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Sample records for del glaucoma neovascular

  1. Management of neovascular glaucoma.

    Science.gov (United States)

    Ajvazi, Halil; Goranci, Ilhami; Lutaj, Pajtim

    2013-01-01

    Neovascular glaucoma is an atrophic optic neuropathy resulting from the neovascularization of the iridocorneal angle increasing the intraocular pressure. To show the incidence of NVG in comparison to the other types of glaucoma and to compare with the relevant literature data and other referent clinics. In this study were included 116 patients with NVG, of whom 75 or 64.7% male and 41 or 35.3% female, treated from January 2003 until February 2013. Visual acuity damages from NVG, were classified as big damages with 84.7% of cases and minor damages with 15.3% of cases. Cases with heavy damages were the cases with blindness, L+P+/- up to V = 0.3 and cases with slightly damages with V = 0.4-1.0. NVG caused by PDR with 52 cases or 44.8% and CRVO with 12 cases or 10.3%. We should be focused on prevention of diabetic retinopathy which requires interdisciplinary cooperation. In cases when diabetic retinopathy is present, we have to advise patients to undergo PRP as soon as possible, since it is the only way to prevent NVG and heavy consequences.

  2. [Current trends in neovascular glaucoma treatment].

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    Vancea, P P; Abu-Taleb, A

    2005-01-01

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

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

    Science.gov (United States)

    Călugăru, D; Călugăru, M

    2012-01-01

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

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

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    Netland, Peter A.

    2009-01-01

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

  5. Purtscher's retinopathy followed by neovascular glaucoma

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    Kuroda M

    2013-11-01

    Full Text Available Masasko Kuroda,1 Akihiro Nishida,1 Masashi Kikuchi,2 Yasuo Kurimoto11Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; 2Kikuchi Eye Clinic, Kobe, Hyogo, JapanAbstract: We report the case of a 66-year-old Japanese man who developed neovascular glaucoma secondary to Purtscher's retinopathy following a head injury. The patient presented at our hospital with blurred vision and a visual field abnormality in his left eye 1 month after suffering from a head injury. Upon initial presentation, his best-corrected visual acuity on a decimal chart was 1.5 oculus dexter and 0.6 oculus sinister. The intraocular pressure (IOP was 12 mmHg in both eyes. Fundus examination of the left eye revealed multiple white lesions in the posterior pole. Optical coherence tomography demonstrated retinal edema, particularly in the inner retina. On the basis of these findings, a diagnosis of Purtscher's retinopathy was made. One month after the initial examination, the visual acuity in the left eye deteriorated to 0.01 in decimal chart, and the IOP increased to 37 mmHg. Gonioscopy showed angle neovascularization. The patient received an intravitreal bevacizumab injection and panretinal photocoagulation. Subsequently, the IOP normalized and the angle neovascularization regressed.Keywords: blurred vision, visual field, retinal edema, head injury, head trauma

  6. [Micro-trephination of the limbus in neovascular glaucoma].

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    Sergienko, N M; Torchinskaia, N V

    2001-01-01

    Microtrephination of the limb was carried out for neovascular glaucoma on 112 eyes. The technique of the operation is described and its results are analyzed. Electric microtrephine (0.6 mm) allows making perforations in the limb as oblique microchannels connecting the anterior chamber and the subconjunctival space. Mitomycin C, an antimetabolic drug, was used for neovascularization control near the channels and filtration pad. High efficiency, low invasiveness, and low incidence of postoperative complications recommend this operation as an alternative method for the treatment of neovascular glaucoma.

  7. Intravitreal Bevacizumab (Avastin Injection for Neovascular Glaucoma

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    Shahin Yazdani

    2008-12-01

    Full Text Available

    PURPOSE: To report two cases with neovascular glaucoma secondary to ischemic central retinal vein occlusion (CRVO who were treated with intravitreal bevacizumab. CASE REPORT: Two patients were referred for neovascular glaucoma following CRVO. Visual acuity was light perception. Both eyes had extensive iris neovascularization (NVI, synechial angle closure and high intraocular pressure (IOP in spite of anti-glaucoma medications. After obtaining informed consent, both eye received an intravitreal injection of 2.5 mg (0.1 ml bevacizumab (Avastin. Both eyes demonstrated dramatic IOP reduction together with decreased severity and extent of NVI during 4 weeks of follow up. Visual acuity remained unchanged. CONCLUSION: Despite the dramatic short-term response in terms of IOP reduction and regression of neovascularization, due to limited clinical experience, one should consider this novel indication for bevacizumab cautiously.

  1. Adjunctive with versus without intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    ZHOU Min-wen; WANG Wei; HUANG Wen-bin; CHEN Shi-da; LI Xing-yi; GAO Xin-bao; ZHANG Xiu-lan

    2013-01-01

    Background Neovascular glaucoma (NVG) is a refractory disease which is difficult to manage.This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG.Methods This was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012.The sample was divided into two groups according to the pretreatment:with adjunctive IVB injection (the IVB group,n=25 eyes) and without adjunctive IVB injection (the control group,n=28 eyes).The surgical success rate,number of antiglaucoma medications used,best-corrected visual acuity (BCVA),postoperative complications,regression,and recurrence of iris neovascularization (NVI) were analyzed between the groups.Results The surgical outcomes of the two groups were compared.The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months,respectively.There was a significant difference between the two groups (P=0.041).Mean postoperative intraocular pressures,mean number of postoperative antiglaucoma medications,and BCVA were not significant between the two groups.The NVI in 22 (88.0%) eyes had completely regressed within 2-8 days after IVB.However,NVI recurred in 10 eyes (40.0%) 2-9 months later after IVB.The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes,while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P=0.026).Conclusions This study showed that preoperative IVB injection reduced NVI remarkably,decreased hyphema,and led to higher surgical success rates.Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.

  2. Caracterización del glaucoma juvenil

    Directory of Open Access Journals (Sweden)

    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

  3. Ranibizumab Plus Combined Surgery for Treatment of Neovascular Glaucoma with Vitreous Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xiu-Juan Li; Xiao-Peng Yang; Qiu-Ming Li; Yu-Ying Wang; Xiao-Bei Lyu

    2015-01-01

    Background:Neovascular glaucoma (NVG) is a refractory glaucoma.The management of NVG is very difficult,and it is more difficult when combined with vitreous hemorrhage.The aim of this study was to investigate the effects of ranibizumab plus combined surgery for NVG with vitreous hemorrhage.Methods:A total of 26 eyes of 26 NVG patients with vitreous hemorrhage were recruited in this study.The patients aged from 36 to 63 years with a mean age of 51.97 ± 7.60 years.The mean intraocular pressure (IOP) was 46.38 ± 5.75 mmHg (1 mmHg =0.133 kPa) while being treated with the maximum medical therapy.The mean best-corrected visual acuities converted to logarithm of the minimum angle of resolution (logMAR BCVA) was 2.62 ± 0.43.All the patients underwent intravitreal injection of 0.5 mg (0.05 ml) ranibizumab combined with pars plana vitrectomy (PPV),pars plana lensectomy (PPL) with a preserved anterior capsule,panretinal photocoagulation (PRP),and trabeculectomy (intravitreal ranibizumab [IVR] + PPV + PPL + PRP + trabeculectomy).The IOP and logMAR BCVA were the main outcome measures in this study.Results:The follow-up period was 12 months.The mean postoperative IOPs were 26.38 ± 3.75 mmHg,21.36 ± 3.32 mmHg,1 8.57 ± 3.21 mmHg,and 16.68 ± 2.96 mmHg,respectively at 7 days,1 month,3 months,and 12 months after PPV + PPL + PRP + trabeculectomy.At the last follow-up,the mean IOP was significantly lower than the preoperative one (t =6.612,P =0.001).At 7 days,1 month,3 months,and 12 months after PPV + PPL + PRP + trabeculectomy,the mean logMAR BCVA were 1.30 ± 0.36,1.29 ± 0.37,1.29 ± 0.39,and 1.26 ± 0.29,respectively.At the last follow-up,the mean logMAR BCVA was significantly improved,and the difference was statistically significant compared with preoperative one (t =6.133,P =0.002).The logMAR BCVA improved in 22 eyes (84.62%),and remained stable in 4 eyes (15.38%).The neovascularization in the iris and the angle regressed significantly in all patients 7 days after

  4. Ranibizumab Plus Combined Surgery for Treatment of Neovascular Glaucoma with Vitreous Hemorrhage

    Directory of Open Access Journals (Sweden)

    Xiu-Juan Li

    2015-01-01

    Full Text Available Background: Neovascular glaucoma (NVG is a refractory glaucoma. The management of NVG is very difficult, and it is more difficult when combined with vitreous hemorrhage. The aim of this study was to investigate the effects of ranibizumab plus combined surgery for NVG with vitreous hemorrhage. Methods: A total of 26 eyes of 26 NVG patients with vitreous hemorrhage were recruited in this study. The patients aged from 36 to 63 years with a mean age of 51.97 ± 7.60 years. The mean intraocular pressure (IOP was 46.38 ± 5.75 mmHg (1 mmHg = 0.133 kPa while being treated with the maximum medical therapy. The mean best-corrected visual acuities converted to logarithm of the minimum angle of resolution (logMAR BCVA was 2.62 ± 0.43. All the patients underwent intravitreal injection of 0.5 mg (0.05 ml ranibizumab combined with pars plana vitrectomy (PPV, pars plana lensectomy (PPL with a preserved anterior capsule, panretinal photocoagulation (PRP, and trabeculectomy (intravitreal ranibizumab [IVR] + PPV + PPL + PRP + trabeculectomy. The IOP and logMAR BCVA were the main outcome measures in this study. Results: The follow-up period was 12 months. The mean postoperative IOPs were 26.38 ± 3.75 mmHg, 21.36 ± 3.32 mmHg, 18.57 ± 3.21 mmHg, and 16.68 ± 2.96 mmHg, respectively at 7 days, 1 month, 3 months, and 12 months after PPV + PPL + PRP + trabeculectomy. At the last follow-up, the mean IOP was significantly lower than the preoperative one (t = 6.612, P = 0.001. At 7 days, 1 month, 3 months, and 12 months after PPV + PPL + PRP + trabeculectomy, the mean logMAR BCVA were 1.30 ± 0.36, 1.29 ± 0.37, 1.29 ± 0.39, and 1.26 ± 0.29, respectively. At the last follow-up, the mean logMAR BCVA was significantly improved, and the difference was statistically significant compared with preoperative one (t = 6.133, P = 0.002. The logMAR BCVA improved in 22 eyes (84.62%, and remained stable in 4 eyes (15.38%. The neovascularization in the iris and the angle

  5. Role of Platelet Parameters on Neovascular Glaucoma: A Retrospective Case-Control Study in China

    Science.gov (United States)

    Li, Shengjie; Cao, Wenjun; Sun, Xinghuai

    2016-01-01

    Purpose Retinal vein occlusion (RVO) and diabetic retinopathy (DR) are two major sight-threatening diseases which may lead to neovascular glaucoma (NVG). The aim of this study was to explore the association between platelet parameters and NVG. Methods A total of 185 subjects were enrolled for the study from January, 2012 to December, 2015 at the Eye-ENT Hospital of Fudan University. Patients include those with NVG secondary to RVO (RVO group, n = 38), patients with NVG secondary to DR (DR group, n = 47), diabetics mellitus without retinopathy (DM group, n = 52), and healthy individuals (control group, n = 48). A complete ophthalmological examination including visual field examination, A-scan ultrasound, Fundus photography, and measurement of platelet parameters were performed for NVG subjects. Results There was no statistical difference in the mean age and gender among the RVO, DR, and control groups (p>0.05). The mean level of platelet distribution width (PDW) was higher (p<0.001) in the RVO group (15.16±2.13fl) and DR group (16.17±1.66fl) when compared with the control group (13.77±2.99fl). The mean plateletcrit (PCT) value of the RVO group (0.229±0.063%) was also higher (p = 0.049) than the control group (0.199±0.045). In the DR group, mean platelet volume (MPV) value (10.72±1.57fl) was significantly higher (p = 0.002) than the control group (9.75±0.89fl). A similar trend was observed when platelet parameters were compared among the 3 groups with respect to age. The mean level of PDW was significantly higher (p<0.001) in the DR group (16.17±1.66fl) compared with the DM group (13.80±3.32fl). Stepwise multiple logistic regression analysis revealed that PDW (OR = 1.44, 95%CI = 1.149–1.805, p = 0.002) and MPV (OR = 1.503, 95%CI = 1.031–2.192, p = 0.034) were associated with the DR group, PDW (OR = 1.207, 95%CI = 1.010–1.443, p = 0.039) and PCT (OR = 1.663, 95%CI = 1.870–2.654, p = 0.036) were associated with the RVO group. Conclusion Our results

  6. Adjuvant treatment of neovascular glaucoma with anti-VEGF%抗VEGF药物辅助治疗新生血管性青光眼

    Institute of Scientific and Technical Information of China (English)

    师留坤; 杨瑾

    2015-01-01

    Neovascular glaucoma (NVG) is a severe complication of ocular ischemia diseases.High concentration of vascular endothelial growth factor (VEGF) exists in anterior segment which leads to iris neovascularization.Aqueous humor outflow will be blocked.Anti-VEGF agent can combine with VEGF receptor and block VEGF, and to a certain extent delay the appearance of iris neovascularization.Intravitreal or intracameral injection of anti-VEGF agents (such as bevacizumab, ranibizumab and so on) combined with the traditional treatment such as trabecutectomy, glaucoma valve implantation, vitrectomy, panretinal photocoagulation are good choices to treat neovascular glaucoma.%新生血管性青光眼(neovascular glaucoma,NVG)为眼内缺血性疾病造成的严重并发症.由于缺血产生高浓度的血管内皮生长因子(vascular endothelial growth factor,VEGF),在前房中导致虹膜新生血管的形成并持续存在,引起房水排出受阻.抗VEGF药物可与VEGF受体结合,使VEGF失活,从而延迟虹膜新生血管的形成.抗VEGF药物(贝伐单抗、雷珠单抗等)经前房或玻璃体腔注射联合传统治疗手段如小梁切除术、青光眼减压阀植入术、玻璃体切除术、全视网膜光凝术等可治疗NVG.

  7. Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report

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    Liebmann Jeffrey M

    2011-06-01

    Full Text Available Abstract Introduction We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision. Case presentation A 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye. He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication. Conclusion Functional vision can be regained despite long-standing retinal detachment.

  8. Claves para el diagnóstico precoz del glaucoma (Keys to early diagnosis of glaucoma

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    Molleda-Carbonell José Mª

    2009-03-01

    Full Text Available ResumenEl diagnóstico precoz del glaucoma es un problema en oftalmologíaveterinaria. Basándose en los síntomas clínicos habituales el diagnóstico suele hacerse en un punto en el que la visión ha sufrido un importante deterioro. Basados en el hecho de que el glaucoma es una enfermedad neurodegenerativa del nervio óptico y que sus primeras manifestaciones son degeneración y muerte de las células ganglionares de la retina, degeneración de axones del nervio óptico y por tanto disminución de la capa de fibras nerviosas nerviosas, con aumento de la excavación papilar, disminución del anillo neuro-retniano y desestabilización de la cabeza del nervio óptico, es obvio que el diagnóstico debe de centrarse en detectar, loantes posible, estos cambios. En la actualidad, sin menospreciar latonometría y la gonioscopia se debe profundizar en aquellas técnicas que como la oftalmoscopia de la retina y papila evalúen el daño y progresión del nervio óptico. Así junto al estudio de la progresión de la excavación papilar frente a la disminución del anillo neurorretiniano, es necesario avanzar en el uso de técnicas actuales como la tomografía de coherencia óptica (OCT y el analizador de fibras nerviosas GDX, que detectan daños y su progresión en la capa de fibras nerviosas de la retina incluso antes de que se traduzcan en una pérdida apreciable de la función visual.SummaryEarly diagnosis of glaucoma is a problem in veterinary ophthalmologybecause the diagnosis is based on the clinical sings when there is animportant visual alteration. Two groups of eye conditions have beenproposed in glaucoma. One of them has the common feature aboutprogressive optic neuropaty involving loss of retinal ganglion cells, getting smaller the neuroretinal rim, loss of nerve fibre layer and generalised or focal enlargement of the cup. Only a preventive glaucoma diagnosis can preserve effectively the vision. Early detection is the key to protecting the

  9. A case involving an Ahmed™ glaucoma valve transferred from the vitreous into the anterior chamber of the eye with a silicone oil tamponade for the treatment of neovascular glaucoma

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    Miki M

    2013-02-01

    Full Text Available Michiko Miki, Mari Ueki, Tetsuya Sugiyama, Shota Kojima, Tsunehiko IkedaDepartment of Ophthalmology, Osaka Medical College, Takatsuki, JapanPurpose: To report the short-term efficacy and safety of the transfer of an Ahmed™ glaucoma valve (AGV™ tube from the vitreous into the anterior chamber, in a patient with neovascular glaucoma who had undergone pars plana AGV™ implantation and ultimately needed a silicone oil tamponade.Case: A 41-year-old male with proliferative diabetic retinopathy in both eyes was referred to us for treatment in December 2009. Although the patient previously underwent several surgeries, he ultimately lost vision in his right eye. His left eye suffered from neovascular glaucoma after undergoing a pars plana vitrectomy for tractional retinal detachment. After several vitreous and glaucoma surgeries, the patient underwent implantation of a pars plana AGV™. Postoperatively, although his intraocular pressure was stabilized at approximately 10 mmHg, he had repeated vitreous hemorrhage and hyphema without improvement. He ultimately underwent PPV with a silicone oil tamponade and at the same time, the AGV™ tube was pulled out from the vitreous and inserted into the anterior chamber in order to avoid complications caused by the silicone oil.Results: At 19 months postoperative, the patient’s intraocular pressure had stabilized at 10 mmHg with no recurrence of vitreous hemorrhage and hyphema. Eventually, he lost vision in his left eye because of cerebral hemorrhage.Conclusion: The findings show that insertion of a pars plana AGV™ tube into the anterior chamber in a patient undergoing a silicone oil tamponade is both effective and safe in the short-term.Keyword: tube implantation, glaucoma surgery, tube transfer, pars plana, proliferative diabetic retinopathy, intraocular pressure

  10. Glaucoma

    Science.gov (United States)

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

  11. Fármacos microencapsulados para el tratamiento del glaucoma

    OpenAIRE

    De Arriba Aldecoa, Garbiñe

    2016-01-01

    Sobre la base de la problemática de los tratamientos terapéuticos del glaucoma, en especial cuando se administran en forma de gotas oculares y dado el empleo de los beta-bloqueantes como el grupo de fármacos utilizados como primera opción de tratamiento; y teniendo en cuenta las ventajas que ofrece la microencapsulación de fármacos en el sector farmacéutico y el uso de las ciclodextrinas como agentes encapsulantes, el objetivo de este trabajo se centra en la microencapsulación del fármaco ...

  12. Caracterización del glaucoma juvenil Characterization of juvenile glaucoma

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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 cl��nica 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

  13. 青光眼引流器植入术在新生血管性青光眼治疗中的疗效观察%Efficacy of Ex-PRESS glaucoma drainage device implantation on the treatment of neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    杨露; 刘若屏; 岳向东; 谢九冰; 杨杉杉

    2014-01-01

    目的:观察青光眼引流器植入术对新生血管性青光眼的治疗作用。方法回顾性总结33例新生血管性青光眼行青光眼引流器植入术的治疗结果。结果术后眼压控制较好,视力损伤小,并发症少。结论青光眼引流器植入术恢复快,对视力损伤小,对新生血管性青光眼是一种疗效较好的治疗方法。%Objective To observe the Ex-PRESS glaucoma drainage device implantation for the treatment of neo-vascular glaucoma .Methods This is a retrospective study of 33 cases of neovascular glaucoma that were treated with Ex-PRESS glaucoma drainage device implantation .Results In patients treated with Ex-PRESS glaucoma drainage device im-plantation , postoperative intraocular pressure was controlled better , vision loss was smaller , and there were less ocular com-plications .Conclusion Ex-PRESS glaucoma drainage device implantation can quickly restore intraocular pressure , im-pose smaller damage to eyes , and proved to be an effective and safe treatment for neovascular glaucoma .

  14. GLAUCOMA. ' ~ '

    African Journals Online (AJOL)

    trabeculoplasty as primary therapy for glaucoma has been a matter of debate and research for many years. Arguments ... angle closure glaucoma (26.6%), 300,000 children. (1.3%) have .... The results from this study mirror the guidelines in the ...

  15. Prevención y tratamiento actual del glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  16. Curative effect observation of the Ex-PRESS glaucoma drainage device implantation in the treatment of neovascular glaucoma%Ex-PRESS青光眼引流器植入术在新生血管性青光眼治疗中疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨露; 刘若屏; 岳向东; 谢九冰; 杨杉杉

    2015-01-01

    目的 观察Ex-PRESS青光眼引流器植入术对新生血管性青光眼的治疗作用.方法 对2012年11月至2013年12月在唐山市眼科医院回顾性总结33例新生血管性青光眼,行Ex-PRESS青光眼引流器植入术的治疗.结果 术后眼压控制较好,视力损伤小,并发症少.结论 Ex-PRESS青光眼引流器植入术恢复快,对视力损伤小,对新生血管性青光眼是一种疗效较好地治疗方法.%Objective To observe the Ex-PRESS glaucoma drainage device implantation for the treatment of neovascular glaucoma.Methods Retrospective summary 33 cases of neovascular glaucoma treatment for Ex-PRESS glaucoma drainage device implantation.Results Postoperative intraocular pressure control,vision loss was small,less complications.Conclusions Ex-PRESS glaucoma drainage device implantation quick recovery,small damage to eyesight,curative effect of neovascular glaucoma is a kind of good treatment.

  17. Glaucoma

    Science.gov (United States)

    ... headache, eye pain and blurred vision. Schedule eye exams Open-angle glaucoma gives few warning signs until ... doctor about an appropriate exercise program. Limit your caffeine. Drinking beverages with large amounts of caffeine may ...

  18. Glaucoma

    Medline Plus

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

  19. Glaucoma

    Medline Plus

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

  20. Glaucoma

    Medline Plus

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

  1. Glaucoma

    Medline Plus

    Full Text Available ... Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ... Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Glaucoma Embedded ...

  2. Glaucoma

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home > NEI YouTube Videos > NEI YouTube Videos: Glaucoma NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  3. VEGF抑制剂在新生血管性青光眼治疗中的应用%Application of anti -vascular endothelial growth factor on the treatment of neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    吴平; 李平华

    2015-01-01

    新生血管性青光眼( neovascular glaucoma,NVG)是一种常见的继发性青光眼,常继发于糖尿病性视网膜病变、视网膜中央静脉阻塞和视网膜缺血综合征。其发病机制复杂,传统的治疗方式虽然能短暂缓解高眼压、消退虹膜新生血管,但对NVG的长期控制效果并不明显。随着近年来对NVG发病机制的深入研究及VEGF抑制剂在眼科疾病中的使用,NVG的治疗迎来了新的曙光。本文就 VEGF 抑制剂在新生血管性青光眼治疗中的应用做一综述,以期为NVG的治疗提供新的思路。%Abstract•Neovascular glaucoma ( NVG) is a common secondary glaucoma, often occurs secondary to diabetic retinopathy, central retinal vein occlusion and retinal ischemia syndrome. lts pathogenesis is complicated. Though conventional treatmentscan brieflyreduce elevated intraocular pressure, degenerate iris neovascularization, the long-term effect for controlling NVG is not obvious. The treatment of NVG ushers in a new dawn with the in-depth study on the pathogenesis of NVG and the use of vascular endothelial growth factor ( VEGF ) inhibitors in ophthalmic diseases. ln this paper, the applications of VEGF inhibitors on the treatment of neovascular glaucoma are reviewed to provide new thoughts for the treatment of NVG.

  4. Glaucoma

    Directory of Open Access Journals (Sweden)

    Geraldo Vicente de Almeida

    2007-05-01

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

  5. Reasonable selection of neovascular glaucoma therapy%新生血管性青光眼治疗方案合理性选择

    Institute of Scientific and Technical Information of China (English)

    宋哲; 赛自金

    2013-01-01

    新生血管性青光眼(neovascular glaucoma,NVG)在临床中随着基础病如:糖尿病、高血压等的增多而越来越多.虽然其诊断简单,但是治疗却比较复杂,在晚期,由于患者疼痛,解除患者痛苦采用多种方法如睫状体冷冻、光凝术、球后酒精注射、氯丙嗪术、甚至眼球摘除术.摘除眼球给患者带来诸多不便,面对错综复杂的治疗方案,那么如何选择比较科学合理方法对患者尤为重要,目前尽可能避免眼球摘除术;慎用酒精或者氯丙嗪球后注射术.应结合眼科新进展采用多种方法控制眼压,减轻患者痛苦,制订科学而合理的个体化治疗是治疗NVG必然趋势.%Neovascular glaucoma (NVG)is increasing in clinical with the increase of basic diseases such as diabetes mellitus, hypertension. It is easy to diagnose, but the treatment is more complex. In the late, because the pain of patients, a variety of methods such as the ciliary body cryotherapy, photocoagulation, retrobulbar alcohol injection, chlorpromazine, even enucleation of eyeball were used to relieve pain of patients. Enucleation of eyeball brings inconvenience to the patients. Then how to choose the reasonable method is particularly important for patients, in the face of complicated treatments, as far as possible to avoid enucleation. Alcohol or retrobulbar injection of chlorpromazine should be careful used and should be combined with the new progress in the Department of Ophthalmology. Using a variety of methods to control intraocular pressure, alleviate the suffering of patients, to formulate a scientific and reasonable individualized treatment is the treatment of NVG trend.

  6. Risk Factors for Neovascular Glaucoma After Proton Beam Therapy of Uveal Melanoma: A Detailed Analysis of Tumor and Dose–Volume Parameters

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Kavita K., E-mail: kmishra@radonc.ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Daftari, Inder K.; Weinberg, Vivian [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Cole, Tia [The Tumori Foundation, San Francisco, California (United States); Quivey, Jeanne M.; Castro, Joseph R.; Phillips, Theodore L. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Char, Devron H. [The Tumori Foundation, San Francisco, California (United States)

    2013-10-01

    Purpose: To determine neovascular glaucoma (NVG) incidence and identify contributing tumor and dosing factors in uveal melanoma patients treated with proton beam radiation therapy (PBRT). Methods and Materials: A total of 704 PBRT patients treated by a single surgeon (DHC) for uveal melanoma (1996-2010) were reviewed for NVG in our prospectively maintained database. All patients received 56 GyE in 4 fractions. Median follow-up was 58.3 months. Analyses included the Kaplan-Meier method to estimate NVG distributions, univariate log–rank tests, and Cox's proportional hazards multivariate analysis using likelihood ratio tests to identify independent risk factors of NVG among patient, tumor, and dose–volume histogram parameters. Results: The 5-year PBRT NVG rate was 12.7% (95% confidence interval [CI] 10.2%-15.9%). The 5-year rate of enucleation due to NVG was 4.9% (95% CI 3.4%-7.2%). Univariately, the NVG rate increased significantly with larger tumor diameter (P<.0001), greater height (P<.0001), higher T stage (P<.0001), and closer proximity to the disc (P=.002). Dose–volume histogram analysis revealed that if >30% of the lens or ciliary body received ≥50% dose (≥28 GyE), there was a higher probability of NVG (P<.0001 for both). Furthermore, if 100% of the disc or macula received ≥28 GyE, the NVG rate was higher (P<.0001 and P=.03, respectively). If both anterior and posterior doses were above specified cut points, NVG risk was highest (P<.0001). Multivariate analysis confirmed significant independent risk factors to include tumor height (P<.0001), age (P<.0001), %disc treated to ≥50% Dose (<100% vs 100%) (P=.0007), larger tumor diameter (P=.01), %lens treated to ≥90% Dose (0 vs >0%-30% vs >30%) (P=.01), and optic nerve length treated to ≥90% Dose (≤1 mm vs >1 mm) (P=.02). Conclusions: Our current PBRT patients experience a low rate of NVG and resultant enucleation compared with historical data. The present analysis shows that tumor height

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

    Directory of Open Access Journals (Sweden)

    Armando Rafael Milanés Armengol

    2010-11-01

    primario de ángulo abierto. Métodos: estudio clínico-epidemiológico, prospectivo y longitudinal en enfermos de glaucoma primario de ángulo abierto que asistieron a la Consulta Provincial de Glaucoma del Hospital General Universitario “Dr. Gustavo Aldereguía Lima” de Cienfuegos, en los meses de enero y febrero del año 2009. Se analizaron: edad, sexo, antecedentes patológicos familiares y personales, hábitos tóxicos y tiempo de diagnóstico de la enfermedad. Resultados: hubo prevalencia de glaucoma primario de ángulo abierto (87, 5 %, predominó el sexo femenino (53, 6 % y los mayores de 61 años, así como el color blanco de la piel (52 y 62 % respectivamente. La hipertensión arterial fue la entidad más referida como antecedente patológico personal y familiar (62 y 42 % respectivamente, el glaucoma y la miopía predominaron en los antecedentes oculares. Los hábitos tóxicos más frecuentes fueron la ingestión de más de 2 tazas de café diariamente (53 % y el hábito de fumar (32 %. El mayor número de pacientes presentó más de 5 años de evolución de su enfermedad. Conclusiones: el glaucoma primario de ángulo abierto se presentó fundamentalmente en pacientes femeninas y en aquellos con antecedentes de hipertensión arterial, glaucoma y miopía, así como en mayores de 61 añ

  8. 光凝虹膜联合小梁切除及应用丝裂霉素治疗新生血管性青光眼%Laser treatment of iris neovascularization combined with trabeculectomy and MMC for neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    张利华; 王蕾

    2011-01-01

    目的 评价氩绿激光行虹膜及前房角新生血管光凝联合小梁切除术,术中应用丝裂霉素C (MMC)治疗新生血管性青光眼的疗效.方法 对28例(28眼)新生血管性青光眼先用氩激光对虹膜及前房角小梁网新生血管进行直接覆盖光凝,观察新生血管闭塞萎缩后,行小梁切除术联合术中应用0.2mg/ml MMC,术后观察降眼压效果、结膜滤过泡情况、眼前节炎症反应及其它手术并发症;随访时间为6~24个月.结果 28例术后第1周平均眼压(10.52±3.16)mm Hg较术前平均眼压(48.36 +5.87)mm Hg明显降低(t=14.86,P=0.000),随访时眼压控制良好,平均(17.48±3.23)mm Hg,仅3例需用药物控制,术后眼压较治疗前有显著意义的降低(P<0.01).23例结膜滤过泡弥散隆起,4例较为扁平,1例结膜切口Ⅱ期愈合;6个月后功能性滤过泡存在有21例(21/28).术中6例少量前房出血,术后2例继发少量前房出血.新生血管在术后早期全部消退,3月后出现3例(3/28);余无其它严重并发症发生.结论 氩激光联合小梁切除术加术中应用丝裂霉素C是治疗新生血管性青光眼的一种有效方法.%Objective To evaluate the effectiveness of laser coagulation of iris neovascularization combined with trabeculectomy and used MMC in the operation for neovascular glaucoma. Methods In 28 cases( 16male, 12female) of neovascular glaucoma, the green argon laser therapy to iris and Trabec-ular meshwork neovascularization was first conducted followed by routine trabeculectomy. Mitomycin C was applied in all cases. The change of intraocular pressure (IOP) , filtering bleb as well as the reaction in the anterior segment of the eye was carefully observed after the surgery. The follow - up period was 6 ~24months. Results The IOP was( 10. 52 ±3. 16)mm Hg which was significantly (t = 14. 86, P = 0. 000) lower than that before the surgery(48. 36+5. 87)mm Hg. At the time of the last visit, the IOP was( 17. 48 ±3. 23) mm Hg

  9. 睫状体和周边视网膜冷凝治疗晚期新生血管性青光眼%Treatment of neovascular glaucoma by ciliary body cryotherapy combined with peripheral retinal cryotherapy

    Institute of Scientific and Technical Information of China (English)

    秦萍; 魏星; 刘玥; 许耀

    2011-01-01

    目的 观察睫状体冷凝联合周边视网膜冷凝治疗晚期新生血管性青光眼的临床疗效.方法 回顾分析了药物不能控制或已行其他抗青光眼手术失败而接受睫状体冷凝联合周边视网膜冷凝手术治疗的新生血管性青光眼48例(48眼).观察眼压、视力、虹膜新生血管改变及术后并发症.结果28眼眼压<21mm Hg,19眼联合降眼压药物点眼眼压< 30mm Hg.虹膜新生血管完全消退31眼(64.58%),新生血管较术前明显减少17眼(35.42%).术后视力提高14眼(29.17%),视力不变27眼(56.25%),视力下降7眼(14.58%).术后并发症:早期多数出现一过性眼压升高,出现眼球萎缩1例.结论睫状体冷凝联合周边视网膜冷凝能有效降低眼压,使部分患者得以保留原有视力,少数有所提高,操作简单,易于掌握,是一种较为安全有效的手术方法.%Objective To observe the treatment of ciliary body cryotherapy combined with peripheral retinal cryotherapy for neovascular glaucoma. Methods A retrospective analysis of the drug can not control or failure of other anti - glaucoma surgery received peripheral retinal cryotherapy ciliary body cryotherapy combined surgical treatment of 48 cases of neovascular glaucoma (48 eyes). To observe the change of intraocular pressure, visual acuity, iris neovascularization and complications. Results IOP: the IOP of 28 eyes all controlled uder 21mm Hg, the IOP of 19 eyes which joint antiglau-coma medications controlled under 30mm Hg. Iris neovascularization decreased in 31 eyes (64. 58% ) , neovascularization significantly reduced compared with the preoperative thinning 17 eyes (35. 42% ). Visual acuity; visual acuity was improved in 14 eyes (29. 17% ), no change in 21 eyes (56. 25% ) , decreased vision in 13 eyes (27. 08% ). Postoperative complications; early majority had transient elevation of intraocular pressure. One case of ocular atrophy occurs. Conclusions Ciliary body cryotherapy combined

  10. No cumplimiento del tratamiento farmacológico en pacientes con glaucoma primario de ángulo abierto

    Directory of Open Access Journals (Sweden)

    Ariana Fernández García

    2012-06-01

    Full Text Available Fundamento: el tratamiento precoz y su cumplimiento, por parte del paciente, son las formas más efectivas de prevenir la ceguera por glaucoma. Objetivos: identificar el cumplimiento o no cumplimiento del tratamiento en pacientes con glaucoma primario de ángulo abierto. Métodos: estudio descriptivo,  transversal en 106 pacientes con glaucoma primario de ángulo abierto confirmado, atendidos en el Servicio de Glaucoma del Hospital Dr. Salvador Allende de Ciudad de La Habana durante el primer trimestre de 2011. Se analizaron las siguientes variables: edad, sexo, escolaridad, antecedentes patológicos personales y antecedentes familiares de glaucoma, tratamiento y su cumplimiento, autovaloración del estado de salud general y visual. Resultados: la edad promedio fue de 60,7 años; 72,7 % mujeres; el 51,9 % resultó no cumplidor del tratamiento farmacológico. El 91, 6 % de los pacientes utilizan monoterapia y el 73,6 % de los casos emplean timolol en monoterapia o en combinación con otro fármaco. El 68, 9 % tenía antecedentes familiares de glaucoma. La hipertensión arterial (51, 1 % fue la enfermedad crónica más reportada. La valoración del estado de salud general y visual más referida fue la regular (42, 5 % y 49, 1 % respectivamente.  Conclusiones: más de la mitad de los pacientes fueron no cumplidores del tratamiento farmacológico indicado para el control de la enfermedad, comportamiento que estuvo relacionado con la edad en los casos estudiados.

  11. 糖尿病新生血管性青光眼 Ahmed 引流阀植入术%Ahmed valve implantation in diabetic patients with neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    苗培建; 张雪翎; 刘振英; 张正培

    2016-01-01

    目的:观察Ahmed引流阀植入治疗糖尿病新生血管性青光眼( NVG)的效果。方法2005年12月至2013年5月住院的38例(38眼)采用Ahmed引流阀植入治疗的糖尿病NVG临床资料,进行回顾性分析。结果38例中术后早期出现低眼压浅前房7例,短暂性眼压升高4例,前房积血12例,阀门管堵塞2例。术前与术后出院时眼压比较,平均下降(34.17±14.99)mmHg(1 mmHg=0.133 kPa),差异有统计学意义(P<0.01)。视力提高11例,下降1例,不变26例。结论围手术期血糖的稳定控制,术中的个性化治疗,术后及时发现并给予正确的处理,可以取得较好的临床疗效。%Objective To observe surgical outcomes of Ahmed valve implantation in diabetic patients with neovascular glaucoma .Methods The clinical data of 38 eyes of 38 patients with diabetic neovascular glaucoma were retrospectively analyzed .They had undergone Ahmed valve implantation in Eye Institute of Xuzhou from Dec.2005 to May 2013.Results In the 38 patients, 7 cases were observed with ocular hypotension and shallow anterior chamber , 4 cases with transient ocular hypertension , 12 cases with hyphema and two cases with valve tube blockage in the early stage after the operation .Compared with the preoperative IOP, the postoperative IOP was reduced by (34.17 ±14.99) mmHg, and the difference was statistically significant (P<0.01).There were 11 cases with improved vision, one case with decreased vision, and 26 cases with unchanged vision .Conclusion Stable control of blood sugar perioperatively , individualized treatment during operation , timely detection and right treatment of postoperative complications , can make the surgery get more satisfactory clinical efficacy .

  12. Panretinal cryotherapy in neovascular disease.

    OpenAIRE

    Vernon, S A; Cheng, H.

    1988-01-01

    Panretinal cryotherapy (PRC) was used to treat 15 eyes with rubeosis, nine of which had established neovascular glaucoma, and seven eyes with proliferative diabetic retinopathy. The rubeosis regressed, with preservation of vision and return to normal of intraocular pressure, in all but one eye. With one exception all eyes with proliferative retinopathy also showed new vessel regression after treatment. PRC may be considered an effective alternative to retinal photocoagulation in the treatment...

  13. Glaucoma secondary to systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    Zhang Jing; Huang Wenbin; Gao Xinbo; Che Huixin; Yu Keming; Zhang Xiulan

    2014-01-01

    Background Glaucoma secondary to systemic lupus erythematosus (SLE) (") an uncommon but serious complication that threatens vision and therefore cannot be neglected.A few cases of secon(ca)ry glaucoma resulting from lupus-induced or iatrogenic ocular impairments have been reported in association with SLE.However,a systematic analysis of the diagnosis and treatment of glaucoma secondary to SLE has not been reported in the literature.The aim of this study is to further investigate the relationship between glaucoma and SLE.Methods In this study,we reviewed nine eyes of five patients diagnosed with secondary glaucoma associated with SLE,including one case of neovascular glaucoma and four cases of steroid-induced glaucoma.Results Neovascular glaucoma was successfully treated by Ahmed glaucoma valve implantation surgery with adjunctive ranibizumab intravitreal injection,followed by panretinal photocoagulation (PRP).The steroid-induced glaucoma in eight eyes of four cases were controlled by trabeculectomy along with antiproliferative agents.Conclusion Regular follow-up ocular examinations should be conducted to ensure early diagnosis and treatment of secondary glaucoma in SLE patients to improve the prognosis of vision.

  14. Variability of blood pressure and blood glucose during perioperative period for patients with secondary neovascular glaucoma after silicone oil removed in PDR

    Directory of Open Access Journals (Sweden)

    Fu-Lin Gao

    2015-06-01

    Full Text Available AIM:To research blood pressure and blood glucose variability during peroperative period for patients with secondary neovasular glaucoma(NVGafter silicone oil removed in proliferative diabetic retinaopathy(PDR.METHODS: Totally, 271 patients(271 eyesundergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyeswith secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1~12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%variability during peroperative period was statisticed and compared by software of SPSS 11.0.RESULTS: Fourteen eyes(5.2%of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%, average ages was 57.07 years(49~68 years. NVG presented in the 107~ 135d after vitrectomy and 7~45d(average 31.78dafter silicon-oil removed. Diabetes mellitus was 10~15(average 13.2a. In NVG group, the variability of blood glucose was 4.0~10.2mmol/L(mean 8.52±3.24mmol/L, variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0~8.2mmol/L(mean 7.22±0.24mmol/L, variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(PPPPCONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.

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

    Directory of Open Access Journals (Sweden)

    Ariana Fernández García

    2012-06-01

    Full Text Available

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


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

  16. Nueva metodología de estimulación del electrorretinograma a patrón en el glaucoma New methodology for stimulating the pattern-electroretinography in glaucoma

    Directory of Open Access Journals (Sweden)

    Melba Márquez Fernández

    2002-06-01

    Full Text Available Se realiza una nueva metodología de estimulación para la exploración del electrorretinograma a patrón (PERG en el diagnóstico del glaucoma para lo cual se utilizaron 2 grupos, uno normal y otro portador de la enfermedad comprobando la efectividad por la prolongación del tiempo y disminución de su amplitud. Se estudiaron la efectividad de la estimulación del área de Bjerrum y la sensibilidad de la onda N95.A new stimulation methodology was applied to explore the pattern electroretinogram (PERG in the diagnosis of glaucoma. 2 groups were used, a normal one and the other carrier of the disease. The effectiveness was proved by the time prolongation and the reduction of its amplitude. The efficacy of the stimulation of the Bjerrum area and the sensitivity of the N95 wave were also studied.

  17. Clinical Observation on Cyclocryotherapy and Trabeculectomy Combined with Wufeng Jueming and Raw Typha Decoction for 15 Cases of Neovascular Glaucoma%睫状体冷凝及小梁切除术联合乌风决明合生蒲黄汤治疗新生血管性青光眼15例临床观察

    Institute of Scientific and Technical Information of China (English)

    陈宗贤; 张敏; 向红; 李雪娜

    2013-01-01

    目的 观察睫状体冷凝及小梁切除术联合乌风决明合生蒲黄汤治疗新生血管性青光眼的临床疗效.方法 将30例新生血管性青光眼患者随机分为试验组和对照组各15例,试验组采用睫状体冷凝及小梁切除术联合术后应用乌风决明合生蒲黄汤,对照组采用睫状体冷凝及小梁切除术联合术后应用甲钴胺片.两组疗程均为2周.观察两组术后眼压、视力、新生血管回退等情况.结果 术后1个月及术后6个月试验组与对照组眼压比较差异均有统计学意义(P<0.01).试验组术后6个月视力提高8例(53.33%),稳定5例(33.33%),下降2例(13.34%);对照组术后6个月视力提高6例(40.00%),稳定6例(40.00%),下降3例(20.00%),两组比较差异无统计学意义(P>0.05).试验组术后6个月新生血管全部回退9例(60.00%),部分回退4例(26.67%),无回退2例(13.33%);对照组术后6个月新生血管全部回退3例(20.00%),部分回退7例(46.67%),无回退5例(33.33%),两组比较差异有统计学意义(P<0.05).结论 睫状体冷凝及小梁切除术联合乌风决明合生蒲黄汤治疗新生血管性青光眼可以有效控制眼压,提高视力,促进新生血管消退,具有较好的临床疗效.%Objective To observe the therapeutic effect of cyclocryotherapy and trabeculectomy combined with decoction based on Wufeng Jueming Pill (pill of Concha Haliotidis for glaucoma) and Raw Typha Decoction (decoction of raw Pollen Typhae) for neovascular glaucoma. Methods Thirty cases of neovascular glaucoma were randomized into test group and control group, with 15 in each. The test group was given combo therapy of cyclocryotherapy, trabeculectomy and the decoction. The control group was treated with cyclocryotherapy, trabeculectomy and mecobalamin tablets. The treatment course lasted for 2 weeks. The intraocular pressure (IOP) , eyesight and iris neovascularization were observed. Results There were significant

  18. CRYOTHERAPY OF CILIARY BODY AND ITS PERIPHERAl RETINA FOR NEOVASCULAR GLAUCOMA%睫状体及周边视网膜冷凝治疗新生血管性青光眼

    Institute of Scientific and Technical Information of China (English)

    王玲; 王大博; 潘晓晶

    2011-01-01

    目的 评价因某些原因不能行全视网膜光凝治疗的新生血管性青光眼行睫状体及周边视网膜冷凝治疗的临床效果.方法 应用英国D.O.R.C.1500.02冷凝器对42例(42眼)新生血管性青光眼进行睫状体及周边视网膜冷凝治疗.结果 术后随访6~24个月,30例(71.43%)眼压在正常范围;5例(11.90%)眼压轻度升高,局部用5 g/L噻吗洛尔滴眼液控制到正常;7例(11.67%)眼压未得到控制,1月后再次行冷凝治疗后眼压在正常范围.未见持续性低眼压及眼球萎缩发生.结论 对于屈光问质混浊等无法进行全视网膜光凝治疗的新生血管性青光眼,睫状体及周边视网膜冷凝是一种有效的治疗方法.%Objective To evaluate the effect of cryotherapy of ciliary body and its peripheral retina on patients with neovascular glaucoma (NG) who were not indicated for whole-retina photocoagulation of some reasons. Methods Using UK-made D. O. R. C. 1500.02 condensator, the ciliary body and its peripheral retina of 42 NG eyes were treated with cryotherapy. Results Post-operative follow-up for 6-24 months showed that the IOP was kept within normal limits in 30 eyes (71.43%); five (11.90%) were slightly elevated and controlled with 5 g/L timolol; in seven (11.67 %) failed, the IOP returned to normal one month later after a second cryotherapy. Eyeball atrophy or persistent low IOP was not encountered. Conclusion Cryotherapy of ciliary body and its peripheral retina is an effective method for patients with NG not indicated for whole-retina photocoagulation due to refractive media opacity.

  19. Treatment of neovascular glaucoma by anterior retina condensation in combination with pars plana vitrectomy%前部视网膜冷凝联合玻璃体切除术治疗中早期NVG

    Institute of Scientific and Technical Information of China (English)

    肖丽波; 薛黎萍; 李云琴; 韦春玲

    2011-01-01

    目的:探讨前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼(neovascular glaucoma, NVG)的临床效果.方法:采用前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼31例31眼,术中全视网膜光凝.结果:患者31眼,术前眼压41.1±6.2mmHg,术后观察3~25(平均9.8)mo,眼压22.6±6.9mmHg,术前术后眼压差别具有统计学意义(P=0.002);25例眼压控制正常,眼压19.8±2 4mmHg,6例眼压34±8.2mmHg,其中3例局部药物治疗眼压控制正常,2例行二次手术,玻璃体腔青光眼阀植入术后,眼压控制满意,1例无效,患眼无光感,疼痛,行眼内容摘除术.20眼视力有不同程度的提高,5例视力不变,5例视力下降,1例无光感.30例虹膜面新生血管绝大部分或完全消退,角膜透明,前房无积血,所有病例眼部疼痛消失或明显缓解.结论:前部视网膜冷凝联合玻璃体切除术可消退虹膜面的新生血管,有利于术后眼压的控制,恢复部分视力,为中早期新生血管性青光眼提供了一个行之有效的治疗方案.

  20. Long-term Results of Carbon Ion Radiation Therapy for Locally Advanced or Unfavorably Located Choroidal Melanoma: Usefulness of CT-based 2-Port Orthogonal Therapy for Reducing the Incidence of Neovascular Glaucoma

    Energy Technology Data Exchange (ETDEWEB)

    Toyama, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Department of Heavy Particle Therapy and Radiation Oncology, Faculty of Medicine, Saga University, Saga (Japan); Tsuji, Hiroshi, E-mail: h_tsuji@nirs.go.jp [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Mizoguchi, Nobutaka; Nomiya, Takuma; Kamada, Tadashi [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Tokumaru, Sunao [Department of Heavy Particle Therapy and Radiation Oncology, Faculty of Medicine, Saga University, Saga (Japan); Mizota, Atsushi [Department of Ophthalmology, Teikyo University School of Medicine, Tokyo (Japan); Ohnishi, Yoshitaka [Department of Ophthalmology, Wakayama Medical University, Wakayama (Japan); Tsujii, Hirohiko [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)

    2013-06-01

    Purpose: To determine the long-term results of carbon ion radiation therapy (C-ion RT) in patients with choroidal melanoma, and to assess the usefulness of CT-based 2-port irradiation in reducing the risk of neovascular glaucoma (NVG). Methods and Materials: Between January 2001 and February 2012, a total of 116 patients with locally advanced or unfavorably located choroidal melanoma received CT-based C-ion RT. Of these patients, 114 were followed up for more than 6 months and their data analyzed. The numbers of T3 and T2 patients (International Union Against Cancer [UICC], 5th edition) were 106 and 8, respectively. The total dose of C-ion RT varied from 60 to 85 GyE, with each dose given in 5 fractions. Since October 2005, 2-port therapy (51 patients) has been used in an attempt to reduce the risk of NVG. A dose-volume histogram analysis was also performed in 106 patients. Results: The median follow-up was 4.6 years (range, 0.5-10.6 years). The 5-year overall survival, cause-specific survival, local control, distant metastasis-free survival, and eye retention rates were 80.4% (95% confidence interval 89.0%-71.8%), 82.2% (90.6%-73.8%), 92.8% (98.5%-87.1%), 72.1% (81.9%-62.3%), and 92.8% (98.1%-87.5%), respectively. The overall 5-year NVG incidence rate was 35.9% (25.9%-45.9%) and that of 1-port group and 2-port group were 41.6% (29.3%-54.0%) and 13.9% (3.2%-24.6%) with statistically significant difference (P<.001). The dose-volume histogram analysis showed that the average irradiated volume of the iris-ciliary body was significantly lower in the non-NVG group than in the NVG group at all dose levels, and significantly lower in the 2-port group than in the 1-port group at high dose levels. Conclusions: The long-term results of C-ion RT for choroidal melanoma are satisfactory. CT-based 2-port C-ion RT can be used to reduce the high-dose irradiated volume of the iris-ciliary body and the resulting risk of NVG.

  1. Ecografía Doppler oftálmica en el diagnóstico precoz del glaucoma

    OpenAIRE

    2013-01-01

    1. INTRODUCCIÓN o MOTIVACIÓN El término glaucoma engloba un grupo de neuropatías ópticas caracterizadas por la pérdida lenta y progresiva de las fibras del nervio óptico (NO) que conduce a cambios morfológicos característicos de la papila (excavación del NO) y de la capa de fibras nerviosas retinianas (CFNR) que se traducen en la pérdida de campo visual (CV) con un patrón también característico (1, 2). Inicialmente es asintomático pero conduce a una pérdida progresiva e irreversible del CV. I...

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

    Institute of Scientific and Technical Information of China (English)

    庞彦利

    2016-01-01

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

  3. Glaucoma Foundation

    Science.gov (United States)

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

  4. Altered aquaporin expression in glaucoma eyes.

    Science.gov (United States)

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

    2014-09-01

    Aquaporins (AQP) are channels in the cell membrane that mainly facilitate a passive transport of water. In the eye, AQPs are expressed in the ciliary body and retina and may contribute to the pathogenesis of glaucoma and optic neuropathy. We investigated the expression of AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9 in human glaucoma eyes compared with normal eyes. Nine glaucoma eyes were examined. Of these, three eyes were diagnosed with primary open angle glaucoma; three eyes had neovascular glaucoma; and three eyes had chronic angle-closure glaucoma. Six eyes with normal intraocular pressure and without glaucoma were used as control. Immunohistochemistry was performed using antibodies against AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9. For each specimen, optical densities of immunoprecipitates were measured using Photoshop and the staining intensities were calculated. Immunostaining showed labelling of AQP7 and AQP9 in the nonpigmented ciliary epithelium and the staining intensities were significantly decreased in glaucoma eyes (p = 0.003; p = 0.018). AQP7 expression in the Müller cell endfeet was increased (p = 0.046), and AQP9 labelling of the retinal ganglion cells (RGC) showed decreased intensity (p = 0.037). No difference in AQP1, AQP4 and AQP9 expression was found in the optic nerve fibres. This study is the first investigating AQPs in human glaucoma eyes. We found a reduced expression of AQP9 in the retinal ganglion cells of glaucoma eyes. Glaucoma also induced increased AQP7 expression in the Müller cell endfeet. In the ciliary body of glaucoma eyes, the expression of AQP7 and AQP9 was reduced. Therefore, the expression of AQPs seems to play a role in glaucoma.

  5. Glaucoma Symptoms

    Science.gov (United States)

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

  6. Glaucoma (image)

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    李丽; 关新辉; 易湘龙

    2016-01-01

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

  8. Evolución del glaucoma primario de ángulo estrecho postiridotomía periférica con Nd: YAG láser Evolution of primary narrow-angle glaucoma after peripheral Nd YAG: laser iridotomy

    Directory of Open Access Journals (Sweden)

    Francisco García González

    2006-12-01

    Full Text Available Con este trabajo se evaluó la evolución del glaucoma primario de ángulo estrecho (GPAE en sus distintos estadios evolutivos después de realizada una iridotomía periférica profiláctica o terapéutica con Nd: YAG láser. Se seleccionaron 50 pacientes con GPAE, de ellos se estudiaron 94 ojos. Se realizó iridotomía profiláctica en 38 ojos y terapéutica en 56. Entre las iridotomías, 72,4 % tenía entre 2 y 7 años de evolución al momento de la evaluación. La presión intraocular disminuyó después de la iridotomía: La relación excavación/ papila se mantuvo igual, la mayoría no tuvo modificaciones en la agudeza visual, el campo visual se mantuvo igual en 59,6 %, el ángulo de la cámara anterior preiridotomía era estrecho o muy estrecho en 92,6 % de los ojos y postiridotomía 70,4 % presentaba ángulo abierto. Se controlaron solo con la iridotomía 44 ojos (46,8 %, 19 (20,2 % requirieron tratamiento médico adicional y 31 (33 %, tratamiento quirúrgico o medico-quirúrgico para el control del glaucoma. La complicación más frecuente fue el sangrado ligero del iris con 71,2 %This paper made an evaluation of primary narrow-angle glaucoma at its different evolutionary stages after either prophylactic or therapeutic peripheral Nd YAG laser iridotomy. Fifty patients presenting with primary narrow angle glaucoma were selected, of whom 94 eyes were really studied. Prophylactic iridotomy was performed in 38 eyes and therapeutical iridotomy in the other 56. Of the total amount of iridotomies, 92,4% showed 2 to 7 years of evolution at the time of evaluation. Intraocular pressure diminished after iridotomy. Excavation /papilla ratio kept the same, most of the patients had no change in their visual acuity, the visual field remained unchanged in 59,6% of cases. The anterior chamber angle was narrow or very narrow in 92,6% of eyes but after iridotomy 70,4% showed open angle. Primary glaucoma was under control only with iridotomy in 44 eyes (46

  9. Unusual Presentation of Phacolytic Glaucoma: Simulating Microbial Keratitis

    Directory of Open Access Journals (Sweden)

    Srikant Kumar Sahu

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Alberto Izzotti

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

  11. Altered aquaporin expression in glaucoma eyes

    DEFF Research Database (Denmark)

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

    2014-01-01

    Aquaporins (AQP) are channels in the cell membrane that mainly facilitate a passive transport of water. In the eye, AQPs are expressed in the ciliary body and retina and may contribute to the pathogenesis of glaucoma and optic neuropathy. We investigated the expression of AQP1, AQP3, AQP4, AQP5......, AQP7 and AQP9 in human glaucoma eyes compared with normal eyes. Nine glaucoma eyes were examined. Of these, three eyes were diagnosed with primary open angle glaucoma; three eyes had neovascular glaucoma; and three eyes had chronic angle-closure glaucoma. Six eyes with normal intraocular pressure...... of AQP7 and AQP9 in the nonpigmented ciliary epithelium and the staining intensities were significantly decreased in glaucoma eyes (p = 0.003; p = 0.018). AQP7 expression in the Müller cell endfeet was increased (p = 0.046), and AQP9 labelling of the retinal ganglion cells (RGC) showed decreased...

  12. Comparación en términos de no inferioridad de la eficacia de latanoprost sin conservantes vs xalatan ® en el tratamiento del glaucoma ángulo abierto

    OpenAIRE

    Barnuevo Espinosa, Mª Dolores

    2014-01-01

    El glaucoma, ha sido definido por la Academia Americana de Oftalmología, como una neuropatía óptica multifactorial, en la que existe una pérdida adquirida y progresiva de las células ganglionares de la retina. La desaparición de las fibras nerviosas de la retina provoca un daño, característico, en la cabeza del nervio óptico, lo que origina pérdida del campo visual. El glaucoma es considerado como la segunda causa de ceguera evitable en todo el mundo. El único factor de riesgo cuya modificaci...

  13. Glaucoma Research Foundation

    Science.gov (United States)

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

  14. Malignant glaucoma

    Directory of Open Access Journals (Sweden)

    Sebastião Cronemberger

    2012-10-01

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

  15. Feline Glaucoma.

    Science.gov (United States)

    McLellan, Gillian J; Teixeira, Leandro B C

    2015-11-01

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

  16. Glaucoma medications.

    Science.gov (United States)

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

    2013-01-01

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

  17. Molecular Genetics in Glaucoma

    OpenAIRE

    Liu, Yutao; Allingham, R Rand

    2011-01-01

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

  18. Glaucoma, Open-Angle

    Science.gov (United States)

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

  19. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

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

  20. Get Tested for Glaucoma!

    Science.gov (United States)

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

  1. Glaucoma facomórfico y ultrabiomicroscopia

    Directory of Open Access Journals (Sweden)

    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.

  2. Conjunctival erosion after glaucoma drainage device surgery: A feasible option

    Directory of Open Access Journals (Sweden)

    Suneeta Dubey

    2013-01-01

    Full Text Available Glaucoma drainage devices (GDDs have been used in the management of complicated glaucomas. GDDs are associated with various complications such as tube migration, tube or plate exposure or extrusion, ocular motility disturbance and infection. Erosion of conjunctiva and exposure of the GDD remains a risk factor for the development of endophthalmitis. A wide range of materials have been used for this purpose, including sclera, dura, pericardium, fascia lata and cornea. However, there is no evidence to prove that any of these methods is superior to another for providing tectonic durability in the long term. In this report, we present a case of neovascular glaucoma, who developed conjunctival melting over the tube of an Ahmed Glaucoma Valve implant and was successfully managed with Cap Doxycycline.

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

    Directory of Open Access Journals (Sweden)

    Rhutuja A

    2015-12-01

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

  4. Polymeric materials for neovascularization

    Science.gov (United States)

    DeVolder, Ross John

    Revascularization therapies have emerged as a promising strategy to treat various acute and chronic wounds, cardiovascular diseases, and tissue defects. It is common to either administer proangiogenic growth factors, such as vascular endothelial growth factor (VEGF), or transplant cells that endogenously express multiple proangiogenic factors. Additionally, these strategies utilize a wide variety of polymeric systems, including hydrogels and biodegradable plastics, to deliver proangiogenic factors in a sophisticated manner to maintain a sustained proangiogenic environment. Despite some impressive results in rebuilding vascular networks, it is still a challenging task to engineer mature and functional neovessels in target tissues, because of the increasing complexities involved with neovascularization applications. To resolve these challenges, this work aims to design a wide variety of proangiogenic biomaterial systems with tunable properties used for neovascularization therapies. This thesis describes the design of several biomaterial systems used for the delivery of proangiogenic factors in neovascularization therapies, including: an electrospun/electrosprayed biodegradable plastic patch used for directional blood vessel growth (Chapter 2), an alginate-g-pyrrole hydrogel system that biochemically stimulates cellular endogenous proangiogenic factor expression (Chapter 3), an enzyme-catalyzed alginate-g-pyrrole hydrogel system for VEGF delivery (Chapter 4), an enzyme-activated alginate-g-pyrrole hydrogel system with systematically controllable electrical and mechanical properties (Chapter 5), and an alginate-g-pyrrole hydrogel that enables the decoupled control of electrical conductivity and mechanical rigidity and is use to electrically stimulate cellular endogenous proangiogenic factor expression (Chapter 6). Overall, the biomaterial systems developed in this thesis will be broadly useful for improving the quality of a wide array of molecular and cellular based

  5. 新生血管性青光眼血管内皮生长因子和血小板衍生生长因子含量及其相关影响因素%Levels of vascular endothelial growth factor and platelet-derived growth factor in neovascular glaucoma eyes and their associated diathesis

    Institute of Scientific and Technical Information of China (English)

    郭斌; 杨新光; 范钦华; 李运明

    2011-01-01

    Objective To determine the intraocular levels of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) in patients with neovascular glaucoma (NVG) and to evaluate the relationship between probable clinical diathesis and associated levels. Methods Experimental study. Fifty-four NVG eyes of 54 patients and 10 fresh healthy donor eyes for corneal transplantation as controls were selected. The levels of VEGF and PDGF in aqueous humor and vitreous liquid aspirates from them were measured. Of the 54 eyes, 17 had central retinal vein occlusion (CRVO), 22 had diabetic retinopathy (DR), 4 had retinal vasculitis (Eales disease),4 had retinal detachments (RD) and 7 had unidentified NVG (NA). Among them, the number of NVG cases with iris neovascularization grades Ⅰ , Ⅱ, Ⅲ and Ⅳ were 17, 12, 13 and 12, respectively,and 36 eyes were treated with prophylactic retinal photocoagulation and/or cryotherapy. The levels of VEGF and PDGF were measured using an enzyme-linked immunosorbent assay (ELISA) method. The differences in VEGF and PDGF levels between the NVG and control groups were analyzed with a Mann-Whitney U test. The differences in the various primary causes, in the iris neovascularization grades and between the prophylactic-treated and untreated groups were analyzed with ANOVA, LSD-t and independent samples t test, respectively. The correlation analysis between VEGF and PDGF levels in each group were checked with a Pearson test. Results The free VEGF and PDGF concentrations in aqueous humor from NVG patients were (926.3±223.5)ng/L and (226.2±81.5)ng/L and the concentrations in vitreous liquid were (1096.1±235.9)ng/L and (375.3±141.5)ng/L, which were higher than concentrations in normal control eyes (aqueous humor: ZVEGF=-4.993, ZPDGF=-4.891, vitreous liquid: ZVEGF=-4.991, ZPDGF=-4.992, all P=0.000). The free VEGF concentrations in aqueous humor and vitreous liquid from NVG secondary to CRVO were higher than those in the NA group

  6. Daily Life with Glaucoma

    Science.gov (United States)

    ... Glaucoma Research Foundation www.glaucoma.org 251 Post Street, Suite 600 San Francisco , CA 94108 (415) 986-3162 (800) 826-6693 question@ glaucoma.org Informacion en Español Accessibility Statement Privacy Policy Terms & Conditions of Use Photography Credits What is Glaucoma? Care and Treatment Research ...

  7. Ocular neovascularization associated with central and hemicentral retinal vein occlusion.

    Science.gov (United States)

    Hayreh, Sohan Singh; Zimmerman, M Bridget

    2012-09-01

    To investigate the incidence of ocular neovascularization (NV) in central and hemicentral retinal vein occlusion. The study comprised consecutive 912 (673 nonischemic and 239 ischemic) central retinal vein occlusion and 190 (147 nonischemic, 43 ischemic) hemicentral retinal vein occlusion eyes. Ophthalmic evaluation at initial and follow-up visits included recording visual acuity, visual fields, and detailed anterior segment and fundus examinations and fluorescein fundus angiography. In ischemic central retinal vein occlusion, within 6 months from time of onset, the cumulative probability of development of iris NV was 49%, angle NV 37%, NV glaucoma 29%, retinal NV 9%, and disk NV 6%. More severe peripheral retinal hemorrhages were significantly associated with iris NV (P = 0.005), angle NV (P = 0.0004), and NV glaucoma (P = 0.012). Eyes that developed disk NV had more cotton wool spots (P = 0.058) than those without. In ischemic hemicentral retinal vein occlusion, within 12 months of onset, the cumulative probability of development of retinal NV was 29%, disk NV 12%, and iris NV 12%; within 6 months of onset, angle NV was found in 10% and NV glaucoma in 5%. Anterior chamber flare was associated with anterior segment NV and may precede the development of NV. Patients who developed NV were significantly younger, and there was a greater prevalence of NV glaucoma in patients with primary open angle glaucoma. In ischemic central retinal vein occlusion, anterior segment NV is much more common than posterior segment NV, and the cumulative chance of developing anterior segment NV is maximum during the first 6 months. In ischemic hemicentral retinal vein occlusion, posterior segment NV is much more common than anterior segment NV.

  8. SCORE Study Report #11: Incidences of Neovascular Events in Eyes with Retinal Vein Occlusion

    Science.gov (United States)

    Chan, Clement K.; Ip, Michael S.; VanVeldhuisen, Paul C.; Oden, Neal L.; Scott, Ingrid U.; Tolentino, Michael J.; Blodi, Barbara A.

    2010-01-01

    Purpose To investigate in The Standard Care versus COrticosteroid for REtinal Vein Occlusion (SCORE) Study: 1) incidences of neovascular events and retinal capillary nonperfusion (abbreviated as “nonperfusion”), and their relationship with treatment groups; 2) neovascular incidences by nonperfusion status; and 3) pertinent baseline factors for their potential risk for neovascular events. Design Two multi-center, randomized clinical trials: one evaluating participants with central retinal vein occlusion (CRVO) and the other evaluating participants with branch retinal vein occlusion (BRVO). Participants At 36 months, data were available for 81 participants with CRVO and 128 with BRVO. Intervention Standard care (observation or grid photocoagulation) versus 1 mg or 4 mg intravitreal triamcinolone. Main Outcome Measures Neovascularization of the iris (NVI), neovascular glaucoma (NVG), disc or retinal neovascularization (NVD/NVE), pre-retinal or vitreous hemorrhage (PRH/VH), and nonperfusion. Results Cumulative 36-month incidences for CRVO and BRVO eyes, respectively, were: 8.5% and 2.4% for NVI or NVG; 8.8 % and 7.6% for NVD/NVE or PRH/VH. There were no differences in incidences of neovascular events or risk of nonperfusion when comparing the 3 treatment groups within diseases. For CRVO at 36 months, 16.6% of eyes with ≥ 5.5 disc areas of nonperfusion vs. 4.0% of eyes with retinal capillary details caused by dense hemorrhage at baseline for CRVO eyes. Increased risk of neovascularization was noted below the historical threshold of 10 disc areas of nonperfusion for retinal vein occlusion. PMID:21440942

  9. Inflammatory choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Neri Piergiorgio

    2009-01-01

    Full Text Available Purpose and Methods: Choroidal neovascularization (CNV can be a severe sight-threatening sequela, which can be secondary to both infectious and noninfectious uveitis. This review summarizes the different diseases associated with CNV, highlighting new treatment modalities and the possible strategies, which could be applied for the therapy of this occurrence. Results: Since CNV can often originate from posterior pole lesions and can be hard to identify, an accurate examination is mandatory in order to identify the correct diagnosis. In the majority of cases, fluorescein angiography (FA, indocyanine green angiography (ICGA and optical coherence tomography (OCT enable the determination of the clinical characteristics of the CNV. An infectious disease should be looked for to include a suitable therapy when available. The treatment strategy for CNV secondary to noninfectious uveal inflammations should be directed at controlling the inflammatory process. Systemic corticosteroids with or without immunosuppressive agents are indicated even when the CNV occurs with apparently inactive uveitis: Chronic subclinical inflammation can be the basis for the pathogenesis of CNV. Additional therapies aimed directly at the neovascular process, such as the intravitreal anti-Vascular Endothelial Growth Factor (VEGF agents, are recommended particularly when the therapy shows an insufficient response. Conclusion: CNV secondary to uveitis is a severe sequela leading to significant visual impairment. ICGA is mandatory in order to obtain relevant information about the choroidal status. Several therapeutic options have been considered, but no guidelines are provided at the moment. Moreover, the current data are still only based on case reports or small series. For such reasons, further trials are mandatory to validate the preliminary available results.

  10. Glaucoma in Asian Populations

    Science.gov (United States)

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

  11. Glaucoma Treatments and Drugs

    Science.gov (United States)

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

  12. African Americans and Glaucoma

    Science.gov (United States)

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

  13. Five Common Glaucoma Tests

    Science.gov (United States)

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

  14. Screening for Glaucoma

    Science.gov (United States)

    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 ...

  15. El impacto socioeconómico del glaucoma primario de ángulo abierto en México

    Directory of Open Access Journals (Sweden)

    José Eduardo Erasmo García Luna Martínez

    2016-09-01

    Conclusión: El GPAA es una enfermedad que genera altos costos para la sociedad mexicana. Los esfuerzos deben enfocarse en el diseño de un tamizaje adecuado, que permita el diagnóstico temprano y el inicio de tratamiento oportuno, para así disminuir los costos del GPAA.

  16. Genetic bases for glaucoma.

    Science.gov (United States)

    Fuse, Nobuo

    2010-05-01

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

  17. Pediatric Glaucoma: Pharmacotherapeutic Options.

    Science.gov (United States)

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

    2016-06-01

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

  18. Natural history of glaucoma

    Directory of Open Access Journals (Sweden)

    Pan Ying

    2011-12-01

    Full Text Available Purpose: To present an overview of the recent observations and research that shed light on the understanding of open and closed angle glaucoma. Methods: Literature review. Results: Glaucoma is a major eye problem afflicting millions of people worldwide. As the population increases, the number of people with glaucoma also increases, with glaucoma becoming an increasing public health concern. This paper presents the natural history of open angle and angle closure glaucoma. We examine the glaucomatous progression in terms of changes in optic disk morphology and visual fi elds as well as the risk factors for progression. Conclusions: This present review highlights the magnitude of glaucoma globally and the need for a greater understanding of this disease and its natural progression.

  19. Benzalkonium chloride and glaucoma.

    Science.gov (United States)

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

    2014-01-01

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

  20. The choroid in glaucoma.

    Science.gov (United States)

    Banitt, Michael

    2013-03-01

    Prior studies have not conclusively established a relationship between the choroid and glaucoma. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting the changes in the choroid as they relate to glaucoma. When applied to the SD-OCT, the technique of enhanced depth imaging allows for reproducible measurements of choroidal thickness. Nine reports have been published about choroidal thickness within the macula, as measured by OCT, in eyes with glaucoma. In six publications, there was no significant difference between the macular choroidal thicknesses of patients with glaucoma compared with those without glaucoma. Additional five studies have reported on peripapillary choroidal thickness in glaucoma patients. Although three of the studies determined that the peripapillary choroid is thinner in glaucoma patients, two others failed to establish this relationship. The SD-OCT is capable of reproducibly measuring choroidal thickness in the peripapillary and macular areas. In those with glaucoma, choroidal thickness does not change within the macula. In a few subsets of glaucoma, the peripapillary choroid is thinner when compared with normals.

  1. Beals–Hecht syndrome and choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Roberto Gallego-Pinazo

    2010-07-01

    Full Text Available Roberto Gallego-Pinazo1, Ruth López-Lizcano1, José María Millán2,3, J Fernando Arevalo5, J Luis Mullor6, Manuel Díaz-Llopis1,3,41Department of Ophthalmology, 2Department of Genetics, Unit of Experimental Opthalmology, Hospital Universitario La Fe, Valencia, Spain; 3Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Valencia, Spain; 4Faculty of Medicine, University of Valencia, Valencia, Spain; 5Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 6Unit of Experimental Opthalmology, Fundación Parala Investigación del Hospital La Fe, Valencia, SpainPurpose: To describe a case of choroidal neovascularization (CNV in a female diagnosed with Beals–Hecht syndrome.Methods: A retrospective, interventional case is described in a 26-year-old female complaining of metamorphopsia and visual loss in her left eye (counting fingers. The fluorescein angiogram and the optical coherence tomography supported the diagnosis of CNV. Intravitreal ranibizumab was administered.Results: After the third intravitreal ranibizumab, her visual acuity improved to 0.8 and the morphology of the macular area was restored.Conclusions: To our knowledge this is the first report of CNV in Beals–Hecht syndrome treated with ranibizumab. Self-monitoring by periodically performing Amsler grid test is strongly recommended in these patients in order to achieve an early diagnosis of eventual CNV and avoid visual acuity loss.Keywords: Beals–Hecht syndrome, connective tissue disease, choroidal neovascularization, ranibizumab

  2. [Glaucoma and retinal surgery].

    Science.gov (United States)

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

    2010-05-01

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

  3. Neovascularization in Left Atrial Myxoma

    Science.gov (United States)

    Dubey, Laxman; Chaurasia, Amit Kumar

    2012-01-01

    Abstract We report a case with a left atrial mass who underwent coronary angiography to rule out coronary artery disease. Coronary angiography revealed an anomalous tortuous vascular structure originating from the left circumflex coronary artery to the left atrial tumor suggestive of neovascularization. Preoperative coronary angiography is useful for coronary artery evaluation and also provides additional information regarding the feeding vessel supplying the mass. PMID:24757609

  4. [Music and Glaucoma].

    Science.gov (United States)

    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.

  5. Genetic Epidemiology of Glaucoma

    NARCIS (Netherlands)

    L.M.E. van Koolwijk (Leonieke)

    2011-01-01

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

  6. Painless Treatment for Glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈宏

    1995-01-01

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

  7. Diabetes and Your Eyesight (Glaucoma)

    Science.gov (United States)

    ... Glaucoma Research Foundation www.glaucoma.org 251 Post Street, Suite 600 San Francisco , CA 94108 (415) 986-3162 (800) 826-6693 question@ glaucoma.org Informacion en Español Accessibility Statement Privacy Policy Terms & Conditions of Use Photography Credits What is Glaucoma? Care and Treatment Research ...

  8. Glaucoma Genes and Mechanisms.

    Science.gov (United States)

    Wiggs, Janey L

    2015-01-01

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

  9. [Vascular factors in glaucoma].

    Science.gov (United States)

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

    2015-12-01

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

  10. Combined surgical intervention at terminal glaucoma

    Directory of Open Access Journals (Sweden)

    O. A. Kiseleva

    2012-01-01

    Full Text Available Purpose: to investigate hypotensive efficiency of new surgical intervention at terminal primary and neovascular glaucoma.Methods. Operation has been executed on 35 eyes of 35 patients with terminal primary (23 eyes and secondary (12 eyes neo- vascular glaucoma. A fornix based conjunctival flap was prepared in inferior part of a limbus. 1.5 mm transparent scleral incision 3 mm from limbus was performed. Goniocyclodialysis with spatula was carrying out. then 0.3 ml of viscoelastic solution was entered in cyclodialysis cleft. On sclera put cryoapplications, located in two ranks (on 6 in everyone. the period of postoperative follow-up has averaged 15.6±1.3 months.Results: In 1 month IOP did not exceed 25 mm hg and the painful syndrome has been stopped in all cases. In 1 year after operation normalization IOP took place on 27 eyes (77.2%, from them on 8 was local hypotensive therapy added. With 8 patients (22.8% IOP instillation of 2 preparations remained at level of 28-30 mm Hg, however the painful syndrome was absent.Conclusion: Long-term hypotensive effect of new operation is reached at the expense of the double mechanism: reduction of production of aqueous humor for the account cryopexy of ciliary body and improvements aqueous outflow for formations cyclodialysis cleft.

  11. New possibilities of excessive postoperative scarring prophylaxis by glaucoma surgery

    Directory of Open Access Journals (Sweden)

    A. Yu. Slonimskiy

    2014-07-01

    Full Text Available Purpose: to access the possibilities of new biodegradable drainage implant Glautex in the original method of glaucoma surgical treatment.Methods: 152 patients (158 eyes have had a penetrating and nonpenetrating antiglaucoma surgical treatment with the use of Glautex. Patients were divided in 3 groups: 1st group — 90 patients (93 eyes, where valve trabeculectomy with the use of biodegrad- able drainage Glautex has been performed. 2nd group — 33 patients (35 eyes with refractory glaucoma (previously operated glau- coma, postkeratoplasty, neovascular glaucoma etc. with the same type of antiglaucoma surgery. 3rd group — 29 patients (30 eyes with deep non-penetrating sclerectomy with the use of Glautex.Results: Stable IOP has been obtained in all cases within 6 to 12 months’ time. Complete biodegradation of the implant took place in 4-5 months, which was confirmed by ultrasound biomicroscopy. We have obtained no cases of inflammation in postoperative period. No cases of blebitis and cystoid blebs have been noted. the choroidal detachment, requiring surgical treatment was noted on 7 eyes (7.5% in the 1st group; in the 2nd group — on 3 eyes (8.6%. the 3rd group (nonpenetrating glaucoma surgery had 2 cases of flat choroidal detachment, which have successfully cured after medical nonsurgical treatment.Conclusion: Use of the new biodegradable drainage implant Glautex provides stable decrease of IOP due to prevention of sclero- conjunctival and sclero-scleral adhesions. Glautex may be used in all cases of glaucoma surgery (penetrating and nonpenetrating with the scleral flap formation. the proposed new method is applicable for all types of glaucoma

  12. Glaucoma in Costa RIca. Initial approaches

    OpenAIRE

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

    2004-01-01

    El glaucoma es la segunda causa de ceguera irreversible en el mundo. El componente genetico de algunos de los distintos tipos ha sido demostrado: seis loci (GLC1AGLC1F) y dos genes (TIGNMY0C y OPTN) se conocen. hasta ahora, como responsables de la aparicion de glauet)-- mas primarios de angulo abierto tanto del tipo juvenil (JOAG) como del tipo de adultos (COAG). Ademas, dos loci (GLC3A,GLC3B) y un gene (CYPIBI) se hen descubierto coma causal del tipu primariu congenit...

  13. Glaucoma: Screening Can Save Your Sight!

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Screening Can Save Your Sight! Past Issues / Fall 2009 Table of Contents People with glaucoma see the world through a tunnel. Glaucoma is ...

  14. ACUPUNCTURE AND GLAUCOMA

    Institute of Scientific and Technical Information of China (English)

    WANG Ying; HU Shi-xing; BAI Peng

    2006-01-01

    It is to recognize glaucoma in view of Chinese medicine and synthesize the treatments and mechanisms of acupuncture on glaucoma in the paper. It is indicated in the results that acupuncture plays the importance in lowering ocular tension, improving ocular circulation and protecting optic nerve. Additionally,acupuncture inhibits probably the cellular apoptosis of optic ganglion and provides definite actions on psychological factors of glaucoma. Acupuncture cannot replace operation and medicinal therapy in lowing ocular tension, but their coordinated and auxiliary effects are quite clear and definite.

  15. Natural history of glaucoma

    National Research Council Canada - National Science Library

    Pan, Ying; Varma, Rohit

    2011-01-01

    .... This paper presents the natural history of open angle and angle closure glaucoma. We examine the glaucomatous progression in terms of changes in optic disk morphology and visual fields as well as the risk factors for progression...

  16. Objective perimetry in glaucoma.

    Science.gov (United States)

    Klistorner, A; Graham, S L

    2000-12-01

    Objective perimetry in glaucoma is described using the multifocal pattern visually evoked potential (VEP). A multichannel recording technique was used to improve signal detection in healthy volunteers and assess its ability to detect glaucoma and early changes in patients with suspected glaucoma. Prospective, case-control study. Thirty healthy volunteers, 30 patients with suspected glaucoma, and 30 patients with glaucomatous visual field defects were tested. The VEP was recorded using cortically scaled, multifocal, pseudorandomly alternated pattern stimuli with the VERIS system (Electro-Diagnostic Imaging, Inc., San Francisco, CA). An array of four bipolar occipital electrodes provided four differently oriented channels for simultaneous recording. Signals were compared for different locations within the field up to 26 degrees of eccentricity. Healthy volunteers, patients with suspected glaucoma, and glaucoma patients with established visual field defects were tested, and results were compared with Humphrey visual fields (Humphrey Systems, Dublin, CA) performed on the same day. For reproducibility, five healthy volunteers were each tested on four separate days. The patients with suspected glaucoma and the established glaucoma patients were analyzed for intereye asymmetry of signals, and these data were compared with the asymmetry values of the healthy volunteers. Multiple recording channels significantly enhanced the recording of signals from parts of the visual field not reliably sampled with a single channel technique in all healthy volunteers, particularly along the horizontal meridian (P: < 0.001). Signal amplitude did not decline with age in healthy volunteers. Recordings showed good reproducibility within individuals. In all 30 glaucoma patients, the Humphrey visual field defects were well demonstrated by the VEP, and topographic location was strongly correlated (r(s) = 0.79). Despite large interindividual variations in amplitude, scotomas were well

  17. Glaucoma in developing countries

    Directory of Open Access Journals (Sweden)

    Ravi Thomas

    2012-01-01

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

  18. Benzalkonium Chloride and Glaucoma

    OpenAIRE

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

    2014-01-01

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

  19. Neuroprotection in glaucoma

    Directory of Open Access Journals (Sweden)

    Azadeh Doozandeh

    2016-01-01

    Full Text Available Glaucoma is a degenerative optic neuropathy characterized by retinal ganglion cell (RGC loss and visual field defects. It is known that in some glaucoma patients, death of RGCs continues despite intraocular pressure (IOP reduction. Neuroprotection in the field of glaucoma is defined as any treatment, independent of IOP reduction, which prevents RGC death. Glutamate antagonists, ginkgo biloba extract, neurotrophic factors, antioxidants, calcium channel blockers, brimonidine, glaucoma medications with blood regulatory effect and nitric oxide synthase inhibitors are among compounds with possible neuroprotective activity in preclinical studies. A few agents (such as brimonidine or memantine with neuroprotective effects in experimental studies have advanced to clinical trials; however the results of clinical trials for these agents have not been conclusive. Nevertheless, lack of compelling clinical evidence has not prevented the off-label use of some of these compounds in glaucoma practice. Stem cell transplantation has been reported to halt experimental neurodegenerative disease processes in the absence of cell replacement. It has been hypothesized that transplantation of some types of stem cells activates multiple neuroprotective pathways via secretion of various factors. The advantage of this approach is a prolonged and targeted effect. Important concerns in this field include the secretion of unwanted harmful mediators, graft survival issues and tumorigenesis. Neuroprotection in glaucoma, pharmacologically or by stem cell transplantation, is an interesting subject waiting for broad and multidisciplinary collaborative studies to better clarify its role in clinical practice.

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

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyeva

    2014-10-01

    Full Text Available Glaucoma and diabetic retinopathy (DR are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics are optical coherence tomography and Heidelberg retina tomography. They give an opportunity to estimate the dynamics of pathological process and the efficiency of surgical and pharmacological treatment. Optical scanning of an optic disk and peripapillary retina gives a chance to estimate up to 20 morphometric parameters. Determination of retinal nerve fiber layer (RNFL thickness in peripapillary zone reflects a condition of nerve fibers and extent of their defeat. It is shown that in glaucoma there is a thinning of RNFL and a neuroretinal rim. In early diagnostics of glaucoma the parameters of optic disk characterizing neuroretinal rim are considered the most informative. OCT considerably expands diagnostic research possibilities of structural and morphological retinal changes in a macular zone in patients with DR and DME. Measurement of retinal thickness in macular area is a key point in diagnostics and tactics of treatment. The standard method of DR therapy is retinal laser coagulation. However, laser photocoagulation as monotherapy is not effective enough in patients with diffuse and cystoid macular edema. It is more reasonable to use retinal laser photocoagulation in combination with antiangiogenic therapy for treatment of the diabetic macular edema (DME and DR. The special emphasis is put on development of treatment algorithm of combination of glaucoma and diabetic retinopathy. Therapy of neovascular glaucoma in patients with diabetes

  1. Incidence and Clinical Features of Neovascularization of the Iris following Acute Central Retinal Artery Occlusion.

    Science.gov (United States)

    Jung, Young Ho; Ahn, Seong Joon; Hong, Jeong-Ho; Park, Kyu Hyung; Han, Moon-Ku; Jung, Cheolkyu; Woo, Se Joon

    2016-10-01

    To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients with NVI following acute central retinal artery occlusion (CRAO). A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital between January 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excluding patients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, or NVI detected before CRAO attack. Fluorescein angiography (FA) was applied until retinal arterial reperfusion was achieved, typically within 1 to 3 months. The incidence of NVI was 10.9% (12 out of 110 patients). Neovascular glaucoma was found in seven patients (6.4%). The mean time to NVI diagnosis after CRAO events was 3.0 months (range, 1 week to 15 months). The cumulative incidence was 5.5% at 3 months, 7.3% at 6 months, and 10.9% at 15 months. Severely narrowed ipsilateral carotid arteries were observed in only three patients (27.3%). The other nine patients (75.0%) showed no predisposing conditions for NVI, such as proliferative diabetic retinopathy or central retinal vein occlusion. Reperfusion rate and prevalence of diabetes were significantly different between patients with NVI and patients without NVI (reperfusion: 0% [NVI] vs. 94.7% [no NVI], p < 0.001; diabetes: 50.0% [NVI] vs. 17.3% [no NVI], p = 0.017). CRAO may lead to NVI and neovascular glaucoma caused by chronic retinal ischemia from reperfusion failure. Our results indicate that follow-up fluorescein angiography is important to evaluate retinal artery reperfusion after acute CRAO events, and that prophylactic treatment such as panretinal photocoagulation should be considered if retinal arterial perfusion is not recovered.

  2. Incidence and Clinical Features of Neovascularization of the Iris following Acute Central Retinal Artery Occlusion

    Science.gov (United States)

    Jung, Young Ho; Ahn, Seong Joon; Hong, Jeong-Ho; Park, Kyu Hyung; Han, Moon-Ku; Jung, Cheolkyu

    2016-01-01

    Purpose To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients with NVI following acute central retinal artery occlusion (CRAO). Methods A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital between January 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excluding patients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, or NVI detected before CRAO attack. Fluorescein angiography (FA) was applied until retinal arterial reperfusion was achieved, typically within 1 to 3 months. Results The incidence of NVI was 10.9% (12 out of 110 patients). Neovascular glaucoma was found in seven patients (6.4%). The mean time to NVI diagnosis after CRAO events was 3.0 months (range, 1 week to 15 months). The cumulative incidence was 5.5% at 3 months, 7.3% at 6 months, and 10.9% at 15 months. Severely narrowed ipsilateral carotid arteries were observed in only three patients (27.3%). The other nine patients (75.0%) showed no predisposing conditions for NVI, such as proliferative diabetic retinopathy or central retinal vein occlusion. Reperfusion rate and prevalence of diabetes were significantly different between patients with NVI and patients without NVI (reperfusion: 0% [NVI] vs. 94.7% [no NVI], p < 0.001; diabetes: 50.0% [NVI] vs. 17.3% [no NVI], p = 0.017). Conclusions CRAO may lead to NVI and neovascular glaucoma caused by chronic retinal ischemia from reperfusion failure. Our results indicate that follow-up fluorescein angiography is important to evaluate retinal artery reperfusion after acute CRAO events, and that prophylactic treatment such as panretinal photocoagulation should be considered if retinal arterial perfusion is not recovered. PMID:27729755

  3. New Tool to Predict Glaucoma

    Science.gov (United States)

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

  4. Does Marijuana Help Treat Glaucoma?

    Science.gov (United States)

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

  5. Does Your Child Have Glaucoma?

    Science.gov (United States)

    ... Donate In This Section Does Your Child Have Glaucoma? email Send this article to a friend by ... a pediatric ophthalmologist. Signs and Symptoms of Childhood Glaucoma What to watch for in children under the ...

  6. Disorder of blood-aqueous barrier following Ahmed Glaucoma Valve implantation

    Institute of Scientific and Technical Information of China (English)

    ZHOU Min-wen; WANG Wei; CHEN Shi-da; HUANG Wen-bin; ZHANG Xiu-lan

    2013-01-01

    Background Ahmed Glaucoma Valve implantation (AGVI) is used to treat refractory glaucoma.Breakdown of the blood-aqueous barrier (BAB) has been noted after some surgical techniques.The current study was designed to assess BAB disruption after AGVI.Methods Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month.Results Before AGVI the mean aqueous flare values in all eyes were (15.17±9.84) photon counts/ms.After AGVI,the values significantly increased at day 1,day 3,and week 1 compared to those before AGVI (all P <0.05) with a peak at day 3.They returned to pre-operative levels at week 2,and were lower than preoperative level at month 1.Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history,but there were no significant differences at all time points postoperatively (all P >0.05).Furthermore,eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 (all P <0.05).When comparing eyes with other refractory glaucoma conditions,neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI,but no significant differences were observed at all time points,postoperatively (all P>0.05).Conclusions The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI.However,such conditions were resolved within 1 month postoperatively.Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.

  7. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  8. Matrix Metalloproteinases Expression in Choroidal Neovascular Membranes

    Institute of Scientific and Technical Information of China (English)

    Jun Zeng; Deyong Jiang; Xiangping Liu; Xiaohua Zhu; Luosheng Tang

    2004-01-01

    Purpose: To investigate the expression of matrix metalloproteinases (MMPs) in choroidal neovascular membranes with age-related macular degeneration (AMD).Methods: Seventeen choroidal neovascular membranes surgically removed from AMD patients with pars plana vitrectomy and subretinal membranes peeling were investigated.The expression of MMP-2 and MMP-9 was determined with immunohistochemical technique.Results: Immunohistochemistry staining in choroidal neovascular membranes for MMP2 and MMP-9 was observed in 17 specimens. There was no detective of MMP-2 and MMP-9 in normal retinas.Conclusions: MMP-2 and MMP-9 were found in choroidal neovascular membranes, may degrade the Bruch membrane and be associated with the perforation of new vessels into Bruch membrane, involving a basic pathogenic process of AMD.

  9. Estudio de la eficacia clínica de la brimonidina vs. timolol en el tratamiento del glaucoma primario de ángulo abierto Study of the clinical efficiency of briomonidine vs. timolol in the treatment of open-angle primary glaucoma

    Directory of Open Access Journals (Sweden)

    Ibis Sedeño Cruz

    2002-06-01

    Full Text Available Se estudiaron 36 pacientes con diagnóstico de glaucoma primario de ángulo abierto (GPAA, sin tratamiento previo, a los que se les indicó durante 2 meses, timolol 0,5 % (1 gota 2 veces al día, y seguidamente, previo lavado de hipotensor, brimonidina 0,2 %; se evaluó la presión intraocular (PIO y las reacciones adversas en la consulta inicial, 1ra semana, 1er mes y 2do mes de iniciado el tratamiento. Los resultados mostraron un descenso de la PIO media con respecto a la inicial (sin tratamiento con ambos medicamentos durante los 2 meses de tratamiento; obteniéndose con el timolol una PIO media de 17,1 mm Hg y con la brimonidina de 16,1 mm Hg, lo que corresponde a un descenso de 7,7 mm Hg y de 6,9 mm Hg, respectivamente. Las reacciones adversas sistémicas más frecuentes con el uso de la brimonidina fueron: sequedad bucal y cefalea, mientras que las locales fueron: prurito ocular e hiperemia ocular. La intensidad de estos síntomas fue de leve a moderada. El estudio mostró que la brimonidina tiene una efectividad similar a la del timolol en la reducción de la presión intraocular, con buena tolerabilidad.36 patients with diagnosis of open-angle primary glaucoma (OAPG without previous treatment were studied. They were indicated timolol 0.5 % (1 drop twice a day and after that, previous lavage with hypotensor, brimonidine 0.2 %. The intraocular pressure (IOP and the adverse reactions were evaluated on the initial visit and on the first week, the first month and the second month. The results showed a decrease of the mean IOP compared with the initial (without treatment with both drugs during the 2 months of treatment. A mean IOP of 17.1 mm Hg was obtained with timolol and 16.1 mm Hg with brimonidine. It represents a reduction of 7.7 mm Hg and 6.9 mm Hg, respectively. The most frequent systemic adverse reactions with the administration of brimonidine were dry mouth and headache, whereas the local adverse reactions were ocular pruritus and

  10. [Dyslipidaemia and glaucoma].

    Science.gov (United States)

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

    2014-12-01

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

  11. 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

  12. 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:

  13. [Corneal endothelium in glaucoma].

    Science.gov (United States)

    Stefan, C; Nicolae, Miruna; Pop, Adina

    2012-01-01

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

  14. OCT Imaging in Glaucoma

    Science.gov (United States)

    Nevins, Jessica E.; Wollstein, Gadi; Schuman, Joel S.

    The precise micron scale quantification of ocular structures provided by OCT turn this technology to be a valuable tool in clinical evaluation of glaucoma patients. This chapter describes the clinical utility of OCT from choosing the scan pattern and scan location to the interpretation of the test outcome.

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

    Science.gov (United States)

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

  16. Genetics Home Reference: early-onset glaucoma

    Science.gov (United States)

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

  17. Single intravitreal ranibizumab for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Shatriah I

    2011-08-01

    Full Text Available Saidin Nor-Masniwati, Ismail Shatriah, Embong ZunainaDepartment of Ophthalmology, Universiti Sains Malaysia, Kelantan, MalaysiaAbstract: We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks’ duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.Keywords: myopia, choroidal neovascularization, antivascular endothelial growth factor

  18. Lenticular neovascularization subsequent to traumatic cataract formation.

    Science.gov (United States)

    Kabat, Alan G

    2011-09-01

    To report a series of cases involving neovascularization within the human crystalline lens-a normally avascular structure-after ocular trauma. This is a retrospective, consecutive observational case series with review of the prevailing literature. Four individuals with a history of ocular trauma and subsequent cataract development were examined between May 2004 and April 2007. All had hypermature cataracts and intraocular inflammation, presumably secondary to phacolysis; two of the four had concurrent hyphema and ocular hypertension in the involved eye. All subjects in this series were found to display a discrete network of blood vessels within the structure of the crystalline lens, just beneath the anterior lens capsule. Neovascularization of the crystalline lens has received little attention in the ophthalmic literature, having been described only rarely in individual case reports. This manuscript details the first known case series involving lenticular neovascularization, and offers insight into its possible developmental mechanism.

  19. 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.

  20. Glaucoma in Costa Rica: Initial approaches

    Directory of Open Access Journals (Sweden)

    Gabriela Chavarría-Soley

    2004-09-01

    Full Text Available Glaucoma is the second most frequent cause of irreversible blindness worldwide. Genetic factors have been implicated in the development of the disease. So far six loci (GLC1A-GLC1F and two genes (TIGR/MYOC and OPTN are involved in the development of juvenile (JOAG and adult onset or chronic primary open angle glaucoma (COAG, while two loci (GLC3A,GLC3B and one gene (CYP1B1 are known for primary congenital glaucoma (PCG. Here we summarize the results of the first genetic studies of glaucoma in Costa Rica. Nine families: 1 with JOAG, 1 with PCG and 7 with COAG were screened for mutations at the known genes. A10 bp duplication, 1546-1555dupTCATGCCACC, at the CYP1B1 gene, causes, in homozygous state, glaucoma in the consanguineous PCG family. This mutation has been found in different countries and generates an early stop codon that termitates protein synthesis 140 amino acids earlier than the normal allele. In exon 1 of the TIGR/MYOC the innocuous Arg76Lys variant was found in two of the COAG families. In the OPTN gene two variants in the coding region (Thr34Thr, Met 98Lys and 7 intronic changes were found in other Costa Rican glaucoma patients. One of the COAG families was chosen for a genome scan with 379 microsatellite markers and linkage analysis. LOD scores "suggestive" of linkage were obtained for several chromosomal regions. Evidence indicates that hereditary glaucoma in Costa Rica is highly heterogeneous and that further studies in the country will probably disclose some up to now unknown genes responsible for the disease. Rev. Biol. Trop. 52(3: 507-520. Epub 2004 Dic 15.El glaucoma es la segunda causa de ceguera irreversible en el mundo. El componente genético de algunos de los distintos tipos ha sido demostrado: seis loci (GLC1A-GLC1F y dos genes (TIGR/MYOC y OPTN se conocen, hasta ahora, como responsables de la aparición de glaucomas primarios de ángulo abierto tanto del tipo juvenil (JOAG como de l tipo de adultos (COAG. Además, dos

  1. MEMS glaucoma monitoring device

    Science.gov (United States)

    Shankar, Smitha; Austin, Michael

    2007-04-01

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

  2. [Hearing disorders with glaucoma].

    Science.gov (United States)

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

    2014-02-01

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

  3. Ceratoplastia penetrante e glaucoma Penetrating keratoplasty and glaucoma

    Directory of Open Access Journals (Sweden)

    Márcio Eulálio Barreto Soares

    2007-08-01

    Full Text Available O objetivo deste artigo é discutir os conhecimentos atuais sobre a abordagem clínica e terapêutica da ceratoplastia penetrante e do glaucoma a ela associado.The aim of this article is to make a review about glaucoma associated with penetrating keratoplasty, describing since its incidence and risk factors until the different options for treatment.

  4. Factors Related to Prognosis of Refractory Glaucoma with Diode Laser Transscleral Cyclophotocoagulation Treatment

    Institute of Scientific and Technical Information of China (English)

    Shun-hua Zhang; Fang-tian Dong; Jin Mao; Ai-ling Bian

    2011-01-01

    Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation (TSCP) in a midterm observation.Methods Fifty-four consecutive patients (54 eyes) with refractory glaucoma were enrolled and underwent TSCP (power of 1.5-2.0 W, exposure time of 2 seconds and 20-50 applications). Patients were regularly followed up for 12 months. Intraocular pressure (10P) was measured before TSCP treatment and at each follow-up visit. Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit. Difference of age between the sensitive and insensitive groups was evaluated with Independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test. The success rate of different types of glaucoma to TSCP was calculated.Results A total of 32 patients were sensitive to TSCP (sensitive group) and 22 patients were insensitive to TSCP (insensitive group). The success rates of female (77.8%, 14/18) and cases being over 50 years (71.4%, 20/28) were higher than those of male (50.0%, 18/36) and ones being under 50 years (46.2%,12/26) (all P>0.05). The age of the sensitive and insensitive groups was 56.0±15.5 and 46.4±15.4 years,respectively (P=0.029). The age (P=0.029) and gender distribution (P=0.046) of the two groups had significant difference. The success rate of neovascular glaucoma, primary angle-closure glaucoma, primary open angle glaucoma, traumatic glaucoma, uveitic glaucoma, and secondary glaucoma after silicone oil injection to TSCP was 57.1%, 100.0%, 50.0%, 20.0%, 81.8%, and 0%, respectively.Conclusion Age, gender, and type of glaucoma appear to be associated with effect of TSCP on 10P control.

  5. The medical management of glaucoma

    African Journals Online (AJOL)

    medical and surgical interventions are accessible in the management of glaucoma. ... carbonic anhydrase inhibitors, beta antagonists, alpha 2 adrenergic agonists, ... and closed angle glaucoma in relation to the drainage systems within the anterior ... central corneal thickness in the presence of risk factors is suggestive.

  6. Aggravation of glaucoma with fluvoxamine.

    Science.gov (United States)

    Jiménez-Jiménez, F J; Ortí-Pareja, M; Zurdo, J M

    2001-12-01

    To report a case of aggravation of glaucoma associated with the use of fluvoxamine. A 66-year-old while woman diagnosed with narrow-angle glaucoma showed an increase in intraocular pressure and experienced orbital pain and blurred vision after the initiation of fluvoxamine for tension-type headache. These symptoms disappeared and intraocular pressure normalized after withdrawal of this drug. Aggravation of narrow-angle glaucoma is a well-known adverse effect of tricyclic antidepressants. Because this adverse effect had been rarely reported to date with selective serotonin-reuptake inhibitors (paroxetine and fluoxetine), we used fluvoxamine in our patient. The disappearance of ocular symptoms and the normalization of intraocular pressure two days after stopping fluvoxamine suggest a possible relationship between fluvoxamine and aggravation of glaucoma. Fluvoxamine should be considered as a drug that can induce or aggravate narrow-angle glaucoma.

  7. 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.

  8. Primary open-angle glaucoma genes

    OpenAIRE

    Fingert, J.H.

    2011-01-01

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

  9. Gene therapy in glaucoma-3: Therapeutic approaches

    OpenAIRE

    Mohamed Abdel-Monem Soliman Mahdy

    2010-01-01

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

  10. Glaucoma in atomic bomb survivors.

    Science.gov (United States)

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

    2013-10-01

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

  11. Glaucoma: role of neuroprotective agents

    Directory of Open Access Journals (Sweden)

    Achyut N. Pandey

    2014-10-01

    Full Text Available Glaucoma is an optic neuropathy, considered as the second leading cause of blindness worldwide. Glaucoma is characterized by selective death of retinal ganglion cells (RGC and a progressive loss of vision. Elevated intraocular pressure (IOP is one of the most important risk factors for developing glaucoma and hence we mainly focus on lowering IOP to arrest the progression of glaucoma. However, many patients continue to demonstrate a clinically downhill course despite the control of initially raised IOP. In fact, some patients develop what is called normal tension glaucoma, not associated to an increased IOP. This emphasizes that several pressure-independent mechanisms are responsible for the development and progression of glaucomatous neuropathy and that high IOP and vascular insufficiency in the optic nerve head are only risk factors for the development of glaucoma, and are not the only target for the treatment of glaucoma. The reason is that the process of RGC death is thought to be biphasic, and the primary injury is followed by a slower secondary degeneration related to a noxious environment surrounding the apoptotic cells. This environment is characterized by changes in the extra-cellular ionic concentrations, increased amounts of free radicals, neurotrophins (NT depletion and increased glutamate-induced excitotoxicity due to high extra-cellular glutamate levels, which binds to N-methyl-D-aspartate (NMDA receptors leading to an abnormally high intracellular Ca2+ concentration. Neuroprotection is a process that attempts to preserve the remaining cells that are still vulnerable to damage, and the main aim of neuroprotective therapy is to employ pharmacologic or other means to attenuate the hostility of the environment surrounding the degenerating cells, or to supply the cells with the tools to deal with this aggression, providing resilience to the insult. Several agents have been reported neuroprotective in glaucoma, both in clinical assays

  12. Advanced glaucoma: Management pearls

    Directory of Open Access Journals (Sweden)

    Girum W Gessesse

    2013-01-01

    Full Text Available A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient′s perspective. The physician may also feel that they are in a difficult position managing the patient′s disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ′biopsychosociospiritual′ (BPSS profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health, psychological considerations (e.g., fear, depression, socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite, and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life.

  13. Cost and detection rate of glaucoma screening with imaging devices in a primary care center

    Directory of Open Access Journals (Sweden)

    Anton A

    2017-02-01

    Full Text Available Alfonso Anton,1–4 Monica Fallon,3,5 Francesc Cots,2 María A Sebastian,6 Antonio Morilla-Grasa,4 Sergi Mojal,3 Xavier Castells2 1Medicine School, Universidad Internacional de Cataluña, 2Servei d’Estudies, Parc de Salut Mar, 3Instituto Hospital del Mar de Investigaciones Médicas (IMIM, 4Glaucoma Department, Instituto Catalán de Retina (ICR, 5Universidad Autónoma de Barcelona, 6Centro de Atención Primaria Larrard, Barcelona, Spain Purpose: To analyze the cost and detection rate of a screening program for detecting glaucoma with imaging devices. Materials and methods: In this cross-sectional study, a glaucoma screening program was applied in a population-based sample randomly selected from a population of 23,527. Screening targeted the population at risk of glaucoma. Examinations included optic disk tomography (Heidelberg retina tomograph [HRT], nerve fiber analysis, and tonometry. Subjects who met at least 2 of 3 endpoints (HRT outside normal limits, nerve fiber index ≥30, or tonometry ≥21 mmHg were referred for glaucoma consultation. The currently established (“conventional” detection method was evaluated by recording data from primary care and ophthalmic consultations in the same population. The direct costs of screening and conventional detection were calculated by adding the unit costs generated during the diagnostic process. The detection rate of new glaucoma cases was assessed. Results: The screening program evaluated 414 subjects; 32 cases were referred for glaucoma consultation, 7 had glaucoma, and 10 had probable glaucoma. The current detection method assessed 677 glaucoma suspects in the population, of whom 29 were diagnosed with glaucoma or probable glaucoma. Glaucoma screening and the conventional detection method had detection rates of 4.1% and 3.1%, respectively, and the cost per case detected was 1,410 and 1,435€, respectively. The cost of screening 1 million inhabitants would be 5.1 million euros and would allow

  14. 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 ...

  15. In Vitro Model of Human Choroidal Neovascular

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Choroidal capillary endothelia cell (CEC) plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed.The isolation of human choroidal CECs using micro dissection followed by the use of superparamagnetic beads (Dynabeads) coated with the CD 31, which selectively binds to the endothelial cell surface. Cells bound to beads were isolated using a magnetic particle concentrator. The CECs were planted into type Ⅳ collagen coated 24 well plates. The results show that the primary cultured CEC is induced to tube formation in collagen Ⅳ coated environment, which can be presented as an in vitro model of choroidal neovascularization.

  16. 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.

  17. Glaucoma after Congenital Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Mahmoodreza Panahi Bazaz

    2014-05-01

    Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.

  18. Transthyretin represses neovascularization in diabetic retinopathy

    Science.gov (United States)

    Shao, Jun

    2016-01-01

    Purpose The apoptosis of human umbilical vein endothelial cells has been reportedly induced by the protein transthyretin (TTR). In human ocular tissue, TTR is generally considered to be secreted mainly by retinal pigment epithelial cells (hRPECs); however, whether TTR affects the development of neovascularization in diabetic retinopathy (DR) remains unclear. Methods Natural and simulated DR media were used to culture human retinal microvascular endothelial cells (hRECs). Hyperglycemia was simulated by increasing the glucose concentration from 5.5 mM up to 25 mM, while hypoxia was induced with 200 µM CoCl2. To understand the effects of TTR on hRECs, cell proliferation was investigated under natural and DR conditions. Overexpression of TTR, an in vitro wound-healing assay, and a tube formation assay were employed to study the repression of TTR on hRECs. Real-time fluorescence quantitative PCR (qRT-PCR) was used to study the mRNA levels of DR-related genes, such as Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2. Results The proliferation of hRECs was significantly decreased in the simulated hyperglycemic and hypoxic DR environments. The cells were further repressed by added exogenous or endogenous TTR only under hyperglycemic conditions. The in vitro migration and tube formation processes of the hRECs were inhibited with TTR; furthermore, in the hyperglycemia and hyperglycemia/hypoxia environments, the levels of Tie2 and Angpt1 mRNA were enhanced with exogenous TTR, while those of VEGFR1, VEGFR2, and Angpt1 were repressed. Conclusions In hyperglycemia, the proliferation, migration, and neovascularization of hRECs were significantly inhibited by TTR. The key genes for DR neovascularization, including Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2, were regulated by TTR. Under DR conditions, TTR significantly represses neovascularization by inhibiting the proliferation, migration and tube formation of hRECs. PMID:27746673

  19. Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

    Science.gov (United States)

    Yu, Jea H.; Nguyen, Chuck; Gallemore, Esmeralda

    2016-01-01

    Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG). On average, intraocular pressure was reduced from 39 ± 14 mmHg to 15 ± 2 mmHg and the number of glaucoma medications was reduced from 4 ± 1 to 0. Preoperative and most recent visual acuities were hand-motion (HM) and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis. PMID:27747118

  20. Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

    Directory of Open Access Journals (Sweden)

    Jea H. Yu

    2016-01-01

    Full Text Available Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG. On average, intraocular pressure was reduced from 39±14 mmHg to 15±2 mmHg and the number of glaucoma medications was reduced from 4±1 to 0. Preoperative and most recent visual acuities were hand-motion (HM and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis.

  1. Caracterización de un modelo murino de glaucoma: implicación funcional de la señalización del receptor P2X7 en procesos neurodegenerativos de la retina

    OpenAIRE

    Pérez de Lara, María Jesús

    2016-01-01

    El glaucoma es una de las causas más comunes de discapacidad visual y una de las enfermedades neurodegenerativas oculares más frecuentes de pérdida irreversible de visión. La afectación originada en la retina se caracteriza por la degeneración de las células ganglionares y la pérdida de axones. La presión intraocular es un factor de riesgo importante en el glaucoma, entre otros factores, implicando mecanismos bioquímicos que desencadenan la muerte de las células ganglionares. El ratón DBA/2J ...

  2. 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.

  3. Scanning laser polarimetry in glaucoma

    Directory of Open Access Journals (Sweden)

    Tanuj Dada

    2014-01-01

    Full Text Available 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.

  4. Neo-Vascular Glaucoma: Etiology and Outcome of Treatment in Lagos

    African Journals Online (AJOL)

    tulyasys

    Patients with diabetes mellitus, hypertension or both constituted ... therapy of IOP lowering medications, intravitreal bevacizumab and pan-retina photocoagulation. A routine eye ... In the non-affected eye, 6 (19.4%) patients had visual acuity of ...

  5. Choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion

    Directory of Open Access Journals (Sweden)

    Samuray Tuncer

    2013-01-01

    Full Text Available Choroidal nevi are the most common benign pigmented lesions of the fundus. Choroidal neovascularization is a rare complication of choroidal nevi. We report herein a young patient managed successfully with intravitreal bevacizumab injections for juxtapapillary choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion.

  6. 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.

  7. Normal-tension glaucoma (Low-tension glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  8. Epidemiology of Glaucoma in Asia-Pacific

    Institute of Scientific and Technical Information of China (English)

    P.Siva; Reddy

    1992-01-01

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

  9. A new classification of glaucomas

    Directory of Open Access Journals (Sweden)

    Bordeianu CD

    2014-09-01

    Full Text Available Constantin-Dan Bordeianu Private Practice, Ploiesti, Prahova, Romania Purpose: To suggest a new glaucoma classification that is pathogenic, etiologic, and clinical.Methods: After discussing the logical pathway used in criteria selection, the paper presents the new classification and compares it with the classification currently in use, that is, the one issued by the European Glaucoma Society in 2008.Results: The paper proves that the new classification is clear (being based on a coherent and consistently followed set of criteria, is comprehensive (framing all forms of glaucoma, and helps in understanding the sickness understanding (in that it uses a logical framing system. The great advantage is that it facilitates therapeutic decision making in that it offers direct therapeutic suggestions and avoids errors leading to disasters. Moreover, the scheme remains open to any new development.Conclusion: The suggested classification is a pathogenic, etiologic, and clinical classification that fulfills the conditions of an ideal classification. The suggested classification is the first classification in which the main criterion is consistently used for the first 5 to 7 crossings until its differentiation capabilities are exhausted. Then, secondary criteria (etiologic and clinical pick up the relay until each form finds its logical place in the scheme. In order to avoid unclear aspects, the genetic criterion is no longer used, being replaced by age, one of the clinical criteria. The suggested classification brings only benefits to all categories of ophthalmologists: the beginners will have a tool to better understand the sickness and to ease their decision making, whereas the experienced doctors will have their practice simplified. For all doctors, errors leading to therapeutic disasters will be less likely to happen. Finally, researchers will have the object of their work gathered in the group of glaucoma with unknown or uncertain pathogenesis, whereas

  10. Research on inhibition of corneal neovascularization

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    Zhang-Hui Yang

    2015-12-01

    Full Text Available Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNVmay occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

  11. 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.

  12. View How Glaucoma May Affect Vision

    Science.gov (United States)

    ... inbox. Sign up View How Glaucoma May Affect Vision Normal Vision This is an example of normal vision. This is also an example of how someone ... gradual and often imperceptible failing of side (peripheral) vision. Intermediate Glaucoma As glaucoma progresses, the center of ...

  13. Modern technologies of refractory glaucoma treatment. Review

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    A. Yu. Rascheskov

    2014-07-01

    Full Text Available this article presents a review of available literature concerning basic directions of refractory glaucoma treatment. the surgical management of refractory glaucoma is presented by two main groups of surgical techniques: filtering surgery (including surgery with the use of antimetabolites and implants and cyclodestructive procederes. types of glaucoma drainages are described, modern valve drainage system is presented.

  14. Gene therapy in glaucoma-3: Therapeutic approaches.

    Science.gov (United States)

    Mahdy, Mohamed Abdel-Monem Soliman

    2010-09-01

    Despite new and improving diagnostic and therapeutic options for glaucoma, blindness from glaucoma is increasing and glaucoma remains a major public health problem. The role of heredity in ocular disease including glaucoma is attracting greater attention as the knowledge and recent advances of Human Genome Project and the HapMap Project have made genetic analysis of many human disorders possible.Glaucoma offers a variety of potential targets for gene therapy. All risk factors for glaucoma and their underlying causes are potentially susceptible to modulation by gene transfer. As genetic defects responsible for glaucoma are identified and the biochemical mechanisms underlying the disease are recognized, new methods of therapy can be developed. Genetic tests are indicated for treatment, diagnosis, prognosis, counseling, and research purposes; however, there is significant overlap among them. One of the important genetic tests for glaucoma is OcuGene. Therefore, it is of utmost importance for the glaucoma specialists to be familiar with and understand the basic molecular mechanisms, genes responsible for glaucoma, and the ways of genetic treatment.Recently, several promising genetic therapeutic approaches had been investigated. Some are either used to stop apoptosis and halt further glaucomatous damage, wound healing modulating effect or long lasting intraocular pressure lowering effects than the conventional commercially available antiglaucoma medications. METHOD OF LITERATURE SEARCH: The literature was searched on the Medline database using the PubMed interface. The key words for search were glaucoma, gene therapy, and genetic diagnosis of glaucoma.

  15. Chinical Analysis of Steroid Glaucoma

    Institute of Scientific and Technical Information of China (English)

    LingxunKong; ChengZhang

    1995-01-01

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

  16. Glaucoma de pressão normal Normal tension glaucoma

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    Ivan Maynart Tavares

    2005-08-01

    Full Text Available O glaucoma de pressão normal é neuropatia óptica caracterizada por diminuição da camada de fibras nervosas da retina, aumento da relação escavação/disco e defeito de campo visual, porém sem evidência de aumento da pressão intra-ocular. Os pacientes com glaucoma de pressão normal constituem um grupo heterogêneo em que várias condições sistêmicas podem ser encontradas e apresentam sinais clínicos oculares somente facilmente identificados nos estágios muito avançados da doença. E seu tratamento apresenta desafios maiores do que os existentes no tratamento dos glaucomas hipertensivos. O presente texto propõe uma revisão da patogênese e do diagnóstico diferencial, discutindo os aspectos vasculares, reumáticos, neurológicos e genéticos que devem ser investigados, assim como do tratamento dessa doença. Os autores pesquisaram os bancos de dados do PubMed (MEDLINE, LILACS e Cochrane Library (CENTRAL.Normal tension glaucoma is an optic neuropathy in which the retinal nerve fiber layer thickness is reduced, the optic nerve is pathologically excavated, and the visual field is disturbed, although intraocular pressure is classified as normal. Patients with normal tension glaucoma are a heterogeneous group in which many systemic pathologic conditions may be present, and presenting ocular clinical signs that are difficult to be identified in the early stages of the disease. Treatment is more challenging than in hypertensive glaucomas. The authors sought to review the pathophysiology and differential diagnosis of this condition assessing vascular, rheumatic, neurological and genetic aspects that should be studied, as well as its treatment. The sources of references are PubMed (MEDLINE, LILACS and Cochrane Library (CENTRAL databases.

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

    OpenAIRE

    Yoanner Martín Perera; Ibraín Piloto Díaz; Germán Álvarez Cisneros; Francisco Fumero González; Darlen Rodríguez Rivero; Lizet Sánchez Acosta

    2012-01-01

    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 ...

  18. Lonafarnib is a potential inhibitor for neovascularization.

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    Linlin Sun

    Full Text Available Atherosclerosis is a common cardiovascular disease that involves the build-up of plaque on the inner walls of the arteries. Intraplaque neovacularization has been shown to be essential in the pathogenesis of atherosclerosis. Previous studies showed that small-molecule compounds targeting farnesyl transferase have the ability to prevent atherosclerosis in apolipoprotein E-deficient mice, but the underlying mechanism remains to be elucidated. In this study, we found that lonafarnib, a specific inhibitor of farnesyl transferase, elicits inhibitory effect on vascular endothelial capillary assembly in vitro in a dose-dependent manner. In addition, we showed that lonafarnib treatment led to a dose-dependent decrease in scratch wound closure in vitro, whereas it had little effect on endothelial cell proliferation. These data indicate that lonafarnib inhibits neovascularization via directly targeting endothelial cells and disturbing their motility. Moreover, we demonstrated that pharmacological inhibition of farnesyl transferase by lonafarnib significantly impaired centrosome reorientation toward the leading edge of endothelial cells. Mechanistically, we found that the catalytic β subunit of farnesyl transferase associated with a cytoskeletal protein important for the establishment and maintenance of cell polarity. Additionally, we showed that lonafarnib remarkably inhibited the expression of the cytoskeletal protein and interrupted its interaction with farnesyl transferase. Our findings thus offer novel mechanistic insight into the protective effect of farnesyl transferase inhibitors on atherosclerosis and provide encouraging evidence for the potential use of this group of agents in inhibiting plaque neovascularization.

  19. Ocular perfusion pressure in glaucoma.

    Science.gov (United States)

    Costa, Vital P; Harris, Alon; Anderson, Douglas; Stodtmeister, Richard; Cremasco, Fernanda; Kergoat, Helene; Lovasik, John; Stalmans, Ingborg; Zeitz, Oliver; Lanzl, Ines; Gugleta, Konstantin; Schmetterer, Leopold

    2014-06-01

    This review article discusses the relationship between ocular perfusion pressure and glaucoma, including its definition, factors that influence its calculation and epidemiological studies investigating the influence of ocular perfusion pressure on the prevalence, incidence and progression of glaucoma. We also list the possible mechanisms behind this association, and discuss whether it is secondary to changes in intraocular pressure, blood pressure or both. Finally, we describe the circadian variation of ocular perfusion pressure and the effects of systemic and topical medications on it. We believe that the balance between IOP and BP, influenced by the autoregulatory capacity of the eye, is part of what determines whether an individual will develop optic nerve damage. However, prospective, longitudinal studies are needed to better define the role of ocular perfusion pressure in the development and progression of glaucoma.

  20. Pediatric genetic diseases causing glaucoma

    Science.gov (United States)

    Ichhpujani, Parul; Singh, Rohan B.

    2014-01-01

    Glaucomatous optic neuropathy may be considered as an endpoint of multiple systemic factors. Genetic conditions commonly causing glaucoma in children and adolescents include Axenfeld-Reiger syndrome, aniridia, Marfan syndrome, Weill-Marchessani syndrome, Sturge-Weber syndrome, Rubinstein-Taybi syndrome, nevus of Ota, congenital rubella and neurofibromatosis type 1. In the recent years, with the advancements in genetic research our understanding of the fundamental causes of glaucoma associated with inherited disorders has improved. In addition to intraocular pressure reduction, it is important for the clinician to be familiar with the multiple systemic associations with glaucoma, to re-evaluate treatment frequently, and to target the underlying disease process, if present. PMID:27625878

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

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    Ambika Hoguet

    2016-01-01

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

  2. The Use of Microperimetry to Detect Functional Progression in Non-Neovascular Age-Related Macular Degeneration: A Systematic Review.

    Science.gov (United States)

    Wong, Evan N; Chew, Avenell L; Morgan, William H; Patel, Praveen J; Chen, Fred K

    2017-01-01

    We reviewed the current literature on the ability of microperimetry to detect non-neovascular age-related macular degeneration (AMD) disease progression. The index test was retinal sensitivity measurement assessed by microperimetry and comparators were other functional measures (best-corrected and low-luminance visual acuities, and fixation stability) and structural parameters [retinal thickness, choroidal thickness, and area of geographic atrophy (GA) determined by color fundus photographs, short-wave or near-infrared fundus autofluorescence]. The reference standard was area of GA. The literature search was conducted in January 2016 and included MEDLINE, EMBASE, the Cochrane Library, Biosis, Science Citation Index, ProQuest Health and Medicine, CINAHL, and Highwire Press. We included 6 studies that enrolled 41 eyes with intermediate AMD (from a single study) and 80 eyes with GA secondary to AMD. Retinal sensitivity measured by microperimetry was the only functional measure that consistently detected progression in each cohort. Insufficient reported data precluded meta-analysis. Various microperimetry parameters were used to assess cohort-level change in retinal sensitivity, but the methods of analysis have yet to mature in complexity in comparison with established glaucoma field progression analysis. Microperimetry-assessed retinal sensitivity measurement may be more sensitive in detecting progression than other functional measures in non-neovascular AMD. However, the lack of standardized testing protocol and methods of progression analysis hindered comparison. Harmonization of testing protocol and development of more robust methods of analyzing raw microperimetric data will facilitate clinical implementation of this valuable retinal assessment tool.

  3. Swept Source OCT Angiography of Neovascular Macular Telangiectasia Type 2

    Science.gov (United States)

    Zhang, Qinqin; Wang, Ruikang K.; Chen, Chieh-Li; Legarreta, Andrew D.; Durbin, Mary K.; An, Lin; Sharma, Utkarsh; Stetson, Paul F.; Legarreta, John E.; Roisman, Luiz; Gregori, Giovanni; Rosenfeld, Philip J.

    2015-01-01

    Objective To image subretinal neovascularization in proliferative macular telangiectasia type 2 (MacTel2) using swept source optical coherence tomography based microangiography (OMAG). Study Design Patients with MacTel2 were enrolled in a prospective, observational study known as the MacTel Project and evaluated using a high-speed 1050nm swept-source OCT (SS-OCT) prototype system. The OMAG algorithm generated en face flow images from three retinal layers, as well as the region bounded by the outer retina and Bruch’s membrane, the choriocapillaris, and the remaining choroidal vasculature. The en face OMAG images were compared to images from fluorescein angiography (FA) and indocyanine green angiography (ICGA). Results Three eyes with neovascular MacTel2 were imaged. The neovascularization was best identified from the en face OMAG images that included a layer between the outer retinal boundary and Bruch’s membrane. OMAG images identified these abnormal vessels better than FA and were comparable to the images obtained using ICGA. In all three cases, OMAG identified choroidal vessels communicating with the neovascularization, and these choroidal vessels were evident in the two cases with ICGA imaging. In one case, monthly injections of bevacizumab reduced the microvascular complexity of the neovascularization, as well as the telangiectatic changes within the retinal microvasculature. In another case, less frequent bevacizumab therapy was associated with growth of the subretinal neovascular complex. Conclusions OMAG imaging provided detailed, depth-resolved information about subretinal neovascularization in MacTel2 eyes demonstrating superiority to FA imaging and similarities to ICGA imaging for documenting the retinal microvascular changes, the size and extent of the neovascular complex, the communications between the neovascular complex and the choroidal circulation, and the response to monthly bevacizumab therapy. PMID:26457402

  4. 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

  5. Corneal neovascularization and contemporary antiangiogenic therapeutics.

    Science.gov (United States)

    Hsu, Chih-Chien; Chang, Hua-Ming; Lin, Tai-Chi; Hung, Kuo-Hsuan; Chien, Ke-Hung; Chen, Szu-Yu; Chen, San-Ni; Chen, Yan-Ting

    2015-06-01

    Corneal neovascularization (NV), the excessive ingrowth of blood vessels from conjunctiva into the cornea, is a common sequela of disease insult that can lead to visual impairment. Clinically, topical steroid, argon laser photocoagulation, and subconjunctival injection of bevacizumab have been used to treat corneal NV. Sometimes, the therapies are ineffective, especially when the vessels are large. Large vessels are difficult to occlude and easily recanalized. Scientists and physicians are now dedicated to overcoming this problem. In this article, we briefly introduce the pathogenesis of corneal NV, and then highlight the existing animal models used in corneal NV research-the alkali-induced model and the suture-induced model. Most of all, we review the potential therapeutic targets (i.e., vascular endothelial growth factor and platelet-derived growth factor) and their corresponding inhibitors, as well as the immunosuppressants that have been discovered in recent years by corneal NV studies.

  6. [Photodynamic therapy in treatment of chorioid neovascularization].

    Science.gov (United States)

    Avetisov, S E; Budzinskaia, M V; Kiseleva, T N; Kazarian, E E; Gurova, I V; Loshchenov, V B; Shevchik, S A; Kuz'min, S G; Vorozhtsov, G N

    2007-01-01

    The authors studied the effectiveness of photodynamic therapy (PDT) with Photosence, a Russian photosensitizer, in treatment of chorioid neovascularization (CNV) in cases of age-related macular degeneration (ARMD) and pathological myopia (PM). The subjects were 73 patients with CNV suffering from ARMD and PM. The efficiency of PDT and complex conservative therapy was compared using vision acuity measurement, retinal morphometry, and fluorescent eye ground angiography (FEGA), performed before treatment, immediately after treatment, and 1, 3, 6, and 12 months later. The study showed that PDT in patients with CNV, ARMD and PM was more efficient than pharmacotherapy. Vision acuity improved or stabilized, and the parameters of retinal morphometry and FEGA improved as well. The results of the study evidence high efficiency of PDT with Photosence in treatment of CNV with ARMD and PM.

  7. Targeting Neovascularization in Ischemic Retinopathy: Recent Advances

    Science.gov (United States)

    Al-Shabrawey, Mohamed; Elsherbiny, Mohamed; Nussbaum, Julian; Othman, Amira; Megyerdi, Sylvia; Tawfik, Amany

    2014-01-01

    Pathological retinal neovascularization (RNV) is a common micro-vascular complication in several retinal diseases including retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration and central vein occlusion. The current therapeutic modalities of RNV are invasive and although they may slow or halt the progression of the disease they are unlikely to restore normal acuity. Therefore, there is an urgent need to develop treatment modalities, which are less invasive and therefore associated with fewer procedural complications and systemic side effects. This review article summarizes our understanding of the pathophysiology and current treatment of RNV in ischemic retinopathies; lists potential therapeutic targets; and provides a framework for the development of future treatment modalities. PMID:25598837

  8. Monitoring of stable glaucoma patients

    NARCIS (Netherlands)

    K.M. Holtzer-Goor (Kim); N.S. Klazinga (Niek); M.A. Koopmanschap (Marc); H.G. Lemij (Hans); T. Plochg; E. van Sprundel (Esther)

    2010-01-01

    textabstractA high workload for ophthalmologists and long waiting lists for patients challenge the organization of ophthalmic care. Tasks that require less specialized skills, like the monitoring of stable (well controlled) glaucoma patients could be substituted from ophthalmologists to other profes

  9. SQSTM1 Mutations and Glaucoma.

    Directory of Open Access Journals (Sweden)

    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.

  10. What is the Real Cause of Glaucoma?

    Directory of Open Access Journals (Sweden)

    Alireza Mehdizadeh

    2010-03-01

    Full Text Available Introduction: The term glaucoma refers to a group of diseases that have a characteristic optic neuropathy with associated visual field loss in common. Intraocular pressure has been considered to be the only causal factor for glaucoma and the only factor that can be manipulated to alter the course of the disease. But considering high intraocular pressure as the only factor responsible for glaucoma confronts us with two problems. First, measurement methods of intraocular pressure are based on superficial pressure of the cornea, therefore, some factors such as corneal thickness and geometrical errors of measurement are included. Second, risk of glaucoma damage changes by changing scleral thickness and size of the eye globe even with equal intraocular pressures. So, there should be some other factors than pressure, which are responsible for glaucoma. Hypothesis: Here, this hypothesis is proposed: stress is responsible for glaucoma and intraocular pressure is just one of the determinants of stress, whereas stress is also dependent on other factors including radius and thickness of sclera. Stress causes strain and obstruction of retinal vessels. Discussion: In fact, a series of factors together determine whether an individual will be affected with glaucoma or not. These factors include intraocular pressure, scleral thickness, radius of the eye globe, and optic nerve head compliance against increased stress. Our hypothesis can explain the existence of normal-pressure glaucoma. It presents a better method for screening of glaucoma and new modalities for glaucoma treatment.

  11. Keratoconus associated with choroidal neovascularization: a case report

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    Oh Joo

    2010-02-01

    Full Text Available Abstract Introduction Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane. Case presentation A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis® five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes. Conclusion Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions.

  12. Ex-PRESS miniature glaucoma shunt in treatment of refractory glaucoma.

    Science.gov (United States)

    Kovačević, Suzana; Čanović, Samir; Didović, Ana; Kolega, Marija Škara; Bašić, Jadranka Katušić

    2015-03-01

    Refractory glaucoma in a complicated type of glaucoma of different ethyologies with one same characteristic--intraocular pressure of great resistance to therapy. There are different methods of treatment in such glaucomas, primary surgical options. Ex-PRESS miniature glaucoma shunt implantation was our treatment of choice. In our group of patients we achieved stabile intraocular pressure values in 4 month period of time with no serious or unexpected complications.

  13. Glaucoma secundario a neurofibromatosis tipo-1

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    Anay Martínez Díaz

    2012-02-01

    Full Text Available Paciente de 59 años de edad, con antecedentes de neurofibromatosis tipo 1 y trauma contuso del ojo derecho desde hace años. Acudió a consulta de oftalmología refiriendo disminución lenta de la visión; al examen físico se constató una agudeza visual de 0.6 en ambos ojos, así como disminución concéntrica del campo visual en la perimetría por confrontación. El examen objetivo mostró en los anexos una pingüécula en ojo derecho y pterigion grado II en ojo izquierdo; en segmento anterior, múltiples nódulos de Lisch en el iris de ambos ojos, y en el ojo derecho, pupila ligeramente midriática, pero reactiva. Se le realizó gonoscopia, oftalmoscopia y perimetría Humphry; en esta última se halló un escotoma arqueado en ojo derecho, y un defecto superior arqueado en el ojo izquierdo. Se concluyó el caso con los diagnósticos de catarata presenil incipiente y glaucoma secundario a neurofibromatosis tipo 1.

  14. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

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    Sertan Goktas

    2014-01-01

    Full Text Available Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1 or subconjunctival instillation of 1 mg/mL tigecycline (group 3 for 7 days. Control rats received topical (group 2 or subconjunctival (group 4 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI, 44.2–55.8% and 33.5% (95% CI, 26.6–39.2%, respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group (P=0.03 and P<0.001, resp.. Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization.

  15. Cannabinoides y su posible uso en el glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  16. Glaucoma in Costa Rica. Initial approaches

    OpenAIRE

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

    2014-01-01

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

  17. NOVELTIES IN MEDICAL TREATMENT OF GLAUCOMA.

    Science.gov (United States)

    Cornel, Stefan; Mihaela, Timaru Cristina; Adriana, Iliescu Daniela; Mehdi, Batras; Algerino, De Simone

    2015-01-01

    The purpose of this study is to review the current medical treatment and the new and better alternatives for patients with glaucoma. Glaucoma refers to a group of related eye disorders that have in common an optic neuropathy associated with visual function loss. It is one of the leading causes of irreversible blindness worldwide. Glaucoma can damage vision gradually so it may not be noticed until the disease is at an advanced stage. Early diagnosis and treatment can minimize or prevent optic nerve damage and limit glaucoma-related vision loss. Nowadays, research continues for the improvement of current medical treatment.

  18. Medical Treatment of Primary Canine Glaucoma.

    Science.gov (United States)

    Alario, Anthony F; Strong, Travis D; Pizzirani, Stefano

    2015-11-01

    Glaucoma is a painful and often blinding group of ocular diseases for which there is no cure. Although the definition of glaucoma is rapidly evolving, elevated intraocular pressure (IOP) remains the most consistent risk factor of glaucoma in the canine patient. Therapy should be aimed at neuroprotection. The mainstay of therapy focuses on reducing IOP and maintaining a visual and comfortable eye. This article discusses the most current ocular hypotensive agents, focusing on their basic pharmacology, efficacy at lowering IOP, and recommended use in the treatment of idiopathic canine glaucoma.

  19. Glaucoma: present challenges and future trends.

    Science.gov (United States)

    Bettin, Paolo; Di Matteo, Federico

    2013-01-01

    The authors indicate four key issues which, in their opinion, represent the most stimulating challenges in the field of glaucoma today, and describe the present approaches and the developments that can be expected or advised in the near future: (1) Glaucoma is often undiagnosed or diagnosed too late. Accurate detection is crucial to correctly recognize and treat affected subjects, thus reducing the disability and the social burden of the disease. Is glaucoma screening advisable and cost-effective? What strategies can be implemented to achieve an earlier diagnosis? (2) What role can genetics play in glaucoma clinics? (3) What are the fundamentals and the limits of medical hypotensive and nonhypotensive treatment of glaucoma today, and what novelties could be introduced in the next few years? (4) What are the current and future options for glaucoma surgery? Should we aim at reducing aqueous production or at enhancing aqueous outflow? What are the success figures and the pros and cons of ab externo procedures with external filtration (trabeculectomy, nonpenetrating techniques and glaucoma drainage devices) and of ab externo techniques with internal filtration (viscocanalostomy and canaloplasty)? Will microinvasive procedures ever play a role in the treatment of the disease? These questions and the possible future developments in the management of glaucoma are discussed critically, based on the current clinical state of the art, on a review of the literature, and on an everyday experience in a busy university hospital glaucoma service.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Neovascular events in eyes with central retinal vein occlusion undergoing serial bevacizumab or ranibizumab intravitreal injections: A retrospective review

    Directory of Open Access Journals (Sweden)

    Francis Char DeCroos

    2014-01-01

    Conclusion: Neovascular events occur in eyes with CRVO undergoing serial anti-VEGF therapy, and these events may be delayed compared to the natural history of CRVO-associated neovascularization. Iris neovascularization occurred most frequently.

  2. Uso de la triamcinolona subtenoniana en pacientes con rubeosis del iris Use of intravitreal triamcinolone in patients with iris rubeosis

    Directory of Open Access Journals (Sweden)

    Irene Rojas Rondón

    2008-12-01

    Full Text Available OBJETIVO: Describir el comportamiento de la rubeosis del iris luego de la aplicación de triamcinolona subtenoniana. MÉTODOS: Se realizó un estudio descriptivo de corte longitudinal con 25 pacientes para un total de 32 ojos con diferentes afecciones oculares. Se efectuaron pruebas estadísticas con las variables del estudio y en algunas se utilizó la prueba de los signos de comparación para datos pareados y en otras se aplicó chi cuadrado. Se caracterizaron las variables: edad, sexo, causa de rubeosis del iris y sus estadios, síntomas y tratamiento con láser de panfotocoagulación retiniana. RESULTADOS: La retinopatía diabética proliferativa fue la afección más frecuente en el 76 % de los pacientes, seguida de la oclusión de la vena central retiniana. Del total de pacientes tratados, el 37,5 % evolucionó satisfactoriamente el estado de la rubeosis del iris. Fue mayor el número de pacientes que mejoraron el grado de la rubeosis con tratamiento combinado de láser y triamcinolona subtenoniana, aunque estadísticamente no fue significativo. El estado de la rubeosis mejoró en más de la mitad de los pacientes con tiempo de evolución menor de 6 meses. En aquellos con un tiempo mayor de 6 meses y neovascularización del iris grado III, se pudo estabilizar el glaucoma neovascular. CONCLUSIÓN: Se plantea que la triamcinolona subtenoniana constituye una alternativa para el manejo de este tipo de pacientes.OBJECTIVE: To describe the behaviour of iris rubeosis after using intravitreal triamcinolone. METHODS: A longitudinal descriptive study was performed on 25 patients for a total number of 32 eyes with several ocular diseases. Statistical tests were made with the study variables; sign comparison for paired data and Chi square tests were applied. The variables were age, sex, cause of iris rubeosis and its staging, symptoms and treatment with retinal photocoagulation laser. RESULTS: Proliferative diabetic retinopathy was the most common

  3. Characterization of a spontaneous retinal neovascular mouse model.

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    Eiichi Hasegawa

    Full Text Available BACKGROUND: Vision loss due to vascular disease of the retina is a leading cause of blindness in the world. Retinal angiomatous proliferation (RAP is a subgroup of neovascular age-related macular degeneration (AMD, whereby abnormal blood vessels develop in the retina leading to debilitating vision loss and eventual blindness. The novel mouse strain, neoretinal vascularization 2 (NRV2, shows spontaneous fundus changes associated with abnormal neovascularization. The purpose of this study is to characterize the induction of pathologic angiogenesis in this mouse model. METHODS: The NRV2 mice were examined from postnatal day 12 (p12 to 3 months. The phenotypic changes within the retina were evaluated by fundus photography, fluorescein angiography, optical coherence tomography, and immunohistochemical and electron microscopic analysis. The pathological neovascularization was imaged by confocal microscopy and reconstructed using three-dimensional image analysis software. RESULTS: We found that NRV2 mice develop multifocal retinal depigmentation in the posterior fundus. Depigmented lesions developed vascular leakage observed by fluorescein angiography. The spontaneous angiogenesis arose from the retinal vascular plexus at postnatal day (p15 and extended toward retinal pigment epithelium (RPE. By three months of age, histological analysis revealed encapsulation of the neovascular lesion by the RPE in the photoreceptor cell layer and subretinal space. CONCLUSIONS: The NRV2 mouse strain develops early neovascular lesions within the retina, which grow downward towards the RPE beginning at p15. This retinal neovascularization model mimics early stages of human retinal angiomatous proliferation (RAP and will likely be a useful in elucidating targeted therapeutics for patients with ocular neovascular disease.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Ratna Sitompul

    2011-11-01

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

  6. 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.

  7. Cirugía Combinada de Catarata y Glaucoma con Sutura Retirables

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    Oscar Vicente Beaujon-Balbi

    2015-02-01

    Full Text Available La asociación de catarata y glaucoma representa un reto para el oftalmólogo que debe decidir si realiza una cirugía de glaucoma o catarata o combinada. Presentamos nuestros resultados de cirugías de facoemulsificación de catarata, implante intraocular y trabeculectomía con MMC y suturas retirables. Se incluyen 60 ojos de 44 pacientes operados de Enero 2008 a Diciembre de 2011 con una edad promedio de 67,02 (+/-10,41 años. El 80% eran glaucomas de ángulo abierto (GAA y 20% por cierre angular (GPCA. La presión intraocular previa fue de 23,28 (+/- 5,89 mmHg en GPAA y  26,08 (+/- 10,66 en GPCA con una relación excavación/disco fue de 0,81 y 0,74 respectivamente. La agudeza visual preoperatoria mejor corregida (logmar fue de 0,581 (+/- 0,41 mejorando a 0,28 (+/- 0,38 en general y 0,60 (+/-0,41 a 0,25 (+/-0,37 en GPAA y 0,53 (+/- 0,44 a 0,39 (+/-0,40 en GPCA. La reducción de la Presión Intraocular fue de 48,24% en promedio siendo del 48,86% en GPAA y 52,72% en GPCA. La sobrevida de la cirugía fue de 0,91 en el glaucoma de ángulo abierto y de 0,90 en el glaucoma por cierre angular a los 50 y 30 meses de seguimiento respectivamente. En conclusión, la cirugía combinada por un solo puerto es efectiva en el control del paciente con glaucoma y catarata.

  8. Radiation therapy for neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Robert Petrarca

    2011-01-01

    Full Text Available Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King’s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF therapies represent the standard of care for most patients presenting with neovascular (wet age-related macular degeneration (neovascular AMD. Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET. Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002, with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.Keywords: wet age-related macular degeneration, neovascular, radiation therapy, epimacular brachytherapy, stereotactic radiosurgery, anti-VEGF

  9. Molecular mechanisms underlying primary open angle glaucoma

    NARCIS (Netherlands)

    Janssen, S.F.

    2014-01-01

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

  10. Normal tension glaucoma and Alzheimer disease

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  11. Acute angle closure glaucoma following ileostomy surgery

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    Mariana Meirelles Lopes

    2015-02-01

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

  12. Neuroprotection in glaucoma: present and future

    Institute of Scientific and Technical Information of China (English)

    CHEN Shi-da; WANG Lu; ZHANG Xiu-lan

    2013-01-01

    Objective To review the updated research on neuroprotection in glaucoma,and summarize the potential agents investigated so far.Data sources The data in this review were collected from PubMed and Google Scholar databases published in English up to September 2012,with keywords including glaucoma,neuroprotection,and retinal ganglion cells,both alone and in combination.Publications from the past ten years were selected,but important older articles were not excluded.Study selection Articles about neuroprotection in glaucoma were selected and reviewed,and those that are cited in articles identified by this search strategy and judged relevant to this review were also included.Results Although lowering the intraocular pressure is the only therapy approved as being effective in the treatment of glaucoma,increasing numbers of studies have discovered various mechanisms of retinal ganglion cells death in the glaucoma and relevant neuroprotective strategies.These strategies target neurotrophic factor deprivation,excitotoxic damage,oxidative stress,mitochondrial dysfunction,inflammation,activation of intrinsic and extrinsic apoptotic signals,ischemia,and protein misfolding.Exploring the mechanism of axonal transport failure,synaptic dysfunction,the glial system in glaucoma,and stem cell used in glaucoma constitute promising research areas of the future.Conclusions Neuroprotective strategies continue to be refined,and future deep investment in researching the pathogenesis of glaucoma may provide novel and practical neuroprotection tactics.Establishing a system to assess the effects of neuroprotection treatments may further facilitate this research.

  13. Glaucoma Genetics: Recent Advances and Future Directions.

    Science.gov (United States)

    Aung, Tin; Khor, Chiea Chuen

    2016-01-01

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

  14. [Molecular genetic aspects of glaucoma pathogenesis].

    Science.gov (United States)

    Boĭko, E V; Churashov, S V; Kamilova, T A

    2013-01-01

    To improve our understanding of glaucoma pathophysiology it is important to investigate endophenotypes which are determined by heritable quantitative traits, such as intraocular pressure, vertical cup-to-disc ratio, optic disc area, and central corneal thickness. Glaucoma is associated with increased intraocular pressure and defects of trabecular meshwork and anterior chamber which lead to derangement of intraocular fluid outflow, progressive optic nerve degeneration, loss of nerve cells, and blindness. Factors that are not affected by intraocular pressure also contribute to glaucoma degeneration. In progressive degenerative diseases, such as glaucoma, chronic astrocyte activation exacerbates the damage to neurons and impairs the regeneration of their axons. This review considers the polymorphism of predisposition factors to glaucoma-associated endophenotypes, optic nerve degeneration, and side effects of antiglaucomatous drugs.

  15. Animal models of glucocorticoid-induced glaucoma.

    Science.gov (United States)

    Overby, Darryl R; Clark, Abbot F

    2015-12-01

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

  16. Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

    Directory of Open Access Journals (Sweden)

    Kato N

    2015-08-01

    Full Text Available Noriko Kato,1,2 Genichiro Takahashi,1,2 Koichi Kumegawa,1,2 Yoshiaki Kabata,1,2 Hiroshi Tsuneoka1 1Department of Ophthalmology, Jikei University, School of Medicine, 2Katsushika Medical Center, Tokyo, Japan Background: We investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy. Methods: Ex-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE in 22 eyes. Mean intraocular pressure (IOP in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated. Results: Mean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG and neovascular glaucoma (NTG, or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP <30% of the preoperative IOP, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required; 5 mmHg ≤ postoperative IOP ≤21 mmHg, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required. With regard to postoperative complications and postoperative treatment, the incidence of hyphema was significantly lower in the Ex-PRESS group, but no other significant intergroup differences were seen. The height of the filtering bleb was lower in the Ex-PRESS group. Conclusion: Postoperative outcomes in the Ex-PRESS and TLE groups were comparable. The incidence of hyphema was significantly lower in the Ex-PRESS group. Ex-PRESS insertion

  17. Scanning the macula for detecting glaucoma

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    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

  18. 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

  19. Clinical correlates of common corneal neovascular diseases: a literature review

    Institute of Scientific and Technical Information of China (English)

    Nizar; Saleh; Abdelfattah; Mohamed; Amgad; Amira; A; Zayed; Hamdy; Salem; Ahmed; E; Elkhanany; Heba; Hussein; Nawal; Abd; El-Baky

    2015-01-01

    A large subset of corneal pathologies involves the formation of new vessels(neovascularization), leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization(CNV) by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis,contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatment available so far.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Glaucoma at the Hamilton Glaucoma Center and the University of California, San Diego

    Institute of Scientific and Technical Information of China (English)

    Robert N. Weinreb

    2011-01-01

    @@ Known for its unique cross-disciplinary investigative programs and clinical excellence, the scientists and clinicians at the Hamilton Glaucoma Center of the University of California, San Diego seek to enhance the discovery and translation of innovative research to clinical glaucoma care to prevent and cure glaucoma blindness.With state of the art laboratory and clinical facilities located on the La Jolla campus (Figure 1), the Center is a home for a worldrenowned team of scientists and staff.More than 100 post-doctoral fellows in Glaucoma, many of whom hold distinguished academic positions throughout the world, have been trained at the Hamilton Glaucoma Center and the University of California, San Diego.At the core of Hamilton Glaucoma Center activities are the outstanding faculty that are described below.

  2. Neuroinflammation in glaucoma: A new opportunity.

    Science.gov (United States)

    Williams, Pete A; Marsh-Armstrong, Nick; Howell, Gareth R

    2017-02-24

    Mounting evidence suggests neuroinflammation is a key process in glaucoma, yet the precise roles are not known. Understanding these complex processes, which may also be a key in other common neurodegenerations such as Alzheimer's disease, will lead to targeted therapeutics for a disease that affects as many as 80 million people worldwide. Here, we define neuroinflammation as any immune-relevant response by a variety of cell types including astrocytes, microglia, and peripherally derived cells occurring in the optic nerve head and/or retina. In this review article, we first discuss clinical evidence for neuroinflammation in glaucoma and define neuroinflammation in glaucoma. We then review the inflammatory pathways that have been associated with glaucoma. Finally, we set out key research directions that we believe will greatly advance our understanding of the role of neuroinflammation in glaucoma. This review arose from a discussion of neuroinflammation in glaucoma at the 2015 meeting of the The Lasker/IRRF Initiative for Innovation in Vision Science. This manuscript sets out to summarize one of these sessions; "Inflammation and Glaucomatous Neurodegeneration", as well as to review the current state of the literature surrounding neuroinflammation in glaucoma.

  3. Complex genetic mechanisms in glaucoma: An overview

    Directory of Open Access Journals (Sweden)

    Rao Kollu

    2011-12-01

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

  4. Complex genetic mechanisms in glaucoma: an overview.

    Science.gov (United States)

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

    2011-01-01

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

  5. Relation between Glaucoma and Sensorineural Hearing Loss

    Directory of Open Access Journals (Sweden)

    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.

  6. What’s new in glaucoma treatment?

    Directory of Open Access Journals (Sweden)

    Richard Wormald

    2006-09-01

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

  7. Oral microbiome link to neurodegeneration in glaucoma.

    Directory of Open Access Journals (Sweden)

    Konstantin Astafurov

    Full Text Available BACKGROUND: Glaucoma is a progressive optic nerve degenerative disease that often leads to blindness. Local inflammatory responses are implicated in the pathology of glaucoma. Although inflammatory episodes outside the CNS, such as those due to acute systemic infections, have been linked to central neurodegeneration, they do not appear to be relevant to glaucoma. Based on clinical observations, we hypothesized that chronic subclinical peripheral inflammation contributes to neurodegeneration in glaucoma. METHODS: Mouthwash specimens from patients with glaucoma and control subjects were analyzed for the amount of bacteria. To determine a possible pathogenic mechanism, low-dose subcutaneous lipopolysaccharide (LPS was administered in two separate animal models of glaucoma. Glaucomatous neurodegeneration was assessed in the retina and optic nerve two months later. Changes in gene expression of toll-like receptor 4 (TLR4 signaling pathway and complement as well as changes in microglial numbers and morphology were analyzed in the retina and optic nerve. The effect of pharmacologic blockade of TLR4 with naloxone was determined. FINDINGS: Patients with glaucoma had higher bacterial oral counts compared to control subjects (p<0.017. Low-dose LPS administration in glaucoma animal models resulted in enhancement of axonal degeneration and neuronal loss. Microglial activation in the optic nerve and retina as well as upregulation of TLR4 signaling and complement system were observed. Pharmacologic blockade of TLR4 partially ameliorated the enhanced damage. CONCLUSIONS: The above findings suggest that the oral microbiome contributes to glaucoma pathophysiology. A plausible mechanism by which increased bacterial loads can lead to neurodegeneration is provided by experiments in animal models of the disease and involves activation of microglia in the retina and optic nerve, mediated through TLR4 signaling and complement upregulation. The finding that commensal

  8. Psychological aspects of children with developmental glaucoma

    OpenAIRE

    Carla Ferracina; Adriana Maria Rodrigues; Ricardo Belfort; Paulo Augusto Arruda Mello

    2004-01-01

    OBJETIVO: Avaliar as seguintes características psicológicas de crianças portadoras de glaucoma de desenvolvimento: imaturidade, ansiedade, dependência e sociabilização. MÉTODO: Foram avaliadas 15 crianças com glaucoma do desenvolvimento pertencentes ao ambulatório do Glaucoma Congênito e 15 crianças sem nenhum problema visual pelo teste projetivo do desenho livre. RESULTADOS: No grupo de estudo, 66,6% das crianças glaucomatosas se mostraram imaturas, 86,6% eram ansiosas, 73,3% eram dependente...

  9. Biochemical changes and treatment in glaucoma.

    Science.gov (United States)

    Ciotu, I M; Stoian, I; Gaman, L; Popescu, M V; Atanasiu, V

    2015-01-01

    Glaucoma is the second cause of blindness worldwide. This disease is a neurodegenerative disorder characterized by high intraocular pressure, loss of retinal ganglion cells (apoptosis). Even though there is much research done in this field, the results have not yet managed to stop the progression of glaucoma or to heal this pathology. Free oxygen radicals play a major role; they are formed in the aqueous humor and in the vitreous and they produce apoptosis of the neurons in the optic nerve head, degradation of the trabecular meshwork cells. The purpose of the article is to help in trying to understand the physiopathology of glaucoma and the efficacy of its treatments.

  10. CURRENT OPTIONS FOR SURGICAL TREATMENT OF GLAUCOMA.

    Science.gov (United States)

    Stefan, Cornel; Batras, Mehdi; Iliescu Daniela, Adriana; Timaru Cristina, Mihaela; De Simone, Algerino; Hosseini-Ramhormozi, Jalaladin

    2015-01-01

    The purpose of this study is to review current surgical treatment and new and better alternatives for patients with glaucoma. Glaucoma refers to a group of related eye disorders that have in common an optic neuropathy associated with visual function loss. It is one of the leading causes of irreversible blindness worldwide. Optic nerve damage and glaucoma-related vision loss can be prevented or limited by early diagnosis and treatment. Surgery offers a better control of the intraocular pressure then medical therapy. Nowadays, research continues for improving current surgical alternatives for treatment.

  11. Valor de la ecobiometría en el glaucoma primario de ángulo estrecho Value of ecobiometry in the primary closed-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Ibis Sedeño Cruz

    1999-06-01

    Full Text Available Se evalúa la importancia de la ecobiometría en el sistema diagnóstico del glaucoma primario de ángulo estrecho. A manera de ensayo clínico se estudiaron 105 ojos con esta enfermedad que se agruparon gonioscópicamente. Se les realizó ecobiometría como complemento diagnóstico. Se comprobó una relación directa de la amplitud de ángulo con la distancia axil y la profundidad de la cámara anterior y una relación inversa con el grosor del cristalino. Se observó que la profundidad de la cámara anterior menor de 2 mm constituye un alto riesgo para el desarrollo de un glaucoma agudo. El análisis ecobiométrico permitió conocer mejor el estado anatómico del ojo, facilitando una orientación terapéutica oportunaThe importance of ecobiometry for diagnosing primary closed-angle glaucoma is evaluated in this paper. 105 eyes with this diseases were clinically studied and gruoped according to the results of gonioscopy. Ecobiometry was performed as a diagnostic complement. A direct relationship between the exten of the angle and the axial distance and the depth of the anterior chamber was observed. An inversa relationship between the extent of the angle and the width of the crystalline lens was found. A depth of the anterior chamber under 2 mm is a high risk for the development of acute glaucoma. The ecobiometric analysis allowed to know the anatomical state of the eye better, making possible an opportune therapeutic guidance

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

    Science.gov (United States)

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

    2013-01-01

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

  13. Neovascularity as a prognostic marker in renal cell carcinoma.

    Science.gov (United States)

    Bauman, Tyler M; Huang, Wei; Lee, Moon Hee; Abel, E Jason

    2016-11-01

    Endothelial markers platelet and endothelial cell adhesion molecule (PECAM-1), cluster of differentiation (CD31) and endoglin (CD105) may be used to identify endothelium and activated endothelium, respectively, with the CD105/CD31 ratio used to measure neovascularity. This study investigated the hypothesis that neovascularity in renal cell carcinoma (RCC) is associated with more aggressive RCC tumors and can be used to predict oncological outcomes. Multiplexed immunohistochemistry using antibodies to detect endoglin and PECAM-1 was performed on tissue microarray of benign kidney samples and RCC tumors including clear cell, papillary, chromophobe, and collecting duct and unclassified tumors (combined for statistics), and multispectral imaging was used for analysis. The CD105/CD31 ratio was compared with clinical and pathologic features of RCC as well as clinical outcomes after surgery using Cox proportional hazards regression and Kaplan-Meier analysis. A total of 502 tumor samples and 122 normal kidney samples from 251 RCC patients were analyzed. The average CD105/CD31 expression ratio, an indicator of neovascularization, was increased in higher pathologic stage tumors (P< .0001). Among RCC morphotypes, the ratio was lower in papillary RCC morphotype tumors (P= .001) and higher in collecting duct/unclassified tumors (P= .0001) compared with clear cell RCC. Among nuclear grades, grade 4 RCC displayed a significantly elevated CD105/CD31 ratio (P< .0001). In multivariable analysis, increased neovascularity was associated with decreased overall survival (hazard ratio, 1.54 [95% confidence interval, 1.06-2.23]; P= .02). In patients receiving anti-vascular endothelial growth factor therapy (VEGF, n = 13) for metastatic RCC, a low CD105/CD31 ratio was associated with increased survival (P= .02). We conclude that higher neovascularity is associated with worse outcomes after surgery for RCC. The ratio of CD105/CD31 expression is a potential indicator of response to anti

  14. Broad spectrum antiangiogenic treatment for ocular neovascular diseases.

    Directory of Open Access Journals (Sweden)

    Ofra Benny

    Full Text Available UNLABELLED: Pathological neovascularization is a hallmark of late stage neovascular (wet age-related macular degeneration (AMD and the leading cause of blindness in people over the age of 50 in the western world. The treatments focus on suppression of choroidal neovascularization (CNV, while current approved therapies are limited to inhibiting vascular endothelial growth factor (VEGF exclusively. However, this treatment does not address the underlying cause of AMD, and the loss of VEGF's neuroprotective can be a potential side effect. Therapy which targets the key processes in AMD, the pathological neovascularization, vessel leakage and inflammation could bring a major shift in the approach to disease treatment and prevention. In this study we have demonstrated the efficacy of such broad spectrum antiangiogenic therapy on mouse model of AMD. METHODS AND FINDINGS: Lodamin, a polymeric formulation of TNP-470, is a potent broad-spectrum antiangiogenic drug. Lodamin significantly reduced key processes involved in AMD progression as demonstrated in mice and rats. Its suppressive effects on angiogenesis, vascular leakage and inflammation were studied in a wide array of assays including; a Matrigel, delayed-type hypersensitivity (DTH, Miles assay, laser-induced CNV and corneal micropocket assay. Lodamin significantly suppressed the secretion of various pro-inflammatory cytokines in the CNV lesion including monocyte chemotactic protein-1 (MCP-1/Ccl2. Importantly, Lodamin was found to regress established CNV lesions, unlike soluble fms-like tyrosine kinase-1 (sFlk-1. The drug was found to be safe in mice and have little toxicity as demonstrated by electroretinography (ERG assessing retinal and by histology. CONCLUSIONS: Lodamin, a polymer formulation of TNP-470, was identified as a first in its class, broad-spectrum antiangiogenic drug that can be administered orally or locally to treat corneal and retinal neovascularization. Several unique properties

  15. A Mouse Model for Laser-induced Choroidal Neovascularization.

    Science.gov (United States)

    Shah, Ronil S; Soetikno, Brian T; Lajko, Michelle; Fawzi, Amani A

    2015-12-27

    The mouse laser-induced choroidal neovascularization (CNV) model has been a crucial mainstay model for neovascular age-related macular degeneration (AMD) research. By administering targeted laser injury to the RPE and Bruch's membrane, the procedure induces angiogenesis, modeling the hallmark pathology observed in neovascular AMD. First developed in non-human primates, the laser-induced CNV model has come to be implemented into many other species, the most recent of which being the mouse. Mouse experiments are advantageously more cost-effective, experiments can be executed on a much faster timeline, and they allow the use of various transgenic models. The miniature size of the mouse eye, however, poses a particular challenge when performing the procedure. Manipulation of the eye to visualize the retina requires practice of fine dexterity skills as well as simultaneous hand-eye-foot coordination to operate the laser. However, once mastered, the model can be applied to study many aspects of neovascular AMD such as molecular mechanisms, the effect of genetic manipulations, and drug treatment effects. The laser-induced CNV model, though useful, is not a perfect model of the disease. The wild-type mouse eye is otherwise healthy, and the chorio-retinal environment does not mimic the pathologic changes in human AMD. Furthermore, injury-induced angiogenesis does not reflect the same pathways as angiogenesis occurring in an age-related and chronic disease state as in AMD. Despite its shortcomings, the laser-induced CNV model is one of the best methods currently available to study the debilitating pathology of neovascular AMD. Its implementation has led to a deeper understanding of the pathogenesis of AMD, as well as contributing to the development of many of the AMD therapies currently available.

  16. Dry Eyes and Glaucoma: Double Trouble

    Science.gov (United States)

    ... News About Us Donate In This Section Dry Eyes and Glaucoma: Double Trouble email Send this article ... disease bothers the patient more. What Causes Dry Eye Syndrome? Dry eye can be caused by many ...

  17. GLAUCOMA: Case Study of a Nigerian Family

    African Journals Online (AJOL)

    members of patients with primary open angle glaucoma to reduce the problems ... some traditional herbal medication before presentation. There was no history of ... the fact that she was told that there was no cure for her condition at a hospital.

  18. Methylphenidate (Ritalin)-associated cataract and glaucoma.

    Science.gov (United States)

    Lu, Chao-Kung; Kuang, Tung-Mei; Chou, Joe Ching-Kuang

    2006-12-01

    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.

  19. 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...

  20. 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.

  1. A link between diabetes mellitus and glaucoma

    DEFF Research Database (Denmark)

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

    2016-01-01

    and the Danish National Patient Register. Results A total of 6,343,747 individuals in the period 1996–2012 were included. The overall incidence rates of new-onset glaucoma were 0.07 and 0.36 per 1,000 person-years for the reference population and for diabetes mellitus, respectively. Patients treated with anti-diabetic......Purpose To determine the effect of anti-diabetic medication on glaucoma. Furthermore, to investigate if diabetic comorbidities and concomitant medications are associated with glaucoma in patients treated with anti-diabetic medication. Methods Retrospective nationwide cohort study, spanning a 16......-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...

  2. Haematological Parameters in Open Angle Glaucoma Patients ...

    African Journals Online (AJOL)

    GA Akinlabi, VI Iyawe. Abstract. There is potential for blood related factors to affect aqueous production or optic nerve functions. ... Here we compare hematological parameters for a group of 68 chronic open-angle glaucoma (OAG) patients and ...

  3. Delayed saccadic eye movements in glaucoma

    Directory of Open Access Journals (Sweden)

    Kanjee R

    2012-11-01

    Full Text Available Raageen Kanjee,1 Yeni H Yücel,1,2 Martin J Steinbach,3,4 Esther G González,3,4 Neeru Gupta1,2,51Ophthalmology and Vision Sciences, Laboratory Medicine and Pathobiology, St Michael's Hospital, University of Toronto, 2Keenan Research Centre at the Li Ka Shing Knowledge Institute of St Michael's Hospital, 3Toronto Western Hospital, University Health Network, 4Centre for Vision Research, York University, 5Glaucoma and Nerve Protection Unit, St Michael's Hospital, Toronto, ON, CanadaPurpose: To determine whether saccadic eye movements are altered in glaucoma patients.Patients and methods: Sixteen patients with glaucoma and 21 control subjects were prospectively studied. Patients participated in a pro-saccade step task. Saccades were recorded using a noninvasive infrared oculometric device with head-mounted target projection. Medians of saccade reaction time, duration, amplitude, and peak velocity; frequency of express saccades; and percentage of trials with direction error were recorded. t-tests were used to compare the glaucoma and age-matched control groups. A correlation analysis of saccade parameters with visual field loss was also performed.Results: Median saccade reaction times were significantly prolonged in glaucoma patients compared with controls (220.9 ± 49.02 ms vs 192.1 ± 31.24 ms; t-test: P = 0.036. Median duration, median amplitude, and median peak velocity of saccades did not show significant differences between glaucoma and control groups (P > 0.05. Frequency of express saccades was significantly decreased in glaucoma patients compared with controls (1.75 ± 2.32 vs 7.0 ± 6.99; t-test: P = 0.007. Saccade parameters in glaucoma patients showed no significant correlation with visual field loss.Conclusion: Saccadic eye movements are significantly delayed in patients with early, moderate, or advanced glaucoma. Determination of median saccade reaction time may offer a novel functional test to quantify visual function in glaucoma

  4. Peripapillary and Macular Choroidal Thickness in Glaucoma

    Directory of Open Access Journals (Sweden)

    Hamid Hosseini

    2014-01-01

    Full Text Available Purpose: To compare choroidal thickness (CT between individuals with and without glaucomatous damage and to explore the association of peripapillary and submacular CT with glaucoma severity using spectral domain optical coherence tomography (SD-OCT. Methods: Ninety-one eyes of 20 normal subjects and 43 glaucoma patients from the UCLA SD-OCT Imaging Study were enrolled. Imaging was performed using Cirrus HDOCT. Choroidal thickness was measured at four predetermined points in the macular and peripapillary regions, and compared between glaucoma and control groups before and after adjusting for potential confounding variables. Results: The average (± standard deviation mean deviation (MD on visual fields was −0.3 (±2.0 dB in controls and −3.5 (±3.5 dB in glaucoma patients. Age, axial length and their interaction were the most significant factors affecting CT on multivariate analysis. Adjusted average CT (corrected for age, axial length, their interaction, gender and lens status however, was not different between glaucoma patients and the control group (P=0.083 except in the temporal parafoveal region (P=0.037; nor was choroidal thickness related to glaucoma severity (r=−0.187, P=0.176 for correlation with MD, r=−0.151, P=0.275 for correlation with average nerve fiber layer thickness. Conclusions: Choroidal thickness of the macular and peripapillary regions is not decreased in glaucoma. Anatomical measurements with SD-OCT do not support the possible influence of the choroid on the pathophysiology of glaucoma.

  5. Transscleral photodisruption for the treatment of glaucoma

    Science.gov (United States)

    Sacks, Zachary S.; Loesel, Frieder H.; Durfee, Charles G., III; Kurtz, Ron M.; Juhasz, Tibor; Mourou, Gerard A.

    1999-03-01

    To evaluate transscleral glaucoma surgery techniques using ultrashort pulsed lasers, we attempted to produce photodisruption on the inner surface of the sclera without damaging the overlying tissue. We identified two methods, using pulses centered at 1700 nm and a transparency inducing drug, to produce the spatial and temporal confinement of the pulse necessary to produce photodisruption in the highly scattering sclera. When fully developed these concepts may help address the longstanding limitations of current glaucoma surgical techniques.

  6. New trends in glaucoma risk, diagnosis & management.

    Science.gov (United States)

    Kersey, Thomas; Clement, Colin I; Bloom, Phillip; Cordeiro, M Francesca

    2013-04-01

    Recent advances have seen a surge of new ideas and technologies to aid in the detection, treatment and further understanding of glaucoma. These technologies and advances are discussed to provide information on risk-factors, diagnosis and treatment. Glaucoma has never before seen such an advance in research and therapies coming forward in to the clinical workplace. It is an exciting time for physicians and researchers alike and over the next decade will certainly see advances in early detection, efficacious treatments and neuroprotection.

  7. Gene therapy in glaucoma-3: Therapeutic approaches

    Directory of Open Access Journals (Sweden)

    Mohamed Abdel-Monem Soliman Mahdy

    2010-01-01

    Recently, several promising genetic therapeutic approaches had been investigated. Some are either used to stop apoptosis and halt further glaucomatous damage, wound healing modulating effect or long lasting intraocular pressure lowering effects than the conventional commercially available antiglaucoma medications. Method of Literature Search The literature was searched on the Medline database using the PubMed interface. The key words for search were glaucoma, gene therapy, and genetic diagnosis of glaucoma.

  8. The optic nerve head in glaucoma

    Directory of Open Access Journals (Sweden)

    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’.

  9. Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Roberto Gallego-Pinazo

    2011-02-01

    Full Text Available Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Ester Francés-Muñoz1, J María Millán2,3, J Fernando Arevalo4, J Luis Mullor5, Manuel Díaz-Llopis1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 5Unit of Experimental Ophthalmology, Fundación para la Investigación del Hospital Universitario La Fe, Valencia, Spain; 6University of Valencia, Faculty of Medicine, Valencia, SpainBackground: The aim of our study was to evaluate the functional and anatomic outcomes of intravitreal ranibizumab for the treatment of symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration.Methods: This was a prospective, single-center, uncontrolled, interventional pilot study. Six consecutive eyes (six patients with drusenoid pigment epithelial detachment with a visual acuity of 20/63 to 20/100 and no evidence of choroidal neovascularization in age-related macular degeneration participated. Patients were given at least one intravitreal ranibizumab injection and were followed for a mean of 66.67 ± 10.3 weeks. Main outcome measures included best-corrected visual acuity (BCVA measured by Early Treatment Diabetic Retinopathy Study charts and optical coherence tomography, and central macular thickness measured by optical coherence tomography.Results: The mean number of intravitreal ranibizumab injections was 3.0 at the end of follow-up. Regarding BCVA and optical coherence tomography, 33.3% of eyes gained between 19 and 21 letters of BCVA, with a median decrease in central macular thickness of 21 µm. There was a statistically significant difference between baseline and final BCVA (P = 0.046. There was a positive

  10. 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.

  11. The role of matricellular proteins in glaucoma.

    Science.gov (United States)

    Wallace, Deborah M; Murphy-Ullrich, Joanne E; Downs, J Crawford; O'Brien, Colm J

    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. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  12. PRIMARY OPEN ANGLE GLAUCOMA IN THYROID DISORDER

    Directory of Open Access Journals (Sweden)

    Pragati Garg

    2016-07-01

    Full Text Available PURPOSE To assess the association of thyroid profile with open angle glaucoma. DESIGN Cross-sectional observational study. MATERIAL AND METHOD 128 cases of diagnosed thyroid disorder were enrolled. 5 cases dropped out. Ocular examination included applanation tonometry, stereoscopic optic disc photography, and automated perimetry. Correlative association of thyroid disorder and open angle glaucoma was assessed. RESULTS Of 123 patients of thyroid disorder, 87.8% had hypothyroidism and remaining 12.2% had hyperthyroidism. 15.74% of hypothyroidism and 20% of hyperthyroidism patients had open angle glaucoma, which was statistically significant (Pearson chi-square: Value=6.548, df=2, p=0.040. On multivariate analysis with other risk factors like female sex, family history of glaucoma, myopia, hypertension, and diabetes; it was found that hypothyroidism is an independent risk factor for open angle glaucoma. CONCLUSION All patients having thyroid disorder should be investigated for early diagnosis of open angle glaucoma so that if need be antiglaucoma treatment is started at the earliest and the eye maybe saved from any further deterioration.

  13. Epidemiology of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital

    Institute of Scientific and Technical Information of China (English)

    QIAO Chun-yan; WANG Liang-hai; TANG Xin; WANG Tao; YANG Di-ya; WANG Ning-li

    2009-01-01

    Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes.Results Pediatric patients (n=1452) accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and et all ages, with a total ratio of boys to girls of 2.32:1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years.Patients with traumatic glaucoma were the second most common group (n=128, 12.13%), and presented at older age (the median presenting age was 11 years). The majority of traumatic glaucoma occurred in children between 10 and 15 years of age (n=72, 56.25%). Aphakic glaucoma was the third most common (9.19%) subtype.Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.

  14. 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 questionn

  15. Study of topical corticosteroid response in glaucoma suspects and family members of established glaucoma patients

    Directory of Open Access Journals (Sweden)

    Jilani F

    1987-01-01

    Full Text Available The present study was conducted to study the topical steroid response in glaucoma suspects and family members of established glaucoma patients and its hereditary pattern The cases understudy were divided into three groups, namely normal (25 cases, suspected open angle glaucoma cases (20 and family members of established open angle glaucoma cases (33. After preliminary examination each patient was advised to put dexamethasone drop 1 % in one eye and a placebo in other eye. The IOP was noted after three weeks It was found that 80% of all eyes under study showed a rise in IOP after use of topical dexamethasone. The highest mean IOP was found in primary open angle glaucoma suspects, and the highest mean post-corticosteroid rise in IOP of 8.91 mm Hg was found among family members of established open angle glaucoma patients. The lOP response to topical corticosteroids was found to be of three phenotypical types viz., poor responders (nn, moderate responders (ng and high responders (gg. Normal subjects were generally poor responders. Suspected open angle glaucoma cases were generally high responders. However, family members of established open angle glaucoma cases showed the highest percentage of presence of responder gene.

  16. Current status of epibulbar anti-glaucoma drainage devices in glaucoma surgery.

    Science.gov (United States)

    Thieme, Hagen

    2012-10-01

    The term "glaucoma" covers a heterogeneous group of progressive optic neuropathies that are accompanied by characteristic visual-field defects. Primary open-angle glaucoma, the most common type, progresses insidiously and causes blindness if untreated. All current forms of treatment aim at lowering the intraocular pressure (IOP) in patients whose IOP is elevated. The implantation of anti-glaucoma drainage systems is one of the available options for surgical treatment. This review is based on pertinent literature retrieved by a selective search, including glaucoma treatment guidelines from Germany and abroad. A paradigm shift is currently underway regarding the indications for the implantation of anti-glaucoma drainage systems. Trabeculectomy (a "fistulating" operation in which the aqueous humor is led out of the eye under the conjunctiva) is still considered the surgical gold standard, but drainage systems have been implanted with increasing frequency in recent years. Studies have shown that these systems are more likely to be beneficial the earlier they are implanted in the course of the patient's disease. Five-year follow-up data from the randomized, multicenter Tube Versus Trabeculectomy (TVT) study have now revealed that anti-glaucoma drainage systems are equivalent to trabeculectomy with respect to long-term IOP reduction, complication rates, and absolute and relative clinical success rates. Glaucoma is a major clinical and socio-economic problem whose surgical treatment increasingly involves the implantation of anti-glaucoma drainage systems.

  17. 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 questionn

  18. 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

  19. Maladaptive coping strategies and glaucoma progression.

    Science.gov (United States)

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

    2016-08-01

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

  20. Glaucoma

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  8. Decreased magnesium level and membrane potential of glaucoma patients

    Directory of Open Access Journals (Sweden)

    Johnkennedy Nnodim

    2016-08-01

    The result probably suggests, that decrease in magnesium aggravates glaucoma while decrease in membrane potential could cause poor energy transmission and hence affect ocular blood flow. Hence, decreased magnesium and membrane potential levels contributes greatly to glaucoma.

  9. First Case of Zika-Linked Glaucoma Diagnosed in Infant

    Science.gov (United States)

    ... gov/news/fullstory_162294.html First Case of Zika-Linked Glaucoma Diagnosed in Infant Brazilian baby developed ... who developed glaucoma after being exposed to the Zika virus while in the womb has been reported ...

  10. Glaucoma awareness among ophthalmic patients at Menelik II ...

    African Journals Online (AJOL)

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    Raising awareness about glaucoma among the general public, ophthalmic patients and health professionals would ... media to be the main source of information about glaucoma. ..... This can be seen in relation to that of rural Indian study in ...

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

    Science.gov (United States)

    ... 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 ...

  12. Experimental Contact Lens to Prevent Glaucoma-Induced Blindness

    Science.gov (United States)

    ... Home Page An Experimental Contact Lens to Prevent Glaucoma-Induced Blindness By Sharon Reynolds Posted January 23, 2014 An experimental contact lens design releases a glaucoma medicine at a steady rate for up to ...

  13. Estudio de correlación entre la capa de fibras nerviosas peripapilar y macular y el campo visual en pacientes con glaucoma

    OpenAIRE

    2013-01-01

    El glaucoma es una enfermedad crónica y progresiva que cursa con una pérdida irreversible y permanente de las células ganglionares de la retina que, sin el diagnóstico y tratamientos adecuados, puede conducir a la ceguera. Se estima que el glaucoma, actualmente, afecta a más de 66 millones de personas en el mundo y, debido a la repercusión socioeconómica que ello acarrea, las mejoras en el conocimiento del comportamiento de esta enfermedad conllevarían una disminución del número de paci...

  14. Determinants of glaucoma awareness and knowledge in urban Chennai

    Directory of Open Access Journals (Sweden)

    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.

  15. What should be done in glaucoma research in China

    Institute of Scientific and Technical Information of China (English)

    GE Jian

    2007-01-01

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

  16. Oral fluoroquinolones and risk of glaucoma.

    Science.gov (United States)

    Yang, Louis; Etminan, Mahyar; Mikelberg, Frederick S

    2014-09-01

    To evaluate the risk of developing glaucoma in patients taking systemic fluoroquinolones. A case-control study was carried out among a cohort of subjects who had visited an ophthalmologist in the Province of British Columbia, Canada from 2000 to 2007. Cases were identified as those newly diagnosed with glaucoma (ICD-9 360). For each case, 5 controls were selected and matched to the cases by age and calendar time. Crude and adjusted rate ratios (RRs) for current, recent, past, and distant use of fluoroquinolones were calculated. From the cohort of 989,591 subjects, 178,264 subjects were diagnosed with glaucoma and 891,320 were corresponding controls. The 2 groups had same average age of 65 and comparable systemic comorbidities including hypertension, coronary artery disease, and diabetes. There was no statistically significant association between the use of systemic fluoroquinolones and the development of glaucoma for current use [RR=1.01 (95% confidence interval (CI), 0.95-1.07)], recent use [RR=1.00 (95% CI, 0.92-1.08)], or past use [RR=0.94 (95% CI, 0.90-1.00)]. Distant use of systemic fluoroquinolones had a small statistically significant increased risk of developing glaucoma [RR=1.12 (95% CI, 1.09-1.14)]. There was no detected increased association of the development of glaucoma with current, recent, or past use of systemic fluoroquinolone but a minimal statistically significant increased risk was associated with distant use. Future studies should further examine a potential delayed response with fluoroquinolones and glaucoma.

  17. Current and emerging treatment options for myopic choroidal neovascularization

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    El Matri L

    2015-04-01

    Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  19. Long-term outcomes of ahmed glaucoma valve implantation in refractory glaucoma at Farabi Eye Hospital, Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Reza Zarei

    2016-01-01

    Conclusion: 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.

  20. Prevalence of outer retinal tubulation in eyes with choroidal neovascularization

    OpenAIRE

    Giachetti Filho, Richard Geraldo; Zacharias,Leandro Cabral; Monteiro,Thaís Vera; Preti, Rony Carlos; Pimentel, Sérgio Gianoti

    2016-01-01

    Background Outer retinal tubulations (ORTs) are branching tubular structures located in the outer nuclear layer of the retina. The goal of this study is to determine the prevalence of ORTs observed in eyes with choroidal neovascularization (CNV) undergoing treatment with anti-angiogenic intravitreous injection (IVI) with anti-VEGF (vascular endothelial growth factor) at the Ophthalmology Department of a tertiary hospital in São Paulo, Brazil. Methods This is a descriptive study based on medic...

  1. Stereotactic radiotherapy in neovascular age-related macular degeneration

    OpenAIRE

    Ranjbar, Mahdy; Kurz, Maximilian; Holzhey, Annekatrin; Melchert, Corinna; Rades, Dirk; Grisanti, Salvatore

    2016-01-01

    Abstract Stereotactic radiotherapy (SRT) is a new approach to treat neovascular age-related macular degeneration (nAMD). The INTREPID trial suggested that SRT could reduce the frequency of regular intravitreal injections (IVIs) with antivascular endothelial growth factor drugs, which are necessary to control disease activity. However, the efficacy of SRT in nAMD and resulting morphological changes have not been validated under real-life circumstances, an issue, which we would like to address ...

  2. The role of inflammation in the pathogenesis of glaucoma

    DEFF Research Database (Denmark)

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

    2013-01-01

    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....

  3. Treatment of neovascular age-related macular degeneration: Current therapies

    Directory of Open Access Journals (Sweden)

    Albert J Augustin

    2009-01-01

    Full Text Available Albert J Augustin, Stefan Scholl, Janna KirchhofDepartment of Ophthalmology, Klinikum Karlsruhe, GermanyAbstract: Choroidal neovascularization (CNV secondary to age-related macular degeneration (AMD is now the leading cause of blindness and severe vision loss among people over the age of 40 in the Western world. Its prevalence is certain to increase substantially as the population ages. Treatments currently available for the disease include laser photocoagulation, verteporfin photodynamic therapy, and intravitreal injections of corticosteroids and anti-angiogenic agents. Many studies have reported the benefits of each of these treatments, although none is without its risks. No intervention actually cures AMD, nor the neovascularization associated with it. However, its symptoms are treated with varying degrees of success. Some treatments stabilize or arrest the progress of the disease. Others have been shown to reverse some of the damage that has already been done. These treatments can even lead to visual improvement. This paper will review the major classes of drugs and therapies designed to treat this condition.Keywords: wet AMD, neovascularization, PDT, steroids, anti-angiogenesis

  4. Treatment of Corneal Neovascularization Using Anti-VEGF Bevacizumab

    Directory of Open Access Journals (Sweden)

    Deli Krizova

    2014-01-01

    Full Text Available Purpose. To evaluate antiangiogenic effect of local use of bevacizumab (anti-VEGF antibody in patients with corneal neovascularization. Methods. Patients were divided into two groups. All patients suffered from some form of corneal neovascularization (NV. Patients in group A received 0.2–0.5 mL of bevacizumab solution subconjunctivally (concentration 25 mg/mL in a single dose. Group A included 28 eyes from 27. Patients in group B applied bevacizumab eye drops twice daily (concentration 2.5 mg/mL for two weeks. Group B included 38 eyes from 35 patients. We evaluated the number of corneal segments affected by NV, CDVA, and the incidence of complications and subjective complaints related to the treatment. The minimum follow-up period was six months. Results. By the 6-month follow-up, in group A the percentage reduction of the affected peripheral segments was 21.6% and of the central segments was 9.6%; in group B the percentage reduction of the central segments was 22.7% and of the central segments was 38.04%. In both groups we noticed a statistically significant reduction in the extent of NV. Conclusion. The use of bevacizumab seems to be an effective and safe method in the treatment of corneal neovascularization, either in the subconjunctival or topical application form.

  5. Ranibizumab: the evidence of its therapeutic value in neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Peter K. Kaiser

    2008-07-01

    Full Text Available Peter K. KaiserCole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USAIntroduction: Neovascular age-related macular degeneration (AMD is the leading cause of severe, irreversible visual impairment in people over 60 years of age. Neovascular AMD is characterized by abnormal growth of blood vessels under the retina, specifically the macula. These vessels leak blood and fluids, damaging the retina and its photoreceptors, resulting in permanent loss of central vision. Vascular endothelial growth factor-A (VEGF-A has been shown to play a critical role in the pathogenesis of neovascular AMD. In the US, ranibizumab, a VEGF-A blocker, is approved and indicated for the treatment of patients with neovascular AMD.Aims: To review the clinical evidence for ranibizumab in the treatment of neovascular AMD.Evidence review: Phase III clinical trial data have established ranibizumab as a safe and well-tolerated treatment for neovascular AMD. Monthly intravitreal injections of ranibizumab result in a statistically significantly greater proportion of patients losing <15 letters of visual acuity (VA and statistically significant increases in the mean number of letters gained compared with controls. Anatomically, ranibizumab results in stabilization in the mean area of choroidal neovascularization (CNV and statistically significant reductions in the mean area of leakage compared with controls. Although there is limited economic evidence available, ranibizumab therapy for neovascular AMD appears to deliver a significant degree of value gain in terms of quality of life when compared with other neovascular AMD interventions.Place in therapy: Clinical evidence establishes ranibizumab as a first-line therapy option for virtually all treatable neovascular AMD patients. Updating neovascular AMD treatment guidelines to reflect the evidence base for ranibizumab as a preferred first-line therapy would be beneficial for physicians in making informed treatment

  6. 24-h Efficacy of Glaucoma Treatment Options.

    Science.gov (United States)

    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.

  7. A new futuristic glaucoma therapeutic management paradigm

    Directory of Open Access Journals (Sweden)

    Anusuya Gehlot

    2015-04-01

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

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

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    Andrea Russo

    2009-01-01

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

  9. Choroidal neovascular membrane associated with choroidal osteoma (CO treated with trans-pupillary thermo therapy.

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    Sharma Sumita

    2004-01-01

    Full Text Available Choroidal neovascular membrane, a known complication of choroidal osteoma causing visual loss when located subfoveally, can be successfully treated with transpupillary thermo therapy.

  10. Peripapillary subretinal neovascularization and serous macular detachment. Association with congenital optic nerve pits.

    Science.gov (United States)

    Borodic, G E; Gragoudas, E S; Edward, W O; Brockhurst, R J

    1984-02-01

    Congenital anomalous disc changes were associated with acquired macular detachment and peripapillary choroidal neovascularization in two cases. The anomalous disc changes resembled optic nerve pits. In one case, the peripapillary choroidal neovascularization was treated with argon laser photocoagulation, with subsequent reattachment of the macula and considerable improvement in the visual acuity. Although the pathogenesis of macular detachment occurring with optic nerve pits is usually not disclosed by fluorescein angiography, leakage from choroidal neovascularization can occur with this congenital defect and may contribute to the formation of a neurosensory macular detachment. If found, choroidal neovascularization may represent a remedial cause for visual loss in a condition with an otherwise poor prognosis.

  11. Peripapillary subretinal neovascularization in sarcoidosis: remission and exacerbation during oral corticosteroid therapy.

    Science.gov (United States)

    Abe, Koji; Shiraki, Kunihiko; Yasunari, Takaharu; Kohno, Takeya; Miki, Tokuhiko

    2002-01-01

    In sarcoidosis, peripapillary subretinal neovascularization is rare. The role of corticosteroid therapy for subretinal neovascularization is controversial. A 38-year-old female patient weighing 38 kg with histologically diagnosed sarcoidosis presented with peripapillary subretinal neovascularization, retinal phlebitis, a hyperemic disc, and snowball vitreous opacities in the left eye. Oral betamethasone therapy at an initial dose of 3 mg/day reduced the size of subretinal neovascular membrane, and the membrane became fibrous. Despite the total initial 140 mg of betamethasone given over 2.5 months and the additional total 700 mg of prednisolone given over the next 2 months, the subretinal neovascularization recurred. Six months after the first recurrence, a second recurrence developed during the tapering-off period of oral corticosteroid therapy. At the second recurrence, the oral corticosteroid therapy was ineffective in reducing the size of the neovascular membrane. In our patient, oral corticosteroids temporarily suppressed peripapillary subretinal neovascularization but failed to prevent extension of neovascular membrane to the fovea because of recurrent sarcoidosis. Over time, oral corticosteroids appear to lose their effectiveness for treating repeated recurrence of peripapillary subretinal neovascularization associated with sarcoidosis.

  12. Activity Limitation in Glaucoma: Objective Assessment by the Cambridge Glaucoma Visual Function Test.

    Science.gov (United States)

    Skalicky, Simon E; McAlinden, Colm; Khatib, Tasneem; Anthony, Louise May; Sim, Sing Yue; Martin, Keith R; Goldberg, Ivan; McCluskey, Peter

    2016-11-01

    We design and evaluate a computer-based objective simulation of activity limitation related to glaucoma. A cross-sectional study was performed involving 70 glaucoma patients and 14 controls. Mean age was 69.0 ± 10.2 years; 49 (58.3%) were male. The Cambridge Glaucoma Visual Function Test (CGVFT) was administered to all participants. Rasch analysis and criterion, convergent, and divergent validity tests assessed the psychometric properties of the CGVFT. Regression modeling was used to determine factors predictive of CGVFT person measures. Sociodemographic information, better and worse eye visual field parameters, visual acuity, contrast sensitivity, and the Rasch-analyzed Glaucoma Activity Limitation-9 (GAL-9) and Visual Function Questionnaire Utility Index (VFQUI) questionnaire responses were recorded. From 139 pilot CGVFT items, 59 had acceptable fit to the Rasch model, with acceptable precision (person separation index, 2.13) and targeting. Cambridge Glaucoma Visual Function Test person measure (logit) scores increased between controls (-0.20 ± 0.08) and patients with mild (-0.15 ± 0.08), moderate (-0.13 ± 0.10), and severe (-0.05 ± 0.10) glaucoma (P < 0.001, ANOVA) indicating good criterion validity. Correlation coefficients of 0.455 (P < 0.001) between CGVFT and GAL-9 person measures and 0.399 (P = 0.005) between CGVFT and VFQUI person measures demonstrated convergent validity. Divergent validity was suboptimal. On multivariable analysis, lower better eye mean deviation and greater age were associated with worsening CGVFT person measures (P ≤ 0.001). The CGVFT is a computerized visual challenge test administered to a cohort of glaucoma patients. It may benefit glaucoma patients, careers, health care providers, and policy makers, providing increased awareness of activity limitation due to glaucoma.

  13. Ultrasound imaging of breast tumor perfusion and neovascular morphology.

    Science.gov (United States)

    Hoyt, Kenneth; Umphrey, Heidi; Lockhart, Mark; Robbin, Michelle; Forero-Torres, Andres

    2015-09-01

    A novel image processing strategy is detailed for simultaneous measurement of tumor perfusion and neovascular morphology parameters from a sequence of dynamic contrast-enhanced ultrasound (DCE-US) images. After normalization and tumor segmentation, a global time-intensity curve describing contrast agent flow was analyzed to derive surrogate measures of tumor perfusion (i.e., peak intensity, time-to-peak intensity, area under the curve, wash-in rate, wash-out rate). A maximum intensity image was generated from these same segmented image sequences, and each vascular component was skeletonized via a thinning algorithm. This skeletonized data set and collection of vessel segments were then investigated to extract parameters related to the neovascular network and physical architecture (i.e., vessel-to-tissue ratio, number of bifurcations, vessel count, average vessel length and tortuosity). An efficient computation of local perfusion parameters was also introduced and operated by averaging time-intensity curve data over each individual neovascular segment. Each skeletonized neovascular segment was then color-coded by these local measures to produce a parametric map detailing spatial properties of tumor perfusion. Longitudinal DCE-US image data sets were collected in six patients diagnosed with invasive breast cancer using a Philips iU22 ultrasound system equipped with a L9-3 transducer and Definity contrast agent. Patients were imaged using US before and after contrast agent dosing at baseline and again at weeks 6, 12, 18 and 24 after treatment started. Preliminary clinical results suggested that breast tumor response to neoadjuvant chemotherapy may be associated with temporal and spatial changes in DCE-US-derived parametric measures of tumor perfusion. Moreover, changes in neovascular morphology parametric measures may also help identify any breast tumor response (or lack thereof) to systemic treatment. Breast cancer management from early detection to therapeutic

  14. The effect of subconjunctival suramin on corneal neovascularization in rabbits.

    Science.gov (United States)

    Lee, Hyun Soo; Chung, Sung Kun

    2010-01-01

    To evaluate the effect of subconjunctival injection of suramin on corneal neovascularization in rabbits. Corneal neovascularization was induced by silk suturing of the corneal stroma in 40 eyes of 40 male New Zealand white rabbits. Five days after suture placement, all rabbits were randomly divided into 4 groups of 10 rabbits and were treated subconjunctivally with balanced salt solution 0.1 mL (group 1), suramin 0.1 mL (10 mg/mL and 100 mg/mL, groups 2 and 3, respectively), and bevacizumab 2.5 mg/0.1 mL (group 4). Digital photographs of eyes were obtained and analyzed on days 7, 14, and 28 after subconjunctival injections. In addition, vascular endothelial growth factor (VEGF) enzyme-linked immunosorbent assay (ELISA) and immunohistochemical analyses were used to estimate the level of VEGF and the expression of VEGF and basic FGF in neovascularized cornea, respectively. The neovascularized area in control was increased significantly for 14 days after subconjunctival injection, but slightly decreased on day 28. On days 7 and 14, group 4 exhibited greater antiangiogenic effect than group 3, but group 3 exhibited greater antiangiogenic effect than group 4 on day 28. VEGF ELISA analysis showed the mean concentration of VEGF in group 4 was significantly lower than with other treatments for the first 14 days, but the mean concentration of VEGF in group 4 was similar to that with group 3 on day 28. Immunohistochemical analysis showed that the expressions of both VEGF and basic fibroblast growth factor (FGF) were reduced in group 3 and that bevacizumab reduced VEGF expression relative to basic FGF on day 28. Subconjunctival suramin 100 mg/mL exhibited less antiangiogenic effect than bevacizumab 2.5 mg during the early period of treatment, but it had a longer effect than that of bevacizumab later. Therefore, the combination of subconjunctival bevacizumab and suramin may provide a more potent effect in early treatment as well as a longer antiangiogenic effect in

  15. Implante de Schocket modificado em glaucomas refratários: resultados a longo prazo Modified Schocket implant for refractory glaucoma: long-term results

    Directory of Open Access Journals (Sweden)

    João Antonio Prata Jr

    2000-12-01

    Full Text Available Objetivo:Analisar os resultados a longo prazo obtidos com o implante de Schocket modificado. Métodos: Os prontuários de 45 pacientes (45 cirurgias submetidas ao implante de Schocket modificado com pelo menos um ano de acompanhamento foram analisados. Estudou-se as taxas de sucesso (sucesso=PoPurpose: To analyze long-term results of modified Schocket implant. Methods: The records of 45 patients (45 surgeries with at least one year follow-up who received a modified Schocket implant were analyzed. Comparisons were made regarding success rates (final IOP< 22 mmHg, survival time, diag- nosis, initial and final IOP, percentual postoperative intraocular pressure (IOP reduction and complications. Results: After a mean follow-up of 31.9 ± 19.9 months 28 cases (62.2% were considered successful. Mean survival time was 38.9 months and success probability around 30 months 0.74. Initial IOP was 37.2 ± 11.3 mmHg and final IOP was 16.3 ± 9.3 mmHg and postoperative IOP reduction was 49.6 ± 32.6%. Survival analysis in the different diagnosis groups (neovascular, congenital, aphakic, postkeratoplasty did not reveal statistical significance. Conclusion: The results suggest that the modified Schocket implant provides satisfactory long-term control of refrac- tory glaucomas.

  16. Current concepts in the pathophysiology of glaucoma

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    Agarwal Renu

    2009-01-01

    Full Text Available Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons. Extensive investigations into the pathophysiology of glaucoma now reveal the role of multiple factors in the development of retinal ganglion cell death. A better understanding of the pathophysiological mechanisms involved in the onset and progression of glaucomatous optic neuropathy is crucial in the development of better therapeutic options. This review is an effort to summarize the current concepts in the pathophysiology of glaucoma so that newer therapeutic targets can be recognized. The literature available in the National Medical Library and online Pubmed search engine was used for literature review.

  17. Clinical characteristics and current treatment of glaucoma.

    Science.gov (United States)

    Cohen, Laura P; Pasquale, Louis R

    2014-06-02

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

  18. 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...... a regression discontinuity study design. This analysis provides our main finding, namely that prescription of antihypertensive medication leads to a significant reduction in the risk of developing glaucoma. Therefore, although hypertension—as indicated by the use of antihypertensive medication—is positively...

  19. Analysis of CYP1B1 in pediatric and adult glaucoma and other ocular phenotypes

    Science.gov (United States)

    Reis, Linda M.; Tyler, Rebecca C.; Weh, Eric; Hendee, Kathryn E.; Kariminejad, Ariana; Abdul-Rahman, Omar; Ben-Omran, Tawfeg; Manning, Melanie A.; McCarty, Catherine A.; Kitchner, Terrie E.; Costakos, Deborah

    2016-01-01

    Purpose The CYP1B1 gene encodes an enzyme that is a member of the cytochrome P450 superfamily. Mutations in CYP1B1 have been mainly reported in recessive pediatric ocular phenotypes, such as primary congenital glaucoma (PCG) and congenital glaucoma with anterior segment dysgenesis (CG with ASD), with some likely pathogenic variants also identified in families affected with adult-onset primary open angle glaucoma (POAG). Methods We examined CYP1B1 in 158 pediatric patients affected with PCG (eight), CG with ASD (22), CG with other developmental ocular disorders (11), juvenile glaucoma with or without additional ocular anomalies (26), and ASD or other developmental ocular conditions without glaucoma (91); in addition, a large cohort of adult patients with POAG (193) and POAG-negative controls (288) was examined. Results Recessive pathogenic variants in CYP1B1 were identified in two PCG pedigrees, three cases with CG and ASD, and two families with CG and other ocular defects, such as sclerocornea in one patient and microphthalmia in another individual; neither sclerocornea nor microphthalmia has been previously associated with CYP1B1. Most of the identified causative mutations are new occurrences of previously reported pathogenic alleles with two novel variants identified: a c.1325delC, p.(Pro442Glnfs*15) frameshift allele in a family with PCG and a c.157G>A, p.(Gly53Ser) variant identified in a proband with CG, Peters anomaly, and microphthalmia. Analysis of the family history in the CYP1B1-positive families revealed POAG in confirmed or presumed heterozygous relatives in one family with PCG and two families with ASD/CG; POAG was associated with the c.1064_1076del, p.(Arg355Hisfs*69) allele in two of these pedigrees. Screening of an unrelated POAG cohort identified the same c.1064_1076del heterozygous allele in one individual with sporadic POAG but not in age- and ethnicity-matched POAG-negative individuals. Overall, there was no significant enrichment for mutant

  20. Avaliação oftalmológica em pacientes submetidos a implante de drenagem em glaucomas refratários Ophthalmologic evaluation of patients submitted to drainage implant in refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Natália Pimentel Moreno

    2009-04-01

    Full Text Available OBJETIVO: Avaliar aspectos pré e pós-operatórios em pacientes submetidos a implantes de drenagem. MÉTODOS: Foi realizado estudo retrospectivo, com pacientes submetidos a implante de drenagem no setor de glaucoma do Hospital Oftalmológico de Sorocaba no período de janeiro de 2004 a dezembro de 2006. No estudo foram avaliadas as seguintes características: sexo, idade, olho operado, tipo de glaucoma, número de cirurgias oculares anteriores, pressão intraocular prévia e após, conforme tempo de seguimento. Foram observadas a acuidade visual pré e pós-implante, o número de medicações antiglaucomatosas prescritas pós-implante, as principais complicações e reintervenções necessárias. RESULTADOS: Entre os 92 pacientes a proporção foi de 60 (65,3% do sexo masculino e 32 (34,7% do feminino. Os principais tipos de glaucoma foram: 38,9% (n=37 secundário a transplante de córnea e 25,3% (n=24 glaucoma neovascular. A média da pressão intraocular pré-implante foi de 32 (±11,29 mmHg e pós-implante foi de 18, (±8,16 mmHg em 95 (100% pacientes, 15,00 (±11,00 mmHg em 95 (100%, 16 (±11,64 mmHg em 54 (55,7% e 20 (±10,14 mmHg em 21 (21,6% para o período de 2 meses, 6 meses, 1 ano e 2 anos, respectivamente. As complicações mais frequentes foram extrusão do implante (8,5% e atalamia (5,4%. CONCLUSÃO: Observou-se evolução satisfatória nos pós-implantes, independente das diversas causas do glaucoma. Neste estudo foi encontrada redução significante da pressão intraocular 2 meses, 1 ano e 2 anos (pPURPOSE: To evaluate aspects of patients submitted to drainage implant procedures before and after surgery. METHODS: A retrospective study was done, with patients submitted to drainage implant procedures in the Glaucoma Sector of the Hospital Oftalmológico de Sorocaba, from January, 2004 to December, 2006. The following characteristics were evaluated: gender, age, treated eye, glaucoma type, number of previous ophthalmologic surgeries

  1. Glaucoma Detection From Fundus Image Using Opencv

    Directory of Open Access Journals (Sweden)

    K. Narasimhan

    2012-12-01

    Full Text Available This study proposes a semi automated method for glaucoma detection using CDR and ISNT ratio of a fundus image. CDR (Cup to Disc Ratio is ratio of area of Optic Cup to area of Optic Disc. For a patient with glaucoma Optic Cup size increases while the Optic Disc size remains same and hence CDR will be high for glaucoma patient than normal fundus image. The ROI of green plane is taken and K-Means clustering technique is recursively applied and Optic Disc and Optic Cup is segmented. Through elliptic fiiting, area of Optic Disc and Cup is determined and hence CDR is calculated. ISNT is another parameter used for the diagnosis of glaucoma which is determined through the ratio of area of blood vessels in Inferior Superior to Nasal Temporal side. Blood vessels will shift to Nasal side for glaucoma patients, hence value will be less for glaucoma patient than normal fundus image. Matched filter and Local entropy thresholding is applied to extract blood vessels. The code is programmed in C++ using OpenCV library functions. OpenCV (Open Source Computer Vision Library is a library of programming functions developed by Intel. Core, highgui, imgproc, ml are the main libraries used from OpenCV. The optimized functions in OpenCV increase the speed of operation and is very much suitable for real time mass screening purpose. A batch of 50 retinal images (25 normal set and 25 abnormal set obtained from the Aravind Eye Hospital, is used to assess the performance of the proposed system.

  2. [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.

  3. Glaucoma alters the circadian timing system.

    Directory of Open Access Journals (Sweden)

    Elise Drouyer

    Full Text Available Glaucoma is a widespread ocular disease and major cause of blindness characterized by progressive, irreversible damage of the optic nerve. Although the degenerative loss of retinal ganglion cells (RGC and visual deficits associated with glaucoma have been extensively studied, we hypothesize that glaucoma will also lead to alteration of the circadian timing system. Circadian and non-visual responses to light are mediated by a specialized subset of melanopsin expressing RGCs that provide photic input to mammalian endogenous clock in the suprachiasmatic nucleus (SCN. In order to explore the molecular, anatomical and functional consequences of glaucoma we used a rodent model of chronic ocular hypertension, a primary causal factor of the pathology. Quantitative analysis of retinal projections using sensitive anterograde tracing demonstrates a significant reduction (approximately 50-70% of RGC axon terminals in all visual and non-visual structures and notably in the SCN. The capacity of glaucomatous rats to entrain to light was challenged by exposure to successive shifts of the light dark (LD cycle associated with step-wise decreases in light intensity. Although glaucomatous rats are able to entrain their locomotor activity to the LD cycle at all light levels, they require more time to re-adjust to a shifted LD cycle and show significantly greater variability in activity onsets in comparison with normal rats. Quantitative PCR reveals the novel finding that melanopsin as well as rod and cone opsin mRNAs are significantly reduced in glaucomatous retinas. Our findings demonstrate that glaucoma impacts on all these aspects of the circadian timing system. In light of these results, the classical view of glaucoma as pathology unique to the visual system should be extended to include anatomical and functional alterations of the circadian timing system.

  4. A review of the surgical approaches to glaucoma treatment

    Directory of Open Access Journals (Sweden)

    Spratt Alexander

    2013-07-01

    Full Text Available The conventional approach of initially treating glaucoma medically and holding surgical intervention as a reserve option was endorsed by the findings of the Collaborative Initial Glaucoma Treatment Study (CIGTS study.1 This study reported that patients had similar visual field outcomes at five years from either medical treatment or immediate filtration surgery and supported the status quo of glaucoma management. The market for medical treatments has since increased and polypharmacy is now an accepted norm for glaucoma treatment. Surgical remedies for glaucoma have existed in a less pressured environment such that trabeculectomy, after four decades of slow evolution and complications, remains the most commonly performed type of glaucoma surgery worldwide. This ecosystem has begun to change in recent years. New surgical alternatives have arrived, reached a sizeable number and gained considerable traction as viable competitors to conventional glaucoma medical and surgical treatments. This raises important questions as to how these advances in glaucoma surgical options may affect the future landscape of glaucoma treatment. Has trabeculectomy already yielded some of its high ground? Why has trabeculectomy not been able to evolve more rapidly in response to new competitive pressures? If trabeculectomy has reached its evolutionary zenith are the newer alternatives any better? And, is it time to re-examine the conventional ‘medical before surgical’ approach to glaucoma? This article reviews the evidence for current surgical techniques available to patients with glaucoma.

  5. Glaucoma detection based on deep convolutional neural network.

    Science.gov (United States)

    Xiangyu Chen; Yanwu Xu; Damon Wing Kee Wong; Tien Yin Wong; Jiang Liu

    2015-08-01

    Glaucoma is a chronic and irreversible eye disease, which leads to deterioration in vision and quality of life. In this paper, we develop a deep learning (DL) architecture with convolutional neural network for automated glaucoma diagnosis. Deep learning systems, such as convolutional neural networks (CNNs), can infer a hierarchical representation of images to discriminate between glaucoma and non-glaucoma patterns for diagnostic decisions. The proposed DL architecture contains six learned layers: four convolutional layers and two fully-connected layers. Dropout and data augmentation strategies are adopted to further boost the performance of glaucoma diagnosis. Extensive experiments are performed on the ORIGA and SCES datasets. The results show area under curve (AUC) of the receiver operating characteristic curve in glaucoma detection at 0.831 and 0.887 in the two databases, much better than state-of-the-art algorithms. The method could be used for glaucoma detection.

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

    Science.gov (United States)

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

    2015-01-01

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

  7. [Differential diagnosis of juvenile normal pressure glaucoma].

    Science.gov (United States)

    Geidel, K; Wiedemann, P; Unterlauft, J D

    2016-12-05

    The case of a 50-year-old female patient with autosomal dominant optic atrophy is described, which was initially misinterpreted and treated as normal pressure glaucoma. Bilateral partial optic atrophy can be diagnosed by chance with mild manifestation of symptoms and can initially be misinterpreted as glaucoma. Taking a detailed medical history and performing a thorough optic nerve head examination can raise the suspicion of hereditary optic atrophy. The reliable detection of autosomal dominant optic atrophy by genetic investigations should be strived for in such cases.

  8. Management of coexisting cataract and glaucoma.

    Science.gov (United States)

    Crichton, Andrew

    2010-03-01

    The optimal management of cataract in the glaucoma patient must be constantly updated as advances in both subspecialties impact the surgical decision. The primary considerations at this time include combining the procedures as opposed to sequential operations and optimizing the effectiveness of the operations while reducing complications. Recent findings would certainly suggest an individualized approach based not only on the glaucoma and cataract condition of the patient but also on the experience of the surgeon with varied techniques. Further time and research are required to determine whether certain approaches or techniques will become more universally adopted. At present, there certainly is support for a variety of approaches.

  9. Relationship between neovascularization and clinical severity in Achilles tendinopathy in 556 paired measurements.

    Science.gov (United States)

    De Jonge, S; Warnaars, J L F; De Vos, R J; Weir, A; van Schie, H T M; Bierma-Zeinstra, S M A; Verhaar, J A N; Tol, J L

    2014-10-01

    Neovascularization is frequently observed in tendinopathy. Previous studies have focused on the role of neovascularization in Achilles tendinopathy, but have been conducted in small series. It is still unclear whether the degree of neovascularization is related to severity of symptoms. The purpose was to study the relationship between ultrasonographic neovascularization and clinical severity in patients with Achilles tendinopathy. In this prospective cohort study, data on 127 patients (141 tendons) were assembled from databases of three clinical trials. All patients followed an eccentric exercise program. The Öhberg neovascularization score (0-4+) and Victorian Institute of Sports Assessment-Achilles (VISA-A) score (split into domains: pain, function and activity) were collected during baseline and follow-up. The relationship between neovascularization and VISA-A score was calculated. At baseline, 107 tendons (76%) showed some degree of neovascularization. In 556 coupled measurements, neovascularization was weakly related to the VISA-A score [Exp (B) 1.017, 95% confidence interval (CI), 1.007-1.026]. No significant relationship was found between neovascularization and the pain domain (P = 0.277) and the activity domain (P = 0.283), but there was between neovascularization and the function domain of the VISA-A score [Exp (B) = 1.067, 95% CI 1.018-1.119]. In conclusion, neovascularization in Achilles tendinopathy is weakly related to clinical severity, mainly based on the function domain of the VISA-A score. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Combined extracapsular cataract extraction with ahmed glaucoma valve implantation in phacomorphic glaucoma

    Directory of Open Access Journals (Sweden)

    Das Jaya

    2002-01-01

    Full Text Available Purpose: To report a retrospective analysis of a combined procedure of extracapsular cataract extraction (ECCE with heparin surface modified (HSM posterior chamber intraocular lens (PCIOL implantation along with primary Ahmed glaucoma valve (AGV implantation in an attempt to optimize visual acuity gains and intraocular pressure (IOP control in patients with phacomorphic glaucoma. Methods: ECCE with HSM PC IOL and AGV implantation was performed through two separate incisions in 15 patients diagnosed with phacomorphic glaucoma. Postoperative improvement in visual acuity and IOP control were monitored. Results: A steady control of IOP was maintained in all patients with minimum anti-glaucoma medications. The average visual acuity was approximately 6/24 at 3 months. Conclusion: Superior preoperative IOP control and a shorter phacomorphic attack resulted in better postoperative vision. The successful maintenance of IOP within the desired range in this study suggests that the procedure should be performed under similar conditions.

  11. Congenital glaucoma due to dominant goniodysgenesis. A new concept of the heredity of glaucoma.

    OpenAIRE

    Jerndal, T

    1983-01-01

    Three typical pedigrees with hereditary glaucoma are presented, in which dominant goniodysgenesis is shown to be the actual genetic trait. Because of a marked variation in the expressivity of dysgenesis, the symptoms of the genetic malformation (elevated intraocular pressure and subsequent glaucoma) may appear early or late in life. Therefore, there is no justification in letting the patient's age at the onset of the symptoms decide the classification or the mode of inheritance of the glaucom...

  12. RAGE regulates immune cell infiltration and angiogenesis in choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Mei Chen

    Full Text Available PURPOSE: RAGE regulates pro-inflammatory responses in diverse cells and tissues. This study has investigated if RAGE plays a role in immune cell mobilization and choroidal neovascular pathology that is associated with the neovascular form of age-related macular degeneration (nvAMD. METHODS: RAGE null (RAGE-/- mice and age-matched wild type (WT control mice underwent laser photocoagulation to generate choroidal neovascularization (CNV lesions which were then analyzed for morphology, S100B immunoreactivity and inflammatory cell infiltration. The chemotactic ability of bone marrow derived macrophages (BMDMs towards S100B was investigated. RESULTS: RAGE expression was significantly increased in the retina during CNV of WT mice (p<0.001. RAGE-/- mice exhibited significantly reduced CNV lesion size when compared to WT controls (p<0.05. S100B mRNA was upregulated in the lasered WT retina but not RAGE-/- retina and S100B immunoreactivity was present within CNV lesions although levels were less when RAGE-/- mice were compared to WT controls. Activated microglia in lesions were considerably less abundant in RAGE-/- mice when compared to WT counterparts (p<0.001. A dose dependent chemotactic migration was observed in BMDMs from WT mice (p<0.05-0.01 but this was not apparent in cells isolated from RAGE-/- mice. CONCLUSIONS: RAGE-S100B interactions appear to play an important role in CNV lesion formation by regulating pro-inflammatory and angiogenic responses. This study highlights the role of RAGE in inflammation-mediated outer retinal pathology.

  13. OCT Angiography Identification of Choroidal Neovascularization Secondary to Acute Zonal Occult Outer Retinopathy.

    Science.gov (United States)

    Levison, Ashleigh L; Baynes, Kimberly; Lowder, Careen Y; Srivastava, Sunil K

    2016-01-01

    A 74-year-old female with acute zonal occult outer retinopathy presented with a new lesion suspicious for choroidal neovascularization (CNV) in her right eye. Optical coherence tomography angiography (OCTA) confirmed the presence of CNV. OCTA is a new imaging technique that may help guide diagnosis and management of choroidal neovascular membranes in uveitic diseases.

  14. Circulating human CD34(+) progenitor cells modulate neovascularization and inflammation in a nude mouse model

    NARCIS (Netherlands)

    van der Strate, B. W. A.; Popa, E. R.; Schipper, M.; Brouwer, L. A.; Hendriks, M.; Harmsen, M. C.; van Luyn, M. J. A.

    2007-01-01

    CD34(+) progenitor cells hold promise for therapeutic neovascularization in various settings. In this study, the role of human peripheral blood CD34(+) cells in neovascularization and inflammatory cell recruitment was longitudinally studied in vivo. Human CD34(+) cells were incorporated in Matrigel,

  15. Correlation between clinical and histological features in a pig model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik;

    2006-01-01

    To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features.......To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features....

  16. The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Harun Çakmak

    2013-01-01

    Full Text Available Purpose. To evaluate association between erectile dysfunction (ED and neovascular age-related macular degeneration (AMD. Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF questionnaire’s erectile function (EF domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73 and 60 (54–68, in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16 in neovascular AMD and 18 (9.5–27 in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4% had some degree of ED, whereas 68 men (64.8% had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (. There was a significant association between ED and neovascular AMD (. Conclusions. Our results suggested that neovascular AMD has a high association with ED.

  17. Methylphenidate (Ritalin-associated Cataract and Glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  18. Molteno3 Implantation as Primary Glaucoma Surgery

    Directory of Open Access Journals (Sweden)

    Juha O. Välimäki

    2014-01-01

    Full Text Available Purpose. To determine the outcome of Molteno3 implantation as primary glaucoma surgery and to analyze the factors influencing the surgical outcome. Methods. This is a retrospective clinical study of 106 consecutive eyes (97 patients with no previous glaucoma surgery. Surgical failure was defined as an IOP > 21 mmHg or less than a 20% reduction below baseline, or IOP ≤ 5 mmHg, on two consecutive visits after 3 months follow-up, or reoperation for glaucoma or loss of light perception. Results. At the end of the follow-up (mean, 35 months; range, 12–71 months, the mean postoperative IOP (14.2 ± 4.4 mmHg was statistically significantly lower than the preoperative IOP (35.2 ± 9.7 mmHg (P<0.001. Life-table success rates were 97%, 94%, and 91% after follow-up of 12, 24, and 36 months, respectively. Success rate for an IOP ≤ 18 mmHg was 77% at the last visit. Success was not influenced by previous cataract surgery, sex, age, laser trabeculoplasty (LTP, preoperative IOP, or number of antiglaucoma medications. Forty-seven eyes had 66 postoperative complications. Conclusions. The primary Molteno3 implant provided significant IOP lowering with minimal and manageable complications in uncontrolled glaucoma. Neither previous cataract surgery nor LTP had any detrimental effect on surgical success.

  19. Diffuse loss of sensitivity in early glaucoma.

    Science.gov (United States)

    Henson, D B; Artes, P H; Chauhan, B C

    1999-12-01

    To establish whether there is significant diffuse loss of sensitivity in a population of patients with early glaucoma. The differential light sensitivities at the 10 most sensitive locations from within the central 24 degrees of program 30-2 of the Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA) were compared in 38 pairs of age-matched subjects, one of each pair with early primary open-angle glaucoma (POAG) and the other with normal eyes. All subjects had had experience with automated perimetry and had clear media, visual acuity of 20/25 or better, and one or fewer false-positive or false-negative responses to catch trials. The mean difference in age between the subjects with glaucoma and normal subjects was 29 days (P = 0.44, maximum 1.42 years). The mean paired difference in pupil size was 0.16 mm (P = 0.26), and visual acuity was higher in the glaucoma-affected subjects (P = 0.044). The 10 highest sensitivity measurements in the POAG-affected subjects were found to be lower by a median of between 1.0 and 2.0 dB than those in the normal pair members (0.0001pupil size and media opacity.

  20. Ahmed glaucoma valve implant: surgical technique and complications

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Andréia Peltier Urbano

    2003-01-01

    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

  2. [Compliance of treatment in glaucoma patients].

    Science.gov (United States)

    Banc, Ana; Stan, Cristina

    2013-01-01

    To evaluate the treatment compliance level of glaucoma patients and the correlation between the compliance level and a series of patient's demographic characteristics. We conducted an observational study in which we studied 100 glaucoma patients who answered the questions we included into a questionnaire. We defined and calculated a broad compliance score and a narrow score, and we investigated the connection between the first score and age, gender, demographic location (urban versus rural), education level, current occupation and duration of disease respectively. The mean of the broad compliance score was 9.64 +/- 1.72, which represents 80% of the maximum value of the score, and the mean of the narrow compliance score was 4.73 +/- 1.12, (78% of the maximum value). The correlation coefficient between score and age was z = -0.09 (p value = 0.19), the Z value for the evaluation of the connection between score and gender was -1.16 (p value = 0.24), and for the connection between compliance score and demographic location Z value = -2.42 (p value = 0.01). Chi-square value for the evaluation of the relation between the score and education level was 14.66 (p value = 0.001), and for the current occupation Chi-square value = 3.47 (p value = 0.06). The correlation coefficient between score and disease duration was tau = 0.09 (p value = 0.23). According to the answers the patients gave, we identified the parameters that require more attention in the ophthalmologist - glaucoma patient communication: genetic transmission of glaucoma, treatment's side effects, number of visits to the ophthalmologist, awareness of the life-long gradului period of treatment. In this study, the compliance level of glaucoma patients is relatively high and we observe a correlation between the compliance level and demographic location, and between the compliance level and patient's education level respectively.,

  3. Latanoprost in the treatment of glaucoma

    Directory of Open Access Journals (Sweden)

    Alm A

    2014-09-01

    Full Text Available Albert AlmDepartment of Neuroscience, Ophthalmology, University Hospital, Uppsala, SwedenAbstract: Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1–2 hours after topical dosing (15–30 ng/mL. Metabolism occurs mainly in the liver. Latanoprost (0.005% has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy–tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative

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

    OpenAIRE

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

    2015-01-01

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

  5. Nanotechnology in corneal neovascularization therapy--a review.

    Science.gov (United States)

    Gonzalez, Lilian; Loza, Raymond J; Han, Kyu-Yeon; Sunoqrot, Suhair; Cunningham, Christy; Purta, Patryk; Drake, James; Jain, Sandeep; Hong, Seungpyo; Chang, Jin-Hong

    2013-03-01

    Nanotechnology is an up-and-coming branch of science that studies and designs materials with at least one dimension sized from 1-100 nm. These nanomaterials have unique functions at the cellular, atomic, and molecular levels. The term "nanotechnology" was first coined in 1974. Since then, it has evolved dramatically and now consists of distinct and independent scientific fields. Nanotechnology is a highly studied topic of interest, as nanoparticles can be applied to various fields ranging from medicine and pharmacology, to chemistry and agriculture, to environmental science and consumer goods. The rapidly evolving field of nanomedicine incorporates nanotechnology with medical applications, seeking to give rise to new diagnostic means, treatments, and tools. Over the past two decades, numerous studies that underscore the successful fusion of nanotechnology with novel medical applications have emerged. This has given rise to promising new therapies for a variety of diseases, especially cancer. It is becoming abundantly clear that nanotechnology has found a place in the medical field by providing new and more efficient ways to deliver treatment. Ophthalmology can also stand to benefit significantly from the advances in nanotechnology research. As it relates to the eye, research in the nanomedicine field has been particularly focused on developing various treatments to prevent and/or reduce corneal neovascularization among other ophthalmologic disorders. This review article aims to provide an overview of corneal neovascularization, currently available treatments, and where nanotechnology comes into play.

  6. MicroRNA signature and function in retinal neovascularization

    Institute of Scientific and Technical Information of China (English)

    Saloni; Agrawal; Brahim; Chaqour

    2014-01-01

    Ischemic retinopathies are clinically well-defined chronic microvascular complications characterized by gradually progressive alterations in the retinal microvasculature and a compensatory aberrant neovascularization of the eye. The subsequent metabolic deficiencies result in structural and functional alterations in the retina which is highly susceptible to injurious stimuli such as diabe-tes, trauma, hyperoxia, inflammation, aging and dys-plipidemia. Emerging evidence indicates that an effec-tive therapy may require targeting multiple components of the angiogenic pathway. Conceptually, mircoRNA(miRNA)-based therapy provides the rationale basis for an effective antiangiogenic treatment. miRNAs are an evolutionarily conserved family of short RNAs, each regulating the expression of multiple protein-coding genes. The activity of specific miRNAs is important for vascular cell signaling and blood vessel formation and function. Recently, important progress has been made in mapping the miRNA-gene target network andmiRNA-mediated gene expression control. Here wehighlight the latest findings on angiogenic and antian-giogenic miRNAs and their targets as well as potentiaimplications in ocular neovascular diseases. Emphasis isplaced on how specific vascular-enriched miRNAs regu-late cell responses to various cues by targeting severafactors, receptors and/or signaling molecules in orderto maintain either vascular function or dysfunction. Fur-ther improvement of our knowledge in not only miRNAspecificity, turnover, and transport but also how miRNAsequences and functions can be altered will enhancethe therapeutic utility of such molecules.

  7. Thrombospondin-1 Expression in RPE and Choroidal Neovascular Membranes

    Institute of Scientific and Technical Information of China (English)

    Shikun He; Francesca Incardona; Manlin Jin; Stephen J. Ryan; David R. Hinton

    2006-01-01

    Purpose: To investigate the expression of thrombospondin 1 (TSP-1) in retinal pigment epithelium (RPE) and choroidal neovascular membranes (CNVMs) from patients with age-related macular degeneration (AMD).Methods: Tissue sections from normal human fetal and adult eyes and surgically removed CNVMs were immunostained for TSP-1 localization. Polymerase chain reaction and Western blotting were used to analyze TSP-1 mRNA and protein from human RPE cells, respectively. TSP-1 in the supernatant of cultured RPE cells and eye explants were measured using enzyme-linked immunosorbent assay. MTT assay was used to evaluate the RPE survival after TSP-1 treatment.Results: The strongest immunostaining for TSP-1 was observed in the RPE monolayer around drusen in early AMD. The intensity of TSP-1 staining in normal eye sections was much weaker than that of early AMD and CNVM. TSP-1 mRNA was positive in cultured fetal and adult RPE cells. There was increasing secretion of TSP-1 into the supernatant of cultured RPE and eye explants. The specific band of TSP-1 was identified by Western blot. No significant inhibition of RPE survival was found with the exposure to TSP-1.Conclusions: TSP-1 expression in drusen and CNVM was upregulated and associated with RPE monolayer. TSP-1 may be a natural negative regulator for choroidal neovascularization.

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

    Directory of Open Access Journals (Sweden)

    A. Belzunce

    2004-12-01

    Full Text Available Fundamentos. Conocer si los factores de riesgo cardiovascular se distribuyen de modo distinto en pacientes con glaucoma primario de ángulo abierto (GPAA o en pacientes controles. Cuantificar la prevalencia de estos factores en el GPAA. Analizar la patología concomitante más prevalente en este grupo de pacientes y analizar sus implicaciones en el tratamiento médico del GPAA. Material y Métodos. Estudio observacional transversal sobre población hospitalaria con diagnóstico de GPAA. Se seleccionaron mediante muestreo consecutivo 50 pacientes ingresados en un hospital terciario por cualquier motivo con antecedentes de GPAA y se compararon con un grupo control de 50 pacientes con ingreso hospitalario durante el mismo período y sin diagnóstico de GPAA. Se incluyeron las variables edad, sexo, motivo de ingreso codificado según su grupo relacionado por diagnóstico (GRD y categoría diagnóstica mayor (CDM, tratamiento del glaucoma, antecedentes personales incluyendo la presencia o no de: accidente cerebrovascular, diabetes, hipertensión arterial, cardiopatía isquémica, fenómeno de Raynaud, hipotensión, dislipemia y tabaquismo. Resultados. Existe una asociación aunque no llega al nivel de significación estadística entre el GPAA y el accidente cerebrovascular (razón de prevalencias=2,16; IC al 95%=1,01-2,20; p=0,074*, la hipotensión arterial (razón de prevalencias=5; intervalo de confianza=1,14-2,63; p=0,092* y la hipertensión arterial (razón de prevalencias=1,35; p=0,16. Con el tamaño de la muestra no se encontró asociación con el resto de las variables estudiadas. El motivo de ingreso hospitalario más frecuente en este grupo de pacientes es debido a trastornos del sistema respiratorio y circulatorio (24 y 22% respectivamente siendo la neumonía el GRD más frecuente (10%. En el grupo control: las enfermedades del sistema circulatorio seguidas de las del sistema respiratorio (24 y 16% respectivamente. La reagudización de la

  9. 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.

  10. Recent advances on micro-invasive glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Guo-Jin Zuo

    2017-02-01

    Full Text Available Glaucoma is the second major causes of blindness after cataract. The conventional trabeculectomy and shunt implantation is still the most common surgical procedure in treatment of glaucoma. However, the limitations of the treatments are the security and failure rate. Micro-invasive glaucoma surgery(MIGSis an emerging category which shares the following five characteristics compared with traditional glaucoma surgery:(1an interno microincision,(2micro-invasion,(3definite curative effect,(4high safety, and(5rapid recovery. moreover, it can also reduce the use of glaucoma medication after operation. This kind of surgery can be conducted in three different space, such as Schlemm canal, the suprachoroidal space, and the subconjunctival space. This article reviews briefly the new techniques of micro-invasive glaucoma surgery.

  11. Glaucoma: genes, phenotypes, and new directions for therapy.

    Science.gov (United States)

    Fan, Bao Jian; Wiggs, Janey L

    2010-09-01

    Glaucoma, a leading cause of blindness worldwide, is characterized by progressive optic nerve damage, usually associated with intraocular pressure. Although the clinical progression of the disease is well defined, the molecular events responsible for glaucoma are currently poorly understood and current therapeutic strategies are not curative. This review summarizes the human genetics and genomic approaches that have shed light on the complex inheritance of glaucoma genes and the potential for gene-based and cellular therapies that this research makes possible.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Gender difference in the pathophysiology and treatment of glaucoma.

    Science.gov (United States)

    Tehrani, Shandiz

    2015-02-01

    Glaucoma is the principal cause of irreversible blindness in the world, the second leading cause of blindness in the United States, and it results in optic nerve head axonal degeneration and corresponding visual field deficits. Intraocular pressure (IOP) is the only known modifiable risk factor in glaucoma. Non-modifiable risk factors for glaucoma include age, ethnicity, central corneal thickness, and family history. While our understanding of the role of gender as a risk factor in glaucoma development and progression remains nascent, multiple observations have shown gender differences in the incidence and prevalence of glaucoma. Depending on the type of glaucoma, hormone therapy, oral contraceptive use and menopausal status have also been associated with glaucoma. In addition, pregnancy leads to changes in IOP, while the treatment of glaucoma must be tailored based on the systemic effects of topical therapeutics on the mother and fetus. This review will focus on the epidemiologic, anatomic and endocrinologic differences in male and female glaucoma patients. In addition, this review will discuss treatment modalities that may be more appropriate for one gender than the other, especially with respect to a woman's pregnancy status.

  14. Common and rare genetic risk factors for glaucoma.

    Science.gov (United States)

    Wang, Ryan; Wiggs, Janey L

    2014-09-18

    The characterization of genes responsible for glaucoma is the critical first step toward the development of gene-based diagnostic and screening tests, which could identify individuals at risk for disease before irreversible optic nerve damage occurs. Early-onset forms of glaucoma affecting children and young adults are typically inherited as Mendelian autosomal dominant or recessive traits whereas glaucoma affecting older adults has complex inheritance. In this report, we present a comprehensive overview of the genes and genomic regions contributing to inherited glaucoma.

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Two cases of malignant glaucoma unresolved by pars plana vitrectomy

    Directory of Open Access Journals (Sweden)

    Hosoda Y

    2014-04-01

    Full Text Available Yoshikatsu Hosoda, Tadamichi Akagi, Nagahisa YoshimuraDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanAbstract: Malignant glaucoma, which is characterized by a shallow or flat anterior chamber with high intraocular pressure, can usually be resolved by pars plana vitrectomy with anterior hyaloidectomy. We describe two cases in which malignant glaucoma was refractory to conventional treatment and complete vitrectomy. Case one an 88-year-old woman with pseudoexfoliation glaucoma underwent trabeculotomy and subsequently developed malignant glaucoma. Four months after transient recovery by pars plana vitrectomy, the malignant glaucoma recurred. She underwent peripheral iridectomy and local zonulectomy with successful control of her intraocular pressure. In case two, an 85-year-old man had a history of pseudoexfoliation glaucoma. Seven months after phacoemulsification and intraocular lens implantation, he developed malignant glaucoma that was refractory to pars plana vitrectomy. He underwent peripheral iridectomy, goniosynechialysis and trabectome surgery resulting in the successful control of his intraocular pressure. In rare cases of malignant glaucoma refractive to vitrectomy, peripheral iridectomy with or without local zonulectomy is a reasonable and minimally invasive surgical procedure.Keywords: malignant glaucoma, pars plana vitrectomy, peripheral iridectomy

  17. Techniques of Glaucoma Detection From Color Fundus Images: A Review

    Directory of Open Access Journals (Sweden)

    Malaya Kumar Nath

    2012-09-01

    Full Text Available Glaucoma is a generic name for a group of diseases which causes progressive optic neuropathy and vision loss due to degeneration of the optic nerves. Optic nerve cells act as transducer and convert light signal entered into the eye to electrical signal for visual processing in the brain. The main risk factors of glaucoma are elevated intraocular pressure exerted by aqueous humour, family history of glaucoma (hereditary and diabetes. It causes damages to the eye, whether intraocular pressure is high, normal or below normal. It causes the peripheral vision loss. There are different types of glaucoma. Some glaucoma occurs suddenly. So, detection of glaucoma is essential for minimizing the vision loss. Increased cup area to disc area ratio is the significant change during glaucoma. Diagnosis of glaucoma is based on measurement of intraocular pressure by tonometry, visual field examination by perimetry and measurement of cup area to disc area ratio from the color fundus images. In this paper the different signal processing techniques are discussed for detection and classification of glaucoma.

  18. Clinical evidence in concurrence of retinitis pigmentosa and glaucoma

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  19. The role of biomaterial properties in peri-implant neovascularization

    Science.gov (United States)

    Raines, Andrew Lawrence

    An understanding of the interactions between orthopaedic and dental implant surfaces with the surrounding host tissue is critical in the design of next generation implants to improve osseointegration and clinical success rates. Critical to the process of osseointegration is the rapid establishment of a patent neovasculature in the peri-implant space to allow for the delivery of oxygen, nutrients, and progenitor cells. The central aim of this thesis is to understand how biomaterials regulate cellular and host tissue response to elicit a pro-angiogenic microenvironment at the implant/tissue interface. To address this question, the studies performed in this thesis aim to (1) determine whether biomaterial surface properties can modulate the production and secretion of pro-angiogenic growth factors by cells, (2) determine the role of integrin and VEGF-A signaling in the angiogenic response of cells to implant surface features, and (3) to determine whether neovascularization in response to an implanted biomaterial can be modulated in vivo. The results demonstrate that biomaterial surface microtopography and surface energy can increase the production of pro-angiogenic growth factors by osteoblasts and that these growth factors stimulate the differentiation of endothelial cells in a paracrine manner and the results suggest that signaling through specific integrin receptors affects the production of angiogenic growth factors by osteoblast-like cells. Further, using a novel in vivo model, the results demonstrate that a combination of a rough surface microtopography and high surface energy can improve bone-to-implant contact and neovascularization. The results of these studies also suggest that VEGF-A produced by osteoblast-like cells has both an autocrine and paracrine effect. VEGF-A silenced cells exhibited reduced production of both pro-angiogenic and osteogenic growth factors in response to surface microtopgraphy and surface energy, and conditioned media from VEGF

  20. The association between Neovascular Age-related Macular Degeneration and Regulatory T cells in peripheral blood

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Falk, Mads; Sørensen, Torben Lykke

    2015-01-01

    PURPOSE: To investigate regulatory T cells (Tregs) and subsets of the Treg population in patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Twenty-one neovascular AMD cases and 12 age-matched controls without retinal pathology were selected. Patients were recr...... were found in the percentages of CD4(+) lymphocytes, CD25(high)CD127(low) Tregs, CD45RA(+) naïve Tregs, or CD31(+) recent thymic emigrant Tregs. CONCLUSION: Our data does not indicate an altered state of systemic Treg cells in neovascular AMD....

  1. Glaucoma congenito primario : uma entidade genetica heterogenea

    OpenAIRE

    Andrea Trevas Maciel

    1986-01-01

    Resumo: A visão clássica sobre o mecanismo de herança do glaucoma congênito primário é a que essa anomalia é sempre transmitida de modo autossômico recessivo monogênico. A análise dos dados familiais de 1408 portadores dessa anomalia mostra que o glaucoma congênito primário é, na verdade, uma entidade genética heterogênea, visto que foi possível detectar pelo menos duas formas autossômicas monogênicas dessa doença, sendo uma dominante e outra recessiva. Há, ainda, um grande contingente de anô...

  2. Lasers in the treatment of glaucoma

    Science.gov (United States)

    Kecik, Tadeusz

    1995-03-01

    The task of the laser methods of glaucoma treatment used up to the present day is to reduce the intraocular pressure. They are the modification of the surgical procedures. The radiation of the laser is the tool that enables us to perform the procedure in a more precise and safe manner. Most of the procedures are ambulatory, thus, making the expenses for the treatment lower. The results of the treatment are satisfactory, and in many cases, enable the patient to avoid surgical procedures. In practice, for the anti-glaucoma procedures the argon laser, YAG Nd+3, of free generation, and Q-switch, Holm laser, are being used. The perspectives to use other lasers also exist.

  3. Evidence-based Management of Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Yangfan Yang; Minbin Yu

    2005-01-01

    Purpose: The evidence-based medicine (EBM) is a new medical mode that is completely different from traditional experience-based medicine. The core of EBM is that decision-making during clinical practices must be based on objective research results.With the rapid development of modern ophthalmology, some former viewpoints according to experience-based medicine face challenges. Evidence-based ophthalmology (EBO) is imperative under the situation. Glaucoma, as a disease resulting in blindness, which can not be cured by operation, is thought more and more of by medical management officials and doctors. One challenge for ophthalmologists entering the 21st century will be to make clinical decisions based on valid information or evidence rather than intuition, hearsay, or peer practice. How can we do? Here reviews the application of EBM in medical management of glaucoma since EBM' s naissance and give a reference.

  4. 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.

  5. Copper vapor laser prospects in glaucoma treatment

    Science.gov (United States)

    Nesterov, Arcady P.; Novoderezhkin, Vladimir I.; Egorov, Alexey E.; Shaban, Naim; Ponomarev, Igor V.

    1996-05-01

    New advances of copper vapor laser (CVL-laser) have been studied. Two wavelength radiation of the laser (511 nm and 578 nm) gives deeper permeability into organic tissues. Besides, the short pulse prevents the warm relaxation of small vessels. The technical data of CVL-laser: operating regime -- pulse, pulse duration -- 20 ns, pulse frequency 15000 pulse/sec. The shutter works in intervals from 0.05 to 2.0 sec. The power varies in accordance with wavelength: 511 nm (green) -- 1.5 W, 578 nm (yellow) -- 1, 2 W. The diameter of coagulate may be different: 100, 150, 400, 1000 mkm. We chose CVL-laser 'Femta,' created by P. N. Lebedev Physical Institute of RAS, for ophthalmological use. Thirty eight eyes of 37 patients with different types and stages of glaucoma were studied and treated with CVL-laser. The operations of photomydriasis, gonioplasty and trabeculoplasty have been performed. CVL- laser demonstrated efficient application in treatment of interior eye segment of glaucoma patients. The advantages and disadvantages of the CVL-laser application in glaucoma surgery were discussed.

  6. [Basic biochemical processes in glaucoma progression].

    Science.gov (United States)

    von Thun und Hohenstein-Blaul, N; Kunst, S; Pfeiffer, N; Grus, F H

    2015-05-01

    The term glaucoma summarizes a group of eye diseases that are accompanied by impairments of the optic nerve and related visual field deficits. An early diagnosis of glaucoma is currently not possible due to a lack of diagnostic tests; therefore, in most cases the disease is diagnosed many years after onset, which prevents an early therapy. The known risk factors for the development and progression of glaucomatous optic neuropathy comprise elevated intraocular pressure and a broad range of pressure fluctuations as well as lipometabolic disorders, genetic factor and diabetes. The consequences include the induction of anti-inflammatory proteins, elevated levels of oxidative stress and the destruction of retinal ganglion cells. Changes in the autoantibody repertoire have also been observed in the course of the disease. Basic ophthalmological research therefore focuses on the investigation of basic biochemical processes in the course of the disease. A better understanding of physiological and biochemical events is sought in order to develop new and more sensitive diagnostic options and to allow more targeted therapeutic measures. The understanding of biochemical processes allows a better insight into glaucoma progression to be gained, which will lead to improvements in diagnosis and therapy.

  7. Cluster headache or narrow angle glaucoma?

    Directory of Open Access Journals (Sweden)

    Prasad Palimar

    1991-01-01

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

  8. Choroidal Neovascularization in a Patient with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Giuseppe Casalino

    2014-08-01

    Full Text Available Purpose: To report a case of subfoveal choroidal neovascularization (CNV in a patient with Crohn's disease (CD and to discuss a possible association between these two conditions. Methods: This is an observational case report. Results: A 69-year-old male affected by CD was referred to our department because of sudden visual acuity drop in the left eye. A subfoveal CNV was diagnosed based on slit-lamp fundus biomicroscopy and fluorescein angiography. Color fundus photography, infrared autofluorescence and spectral-domain optical coherence tomography imaging of both eyes were also performed. Following six intravitreal ranibizumab injections, visual improvement was obtained with no related adverse events. Conclusion: We report a case of CNV as a possible rare extraintestinal manifestation of CD. The use of ranibizumab successfully impacted on CNV, while not affecting CD, which remained quiescent.

  9. Single clear corneal incision for glaucoma drainage device shortening in pediatric glaucoma.

    Science.gov (United States)

    Radke, Phillip M; Bitrian, Elena; Grajewski, Alana L

    2016-06-01

    Glaucoma drainage devices are commonly used for management of glaucoma in adults and children. With time, the position of the tube can change and cause damage such as corneal scarring, iris or lens contact, and uveitis. Most of these problems can be improved with tube shortening and/or excision of adherent iris or fibrous tissue. We describe a surgical technique that uses a single clear corneal incision to externalize and trim the shunt in pediatric patients. The technique has a short surgical. We review the indications and outcomes for this procedure in 13 eyes of 12 children who required shunt revision.

  10. Análisis genético- molecular de glaucoma primario de ángulo abierto en familias peruanas

    OpenAIRE

    Guevara, María Luisa

    2011-01-01

    OBJETIVOCaracterizar e identificar el componente genético del glaucoma primario de ángulo abierto (GPAA) en tres familias peruanas con reiterada presencia de GPAA.MATERIAL Y MÉTODOEs un estudio de casos familiares, con una muestra de tres familias que representan un total de 39 individuos de los cuales 25 afectados con diagnostico de GPAA. El criterio diagnóstico fue presión intraocular (PIO) > 22 mm Hg y/o excavación del disco óptico mayor a 0.6, y que sea primario o esencial. Se extrajo ...

  11. [Health economical aspects of telemedical glaucoma monitoring].

    Science.gov (United States)

    Swierk, T; Jürgens, C; Grossjohann, R; Flessa, S; Tost, F

    2011-04-01

    Telemedical home monitoring of glaucoma patients is not covered by health insurance in Germany. Various clinical studies have indicated that 24 h monitoring of intraocular and blood pressure of glaucoma patients allows a better evaluation of the individual disease condition. If the necessary parameters can be collected with telemedical home monitoring it will be possible to reduce the number of 24 h intraocular pressure profiles which necessitate hospital admission. Therefore inpatient 24 h profiles have been chosen as a health economical allocation base with a presentable economical value for the comparative examination. Assuming an at least identical or even higher clinical outcome of the telemedical glaucoma home monitoring inpatient 24 h profiles were chosen as a health economical allocation base to compare and contrast these methods. All procedures of the inpatient 24 h profiles at the ophthalmic clinic of Greifswald were measured using the stopwatch method. In a 1 day test run all activities of the medical staff were identified and documented in a list and afterwards measurements were carried out over 7 days with several stopwatches to allow the documentation of parallel activities. To determine the consumption of resources in telemedical home monitoring the self-documentation of all employees involved in the research project TT-MV were evaluated. Expert interviews helped to determine the economically relevant data about the applied medical technology, e.g. measuring devices, server and electronic health records. The number and complexity of the subprocesses of the inpatient 24 h intraocular pressure profiles were significantly higher compared to telemedical home monitoring. The total costs of the inpatient 24 h profiles were 571.21 € per patient including 291.21 € for medical care and 280 € for accommodation. In contrast the total costs of telemedical home monitoring were 288.72 € per patient. A direct cost comparison shows that telemedical home

  12. Retrobulbar diameter of optic nerve in glaucoma

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

    Full Text Available Introduction. The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO and measuring of its retrobulbar diameter. With B-scan, by Schraeder's method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. Objective. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. Methods. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. Results. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r=0.109; p>0.05. Conclusion. In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values, even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.

  13. 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.

  14. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration

    DEFF Research Database (Denmark)

    Larsen, Michael; Schmidt-Erfurth, Ursula; Lanzetta, Paolo;

    2012-01-01

    To compare the efficacy and safety of same-day verteporfin photodynamic therapy (PDT) and intravitreal ranibizumab combination treatment versus ranibizumab monotherapy in neovascular age-related macular degeneration....

  15. Implementation studies of ranibizumab for neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi

    2013-01-01

    , and type 2 CNV lesions, which have penetrated the RPE and evolve within the subretinal space. The natural course of neovascular AMD leads to visual disability in a majority of cases within the first years after onset, primarily caused by the development of subfoveal fibrous tissue and atrophy of the RPE......The pathogenesis of AMD is associated with age changes plus pathological changes involving oxidative stress and an altered inflammatory response leading to injury of retinal pigment epithelial cells and the adjacent choroidea and photoreceptor cells. AMD is divided into early, intermediate...... and advanced AMD. The advanced form of AMD is further divided into non-neovascular AMD and neovascular AMD. The diagnosis of neovascular AMD is based on FA and clinical characteristics of the eyes. The CNV lesions are by their growth pattern divided into type 1 CNV lesions, which grow primarily beneath the RPE...

  16. glaucoma proceedingings of the ophthalmological society of nigeria ...

    African Journals Online (AJOL)

    2016-11-04

    VCDR difference of 0.2 and above and were considered Glaucoma. Suspects ... and Intraocular Pressure in Primary Open Angle Glaucoma ... [Downloaded free from http://www.nigerianjournalofophthalmology.com on Friday, November 04, 2016, ..... and shots used was 1535.4 mW and 47.9 (seeing eyes) and 1616.7.

  17. Latanoprost systemic exposure in pediatric and adult patients with glaucoma

    DEFF Research Database (Denmark)

    Raber, Susan; Courtney, Rachel; Maeda-Chubachi, Tomoko

    2011-01-01

    To evaluate short-term safety and steady-state systemic pharmacokinetics (PK) of latanoprost acid in pediatric subjects with glaucoma or ocular hypertension who received the adult latanoprost dose.......To evaluate short-term safety and steady-state systemic pharmacokinetics (PK) of latanoprost acid in pediatric subjects with glaucoma or ocular hypertension who received the adult latanoprost dose....

  18. [Malignant glaucoma following blunt trauma of the eye

    NARCIS (Netherlands)

    Theelen, T.; Klevering, B.J.

    2005-01-01

    PURPOSE: Ciliary block glaucoma most commonly occurs after intraocular surgery. We report a case of malignant glaucoma following blunt trauma of the eye with no previous surgery or laser. PATIENT: A 54-year-old female suffered from acute elevation of intraocular pressure on her right eye after blunt

  19. Role of mitochondria in the pathogenesis and treatment of glaucoma

    Institute of Scientific and Technical Information of China (English)

    YANG Xue-jiao; GE Jian; ZHUO Ye-hong

    2013-01-01

    Objective To gain insight into the potential mechanism of mitochondria dysfunction in pathogenesis,progression and therapeutic management of glaucoma.Data sources The data used in this review were mainly published in English from 2000 to present obtained from PubMed.The search terms were "mitochondria","glaucoma" and 'trabecular meshwork" or "retinal ganglion cells".Study selection Articles studying the mitochondria-related pathologic mechanism and treatment of glaucoma were selected and reviewed.Results Mitochondrial dysfunction or injury was demonstrated in different eye tissue of glaucoma.A variety of potential injuries (light,toxic materials,oxidative injury,mechanical stress,aging,etc.) and the inherent DNA defects are deemed to cause mitochondrial structural and functional destruction in trabecular meshwork cells,retinal ganglion cells,etc.of glaucoma.In addition,various new experimental and therapeutic interventions were used to preserve mitochondrial function,which may be useful for protecting against optic nerve degeneration or reducing the death of retinal ganglion cells in glaucoma.Conclusions Mitochondria play an important role in the pathogenesis of glaucoma,various strategies targeting mitochondrial protection might provide a promising way to delay the onset of glaucoma or protect RGCs against glaucomatous damage.

  20. INTRAOCULAR PRESSURE ASYMMETRY: AN INDICATOR FOR GLAUCOMA DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Rekha R.

    2016-05-01

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

  1. Common genetic variants associated with open-angle glaucoma

    NARCIS (Netherlands)

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

    2011-01-01

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

  2. The interactions of genes, age, and environment in glaucoma pathogenesis.

    Science.gov (United States)

    Doucette, Lance P; Rasnitsyn, Alexandra; Seifi, Morteza; Walter, Michael A

    2015-01-01

    Glaucoma, a progressive degenerative condition that results in the death of retinal ganglion cells, is one of the leading causes of blindness, affecting millions worldwide. The mechanisms underlying glaucoma are not well understood, although years of studies have shown that the largest risk factors are elevated intraocular pressure, age, and genetics. Eleven genes and multiple loci have been identified as contributing factors. These genes act by a number of mechanisms, including mechanical stress, ischemic/oxidative stress, and neurodegeneration. We summarize the recent advances in the understanding of glaucoma and propose a unified hypothesis for glaucoma pathogenesis. Glaucoma does not result from a single pathological mechanism, but rather a combination of pathways that are influenced by genes, age, and environment. In particular, we hypothesize that, in the presence of genetic risk factors, exposure to environment stresses results in an earlier age of onset for glaucoma. This hypothesis is based upon the overlap of the molecular pathways in which glaucoma genes are involved. Because of the interactions between these processes, it is likely that there are common therapies that may be effective for different subtypes of glaucoma.

  3. Giant prolactinoma mimicking low-tension glaucoma at presentation.

    Science.gov (United States)

    Karl, David; Gillan, Stewart Neil; Goudie, Colin; Sanders, Roshini

    2015-02-06

    We describe a case of a 68-year-old man, referred by his optometrist with suspected low-tension glaucoma, who presented with advanced cupped optic discs and field of vision loss that were subsequently found to be due to a giant prolactinoma. Failing vision in low-tension glaucoma suspects should have a low threshold for neuroimaging.

  4. 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

  5. Primary congenital glaucoma associated with Patau syndrome with long survival.

    Science.gov (United States)

    Jaru-Ampornpan, Pimkwan; Kuchtey, John; Dev, V G; Kuchtey, Rachel

    2010-06-23

    Ocular abnormalities are common in Patau syndrome (trisomy 13), but only a few cases with congenital glaucoma have been reported, some of which were associated with other ocular defects. This report describes a case of primary congenital glaucoma in an 11-year-old patient with full trisomy 13.

  6. 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 k

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  8. 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 k

  9. 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

  10. Management of neovascular Age-related macular degeneration: A review on landmark randomized controlled trials

    OpenAIRE

    Aniruddha Agarwal; Kanika Aggarwal; Vishali Gupta

    2016-01-01

    In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have...

  11. Regulation of signaling events involved in the pathophysiology of neovascular AMD

    OpenAIRE

    Wang, Haibo; Hartnett, M. Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual’s genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than ha...

  12. Glaucoma and globe enlargement associated with neurofibromatosis type 1.

    Science.gov (United States)

    Morales, Jose; Chaudhry, Imtiaz A; Bosley, Thomas M

    2009-09-01

    To describe the features of glaucoma and globe enlargement sometimes associated with neurofibromatosis type 1 (NF1). Single institution, retrospective, and cross-sectional study. Eighty medical records of patients treated at King Khaled Eye Specialist Hospital in Saudi Arabia with NF1 were reviewed, and 46 patients were examined. We reviewed the charts of patients with NF1 and examined available individuals, including gonioscopy, axial length, and ultrasound biomicroscopy in appropriate patients. Presence and type of glaucoma, anterior chamber angle abnormalities, globe axial length, ultrasound biomicroscopy, and visual outcome. Two patient groups were identified: Group 1 had 56 patients with orbito-facial NF1, and group 2 had 24 patients with NF1 but without orbito-facial involvement. Group 1 included 13 patients with glaucoma (23%), which occurred only ipsilateral to the orbito-facial involvement and generally presented before age 3 years. Glaucoma surgery was required in all of these patients, and visual prognosis was poor. In group 1, mean axial length on the side affected by NF1 was 29.8+/-4.1 mm in patients with glaucoma and 25.6+/-2.0 mm in patients without glaucoma. Patients with glaucoma (Pglobes on the affected side. Group 2 patients had a mean axial length of 23.6+/-1.6 mm for both eyes without significant globe asymmetry. In this Arab population, glaucoma associated with orbito-facial NF1 occurred less often than the 50% rate that is typically cited. Glaucoma presented early in life and only in patients with ipsilateral orbito-facial involvement. Glaucoma in this setting was always associated with globe enlargement. Glaucoma required surgery, and visual prognosis was poor because of glaucoma and concurrent pathology. Globe enlargement was most severe when associated with glaucoma but also present on the side with orbito-facial involvement in patients without glaucoma. The presence of neurofibroma may induce globe enlargement on the affected side in

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

    Science.gov (United States)

    Chan, Jessica E; Netland, Peter A

    2015-01-01

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

  14. Present and New Treatment Strategies in the Management of Glaucoma

    DEFF Research Database (Denmark)

    Kolko, Miriam

    2015-01-01

    of RGCs. In this matter, recent approaches aim to rescue RGCs and regenerate axons in order to restore visual function in glaucoma. The present review seeks to provide an overview of the present and new treatment strategies in the management of glaucoma. The treatment strategies are divided into current...... risk factor for progression of the disease. However, it is clear that a significant number of glaucoma patients show disease progression despite of pressure lowering treatments. Much attention has been given to the development of neuroprotective treatment strategies, but the identification of such has...... been hampered by lack of understanding of the etiology of glaucoma. Hence, in spite of many attempts no neuroprotective drug has yet been clinically approved. Even though neuroprotection is without doubt an important treatment strategy, many glaucoma subjects are diagnosed after substantial loss...

  15. Marijuana for Glaucoma: A Recipe for Disaster or Treatment?

    Science.gov (United States)

    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.

  16. Slit2 signaling through Robo1 and Robo2 is required for retinal neovascularization.

    Science.gov (United States)

    Rama, Nicolas; Dubrac, Alexandre; Mathivet, Thomas; Ní Chárthaigh, Róisín-Ana; Genet, Gael; Cristofaro, Brunella; Pibouin-Fragner, Laurence; Ma, Le; Eichmann, Anne; Chédotal, Alain

    2015-05-01

    Ocular neovascular diseases are a leading cause of blindness. Vascular endothelial growth factor (VEGF) blockade improves vision, but not all individuals respond to anti-VEGF treatment, making additional means to prevent neovascularization necessary. Slit-family proteins (Slits) are ligands of Roundabout (Robo) receptors that repel developing axons in the nervous system. Robo1 expression is altered in ocular neovascular diseases, and previous in vitro studies have reported both pro- and anti-angiogenic effects of Slits. However, genetic evidence supporting a role for Slits in ocular neovascularization is lacking. Here we generated conditional knockout mice deficient in various Slit and Robo proteins and found that Slit2 potently and selectively promoted angiogenesis via Robo1 and Robo2 in mouse postnatal retina and in a model of ocular neovascular disease. Mechanistically, Slit2 acting through Robo1 and Robo2 promoted the migration of endothelial cells. These receptors are required for both Slit2- and VEGF-induced Rac1 activation and lamellipodia formation. Thus, Slit2 blockade could potentially be used therapeutically to inhibit angiogenesis in individuals with ocular neovascular disease.

  17. Choroidal osteoma with choroidal neovascular membrane: Successful treatment with intravitreal bevacizumab

    Directory of Open Access Journals (Sweden)

    Neeraj Pandey

    2010-09-01

    Full Text Available Neeraj Pandey, Ayachit GuruprasadMM Joshi Eye Institute, Hubli, Karnataka, IndiaAbstract: An otherwise healthy 27-year-old woman presented with complaints of sudden painless blurred vision in the right eye for one week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal, but OD demonstrated an elevated, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid, suggestive of a choroidal neovascular membrane in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well defined area of hyperfluorescence that increased in size and intensity in the later phases, suggestive of active extrafoveal choroidal neovascular membrane. Optical coherence tomography confirmed the extrafoveal choroidal neovascular membrane with subfoveal fluid. She was treated with intravitreal bevacizumab OD. At the two-week visit, vision OD improved to 20/20. Fluorescein angiography and optical coherence tomography revealed a resolved choroidal neovascular membrane. Intravitreal bevacizumab may be an effective alternative in the management of choroidal neovascular membrane secondary to choroidal osteoma.Keywords: osteoma, choroidal neovascular membrane, optical coherence tomography, bevacizumab

  18. Cathepsin L is required for endothelial progenitor cell-induced neovascularization

    Energy Technology Data Exchange (ETDEWEB)

    Urbich, Carmen; Heeschen, Christopher; Aicher, Alexandra; Sasaki, Ken-ichiro; Bruhl, Thomas; Hofmann, Wolf K.; Peters, Christoph; Reinheckel, Thomas; Pennacchio, Len A.; Abolmaali, Nasreddin D.; Chavakis, Emmanouil; Zeiher, Andreas M.; Dimmeler, Stefanie

    2004-01-15

    Infusion of endothelial progenitor cells (EPCs), but not of mature endothelial cells (ECs), promotes neovascularization after ischemia. We performed a gene expression profiling of EPCs and ECs to identify genes, which might be important for the neovascularization capacity of EPCs. Intriguingly, the protease cathepsin L (CathL) was highly expressed in EPCs as opposed to ECs and is essential for matrix degradation and invasion by EPCs in vitro. CathL deficient mice showed impaired functional recovery after hind limb ischemia supporting the concept for an important role of CathL in postnatal neovascularization. Infused CathL deficient progenitor cells failed to home to sites of ischemia and to augment neovascularization. In contrast, over expression of CathL in mature ECs significantly enhanced their invasive activity and induced their neovascularization capacity in vivo. Taken together, CathL plays a crucial role for the integration of circulating EPCs into the ischemic tissue and is required for neovascularization mediated by EPCs.

  19. Resistance to anti-VEGF therapy in neovascular age-related macular degeneration: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Yang S

    2016-06-01

    Full Text Available Shiqi Yang,1 Jingke Zhao,1 Xiaodong Sun1–3 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 2Eye Research Institute of Shanghai Jiao Tong University, 3Shanghai Key Laboratory of Fundus Disease, Shanghai, People’s Republic of China Abstract: As a progressive chronic disease, age-related macular degeneration (AMD is the leading cause of irreversible vision impairment worldwide. Experimental and clinical evidence has demonstrated that vascular endothelial growth factor (VEGF plays a vital role in the formation of choroidal neovascularization. Intravitreal injections of anti-VEGF agents have been recommended as a first-line treatment for neovascular AMD. However, persistent fluid or recurrent exudation still occurs despite standardized anti-VEGF therapy. Patients suffering from refractory or recurrent neovascular AMD may develop mechanisms of resistance to anti-VEGF therapy, which results in a diminished therapeutic effect. Until now, there has been no consensus on the definitions of refractory neovascular AMD and recurrent neovascular AMD. This article aims at clarifying these concepts to evaluate the efficacy of switching drugs, which contributes to making clinical decision more scientifically. Furthermore, insight into the causes of resistance to anti-VEGF therapy would be helpful for developing possible therapeutic approaches, such as combination therapy and multi-target treatment that can overcome this resistance. Keywords: age-related macular degeneration, vascular endothelial growth factor, choroidal neovascularization, resistance

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. [Medicinal glaucoma therapy. What can we learn from large randomized clinical trials?].

    Science.gov (United States)

    Jünemann, A G M; Huchzermeyer, C; Rejdak, R

    2013-12-01

    The prospective multicenter randomized controlled clinical trials (RCTs) Ocular Hypertension Glaucoma Treatment Study (OHTS), Early Manifest Glaucoma Trial (EMGT), Advanced Glaucoma Intervention Study (AGIS), Collaborative Initial Glaucoma Treatment Study (CITGS) and Collaborative Normal Tension Glaucoma Study (CNGTS) are often named as landmarks for glaucoma management as the results of these studies provided the evidence for numerous therapeutic decisions in clinical practice. The studies confirmed the consensus that reduction of intraocular pressure reduces the risk of glaucoma progression covering the whole spectrum of glaucoma from ocular hypertension to advanced glaucoma. Furthermore, the identification of new risk factors allows a higher precision of assessment of the risk of progression. The RCTs achieved the main goal of high level of evidence, thus making progress in the understanding of glaucoma and its treatment and bridging consensus-based and evidence-based decisions. However, the implementation of the results into clinical practice needs adequate and accurate interpretation of the results.

  3. A novel approach to glaucoma screening and education in Nepal

    Directory of Open Access Journals (Sweden)

    Rens Ger V

    2008-10-01

    Full Text Available Abstract Background Glaucoma is a major cause of blindness worldwide and an increasingly significant global health problem. Glaucoma prevention and management efforts have been challenging due to inherent difficulty in developing a simple and cost-effective screening plan, limited access to health care and educational resources, poverty, and inadequate knowledge of the disease, particularly in developing countries. Starting in 2004 the Tilganga Eye Centre in Kathmandu, Nepal has provided targeted glaucoma screening, treatment, and education through a combination of clinical outreach programs and educational activities for patients. Methods A simple, age-based glaucoma screening algorithm was incorporated into three one-day cataract screening clinics. Using this algorithm, patients who were newly diagnosed with glaucoma were referred to TEC, where medication and surgery were provided free of charge through private donor funding. In addition, we describe two ongoing educational programs for increasing glaucoma awareness: an annual Glaucoma Awareness Week (which includes free screening, treatment, and counseling, and a repeating lecture series which generates new counselors. Results From 2004 to 2007 screening at the annual Glaucoma Awareness Week resulted in the diagnosis of 120 individuals with glaucoma, or 7.6% of total registrants. Attendance increased annually with a trend toward an increasing number of returning patients but a decreasing percentage of newly diagnosed patients, though the absolute numbers have remained relatively stable (range 21 to 38. Data from the three one-day screening clinics in 2006 show that approximately 2 to 4% of patients 50 years of age or older per clinic were newly diagnosed with POAG. Conclusion This multi-faceted approach appears to successfully identify individuals with glaucoma and provide treatment to those who would otherwise not be able to afford it. While more data is needed to validate this model

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma

    Science.gov (United States)

    Yilmaz, Necat; Coban, Deniz Turgut; Bayindir, Asli; Erol, Muhammet Kazim; Ellidag, Hamit Yasar; Giray, Ozlem; Sayrac, Suha; Tekeli, Seckin Ozgur; Eren, Esin

    2016-01-01

    This study entailed a cross-examination of oxidant/antioxidant balance, high-density lipoprotein (HDL)-linked paraoxonase 1 (PON1) phenotypes, and levels of serum routine lipids among patients with normal tension glaucoma (NTG) or pseudoexfoliative glaucoma (PEXG) compared with healthy control groups. We aimed to investigate the links between oxidative stress (OS), HDL-related antioxidant enzyme activities and dyslipidemia in distinct subtypes of glaucoma. The study included 32 patients with NTG, 31 patients with PEXG, and 40 control subjects. Levels of PON1 and arylesterase enzymatic activity, total oxidant status (TOS), and total antioxidant status were measured by spectrophotometry and OS indexes (OSI) were calculated. The phenotype distribution of PON1 was determined using the dual substrate method. Blood serum levels of HDL, low-density lipoprotein, total cholesterol (TC), and triglyceride (TG) were measured. The TOS and OSI values in the NTG group were significantly higher compared with the other groups (both p < 0.01). The phenotype distribution found in the glaucoma and control groups were NTG: QQ, 59.4%; QR, 37.5%; RR, 3.1%; PEXG: QQ, 45.1%; QR, 48.4%; RR, 6.5%; and in the control group: QQ, 42.5%; QR, 50.0%; RR, 7.5%. Serum TC levels were significantly higher than the control in both NTG and PEXG groups, whereas TG was significantly higher in NTG only (p < 0.01 and p < 0.02, respectively). Hyperlipidemia, OS and variations in phenotype distribution of PON1 may play a role in the pathogenesis of different types of glaucoma. PMID:26773174

  6. Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma

    Directory of Open Access Journals (Sweden)

    Necat Yilmaz

    2016-01-01

    Full Text Available This study entailed a cross-examination of oxidant/antioxidant balance, high-density lipoprotein (HDL-linked paraoxonase 1 (PON1 phenotypes, and levels of serum routine lipids among patients with normal tension glaucoma (NTG or pseudoexfoliative glaucoma (PEXG compared with healthy control groups. We aimed to investigate the links between oxidative stress (OS, HDL-related antioxidant enzyme activities and dyslipidemia in distinct subtypes of glaucoma. The study included 32 patients with NTG, 31 patients with PEXG, and 40 control subjects. Levels of PON1 and arylesterase enzymatic activity, total oxidant status (TOS, and total antioxidant status were measured by spectrophotometry and OS indexes (OSI were calculated. The phenotype distribution of PON1 was determined using the dual substrate method. Blood serum levels of HDL, low-density lipoprotein, total cholesterol (TC, and triglyceride (TG were measured. The TOS and OSI values in the NTG group were significantly higher compared with the other groups (both p < 0.01. The phenotype distribution found in the glaucoma and control groups were NTG: QQ, 59.4%; QR, 37.5%; RR, 3.1%; PEXG: QQ, 45.1%; QR, 48.4%; RR, 6.5%; and in the control group: QQ, 42.5%; QR, 50.0%; RR, 7.5%. Serum TC levels were significantly higher than the control in both NTG and PEXG groups, whereas TG was significantly higher in NTG only (p < 0.01 and p < 0.02, respectively. Hyperlipidemia, OS and variations in phenotype distribution of PON1 may play a role in the pathogenesis of different types of glaucoma.

  7. Heterozygote Wdr36-deficient mice do not develop glaucoma.

    Science.gov (United States)

    Gallenberger, Martin; Kroeber, Markus; März, Loreen; Koch, Marcus; Fuchshofer, Rudolf; Braunger, Barbara M; Iwata, Takeshi; Tamm, Ernst R

    2014-11-01

    There is an ongoing controversy regarding the role of WDR36 sequence variants in the pathogenesis of primary open-angle glaucoma (POAG). WDR36 is a nucleolar protein involved in the maturation of 18S rRNA. The function of WDR36 is essential as homozygous Wdr36-deficient mouse embryos die before reaching the blastocyst stage. Here we provide a detailed analysis of the phenotype of heterozygous Wdr36-deficient mice. Loss of one Wdr36 allele causes a substantial reduction in the expression of Wdr36 mRNA. In the eyes of Wdr36(+/-) animals, the structure of the tissues involved in aqueous humor circulation and of the optic nerve head are not different from that of control littermates. In addition, one-year-old Wdr36(+/-) animals do not differ from wild-type animals with regards to intraocular pressure and number of optic nerve axons. The susceptibility of retinal ganglion cells to excitotoxic damage induced by NMDA is similar in Wdr36(+/-) and wild-type animals. Moreover, the amount of optic nerve axonal damage induced by high IOP is not different between Wdr36(+/-) and wild-type mice. Transgenic overexpression of mutated Del605-607 Wdr36 in Wdr36(+/-) animals does not cause changes in the number of optic nerve axons or susceptibility to excitotoxic damage. In addition, analysis of 18S rRNA maturation in Del605-607 Wdr36(+/-) or Wdr36(+/-) mice does not show obvious differences in rRNA processing or in the amounts of precursor forms when compared to wild-type animals. Our data obtained in Wdr36(+/-) mice do not support the assumption of a causative role for WDR36 in the pathogenesis of POAG. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Cost-Effectiveness of Monitoring Glaucoma Patients in Shared Care: an Economic Evaluation alongside a Randomized Controlled Trial

    NARCIS (Netherlands)

    Holtzer-Goor, K.M.; van Sprundel, E.; Lemij, H.G.; Plochg, T.; Klazinga, N.S.; Koopmanschap, M.A.

    2010-01-01

    ABSTRACT: BACKGROUND: Population aging increases the number of glaucoma patients which leads to higher workloads of glaucoma specialists. If stable glaucoma patients were monitored by optometrists and ophthalmic technicians in a glaucoma follow-up unit (GFU) rather than by glaucoma specialists, the

  9. Cost-effectiveness of monitoring glaucoma patients in shared care: An economic evaluation alongside a randomized controlled trial

    NARCIS (Netherlands)

    K.M. Holtzer-Goor (Kim); E. van Sprundel (Esther); H.G. Lemij (Hans); T. Plochg; N.S. Klazinga (Niek); M.A. Koopmanschap (Marc)

    2010-01-01

    textabstractBackground. Population aging increases the number of glaucoma patients which leads to higher workloads of glaucoma specialists. If stable glaucoma patients were monitored by optometrists and ophthalmic technicians in a glaucoma follow-up unit (GFU) rather than by glaucoma specialists, th

  10. A novel implantable glaucoma valve using ferrofluid.

    Directory of Open Access Journals (Sweden)

    Eleftherios I Paschalis

    Full Text Available PURPOSE: To present a novel design of an implantable glaucoma valve based on ferrofluidic nanoparticles and to compare it with a well-established FDA approved valve. SETTING: Massachusetts Eye & Ear Infirmary, Boston, USA. METHODS: A glaucoma valve was designed using soft lithography techniques utilizing a water-immiscible magnetic fluid (ferrofluid as a pressure-sensitive barrier to aqueous flow. Two rare earth micro magnets were used to calibrate the opening and closing pressure. In-vitro flow measurements were performed to characterize the valve and to compare it to Ahmed™ glaucoma valve. The reliability and predictability of the new valve was verified by pressure/flow measurements over a period of three months and X-ray diffraction (XRD analysis over a period of eight weeks. In vivo assessment was performed in three rabbits. RESULTS: In the in vitro experiments, the opening and closing pressures of the valve were 10 and 7 mmHg, respectively. The measured flow/pressure response was linearly proportional and reproducible over a period of three months (1.8 µl/min at 12 mmHg; 4.3 µl/min at 16 mmHg; 7.6 µl/min at 21 mmHg. X-ray diffraction analysis did not show oxidization of the ferrofluid when exposed to water or air. Preliminary in vivo results suggest that the valve is biocompatible and can control the intraocular pressure in rabbits. CONCLUSIONS: The proposed valve utilizes ferrofluid as passive, tunable constriction element to provide highly predictable opening and closing pressures while maintaining ocular tone. The ferrofluid maintained its magnetic properties in the aqueous environment and provided linear flow to pressure response. Our in-vitro tests showed reliable and reproducible results over a study period of three months. Preliminary in-vivo results were very promising and currently more thorough investigation of this device is underway.

  11. Glaucoma detection with damato multifixation campimetry online

    DEFF Research Database (Denmark)

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

    2016-01-01

    Purpose To evaluate Damato Multifixation Campimetry Online (DMCO), a free-of-charge internet-based visual field test. DMCO exists in three versions: DMCO BASIC, DMCO STANDARD, and DMCO ADVANCED. The main focus was (i) to investigate the sensitivity and the specificity of the existing DMCO versions...... 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...

  12. The Role of the IL-20 Subfamily in Glaucoma

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    Mary K. Wirtz

    2016-01-01

    Full Text Available Glaucoma is a common disease that leads to loss of peripheral vision and, if left untreated, ultimately to blindness. While the exact cause(s of glaucoma is still unknown, two leading risk factors are age and elevated intraocular pressure. Several studies suggest a possible link between glaucoma and inflammation in humans and animal models. In particular, our lab recently identified a T104M mutation in IL-20 receptor-B (IL-20RB in primary open angle glaucoma patients from a large pedigree. Several of the interleukin- (IL- 20 family of cytokines and receptors are expressed in ocular tissues including the trabecular meshwork, optic nerve head, and retinal ganglion cells. The DBA/2J mouse develops high intraocular pressures with age and has characteristic optic nerve defects that make it a useful glaucoma model. IL-24 expression is significantly upregulated in the retina of these mice, while IL-20RA expression in the optic nerve is downregulated following pressure-induced damage. The identification of a mutation in the IL-20RB gene in a glaucoma pedigree and changes in expression levels of IL-20 family members in the DBA/2J mouse suggest that disruption of normal IL-20 signaling in the eye may contribute to degenerative processes associated with glaucoma.

  13. Glaucoma and mobility performance: the Salisbury Eye Evaluation Project.

    Science.gov (United States)

    Friedman, David S; Freeman, Ellen; Munoz, Beatriz; Jampel, Henry D; West, Sheila K

    2007-12-01

    To determine the impact of glaucoma on mobility in a population-based cohort. Population-based observational study. Persons examined as part of a population-based eye disease study. Subjects performed a series of tasks, including walking an obstacle course, climbing stairs, performing tandem stands, and walking a 4-meter course. Persons with glaucoma were compared with those without glaucoma to identify differences in mobility. Speed to complete an obstacle course, number of bumps, ability to perform tandem stands, and walking and stair climbing speed. One thousand two hundred fifty subjects participated in the study. In an analysis adjusting for age, race, and gender, walking speed through the obstacle course was 2.4 m/minute slower for persons with bilateral glaucoma, and these individuals experienced 1.65 times the number of bumps when compared with persons without glaucoma (Pwalking course more slowly and had more bumps even after adjusting for use of a mobility aid, comorbidities, and VA. After adjusting for all other factors, persons with bilateral glaucoma walked on average 2.4 m less per minute through the course than those without glaucoma.

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

    Directory of Open Access Journals (Sweden)

    Francesca Di Murro

    2016-12-01

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

  15. 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

  16. Modeling Human Glaucoma: Lessons from the in vitro Models.

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    Aires, Inês Dinis; Ambrósio, António Francisco; Santiago, Ana Raquel

    2017-01-01

    Glaucoma, a leading cause of blindness worldwide, is a degenerative disease characterized by retinal ganglion cell (RGC) loss and optic nerve atrophy. Elevated intraocular pressure (IOP) is a main risk factor for onset and progression of the disease. Since increased IOP is the only modifiable risk factor, relevant models for glaucoma would comprise RGC and optic nerve damage triggered by ocular hypertension. Animal models of glaucoma have greatly contributed to the understanding of the molecular mechanisms of this pathology, and they have also facilitated the development of new pharmacological interventions. Although animal models of glaucoma have provided valuable information about the disease, there is still no ideal model for studying glaucoma due to its complexity. There is a recognized demand for in vitro models that can replace or reduce the need for animal experiments. Several in vitro models have emerged as a great opportunity in the field of glaucoma research, helping to clarify the mechanisms involved in disease progression. Several types of equipment have been developed to expose cells and tissue cultures to elevated pressures. Herein, we discuss the methodology used to increase pressure, the main findings, and the relevance of in vitro models for the study of the pathophysiology of glaucoma.

  17. 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

  18. 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

  19. Neovascularization in canine mammary carcinoma – a case report

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    Alexandra Irimie

    2016-11-01

    Full Text Available The frequency of mammary tumors in canines is three times higher than in women. Contrast enhanced ultrasonography (CEUS is a noninvasive clinical method, that uses special contrast agents (CAs, their role being to layout the microvasculature of different lesions. The aim of this particular method, in this case, was to establish if we can evaluate the malignancy of a mass, given the fact that neovascularization is a malignancy marker. The case is represented by a Silky Terrier breed female dog, 5 years old, that was presented initially with an enlarged polycystic mammary gland and a nervous lactation. The female was initially diagnosed with polycystic mastosis. After 2 more months the mass became denser and enlarged. Before the ovariohisterectomy and unilateral mastectomy surgeries have taken place, a B-Mode standard ultrasound, CEUS and a pulmonary X-ray were performed. Our results integrate this case in “fast in” and “slow in” (type 2 curve. The histological diagnosis was established as a simple cystic papillary carcinoma with a malignancy grade 2. The mean value of the MVD was 13.75 which is a low MVD. We cannot determine a correlation between CEUS and a tumor’s malignancy, and so further studies are needed.

  20. Overload and neovascularization of shoulder tendons in volleyball players

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    Notarnicola Angela

    2012-08-01

    Full Text Available Abstract Background In overhead sports like volleyball, the onset of a rotator cuff tendinopathy due to functional overload is a common observation. An angiofibroblastic etiopathogenesis has been hypothesized, whereby a greater anaerobic metabolism occurs in critical zones of the tendon with a lower degree of vascularization; this would induce collagen and extracellular matrix degradation, that could then trigger a compensatory neovascularization response. We performed a clinical observational study of 80 elite volleyball players, monitoring the perfusion values of the supraspinatus tendons by oximetry. Results No statistically significant differences were found between the oximetry data and age, sex or years of sports activity, nor when comparing the right and left arm or the dominant and non-dominant arm. A statistically significant difference was found for the dominant arm values in relation to the competitive role, higher values being obtained in outside hitters (62.7% than middle hitters (53.7% (p = 0.01, opposite hitters (55.5% (p = 0.02 and libero players (54.4% (p = 0.008, whereas there were no differences in setters (56.2% (p > 0.05. Conclusions The different tendon vascularization values found in players with different roles in the team may be attributed to a response to the specific biomechanical demands posed by the different overhead throwing roles.

  1. Segmentation of choroidal neovascularization in fundus fluorescein angiograms.

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    Abdelmoula, Walid M; Shah, Syed M; Fahmy, Ahmed S

    2013-05-01

    Choroidal neovascularization (CNV) is a common manifestation of age-related macular degeneration (AMD). It is characterized by the growth of abnormal blood vessels in the choroidal layer causing blurring and deterioration of the vision. In late stages, these abnormal vessels can rupture the retinal layers causing complete loss of vision at the affected regions. Determining the CNV size and type in fluorescein angiograms is required for proper treatment and prognosis of the disease. Computer-aided methods for CNV segmentation is needed not only to reduce the burden of manual segmentation but also to reduce inter- and intraobserver variability. In this paper, we present a framework for segmenting CNV lesions based on parametric modeling of the intensity variation in fundus fluorescein angiograms. First, a novel model is proposed to describe the temporal intensity variation at each pixel in image sequences acquired by fluorescein angiography. The set of model parameters at each pixel are used to segment the image into regions of homogeneous parameters. Preliminary results on datasets from 21 patients with Wet-AMD show the potential of the method to segment CNV lesions in close agreement with the manual segmentation.

  2. Overload and neovascularization of shoulder tendons in volleyball players

    Science.gov (United States)

    2012-01-01

    Background In overhead sports like volleyball, the onset of a rotator cuff tendinopathy due to functional overload is a common observation. An angiofibroblastic etiopathogenesis has been hypothesized, whereby a greater anaerobic metabolism occurs in critical zones of the tendon with a lower degree of vascularization; this would induce collagen and extracellular matrix degradation, that could then trigger a compensatory neovascularization response. We performed a clinical observational study of 80 elite volleyball players, monitoring the perfusion values of the supraspinatus tendons by oximetry. Results No statistically significant differences were found between the oximetry data and age, sex or years of sports activity, nor when comparing the right and left arm or the dominant and non-dominant arm. A statistically significant difference was found for the dominant arm values in relation to the competitive role, higher values being obtained in outside hitters (62.7%) than middle hitters (53.7%) (p = 0.01), opposite hitters (55.5%) (p = 0.02) and libero players (54.4%) (p = 0.008), whereas there were no differences in setters (56.2%) (p > 0.05). Conclusions The different tendon vascularization values found in players with different roles in the team may be attributed to a response to the specific biomechanical demands posed by the different overhead throwing roles. PMID:22853746

  3. Stereotactic radiotherapy in neovascular age-related macular degeneration

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    Ranjbar, Mahdy; Kurz, Maximilian; Holzhey, Annekatrin; Melchert, Corinna; Rades, Dirk; Grisanti, Salvatore

    2016-01-01

    Abstract Stereotactic radiotherapy (SRT) is a new approach to treat neovascular age-related macular degeneration (nAMD). The INTREPID trial suggested that SRT could reduce the frequency of regular intravitreal injections (IVIs) with antivascular endothelial growth factor drugs, which are necessary to control disease activity. However, the efficacy of SRT in nAMD and resulting morphological changes have not been validated under real-life circumstances, an issue, which we would like to address in this retrospective analysis. Patients who met the INTREPID criteria for best responders were eligible for SRT. A total of 32 eyes of 32 patients were treated. Thereafter, patients were examined monthly for 12 months and received pro re nata IVI of aflibercept or ranibizumab. Outcome measures were: mean number of injections, best-corrected visual acuity, and morphological changes of the outer retina-choroid complex as well as patient safety. Mean number of IVI decreased by almost 50% during the 12 months after SRT compared to the year before, whereas visual acuity increased by one line (logMAR). Morphological evaluation showed that most changes affect outer retinal layers. Stereotactic radiotherapy significantly reduced IVI retreatment in nAMD patients under real-life circumstances. Therefore, SRT might be the first step to stop visual loss as a result of IVI undertreatment, which is a major risk. PMID:28033280

  4. Early detection of choroidal neovascularization in age related macular degeneration

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    Tural Galbinur

    2012-01-01

    Full Text Available Purpose: to identify factors associated with early detection of choroidal neovascularization CNV in clinical practice.Methods: Seventy six AMD patients who had history of CNV in one eye and presented with CNV in the second eye and evaluated for association with visual acuity (VA at time of presentation. Demographics, clinical data and lesion characteristics were retrospectively collected.Results: Better VA was associated with history of CNV in the fellow eye (p<0.0001, adherence to follow-up every four-months (p=0.015, younger age (p=0.03, smaller lesion (p<0.0001, and non-subfoveal localization (p=0.048. VA of the fellow eye did not correlate with VA at presentation with CNV.Conclusion: these data suggest that experience of CNV, regardless of VA, facilitates early diagnosis in the fellow eye. Adherence to follow-up in the routine clinic setting also facilitates early detection of CNV.

  5. The Risk of glaucoma after early bilateral oophorectomy

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    Vajaranant, Thasarat S.; Grossardt, Brandon R.; Maki, Pauline M.; Pasquale, Louis R.; Sit, Arthur J.; Shuster, Lynne T.; Rocca, Walter A.

    2013-01-01

    Objective Because early estrogen deficiency may increase the susceptibility of the optic nerve to glaucoma, we studied the association of early bilateral oophorectomy with glaucoma. Methods We studied the risk of glaucoma in the Mayo Clinic Cohort Study of Oophorectomy and Aging, by comparing all women who underwent bilateral oophorectomy from 1950 to 1987 with age-matched referent women who did not undergo unilateral or bilateral oophorectomy. Glaucoma diagnostic codes were searched in the records-linkage system of the Rochester Epidemiology Project. Hazards ratios (HR) were calculated over a median follow-up of 25.5 years. Analyses were stratified by age at the time of bilateral oophorectomy (in tertiles). Results Of 1,044 women who underwent bilateral oophorectomy before menopause, 147 developed glaucoma. Of 1,070 referent women, 133 developed glaucoma. Women who underwent bilateral oophorectomy showed no increased risk of glaucoma in the overall group (HR 1.12, 95% CI 0.89–1.42). However, women who underwent oophorectomy before age 43 years (n=344; the first tertile) had a significantly increased risk of glaucoma (HR 1.60, 95% CI 1.15–2.23). The results did not change after adjustment for hypertension, obesity, diabetes, or disorders of lipid metabolism at baseline. Approximately 11% of women with bilateral oophorectomy before age 43 years were treated with estrogen to age 50 years; however, treatment did not reduce the association (HR 1.59, 95% CI 0.81–3.13). Conclusions Bilateral oophorectomy before age 43 years may increase the risk of glaucoma, and estrogen treatment does not appear to attenuate the risk. PMID:24061049

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

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    Ya Xing Wang

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

  7. Research advances on multifocal electroretinogram in primary open angle glaucoma

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    Feng-Fei Mo

    2013-10-01

    Full Text Available Primary open angle glaucoma is a chronic and progressive optic neuropathy. It can lead to serious damage of visual impairment, and it is an important eye disease of blindness. Multifocal electroretinogram is a new way to measure visual electrophysiology. It can measure electroretinogram of the whole visual field of many small parts in a relatively short period of time, and it can reflect the function of regional retina. It has an extremely important value for early diagnosis of primary open angle glaucoma. The research advances on multifocal electroretinogram in diagnosing primary open angle glaucoma were summarized in this paper.

  8. Central retinal artery occlusion (reversible in sickle trait with glaucoma.

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    Radius, R L; Finkelstein, D

    1976-01-01

    We report a case of central retinal artery occlusion in an 18-year-old black woman with sickle-trait haemoglobinopathy and acute glaucoma after hyphaema. The central retinal artery occlusion occurred immediately after treatment of the glaucoma with osmotic agents, raising the possibility that they played a precipitating role. We suggest that osmotic agents be used with extreme caution in sickle patients with glaucoma. The occlusion was treated by anterior chamber paracentesis with eventual return of good vision. The reversibility of retinal and optic nerve function after total ischaemia is discussed. PMID:952815

  9. Aniridia associated with congenital aphakia and secondary glaucoma

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    Moreker Mayur

    2009-01-01

    Full Text Available We report a case of aniridia associated with congenital aphakia and secondary glaucoma. A 35-year-old male presented with aniridia, congenital aphakia and secondary glaucoma in both eyes. After an unsuccessful medical management, he underwent trabeculectomy with mitomycin C and anterior vitrectomy under local anesthesia in his left eye. Postoperatively, at the end of six months, intraocular pressure (IOP in his left eye was controlled without medications. This case highlights the rare association of aniridia with congenital aphakia and secondary glaucoma.

  10. [Progress of research on quality of life of glaucoma patients].

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    Xi, Shu-Xin; Guo, Wen-Yi

    2009-01-01

    Glaucoma is a kind of long life disease characterized by irreversible optic nerve damage, visual field impairment, and visual acuity loss. Both the disease and its medical management could make the patient perceive difficulties in their daily life activities and social function. Therefore, their quality of life would be affected significantly. This report briefly reviews the recent researches on the quality of life and its influencing factors of glaucoma patients. The researches on how to improve the quality of life of glaucoma patients are also reviewed.

  11. Canaloplasty versus Viscocanalostomy in Primary Open Angle Glaucoma

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    Wagdy, Faried Mohammed

    2017-01-01

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

  12. Perioperative management of anticoagulant users scheduled for glaucoma surgery: a survey among the Brazilian Glaucoma Society members

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    Marcos Balbino

    2013-12-01

    Full Text Available PURPOSE: To investigate and describe, among the members of the Brazilian Glaucoma Society (BGS, the practices regarding the perioperative management of anticoagulants (warfarin and aspirin use in patients scheduled for glaucoma surgery. METHODS: The active members of the Brazilian Glaucoma Society answered a questionnaire evaluating different aspects of their current perioperative management of glaucomatous patients taking warfarin or aspirin. RESULTS: A total of 52 participants returned a complete questionnaire. Warfarin or aspirin was routinely interrupted prior to glaucoma surgery by 82.7% of the respondents. The majority of the surgeons who discontinued these medications reported doing so 7 days prior to surgery and resumed their use the day after the procedure. Almost half of our interviewees reported hemorrhagic complications that could be related to anticoagulant therapy. A large number of the surgeons (86.5% preferred a particular surgical technique for anticoagulated patients; however, most of them (88.5% do not change the anesthetic planning in such patients. Finally, the majority of the participants (90.4% refer their anticoagulated patients to a preoperative appointment with a cardiologist or a general practitioner before the surgery. CONCLUSIONS: The majority of Brazilian Glaucoma Society members participating in this study interrupt either warfarin or aspirin prior to glaucoma surgery. Although there is scant information available in the literature to offer definitive guidance, most participants from the Brazilian Glaucoma Society seem to share the same opinion when it comes to perioperative management of anticoagulant users.

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

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    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.

  14. The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy

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    Raza Syed A

    2009-12-01

    Full Text Available Abstract Background Shoulder dysfunction is common and pathology of the rotator cuff tendons and subacromial bursa are considered to be a major cause of pain and morbidity. Although many hypotheses exist there is no definitive understanding as to the origin of the pain arising from these structures. Research investigations from other tendons have placed intra-tendinous neovascularity as a potential mechanism of pain production. The prevalence of neovascularity in patients with a clinical diagnosis of rotator cuff tendinopathy is unknown. As such the primary aim of this pilot study was to investigate if neovascularity could be identified and to determine the prevalence of neovascularity in the rotator cuff tendons and subacromial bursa in subjects with unilateral shoulder pain clinically assessed to be rotator cuff tendinopathy. The secondary aims were to investigate the association between the presence of neovascularity and pain, duration of symptoms, and, neovascularity and shoulder function. Methods Patients with a clinical diagnosis of unilateral rotator cuff tendinopathy referred for a routine diagnostic ultrasound (US scan in a major London teaching hospital formed the study population. At referral patients were provided with an information document. On the day of the scan (on average, at least one week later the patients agreeing to participate were taken through the consent process and underwent an additional clinical examination prior to undergoing a bilateral grey scale and colour Doppler US examination (symptomatic and asymptomatic shoulder using a Philips HDI 5000 Sono CT US machine. The ultrasound scans were performed by one of two radiologists who recorded their findings and the final assessment was made by a third radiologist blinded both to the clinical examination and the ultrasound examination. The findings of the radiologists who performed the scans and the blinded radiologist were compared and any disagreements were resolved

  15. Implementation studies of ranibizumab for neovascular age-related macular degeneration.

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    Bloch, Sara Brandi

    2013-11-01

    The pathogenesis of AMD is associated with age changes plus pathological changes involving oxidative stress and an altered inflammatory response leading to injury of retinal pigment epithelial cells and the adjacent choroidea and photoreceptor cells. AMD is divided into early, intermediate and advanced AMD. The advanced form of AMD is further divided into non-neovascular AMD and neovascular AMD. The diagnosis of neovascular AMD is based on FA and clinical characteristics of the eyes. The CNV lesions are by their growth pattern divided into type 1 CNV lesions, which grow primarily beneath the RPE, and type 2 CNV lesions, which have penetrated the RPE and evolve within the subretinal space. The natural course of neovascular AMD leads to visual disability in a majority of cases within the first years after onset, primarily caused by the development of subfoveal fibrous tissue and atrophy of the RPE. The prognosis of visual acuity in neovascular AMD has been markedly improved by the introduction of an intravitreal administered VEGF inhibitor (ranibizumab) given on a monthly basis. Treatment with ranibizumab for neovascular AMD was introduced in Denmark in 2006 under a fully reimbursed national healthcare plan. Treatment with ranibizumab is given in a variable dosing regimen that varies from the monthly dosing regimen administered in the studies that led to the approval of ranibizumab for neovascular AMD in Europe. The main objectives of this PhD thesis were to evaluate and potentially improve treatment with ranibizumab in a variable OCT guided regimen for neovascular AMD. Another intension of this PhD thesis was to prepare the conditions for future research to further improve the visual prognosis in neovascular AMD treated with anti-VEGF agents. The first study revealed that vision was improved in eyes with active neovascular AMD treated for 1 year in a variable ranibizumab treatment regimen as compared to PDT and the natural course of the disease. We assumed by

  16. Profile of pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital

    Institute of Scientific and Technical Information of China (English)

    Fang Yuan; Long Qingqing; Guo Wenyi; Sun Xinghuai

    2014-01-01

    Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited.To better characterize the epidemiology of pediatric glaucoma in eastern China,we report the clinical profile,etiologies,and treatment modalities in patients <18 years of age in Shanghai Eye,Ear,Nose and Throat Hospital.Methods The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed.The demographic characteristics,the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed.Results A total of 1 142 eyes of 734 pediatric patients (500 males)were included.Congenital glaucoma was the leading subtype,accounting for 47.55% of all patients.The ratio of boys to girls was 2.5:1.Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined.Patients with primary juvenile glaucoma were the second most common group (n=125,17.03%).Traumatic glaucoma was the third most common subtype (n=81,11.03%).The type of surgery was related to the subtype of glaucoma.Conclusions Congenital glaucoma,primary juvenile glaucoma,and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye,Ear,Nose and Throat Hospital.The characteristics of congenital glaucoma in China are similar to those in Western countries.

  17. Surgical Treatment of Canine Glaucoma: Filtering and End-Stage Glaucoma Procedures.

    Science.gov (United States)

    Maggio, Federica; Bras, Dineli

    2015-11-01

    Canine glaucoma is a common cause of vision loss associated with raised intraocular pressure, and leads to damage of the retina and optic nerve head. In most cases, medical treatment alone cannot provide long-term management of intraocular pressure control and preservation of vision. Surgical intervention is usually recommended to either decrease aqueous humor production, or increase its outflow. Among the current available procedures, filtering techniques are aimed at increasing aqueous humor outflow. Proper surgical timing and a combination of cyclodestructive and filtering procedures have been recently suggested to improve the long-term success of surgical treatment in dogs. Bleb fibrosis and surgical failure are still common occurrences in filtration surgery with relapse of glaucoma and vision loss. End stage procedures, such as enucleation, evisceration with intrascleral prosthesis, and chemical ablation of the ciliary bodies are then recommended to address chronic discomfort in buphthalmic and blind eyes.

  18. Bilateral Hypertensive Retinopathy Complicated with Retinal Neovascularization: Panretinal Photocoagulation or Intravitreal Anti-VEGF Treatment

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    Odysseas Georgiadis

    2014-07-01

    Full Text Available Purpose: To present the case of a patient with bilateral hypertensive retinopathy complicated with retinal neovascularization who received anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP in the fellow eye. Methods: A 33-year-old male patient presented with gradual visual loss in both eyes for the last 5 months. At that time, he was examined by an ophthalmologist and occlusive retinopathy due to malignant systematic hypertension was diagnosed. He was put on antihypertensive treatment but no ophthalmic treatment was undertaken. At presentation, 5 months later, best-corrected visual acuity (BCVA was 0.1 in the right eye (RE and 0.9 in the left eye (LE. Fundus examination was compatible with hypertensive retinopathy complicated with retinal neovascularization. Fluorescein angiography (FFA revealed macular ischemia mainly in the RE and large areas of peripheral retinal ischemia and neovascularization with vascular leakage in both eyes. The patient was treated with two anti-VEGF (ranibizumab injections with 2 months interval in the RE and PRP laser in the LE. Results: Follow-up examination after 12 months showed mild improvement in BCVA, and FFA documented regression of retinal neovascularization in both eyes. Conclusion: Hypertensive retinopathy can be rarely complicated with retinal neovascularization. Treatment with PRP can be undertaken. In our case, the use of an intravitreal anti-VEGF agent seemed to halt its progression satisfactorily.

  19. Resistance to anti-VEGF therapy in neovascular age-related macular degeneration: a comprehensive review.

    Science.gov (United States)

    Yang, Shiqi; Zhao, Jingke; Sun, Xiaodong

    2016-01-01

    As a progressive chronic disease, age-related macular degeneration (AMD) is the leading cause of irreversible vision impairment worldwide. Experimental and clinical evidence has demonstrated that vascular endothelial growth factor (VEGF) plays a vital role in the formation of choroidal neovascularization. Intravitreal injections of anti-VEGF agents have been recommended as a first-line treatment for neovascular AMD. However, persistent fluid or recurrent exudation still occurs despite standardized anti-VEGF therapy. Patients suffering from refractory or recurrent neovascular AMD may develop mechanisms of resistance to anti-VEGF therapy, which results in a diminished therapeutic effect. Until now, there has been no consensus on the definitions of refractory neovascular AMD and recurrent neovascular AMD. This article aims at clarifying these concepts to evaluate the efficacy of switching drugs, which contributes to making clinical decision more scientifically. Furthermore, insight into the causes of resistance to anti-VEGF therapy would be helpful for developing possible therapeutic approaches, such as combination therapy and multi-target treatment that can overcome this resistance.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. MYOCILIN LEVELS IN PRIMARY OPEN-ANGLE GLAUCOMA AND PSEUDOEXFOLIATION GLAUCOMA HUMAN AQUEOUS HUMOR

    Science.gov (United States)

    Howell, Kyle G.; Vrabel, Anne M.; Chowdhury, Uttio Roy; Stamer, W. Daniel; Fautsch, Michael P.

    2010-01-01

    Purpose To determine the concentration of myocilin in primary open-angle and pseudoexfoliation glaucoma aqueous humor. Methods Aqueous humor was collected during surgery from patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PEXG), and elective cataract removal (control). Volume-equivalent aqueous samples were separated on SDS-PAGE gradient gels. Quantification of myocilin levels was performed using Western blots probed with two independent N-terminal polyclonal anti-myocilin antibodies (AB1 and AB2) followed by densitometry. Myocilin levels in aqueous humor were quantified by plotting the densitometry readings of the aqueous samples against a recombinant myocilin standard curve. Total protein concentration was determined by Bradford protein assay. Transforming growth factor beta 2 (TGFβ2) levels were assessed by ELISA. Results Myocilin levels are significantly elevated in human POAG aqueous humor when compared to control aqueous humor (AB1: 0.66 ± 0.53 ng/μl vs. 0.23 ± 0.20 ng/μl, phumor compared to control aqueous (AB1: 0.26 ± 0.20% vs. 0.10 ± 0.20%, phumor when compared to control aqueous humor. No correlation between myocilin and TGFβ2 levels was observed. Conclusions Myocilin is elevated in POAG, but not PEXG aqueous humor. PMID:20179615

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Ganglion cell death in glaucoma: from mice to men.

    Science.gov (United States)

    Nickells, Robert W

    2007-01-01

    Glaucoma results from the degeneration of retinal ganglion cells and their axons. Over the last 20 years several important advancements have been made in our understanding of the molecular pathology of this disease, particularly through the development of rat models of experimental glaucoma and the characterization of a spontaneous secondary form of glaucoma in DBA/2 substrains of inbred mice. One of these advances is the observation that ganglion cells die by apoptosis, an intrinsic molecular pathway of programmed cell death. An important aspect of this cell death process is the concept that these cells actually undergo compartmentalized self-destruction. Importantly, genetic evidence now suggests that axons die independently of the apoptotic program that executes the cell body or soma. This review briefly summarizes some of the most significant developments in glaucoma research, with respect to the process of ganglion cell degeneration.

  5. A link between diabetes mellitus and glaucoma - Danish Nationwide Study

    DEFF Research Database (Denmark)

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

    Purpose To determine the effect of anti-diabetic medication on glaucoma. Furthermore, to investigate if diabetic comorbidities and concomitant medications are associated with glaucoma in patients treated with anti-diabetic medication. Methods Retrospective nationwide cohort study, spanning a 16......-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...... and the Danish National Patient Register. Results A total of 6,343,747 individuals in the period 1996–2012 were included. The overall incidence rates of new-onset glaucoma were 0.07 and 0.36 per 1,000 person-years for the reference population and for diabetes mellitus, respectively. Patients treated with anti...

  6. [Glaucoma therapy - current overview of data and information].

    Science.gov (United States)

    Výborný, P; Sičáková, S; Dohnalová, P; Feřtek, M; Doležal, T

    2013-08-01

    The authors submit the overview of the actual situation in the glaucoma therapy. They follow up the trends in antiglaucomatic treatment in the last period including financial aspects of medicament and surgical treatment. Attention is paid especially to medicaments management, actual overview of available antiglaucomatic drugs, function and position of generic drugs and differences among them, the daily dose of benzalconium chloride in glaucoma treatment, actual average of patients supplementary payments at the drug purchase in the pharmacy, surgical treatment costs and legal issues. Pharmacologists viewpoints and the Czech State Drug Control Authority (SÚKL) opinions complete the professionals point of the view and facilitate his/her complete orientation in glaucoma therapy issues. Key words: glaucoma, prescription, surgical treatment, treatment costs, legal issues.

  7. Incorporating privileged genetic information for fundus image based glaucoma detection.

    Science.gov (United States)

    Duan, Lixin; Xu, Yanwu; Li, Wen; Chen, Lin; Wing, Damon Wing Kee; Wong, Tien Yin; Liu, Jiang

    2014-01-01

    Visual features extracted from retinal fundus images have been increasingly used for glaucoma detection, as those images are generally easy to acquire. In recent years, genetic researchers have found that some single nucleic polymorphisms (SNPs) play important roles in the manifestation of glaucoma and also show superiority over fundus images for glaucoma detection. In this work, we propose to use the SNPs to form the so-called privileged information and deal with a practical problem where both fundus images and privileged genetic information exist for the training subjects, while the test objects only have fundus images. To solve this problem, we present an effective approach based on the learning using privileged information (LUPI) paradigm to train a predictive model for the image visual features. Extensive experiments demonstrate the usefulness of our approach in incorporating genetic information for fundus image based glaucoma detection.

  8. U.S. Glaucoma Cases Expected to Surge by 2030

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162924.html U.S. Glaucoma Cases Expected to Surge by 2030 Routine ... Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. Recent Health ...

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

    Science.gov (United States)

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

    2013-02-01

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

  10. Spectrum of Glaucoma Presentation in a Nigerian Tertiary Hospital

    African Journals Online (AJOL)

    tulyasys

    management strategy that will help in reducing glaucoma blindness. Materials and .... of the patients (inclusive of the NTG and JOAG patients). The most common form ... education, the increased availability of ophthalmology services, even in ...

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

    Indian Academy of Sciences (India)

    Kunal Ray; Suddhasil Mookherjee

    2009-12-01

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

  12. Risk of Retinal Neovascularization in Cases of Uveitis.

    Science.gov (United States)

    Patel, Apurva K; Newcomb, Craig W; Liesegang, Teresa L; Pujari, Siddharth S; Suhler, Eric B; Thorne, Jennifer E; Foster, C Stephen; Jabs, Douglas A; Levy-Clarke, Grace A; Nussenblatt, Robert B; Rosenbaum, James T; Sen, H Nida; Artornsombudh, Pichaporn; Kothari, Srishti; Kempen, John H

    2016-03-01

    To evaluate the risk of and risk factors for retinal neovascularization (NV) in cases of uveitis. Retrospective cohort study. Patients with uveitis at 4 US academic ocular inflammation subspecialty practices. Data were ascertained by standardized chart review. Prevalence data analysis used logistic regression. Incidence data analysis used survival analysis with time-updated covariates where appropriate. Prevalence and incidence of NV. Among uveitic eyes of 8931 patients presenting for initial evaluation, 106 of 13,810 eyes had NV (prevalence = 0.77%, 95% confidence interval [CI], 0.60-0.90). Eighty-eight more eyes developed NV over 26,465 eye-years (incidence, 0.33%/eye-year; 95% CI, 0.27-0.41). Factors associated with incident NV include age 35 years (adjusted hazard ratio [aHR], 2.4; 95% CI, 1.5-3.9), current cigarette smoking (aHR, 1.9; 95% CI, 1.1-3.4), and systemic lupus erythematosus (aHR, 3.5, 95% CI, 1.1-11). Recent diagnosis of uveitis was associated with an increased incidence of NV (compared with patients diagnosed >5 years ago, aHR, 2.4 [95% CI, 1.1-5.0] and aHR, 2.6 [95% CI, 1.2-6.0] for diagnosis within uveitis, intermediate uveitis (aHR, 3.1; 95% CI, 1.5-6.6), posterior uveitis (aHR, 5.2; 95% CI, 2.5-11), and panuveitis (aHR, 4.3; 95% CI, 2.0-9.3) were associated with a similar degree of increased NV incidence. Active (aHR, 2.1, 95% CI, 1.2-3.7) and slightly active (aHR, 2.4, 95% CI, 1.3-4.4) inflammation were associated with an increased incidence of NV compared with inactive inflammation. Neovascularization incidence also was increased with retinal vascular occlusions (aHR, 10, 95% CI, 3.0-33), retinal vascular sheathing (aHR, 2.6, 95% CI, 1.4-4.9), and exudative retinal detachment (aHR, 4.1, 95% CI, 1.3-13). Diabetes mellitus was associated with a somewhat increased incidence of retinal NV (aHR, 2.3, 95% CI, 1.1-4.9), and systemic hypertension (aHR 1.5, 95% CI, 0.89-2.4) was associated with nonsignificantly increased NV incidence. Results were

  13. The Active Metabolite of Leflunomide A771726 Inhibits Corneal Neovascularization

    Institute of Scientific and Technical Information of China (English)

    Mingchang ZHANG; Nian HAO; Fang BIAN

    2008-01-01

    The effects of A771726, the active metabolite of leflunomide, on experimental rat corneal neovascularization (NV) in vivo and on cultured human umbilical vein endothelial cells in vitro were studied. The corneal NV was induced by alkali burn in 40 SD rats. The rats were randomly divided into 4 groups with 10 rats in each group. Group A was treated with 0.9% sodium chloride (control group), and group B, group C and group D were given different concentrations of A771726 eye drops (0.5%,l.0%,2.0% respectively) 4 times daily during days 0-28. The occurrence and development of corneal NV were observed at 4,7,14,21 and 28 day after alkali burn by a slit lamp microscope. The cultured human umbilical vein endothelial cells (ECV-304) were incubated with A771726 solution at different concentrations (20,40,80,160,320μmol/L) for 36h. The proliferation of cells was assessed by methyl thiazolyl tetrazolium (MTT), and the expression of proliferating cell nuclear antigen (PCNA) in cells was detected by using immunofluorescence under the laser confocal microscope. The rat model showed that the onset of corneal NV was delayed and progression of corneal NV was inhibited in the groups C and D. The corneal NV areas in groups C and D were significantly smaller than in groups A and B (P0.05). A771726 solution (≥40μmol/L) could inhibit proliferation of human umbilical vein endothelial cells and decrease the expression of PCNA in cells significantly. A771726, as the active metabolite of leflunomide, strongly prevented corneal NV induced by alkali burn in the in vivo model, and inhibited proliferation of human umbilical vein endothelial cells in the in vitro model. Therefore, A771726 may serve as an angiogenic inhibitor in the treatment of corneal NV.

  14. Placental Growth Factor Promotes Cardiac Muscle Repair via Enhanced Neovascularization

    Directory of Open Access Journals (Sweden)

    Jianfeng Zhang

    2015-06-01

    Full Text Available Background/Aims: Transplantation of mesenchymal stem cells (MSCs improves post-injury cardiac muscle repair using ill-defined mechanisms. Recently, we have shown that production and secretion of placental growth factor (PLGF by MSCs play a critical role in the MSCs-mediated post-injury cardiac muscle repair. In this study, we addressed the underlying molecular mechanisms, focusing specifically on the interactions between MSCs, macrophages and endothelial cells. Methods: We isolated macrophages (BM-MΦ from mouse bone-marrow derived cells based on F4/80 expression by flow cytometry. BM-MΦ were treated with different doses of PLGF. Cell number was analyzed by a MTT assay. Macrophage polarization was examined based on CD206 expression by flow cytometry. PLGF levels in macrophage subpopulations were analyzed by RT-qPCR and ELISA. Effects of macrophages on vascularization were evaluated by a collagen gel assay using Human umbilical vein endothelial cells (HUVECs co-cultured with PLGF-treated macrophages. Results: PLGF did not increase macrophage number, but dose-dependently polarized macrophages into a M2 subpopulation. M2 macrophages expressed high levels of PLGF. PLGF-polarized M2 macrophages significantly increased tubular structures in the collagen gel assay. Conclusion: Our data suggest that MSCs-derived PLGF may induce macrophage polarization into a M2 subpopulation, which in turn releases more PLGF to promote local neovascularization for augmenting post-injury cardiac muscle repair. This study thus sheds novel light on the role of PLGF in cardiac muscle regeneration.

  15. Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Ellabban AA

    2012-05-01

    Full Text Available Abdallah A Ellabban, Akitaka Tsujikawa, Ken Ogino, Sotaro Ooto, Kenji Yamashiro, Akio Oishi, Nagahisa YoshimuraDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanPurpose: To study changes in choroidal thickness with ranibizumab treatment for choroidal neovascularization (CNV.Design: Prospective case series.Methods: This prospective study consisted of 60 CNV-affected eyes of 60 patients treated with intravitreal injections of ranibizumab using an on-demand protocol after an initial loading phase. The eyes studied included 20 with age-related macular degeneration (AMD, 20 with polypoidal choroidal vasculopathy (PCV, and 20 with myopic CNV. In the eyes with AMD and PCV, choroidal thickness at the fovea was measured with optical coherence tomography using enhanced depth imaging. In eyes with myopic CNV, the choroidal thickness was measured using standard optical coherence tomography without the enhanced depth imaging technique.Results: With ranibizumab treatment, central retinal thickness decreased significantly (P < 0.001 and visual acuity improved significantly (P < 0.001. However, central choroidal thickness (167.2 ± 108.3 µm showed no significant change at 1 month after the loading phase (165.2 ± 107.8 µm, P = 0.120 or at final examination (164.8 ± 107.7 µm, P = 0.115. At baseline, central retinal thickness in eyes with AMD was significantly greater that those with PCV (P = 0.005 or high myopia (P = 0.029. However, central choroidal thickness in eyes with myopic CNV was significantly thinner than in eyes with AMD (P < 0.001 or PCV (P < 0.001. In each type of disease, there was no significant change in central choroidal thickness with ranibizumab treatment.Conclusion: The effect of ranibizumab on the choroidal thickness is minimal, if any.Keywords: choroidal thickness, ranibizumab, optical coherence tomography

  16. Modified Vitreous Surgery for Subretinal Neovascularization and Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    LinLu; LezhengWU

    1995-01-01

    Purpose:To modify vitreous surgery for subretinal neovascularization(SRNV)and to detrmine the effects of this operation.Methods:Six patients with SRNV were performed with this operation,The meth-ods of examination before and after operation included;testing the best-corrected visual acuity before operation and 1,3or6months after operation;30degrees and visual acuity before operation and 1,3or6months after operation;30degrees and macular 10degrees Humphrey visual field examination:FFA examination preop-eratively and 1,3or6months postoperatiely.Modified surgery procedureis;a preventive buckling;pars plana vitrectomy;peeling the vitreous cortical;no in-traocular diathermy;small retinotomy;subretinal surgery;air-fluid exchang.Results:SRNV was taken off in4cases.Subretinal hemorrhage was washed in2cases.After4to7months follow-up,the visual acuity was improved in 4cases,unchanged in 2cases.The visual field was improved in 4cases.unchanged in 1case,decraesed in 1case,The complications included macular hole due to surgery in lcase and subretinal hemorrage in 1case.Conclusion;The surgery criteria were:1)massive subretinal hemorrhage;2)some patients of SRN V included;FFA evidence they showed the membrane is beneath fovea,the bestV.Ais20/100orlower.and can't be treated by laser and the pa-tient consent.This modified subretinal operation is safe,and effective for massive hemorrhage and some SRNVS.

  17. Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice

    Directory of Open Access Journals (Sweden)

    Alina Adriana Ivanescu

    2015-07-01

    Full Text Available We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids on choroidal neovascularization (CNV. Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline, group S (oral supplement, intravitreal saline, group V + aVEGF (oral vehicle, intravitreal anti-VEGF, and group S + aVEGF (oral supplement, intravitreal anti-VEGF. Vehicle and nutritional supplements were administered daily for 38 days beginning 10 days before laser. Intravitreal injections were administered 48 h after laser. Fluorescein angiography (FA and flat-mount CD31 staining evaluated leakage and CNV lesion area. Expression of VEGF, MMP-2 and MMP-9 activity, and NLRP3 were evaluated with RT-PCR, zymography, and western-blot. Leakage, CNV size, VEGF gene and protein expression were lower in groups V + aVEGF, S + aVEGF, and S than in V (all p < 0.05. Additionally, MMP-9 gene expression differed between groups S + aVEGF and V (p < 0.05 and MMP-9 activity was lower in S + aVEGF than in V and S (both p < 0.01. Levels of MMP-2 and NLRP3 were not significantly different between groups. Nutritional supplements either alone or combined with anti-VEGF may mitigate CNV development and inhibit retinal disease involving VEGF overexpression and CNV.

  18. 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

  19. Smoking and incidence of glaucoma: The SUN Cohort.

    Science.gov (United States)

    Pérez-de-Arcelus, Mónica; Toledo, Estefanía; Martínez-González, Miguel Á; Martín-Calvo, Nerea; Fernández-Montero, Alejandro; Moreno-Montañés, Javier

    2017-01-01

    Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma.In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis.During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26-2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88-1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose-response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10-2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37-1.21]; P = 0.189).Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers.

  20. [Visual field progression in glaucoma: cluster analysis].

    Science.gov (United States)

    Bresson-Dumont, H; Hatton, J; Foucher, J; Fonteneau, M

    2012-11-01

    Visual field progression analysis is one of the key points in glaucoma monitoring, but distinction between true progression and random fluctuation is sometimes difficult. There are several different algorithms but no real consensus for detecting visual field progression. The trend analysis of global indices (MD, sLV) may miss localized deficits or be affected by media opacities. Conversely, point-by-point analysis makes progression difficult to differentiate from physiological variability, particularly when the sensitivity of a point is already low. The goal of our study was to analyse visual field progression with the EyeSuite™ Octopus Perimetry Clusters algorithm in patients with no significant changes in global indices or worsening of the analysis of pointwise linear regression. We analyzed the visual fields of 162 eyes (100 patients - 58 women, 42 men, average age 66.8 ± 10.91) with ocular hypertension or glaucoma. For inclusion, at least six reliable visual fields per eye were required, and the trend analysis (EyeSuite™ Perimetry) of visual field global indices (MD and SLV), could show no significant progression. The analysis of changes in cluster mode was then performed. In a second step, eyes with statistically significant worsening of at least one of their clusters were analyzed point-by-point with the Octopus Field Analysis (OFA). Fifty four eyes (33.33%) had a significant worsening in some clusters, while their global indices remained stable over time. In this group of patients, more advanced glaucoma was present than in stable group (MD 6.41 dB vs. 2.87); 64.82% (35/54) of those eyes in which the clusters progressed, however, had no statistically significant change in the trend analysis by pointwise linear regression. Most software algorithms for analyzing visual field progression are essentially trend analyses of global indices, or point-by-point linear regression. This study shows the potential role of analysis by clusters trend. However, for best

  1. Mechanism and Etiology of Primary Chronic Angle Closure Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

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

  2. CYPBI mutations in portuguese patients with primary congenital glaucoma

    OpenAIRE

    Carvalho, Ana Rita Simões

    2011-01-01

    Trabalho de projecto de mestrado integrado em Medicina (Oftalmologia) apresentado à Faculdade de Medicina da Universidade de Coimbra Introduction: Primary congenital glaucoma (PCG) is a rare autosomal recessive trabeculodysgenesis. Genetic heterogeneity has been identified but mutations in the CYP1B1 gene seem to be an important etiology in different populations. Objectives: To clinically characterize 34 Portuguese patients with primary congenital glaucoma, to analyze the role ...

  3. Current Imaging Modalities for assessing Ocular Blood Flow in Glaucoma

    OpenAIRE

    Mohindroo, Chirayu; Ichhpujani, Parul; Kumar, Suresh

    2016-01-01

    Glaucoma may be caused by an interplay of elevated intraocular pressure (IOP), vascular, genetic, anatomical, brain, and immune factors. The direct assessment of ocular hemodynam-ics offers promise for glaucoma detection, differentiation, and possibly new treatment modalities. All the methods currently in use to measure ocular blood flow have inherent limitations and measure different aspects of ocular blood flow. This review article attempts to provide detailed information on ocular perfu-si...

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

    Directory of Open Access Journals (Sweden)

    Shcherbinina I.V.

    2010-12-01

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

  5. Infected Baerveldt Glaucoma Drainage Device by Aspergillus niger

    Directory of Open Access Journals (Sweden)

    Nurul-Laila Salim

    2015-01-01

    Full Text Available Fungal endophthalmitis is rare but may complicate glaucoma drainage device surgery. Management is challenging as the symptoms and signs may be subtle at initial presentation and the visual prognosis is usually poor due to its resistant nature to treatment. At present there is lesser experience with intravitreal injection of voriconazole as compared to Amphotericin B. We present a case of successfully treated Aspergillus endophthalmitis following Baerveldt glaucoma drainage device implantation with intravitreal and topical voriconazole.

  6. Fluorocoxib A enables targeted detection of cyclooxygenase-2 in laser-induced choroidal neovascularization

    Science.gov (United States)

    Uddin, Md. Jashim; Moore, Chauca E.; Crews, Brenda C.; Daniel, Cristina K.; Ghebreselasie, Kebreab; McIntyre, J. Oliver; Marnett, Lawrence J.; Jayagopal, Ashwath

    2016-09-01

    Ocular angiogenesis is a blinding complication of age-related macular degeneration and other retinal vascular diseases. Clinical imaging approaches to detect inflammation prior to the onset of neovascularization in these diseases may enable early detection and timely therapeutic intervention. We demonstrate the feasibility of a previously developed cyclooxygenase-2 (COX-2) targeted molecular imaging probe, fluorocoxib A, for imaging retinal inflammation in a mouse model of laser-induced choroidal neovascularization. This imaging probe exhibited focal accumulation within laser-induced neovascular lesions, with minimal detection in proximal healthy tissue. The selectivity of the probe for COX-2 was validated in vitro and by in vivo retinal imaging with nontargeted 5-carboxy-X-rhodamine dye, and by blockade of the COX-2 active site with nonfluorescent celecoxib prior to injection of fluorocoxib A. Fluorocoxib A can be utilized for imaging COX-2 expression in vivo for further validation as an imaging biomarker in retinal diseases.

  7. OCULAR BIOMETRY IN ANGLE CLOSURE GLAUCOMA AND SENILE CATARACT

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  8. Discovery of novel inhibitors for the treatment of glaucoma

    Science.gov (United States)

    Cholkar, Kishore; Trinh, Hoang M.; Pal, Dhananjay; Mitra, Ashim K

    2015-01-01

    Introduction Glaucoma is a neurodegenerative disease with heterogeneous causes that result in retinal ganglionic cell death (RGC). The discovery of ocular anti-hypertensives has shifted glaucoma therapy, largely, from surgery to medical intervention. Indeed, several intraocular pressure (IOP) lowering drugs, with different mechanisms of action and RGC protective property, have been developed. Areas covered In this review, the authors discuss the main new class of kinase inhibitors used as glaucoma treatments, which lower IOP by enhancing drainage and/or lowering production of aqueous humor. The authors include novel inhibitors under preclinical evaluation and investigation for their anti-glaucoma treatment. Additionally, the authors look at treatments that are in clinics now and which may be available in the near future. Expert opinion Treatment of glaucoma remains challenging because the exact cause is yet to be delineated. Neuroprotection to the optic nerve head is undisputable. The novel ROCK inhibitors have the capacity to lower IOP and provide optic nerve and RGC protection. In particular, the S-isomer of roscovitine has the capacity to lower IOP and provide neuroprotection. Combinations of selected drugs, which can provide maximal and sustained IOP lowering effects as well as neuroprotection, are paramount to the prevention of glaucoma progression. In the near future, microRNA intervention may be considered as a potential therapeutic target. PMID:25575654

  9. Glaucoma progression detection using nonlocal Markov random field prior.

    Science.gov (United States)

    Belghith, Akram; Bowd, Christopher; Medeiros, Felipe A; Balasubramanian, Madhusudhanan; Weinreb, Robert N; Zangwill, Linda M

    2014-10-01

    Glaucoma is neurodegenerative disease characterized by distinctive changes in the optic nerve head and visual field. Without treatment, glaucoma can lead to permanent blindness. Therefore, monitoring glaucoma progression is important to detect uncontrolled disease and the possible need for therapy advancement. In this context, three-dimensional (3-D) spectral domain optical coherence tomography (SD-OCT) has been commonly used in the diagnosis and management of glaucoma patients. We present a new framework for detection of glaucoma progression using 3-D SD-OCT images. In contrast to previous works that use the retinal nerve fiber layer thickness measurement provided by commercially available instruments, we consider the whole 3-D volume for change detection. To account for the spatial voxel dependency, we propose the use of the Markov random field (MRF) model as a prior for the change detection map. In order to improve the robustness of the proposed approach, a nonlocal strategy was adopted to define the MRF energy function. To accommodate the presence of false-positive detection, we used a fuzzy logic approach to classify a 3-D SD-OCT image into a "non-progressing" or "progressing" glaucoma class. We compared the diagnostic performance of the proposed framework to the existing methods of progression detection.

  10. Incorporating corneal pachymetry into the management of glaucoma.

    Science.gov (United States)

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

    2009-09-01

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

  11. Updates on the Surgical Management of Pediatric Glaucoma.

    Science.gov (United States)

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

    2016-01-01

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

  12. 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.

  13. Glaucoma detection based on local binary patterns in fundus photographs

    Science.gov (United States)

    Alsheh Ali, Maya; Hurtut, Thomas; Faucon, Timothée.; Cheriet, Farida

    2014-03-01

    Glaucoma, a group of diseases that lead to optic neuropathy, is one of the most common reasons for blindness worldwide. Glaucoma rarely causes symptoms until the later stages of the disease. Early detection of glaucoma is very important to prevent visual loss since optic nerve damages cannot be reversed. To detect glaucoma, purely data-driven techniques have advantages, especially when the disease characteristics are complex and when precise image-based measurements are difficult to obtain. In this paper, we present our preliminary study for glaucoma detection using an automatic method based on local texture features extracted from fundus photographs. It implements the completed modeling of Local Binary Patterns to capture representative texture features from the whole image. A local region is represented by three operators: its central pixel (LBPC) and its local differences as two complementary components, the sign (which is the classical LBP) and the magnitude (LBPM). An image texture is finally described by both the distribution of LBP and the joint-distribution of LBPM and LBPC. Our images are then classified using a nearest-neighbor method with a leave-one-out validation strategy. On a sample set of 41 fundus images (13 glaucomatous, 28 non-glaucomatous), our method achieves 95:1% success rate with a specificity of 92:3% and a sensitivity of 96:4%. This study proposes a reproducible glaucoma detection process that could be used in a low-priced medical screening, thus avoiding the inter-experts variability issue.

  14. The inhibitory effect of thalidomide analogue on corneal neovascularization in rabbits.

    Science.gov (United States)

    Lee, You Kyung; Chung, Sung Kun

    2013-08-01

    To evaluate the effect of thalidomide analogue CC-3052 on corneal neovascularization in the rabbit model. Corneal neovascularization was induced in 15 rabbits by a silk suture in the corneal stroma. At 1 week after suturing, 30 eyes were divided into 5 groups of 6 eyes each. Three groups were treated with topical CC-3052 at 3 different concentrations: 0.25% (group 1), 0.5% (group 2), and 1.0% (group 3). All treatments were performed twice a day for a week. A 0.5% concentration of CC-3052 was injected subconjunctivally once in group 4. In group 5, a topical balanced salt solution was added twice a day for a week as the experimental control group. Rabbit corneas were photographed by a digital camera and examined by the operating microscope. Half of the corneal specimens were analyzed histopathologically, and the other half were used to measure the concentration of tumor necrosis factor α and vascular endothelial growth factor (VEGF) messenger RNA by reverse transcriptase-polymerase chain reaction. The neovascularized area was decreased in all treatment groups compared with the control group. There was a significant difference in the percentage and score of corneal neovascularization between the control and all treatment groups. Inflammation, fibroblast, neovascularization, and anti-VEGF antibody intensities were significantly lower in the control group. The concentration of VEGF and tumor necrosis factor α was significantly lower in the control group. There was no difference between the treatment groups. Topical and subconjunctival administration of thalidomide analogue CC-3052 was found to be effective for the inhibition of corneal neovascularization.

  15. Laser-induced primate glaucoma. II. Histopathology.

    Science.gov (United States)

    Radius, R L; Pederson, J E

    1984-11-01

    A sustained, moderate pressure elevation was produced in 15 nonhuman primate eyes by application of laser energy to the trabecular meshwork. By light and electron microscopy, the trabecular beams were blunted, and scattered synechiae were present. Backward bowing of the lamina cribrosa, partial loss of the myelin sheath surrounding axonal segments just posterior to the lamina, and diffuse axonal loss involving the entire nerve cross section were noted. A quantitative analysis of this axonal loss revealed that eyes with moderate nerve head damage (cup-disc ratio, 0.6 to 0.8) had only 38% to 69% of the expected normal axonal count. The eyes with nearly total cupping (cup-disc ratio, 0.9 to 1.0) maintained between 10% and 36% of the normal axonal count. The disc changes in these experimental eyes are similar to those previously described in human eyes with glaucoma.

  16. [Preservatives from the perspective of glaucoma surgery].

    Science.gov (United States)

    Thieme, H; van der Velden, K K

    2012-11-01

    Trabeculectomy is still the gold standard in the surgical treatment of glaucoma patients. Development of a bleb is the primary goal of this procedure and the conjunctival status is therefore decisive. Only a good functioning bleb renders good intraocular pressure (IOP) control. Scar tissue formation leads to bleb failure which is quite common despite the use of antiproliferative agents, such as mitomycin C and 5 fluoruracil. Wound healing is important and is influenced and impaired by the chronic use of topical antiglaucoma drugs. Therefore, complete abstinence is recommended from 4-6 weeks prior to a planned trabeculectomy; however, it seems mandatory to completely abolish preservatives such as drops containing benzalkonium chloride to enhance trabeculectomy success rates.

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

    Science.gov (United States)

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

    2015-12-01

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

  18. The Wills Eye Glaucoma App: Interest of Patients and Their Caregivers in a Smartphone-based and Tablet-based Glaucoma Application.

    Science.gov (United States)

    Waisbourd, Michael; Dhami, Hermandeep; Zhou, Chen; Hsieh, Michael; Abichandani, Pramod; Pro, Michael J; Moster, Marlene R; Katz, L Jay; Hark, Lisa A; Myers, Jonathan S

    2016-09-01

    To evaluate the interest of glaucoma patients and their caregivers in a smartphone-based and tablet-based glaucoma application (App), developed by the Wills Eye Glaucoma Research Center in collaboration with Drexel University. Cross-sectional survey of patients with glaucoma and their caregivers. Main outcome measures are answers to survey questions regarding how receptive participants are to using the Glaucoma App. Fifty subjects completed the survey. The mean age (SD) was 59.5 (±17.3) years. A total of 88.6% of the participants lived in a household with access to a smartphone or tablet. The majority (72.3%) of participants would consider downloading the Glaucoma App, and younger participants (App if it was free of charge, compared with a version that costs $3, P=0.018. Although only about one third (37.8%) of participants used eye drop reminders, nearly 3 of 4 (72.9%) participants were receptive to using the automated reminder feature of the Glaucoma App. Glaucoma patients and their caregivers were very interested in using a Glaucoma App; however, many were not willing to spend $3 for an App they seem to value. The free Wills Eye Glaucoma App currently available on the Apple store, includes educational videos, eye drop and appointment reminders, medical and ocular data storage, visual field tutorial, and intraocular pressure tracker. These features aim to increase patients' level of knowledge about glaucoma and improve their adherence to medication and follow-up appointment recommendations.

  19. Adaptive optics optical coherence tomography in glaucoma.

    Science.gov (United States)

    Dong, Zachary M; Wollstein, Gadi; Wang, Bo; Schuman, Joel S

    2017-03-01

    Since the introduction of commercial optical coherence tomography (OCT) systems, the ophthalmic imaging modality has rapidly expanded and it has since changed the paradigm of visualization of the retina and revolutionized the management and diagnosis of neuro-retinal diseases, including glaucoma. OCT remains a dynamic and evolving imaging modality, growing from time-domain OCT to the improved spectral-domain OCT, adapting novel image analysis and processing methods, and onto the newer swept-source OCT and the implementation of adaptive optics (AO) into OCT. The incorporation of AO into ophthalmic imaging modalities has enhanced OCT by improving image resolution and quality, particularly in the posterior segment of the eye. Although OCT previously captured in-vivo cross-sectional images with unparalleled high resolution in the axial direction, monochromatic aberrations of the eye limit transverse or lateral resolution to about 15-20 μm and reduce overall image quality. In pairing AO technology with OCT, it is now possible to obtain diffraction-limited resolution images of the optic nerve head and retina in three-dimensions, increasing resolution down to a theoretical 3 μm(3). It is now possible to visualize discrete structures within the posterior eye, such as photoreceptors, retinal nerve fiber layer bundles, the lamina cribrosa, and other structures relevant to glaucoma. Despite its limitations and barriers to widespread commercialization, the expanding role of AO in OCT is propelling this technology into clinical trials and onto becoming an invaluable modality in the clinician's arsenal. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Wayfinding and Glaucoma: A Virtual Reality Experiment.

    Science.gov (United States)

    Daga, Fábio B; Macagno, Eduardo; Stevenson, Cory; Elhosseiny, Ahmed; Diniz-Filho, Alberto; Boer, Erwin R; Schulze, Jürgen; Medeiros, Felipe A

    2017-07-01

    Wayfinding, the process of determining and following a route between an origin and a destination, is an integral part of everyday tasks. The purpose of this study was to investigate the impact of glaucomatous visual field loss on wayfinding behavior using an immersive virtual reality (VR) environment. This cross-sectional study included 31 glaucomatous patients and 20 healthy subjects without evidence of overall cognitive impairment. Wayfinding experiments were modeled after the Morris water maze navigation task and conducted in an immersive VR environment. Two rooms were built varying only in the complexity of the visual scene in order to promote allocentric-based (room A, with multiple visual cues) versus egocentric-based (room B, with single visual cue) spatial representations of the environment. Wayfinding tasks in each room consisted of revisiting previously visible targets that subsequently became invisible. For room A, glaucoma patients spent on average 35.0 seconds to perform the wayfinding task, whereas healthy subjects spent an average of 24.4 seconds (P = 0.001). For room B, no statistically significant difference was seen on average time to complete the task (26.2 seconds versus 23.4 seconds, respectively; P = 0.514). For room A, each 1-dB worse binocular mean sensitivity was associated with 3.4% (P = 0.001) increase in time to complete the task. Glaucoma patients performed significantly worse on allocentric-based wayfinding tasks conducted in a VR environment, suggesting visual field loss may affect the construction of spatial cognitive maps relevant to successful wayfinding. VR environments may represent a useful approach for assessing functional vision endpoints for clinical trials of emerging therapies in ophthalmology.

  1. Imaging polarimetry in patients with neovascular age-related macular degeneration

    Science.gov (United States)

    Elsner, Ann E.; Weber, Anke; Cheney, Michael C.; VanNasdale, Dean A.; Miura, Masahiro

    2007-01-01

    Imaging polarimetry was used to examine different components of neovascular membranes in age-related macular degeneration. Retinal images were acquired with a scanning laser polarimeter. An innovative pseudo-color scale, based on cardinal directions of color, displayed two types of image information: relative phases and magnitudes of birefringence. Membranes had relative phase changes that did not correspond to anatomical structures in reflectance images. Further, membrane borders in depolarized light images had significantly higher contrasts than those in reflectance images. The retinal birefringence in neovascular membranes indicates optical activity consistent with molecular changes rather than merely geometrical changes. PMID:17429494

  2. Regulation of signaling events involved in the pathophysiology of neovascular AMD.

    Science.gov (United States)

    Wang, Haibo; Hartnett, M Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual's genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than half of patients treated for neovascular AMD, and treatments remain inadequate for atrophic AMD. Many studies focus on genetic predisposition or the association of outcomes in trials of human neovascular AMD but are unable to evaluate the effects between different cell types involved in AMD and the signaling events that take place to cause pathologic biologic events. This manuscript complements other reviews in that it describes what is known generally in human AMD studies and clinical trials testing methods to inhibit vascular endothelial growth factor (VEGF inhibitors) and presents pathologic signaling events that develop in two important cell types, the RPE cells and the CECs, when stimulated by stresses or placed into conditions similar to what is currently understood to occur in neovascular AMD. This manuscript complements other reviews by discussing signaling events that are activated by cell-cell or cell-matrix interactions. These considerations are particularly important when considering growth factors, such as VEGF, which are important in physiologic and pathologic processes, or GTPases that are present but active only if GTP bound. In either case, it is essential to understand the role of signaling activation to distinguish what is pathologic from what is physiologic. Particularly important is the essential role of activated Rac1 in CEC transmigration of the RPE monolayer, an important step in blindness associated with neovascular AMD. Other concepts discussed include

  3. Clinical correlates of common corneal neovascular diseases:a literature review

    Directory of Open Access Journals (Sweden)

    Nizar Saleh Abdelfattah

    2015-02-01

    Full Text Available A large subset of corneal pathologies involves the formation of new blood and lymph vessels (neovascularization, leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization (CNV by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis, contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatments available so far.

  4. Subfoveal choroidal thickness changes after intravitreal bevacizumab therapy for neovascular age-related macular degeneration

    Institute of Scientific and Technical Information of China (English)

    Cihan; ünlü; Gurkan; Erdogan; Betul; Onal; Gunay; Betul; Ilkay; Sezgin; Akcay; Esra; Kardes

    2015-01-01

    <正>Dear Sir,Iam Dr.Cihanünlü,from the Department of Opthalmology,ümraniye Training and Research Hospital,Istanbul,Turkey.I write to present our study findings on subfoveal choroidal thickness(SFCT)changes after intravitreal bevacizumab(IVB)therapy for neovascular age-related macular degeneration(AMD).AMD is the leading cause of severe visual loss in adults older than 60y[1].Visual loss in late stages of AMD may be the result of one of the two processes:geographic atrophy(GA)or choroidal neovascularization(CNV).Many types of

  5. Risk factors for late presentation of chronic glaucoma in an Iranian population

    Directory of Open Access Journals (Sweden)

    Behzad Fallahi Motlagh

    2016-01-01

    Conclusion: Our study shows that several risk factors present for late presentation in chronic glaucoma. Our results suggest planning screening programs in high-risk individuals for early detection of glaucoma and prevention of blindness.

  6. Pars plana Baerveldt tube insertion with pars plana vitrectomy for refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Anton M Kolomeyer

    2012-01-01

    Conclusions: Pars plana Baerveldt tube implantation with PPV can preserve vision, reduce IOP, and decrease the number of glaucoma medications necessary to achieve target IOP in patients with recalcitrant glaucoma.

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

    Science.gov (United States)

    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.

  8. Gene therapy in glaucoma-part 2: Genetic etiology and gene mapping

    OpenAIRE

    Mohamed Abdel-Monem Soliman Mahdy

    2010-01-01

    Glaucoma diagnosis, identification of people at risk, initiation of treatment and timing of surgical intervention remains a problem. Despite new and improving diagnostic and therapeutic options for glaucoma, blindness from glaucoma is increasing and glaucoma remains a major public health problem. The role of heredity in ocular disease is attracting greater attention as the knowledge and recent advances of Human Genome Project and the HapMap Project have made genetic analysis of many human dis...

  9. Socioeconomics of long-term glaucoma therapy in India

    Directory of Open Access Journals (Sweden)

    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.

  10. The patient health questionnaire-9: validation among patients with glaucoma.

    Directory of Open Access Journals (Sweden)

    Vijaya K Gothwal

    Full Text Available BACKGROUND: Depression and anxiety are two common normal responses to a chronic disease such as glaucoma. This study analysed the measurement properties of the depression screening instrument - Patient Health Questionnaire-9 (PHQ-9 using Rasch analysis to determine if it can be used as a measure. METHODS: In this hospital-based cross-sectional study, the PHQ-9 was administered to primary glaucoma adults attending a glaucoma clinic of a tertiary eye care centre, South India. All patients underwent a comprehensive clinical evaluation. Patient demographics and sub-type of glaucoma were abstracted from the medical record. Rasch analysis was used to investigate the following properties of the PHQ-9: behaviour of the response categories, measurement precision (assessed using person separation reliability, PSR; minimum recommended value 0.80, unidimensionality (assessed using item fit [0.7-1.3] and principal components analysis of residuals, and targeting. RESULTS: 198 patients (mean age ± standard deviation  = 59.83±12.34 years; 67% male were included. The native PHQ-9 did not fit the Rasch model. The response categories showed disordered thresholds which became ordered after category reorganization. Measurement precision was below acceptable limits (0.62 and targeting was sub-optimal (-1.27 logits. Four items misfit that were deleted iteratively following which a set of five items fit the Rasch model. However measurement precision failed to improve and targeting worsened further (-1.62 logits. CONCLUSIONS: The PHQ-9, in its present form, provides suboptimal assessment of depression in patients with glaucoma in India. Therefore, there is a need to develop a new depression instrument for our glaucoma population. A superior strategy would be to use the item bank for depression but this will also need to be validated in glaucoma patients before deciding its utility.

  11. Target IOP as a measure of glaucoma surgery efficacy

    Directory of Open Access Journals (Sweden)

    S. Yu. Petrov

    2015-01-01

    Full Text Available There are numerous criteria of glaucoma surgery efficacy. Among them, IOP level is of special importance. The development of tolerant and target IOP concepts as well as IOP tolerability issue are reviewed below. Individual normal IOP values and their role in glaucoma surgery evaluation are described. The gradation of glaucoma surgery effect and target IOP level depending on optic nerve damage degree as well as statistical principles of scientific data presentation are discussed. Current controversies forced World Glaucoma Association (WGA to develop Guidelines on Design & Reporting Glaucoma Trials (2009 which are now recommended for modern studies. The assessment of appropriate IOP reduction is the keystone of this paper. In addition, the results of the above-mentioned studies were analyzed and own recommendations were developed. Two approaches to evaluate glaucoma surgery efficacy are proposed, i.e., by true IOP (P0 and by IOP decrease from baseline (in %. In the last three decades, novel micro-invasive techniques that prolong glaucoma surgery effect were developed. Among them are suture removal (which can be cut or pulled out, laser suture lysis, Nd:YAG laser goniopuncture following non-penetrating surgery, filtering bleb and sub-scleral space needling revision in the early and late postoperative period. These procedures significantly increased hypotensive effect in the late post-op period (up to 96.7 %. Repeated surgery rate and medical therapy need were the primary surgical outcome while complete and partial success rates were the secondary outcome. Baseline IOP was defined as an IOP level on maximum medical therapy pre-operatively. Medical therapy is an important efficacy criterion as well. The number of drugs used (prostaglandin analogues, beta blockers etc. should be specified. When interpreting surgical outcomes, statistical methods must be considered. The required minimum is Kaplan-Meier survival analysis, scatter diagram, and box

  12. Target IOP as a measure of glaucoma surgery efficacy

    Directory of Open Access Journals (Sweden)

    S. Yu. Petrov

    2014-01-01

    Full Text Available There are numerous criteria of glaucoma surgery efficacy. Among them, IOP level is of special importance. The development of tolerant and target IOP concepts as well as IOP tolerability issue are reviewed below. Individual normal IOP values and their role in glaucoma surgery evaluation are described. The gradation of glaucoma surgery effect and target IOP level depending on optic nerve damage degree as well as statistical principles of scientific data presentation are discussed. Current controversies forced World Glaucoma Association (WGA to develop Guidelines on Design & Reporting Glaucoma Trials (2009 which are now recommended for modern studies. The assessment of appropriate IOP reduction is the keystone of this paper. In addition, the results of the above-mentioned studies were analyzed and own recommendations were developed. Two approaches to evaluate glaucoma surgery efficacy are proposed, i.e., by true IOP (P0 and by IOP decrease from baseline (in %. In the last three decades, novel micro-invasive techniques that prolong glaucoma surgery effect were developed. Among them are suture removal (which can be cut or pulled out, laser suture lysis, Nd:YAG laser goniopuncture following non-penetrating surgery, filtering bleb and sub-scleral space needling revision in the early and late postoperative period. These procedures significantly increased hypotensive effect in the late post-op period (up to 96.7 %. Repeated surgery rate and medical therapy need were the primary surgical outcome while complete and partial success rates were the secondary outcome. Baseline IOP was defined as an IOP level on maximum medical therapy pre-operatively. Medical therapy is an important efficacy criterion as well. The number of drugs used (prostaglandin analogues, beta blockers etc. should be specified. When interpreting surgical outcomes, statistical methods must be considered. The required minimum is Kaplan-Meier survival analysis, scatter diagram, and box

  13. 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

  14. The analysis of pathogenic mechanism in hospitalized patients with mixed glaucoma%混合型青光眼住院病人的致病机制构成分析

    Institute of Scientific and Technical Information of China (English)

    赵军; 成洪波; 黄丽娜; 罗润来

    2010-01-01

    Objective To analyze the pathogenic mechanism in hospitalized patients with mixed glaucoma. Methods The clinical data of 76 cases (109 eyes) in hospitalized patients with mixed glaucoma from 2005 to 2009 were collected. The compositions of the pathogenic mechanism were analyzed according to intraocular pressure, the ratio of C/D, the results of visual field, gonioscope and ultrasound biomicroscopy (UBM). Results There were 12 pathogenic mechanisms in the cases including PACG, POAG, congenital glaucoma, neovascular glaucoma, glaucomatocyclitic syndrome, and Fuchs syndrome, iriditis, ocular trauma, swelling crystal body, cysts in the ciliary body, exofoliation syndrome and corticosteroid-induced glaucoma. There were 7 mixed mechanisms in the cases including POAG combined with PACG (35 eyes, 32.1%); PACG combined with secondary angle-closure glaucoma (32 eyes, 29.4 %); PACG combined with secondary open-angle glaucoma (13 eyes, 11.9%); POAG combined with secondary open-angle glaucoma (11 eyes, 10.1 %); POAG combined with secondary angle-closure glaucoma (10 eyes, 9.2 %); congenital glaucoma combined with secondary glaucoma (5 eyes, 4.6%) and secondary glaucoma combined with another secondary glaucoma (3 eyes, 2.8%). Conclusions The multi-analysis of pathogenic mechanisms in patients with glaucoma is very essential in order to choose appropriate treatment. It is helpful for analyzing the pathogenic mechanism of MG with UBM. The main type of MG is POAG combined with PACG.%目的 分析混合型青光眼(mixed glaucoma,MG)住院病人的致病机制.方法 收集 2005年~2009年连续住院患者MG 109只眼(76例)的临床资料,结合眼压、C/D、视野、前房角镜及超声生物显微镜(ultrasound biomicroscopy,UBM)等临床资料,分类分析其混合致病机制的构成.结果 (1)本组病例存在12个致病机制类型:原发性开角型青光眼(primary open-angle glaucoma,POAG、原发性闭角型青光眼(primary angle-closure glaucoma,PACG)、先天性

  15. Association of open-angle glaucoma loci with incident glaucoma in the Blue Mountains Eye Study.

    Science.gov (United States)

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

    2015-01-01

    To determine if open-angle glaucoma (OAG)-associated single nucleotide polymorphisms (SNPs) are associated with incident glaucoma and if such genetic information is useful in OAG risk prediction. Case-control from within a population-based longitudinal study. study population: Individuals aged over 49 years of age living in the Blue Mountains region west of Sydney and enrolled in the Blue Mountains Eye Study. observation: Cases for this sub-study (n = 67) developed incident OAG between baseline and 10-year visits, in either eye, while controls (n = 1919) had no evidence for OAG at any visit. All participants had an ocular examination and DNA genotyped for reported OAG risk SNPs. main outcome measure: Incident OAG. Two loci also known to be associated with cup-to-disc ratio as well as OAG (9p21 near CDKN2B-AS1 and SIX1/SIX6) were both significantly associated with incident OAG in the Blue Mountains Eye Study cohort (P = .006 and P = .004, respectively). The TMCO1 locus was nominally associated (P = .012), while the CAV1/CAV2 and 8q22 loci were not associated. Multivariate logistic regression and neural network analysis both indicated that the genetic risk factors contributed positively to the predictive models incorporating traditional risk factors. This study shows that previously reported genetic variations related to OAG and cup-to-disc ratio are associated with the onset of OAG and thus may become useful in risk prediction algorithms designed to target early treatment to those most at risk of developing glaucoma. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Estimated Prevalence of Glaucoma in South Korea Using the National Claims Database

    Directory of Open Access Journals (Sweden)

    Sang Jin Seo

    2016-01-01

    Full Text Available Purpose. To estimate the prevalence of glaucoma and costs associated with glaucoma care in South Korea between 2008 and 2013 using the Korean national claims database. Design. Retrospective cross-sectional study from a national claims database. Methods. Patients who were diagnosed with glaucoma between 2008 and 2013 were retrospectively identified in the national claims database using glaucoma diagnostic codes. For each year, the prevalence of glaucoma and direct medical costs associated with glaucoma care were estimated. Result. The prevalence of glaucoma in patients ≥40 years of age increased from 0.79% in 2008 to 1.05% in 2013. The number of patients with glaucoma increased by 54% between 2008 and 2013 (9% average annual increase. The prevalence of glaucoma increased with age and was higher in males than in females. The cost to care for glaucoma patients increased from $16.5 million in 2008 to $29.2 million in 2013, which translated into an 81% increase over the 6 years examined (12.7% average annual increase. Conclusion. The estimated prevalence and socioeconomic burden of glaucoma have steadily increased each year in South Korea. Nevertheless, many glaucoma patients remain undiagnosed in the present study using national claims database.

  17. Glaucoma drainage device surgery after vitreoretinal surgery : incidence and risk factors

    NARCIS (Netherlands)

    de Vries, Margriet M; Müskens, Rogier P H M; Renardel de Lavalette, Victor W; Hooymans, Johanna M M; Jansonius, Nomdo M

    2016-01-01

    Purpose: The initial success of vitreoretinal surgery can be annihilated by an acceleration of preexisting glaucoma or the development of secondary glaucoma. Aim of this study was to determine the incidence of and risk factors for medically uncontrollable glaucoma after vitreoretinal surgery. Method

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  19. [Pay attention to the fine management of the diagnosis and treatment of glaucoma].

    Science.gov (United States)

    Wang, N L

    2016-06-11

    During the clinical practice of glaucoma, the fine management is needed in patient's eye history taking, clinical material organization, the standardization, normalization, advantage complement of clinical examination and compliance evaluation of anti-glaucoma medication. The fine management of the glaucoma diagnosis and treatment will enable the greatest extent of visual protection.(Chin J Ophthalmol, 2016, 52: 401-403).

  20. Glaucoma drainage device surgery after vitreoretinal surgery: Incidence and risk factors

    NARCIS (Netherlands)

    M.M. De Vries (Margriet M.); R.P.H.M. Müskens (Rogier); V.W. Renardel De Lavalette (Victor W.); J.M.M. Hooymans (Johanna); N.M. Jansonius (Nomdo)

    2016-01-01

    textabstractPurpose The initial success of vitreoretinal surgery can be annihilated by an acceleration of preexisting glaucoma or the development of secondary glaucoma. Aim of this study was to determine the incidence of and risk factors for medically uncontrollable glaucoma after vitreoretinal surg