura en escolares de la Educación Primaria

Directory of Open Access Journals (Sweden)

Sc Idevis Lores-Leyva

2017-11-01

Full Text Available Se abordan fundamentos teóricos metodológicos relacionados con la atención logopédica a los escolares primarios con trastornos en la lectura y la escritura y algunos elementos indispensables que deben dominar los maestros primarios para la atención a estos escolares, con ejercicios prácticos para todo tipo de dislexia y disgrafia que brindan atención diferenciada a estos trastornos además de un breve resumen con los resultados obtenidos en la escuela primaria”Fabio Rosell del Río” de la provincia Guantánamo.

Primary angle closure glaucoma in a myopic kinship.

Science.gov (United States)

Hagan, J C; Lederer, C M

1985-03-01

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

[Study of corvitin efficiency in primary glaucoma].

Science.gov (United States)

Mykheĭtseva, I M; Kashyntseva, L T; Artemov, O V; Khramenko, N I

2012-01-01

There were concluded our results of animal experimental investigation and clinical observation of the quercetin-containing preparation corvitin (C) in primary glaucoma treatment. On the model of disease it is shown for rabbit, that introduction of 0.5 ml 2 % C as factious instillation into the eye a basely decreased eye blood flow was increased twice, mionectic at glaucoma eye hydrodynamics was normalized : the outflow of liquid increased on 58 %, inflow - on 52 %, intraocular pressure went down on 14%. Intravenous inflowing of C brought down expressed of oxidative stress - M[see text]A in blood is decreased on 40 %, level of endothelial dysfunction marker NO is increased on 70 %. On the model of glaucoma for rats C, entered protractedly, showed the neuroprotective actions on the neurons of retina, promoting survivability of ganglion cells, that it is shown on histological preparations. Application C in the clinic of glaucoma (intravenously a 0.5 g of preparation in 100 ml of solution) improved for patients a blood supply in the eye on 25 %, and also rendered a positive antioxidant and metabolic effect. Noted positive influences of C concurrently to important pathogeneses factors such as regional eye blood supply, eye hydrodynamics, oxidative stress, metabolic changes, survival of retina neurons grounds to talk about new strategy of pathogenesis therapy of glaucoma.

Glaucoma Patient-Reported Concerns and Associated Factors.

Science.gov (United States)

Mogil, Rachel S; Tirsi, Andrew; Lee, Jung Min; Tello, Celso; Park, Sung Chul

2017-06-01

To assess the character and degree of concerns of glaucoma patients and identify demographic/clinical factors affecting the concerns. Prospective cross-sectional study. A questionnaire that addressed patients' concerns was administered to consecutive glaucoma patients. Severity of concern was scored with a scale of 0-5 in order of increasing severity. Age, sex, intraocular pressure, visual field (VF) mean deviation (MD), number of antiglaucoma medications, history of glaucoma surgery, and employment status were recorded. Questionnaire results of 152 patients (mean VF MD, -8.03 ± 7.86 dB [better eye] and -16.06 ± 10.22 dB [worse eye]; mean age, 69 ± 14 years) were analyzed. Severity of concern was greatest for general eyesight (2.92/5.00) and visual symptoms (2.78/5.00), followed by activities (2.20/5.00) and socioeconomic factors (2.13/5.00), and then ocular symptoms (1.69/5.00) (P factors correlated with VF MD of the better eye (r = -0.245; P = .003) and age (r = -0.260; P = .001). Glaucoma patients reported varied degrees of concern regarding items associated with quality of life. Certain items may be more concerning than others. Severity of some concerns increased with more severe VF loss, prior glaucoma surgery, or younger age. Copyright © 2017 Elsevier Inc. All rights reserved.

Building a glaucoma interaction network using a text mining approach.

Science.gov (United States)

Soliman, Maha; Nasraoui, Olfa; Cooper, Nigel G F

2016-01-01

The volume of biomedical literature and its underlying knowledge base is rapidly expanding, making it beyond the ability of a single human being to read through all the literature. Several automated methods have been developed to help make sense of this dilemma. The present study reports on the results of a text mining approach to extract gene interactions from the data warehouse of published experimental results which are then used to benchmark an interaction network associated with glaucoma. To the best of our knowledge, there is, as yet, no glaucoma interaction network derived solely from text mining approaches. The presence of such a network could provide a useful summative knowledge base to complement other forms of clinical information related to this disease. A glaucoma corpus was constructed from PubMed Central and a text mining approach was applied to extract genes and their relations from this corpus. The extracted relations between genes were checked using reference interaction databases and classified generally as known or new relations. The extracted genes and relations were then used to construct a glaucoma interaction network. Analysis of the resulting network indicated that it bears the characteristics of a small world interaction network. Our analysis showed the presence of seven glaucoma linked genes that defined the network modularity. A web-based system for browsing and visualizing the extracted glaucoma related interaction networks is made available at http://neurogene.spd.louisville.edu/GlaucomaINViewer/Form1.aspx. This study has reported the first version of a glaucoma interaction network using a text mining approach. The power of such an approach is in its ability to cover a wide range of glaucoma related studies published over many years. Hence, a bigger picture of the disease can be established. To the best of our knowledge, this is the first glaucoma interaction network to summarize the known literature. The major findings were a set of

Scleral fibroblast response to experimental glaucoma in mice

Science.gov (United States)

Tezel, Gülgün; Cone-Kimball, Elizabeth; Steinhart, Matthew R.; Jefferys, Joan; Pease, Mary E.; Quigley, Harry A.

2016-01-01

Purpose To study the detailed cellular and molecular changes in the mouse sclera subjected to experimental glaucoma. Methods Three strains of mice underwent experimental bead-injection glaucoma and were euthanized at 3 days and 1, 3, and 6 weeks. Scleral protein expression was analyzed with liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) using 16O/18O labeling for quantification in 1- and 6-week tissues. Sclera protein samples were also analyzed with immunoblotting with specific antibodies to selected proteins. The proportion of proliferating scleral fibroblasts was quantified with Ki67 and 4’,6-diamidino-2-phenylindole (DAPI) labeling, and selected proteins were studied with immunohistochemistry. Results Proteomic analysis showed increases in molecules involved in integrin-linked kinase signaling and actin cytoskeleton signaling pathways at 1 and 6 weeks after experimental glaucoma. The peripapillary scleral region had more fibroblasts than equatorial sclera (p=0.001, n=217, multivariable regression models). There was a sixfold increase in proliferating fibroblasts in the experimental glaucoma sclera at 1 week and a threefold rise at 3 and 6 weeks (p=0.0005, univariate regression). Immunoblots confirmed increases for myosin, spectrin, and actinin at 1 week after glaucoma. Thrombospondin-1 (TSP-1), HINT1, vimentin, actinin, and α-smooth muscle actin were increased according to immunohistochemistry. Conclusions Scleral fibroblasts in experimental mouse glaucoma show increases in actin cytoskeleton and integrin-related signaling, increases in cell division, and features compatible with myofibroblast transition. PMID:26900327

Comparison of polypropylene and silicone Ahmed Glaucoma Valves.

Science.gov (United States)

Ishida, Kyoko; Netland, Peter A; Costa, Vital P; Shiroma, Lineu; Khan, Baseer; Ahmed, Iqbal Ike K

2006-08-01

To evaluate and compare the clinical outcomes after implantation of the silicone plate and the polypropylene plate Ahmed Glaucoma Valves. Prospective, multicenter, comparative series. A total of 132 patients with uncontrolled glaucoma were treated with either the silicone or polypropylene Ahmed Glaucoma Valve implant. Success was defined according to 2 criteria: (1) intraocular pressure (IOP) of 6 mmHg or more or 21 mmHg or less, and (2) IOP reduction of at least 30% relative to preoperative values. Eyes requiring further glaucoma surgery, including cyclophotocoagulation, or showing loss of light perception were classified as failures. Average follow-up was 12.8 months (range, 6-30 months) for the silicone plate group and 14.5 months (range, 6-30 months) for the polypropylene plate group (P = 0.063). At the last follow-up examination, the mean IOP was 13.8+/-3.9 mmHg and 17.3+/-6.5 mmHg (PAhmed Glaucoma Valve (model FP7) showed improved IOP reduction compared with the polypropylene (model S2) implant. Differences observed in mean IOP, success rate, and complications suggest that plate material may influence clinical outcome.

Custo real do tratamento do glaucoma para o paciente The real cost of glaucoma treatment for an outpatient

Directory of Open Access Journals (Sweden)

Larissa Pedroso

1999-12-01

Full Text Available Objetivo: Avaliar o custo do tratamento do glaucoma para o paciente, numa instituição de ensino médico. Casuística e Métodos: Foram aplicados, aleatoriamente, questionários, na forma de entrevista ativa, a 94 pacientes do ambulatório do Setor de Glaucoma do Departamento de Oftalmologia da Universidade Federal de São Paulo, analisando gastos pessoais e com medicamentos antiglaucomatosos. Os dados foram agrupados, tabulados e foi realizada separação da amostra em dois grupos: pacientes cirúrgicos e não-cirúrgicos. Resultados: A mediana do gasto total anual estimado com glaucoma foi de R$ 480,15, o equivalente a 13% da renda anual mediana dos pacientes. Separadamente, o grupo dos pacientes cirúrgicos obteve uma mediana dos gastos totais estimados de R$ 677,94, o que corresponde a 19% da renda mediana anual. Já o grupo dos pacientes não-cirúrgicos, apresentou mediana de R$ 393,54, representando 11% da renda mediana anual. Foi encontrada diferença estatisticamente significante entre os grupos cirúrgico e não-cirúrgico para o gasto total anual (p = 0,012. Conclusão: Observou-se que o custo do tratamento na renda familiar de pessoas portadoras de glaucoma é considerável, mesmo em uma instituição públicaPurpose: To evaluate the cost of glaucoma treatment for an outpatient in a public university hospital. Patients and Methods: Ninety-four outpatients were ran-domly Glaucoma Clinic of the Ophthalmology Department of the Universidade Federal de São Paulo, submitted to questionnaires at the regarding personal and antiglaucoma medicine expenses. Data collected, tabulated and the sample was divided into two were groups: surgical and nonsurgical. Results: The median estimated total spent annually on glaucoma treatment was R$ 480.15, equivalent to 13% of the median annual family income of the patients. When the sample was divided into two groups, the figures were quite different. The surgical group had a median annual estimated total

Changes to the Aqueous Humor Proteome during Glaucoma.

Science.gov (United States)

Kaeslin, Martha Andrea; Killer, Hanspeter Ezriel; Fuhrer, Cyril Adrian; Zeleny, Nauke; Huber, Andreas Robert; Neutzner, Albert

2016-01-01

To investigate the aqueous humor proteome in patients with glaucoma and a control group. Aqueous humor was obtained from five human donors diagnosed with primary open angle glaucoma (POAG) and five age- and sex-matched controls undergoing cataract surgery. Quantitative proteome analysis of the aqueous humor by hyper reaction monitoring mass spectrometry (HRM-MS) based on SWATH technology was performed. Expression levels of 87 proteins were found to be different between glaucomatous and control aqueous humor. Of the 87 proteins, 34 were significantly upregulated, whereas 53 proteins were downregulated in the aqueous humor from glaucoma patients compared to controls. Differentially expressed proteins were found to be involved in cholesterol-related, inflammatory, metabolic, antioxidant as well as proteolysis-related processes. Glaucoma leads to profound changes to the aqueous humor proteome consistent with an altered metabolic state, an inflammatory response and impaired antioxidant defense.

[Perimetric changes in advanced glaucoma].

Science.gov (United States)

Feraru, Crenguta Ioana; Pantalon, Anca

2011-01-01

The evaluation of various perimetric aspects in advanced glaucoma stages correlated to morpho-functional changes. MATHERIAL AND METHOD: Retrospective clinical trial over a 10 months time period that included patients with advanced glaucoma stages, for which there have been recorded several computerised visual field tests (central 24-2 strategy, 10-2 strategy with either III or V--Goldman stimulus spot size) along with other morpho-funtional ocular paramaters: VA, lOP optic disk analysis. We included in our study 56 eyes from 45 patients. In most cases 89% it was an open angle glaucoma (either primary or secondary) Mean visual acuity was 0.45 +/- 0.28. Regarding the perimetric deficit 83% had advanced deficit, 9% moderate and 8% early visual changes. As perimetric type of defect we found a majority with general reduction of sensitivity (33 eyes) + ring shape scotoma. In 6 eyes (10.7%) having left only a central isle of vision we performed the central 10-2 strategy with III or V Goldmann stimulus spot size. Statistic analysis showed scarce correlation between the visual acuity and the quantitative perimetric parameters (MD and PSD), and variance analysis found present a multiple correlation parameter p = 0.07 that proves there is no liniary correspondence between the morpho-functional parameters: VA-MD(PSD) and C/D ratio. In advanced glaucoma stages, the perimetric changes are mostly severe. Perimetric evaluation is essential in these stages and needs to be individualised.

Subpoblaciones neuronales presentes en cultivos primarios de ganglio espinal y su relación con la infección in vitro por virus de rabia

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Hernán Hurtado

2000-02-01

="font-size: 8.5pt; font-family: Symbol">mm siendo sólo el 15% de gran tamaño (>25 mm. De igual manera se encontró que el virus infecta el 34% del total neuronal, distribuido este porcentaje en neuronas de todos los tamaños. Con el análisis inmunocitoquímico se encontró que el 46, 48, 23, 26 y 22% de las neuronas presentan inmunoreactividad para SP, NPY, GAL, CGRP y VIP, respectivamente. De igual manera, el análisis morfométrico demostró que aunque estos neuropéptidos están presentes en neuronas de todos los tamaños, mas del 95% de las neuronas marcadas para GAL y CGRP son neuronas pequeñas, mientras que la distribución de VIP, SP y NPY no presenta una preferencia por ningún tamaño neuronal en particular. Finalmente el análisis estadístico realizado sobre los ensayos de doble marcaje virus-neuropéptidos demostró que hay una asociación altamente significativa entre las neuronas infectadas que a su vez presentan marcaje para SP y NPY (P<0.001. Todo esto nos permite concluir que es posible caracterizar las subpoblaciones neuronales presentes en cultivos de primarios de ganglio espinal por criterios morfológicos y bioquímicos y que por lo menos dos de estas subpoblaciones presentan una mayor susceptibilidad a la infección in vitro por el virus de rabia. Este trabajo aporta la primera evidencia de susceptibilidad neuronal diferencial hacia la infección por virus de la rabia en un modelo in vitro.

Ahmed glaucoma valve in uveitic patients with fluocinolone acetonide implant-induced glaucoma: 3-year follow-up

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Kubaisi B

2018-05-01

Full Text Available Buraa Kubaisi,1,2 Arash Maleki,1,2 Aseef Ahmed,1,2 Neel Lamba,1,2 Haitham Sahawneh,1,2 Andrew Stephenson,1,2 Alyssa Montieth,1,2 Shobha Topgi,3 C Stephen Foster1,2,4 1Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA; 2Ocular Immunology & Uveitis Foundation, Waltham, MA, USA; 3The State University of New York Downstate, Brooklyn, NY, USA; 4Harvard Medical School, Boston, MA, USA Purpose: To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV in eyes with noninfectious uveitis that had fluocinolone acetonide intravitreal implant (Retisert™-induced glaucoma. Methods: This retrospective study reviewed the safety and efficacy of AGV implantation in patients with persistently elevated intraocular pressure (IOP after implantation of a fluocinolone acetonide intravitreal implant at the Massachusetts Eye Research and Surgery Institution between August 2006 and November 2015. Results: Nine patients with 10 uveitic eyes were included in this study, none of which had preexisting glaucoma in the study eye. Mean patient age was 42 years; 6 patients were female and 3 were male. Baseline mean IOP was 30.6 mmHg prior to AGV placement while mean IOP-lowering medications were 2.9. In the treatment groups, there was a statistically significant reduction in post-AGV IOP. IOP was lowest at 1-week after AGV implantation (9.0 mmHg. Nine out of 10 eyes achieved an IOP below target value of 22 mmHg and/or a 20% reduction in IOP from baseline 1 month and 1 year following AGV placement. All other postoperative time points showed all 10 eyes reaching this goal. A statistically significant decrease in IOP-lowering medication was seen at the 1-week, 1-month, and 3-year time points compared to baseline, while a statistically significant increase was seen at the 3-month, 6-month, and 2-year post-AGV time points. No significant change in retinal nerve thickness or visual field analysis was found. Conclusion: AGV is an effective and safe method of

No evidence of a causal relationship between hypothyroidism and glaucoma

DEFF Research Database (Denmark)

Thvilum, Marianne; Brandt, Frans; Brix, Thomas Heiberg

2018-01-01

Background An interrelationship between hypothyroidism and glaucoma, due to a shared autoimmune background or based on deposition of mucopolysaccharides in the trabecular meshwork in the eye, has been suggested but is at present unsubstantiated. Therefore, our objective was to investigate......-hypothyroid controls according to age and sex. Prevalence of glaucoma was recorded and cases and controls were followed over a mean of 7.1 years (range 0±17). Logistic and Cox regression models were used to assess the risk of glaucoma before and after the diagnosis of hypothyroidism, respectively. Results Overall, we...... found a higher prevalence of glaucoma in subjects with hypothyroidism as compared to controls (4.6% vs. 4.3%, p glaucoma [1.09; 95% confidence interval (CI): 1.04-1.13]. Based on the Cox regression...

awareness and knowledge of glaucoma among adult patients

African Journals Online (AJOL)

PATIENTS AT THE EYE CLINIC OF A TEACHING HOSPITAL. G. NKUM1, S. LARTEY2, ... Background: Primary open angle glaucoma (POAG) is an irreversible .... If patients are aware of the risk factors and presentation of glaucoma, there will ...

The Pathway From Genes to Gene Therapy in Glaucoma: A Review of Possibilities for Using Genes as Glaucoma Drugs.

Science.gov (United States)

Borrás, Teresa

2017-01-01

Treatment of diseases with gene therapy is advancing rapidly. The use of gene therapy has expanded from the original concept of re-placing the mutated gene causing the disease to the use of genes to con-trol nonphysiological levels of expression or to modify pathways known to affect the disease. Genes offer numerous advantages over conventional drugs. They have longer duration of action and are more specific. Genes can be delivered to the target site by naked DNA, cells, nonviral, and viral vectors. The enormous progress of the past decade in molecular bi-ology and delivery systems has provided ways for targeting genes to the intended cell/tissue and safe, long-term vectors. The eye is an ideal organ for gene therapy. It is easily accessible and it is an immune-privileged site. Currently, there are clinical trials for diseases affecting practically every tissue of the eye, including those to restore vision in patients with Leber congenital amaurosis. However, the number of eye trials compared with those for systemic diseases is quite low (1.8%). Nevertheless, judg-ing by the vast amount of ongoing preclinical studies, it is expected that such number will increase considerably in the near future. One area of great need for eye gene therapy is glaucoma, where a long-term gene drug would eliminate daily applications and compliance issues. Here, we review the current state of gene therapy for glaucoma and the possibilities for treating the trabecular meshwork to lower intraocular pressure and the retinal ganglion cells to protect them from neurodegeneration. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

Challenges in the management of glaucoma in developing countries.

Science.gov (United States)

Butt, Nadeem Hafeez; Ayub, Muhammad Hammad; Ali, Muhammad Hassaan

2016-01-01

Glaucoma is the most common optic neuropathy characterized by normal to raised intraocular pressure (IOP), visual field defects, loss of retinal nerve fiber layer, thinning of the neuroretinal rim, and cupping of the optic disc. IOP reduction by medical, laser, or surgical therapies remains the only clinically proven treatment of glaucoma. The challenges in glaucoma management are diverse. They include early detection and diagnosis, setting of appropriate target IOP, choice of treatment, monitoring of quality of life and sight, and compliance with the treatment. Early diagnosis can be made by assessing optic nerve structure using imaging devices and optic nerve function through perimetry. Reducing IOP and controlling its fluctuations are considered to be the most important factors in limiting progression of glaucoma. Selection of the best suitable therapy out of medical, surgical, or laser treatment options is yet another management challenge. Patients suffering from glaucoma experience poor quality of life owing to the diagnosis itself, functional visual loss, inconvenience and cost of treatment, and side effects of treatment. All these factors lead to poor compliance, adherence, and persistence to treatment, and further progression of the disease. It is, therefore, important that ophthalmologists keep all the aforementioned factors in mind when managing patients with glaucoma.

Detection of Glaucoma Using Image Processing Techniques: A Critique.

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Kumar, B Naveen; Chauhan, R P; Dahiya, Nidhi

2018-01-01

The primary objective of this article is to present a summary of different types of image processing methods employed for the detection of glaucoma, a serious eye disease. Glaucoma affects the optic nerve in which retinal ganglion cells become dead, and this leads to loss of vision. The principal cause is the increase in intraocular pressure, which occurs in open-angle and angle-closure glaucoma, the two major types affecting the optic nerve. In the early stages of glaucoma, no perceptible symptoms appear. As the disease progresses, vision starts to become hazy, leading to blindness. Therefore, early detection of glaucoma is needed for prevention. Manual analysis of ophthalmic images is fairly time-consuming and accuracy depends on the expertise of the professionals. Automatic analysis of retinal images is an important tool. Automation aids in the detection, diagnosis, and prevention of risks associated with the disease. Fundus images obtained from a fundus camera have been used for the analysis. Requisite pre-processing techniques have been applied to the image and, depending upon the technique, various classifiers have been used to detect glaucoma. The techniques mentioned in the present review have certain advantages and disadvantages. Based on this study, one can determine which technique provides an optimum result.

Economic impact of primary open-angle glaucoma in Australia.

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Dirani, Mohamed; Crowston, Jonathan G; Taylor, Penny S; Moore, Peter T; Rogers, Sophie; Pezzullo, M Lynne; Keeffe, Jill E; Taylor, Hugh R

2011-01-01

Glaucoma is the World's leading cause of irreversible blindness, and poses serious public health and economic concerns.   Review. Published randomized trials and population-based studies since 1985. We report the economic impact of primary open-angle glaucoma and model the effect of changes in detection rates and management strategies. The cost-effectiveness of different interventions to prevent vision loss from primary open-angle glaucoma was measured in terms of financial cost (Australian dollars) and disability-adjusted life years. The prevalence of glaucoma in Australia is expected to increase from 208 000 in 2005 to 379 000 in 2025 because of the aging population. Health system costs over the same time period are estimated to increase from $AU355 million to $AU784 million. Total costs (health system costs, indirect costs and costs of loss of well-being) will increase from $AU1.9 billion to $AU4.3 billion in Australia. Primary open-angle glaucoma poses a significant economic burden, which will increase substantially by 2025. This dynamic model provides a valuable tool for ongoing policy formulation and determining the economic impact of interventions to better prevent visual impairment and blindness from glaucoma. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Dynamic tube movement after reimplantation of Ahmed glaucoma valve in a child with glaucoma in aphakia

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Senthil, Sirisha; Badakare, Akshay

2014-01-01

A 10-year-old girl underwent an Ahmed glaucoma valve (AGV) implantation as a primary procedure for glaucoma in aphakia due to congenital cataract surgery. Following an unintended accidental excision of AGV tube during bleb revision for hypertensive phase, AGV was explanted and a second AGV was implanted in the same quadrant after 2 weeks. This resulted in a rare complication of dynamic tube movement in the anterior chamber with tube corneal touch and localised corneal oedema. Excision of the offending unstable tube and placement of a paediatric AGV in a different quadrant led to resolution of this complication, stable vision and well-controlled intraocular pressure. This case highlights the possible causes of dynamic tube, related complications and its management. This case also highlights the importance of understanding the various physiological phases after glaucoma drainage device implantation and their appropriate management. PMID:24695662

Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis.

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Tan HaiBo

Full Text Available To compare the efficacy and safety of Ahmed glaucoma valve implantation (AGV with trabeculectomy in the management of glaucoma patients.A comprehensive literature search (PubMed, Embase, Google, and the Cochrane library was performed, including a systematic review with meta-analysis of controlled clinical trials comparing AGV versus trabeculectomy. Efficacy estimates were the weighted mean differences (WMDs for the percentage intraocular pressure reduction (IOPR % from baseline to end-point, the reduction in glaucoma medications, and the odds ratios (ORs for complete and qualified success rates. Safety estimates were the relative risks (RRs for adverse events. All outcomes were reported with a 95% confidence interval (CI. Statistical analysis was performed using the RevMan 5.0 software.Six controlled clinical trials were included in this meta-analysis. There was no significant difference between the AGV and trabeculectomy in the IOPR% (WMD = -3.04, 95% CI: -8.36- 2.26; P = 0.26. The pooled ORs comparing AGV with trabeculectomy were 0.46 (0.22, 0.99 for the complete success rate (P = 0.05 and 0.97 (0.78-1.20 for the quantified success rate (P = 0.76. No significant difference in the reduction in glaucoma medicines was observed (WMD = 0.24; 95% CI: -0.27-0.76; P = 0.35. AGV was found to be associated with a significantly lower frequency of all adverse events (RR = 0.71; 95%CI: 1.14-0.97; p = 0.001 than trabeculectomy, while the most common complications did not differ significantly (all p> 0.05.AGV was equivalent to trabeculectomy in reducing the IOP, the number of glaucoma medications, success rates, and rates of the most common complications. However, AGV was associated with a significantly lower frequency of overall adverse events.

Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis.

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HaiBo, Tan; Xin, Kang; ShiHeng, Lu; Lin, Liu

2015-01-01

To compare the efficacy and safety of Ahmed glaucoma valve implantation (AGV) with trabeculectomy in the management of glaucoma patients. A comprehensive literature search (PubMed, Embase, Google, and the Cochrane library) was performed, including a systematic review with meta-analysis of controlled clinical trials comparing AGV versus trabeculectomy. Efficacy estimates were the weighted mean differences (WMDs) for the percentage intraocular pressure reduction (IOPR %) from baseline to end-point, the reduction in glaucoma medications, and the odds ratios (ORs) for complete and qualified success rates. Safety estimates were the relative risks (RRs) for adverse events. All outcomes were reported with a 95% confidence interval (CI). Statistical analysis was performed using the RevMan 5.0 software. Six controlled clinical trials were included in this meta-analysis. There was no significant difference between the AGV and trabeculectomy in the IOPR% (WMD = -3.04, 95% CI: -8.36- 2.26; P = 0.26). The pooled ORs comparing AGV with trabeculectomy were 0.46 (0.22, 0.99) for the complete success rate (P = 0.05) and 0.97 (0.78-1.20) for the quantified success rate (P = 0.76). No significant difference in the reduction in glaucoma medicines was observed (WMD = 0.24; 95% CI: -0.27-0.76; P = 0.35). AGV was found to be associated with a significantly lower frequency of all adverse events (RR = 0.71; 95%CI: 1.14-0.97; p = 0.001) than trabeculectomy, while the most common complications did not differ significantly (all p> 0.05). AGV was equivalent to trabeculectomy in reducing the IOP, the number of glaucoma medications, success rates, and rates of the most common complications. However, AGV was associated with a significantly lower frequency of overall adverse events.

Anterior lamina cribrosa surface position in idiopathic intracranial hypertension and glaucoma

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Villarruel, Jenni Martinez; Li, Xiao Q.; 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...

Clinical study of secondary glaucoma after silicone oil tamponade

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Xiao-Chun Chen

2013-12-01

Full Text Available AIM: To evaluate the related risk factors and treatment method of secondary glaucoma after pars plana vitrectomy and silicone oil tamponade.METHODS: The retrospective study analyzed 114 patients(118 eyeswho were treated with pars plana vitrectomy combined with silicone oil tamponade. Lenses were reserved in 78 eyes and were taken away in 40 eyes among which intraocular lens were implanted in 17 eyes. There were 39 eyes in which the filling time of silicone was no more than 6 months while 79 eyes in which the filling time was more than 6 months. The follow-up time was(16.2±4.9months. Primary and secondary glaucoma were excluded before the vitrectomy. Silicone oil glaucoma(SOGwas diagnosed when intraocular pressure(IOPwas measured higher than 21mmHg(1mmHg=0.133kPathree times in succession at least 1 month after silicone oil tamponade and inflammation and neovascular glaucoma should be excluded. Anti-glaucoma drugs were administrated once SOG was diagnosed. If the IOP was not controlled after 2 weeks, the silicone oil was taken away. If the IOP was still high, the anti-glaucoma surgery was operated. The data was analyzed by the SPSS 16.0 software using a binary logistic regression analysis. RESULTS: Among the 32 eyes of SOG, lenses were removed in 16 eyes(50%. The filling time of silicone oil was more than 6 months in 27 eyes(84.4%and silicone oil emulsion happened in 20 eyes(62.5%. IOP returned normal in 17 eyes after administrating anti-glaucoma medication within 2 weeks. Silicone oils were taken away in 15 eyes. However, 4 eyes still had high IOP after surgery; one of them was given anti-glaucoma drugs once more; two of them underwent trabeculectomy and one of them underwent cyclophotocoagulation. The lens conditions(whether it was taken away or not, P=0.024, the silicone oil filling time(whether the time was more than 6 months, P=0.014, and the status of the silicone oil(whether emulsification occurred or not, P=0.000were all found to be

Ahmed glaucoma valve in children: A review☆

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Nassiri, Nariman; Nouri-Mahdavi, Kouros; Coleman, Anne L.

2011-01-01

Pediatric glaucoma is potentially a blinding disease. Although goniotomy and trabeculotomy are associated with good early success rates, eventually 20% of these procedures fail and many children will require additional surgery to control the IOP in the long-term. In this review, we reported that adequate IOP control can be achieved with the placement of Ahmed glaucoma valve and can last 5 or more years. However, most patients will need one or more glaucoma medications at some point after surgery. In addition, the implants may be associated with pupillary irregularities, lenticular opacification as well as tube-related complications, particularly in the first year of life, as the globe is enlarging with age. PMID:23960945

BILATERAL STEROID INDUCED GLAUCOMA IN VERNAL KERATOCONJUNCTIVITIS

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Bangal Surekha V, Bankar Mahima S, Bhandari Akshay J, Kalkote Prasad R

2015-01-01

Full Text Available Vernal Keratoconjunctivits (VKC is a bilateral recurrent allergic interstitial conjunctival inflammation with a periodic seasonal incidence and of self limiting nature, mainly affecting the younger population. Patients of VKC on steroid therapy are at higher risk of developing steroid induced glaucoma. Raised intraocular pressure due to steroids typically occurs within few weeks of starting steroid therapy and comes back to normal on immediate stoppage of steroids. A case of steroid induced glaucoma in a 30 years old female with vernal keratoconjunctivitis. She was on topical steroids for 3-4 years. She was incompliant with the instructions to stop steroids. She eventually developed steroid induced glaucoma and glaucomatous optic neuropathy with tunnel vision.

Unilateral glaucoma in Sotos syndrome (cerebral gigantism).

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Yen, M T; Gedde, S J; Flynn, J T

2000-12-01

To report a patient with unilateral glaucoma associated with Sotos syndrome. Sotos syndrome (cerebral gigantism) is a disorder of growth and development with characteristic facial changes and normal endocrine function. Ocular manifestations may also include megalocornea, iris hypoplasia, cataracts, megalophthalmos, strabismus, nystagmus, and retinal dystrophy. Case report. A 50 year-old man with the clinical features of Sotos syndrome presented with complaints of decreased vision in the left eye. Ophthalmologic examination revealed bilateral megalocornea, megalophthalmos, iris hypoplasia and transillumination defects, cataracts, and unilateral glaucoma. Intraocular pressure was lowered, and visual field loss was stabilized with topical medications. Sotos syndrome patients should be examined routinely to allow for early detection and treatment of potential ocular problems, including glaucoma.

Rational Basis For Nutraceuticals In The Treatment Of Glaucoma.

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Morrone, Luigi Antonio; Rombola, Laura; Adornetto, Annagrazia; Corasaniti, Maria Tiziana; Russo, Rossella

2017-11-09

Glaucoma, the second leading cause of blindness worldwide, is a chronic optic neuropathy characterized by progressive retinal ganglion cell (RGC) axons degeneration and death. The pathogenesis of primary open-angle glaucoma (OAG), the most common type, is still largely unknown and it is often associated with increased intraocular pressure (IOP) although IOP-independent mechanisms play also a role. Neurodegenerative process, including oxidative stress, excitotoxicity and neuroinflammation, and an impaired ocular blood flow are examples of mechanisms supposed to contribute to the IOP independent deterioration in OAG. For these reasons glaucoma progress it is not always under the control of currently available drugs. Interestingly, recent studies have suggested a link between dietary factors and glaucoma risk. Particularly, some nutrients have proven capable of lower IOP, increase circulation to the optic nerve, modulate excitotoxicity and promote RGC survival, but the lack of clinical trials limit their current therapeutic use. The finding of appropriate use of nutraceuticals that may be able to modify the risk of glaucoma may provide insight into glaucoma pathogenesis and decrease the need for, and therefore the side effects from, conventional therapies. For these reasons the effects of nutrients with anti-oxidant and neuroprotective properties are of great interest and nutraceuticals may offer some therapeutic potential. Although a further rigorous evaluation of nutraceuticals in the treatment of glaucoma is needed to determine their safety and efficacy, in this review we summarize the potential of nutritional supplements for limiting retinal damage and improving RGC survival. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Normal tension glaucoma management: a survey of contemporary practice.

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Symes, Richard J; Mikelberg, Frederick S

2017-08-01

The aim of this study was to investigate contemporary practice patterns with respect to normal tension glaucoma (NTG) management and to determine whether the 2 largest NTG trials have influenced ophthalmologists' clinical practice. A survey questionnaire was sent to ophthalmologists via the American Glaucoma Society, the Canadian Glaucoma Society, and the Canadian Ophthalmological Society. The questionnaire was designed to investigate ophthalmologists' usual practice with respect to NTG and the extent to which practice has been influenced by the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Low pressure Glaucoma Treatment Study (LoGTS). In total, 419 ophthalmologists completed the survey. Of these, 264 respondents were glaucoma subspecialists. The survey showed that 95% and 64% of ophthalmologists were familiar with the CNTGS and the LoGTS, respectively. Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice. The first-choice topical drug for NTG was a prostaglandin analogue (88% of respondents) or brimonidine (10% of respondents). Most ophthalmologists treat NTG more aggressively than recommended by the CTNGS protocol. Most ophthalmologists felt that the LoGTS results had no impact on their normal clinical practice. The prostaglandin analogues are, by far, the most popular choice of drug for contemporary management of NTG. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

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

Inhibición dual de la neprilisina y del receptor de la angiotensina (ARNI: una alternativa en los pacientes con falla cardiaca

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Beatriz Wills

2016-03-01

Full Text Available La falla cardiaca (FC es la causa más común de admisión hospitalaria en adultos en el mundo. Además, de su importante prevalencia la FC tiene un alta tasa de mortalidad, se estima que aproximadamente el 50% de los pacientes con FC mueren a los 5 años posterior al egreso hospitalario. Esto ha motivado el desarrollo de nuevas terapias seguras y efectivas para el manejo de esta entidad. El LCZ696 es un inhibidor dual de la neprilisina y del receptor de angiotensina II que demostró en estudios de fase III disminuir el desenlace primario de muerte cardiovascular y hospitalización por empeoramiento de la FC y muerte global. Probablemente el LCZ696 se convertirá en la piedra angular del manejo en pacientes con FC con fracción de eyección deprimida.

Trastornos oculares y otras enfermedades en casos con síndrome de Waardenburg Ocular disorders and other diseases in patients suffering from Waardenburg’s syndrome

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Fidel Castro Pérez

2012-12-01

Full Text Available Introducción: el síndrome de Waardenburg es una entidad infrecuente, hereditaria, que presenta heterocromía del iris, Distopia cantorum y cursa con cierto grado de discapacidad cuando aparece la hipoacusia neurosensorial entre otras alteraciones. Objetivo: determinar las alteraciones oculares y otras enfermedades crónicas de una familia afectada con el síndrome de Waardenburg. Material y método: estudio de casos, observacional, transversal y descriptivo realizado a una familia con síndrome de Waardenburg en el municipio Sandino. Se confeccionó base de datos automatizada. Las variables utilizadas fueron los trastornos de la agudeza visual, refracción visual y otras alteraciones. Se utilizaron medidas de frecuencia: absolutas y relativas porcentuales. Resultados: entre las alteraciones visuales crónicas 17 presentaron trastornos de la refracción, cuatro individuos padecían glaucoma y uno cataratas, no se encontró ningún caso de discapacidad visual. Los 4 individuos con hipertensión arterial, dos coinciden con los que padecen de glaucoma y la otra es diabética. Conclusiones: fueron detectados varios trastornos de la refracción y la agudeza visual, sin llegar a la discapacidad.Introduction: Waardenburg’s syndrome is a rare, hereditary entity which presents heterochromia of the iris, dystopia canthorum and having a certain degree of disability when sensorineural hypoacusis appears; among other alterations. Objective: to determine ocular alterations and other chronic diseases that a family suffering from Waardenburg’s syndrome present. Material and Method: observational, cross-sectional and descriptive case study carried out with a family suffering from Waardenburg’s syndrome in Sandino municipality, Pinar del Rio. A database was created. The variables used were visual acuity, visual refraction and other alterations. Absolute and relative percentages were used as measures of frequency. Results: among these chronic visual

Autoinjerto conjuntival y membrana amniótica en la cirugía del pterigión primario Use of conjunctival autograft and amniotic membrane in primary pterygium surgery

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Keyly Fernández García

2012-12-01

Full Text Available Objetivo: comparar la efectividad del autoinjerto conjuntival y el injerto de membrana amniótica en la cirugía del pterigión primario en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de septiembre de 2009 a septiembre de 2010. Métodos: estudio prospectivo, comparativo y aleatorio. El universo estuvo constituido por 80 pacientes (80 ojos con diagnóstico de pterigión primario que se les realizó escisión quirúrgica de la hiperplasia fibrovascular nasal primaria. Se dividieron en 2 grupos al azar simple. Al grupo A (40 ojos se le implantó injerto de membrana amniótica y al grupo B (40 ojos autoinjerto de conjuntiva. Resultados: en seis meses de seguimiento se presentaron cuatro recurrencias (10 % en el grupo A y solo dos casos en el grupo B (5 %. En ninguno de los pacientes hubo complicación. Fue más efectivo el autoinjerto conjuntival. Conclusiones: la recidiva fue más frecuente en la cirugía con membrana amniótica aunque no existió una diferencia significativa. Se consideran ambas técnicas efectivas en esta afección.Objective: to compare the effectiveness of the conjunctival autograft and the amniotic membrane graft in the primary pterygium surgery at “Ramón Pando Ferrer” Cuban Institute of Ophthalmology from September 2009 to September 2010. Methods: a prospective, random and comparative study. The universe was composed by 80 eyes from 80 patients diagnosed with primary pterygium. They had undergone the surgical excision of a primary nasal fibrovascular hyperplasia. They were divided in two single-randomized groups (A and B; the group A patients (40 eyes were implanted with amniotic membrane graft whereas those of group B (40 eyes were implanted with conjunctival autograft. Results: during the 6 month follow-up, 4 recurrences were reported (10 % in group A and only 2 in group B (5 %. No complications were presented in both groups. The conjunctival autograft was more effective. Conclusions: the relapse was more

Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel

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Zhi-Ke Xu

2015-02-01

Full Text Available AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGVimplantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases(44 eyesof refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP, visual acuity, and complication of post-operation were contrasted with those of pre-operation. RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes, choroidal detachment(3 eyes, drainage tube shift(1 eye, hyphema(6 eyes, drainage tube blockage(1 eye, expulsive choroidal hemorrhage(1 eye, and fiber wrap of drainage tray(5 eyes.CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.

Habilidades fonológicas, precisión lectora y velocidad en pacientes con dislexia.

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Julieta Fumagalli

2016-01-01

Full Text Available La conciencia fonológica es un tema central en las investigaciones sobre lectura y está relacionada con las dificultades lectoras. Sin embargo, investigaciones realizadas en distintos sistemas ortográficos señalan que la velocidad de procesamiento también puede ser una causa del déficit lector. En este marco, el propósito de este trabajo fue comparar el rendimiento de cinco pacientes disléxicos con el de tres grupos controles de niños de 1er grado, 3er grado y 5to grado de nivel primario sin dificultades en el aprendizaje de la lectura. Los participantes normolectores y los pacientes fueron evaluados con tres pruebas que evalúan conciencia fonológica diseñada ad hoc y una tarea de lectura de palabras y no palabras estandarizada. Se registraron tanto las respuestas correctas como el tiempo requerido para la resolución de las tareas. En base a los datos, se pudieron identificar distintos perfiles de rendimiento en los pacientes disléxicos según la cantidad de aciertos y la velocidad para resolver las tareas.

Simultaneous Implantation of an Ahmed and Baerveldt Glaucoma Drainage Device for Uncontrolled Intraocular Pressure in Advanced Glaucoma.

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Rao, Veena S; Christenbury, Joseph; Lee, Paul; Allingham, Rand; Herndon, Leon; Challa, Pratap

2017-02-01

To evaluate efficacy and safety of a novel technique, simultaneous implantation of Ahmed and Baerveldt shunts, for improved control of intraocular pressure (IOP) in advanced glaucoma with visual field defects threatening central fixation. Retrospective case series; all patients receiving simultaneous Ahmed and Baerveldt implantation at a single institution between October 2004 and October 2009 were included. Records were reviewed preoperatively and at postoperative day 1, week 1, month 1, month 3, month 6, year 1, and yearly until year 5. Outcome measures included IOP, best-corrected visual acuity, visual field mean deviation, cup to disc ratio, number of glaucoma medications, and complications. Fifty-nine eyes were identified; mean (±SD) follow-up was 26±23 months. Primary open-angle glaucoma was most common (n=37, 63%). Forty-six eyes (78%) had prior incisional surgery. Mean preoperative IOP was 25.5±9.8 mm Hg. IOP was reduced 50% day 1 (Pglaucoma tube implantation with effects persisting over postoperative year 1 and up to year 5. Complications were higher than that seen in reports of single shunt implantation, which may be explained by patient complexity in this cohort. This technique may prove a promising novel approach for management of uncontrolled IOP in advanced glaucoma.

Changes to the Aqueous Humor Proteome during Glaucoma.

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Martha Andrea Kaeslin

Full Text Available To investigate the aqueous humor proteome in patients with glaucoma and a control group.Aqueous humor was obtained from five human donors diagnosed with primary open angle glaucoma (POAG and five age- and sex-matched controls undergoing cataract surgery. Quantitative proteome analysis of the aqueous humor by hyper reaction monitoring mass spectrometry (HRM-MS based on SWATH technology was performed.Expression levels of 87 proteins were found to be different between glaucomatous and control aqueous humor. Of the 87 proteins, 34 were significantly upregulated, whereas 53 proteins were downregulated in the aqueous humor from glaucoma patients compared to controls. Differentially expressed proteins were found to be involved in cholesterol-related, inflammatory, metabolic, antioxidant as well as proteolysis-related processes.Glaucoma leads to profound changes to the aqueous humor proteome consistent with an altered metabolic state, an inflammatory response and impaired antioxidant defense.

Surgical Outcomes of Additional Ahmed Glaucoma Valve Implantation in Refractory Glaucoma.

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Ko, Sung Ju; Hwang, Young Hoon; Ahn, Sang Il; Kim, Hwang Ki

2016-06-01

To evaluate the surgical outcomes of the implantation of an additional Ahmed glaucoma valve (AGV) into the eyes of patients with refractory glaucoma following previous AGV implantation. This study is a retrospective review of the clinical histories of 23 patients who had undergone a second AGV implantation after a failed initial implantation. Age, sex, prior surgery, glaucoma type, number of medications, intraocular pressure (IOP), visual acuity, and surgical complications were analyzed. Surgical success was defined as IOP maintained below 21 mm Hg, with at least a 20% overall reduction in IOP, regardless of the use of IOP-lowering medications. Following the implantation of a second AGV, the mean IOP decreased from 39.3 to 18.5 mm Hg (52.9% reduction, P<0.001). The mean number of postoperative IOP-lowering medications administered decreased from 2.8 to 1.7 after the second AGV implantation (P<0.001). The cumulative probability of success for the procedure was 87% after 1 year and 52% after 3 years. Three patients (13.0%) experienced bullous keratopathy after the second AGV implantation. None of the patients showed any evidence of diplopia or ocular movement limitation as a result of the presence of 2 AGVs in the same eye. Prior trabeculectomy was found to be a significant risk factor for failure (P=0.027). A second AGV implantation can be a good choice of surgical treatment when the first AGV has failed to control IOP.

Anisohypermetropia as a sign of unilateral glaucoma in the pediatric population

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Tan DKL

2017-06-01

Full Text Available Deborah KL Tan,1,2 Gillian H Teh,2,3 Ching Lin Ho,2,4 Boon Long Quah1,2 1Department of Paediatric Ophthalmology and Adult Strabismus, Singapore National Eye Centre, 2Singapore Eye Research Institute, 3Department of General Cataract and Comprehensive Ophthalmology, 4Department of Glaucoma, Singapore National Eye Centre, Singapore Abstract: Childhood glaucoma poses a diagnostic and therapeutic challenge to ophthalmologists. Difficulty in examination and limitations on ability to perform structural and functional testing of optic nerve make diagnosis and verification of glaucoma control difficult in children. It is well known that an excessive loss of hyperopia is a useful sign in alerting the examining ophthalmologist to the possible diagnosis of glaucoma. We present an interesting case of juvenile onset glaucoma presenting with anisohypermetropic amblyopia in one eye and normal vision in the fellow eye that has glaucoma. It is an unusual case as the left eye with abnormal vision from hypermetropic amblyopia, though by itself requiring treatment, was a red herring for a potentially blinding condition in the fellow eye with normal vision and lower and less amblyogenic hyperopia on examination. We believe that glaucomatous enlargement of the right eye resulted in significant loss of hyperopia in that eye and in turn contributed to anisohypermetropic amblyopia in the left eye. To the best of our knowledge, this is the first reported case of juvenile onset glaucoma presenting with anisohypermetropic amblyopia in one eye and normal vision in the fellow eye that has glaucoma. Keywords: childhood glaucoma, anisometropia, anisohypermetropia, amblyopia, myopic shift

Lifestyles guide and glaucoma (II). Diet, supplements, drugs, sleep, pregnancy, and systemic hypertension.

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Antón-López, A; Moreno-Montañés, J; Duch-Tuesta, S; Corsino Fernández-Vila, P; García-Feijoo, J; Millá-Griñó, E; Muñoz-Negrete, F J; Pablo-Júlvez, L; Rodríguez-Agirretxe, I; Urcelay-Segura, J L; Ussa-Herrera, F; Villegas-Pérez, M P

2018-02-01

To establish evidence based guidelines to advise patients on the relationship between habits, diet, certain circumstances, diseases and glaucoma. Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-based Medicine classification. The evidence on the relationship between diet or supplements and the incidence or progression of glaucoma is insufficient to make a general recommendation for glaucoma patients. Although some studies on normal tension glaucoma suggest that Gingko biloba could reduce glaucoma progression, the results do not allow a general recommendation for all these patients. Similarly, the evidence on the usefulness of vitamin supplements is not conclusive. The studies on smoking do not clearly demonstrate the relationship between this habit and incidence of glaucoma. Marihuana is not a useful treatment for glaucoma. Although the results on the relationship between sleep apnoea and glaucoma are heterogeneous, it is recommended that patients with moderate to intense apnoea are tested for glaucoma. Pregnancy does not influence the course of the disease, but several hypotensive drugs may be harmful for the foetus. Nocturnal systemic hypotension is a risk factor for glaucoma progression. Certain habits, circumstances, or diseases may have an influence on the onset or progression of glaucoma. It is important to have adequate information about the scientific evidence in the publications in order to properly advise patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Composite fibrous glaucoma drainage implant

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Klapstova, A.; Horakova, J.; Shynkarenko, A.; Lukas, D.

2017-10-01

Glaucoma is a frequent reason of loss vision. It is usually caused by increased intraocular pressure leading to damage of optic nerve head. This work deals with the development of fibrous structure suitable for glaucoma drainage implants (GDI). Commercially produced metallic glaucoma implants are very effective in lowering intraocular pressure. However, these implants may cause adverse events such as damage to adjacent tissue, fibrosis, hypotony or many others [1]. The aim of this study is to reduce undesirable properties of currently produced drains and improve their properties by creating of the composite fibrous drain for achieve a normal intraocular pressure. Two types of electrospinning technologies were used for the production of very small tubular implants. First type was focused for production of outer part of tubular drain and the second type of electrospinning method made the inner part of shape follows the connections of both parts. Complete implant had a special properties suitable for drainage of fluid. Morphological parameters, liquid transport tests and in-vitro cell adhesion tests were detected.

Is glaucoma blindness a disease of deprivation and ignorance? A case-control study for late presentation of glaucoma in India

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Gogate Parikshit

2011-01-01

Full Text Available Aim: The aim was to identify the presenting symptoms and social risk factors for late presentation of primary glaucoma in newly diagnosed cases. Materials and Methods: It was a case-control study in a tertiary eye care center in Maharashtra, India. Newly diagnosed patients with primary glaucoma were classified as cases (late presenters where there was no perception of light in one eye or severe visual field loss affecting an area within 20° of fixation or a cup-disc (C:D ratio ≥0.8 and controls (early presenters, presenting relative scotoma within 20° of fixation or a C:D ratio <0.8, but >0.5. All patients underwent a comprehensive ocular examination including gonioscopy, perimetry, and detailed family and social history. Occupation, education, and socioeconomic status were graded. SPSS version 12.0 was used, and univariate and multivariate logistic regression analysis was performed. Results: Gradual progressive painless loss of vision was the commonest symptom (175, 87.5%. Primary angle closure glaucoma was more common in females (P = 0.001 and lower socioeconomic groups (P = 0.05. Patients who were less educated were more likely to have late presentation of glaucoma (P < 0.001, odds ratio = 0.07; 95% CI, 0.02-0.25. Knowledge of family history of glaucoma (P = 0.80, odds ratio = 1.16; 95% CI, 0.36-3.71 and eye clinic attendance in past 2 years still resulted in late presentation (P = 0.45, odds ratio = 1.34, 95% CI, 0.63-2.82. Conclusion: Lack of education and awareness of glaucoma were major risk factors for late presentation.

Current Surgical Options for the Management of Pediatric Glaucoma

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Jose Morales

2013-01-01

Full Text Available Currently, there are numerous choices for the treatment of pediatric glaucoma depending on the type of glaucoma, the age of the patient, and other particularities of the condition discussed in this review. Traditionally, goniotomy and trabeculotomy ab externo have been the preferred choices of treatment for congenital glaucoma, and a variety of adult procedures adapted to children have been utilized for other types of pediatric glaucoma with variable results and complications. More recently, seton implantations of different types have become more popular to use in children, and newer techniques have become available including visualized cannulation and opening of Schlemm’s canal, deep sclerectomy, trabectome, and milder more directed cyclodestructive procedures such as endolaser and transcleral diode laser cyclophotocoagulation. This paper reviews the different surgical techniques currently available, their indications, results, and most common complications to allow the surgeon treating these conditions to make a more informed choice in each particular case. Although the outcome of surgical treatment in pediatric glaucoma has improved significantly, its treatment remains challenging.

Tank-Binding Kinase 1 (TBK1) Gene and Open-Angle Glaucomas (An American Ophthalmological Society Thesis).

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Fingert, John H; Robin, Alan L; Scheetz, Todd E; Kwon, Young H; Liebmann, Jeffrey M; Ritch, Robert; Alward, Wallace L M

2016-08-01

To investigate the role of TANK-binding kinase 1 ( TBK1 ) gene copy-number variations (ie, gene duplications and triplications) in the pathophysiology of various open-angle glaucomas. In previous studies, we discovered that copy-number variations in the TBK1 gene are associated with normal-tension glaucoma. Here, we investigated the prevalence of copy-number variations in cohorts of patients with other open-angle glaucomas-juvenile-onset open-angle glaucoma (n=30), pigmentary glaucoma (n=209), exfoliation glaucoma (n=225), and steroid-induced glaucoma (n=79)-using a quantitative polymerase chain reaction assay. No TBK1 gene copy-number variations were detected in patients with juvenile-onset open-angle glaucoma, pigmentary glaucoma, or steroid-induced glaucoma. A TBK1 gene duplication was detected in one (0.44%) of the 225 exfoliation glaucoma patients. TBK1 gene copy-number variations (gene duplications and triplications) have been previously associated with normal-tension glaucoma. An exploration of other open-angle glaucomas detected a TBK1 copy-number variation in a patient with exfoliation glaucoma, which is the first example of a TBK1 mutation in a glaucoma patient with a diagnosis other than normal-tension glaucoma. A broader phenotypic range may be associated with TBK1 copy-number variations, although mutations in this gene are most often detected in patients with normal-tension glaucoma.

Sobrecarga en el cuidador de paciente con infarto agudo al miocardio

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Norma Lizbeth Ávila Estrada

2012-12-01

Full Text Available Introducción: Las enfermedades cardiovasculares constituyen la primera causa de muerte en México, generando un impacto social persistente que involucra tanto a quien lo padece como a quienes lo rodean. Objetivo: Determinar el nivel de sobrecarga en el cuidador con pacientes de infarto agudo miocardio (IAM en el Hospital General de Durango. Materiales y Métodos: Estudio descriptivo no experimental, transversal; 54 familiares de pacientes hospitalizados con diagnóstico de IAM en el Hospital General Durango, no probabilístico por conveniencia. Resultados: La edad promedio en el estudio es de 18 a 25 años correspondiendo al 37%, de los cuales el 66.7% es femenino, 59.3% tiene escolaridad de medios superior, el 72.2% son de procedencia de la ciudad de Durango, con respecto al parentesco del cuidador con la persona que demanda cuidado esta es en su mayoría hijo con un porcentaje de 20.4%; también un alto porcentaje 81.5 % convive con el enfermo y un 63.0% trabaja fuera del hogar, y un 27.8% ha dejado el trabajo parcialmente; el resultado revelo que existe un nivel medio de sobrecarga del 44.2% en el cuidador primario. Discusión y Conclusiones: Son identificables los niveles de sobrecarga en cuidadores de pacientes con IAM generando una serie de variables que alteran la relación cuidador-paciente trayendo consigo una sobrecarga de tipo medio. (Rev Cuid 2012;3(3:342-8.Palabras clave: Cuidados Posteriores, Absentismo Familiar, Atención no Remunerada. (Fuente: DeCS BIREME.

Awareness and Knowledge of Glaucoma in Central India: A Hospital-Based Study.

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Maharana, Prafulla K; Rai, Vaishali G; Pattebahadur, Rajesh; Singhi, Shipra; Chauhan, Ashish K

2017-01-01

To assess the awareness and knowledge of glaucoma among people attending the ophthalmology outpatient department at a tertiary care hospital in central India. A prospective observational study. A questionnaire-based study was conducted, involving persons aged 18 and above attending the ophthalmology outpatient department from October 2014 to September 2015. Data on awareness and knowledge of glaucoma was collected through a face-to-face interview. Fourteen hundred people participated in the study. The mean age of participants was 43 ± 15 years (range, 18-85). The study participants included 53% men and 47% women. Only 27% (n = 380/1400) of the participants were aware of glaucoma. Age, sex, and presence or type of refractive error had no impact on glaucoma awareness. Awareness level was greater in individuals with higher education levels and those belonging to an upper socioeconomic class (SEC). Multiple logistic regression analysis revealed significantly higher levels of glaucoma awareness among participants belonging to the upper 2 SECs (P = 0.05) and those educated above the high school level (P = 0.001). The most common source of awareness was close acquaintance with relatives, famly members, and friends of glaucoma patients. Awareness of glaucoma in India is low. Lack of education and lower socioeconomic status are the major risk factors for late preentation of glaucoma. Continuous presence of a low level of awareness and the same factors accounting for it warrants the need for an aggressive and refined approach to increase awareness of glaucoma to prevent glaucoma-related blindness. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

Optic Disc Drusen and Family History of Glaucoma-Results of a Patient-directed Survey.

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Gramer, Gwendolyn; Gramer, Eugen; Weisschuh, Nicole

2017-10-01

Prospective evaluation of family history (FH) of glaucoma and FH of optic disc drusen (ODD) in patients with sonographically confirmed ODD. A total of 87 patients with ODD interviewed all their first-degree and second-degree relatives using a detailed questionnaire on whether an ophthalmologist had diagnosed or excluded glaucoma or ocular hypertension (OH). Using a second questionnaire, 62 of these patients also provided information about ODD in their FH. Control groups for FH of glaucoma consisted of 2170 patients with glaucoma or OH evaluated with the same methods and identical questions for FH of glaucoma in a previous study, and of 176 healthy individuals without glaucoma or ODD who were interviewed on family history of glaucoma. Glaucoma in FH was significantly more frequent in patients with ODD with an incidence of 20.7% compared with healthy controls with an incidence of 2.8%, and half as frequent as in glaucoma patients with an incidence of 40%. ODD in FH were found in 9.7% of patients with ODD. As there is a high frequency of family history of glaucoma in patients with ODD, evaluation of FH of ODD and FH of glaucoma is essential in patients with ODD. Glaucoma in FH of ODD patients requires intraocular pressure monitoring and whenever deemed beneficial timely initiation of intraocular pressure-lowering therapy.

Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: A critically evaluated prospective clinical study

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Anita Panda

2011-01-01

Full Text Available Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV in post-penetrating-keratoplasty glaucoma (PKPG. Materials and Methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7 implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 < IOP < 21 mmHg and qualified success as 5 < IOP < 21 mmHg with medications or minor procedures. Results: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001 and the use of medications dropped from 2.92 to 0.39 (P < 0.001 after AGV implantation. The absolute success was achieved in 11 eyes and qualified success in 9. There was no significant change in best corrected visual acuity, graft clarity, or graft thickness. Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy. Conclusions: Postkeratoplasty refractory glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up.

Clinical Outcomes of FP-7/8 Ahmed Glaucoma Valves in the Management of Refractory Glaucoma in the Mainland Chinese Population.

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Zhu, Yingting; Wei, Yantao; Yang, Xuejiao; Deng, Shuifeng; Li, Zuohong; Li, Fei; Zhuo, Yehong

2015-01-01

To evaluate the efficacy and safety of the Ahmed glaucoma valve (AGV) and the risk factors associated with AGV implantation failure in a population of Chinese patients with refractory glaucoma. In total, 79 eyes with refractory glaucoma from 79 patients treated in our institution from November 2007 to November 2010 were enrolled in this retrospective study. The demographic data, preoperative and postoperative intraocular pressures (IOPs), best corrected visual acuity (BCVA), number of anti-glaucoma medications used, completed and qualified surgery success rates and postoperative complications were recorded to evaluate the outcomes of AGV implantation. Factors that were associated with implant failure were determined using Cox proportional hazard regression model analysis and multiple linear regression analysis. The average follow-up time was 12.7±5.8 months (mean±SD). We observed a significant reduction in the mean IOP from 39.9±12.6 mm Hg before surgery to 19.3±9.6 mm Hg at the final follow-up. The complete success rate was 59.5%, and the qualified success rate was 83.5%. The number of previous surgeries was negatively correlated with qualified success rate (Pglaucoma drugs to control IOP (Pglaucoma. Patients with a greater number of previous surgeries were more likely to experience surgical failure, and patients with previous trabeculectomy were more likely to use multiple anti-glaucoma drugs to control postoperative IOP.

A link between diabetes mellitus and glaucoma

DEFF Research Database (Denmark)

Horwitz, A.; Petrovski, B.E; Petrovski, G.

2016-01-01

-year follow-up period. The National Danish Registry of Medicinal Products Statistics was used to identify all claimed prescriptions for glaucoma medication and anti-diabetic drugs. Comorbidities with diabetic retinopathy and diabetic nephropathy were identified using the ICD-10 classification......-diabetic drugs at any time during the study period had a significantly higher overall relative risk of glaucoma (RR = 5.11, p age, gender, diabetic retinopathies and calendar year-fixed effects (RR = 2.05, p ... of glaucoma overall, while treatment with β-blocker and RAS, in combination, are associated with a significantly lower risk (HR = 0.87). Conclusions Use of anti-diabetic drugs is strongly associated with use of anti-glaucomatous drugs. Diabetic complication as well as concomitant antihypertensive medications...

Some diagnostic and therapeutic controversies in glaucoma addressed

NARCIS (Netherlands)

Müskens, Rogier Peter Hendrik Maria

2008-01-01

In the five studies contained in this thesis, several controversies on the diagnosis of and therapy for glaucoma have been addressed. The first part of this thesis consisted of three studies that aimed tot improve existing technologies for diagnosing glaucoma. The latter part consisted of two

The direction of research into visual disability and quality of life in glaucoma

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Garway-Heath David F

2011-08-01

Full Text Available Abstract Background Glaucoma will undoubtedly impact on a person's ability to function as they go about their day-to-day life. The purpose of this study is to investigate the amount of published knowledge in quality of life (QoL and visual disability studies for glaucoma, and make comparisons with similar research in other chronic conditions. Methods A systematic literature search of the Global Health, EMBASE Psychiatry and MEDLINE databases. Title searches for glaucoma and six other example chronic diseases were entered alongside a selection of keywords chosen to capture studies focusing on QoL and everyday task ability. These results were further filtered during a manual search of resulting abstracts. Outcomes were the number of publications per year for each disease, number relating to QoL and type of glaucoma QoL research. Results Fifteen years ago there were no published studies relating to the impact of glaucoma on QoL but by 2009 this had risen to 1.2% of all glaucoma articles. The number of papers relating to QoL as a proportion of all papers in glaucoma in the past 10 years (0.6% is smaller than for AMD and some other disabling chronic diseases. Most QoL studies in glaucoma (82% involve questionnaires. Conclusion QoL studies in glaucoma are increasing in number but represent a tiny minority of the total publications in glaucoma research. There are fewer QoL articles in glaucoma compared to some other disabling chronic conditions. The majority of QoL articles in glaucoma research use questionnaires; performance-based measures of visual disability may offer an additional method of determining how the disease impacts on QoL.

The direction of research into visual disability and quality of life in glaucoma.