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Sample records for ologen oculusgen-glaucoma mmc

  1. Patch Grafting Using an Ologen Collagen Matrix to Manage Tubal Exposure in Glaucoma Tube Shunt Surgery

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    Masaki Tanito

    2018-01-01

    Full Text Available Purpose: To report the results using an ologen Collagen Matrix as a patch graft in eyes with tubal exposure after tube shunt surgery. Case Reports: Case 1 was an 82-year-old man with tubal exposure in his right eye 26 months after receiving a Baerveldt glaucoma implant. The tube was covered by surrounding conjunctival tissue combined with subconjunctival placement of an ologen Collagen Matrix as a patch graft. Two years after implantation, the tube was not exposed. Anterior-segment optical coherence tomography (AS-OCT showed dense conjunctival tissue over the tube. Case 2 was an 82-year-old man with peripheral keratitis, anterior scleritis, and secondary glaucoma in the right eye who underwent tube shunt surgery using an Ahmed glaucoma valve and cataract surgery. Intraoperatively, scleritis-related scleral thinning prevented the tube from being covered fully by an autologous scleral flap. An ologen Collagen Matrix was placed over the scleral flap as a patch graft. Seventeen months after implantation, the tube was not exposed. Case 3 was a 52-year-old man with diabetic maculopathy and steroid-induced glaucoma in the right eye who underwent tube shunt surgery using an Ahmed glaucoma valve. Intraoperatively, a flap defect prevented the tube from being covered fully by an autologous scleral flap. An ologen Collagen Matrix was placed over the scleral flap as a patch graft. Three weeks postoperatively, AS-OCT showed thick subconjunctival tissue over the tube. Three months after implantation, the tube was not exposed. Conclusions: The ologen Collagen Matrix can be used successfully as a patch graft to prevent and treat tubal exposure after tube shunt surgery.

  2. Comparison of 1-year outcomes after Ahmed glaucoma valve implantation with and without Ologen adjuvant.

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    Kim, Tai Jun; Kang, Sohyun; Jeoung, Jin Wook; Kim, Young Kook; Park, Ki Ho

    2018-02-14

    Many studies have investigated the clinical benefits of Ologen for trabeculectomy. However, its benefits for Ahmed glaucoma valve (AGV) implantation have not been investigated as extensively. The aim of this study was to compare the 1-year outcomes of AGV implantation with and without Ologen adjuvant for the treatment of refractory glaucoma. This retrospective study included a total of 20 eyes of 20 glaucoma patients, who were followed for at least 1-year after undergoing AGV implantation. In 12 eyes of 12 patients, conventional AGV (CAGV) surgery was performed, while in 8 eyes of 8 patients, Ologen-augmented AGV (OAGV) implantation was performed. The outcomes were evaluated according to intraocular pressure (IOP) and the number of IOP-lowering medications. Complete success was defined as IOP ≤ 21 mmHg without medications throughout the 1-year follow-up period, and qualified success was defined as IOP ≤ 21 mmHg with or without medications throughout the 1-year follow-up period. The rate of complete success was significantly higher in the OAGV group (50.0%) than in the CAGV group (8.3%) (p = 0.035). There were no significant differences between the two groups in terms of qualified success or incidence of the early hypertensive phase. The IOP changes were similar between the groups within 1-year postoperatively, though the number of IOP-lowering medications was significantly lower in the OAGV group during the early hypertensive phase (p = 0.031, 0.031, and 0.025 at postoperative months 1, 2, and 3, respectively). When subjects were divided into groups according to the occurrence of the early hypertensive phase, the group with early hypertensive phase was more likely to use IOP-lowering medications at postoperative 6 months and 1 year (p = 0.002 and 0.005, respectively). OAGV surgery shows encouraging results for patients with refractory glaucoma, specifically with respect to the achievement of complete success and the reduction of the

  3. A prospective comparative study between trabeculectomy versus trabeculectomy with Ologen for patients with primary open-angle glaucoma at 3-year follow-up

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    Ahmed G Elmahdy

    2017-01-01

    Trabeculectomy with Ologen showed significant advantages over trabeculectomy alone in terms of IOP. Large sample size is needed to confirm the safety and long-term outcome of trabeculectomy with Ologen.

  4. OLOGEN® implant in the management of glaucoma in an unusual case of Axenfeld-Rieger syndrome

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    O K Radhakrishnan

    2014-01-01

    Full Text Available We report an unusual case of Axenfeld-Rieger Syndrome with secondary glaucoma managed with Ologen® implant. A 35-year-old male presented with complaints of decreased vision in both eyes of 22 years duration. His best corrected visual acuity (BCVA was no perception of light in right eye and 20/30 in left eye. Gonioscopy revealed anterior insertion of iris into trabecular meshwork, prominent iris processes and broad-based synechiae with prominent Schwalbe′s line along the angle circumference with cord-like structures taking its origin at the level of Schwalbe′s line in both eyes. Fundus examination revealed total glaucomatous optic atrophy in right eye with 0.9:1 cup disc ratio with bipolar notch in left eye. Humphrey visual field analysis showed superior and inferior arcuate scotoma in left eye. Intraocular pressure measured by Goldman applanation tonometry was 30 mmHg and 26 mmHg in right and left eye, respectively. After an unsuccessful medical management, he underwent trabeculectomy with Ologen® implant under local anesthesia in his left eye. Postoperatively, at the end of one year, intraocular pressure (IOP in his left eye was controlled without medication. This case highlights the management of secondary angle closure glaucoma in Axenfeld-Rieger syndrome with Ologen® implant.

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

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    Saeed AM

    2012-10-01

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

  6. Mitomycin-C Trabeculectomy versus Ahmed Glaucoma Implant in Pediatric Aphakic Glaucoma

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    Mohammad Pakravan

    2008-12-01

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    PURPOSE: To compare the outcomes and complications of mitomycin-C trabeculectomy (MMC-T versus the Ahmed glaucoma implant (AGI for treatment of pediatric aphakic glaucoma. METHODS: In a randomized clinical trial, 30 eyes of 28 children < 16 years of age who had undergone anterior lensectomy-vitrectomy for congenital cataract were assigned to MMC-T (15 eyes of 13 children or AGI (15 eyes of 15 children. Surgical success was classified as complete (IOP 6-21 mmHg without any antiglaucoma medication and partial (IOP 6-21 mmHg with < 2 topical antiglaucoma agents in the absence of any sight-threatening complication or need for further glaucoma surgery, stable cup/disc ratios and visual loss < 2 Snellen lines. Overall success was defined as the sum of complete and partial success. RESULTS: Mean patient age was 9.1±4.1 and 10.9±5.1 years in the MMC-T and AGI groups, respectively (P=0.29. After a mean follow up of 14.8±11 and 13.1±9.7 months; complete, partial and overall success rates were 33.3%, 40% and 73.3% in the MMC-T vs 20%, 66.7% and 86.7% in the AGI groups, respectively (P= 0.361. Complication and failure rates were 40% and 26.7% in the MMC-T group vs 26.7% and 13.3% in the AGI group, respectively (P= 0.439. CONCLUSION: MMC-T and AGI seem to be comparable in terms of success and complications as the initial surgical

  7. Trabeculectomia com mitomicina C em pacientes com glaucoma congênito refratário Trabeculectomy with mitomycin C in patients with refractory congenital glaucoma

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    Sebastião Cronemberger

    2004-06-01

    Full Text Available OBJETIVO: Relatar os resultados do uso de mitomicina C (MMC na cirurgia do glaucoma congênito refratário. MÉTODOS: 44 olhos de 30 pacientes com glaucoma congênito primário refratário, submetidos a trabeculectomia com MMC entre 1993 e 2002 no Serviço de Glaucoma do Hospital São Geraldo, foram estudados retrospectivamente, por meio de análise dos prontuários com seguimento mínimo de seis meses. RESULTADOS: A média de Po reduziu-se de 21,7± 7,2 mmHg no pré-operatório para 12,2±6,8 mmHg no tempo médio de acompanhamento pós-operatório de 42,8 meses (pPURPOSE: To describe the results of mitomycin-C (MMC in refractory congenital glaucoma surgery. METHODS: Fourty-four eyes of 30 patients with refractory primary congenital glaucoma submitted to trabeculectomy with MMC (0.5 mg/ml for 5 minutes between 1993 and 2002 at the São Geraldo Eye Hospital/HC-UFMG were retrospectively studied, through review of medical records with a minimum follow-up of six months. RESULTS: The mean intraocular pressure (IOP under antiglaucomatous medication was reduced from 21.7±7.2 to 12.2± 6.8 mmHg at a mean follow-up of 42.8 months (p<0.001. The only postoperative complication was chronic ocular hipotony (IOP<6mmHg in four eyes (9,1% with aqueous humor leakage from the bleb (positive Seidel test in one of them. No statistical relationship was detected between the incidence of complications and gender (p=0.14, age at the time of surgery (p=0.65, initial IOP (p=0.29, initial number of antiglaucomatous drugs (p=0.39 and number of previous surgeries (p=0.94. CONCLUSION: MMC in filtering surgery of refractory primary congenital glaucoma has shown to be effective in the reduction of IOP. However, the ocular hypotony is a great concern.

  8. Use of Mitomycin C to reduce the incidence of encapsulated cysts following ahmed glaucoma valve implantation in refractory glaucoma patients: a new technique.

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

    2014-09-06

    To evaluate the surgical outcome of Ahmed glaucoma valve (AGV) implantation with a new technique of mitomycin C (MMC) application. This is a retrospective study. All patients with refractory glaucoma underwent FP-7 AGV implantation. Two methods of MMC application were used. In the traditional technique, 6 × 4 mm cotton soaked with MMC (0.25-0.33 mg/ml) was placed in the implantation area for 2-5mins; in the new technique, the valve plate first was encompassed with a thin layer of cotton soaked with MMC, then inserted into the same area. A 200 ml balanced salt solution was applied for irrigation of MMC. The surgical success rate, intraocular pressure (IOP), number of anti-glaucoma medications used, and postoperative complications were analyzed between the groups. The surgical outcomes of two MMC applied techniques were compared. The new technique group had only one case (2.6%) of encapsulated cyst formation out of 38 eyes, while there were eight (19.5%) cases out of 41 eyes the in traditional group. The difference was statistically significant (P = 0.030). According to the definition of success rate, there was 89.5% in the new technique group and 70.7% in the traditional group at the follow-up end point. There was a significant difference between the two groups (P = 0.035). Mean IOP in the new technique group were significantly lower than those of the traditional group at 3 and 6 months (P < 0.05). By using a thin layer of cotton soaked with MMC to encompass the valve plate, the new MMC application technique could greatly decrease the incidence of encapsulated cyst and increase the success rate following AGV implantation.

  9. Device-modified trabeculectomy for glaucoma.

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    Wang, Xue; Khan, Rabeea; Coleman, Anne

    2015-12-01

    Glaucoma is an optic neuropathy that leads to vision loss and blindness. It is the second most common cause of irreversible blindness worldwide. The main treatment for glaucoma aims to reduce intraocular pressure (IOP) in order to slow or prevent further vision loss. IOP can be lowered with medications, and laser or incisional surgeries. Trabeculectomy is the most common incisional surgical procedure to treat glaucoma. Device-modified trabeculectomy is intended to improve drainage of the aqueous humor to lower IOP. Trabeculectomy-modifying devices include Ex-PRESS, Ologen, amniotic membrane, expanded polytetrafluoroethylene (E-PTFE) membrane, Gelfilm and others. However, the effectiveness and safety of these devices are uncertain. To assess the relative effectiveness, primarily with respect to IOP control and safety, of the use of different devices as adjuncts to trabeculectomy compared with standard trabeculectomy in eyes with glaucoma. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2014, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2014), EMBASE (January 1980 to December 2014), PubMed (1948 to December 2014), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to December 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 22 December 2014. We included randomized controlled trials comparing devices used during trabeculectomy with trabeculectomy alone. We also included studies where antimetabolites were used in either or both treatment groups. We used standard procedures

  10. Trabeculectomy With Mitomycin C or Ahmed Valve Implantation in Eyes With Uveitic Glaucoma.

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    Bettis, Daniel I; Morshedi, Richard G; Chaya, Craig; Goldsmith, Jason; Crandall, Alan; Zabriskie, Norm

    2015-01-01

    To report and compare the results of trabeculectomy with mitomycin C (MMC) and Ahmed valve implantation in the management of uveitic glaucoma. The records of 41 eyes of 29 patients who underwent trabeculectomy with MMC or Ahmed valve implantation for uveitic glaucoma were retrospectively reviewed. Seventeen eyes underwent trabeculectomy with MMC, and 24 eyes underwent Ahmed valve implantation. Outcomes included postoperative intraocular pressure (IOP), percent reduction from preoperative IOP, postoperative number of medications, time to failure, and complications. Mean follow-up was 21.2 months in the trabeculectomy group and 23.8 months in the valve group (P=0.06). Mean IOP was reduced from 29.2 to 18.4 mm Hg in the trabeculectomy group (31.3%), compared with a reduction from 33.4 to 15.5 mm Hg in the Ahmed valve group (42.7%, P=0.53). Postoperatively, 1.76 medications were used in the trabeculectomy group, compared with 1.83 medications in the Ahmed valve group (P=0.89). Cumulative success at 1 year was 66.7% in the trabeculectomy group, compared with 100% in the Ahmed valve group (P=0.02). Mean time to failure was 8.36 months with trabeculectomy, and 21.8 months with Ahmed valve (P=0.02). Complications in both groups were typically rare and self-limited, with recurrent inflammation being most common. Although both trabeculectomy with MMC and Ahmed valve implantation are reasonable surgical options in the management of uncontrolled uveitic glaucoma, Ahmed valve implantation was associated with higher cumulative success rate at 1 year and a longer mean time to failure.

  11. Lahore general hospital protocol for treatment of neovascular glaucoma caused by retinal disease

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    Khaqan, H.A.; Haider, S.A.

    2013-01-01

    To evaluate efficacy of LGH (Lahore General Hospital) protocol for treatment of neovascular glaucoma caused by retinal diseases. Material and Methods: This case series was performed on 9 consecutive eyes of nine patients with uncontrolled neovascular glaucoma at Department of Ophthalmology, Unit II, Lahore General Hospital/PGMI, Lahore. All nine patients completed six months follow up. Among them 6 patients were having PDR (proliferative diabetic retinopathy) and 3 patients having CRVO (central retinal vein occlusion). LGH protocol for treatment of neovascular glaucoma was: To give intravitreal injection of avastin and then PRP (Pan Retinal Photocoagulation) or Trabeculectomy with MMC (Mitomycin C), if PRP and intravitreal avastin fails to control the intra ocular-pressure (IOP). Results: Three patients had IOP control after intravitreal injection of avastin and PRP, 5 patients had uncontrolled IOP after intravitreal avastin and two sessions of PRP, so they under went trabeculectomy with MMC. One patient had uncontrolled IOP despite of full treatment protocol. All other 8 patients IOP remained stable for six months. Conclusion: Significant decrease in intraocular pressure was achieved after observing LGH protocol for treatment of NVG (Neovascular Glaucoma) caused by retinal diseases. (author)

  12. A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery

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    Wu ZH

    2013-03-01

    Full Text Available Zhihong Wu,1 Shuning Li,2 Ningli Wang,2 Wanshun Liu,3 Wen Liu3 1General Hospital of Armed Police Forces, Beijing, People’s Republic of China; 2Beijing Tongren Eye Center, Capital Medical University, Beijing, People’s Republic of China 3Ocean University of China, Qingdao, People’s Republic of China Purpose: To investigate the potential usage of biological delivery membranes containing mitomycin C (MMC or 5-fluorouracil (5-FU in the construction of glaucoma-filtering blebs, and to evaluate their safety and efficacy. Methods: Chitosan was selected as the biological membrane carrier to prepare sustained-released membranes. Twelve micrograms of 5-FU or MMC was covalently conjugated onto the membranes by solvent volatilization. Rabbits underwent glaucoma filtration surgery and were randomly allocated into one of the four treatment regimens: glaucoma filtration operation with no implantation of chitosan membrane group (as control, drug-free chitosan membrane implantation group (blank/placebo group, membrane containing 5-FU treatment group (5-FU group, and membrane containing MMC treatment group (MMC group. Each group consisted of 12 rabbits. Intraocular pressure (IOP was measured and evaluated over a 28-day period follow-up preoperatively, then after surgery on days 1, 3, 5, 7, 14, 21, and 28 by Tono-Pen. The aqueous humor was analyzed in each experimental and control groups at days 4, 6, 8, 10, 12, 14, 16, and 20 after operation. Bleb survival and anterior segment were examined with a slit lamp microscope and photographed simultaneously. Two rabbits from each group were killed on day 28 and eight eye samples obtained for histopathological study. Corneas and lenses were examined by transmission and scanning electron microscopy. Results: Both 5-FU and MMC significantly prolonged bleb survival compared with control groups. The filtering bleb’s survival period was significantly more prolonged in the MMC and 5-FU groups (maintained 14 days than the

  13. A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery.

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    Wu, Zhihong; Li, Shuning; Wang, Ningli; Liu, Wanshun; Liu, Wen

    2013-01-01

    To investigate the potential usage of biological delivery membranes containing mitomycin C (MMC) or 5-fluorouracil (5-FU) in the construction of glaucoma-filtering blebs, and to evaluate their safety and efficacy. Chitosan was selected as the biological membrane carrier to prepare sustained-released membranes. Twelve micrograms of 5-FU or MMC was covalently conjugated onto the membranes by solvent volatilization. Rabbits underwent glaucoma filtration surgery and were randomly allocated into one of the four treatment regimens: glaucoma filtration operation with no implantation of chitosan membrane group (as control), drug-free chitosan membrane implantation group (blank/placebo group), membrane containing 5-FU treatment group (5-FU group), and membrane containing MMC treatment group (MMC group). Each group consisted of 12 rabbits. Intraocular pressure (IOP) was measured and evaluated over a 28-day period follow-up preoperatively, then after surgery on days 1, 3, 5, 7, 14, 21, and 28 by Tono-Pen. The aqueous humor was analyzed in each experimental and control groups at days 4, 6, 8, 10, 12, 14, 16, and 20 after operation. Bleb survival and anterior segment were examined with a slit lamp microscope and photographed simultaneously. Two rabbits from each group were killed on day 28 and eight eye samples obtained for histopathological study. Corneas and lenses were examined by transmission and scanning electron microscopy. Both 5-FU and MMC significantly prolonged bleb survival compared with control groups. The filtering bleb's survival period was significantly more prolonged in the MMC and 5-FU groups (maintained 14 days) than the other two groups (maintained 7 days). Significantly lower IOP was observed within the control, blank, and 5-FU groups after surgery on day 14 compared with that before operation, with F-values of 6.567, 11.426, and 13.467, respectively (P < 0.01). The most significant lower IOP was recorded in the MMC group on day 28 postoperation (F-value 26

  14. Mitomycin C versus 5-Fluorouracil for wound healing in glaucoma surgery.

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    Cabourne, Emily; Clarke, Jonathan C K; Schlottmann, Patricio G; Evans, Jennifer R

    2015-11-06

    Raised intraocular pressure is a risk factor for glaucoma. One treatment option is glaucoma drainage surgery (trabeculectomy). Antimetabolites are used during surgery to reduce postoperative scarring during wound healing. Two agents in common use are mitomycin C (MMC) and 5-Fluorouracil (5-FU). To assess the effects of MMC compared to 5-FU as an antimetabolite adjunct in trabeculectomy surgery. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015 Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2015), EMBASE (January 1980 to October 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to October 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 2 October 2015. We included randomised controlled trials where wound healing had been modified with MMC compared to 5-FU. Two review authors independently selected trials and collected data. The primary outcome was failure of a functioning trabeculectomy one year after surgery. Secondary outcomes included mean intraocular pressure at one year. We considered three subgroups: high risk of trabeculectomy failure (people with previous glaucoma surgery, extracapsular cataract surgery, African origin and people with secondary glaucoma or congenital glaucoma); medium risk of trabeculectomy failure (people undergoing trabeculectomy with extracapsular cataract surgery) and low risk of trabeculectomy failure (people who have received no previous surgical eye intervention). We identified 11 trials that enrolled 687 eyes of 679 participants. The

  15. Collagen matrix compared with mitomycin C for treatment of primary open-angle glaucoma with trabeculectomy performed

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    Lei Yu

    2017-09-01

    Full Text Available AIM:To evaluate the effectiveness and safety between trabeculectomy with collagen matrix versus trabeculectomy with mitomycin C(MMCfor patients with primary open-angle glaucoma(POAG.METHODS: In this prospective randomized comparative study from January 2015 to December 2016. Thirty-two eyes presented with POAG were included in this study, 14 eyes treated by trabeculectomy with subconjunctival implant of collagen matrix(study groupand the other 18 eyes treated by trabeculectomy with mitomycin C. Postoperative IOP, the success rate of operation, number of postoperative glaucoma medications and postoperative complications were recorded. Each patient was followed up at least 6mo. RESULTS: The mean postoperative IOP was statistically different between the study group and the control group after 1d(PP>0.05, and the mean postoperative IOP was statistically different between the two groups(PP>0.05. The IOP decreased at 1d after openations compared with before, kept stable at 1wk to 6mo. IOP of study group was lowen than control. IOP was controlled by glaucoma medications in the study group by 28% compared to control group by 33% at 6mo after operation, but there was no significant difference. There was no significant difference between the study group and the control group in complications(PCONCLUSION: Trabeculectomy with collagen matrix implant is comparable to the use of MMC with a similar success rate in open-angle glaucoma and the range in reducing intraocular pressure was significantly higher than that of MMC and it can significantly avoid the occurrence of low IOP postoperatively, transient anterior chamber, conjunctival wound leakage complications has no advantages compared with the use of MMC.

  16. Adjunctive Mitomycin C or Amniotic Membrane Transplantation for Ahmed Glaucoma Valve Implantation: A Randomized Clinical Trial.

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    Yazdani, Shahin; Mahboobipour, Hassan; Pakravan, Mohammad; Doozandeh, Azadeh; Ghahari, Elham

    2016-05-01

    To determine whether adjunctive mitomycin C (MMC) or amniotic membrane transplantation (AMT) improve the outcomes of Ahmed glaucoma valve (AGV) implantation. This double-blind, stratified, 3-armed randomized clinical trial includes 75 eyes of 75 patients aged 7 to 75 years with refractory glaucoma. Eligible subjects underwent stratified block randomization; eyes were first stratified to surgery in the superior or inferior quadrants based on feasibility; in each subgroup, eyes were randomly assigned to the study arms using random blocks: conventional AGV implantation (group A, 25 eyes), AGV with MMC (group B, 25 eyes), and AGV with AMT (group C, 25 eyes). The 3 study groups were comparable regarding baseline characteristics and mean follow-up (P=0.288). A total of 68 patients including 23 eyes in group A, 25 eyes in group B, and 20 eyes group C completed the follow-up period and were analyzed. Intraocular pressure was lower in the MMC group only 3 weeks postoperatively (P=0.04) but comparable at other time intervals. Overall success rate was comparable in the 3 groups at 12 months (P=0.217). The number of eyes requiring medications (P=0.30), time to initiation of medications (P=0.13), and number of medications (P=0.22) were comparable. Hypertensive phase was slightly but insignificantly more common with standard surgery (82%) as compared with MMC-augmented (60%) and AMT-augmented (70%) procedures (P=0.23). Complications were comparable over 1 year (P=0.28). Although adjunctive MMC and AMT were safe during AGV implantation, they did not influence success rates or intraocular pressure outcomes. Complications, including hypertensive phase, were also comparable.

  17. Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

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    Saeed AM

    2014-09-01

    Full Text Available Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC. Methods: A randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP values, and number of IOP-lowering medications needed to achieve the target IOP.Results: Group A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05. There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.Conclusion: Bevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb. Keywords: glaucoma, bevacizumab, mitomycin C, failed trabeculectomy

  18. Intravitreal ranibizumab as adjuvant treatment for neovascular glaucoma

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    Flavia Gazze Ticly

    2013-04-01

    Full Text Available The purpose of this study was to describe a prospective case series of 5 eyes treated with intravitreal ranibizumab injection for neovascular glaucoma (NVG. Five patients with clinically uncontrolled NVG secondary to proliferative diabetic retinopathy (4 patients and central retinal vein occlusion (1 patient, non-responsive to maximal tolerable medication and panretinal photocoagulation, received intravitreal ranibizumab injection (0.5 mg. Patients were seen at 1st, 3rd and 7th day after the ranibizumab injection and when it was necessary. Success was defined as intraocular pressure (IOP 21, despite maximal tolerable medication, underwent trabeculectomy with 0.5mg/ml mitomycin C (MMC for 1 minute. Failure was defined as IOP > 21 mmHg, phthisis bulbi, loss of light perception or additional glaucoma surgery. The primary outcome was 6-month IOP control. Mean IOP before the ranibizumab injection was 37 mmHg (7 mmHg SD. Two out of five eyes underwent only ranibizumab injection, having an IOP control after the procedure. Three patients were submitted to trabeculectomy with MMC on the 7th day after the injection. At 6-month follow-up, the mean IOP was 12mmHg (3 mmHg SD. All eyes showed regression of rubeosis iridis and IOP control. Visual acuity improved in 2 eyes worsened in 1 eye, and remained stable in 2 eyes. These data suggest that intravitreal ranibizumab injection may be a useful tool in the treatment of NVG.

  19. Partial Tenon's capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery.

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    Susanna, R

    2003-08-01

    To verify if partial intraoperative Tenon's capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP0.05). Overall, 74.2% of the patients achieved an IOP glaucoma, PCTR with MMC augmentation showed no additional benefits or complications over MMC augmentation alone; no avascular bleb was obtained with this technique. The incidence of a hypertensive phase was lower than reported in previous studies.

  20. A review of the efficacy of mitomycin C in glaucoma filtration surgery

    Directory of Open Access Journals (Sweden)

    Al Habash A

    2015-10-01

    Full Text Available Ahmed Al Habash,1,2 Leyla Ali Aljasim,1 Ohoud Owaidhah,1 Deepak P Edward1,3 1King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia; 2Department of Ophthalmology, University of Dammam, Dammam, Saudi Arabia; 3Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The success of trabeculectomy, which is considered the gold standard in the surgical treatment of glaucoma, depends on the wound healing response. The introduction of antiproliferative agents such as mitomycin C (MMC has increased the success rates of trabeculectomy. However, complications due to these agents can be challenging to manage. Hence, it is important to determine the most efficacious dose and duration of exposure. Multiple studies suggest that many factors, including but not limited to MMC preparation, different concentrations, different exposure times, and method of application may affect success rate, and these factors were reviewed in this article. We concluded that lower concentrations of MMC that are prepared and applied in a standardized fashion, such as that using the Mitosol® kit (for 2–3 minutes during trabeculectomy, could potentially provide trabeculectomy success rates similar to that reported with off-label preparations, and that such a treatment regime could result in in lower complication rates than higher doses of MMC. Keywords: mitomycin C, Mitosol, filtering surgery, trabeculectomy, outcomes

  1. Controller Architecture Design for MMC-HVDC

    Directory of Open Access Journals (Sweden)

    ZHANG, B.

    2014-05-01

    Full Text Available Compared with high voltage direct current (HVDC, the primary and secondary systems of modular multilevel converter based HVDC (MMC-HVDC are complicated. And the characteristics of the control system determine the properties of the MMC-HVDC system to a certain extent. This paper investigates the design of control architecture. First, the structure and parameters of the 21-level MMC-HVDC are designed. Second, the framework of the control system is studied in details and a complete control system is established. The communication mode and content are built between each layer, and the control system program is developed and debugged. Then The steady state test platform of the sub-module and the relevant control system are designed. Finally, the steady-state tests and the system test of the physical MMC-HVDC simulation system are conducted, which prove that the SMC can control the sub-module (SM efficiently, and the control system could realize efficient start and stop of the physical system. Meanwhile, the capacitor voltage balance between the sub-modules and the basic fault protection and control of the DC voltage and power are verified to be effective.

  2. DC Fault Analysis and Clearance Solutions of MMC-HVDC Systems

    Directory of Open Access Journals (Sweden)

    Zheng Xu

    2018-04-01

    Full Text Available In this paper, the DC short-circuit fault and corresponding clearance solutions of modular multilevel converter-based high-voltage direct current (MMC-HVDC systems are analyzed in detail. Firstly, the analytical expressions of DC fault currents before and after blocking the MMC are derived based on the operation circuits. Before blocking the MMC, the sub-module (SM capacitor discharge current is the dominant component of the DC fault current. It will reach the blocking threshold value in several milliseconds. After blocking the MMC, the SM capacitor is no longer discharged. Therefore, the fault current from the AC system becomes the dominant component. Meanwhile, three DC fault clearance solutions and the corresponding characteristics are discussed in detail, including tripping AC circuit breaker, adopting the full-bridge MMC and employing the DC circuit breaker. A simulation model of the MMC-HVDC is realized in PSCAD/EMTDC and the results of the proposed analytical expressions are compared with those of the simulation. The results show that the analytical DC fault currents coincide well with the simulation results.

  3. Control of transformerless MMC-HVDC during asymmetric grid faults

    DEFF Research Database (Denmark)

    Timofejevs, Artjoms; Gamboa, Daniel; Liserre, Marco

    2013-01-01

    Modular multilevel converter (MMC) is the latest converter topology suitable for the transformerless applications in HVDC transmission. HVDC systems are required to remain connected during grid faults, provide grid support and completely decouple the healthy side from the faulty one. The MMC...

  4. Partial Tenon’s capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery

    Science.gov (United States)

    Susanna, R

    2003-01-01

    Aim: To verify if partial intraoperative Tenon’s capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. Methods: A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. Results: 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP⩽21 mm Hg) at 1 year after surgery was 70.4% in group A and 77.7% in group B (p>0.05). Overall, 74.2% of the patients achieved an IOP ⩽21 mm Hg and 55.2% an IOP⩽17 mm Hg, with or without additional medication administered to lower IOP. The incidence of complications was similar in both groups. Conclusions: In eyes undergoing Ahmed

  5. Cost Models for MMC Manufacturing Processes

    Science.gov (United States)

    Elzey, Dana M.; Wadley, Haydn N. G.

    1996-01-01

    Processes for the manufacture of advanced metal matrix composites are rapidly approaching maturity in the research laboratory and there is growing interest in their transition to industrial production. However, research conducted to date has almost exclusively focused on overcoming the technical barriers to producing high-quality material and little attention has been given to the economical feasibility of these laboratory approaches and process cost issues. A quantitative cost modeling (QCM) approach was developed to address these issues. QCM are cost analysis tools based on predictive process models relating process conditions to the attributes of the final product. An important attribute, of the QCM approach is the ability to predict the sensitivity of material production costs to product quality and to quantitatively explore trade-offs between cost and quality. Applications of the cost models allow more efficient direction of future MMC process technology development and a more accurate assessment of MMC market potential. Cost models were developed for two state-of-the art metal matrix composite (MMC) manufacturing processes: tape casting and plasma spray deposition. Quality and Cost models are presented for both processes and the resulting predicted quality-cost curves are presented and discussed.

  6. Mini-mental state exam for children (MMC) in children with hemiplegic cerebral palsy.

    Science.gov (United States)

    Moura, Ricardo; Andrade, Peterson Marco Oliveira; Fontes, Patrícia Lemos Bueno; Ferreira, Fernanda Oliveira; Salvador, Larissa de Souza; Carvalho, Maria Raquel Santos; Haase, Vitor Geraldi

    2017-01-01

    Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments. The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP. We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument. Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, those with poorer cognitive abilities. The MMC could be useful as a multiprofessional screening instrument for cognitive impairment in children with hemiplegic CP. Results of the MMC in quadriplegic CP children should be interpreted with caution. Diagnosis should be confirmed by further psychological testing.

  7. Analysis of communication based distributed control of MMC for HVDC

    DEFF Research Database (Denmark)

    Huang, Shaojun; Teodorescu, Remus; Mathe, Laszlo

    2013-01-01

    Modular Multilevel Converter (MMC) has gained a lot of interest in industry in the recent years due to its modular design and easy adaption for applications that require different power and voltage level. However, the control and operation of a real MMC consisting of large number of sub modules...

  8. Design of a Dry Dilution Refrigerator for MMC Gamma Detector Arrays

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, Stephan [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Boyd, Stephen [Univ. of New Mexico, Albuquerque, NM (United States); Cantor, Robin

    2017-04-03

    The goal of this LCP is to develop an ultra-high resolution gamma detector based on magnetic microcalorimeters (MMCs) for accurate non-destructive analysis (NDA) of nuclear materials. For highest energy resolution, we will introduce erbium-doped silver (Ag:Er) as a novel sensor material to replace current Au:Er sensors. The detector sensitivity will be increased by developing arrays of 32 Ag:Er pixels read out by 16 SQUID preamplifiers. MMC detectors require operating temperatures of ~15 mK and thus the use of a dilution refrigerator, and the desire for user-friendly operation without cryogenic liquids requires that this refrigerator use pulse-tube pre-cooling to ~4 K. For long-term reliability, we intend to re-design the heat switch that is needed to apply the magnetizing current to the Ag:Er sensor and that used to fail in earlier designs after months of operation. A cryogenic Compton veto will be installed to reduce the spectral background of the MMC, especially at low energies where ultra-high energy resolution is most important. The goals for FY16 were 1) to purchase a liquid-cryogen-free dilution refrigerator and adapt it for MMC operation, and 2) to fabricate Ag:Er-based MMC γ-detectors with improved performance and optimize their response. This report discusses the design of the instruments, and progress in MMC detector fabrication. Details of the MMC fabrication have been discussed in an April 2016 report to DOE.

  9. Glaucoma Medication Preferences among Glaucoma Specialists in Mexico

    OpenAIRE

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

    2017-01-01

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

  10. The Influence of Phacoemulsification on Surgical Outcomes of Trabeculectomy with Mitomycin-C for Uveitic Glaucoma.

    Directory of Open Access Journals (Sweden)

    Asaho Nishizawa

    Full Text Available To evaluate the influence of phacoemulsification after trabeculectomy on the postoperative intraocular pressure (IOP in eyes with uveitic glaucoma (UG.Kumamoto University Hospital, Kumamoto, Japan.A retrospective cohort study.The medical records of patients with UG who had trabeculectomy with mitomycin-C (MMC were reviewed. Complete and qualified surgical failures were defined by an IOP of ≥21 mmHg (condition A, ≥18 mmHg (condition B, or ≥15 mmHg (condition C without and with glaucoma eye drops, respectively. Kaplan-Meier survival analysis, generalized by the Wilcoxon test, and the Cox proportional hazards model analysis were conducted. Post-trabeculectomy phacoemulsification was treated as a time-dependent variable. In 24 (30% of the included 80 eyes, phacoemulsification was included, and they were divided into two groups: groups I (8 eyes with phacoemulsification within 1 year after trabeculectomy and group II (16 eyes after 1 year following trabeculectomy.Multivariable Cox proportional hazards model analysis showed post-trabeculectomy phacoemulsification was a significant factor in both complete success and qualified success based upon condition C (P = 0.0432 and P = 0.0488, respectively, but not for the other conditions. Kaplan-Meier survival analyses indicated significant differences in success probabilities between groups I and group II for complete success and qualified success based upon condition C (P = 0.020 and P = 0.013, respectively. There was also a significant difference for qualified success based upon condition B (P = 0.034, while there was no significant difference for the other conditions.Post-trabeculectomy phacoemulsification, especially within 1 year, can cause poor prognosis of IOP control of UG eyes after trabeculectomy with MMC.

  11. Integrin α5β1 Inhibition by CLT-28643 Reduces Postoperative Wound Healing in a Mouse Model of Glaucoma Filtration Surgery.

    Science.gov (United States)

    Van Bergen, Tine; Zahn, Grit; Caldirola, Patrizia; Fsadni, Mario; Caram-Lelham, Ninus; Vandewalle, Evelien; Moons, Lieve; Stalmans, Ingeborg

    2016-11-01

    To evaluate the therapeutic potential of the small molecule integrin α5β1 inhibitor, CLT-28643, to improve the filtering surgery outcome in a mouse model. Different dose regimens and administration routes of the inhibitor were compared with mitomycin C (MMC), the gold standard in clin ical practice. The efficacy of CLT-28643 on surgical outcome was studied in a mouse model for filtering surgery (n = 40 eyes from 20 mice per group). Single and repeated subconjunctival (SCJ) injections (1 or 2 μg) and topical eye drops (10 μg) of the integrin inhibitor were compared with 2-minute administration of MMC 0.02%. Bleb size, survival, and signs of toxicity were examined until 28 days after surgery. Immunohistochemical analysis of angiogenesis, inflammation, collagen deposition, and integrin α5β1 expression were performed on postoperative days 3, 8, 14, and 28. A masked observer performed all the assessments. Immunostaining showed that integrin α5β1 was highly expressed in the bleb at early time-points after surgery and that CLT-28643 inhibited this upregulation. Efficacy was shown to be dose-dependent for the integrin inhibitor CLT-28643 for bleb area and survival, and the wound healing process. While 2-μg single injection of CLT-28643 improved bleb characteristics in a similar way as 10-μg administered by eye drops and MMC, repeated injections of 2 μg showed superior efficacy compared to MMC, with no corneal toxicity. Administration of the integrin α5β1 inhibitor CLT-28643 has therapeutic potential as an adjunct to glaucoma surgery, possibly with a superior efficacy and tolerability compared with MMC when used at the optimal dose.

  12. Glaucoma

    Medline Plus

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

  13. Suprachoroidal drainage with collagen sheet implant- a novel technique for non-penetrating glaucoma surgery.

    Science.gov (United States)

    Szurman, Peter; Januschowski, Kai; Boden, Karl Thomas; Seuthe, Anna-Maria

    2018-02-01

    Our purpose was both to introduce the new technique of suprachoroidal drainage with collagen sheet implantation as a novel technique of non-penetrating glaucoma surgery and to present first results of a prospective pilot study. A superficial rectangular sclera flap of half-scleral thickness sized 4 × 4.5 mm is dissected anteriorly until clear cornea. Then, a second scleral flap is created underneath the first one sized 3.5x4mm and is cut down full-thickness to the choroid exposing the suprachoroidal space. The flap is then bluntly prepared until the scleral spur is reached. Sharp dissection above the sclera spur exposes Schlemm's canal, which is located directly anteriorly. Schlemm's canal is unroofed, juxtacanalicular meshwork is peeled and the deep flap is cut off at its base. An absorbable collagen sheet (Ologen®, Dahlhausen, Cologne, Germany) is placed into the suprachoroidal space at the level of the ciliary body, and the superficial sclera flap is sutured tightly to prevent leakage. We prospectively analyzed 65 eyes that underwent suprachoroidal drainage with collagen sheet implantation. Mean reduction of intraocular pressure after 3 months was 35.1% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.4 mmHg)(p < 0.01) and after 12 months 35.6% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.0  mmHg)(p < 0.01). The number of topical IOP-reducing medication decreased significantly from 3.5 ± 0.7 to 0.6 ± 0.9 and to 0.9 ± 1.1 after 3 and 12 months, respectively (p < 0.01). No serious complications occurred. Suprachoroidal drainage with collagen sheet implantation seems to be a safe and effective surgical technique for non-penetrating glaucoma surgery that yields the opportunity of a sufficient IOP reduction for eyes unsuitable for canaloplasty.

  14. IGBT Switching Characteristic Curve Embedded Half-Bridge MMC Modelling and Real Time Simulation Realization

    Science.gov (United States)

    Zhengang, Lu; Hongyang, Yu; Xi, Yang

    2017-05-01

    The Modular Multilevel Converter (MMC) is one of the most attractive topologies in recent years for medium or high voltage industrial applications, such as high voltage dc transmission (HVDC) and medium voltage varying speed motor drive. The wide adoption of MMCs in industry is mainly due to its flexible expandability, transformer-less configuration, common dc bus, high reliability from redundancy, and so on. But, when the sub module number of MMC is more, the test of MMC controller will cost more time and effort. Hardware in the loop test based on real time simulator will save a lot of time and money caused by the MMC test. And due to the flexible of HIL, it becomes more and more popular in the industry area. The MMC modelling method remains an important issue for the MMC HIL test. Specifically, the VSC model should realistically reflect the nonlinear device switching characteristics, switching and conduction losses, tailing current, and diode reverse recovery behaviour of a realistic converter. In this paper, an IGBT switching characteristic curve embedded half-bridge MMC modelling method is proposed. This method is based on the switching curve referring and sample circuit calculation, and it is sample for implementation. Based on the proposed method, a FPGA real time simulation is carried out with 200ns sample time. The real time simulation results show the proposed method is correct.

  15. Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.

    Science.gov (United States)

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

    2017-01-01

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

  16. Glaucoma

    Science.gov (United States)

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

  17. Facts about Glaucoma

    Science.gov (United States)

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

  18. One Curve Embedded Full-Bridge MMC Modeling Method with Detailed Representation of IGBT Characteristics

    Science.gov (United States)

    Hongyang, Yu; Zhengang, Lu; Xi, Yang

    2017-05-01

    Modular Multilevel Converter is more and more widely used in high voltage DC transmission system and high power motor drive system. It is a major topological structure for high power AC-DC converter. Due to the large module number, the complex control algorithm, and the high power user’s back ground, the MMC model used for simulation should be as accurate as possible to simulate the details of how MMC works for the dynamic testing of the MMC controller. But so far, there is no sample simulation MMC model which can simulate the switching dynamic process. In this paper, one curve embedded full-bridge MMC modeling method with detailed representation of IGBT characteristics is proposed. This method is based on the switching curve referring and sample circuit calculation, and it is sample for implementation. Based on the simulation comparison test under Matlab/Simulink, the proposed method is proved to be correct.

  19. What Is Glaucoma?

    Science.gov (United States)

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

  20. Adaptive response induced by low concentrations of MMC in human peripheral lymphocytes

    International Nuclear Information System (INIS)

    Sun Shuqing; Wang Bin; Jiang Jie

    1998-01-01

    Samples of cultured human peripheral lymphocytes were pre-treated with mitomycin C (MMC) in concentrations of 0.01∼0.1 μg/mL at 34 h of incubation and then exposed to 1.5 Gy of X-rays. Chromosome aberrations, sister chromatid exchanges and micronuclei for these lymphocytes were observed. The results show that the chromosome aberration rates for lymphocytes pre-treated with MMC in concentrations of 0.5 and 0.075 μg/mL and the frequencies of sister chromatid exchanges for lymphocytes pre-treated with MMC in concentrations of 0.01 μg/mL were significantly lower than their own expected values but the rates of micronuclei for lymphocytes pre-treated with MMC in concentrations of 0.05, 0.075 and 0.1 μg/mL were significantly higher than the expected values. Such results suggest that for studying the cross resistance of lymphocytes to chemicals and ionizing radiation, inconsistent conclusions may be obtained if different endpoints are based on

  1. Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

    Science.gov (United States)

    2007-06-01

    AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant

  2. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath

    2014-01-01

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

  3. Intraoperative Injection vs Sponge-applied Mitomycin C during Trabeculectomy: One-year Study.

    Science.gov (United States)

    S Khouri, Albert; Huang, Grace; Y Huang, Linda

    2017-01-01

    To determine the safety and efficacy of intraoperative injection of mitomycin C (MMC) against conventional sponge-applied MMC during trabeculectomy. This study was a retrospective, comparative case series. Thirty eyes with primary open-angle glaucoma underwent consecutive trabeculectomies with MMC injection (injection group), and thirty eyes with sponge-applied MMC were as controls (sponge group). Data were collected preoperatively and postoperatively at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. Demographic data, applanation intraocular pressure (IOP), best-corrected visual acuity (VA), number of glaucoma medications, postoperative interventions, postoperative complications, and number of visits within 3 months were recorded. In order to stratify data, proportion of eyes achieving >30% IOP reduction from baseline with or without glaucoma medications was calculated and defined as surgical success. Mean IOP reduction at 1 year was significant in both the injection and sponge groups from baseline (46.8 and 37.8% respectively). The injection group had overall lower postoperative IOP and comparable complete treatment success, defined as achieving >30% IOP reduction without glaucoma medications (p = 0.941). The number of postoperative visits within 3 months and the proportion of eyes needing 5-fluorouracil (5-FU) intervention were significantly lower in the injection group (p = 0.03, p = 0.04 respectively). Injection of MMC was as safe and effective as sponge application with comparable estimated complete treatment success, less need for visits within 3 months, and 5-FU intervention. Surgeons may consider intraopera-tive injection of MMC in appropriate patient cohorts given comparable safety and efficacy and several advantages over traditional sponge application. Further study in a prospective, larger, long-term manner is necessary to assess this modality. How to cite this article: Khouri AS, Huang G, Huang LY. Intraoperative Injection vs

  4. Glaucoma Research Foundation

    Science.gov (United States)

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

  5. Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

    Science.gov (United States)

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

    2011-01-01

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

  6. Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma.

    Science.gov (United States)

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

    2018-03-01

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

  7. Glaucoma, Open-Angle

    Science.gov (United States)

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

  8. Equine Glaucoma.

    Science.gov (United States)

    Michau, Tammy Miller

    2017-12-01

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

  9. Voltage Balancing Method on Expert System for 51-Level MMC in High Voltage Direct Current Transmission

    Directory of Open Access Journals (Sweden)

    Yong Chen

    2016-01-01

    Full Text Available The Modular Multilevel Converters (MMC have been a spotlight for the high voltage and high power transmission systems. In the VSC-HVDC (High Voltage Direct Current based on Voltage Source Converter transmission system, the energy of DC link is stored in the distributed capacitors, and the difference of capacitors in parameters and charge rates causes capacitor voltage balance which affects the safety and stability of HVDC system. A method of MMC based on the expert system for reducing the frequency of the submodules (SMs of the IGBT switching frequency is proposed. Firstly, MMC with 51 levels for HVDC is designed. Secondly, the nearest level control (NLC for 51-level MMC is introduced. Thirdly, a modified capacitor voltage balancing method based on expert system for MMC-based HVDC transmission system is proposed. Finally, a simulation platform for 51-level Modular Multilevel Converter is constructed by using MATLAB/SIMULINK. The results indicate that the strategy proposed reduces the switching frequency on the premise of keeping submodule voltage basically identical, which greatly reduces the power losses for MMC-HVDC system.

  10. Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC among a Sample of Health Care Providers in Haiti.

    Directory of Open Access Journals (Sweden)

    Jessy G Dévieux

    Full Text Available Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti.A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year.The sample consisted of medical doctors (31.0%, nurses (49.0%, and other health care professionals (20.0%. Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15-5.71 times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing "the best age to perform MMC" as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%.Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies

  11. Glaucoma: Symptoms and Causes

    Science.gov (United States)

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

  12. Glaucoma Symptoms

    Science.gov (United States)

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

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

    Science.gov (United States)

    Gessesse, Girum W

    2015-07-01

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

  14. Glaucoma

    Medline Plus

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

  15. 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. ...

  16. Glaucoma

    Medline Plus

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

  17. Glaucoma

    Medline Plus

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

  18. Glaucoma

    Medline Plus

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

  19. Investigation of steady state operation and dynamic performance of a MMC based HVDC link

    Energy Technology Data Exchange (ETDEWEB)

    Abildgaard, Elisabeth N.; Rui, Oeyvind A. [Statnett SF, Oslo (Norway); Molinas, Marta [Norwegian Univ. of Science and Technology, Trondheim (Norway). Dept. of Electric Engineering

    2012-07-01

    The Modular Multilevel Converter (MMC) represents an emerging topology with a scalable technology making possible higher voltage and increased power capability of the converter unit. A mathematical model of the MMC is presented, and a control system in the dq reference frame is described. Simulation results for the control system are included. (orig.)

  20. Study on Compensation Control of STATCOM Based on MMC

    Directory of Open Access Journals (Sweden)

    Xie Yan

    2016-01-01

    Full Text Available This paper introduced modular multi-level converter (MMC, which could enhance the voltage and power level by sub-converter modules in series and was easy to extend to any level of output. Its structure and working mechanism were described. By analyzing the energy transfer performance of STATCOM based on MMC working conditions in the compensation, a comprehensive compensation control strategy was proposed based on direct current control mode. By analyzing the higher harmonic components circulation generated by the inconsistencies in the three-phase upper and lower arm voltage, a loop control strategy is proposed for the suppression of the circulation in the arms of the M-STATCOM. The simulation results show the strategy has a better tracking precision and response speed for the compensation control.

  1. X-ray- and mitomycin C (MMC)-induced chromosome aberrations in spermiogenic germ cells and the repair capacity of mouse eggs for the X-ray and MMC damage

    International Nuclear Information System (INIS)

    Matsuda, Yoichi; Utsugi-Takeuchi, Toyoko; Tobari, Izuo; Seki, Naohiko; Chiba Univ.

    1989-01-01

    Chromosome aberrations induced at the first-cleavage metaphase of eggs fertilized with sperm recovered from spermiogenic cells which had been X-irradiated and treated with mitomycin C (MMC) at various stages were observed using in vitro fertilization and embryo culture technique. Furthermore, the repair capacity of the fertilized eggs for X-ray- and MMC-induced DNA damage which was induced in the spermiogenic cells and retained in the sperm until fertilization was investigated by analysis of the potentiation effects of 2 repair inhibitors, 3-aminobenzamide (3AB) and caffeine on the yield of chromosome aberrations. The frequency of chromosome aberrations observed in the eggs fertilized with sperm recovered from speratozoa to late spermatid stage (0-8 days after X-irradiation). The induced chromosome aberrations followed by chromosome exchange through all the spermiogenic stages. The results suggest that the large amount of DNA lesions induced in spermiogenic cells by X-rays and MMC persist as reparable damage until sperm maturation and are effectively repaired in the cytoplasm of the fertilized eggs. (author). 29 refs.; 2 figs.; 2 tabs

  2. Glaucoma

    Medline Plus

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

  3. 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

  4. 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:

  5. Normal-tension glaucoma (Low-tension glaucoma)

    Science.gov (United States)

    Anderson, Douglas R

    2011-01-01

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

  6. 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.

  7. Modeling of solidification of MMC composites during gravity casting process

    Directory of Open Access Journals (Sweden)

    R. Zagórski

    2013-04-01

    Full Text Available The paper deals with computer simulation of gravity casting of the metal matrix composites reinforced with ceramics (MMC into sand mold. The subject of our interest is aluminum matrix composite (AlMMC reinforced with ceramic particles i.e. silicon carbide SiC and glass carbon Cg. The created model describes the process taking into account solidification and its influence on the distribution of reinforcement particles. The computer calculation has been carried out in 2D system with the use of Navier-Stokes equations using ANSYS FLUENT 13. The Volume of Fluid approach (VOF and enthalpy method have been used to model the air-fluid free surface (and also volume fraction of particular continuous phases and the solidification of the cast, respectively.

  8. ANN-PSO Integrated Optimization Methodology for Intelligent Control of MMC Machining

    Science.gov (United States)

    Chandrasekaran, Muthumari; Tamang, Santosh

    2017-08-01

    Metal Matrix Composites (MMC) show improved properties in comparison with non-reinforced alloys and have found increased application in automotive and aerospace industries. The selection of optimum machining parameters to produce components of desired surface roughness is of great concern considering the quality and economy of manufacturing process. In this study, a surface roughness prediction model for turning Al-SiCp MMC is developed using Artificial Neural Network (ANN). Three turning parameters viz., spindle speed ( N), feed rate ( f) and depth of cut ( d) were considered as input neurons and surface roughness was an output neuron. ANN architecture having 3 -5 -1 is found to be optimum and the model predicts with an average percentage error of 7.72 %. Particle Swarm Optimization (PSO) technique is used for optimizing parameters to minimize machining time. The innovative aspect of this work is the development of an integrated ANN-PSO optimization method for intelligent control of MMC machining process applicable to manufacturing industries. The robustness of the method shows its superiority for obtaining optimum cutting parameters satisfying desired surface roughness. The method has better convergent capability with minimum number of iterations.

  9. A Transient Fault Recognition Method for an AC-DC Hybrid Transmission System Based on MMC Information Fusion

    Directory of Open Access Journals (Sweden)

    Jikai Chen

    2016-12-01

    Full Text Available At present, the research is still in the primary stage in the process of fault disturbance energy transfer in the multilevel modular converter based high voltage direct current (HVDC-MMC. An urgent problem is how to extract and analyze the fault features hidden in MMC electrical information in further studies on the HVDC system. Aiming at the above, this article analyzes the influence of AC transient disturbance on electrical signals of MMC. At the same time, it is found that the energy distribution of electrical signals in MMC is different for different arms in the same frequency bands after the discrete wavelet packet transformation (DWPT. Renyi wavelet packet energy entropy (RWPEE and Renyi wavelet packet time entropy (RWPTE are proposed and applied to AC transient fault feature extraction from electrical signals in MMC. Using the feature extraction results of Renyi wavelet packet entropy (RWPE, a novel recognition method is put forward to recognize AC transient faults using the information fusion technology. Theoretical analysis and experimental results show that the proposed method is available to recognize transient AC faults.

  10. Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

    OpenAIRE

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

    2011-01-01

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

  11. Energy Storage Characteristic Analysis of Voltage Sags Compensation for UPQC Based on MMC for Medium Voltage Distribution System

    Directory of Open Access Journals (Sweden)

    Yongchun Yang

    2018-04-01

    Full Text Available The modular multilevel converter (MMC, as a new type of voltage source converter, is increasingly used because it is a distributed storage system. There are many advantages of using the topological structure of the MMC on a unified power quality controller (UPQC, and voltage sag mitigation is an important use of the MMC energy storage system for the power quality compensation process. In this paper, based on the analysis of the topology of the MMC, the essence of energy conversion in a UPQC of voltage sag compensation is analyzed; then, the energy storage characteristics are calculated and analyzed to determine the performance index of voltage sag compensation; in addition, the simulation method is used to verify the voltage sag compensation characteristics of the UPQC; finally, an industrial prototype of the UPQC based on an MMC for 10 kV of medium voltage distribution network has been developed, and the basic functions of UPQC have been tested.

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  14. [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.

  15. Glaucoma (image)

    Science.gov (United States)

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

  16. Glaucoma Foundation

    Science.gov (United States)

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

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

    Science.gov (United States)

    Xu, Yumei; Hong, Tao; Li, Wanming

    2015-02-10

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

  18. Magnetic Microcalorimeter (MMC) Gamma Detectors with Ultra-High Energy Resolution

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, Stephen [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2018-01-19

    The goal of this LCP is to develop ultra-high resolution gamma detectors based on magnetic microcalorimeters (MMCs) for accurate non-destructive analysis (NDA) of nuclear materials. For highest energy resolution, we will introduce erbium-doped silver (Ag:Er) as a novel sensor material, and implement several geometry and design changes to improve the signal-to-noise ratio. The detector sensitivity will be increased by developing arrays of 32 Ag:Er pixels read out by 16 SQUID preamplifiers, and by developing a cryogenic Compton veto to reduce the spectral background. Since best MMC performance requires detector operation at ~10 mK, we will purchase a dilution refrigerator with a base temperature <10 mK and adapt it for MMC operation. The detector performance will be tested with radioactive sources of interest to the safeguards community.

  19. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

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

  20. MMC with parallel-connected MOSFETs as an alternative to wide bandgap converters for LVDC distribution networks

    Directory of Open Access Journals (Sweden)

    Yanni Zhong

    2017-03-01

    Full Text Available Low-voltage direct-current (LVDC networks offer improved conductor utilisation on existing infrastructure and reduced conversion stages, which can lead to a simpler and more efficient distribution network. However, LVDC networks must continue to support AC loads, requiring efficient, low-distortion DC–AC converters. Additionally, increasing numbers of DC loads on the LVAC network require controlled, low-distortion, unity power factor AC-DC converters with large capacity, and bi-directional capability. An AC–DC/DC–AC converter design is therefore proposed in this study to minimise conversion loss and maximise power quality. Comparative analysis is performed for a conventional IGBT two-level converter, a SiC MOSFET two-level converter, a Si MOSFET modular multi-level converter (MMC and a GaN HEMT MMC, in terms of power loss, reliability, fault tolerance, converter cost and heatsink size. The analysis indicates that the five-level MMC with parallel-connected Si MOSFETs is an efficient, cost-effective converter for low-voltage converter applications. MMC converters suffer negligible switching loss, which enables reduced device switching without loss penalty from increased harmonics and filtering. Optimal extent of parallel-connection for MOSFETs in an MMC is investigated. Experimental results are presented to show the reduction in device stress and electromagnetic interference generating transients through the use of reduced switching and device parallel-connection.

  1. Comparison of the visual outcomes between PRK-MMC and phakic IOL implantation in high myopic patients.

    Science.gov (United States)

    Hashemi, H; Miraftab, M; Asgari, S

    2014-09-01

    To compare the visual outcomes between PRK-MMC and phakic IOL in patients with more than 8 diopter (D) of myopia. This comparative study was performed on 23 eyes under treatment with Artiflex (group A) and 23 eyes under treatment with PRK-MMC (group B). Artiflex phakic IOL (Ophtec BV) was used in group A, and the VISX STAR S4 Excimer Laser (Abbott) was used for PRK-MMC in group B. The safety index was 1.11 ± 0.23 and 1.05 ± 0.25 (P = 0.100) and the efficacy index was 1.02 ± 0.11 and 0.98 ± 0.10 (P = 0.266) in group A and B, respectively. At 1 year after surgery, the manifest refraction spherical equivalent was -0.17 ± 1.18 and -0.25 ± 0.18 D in group A and B, respectively (P = 0.471). Mesopic CS showed no significant difference between the two groups in any spatial frequency. Total coma was 0.24 ± 0.17 and 0.67 ± 0.40 μm (P PRK-MMC in the correction of high myopia in terms of visual quality, but the two methods had no difference with regard to visual acuity. Therefore, PRK-MMC can be used when the anterior chamber depth is a limiting factor in the implantation of phakic IOLs.

  2. 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. ...

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

    Directory of Open Access Journals (Sweden)

    Franciele Vegini

    2008-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  5. Overvoltage and Insulation Coordination of Overhead Lines in Multiple-Terminal MMC-HVDC Link for Wind Power Delivery

    Directory of Open Access Journals (Sweden)

    Huiwen He

    2017-01-01

    Full Text Available The voltage-sourced converter-based HVDC link, including the modular multilevel converter (MMC configuration, is suitable for wind power, photovoltaic energy, and other kinds of new energy delivery and grid-connection. Current studies are focused on the MMC principles and controls and few studies have been done on the overvoltage of transmission line for the MMC-HVDC link. The main reason is that environmental factors have little effect on DC cables and the single-phase/pole fault rate is low. But if the cables were replaced by the overhead lines, although the construction cost of the project would be greatly reduced, the single-pole ground fault rate would be much higher. This paper analyzed the main overvoltage types in multiple-terminal MMC-HVDC network which transmit electric power by overhead lines. Based on ±500 kV multiple-terminal MMC-HVDC for wind power delivery project, the transient simulation model was built and the overvoltage types mentioned above were studied. The results showed that the most serious overvoltage was on the healthy adjacent line of the faulty line caused by the fault clearing of DC breaker. Then the insulation coordination for overhead lines was conducted according to the overvoltage level. The recommended clearance values were given.

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

    Science.gov (United States)

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

    2009-01-01

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

  7. Glaucoma: Hot Topics in Pharmacology.

    Science.gov (United States)

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

    2017-01-01

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

  8. 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.

  9. The U.S. Army Surface Ablation Study: comparison of PRK, MMC-PRK, and LASEK in moderate to high myopia.

    Science.gov (United States)

    Sia, Rose K; Ryan, Denise S; Edwards, Jayson D; Stutzman, Richard D; Bower, Kraig S

    2014-04-01

    To compare visual outcomes following photorefractive keratectomy (PRK), PRK with mitomycin C (MMC-PRK), and LASEK in moderate and high myopia in military personnel. This prospective, randomized contralateral eye study included 167 patients 21 years or older with manifest spherical equivalent -5.99 ± 1.40 diopters (D) (range: -3.88 to -9.38 D) randomized to either MMC-PRK or LASEK treatment in their dominant eye and conventional PRK without MMC in the fellow eye. All procedures were performed using the LADARVision 4000 Excimer Laser System (Alcon Surgical Inc., Ft. Worth, TX). High- and low-contrast visual acuities, manifest refraction, endothelial cell count, and corneal haze were evaluated up to 12 months postoperatively. At 12 months postoperatively, visual outcomes were comparable among the treatment groups. Corneal haze of any grade was less common in MMC-PRK compared to PRK at 1 month (21.4% vs 31.0%; P PRK compared to LASEK at 1 month (21.4% vs 55.9%; P PRK. Clinically significant haze (grade 2 or higher) developed after PRK (4 eyes) and LASEK (2 eyes), but not after MMC-PRK. MMC-PRK showed some benefits in minimizing corneal haze formation. One year after surgery, there was no discernible difference in the postoperative refractive outcomes among the three methods. Copyright 2014, SLACK Incorporated.

  10. 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 ...

  11. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  15. Nanotechnology Applications for Glaucoma.

    Science.gov (United States)

    Cetinel, Sibel; Montemagno, Carlo

    2016-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-09

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

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

    OpenAIRE

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

    2015-01-01

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

  20. Experience with the Ahmed Glaucoma Valve

    African Journals Online (AJOL)

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

  1. [Secondary glaucoma in Paraguay. Etiology and incidence].

    Science.gov (United States)

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

    1999-06-01

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

  2. Lifetime Estimation of MMC for Offshore Wind Power HVDC Application

    DEFF Research Database (Denmark)

    Liu, Hui; Ma, Ke; Loh, Poh Chiang

    2014-01-01

    of these could lead to thermo-mechanical fatigues in the components and joints of the power modules and thereby causing reliability challenge. This study focuses on the lifetime evaluation of MMC based on power cycling and thermal cycling considering the mission profiles in the High Voltage Direct Current (HVDC...

  3. Lifetime Estimation of MMC for Offshore Wind Power HVDC Application

    DEFF Research Database (Denmark)

    Liu, Hui; Ma, Ke; Qin, Zian

    2016-01-01

    of these could lead to thermomechanical fatigues in the components and joints of the power modules and thereby causing reliability challenge. This study focuses on the lifetime evaluation of MMC based on power cycling and thermal cycling considering the mission profiles in the High Voltage Direct Current (HVDC...

  4. Neuroprotection in glaucoma

    Directory of Open Access Journals (Sweden)

    Azadeh Doozandeh

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  6. [Uveitic Secondary Glaucoma].

    Science.gov (United States)

    Lommatzsch, Claudia; Heinz, Carsten

    2018-05-01

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

  7. 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.

  8. Trabeculectomy with mitomycin-c

    International Nuclear Information System (INIS)

    Baig, M.S.A.; Ali, M.A.

    2008-01-01

    To study the efficacy and safety of trabeculectomy augmented with intra-operative application of Mitomycin- C (MMC) in various types of refractory glaucomas. Forty patients with a number of refractory glaucomas who underwent trabeculectomies with MMC. MMC 0.02% (0.2mg/ml) was applied to 52 eyes of 40 patients being operated for trabeculectomies under the partial thickness scleral flap with an exposure time of three minutes. Visual outcome, control of intraocular pressure (IOP) and complications were evaluated. There were 25 males and 15 females in the study with an average age of 41.3 (range 1-65) years and an average follow up of 26.4 months (range 12-60 months). The average preoperative IOP was 32.5mm Hg (range 24- 52 mmHg) on an average of 1.34 medications, and the mean postoperative IOP after one year in successful cases was 14.42mmHg (range 12-18 mm Hg) without any medication (qualified success) in 45(86.5%) cases; five patients required one medication. Early postoperative complications included hypotony of more than one month duration in 11(21.2%) cases, hyphema of more than one week duration in 7(13.5%) and epithelial defect in 3(5.76%) cases. Late complication included cataract in 21(40.4%) cases, uncontrolled intraocular pressure despite medical therapy in two (3.84%) cases who further underwent Ahmed glaucoma valve implantation. One case (1.92%) of hypotonous maculopathy was noted. Trabeculectomy with MMC is a promising, safe and effective modality in the management of refractory glaucomas. As the complications related to bleb thinning increases with time, hence further study is required to determine the long term complications. (author)

  9. Glaucoma treatment trends: a review.

    Science.gov (United States)

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

    2017-02-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  11. [OCT and neovascular glaucoma].

    Science.gov (United States)

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

    2007-06-01

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

  12. Glaucoma: a brief update for 2017

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  15. 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.

  16. Angle closure glaucoma in congenital ectropion uvea

    Directory of Open Access Journals (Sweden)

    Grace M. Wang

    2018-06-01

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

  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. Fabrication of BN/Al(-Mg) metal matrix composite (MMC) by pressureless infiltration technique

    Energy Technology Data Exchange (ETDEWEB)

    Jung, W.G.; Kwon, H. [School of Advanced Materials Eng., Kookmin Univ., Seoul (Korea)

    2004-07-01

    BN/Al(-Mg) metal matrix composite (MMC) was fabricated by the pressureless infiltration technique. The phase characterizations of the composites were analyzed using the SEM, TEM, EDS and EPMA on reaction products after the electrochemical dissolution of the matrix. It is confirmed that aluminum nitride (AlN) was formed by the reaction of Mg{sub 3}N{sub 2} and Al alloy melt. Plate type AlN and polyhedral type Mg(-Al) boride were formed by the reaction between Mg{sub 3}N{sub 2}, BN and molten Al in the composite. The reaction mechanism in the fabrication of BN/Al(-Mg) MMC was derived from the phase analysis results and the thermodynamic investigation. (orig.)

  19. Progress of inflammatory cytokines in glaucoma

    Directory of Open Access Journals (Sweden)

    Ping Hu

    2015-12-01

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

  20. Clinical Metabolomics and Glaucoma.

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dong-Dao Song

    2016-06-01

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

  4. Altered aquaporin expression in glaucoma eyes

    DEFF Research Database (Denmark)

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

    2014-01-01

    Aquaporins (AQP) are channels in the cell membrane that mainly facilitate a passive transport of water. In the eye, AQPs are expressed in the ciliary body and retina and may contribute to the pathogenesis of glaucoma and optic neuropathy. We investigated the expression of AQP1, AQP3, AQP4, AQP5......, AQP7 and AQP9 in human glaucoma eyes compared with normal eyes. Nine glaucoma eyes were examined. Of these, three eyes were diagnosed with primary open angle glaucoma; three eyes had neovascular glaucoma; and three eyes had chronic angle-closure glaucoma. Six eyes with normal intraocular pressure...... and without glaucoma were used as control. Immunohistochemistry was performed using antibodies against AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9. For each specimen, optical densities of immunoprecipitates were measured using Photoshop and the staining intensities were calculated. Immunostaining showed labelling...

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

    OpenAIRE

    Ranganath, Akshatha; Hashim, Adnan

    2011-01-01

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

  6. Conditional dissipation of scalars in homogeneous turbulence: Closure for MMC modelling

    Science.gov (United States)

    Wandel, Andrew P.

    2013-08-01

    While the mean and unconditional variance are to be predicted well by any reasonable turbulent combustion model, these are generally not sufficient for the accurate modelling of complex phenomena such as extinction/reignition. An additional criterion has been recently introduced: accurate modelling of the dissipation timescales associated with fluctuations of scalars about their conditional mean (conditional dissipation timescales). Analysis of Direct Numerical Simulation (DNS) results for a passive scalar shows that the conditional dissipation timescale is of the order of the integral timescale and smaller than the unconditional dissipation timescale. A model is proposed: the conditional dissipation timescale is proportional to the integral timescale. This model is used in Multiple Mapping Conditioning (MMC) modelling for a passive scalar case and a reactive scalar case, comparing to DNS results for both. The results show that this model improves the accuracy of MMC predictions so as to match the DNS results more closely using a relatively-coarse spatial resolution compared to other turbulent combustion models.

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

    Science.gov (United States)

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

    2013-03-01

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

  8. Genetics Home Reference: early-onset glaucoma

    Science.gov (United States)

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

  9. Interactions Between Indirect DC-Voltage Estimation and Circulating Current Controllers of MMC-Based HVDC Transmission Systems

    DEFF Research Database (Denmark)

    Wickramasinghe, Harith R.; Konstantinou, Georgios; Pou, Josep

    2018-01-01

    Estimation-based indirect dc-voltage control in MMCs interacts with circulating current control methods. This paper proposes an estimation-based indirect dc-voltage control method for MMC-HVDC systems and analyzes its performance compared to alternative estimations. The interactions between......-state and transient performance is demonstrated using a benchmark MMC-HVDC transmission system, implemented in a real-time digital simulator. The results verify the theoretical evaluations and illustrate the operation and performance of the proposed indirect dc-voltage control method....

  10. Graft failure: III. Glaucoma escalation after penetrating keratoplasty.

    Science.gov (United States)

    Greenlee, Emily C; Kwon, Young H

    2008-06-01

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

  11. Arguments Against Funding Glaucoma Treatment and Rebuttal

    African Journals Online (AJOL)

    2018-03-01

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

  12. 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

  13. The Philadelphia Glaucoma Detection and Treatment Project

    Science.gov (United States)

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

    2016-01-01

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

  14. Glaucoma in Asian Populations

    Science.gov (United States)

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

  15. 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, ...

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  19. 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 ...

  20. Competition and regulation in the gas industry: an evaluation of the MMC report on gas in the UK

    International Nuclear Information System (INIS)

    Stoppard, M.

    1993-01-01

    The advantages and disadvantages of a more competitive gas market in the UK are examined, and the Monopolies and Mergers Commission (MMC) references and recommendations are outlined. An assessment of the findings of the MMC report is given covering the structure of British Gas, the monopoly threshold, setting charges for the tariff market and transportation, services, market share targets, the regulatory system, and guarantees to shareholders. (UK)

  1. Modelisation et simulation d'une liaison HVDC de type VSC-MMC

    Science.gov (United States)

    Saad, Hani Aziz

    High-voltage direct current transmission systems (HVDC) are rapidly expanding in the world. Two main factors are responsible for this expansion. The first is related to the difficulty of building new overhead lines to ensure the development of high-voltage AC grids, which makes the usage of underground cables more common. However, the use of such cables is limited in length to a few tens of km because of the capacitive current generated by the cable itself. Beyond this length limit, the solution is usually to transmit in DC. The second factor is related to the development of offshore wind power plants that require connecting powers of several hundred of MW to the mainland grid by cables whose lengths can reach several hundreds of km and consequently require HVDC transmission system. Several HVDC projects are currently planned and developed by the French transmission system operator RTE. One of such projects is the INELFE interconnection project, with a capacity of 2,000 MW, between France and Spain. This thesis has been funded by RTE, in order to model and simulate in off-line and real time modes, modern HVDC interconnections. The delivered simulation means are used to examine targeted HVDC system performances and risks of abnormal interactions with surrounding power systems. The particularity of the INELFE HVDC system is the usage of a dedicated control system that will largely determine the dynamic behaviour of the system for both large disturbances (faults on the network) and small perturbations (power step changes). Various VSC topologies, including the conventional two-level, multi-level diode-clamped and floating capacitor multi-level converters, have been proposed and reported in the literature. However, due to the complexity of controls and practical limitations, the VSC-HVDC system installations have been limited to the two-level and three-level diode-clamped converters. Recently, the development of modular technology called MMC (Modular Multilevel

  2. Angle closure glaucoma in congenital ectropion uvea.

    Science.gov (United States)

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

    2018-06-01

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

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

    Science.gov (United States)

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

    2004-09-01

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

  4. Effect of TiH2 in the preparation of MMC Ti based with TiC reinforcement

    International Nuclear Information System (INIS)

    Peillon, N.; Fruhauf, J.B.; Gourdet, S.; Feraille, J.; Saunier, S.; Desrayaud, C.

    2015-01-01

    Highlights: • Using TiH 2 precursors promotes the MMC densification and microstructure homogeneity. • Clear description of the TiH 2 interest and limitations. • Coupling of TGA, TMA and EBSD analyses to investigate the sintering process of MMC. • Process parameters: granulometry, precursor composition, temperature and rate. - Abstract: Many studies were carried out on the elaboration Metal Matrix Composites (MMCs) and a wide variety of process is reported in the bibliography. For titanium based MMC, the basis material for these elaboration techniques mainly consists of atomized titanium powder. In this work a titanium hydride powder is used to elaborate Ti/TiC MMC. Although an additional dehydrogenation operation is required a significant decrease of the sintering temperature is expected with this basis powder. In this context, the behavior of titanium hydride powder mixed with 0, 10 and 20 vol.% TiC reinforcement is studied during densification by free sintering. The effects of particle size, temperature and rate of sintering reinforcement are discussed. The comparison of the TiH 2 process with Ti HDH (Hydride Dehydride) and atomized Ti mixture is made with 10 vol.% reinforcement. The results indicate that the sintering temperature is lowered and the final densities achieved are higher if the hydride is used. Interactions between dehydrogenation and sintering mechanisms clearly appear for the higher sintering temperature rate (10 °C/min) and need specific attention to prevent porosity nucleation through hydrogen entrapment

  5. Glaucoma and clinical characteristics in Vietnamese Americans.

    Science.gov (United States)

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

    2011-08-01

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

  6. Glaucoma

    Medline Plus

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

  7. 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

  8. 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.

  9. GENDER AND AGE FEATURES OF GLAUCOMA

    Directory of Open Access Journals (Sweden)

    O. V. Makarenk

    2014-02-01

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

  10. Clinical findings following Ahmed Glaucoma Valve™ implantation in pediatric glaucoma

    Directory of Open Access Journals (Sweden)

    Amir Pirouzian

    2008-03-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Daniel E. Grigera

    2013-06-01

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

  13. Fatal intoxication with 3-methyl-N-methylcathinone (3-MMC) and 5-(2-aminopropyl)benzofuran (5-APB).

    Science.gov (United States)

    Adamowicz, Piotr; Zuba, Dariusz; Byrska, Bogumiła

    2014-12-01

    The emergence of a large number of new psychoactive substances (NPSs) in recent years poses a serious problem to clinical and forensic toxicologists. Here we report a patient who administrated ca. 500mg of 3-MMC (3-methyl-N-methylcathinone) and 400mg of 5-APB (5-(2-aminopropyl)benzofuran) in combination with 80g of ethyl alcohol. The clinical manifestations included agitation, seizures, hypertension, tachycardia, hyperthermia and bradycardia. The patient did not recover and died around 4h after the use of drugs. The cause of death was acute cardiovascular collapse that occurred following mixed intoxication with NPSs and alcohol. Toxicological analysis of post-mortem blood revealed 3-MMC and 5-APB in concentrations of 1.6μg/mL and 5.6μg/mL, respectively. Moreover, the serum alcohol concentration was 1.4g/L in ante-mortem sample collected 1h after admission to the hospital. This is the first report on blood concentration of 3-MMC and 5-APB in fatal intoxication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. THE TREATMENT OF OPEN- AND NARROW-ANGLE GLAUCOMA

    African Journals Online (AJOL)

    1971-04-10

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

  15. Two-year survival of Ahmed valve implantation in the first 2 years of life with and without intraoperative mitomycin-C.

    Science.gov (United States)

    Al-Mobarak, Faisal; Khan, Arif O

    2009-10-01

    To evaluate the effect of intraoperative mitomycin-C (MMC) on polypropylene Ahmed glaucoma valve (AGV) survival 2 years after implantation during the first 2 years of life. Retrospective institutional comparative series (1995-2005). Thirty-one eyes of 27 patients (23 unilateral, 4 bilateral; 16 boys, 11 girls) undergoing AGV implantation at a mean age of 11.1 months (standard deviation [SD], 5.46), all of which had 2 years of regular postoperative follow-up. MMC was applied intraoperatively in those cases in the area of AGV implantation in 16 (52%) and was not applied in 15 (48%). In some eyes, MMC was applied intraoperatively in cases done by the surgeons who routinely used MMC for all AGV implantation in young children. Failure was defined as intraocular pressure (IOP) > 22 mmHg with or without glaucoma medications, the need for an additional procedure for IOP control, or the occurrence of significant complications (e.g., endophthalmitis, retinal detachment, persistent hypotony [IOP < 5 mmHg]). Survival was the absence of failure. Failure or significant complications as defined. Mean survival for the non-MMC eyes (22.15 months; standard error [SE], 1.93) was significantly longer than survival for the MMC eyes (16.25 months; SE, 2.17) by the log-rank test (P = 0.025). The difference in cumulative survival at 2 years was also significantly different by log-rank test (P = 0.001): 80.0% (SE 10.3) and 31.3% (SE 11.6), respectively. Rather than improved survival, intraoperative use of MMC was associated with shorter survival 2 years after AGV implantation during the first 2 years of life. We speculate that MMC-induced tissue death can stimulate a reactive fibrosis around the AGV in very young eyes.

  16. Update on pigment dispersion syndrome and pigmentary glaucoma.

    Science.gov (United States)

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

    2017-03-01

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

  17. 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.

  18. Glaucoma

    Medline Plus

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

  19. Scanning the macula for detecting glaucoma

    Directory of Open Access Journals (Sweden)

    Viquar U Begum

    2014-01-01

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

  20. Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy

    Directory of Open Access Journals (Sweden)

    Zhi-Qin Wu

    2016-07-01

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

  1. Microplasticity of MMC. Experimental results and modelling

    International Nuclear Information System (INIS)

    Maire, E.; Lormand, G.; Gobin, P.F.; Fougeres, R.

    1993-01-01

    The microplastic behavior of several MMC is investigated by means of tension and compression tests. This behavior is assymetric : the proportional limit is higher in tension than in compression but the work hardening rate is higher in compression. These differences are analysed in terms of maxium of the Tresca's shear stress at the interface (proportional limit) and of the emission of dislocation loops during the cooling (work hardening rate). On another hand, a model is proposed to calculate the value of the yield stress, describing the composite as a material composed of three phases : inclusion, unaffected matrix and matrix surrounding the inclusion having a gradient in the density of the thermally induced dilocations. (orig.)

  2. Microplasticity of MMC. Experimental results and modelling

    Energy Technology Data Exchange (ETDEWEB)

    Maire, E. (Groupe d' Etude de Metallurgie Physique et de Physique des Materiaux, INSA, 69 Villeurbanne (France)); Lormand, G. (Groupe d' Etude de Metallurgie Physique et de Physique des Materiaux, INSA, 69 Villeurbanne (France)); Gobin, P.F. (Groupe d' Etude de Metallurgie Physique et de Physique des Materiaux, INSA, 69 Villeurbanne (France)); Fougeres, R. (Groupe d' Etude de Metallurgie Physique et de Physique des Materiaux, INSA, 69 Villeurbanne (France))

    1993-11-01

    The microplastic behavior of several MMC is investigated by means of tension and compression tests. This behavior is assymetric : the proportional limit is higher in tension than in compression but the work hardening rate is higher in compression. These differences are analysed in terms of maxium of the Tresca's shear stress at the interface (proportional limit) and of the emission of dislocation loops during the cooling (work hardening rate). On another hand, a model is proposed to calculate the value of the yield stress, describing the composite as a material composed of three phases : inclusion, unaffected matrix and matrix surrounding the inclusion having a gradient in the density of the thermally induced dilocations. (orig.).

  3. 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.

  4. Feasibility analysis of Triptolide's role in treating filtering bleb fibrosis after the filtration surgery of glaucoma

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    Ting Chen

    2014-06-01

    Full Text Available At present, filtration surgery remains an important treatment of glaucoma, and filtering bleb fibrosis is the main cause for treatment failure. Filtering bleb fibrosis is a common fiber hyperplastic disease, and it relates to the activation and proliferation of fibroblasts and the excessive production of extracellular matrix(ECMsuch as collagen protein. The most frequently-used drugs for filtering bleb fibrosis in clinic are 5-fluoro-2,4(1h, 3hpyrimidinedione(5-Fuand mitomycin(MMC. Although they are effective in some degree, they also have some serious side effects which restrict their clinical use. Triptolide(TPLis a major active component of the medicinal plant, tripterygium wilfordii hook.f.(TWHF. TPL has multiple pharmacological activities including immunosuppressive, anti-inflammatory, anti-cancer and anti-fertility activity. Reviewing related literatures published in recent ten years, we confirmed that TPL seemed to possess a pharmacological activity in treating filtering bleb fibrosis. Since it has three major functions: 1. inhibit the activation and proliferation of fibroblasts and the excessive production of collagen protein; 2. alleviate the inflammatory reaction after surgical wound to suppress fibrous scar formation; 3.TPL has a protective effect on retinal ganglion cells(RGCs. We further find that TPL's anti-fibrosis activity mainly results from that it inhibits TGF-β/Smad,NF-κB and PI3K/AKT signal transduction pathway. This comprehensive analysis about the feasibility of Triptolide's role in treating filtering bleb fibrosis after the filtration surgery of glaucoma can help us develop new drugs for filtering bleb fibrosis and exploit TPL's clinical value on some level.

  5. Glaucoma evolution in patients with diabetes.

    Science.gov (United States)

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

    2014-01-01

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

  6. Glaucoma in patients with uveitis.

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

    1990-01-01

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

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

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

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

    Science.gov (United States)

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

    2015-02-01

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

  9. Childhood glaucoma surgery in the 21st Century

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Stephen, Cook; Benjamin, Longo-Mbenza

    2013-01-01

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

  11. GLAUCOMA IN PSEUDOEXFOLIATION- CLINICAL PROSPECTIVE STUDY

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    Balasubramanian M. Manickavelu

    2018-01-01

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

  12. Determinants of glaucoma awareness and knowledge in urban Chennai

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    Sathyamangalam Ramesh

    2009-01-01

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

  13. 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

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

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    Andréia Peltier Urbano

    2003-01-01

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

  15. Pesquisaje de glaucoma

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    Aldo Sigler Villanueva

    1996-06-01

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

  16. New pharmacotherapy for the treatment of glaucoma.

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

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    Akagi T

    2015-06-01

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

  19. New Tool to Predict Glaucoma

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

  20. Does Your Child Have Glaucoma?

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

  1. Does Marijuana Help Treat Glaucoma?

    Science.gov (United States)

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

  2. Propionibacterium acnes endophthalmitis in Ahmed glaucoma valve.

    Science.gov (United States)

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

    2001-01-01

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

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

    Science.gov (United States)

    Ranganath, Akshatha; Hashim, Adnan

    2011-01-01

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

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

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    Akshatha Ranganath

    2011-01-01

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

  5. Glaucoma

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

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

    Science.gov (United States)

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

    2017-12-28

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

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

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    Dewang Angmo

    2015-01-01

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

  8. Evaluation of Ocular Surface Disease in Patients with Glaucoma

    Science.gov (United States)

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

    2013-01-01

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

  9. Driving patterns in older adults with glaucoma.

    Science.gov (United States)

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

    2013-02-21

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

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

    Science.gov (United States)

    Gramer, Gwendolyn; Gramer, Eugen

    2018-04-01

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

  11. Glaucoma Drainage Device Erosion Following Ptosis Surgery.

    Science.gov (United States)

    Bae, Steven S; Campbell, Robert J

    2017-09-01

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

  12. Monitoring dynamics of aqueous humor in glaucoma

    International Nuclear Information System (INIS)

    Vyborny, P.; Hornova, J.

    1985-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Cheng CS

    2016-07-01

    Full Text Available Clarissa Shu Ming Cheng,1,2 Yi Fang Lee,2 Charles Ong,3 Zhu Li Yap,2 Andrew Tsai,2 Aditi Mohla,2 Monisha E Nongpiur,4 Tin Aung,2,4 Shamira A Perera2,4 1Department of Ophthalmology, Tan Tock Seng Hospital, 2Department of Ophthalmology, Singapore National Eye Centre, 3Yong Loo Lin School of Medicine, National University of Singapore, 4Singapore Eye Research Institute, Singapore National Eye Centre, Singapore Background: To compare retinal vessel oxygenation and vessel caliber in primary angle-closure glaucoma (PACG, primary open-angle glaucoma (POAG, normal-tension glaucoma (NTG, and normal controls, as well as between eyes of asymmetrical glaucoma severity.Methods: This was a prospective, cross-sectional study. The 159 subjects (PACG, n=39; POAG, n=41; NTG, n=41; normal controls, n=38 underwent retinal oxygen saturation measurements using the Oxymap T1 Retinal Oximeter, optical coherence tomography, and Humphrey visual field testing. Retinal oxygen saturation and vessel diameter were compared between the glaucoma groups and normal controls, as well as between eyes of asymmetrical glaucoma severity. Kruskal–Wallis test was performed for comparison among different subtypes of glaucoma. Wilcoxon signed-rank test was used to compare the inter-eye differences.Results: Compared to normal controls, arteriolar oxygen saturation was increased in PACG eyes (P=0.048 but not in POAG or NTG eyes. There were no significant differences in oxygen saturation in venules or arteriovenous (AV difference in all three glaucoma groups. Venular diameter was significantly reduced in all glaucoma groups compared to normal controls (P<0.001, but no such change was observed in arteriolar diameter (P=0.10. When comparing between eyes of asymmetrical glaucoma severity, arteriolar oxygen saturation (P=0.03 and AV difference (P=0.04 were significantly higher, while arteriolar diameter was significantly lower (P=0.001 in the worse eye in PACG group. There were no significant

  14. Determinants of glaucoma awareness in urban punjab

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  15. Evaluation of a glaucoma patient

    Science.gov (United States)

    Thomas, Ravi; Loibl, Klaus; Parikh, Rajul

    2011-01-01

    The diagnosis of glaucoma is usually made clinically and requires a comprehensive eye examination, including slit lamp, applanation tonometry, gonioscopy and dilated stereoscopic evaluation of the optic disc and retina. Automated perimetry is obtained if glaucoma is suspected. This establishes the presence of functional damage and provides a baseline for follow-up. Imaging techniques are not essential for the diagnosis but may have a role to play in the follow-up. We recommend a comprehensive eye examination for every clinic patient with the objective of detecting all potentially sight-threatening diseases, including glaucoma. PMID:21150033

  16. Management of Blood Pressure in Patients with Glaucoma.

    Science.gov (United States)

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

    2017-09-19

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

  17. 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

  18. Goniodysgenesis in familial primary open-angle glaucoma

    NARCIS (Netherlands)

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

    1994-01-01

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

  19. Glaucoma

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  20. Glaucoma

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  1. 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 ...

  2. Tool material effect on the friction stir butt welding of AA2124-T4 Alloy Matrix MMC

    Directory of Open Access Journals (Sweden)

    Yahya Bozkurt

    2018-01-01

    Full Text Available The purpose of the present work is to study on the effect of material properties tool on friction stir butt welding of AA2124-T4 alloy matrix MMC. Uncoated tool, coated tool with a CrN, and coated tool with AlTiN were used to weld aluminum MMC plates. Macrostructure and microstructure observations, ultimate tensile strength, wear resistance, and chemical analysis were carried out to determine the appropriate tool for joining these composite plates. Results showed that the good welded joints could be obtained when a tool is coated with AlTiN.

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

    Science.gov (United States)

    Wright, Heathcote R; Diamond, Jeremy P

    2015-03-01

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

  4. Glaucoma

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  5. Glaucoma

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    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 ...

  6. Glaucoma

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    Full Text Available ... Clinical Director Laboratories, Sections and Units Division of Epidemiology and Clinical Applications eyeGENE Research Directors Office Office ... Diabetic Eye Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and ...

  7. 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.

  8. Potential applications of optical coherence tomography angiography in glaucoma.

    Science.gov (United States)

    Dastiridou, Anna; Chopra, Vikas

    2018-05-01

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

  9. Glaucoma

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    Full Text Available ... Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence ... is maintained by the NEI Office of Science Communications, Public Liaison, and Education. Technical questions about this ...

  10. ASSOCIATION BETWEEN GLAUCOMA AND BLOOD GROUPS

    Directory of Open Access Journals (Sweden)

    F. Ghannadi R. Varmazyar

    2006-09-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. 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.

  13. Profile of glaucoma in a major eye hospital in North India

    Directory of Open Access Journals (Sweden)

    Das Jayachandra

    2001-01-01

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

  14. Glaucoma

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  15. Glaucoma

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

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

    OpenAIRE

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

    2013-01-01

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

  17. Ocular hemodynamics and glaucoma: the role of mathematical modeling.

    Science.gov (United States)

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

    2013-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Aqueous shunt implantation in glaucoma

    Directory of Open Access Journals (Sweden)

    Jing Wang

    2017-01-01

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

  1. The role of inflammation in the pathogenesis of glaucoma

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  2. Childhood glaucoma profile in Dakahelia, Egypt: a retrospective study

    Directory of Open Access Journals (Sweden)

    Tharwat H. Mokbel

    2018-04-01

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

  3. Glaucoma

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  4. Mechanisms and FEM Simulation of Chip Formation in Orthogonal Cutting In-Situ TiB₂/7050Al MMC.

    Science.gov (United States)

    Xiong, Yifeng; Wang, Wenhu; Jiang, Ruisong; Lin, Kunyang; Shao, Mingwei

    2018-04-15

    The in-situ TiB₂/7050Al composite is a new kind of Al-based metal matrix composite (MMC) with super properties, such as low density, improved strength, and wear resistance. This paper, for a deep insight into its cutting performance, involves a study of the chip formation process and finite element simulation during orthogonal cutting in-situ TiB₂/7050Al MMC. With chips, material properties, cutting forces, and tool geometry parameters, the Johnson-Cook (J-C) constitutive equation of in-situ TiB₂/7050Al composite was established. Then, the cutting simulation model was established by applying the Abaqus-Explicit method, and the serrated chip, shear plane, strain rate, and temperature were analyzed. The experimental and simulation results showed that the obtained material's constitutive equation was of high reliability, and the saw-tooth chips occurred commonly under either low or high cutting speed and small or large feed rate. From result analysis, it was found that the mechanisms of chip formation included plastic deformation, adiabatic shear, shearing slip, and crack extension. In addition, it was found that the existence of small, hard particles reduced the ductility of the MMC and resulted in segmental chips.

  5. Application of MMC model on simulation of shearing process of thick hot-rolled high strength steel plate

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Liang; Li, Shuhui [Shanghai Key Laboratory of Digital Manufacture for Thin-walled Structures, Shanghai Jiao Tong University, Shanghai 200240 (China); Yang, Bing; Gao, Yongsheng [Automotive Steel Research Institute, R and D Center, BaoShan Iron and Steel Co.,Ltd, Shanghai 201900 (China)

    2013-12-16

    Shear operation is widely used as the first step in sheet metal forming to cut the sheet or plate into the required size. The shear of thick hot-rolled High Strength Steel (HSS) requires large shearing force and the sheared edge quality is relatively poor because of the large thickness and high strength compared with the traditional low carbon steel. Bad sheared edge quality will easily lead to edge cracking during the post-forming process. This study investigates the shearing process of thick hot-rolled HSS plate metal, which is generally exploited as the beam of heavy trucks. The Modified Mohr-Coulomb fracture criterion (MMC) is employed in numerical simulation to calculate the initiation and propagation of cracks during the process evolution. Tensile specimens are designed to obtain various stress states in tension. Equivalent fracture strains are measured with Digital Image Correlation (DIC) equipment to constitute the fracture locus. Simulation of the tension test is carried out to check the fracture model. Then the MMC model is applied to the simulation of the shearing process, and the simulation results show that the MMC model predicts the ductile fracture successfully.

  6. Application of MMC model on simulation of shearing process of thick hot-rolled high strength steel plate

    International Nuclear Information System (INIS)

    Dong, Liang; Li, Shuhui; Yang, Bing; Gao, Yongsheng

    2013-01-01

    Shear operation is widely used as the first step in sheet metal forming to cut the sheet or plate into the required size. The shear of thick hot-rolled High Strength Steel (HSS) requires large shearing force and the sheared edge quality is relatively poor because of the large thickness and high strength compared with the traditional low carbon steel. Bad sheared edge quality will easily lead to edge cracking during the post-forming process. This study investigates the shearing process of thick hot-rolled HSS plate metal, which is generally exploited as the beam of heavy trucks. The Modified Mohr-Coulomb fracture criterion (MMC) is employed in numerical simulation to calculate the initiation and propagation of cracks during the process evolution. Tensile specimens are designed to obtain various stress states in tension. Equivalent fracture strains are measured with Digital Image Correlation (DIC) equipment to constitute the fracture locus. Simulation of the tension test is carried out to check the fracture model. Then the MMC model is applied to the simulation of the shearing process, and the simulation results show that the MMC model predicts the ductile fracture successfully

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

  9. Simplified Analytic Approach of Pole-to-Pole Faults in MMC-HVDC for AC System Backup Protection Setting Calculation

    Directory of Open Access Journals (Sweden)

    Tongkun Lan

    2018-01-01

    Full Text Available AC (alternating current system backup protection setting calculation is an important basis for ensuring the safe operation of power grids. With the increasing integration of modular multilevel converter based high voltage direct current (MMC-HVDC into power grids, it has been a big challenge for the AC system backup protection setting calculation, as the MMC-HVDC lacks the fault self-clearance capability under pole-to-pole faults. This paper focused on the pole-to-pole faults analysis for the AC system backup protection setting calculation. The principles of pole-to-pole faults analysis were discussed first according to the standard of the AC system protection setting calculation. Then, the influence of fault resistance on the fault process was investigated. A simplified analytic approach of pole-to-pole faults in MMC-HVDC for the AC system backup protection setting calculation was proposed. In the proposed approach, the derived expressions of fundamental frequency current are applicable under arbitrary fault resistance. The accuracy of the proposed approach was demonstrated by PSCAD/EMTDC (Power Systems Computer-Aided Design/Electromagnetic Transients including DC simulations.

  10. Glaucoma Blindness at a Tertiary Eye Care Center.

    Science.gov (United States)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

    de Jong, Leo A. M. S.

    2009-01-01

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

  12. 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

  13. 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...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Huang J

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Shugyoku Ra

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

  17. Importance of intraocular pressure in glaucoma

    Science.gov (United States)

    Joos, Karen M.

    1999-06-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Jesus Jimenez-Roman

    2017-09-01

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

  20. Macular thickness after glaucoma filtration surgery.

    Science.gov (United States)

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

    2013-09-01

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

  1. 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.

  2. On fatigue crack growth mechanisms of MMC: Reflection on analysis of 'multi surface initiations'

    International Nuclear Information System (INIS)

    Mkaddem, A.; El Mansori, M.

    2009-01-01

    This work attempts to examine the mechanisms of fatigue when cracks synergetically initiate in more than one site at the specimen surface. The metal matrix composites (MMC) i.e. silicon carbide particles reinforced aluminium matrix composites (Al/SiC p -MMC), seem to be good candidates to accelerate fatigue failures following multi surface initiations (MSI). Closure effects of MSI mechanisms on the variation of fatigue behaviour are explored for various stress states. Experiments were carried out using non pre-treated and pre-treated specimens. Using an Equivalent Ellipse Method (EEM), it is shown that the aspect of surface finish of specimen plays an important role on crack growth. Scanning Electron Microscope (SEM) inspections have lead to distinguishing the initiation regions from propagation regions and final separation regions. It is also revealed that the total lifetime of specimens is sensitive to heat treatment. Moreover, it is found that the appearance of MSI in cycled materials is more probable at high level of fatigue loads.

  3. Understanding practice patterns of glaucoma sub-specialists in India

    Directory of Open Access Journals (Sweden)

    Nikhil S. Choudhari

    2017-10-01

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

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

    African Journals Online (AJOL)

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

  5. Anticlotting agents and the surgical management of glaucoma.

    Science.gov (United States)

    Sozeri, Yasemin; Salim, Sarwat

    2018-03-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  7. Normal tension glaucoma and Alzheimer disease

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  8. First-in-human phase I study of ISTH0036, an antisense oligonucleotide selectively targeting transforming growth factor beta 2 (TGF-β2, in subjects with open-angle glaucoma undergoing glaucoma filtration surgery.

    Directory of Open Access Journals (Sweden)

    Norbert Pfeiffer

    Full Text Available To evaluate the safety and tolerability of intravitreal ISTH0036, an antisense oligonucleotide selectively targeting transforming growth factor beta 2 (TGF-β2, in patients with primary open angle glaucoma (POAG undergoing trabeculectomy (TE; glaucoma filtration surgery.In this prospective phase I trial glaucoma patients scheduled for TE with mitomycin C (MMC received a single intravitreal injection of ISTH0036 at the end of surgery in escalating total doses of 6.75 μg, 22.5 μg, 67.5 μg or 225 μg, resulting in calculated intraocular ISTH0036 concentrations in the vitreous humor of approximately 0.3 μM, 1 μM, 3 μM or 10 μM after injection, respectively. Outcomes assessed included: type and frequency of adverse events (AEs, intraocular pressure (IOP, numbers of interventions post trabeculectomy, bleb survival, visual acuity, visual field, electroretinogram (ERG, slit lamp biomicroscopy and optic disc assessment.In total, 12 patients were treated in the 4 dose groups. Main ocular AEs observed were corneal erosion, corneal epithelium defect, or too high or too low IOP, among others. No AE was reported to be related to ISTH0036. All other safety-related analyses did not reveal any toxicities of concern, either. The mean medicated preoperative IOP at decision time-point for surgery was 27.3 mmHg +/- 12.6 mmHg (SD. Mean IOP (±SD for dose levels 1, 2, 3, and 4 were at Day 43 9.8 mmHg ± 1.0 mmHg, 11.3 mmHg ± 6.7 mmHg, 5.5 mmHg ± 3.0 mmHg and 7.5 mmHg ± 2.3 mmHg SD; and at Day 85 9.7 mmHg ± 3.3 mmHg, 14.2 mmHg ± 6.5 mmHg, 5.8 mmHg ± 1.8 mmHg and 7.8 mmHg ± 0.6 mmHg, respectively. In contrast to IOP values for dose levels 1 and 2, IOP values for dose levels 3 and 4 persistently remained below 10 mmHg throughout the observation period.This first-in-human trial demonstrates that intravitreal injection of ISTH0036 at the end of TE is safe. Regarding IOP control, single-dose ISTH0036 administration of 67.5 μg or 225 μg at the time of TE

  9. 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.

  10. The Management of Secondary Glaucoma in Nanophthalmic Patients

    Institute of Scientific and Technical Information of China (English)

    Shengsong Huang; Minbin Yu; Changyu Qiu; Tiancai Ye

    2002-01-01

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

  11. Ahmed glaucoma valve implant: surgical technique and complications.

    Science.gov (United States)

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

    2017-01-01

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

  12. Time dependent enhanced resistance against antibiotics & metal salts by planktonic & biofilm form of Acinetobacter haemolyticus MMC 8 clinical isolate

    Directory of Open Access Journals (Sweden)

    Sharvari Vijaykumar Gaidhani

    2014-01-01

    Full Text Available Background & objectives: Available literature shows paucity of reports describing antibiotic and metal resistance profile of biofilm forming clinical isolates of Acinetobacter haemolyticus. The present study was undertaken to evaluate the antibiotic and metal resistance profile of Indian clinical isolate of A. haemolyticus MMC 8 isolated from human pus sample in planktonic and biofilm form. Methods: Antibiotic susceptibility and minimum inhibitory concentration were determined employing broth and agar dilution techniques. Biofilm formation was evaluated quantitatively by microtiter plate method and variation in complex architecture was determined by scanning electron microscopy. Minimum biofilm inhibiting concentration was checked by Calgary biofilm device. Results: Planktonic A. haemolyticus MMC 8 was sensitive to 14 antibiotics, AgNO 3 and HgC1 2 resistant to streptomycin and intermediately resistant to netilmycin and kanamycin. MMC 8 exhibited temporal variation in amount and structure of biofilm. There was 32 - 4000 and 4 - 256 fold increase in antibiotic and metal salt concentration, respectively to inhibit biofilm over a period of 72 h as against susceptible planktonic counterparts. Total viable count in the range of 10 5 -10 6 cfu / ml was observed on plating minimum biofilm inhibiting concentration on Muller-Hinton Agar plate without antimicrobial agents. Biofilm forming cells were several folds more resistant to antibiotics and metal salts in comparison to planktonic cells. Presence of unaffected residual cell population indicated presence of persister cells. Interpretation & conclusions: The results indicate that biofilm formation causes enhanced resistance against antibiotics and metal salts in otherwise susceptible planktonic A. haemolyticus MMC 8.

  13. Glaucoma after corneal replacement.

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Wesselink, Christiaan; Jansonius, Nomdo M

    2017-09-01

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

  16. Design of low cost glaucoma screening

    NARCIS (Netherlands)

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

    1997-01-01

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

  17. Retinal oxygen saturation before and after glaucoma surgery.

    Science.gov (United States)

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

    2017-08-01

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

  18. Consultant medical trainers, modernising medical careers (MMC and the European time directive (EWTD: tensions and challenges in a changing medical education context

    Directory of Open Access Journals (Sweden)

    Payne Heather

    2008-05-01

    Full Text Available Abstract Background We analysed the learning and professional development narratives of Hospital Consultants training junior staff ('Consultant Trainers' in order to identify impediments to successful postgraduate medical training in the UK, in the context of Modernising Medical Careers (MMC and the European Working Time Directive (EWTD. Methods Qualitative study. Learning and continuing professional development (CPD, were discussed in the context of Consultant Trainers' personal biographies, organisational culture and medical education practices. We conducted life story interviews with 20 Hospital Consultants in six NHS Trusts in Wales in 2005. Results Consultant Trainers felt that new working patterns resulting from the EWTD and MMC have changed the nature of medical education. Loss of continuity of care, reduced clinical exposure of medical trainees and loss of the popular apprenticeship model were seen as detrimental for the quality of medical training and patient care. Consultant Trainers' perceptions of medical education were embedded in a traditional medical education culture, which expected long hours' availability, personal sacrifices and learning without formal educational support and supervision. Over-reliance on apprenticeship in combination with lack of organisational support for Consultant Trainers' new responsibilities, resulting from the introduction of MMC, and lack of interest in pursuing training in teaching, supervision and assessment represent potentially significant barriers to progress. Conclusion This study identifies issues with significant implications for the implementation of MMC within the context of EWTD. Postgraduate Deaneries, NHS Trusts and the new body; NHS: Medical Education England should deal with the deficiencies of MMC and challenges of ETWD and aspire to excellence. Further research is needed to investigate the views and educational practices of Consultant Medical Trainers and medical trainees.

  19. 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.

  20. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Cham A

    2016-06-01

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

  1. Analysis of Back-to-Back MMC for Medium Voltage Applications under Faulted Condition

    DEFF Research Database (Denmark)

    Bose, Anurag; Martins, Joäo Pedro Rodrigues; Chaudhary, Sanjay K.

    2017-01-01

    This paper analyzes a 10MW medium voltage Back-to-Back (BTB) Modular Multilevel Converter (MMC) without a DC-Link capacitor with halfbridge submodules. It focusses on the system behavior under single-line-to-ground (SLG) fault when there is no capacitor on the DC-Link.The fault current is compute...... to prevent DC overvoltages in the sub-modules during faults....

  2. The role of matricellular proteins in glaucoma.

    LENUS (Irish Health Repository)

    Wallace, Deborah M

    2014-07-01

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

  3. Glaucoma and Driving: On-Road Driving Characteristics

    Science.gov (United States)

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

    2016-01-01

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

  4. Demographic features of subjects with congenital glaucoma

    Science.gov (United States)

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

    2014-01-01

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

  5. Glaucoma and Driving: On-Road Driving Characteristics.

    Directory of Open Access Journals (Sweden)

    Joanne M Wood

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

  6. Glaucoma and Driving: On-Road Driving Characteristics.

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Antihypertensive medication postpones the onset of glaucoma

    DEFF Research Database (Denmark)

    Horwitz, Anna; Klemp, Marc; Jeppesen, Jørgen

    2017-01-01

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

  10. Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

    Science.gov (United States)

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

    2006-12-01

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

  11. Central corneal thickness among glaucoma patients attending ...

    African Journals Online (AJOL)

    AAU_CHS

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

  12. Glaucoma and cataract surgery: two roads merging into one.

    Science.gov (United States)

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

    2016-01-01

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

  13. 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.

  14. 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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Razeghinejad

    2016-09-01

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

  17. Relationship between retinal lattice degeneration and open angle glaucoma.

    Science.gov (United States)

    Rahimi, Mansour

    2005-01-01

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

  18. Willingness to Use Mobile Health in Glaucoma Patients.

    Science.gov (United States)

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

    2017-10-01

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

  19. Mechanisms and FEM Simulation of Chip Formation in Orthogonal Cutting In-Situ TiB2/7050Al MMC

    Science.gov (United States)

    Wang, Wenhu; Jiang, Ruisong; Lin, Kunyang; Shao, Mingwei

    2018-01-01

    The in-situ TiB2/7050Al composite is a new kind of Al-based metal matrix composite (MMC) with super properties, such as low density, improved strength, and wear resistance. This paper, for a deep insight into its cutting performance, involves a study of the chip formation process and finite element simulation during orthogonal cutting in-situ TiB2/7050Al MMC. With chips, material properties, cutting forces, and tool geometry parameters, the Johnson–Cook (J–C) constitutive equation of in-situ TiB2/7050Al composite was established. Then, the cutting simulation model was established by applying the Abaqus–Explicit method, and the serrated chip, shear plane, strain rate, and temperature were analyzed. The experimental and simulation results showed that the obtained material’s constitutive equation was of high reliability, and the saw-tooth chips occurred commonly under either low or high cutting speed and small or large feed rate. From result analysis, it was found that the mechanisms of chip formation included plastic deformation, adiabatic shear, shearing slip, and crack extension. In addition, it was found that the existence of small, hard particles reduced the ductility of the MMC and resulted in segmental chips. PMID:29662047

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  1. Optineurin, a multifunctional protein involved in glaucoma

    Indian Academy of Sciences (India)

    MADHU

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

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

    African Journals Online (AJOL)

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

  3. [Influence of Luxury Foodstuffs on Glaucoma].

    Science.gov (United States)

    Huber-van der Velden, K K

    2017-02-01

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

  4. Glaucoma in Asia: regional prevalence variations and future projections.

    Science.gov (United States)

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

    2016-01-01

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

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

    African Journals Online (AJOL)

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

  6. Trabectome surgery for primary and secondary open angle glaucomas.

    Science.gov (United States)

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

    2013-12-01

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

  7. Fornix-based versus limbal-based conjunctival trabeculectomy flaps for glaucoma.

    Science.gov (United States)

    Al-Haddad, Christiane; Abdulaal, Marwan; Al-Moujahed, Ahmad; Ervin, Ann-Margret

    2015-11-25

    complications of fornix- versus limbal-based trabeculectomy for glaucoma, irrespective of glaucoma type, publication status, and language. We excluded studies on children less than 18 years of age, since wound healing is different in this age group and the rate of bleb scarring postoperatively is high. Two review authors independently extracted data and assessed trial quality. We contacted study authors for additional information.The primary outcome was the proportion of failed trabeculectomies at 24 months. Failure was defined as the need for repeat surgery or uncontrolled IOP (more than 22 mmHg), despite additional topical/systemic medications. Needling and 5-fluorouracil (5-FU) injections were allowed only during the first six months postoperatively; additional needling or 5-FU injections were considered as failure. Mean post-operative IOP at 12 and 24 months also was recorded. The review included six trials with a total of 361 participants. Two studies were conducted in America and one each in Germany, Greece, India, and Saudi Arabia. The participants of four trials had open-angle glaucoma; one study included participants with primary open-angle or primary closed-angle glaucoma, and one study did not specify the type of glaucoma. Three studies used a combined procedure (phacotrabeculectomy). Trabeculectomy with mitomycin C (MMC) was performed in four studies, and trabeculectomy with 5-fluorouracil (5-FU) was performed in only one study.None of the included trials reported trabeculectomy failure at 24 months. Only one trial reported the failure rate of trabeculectomy as a late complication. Failure was higher among participants randomised to the limbal-based surgery: 1/50 eyes failed trabeculectomy in the fornix group compared with 3/50 in the limbal group (risk ratio (RR) 0.33, 95% confidence interval (95% CI) 0.04 to 3.10); therefore we are very uncertain as to the relative effect of the two procedures on failure rate.Four studies including 252 participants provided

  8. Visual disability and quality of life in glaucoma patients.

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  10. Glaucoma detection with damato multifixation campimetry online

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  11. 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.

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

    Science.gov (United States)

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

    2003-06-01

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

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

    Science.gov (United States)

    Niyadurupola, Nuwan; Broadway, David C

    2008-12-01

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

  14. Acupuncture for glaucoma.

    Science.gov (United States)

    Law, Simon K; Li, Tianjing

    2013-05-31

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

  15. 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.

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

    Science.gov (United States)

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

    2013-01-01

    The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.

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

    Directory of Open Access Journals (Sweden)

    N. I. Kurysheva

    2016-01-01

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

  18. Traumatic glaucoma due to paintball injuries: A case series

    Directory of Open Access Journals (Sweden)

    Kelly M. Lee

    2017-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Yingting Zhu

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

  20. Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study

    Science.gov (United States)

    2017-05-02

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

  1. Socioeconomics of long-term glaucoma therapy in India

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    Bhagabat Nayak

    2015-01-01

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

  2. Cyclo-photocoagulation in the management of aphakic glaucoma

    International Nuclear Information System (INIS)

    Lee, P.-F.

    1984-01-01

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

  3. 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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  6. Experimental Contact Lens to Prevent Glaucoma-Induced Blindness

    Science.gov (United States)

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

  7. 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.

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

    Science.gov (United States)

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

    2013-01-01

    Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Results: Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Conclusion: Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma. PMID:23741130

  9. Update on normal tension glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  10. Areas and factors associated with patients’ dissatisfaction with glaucoma care

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    Foo VH

    2017-10-01

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

  11. The optic nerve head in glaucoma

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    Rupert RA Bourne

    2006-09-01

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

  12. 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 ...

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2017-08-01

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

  15. Neuroprotection in glaucoma

    Science.gov (United States)

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

    2011-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Ganglion cell complex scan in the early prediction of glaucoma.

    Science.gov (United States)

    Ganekal, S

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

  20. Coincidence of retinitis pigmentosa and pseudoexfoliative glaucoma

    Directory of Open Access Journals (Sweden)

    Božić Marija

    2017-01-01

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

  1. Primary angle closure glaucoma in a myopic kinship.

    Science.gov (United States)

    Hagan, J C; Lederer, C M

    1985-03-01

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

  2. [Study of corvitin efficiency in primary glaucoma].

    Science.gov (United States)

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

    2012-01-01

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

  3. Glaucoma Patient-Reported Concerns and Associated Factors.

    Science.gov (United States)

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

    2017-06-01

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

  4. 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

  5. Scleral fibroblast response to experimental glaucoma in mice

    Science.gov (United States)

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

    2016-01-01

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

  6. Comparison of polypropylene and silicone Ahmed Glaucoma Valves.

    Science.gov (United States)

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

    2006-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Larissa Pedroso

    1999-12-01

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

  8. Changes to the Aqueous Humor Proteome during Glaucoma.

    Science.gov (United States)

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

    2016-01-01

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

  9. [Perimetric changes in advanced glaucoma].

    Science.gov (United States)

    Feraru, Crenguta Ioana; Pantalon, Anca

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kubaisi B

    2018-05-01

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

  11. No evidence of a causal relationship between hypothyroidism and glaucoma

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  12. awareness and knowledge of glaucoma among adult patients

    African Journals Online (AJOL)

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

  13. Challenges in the management of glaucoma in developing countries.

    Science.gov (United States)

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

    2016-01-01

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

  14. Detection of Glaucoma Using Image Processing Techniques: A Critique.

    Science.gov (United States)

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

    2018-01-01

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

  15. Economic impact of primary open-angle glaucoma in Australia.

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Senthil, Sirisha; Badakare, Akshay

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tan HaiBo

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    Purpose: To compare the anterior lamina cribrosa (LC) surface position in patients with idiopathic intracranial hypertension (IIH), primary open-angle glaucoma (high-tension glaucoma [HTG] and normal-tension glaucoma [NTG]), and healthy controls using enhanced depth imaging spectral-domain optical...

  20. Clinical study of secondary glaucoma after silicone oil tamponade

    Directory of Open Access Journals (Sweden)

    Xiao-Chun Chen

    2013-12-01

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

  1. Ahmed glaucoma valve in children: A review☆

    Science.gov (United States)

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

    2011-01-01

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

  2. BILATERAL STEROID INDUCED GLAUCOMA IN VERNAL KERATOCONJUNCTIVITIS

    Directory of Open Access Journals (Sweden)

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

    2015-01-01

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

  3. Unilateral glaucoma in Sotos syndrome (cerebral gigantism).

    Science.gov (United States)

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

    2000-12-01

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

  4. Rational Basis For Nutraceuticals In The Treatment Of Glaucoma.

    Science.gov (United States)

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

    2017-11-09

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

  5. Normal tension glaucoma management: a survey of contemporary practice.

    Science.gov (United States)

    Symes, Richard J; Mikelberg, Frederick S

    2017-08-01

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

  6. Glaucoma associated with the management of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    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

  7. Matched optical quality comparison of 3-year results of PRK–MMC and phakic IOL implantation in the correction of high myopia

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    Miraftab, M; Hashemi, H; Asgari, S

    2015-01-01

    Aims To compare 3-year results of PRK–MMC and phakic intraocular lens (PIOL) implantation in patients with >8.0 diopters (D) of myopia. Methods This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK–MMC (group B). This report compares 3-year treatment results in these two groups. Results At 3 years after surgery, uncorrected visual acuity was 0.02±0.06 LogMAR in group A and 0.04±0.07 LogMAR in group B (P=0.639). Mean best corrected visual acuity in group A (0.004±0.02) was better than group B (0.03±0.07 LogMAR) (P=0.035). Mean manifest refraction spherical equivalent was −0.16±0.21 and −0.09±0.20D (P=0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P=0.024). CS6 decreased significantly only in group B (P=0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16±0.18 μm, P=0.003) and reduction in spherical aberration (SA; 0.16±0.08 μm, PPRK–MMC for treating patients with >8.0D myopia. However, for patients with an inadequate aqueous depth, PRK–MMC can be an acceptable treatment option with a potential for decreased quality of vision. PMID:25976638

  8. Matched optical quality comparison of 3-year results of PRK-MMC and phakic IOL implantation in the correction of high myopia.

    Science.gov (United States)

    Miraftab, M; Hashemi, H; Asgari, S

    2015-07-01

    To compare 3-year results of PRK-MMC and phakic intraocular lens (PIOL) implantation in patients with >8.0 diopters (D) of myopia. This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK-MMC (group B). This report compares 3-year treatment results in these two groups. At 3 years after surgery, uncorrected visual acuity was 0.02±0.06 LogMAR in group A and 0.04±0.07 LogMAR in group B (P=0.639). Mean best corrected visual acuity in group A (0.004±0.02) was better than group B (0.03±0.07 LogMAR) (P=0.035). Mean manifest refraction spherical equivalent was -0.16±0.21 and -0.09±0.20D (P=0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P=0.024). CS6 decreased significantly only in group B (P=0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16±0.18 μm, P=0.003) and reduction in spherical aberration (SA; 0.16±0.08 μm, PPRK-MMC for treating patients with >8.0D myopia. However, for patients with an inadequate aqueous depth, PRK-MMC can be an acceptable treatment option with a potential for decreased quality of vision.

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

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    Zhi-Ke Xu

    2015-02-01

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

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

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

    2017-02-01

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

  11. Changes to the Aqueous Humor Proteome during Glaucoma.

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    Martha Andrea Kaeslin

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

  12. A novel method for simultaneous production of two ribosome-inactivating proteins, α-MMC and MAP30, from Momordica charantia L.

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    Meng, Yao; Lin, Sen; Liu, Shuangfeng; Fan, Xiang; Li, Gangrui; Meng, Yanfa

    2014-01-01

    Alpha-momorcharin (α-MMC) and momordica anti-HIV protein (MAP30) from Momordica charantia L. have been confirmed to possess anti-tumor and anti-virus activities. Traditional purification methods of these two ribosome-inactivating proteins (RIPs) were separate which was time consuming and cost effective as well as low efficient. In order to obtain sufficient samples for researches, a strategy combining ion-exchange and gel filtration chromatography was developed and optimized in this study. Using this novel purification method, averagely 1162 mg of α-MMC and 535 mg of MAP30 were obtained from 400 g of Momordica charantia L seeds. The homogeneities of them were assessed by electrophoresis analysis. Determination of molecular weights of α-MMC and MAP30 were 28.585 kDa and 29.094 kDa by MALDI-TOF/TOF and pI were 9.02 and 9.12, respectively. The single glycoproteins were identified by Periodate-Schiff's base (PAS) and the saccharide content was tested to be 1.25% and 1.1% by anthrone-sulfuric acid method. Biological activities were evidenced by their ability to inhibit proliferation of lung adenocarcinoma A549 cell and to convert supercoiled plasmid pUC18 into relaxed forms. Finally, we also found that both two RIPs exhibited no superoxide dismutase (SOD) activity.

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

    Science.gov (United States)

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

    2016-06-01

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

  14. Anisohypermetropia as a sign of unilateral glaucoma in the pediatric population

    Directory of Open Access Journals (Sweden)

    Tan DKL

    2017-06-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

  16. Composite fibrous glaucoma drainage implant

    Science.gov (United States)

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

    2017-10-01

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

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

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    Gogate Parikshit

    2011-01-01

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

  18. Current Surgical Options for the Management of Pediatric Glaucoma

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    Jose Morales

    2013-01-01

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

  19. 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.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    Gramer, Gwendolyn; Gramer, Eugen; Weisschuh, Nicole

    2017-10-01

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

  2. Trabeculectomy with double low dose of mitomycin C – two years of follow-up

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    Errico D

    2011-12-01

    Full Text Available Donato Errico1, Francesca Scrimieri1, Roberta Riccardi1, Romolo Fedeli1, Giancarlo Iarossi21Opthalmology Unit, Glaucoma Service, Azienda Ospedaliera, Cardinale G Panìco, Tricase (Le, Italy; 2Department of Opthalmology, Ospedale Pediatrico Bambino Gesù, Rome, ItalyPurpose: To evaluate the efficacy and the safety of a surgical technique in which classic trabeculectomy ab externo is performed with a double application of low-dose mitomycin C (MMC in uncontrolled open-angle glaucoma (OAG patients.Method: A consecutive series of 43 white patients (43 eyes with uncontrolled primary OAG underwent trabeculectomy surgery. A double application of MMC (0.1% was performed: the first under the Tenon's capsule for 3 minutes, and the second below the scleral flap for 1 or 2 minutes, according to the risk factors. Complete success was defined as intraocular pressure (IOP <14 mmHg without any additional glaucoma surgery or medication. Qualified success was defined as IOP <14 mmHg with additional needling revision.Results: Mean preoperative IOP was 29.9 mmHg (SD 3.8 for all eyes evaluated. At 1 day postoperative, mean IOP was 6.7 mmHg (SD 1.26. At the end of the first 2 weeks postoperative, mean IOP was 8.6 mmHg (SD 1.7, at 12 months mean IOP was 11.3 mmHg (SD 1.4; P < 0.0001 and at 24 months mean IOP was 11.4 mmHg (SD 1.5; P < 0.0001. At 3 months, two eyes (5.4% underwent needling of the bleb for cystic blebs formation.Conclusion: In this study we presented the results after 2 years of follow-up of OAG undergoing trabeculectomy with dual administration of MMC (0.1 mg/mL. After 24 months, complete success was achieved in 93% of patients and a qualified success in 100% of patients.Keywords: glaucoma, trabeculectomy, mitomycin C

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

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    Anita Panda

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  5. A link between diabetes mellitus and glaucoma

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Garway-Heath David F

    2011-08-01

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

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

    Science.gov (United States)

    Glen, Fiona C; Crabb, David P; Garway-Heath, David F

    2011-08-04

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

  9. A decision-making schema for the detection of glaucoma.

    Science.gov (United States)

    Cockburn, D M

    1979-02-01

    A schema is proposed for management of optometrical patients who may have glaucoma or any of 22 risk factors of glaucoma. The assessment system has established decision points and management pathways based on risk factors in glaucoma which employ only clinical procedures appropriate to current optometrical practice. This schema is particularly designed to permit diagnosis of early angle-closure glaucoma while the disease is in the symptomless phase, prior to chronic elevation of intraocular pressure and the development of damage to the optic disc and visual fields. A recommendation is made for inclusion of the Van Herick test as routine and in the assessment of patients entering the schema. Gonioscopy should form part of the diagnostic workup, but an alternative pathway is established for use when this technique is omitted.

  10. Trabeculectomia com mitomicina-C no tratamento de glaucomas refratários: avaliação dos resultados de 108 casos

    Directory of Open Access Journals (Sweden)

    Mandia Júnior Carmo

    2002-01-01

    Full Text Available Objetivo: Avaliar o comportamento da pressão intra-ocular (PIO e a possibilidade de eventuais complicações do uso da mitomicina-C (MMC nas trabeculectomias de pacientes com glaucoma refratário. Métodos:Foram estudados prospectivamente 108 olhos de 92 pacientes submetidos à trabeculectomia com mitomicina-C a 0,2 mg/ml por 5 minutos. O tempo de seguimento foi de 11,92 ± 5,13 meses, com mínimo de 6 e máximo de 24 meses. A média de idade foi de 39,59 ± 24,05 anos, variando de 3 a 87 anos. A média da pressão intra-ocular no período pré-operatório dos 108 olhos foi de 32,36 ± 9,90 mmHg, e a mediana de 30 mmHg, variando de 18 a 68 mmHg. Resultados:A média da pressão intra-ocular no período pós-operatório foi de 13,74 ± 9,68 mmHg e a mediana de 12 mmHg, variando de 1 a 60 mmHg. Houve sucesso em 90,7% dos olhos. Em 76,8% não houve necessidade de medicação suplementar. Não houve diferença significante (p > 0,75 quanto aos resultados pressóricos e às complicações, nos pacientes submetidos ou não à intervenção prévia. Em 25% dos olhos houve complicações; atalamia (11,11% e hipotonia (7,41% foram as mais freqüentes. Conclusão:Trata-se de procedimento eficaz para o tratamento de glaucomas refratários com baixo índice de complicações.

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

    NARCIS (Netherlands)

    de Jong, Leo; Lafuma, Antoine; Aguadé, Anne-Sophie; Berdeaux, Gilles

    2011-01-01

    This study compared the efficacy of the EX-PRESS(®) glaucoma filtration device and trabeculectomy in primary open-angle glaucoma up to five years after surgery. Patients from a previously reported randomized, open-label, parallel-arm clinical trial in which 78 patients received either the EX-PRESS

  12. Glaucoma--diabetes of the brain: a radical hypothesis about its nature and pathogenesis.

    Science.gov (United States)

    Faiq, Muneeb A; Dada, Rima; Saluja, Daman; Dada, Tanuj

    2014-05-01

    Glaucoma is the leading cause of irreversible blindness characterized by irremediable loss of retinal ganglion cells. Its risk increases with progressing age and elevated intraocular pressure. Studies have established that glaucoma is a neurodegenerative disorder in which the damage involves many brain tissues from retina to the lateral geniculate nucleus. Despite lot of research, complete pathomechanism of glaucoma is not known and there is no treatment available except modification of intraocular pressure pharmacologically and/or surgically. We here present a hypothesis inspired by studies across many areas of molecular and clinical sciences in an integrative manner that leads to a uniquely unconventional understanding of this disorder. Our hypothesis postulates that glaucoma may possibly be the diabetes of the brain. Based on the remarkable similarities between glaucoma and diabetes we propose glaucoma also to be a type of diabetes. Glaucoma and diabetes share many aspects from various molecular mechanisms to involvement of insulin and possible use of antidiabetics in glaucoma therapy. Additionally, Alzheimer's disease has already been proposed to be diabetes type-3. We show that Alzheimer's disease is cerebral glaucoma and diabetes at the same time which, by transitive property of similarities, again leads to our hypothesis that glaucoma is diabetes of the brain. Our proposition may lead to appreciation of certain important facets of glaucoma which have previously not been given due consideration. It also may lead to an alternative classification of diabetes as pancreatic and brain diabetes thereby widening the vision arena of the understanding of both these disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Outcomes of Ahmed Glaucoma Valve Revision in Pediatric Glaucoma.

    Science.gov (United States)

    Al-Omairi, Ahmed Mansour; Al Ameri, Aliah H; Al-Shahwan, Sami; Khan, Arif O; Al-Jadaan, Ibrahim; Mousa, Ahmed; Edward, Deepak P

    2017-11-01

    Encapsulation of the Ahmed glaucoma valve (AGV) plate is a common cause for postoperative elevation of intraocular pressure, especially in children. Many reports have described the outcomes of AGV revision in adults. However, the outcomes of AGV revision in children are poorly documented. The aim of this study was to determine the outcomes of AGV revision in children. Retrospective cross-sectional study. A retrospective chart review of patients less than 15 years of age who underwent AGV revision with a minimum postoperative follow-up of 6 months was conducted. Outcome measures included reduction in intraocular pressure from baseline, survival analysis, and reduction in the number of antiglaucoma medications. Postoperative complications were also noted. Complete success was defined as an IOP of 21 mm Hg or less without medications, while qualified success was defined as having an IOP of 21 mm Hg or less with medications. A total of 44 eyes met the inclusion criteria. Primary congenital glaucoma was present in 39 eyes (88.6%), aphakic glaucoma in 4 eyes (9.1%), and Peters anomaly-associated glaucoma in 1 eye (2.3%). The mean number of previous surgeries was 1.4, and the mean age was 6.7 years (range, 1.9-13 years) with a median follow-up of 12 months (range, 6-24 months). The IOP was reduced from a preoperative mean of 30.4 (± 10.3) to 24.9 (± 10.6) mm Hg at 6 months postoperatively. Kaplan-Meier analysis showed that the complete success rate at 1 month was 100% followed by a rapid decline at 6 months to 38.6%, 27.7% at 1 year, and 5.5% at 2 years. Qualified success rate was 100% at 1 month followed by a 6-month and 1-year survival rate of approximately 50% and a 2-year survival rate of approximately 16%. The median survival time was 14 months. No specific risk factors for failure were identified. Visual acuity remained unchanged following revision. The most common complication was recurrence of encapsulation with elevated IOP (15.9%). Other

  14. A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations.

    Science.gov (United States)

    Riva, Ivano; Roberti, Gloria; Katsanos, Andreas; Oddone, Francesco; Quaranta, Luciano

    2017-04-01

    The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

  15. Expanded polytetrafluoroethylene membrane alters tissue response to implanted Ahmed glaucoma valve.

    Science.gov (United States)

    DeCroos, Francis Char; Ahmad, Sameer; Kondo, Yuji; Chow, Jessica; Mordes, Daniel; Lee, Maria Regina; Asrani, Sanjay; Allingham, R Rand; Olbrich, Kevin C; Klitzman, Bruce

    2009-07-01

    Long-term intraocular pressure control by glaucoma drainage implants is compromised by the formation of an avascular fibrous capsule that surrounds the glaucoma implant and increases aqueous outflow resistance. It is possible to alter this fibrotic tissue reaction and produce a more vascularized and potentially more permeable capsule around implanted devices by enclosing them in a porous membrane. Ahmed glaucoma implants modified with an outer 5-microm pore size membrane (termed porous retrofitted implant with modified enclosure or PRIME-Ahmed) and unmodified glaucoma implants were implanted into paired rabbit eyes. After 6 weeks, the devices were explanted and subject to histological analysis. A tissue response containing minimal vascularization, negligible immune response, and a thick fibrous capsule surrounded the unmodified Ahmed glaucoma implant. In comparison, the tissue response around the PRIME-Ahmed demonstrated a thinner fibrous capsule (46.4 +/- 10.8 microm for PRIME-Ahmed versus 94.9 +/- 21.2 microm for control, p vascularized near the tissue-material interface. A prominent chronic inflammatory response was noted as well. Encapsulating the aqueous outflow pathway with a porous membrane produces a more vascular tissue response and thinner fibrous capsule compared with a standard glaucoma implant plate. Enhanced vascularity and a thinner fibrous capsule may reduce aqueous outflow resistance and improve long-term glaucoma implant performance.

  16. Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes

    OpenAIRE

    Erçalık, Nimet Yeşim; İmamoğlu, Serhat

    2018-01-01

    Purpose. To evaluate the outcomes of Ahmed glaucoma valve (AGV) implantation in vitrectomized eyes. Materials and Methods. The medical records of 13 eyes that developed glaucoma due to emulsified silicon oil or neovascularization following pars plana vitrectomy and underwent AGV implantation were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of antiglaucoma medications, and postoperative complications. Surgical...

  17. The prevalence and types of glaucoma in malay people: the Singapore Malay eye study.

    Science.gov (United States)

    Shen, Sunny Y; Wong, Tien Y; Foster, Paul J; Loo, Jing-Liang; Rosman, Mohamad; Loon, Seng-Chee; Wong, Wan Ling; Saw, Seang-Mei; Aung, Tin

    2008-09-01

    To assess the prevalence and types of glaucoma in an Asian Malay population. The Singapore Malay Eye Study is a population-based, cross-sectional survey that examined 3280 (78.7% response) persons aged 40 to 80 years. Participants underwent a standardized clinical examination including slit-lamp biomicroscopy, Goldmann applanation tonometry, and dilated optic disc assessment. Participants who were suspected to have glaucoma also underwent visual field examination (24-2 SITA standard, Humphrey Visual Field Analyzer II), gonioscopy, and repeat applanation tonometry. Glaucoma was defined according to International Society for Geographical and Epidemiologic Ophthalmology criteria. Of the 3280 participants, 150 (4.6%) had diagnosed glaucoma, giving an age- and sex-standardized prevalence of 3.4% (95% confidence interval [CI], 3.3%-3.5%). The age- and sex-standardized prevalence of primary open-angle glaucoma was 2.5% (95% CI, 2.4%-2.6%), primary angle-closure glaucoma 0.12% (95% CI, 0.10%-0.14%), and secondary glaucoma 0.61% (95% CI, 0.59%-0.63%). Of the 150 glaucoma cases, only 12 (8%) had a previous known history of glaucoma. Twenty-seven (18%) eyes had low vision (based on best corrected visual acuity logarithm of the minimal angle of resolution [logMAR] >0.30 to /=1.00). The prevalence of glaucoma among Malay persons 40 years of age and older in Singapore is 3.4%, comparable to ethnic Chinese people in Singapore and other racial/ethnic groups in Asia. As in Chinese, Caucasians, and African people, primary open-angle glaucoma was the main form of glaucoma in this population. More than 90% of glaucoma cases were previously undetected.

  18. Barriers to glaucoma case finding as perceived by optometrists in Ireland.

    Science.gov (United States)

    Barrett, Catriona; O'Brien, Colm; Butler, John S; Loughman, James

    2018-01-01

    This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95 per cent CI 1.3-8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ 2 [1] = 13.52, p glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest. The responses also indicate a lack of funding for the level of diagnostic testing required for accurate glaucoma diagnosis. Recent increases in the state's eye examination fees look likely to address the identified time and financial barriers to glaucoma detection in Ireland. Future work should look to analyse the effects of increased funding on optometric case finding for glaucoma. © 2017 Optometry Australia.

  19. Orofacial pain and headaches associated with exfoliation glaucoma.

    Science.gov (United States)

    Noma, Noboru; Iwasa, Mayumi; Young, Andrew; Ikeda, Mariko; Hsu, Yung-Chu; Yamamoto, Maasa; Inoue, Kenji; Imamura, Yoshiki

    2017-12-01

    Exfoliation syndrome is the most common identifiable cause of open-angle glaucoma. The authors report a case of exfoliation glaucoma in a patient who had orofacial pain. A 77-year-old woman was treated at the orofacial pain clinic for left-sided facial pain and headaches of 7 months' duration. Her cataracts and open-angle glaucoma had been diagnosed approximately 3 years earlier. Her main symptoms were orofacial pain, eye redness, inflammation of the eyelids, and eyelid edema. Magnetic resonance imaging showed no evidence of intracranial or extracranial pathology. Hemicrania continua was considered as a possible diagnosis. Indomethacin was prescribed but did not affect her headaches. She then went to an ophthalmologist to rule out secondary headaches. Intraocular pressure was 13 millimeters of mercury in the right eye and 67 mm Hg in the left eye. The ophthalmologist made a diagnosis of exfoliation glaucoma, and the patient underwent surgical treatment for the glaucoma and cataracts. After surgery, she was free of symptoms, and intraocular pressure was 15 mm Hg in the left eye. During differential diagnosis, dentists need to consider intraoral and systemic conditions that can mimic odontogenic or orofacial pain disorders in the patient's medical history and that have a higher incidence associated with the patient's age. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. Glaucoma and keratoprosthesis surgery: role of adjunctive cyclophotocoagulation.

    Science.gov (United States)

    Rivier, Delphine; Paula, Jayter S; Kim, Eva; Dohlman, Claes H; Grosskreutz, Cynthia L

    2009-01-01

    To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (DLTSC) to control intraocular pressure (IOP) in keratoprosthesis patients with uncontrolled glaucoma. Between 1993 and 2007, 18 eyes of 18 patients underwent DLTSC, either before (n=3), during (n=1), or after (n=14) keratoprosthesis surgery. Keratoprosthesis type I was used in 72%. All but one of these patients received an Ahmed Glaucoma Valve, either with or after the keratoprosthesis placement. Best-corrected visual acuity, IOP (assessed by digital palpation), number of medications, and complications were recorded preoperatively, at day 7, at 1, 3, and 6 months then every 6 months postoperatively. Mean follow-up was 26.6+/-19.6 months (mean+/-SD) and mean age was 50.1+/-15.6 years. Glaucoma was identified in 11 eyes before keratoprosthesis surgery and in 7 eyes after. Mean postoperative IOP was significantly reduced at 6, 12, 24, 36, and 48 months after DLTSC. DLTSC was repeated in 6 eyes. At final visit, mean best-corrected visual acuity was not decreased and there were no statistically significant differences in the number of glaucoma medications. Two patients had complications after DLTSC: a conjunctival dehiscence and a fungal endophthalmitis. DLTSC has beneficial long-term effects in the control of IOP and can be considered in the management of keratoprosthesis patients with refractory glaucoma.

  1. Current concepts in the pathophysiology of glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  2. Alteration in ocular blood flow and its effect on the progression of glaucoma

    Directory of Open Access Journals (Sweden)

    Sher Zaman Safi

    2017-04-01

    Full Text Available Glaucoma is a multifactorial neurodegenerative disease that can result in permanent vision loss by damaging optic nerves due to higher pressure in the eye. Although most of the fundamental pathophysiological mechanisms involved in glaucoma are undetermined but alteration in ocular blood flow(OBFin tissues such as optic nerve, retina, choroid and iris is an important risk factor for glaucoma. Various factors such as limited knowledge of the factors causing optic nerve damage, confusion in the measurement assays and lack of therapies, make hindrances in the understanding of glaucoma. Researchers are continuously accumulating evidence to suggest that alterations in OBF play important role in the pathogenesis of glaucoma but most of the times they have diverse and contradictory conclusions regarding changes in the OBF and risk of glaucoma. In this article we have reviewed different aspects of glaucoma and the effect of OBF in the disease progression

  3. The prevalence and incidence of glaucoma in Denmark in a fifteen year period

    DEFF Research Database (Denmark)

    Kolko, Miriam; Horwitz, Anna; Thygesen, John

    2015-01-01

    PURPOSE: The purpose of the present study was to describe the prevalence, incidence and geographic variation of glaucoma in Denmark in the period from 1996 to 2011. Moreover, the aim was to identify the treatment patterns of glaucoma within the studied period. METHODS: All Danish citizens were...... included throughout the study period. The National Prescription Registry was used to identify all claimed prescriptions for glaucoma medication. RESULTS: A total of 116,592 incident glaucoma patients were identified. Average age at onset was 66 years (range: 0-105 years), 55% were women. The prevalence...... of glaucoma increased from 0.79% to 1.72% during the investigated period. In 2011 glaucoma affected 3.76% of the population above 50 years and 10% in patients above 80 years. The age-specific incidence rate of glaucoma seemed to be constant and the increasing prevalence was primarily attributed to an aging...

  4. Oxidant/antioxidant balance in the aqueous humor of patients with glaucoma

    Directory of Open Access Journals (Sweden)

    Esra Ergan

    2016-02-01

    Full Text Available AIM: To evaluate total antioxidant status (TAS, total oxidant status (TOS, and the oxidative stress index (OSI of the aqueous humor (AH in patients with glaucoma. METHODS: The prospective study was composed of a study group (n=31 and a control group (n=31. Fifteen patients in the study group were diagnosed with primary open angle glaucoma (POAG, and 16 patients were diagnosed with pseudoexfoliation glaucoma (PEG. The control group was composed of non-glaucomatous patients with cataracts. AH samples were collected and analyzed for TAS, TOS, and OSI levels. RESULTS: Mean AH TAS level was significantly higher in patients with glaucoma than that in the control group (P<0.01. Mean TOS and OSI levels tended to increase in patients with glaucoma. No significant differences in TAS, TOS, or OSI levels were observed between patients with POAG and PEG. CONCLUSION: High levels of TAS were observed in patients with glaucoma, which was likely a response to the increased oxidative stress observed in these patients.

  5. Prevalência de diabetes mellitus tipo 2 e outros fatores de risco associados em pacientes com glaucoma Prevalence of type 2 diabetes mellitus and other associated risk factors in glaucoma patients

    Directory of Open Access Journals (Sweden)

    Jacqueline Coblentz

    2010-02-01

    Full Text Available OBJETIVO: Avaliar a prevalência de diabéticos em uma amostra de pacientes com glaucoma; verificar se existe associação entre diabetes mellitus e glaucoma na amostra estudada; verificar outros fatores de risco associados. MÉTODOS: Foram analisados de forma retrospectiva os prontuários de 50 pacientes com diagnóstico de glaucoma. Os dados registrados foram sexo, idade, raça, história familiar de glaucoma e história pessoal de diabetes mellitus tipo 2. RESULTADOS: Do total de pacientes avaliados, 5 (10% apresentavam diabetes mellitus tipo 2. Destes, 3 eram mulheres e 2 eram homens, com mediana de idade de 81 anos (71-88. A prevalência de diabetes nos pacientes com glaucoma não mostrou diferenças significativas (OR: 1,476; Intervalo de Confiança 95%: 0,4438 a 4,910; p= 0,5352 quando comparada à prevalência de diabetes mellitus tipo 2 na população geral brasileira (7,6%. CONCLUSÃO: Nesta amostra de pacientes com glaucoma, a prevalência de diabetes mellitus tipo 2 foi pouco mais elevada que a da população. Entretanto, nenhuma associação foi encontrada entre diabetes mellitus e glaucoma.PURPOSE: To evaluate prevalence of diabetes mellitus in a group of patients with glaucoma; to verify if there is association between diabetes mellitus and glaucoma; to verify other associated risk factors. METHODS: Fifty(50 glaucoma patients had their medical records analyzed in a retrospective way. Registered data included sex, age, ethnic group, family history of glaucoma and personal history of type 2 diabetes mellitus. RESULTS: Five (10% of all evaluated patients had type 2 diabetes mellitus. 3 of them were female and 2 were male, median age of 81 years old (71-88. Prevalence of diabetes in glaucoma patients did not show significant differences. (OR: 1.476; 95% Confidence Interval: 0.4438 to 4.910; p= 0.5352 when compared to the prevalence of type 2 diabetes mellitus in general brazilian population (7.6%. CONCLUSION: In this group of patients

  6. Traumatic glaucoma with features of unilateral pigment dispersion.

    Science.gov (United States)

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

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

  7. Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field.

    Science.gov (United States)

    Zhang, Xinbo; Dastiridou, Anna; Francis, Brian A; Tan, Ou; Varma, Rohit; Greenfield, David S; Schuman, Joel S; Huang, David

    2017-12-01

    To compare longitudinal glaucoma progression detection using optical coherence tomography (OCT) and visual field (VF). Validity assessment. We analyzed subjects with more than 4 semi-annual follow-up visits (every 6 months) in the multicenter Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of the peripapillary retinal nerve fiber layer (NFL) and ganglion cell complex (GCC). OCT-based progression detection was defined as a significant negative trend for either NFL or GCC. VF progression was reached if either the event or trend analysis reached significance. The analysis included 356 glaucoma suspect/preperimetric glaucoma (GS/PPG) eyes and 153 perimetric glaucoma (PG) eyes. Follow-up length was 54.1 ± 16.2 months for GS/PPG eyes and 56.7 ± 16.0 for PG eyes. Progression was detected in 62.1% of PG eyes and 59.8% of GS/PPG eyes by OCT, significantly (P glaucoma. While the utility of NFL declines in advanced glaucoma, GCC remains a sensitive progression detector from early to advanced stages. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. 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.

  9. Conjunctival erosion after glaucoma drainage device surgery: a feasible option.

    Science.gov (United States)

    Dubey, Suneeta; Prasanth, Baswati; Acharya, Manisha C; Narula, Ritesh

    2013-07-01

    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.

  10. Ultrasound spectroscopy: application on MMC and PMC materials

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Ricardo B [Los Alamos National Laboratory; Vuorinen, Jyki [TAMPERE UNIV TECHNOLOGY; Kuokkala, Veli - Tapani [TAMPERE UNIV TECHNOLOGY

    2010-01-01

    Resonant Ultrasound Spectroscopy (RUS) is a simple technique for measuring the second-order elastic constants and ultrasonic attenuation of solids. The technique is based on measuring the spectrum of mechanical resonances for a sample of known shape (usually a sphere, cylinder, or parallelepiped). This spectrum cannot be deconvoluted to deduce the elastic constants. Instead, an approximate spectrum is calculated from the known sample dimensions, its mass, and a set of 'guessed' elastic constants. A multidimensional minimization of the rms difference between the measured and calculated spectra enables us to deduce all the elastic constants of the solid from a single frequency scan. Currently, the technique can be applied to crystals of orthorhombic symmetry (9 elastic constants) or higher using desktop computers and software developed for this purpose. Composite materials, especially fiber composites, can take full advantage of the RUS technique as they typically have low symmetry. In this paper we summarize the RUS technique and provide examples of its application to the elastic characterization of both fiber reinforced MMC's, and fiber reinforced PMC's.

  11. Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence.

    Science.gov (United States)

    Cook, Paul F; Bremer, Robert W; Ayala, A J; Kahook, Malik Y

    2010-10-05

    Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice. Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention. A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence. The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients' medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is

  12. Loss of Melanopsin-Expressing Retinal Ganglion Cells in Severely Staged Glaucoma Patients

    DEFF Research Database (Denmark)

    Obara, Elisabeth Anne; Hannibal, Jens; Heegaard, Steffen

    2016-01-01

    Purpose: Multiple studies have shown overwhelming evidence supporting the impairment of melanopsin function due to glaucoma. However, few studies have been carried out in humans analyzing the histology of melanopsin-expressing retinal ganglion cells (mRGCs) in retinas with glaucoma. The aim...... of this study was to analyze the pattern of expression of mRGCs relative to RGCs in the normal retina and retinas harboring varying stages of glaucoma. Methods: Paraffin-embedded human donor eyes with glaucoma (n = 11) and age-matched controls (n = 10) were obtained from Department of Pathology at Rigshospital...... difference was observed in mRGC expression in the normal retinas and mild-staged retinas with glaucoma; the densities of mRGCs were 3.08 ± 0.47 and 3.00 ± 0.13 cell counts/mm2, respectively. However, the severely staged retinas with glaucoma showed a significant loss in mRGCs density, 1.09 ± 0.35 cell counts...

  13. Structural and functional assessment of macula to diagnose glaucoma.

    Science.gov (United States)

    Rao, H L; Hussain, R S M; Januwada, M; Pillutla, L N; Begum, V U; Chaitanya, A; Senthil, S; Garudadri, C S

    2017-04-01

    PurposeTo compare the diagnostic abilities of structural (ganglion cell-inner plexiform layer (GCIPL) thickness measured using spectral domain optical coherence tomography (SDOCT)) and functional (visual sensitivities measured using standard automated perimetry (SAP) and microperimetry (MP)) assessments of macula in glaucoma.MethodsIn a prospective study, 46 control eyes (28 subjects) and 61 glaucoma eyes (46 patients) underwent visual sensitivity estimation at macula (central 10°) by SAP and MP, and GCIPL thickness measurement at macula by SDOCT. Glaucoma was diagnosed by experts based on the optic disc and retinal nerve fiber layer changes. Area under the receiver-operating characteristic (AUC) curves and sensitivities at 95% specificity were used to assess the diagnostic ability of visual sensitivity and GCIPL measurements at various macular sectors.ResultsAUCs of GCIPL parameters ranged between 0.58 and 0.79. AUCs of SAP and MP sensitivities ranged between 0.59 and 0.71, and 0.59 and 0.72, respectively. There were no statistically significant differences between the AUCs of corresponding sector measurements (P>0.10 for all comparisons). Sensitivities at 95% specificities ranged from 31-59% for GCIPL parameters, 16-34% for SAP, and 8-38% for MP parameters. Sensitivities were significantly better with GCIPL compared with SAP and MP parameters in diagnosing glaucoma. Inferotemporal, inferior, and superotemporal sector measurements of GCIPL and visual sensitivity showed the best abilities to diagnose glaucoma.ConclusionsComparing the diagnostic abilities of structural and functional tests at macula in glaucoma, GCIPL thickness measurements with SDOCT performed better than the visual sensitivity measurements by SAP and MP.

  14. Análogos das prostaglandinas diminuem a sensibilidade do teste provocativo da ibopamina no glaucoma Prostaglandin analogues reduce the ibopamine provocative test specificity in glaucoma

    Directory of Open Access Journals (Sweden)

    Leopoldo Magacho

    2006-04-01

    Full Text Available OBJETIVO: Avaliar o desempenho do teste provocativo da ibopamina em pacientes com glaucoma usuários de drogas hipotensoras. MÉTODOS: Pacientes glaucomatosos foram recrutados do Centro de Referência em Oftalmologia (CEROF da Universidade Federal de Goiás, e suas drogas hipotensoras em uso registradas. Indivíduos normais foram amigos e parentes dos pacientes. A seguir, foram instiladas duas gotas de ibopamina 2% com intervalo de 5 minutos. A pressão intra-ocular (Pio foi medida previamente, e após 30, 60 e 180 minutos. No nosso estudo, o teste da ibopamina foi considerado positivo quando a pressão intra-ocular excedeu 4 mmHg em pelo menos uma das medidas. RESULTADOS: Cinquenta e oito olhos de 58 indivíduos (38 glaucomatosos e 20 normais foram incluídos no estudo. O aumento da pressão intra-ocular foi maior nos pacientes com glaucoma aos 30, 60 e 180 minutos (pPURPOSE: To evaluate the ibopamine provocative test for the diagnosis of glaucoma in glaucoma patients using antiglaucomatous drugs. METHODS: Two 2% ibopamine eyedrops were instilled 5 minutes apart in one eye selected at random in both glaucoma and normal subjects. The intraocular pressure (IOP was assessed prior to the drops and 30, 60 and 180 minutes after instillation. The test was considered positive when there was an intraocular pressure increase of greater than 4 mmHg at any one of the timepoints. The amount of intraocular pressure change was compared to the types of medical treatment. RESULTS: Fifty-eight eyes were included (38 glaucoma patients and 20 normal individuals. The intraocular pressure rise was significantly higher in glaucoma patients (p<0.001 at all times. The sensitivity and specificity of the ibopamine test were 68% (87% if we exclude eyes using prostaglandin analogues and 95%, respectively. Glaucoma patients using prostaglandin analogues did not present a significant intraocular pressure elevation. CONCLUSION: The ibopamine provocative test may be an

  15. Glaucomas in Africas

    African Journals Online (AJOL)

    Murdoch

    happens in all secondary glaucomas. There was confusion some years ago in our understanding of the disease, since intraocular pressure was included in the definition of the disease. With the advent of population studies it became apparent that, in some populations, a significant proportion of those with the characteristic ...

  16. A Rare Manifestation of Uveitis-glaucoma-hyphema Syndrome.

    Science.gov (United States)

    Sousa, David Cordeiro; Leal, Inês; Faria, Mun Yueh; Pinto, Luís Abegão

    2016-01-01

    To report a case of a patient who developed uveitis-glaucoma-hyphema (UGH) syndrome after an uneventful cataract surgery and to discuss risk factors, diagnostic challenges, management options, and clinical implications. Uveitis-glaucoma-hyphema syndrome is a rare but potentially serious cataract surgery complication. Clinical manifestations include increased intraocular pressure (IOP), anterior chamber inflammation, and recurrent hyphema or microhyphema. Uveitis-glaucoma-hyphema Plus syndrome also includes accompanying vitreous hemorrhage. Although classically associated with rigid anterior chamber intraocular lenses (lOLs), cases of malpositioning and subluxated posterior chamber lOLs have also been described as possible triggers. We report a case of a 70-year-old Caucasian man who developed UGH Plus syndrome after an uneventful cataract surgery with an lOL implanted in the capsular bag. During postoperative follow-up, persistent intraocular inflammation, increased IOP, hyphema, and vitreous hemorrhage were consistent with this diagnosis. Slit-lamp examination demonstrated progressive localized iris atrophy, compatible with chafing of the posterior iris by the IOL haptic as the trigger for UGH syndrome. A pars plana vitrectomy was performed and a retropupillary intraocular lens was implanted. No further complications occurred during follow-up. Given the increasing prevalence of single-piece lOLs implanted in the capsular bag, it is important to recognize UGH syndrome as a rare but potentially serious complication. How to cite this article: Sousa DC, Leal I, Faria MY, Pinto LA. A Rare Manifestation of Uveitis-glaucoma-hyphema Syndrome. J Curr Glaucoma Pract 2016;10(2):76-78.

  17. Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol.

    Science.gov (United States)

    King, Anthony J; Fernie, Gordon; Azuara-Blanco, Augusto; Burr, Jennifer M; Garway-Heath, Ted; Sparrow, John M; Vale, Luke; Hudson, Jemma; MacLennan, Graeme; McDonald, Alison; Barton, Keith; Norrie, John

    2017-10-26

    Presentation with advanced glaucoma is the major risk factor for lifetime blindness. Effective intervention at diagnosis is expected to minimise risk of further visual loss in this group of patients. To compare clinical and cost-effectiveness of primary medical management compared with primary surgery for people presenting with advanced open-angle glaucoma (OAG). Design : A prospective, pragmatic multicentre randomised controlled trial (RCT). Twenty-seven UK hospital eye services. Four hundred and forty patients presenting with advanced OAG, according to the Hodapp-Parish-Anderson classification of visual field loss. Participants will be randomised to medical treatment or augmented trabeculectomy (1:1 allocation minimised by centre and presence of advanced disease in both eyes). The primary outcome is vision-related quality of life measured by the National Eye Institute-Visual Function Questionnaire-25 at 24 months. Secondary outcomes include generic EQ-5D-5L, Health Utility Index-3 and glaucoma-related health status (Glaucoma Utility Index), patient experience, visual field measured by mean deviation value, logarithm of the mean angle of resolution visual acuity, intraocular pressure, adverse events, standards for driving and eligibility for blind certification. Incremental cost per quality-adjusted life-year (QALY) based on EQ-5D-5L and glaucoma profile instrument will be estimated. The study will report the comparative effectiveness and cost-effectiveness of medical treatment against augmented trabeculectomy in patients presenting with advanced glaucoma in terms of patient-reported health and visual function, clinical outcomes and incremental cost per QALY at 2 years. Treatment of Advanced Glaucoma Study will be the first RCT reporting outcomes from the perspective of those with advanced glaucoma. ISRCTN56878850, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  18. Costos directos del glaucoma primario de ángulo abierto

    OpenAIRE

    Fernández García, Ariana; Triana Casado, Idalia; Villar Valdés, Rosendo

    2012-01-01

    Introducción: la magnitud del costo asociado al glaucoma primario de ángulo abierto deriva de la atención sanitaria y de la disminución de la calidad de vida del paciente. Objetivos: estimar los costos del glaucoma primario de ángulo abierto en los pacientes atendidos durante el 2010 en el servicio de glaucoma del hospital "Dr. Salvador Allende." Métodos: se realizó un estudio retrospectivo, en el campo de la Evaluación Económica en Salud es un estudio del tipo de descripción de costos, que a...

  19. Impact of Glaucoma and Dry Eye on Text-Based Searching

    Science.gov (United States)

    Sun, Michelle J.; Rubin, Gary S.; Akpek, Esen K.; Ramulu, Pradeep Y.

    2017-01-01

    Purpose We determine if visual field loss from glaucoma and/or measures of dry eye severity are associated with difficulty searching, as judged by slower search times on a text-based search task. Methods Glaucoma patients with bilateral visual field (VF) loss, patients with clinically significant dry eye, and normally-sighted controls were enrolled from the Wilmer Eye Institute clinics. Subjects searched three Yellow Pages excerpts for a specific phone number, and search time was recorded. Results A total of 50 glaucoma subjects, 40 dry eye subjects, and 45 controls completed study procedures. On average, glaucoma patients exhibited 57% longer search times compared to controls (95% confidence interval [CI], 26%–96%, P Dry eye subjects demonstrated similar search times compared to controls, though worse Ocular Surface Disease Index (OSDI) vision-related subscores were associated with longer search times (P dry eye (P > 0.08 for Schirmer's testing without anesthesia, corneal fluorescein staining, and tear film breakup time). Conclusions Text-based visual search is slower for glaucoma patients with greater levels of VF loss and dry eye patients with greater self-reported visual difficulty, and these difficulties may contribute to decreased quality of life in these groups. Translational Relevance Visual search is impaired in glaucoma and dry eye groups compared to controls, highlighting the need for compensatory strategies and tools to assist individuals in overcoming their deficiencies. PMID:28670502

  20. The interrelation between hypothyroidism and glaucoma: a critical review and meta-analyses.

    Science.gov (United States)

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

    2017-12-01

    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 patients) as exposure and hypothyroidism as outcome. Among these, we found a non-significantly increased risk of hypothyroidism associated with glaucoma (RR 1.65; 95% confidence interval [CI]: 0.97-2.82). Based on five studies (168 006 patients) with hypothyroidism as exposure and glaucoma as outcome, we found the risk of glaucoma to be significantly increased (RR 1.33; 95% CI: 1.13-1.58). Based on these meta-analyses, there seems to be an association between hypothyroidism and glaucoma, which does not seem to be the case between glaucoma and hypothyroidism. However, larger scale studies with better phenotype classification, longer follow-up and taking comorbidity and other biases into consideration are needed to address a potential causal relationship. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Reversible Venting Stitch for Fenestrating Valve-less Glaucoma Shunts.

    Science.gov (United States)

    Akil, Handan; Vu, Priscilla Q; Nguyen, Anhtuan H; Nugent, Alexander; Chopra, Vikas; Francis, Brian A; Tan, James C

    2017-12-01

    The purpose of this is to describe a venting stitch modification for valveless glaucoma aqueous shunts and characterize early postoperative intraocular pressure (IOP) and glaucoma medication use following the modification. Retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute. Twenty-four patients received a glaucoma shunt with venting stitch modification (modified BGI) and 37 patients received an unmodified shunt (BGI-only). IOP, number of glaucoma medications, and number of hypotony cases (intraocular pressure ≤5 mm Hg) were compared between the groups. T-tests were used for statistical analysis. At postoperative-day 1, mean IOP was significantly lower compared with preoperatively in the modified BGI group (14 mm Hg; reduced by 51%; P<0.0001) but not the BGI-only group (27 mm Hg; P=0.06). IOP difference between groups persisted till immediately before tube opening (P=0.005) and fewer IOP-lowering medications needed in the modified BGI group (P<0.0001). One case (4.2%) of postoperative hypotony was encountered with BGI modification, which resolved after the stitch was removed in clinic. The venting stitch valveless shunt modification allows for effective, reliable, and safe control of early postoperative IOP.

  2. Modulation of the immune system for the treatment of glaucoma.

    Science.gov (United States)

    Bell, Katharina; Und Hohenstein-Blaul, Nadine von Thun; Teister, Julia; Grus, Franz H

    2017-07-19

    At present intraocular pressure (IOP) lowering therapies are the only approach to treat glaucoma. Neuroprotective strategies to protect the retinal ganglion cells (RGC) from apoptosis are lacking to date. Results from clinical studies revealed altered immunoreactivities against retinal and optic nerve antigens in sera and aqueous humor of glaucoma patients and point toward an autoimmune involvement in glaucomatous neurodegeneration and RGC death. IgG accumulations along with plasma cells were found localised in human glaucomatous retinae in a pro-inflammatory environment possibly maintained by microglia. Animal studies show that antibodies (e.g. anti- heat shock protein 60 and anti-myelin basic protein) elevated in glaucoma patients provoke autoaggressive RGC loss and are associated with IgG depositions and increased microglial cells. We demonstrate that intermittent IOP elevation in a rat model is sufficient to provoke glaucoma-like neurodegeneration and elicits correlating changes of IgG autoantibody reactivities. On the other hand, antibodies (e.g. anti-glial fibrillary acidic protein and anti-gamma-Synuclein) found decreased in glaucoma patients hold neuroprotective potential on immortalised neuroretinal cells and RGC in an adolescent porcine retina organ culture. We believe that our work not only demonstrates an autoimmune component in glaucoma, but also opens up new options for glaucoma diagnostics and treatment. Nevertheless the immune system also consists of other cells involved not only in the adaptive, but also innate immune system. Studies addressing changes in T lymphocytes, macrophages but also local immune responses in the retina have been performed and also hold promising results. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  3. Malignant glaucoma after cataract surgery.

    Science.gov (United States)

    Varma, Devesh K; Belovay, Graham W; Tam, Diamond Y; Ahmed, Iqbal Ike K

    2014-11-01

    To report a series of eyes that developed malignant glaucoma after cataract surgery. Private academic practice, Toronto, Ontario, Canada. Retrospective case series. Eyes that developed malignant glaucoma after cataract surgery were treated with medical therapy. This was followed by laser iridozonulohyaloidotomy, anterior chamber reformation and intraocular lens (IOL) pushback, and finally with surgical iridozonulohyaloidovitrectomy if all other measures were unsuccessful. Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) by anterior segment optical coherence tomography were analyzed before treatment and after treatment. The study evaluated 20 eyes of 18 female patients aged 44 to 86 years. Preoperatively, the mean refraction was +3.11 diopters (D) ± 2.89 (SD), the mean axial length was 21.30 ± 1.40 mm, and all eyes had narrow or closed angles. Malignant glaucoma was diagnosed a mean of 5.8 ± 7.1 weeks postoperatively. At diagnosis, the mean refraction was -2.15 ± 2.95 D; the mean ACD, 2.49 ± 0.72 mm; and the mean IOP, 28.3 ± 10.8 mm Hg on a mean of 1.3 ± 1.6 medications. Two eyes responded to cycloplegia, 7 to laser iridozonulohyaloidotomy, and 6 to anterior chamber reformation-IOL pushback; 5 eyes required vitrectomy. Posttreatment, the mean refraction was -0.56 ± 1.07 D; the mean ACD, 3.30 ± 0.50 mm; and the mean IOP, 14.4 ± 4.60 mm Hg on a mean of 1.2 ± 1.4 medications. Cycloplegia was discontinued in 17 eyes. Malignant glaucoma can occur after phacoemulsification and presents with myopic surprise, anterior chamber shallowing and, possibly, elevated IOP. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Novel and known MYOC exon 3 mutations in an admixed Peruvian primary open-angle glaucoma population

    OpenAIRE

    Mendoza Reinoso, Veronica; Patil, Teja S.; Guevara Fujita, María Luisa; Fernández, Silvia; Vargas, Enrique; Castillo Herrera, Wilder; Perez Grossmann, Rodolfo; Lizaraso Caparó, Frank; Richards, Julia E.; Fujita, Ricardo

    2012-01-01

    Purpose: The aim of this study was to characterize a representative sample of the Peruvian population suffering openangle glaucoma (OAG) with respect to the myocilin gene (MYOC) mutations, glaucoma phenotype, and ancestry for future glaucoma risk assessment. Methods: DNA samples from 414 unrelated Peruvian subjects, including 205 open-angle glaucoma cases (10 juvenile glaucoma [JOAG], 19 normal-tension glaucoma [NTG], and 176 POAG) and 209 randomly sampled controls, were screen...

  5. Outcomes of Gonioscopy-assisted Transluminal Trabeculotomy (GATT) in Eyes With Prior Incisional Glaucoma Surgery.

    Science.gov (United States)

    Grover, Davinder S; Godfrey, David G; Smith, Oluwatosin; Shi, Wei; Feuer, William J; Fellman, Ronald L

    2017-01-01

    To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior incisional glaucoma surgery. A retrospective review was performed for all patients who underwent a GATT procedure with a history of prior incisional glaucoma surgery. Thirty-five eyes of 35 patients were treated. The mean age was 67.7 years. Nineteen eyes had a prior trabeculectomy, 13 eyes had a prior glaucoma drainage device, 4 eyes had a prior trabectome, and 5 eyes had prior endocyclophotocoagulation. Mean follow-up time was 22.7 months. For all eyes, the mean preoperative intraocular pressure (IOP) (SD) was 25.7 (6.5) mm Hg on 3.2 (1.0) glaucoma medications and at 24 months, the mean IOP (SD) was 15.4 (4.9) mm Hg on 2.0 (1.4) glaucoma medications (P<0.001). The prior trabeculectomy group had a preoperative IOP (SD) of 24.6 (6.4) mm Hg on 3.2 (1.0) medications and at month 24, the mean IOP (SD) was 16.7 (5.6) mm Hg on 2.1 (1.4) glaucoma medications. In the prior glaucoma drainage device group, the mean preoperative IOP (SD) was 27.0 (7.1) mm Hg on 3.4 (1.1) glaucoma medications and at 24 months, the mean IOP (SD) was 12.9 (2.6) mm Hg on 2.1 (1.2) glaucoma medications. At 24 months, the cumulative proportion of failure was 0.4 and the cumulative proportion of reoperation was 0.29. GATT appears to be safe and successful in treating 60% to 70% of open-angle patients with prior incisional glaucoma surgery. When considering all eyes, there was a significant decrease in IOP and required glaucoma medications at 24 months. This surgery should be considered in certain patients with open angles who have failed a primary traditional glaucoma surgery.

  6. Incidence of short-term complications and associated factors after primary trabeculectomy in Chiang Mai University Hospital.

    Science.gov (United States)

    Leeungurasatien, Thidarat; Khunsongkiet, Preeyanuch; Pathanapitoon, Kassara; Wiwatwongwana, Damrong

    2016-10-01

    To determine the incidence of early postoperative complications and associated factors after primary trabeculectomy in Thai glaucoma patients. This was a retrospective observational study performed in Chiang Mai University Hospital. One hundred and eighteen glaucoma patients participated in the study. All glaucoma patients underwent primary trabeculectomy with mitomycin C (MMC) using fornix-based conjunctival flap technique between December 2011 and May 2013. Surgical complications during the first 3 months of follow-up were recorded, and associated risk factors were analyzed. The incidence of posttrabeculectomy complications was the main outcome measure. One hundred and eighteen eyes of 118 patients were included. Early postoperative complications developed in 55 eyes (56.7%). Complications included hypotony (25 eyes, 27.2%), serous choroidal detachment (CD) (14 eyes, 15.6%), subconjunctival hemorrhage (12 eyes, 13.0%), hyphema (11 eyes, 12.4%), bleb leak (8 eyes, 8.8%), encapsulated bleb (2 eyes, 2.2%), aqueous misdirection (1 eyes, 1.1%), corneal epithelial defect (1 eyes, 1.1%), and overfiltration (1 eyes, 1.1%). There were no reported cases of endophthalmitis or blebitis. Hypotony was associated with serous CD (P = 0.006), and hyphema was associated with neovascular glaucoma (NVG) patients (P = 0.009). NVG was not associated with the increased rate of surgical failure (P = 0.083). The incidence of early complications after first-time trabeculectomy with MMC was high (56.7%) in this Thai clinic setting, but most were transient and self-limited conditions. The correlations between hypotony and CD as well as hyphema and NVG were compatible with the previous studies.

  7. Is there an association between glaucoma and capillaroscopy in patients with systemic sclerosis?

    Science.gov (United States)

    Gomes, Beatriz Fiuza; Souza, Rebeca; Valadão, Thiago; Kara-Junior, Newton; Moraes, Haroldo Vieira; Santhiago, Marcony R

    2018-02-01

    To evaluate the relationship between glaucoma diagnosis and the nailfold capillaroscopy pattern in patients with systemic sclerosis. An observational study in a cohort of patients with SSc was conducted. Patients with at least one nailfold videocapillaroscopy and one ophthalmology examination at the same year were included. Data collected were: age, sex; type of systemic sclerosis according to the degree of skin impairment, self-reported ethnicity, disease duration, current use and dosage of systemic corticosteroid, current use and dosage of bosentan ® , intraocular pressure, central corneal thickness, diagnosis of glaucoma and capillaroscopy pattern. Thirty-one patients with systemic sclerosis were enrolled, 23% had glaucoma. There was no statistically significant association between glaucoma diagnosis and the capillaroscopic pattern (p = 0.86). There was also no significant difference (p = 0.66) regarding intraocular pressure between patients with mild (13.9 ± 3.8 mmHg) and severe capillaroscopic pattern (14.4 ± 2.8 mmHg). The odds ratio of glaucoma for severe capillaroscopic pattern compared to mild was 1.6 (95% confidence interval: 0.3-9.5). Up to 23% of patients with SSc have glaucoma. The high prevalence of glaucoma in SSc suggests a possible systemic vascular disturbance as the cause. However, there seems to be no significant association between the capillaroscopy pattern and glaucoma in systemic sclerosis. Further research is required to improve the understanding of glaucoma in the context of systemic sclerosis.

  8. [The role of patient compliance in the management of glaucoma].

    Science.gov (United States)

    Popović Suić, Smiljka; Cerovski, Branimir; Jukić, Tomislav

    2008-02-01

    The aim of the study was to evaluate patient cooperation in glaucoma treatment. We evaluated data collected by an anonymous questionnare from 98 glaucoma patients who answered 6 questions regarding their compliance and persistence in glaucoma treatment. Study results revealed 50% of patients to fail taking their antiglaucoma therapy regularly. Patients on monotherapy showed better compliance and higher level of satisfaction with treatment than those on combination antiglaucoma therapy consisting of 2 or 3 eyedrops. Discontinuation of persistence was recorded in 31% of patients, whereas 51% of patients did not present for control visits every six months as suggested by their ophthalmologist. Patients are more compliant and persistent with antiglaucoma monotherapy than with combined therapy. Greater compliance and persistence with ocular hypotensive therapy may improve the outcomes in glaucoma.

  9. What was Glaucoma Called Before the 20th Century?

    Science.gov (United States)

    Leffler, Christopher T.; Schwartz, Stephen G.; Giliberti, Francesca M.; Young, Matthew T.; Bermudez, Dennis

    2015-01-01

    Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”. PMID:26483611

  10. Minimally invasive glaucoma surgery: current status and future prospects

    Directory of Open Access Journals (Sweden)

    Richter GM

    2016-01-01

    Full Text Available Grace M Richter,1,2 Anne L Coleman11UCLA Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, CA, USA; 2USC Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USAAbstract: Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy; suprachoroidal shunts (Cypass micro-stent; reducing aqueous production (endocyclophotocoagulation; and subconjunctival filtration (XEN gel stent. The data on each surgical procedure for each of these approaches are reviewed in this article, patient selection pearls learned to date are discussed, and expectations for the future are examined. Keywords: MIGS, microincisional glaucoma surgery, trabecular stent, Schlemm’s canal, suprachoroidal shunt, ab interno

  11. Superior versus inferior Ahmed glaucoma valve implantation.

    Science.gov (United States)

    Pakravan, Mohammad; Yazdani, Shahin; Shahabi, Camelia; Yaseri, Mehdi

    2009-02-01

    To compare the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA) implantation in the superior versus inferior quadrants. Prospective parallel cohort study. A total of 106 eyes of 106 patients with refractory glaucoma. Consecutive patients with refractory glaucoma underwent AGV implantation in the superior or inferior quadrants. Main outcome measures included intraocular pressure (IOP) and rate of complications. Other outcome measures included best corrected visual acuity (BCVA), number of glaucoma medications, and success rate (defined as at least 30% IOP reduction and 5glaucoma surgery, phthisis bulbi, or loss of light perception. Of a total of 106 eyes, 58 and 48 eyes underwent AGV implantation in the superior and inferior quadrants, respectively. Baseline characteristics were comparable in the study groups, except for preoperative IOP, which was higher in the superior group (P = 0.01). Patients were followed for a mean period of 10.6+/-8.49 months and 10.58+/-6.75 months in the superior and inferior groups, respectively (P = 0.477). BCVA was comparable between the groups at all postoperative visits (P>0.122). After 1 year, statistically significant but comparable IOP reduction from baseline (Pglaucoma medications was comparable after 1 year (1.3+/-1.2 vs. 1.9+/-0.8 for superior and inferior implants, respectively, P = 0.256). Success rates were also similar at 1 year: 27 eyes (81.8%) versus 20 eyes (95.2%) for superior and inferior implants, respectively (P = 0.227). However, the overall rate of complications, such as implant exposure necessitating removal, cosmetically unappealing appearance, and endophthalmitis, was higher in the inferior group: 12 eyes (25%) versus 3 eyes (5.2%) for superior and inferior groups, respectively, (P = 0.004). Superior and inferior AGV implants have similar intermediate efficacy in terms of IOP reduction, decrease in number of glaucoma medications, and preservation of vision. However

  12. Neuroprotective therapies for glaucoma

    Directory of Open Access Journals (Sweden)

    Song W

    2015-03-01

    Full Text Available Wei Song, Ping Huang, Chun Zhang Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China Abstract: Glaucoma is the second leading cause for blindness worldwide. It is mainly caused by glaucomatous optic neuropathy (GON characterized by retinal ganglion cell loss, which leads to visual field defect and blindness. Up to now, the main purpose of antiglaucomatous therapies has been to lower intraocular pressure (IOP through surgeries and medications. However, it has been found that progressive GON is still present in some patients with effective IOP decrease. Therefore, risk factors other than IOP elevation, like neurotrophin deprivation and excitotoxicity, contribute to progressive GON. Novel approaches of neuroprotection may be more effective for preserving the function of the optic nerve. Keywords: glaucoma, glaucomatous optic neuropathy, retinal ganglion cells, neuro­protection

  13. Longer-term Baerveldt to Trabectome glaucoma surgery comparison using propensity score matching.

    Science.gov (United States)

    Kostanyan, Tigran; Shazly, Tarek; Kaplowitz, Kevin B; Wang, Steven Z; Kola, Sushma; Brown, Eric N; Loewen, Nils A

    2017-12-01

    To apply propensity score matching to compare Baerveldt glaucoma drainage implant (BGI) to Trabectome-mediated ab interno trabeculectomy (AIT). Recent data suggests that AIT can produce results similar to BGI which is traditionally reserved for more severe glaucoma. BGI and AIT patients with at least 1 year of follow-up were included. The primary outcome measures were intraocular pressure (IOP), number of glaucoma medications, and a Glaucoma Index (GI) score. GI reflected glaucoma severity based on visual field, the number of preoperative medications, and preoperative IOP. Score matching used a genetic algorithm consisting of age, gender, type of glaucoma, concurrent phacoemulsification, baseline number of medications, and baseline IOP. Patients with neovascular glaucoma, with prior glaucoma surgery, or without a close match were excluded. Of 353 patients, 30 AIT patients were matched to 29 BGI patients. Baseline characteristics including, IOP, the number of glaucoma medications, type of glaucoma, the degree of VF loss and GI were not significantly different between AIT and BGI. BGI had a preoperative IOP of 21.6 ± 6.3 mmHg compared to 21.5 ± 7.4 for AIT on 2.8 ± 1.1 medications and 2.5 ± 2.3 respectively. At 30 months, the mean IOP was 15.0 ± 3.9 mmHg for AIT versus 15.0 ± 5.7 mmHg for BGI (p > 0.05), while the number of drops was 1.5 ± 1.3 for AIT (change: p = 0.001) versus 2.4 ± 1.2 for BGI (change: p = 0.17; AIT vs BGI: 0.007). Success, defined as IOP  0.05) and 50% versus 52% at 2.5 years. A propensity score matched comparison of AIT and BGI demonstrated a similar IOP reduction through 1 year. AIT required fewer medications.

  14. Use of a 350-mm2 Baerveldt glaucoma drainage device to maintain vision and control intraocular pressure in dogs with glaucoma: a retrospective study (2013-2016).

    Science.gov (United States)

    Graham, Kathleen L; Donaldson, David; Billson, Francis A; Billson, F Mark

    2017-09-01

    To evaluate the 350-mm 2 Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin-C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology. Retrospective case series. Twenty-eight client-owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma. The medical records of all dogs undergoing placement of a 350-mm 2 Baerveldt GDD at a veterinary ophthalmology referral service between 2013 and 2016 were reviewed. Signalment, diagnosis, duration and previous treatment of glaucoma, previous intraocular surgery, IOP, visual, and surgical outcomes were recorded. IOP was maintained glaucoma medication were required following surgery. Vision was retained in 18 of 27 (66.7%) eyes with vision at the time of surgery. No eyes that were blind at the time of surgery (n = 5) had restoration of functional vision. Complications following surgery included hypotony (26/32; 81.3%), intraocular hypertension (24/32; 75.0%), and fibrin formation within the anterior chamber (20/32; 62.5%). The average follow-up after placement of the GDD was 361.1 days (median 395.6 days). Efforts to minimize postoperative hypotony and address the fibroproliferative response following placement of a 350-mm 2 Baerveldt GDD showed an increased success rate to other reports of this device in dogs and offers an alternative surgical treatment for controlling intraocular pressure in dogs with glaucoma. © 2016 American College of Veterinary Ophthalmologists.

  15. Preparation of an antitumor and antivirus agent: chemical modification of α-MMC and MAP30 from Momordica Charantia L. with covalent conjugation of polyethyelene glycol.

    Science.gov (United States)

    Meng, Yao; Liu, Shuangfeng; Li, Juan; Meng, Yanfa; Zhao, Xiaojun

    2012-01-01

    Alpha-momorcharin (α-MMC) and momordica anti-HIV protein (MAP30) derived from Momordica charantia L. have been confirmed to possess antitumor and antivirus activities due to their RNA-N-glycosidase activity. However, strong immunogenicity and short plasma half-life limit their clinical application. To solve this problem, the two proteins were modified with (mPEG)(2)-Lys-NHS (20 kDa). In this article, a novel purification strategy for the two main type I ribosome-inactivating proteins (RIPs), α-MMC and MAP30, was successfully developed for laboratory-scale preparation. Using this dramatic method, 200 mg of α-MMC and about 120 mg of MAP30 was obtained in only one purification process from 200 g of Momordica charantia seeds. The homogeneity and some other properties of the two proteins were assessed by gradient SDS-PAGE, electrospray ionization quadruple mass spectrometry, and N-terminal sequence analysis as well as Western blot. Two polyethylene glycol (PEG)ylated proteins were synthesized and purified. Homogeneous mono-, di-, or tri-PEGylated proteins were characterized by matrix-assisted laser desorption ionization-time of flight mass spectrometry. The analysis of antitumor and antivirus activities indicated that the serial PEGylated RIPs preserved moderate activities on JAR choriocarcinoma cells and herpes simplex virus-1. Furthermore, both PEGylated proteins showed about 60%-70% antitumor and antivirus activities, and at the same time decreased 50%-70% immunogenicity when compared with their unmodified counterparts. α-MMC and MAP30 obtained from this novel purification strategy can meet the requirement of a large amount of samples for research. Their chemical modification can solve the problem of strong immunogenicity and meanwhile preserve moderate activities. All these findings suggest the potential application of PEGylated α-MMC and PEGylated MAP30 as antitumor and antivirus agents. According to these results, PEGylated RIPs can be constructed with

  16. Flicker-defined form perimetry in glaucoma patients.

    Science.gov (United States)

    Horn, Folkert K; Kremers, Jan; Mardin, Christian Y; Jünemann, Anselm G; Adler, Werner; Tornow, Ralf P

    2015-03-01

    To assess the potential of flicker-defined form (FDF) perimetry to detect functional loss in patient groups with beginning glaucoma, and to evaluate the dynamic range of the FDF stimulus in individual patients and at individual test positions. FDF perimetry and standard automated perimetry (SAP) were performed at identical test locations (adapted G1 protocol) in 60 healthy subjects and 111 glaucoma patients. All patients showed glaucomatous optic disc appearance. Grouping within the glaucoma cohort was based on SAP-performance: 33 "preperimetric" open-angle glaucoma (OAG) patients, 28 "borderline" OAG (focal defects and SAP-mean defect (MD) <2 dB), 33 "early" OAG (SAP-MD < 5 dB), 17 "advanced" OAG. All participants were experienced in psychophysical and perimetric tests. Defect values and the areas under receiver operating characteristic curves (ROC) in patient groups were statistically compared. The values of FDF-MD in the preperimetric, borderline, and early OAG group were 2.7 ± 3.4 dB, 5.5 ± 2.6 dB, and 8.5 ± 3.4 dB respectively (all significantly above normal). The percentage of patients exceeding normal FDF-MD was 27.3 %, 60.7 %, and 87.9 % respectively. The age-adjusted FDF-mean defect (MD) of the G1X-protocol was not significantly correlated with refractive error, lens opacity, pupil size, or gender. Occurrence of ceiling effects (inability to detect targets at highest contrast) showed a high correlation with visual field losses (R = 0.72, p < 0.001). Local analysis indicates that SAP losses exceeding 5 dB could not be distinguished with the FDF technique. The FDF stimulus was able to detect beginning glaucoma damage. Patients with SAP-MD values exceeding 5 dB should be monitored with conventional perimetry because of its larger dynamic range.

  17. Diagnostic Accuracy of Nonmydriatic Fundus Photography for the Detection of Glaucoma in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Francisco J. Muñoz-Negrete

    2015-01-01

    Full Text Available Purpose. To determine the diagnostic accuracy for glaucoma of a set of criteria with nonmydriatic monoscopic fundus photography (NMFP in diabetics. Methods. Diabetics recruited from a screening program for diabetic retinopathy and diabetic glaucoma patients recruited from our glaucoma unit were included. Any patient with evidence of diabetic retinopathy was excluded. Diabetic patients had to have no visual field defects to be included as controls. Glaucoma patients had to have a glaucomatous field defect in at least one eye to be included. One NMFP was taken per eye for all subjects. These photographs were evaluated by two masked glaucoma specialists for the presence of the following: bilateral cup to disc (C/D ratio ≥0.6, notching or thinning of the neuroretinal rim, disc hemorrhages, and asymmetry in the C/D ratio between both eyes ≥0.2. This evaluation led to a dichotomous classification: if any of the above criteria was present, the patient was classified as glaucoma. If none were present, the patient was classified as normal. Results. 72 control subjects and 72 glaucoma patients were included. Evaluation of NMFP had a sensitivity of 79.17% and a specificity of 80.56% for specialist 1 and a sensitivity of 72.22% and a specificity of 88.88% for specialist 2 for the detection of glaucoma. The overall accuracy was 79.83% and 80.55%, respectively. Discussion. NMFP evaluation by a glaucoma specialist may be useful for the detection of glaucoma in diabetics.

  18. A simple derivation of the waiting time distributions in a non-preemptive M/M/c queue with priorities

    NARCIS (Netherlands)

    van Vianen, Lars A.; Gabor, Adriana F.; van Ommeren, Jan C.W.

    2014-01-01

    In this article we give a new derivation for the waiting time distributions in an M=M=c queue with multiple priorities and a common service rate by using elementary lattice paths counting. An advantage of the approach is that it does not require inversion of the Laplace-Stieltjes transform.

  19. A simple derivation of the waiting time distributions in a non-preemptive M/M/c queue with priorities

    NARCIS (Netherlands)

    L.A. van Vianen (Lars); A.F. Gabor (Adriana); J.C.W. van Ommeren (Jan-Kees)

    2014-01-01

    textabstractIn this article we give a new derivation for the waiting time distributions in an M/M/c queue with multiple priorities and a common service rate by using elementary lattice paths counting. An advantage of the approach is that it does not require inversion of the Laplace-Stieltjes

  20. Outcomes of Ahmed valve surgery for refractory glaucoma in Dhahran, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Tariq Alasbali

    2015-06-01

    Full Text Available AIM:To evaluate the outcomes of Ahmed glaucoma valve (AGV implantation surgery for refractory glaucoma.METHODS:This one-armed historical cohort study was conducted in 2011. Refractory glaucoma was defined as eyes with an intraocular pressure (IOP greater than 21 mm Hg with maximally tolerated glaucoma medications, failed surgeries, or both. For all eyes with refractory glaucoma that underwent AGV implantation, data were collected on IOP, the best corrected visual acuity (BCVA and glaucoma medications preoperatively and 4, 6, 12, 24 and 56wk postoperatively. Logarithm values of IOP were calculated and compared.RESULTS: The study group was comprised of 30 patients (30 eyes, 16 males and 14 females with refractory glaucoma. Mean preoperative IOP was 39.3±13.8 mm Hg. Postoperative mean IOP was 15.7±7.1 mm Hg, 19.6±12.8 mm Hg and 13.9±14.2 mm Hg at 12, 24 and 56wk respectively. BCVA was ≥ 6/60 in 11 eyes preoperatively, and five eyes had BCVA≥6/60 at 56wk postoperatively. Preoperatively, more than four medications were used to treat glaucoma in 21 eyes. At 12wk postoperatively, no medications were required to control IOP in 20 eyes. At 56wk postoperatively, at least one medication was required to control IOP in 10 eyes. Over the entire follow up period, four eyes were treated with yttrium aluminium garnet (YAG laser and 14 eyes required a second surgery. The AGV was removed in four eyes.CONCLUSION: AGV implantation reduced IOP and the number of medications required to control refractory glaucoma. However, there was a higher risk of decreased vision. Long-term follow up and prompt intervention are recommended.

  1. Exfoliation syndrome and exfoliation glaucoma-associated LOXL1 variations are not involved in pigment dispersion syndrome and pigmentary glaucoma.

    Science.gov (United States)

    Rao, Kollu Nageswara; Ritch, Robert; Dorairaj, Syril K; Kaur, Inderjeet; Liebmann, Jeffrey M; Thomas, Ravi; Chakrabarti, Subhabrata

    2008-07-09

    Single nucleotide polymorphisms (SNPs) in the LOXL1 gene have been implicated in exfoliation syndrome (XFS) and exfoliation glaucoma (XFG). We have shown that these SNPs are not associated with the primary glaucomas such as primary open-angle (POAG) glaucoma and primary angle-closure glaucoma (PACG). To further establish the specificity of LOXL1 SNPs for XFS and XFG, we determined whether these SNPs were involved in pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG). Three SNPs of LOXL1 (rs1048661, rs3825942, and rs2165241) were screened in a cohort of 78 unrelated and clinically well characterized glaucoma cases comprising of PG (n=44) and PDS (n=34) patients as well as 108 ethnically matched normal controls of Caucasian origin. The criteria for diagnosis of PDS/PG were Krukenberg spindle, hyperpigmentation of the trabecular meshwork, and wide open angle. Transillumination defects were detected by infrared pupillography, and the presence of a Zentmayer ring was considered as a confirmatory sign. All three SNPs were genotyped in cases and controls by resequencing the genomic region of LOXL1 harboring these variants and were further confirmed by polymerase chain reaction (PCR)-based restriction digestions. Haplotypes were generated from the genotype data, and the linkage disequilibrium (LD) and haplotype analysis were done with Haploview software that uses the expectation maximization (EM) algorithm. The LOXL1 SNPs showed no significant association with PDS or PG. There was no significant difference in the frequencies of the risk alleles of rs1048661 ('G' allele; p=0.309), rs3825942 ('G' allele' p=0.461), and rs2165241 ('T' allele; p=0.432) between PG/PDS cases and controls. Similarly, there was no involvement of the XFS/XFG-associated haplotypes, 'G-G' (p=0.643; [OR=1.08, 95%CI, 0.59-1.97]) and 'T-G' (p=0.266; [OR=1.35, 95%CI, 0.70-2.60]), with the PDS/PG phenotypes. The risk haplotype 'G-G' was observed in ~55% of the normal controls. There was no

  2. Monochromatic Pupillometry in Unilateral Glaucoma Discloses no Adaptive Changes Subserved by the ipRGCs

    DEFF Research Database (Denmark)

    Nissen, Claus; Sander, Birgit Agnes; Milea, Dan

    2014-01-01

    PURPOSE: To detect signs of a possible adaptive mechanism of the intrinsically photosensitive ganglion cells in unilateral glaucoma. METHOD: Eleven patients with unilateral glaucoma, classified by automated perimetry (glaucoma: mean deviation ... in the glaucomatous eyes of unilateral glaucoma. No difference was detected between the pupillary light response of the unafflicted fellow eyes and that of a healthy, age-matched control group. Thus no sign of an adaptive mechanism was detected, neither in the glaucomatous nor in the unafflicted fellow eyes......, and consequently glaucoma appears to differ from non-arteritic anterior ischemic optic neuropathy....

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

    Science.gov (United States)

    Kubaisi, Buraa; Maleki, Arash; Ahmed, Aseef; Lamba, Neel; Sahawneh, Haitham; Stephenson, Andrew; Montieth, Alyssa; Topgi, Shobha; Foster, C Stephen

    2018-01-01

    To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) in eyes with noninfectious uveitis that had fluocinolone acetonide intravitreal implant (Retisert™)-induced glaucoma. This retrospective study reviewed the safety and efficacy of AGV implantation in patients with persistently elevated intraocular pressure (IOP) after implantation of a fluocinolone acetonide intravitreal implant at the Massachusetts Eye Research and Surgery Institution between August 2006 and November 2015. Nine patients with 10 uveitic eyes were included in this study, none of which had preexisting glaucoma in the study eye. Mean patient age was 42 years; 6 patients were female and 3 were male. Baseline mean IOP was 30.6 mmHg prior to AGV placement while mean IOP-lowering medications were 2.9. In the treatment groups, there was a statistically significant reduction in post-AGV IOP. IOP was lowest at 1-week after AGV implantation (9.0 mmHg). Nine out of 10 eyes achieved an IOP below target value of 22 mmHg and/or a 20% reduction in IOP from baseline 1 month and 1 year following AGV placement. All other postoperative time points showed all 10 eyes reaching this goal. A statistically significant decrease in IOP-lowering medication was seen at the 1-week, 1-month, and 3-year time points compared to baseline, while a statistically significant increase was seen at the 3-month, 6-month, and 2-year post-AGV time points. No significant change in retinal nerve thickness or visual field analysis was found. AGV is an effective and safe method of treatment in fluocinolone acetonide intravitreal implant-induced glaucoma. High survival rate is expected for at least 3 years.

  4. Daily Life with Glaucoma

    Science.gov (United States)

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

  5. Evaluation of two different operations to implant the Ahmed glaucoma valve in patients with refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Yue Wu

    2016-04-01

    Full Text Available AIM:To evaluate the efficacy and safety of Ahmed glaucoma valve(AGVimplantation surgery using different methods. METHODS:This was a retrospective study of patients with refractory glaucoma in whom AGV implantation was performed between June 2011 and September 2014. According to the method of tube insertion into the anterior chamber, the sample was divided into two groups, needle-generated scleral tunnel and scleral flap. The surgical success rate, intraocular pressure(IOP, number of antiglaucoma medications used, best correct visual acuity, postoperative complications, and operation duration were analyzed between the two groups. RESULTS:Compared with preoperative data, the two groups showed statistically significant decrease on IOP and the number of antiglaucoma medication used at all follow-up points(PP=0.932; however, statistically significant differences were detected when flat anterior chamber complications between the needle-generated scleral tunnel group(6%and the scleral flap group(24%were compared(P=0.032. CONCLUSION:AGV implantation may be an effective method in managing refractory glaucoma, since the two methods have similar efficacy. However, the needle-generated scleral tunnel technique application could greatly decrease the incidence of flat anterior chamber complications and decrease the duration of the operation.

  6. 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.

  7. The Advanced Glaucoma Intervention Study (AGIS): 9. Comparison of glaucoma outcomes in black and white patients within treatment groups.

    Science.gov (United States)

    2001-09-01

    To compare in eyes of black and white patients the progression of glaucoma after failure of medical therapy and upon start of surgical intervention. Cohort study analysis of data from a randomized clinical trial. This multicenter study included open-angle glaucoma patients who had failed medical therapy: 451 eyes of 332 black patients, 325 eyes of 249 white patients. Eyes were randomly assigned to an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence; they had been followed for 7 to 11 years at database closure. Main outcome measures were decrease of visual field (DVF), sustained decrease of visual field (SDVF), decrease of visual acuity (DVA), sustained decrease of visual acuity (SDVA), and failure of first surgical glaucoma intervention. Statistical methods included logistic regression to obtain average adjusted black-white odds ratios for binary outcomes, and Cox regression to estimate adjusted black-white risk ratios for time-to-event outcomes. In the ATT sequence blacks were at lower risk than whites of failure of first intervention (ALT, RR = 0.68, P = 0.040). In the TAT sequence blacks were at higher risk than whites of failure of the first intervention (trabeculectomy, RR = 1.79, P = 0.033), of intraocular pressure > or =18 mm Hg (average OR = 1.41, P = 0.026), and of DVF (average OR = 1.78, P = 0.007). In both treatment sequences, the average number of prescribed medications was greater for blacks than whites (P < or = 0.002). The results support the hypothesis that after failure of medical therapy and upon initiation of surgical intervention, an initial intervention with trabeculectomy retards the progression of glaucoma more effectively in white than in black patients. The data provide a weak suggestion that an initial surgical intervention with ALT retards the progression of glaucoma more effectively in black than in white patients.

  8. A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.

    Science.gov (United States)

    Kotecha, A; Brookes, J; Foster, P J

    2017-06-01

    PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.

  9. Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome

    Directory of Open Access Journals (Sweden)

    Sivaraman KR

    2013-03-01

    Full Text Available Kavitha R Sivaraman, Chirag G Patel, Thasarat S Vajaranant, Ahmad A ArefDepartment of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago School of Medicine, Chicago, IL, USAAbstract: Primary pigment dispersion syndrome (PPDS is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more often unilateral and acquired as a result of surgery, trauma, or intraocular tumor, but can likewise lead to pigmentary glaucoma. We report two cases of patients with bilateral PPDS who developed secondary pigment dispersion and pigmentary glaucoma in one eye. Patients with PPDS who acquire a secondary mechanism of pigment dispersion may be at an increased risk of progression to pigmentary glaucoma, presumably due to an increased burden of liberated pigment. In addition to regular surveillance for progression to glaucoma from PPDS, secondary causes of pigmentary dispersion in these eyes should be considered when patients present with grossly asymmetric findings. When secondary pigment dispersion is identified in eyes with PPDS, we recommend prompt intervention to alleviate the cause of secondary pigment dispersion and/or aggressive control of intraocular pressure to limit glaucomatous damage.Keywords: primary pigment dispersion syndrome, pigmentary glaucoma

  10. Critical Assessment of Implantable Drug Delivery Devices in Glaucoma Management

    Directory of Open Access Journals (Sweden)

    Dharani Manickavasagam

    2013-01-01

    Full Text Available Glaucoma is a group of heterogeneous disorders involving progressive optic neuropathy that can culminate into visual impairment and irreversible blindness. Effective therapeutic interventions must address underlying vulnerability of retinal ganglion cells (RGCs to degeneration in conjunction with correcting other associated risk factors (such as elevated intraocular pressure. However, realization of therapeutic outcomes is heavily dependent on suitable delivery system that can overcome myriads of anatomical and physiological barriers to intraocular drug delivery. Development of clinically viable sustained release systems in glaucoma is a widely recognized unmet need. In this regard, implantable delivery systems may relieve the burden of chronic drug administration while potentially ensuring high intraocular drug bioavailability. Presently there are no FDA-approved implantable drug delivery devices for glaucoma even though there are several ongoing clinical studies. The paper critically assessed the prospects of polymeric implantable delivery systems in glaucoma while identifying factors that can dictate (a patient tolerability and acceptance, (b drug stability and drug release profiles, (c therapeutic efficacy, and (d toxicity and biocompatibility. The information gathered could be useful in future research and development efforts on implantable delivery systems in glaucoma.

  11. Heidelberg Retina Tomograph for the Detection of Glaucoma

    Directory of Open Access Journals (Sweden)

    Barbara Cvenkel

    2012-06-01

    Full Text Available Heidelberg Retina Tomograph (HRT is a confocal scanning laser ophthalmoscope which acquires and analyzes 3-dimensional images of the optic nerve head. The latest instrument HRT3 includes software with larger ethinic-specific normative database. This review summarizes relevant published literature on HRT in diagnosing glaucoma, detecting glaucoma progression, the diagnostic accuracy of HRT among other imaging devices and its role in clinical practice.

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

    Directory of Open Access Journals (Sweden)

    Eglis Esteban García Alcolea

    2009-04-01

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

  13. Brain MRI findings in infants with primary congenital glaucoma

    International Nuclear Information System (INIS)

    Dai, A. Ibrahym; Saygili, O.

    2007-01-01

    Congenital glaucoma appears in the first months of life, eventually at birth. Isolated congenital glaucoma is characterized by minor malformations of the irido-corneal angle of the anterior chamber of the eye. Clinical manifestations include tearing, photophobia and enlargement of the globe appearing in the first months of life. Imaging technology such as optical coherence tomography and measurement of central corneal thickness may play an important role in the assessment of children with suspected or known glaucoma. However, no MRI findings of the CNS in patients with primary congenital glaucoma (PCG) were reported in the literature. The purpose of this study was to investigate MRI findings of the brain in infants with PCG. We reviewed the radiological and histopathological and clinical characteristics of infants with primary congenital glaucoma. The records of 17 patients with PCG were reviewed and the MRIs of the brain and associated manifestations were analyzed. Three patients with PCG had abnormal MRI findings suggesting agenesis of the corpus callosum. Two infants had delayed myelinization of the brain. Significant abnormal optic nerve excavation and increased corneal diameters in 2 patients with delayed myelinization may suggest that intraocular pressure can be more striking and more severe, revealing a close relationship with PCG and abnormal myelinization in white matter. Studies with more patients are needed to confirm these results. (author)

  14. Comparison of the Ahmed glaucoma valve with the Baerveldt glaucoma implant: a meta-analysis.

    Science.gov (United States)

    Wang, Yi-Wen; Wang, Ping-Bao; Zeng, Chao; Xia, Xiao-Bo

    2015-10-13

    This study aims to compare the efficacy and safety of the Ahmed glaucoma valve (AGV) with the Baerveldt glaucoma implant (BGI) in glaucoma patients. Databases were searched to identify studies that met pre-stated inclusion criteria, involving randomized controlled clinical trials (RCTs) and non-randomized controlled clinical trials. Treatment effect was analyzed using a random-effect model. Ten controlled clinical trials (1048 eyes) were analyzed, involving two RCTs and eight retrospective comparative studies. Short-term results (6-18 months) and long-term results (>18 months) were analyzed separately. There was no significant difference in the success rate for short-term follow-up between the AGV and BGI groups (5 studies, 714 eyes, odds ratio [OR]: 0.97; 95 % confidence interval [CI]: 0.56, 1.66; P = 0.90). For long-term pooled results (7 studies, 835 eyes), the success rate of AGVs was lower than that of BGIs (OR: 0.73; 95 % CI: 0.54, 0.99, P = 0.04), However, subgroup and sensitivity analyses did not show a significant difference in the success rate between the two groups (P ≥0.05). The AGV group had a higher mean intraocular pressure than the BGI group in short-term (6 studies, 685 eyes, weighted mean difference [WMD]: 2.12 mmHg; 95 % CI: 0.72-3.52; P glaucoma medications after implantation than the AGV group in two follow-up periods (all P <0.05). The AGV was found to be associated with a significantly lower frequency of total complications (8 studies, 971 eyes, OR: 0.67; 95 % CI: 0.50-0.90; P = 0.007) and severe complications (8 studies, 971 eyes, OR: 0.57; 95 % CI: 0.36-0.91; P = 0.02) than the BGI. The study showed no significant difference in success rate between the two groups. The BGI was more effective for control of intraocular pressure and required fewer medications than the AGV, but the AGV had lower incidence of total and severe complications than the BGI.

  15. Progressive Macula Vessel Density Loss in Primary Open-Angle Glaucoma: A Longitudinal Study.

    Science.gov (United States)

    Shoji, Takuhei; Zangwill, Linda M; Akagi, Tadamichi; Saunders, Luke J; Yarmohammadi, Adeleh; Manalastas, Patricia Isabel C; Penteado, Rafaella C; Weinreb, Robert N

    2017-10-01

    To characterize the rate of macula vessel density loss in primary open-angle glaucoma (POAG), glaucoma-suspect, and healthy eyes. Longitudinal, observational cohort from the Diagnostic Innovations in Glaucoma Study. One hundred eyes (32 POAG, 30 glaucoma-suspect, and 38 healthy) followed for at least 1 year with optical coherence tomography angiography (OCT-A) imaging on at least 2 visits were included. Vessel density was calculated in the macula superficial layer. The rate of change was compared across diagnostic groups using a multivariate linear mixed-effects model. Baseline macula vessel density was highest in healthy eyes, followed by glaucoma-suspect and POAG eyes (P macula whole en face vessel density was significantly faster in glaucoma eyes (-2.23%/y) than in glaucoma-suspect (0.87%/y, P = .001) or healthy eyes (0.29%/y, P = .004). Conversely, the rate of change in ganglion cell complex (GCC) thickness was not significantly different from zero in any diagnostic group, and no significant differences in the rate of GCC change among diagnostic groups were found. With a mean follow-up of less than 14 months, eyes with POAG had significantly faster loss of macula vessel density than either glaucoma-suspect or healthy eyes. Serial OCT-A measurements also detected glaucomatous change in macula vessel density in eyes without evidence of change in GCC thickness. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

    Kolko, Miriam

    2015-01-01

    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...... 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...

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

    Directory of Open Access Journals (Sweden)

    Yan Guo

    2014-04-01

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

  18. Aqueous shunts for glaucoma.

    Science.gov (United States)

    Tseng, Victoria L; Coleman, Anne L; Chang, Melinda Y; Caprioli, Joseph

    2017-07-28

    Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase.com (1947 to August 2016), PubMed (1948 to August 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to August 2016), ClinicalTrials.gov (www.clinicaltrials.gov); searched 15 August 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 15 August 2016. We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 15 August 2016. We also searched the reference lists of identified trial reports and the Science Citation Index to find additional trials. We included randomized controlled trials that compared various types of aqueous shunts with standard surgery or to each other in eyes with glaucoma. Two review authors independently screened search results for eligibility, assessed the risk of bias, and extracted data from included trials. We contacted trial investigators when data were unclear or not reported. We graded the certainty of the evidence using the GRADE approach. We followed standard methods as recommended by Cochrane. We included 27 trials with a total of 2099 participants with mixed diagnoses and comparisons of interventions. Seventeen studies reported adequate methods of randomization, and seven reported adequate allocation concealment. Data collection and follow-up times varied.Four trials compared an aqueous shunt (Ahmed or Baerveldt) with trabeculectomy, of which

  19. Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma

    OpenAIRE

    Azad, Raj V; Chandra, Parijat; Chandra, Anuradha; Gupta, Aparna; Gupta, Viney; Sihota, Ramanjit

    2014-01-01

    Purpose: To compare clarity, exposure and quality of anterior chamber angle visualization in congenital glaucoma patients, using RetCam and indirect gonioscopy images. Design: Cross-sectional study Participants. Congenital glaucoma patients over age of 5 years. Materials and Methods: A prospective consecutive pilot study was done in congenital glaucoma patients who were older than 5 years. Methods used are indirect gonioscopy and RetCam imaging. Clarity of the image, extent of angle visible a...

  20. Initial clinical experience with Ahmed Valve implantation in refractory pediatric glaucoma

    OpenAIRE

    Novak-Lauš, Katia; Škunca Herman, Jelena; Šimić Prskalo, Marija; Jurišić, Darija; Mandić, Zdravko

    2016-01-01

    The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of I...

  1. Economic burden of glaucoma in Rivers State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adio AO

    2012-12-01

    Full Text Available Adedayo O Adio,1 Alfred A Onua21University Of Port Harcourt Teaching Hospital, 2Braithwaite Memorial Specialist Hospital, Port Harcourt, Rivers State, NigeriaBackground: Primary open angle glaucoma is reported to blind 150,000 people in the Nigerian population and over 7000 in Rivers State, and requires constant follow-up. Compliance is a challenge, given that most inhabitants live below the poverty line. This study was performed to determine how Nigerian patients are affected economically by the disease.Methods: Consecutive adult patients attending the eye clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, with a diagnosis of primary open angle glaucoma and on outpatient antiglaucoma treatment in the first 6 months of 2006, were recruited for the study. The lowest paid government worker was on USD50 (N7500.00 per month and the gross domestic product per capita was USD1150 for the period under review.Results: We enrolled 120 consecutive patients of mean age 52.7 ± 10.4 years, with a male to female ratio of 2:3. The most common occupations were in the civil service (n = 56, 46.7%. All participants were on topical antiglaucoma treatment. The average cost of medical antiglaucoma medication was N6000 (USD40 per month. Computed to include indirect costs, including medical laboratory tests, transportation, and care by patient escorts, an average sum of USD105.4 (N15,810 was spent by each patient per month. Most of the patients (73.3% were responsible for their own treatment costs. No patient accepted the cheaper option of surgery (USD275.4, N41,310. Eighty of the patients (66.7% visited our eye clinic monthly. Direct and indirect loss to the economy was USD3,064587 per annum from those already blind. This was in addition to the USD 4.1 million being spent yearly on medical treatment by those who were visually impaired by glaucoma.Conclusion: Middle-income earners spent over 50% of their monthly income and low

  2. Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome.

    Science.gov (United States)

    Sharan, Sapna; Swamy, Brighu; Taranath, Deepa Ajay; Jamieson, Robyn; Yu, Tao; Wargon, Orli; Grigg, John R

    2009-08-01

    Treatment of the capillary vascular malformation (port-wine stain) in Sturge-Weber syndrome with the use of a laser is helpful cosmetically. However, concerns have been raised that laser obliteration of port-wine stains may result in ocular hypertension. The aim of this study was to review clinical features and management of ocular complications of SWS and assess the effects of dermatological laser treatment on the incidence of glaucoma or ocular hypertension. This retrospective cohort study was conducted in an institutional setting. All patients had involvement of the face. Patients who underwent skin laser to the port-wine vascular malformation were analyzed further. Ocular involvement, glaucoma, and skin laser treatment and the relationship to ocular hypertension/glaucoma were observed. Forty-one Sturge-Weber syndrome patients with port-wine vascular malformation were analyzed. Glaucoma was observed in 24 patients (58.5%) at mean age of 2.9 years (range, 0.0-16.5). Of these, 18 (75.0%) were treated with medical therapy, and 10 (41.7%) required trabeculectomy, with 2 of these requiring Seton implant. Of the 41 patients, 28 (68.3%) underwent laser to face/forehead. Mean age of laser commencement was 5 years (range, 0.4-16.5). Thirteen did not undergo laser treatment. Fourteen of the 28 and 10 of the 13 developed ocular hypertension/glaucoma. This retrospective review did not find evidence to suggest that laser treatment of port-wine vascular malformations causes glaucoma or that it can worsen a preexisting ocular hypertension or glaucoma. Statistical analysis was inconclusive.

  3. New MMC capacitor voltage balancing using sorting-less strategy in nearest level control

    DEFF Research Database (Denmark)

    Ricco, Mattia; Máthé, Lászlo; Teodorescu, Remus

    2016-01-01

    This paper proposes a new strategy for balancing the Capacitor Voltages (CVs) for Modular Multilevel Converters (MMCs). The balancing is one of the main challenges in MMC applications and it is usually solved by adopting a global arm control approach. For performing such an approach, a sorted list...... of the SubModules (SMs) according to their capacitor voltages is required. A common way to accomplish this task is to implement a sorting algorithm in the same controller used for the modulation technique. However, the execution time and the computational efforts of these kinds of algorithms increase very...

  4. [Hemodynamic component in glaucoma and its association with risk factors and cardiovascular disease].

    Science.gov (United States)

    Muñoz de Escalona-Rojas, José Enrique; Cantero-Hinojosa, Jesús; Garrido-Pareja, Fermín; García-Serrano, José Luis; Padilla-Torres, José Francisco

    2014-08-19

    We sought to study the association of glaucoma with vascular disease, with 2 independent pathways: the association of glaucoma with cardiovascular disease (CVD) and the study of ocular hemodynamic variables (OHV) in glaucoma. Cross-sectional study consisting of 73 patients: 25 without glaucoma, 28 primary open-angle glaucoma (POAG) and 20 normal-tension glaucoma (NTG). OHV, cardiovascular risk factors (CVRF) and CVD were determined. We found a greater number of CVRF and CVD in patients affected by POAG (P=.002 and P=.016) and NTG (P=.001 and P=.010) compared to the control group. With regard to OHV, in patients suffering from POAG, we found lower systolic and diastolic velocities and higher resistance index in the central retinal artery (P<.05). Moreover, in both types of glaucoma, we found higher resistance index in the posterior ciliary artery (P<.05). There is a statistically significant association between the presence of CVD and/or CVRF and glaucomatous disease, a finding that is supplemented with data from the OHV. These values indicate a worst ocular perfusion in patients with glaucomatous disease. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  5. Cost-effectiveness of community screening for glaucoma in rural India: a decision analytical model.

    Science.gov (United States)

    John, D; Parikh, R

    2018-02-01

    Studies in several countries have demonstrated the cost-effectiveness of population-based screening for glaucoma when targeted at high-risk groups such as older adults and with familial history of disease. This study conducts a cost-effective analysis of a hypothetical community screening and subsequent treatment programme in comparison to opportunistic case finding for glaucoma in rural India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in rural areas of India. A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a rural-based population aged between 40 and 69 years in India. The treatment pathway included both primary open-angle glaucoma and angle-closure disease. The data on costs of screening and treatment were provided by an administrator of a tertiary eye hospital in Eastern India. The probabilities for the screening and treatment pathway were derived from published literature and a glaucoma specialist. The glaucoma prevalence rates were adapted from the Chennai Glaucoma Study findings. An incremental cost-effectiveness ratio value of ₹7292.30 per quality-adjusted life-year was calculated for a community-screening programme for glaucoma in rural India. The community screening for glaucoma would treat an additional 2872 cases and prevent 2190 person-years of blindness over a 10-year period. Community screening for glaucoma in rural India appears to be cost-effective when judged by a ratio of willingness-to-pay thresholds as per WHO-CHOICE guidelines. For community screening to be cost-effective, adequate resources, such as trained medical personnel and equipment would need to be made available. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Long Term Results of Visual Field Progression Analysis in Open Angle Glaucoma Patients Under Treatment.

    Science.gov (United States)

    Kocatürk, Tolga; Bekmez, Sinan; Katrancı, Merve; Çakmak, Harun; Dayanır, Volkan

    2015-01-01

    To evaluate visual field progression with trend and event analysis in open angle glaucoma patients under treatment. Fifteen year follow-up results of 408 eyes of 217 glaucoma patients who were followed at Adnan Menderes University, Department of Ophthalmology between 1998 and 2013 were analyzed retrospectively. Visual field data were collected for Mean Deviation (MD), Visual Field Index (VFI), and event occurrence. There were 146 primary open-angle glaucoma (POAG), 123 pseudoexfoliative glaucoma (XFG) and 139 normal tension glaucoma (NTG) eyes. MD showed significant change in all diagnostic groups (pfield indices. We herein report our fifteen year follow-up results in open angle glaucoma.

  7. [Basic and clinical studies of pressure-independent damaging factors of open angle glaucoma].

    Science.gov (United States)

    Araie, Makoto

    2011-03-01

    Pathogenesis of open-angle glaucoma involves both pressure-dependent damaging factors and pressure-independent damaging factors. The high prevalence of open-angle glaucoma with normal pressure (normal-tension glaucoma) in Japan implies that treatment of pressure-independent damaging factors in Japanese open-angle glaucoma patients is of importance. In an attempt to investigate the roles of pressure-independent damaging factors in open-angle glaucoma, we carried out basic and clinical studies and obtained the following results. 1. The rate of deterioration of visual field after trabeculectomy in normal tension glaucoma patients with post-operative intraocular pressure (IOP) of 10 mmHg was found to be -0.25 dB/year of mean deviation (MD), suggesting that contribution of pressure-independent damaging factors to the deterioration of MD in open-angle glaucoma is around -0.25 dB/year of mean deviation (MD). 2. Experiments using isolated purified cultured retinal ganglion cells (RGCs) indicated that calcium-channel blockers and some of antiglaucoma drugs showed neuroprotective effects on RGCs at concentrations of 0.01 microM or higher. 3. In mice, damage to RGCs resulted in secondary degeneration of neurons and activation of glial cells in the lateral geniculate nucleous (LGN) and superior colliculus, and these secondary changes in the central nervous system (CNS) due to RGC damage was partly ameliorated by systemic administration of memantine. 4. Mice experimental high IOP glaucoma models could be established using laser irradiation of the limbal area, and the usefulness of Tonolab in IOP measurements of mice eye was confirmed. 5. Monkey experimental high IOP glaucoma models revealed that in the glaucomatous optic nerve head vaso-constrictive reactions to an alpha-1 agonist was abolished, while vasodilative reaction to a prostaglandin FP receptor agonist was retained. 6. In monkeys with experimental high IOP glaucoma, secondary damage to neurons in the LGN and the glial

  8. Clinical Features of Primary Glaucoma in South East Nigeria ...

    African Journals Online (AJOL)

    Background: The clinical course of glaucoma depends on the type, onset, severity and response to treatment. The intraocular pressure and heredity also play a role in its presentation as members of the same family tend to have the same type of glaucoma. This paper seeks to address the problem of primary open angle ...

  9. Prevalent practice patterns in glaucoma: Poll of Indian ophthalmologists at a national conference

    Directory of Open Access Journals (Sweden)

    Nikhil Shreeram Choudhari

    2016-01-01

    Full Text Available Purpose: The aim of this study is to explore and compare the prevailing practice patterns in the diagnosis and management of glaucoma among subspecialists and general ophthalmologists in India. Materials and Methods: This is an interactive audience response system (ARS based poll of ophthalmologists attending the annual conference of the Glaucoma Society of India in 2013. Results: The information was obtained from 379 ophthalmologists (146 glaucoma specialists, 54 nonglaucoma subspecialists, and 179 general ophthalmologists. The majority of polled ophthalmologists (236; 62% had 10 or more years of experience in ophthalmology. The glaucoma specialists differed from nonglaucomatologists in their preference for Goldmann applanation tonometer (P < 0.01, four-mirror gonioscope (P < 0.01, Humphrey perimeter (P < 0.01, laser peripheral iridotomy in primary angle closure disease (P = 0.03, postiridotomy gonioscopy (P < 0.01, and usage of antifibrotic agents during filtering surgery (P < 0.01. Optical coherence tomography was the most preferred imaging modality and was utilized more often by the subspecialists than general ophthalmologists. The ophthalmologists also differed in their choice of antiglaucoma medications. More glaucoma specialists were performing surgery on children with congenital glaucoma (P < 0.01, implanting glaucoma drainage devices (P < 0.01, and using scientific journals to upgrade knowledge (P = 0.03 than the other ophthalmologists. Conclusions: This poll is the first of its kind in India, in its usage of the ARS, and in comparing the practice patterns of care for glaucoma among subspecialists and general ophthalmologists. It has revealed substantial diversity in a few areas among those who did and did not receive specialty training in glaucoma.

  10. Neuroprotective effect of edaravone in experimental glaucoma model in rats: a immunofluorescence and biochemical analysis

    Directory of Open Access Journals (Sweden)

    Arzu Toruk Aksar

    2015-04-01

    Full Text Available AIM: To evaluate the neuroprotective activity of systemically administered edaravone in early and late stage of experimental glaucoma in rats. METHODS: In this study, 60 Wistar albino rats were used. Experimental glaucoma model was created by injecting hyaluronic acid to the anterior chamber once a week for 6wk in 46 of 60 subjects. Fourteen subjects without any medication were included as control group. Edaravone administered intraperitoneally 3 mg/kg/d to the 15 of 30 subjects starting at the onset of glaucoma induction and also administered intraperitoneally 3 mg/kg/d to the other 15 subjects starting at three weeks after the onset of glaucoma induction. The other 16 subjects who underwent glaucoma induction was administered any therapy. Retinal ganglion cells (RGCs have been marked with dextran tetramethylrhodamine (DTMR retrograde at the end of the sixth week and after 48h, subjects were sacrificed by the method of cardiac perfusion. Alive RGC density was assessed in the whole-mount retina. Whole-mount retinal tissues homogenized and nitric oxide (NO, malondialdehyde (MDA and total antioxidant capacity (TAC values were measured biochemically. RESULTS: RGCs counted with Image-Pro Plus program, in the treatment group were found to be statistically significantly protected, compared to the glaucoma group (Bonferroni, P<0.05. The neuroprotective activity of edaravone was found to be more influential by administration at the start of the glaucoma process. Statistically significant lower NO levels were determined in the glaucoma group comparing treatment groups (Bonferroni, P<0.05. MDA levels were found to be highest in untreated glaucoma group, TAC levels were found to be lower in the glaucoma induction groups than the control group (Bonferroni, P<0.05. CONCLUSION: Systemic administration of Edaravone in experimental glaucoma showed potent neuroprotective activity. The role of oxidative stress causing RGC damage in glaucoma was supported by this

  11. Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome.

    Science.gov (United States)

    Sivaraman, Kavitha R; Patel, Chirag G; Vajaranant, Thasarat S; Aref, Ahmad A

    2013-01-01

    Primary pigment dispersion syndrome (PPDS) is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more often unilateral and acquired as a result of surgery, trauma, or intraocular tumor, but can likewise lead to pigmentary glaucoma. We report two cases of patients with bilateral PPDS who developed secondary pigment dispersion and pigmentary glaucoma in one eye. Patients with PPDS who acquire a secondary mechanism of pigment dispersion may be at an increased risk of progression to pigmentary glaucoma, presumably due to an increased burden of liberated pigment. In addition to regular surveillance for progression to glaucoma from PPDS, secondary causes of pigmentary dispersion in these eyes should be considered when patients present with grossly asymmetric findings. When secondary pigment dispersion is identified in eyes with PPDS, we recommend prompt intervention to alleviate the cause of secondary pigment dispersion and/or aggressive control of intraocular pressure to limit glaucomatous damage.

  12. Genetic Algorithm with Maximum-Minimum Crossover (GA-MMC) Applied in Optimization of Radiation Pattern Control of Phased-Array Radars for Rocket Tracking Systems

    Science.gov (United States)

    Silva, Leonardo W. T.; Barros, Vitor F.; Silva, Sandro G.

    2014-01-01

    In launching operations, Rocket Tracking Systems (RTS) process the trajectory data obtained by radar sensors. In order to improve functionality and maintenance, radars can be upgraded by replacing antennas with parabolic reflectors (PRs) with phased arrays (PAs). These arrays enable the electronic control of the radiation pattern by adjusting the signal supplied to each radiating element. However, in projects of phased array radars (PARs), the modeling of the problem is subject to various combinations of excitation signals producing a complex optimization problem. In this case, it is possible to calculate the problem solutions with optimization methods such as genetic algorithms (GAs). For this, the Genetic Algorithm with Maximum-Minimum Crossover (GA-MMC) method was developed to control the radiation pattern of PAs. The GA-MMC uses a reconfigurable algorithm with multiple objectives, differentiated coding and a new crossover genetic operator. This operator has a different approach from the conventional one, because it performs the crossover of the fittest individuals with the least fit individuals in order to enhance the genetic diversity. Thus, GA-MMC was successful in more than 90% of the tests for each application, increased the fitness of the final population by more than 20% and reduced the premature convergence. PMID:25196013

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

    Directory of Open Access Journals (Sweden)

    Yoanner Martín Perera

    2012-01-01

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

  14. Glaucoma associated with iridocorneal endothelial syndrome in 203 Indian subjects.

    Directory of Open Access Journals (Sweden)

    Premanand Chandran

    Full Text Available To report the demographic profile, clinical features, and prevalence of glaucoma and its management in patients with Iridocorneal endothelial (ICE syndrome.Retrospective review of 203 consecutive subjects with ICE syndrome at a tertiary eye care centre between January 1988 and June 2013.ICE syndrome was present in 223 eyes of 203 subjects, 124 (61% were female and 79 (39% were male. The median age at presentation was 43 years (1st (Q1 and 3rd (Q3 quartile; 34, 51 years. ICE syndrome was unilateral in 183 (90% subjects, and bilateral in 20 (10% subjects. The most common clinical variant was progressive iris atrophy (PIA, 115; 52% eyes, followed by Chandler syndrome (CS, 87; 39% eyes and Cogan-Reese syndrome (CRS, 21; 9% eyes. Glaucoma was found in 156 eyes (70% at presentation and the median (Q1, Q3 intraocular pressure in eyes with glaucoma was 24 (16, 38 mm Hg. Seven eyes developed glaucoma during the follow-up period, increasing the percentage of eyes with glaucoma to 73%. Intraocular pressure was managed medically in 81 eyes (50% and the other 82 eyes (50% required surgical intervention. Corneal edema was present in 124 eyes (56% of which, 32 eyes (14% required keratoplasty.In our study on ICE syndrome in Indian population, the presentation was predominantly uniocular and more common in middle aged women. Progressive iris atrophy was the most common clinical variant. ICE syndrome was associated with glaucoma in over 70% of the eyes and half of the eyes had corneal edema.

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

    Directory of Open Access Journals (Sweden)

    Gupta D

    2017-02-01

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

  16. Glaucoma management in patients with osteo-odonto-keratoprosthesis (OOKP): the Singapore OOKP Study.

    Science.gov (United States)

    Kumar, Rajesh S; Tan, Donald T H; Por, Yong-Ming; Oen, Francis T; Hoh, Sek-Tien; Parthasarathy, Anand; Aung, Tin

    2009-01-01

    To report diagnostic modalities and treatment options for glaucoma in eyes with osteo-odonto keratoprosthesis (OOKP). Eyes that underwent OOKP were evaluated for glaucoma at the time of the first postoperative visit, then at 1 and 3 months after the procedure, and thereafter every 6 months. All eyes underwent stereo-biomicroscopic optic nerve head (ONH) assessment, kinetic (Goldmann perimetry) and automated static visual field testing, ONH photography, Heidelberg retina tomograph, scanning laser polarimetery (GDx), and optical coherence tomography. Treatment of glaucoma was also reviewed. Average follow-up period was 19.1 (range: 5 to 31) months. Of the 15 eyes that underwent OOKP, 5 eyes had preexisting glaucoma. None of the other 10 eyes developed glaucoma after OOKP. ONH photography and visual field testing were the most reliable methods to assess status of the disease, whereas Heidelberg retina tomograph and optical coherence tomography could be performed with reasonable reproducibility and quality; GDx imaging was poor. All patients with glaucoma were treated with oral acetazolamide 500 mg twice a day. Transscleral cyclophotocoagulation was performed in 3 eyes at stage 2 of OOKP surgery. Progression of glaucoma was noted in 2 eyes on the basis of optic disc photographs and automated perimetry. Visual field testing and optic disc assessment with optic disc photographs seem to be effective methods to monitor eyes with OOKP for glaucoma. Treatment strategies include oral medications to lower intraocular pressure and cyclophotocoagulation.

  17. Making Basic Science Studies in Glaucoma More Clinically Relevant: The Need for a Consensus.

    Science.gov (United States)

    Toris, Carol B; Gelfman, Claire; Whitlock, Andy; Sponsel, William E; Rowe-Rendleman, Cheryl L

    2017-09-01

    Glaucoma is a chronic, progressive, and debilitating optic neuropathy that causes retinal damage and visual defects. The pathophysiologic mechanisms of glaucoma remain ill-defined, and there is an indisputable need for contributions from basic science researchers in defining pathways for translational research. However, glaucoma researchers today face significant challenges due to the lack of a map of integrated pathways from bench to bedside and the lack of consensus statements to guide in choosing the right research questions, techniques, and model systems. Here, we present the case for the development of such maps and consensus statements, which are critical for faster development of the most efficacious glaucoma therapy. We underscore that interrogating the preclinical path of both successful and unsuccessful clinical programs is essential to defining future research. One aspect of this is evaluation of available preclinical research tools. To begin this process, we highlight the utility of currently available animal models for glaucoma and emphasize that there is a particular need for models of glaucoma with normal intraocular pressure. In addition, we outline a series of discoveries from cell-based, animal, and translational research that begin to reveal a map of glaucoma from cell biology to physiology to disease pathology. Completion of these maps requires input and consensus from the global glaucoma research community. This article sets the stage by outlining various approaches to such a consensus. Together, these efforts will help accelerate basic science research, leading to discoveries with significant clinical impact for people with glaucoma.

  18. Gait Implications of Visual Field Damage from Glaucoma.

    Science.gov (United States)

    Mihailovic, Aleksandra; Swenor, Bonnielin K; Friedman, David S; West, Sheila K; Gitlin, Laura N; Ramulu, Pradeep Y

    2017-06-01

    To evaluate fall-relevant gait features in older glaucoma patients. The GAITRite Electronic Walkway was used to define fall-related gait parameters in 239 patients with suspected or manifest glaucoma under normal usual-pace walking conditions and while carrying a cup or tray. Multiple linear regression models assessed the association between gait parameters and integrated visual field (IVF) sensitivity after controlling for age, race, sex, medications, and comorbid illness. Under normal walking conditions, worse IVF sensitivity was associated with a wider base of support (β = 0.60 cm/5 dB IVF sensitivity decrement, 95% confidence interval [CI] = 0.12-1.09, P = 0.016). Worse IVF sensitivity was not associated with slower gait speed, shorter step or stride length, or greater left-right drift under normal walking conditions ( P > 0.05 for all), but was during cup and/or tray carrying conditions ( P < 0.05 for all). Worse IVF sensitivity was positively associated with greater stride-to-stride variability in step length, stride length, and stride velocity ( P < 0.005 for all). Inferior and superior IVF sensitivity demonstrated associations with each of the above gait parameters as well, though these associations were consistently similar to, or weaker than, the associations noted for overall IVF sensitivity. Glaucoma severity was associated with several gait parameters predictive of higher fall risk in prior studies, particularly measures of stride-to-stride variability. Gait may be useful in identifying glaucoma patients at higher risk of falls, and in designing and testing interventions to prevent falls in this high-risk group. These findings could serve to inform the development of the interventions for falls prevention in glaucoma patients.

  19. 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

  20. Prevalence and Determinants of Glaucoma in Citizens of Qatar Aged 40 Years or Older: A Community-Based Survey

    Science.gov (United States)

    Al-Mansouri, Fatma A.; Kanaan, Aida; Gamra, Hamad; Khandekar, Rajiv; Hashim, Shakeel P.; Al Qahtani, Omar; Ahmed, Mohd. Farouk

    2011-01-01

    Background: We present the prevalence and determinants of glaucoma among subjects 40 years of age and older in Qatar. Materials and Methods: This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of glaucoma was collected by the nurses. Ophthalmologists evaluated the optic disc and retina using a digital camera housed in a mobile van. Visual field was tested with an automated perimeter, the intraocular pressure with an applanation tonometer and the angle of the anterior chamber by gonioscopy. A panel of glaucoma experts diagnosed subjects with glaucoma. Results: This survey enrolled 3,149 (97.3%) participants. The age- and sex-adjusted prevalence of glaucoma in the population aged 40 years and older was 1.73% (95% confidence intervals [CI] 1.69-1.77). Accordingly, 5,641 individuals in this age group in Qatar would have glaucoma. Chronological age of 60 years and older (Odds ratio [OR] 11.1) and the presence of myopia (OR 1.78) were predictors of glaucoma. Open-angle glaucoma was diagnosed in 44 (65.7%) individuals with glaucoma. In nine (13.4%) and 15 (20.9%) subjects, angle closure glaucoma and other (post-traumatic, pseudoexfoliation) glaucoma were present. Bilateral blindness (vision glaucoma, respectively. Glaucoma was treated in 36 (54%) subjects. Conclusions: The prevalence of glaucoma among citizens of Qatar aged 40 years and older was 1.71%. Glaucoma was associated with the age of 60 years and older and the presence of myopia. PMID:21731325

  1. The medical management of glaucoma

    African Journals Online (AJOL)

    medical and surgical interventions are accessible in the management of glaucoma. This article ..... Cannabinoids. With the recent attention cannabis has been receiving in the management of pain and other cancer related conditions, it.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Long-term results of Ahmed glaucoma valve implantation in Egyptian population.

    Science.gov (United States)

    Elhefney, Eman; Mokbel, Tharwat; Abou Samra, Waleed; Kishk, Hanem; Mohsen, Tarek; El-Kannishy, Amr

    2018-01-01

    To evaluate the long-term results and complications of Ahmed glaucoma valve (AGV) implantation in a cohort of Egyptian patients. A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure (IOP) measurement before surgery and at 1d, weekly for the 1 st month, 3, 6mo, and 1y after surgery and yearly afterward for 5y. IOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as IOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery. IOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes (41.1%), complicated cataract in 9 eyes (7.25%), recessed tube in 8 eyes (6.45%), tube exposure in 6 eyes (4.8%) and corneal touch in 6 eyes (4.8%). Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes (1.6%). Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful IOP control after AGV implantation. However, effective complications management can improve the rate of success.

  4. Long-term results of Ahmed glaucoma valve implantation in Egyptian population

    Directory of Open Access Journals (Sweden)

    Eman Elhefney

    2018-03-01

    Full Text Available AIM: To evaluate the long-term results and complications of Ahmed glaucoma valve (AGV implantation in a cohort of Egyptian patients. METHODS: A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure (IOP measurement before surgery and at 1d, weekly for the 1st month, 3, 6mo, and 1y after surgery and yearly afterward for 5y. IOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as IOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. RESULTS: Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery. IOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes (41.1%, complicated cataract in 9 eyes (7.25%, recessed tube in 8 eyes (6.45%, tube exposure in 6 eyes (4.8% and corneal touch in 6 eyes (4.8%. Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes (1.6%. CONCLUSION: Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful IOP control after AGV implantation. However, effective complications management can improve the rate of success.

  5. Regional vascular density-visual field sensitivity relationship in glaucoma according to disease severity.

    Science.gov (United States)

    Shin, Joong Won; Lee, Jiyun; Kwon, Junki; Choi, Jaewan; Kook, Michael S

    2017-12-01

    To study whether there are global and regional relationships between peripapillary vascular density (pVD) assessed by optical coherence tomography angiography (OCT-A) and visual field (VF) mean sensitivity at different glaucoma stages. Microvascular images and peripapillary retinal nerve fibre layer (pRNFL) thicknesses were obtained using a Cirrus OCT-A device in 91 glaucoma subjects. The pVD was measured at various spatial locations according to the Garway-Heath map, using a MATLAB software (The MathWorks, Natick, Massachusetts). VF mean sensitivity (VFMS) was recorded in the 1/L scale. Global and regional vasculature-function (pVD vs VFMS) relationships were assessed in separate patient groups at mild and moderate-to-advanced stages of glaucoma. The pVDs at superotemporal and inferotemporal regions were significantly associated with corresponding VFMS in mild glaucoma (pglaucoma, there were significant associations between pVD and VFMS, regardless of location. The association between global pVD and VFMS was significantly stronger than that between global pRNFL thickness and VFMS in moderate-to-advanced stage glaucoma (p glaucoma. OCT-A may be useful in monitoring glaucoma at various stages. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Glaucoma and Cytochrome P4501B1 Gene Mutations

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    Mukesh Tanwar

    2010-01-01

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

  7. Early Ahmed glaucoma valve implantation after penetrating keratoplasty leads to better outcomes in an Asian population with preexisting glaucoma.

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    Ming-Cheng Tai

    Full Text Available BACKGROUND: To evaluate the efficacy of Ahmed Glaucoma Valve (AGV surgery and the optimal interval between penetrating keratoplasty (PKP and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP. METHODOLOGY/PRINCIPAL FINDINGS: In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs, graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1 and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2. Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98, but significant differences for IOP control (p = 0.049 and the maintenance of visual acuity (VA (p21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema. CONCLUSIONS/SIGNIFICANCE: Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation.

  8. Early Ahmed Glaucoma Valve Implantation after Penetrating Keratoplasty Leads to Better Outcomes in an Asian Population with Preexisting Glaucoma

    Science.gov (United States)

    Tai, Ming-Cheng; Chen, Yi-Hao; Cheng, Jen-Hao; Liang, Chang-Min; Chen, Jiann-Torng; Chen, Ching-Long; Lu, Da-Wen

    2012-01-01

    Background To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) surgery and the optimal interval between penetrating keratoplasty (PKP) and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP. Methodology/Principal Findings In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs), graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1) and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2). Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98), but significant differences for IOP control (p = 0.049) and the maintenance of visual acuity (VA) (pglaucoma, a history of previous PKP, and a preoperative IOP that was >21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema. Conclusions/Significance Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation. PMID:22629464

  9. Prevalence of glaucoma in an urban West African population: the Tema Eye Survey.

    Science.gov (United States)

    Budenz, Donald L; Barton, Keith; Whiteside-de Vos, Julia; Schiffman, Joyce; Bandi, Jagadeesh; Nolan, Winifred; Herndon, Leon; Kim, Hanna; Hay-Smith, Graham; Tielsch, James M

    2013-05-01

    Multiple studies have found an increased prevalence, younger age at onset, and more severe course of glaucoma in people of African descent, but these findings are based on studies conducted outside Africa. To determine the prevalence of glaucoma in an urban West African population of adults. A population-based, cross-sectional study of adults 40 years and older conducted from September 1, 2006, through December 31, 2008, from 5 communities in Tema, Ghana. Participants from randomly selected clusters underwent a screening examination that consisted of visual acuity, frequency doubling perimetry, applanation tonometry, and optic disc photography. Participants who failed any of these tests were referred for complete examination, including gonioscopy, standard automated perimetry, and stereoscopic optic disc photography. A total of 6806 eligible participants were identified, and 5603 (82.3%) were enrolled in the study. The field examination referred 1869 participants (33.3%) to the clinic examination, and 1538 (82.2%) came for complete examination. A total of 362 participants were identified as having glaucoma of any type and category. Primary open-angle glaucoma was the underlying diagnosis in 342 participants (94.5%). The prevalence of primary open-angle glaucoma was 6.8% overall, increasing from 3.7% among those 40 to 49 years old to 14.6% among those 80 years and older, and was higher in men than in women in all age groups, with an overall male-female prevalence ratio of 1.5. Of the participants with glaucoma, 9 (2.5%) were blind using World Health Organization criteria, and only 12 (3.3%) were aware that they had glaucoma. The prevalence of glaucoma is higher in this urban West African population than in previous studies of people of East or South African and of non-African descent. Strategies to identify affected persons and effectively manage the burden of glaucoma are needed in West Africa.

  10. Prevalence of primary glaucoma in an urban South Indian population

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    Jacob Aby

    1998-01-01

    Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

  11. Intraocular pressure control after the implantation of a second Ahmed glaucoma valve.

    Science.gov (United States)

    Jiménez-Román, Jesús; Gil-Carrasco, Félix; Costa, Vital Paulino; Schimiti, Rui Barroso; Lerner, Fabián; Santana, Priscila Rezende; Vascocellos, Jose Paulo Cabral; Castillejos-Chévez, Armando; Turati, Mauricio; Fabre-Miranda, Karina

    2016-06-01

    The objective of this study is to evaluate the efficacy and safety of a second Ahmed glaucoma valve (AGV) in eyes with refractory glaucoma that had undergone prior Ahmed device implantation. This multicenter, retrospective study evaluated 58 eyes (58 patients) that underwent a second AGV (model S2-n = 50, model FP7-n = 8) due to uncontrolled IOP under maximal medical therapy. Outcome measures included IOP, visual acuity, number of glaucoma medications, and postoperative complications. Success was defined as IOP glaucoma medications preoperatively at 12 and 30 months were 3.17 ± 0.16 (n = 58), 1.81 ± 0.2 (n = 42), and 1.83 ± 0.35 (n = 18), respectively. The reductions in mean IOP and number of medications were statistically significant at all time intervals (P glaucoma, and is associated with relatively few complications.

  12. Mitomycin C-augmented trabeculectomy: subtenon injection versus soaked sponges: a randomised clinical trial.

    Science.gov (United States)

    Pakravan, Mohammad; Esfandiari, Hamed; Yazdani, Shahin; Douzandeh, Azadeh; Amouhashemi, Nassim; Yaseri, Mehdi; Pakravan, Parto

    2017-09-01

    To compare the efficacy and safety of subtenon injection of mitomycin C (MMC) with that of conventional application of MMC-soaked sponges in trabeculectomy. In this multicentre randomised clinical trial, 80 consecutive open-angle glaucoma cases were randomised into two groups; group 1 received a subtenon injection of 0.1 mL of 0.01% MMC, while group 2 received 0.02% MMC-soaked sponges. Primary outcome measure was intraocular pressure (IOP), and secondary outcome measures were endothelial cell count (ECC) changes and bleb morphology according to the Indiana Bleb Appearance Grading Scale. Outcome measures were compared at 1, 3 and 6 months postoperatively. Complete and qualified success was defined as IOP within 6-15 mm Hg without and with medications at month 6, respectively. Mean preoperative IOP was 21.8±5.1 in group 1, which reduced to 10.3±3.7 mm Hg at final visit (pinjection of MMC is a safe and effective alternative to the conventional soaked sponge method. This method produces more favourable bleb morphology after trabeculectomy. NCT02385370, Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Retrobulbar diameter of optic nerve in glaucoma

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    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.

  14. Trabeculoplastia selectiva con láser en glaucoma primario de ángulo cerrado Use of selective laser trabeculoplasty in primary closed angle glaucoma

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    Ailen Garcés Fernández

    2010-06-01

    Full Text Available OBJETIVOS: Determinar eficacia y seguridad de la trabeculoplastia selectiva láser en pacientes portadores de glaucoma primario de ángulo cerrado, operados de cataratas y/o glaucoma, e identificar la frecuencia de los principales efectos adversos. MÉTODOS: Investigación observacional descriptiva prospectiva en 35 pacientes (50 ojos portadores de glaucoma primario de ángulo cerrado sometidos a cirugía de cataratas y/o glaucoma, en el Instituto Cubano Oftalmológico "Ramón Pando Ferrer" entre mayo y noviembre de 2007. Se utilizó equipo Tango LT 5106-T, de Laserex. RESULTADOS: Predominaron pacientes femeninas, mayores de 60 años y piel no blanca, hipermétropes, elevada frecuencia de enfermedades crónicas no transmisibles. Se logró un 41,2 % de reducción de la presión intraocular a los 6 meses. La técnica en pacientes con antecedentes de cirugía filtrante previa mostró resultados muy similares a los no intervenidos. La terapia mostró efectividad en 88 % de los ojos, se logró disminuir la terapia médica hipotensora. Eventos adversos: picos tensionales, epiteliopatía corneal y dispersión de pigmentos. CONCLUSIONES: La técnica láser resultó ser eficaz para lograr control tensional y/o reducción de terapia médica antihipertensiva ocular en este tipo de pacientes.OBJECTIVES: To determine the efficiency and safety of selective laser trabeculoplasty in patients who suffered primary close angle glaucoma and were operated from cataract and/or glaucoma, and to identify the frequency of the main adverse effects. METHODS: Prospective descriptive and observational research study of 35 patients (50 eyes carrying primary close angle glaucoma, who were operated on from cataract and/or glaucoma at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from May to November 2007. The equipment called Tango LT 5106-T from Laserex was used. RESULTS: Female patients, people over 60 years-old, Caucausians, hypermetropics, high frequency of non

  15. Genome-wide association study identifies a novel canine glaucoma locus.

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    Saija J Ahonen

    Full Text Available Glaucoma is an optic neuropathy and one of the leading causes of blindness. Its hereditary forms are classified into primary closed-angle (PCAG, primary open-angle (POAG and primary congenital glaucoma (PCG. Although many loci have been mapped in human, only a few genes have been identified that are associated with the development of glaucoma and the genetic basis of the disease remains poorly understood. Glaucoma has also been described in many dog breeds, including Dandie Dinmont Terriers (DDT in which it is a late-onset (>7 years disease. We designed clinical and genetic studies to better define the clinical features of glaucoma in the DDT and to identify the genetic cause. Clinical diagnosis was based on ophthalmic examinations of the affected dogs and 18 additionally investigated unaffected DDTs. We collected DNA from over 400 DTTs and a genome wide association study was performed in a cohort of 23 affected and 23 controls, followed by a fine mapping, a replication study and candidate gene sequencing. The clinical study suggested that ocular abnormalities including abnormal iridocorneal angles and pectinate ligament dysplasia are common (50% and 72%, respectively in the breed and the disease resembles human PCAG. The genetic study identified a novel 9.5 Mb locus on canine chromosome 8 including the 1.6 Mb best associated region (p = 1.63 × 10(-10, OR = 32 for homozygosity. Mutation screening in five candidate genes did not reveal any causative variants. This study indicates that although ocular abnormalities are common in DDTs, the genetic risk for glaucoma is conferred by a novel locus on CFA8. The canine locus shares synteny to a region in human chromosome 14q, which harbors several loci associated with POAG and PCG. Our study reveals a new locus for canine glaucoma and ongoing molecular studies will likely help to understand the genetic etiology of the disease.

  16. Determination Of Association Of Pigmentary Glaucoma With Pigment Dispersion Syndrome.

    Science.gov (United States)

    Shah, Imtiaz Ali; Shah, Shujaat Ali; Nagdev, Partab Rai; Abbasi, Safdar Ali; Abbasi, Naeem Ali; Katpar, Safdar Akhtar

    2017-01-01

    Pigment Dispersion Syndrome (PDS) is an autosomal dominant disorder of white males between 20 to 40 years of age characterized by deposition of pigment on the lens, zonules of lens, trabecular meshwork and corneal endothelium (Krukenberg's spindle) in addition to radial, spoke like transillumination defects in the mid peripheral iris. This study was conducted to determine the frequency of occurrence of Pigmentary Glaucoma in patients with Pigment Dispersion Syndrome (PDS). This longitudinal follow up study included patients presenting with Krukenberg's spindle on the endothelial side of cornea and pigmentation of angle of anterior chamber seen on slit lamp examination and gonioscopy. Seventy-two cases of PDS were included in the study, amongst them 63 (87.50%) were males. Mean age was 35.00±6.54 years (range 24-46 years). Forty-seven (65.28%) patients had an IOP in the range of 10-14 mmHg, 22 (30.56%) patients had an IOP in the range of 15-18 mmHg and 3 (4.17%) patients developed an IOP of greater than 19 mmHg. Fundoscopy showed myopic degeneration in 49 (68.06%) patients and optic disc cupping in 3 (4.17%) patients. Four (5.56%) patients had refractive error between +1D to +3D, 9 (12.50%) patients had refractive error between -1D to -4D, 21 (29.17%) patients had refractive error between -5 D to -8 D and 38 (52.78%) patients had refractive error between -9 D to -12 D. Our study showed that one patient having PDS developed glaucoma at 5 years of follow up and three patients developed glaucoma at 14 years of follow up. On the basis of this study we conclude that early onset primary open angle glaucoma associated with PDS or Juvenile glaucoma associated with PDS might have been mistaken as Pigmentary Glaucoma in Pakistani patients and a distinct entity in the form of Pigmentary Glaucoma may be non-existent.

  17. Association Between Zolpidem Use and Glaucoma Risk: A Taiwanese Population-Based Case-Control Study

    OpenAIRE

    Ho, Yi-Hao; Chang, Yue-Cune; Huang, Wei-Cheng; Chen, Hsin-Yi; Lin, Che-Chen; Sung, Fung-Chang

    2015-01-01

    Background To date, the relationship between zolpidem use and subsequent risk of glaucoma in a Taiwanese population has not been assessed. Methods We used data from the National Health Insurance system to investigate whether zolpidem use was related to glaucoma risk. A 1:4 matched case-control study was conducted. The cases were patients newly diagnosed with glaucoma from 2001 to 2010. The controls were randomly selected non-glaucoma subjects matched by sex and age (?5 years). Zolpidem exposu...

  18. National and subnational prevalence and burden of glaucoma in China: A systematic analysis.

    Science.gov (United States)

    Song, Peige; Wang, Jiawen; Bucan, Kajo; Theodoratou, Evropi; Rudan, Igor; Chan, Kit Yee

    2017-12-01

    Glaucoma, the second leading cause of blindness, affects approximately 64.3 million individuals worldwide. In China, demographic ageing is in rapid progress. Yet detailed and up-to-date estimates of the scale of glaucoma are rare. We aimed to quantify and understand the prevalence and burden of glaucoma in China from 1990 to 2015, with projections until 2050. For this systematic review and meta-analysis, we searched China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline using comprehensive search strategies to identify all relevant articles that have reported the prevalence of glaucoma in the general Chinese population. We used a multilevel mixed-effect meta-regression to estimate the prevalence rates of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and a random-effects meta-analysis to pool the overall prevalence of secondary glaucoma. United Nations population data were used to estimate and project the number of people with glaucoma from 1990 to 2050. Univariable and multivariable meta-regressions were conducted to assess the association between the prevalence of POAG and PACG and relevant demographic and geographic factors. The national burden of POAG and PACG in the years 2000 and 2010 were distributed to six geographic regions accordingly. From 1990 to 2015, the prevalence of all glaucoma ranged from 2.59% (95% CI = 1.96-3.49) to 2.58% (95% CI = 1.94-3.47). For different subtypes of glaucoma, the overall prevalence of POAG ranged from 1.03% (95% CI = 0.67-1.58) in 1990 to 1.02% (95% CI = 0.67-1.57) in 2015, PACG from 1.41% (95% CI = 1.18-1.68) to 1.40% (95% CI = 1.17-1.68). The overall prevalence of secondary glaucoma was 0.15% (95% CI = 0.10-0.23) during this period. The number of people with all glaucoma in China was 5.92 million (95% CI = 4.47-7.97) in 1990, and 13.12 million (95% CI = 9.88-17.68) in 2015

  19. Morbidity from primary glaucoma and its gender-specific aspects amongst the population of Siberian industrial town

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    A. L. Onischenko

    2015-01-01

    Full Text Available Aim: To analyze visual morbidity attributable to primary glaucoma, its eight-year dynamics, and gender differences in Siberian industrial town inhabitants.Methods: Medical records (out-patient and in-patient departments from the database of the sectional information analysis center of Novokuznetsk Health Administration over an eight-year period (2004-2011 were studied. Individual patients diagnosed with primary glaucoma in 2004‑2011 were reviewed only.Results: Standardized primary glaucoma morbidity rate in men and women aged over 40 years was 3.5±0.3 ‰ and 2.6±0.26 ‰, respectively. Men were diagnosed with primary glaucoma earlier than women. In male residents aged over 70 years, primary glaucoma was found more often than in female residents. Male glaucoma patients required in-patient treatment more often than female patients. Primary glaucoma was diagnosed in men and women at 66.1±11.6 and 67.0±10.9 years (on average, respectively (U = 2.27, p = 0.023. 441 of 5424 patients (8.1 % diagnosed with glaucoma in 2004‑2011 subsequently died. The average age at death was 69.0±7.2 years, the median (25 %; 75 % was 71 years (66 years; 75 years. Patients who were diagnosed with primary glaucoma survived for 2.6±1.8 years. The median (25 %; 75 % was 2 years (1 year; 4 years. The distribution of the variable that characterized the difference between the age at death and the age of diagnosis making was abnormal (D = 0.151, p<0.001. Half of glaucoma patients died in the first two years after glaucoma has been diagnosed. Less than 20 % of patients (16 % men, 18 % women survived for ≥4 years after primary glaucoma diagnosis has been made. Conclusion: The analysis of morbidity and mortality rates as well as disability due to impaired vision is of great importance to health official and practitioners. Stably low glaucoma morbidity rate in Siberian industrial town inhabitants indicates a great lack of glaucoma specialists and forces

  20. Glaucoma correlates with increased risk of Parkinson's disease in the elderly: a national-based cohort study in Taiwan.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2017-08-01

    Very little is known about the association between glaucoma and Parkinson's disease in the elderly. The objective of this study was to determine whether glaucoma is associated with Parkinson's disease in older people in Taiwan. A retrospective cohort study was conducted to analyze the Taiwan National Health Insurance Program database from 2000 to 2010. We included 4330 subjects aged 65 years or older with newly diagnosed glaucoma as the glaucoma group, and 17,000 randomly selected subjects without a glaucoma diagnosis as the non-glaucoma group. Both groups were matched for sex, age, other comorbidities, and index year of glaucoma diagnosis. The incidence of Parkinson's disease at the end of 2011 was measured. A multivariable Cox proportional hazard regression model was used to measure the hazard ratio and 95% confidence intervals for Parkinson's disease associated with glaucoma. The overall incidence of Parkinson's disease was 1.28-fold higher in the glaucoma group than that in the non-glaucoma group (7.73 vs. 6.02 per 1000 person-years; 95% confidence interval 1.18, 1.40). After controlling for potential confounding factors, the adjusted hazard ratio of Parkinson's disease was 1.23 for the glaucoma group (95% confidence interval 1.05, 1.46), compared with the non-glaucoma group. Older people with glaucoma correlate with a small but statistically significant increase in the risk for Parkinson's disease. Whether glaucoma may be a non-motor feature of Parkinson's disease in older people requires further research to confirm.

  1. [Results of fistulizing and Ahmed valve surgery for treatment of refractory glaucoma].

    Science.gov (United States)

    Bikbov, M M; Babushkin, A E; Chaĭka, O V; Orenburkina, O I; Matiukhina, E N

    2014-01-01

    Surgical results of 76 patients (76 eyes) aged 25-79 years with secondary refractory glaucoma were analyzed. The best hypotensive effect and visual functions integrity were achieved with Ahmed valve implantation (86.7% and 83.3% of cases respectively); after conventional fistulizing surgery the hypotensive effect was observed in 45.5%, noncompromised vision--in 54.5% of cases. Tunnel trabeculectomy with iridocycloretraction led to normalization of intraocular pressure and stabilization of visual functions in 81.3% and 68.8% of cases respectively and thus can be considered as an alternative to fistulizing surgery in patients with secondary refractory glaucoma. Uveal glaucoma is a relative contraindication to Ahmed valve implantation, while neovascular glaucoma is that to tunnel trabeculectomy with iridocycloretraction.

  2. In-silico design of novel myocilin inhibitors for glaucoma therapy ...

    African Journals Online (AJOL)

    Purpose: To explore newer computational approaches in the design of novel myocilin inhibitors for the treatment of glaucoma. Methods: An in-silico virtual screening technique based on simulation of molecular docking was utilised to design a novel myocilin inhibitors for the treatment of glaucoma. The designed novel ...

  3. Association between zolpidem use and glaucoma risk: a Taiwanese population-based case-control study.

    Science.gov (United States)

    Ho, Yi-Hao; Chang, Yue-Cune; Huang, Wei-Cheng; Chen, Hsin-Yi; Lin, Che-Chen; Sung, Fung-Chang

    2015-01-01

    To date, the relationship between zolpidem use and subsequent risk of glaucoma in a Taiwanese population has not been assessed. We used data from the National Health Insurance system to investigate whether zolpidem use was related to glaucoma risk. A 1:4 matched case-control study was conducted. The cases were patients newly diagnosed with glaucoma from 2001 to 2010. The controls were randomly selected non-glaucoma subjects matched by sex and age (± 5 years). Zolpidem exposure and/or the average dosage of zolpidem used (mg/year) were evaluated. Medical comorbidities were considered as confounding factors. Multiple logistic regression models were used to evaluate the potential risk of zolpidem exposure on glaucoma with/without adjustment for the effects of confounding variables. The exposure rate of zolpidem use in the glaucoma group was significantly higher than that of the control group (2.8% vs. 2.0%, P zolpidem use vs. those without was 1.19 (95% confidence interval [CI], 1.02-1.38). Compared to non-zolpidem users, zolpidem users with an average dose of more than 200 mg/year had significantly increased risk of glaucoma (OR 1.31, 95% CI 1.03-1.68). This study suggests that the use of zolpidem might increase the risk of subsequent glaucoma. Further confirmatory studies are recommended to clarify this important issue.

  4. Economic burden of glaucoma in Rivers State, Nigeria.

    Science.gov (United States)

    Adio, Adedayo O; Onua, Alfred A

    2012-01-01

    Primary open angle glaucoma is reported to blind 150,000 people in the Nigerian population and over 7000 in Rivers State, and requires constant follow-up. Compliance is a challenge, given that most inhabitants live below the poverty line. This study was performed to determine how Nigerian patients are affected economically by the disease. Consecutive adult patients attending the eye clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, with a diagnosis of primary open angle glaucoma and on outpatient antiglaucoma treatment in the first 6 months of 2006, were recruited for the study. The lowest paid government worker was on USD50 (N7500.00) per month and the gross domestic product per capita was USD1150 for the period under review. We enrolled 120 consecutive patients of mean age 52.7 ± 10.4 years, with a male to female ratio of 2:3. The most common occupations were in the civil service (n = 56, 46.7%). All participants were on topical antiglaucoma treatment. The average cost of medical antiglaucoma medication was N6000 (USD40) per month. Computed to include indirect costs, including medical laboratory tests, transportation, and care by patient escorts, an average sum of USD105.4 (N15,810) was spent by each patient per month. Most of the patients (73.3%) were responsible for their own treatment costs. No patient accepted the cheaper option of surgery (USD275.4, N41,310). Eighty of the patients (66.7%) visited our eye clinic monthly. Direct and indirect loss to the economy was USD3,064587 per annum from those already blind. This was in addition to the USD 4.1 million being spent yearly on medical treatment by those who were visually impaired by glaucoma. Middle-income earners spent over 50% of their monthly income and low-income earners spend all their monthly earnings on treatment for glaucoma. This situation often resulted in noncompliance with treatment and hospital follow-up visits. To reduce the economic burden of glaucoma

  5. Primary Trabeculectomy Outcomes by Glaucoma Fellows in a Tertiary Hospital in Brazil.

    Science.gov (United States)

    Abe, Ricardo Y; Shigueoka, Leonardo S; Vasconcellos, José P C; Costa, Vital P

    2017-11-01

    To examine outcomes of trabeculectomy with mitomycin C for uncontrolled glaucoma when performed by glaucoma trainee surgeons. Retrospective case series of patients who underwent trabeculectomy with mitomycin C. Primary outcome was to assess the rate of failure, which was defined as intraocular pressure in 2 consecutive visits >18 or glaucoma surgery, or loss of light perception. The secondary outcome was to investigate risk factors for failure and surgical complications. One hundred forty-three eyes from 126 glaucoma patients underwent primary trabeculectomy between 2013 and 2014 at University of Campinas. Mean follow-up time was 1.47±0.96 years. Kaplan-Meier analysis showed cumulative survival rates of 70.1%, 62.5%, and 57.8%, after 1, 2, and 3 years, respectively. Multivariate analysis with generalized estimating equations revealed that neovascular glaucoma [odd ratios (OR): 5.05, P=0.043], suture lysis (OR: 8.89, P=0.011), and early bleb leak (OR: 4.63, P=0.011) were risk factors for failure. A success rate of approximately 60% was obtained 3 years after primary trabeculectomy performed by trainees. Patients with neovascular glaucoma, who underwent suture lysis and who presented an early bleb leak had an increased risk for failure during follow-up.

  6. Diagnosis System for Diabetic Retinopathy and Glaucoma Screening to Prevent Vision Loss

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    Siva Sundhara Raja DHANUSHKODI

    2014-03-01

    Full Text Available Aim: Diabetic retinopathy (DR and glaucoma are two most common retinal disorders that are major causes of blindness in diabetic patients. DR caused in retinal images due to the damage in retinal blood vessels, which leads to the formation of hemorrhages spread over the entire region of retina. Glaucoma is caused due to hypertension in diabetic patients. Both DR and glaucoma affects the vision loss in diabetic patients. Hence, a computer aided development of diagnosis system for Diabetic retinopathy and Glaucoma screening is proposed in this paper to prevent vision loss. Method: The diagnosis system of DR consists of two stages namely detection and segmentation of fovea and hemorrhages. The diagnosis system of glaucoma screening consists of three stages namely blood vessel segmentation, Extraction of optic disc (OD and optic cup (OC region and determination of rim area between OD and OC. Results: The specificity and accuracy for hemorrhages detection is found to be 98.47% and 98.09% respectively. The accuracy for OD detection is found to be 99.3%. This outperforms state-of-the-art methods. Conclusion: In this paper, the diagnosis system is developed to classify the DR and glaucoma screening in to mild, moderate and severe respectively.

  7. Factors associated with lifetime risk of open-angle glaucoma blindness.

    Science.gov (United States)

    Peters, Dorothea; Bengtsson, Boel; Heijl, Anders

    2014-08-01

    To investigate factors associated with bilateral glaucoma blindness, particularly factors available at the time of diagnosis. Retrospective chart review of all patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PEXG) followed at the Department of Ophthalmology or Low Vision Center of Skåne University Hospital, Malmö, Sweden, who died between January 2006 and June 2010. Disease stage at diagnosis was defined by a simplified version of Mills' glaucoma staging system using perimetric mean deviation (MD) to define six stages of severity. Blindness was defined according to WHO criteria. We used logistic regression analysis to examine the association between risk factors and glaucoma blindness. Four hundred and 23 patients were included; 60% POAG and 40% PEXG. Sixty-four patients (15%) became blind from glaucoma. Blind patients had significantly longer mean duration with diagnosed disease than patients who did not go blind (14.8 years ± 5.8 versus 10.6 years ± 6.5, p blindness increased with higher intraocular pressure (IOP) (OR 1.08, 95% CI 1.03-1.13) and with each stage of more advanced field loss at time of diagnosis (OR 1.80 95% CI 1.34-2.41). Older age at death was also associated with an increased risk of blindness (OR 1.09 95% CI 1.03-1.14), while age at diagnosis was unimportant. PEXG was not an independent risk factor for blindness. Higher IOP and worse visual field status at baseline were important risk factors, as was older age at death. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Predicting Visual Disability in Glaucoma With Combinations of Vision Measures.

    Science.gov (United States)

    Lin, Stephanie; Mihailovic, Aleksandra; West, Sheila K; Johnson, Chris A; Friedman, David S; Kong, Xiangrong; Ramulu, Pradeep Y

    2018-04-01

    We characterized vision in glaucoma using seven visual measures, with the goals of determining the dimensionality of vision, and how many and which visual measures best model activity limitation. We analyzed cross-sectional data from 150 older adults with glaucoma, collecting seven visual measures: integrated visual field (VF) sensitivity, visual acuity, contrast sensitivity (CS), area under the log CS function, color vision, stereoacuity, and visual acuity with noise. Principal component analysis was used to examine the dimensionality of vision. Multivariable regression models using one, two, or three vision tests (and nonvisual predictors) were compared to determine which was best associated with Rasch-analyzed Glaucoma Quality of Life-15 (GQL-15) person measure scores. The participants had a mean age of 70.2 and IVF sensitivity of 26.6 dB, suggesting mild-to-moderate glaucoma. All seven vision measures loaded similarly onto the first principal component (eigenvectors, 0.220-0.442), which explained 56.9% of the variance in vision scores. In models for GQL scores, the maximum adjusted- R 2 values obtained were 0.263, 0.296, and 0.301 when using one, two, and three vision tests in the models, respectively, though several models in each category had similar adjusted- R 2 values. All three of the best-performing models contained CS. Vision in glaucoma is a multidimensional construct that can be described by several variably-correlated vision measures. Measuring more than two vision tests does not substantially improve models for activity limitation. A sufficient description of disability in glaucoma can be obtained using one to two vision tests, especially VF and CS.

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

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    Idalia Triana Casado

    2011-05-01

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

  10. Are we ready for genetic testing for primary open-angle glaucoma?

    Science.gov (United States)

    Khawaja, Anthony P; Viswanathan, Ananth C

    2018-05-01

    Following a dramatic reduction in the cost of genotyping technology in recent years, there have been significant advances in the understanding of the genetic basis of glaucoma. Glaucoma patients represent around a quarter of all outpatient activity in the UK hospital eye service and are a huge burden for the National Health Service. A potential benefit of genetic testing is personalised glaucoma management, allowing direction of our limited healthcare resources to the glaucoma patients who most need it. Our review aims to summarise recent discoveries in the field of glaucoma genetics and to discuss their potential clinical utility. While genome-wide association studies have now identified over ten genes associated with primary open-angle glaucoma (POAG), individually, variants in these genes are not predictive of POAG in populations. There are data suggesting some of these POAG variants are associated with conversion from ocular hypertension to POAG and visual field progression among POAG patients. However, these studies have not been replicated yet and such genetic testing is not currently justified in clinical care. In contrast, genetic testing for inherited early-onset disease in relatives of POAG patients with a known genetic mutation is of clear benefit; this can support either regular review to commence early treatment when the disease develops, or discharge from ophthalmology services of relatives who do not carry the mutation. Genetic testing for POAG at a population level is not currently justified.

  11. Infected Baerveldt Glaucoma Drainage Device by Aspergillus niger

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    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.

  12. Exploring Serum Levels of Brain Derived Neurotrophic Factor and Nerve Growth Factor Across Glaucoma Stages.

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    Francesco Oddone

    Full Text Available To investigate the serum levels of Brain Derived Neurotrophic Factor (BDNF and Nerve Growth Factor (NGF in patients affected by primary open angle glaucoma with a wide spectrum of disease severity compared to healthy controls and to explore their relationship with morphological and functional glaucoma parameters.45 patients affected by glaucoma at different stages and 15 age-matched healthy control subjects underwent visual field testing, peripapillary retinal nerve fibre layer thickness measurement using Spectral Domain Optical Coherence Tomography and blood collection for both neurotrophins detection by Enzyme-Linked Immunosorbent Assay. Statistical analysis and association between biostrumental and biochemical data were investigated.Serum levels of BDNF in glaucoma patients were significantly lower than those measured in healthy controls (261.2±75.0 pg/ml vs 313.6±79.6 pg/ml, p = 0.03. Subgroups analysis showed that serum levels of BDNF were significantly lower in early (253.8±40.7 pg/ml, p = 0.019 and moderate glaucoma (231.3±54.3 pg/ml, p = 0.04 but not in advanced glaucoma (296.2±103.1 pg/ml, p = 0.06 compared to healthy controls. Serum levels of NGF in glaucoma patients were significantly lower than those measured in the healthy controls (4.1±1 pg/mL vs 5.5±1.2 pg/mL, p = 0.01. Subgroups analysis showed that serum levels of NGF were significantly lower in early (3.5±0.9 pg/mL, p = 0.0008 and moderate glaucoma (3.8±0.7 pg/ml, p<0.0001 but not in advanced glaucoma (5.0±0.7 pg/ml, p = 0.32 compared to healthy controls. BDNF serum levels were not related to age, visual field mean deviation or retinal nerve fibre layer thickness either in glaucoma or in controls while NGF levels were significantly related to visual field mean deviation in the glaucoma group (r2 = 0.26, p = 0.004.BDNF and NGF serum levels are reduced in the early and moderate glaucoma stages, suggesting the possibility that both factors could be further investigated

  13. The Non-Human Primate Experimental Glaucoma Model

    Science.gov (United States)

    Burgoyne, Claude F.

    2015-01-01

    The purpose of this report is to summarize the current strengths and weaknesses of the non-human primate (NHP) experimental glaucoma (EG) model through sections devoted to its history, methods, important findings, alternative optic neuropathy models and future directions. NHP EG has become well established for studying human glaucoma in part because the NHP optic nerve head (ONH) shares a close anatomic association with the human ONH and because it provides the only means of systematically studying the very earliest visual system responses to chronic IOP elevation, i.e. the conversion from ocular hypertension to glaucomatous damage. However, NHPs are impractical for studies that require large animal numbers, demonstrate spontaneous glaucoma only rarely, do not currently provide a model of the neuropathy at normal levels of IOP, and cannot easily be genetically manipulated, except through tissue-specific, viral vectors. The goal of this summary is to direct NHP EG and non-NHP EG investigators to the previous, current and future accomplishment of clinically relevant knowledge in this model. PMID:26070984

  14. XEN Gel Implant: a new surgical approach in glaucoma.

    Science.gov (United States)

    Chaudhary, Ankita; Salinas, Lauriane; Guidotti, Jacopo; Mermoud, André; Mansouri, Kaweh

    2018-01-01

    Glaucoma is a leading cause of blindness worldwide. Intraocular pressure (IOP) lowering is the only effective treatment strategy. Traditional glaucoma surgeries are generally considered to be unpredictable and associated with a high rate of complications. This has led to the development of a novel XEN Gel Implant, a type of minimally invasive glaucoma surgery (MIGS), lowering the IOP without extensive surgical dissection. Areas covered: A literature search was undertaken on PubMed using the terms XEN glaucoma, gelatin microstent, and MIGS. All the articles and case reports on XEN Gel Implant and selected articles on MIGS were studied and reviewed. We have discussed the results of most studies on XEN Gel Implant related to its efficacy, safety and success. Expert commentary: The XEN Gel Implant effectively lowers IOP and medication use, with a favorable safety profile. Long-term data on its success and cost-effectiveness are lacking. The studies have shown it to be without any serious adverse events and to have good safety profile encouraging future research on this novel implant. There is a need to correctly identify selection criteria for patients, who would benefit the most from the XEN Gel Implant.

  15. Effect of Ahmed valve implantation on late neovascular glaucoma

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    Ping-An Mao

    2013-09-01

    Full Text Available AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma. METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 caseswith late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

  16. Glaucoma and quality of life: fall and driving risk.

    Science.gov (United States)

    Montana, Cynthia L; Bhorade, Anjali M

    2018-03-01

    Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. Studies continue to support that glaucoma patients, particularly those with advanced disease, have an increased risk of falling or unsafe driving. Risk factors, however, remain variable and include severity and location of visual field defects, contrast sensitivity, and performance on divided attention tasks. Such variability is likely because of the multifactorial nature of ambulating and driving and compensatory strategies used by patients. Falls and unsafe driving remain a serious public health issue for older adults with glaucoma. Ambulation and driving are complex tasks and there is no consensus yet, regarding the best methods for risk stratification and targeted interventions to increase safety. Therefore, comprehensive and individualized assessments are recommended to most effectively evaluate a patient's risk for falling or unsafe driving.

  17. Longitudinal analysis of progression in glaucoma using spectral-domain optical coherence tomography.

    Science.gov (United States)

    Wessel, Julia M; Horn, Folkert K; Tornow, Ralf P; Schmid, Matthias; Mardin, Christian Y; Kruse, Friedrich E; Juenemann, Anselm G; Laemmer, Robert

    2013-05-01

    To compare the longitudinal loss of RNFL thickness measurements by SD-OCT in healthy individuals and glaucoma patients with or without progression concerning optic disc morphology. A total of 62 eyes, comprising 38 glaucomatous eyes with open angle glaucoma and 24 healthy controls, were included in the study (Erlangen Glaucoma Registry, NTC00494923). All patients were investigated annually over a period of 3 years by Spectralis SD-OCT measuring peripapillary RNFL thickness. By masked comparative analysis of photographs, the eyes were classified into nonprogressive and progressive glaucoma cases. Longitudinal loss of RNFL thickness was compared with morphological changes of optic disc morphology. Mixed model analysis of annual OCT scans revealed an estimated annual decrease of the RNFL thickness by 2.12 μm in glaucoma eyes with progression, whereas glaucoma eyes without progression in optic disc morphology lost 1.18 μm per year in RNFL thickness (P = 0.002). The rate of change in healthy eyes was 0.60 μm and thereby also significantly lower than in glaucoma eyes with progression (P < 0.001). The intrasession variability of three successive measurements without head repositioning was 1.5 ± 0.7 μm. The loss of mean RNFL thickness exceeded the intrasession variability in 60% of nonprogressive eyes, and in 85% of progressive eyes after 3 years. LONGITUDINAL MEASUREMENTS OF RNFL THICKNESS USING SD-OCT SHOW A MORE PRONOUNCED REDUCTION OF RNFL THICKNESS IN PATIENTS WITH PROGRESSION COMPARED WITH PATIENTS WITHOUT PROGRESSION IN GLAUCOMATOUS OPTIC DISC CHANGES. (www.clinicaltrials.gov number, NTC00494923.).

  18. Pattern-reversal electroretinograms in unilateral glaucoma.

    Science.gov (United States)

    Wanger, P; Persson, H E

    1983-06-01

    Pattern-reversal and flash electroretinograms (ERG) and oscillatory potentials (OP) were recorded from 11 patients with unilateral glaucoma. All glaucomatous eyes had reduced amplitudes both compared to the opposite eye in the same patient and to reference values. In 10 of the 11 cases this reduction was below the level of normal variation. The difference in pattern-reversal ERG amplitude means from glaucomatous and opposite eyes was statistically significant. No differences were observed in flash ERGs or OPs. The histopathologic correlate to the visual field defects in glaucoma is retinal ganglion cell degeneration. The present electrophysiologic findings support the view, based on results from animal experiments, that the pattern-reversal ERG reflects ganglion cell activity.

  19. The treatment of malignant glaucoma in nanophthalmos: a case report.

    Science.gov (United States)

    Wang, Jie; Du, Ergang; Tang, Jinfei

    2018-02-23

    The management of eyes with nanophthalmos is a dilemma for ophthalmologists due to various complications, especial the eye with malignant glaucoma. We report a case of effective treatment for malignant glaucoma in nanophthalmos. An 82-year-old man was performed phacoemulsification in the right eye with normal ocular pressure and nanophthalmos. The surgery was uneventful: an intraocular lens (IOL) was placed and centered in the capsular bag. 2 months later, the patient presented with malignant glaucoma, and the intraocular pressure fluctuated between 18.6 mmHg and 30.8 mmHg with antiglaucoma medications. The patient did not respond to surgical peripheral iridotomy and goniosynechialysis. Then a single treatment with laser peripheral lens posterior capsulotomy and vitreous anterior membranectomy was performed. The intraocular pressure normalized, and the anterior chamber deepened within 24 h. The patient's condition remained stable for 9 months with no further treatment, and his Snellen corrected distance visual acuity was 20/50. The left eye of this patient was treated by combined surgery including phacoemulsification, IOL implantation, anterior vitrectomy, surgical peripheral iridotomy (PI), and goniosynechialysis. No intraoperative or postoperative complications were observed. This case suggests that it is essential to choose a suitable treatment for nanophthalmos patients to deal with malignant glaucoma and to reduce the incidence of malignant glaucoma.

  20. Investigation on the mechanism of peripheral axonal injury in glaucoma

    Directory of Open Access Journals (Sweden)

    Jun- Hong Zhao

    2013-05-01

    Full Text Available AIM: To compare the angles of longitudinal section of sclera around optic nerve heads and the never fiber layer changes in healthy adults and patients with glaucoma, and to investigate the mechanism of peripheral retinal axonal injury, with the combined knowledge of biomechanics. METHODS: The optical nerves and their peripheral tissue specimen in the 12 eyes from health adult donators and 12 eyes from glaucoma patient donators were dyed by Glees' method to compare the angles of longitudinal section of sclera around optic nerve heads(through optic nerve center, and to observe the anatomical features of the peripheral retinal axons. RESULTS: The mean angle of longitudinal section of sclera around optic nerve in healthy adults was 73.3°, while that in patients with absolute glaucoma was 75.6°. The difference showed no significance(t=1.44, P>0.05. There was a sharp bend in the course of peripheral optical fiber in healthy adults. However, the optic nerve fiber disappeared completely in patients with glaucoma end stage. CONCLUSION: The angle between the medial edge and leading edge of sclera(around optic nerve headsis an acute angle. The optical fiber in glaucoma end stage disappeared completely. The phenomenon may be related to high intraocular pressure, the sclera shape, the shear modulus of sclera and axons, and “axonal bending-injury” mechanism.