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Sample records for previous glaucoma filtering

  1. Quarter-Shifted Microincisional Sutureless Vitrectomy in Patients with a Glaucoma Drainage Implant or Filtering Bleb.

    Science.gov (United States)

    Song, Ji Hun; Jang, Seran; Cho, Eun Hyung; Ahn, Jaehong

    2017-05-01

    When vitrectomy is performed in eyes that have undergone glaucoma surgery, the site of sclerotomy often overlaps with the previous glaucoma operation site. It can lead to serious complications such as postoperative hypotony, leakage, and/or infection. Our technique involves modification of surgeon's position and two sclerotomy sites 45° away from the original position, with an infusion cannula inserted infranasally to avoid damage to the glaucoma drainage implant or filtering bleb. The modified approach was applied to seven eyes with various indications. Vitrectomy was successfully completed, and there were no sclerotomy site complications, leakage, or hypotony in any case. Good intraocular pressure control was maintained throughout the postoperative course in all cases. © Copyright: Yonsei University College of Medicine 2017.

  2. Glaucoma

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    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 ...

  3. 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. ...

  4. Glaucoma

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

  5. Glaucoma

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    Full Text Available ... Disease Education Program Glaucoma Education Program Low Vision Education Program Hispanic/Latino Program Vision and Aging Program ... Insufficiency Diabetic Eye Disease Dilated ...

  6. Glaucoma

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  7. Glaucoma

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  8. Glaucoma

    Science.gov (United States)

    ... NEI YouTube Videos: Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low ...

  9. Glaucoma

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  10. Glaucoma

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  11. Glaucoma

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    Full Text Available ... Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of ... National Eye Health Education Program (NEHEP) Diabetic Eye Disease Education Program Glaucoma Education Program Low Vision Education ...

  12. Glaucoma

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

  13. Glaucoma

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    Full Text Available ... Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding ... Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low ...

  14. 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 ...

  15. Glaucoma

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    Full Text Available ... and other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of ... National Eye Health Education Program (NEHEP) Diabetic Eye Disease Education Program Glaucoma Education Program Low Vision Education ...

  16. Glaucoma

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    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 ...

  17. Glaucoma

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

  18. Glaucoma

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    Full Text Available ... Jobs Fellowships NEI Summer Intern Program Diversity In Vision Research & Ophthalmology (DIVRO) Student Training Programs To search for ... Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive ... NEI Home Contact Us A-Z Site Map NEI on Social Media Information ...

  19. Glaucoma

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

  20. Corneal decompensation following filtering surgery with the Ex-PRESS® mini glaucoma shunt device

    Directory of Open Access Journals (Sweden)

    Tojo N

    2015-03-01

    Full Text Available Naoki Tojo, Atsushi Hayashi, Akio Miyakoshi Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan Purpose: To report a case of corneal decompensation due to the Ex-PRESS® mini glaucoma shunt device (Ex-PRESS.Patient and methods: A 75-year-old man had pseudoexfoliation glaucoma in his right eye. He underwent filtration surgery with Ex-PRESS. His intraocular pressure was 7 mmHg after 9 months.Results: We observed partial decompensation of the corneal endothelium adjacent to the filtering bleb. Specular microscopy revealed a marked decrease in the endothelial cell density at the center of the cornea.Conclusion: Anterior segment optical coherence tomography is very useful for evaluating corneal edema and the position of Ex-PRESS. It is important to follow up with an examination of the corneal endothelial cells. Keywords: Ex-PRESS, bullous keratopathy, trabeculectomy, complication, cornea 

  1. Biodegradable radioactive implants for glaucoma filtering surgery produced by ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Assmann, W. [Department fuer Physik, Ludwig-Maximilians-Universitaet Muenchen, 85748 Garching (Germany)]. E-mail: walter.assmann@lmu.de; Schubert, M. [Department fuer Physik, Ludwig-Maximilians-Universitaet Muenchen, 85748 Garching (Germany); Held, A. [Augenklinik, Technische Universitaet Muenchen, 81675 Munich (Germany); Pichler, A. [Augenklinik, Technische Universitaet Muenchen, 81675 Muenchen (Germany); Chill, A. [Zentralinstitut fuer Medizintechnik, Technische Universitaet Muenchen, 85748 Garching (Germany); Kiermaier, S. [Zentralinstitut fuer Medizintechnik, Technische Universitaet Muenchen, 85748 Garching (Germany); Schloesser, K. [Forschungszentrum Karlsruhe, 76021 Karlsruhe (Germany); Busch, H. [NTTF GmbH, 53619 Rheinbreitbach (Germany); Schenk, K. [NTTF GmbH, 53619 Rheinbreitbach (Germany); Streufert, D. [Acri.Tec GmbH, 16761 Hennigsdorf (Germany); Lanzl, I. [Augenklinik, Technische Universitaet Muenchen, 81675 Munich (Germany)

    2007-04-15

    A biodegradable, {beta}-emitting implant has been developed and successfully tested which prevents fresh intraocular pressure increase after glaucoma filtering surgery. Ion implantation has been used to load the polymeric implants with the {beta}-emitter {sup 32}P. The influence of ion implantation and gamma sterilisation on degradation and {sup 32}P-fixation behavior has been studied by ion beam and chemical analysis. Irradiation effects due to the applied ion fluence (10{sup 15} ions/cm{sup 2}) and gamma dose (25 kGy) are found to be tolerable.

  2. Early cystic bleb needling revision after glaucoma filtering surgery with toxic keratopathy

    Directory of Open Access Journals (Sweden)

    S. Yu. Petrov

    2015-01-01

    Full Text Available Clinical case of high thin-wall cystic limited filtering bleb needling revision in the early post-op period after trabeculectomy with sinusotomy accompanied by toxic keratopathy is presented. Optical coherence tomography (OCT demonstrated that filtering bleb height was 2700 μm and bleb wall thickness was 70 μm. Bleb needling revision with its lateralwall dissection and subconjunctival injection of dexamethasone, fluorouracil, and ranibizumab near to the bleb site was performed. In 1.5 hours after the procedure, bleb height decreased to 550 μm (by 5 times while bleb wall thickness increased up to 100 μm. Topical antibacterial, steroid, and non-steroid anti-inflammatory therapy was recommended. The next day IOP level reduced from 11 mm Hg to 4.5 mm Hg. It was accompanied by choroidal effusion that was managed conservatively with cycloplegic agents (drops and injections for 3 days. On day 6, central corneal edema affecting all layers, Descemet’s membrane folds, and ocular hypertension were revealed. Metabolic therapy resolved corneal edema within 3 days. Re-needling bleb revision decreased IOP level to 6.2 mm Hg. This resulted in transient Descemet’s membrane folds. This paper describes filtering bleb needling revision with its lateral wall dissection and anti-inflammatory, cytostatic, and anti-VEGF agents use to prolong glaucoma filtering surgery effect in excessive scarring. The procedure was accompanied by toxic corneal endothelium decompensation with corneal edema and Descemet’s membrane folds treated with active metabolic therapy.

  3. Effect of benzalkonium chloride?free travoprost on intraocular pressure and ocular surface symptoms in patients with glaucoma previously on latanoprost: an open-label study

    OpenAIRE

    Lopes, Joao F.; Hubatsch, Douglas A.; Amaris, Patricia

    2015-01-01

    Background Prostaglandin analogs reduce intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension; however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Methods This was an open-label, single-arm study conducted in Latin America from February 2012 to May 2013. Patients with open-angle glaucoma or ocular hypertension who were intolerant of latanoprost 0.005?% were transitioned to recei...

  4. 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, ...

  5. 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 ...

  6. 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 ...

  7. Assessment of thermal effects in a model of the human head implanted with a wireless active microvalve for the treatment of glaucoma creating a filtering bleb

    Science.gov (United States)

    Schaumburg, F.; Guarnieri, F. A.

    2017-05-01

    A 3D anatomical computational model is developed to assess thermal effects due to exposure to the electromagnetic field required to power a new investigational active implantable microvalve for the treatment of glaucoma. Such a device, located in the temporal superior eye quadrant, produces a filtering bleb, which is included in the geometry of the model, together with the relevant ocular structures. The electromagnetic field source—a planar coil—as well as the microvalve antenna and casing are also included. Exposure to the electromagnetic field source of an implanted and a non-implanted subject are simulated by solving a magnetic potential formulation, using the finite element method. The maximum SAR10 is reached in the eyebrow and remains within the limits suggested by the IEEE and ICNIRP standards. The anterior chamber, filtering bleb, iris and ciliary body are the ocular structures where more absorption occurs. The temperature rise distribution is also obtained by solving the bioheat equation with the finite element method. The numerical results are compared with the in vivo measurements obtained from four rabbits implanted with the microvalve and exposed to the electromagnetic field source.

  8. Effect of benzalkonium chloride-free travoprost on intraocular pressure and ocular surface symptoms in patients with glaucoma previously on latanoprost: an open-label study.

    Science.gov (United States)

    Lopes, Joao F; Hubatsch, Douglas A; Amaris, Patricia

    2015-11-12

    Prostaglandin analogs reduce intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension; however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). This was an open-label, single-arm study conducted in Latin America from February 2012 to May 2013. Patients with open-angle glaucoma or ocular hypertension who were intolerant of latanoprost 0.005 % were transitioned to receive once-daily BAK-free travoprost 0.004 % containing polyquaternium-1 (Travatan® preserved with POLYQUAD® [PQ], Alcon Laboratories, Inc; Fort Worth, TX) for 12 weeks. Mean change in IOP from baseline (primary efficacy endpoint) and the percentage of patients who achieved a target IOP of ≤18 mmHg were evaluated at all on-therapy visits. Ocular hyperemia, patient preference, and self-projected adherence were assessed at week 12. Adverse events (AEs) were monitored throughout the study. All enrolled patients were included in the analysis (n = 191); the majority of patients (90.6 %, n = 173/191) completed the study. Mean (SD) patient age was 67.5 (11.3) years, and mean baseline IOP was 14.8 mmHg. Mean IOP was reduced by 0.94 mmHg at week 6 and by 1.09 mmHg at week 12 (P glaucoma or ocular hypertension who were intolerant of latanoprost. BAK-free travoprost 0.004 % is a viable alternative for patients who require switching their IOP-lowering medications because of tolerability issues. ClinicalTrials.gov identifier, NCT01510145.

  9. Spontaneous, late, in-the-bag intraocular lens subluxation in a patient with a previous acute angle-closure glaucoma attack.

    Science.gov (United States)

    Su, Wei-Wen; Chang, Shirley H L

    2004-08-01

    Cataract surgery was performed in a 49-year-old woman 16 months after an acute angle-closure glaucoma attack. Zonular dialysis was observed during surgery, but the intraocular lens (IOL) was implanted in the capsular bag uneventfully. At 4 1/2 months, 1 IOL loop wrapped in the bag herniated into the anterior chamber. The patient had no history of trauma. The IOL loop remained in the anterior chamber for 9 months, until the subluxated IOL spontaneously returned to its original position. Six months later, the IOL again dislocated into the anterior chamber.

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

    Directory of Open Access Journals (Sweden)

    Janulevičienė I

    2012-01-01

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

  11. Glaucoma, Open-Angle

    Science.gov (United States)

    ... Specific Prevalence Rates for Glaucoma by Age and Race/Ethnicity The prevalence of glaucoma increases with advancing ... Race/Ethnicity 2010 Prevalence Rates of Glaucoma by Race In 2010, glaucoma affected about 1.9 percent ...

  12. Is Episcleritis Associated to Glaucoma?

    Science.gov (United States)

    Pikkel, Joseph; Chassid, Otzem; Srour, Ward; Busool, Yumna; Vainer, Larisa; Epstein, Irena; Beiran, Itzchak

    2015-12-01

    The aim of this study was to show possible connection between episcleritis and open-angle glaucoma. This was a retrospective study. Data on 21 patients who suffered from episcleritis and had no previous attack of episcleritis or glaucoma were collected for a period of 8 years (from 2004 to 2011). Six of the 21 patients of the study group (28.6%) were diagnosed as suffering from glaucoma. Four patients had a diffuse conjunctival congestion, 1 had sectoral congestion, and for 1 patient there was no record of conjunctival congestion. Two of the 6 patients with episcleritis and glaucoma experienced recurrent episcleritis events during the follow-up period. This study suggests an association between episcleritis and open-angle glaucoma.

  13. Glaucoma Symptoms

    Science.gov (United States)

    ... difference. Support glaucoma research to help find a cure. Give Now About Research Programs Leadership Partners Accountability Careers Research Research We Fund Alzheimer’s Disease Research Program Macular Degeneration Research Program National ...

  14. Bimatoprost 0.01% or 0.03% in patients with glaucoma or ocular hypertension previously treated with latanoprost: two randomized 12-week trials

    Directory of Open Access Journals (Sweden)

    Myers JS

    2014-03-01

    Full Text Available Jonathan S Myers,1 Steven Vold,2 Fiaz Zaman,3 Julia M Williams,4 David A Hollander41Wills Eye Hospital, Philadelphia, PA, USA; 2Vold Vision, PLLC, Bentonville, AR, USA; 3Houston Eye Associates, Houston, TX, USA; 4Allergan, Inc., Irvine, CA, USABackground: The purpose of this study was to evaluate the intraocular pressure (IOP-lowering efficacy and safety of bimatoprost 0.01% or 0.03% as monotherapy in patients treated with latanoprost 0.005% monotherapy who require additional IOP lowering for their ocular hypertension or open-angle glaucoma.Methods: Two prospective, investigator-masked, randomized, parallel-group, multicenter studies enrolled patients with baseline IOP ≥20 mmHg after ≥30 days of latanoprost 0.005% monotherapy. Patients were randomized to 12 weeks of study treatment (study 1, bimatoprost 0.01% once daily or bimatoprost 0.01% once daily plus brimonidine 0.1% three times daily; study 2, bimatoprost 0.03% once daily or bimatoprost 0.03% once daily plus fixed-combination brimonidine 0.2%/timolol 0.5% twice daily. Patient evaluations at weeks 4 and 12 included IOP at 8 am, 10 am, and 4 pm and safety assessments. Results in the monotherapy study arms (bimatoprost 0.01% or 0.03% are presented.Results: Latanoprost-treated baseline mean diurnal IOP (± standard error of the mean was 22.2±0.3 mmHg and 22.1±0.4 mmHg in the bimatoprost 0.01% and bimatoprost 0.03% treatment arms, respectively (P=0.957. In both treatment arms, mean (± standard error of the mean reduction in IOP from latanoprost-treated baseline was statistically significant at each time point at both follow-up visits (P<0.001, ranging from 3.7±0.4 (17.0% mmHg to 4.4±0.4 (19.9% mmHg with bimatoprost 0.01% and from 2.8±0.5 (12.8% mmHg to 3.9±0.5 (16.7% mmHg with bimatoprost 0.03%. Mean percentage IOP reduction from latanoprost-treated baseline was numerically greater with bimatoprost 0.01% than with bimatoprost 0.03% throughout follow-up. The incidence of conjunctival

  15. Modified Descemet’s Stripping Automated Endothelial Keratoplasty: The Use of Ophthalmic Viscoelastic Devices in Hypotonic Eyes That Had Undergone Glaucoma Filtering Surgeries

    Directory of Open Access Journals (Sweden)

    Itaru Oyakawa

    2018-01-01

    Full Text Available Purpose. Descemet’s stripping automated endothelial keratoplasty (DSAEK is more difficult in hypotonic eyes with filtering bleb, due to the difficulties in elevating the intraocular pressure (IOP. We report a new method that uses ophthalmic viscoelastic devices (OVDs to achieve good graft adhesion. Case Presentation. We performed modified DSAEK surgery on 2 eyes of 2 patients, who had previously undergone a trabeculectomy. Both eyes had functioning filtering blebs; the IOP was lower than 10 mmHg without medication. After the graft was inserted into the anterior chamber, the conjunctiva was penetrated, apart from the bleb, using a 30 G needle, and Healon V® was injected into the bleb until the encapsulated space was filled completely. Air was subsequently injected into the anterior chamber to promote the graft attachment to the back surface of the cornea. The IOP was elevated above 40 mmHg in both eyes 1 h after surgery and then decreased to less than 30 mmHg over the subsequent 3 h period. The implanted graft showed good adhesion and no dislocation. Conclusions. Our novel DSAEK procedure that adds one step of OVD injection into the filtering bleb may be useful for hypotonic eyes that had undergone filtering surgeries.

  16. 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....

  17. 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.

  18. Get Tested for Glaucoma!

    Science.gov (United States)

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

  19. Telemedicine screening of glaucoma.

    Science.gov (United States)

    Li, H K; Tang, R A; Oschner, K; Koplos, C; Grady, J; Crump, W J

    1999-01-01

    Glaucoma is a major cause of blindness. More than 80,000 Americans suffer permanent vision loss from the disease. Widespread screening is fundamental in limiting the incidence of glaucoma-associated blindness. This pilot study explored the use of stereo digital images taken at a primary care center for telemedicine review by an off-site specialist as a means of screening for glaucoma. Thirty-two diabetic patients were screened at a family medicine clinic. None had previously been diagnosed with glaucoma. A senior optometry student took stereoscopic digital and 35-mm optic disc photographs with a nonmydriatic retinal camera. The digital images were forwarded to a remote ophthalmologist for review. The conventional color stereo slide pairs of the same eyes were subsequently reviewed for comparison. Agreement on signs of glaucomatous disc changes between the two imaging systems was analyzed. Twenty-six of 32 eyes' digital and 35-mm photographs were analyzed. Six of 32 eyes (18.8%) could not be compared due to lack of matching 35-mm slides or digital images. Out of 26 eyes, lamina cribosa visibility was undeterminable in 8 eyes' digital images and 3 other eyes' 35-mm slides. Agreement among digital images and 35-mm slides of the remaining eyes was: 100%-vertical elongation, barring of vessels, bayoneting of vessels, and drance hemorrhage; 96.2%-focus notching of rim and rim pallor; 93.3%-lamina cribosa visability; 92. 3%-overpass cupping; 88.5%-focal enlargement; 84.6%-parapapillary halo; 80%-nerve fiber visibility; 65.4%-parapapillary atrophy. Parapapillary halo (p = 0.046) and nerve fiber layer visibility (p = 0.18) were detected on some 35-mm slides but not seen on matching digital views. Evaluations of cup-to-disc ratio (C/D) using both methods were in general agreement. However, some digital images were noted as too dark for assessing fine glaucomatous disc changes. Stereo digital images taken with a nonmydriatic camera by nonophthalmic photographers is a

  20. Five Common Glaucoma Tests

    Science.gov (United States)

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

  1. Glaucoma Research Foundation

    Science.gov (United States)

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

  2. Daily Life with Glaucoma

    Science.gov (United States)

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

  3. 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.

  4. 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

  5. Efficacy and Tolerability of Fixed-Combination Brinzolamide/Timolol in Latin American Patients with Open-Angle Glaucoma or Ocular Hypertension Previously on Brimonidine/Timolol Fixed Combination

    OpenAIRE

    Alezzandrini, Arturo; Hubatsch, Douglas; Alfaro, Rene

    2014-01-01

    Introduction Fixed-combination glaucoma medications are commonly used to achieve target intraocular pressure (IOP) reduction in patients uncontrolled with monotherapy; however, ocular discomfort associated with eye drops can decrease adherence. This study assessed the efficacy and tolerability of twice-daily fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC) in Latin American patients transitioned from fixed-combination brimonidine 0.2%/timolol 0.5% (BRIM/TIM-FC) because of insuffi...

  6. 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.

  7. 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...

  8. Efficacy and tolerability of fixed-combination brinzolamide/timolol in Latin American patients with open-angle glaucoma or ocular hypertension previously on brimonidine/timolol fixed combination.

    Science.gov (United States)

    Alezzandrini, Arturo; Hubatsch, Douglas; Alfaro, Rene

    2014-09-01

    Fixed-combination glaucoma medications are commonly used to achieve target intraocular pressure (IOP) reduction in patients uncontrolled with monotherapy; however, ocular discomfort associated with eye drops can decrease adherence. This study assessed the efficacy and tolerability of twice-daily fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC) in Latin American patients transitioned from fixed-combination brimonidine 0.2%/timolol 0.5% (BRIM/TIM-FC) because of insufficient IOP control or treatment intolerance. This 8-week, open-label, prospective study was conducted at six sites in Argentina, Chile, and Mexico. Enrolled patients were aged ≥18 years with open-angle glaucoma (including primary, exfoliative, or pigment-dispersion glaucoma) or ocular hypertension with IOP of 19-35 mmHg in ≥1 eye at baseline (on BRIM/TIM-FC). Patients self-administered BRINZ/TIM-FC to both eyes at 8 a.m. and 8 p.m. daily for 8 weeks. The primary and secondary efficacy endpoints were mean IOP change from baseline at week 8 and percentage of patients achieving target IOP (≤18 mmHg) at week 8, respectively. Exploratory endpoints included patient and investigator preference for treatment at week 8. Adverse events (AEs) were assessed as the safety endpoint. Fifty patients (mean ± SD age, 66.7 ± 11.5 years) received BRINZ/TIM-FC, and 49 were included in the intent-to-treat population. Mean ± SD IOP was significantly reduced from baseline after 8 weeks of treatment with BRINZ/TIM-FC (-3.6 ± 3.0 mmHg; P < 0.0001, Wilcoxon signed-rank test; 17.1% reduction). Overall, 55.3% of patients achieved IOP ≤18 mmHg at week 8. Significantly more patients (89.4%) and investigators (95.7%) preferred BRINZ/TIM-FC to BRIM/TIM-FC (both P < 0.0001, exact binomial test). Of the 13 AEs observed, 8 were related to BRINZ/TIM-FC; the most common treatment-related AEs were eye irritation (n = 4) and abnormal sensation in the eye (n = 2). BRINZ/TIM-FC provides an

  9. 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

  10. Telemedicine model to prevent blindness from familial glaucoma.

    Science.gov (United States)

    Staffieri, Sandra E; Ruddle, Jonathan B; Kearns, Lisa S; Barbour, Julie M; Edwards, Thomas L; Paul, Padma; Mackey, David A

    2011-11-01

    To develop, implement and evaluate a telemedicine model to reduce glaucoma blindness through the early detection of undiagnosed glaucoma in high-risk individuals. Prospective study, private ophthalmology practice and public outpatient clinics in Tasmania. One hundred and thirty-three individuals with primary open-angle glaucoma were invited to enrol their first-degree relatives (FDRs) to undergo an eye examination. Within the study period, 211 FDRs were available for examination. A registered nurse was trained to perform the required assessments. Clinical data were entered into a purpose-built database, converted to a portable document format and graded offsite by an ophthalmologist to determine the presence, absence or risk of developing glaucoma. Participants were notified of the grading result and recommendations for review. Incidence of undiagnosed glaucoma in a high-risk population. Previously undiagnosed glaucoma was identified in 5% of those examined. For every 19 participants screened, one new case of previously undiagnosed case of glaucoma was identified. Additionally 15% of participants showed suspicious signs of glaucoma, and 6% had ocular hypertension. A telemedicine model is an efficient method for screening, grading and notifying participants of examination results. Nurses can be adequately trained to undertake the initial screening examinations, with grading of the results performed offsite by a suitably qualified ophthalmologist. Targeted screening for glaucoma increases the yield of identifying individuals with undiagnosed glaucoma or those at greatest risk. Cost efficiencies for this model of glaucoma screening should be further explored and implemented to prevent blindness from familial glaucoma. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  11. Seasonal Variation in the Incidence of Late-onset Bleb-related Infection After Filtering Surgery in Japan: The Japan Glaucoma Society Survey of Bleb-related Infection Report 3.

    Science.gov (United States)

    Sagara, Hideto; Yamamoto, Tetsuya; Sekiryu, Tetsuju; Ogasawara, Masashi; Tango, Toshiro

    2016-01-01

    To investigate seasonal variations in the incidence of late-onset bleb-related infection after filtering surgery in Japan and the relationship between season and other factors. This multicenter, prospective study is part of a 5-year-long Japan Glaucoma Society survey of bleb-related infection. We analyzed 156 cases of first-time infections (106 men, 50 women) encountered over 5 years to determine the seasonal variation using the Roger test and the relationships between season, sex, and age by logistic regression analysis. We noted significant monthly seasonal variation in the incidence of infection, which was the highest in January and February (23 and 18 infections, respectively; P=0.018) and lowest from August to November (9, 9, 11, and 8 infections, in that order). Multiple logistic regression analysis revealed that infections were most frequent among women in spring (odds ratio, 8.43; P=0.005). Staphylococcus aureus and Streptococcus spp. infections were more frequent in warmer seasons than in winter. Less virulent species, namely, coagulase-negative Staphylococcus spp., Corynebacterium spp., and Enterococcus spp., were frequently detected in winter. Coagulase-negative Staphylococcus spp. and Haemophilus influenzae were more frequent in women and men, respectively. The incidence of late-onset bleb-related infection showed significant seasonal variation and sex differences. The climate in Japan may influence the incidence of bleb-related infection. Moreover, besides climate, physical activity level and lifestyle may contribute to the seasonal variation in the incidence and sex differences in the involved bacterial agents of bleb-related infections in Japan.

  12. The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences ...

    African Journals Online (AJOL)

    BACKGROUND: 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. METHODS: A retrospective review was conducted on the charts of consecutive ...

  13. Screening for Glaucoma

    Science.gov (United States)

    ... African Americans and older adults, talk to their primary care clinician or eye care specialist for advice about glaucoma screening. Glaucoma is a serious disease that affects the health and quality of life of millions of Americans. The Task Force encourages ...

  14. Glaucoma in Asian Populations

    Science.gov (United States)

    ... is expected to become an even more serious problem as the world population and longevity increases. The other major glaucoma type ... of all cases of blindness from glaucoma in China. There is great racial diversity among Asian populations, and these differences are represented in the presentation ...

  15. [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.

  16. Does Your Child Have Glaucoma?

    Science.gov (United States)

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

  17. New Tool to Predict Glaucoma

    Science.gov (United States)

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

  18. Diabetes and Your Eyesight (Glaucoma)

    Science.gov (United States)

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

  19. Animal Models of Glaucoma

    Directory of Open Access Journals (Sweden)

    Rachida A. Bouhenni

    2012-01-01

    Full Text Available Glaucoma is a heterogeneous group of disorders that progressively lead to blindness due to loss of retinal ganglion cells and damage to the optic nerve. It is a leading cause of blindness and visual impairment worldwide. Although research in the field of glaucoma is substantial, the pathophysiologic mechanisms causing the disease are not completely understood. A wide variety of animal models have been used to study glaucoma. These include monkeys, dogs, cats, rodents, and several other species. Although these models have provided valuable information about the disease, there is still no ideal model for studying glaucoma due to its complexity. In this paper we present a summary of most of the animal models that have been developed and used for the study of the different types of glaucoma, the strengths and limitations associated with each species use, and some potential criteria to develop a suitable model.

  20. 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

  1. 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 ...

  2. 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.

  3. 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.

  4. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... and silently clouds vision, without any pain. Photo courtesy of NEI Glaucoma Symptoms At first, open-angle ... steady rate for up to a month. Photo courtesy of: Peter Mallen, Massachusetts Eye and Ear Laboratory/ ...

  5. African Americans and Glaucoma

    Science.gov (United States)

    ... Americans are still unknown. However, research shows that African Americans are genetically more at risk for glaucoma, making early detection and treatment all the more important. In studies such as the Baltimore Eye Survey and the ...

  6. [Translaminar Gradient and Glaucoma].

    Science.gov (United States)

    Čmelo, J

    2017-01-01

    The cribriform plate is a threshold of the intraocular pressure (VOT) and of the intracranial pressure (IKT). The difference between the VOT and IKT is referred to as translaminar gradient (TLG). The goal was to evaluate the Glaucoma progression (visual field, fundus examination, HRT) with / without topical anti-glaucomatous therapy) in relation to the TLG. the significance of TLG has been studied in two groups. I. Group: 57 patients diagnosed and treatment of Primary Open-Angle Glaucoma (PGOU), 10 patients with Ocular hypertension (OH), 7 patients with Normal-Tension Glaucoma (NTG), and 75 healthy without glaucoma. The examinations of TLG were carried out once and retrospectively. In II. group there were prospectively studied 14 patients with OH and 24 patients with newly detected PGOU without local therapy. The examinations were performed 4 times at intervals of 10 to 11 months. All tests included a basic eye examination, ORA tonometry, HRT examination, gonioscopy, Color Doppler sonography of blood vessels of the eye and orbit. Venous pulsation pressure (VPT) has been recorded by the Ophthalmodynamometer Meditron (D-ODM). In case of spontaneous retinal venous pulsation, VPT was considered as the same pressure as the VOT. The TLG was calculated with formula of Querfurth: ICT = 0.29 + 0.74 (VOT / PI (AO)). [PI(AO) - Pulsatility index of the Ophthalmic artery (AO)]. I. group: TLG was in the control group without Glaucoma: 12.2 ± 2.0 torr. The NTG group: 9.0 ± 1.70 mm Hg. PGOU: 11.1 ± 1.91 mm Hg. OH: 12.6 ± 0.85 mm Hg. IKT alone does not show a significant relationship to the presence of glaucoma, ocular hypertension. II. Group: The average TLG in Ocular Hypertension (14 patients) has been 3.8 ± 1.2 torr. 2 patients (OH) had TLG 10 torr. and 15 torr. After 4 years in one of them (TLG = 15 torr.) there was recorded Glaucoma progression. In the PGOU group before antiglaucoma therapy, TLG was 15.0 ± 4.8 torr for all patients. After setting up local anti-glaucoma

  7. 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

  8. Snoring and Glaucoma

    Science.gov (United States)

    Wang, Ya Xing; Xu, Liang; Li, Jian Jun; Yang, Hua; Zhang, Ya Qin; Jonas, Jost B.

    2014-01-01

    Purpose To examine a potential association between snoring and glaucoma in a population-based setting. Methods The population-based Beijing Eye Study 2011 included 3468 subjects with an age of 50+ years. The participants underwent a detailed ophthalmic examination. Glaucoma was determined according to the ophthalmoscopic appearance of the optic nerve head. Snoring assessed in an interview was graded into “severe snoring”, “moderate snoring”, and “no snoring”. Results Data on snoring and glaucoma were available for 3146 subjects. Snoring was reported for 1787 (66.8%) subjects, with moderate snoring reported for 1384 (44.0%) subjects and severe snoring for 403 (12.8%) subjects. In multivariate analysis, prevalence of severe snoring was significantly associated with male gender (P = 0.002; regression coefficient B: 0.36; Odds ratio (OR): 1.44 (95% confidence interval (CI): 1.14, 1.81)), higher body mass index (Psnoring was neither significantly associated with the prevalence of angle-closure glaucoma (P = 0.65), retinal vein occlusions (P = 0.24), neuroretinal rim area (P = 0.19), retinal nerve fiber layer thickness (P = 0.16) nor vertical cup/disc ratio (P = 0.64). Conclusions Severe snoring was not significantly associated with the prevalence of open-angle glaucoma, angle-closure glaucoma or retinal vein occlusions after adjustment for age, gender, body mass index, systolic blood pressure and cognitive function score. Our population-based study did not reveal that snoring was a risk factor for glaucoma and thus did not provide a reason to assess or to treat snoring in patients with glaucoma. PMID:24551196

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. Ab Interno Trabeculectomy With the Trabectome as a Valuable Therapeutic Option for Failed Filtering Blebs.

    Science.gov (United States)

    Wecker, Thomas; Neuburger, Matthias; Bryniok, Laura; Bruder, Kathrin; Luebke, Jan; Anton, Alexandra; Jordan, Jens F

    2016-09-01

    Uncontrolled intraocular pressure (IOP) after glaucoma filtration surgery is a challenging problem in the management of glaucoma patients. The Trabectome is a device for selective electroablation of the trabecular meshwork through a clear cornea incision without affecting the conjunctiva. Minimally invasive glaucoma surgery using the Trabectome is safe and effective as primary glaucoma surgery. Here we investigate the results of ab interno trabeculectomy with the Trabectome for IOP control in patients with a failed filtering bleb. A total of 60 eyes of 60 consecutive patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) were enrolled in this single center observational study. Trabectome surgery was performed alone or in combination with phacoemulsification by 2 experienced surgeons. IOP readings and number of IOP lowering medication as primary outcome parameters were taken by an independent examiner. Intraoperative and postoperative medication were recorded systematically. Mean IOP before surgery was 24.5±3.5 mm Hg and decreased to 15.7±3.4 (-36%) after mean follow-up of 415 days. The number of necessary IOP lowering medication dropped from 2.1±1.3 to 1.8±1.2 (14% reduction from baseline). A total of 25% (n=15) of cases reported here needed additional surgery after 517 days (range: 6 to 1563 d). No major complications were observed. After mean follow-up, we found a qualified success rate for PXG of 87% and 50% for POAG as revealed by the Kaplan-Meier analysis according to the definitions for success in advanced glaucoma cases according to the World Glaucoma Association (40% reduction from baseline IOP and maximum IOP of 15 mm Hg). Trabectome surgery for uncontrolled IOP after trabeculectomy is safe and effective especially in PXG patients. Given the demanding subgroup of patients studied here, it is not surprising that success rates are lower compared with previous studies investigating the Trabectome for primary glaucoma surgery

  14. Patient-Physician Communication on Medication Cost during Glaucoma Visits.

    Science.gov (United States)

    Slota, Catherine; Davis, Scott A; Blalock, Susan J; Carpenter, Delesha M; Muir, Kelly W; Robin, Alan L; Sleath, Betsy

    2017-12-01

    This article is the first to investigate the nature of medication cost discussions between ophthalmologists and glaucoma patients. Only 87 of the 275 office visits analyzed had a discussion of medication cost. Providers should consider discussing medication cost with patients to identify potential cost-related barriers to medication use. Glaucoma is an incurable chronic eye disease affecting a growing portion of the aging population. Some of the most commonly utilized treatments require lifelong use, requiring high patient adherence to ensure effectiveness. There are numerous barriers to glaucoma treatment adherence in the literature, including cost. The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. This was a mixed-methods secondary analysis of video-recorded participant office visits (n = 275) from a larger observational study of glaucoma communication. We analyzed medical information, demographic characteristics, and interviewer-administrated questionnaires, as well as verbatim transcripts of interviews. Only 87 participants discussed medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51%), took one glaucoma medication (63%), and had Medicare (49%) as well as a form of prescription insurance (78%). The majority of glaucoma office visits did not discuss medication cost, and providers often did not ask about cost problems. Of the few conversations related to cost, most focused on providers offering potential solutions (n = 50), medical and prescription service coverage (n = 41), and brand or generic medication choices (n = 41). Our findings are similar to previous studies showing few patients have conversations with providers about the cost of glaucoma medications. Providers should consider bringing up medication cost during glaucoma office visits to prompt a discussion of

  15. THE GONIOSETON, A SURGICAL-TREATMENT FOR CHRONIC GLAUCOMA

    NARCIS (Netherlands)

    VANDERVEEN, G; JONGEBLOED, WL; WORST, JGF

    1990-01-01

    A new and simple technique for glaucoma filtering surgery is presented. It is based on the introduction of a stainless steel microspiral or gonioseton into a goniopuncture by way of an ab interno procedure, minimising surgical trauma to the filtration area. Preliminary results are presented.

  16. Does Marijuana Help Treat Glaucoma?

    Science.gov (United States)

    ... Ophthalmologist Patient Stories Español Eye Health / Tips & Prevention Marijuana Sections Does Marijuana Help Treat Glaucoma? Why Eye ... Don't Recommend Marijuana for Glaucoma Infographic Does Marijuana Help Treat Glaucoma? Leer en Español: La marihuana ...

  17. 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.

  18. Prevalence of posterior vitreous detachment in glaucoma patients and controls.

    Science.gov (United States)

    Schwab, Christoph; Glatz, Wilfried; Schmidt, Bernd; Lindner, Ewald; Oettl, Karl; Riedl, Regina; Wedrich, Andreas; Ivastinovic, Domagoj; Velikay-Parel, Michaela; Mossboeck, Georg

    2017-05-01

    To evaluate the impact of oxidative stress - present in glaucoma - on the vitreous. We therefore compare the presence of early and late stages of posterior vitreous detachment (PVD) between patients with glaucoma and controls. The vitreous state was evaluated by the combination of optical coherence tomography and ultrasound. The main outcome was the vitreous state classified into 'no PVD', 'initial PVD' and 'advanced PVD'. We evaluated the vitreous state in 48 patients with glaucoma (age: mean 66.5 ± 11.9 years; visual field deviation: mean 10.4 ± 6.8 dB) and compared the results with 101 previously investigated controls (age: mean 73.6 ± 9.3 years). After one-to-one matching on age and sex, ordinal logistic regression revealed that patients with glaucoma were significantly more likely to exhibit advanced PVD stages compared to non-glaucoma patients (OR 2.60, 95% confidence interval: 1.06-6.36, p = 0.037). Our results suggest that the presence or absence of PVD might be a valuable hint for diagnosing glaucoma - however, further research is needed to determine whether PVD can be used to supplement current glaucoma screening guidelines. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. 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

  20. 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.

  1. 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.

  2. Trabeculoplastia selectiva con láser en glaucoma primario de ángulo cerrado Use of selective laser trabeculoplasty in primary closed angle glaucoma

    Directory of Open Access Journals (Sweden)

    Ailen Garcés Fernández

    2010-06-01

    -communicable chronic diseases prevailed. After six months, the reduction of intraocular pressure amounted to 41,2%. In those patients with a history of previous filtering surgery, the use of this technique showed results very similar to those of the non-operated patients. The therapy proved to be effective in 88% of eyes and the medical hypotensive treatment was reduced. Some adverse events were blood pressure peaks, corneal epitheliopathy and pigment dispersion. CONCLUSIONS: Laser technique was effective to control blood pressure and/or reduction of ocular anti-hypertensive medical therapy in this type of patients.

  3. 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.

  4. The prevalence of glaucoma in the Melbourne Visual Impairment Project.

    Science.gov (United States)

    Wensor, M D; McCarty, C A; Stanislavsky, Y L; Livingston, P M; Taylor, H R

    1998-04-01

    The purpose of the study was to determine the prevalence of glaucoma in Melbourne, Australia. All subjects were participants in the Melbourne Visual Impairment Project (Melbourne VIP), a population-based prevalence study of eye disease that included residential and nursing home populations. Each participant underwent a standardized eye examination, which included a Humphrey Visual Field test, applanation tonometry, fundus examination including fundal photographs, and a medical history interview. Glaucoma status was determined by a masked assessment and consensus adjudication of visual fields, optic disc photographs, intraocular pressure, and glaucoma history. A total of 3271 persons (83% response rate) participated in the residential Melbourne VIP. The overall prevalence rate of definite primary open-angle glaucoma in the residential population was 1.7% (95% confidence limits = 1.21, 2.21). Of these, 50% had not been diagnosed previously. Only two persons (0.1%) had primary angle-closure glaucoma and six persons (0.2%) had secondary glaucoma. The prevalence of glaucoma increased steadily with age from 0.1% at ages 40 to 49 years to 9.7% in persons aged 80 to 89 years. There was no relationship with gender. The authors examined 403 (90.2% response rate) nursing home residents. The age standardized rate for this component was 2.36% (95% confidence limits = 0, 4.88). The rate of glaucoma in Melbourne rises significantly with age. With only half of patients being diagnosed, glaucoma is a major eye health problem and will become increasingly important as the population ages.

  5. Surgical outcomes of membrane-tube-type glaucoma shunt device in indigenous West Africans

    OpenAIRE

    Olawoye, Olusola; Sarimiye, Tarela; Ashaye, Adeyinka; Hwang, Young Hoon; Han, Jong Chul; Ahn, Byung Heon

    2018-01-01

    Purpose The aim of this study was to report the safety and efficacy of the membrane-tube (MT)-type glaucoma shunt device (Finetube MT) in the management of refractory glaucoma in indigenous West Africans. Methods The Finetube MT was implanted into 25 eyes of 25 West African patients with refractory glaucoma. These patients had inadequate intraocular pressure (IOP) control despite maximum tolerable IOP-lowering medications with or without previous ocular surgeries. IOP, postoperative complicat...

  6. 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

  7. 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:

  8. Pesquisaje de glaucoma

    Directory of Open Access Journals (Sweden)

    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.

  9. open angle glaucoma (poag)?

    African Journals Online (AJOL)

    there is a build up of pressure due to poor outflow of aqueous humor. The outflow obstruction could occur at the trabecular meshwork of the anterior chamber angle or subsequently in the episcleral vein due to raised venous pressure. Such build up of pressure results in glaucoma . Elevated intraocular pressure remains the ...

  10. 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 ...

  11. [Corneal endothelium in glaucoma].

    Science.gov (United States)

    Stefan, C; Nicolae, Miruna; Pop, Adina

    2012-01-01

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

  12. Challenges in Glaucoma Management

    African Journals Online (AJOL)

    James Standefer

    is urban oriented, leaving millions in the countryside without ophthalmic care. The utilization of the public health model is not only appropriate but also necessary in these situations. Reluctance to Treat. Many ophthalmologists, even those with good clinical skills, are reluctant to care for glaucoma patients. Surgical treatment ...

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

    Science.gov (United States)

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

  14. Genetics Home Reference: early-onset glaucoma

    Science.gov (United States)

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

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

    Science.gov (United States)

    Hoguet, Ambika; Grajewski, Alana; Hodapp, Elizabeth; Chang, Ta Chen Peter

    2016-02-01

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

  16. 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

  17. Retrospective analysis of the risk factors for developing phacomorphic glaucoma

    Directory of Open Access Journals (Sweden)

    Jacky W Y Lee

    2011-01-01

    Full Text Available Aim : To determine the risk factors for developing phacomorphic glaucoma in eyes with mature cataracts. Materials and Methods : This is a case-control study comprising of 90 eyes with phacomorphic glaucoma and 90 age- and sex-matched control eyes with mature cataracts without phacomorphic glaucoma. Patients with pre-existing glaucoma, previous intraocular surgery and /or absence of documented axial lengths were excluded from this study. Binary logistic regression analysis of the variables, axial length and anterior chamber depth, was performed. Anterior chamber depth of the contralateral eye was used as a proxy measure of the pre-phacomorphic state in the eye with phacomorphic glaucoma as majority of them first presented to our center during the phacomorphic attack without prior measurements of the pre-phacomorphic ACD or lens thickness; therefore, their anterior chamber depth would not be representative of their pre-phacomorphic state. Axial length of 23.7 mm was selected as a cut-off for dichotomized logistic regression based on the local population mean from published demographic data. Results : The mean age was 73.1 ± 10.2 years. All phacomorphic and control eyes were ethnic Chinese. The mean presenting intraocular pressures were 49.5 ± 11.8 mmHg and 16.7 ± 1.7 mmHg in the phacomorphic and control eyes respectively (P 23.7 mm (P = 0.003. Conclusion : Axial length less than ≤ 23.7 mm was a risk factor for developing phacomorphic glaucoma. Eyes with AL shorter than the population mean were 4.3 times as likely to develop phacomorphic glaucoma compared with eyes with longer than average AL. In an area where phacomorphic glaucoma is prevalent and medical resources are limited, patients with AL shorter than their population mean may be considered for earlier elective cataract extraction as a preventive measure.

  18. WHITE ANNULAR RETINAL DYSTROPHY WITH SEVERE GLAUCOMA A New Autosomal Dominant Condition

    NARCIS (Netherlands)

    Morizot, Rodrigo; van Schooneveld, Mary J.; Morizot, Eduardo

    2016-01-01

    Purpose:To report a family with a previously unreported characteristic retinal dystrophy and glaucoma.Methods:Seven family members were diagnosed with an atypical retinal dystrophy and open-angle glaucoma with rapid evolution. Ophthalmic examination, fluorescein angiography, color photography, optic

  19. 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.

  20. 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

  1. Evaluation of the Efficacy and Safety of the New Susanna Glaucoma Drainage Device in Refractory Glaucomas: Short-term Results.

    Science.gov (United States)

    Biteli, Luis G; Prata, Tiago S; Gracitelli, Carolina P B; Kanadani, Fábio N; Villas Boas, Flávia; Hatanaka, Marcelo; Paranhos Junior, Augusto

    2017-04-01

    To assess the efficacy and safety of the new Susanna glaucoma drainage device (SGDD) in patients with neovascular and refractory glaucomas. In this prospective study, patients with neovascular glaucoma or refractory glaucomas (defined as eyes with previous trabeculectomy failure) were enrolled. All eyes had to have intraocular pressure (IOP) above 21 mm Hg despite maximum tolerated topical medication, or recent documentation of anatomic and/or functional progression. Patients underwent glaucoma surgery with the new SGDD in a standardized manner. Postoperative visits were performed at days 1 and 7; months 1, 3, and 6; and every 6 months thereafter. Preoperative and postoperative IOP, number of antiglaucoma medications, surgical complications, and any subsequent related events were recorded. Success criteria were: (I) IOP≥6 and ≤21 mm Hg; (II) IOP≥6 and ≤18 mm Hg. Each criterion was classified as complete (without medication) or qualified (with medication). A total of 58 patients with a mean age of 64.3±11.5 years were included [19 with neovascular glaucoma (group 1) and 39 with failure of first trabeculectomy (group 2)]. Overall, mean follow-up was 7.1±3.8 months, and mean IOP was reduced from 31.5±1.6 (range, 18 to 68) mm Hg to 12.6±0.7 (range, 2 to 28) mm Hg at the last follow-up visit (Pglaucomas, with minor postoperative complications in the short-term.

  2. Mucogenic glaucoma in a child

    Directory of Open Access Journals (Sweden)

    Ta C. Chang

    2017-04-01

    Conclusions and importance: This is the first reported case of mucogenic glaucoma in a pediatric patient. This rare entity should remain on the differential diagnoses of childhood glaucoma associated with nonacquired ocular anomalies. Surgical excision of the iris cyst may be curative.

  3. The medical management of glaucoma

    African Journals Online (AJOL)

    pathophysiology and focuses on the pharmacological options available in the treatment of glaucoma. Keywords: Glaucoma, prostaglandin .... derivatives which reduces aqueous humour production independent to its diuretic mode of .... provide a basis for potential future treatment strategies.32. Table 2. Currently available ...

  4. Dry Eyes and Glaucoma: Double Trouble

    Science.gov (United States)

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

  5. 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.

  6. Baerveldt implant for secondary glaucoma due to iris melanoma

    OpenAIRE

    Annelie N Tan; Juliette GMM Hoevenaars; Carroll AB Webers; et al

    2010-01-01

    Annelie N Tan1, Juliette GMM Hoevenaars1, Carroll AB Webers1, Bertil Damato2, Henny JM Beckers11University Eye Clinic, Maastricht, The Netherlands; 2Ocular Oncology Service Royal Liverpool University Hospital, Liverpool, United KingdomBackground: Proton beam therapy (PBT) is effective in the treatment of iris melanoma. Reported complications after PBT are radiation-induced cataract and raised intraocular pressure (IOP). Filtering glaucoma surgery has generally been avoided because of fears of...

  7. Experimentally Induced Mammalian Models of Glaucoma

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    Makoto Ishikawa

    2015-01-01

    Full Text Available A wide variety of animal models have been used to study glaucoma. Although these models provide valuable information about the disease, there is still no ideal model for studying glaucoma due to its complex pathogenesis. Animal models for glaucoma are pivotal for clarifying glaucoma etiology and for developing novel therapeutic strategies to halt disease progression. In this review paper, we summarize some of the major findings obtained in various glaucoma models and examine the strengths and limitations of these models.

  8. Hypothyroidism and Glaucoma in The United States

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    Kakigi, Caitlin; Kasuga, Toshimitsu; Wang, Sophia Y.; Singh, Kuldev; Hiratsuka, Yoshimune; Murakami, Akira; Lin, Shan C.

    2015-01-01

    Purpose To investigate the association between hypothyroidism and glaucomatous disease. Methods This cross-sectional study included all subjects above the age of 40 years from two nationwide surveys: the 2008 National Health Interview Survey (NHIS) as well as the 2007 and 2008 National Health and Nutrition Examination Survey (NHANES). The presence or absence of glaucoma, thyroid disease and other demographic and health-related information including comorbidities was ascertained via interview. Blood samples were collected from NHANES subjects and analyzed for thyrotropin (TSH). Results A total of 13,599 and 3,839 NHIS and NHANES participants respectively were analyzed to assess for a possible relationship between self-reported glaucoma, and self-reported hypothyroidism as well as self-reported thyroid disease. The unadjusted odds ratio (OR) for NHIS showed a significant association between self-reported glaucoma and self-reported hypothyroidism (OR 1.46, 95% confidence interval [CI] 1.07-1.99). Multivariate logistic regression analysis adjusted for age, gender, race, comorbidities, and health-related behavior, however, showed no association between self-reported glaucoma and hypothyroidism or thyroid disease in both surveys (OR 1.60, 95%CI 0.87-2.95 for NHIS; OR 1.05, 95%CI 0.59-1.88 for NHANES). Conclusion A previously reported association between hypothyroidism and glaucomatous disease was not confirmed in two large U.S. health survey populations. While such an association was noted in the univariate analysis for the NHIS survey, such a relationship was not found in the multivariate analysis after adjustment for potential confounding variables. PMID:26230664

  9. Hypothyroidism and Glaucoma in The United States.

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    Caitlin Kakigi

    Full Text Available To investigate the association between hypothyroidism and glaucomatous disease.This cross-sectional study included all subjects above the age of 40 years from two nationwide surveys: the 2008 National Health Interview Survey (NHIS as well as the 2007 and 2008 National Health and Nutrition Examination Survey (NHANES. The presence or absence of glaucoma, thyroid disease and other demographic and health-related information including comorbidities was ascertained via interview. Blood samples were collected from NHANES subjects and analyzed for thyrotropin (TSH.A total of 13,599 and 3,839 NHIS and NHANES participants respectively were analyzed to assess for a possible relationship between self-reported glaucoma, and self-reported hypothyroidism as well as self-reported thyroid disease. The unadjusted odds ratio (OR for NHIS showed a significant association between self-reported glaucoma and self-reported hypothyroidism (OR 1.46, 95% confidence interval [CI] 1.07-1.99. Multivariate logistic regression analysis adjusted for age, gender, race, comorbidities, and health-related behavior, however, showed no association between self-reported glaucoma and hypothyroidism or thyroid disease in both surveys (OR 1.60, 95%CI 0.87-2.95 for NHIS; OR 1.05, 95%CI 0.59-1.88 for NHANES.A previously reported association between hypothyroidism and glaucomatous disease was not confirmed in two large U.S. health survey populations. While such an association was noted in the univariate analysis for the NHIS survey, such a relationship was not found in the multivariate analysis after adjustment for potential confounding variables.

  10. Aqueous shunts for glaucoma.

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    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

  11. Management of neovascular glaucoma.

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    Ajvazi, Halil; Goranci, Ilhami; Lutaj, Pajtim

    2013-01-01

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

  12. Acupuncture for glaucoma.

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    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

  13. What's new in glaucoma treatment?

    OpenAIRE

    2006-01-01

    Glaucoma treatment: the state of the evidenceInterventions for the treatment of different forms of glaucoma have been tried and tested for many years. The idea that lowering the pressure might be helpful was first proposed more than a hundred years ago. By the 1950s, it was established that raised intraocular pressure (IOP) was glaucoma, and vice versa. However, in the mid 1960s, Fred Hollows and Peter Graham demolished that simple concept by revealing that there were many people in the popul...

  14. Evaluation of a glaucoma patient

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    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.

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

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    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.

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

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    Saija J Ahonen

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

  17. Baerveldt implant for secondary glaucoma due to iris melanoma

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    Annelie N Tan

    2010-05-01

    Full Text Available Annelie N Tan1, Juliette GMM Hoevenaars1, Carroll AB Webers1, Bertil Damato2, Henny JM Beckers11University Eye Clinic, Maastricht, The Netherlands; 2Ocular Oncology Service Royal Liverpool University Hospital, Liverpool, United KingdomBackground: Proton beam therapy (PBT is effective in the treatment of iris melanoma. Reported complications after PBT are radiation-induced cataract and raised intraocular pressure (IOP. Filtering glaucoma surgery has generally been avoided because of fears of seeding.Case report: A 37-year-old man presented with a self-discovered, pigmented lesion on his right iris. Four years later, the pigmented lesion was diagnosed as an iris melanoma, because of documented growth. The patient was treated with PBT but developed secondary glaucoma one month later. The IOP could not be controlled despite maximal medical therapy and selective laser trabeculoplasty (SLT. Finally, Baerveldt implant surgery was performed, resulting in an IOP lowering to 10 mmHg and stabilization of the glaucomatous visual field loss.Conclusion: Our case demonstrates that Baerveldt implant surgery is a reasonable therapy for glaucoma following successful radiotherapy of iris melanoma.Keywords: iris melanoma, proton beam therapy, secondary glaucoma, Baerveldt implant surgery

  18. WHITE ANNULAR RETINAL DYSTROPHY WITH SEVERE GLAUCOMA: A New Autosomal Dominant Condition.

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    Morizot, Rodrigo; van Schooneveld, Mary J; Morizot, Eduardo

    2016-03-01

    To report a family with a previously unreported characteristic retinal dystrophy and glaucoma. Seven family members were diagnosed with an atypical retinal dystrophy and open-angle glaucoma with rapid evolution. Ophthalmic examination, fluorescein angiography, color photography, optic coherence tomography, central visual-field examination, and ultrasonography were performed. Of the 7 patients, 3 had 360° of peripheral white retina and a broad white ring around the optic disc. In three others, it was not possible to observe the peripheral retina, but they also showed a white retinal ring around the optic disc. One patient showed posterior synechiae and iris neovascularization in one eye. The 37-year-old uncle of the proband had a probably related maculopathy. Five patients had severe glaucoma, and the youngest showed borderline intraocular pressure. The authors report a new dominant retinal dystrophy associated with open-angle glaucoma. The early onset and rapidly progressive glaucoma of the patients is atypical.

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

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    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.

  20. Scanning laser polarimetry in glaucoma.

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    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.

  1. The efficacy of Ahmed glaucoma valve drainage devices in cases of adult refractory glaucoma in Indian eyes

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    Parihar, Jitendra K S; Vats, Devendra P; Maggon, Rakesh; Mathur, Vijay; Singh, Anirudh; Mishra, Sanjay K

    2009-01-01

    Aim: To evaluate the efficacy of Ahmed glaucoma valve (AGV) drainage devices in cases of adult refractory glaucoma in Indian eyes. Settings and Design: Retrospective interventional case series study. Materials and Methods: Fifty two eyes of 32 patients of refractory glaucoma in the age group of 35 to 60 years who underwent AGV implantation with or without concomitant procedures from January 2003 to Jan 2007 were studied. Of these, 46 eyes (88%) had undergone filtering surgery earlier whereas remaining eyes underwent primary AGV implantation following failure of maximal medical therapy. The follow up ranged between 12 months to 48 months Results: Eighteen eyes (35%) had undergone phacoemulsification with AGV implantation, penetrating keratoplasty (PK) with AGV and intraocular lens (IOL) implantation in 13 eyes (25%), AGV over preexisting IOL in eight eyes (15%). AGV implantation alone was done in six (11%) eyes. Anterior chamber (AC) reconstruction with secondary IOL and AGV was performed in the remaining eyes. The mean intra ocular pressure (IOP) decreased from 36.3 ± 15.7 mm Hg to 19.6 ± 9.2 mm Hg. Complete success as per criteria was achieved in 46 eyes (88%). None of the eyes had failure to maintain IOP control following AGV. Conclusion: The AGV resulted in effective and sustained control of IOP in cases of adult refractory glaucoma in intermediate follow up. PMID:19700871

  2. The efficacy of Ahmed glaucoma valve drainage devices in cases of adult refractory glaucoma in Indian eyes

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    Parihar Jitendra

    2009-01-01

    Full Text Available Aim: To evaluate the efficacy of Ahmed glaucoma valve (AGV drainage devices in cases of adult refractory glaucoma in Indian eyes. Settings and Design: Retrospective interventional case series study. Materials and Methods : Fifty two eyes of 32 patients of refractory glaucoma in the age group of 35 to 60 years who underwent AGV implantation with or without concomitant procedures from January 2003 to Jan 2007 were studied. Of these, 46 eyes (88% had undergone filtering surgery earlier whereas remaining eyes underwent primary AGV implantation following failure of maximal medical therapy. The follow up ranged between 12 months to 48 months Results: Eighteen eyes (35% had undergone phacoemulsification with AGV implantation, penetrating keratoplasty (PK with AGV and intraocular lens (IOL implantation in 13 eyes (25%, AGV over preexisting IOL in eight eyes (15%. AGV implantation alone was done in six (11% eyes. Anterior chamber (AC reconstruction with secondary IOL and AGV was performed in the remaining eyes. The mean intra ocular pressure (IOP decreased from 36.3 ± 15.7 mm Hg to 19.6 ± 9.2 mm Hg. Complete success as per criteria was achieved in 46 eyes (88%. None of the eyes had failure to maintain IOP control following AGV. Conclusion: The AGV resulted in effective and sustained control of IOP in cases of adult refractory glaucoma in intermediate follow up.

  3. Prevalent practice patterns in glaucoma: Poll of Indian ophthalmologists at a national conference

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    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.

  4. Combining morphometric features and convolutional networks fusion for glaucoma diagnosis

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    Perdomo, Oscar; Arevalo, John; González, Fabio A.

    2017-11-01

    Glaucoma is an eye condition that leads to loss of vision and blindness. Ophthalmoscopy exam evaluates the shape, color and proportion between the optic disc and physiologic cup, but the lack of agreement among experts is still the main diagnosis problem. The application of deep convolutional neural networks combined with automatic extraction of features such as: the cup-to-disc distance in the four quadrants, the perimeter, area, eccentricity, the major radio, the minor radio in optic disc and cup, in addition to all the ratios among the previous parameters may help with a better automatic grading of glaucoma. This paper presents a strategy to merge morphological features and deep convolutional neural networks as a novel methodology to support the glaucoma diagnosis in eye fundus images.

  5. Glaucoma history and risk factors.

    Science.gov (United States)

    McMonnies, Charles W

    Apart from the risk of developing glaucoma there is also the risk that it is not detected and irreversible loss of vision ensues. Some studies of methods of glaucoma diagnosis have examined the results of instrument-based examinations with great if not complete reliance on objective findings in arriving at a diagnosis. The very valuable advances in glaucoma detection instrument technologies, and apparent increasing dependence on them, may have led to reduced consideration of information available from a patient history in those studies. Dependence on objective evidence of glaucomatous pathology may reduce the possibility of detecting glaucoma suspects or patients at risk for becoming glaucoma suspects. A valid positive family history of glaucoma is very valuable information. However, negative family histories can often be unreliable due to large numbers of glaucoma cases being undiagnosed. No evidence of family history is appropriate rather than no family history. In addition the unreliability of a negative family history is increased when patients with glaucoma fail to inform their family members. A finding of no family history can only be stated as no known family history. In examining the potential diagnostic contribution from a patient history, this review considers, age, frailty, race, type and degree of refractive error, systemic hyper- and hypotension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication interactions and side effects, the degree of exposure to intraocular and intracranial pressure elevations and fluctuations, smoking, and symptoms in addition to genetics and family history of the disease. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  6. 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

  7. 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.

  8. Frequency of unplanned interventions in patients attending for a presumed routine glaucoma follow-up appointment.

    Science.gov (United States)

    Calafati, Jennifer; Pradhan, Zia S; Birt, Catherine M

    2016-12-01

    To determine the frequency of patient visits in which an unplanned treatment modification was required in chronic patients attending a glaucoma clinic for routine follow-up and to identify the treatment interventions most commonly employed. Prospective, cross-sectional study. A total of 630 previously stable patients attending a glaucoma clinic for routine follow-up. This was a single-centre survey of all eligible patients returning to an academic glaucoma clinic. Data regarding whether patients' visit remained routine or required intervention, which clinical parameter had changed, and any alterations in treatment regimens were studied. The percentage of patients found to require a change in management was 20.79% (131 of 630 patients); 16.9% were found to have a cause for change because of glaucoma, and the remaining 4% required intervention because of a nonglaucomatous condition. The most common parameter that changed treatment was intraocular pressure (43.87%), followed by visual fields (21.29%). The frequency of abnormal parameters varied within each subtype of glaucoma. The frequency of treatment changes among those with primary open-angle glaucoma was 22.58% compared with 16.5% of glaucoma suspects, 14% of ocular hypertensives, 32% of pseudoexfoliative glaucoma, and 50% of normal tension glaucoma patients. The most common intervention (32.84%) was a change in antiglaucoma medications. The next most frequent interventions were laser procedures (21.90%) and surgery (16.06%). This study suggests that a significant minority of patients attending a glaucoma clinic for a routine appointment require treatment modification. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  9. Study on the deformations of the lamina cribrosa during glaucoma.

    Science.gov (United States)

    Tian, Hanjing; Li, Long; Song, Fan

    2017-06-01

    The lamina cribrosa is the primary site of optic nerve injury during glaucoma, and its deformations induced by elevated intraocular pressure are associated directly with the optic nerve injury and visual field defect. However, the deformations in a living body have been poorly understood yet so far. It is because that integral observation and precise measurement of the deformations in vivo are now almost impossible in the clinical diagnosis and treatment of glaucoma. In the present study, a new mechanical model of the lamina cribrosa is presented by using Reissner's thin plate theory. This model accurately displays the stress and deformation states in the lamina cribrosa under elevated intraocular pressure, in which the shear deformation is not presented by the previous models, however, is demonstrated to play a key role in the optic nerve injury. Further, the deformations of the structures, involving the optic nerve channels and the laminar sheets in the lamina cribrosa, are first investigated in detail. For example, the dislocation of the laminar sheets reaches 18.6μm under the intraocular pressure of 40mmHg, which is large enough to damage the optic nerve axons. The results here confirm some previously proposed clinical speculations on the deformations of the pore shape in the lamina cribrosa under elevated intraocular pressure during glaucoma. Finally, some essentially clinical questions existed during glaucoma, such as the pathological mechanism of the open-angle glaucoma with normal intraocular pressure, are discussed. The present study is beneficial to deeply understanding the optic nerve injury during glaucoma. The lamina cribrosa is the primary site of the optic nerve injury induced by elevated intraocular pressure during glaucoma. Under high intraocular pressure, the optic nerve channel near to the periphery of the lamina cribrosa (Channel A) is deformed to become into a tortuous elliptical horn from a straight cylinder, while the optic nerve channel

  10. View How Glaucoma May Affect Vision

    Science.gov (United States)

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

  11. Optineurin, a multifunctional protein involved in glaucoma ...

    Indian Academy of Sciences (India)

    MADHU

    that in sporadic cases of glaucoma mutations in optineurin are rare, accounting for only about 1% of the cases. Almost all the glaucoma-associated mutations in OPTN are single copy alterations. Most of these mutations are missense mutations. One of the glaucoma-associated mutants (E50K) causes death of retinal.

  12. 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.

  13. Prevalence of Glaucoma in the United States: The 2005–2008 National Health and Nutrition Examination Survey

    Science.gov (United States)

    Gupta, Priya; Zhao, Di; Guallar, Eliseo; Ko, Fang; Boland, Michael V.; Friedman, David S.

    2016-01-01

    Purpose To estimate the prevalence of glaucoma in the US population based on optic nerve head photography, to estimate the prevalence of glaucoma awareness, and to identify demographic and ocular risk factors for being unaware of having glaucoma. Methods The study included 5746 men and women 40 years of age and older participating in the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Each participant had 45° photographs of the macula and optic disc of both eyes. Fundus photographs were first graded by a reading center, and those with a cup-to-disc ratio (CDR) ≥ 0.6 were regraded by three glaucoma specialists to determine the presence or absence of glaucoma. Analyses were performed using NHANES weights to account for the complex multistage probability sampling design. Results The estimated overall prevalence of glaucoma in the US civilian, noninstitutionalized population 40 years of age and older was 2.1% (95% confidence interval [CI], 1.7%–2.6%). Glaucoma affected 2.9 million individuals, including 1.4 million women; 1.5 million men; 2.3 million people 60 years of age and older; and 0.9 million blacks, Mexican Americans, and people of other races. The prevalence of glaucoma was highest in non-Hispanic blacks, followed by non-Hispanic whites, Mexican Americans, and others. Over half of participants with glaucoma were unaware that they had the disease. Conclusions The prevalence of glaucoma based on optic nerve fundus photography assessment in the general US population 40 years of age and older was 2.1%. Approximately half of glaucoma cases were previously undiagnosed. Studies to determine whether and how to identify undiagnosed glaucoma are an important next step. PMID:27168366

  14. Prevalence, types and awareness of glaucoma in a multi-ethnic population in rural China: the Yunnan Minority Eye Study.

    Science.gov (United States)

    Pan, Chen-Wei; Zhao, Chun-Hua; Yu, Min-Bin; Cun, Qing; Chen, Qin; Shen, Wei; Li, Jun; Xu, Jian-Gang; Yuan, Yuansheng; Zhong, Hua

    2016-11-01

    To determine the prevalence, types and awareness of glaucoma in a rural community in China and to examine possible ethnic variations. The Yunnan Minority Eye Study was a multi-ethnic community-based eye survey using random cluster sampling strategies. 2133 Bai, 2205 Han and 2208 Yi Chinese aged 50 years or older participated in this study. Glaucoma including primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG) and secondary glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. The overall age-standardized prevalence of all glaucoma was 2.6% (95% confidence interval [CI]: 2.2-3.1%) in this population. It was 1.8% (95% CI: 1.1-1.9%) for POAG and 0.5% (95% CI: 0.9-1.6%) for PACG, respectively. Among 29 people with secondary glaucoma, 27 (93%) were blind in at least one eye. The presence of primary open-angle glaucoma was associated with male gender (odds ratio [OR] = 2.94; comparing men with women), Yi ethnicity (OR = 2.27; comparing Yi with Han people), higher IOP (OR = 1.09 per mmHg increase), and the presence of myopia (OR = 1.84). Of the 212 participants with glaucoma, only 38 (18%) were aware of the disease and had been diagnosed previously as having glaucoma or suspected glaucoma. Patients who were better educated tended to be aware of the disease. Significant ethnic difference in the prevalence of POAG was observed in this study. The low awareness of glaucoma highlights the pressing need to increase public awareness of this potentially blinding condition in rural China. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

  15. Prevalence of glaucoma suspects and pattern of intra-ocular ...

    African Journals Online (AJOL)

    Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in ...

  16. Aerobic exercise and intraocular pressure in normotensive and glaucoma patients

    Directory of Open Access Journals (Sweden)

    Chatzibalis Theodosios

    2009-08-01

    Full Text Available Abstract Background With the increasing number of people participating in physical aerobic exercise, jogging in particular, we considered that it would be worth knowing if there are should be limits to the exercise with regard to the intraocular pressure (IOP of the eyes. The purpose of this study is to check IOP in healthy and primary glaucoma patients after aerobic exercise. Methods 145 individuals were subdivided into seven groups: normotensives who exercised regularly (Group A; normotensives in whose right eye (RE timolol maleate 0.5% (Group B, latanoprost 0.005% (Group C, or brimonidine tartrate 0.2% (Group D was instilled; and primary glaucoma patients under monotherapy with β-blockers (Group E, prostaglandin analogues (Group F or combined antiglaucoma treatment (Group G instilled in both eyes. The IOP of both eyes was measured before and after exercise. Results A statistically significant decrease was found in IOP during jogging. The aerobic exercise reduces the IOP in those eyes where a b-blocker, a prostaglandin analogue or an α-agonist was previously instilled. The IOP is also decreased in glaucoma patients who are already under antiglaucoma treatment. Conclusion There is no ocular restriction for simple glaucoma patients in performing aerobic physical activity.

  17. Nicotinamide and WLDS Act Together to Prevent Neurodegeneration in Glaucoma

    Directory of Open Access Journals (Sweden)

    Simon W. M. John

    2017-04-01

    Full Text Available Glaucoma is a complex neurodegenerative disease characterized by progressive visual dysfunction leading to vision loss. Retinal ganglion cells are the primary affected neuronal population, with a critical insult damaging their axons in the optic nerve head. This insult is typically secondary to harmfully high levels of intraocular pressure (IOP. We have previously determined that early mitochondrial abnormalities within retinal ganglion cells lead to neuronal dysfunction, with age-related declines in NAD (NAD+ and NADH rendering retinal ganglion cell mitochondria vulnerable to IOP-dependent stresses. The Wallerian degeneration slow allele, WldS, decreases the vulnerability of retinal ganglion cells in eyes with elevated IOP, but the exact mechanism(s of protection from glaucoma are not determined. Here, we demonstrate that WldS increases retinal NAD levels. Coupled with nicotinamide administration (an NAD precursor, it robustly protects from glaucomatous neurodegeneration in a mouse model of glaucoma (94% of eyes having no glaucoma, more than WldS or nicotinamide alone. Importantly, nicotinamide and WldS protect somal, synaptic, and axonal compartments, prevent loss of anterograde axoplasmic transport, and protect from visual dysfunction as assessed by pattern electroretinogram. Boosting NAD production generally benefits major compartments of retinal ganglion cells, and may be of value in other complex, age-related, axonopathies where multiple neuronal compartments are ultimately affected.

  18. Neuroprotection in Glaucoma: A Review

    African Journals Online (AJOL)

    Alasia Datonye

    preventable visual disability, is a progressive neurodegenerative .... Glutamate Excitotoxicity. Oxidative Stress. Protein Misfolding. Awoyesuku E.A, Fiebai B — Neuroprotection in Glaucoma feature of many neurodegenerative diseases, including ... facilitate nascent and stress-induced protein folding and unfolding, and ...

  19. PSEUDOEXFOLIATION SYNDROME IN ETHIOPIAN GLAUCOMA ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... Buckground: Pseudoexfoliation syndrome (PXS) has variable prevalence rates in the glaucoma population depending on geographic location and racial composition of the population studied. There is no data available on this subject in Ethiopia. Objective: To determine the prevalence of PXS among ...

  20. 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.

  1. Monitoring of stable glaucoma patients

    NARCIS (Netherlands)

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

    2010-01-01

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

  2. Effect of sodium hyaluronate in glaucoma trabeculectomy

    Directory of Open Access Journals (Sweden)

    Qing-Hua Zhang

    2017-10-01

    Full Text Available AIM:To study the clinical effects of using sodium hyaluronate in the glaucoma trabeculectomy.METHODS: Totally 46 patients were included in our research and they were divided into two groups. In the study group(23 cases 23 eyes, we used slice with MMC of 0.4mg/mL in trabeculectomy. Before the conjunctiva flap was sewed, a small amount of sodium hyaluronate was injected into the space under scleral flap and the anterior chamber. In control group(23 cases 23 eyes, we only used MMC. After trabeculetomy, shallow anterior chambe formation, intraocular pressure, corneal endothelial injury and the formation of filter-bubble were observed in long term.RESULTS: IOP of study group at 1d after operation was higher than that of control group(PP>0.05. At 3d after operation, visual acuity decreased in 2 eyes(9%of study group, 8 eyes(35%in control group with significant different(P=0.035. At 6mo after operation, visual acuity decreased in 0 of study group, 5 eyes(22%in control group with significant different(P=0.025. The differences on the occurrence of shallow anterior chamber at 7d after operation, formation of filter-bubble at 6mo after operation and corneal endothelial count were significant(PCONCLUSION: Using sodium hyaluronate combined with MMC in trabeculectomy can greatly prevent the formation of shallow anterior chamber, filter-bubble scarring, and corneal endothelium dropout, make it possible to a safer surgery and a better outcome.

  3. [Evaluation of preoperative anxiety in patients requiring glaucoma filtration surgery].

    Science.gov (United States)

    Lemaitre, S; Blumen-Ohana, E; Akesbi, J; Laplace, O; Nordmann, J-P

    2014-01-01

    Preoperative anxiety is often expressed by patients requiring filtration surgery for their glaucoma. So far, there has been no scale for screening this group of patients for preoperative anxiety. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-evaluation questionnaire which has been used in specialties other than ophthalmology and which makes it possible to identify the adult patients with a high level of preoperative anxiety over an upcoming surgical procedure. The purpose of this study is to estimate the preoperative anxiety in glaucoma patients requiring filtration surgery. We performed a prospective study of 36 adult patients with chronic glaucoma not responding to medical treatment and who were about to undergo filtration surgery (trabeculectomy or deep sclerectomy). The APAIS questionnaire was given to the patients after discussing the indication for surgery. A global anxiety score (ranging from 4 to 20) above 10 defined patients with a high level of preoperative anxiety. We attempted to identify among these patients the factors related to filtration surgery which caused them anxiety (lack of control of intraocular pressure, risk of blindness, presence of the filtering bleb). In our sample of patients, we found that glaucoma was a source of anxiety. That was also true for the surgical procedure, though most patients believe that once the decision had been made, their psychological status was not modified by the upcoming procedure. The patient-clinician relationship is important in any chronic disease, all the more so in glaucoma, since this disease remains asymptomatic for a long time. When filtration surgery is necessary, the patients are going to express less preoperative anxiety if they trust their physician and if individualized information has been given to them The French version of the APAIS is a quick scale, easily completed, that can be recommended for evaluating anxiety and patients' need for information prior to filtering

  4. Clinical observation of trabeculectomy with mitomycin and interferon therapy on neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Dao-Hong Wan

    2015-01-01

    Full Text Available AIM:To understand the clinical effect of trabeculectomy with mitomycin and interferon therapy on neovascular glaucoma.METHODS:Neovascular glaucoma patients in our hospital from January 2011 to January 2013 were sampled, from them, 57 cases(57 eyeswere randomly divided into two groups, control group received routine trabeculectomy for treatment, the experimental group accepted combination therapy of trabeculectomy + mitomycin + interferon. The clinical efficacy of two groups were observed. RESULTS:The total effective rate(96%in experimental group was significantly better than that in the control group(76%, and the visual acuity, filtering bleb and postoperative 1wk, 1a of intraocular pressure changes were better than those of the control group, there was a statistically significant difference(PP>0.05.CONCLUSION:Trabeculectomy combined mitomycin and interferon treatment of neovascular glaucoma has exact clinical effect, and is worthy of clinical popularization and application.

  5. 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

  6. Pseudoexfoliation syndrome in Ethiopian glaucoma patients.

    Science.gov (United States)

    Bedri, A; Alemu, B

    1999-05-01

    Pseudoexfoliation syndrome (PXS) has variable prevalence rates in the glaucoma population depending on geographic location and racial composition of the population studied. There is no data available on this subject in Ethiopia. To determine the prevalence of PXS among Ethiopian glaucoma clinic population. A prospective study. The Glaucoma Clinic of Menelik-II-Hospital, which is a tertiary eye care centre in Addis Ababa, Ethiopia. All new patients with glaucoma or ocular hypertension (ocular HPN) seen during the study period from 1st April to 30th September 1996 were included in the study. Our of the 432 new patients of glaucoma or ocular HPN seen during the study, 108 patients (25%) had PXS. The age of PXS cases ranged from 32 years to 86 years (mean 62.3 years). There were 80 males and 28 females. Of the PXS patients, 104 (96.3%) were cases of chronic open angle glaucoma, while angle closure glaucoma and ocular HPN were rare comprising only two patients (1.85%) each. The relatively high prevalence rate of PXS among Ethiopian glaucoma clinic population found in this study stresses the need for further community-based research in order to prevent blindness due to glaucoma associated with PXS.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. [Surgical treatment of neovascular glaucoma].

    Science.gov (United States)

    Fili, S; Kohlhaas, M; Schilling, H; Ligges, U; Zelo, I

    2014-12-01

    The neovascular glaucoma is one of the leading causes for an enucleation. The cyclocryocoagulation, the peripheral retinal cryocoagulation and the intravitreal injection of bevacizumab as combined therapy aim at the reduction of the intraocular pressure and of neovascularisation. This study follows up 135 patients with neovascular glaucoma who underwent the above-mentioned combined therapy consisting of cyclocryocoagulation, peripheral retinal cryocoagulation and intravitreal injection of bevacizumab. The most common causes of neovascular glaucoma in our study are diabetic retinopathy and central retinal vein occlusion. The intraocular pressure was 37.4 mmHg (± 15.8) mmHg preoperatively under maximum antiglaucomatous therapy and was reduced to 19.0 (± 8.5) mmHg direct postoperatively. In the long-term intraocular pressure remained within the normal range in 93.33 % of patients. A successful reduction of the local antiglaucomatous drops of 1.9 substances to 1.7 substances was observed after 3 months. The oral intake of acetazolamide was also statistically significantly reduced. 47.37 % of the patients were normotensive without local therapy and only 3 patients were still on acetazolamide even after 1 year. The most serious complication was a phthisis bulbi in 1.5 % of patients. Overall 98.5 % of patients remained free of pain and maintained visual acuity after the end of the follow-up. Long-term pressure regulation and freedom from pain were successfully achieved. For decompensated neovascular glaucoma with poor vision and painful bulb, the combination of retinal cryocoagulation and intravitreal application of bevacizumab is an important therapeutic option. Georg Thieme Verlag KG Stuttgart · New York.

  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. 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.

  11. Wayfinding and Glaucoma: A Virtual Reality Experiment.

    Science.gov (United States)

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

    2017-07-01

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

  12. Pseudoexfoliation syndrome in Ethiopian glaucoma patients | Bedri ...

    African Journals Online (AJOL)

    Background: Pseudoexfoliation syndrome (PXS) has variable prevalence rates in the glaucoma population depending on geographic location and racial composition of the population studied. There is no data available on this subject in Ethiopia. Objective: To determine the prevalence of PXS among Ethiopian glaucoma ...

  13. 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)

  14. Glaucoma: a brief update for 2017

    African Journals Online (AJOL)

    changes in the optic nerve head (or optic disk). This may lead to functional changes in the patients' visual field, when no other ocular diseases or congenital abnormalities could be found.3. Around 66.8 million people worldwide are afflicted with glaucoma. Predictions are that glaucoma will affect almost. 80 million people by ...

  15. Arguments Against Funding Glaucoma Treatment and Rebuttal

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... prioritization for glaucoma using utilitarian principle, cost effectiveness, and quality adjusted life years. (QALY)], and doubtful capability of Nigeria to afford nationwide expenses required for glaucoma treatment. (dwindling economic resources, rising population and life expectancy, rising inflation on eye-care ...

  16. Acute angle closure glaucoma following ileostomy surgery

    Directory of Open Access Journals (Sweden)

    Mariana Meirelles Lopes

    2015-02-01

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

  17. A Surgical Approach to Pediatric Glaucoma

    Science.gov (United States)

    Khan, Arif O

    2015-01-01

    Glaucoma in children differs from adult-onset disease and typically requires surgical intervention. However, affected children exhibit a spectrum of disease severity and prospective data guiding the choice of operation are lacking. This article reviews common procedures and a surgical approach to pediatric glaucoma. PMID:26069523

  18. Normal tension glaucoma and Alzheimer disease

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  19. Glaucoma valve implants in Nigerians a report of early experience ...

    African Journals Online (AJOL)

    Objective: To show the value of glaucoma valve implant surgery in the management of glaucoma in Nigerians. Design: A prospective study of two glaucoma patients who had an Ahmed glaucoma valve implant at the University of Benin Teaching Hospital and DDS Eye Surgery in Benin City. Materials and method: One ...

  20. Should glaucoma be publicly funded in arguments for funding ...

    African Journals Online (AJOL)

    Glaucoma adversely affects the visual function, impacting negatively on the individual with glaucoma (IWG)'s flourishing life. This work argues for the public funding of glaucoma. The arguments consider the plausible glaucoma's harm to the IWG through impaired visual function, especially its adverse effects on their daily ...

  1. 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.

  2. 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...... 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...

  3. 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)

  4. 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

  5. [The denominations cataract and glaucoma].

    Science.gov (United States)

    Tornquist, R

    1997-01-01

    Since ancient times a grey or white pupil in an nearly blind eye was thought to be caused by a mucous substance in front of the lens. It was called "hypochysis" or "hypochyma" in Greece and "suffusio" in Rome. Later the term "cataract" (=waterfall) was the most popular denomination. A surgical method was tried very early with usually good effect, when with a thin needle, introduced into the eye, the opaque material was removed from the pupillary area. In the middle of the 17th century more careful investigations showed that there was no membrane in front of the lens, but the lens itself was opaque. The final proof was delivered when an extraction of the lens was performed with good effect. In ancient times incurable blindness, which was called glaucoma, was thought to be located to the lens, which probably had a very important role in the seeing process. The name (of Greek orgin) is translated "green" or "blue-green", which was sometimes notified to be the color of the lens, seen through the pupil, in these cases. A period of great confusion followed when the removal of this very important part of the eye did not lead to blindness but rather an improved vision. As there were significant difficulties in identifying the specific color of the pupil the name glaucoma seemed to be very inadequate. In the beginning of the 19th century a disease entity (which is to-day called acute closed-angle glaucoma) seemed to eventually fullfill the demand of a greenlooking pupil. The most characteristic symptoms are pain and a high intraocular pressure causing a corneal edema and a change of the blackness of the pupil to hazy grey (and maybe a little green?).

  6. 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

  7. Conjunctival Microangiopathy in a Patient with Neovascular Glaucoma

    Directory of Open Access Journals (Sweden)

    Anmar M. Abdul-Rahman

    2015-08-01

    Full Text Available Purpose: To report a case of conjunctival microangiopathy secondary to diabetes presenting as a red eye 5 years after glaucoma implant surgery for neovascular glaucoma. Materials and Methods: A 52-year-old Tongan male with a past history of neovascular glaucoma secondary to proliferative diabetic retinopathy underwent slitlamp examination and color photography of the anterior and posterior segment, in addition to anterior segment fluorescein angiography. Results: The conjunctival venules perilimbally demonstrated tortuosity and dilation (saccular, fusiform and tricornuate. Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated. Anterior segment fluorescein angiography showed generalized iris ischemia, extensive perilimbal microvascular degenerative changes and leakage of fluorescein into the anterior chamber. We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye. Conclusions: We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

  8. Glaucoma Surgery Outcome in Rwanda.

    Science.gov (United States)

    De Smedt, Stefan K; Fonteyne, Yannick S; Muragijimana, Felicienne; Palmer, Katie; Murdoch, Ian

    2016-08-01

    To assess long-term intraocular pressure (IOP) outcome after adult trabeculectomy surgery in Central Africa. All adult glaucoma patients who underwent trabeculectomy surgery in the Kabgayi Eye Unit, Rwanda between August 2003 and March 2008 were invited for a follow-up visit. Surgical and clinical data were collected from medical records. At the study visit, best-corrected visual acuity was measured and Goldmann applanation tonometry and biomicroscopy were done. Good IOP outcome was defined as both an IOPglaucoma management in Africa. However, the IOP control reduced at a follow-up duration beyond 2 years, highlighting the importance of regular long-term follow-up.

  9. Glaucoma in Africa: size of the problem and possible solutions.

    Science.gov (United States)

    Cook, Colin

    2009-02-01

    To obtain an estimate of the magnitude of the problem of glaucoma in sub-Saharan Africa, and to evaluate the existing evidence for including glaucoma as a priority disease in our Vision 2020 programs in Africa. A Pubmed search was carried out using "glaucoma prevalence Africa," "glaucoma presentation Africa," "glaucoma blindness Africa," "glaucoma screening Africa," and "glaucoma treatment Africa" as key words. Most glaucoma in Africa is primary chronic open angle glaucoma, it may occur at an earlier age, it may be associated with a higher intraocular pressure, it may be more rapidly progressive, and it may present late. The prevalence of glaucoma in East, Central, and Southern Africa can be conservatively estimated to be 10,000 people for every 1 million population. This prevalence may be higher in West Africa. The annual incidence of glaucoma can be conservatively estimated to be 400 new cases for every 1 million population. Glaucoma is the second leading cause of blindness after cataract, responsible for up to 30% of blindness. Case detection of glaucoma could be carried out at both the primary and secondary level. Primary trabeculectomy with mitomycin C or beta irradiation adjunct may be a suitable treatment. Cases could be followed up after surgery by mid-level eye care workers, using the intraocular pressure as the indicator for adequacy of control, and using a glaucoma register to identify and trace defaulters. Glaucoma should be included as a priority disease in Vision 2020 programs in Africa.

  10. Neuroinflammation in glaucoma: A new opportunity.

    Science.gov (United States)

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

    2017-04-01

    Mounting evidence suggests neuroinflammation is a key process in glaucoma, yet the precise roles are not known. Understanding these complex processes, which may also be a key in other common neurodegenerations such as Alzheimer's disease, will lead to targeted therapeutics for a disease that affects as many as 80 million people worldwide. Here, we define neuroinflammation as any immune-relevant response by a variety of cell types including astrocytes, microglia, and peripherally derived cells occurring in the optic nerve head and/or retina. In this review article, we first discuss clinical evidence for neuroinflammation in glaucoma and define neuroinflammation in glaucoma. We then review the inflammatory pathways that have been associated with glaucoma. Finally, we set out key research directions that we believe will greatly advance our understanding of the role of neuroinflammation in glaucoma. This review arose from a discussion of neuroinflammation in glaucoma at the 2015 meeting of The Lasker/IRRF Initiative for Innovation in Vision Science. This manuscript sets out to summarize one of these sessions; "Inflammation and Glaucomatous Neurodegeneration", as well as to review the current state of the literature surrounding neuroinflammation in glaucoma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. What’s new in glaucoma treatment?

    Directory of Open Access Journals (Sweden)

    Richard Wormald

    2006-09-01

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

  12. 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.

  13. Visual acuity and intraocular pressure after Descemet's stripping endothelial keratoplasty in eyes with and without preexisting glaucoma.

    Science.gov (United States)

    Vajaranant, Thasarat S; Price, Marianne O; Price, Francis W; Gao, Weihua; Wilensky, Jacob T; Edward, Deepak P

    2009-09-01

    (1) To characterize the pattern of intraocular pressure (IOP) changes after Descemet's stripping endothelial keratoplasty (DSEK) in patients without preexisting glaucoma and in those with preexisting glaucoma, with and without prior glaucoma surgery. (2) To compare vision and IOP outcomes among the 3 groups. A retrospective chart review. A total of 805 DSEK cases performed in 641 patients by a single surgeon from December 2003 to August 2007 were available in the database. Only the first-treated eye of each patient with at least 1-year follow-up was included. Four hundred cases qualified: 315 eyes had no glaucoma (C); 64 eyes had glaucoma with no previous glaucoma surgery (G); and 21 eyes had prior glaucoma surgery (GS). Eyes with preexisting retinal problems were included in the analysis. Data analysis included calculation of incidence of postoperative IOP elevation. The study criteria for postoperative IOP elevation were IOP > or =24 mmHg or IOP increase > or =10 mmHg from baseline. Kruskal-Wallis test was used to compare visual acuity (VA) and IOP among the 3 groups preoperatively and at 1-, 3-, 6-, and 12-month postoperative visits. Visual acuity (Snellen) and IOP (millimeters of mercury). The incidence of postoperative IOP elevation by the study criteria was 35%, 45%, and 43% for groups C, G, and GS, respectively. Elevated IOP was medically managed by initiating or increasing glaucoma medications or reducing steroids in 27%, 44%, and 38% of the patients in groups C, G, and GS, respectively. A subsequent glaucoma procedure was performed in 0.3%, 5%, and 19% of patients in groups C, G, and GS, respectively. Only the control group had statistically significant IOP elevation at 12 months (median increase of 2 mmHg) when compared with baseline (Preferences.

  14. 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

  15. Filter arrays

    Energy Technology Data Exchange (ETDEWEB)

    Page, Ralph H.; Doty, Patrick F.

    2017-08-01

    The various technologies presented herein relate to a tiled filter array that can be used in connection with performance of spatial sampling of optical signals. The filter array comprises filter tiles, wherein a first plurality of filter tiles are formed from a first material, the first material being configured such that only photons having wavelengths in a first wavelength band pass therethrough. A second plurality of filter tiles is formed from a second material, the second material being configured such that only photons having wavelengths in a second wavelength band pass therethrough. The first plurality of filter tiles and the second plurality of filter tiles can be interspersed to form the filter array comprising an alternating arrangement of first filter tiles and second filter tiles.

  16. DNA sequence variants in the LOXL1 gene are associated with pseudoexfoliation glaucoma in a U.S. clinic-based population with broad ethnic diversity

    Directory of Open Access Journals (Sweden)

    Miller Joan W

    2008-02-01

    Full Text Available Abstract Background Pseudoexfoliation syndrome is a major risk factor for glaucoma in many populations throughout the world. Using a U.S. clinic-based case control sample with broad ethnic diversity, we show that three common SNPs in LOXL1 previously associated with pseudoexfoliation in Nordic populations are significantly associated with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Methods Three LOXL1 SNPs were genotyped in a patient sample (206 pseudoexfoliation, 331 primary open angle glaucoma, and 88 controls from the Glaucoma Consultation Service at the Massachusetts Eye and Ear Infirmary. The SNPs were evaluation for association with pseudeoexfoliation syndrome, pseudoexfoliation glaucoma, and primary open angle glaucoma. Results The strongest association was found for the G allele of marker rs3825942 (G153D with a frequency of 99% in pseudoexfoliation patients (with and without glaucoma compared with 79% in controls (p = 1.6 × 10-15; OR = 20.93, 95%CI: 8.06, 54.39. The homozygous GG genotype is also associated with pseudoexfoliation when compared to controls (p = 1.2 × 10-12; OR = 23.57, 95%CI: 7.95, 69.85. None of the SNPs were significantly associated with primary open angle glaucoma. Conclusion The pseudoexfoliation syndrome is a common cause of glaucoma. These results indicate that the G153D LOXL1 variant is significantly associated with an increased risk of pseudoexfoliation and pseudoexfoliation glaucoma in an ethnically diverse patient population from the Northeastern United States. Given the high prevalence of pseudooexfoliation in this geographic region, these results also indicate that the G153D LOXL1 variant is a significant risk factor for adult-onset glaucoma in this clinic based population.

  17. 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.

  18. Avances en la genética de los glaucomas Advances in glaucoma genetics

    OpenAIRE

    Elier Ortiz González; Maritza Miqueli Rodríguez; Alberto Omar González García; Aracely Lantigua Cruz

    1999-01-01

    Con esta revisión los autores se han planteado el objetivo de motivar el interés de los oftalmólogos -en especial aquellos involucrados en el diagnóstico y tratamiento de los individuos afectados de glaucoma-, por conocer los avances genéticos de esta entidad. Se actualizan los conocimientos genéticos en el glaucoma primario de ángulo abierto del adulto (GPAA), glaucoma primario de ángulo abierto de comienzo juvenil (GJAA) y glaucoma congénito primario (GC), presentándose tablas que resumen l...

  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. 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

  1. [Criticism of the gonioscopic classifications of the glaucoma: with particular reference to the classification issued by the European Glaucoma Society in 2008].

    Science.gov (United States)

    Bordeianu, Constantin Dan

    2014-01-01

    To critically analyze the gonioscopic classifications of glaucoma, especially of the classification issued by the European Glaucoma Society in 2008, in order to reveal its advantages and shortcomings. The paper tries to determine the extent to which this classification is clear (being based on a coherent and consistently followed set of criteria), is comprehensive (framing all forms of glaucoma), helps to understand the sickness (using a logical framing system), and facilitates therapeutic decision making (offering direct therapeutic suggestions). The paper shows that, compared with all the previous classifications, the 2008 European Glaucoma Society classification is one step ahead (in the way of classifying the group of secondary angle-closure glaucomas), two steps behind (in rejecting two useful categories of congenital glaucoma), and similar in several respects: that it is based on criticizable fundamental and secondary criteria that cannot cover all forms of sickness gathered at a particular crossing; that it uses several equally weighted criteria for one single crossing (division); that it frames one clinical entity in several clinical categories; that it does not reflect reality in some aspects; and that it does not offer direct therapeutic suggestions: after framing a case in a scheme built on the basis of gonioscopic observation, it requires a second stage of pathogenic analysis, so that the ophthalmologist is able to decide the correct treatment only in the third stage. This tortuous thinking pathway, with successive stages - that are not followed by all doctors, explains many of the erroneous therapeutic decisions. All these considerations justify the efforts to find a new classification, able to correct the abovementioned shortcomings.

  2. Initial clinical experience with the trabecular micro-bypass stent in patients with glaucoma.

    Science.gov (United States)

    Spiegel, Detlev; Wetzel, Wolfgang; Haffner, David S; Hill, Richard A

    2007-01-01

    This study was undertaken to evaluate the efficiency of a trabecular micro-bypass stent designed to allow direct aqueous drainage from the anterior chamber into Schlemm's canal in patients with glaucoma. In this prospective case series of 6 patients with open-angle glaucoma, the microstent was inserted ab interno under local anesthesia in an ophthalmic operating room. Patients were seen postoperatively at 1 to 2 d, 1 wk, and 1, 2, 6, and 12 mo. All stents were successfully placed within Schlemm's canal. Mean intraocular pressure (IOP) at preoperative baseline was 20.2+/-6.3 mm Hg (range, 14-31 mm Hg). Mean IOP decreased during the immediate postoperative period to approximately 12 to 13 mm Hg and was stabilized at 14 to 15 mm Hg with reduction of medication throughout 1 y of follow-up. No major complications occurred. According to observations reported in this feasibility study, the microstent was effective in reducing IOP and in decreasing the number of glaucoma medications required to control IOP. Implantation procedures were safe, and stents remained in place throughout the follow-up period. None of the complications traditionally associated with filtering surgery were reported. Further research on this stent in a larger group of patients is needed to assess its role in glaucoma therapy.

  3. 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.

  4. Glaucoma and the Origins of Its Name.

    Science.gov (United States)

    Laios, Konstantinos; Moschos, Marilita M; Androutsos, George

    2016-05-01

    To identify the origins of the name of the disease Glaucoma. Ancient Greek medical literature, Homeric poems, and ancient Greek religion and art were examined. The roots of the name Glaucoma could be traced back to Homeric times. Ancient Greek physicians following the Hippocratic tradition preferred the use of the terms Hypochysis or Hypochyma for the same disease. This fact indicates that the older term Glaucoma did not fulfill strict medical criteria, but had a long history connected to superstition, which the rational ancient Greek physician tried to overcome using terms derived from their fundamental principal of humoral pathology. In ancient Greek medical literature, Glaucoma had a significant place among ocular diseases. The origin of its name could be traced back to Homeric times and could be connected to the ancient belief of a primitive folk about the apotropaic role of animals against diseases, which in this case is represented by the superstitious role of the owl.

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

    Science.gov (United States)

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

    2006-12-01

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

  6. A link between diabetes mellitus and glaucoma

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  7. CYP1B1 Mutations in Individuals With Primary Congenital Glaucoma and Residing in Denmark

    DEFF Research Database (Denmark)

    Grønskov, Karen; Redó-Riveiro, Alba; Sandfeld, Lisbeth

    2016-01-01

    Primary congenital glaucoma (PCG OMIM 231300) can be caused by pathogenic sequence variations in cytochrome P450, subfamily 1, polypeptide 1 (CYP1B1). The purpose of this study was to investigate the contribution of sequence variations in CYP1B1 in a cohort of individuals with PCG residing...... mutations, 5 of which were novel. The frequency of CYP1B1 mutations in this cohort was comparable with other populations. We also detected an individual heterozygous for p.(Tyr81Asn) mutation, previously suggested to cause autosomal dominant primary open-angle glaucoma....

  8. Practice Preferences for Glaucoma Surgery: A Survey of the American Glaucoma Society.

    Science.gov (United States)

    Vinod, Kateki; Gedde, Steven J; Feuer, William J; Panarelli, Joseph F; Chang, Ta C; Chen, Philip P; Parrish, Richard K

    2017-08-01

    The purpose of this study is to assess surgical practice patterns among the American Glaucoma Society (AGS) membership. An anonymous online survey evaluating the use of glaucoma surgeries in various clinical settings was redistributed to AGS members. Survey responses were compared with prior results from 1996, 2002, and 2008 to determine shifts in surgical practice patterns. Questions were added to assess the preferred approach to primary incisional glaucoma surgery and phacoemulsification combined with glaucoma surgery. A total of 252 of 1091 (23%) subscribers to the AGS-net participated in the survey. Percentage use (mean±SD) of trabeculectomy with mitomycin C (MMC), glaucoma drainage device (GDD), and minimally invasive glaucoma surgery (MIGS) as an initial surgery in patients with primary open angle glaucoma was 59%±30%, 23%±23%, and 14%±20%, respectively. Phacoemulsification cataract extraction alone was the preferred surgical approach in 44%±32% of patients with primary open angle glaucoma and visually significant cataract, and phacoemulsification cataract extraction was combined with trabeculectomy with MMC in 24%±23%, with MIGS in 22%±27%, and with GDD in 9%±14%. Although trabeculectomy was selected most frequently to surgically manage glaucoma in 8 of 8 clinical settings in 1996, GDD was preferred in 7 of 8 clinical settings in 2016. The use of GDD has increased and that of trabeculectomy has concurrently decreased over the past 2 decades. Trabeculectomy with MMC is the most popular primary incisional surgery when performed alone or in combination with phacoemulsification cataract extraction. Surgeons frequently manage coexistent cataract and glaucoma with cataract extraction alone, rather than as a combined cataract and glaucoma procedure.

  9. A unique case of keratoconus with Cogan-Reese syndrome and secondary glaucoma

    Directory of Open Access Journals (Sweden)

    Lipi Chakrabarty

    2017-01-01

    Full Text Available Keratoconus (KC, though one of the most common corneal degeneration, still continues to be a mystique regarding its pathogenesis, diagnosis, associations, and management; with newer discoveries and evolutions being reported. We report, what we believe to be another new association of KC- Cogan Reese syndrome with secondary glaucoma. A 32-year-old male, diagnosed as bilateral KC, presented for examination. Unilateral Cogan-Reese syndrome and associated secondary glaucoma was identified. These associations had been missed by previous ophthalmologists. The patient was managed with a rigid contact lens for KC and topical antiglaucoma agents for glaucoma. He was advised regular reviews and is under observation till date. We describe the first case known to us of a new association with KC. This case not only highlights the ophthalmologist's need to look for multiple entities linked to KC; but may also pave way for future insights regarding pathogenesis and genetics of these associated diseases.

  10. A unique case of keratoconus with Cogan-Reese syndrome and secondary glaucoma.

    Science.gov (United States)

    Chakrabarty, Lipi

    2017-01-01

    Keratoconus (KC), though one of the most common corneal degeneration, still continues to be a mystique regarding its pathogenesis, diagnosis, associations, and management; with newer discoveries and evolutions being reported. We report, what we believe to be another new association of KC- Cogan Reese syndrome with secondary glaucoma. A 32-year-old male, diagnosed as bilateral KC, presented for examination. Unilateral Cogan-Reese syndrome and associated secondary glaucoma was identified. These associations had been missed by previous ophthalmologists. The patient was managed with a rigid contact lens for KC and topical antiglaucoma agents for glaucoma. He was advised regular reviews and is under observation till date. We describe the first case known to us of a new association with KC. This case not only highlights the ophthalmologist's need to look for multiple entities linked to KC; but may also pave way for future insights regarding pathogenesis and genetics of these associated diseases.

  11. The optic nerve head in glaucoma

    Directory of Open Access Journals (Sweden)

    Rupert RA Bourne

    2006-09-01

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

  12. The Pathophysiology and Treatment of Glaucoma

    Science.gov (United States)

    Weinreb, Robert N.; Aung, Tin; Medeiros, Felipe A.

    2015-01-01

    IMPORTANCE Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. OBJECTIVE To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. EVIDENCE REVIEW A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. FINDINGS The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. CONCLUSIONS AND RELEVANCE Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries. PMID:24825645

  13. PRIMARY OPEN ANGLE GLAUCOMA IN THYROID DISORDER

    Directory of Open Access Journals (Sweden)

    Pragati Garg

    2016-07-01

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

  14. 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.

  15. Limited vitrectomy in phacomorphic glaucoma

    Directory of Open Access Journals (Sweden)

    Ritika Sachdev

    2017-01-01

    Full Text Available One of the challenging situations for a cataract surgeon is phacoemulsification in the shallow anterior chamber like cases of phacomorphic glaucoma. Some of the main concerns of operating in a narrow space include endothelial decompensation, descemet's detachment, and posterior capsular rents. High vitreous pressure predisposes to posterior capsular rents owing to a reduced concavity of the posterior capsule and increasing the proximity of phaco-tip to the posterior capsule. We describe a technique of limited vitrectomy in such cases. A small gauge 23-G/25-G trocar cannula is passed transconjunctivally, and the liquefied vitreous is allowed to egress. Vitrectomy is done extraocularly till the vitreous pressure lowers down. This technique helps to debulk the vitreous and decompress the globe in a controlled manner. The resultant posterior displacement of iris-lens diaphragm causes a deepening of the anterior chamber to facilitate phacoemulsification.

  16. Ocular Blood Flow and Normal Tension Glaucoma

    Directory of Open Access Journals (Sweden)

    Ning Fan

    2015-01-01

    Full Text Available Normal tension glaucoma (NTG is known as a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and glaucomatous visual field loss, even though the intraocular pressure (IOP does not exceed the normal range. The pathophysiology of NTG remains largely undetermined. It is hypothesized that the abnormal ocular blood flow is involved in the pathogenesis of this disease. A number of evidences suggested that the vascular factors played a significant role in the development of NTG. In recent years, the new imaging techniques, fluorescein angiography, color Doppler imaging (CDI, magnetic resonance imaging (MRI, and laser speckle flowgraphy (LSFG, have been used to evaluate the ocular blood flow and blood vessels, and the impaired vascular autoregulation was found in patients with NTG. Previous studies showed that NTG was associated with a variety of systemic diseases, including migraine, Alzheimer’s disease, primary vascular dysregulation, and Flammer syndrome. The vascular factors were involved in these diseases. The mechanisms underlying the abnormal ocular blood flow in NTG are still not clear, but the risk factors for glaucomatous optic neuropathy likely included oxidative stress, vasospasm, and endothelial dysfunction.

  17. Glaucoma blind registration in Fife (2000-2009) - a retrospective cohort study.

    Science.gov (United States)

    O'Colmain, Una; Anijeet, Deepa; Vosoughi, Marcus; Sinclair, Anne; Sanders, Roshini

    2011-07-01

    To collate information on patients registered blind secondary to glaucoma between 2000 and 2009 and compare findings to an identical study completed a decade earlier between 1990 and 1999. The records of all people registered as blind via the Fife Society for the Blind between 2000 and 2009 were retrospectively examined and those with glaucoma as the primary cause were studied in detail. We compared these results with the results of our previous study, in which we examined the same documents for the preceding decade, 1990-1999. The glaucoma blind registration rate was reduced by 31% in the current study compared to the previous one (60 vs 87 patients, p = 0.013). At the same time, there was a 6% increase in blindness registrations due to all causes (881 vs 938, p = 0.62). Patients were referred with significantly fewer visual symptoms (33% vs 60%, p = 0.002) and glaucoma surgery rates increased from 44% to 62% in the current study (p = 0.013). In the later decade, more patients were offered partial sight registration before blind registration (37% vs 10%, p blind registration in this study (66% vs 33%, p cognitive impairment and/or hearing loss and this was similar to the first study.   The study demonstrates a downward trend in the rates of blind registration due to glaucoma, compared to stable rates of registration for all diseases. Over the time period of the two studies there were refinements in the way glaucoma is managed medically by the hospital eye service and in the community, with a high level of input maintained from the local low vision service. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

  18. Trabeculectomy or Transscleral Cyclophotocoagulation as Initial Treatment of Secondary Childhood Glaucoma in Northern Tanzania.

    Science.gov (United States)

    Fieß, Achim; Shah, Peter; Sii, Freda; Godfrey, Furahini; Abbott, Joe; Bowman, Richard; Bauer, Jacqueline; Dithmar, Stefan; Philippin, Heiko

    2017-07-01

    The purpose is to describe the outcome of trabeculectomy with transscleral cyclophotocoagulation (TSCPC) as an initial intervention for secondary childhood glaucoma in Northern Tanzania. A retrospective, consecutive case series was analyzed of all children with secondary childhood glaucoma who underwent initial trabeculectomy or TSCPC between 2000 and 2013 at a referral eye unit in Northern Tanzania. Retrospective data were collected on causes of glaucoma, intraocular pressure (IOP), visual acuity, complications, and subsequent interventions. Outcomes were evaluated using Kaplan-Meier survival analysis and compared with Cox regression analysis. The main outcome measure was failure (IOP>21 mm Hg). Thirty-six eyes of 27 children (male, 21; median age, 9 y; range, 0.3 to 15 y) with secondary childhood glaucoma underwent trabeculectomy (19 eyes, 53%) or TSCPC (17 eyes, 47%). Causes included ocular trauma (13, 36%), previous cataract surgery (12, 33%), congenital aniridia (5, 14%), Sturge-Weber syndrome (2, 6%), steroid-induced glaucoma (2, 6%), uveitis (1, 3%), and unspecified leucoma (1, 3%). After 12 months, success was achieved in 48% after trabeculectomy and 18% after TSCPC, with visual acuity remaining unchanged in 11 of 14 (79%) and 4 of 5 eyes (80%), respectively. One third of the children did not return for follow-up after 1 year. Distance to the hospital (>100 km) was a significant risk factor for trabeculectomy failure (P=0.031). A high proportion of secondary childhood glaucoma in Northern Tanzania was caused by trauma and previous cataract surgery. Trabeculectomy was associated with better IOP control but also a higher complication rate. The ability to maintain visual function was comparable after both interventions. Failure was associated with a journey to the eye hospital (>100 km) possibly leading to late presentation with advanced disease and erratic follow-up.

  19. 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

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  1. Glaucoma

    Medline Plus

    Full Text Available ... and Aging Program African American Program Training and Jobs Fellowships NEI Summer Intern Program Diversity In Vision ... DIVRO) Student Training Programs To search for current job openings visit HHS USAJobs Home » NEI YouTube Videos » ...

  2. Glaucoma

    Medline Plus

    Full Text Available ... for the media Pressroom Contacts Dustin Hays - Chief, Science Communication dustin.hays@nih.gov Kathryn DeMott, Media ... Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  3. Glaucoma

    Medline Plus

    Full Text Available ... visual function, preservation of sight, and the special health problems and requirements of the blind.” News & Events Events Calendar NEI Press Releases News from NEI Grantees Spokesperson bios ... Frequently asked questions Clinical Studies Publications Catalog ...

  4. Glaucoma

    Science.gov (United States)

    ... y condiciones de los ojos relacionadas con la edad Consejos simples para tener ojos sanos Para Profesionales ... Us A-Z Site Map NEI on Social Media Information in Spanish (Información en español) Website, Social ...

  5. Wien filter

    NARCIS (Netherlands)

    Mook, H.W.

    1999-01-01

    The invention relates to a Wien filter provided with electrodes for generating an electric field, and magnetic poles for generating a magnetic field, said electrodes and magnetic poles being positioned around and having a finite length along a filter axis, and being positioned around the filter axis

  6. Rectifier Filters

    Directory of Open Access Journals (Sweden)

    Y. A. Bladyko

    2010-01-01

    Full Text Available The paper contains definition of a smoothing factor which is suitable for any rectifier filter. The formulae of complex smoothing factors have been developed for simple and complex passive filters. The paper shows conditions for application of calculation formulae and filters

  7. FILTER TREATMENT

    Science.gov (United States)

    Sutton, J.B.; Torrey, J.V.P.

    1958-08-26

    A process is described for reconditioning fused alumina filters which have become clogged by the accretion of bismuth phosphate in the filter pores, The method consists in contacting such filters with faming sulfuric acid, and maintaining such contact for a substantial period of time.

  8. Implantation of a second glaucoma drainage device.

    Science.gov (United States)

    Francis, Brian A; Fernandes, Rodrigo A B; Akil, Handan; Chopra, Vikas; Diniz, Bruno; Tan, James; Huang, Alex

    2017-05-01

    To evaluate success rates in controlling intraocular pressure (IOP) after implantation of a second glaucoma drainage device (GDD) with a Baerveldt glaucoma implant in patients with refractory glaucoma, with a secondary aim of reducing the need for postoperative glaucoma medications. This retrospective, noncomparative, interventional study included patients undergoing a second GDD for uncontrolled glaucoma from a tertiary care glaucoma service. Data were obtained from the medical records for the preoperative period and after the 1st, 15th, and 30th day, 3, 6, and 12 months, and then yearly until the last postoperative visit. Visual acuity, IOP, and number of glaucoma medications (NGM) from the follow-up visits were compared to baseline. Success and failure criteria were analyzed based on IOP level or need of glaucoma medications. Forty-nine patients were studied, with a mean follow-up time of 25 ± 21 months. The mean preoperative IOP was 23.7 ± 8.2 mmHg, and decreased to 14.8 ± 4.0 mmHg after 1 year, 14.4 ± 3.9 mmHg after 2 years, and 16.6 ± 8.5 mmHg after 3 years. The mean preoperative NGM was 3.4 ± 1.3, and decreased to 2.0 ± 1.8 after 1 year, 2.5 ± 1.6 after 2 years, and 2.8 ± 2.0 after 3 years. Absolute success was 9% after 1 year for a postoperative IOP between 5 and 18 mmHg, and 76% for a postoperative IOP between 5 and 21 mmHg. The qualified success was 88% at the first and second years and 83% at the third year. With up to 3 years of follow-up, a second glaucoma drainage device was successful in reducing IOP to below 21 mmHg, but not as successful below 18 mmHg. The success rate is improved with the use of glaucoma medications with up to 3 years of follow-up.

  9. 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

  10. 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.

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

    International Nuclear Information System (INIS)

    Wang, Jieqiong; Li, Ting; Xian, Junfang; Wang, Ningli; He, Huiguang

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

  13. 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.

  14. Filter unit

    International Nuclear Information System (INIS)

    Shiba, Kazuo; Nagao, Koji; Akiyama, Toshio; Tanaka, Fumikazu; Osumi, Akira; Hirao, Yasuhiro.

    1997-01-01

    The filter unit is used by attaching to a dustproof mask, and used in a radiation controlled area such as in a nuclear power plant. The filter unit comprises sheet-like front and back filtering members disposed vertically in parallel, a spacer for keeping the filtering members to a predetermined distance and front and back covering members for covering the two filtering members respectively. An electrostatic filter prepared by applying resin-fabrication to a base sheet comprising 100% by weight of organic fibers as fiber components, for example, wool felt, synthetic fiber non-woven fabric, wool and synthetic fiber blend non-woven fabric and then electrifying the resin is used for the filtering members. Then, residue of ashes can be eliminated substantially or completely after burning them. (I.N.)

  15. The Relationship between Vitamin D and Glaucoma: A Kangbuk Samsung Health Study.

    Science.gov (United States)

    Kim, Hyun Tae; Kim, Joon Mo; Kim, Jung Hoon; Lee, Mi Yeon; Won, Yu Sam; Lee, Jae Yeun; Park, Ki Ho

    2016-12-01

    To investigate the relationship between vitamin D and glaucoma. This retrospective, cross-sectional study included subjects who underwent a health screening at the Health Screening Center of Kangbuk Samsung Hospital from August 2012 to July 2013. All fundus photographs were reviewed by ophthalmologists. The ophthalmologists determined if an eye was glaucomatous based on the criteria set forth by the International Society of Geographical and Epidemiological Ophthalmology and by the appearance of the retinal nerve fiber layer and optic disc. If the subjects previously underwent an ophthalmologic examination, they were enrolled based on the documented history. In addition to fundus photographs, each participant underwent a systemic examination including blood sampling and sociodemographic and behavioral questionnaires. The subjects were divided into five groups according to serum 25-hydroxyvitamin D (25(OH)D) level. Multivariate logistic regression models were constructed to assess possible associations between elevated glaucoma risk and systemic factors with a p < 0.2 on univariate analysis. Of the 169,208 subjects older than 20 years, 123,331 were eligible for the study. There was no difference in the prevalence of glaucoma according to quintile of serum 25(OH)D level based on sex ( p = 0.412 for males, p = 0.169 for females). According to the multivariable-adjusted logistic analysis, the odds ratio of glaucoma for the fourth quintile was significantly lower than that of the first quintile in females (odds ratio, 0.713; 95% confidence interval, 0.520 to 0.979). Lower 25(OH)D level was significantly associated with an elevated risk of glaucoma in females compared with higher 25(OH)D level. Further evaluation is needed to investigate the relationship between glaucoma and vitamin D.

  16. Effectiveness and Cost of a Personalized Reminder Intervention to Improve Adherence to Glaucoma Care.

    Science.gov (United States)

    Pizzi, Laura T; Tran, Judie; Shafa, Anousheh; Waisbourd, Michael; Hark, Lisa; Murchison, Ann P; Dai, Yang; Mayro, Eileen L; Haller, Julia A

    2016-04-01

    Glaucoma is the leadi ng cause of irreversible blindness in the USA. Glaucomatous vision loss is preventable with proper eye care, including appointment adherence. Therefore, interventions that improve appointment adherence can reduce the number of patients with more severe glaucoma. The primary study aim was to determine the efficacy and cost-effectiveness of a multifaceted personal reminder intervention, which included a customized letter and personal telephone outreach, in improving appointment adherence of patients with glaucoma. A secondary study aim was to identify patient characteristics that were associated with non-adherence. This prospective, randomized, controlled study included a cost-effectiveness analysis completed using a decision analytic model. The subjects included 256 patients with glaucoma. Study measures included appointment adherence and incremental cost effectiveness ratios. Patients in the intervention group were more likely to adhere to appointments (82.31 vs. 69.05 %; RR 1.23; 95 % CI 1.04-1.37, p < 0.012) than patients in the usual care group. Patients in the intervention group were 23 % more likely to adhere to appointments (RR 1.23; 95 % CI 1.08-1.41, p < 0.0021) than patients in the usual care group, when adjusting for age, secondary insurance, primary open angle glaucoma diagnosis, number of previous visits at Wills Eye Hospital, and follow-up recommendation using Poisson regression. Per-patient cost of the program was US$11.32, and cost per follow-up attended within the adherence window was US$73.56. A low cost reminder intervention consisting of a personalized letter and telephone outreach significantly improved appointment adherence of patients with glaucoma.

  17. Primary Congenital Glaucoma in Kano, Northern Nigeria | Lawan ...

    African Journals Online (AJOL)

    Primary congenital glaucoma is one of the causes of childhood blindness and it appears to be common in our environment. This study evaluated the pattern of presentation and management of primary congenital glaucoma in children. This was a prospective questionnaire-based study of primary congenital glaucoma

  18. 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 ...

  19. Reappraising first-line treatment in glaucoma management.

    Science.gov (United States)

    Phelan, Peter

    2002-09-01

    Despite treatment, glaucoma patients may still suffer vision loss because of inadequate control of intraocular pressure or late presentation. This article reviews the latest evidence supporting a reappraisal of first-line treatment in the management of glaucoma, including a review of latanoprost, recently approved for first-line treatment of glaucoma and ocular hypertension.

  20. Should glaucoma be public funded in Nigeria? Arguments against ...

    African Journals Online (AJOL)

    Global studies indicate glaucoma treatment can preserve valueable vision, especially when commenced in its early stage and sustained. Despite glaucoma being responsible for blindness in thousands of Nigerians and accompanying disruption of their flourishing lives, Nigeria's funding glaucoma would not be easy to ...

  1. 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 ...

  2. 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

  3. Spectrum of glaucoma presentation in a Nigerian Tertiary Hospital ...

    African Journals Online (AJOL)

    Purpose: The aim of this study was to report the types and severity of glaucoma at presentation in patients attending the glaucoma clinic of the University College Hospital, Ibadan, Nigeria. This information will help in designing an awareness and management strategy that will help in reducing glaucoma blindness. Materials ...

  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. Is angle closure glaucoma a problem in Nigeria? | Olawoye ...

    African Journals Online (AJOL)

    Purpose: The aim of this study was to report the characteristics of angle closure glaucoma (ACG) in eye clinic patients of University College Hospital (UCH), Ibadan, Nigeria. Materials and Methods: A total of 336 consecutive new glaucoma patients of all age groups who presented to the glaucoma clinic of UCH over a 1 year ...

  6. Compliance to Medical Therapy of Primary Open Angle Glaucoma in ...

    African Journals Online (AJOL)

    Background: The aim of this study was to determinethe rate of compliance to medical therapy of primary open angle glaucoma in Enugu with a view to improving patient care and reducing visual deterioration and loss from glaucoma. Method: One hundred and five patients were reviewed from the glaucoma patients who ...

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

    African Journals Online (AJOL)

    admin

    Glaucoma awareness among ophthalmic patients at Menelik. II Hospital, Addis Ababa, Ethiopia. Hiwot Degineh1, Abeba T. Giorgis1. Abstract. Background: Glaucoma is one of the main causes of blindness worldwide that has been considered as a major public health issue. Raising awareness about glaucoma among the ...

  8. Should Glaucoma be Publicly Funded in Arguments for Funding ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... leave patients with glaucoma disabled in that very particular domain. ... The advocacy for the public funding of glaucoma treatment is ... following treatment. All things being equal, IWG in the early stage of glaucoma would necessarily optimize the available treatment in terms of preservation of residual.

  9. 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...

  10. Glaucoma Patients' Trust in the Physician

    Directory of Open Access Journals (Sweden)

    Kelly W. Muir

    2009-01-01

    Full Text Available Objectives. To describe glaucoma patients' trust in the physician and to test the hypothesis that increased interpersonal trust is associated with increased medication adherence. Methods. One hundred ninety-five subjects with open-angle glaucoma seen by multiple glaucoma subspecialists participated in a cross-sectional patient survey and concomitant chart review which included a test of health literacy and the Trust in Physician Scale (TPS, a scale from 1–100, with 100 indicating greatest trust. Charts were reviewed for visual acuity and visual field results. Subjects' pharmacies were contacted to ascertain medication refill rates over the preceding six months. Results. TPS scores ranged from 57.5 to 100, 78.7±8.4 (mean±SD, median 75.0. When age, race, gender, baseline visual acuity and visual field status, education level, and literacy status were considered, only race was associated with TPS. Caucasians expressed slightly higher levels of trust (n=108; TPS 80.1±8.2 than non-Caucasians, (n=87 (82 Africans Americans; TPS 77.1±8.4; P=.012. TPS score was not associated with refill rates (P=.190. Conclusions. Trust in physician is generally high in this group of glaucoma patients but varies slightly by race. Trust in physician was not associated with glaucoma medication adherence in this tertiary care population.

  11. Diagnostic Ability of Automated Pupillography in Glaucoma.

    Science.gov (United States)

    Rao, Harsha L; Kadambi, Sujatha V; Mehta, Pooja; Dasari, Srilakshmi; Puttaiah, Narendra K; Pradhan, Zia S; Rao, Dhanraj A S; Shetty, Rohit

    2017-05-01

    To evaluate the diagnostic ability of automated pupillography measurements in glaucoma and study the effect of inter-eye asymmetry in glaucomatous damage on the diagnostic ability. In an observational, cross-sectional study, 47 glaucoma patients and 42 control subjects underwent automated pupillography using a commercially available device. Diagnostic abilities of the pupillary response measurements were evaluated using area under receiver operating characteristic (ROC) curves (AUC) and sensitivities at fixed specificities. Influence of inter-eye asymmetry in glaucoma [inter-eye mean deviation (MD) difference on visual fields (VF)] on the diagnostic ability of pupillography parameters was evaluated by ROC regression approach. The AUCs of automated pupillography parameters ranged from 0.60 (amplitude score with peripheral blue stimulus) to 0.82 (amplitude score with full field white stimulus, Amp-FF-W). Sensitivity at 95% specificity ranged between 5% (amplitude score with full field blue stimulus) and 45% (amplitude score with full field green stimulus). Inter-eye MD difference significantly affected the diagnostic performance of automated pupillography parameters (p glaucoma. The performance of these pupillography measurements in detecting glaucoma significantly increased with greater inter-eye asymmetry in the glaucomatous damage.

  12. Glaucoma in the English-speaking Caribbean.

    Science.gov (United States)

    Grosvenor, D; Hennis, A

    2011-07-01

    The Barbados Eye Studies have provided the most comprehensive information on the major eye diseases in African origin populations to date. Black Barbadians have among the highest rates of primary open-angle glaucoma (OAG) reported to date in a population-based study (7.0%). Incidence rates of OAG over a nine-year follow-up period were 0.5% per year, and two to five times higher than reported in predominantly Caucasian populations. Risk factors for OAG included older age, male gender higher intraocular pressure, positive glaucoma family history, in addition to lean body mass and a positive cataract history. Low blood pressure to intraocular pressure relationships were also found to increase OAG risk, suggesting an aetiologic role for low vascular perfusion of the optic nerve. Recent analyses revealed a region on chromosome 2 associated with increased OAG risk, which has potential implications for early diagnosis and treatment. Approximately 50% of Barbadians with OAG were unaware of having the disease in the baseline study and this situation remained unchanged nine years later open-angle glaucoma causes painless, irreversible loss of vision and there are clear reasons why screening may be of particular public health importance in high risk African descent populations, given the benefits of early detection and appropriate treatment. There are data that suggest that it would be cost-effective to conduct open-angle glaucoma screening in Barbados and this has implications for policy and care, with the ultimate aim of reducing glaucoma-related blindness.

  13. 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

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

    NARCIS (Netherlands)

    Wesselink, Christiaan; Jansonius, Nomdo M.

    Purpose: To determine the usefulness of frequency doubling perimetry (FDT) for progression detection in glaucoma, compared to standard automated perimetry (SAP). Methods: Data were used from 150 eyes of 150 glaucoma patients from the Groningen Longitudinal Glaucoma Study. After baseline, SAP was

  15. 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

  16. Wien filter

    OpenAIRE

    Mook, H.W.

    1999-01-01

    The invention relates to a Wien filter provided with electrodes for generating an electric field, and magnetic poles for generating a magnetic field, said electrodes and magnetic poles being positioned around and having a finite length along a filter axis, and being positioned around the filter axis such that electric and magnetic forces induced by the respective fields and exerted on an electrically charged particle moving substantially along the fileter axis at a certain velocity

  17. PREVIOUS SECOND TRIMESTER ABORTION

    African Journals Online (AJOL)

    PNLC

    PREVIOUS SECOND TRIMESTER ABORTION: A risk factor for third trimester uterine rupture in three ... for accurate diagnosis of uterine rupture. KEY WORDS: Induced second trimester abortion - Previous uterine surgery - Uterine rupture. ..... scarred uterus during second trimester misoprostol- induced labour for a missed ...

  18. 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.

  19. Cognitive functions and normal tension glaucoma.

    Science.gov (United States)

    Daveckaite, Akvile; Grusauskiene, Evelina; Petrikonis, Kestutis; Vaitkus, Antanas; Siaudvytyte, Lina; Januleviciene, Ingrida

    2017-10-01

    Only a few studies have analyzed the potential link between glaucoma and cognitive function impairment. They have found controversial results. This study aims to perform quick cognitive function assessment with clock drawing test (CDT) using two different scoring systems and compare between normal tension glaucoma (NTG) and cataract patients. Totally, 30 NTG and 30 patients with cataracts were included in a prospective, pilot study. The predrawn circle was given, and patients were asked to draw the clock showing a time of 11:10. The test was evaluated using two methods - Freund method using a 7-point scoring scale (optimal cutoff ≤4) and Rakusa using a 4-point scoring scale (optimal cutoff ≤3). The level of significance was set at P drawing. Further prospective studies are needed to investigate the CDT reliability as fast screening test of cognitive function impairment in glaucoma patients.

  20. Glaucoma alters the circadian timing system.

    Directory of Open Access Journals (Sweden)

    Elise Drouyer

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

  1. [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.

  2. Glaucoma detection with damato multifixation campimetry online

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  3. Managing refractory glaucoma with a fixed combination of bimatoprost (0.03% and timolol (0.5%

    Directory of Open Access Journals (Sweden)

    Moataz E Gheith

    2008-03-01

    tolerability and may also favorably improve eventual surgical outcomes in patients who might require filtering procedures.Keywords: fixed combination, refractory glaucoma, timolol/bimatoprost

  4. 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.

  5. Vision-related quality of life following glaucoma filtration surgery.

    Science.gov (United States)

    Hirooka, Kazuyuki; Nitta, Eri; Ukegawa, Kaori; Tsujikawa, Akitaka

    2017-05-12

    To evaluate vision-related quality of life (VR-QOL) following glaucoma filtration surgery. A total of 103 glaucoma patients scheduled to undergo glaucoma filtration surgery. Prior to and at three months after glaucoma filtration surgery, trabeculectomy or EX-PRESS, all patients completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). A total of 48 patients underwent combined cataract and filtration surgery. The clinical data collected pre- and postoperatively included best-corrected visual acuity (BCVA) and intraocular pressure (IOP). The IOP decreased significantly from 19.0 ± 8.1 mmHg to 9.7 ± 3.9 mmHg (P glaucoma filtration surgery by itself did not decrease the VR-QOL in glaucoma patients, there was significant improvement in the VR-QOL after the patients underwent combined cataract and glaucoma filtration surgery.

  6. PERIPHERAL RETINAL DEGENERATIONS AND RHEGMATOGENOUS DETACHMENT IN PRIMARY CONGENITAL GLAUCOMA.

    Science.gov (United States)

    Gupta, Shikha; Gogia, Varun; Jose, Cijin; Chanana, Bhuvan; Bypareddy, Ravi; Kapoor, Kulwant Singh; Gupta, Viney

    2016-01-01

    To determine the prevalence of peripheral retinal degenerations (PRD) and rhegmatogenous retinal detachment in patients with primary congenital glaucoma (PCG). Records of all patients with PCG operated from year 2000 onwards were evaluated to look for the prevalence of rhegmatogenous retinal detachment. Of these, those children who were old enough to cooperate and had sufficient medial clarity were screened with an indirect ophthalmoscopy in a cross-sectional evaluation from 2010 to 2014. Peripheral retina was examined, and prevalence of PRD was estimated in this subset. For statistical purposes, only one eye of each patient was considered in this cross-sectional analysis. Of the 310 eyes (180 patients with PCG) operated from the year 2000 onwards, a rhegmatogenous retinal detachment was noted in 13 eyes (4%). Mean axial length of these eyes was 26.3 ± 3.2 mm (range, 19.8-34.7 mm). Among the eyes screened for PRD (n = 60), prevalence of pathologic PRD (lattices with/without atrophic holes and isolated holes/tears) was 15%. The average follow-up between glaucoma filtering surgery and the date of last examination was 8.55 ± 3.98 years (range, 5-20 years) in this subset. Mean axial length was significantly greater in eyes with pathologic PRD than in those without (28.1 ± 3.3 mm vs. 25.8 ± 2.6 mm; P = 0.01). For axial length ≥ 26 mm, the odds of having a pathologic PRD were 14.4 times more than those with axial length < 26 mm (P < 0.001; 95% confidence interval, 1.7-120.5). Prevalence of PRD among eyes with PCG is high. Peripheral retinal screening should be performed in eyes with PCG, especially those with axial lengths ≥ 26 mm.

  7. Glaucoma secundario a melanoma uveal

    Directory of Open Access Journals (Sweden)

    Nairovys Gómez Martínez

    2017-09-01

    Full Text Available Introducción: Los tumores localizados en iris y cuerpo ciliar son poco frecuentes y puede ser valorada su resección local como alternativa terapéutica. El melanoma uveal representa el 79-81% de los melanomas oculares y el 3-5% de todos los melanomas. Objetivo: Dar a conocer el caso de una patología infrecuente con pocos casos reportados en la literatura, enfatizar su importancia dentro de los diagnósticos diferenciales y del estudio histopatológico. Descripción del caso: Paciente femenina de 47 años de edad, quien acudió a la consulta de oftalmología, para valoración de una lesión pigmentada en endotelio corneal y en iris asociada a hipertensión ocular y pérdida de la agudeza visual en el ojo izquierdo de cuatro meses de evolución. La biomicroscopía ultrasónica confirmó la presencia de una masa iridiana, localizada en la periferia del iris. El estudio anatomopatológico mostró una proliferación de células névicas pleomórficas que reemplazaban el estroma normal del iris. Conclusiones: En pacientes que presentan una clínica de glaucoma unilateral refractario a tratamiento farmacológico junto con dispersión de pigmento es importante una exploración exhaustiva destacando el papel de la biomicroscopía ultrasónica.

  8. Vitiligo iridis and glaucoma: a rare sequelae of small pox.

    Science.gov (United States)

    Kavitha, S; Patel, S R; Mohini, P; Venkatesh, R; Sengupta, S

    2015-10-01

    Vitiligo iridis refers to focal areas of iris atrophy as sequelae of small pox infection. We report a series of patients with unilateral vitiligo iridis, some of whom presented with secondary open-angle glaucoma. Three patients with vitiligo iridis underwent a comprehensive ophthalmic examination including intraocular pressure (IOP) measurement, slit lamp biomicroscopy, gonioscopy, and fundus evaluation. Patients' facial features were also documented and photographed. All patients were in their sixth decade. Two out the three had elevated IOP (52 mm Hg and 36 mm Hg) in the same eye as vitiligo iridis, at initial presentation. Gonioscopy showed patchy iris hyperpigmentation and fundus evaluation showed glaucomatous optic disc changes in the involved eye. One patient responded favourably to topical antiglaucoma medications, whereas the other was taken up for combined phacoemulsification-trabeculectomy with good results. The third patient had normal IOP in the involved eye. All three patients gave a history of small pox in childhood and had pitted facial scars typical of previous small pox infection. Vitiligo iridis may be associated with the secondary glaucoma as a long-term sequelae of small pox. It may be prudent to periodically follow-up such patients for development of raised IOP in the future.

  9. 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.

  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. Clinical curative effect of Ex-press glaucoma drainage device implantation for refractory glaucoma and related complications

    Directory of Open Access Journals (Sweden)

    Xiao-Qin Luo

    2016-05-01

    Full Text Available AIM:To explore the clinical efficacy of Ex - PRESS drainage device implantation for refractory glaucoma and related complications. METHODS: Fifty-three cases(56 eyeswere randomly selected in our hospital from February 2013 to August 2014 who received Ex-press glaucoma drainage device implantation for refractory glaucoma, 39 males(41 eyesand 14 females(15 eyes, 52.63±10.58 years old; 25 cases(26 eyeswith neovascular glaucoma, 16 patients(18 eyeswith failure of glaucoma filtration surgery, 6 cases(6 eyeswith secondary glaucoma after vitrectomy, and 6 cases(6 eyeswith glaucoma secondary to complicated ocular trauma. Postoperative visual acuity, intraocular pressure(IOP, anterior chamber depth, corneal endothelial cell density and complications, etc. at 1 and 12mo were analyzed and compared with the preoperative. RESULTS: At 12mo after operation, the complete success rate was 62%(35 eyes, the partial success rate was 14%(8 eyes, and the total success rate was 77%. The effective rate was 85% in patients with neovascular glaucoma, 56% in patients with failure of glaucoma filtration surgery, 100% in patients with glaucoma secondary to complicated ocular trauma, 83% in patients with secondary glaucoma after vitrectomy. At 1mo after surgery, visual acuity improved in 28 eyes(50%, unchanged in 18 eyes(32%, decreased in 10 eyes(18%. At 12mo after surgery, visual acuity improved in 19 eyes(34%, unchanged in 18 eyes(32%, decreased in 19 eyes(34%. Preoperative IOP was 29.58±8.66 mmHg, that at 1mo after surgery was 12.75±5.66mmHg, and the difference was significant(PP2, respectively, both decreased compared to that before surgery(2113.47±80.56/mm2, PCONCLUSION: Ex-press glaucoma drainage device implantation for refractory glaucoma, although has some complications, still achieve better clinical efficacy, and is an effective method for refractory glaucoma.

  12. Differential expression profile prioritization of positional candidate glaucoma genes: the GLC1C locus.

    Science.gov (United States)

    Rozsa, Frank W; Scott, Kathleen M; Pawar, Hemant; Samples, John R; Wirtz, Mary K; Richards, Julia E

    2007-01-01

    To develop and apply a model for prioritization of candidate glaucoma genes. This Affymetrix GeneChip (Affymetrix, Santa Clara, Calif) study of gene expression in primary culture human trabecular meshwork cells uses a positional differential expression profile model for prioritization of candidate genes within the GLC1C genetic inclusion interval. Sixteen genes were expressed under all conditions within the GLC1C interval. TMEM22 was the only gene within the interval with differential expression in the same direction under both conditions tested. Two genes, ATP1B3 and COPB2, are of interest in the context of a protein-misfolding model for candidate selection. SLC25A36, PCCB, and FNDC6 are of lesser interest because of moderate expression and changes in expression. Transcription factor ZBTB38 emerges as an interesting candidate gene because of the overall expression level, differential expression, and function. Only 1 gene in the GLC1C interval fits our model for differential expression under multiple glaucoma risk conditions. The use of multiple prioritization models resulted in filtering 7 candidate genes of higher interest out of the 41 known genes in the region. This study identified a small subset of genes that are most likely to harbor mutations that cause glaucoma linked to GLC1C.

  13. 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.

  14. The Complexity of Diagnosing and Monitoring Glaucoma

    NARCIS (Netherlands)

    J.G. van der Schoot (Josine)

    2017-01-01

    markdownabstractGlaucoma is a heterogeneous group of progressive optic neuropathies characterised by an accelerated degeneration of retinal ganglion cells (RGCs) and their axons, resulting in a typical appearance of the optic nerve head and a matching pattern of irreversible visual field loss.

  15. THE PRACTICAL SIGNIFICANCE OF GLAUCOMA INVESTIGATIONS

    African Journals Online (AJOL)

    our attention to the unpleasant side-effects of many anti- glaucoma treatments. He says it is the ... response to pilocarpine without side-effects, treatment may be continued; but if the response is poor and the side- ... lability, jugular compression, caffeine, bulbar compression and postural tension differences, all of which are ...

  16. Altered aquaporin expression in glaucoma eyes

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  17. Trabeculectomy for Congenital Glaucoma in University College ...

    African Journals Online (AJOL)

    Introduction: Congenital glaucoma is an uncommon ocular condition affecting about 1/15,000 live births. About two third of cases are bilateral with a higher prevalence in males. The definitive treatment requires surgery which could be trabeculectomy, trabeculotomy, goniotomy, drainage tubes or a combination of ...

  18. Glaucoma facomórfico y ultrabiomicroscopia

    Directory of Open Access Journals (Sweden)

    María Cristina González González

    2015-01-01

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

  19. Optineurin, a multifunctional protein involved in glaucoma ...

    Indian Academy of Sciences (India)

    MADHU

    It was suggested that impaired trafficking caused by the E50K mutant might be the cause of cell death induced by this mutant in RGCs (Nagabhushana et al. 2010; Park et al. 2010). Transport of neurotrophins in the axons is crucial for the survival of neuronal cells. Blockade of axonal transport has been reported in glaucoma ...

  20. Survey of familial glaucoma shows a high incidence of cytochrome P450, family 1, subfamily B, polypeptide 1 (CYP1B1) mutations in non-consanguineous congenital forms in a Spanish population

    Science.gov (United States)

    Millá, Elena; Mañé, Begoña; Duch, Susana; Hernan, Imma; Borràs, Emma; Planas, Ester; Dias, Miguel de Sousa; Carballo, Miguel

    2013-01-01

    Purpose To identify myocilin (MYOC) and cytochrome P450, family 1, subfamily B, polypeptide 1 (CYP1B1) mutations in a Spanish population with different clinical forms of familial glaucoma or ocular hypertension (OHT). Methods Index patients from 226 families participated in this study. Patients were diagnosed with familial glaucoma or OHT by complete ophthalmologic examination. Screening for MYOC mutations was performed in 207 index patients: 96 with adult-onset primary open-angle glaucoma (POAG), 21 with primary congenital glaucoma (PCG), 18 with juvenile-onset open-angle glaucoma (JOAG), five with Axenfeld-Rieger syndrome (ARS), and 67 with other types of glaucoma. One hundred two of the families (including all those in whom a MYOC mutation was detected) were also screened for CYP1B1 mutations: 45 POAG, 25 PCG, 21 JOAG, four ARS, and seven others. Results We examined 292 individuals (patients and relatives) with a positive family history of glaucoma or OHT. We identified two novel MYOC variants, p.Lys39Arg and p.Glu218Lys, in two families with POAG, and six previously reported MYOC mutations in seven families with POAG (four), JOAG (one), PCG (one), and normotensive glaucoma (one). CYP1B1 mutations were found in 16 index patients with PCG (nine), POAG (three), JOAG (two), and ARS (two). Conclusions The high percentage (9/25=36%) of mutations in CYP1B1 found in non-consanguineous patients with congenital glaucoma mandates genetic testing. However, the percentage of mutations (9/207=4.4%) in MYOC associated with glaucoma is relatively low in our population. The variable phenotype expression of glaucoma, even in families, cannot be explained with a digenic mechanism between MYOC and CYP1B1. PMID:23922489

  1. Glaucoma Mini-Shunt Implantation After Keratoplasty.

    Science.gov (United States)

    Ledesma-Gil, Jasbeth; García-Rodríguez, María de Los Ángeles; Gurria, Lulu U; Graue-Hernández, Enrique O; Navas, Alejandro

    2017-04-01

    To report the outcomes of patients who underwent miniature glaucoma shunt implantation after secondary glaucoma due to keratoplasty. Prospective study of consecutive clinical cases who underwent mini-glaucoma shunt implantation following keratoplasty. In brief, a fornix-based conjunctival flap was performed, approximately 50% thickness scleral flap. Mitomycin C 0.025% placed under Tenon's capsule. A 25-G needle created entry for mini-shunt. Ex-PRESS model P-50 was inserted. Scleral flap and conjunctiva were closed with 10-0 Nylon. STATA 8.0 and SPSS software were used for statistical analysis. Seventeen eyes of 17 patients with a mean age of 39.70 years (SD=18.33, range: 18 to 76). A total of 64.70% were male and 35.30% female. Eleven cases after penetrating keratoplasty, 3 cases after triple procedure, 2 after deep anterior lamellar keratoplasty, and 1 following endothelial keratoplasty. Most of the indications for keratoplasty were keratoconus in 9 cases (52.94%), 4 due to endothelial failure (23.52%), 3 cases of herpetic keratitis (17.64%), and 1 case of post-LASIK ectasia (5.88%). Mean preoperative intraocular pressure was 35.94 mm Hg with maximal medical therapy (SD=9.65, range: 18 to 55). Decreasing intraocular pressure to 12.76 mm Hg postoperatively (SD=2.51, range 10 to 18) (P=0.001). Mean follow-up after mini-glaucoma shunt implantation was 23.76 months (SD=8.73, range: 10 to 35 mo). Preoperative mean uncorrected distance visual acuity (UDVA) was 1.31±0.63 (20/408 Snellen) and postoperative mean UDVA was 0.85±0.40 (20/141 Snellen) (P=0.001). Preoperative mean corrected distance visual acuity (CDVA) was 0.83±0.76 (20/135 Snellen) and postoperative mean CDVA was 0.56±0.44 (20/72 Snellen) (P=0.032). Ex-PRESS miniature glaucoma shunt could be an alternative treatment in postkeratoplasty glaucoma resistant to medical treatment. This technique may be helpful, in trying to avoid corneal damage produced by conventional glaucoma procedures.

  2. A new martingale approach to Kalman Filtering

    NARCIS (Netherlands)

    Bagchi, Arunabha

    1976-01-01

    A new derivation of continuous-time Kalman Filter equations is presented. The underlying idea has been previously used to derive the smoothing equations. A unified approach to filtering and smoothing problems has thus been achieved.

  3. [Compliance of treatment in glaucoma patients].

    Science.gov (United States)

    Banc, Ana; Stan, Cristina

    2013-01-01

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

  4. Diffuse brain damage in normal tension glaucoma.

    Science.gov (United States)

    Giorgio, Antonio; Zhang, Jian; Costantino, Francesco; De Stefano, Nicola; Frezzotti, Paolo

    2018-01-01

    Brain changes within and beyond the visual system have been demonstrated in primary open angle glaucoma (POAG), the most common type of glaucoma. These changes have been often interpreted as a neurodegenerative process due, at least partially, to the raised intraocular pressure (IOP). In this context, normal tension glaucoma (NTG), a form of POAG with IOP acquired multimodal brain MRI in NTG patients (n = 17) and compared them with demographically matched groups of POAG patients with raised IOP (n = 17) and normal controls (NC, n = 29). Voxelwise statistics was performed with nonparametric permutation testing. Both NTG and POAG patients showed, compared to NC, significantly more gray matter atrophy in both the visual system and in nonvisual brain regions and altered diffusion tensor imaging-derived anatomical connectivity (AC; lower fractional anisotropy and/or higher diffusivities). Compared with NTG, POAG had both more atrophic visual cortex and higher axial diffusivity in nonvisual regions. Functional connectivity (FC) with respect to NC was altered in NTG at short-range level [visual network (VN), ventral attention network] and in POAG at long-range level (between secondary VN and limbic network). FC of POAG was higher than NTG in both VN and executive network. This study provides further evidence that diffuse structural and functional abnormalities across glaucoma brain may be, at least partially, independent of raised IOP and the consequent retinal degeneration. This further defines glaucoma as a condition with neurodegeneration spreading. Hum Brain Mapp 39:532-541, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    Andréia Peltier Urbano

    2003-01-01

    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

  6. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  7. Filter systems

    International Nuclear Information System (INIS)

    Vanin, V.R.

    1990-01-01

    The multidetector systems for high resolution gamma spectroscopy are presented. The observable parameters for identifying nuclides produced simultaneously in the reaction are analysed discussing the efficiency of filter systems. (M.C.K.)

  8. Clinical observation of the glaucoma trabeculectomy with tunnel knife making the double-deck scleral flap

    Directory of Open Access Journals (Sweden)

    Min Fu

    2015-07-01

    Full Text Available AIM: To study the trabeculectomy clinical effect of use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap of glaucoma.METHODS:Using the random grouping method to divide 46 cases(60 eyesof glaucoma into the treatment group of 24 cases(32 eyesand control group of 22 cases(28 eyes. The treatment group, tunnel knife was used to make double-deck sclera flap and superficial scleral flap about the size of 5mm×5.5mm,1/3 scleral thickness, under the sclera flap made another one about the size of 3.5mm×4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. In control group, routine glaucoma trabeculectomy was undergone.RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference(PP>0.05. But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference(PPCONCLUSION:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

  9. Correlations between Corneal Biomechanics and Glaucoma Severity in Patients with Primary Open Angle Glaucoma.

    Science.gov (United States)

    Dascalescu, Dana; Corbu, Catalina; Constantin, Mihaela; Cristea, Miruna; Ionescu, Catalina; Cioboata, Miruna; Voinea, Liliana

    2015-09-01

    To investigate the relationship between corneal biomechanical changes and glaucoma severity in primary open angle glaucoma patients. Correlation study. Our study included 70 glaucomatous eyes; they were divided in groups using Glaucoma Staging System Based on Humphrey Visual Field. Ocular Response Analyzer (ORA) was used in order to determine corneal hysteresis (CH) and corneal resistance factor (CRF); ultrasonic pachimetry (Ocuscan) to measure central corneal thickness (CCT) and Humphrey Visual Analyser to determine mean deviation (MD), pattern standard deviation (PSD) and visual field index (VFI). For statistical analysis we used descriptive analysis and linear regression using IBM SPSS Statistics Standard. Out of the 70 eyes with primary open angle glaucoma examined that had visual acuity 0,7 or better, 35 were included in stage 1 (MD 0.01dB -> -6dB), 21 in stage 2 (MD -6.01dB -> -12dB) and 14 in stage 3 (MD -12.01dB -> -20dB). A considerable statistic correlation was found between CH and VFI both in the entire group of primary open angle glaucoma patients( r=0.44, p<0.001), and in stages 1 (r=0.44, p<0.009), 2 (r=0.51, p<0.01) and 3 (r=0.52, p<0.05). The study shows a moderate correlation, statistically significant, between corneal hysteresis and visual field index in glaucoma patients. Ocular response analyzer can be considered an useful instrument in evaluation of primary open angle glaucoma patients.

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

    Directory of Open Access Journals (Sweden)

    Mary Anna Carbone

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

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

    Science.gov (United States)

    Carbone, Mary Anna; Chen, Yuhong; Hughes, Guy A; Weinreb, Robert N; Zabriskie, Norman A; Zhang, Kang; Anholt, Robert R H

    2011-01-01

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

  12. Genetic modification of glaucoma associated phenotypes between AKXD-28/Ty and DBA/2J mice

    Directory of Open Access Journals (Sweden)

    Zabaleta Adriana

    2001-01-01

    Full Text Available Abstract Background Glaucoma is a common disease but its molecular etiology is poorly understood. It involves retinal ganglion cell death and optic nerve damage that is often associated with elevated intraocular pressure. Identifying genes that modify glaucoma associated phenotypes is likely to provide insights to mechanisms of glaucoma. We previously reported glaucoma in DBA/2J mice caused by recessive alleles at two loci, isa and ipd, that cause iris stromal atrophy and iris pigment dispersion, respectively. A approach for identifying modifier genes is to study the effects of specific mutations in different mouse strains. When the phenotypic effect of a mutation is modified upon its introduction into a new strain, crosses between the parental strains can be used to identify modifier genes. The purpose of this study was to determine if the effects of the DBA/2J derived isa and ipd loci are modified in strain AKXD-28/Ty. Results AKXD-28/Ty mice develop glaucoma characterized by intraocular pressure elevation, retinal ganglion loss, and optic nerve excavation. In AKXD-28/Ty, isa causes an iris stromal atrophy phenotype as in DBA/2J. However, the iris pigment dispersion phenotype associated with ipd in DBA/2J does not occur in AKXD-28/Ty. Additionally, a greater severity and speed of retinal and optic nerve damage following intraocular pressure elevation in AKXD-28/Ty compared to DBA/2J mice suggests that AKXD-28/Ty is more susceptible to pressure-induced cell death. Conclusions The consequences of the ipd and isa mutations are modified in the AKXD-28/Ty background. These strains provide a resource for the identification of modifier genes that modulate pigment dispersion and susceptibility to pressure-induced cell death.

  13. Association of a polymorphism in the BIRC6 gene with pseudoexfoliative glaucoma.

    Directory of Open Access Journals (Sweden)

    Humaira Ayub

    Full Text Available Recently an association was observed between alleles in genes of the unfolded protein response pathway and primary open angle glaucoma (POAG. The goal of the current study is to investigate the role of these two genes, protein disulphide isomerase A member 5 (PDIA5 and baculoviral IAP repeat containing 6 (BIRC6, in different forms of glaucoma. 278 patients with POAG, 132 patients with primary angle closure glaucoma (PACG and 135 patients with pseudoexfoliative glaucoma (PEXG were genotyped for single nucleotide polymorphisms (SNPs rs11720822 in PDIA5 and 471 POAG, 184 PACG and 218 PEXG patients were genotyped for rs2754511 in BIRC6. Genotyping was done by allelic discrimination PCR, and genotype and allele frequencies were calculated. Logistic regression analyses were performed using R software to determine the association of these SNPs with glaucoma. The allele and genotype frequencies of rs11720822 in PDIA5 were not associated with POAG, PACG or PEXG. The TT genotype of rs2754511 in BIRC6 was found to be protective for PEXG (p = 0.05, OR 0.42 [0.22-0.81] in the Pakistani population, but not for POAG or PACG. This study did not confirm a previously reported association of risk alleles in PDIA5 and BIRC6 with POAG, but did demonstrate a protective role of the T allele of rs2754511 in the BIRC6 gene in PEXG. This supports a role for the unfolded protein response pathway and regulation of apoptotic cell death in the pathogenesis of PEXG.

  14. Filter and Filter Bank Design for Image Texture Recognition

    Energy Technology Data Exchange (ETDEWEB)

    Randen, Trygve

    1997-12-31

    The relevance of this thesis to energy and environment lies in its application to remote sensing such as for instance sea floor mapping and seismic pattern recognition. The focus is on the design of two-dimensional filters for feature extraction, segmentation, and classification of digital images with textural content. The features are extracted by filtering with a linear filter and estimating the local energy in the filter response. The thesis gives a review covering broadly most previous approaches to texture feature extraction and continues with proposals of some new techniques. 143 refs., 59 figs., 7 tabs.

  15. Sensory pollution from bag-type fiberglass ventilation filters: Conventional filter compared with filters containing various amounts of activated carbon

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Fadeyi, M.O.; Clausen, Geo

    2009-01-01

    was judged to be significantly better than the air downstream of the 6-month-old F7 filter, and was comparable to that from an unused F7 filter. Additionally, the combination filters removed more ozone from the air than the F7 filter, with their respective fractional removal efficiencies roughly scaling......As ventilation filters accumulate particles removed from the airstream, they become emitters of sensory pollutants that degrade indoor air quality. Previously we demonstrated that an F7 bag-type filter that incorporates activated carbon (a "combination filter") reduces this adverse effect compared...... to an equivalent filter without carbon. The aim of the present study was to examine how the amount of activated carbon (AC) used in combination filters affects their ability to remove both sensory offending pollutants and ozone. A panel evaluated the air downstream of four different filters after each had...

  16. 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.

  17. The Endocannabinoid System as a Therapeutic Target in Glaucoma

    Science.gov (United States)

    Cairns, Elizabeth A.; Baldridge, William H.; Kelly, Melanie E. M.

    2016-01-01

    Glaucoma is an irreversible blinding eye disease which produces progressive retinal ganglion cell (RGC) loss. Intraocular pressure (IOP) is currently the only modifiable risk factor, and lowering IOP results in reduced risk of progression of the disorder. The endocannabinoid system (ECS) has attracted considerable attention as a potential target for the treatment of glaucoma, largely due to the observed IOP lowering effects seen after administration of exogenous cannabinoids. However, recent evidence has suggested that modulation of the ECS may also be neuroprotective. This paper will review the use of cannabinoids in glaucoma, presenting pertinent information regarding the pathophysiology of glaucoma and how alterations in cannabinoid signalling may contribute to glaucoma pathology. Additionally, the mechanisms and potential for the use of cannabinoids and other novel agents that target the endocannabinoid system in the treatment of glaucoma will be discussed. PMID:26881140

  18. The Endocannabinoid System as a Therapeutic Target in Glaucoma

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Cairns

    2016-01-01

    Full Text Available Glaucoma is an irreversible blinding eye disease which produces progressive retinal ganglion cell (RGC loss. Intraocular pressure (IOP is currently the only modifiable risk factor, and lowering IOP results in reduced risk of progression of the disorder. The endocannabinoid system (ECS has attracted considerable attention as a potential target for the treatment of glaucoma, largely due to the observed IOP lowering effects seen after administration of exogenous cannabinoids. However, recent evidence has suggested that modulation of the ECS may also be neuroprotective. This paper will review the use of cannabinoids in glaucoma, presenting pertinent information regarding the pathophysiology of glaucoma and how alterations in cannabinoid signalling may contribute to glaucoma pathology. Additionally, the mechanisms and potential for the use of cannabinoids and other novel agents that target the endocannabinoid system in the treatment of glaucoma will be discussed.

  19. Glaucoma in U.S. Civil Aviation: 2005-2014.

    Science.gov (United States)

    DeJohn, Charles A; Mills, William D

    2017-12-01

    Until recently, glaucoma requiring treatment was disqualifying for U.S. pilots and required an aeromedical special issuance waiver. Since 2013 Aerospace Medical Examiners (AMEs) have been authorized to evaluate third-class pilots with mild glaucoma using similar protocols and issue medical certificates without a waiver if these criteria specified in the AME Guide are met. The FAA's medical database was searched for pilots with glaucoma between 2005 and 2014. The National Transportation Safety Board (NTSB) accident database was then searched to determine which pilots with glaucoma had aircraft accidents during that period. The odds of accidents in the glaucoma pilots were compared with the overall pilot accident odds. Of 5000 pilots being treated for glaucoma, 78 were involved in aircraft accidents; however, glaucoma was not cited as the probable cause or contributing factor in any of the accidents. A logistic regression model adjusted for age showed that glaucoma had a protective effect on accident odds. The crude accident rate for third-class pilots with glaucoma was estimated to be 7.2 per 100,000 flight hours, with a fatal accident rate of 1.8 per 100,000. Although these point estimates were slightly higher than the estimated general aviation accident rates, the differences were not statistically significant. These findings suggest that third-class pilots with glaucoma are not at significantly greater risk of an accident than the U.S. general aviation community. It also indicates that FAA certification protocols for certifying and following pilots with glaucoma provide an adequate level of flight safety.DeJohn CA, Mills WD. Glaucoma in U.S. civil aviation: 2005-2014. Aerosp Med Hum Perform. 2017; 88(12):1117-1122.

  20. A Mixed-Methods Evaluation of a Community-Based Glaucoma Check Service in Hackney, London, UK.

    Science.gov (United States)

    Holdsworth, Elizabeth; Datta, Jessica; Marks, Dalya; Kuper, Hannah; Lee, Helen; Leamon, Shaun; Lindfield, Robert; Wormald, Richard; Clarke, Jonathan; Elkarmouty, Ahmed; Macdowall, Wendy

    2017-08-01

    To evaluate the uptake, feasibility and acceptability of a general practice-based optometrist-led glaucoma check service. The service targeted people of black Caribbean and black African descent aged 40-65 years, resident in Hackney, London, United Kingdom. The study used a mixed-method design, including analysis of service data, prospective audit of secondary care referrals patient survey, cost-consequence analysis, and interviews with staff involved in developing and implementing the service. A total of 3040 patients were invited to undergo the free check; 595 (19.6%) booked an appointment and 461 (15.2%) attended. Overall, 31 patients (6.8%) were referred to secondary care, of whom 22 attended and were assessed for glaucoma. Four were diagnosed with glaucoma and eight with suspected glaucoma, i.e. 2.6% of patients who underwent the check. The cost per patient identified with suspected or confirmed glaucoma was £9,013. Staff who were interviewed suggested that patients who attended might be those who routinely attended optometrist appointments, however only 62.4% of survey respondents reported having had an eye examination in the previous two years, and 11.4% of women and 16.0% of men reported never having had an eye examination. This study represents one possible configuration for a glaucoma case-finding service, and it contributes to a wider debate about whether screening, targeted or otherwise, should be offered in the UK. Our findings suggest that general practice is an acceptable setting and that such a service may reach some people not previously engaged with primary eye care services.

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

    Science.gov (United States)

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

    2012-01-01

    The aim of this study was to characterize a representative sample of the Peruvian population suffering open-angle glaucoma (OAG) with respect to the myocilin gene (MYOC) mutations, glaucoma phenotype, and ancestry for future glaucoma risk assessment. 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 screened for nucleotide changes in MYOC exon 3 by conformational sensitive gel electrophoresis (CSGE) and mutation screening. We identified a probable causative novel MYOC missense mutation, Gly326Ser, in one POAG case and found a consistent genotype-phenotype correlation in eight of his relatives. We also found the known causative MYOC mutation Trp286Arg in one JOAG case and one POAG case. A known causative single base MYOC deletion, T1357, was found in one POAG case. Two previously reported silent polymorphisms, Thr325Thr and Tyr347Tyr, were found in both the case and the control populations. A novel missense variant, Met476Arg, was identified in two unrelated controls. The screening of exon 3 of MYOC in a representative sample of 205 independent POAG patients from Peru and 209 matched controls identified novel and previously reported mutations (both pathogenic and nonpathogenic) from other global regions. These results reflect the complex admixture of Amerindian and Old World ancestry in urban populations of Latin America, in general, and in Peru, in particular. It will be important to gather information about the ancestral origin of MYOC and other POAG gene mutations to develop screening panels and risk assessment for POAG in Peru.

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

    Directory of Open Access Journals (Sweden)

    Dewang Angmo

    2015-01-01

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

  3. 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.

  4. Proteus Syndrome: Report of a Case with Developmental Glaucoma

    Science.gov (United States)

    Yuksel, Nursen; Sarman, Hakan; Bayramgurler, Dilek

    2014-01-01

    The purpose of this study was to report developmental glaucoma and pseudopapilledema in a patient with Proteus syndrome. We defined the presence of developmental glaucoma, right pseudopapilledema and myopia in a 4.5-year-old patient with Proteus syndrome. Marked right hemihypertrophy, lipoma, macrodactyly, and asymmetry of the limbs were observed on systemic examination. A cavernoma was also detected in magnetic resonance imaging of the brain. The patient underwent bilateral goniotomy surgery due to glaucoma. The surgical outcomes were satisfactory in both eyes. In conclusions developmental glaucoma and pseudopapilledema might be associated with Proteus syndrome. PMID:24882963

  5. 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.

  6. Glaucoma screening of patients with and without dementia.

    Science.gov (United States)

    Pankow, Laura J; Pryor, Jerry L; Luchins, Daniel J

    2009-01-01

    Glaucoma's damage to peripheral vision compromises mobility to a greater extent than ocular pathology limiting central vision. Half of glaucoma is undiagnosed, as the majority of primary care physicians do not screen for glaucoma. Glaucoma is more prevalent in older adults with dementia than without dementia. This study tested the hypothesis that, in adults 60 and older with dementia, glaucoma screening failure is significantly higher than without dementia. An observational cross-sectional research design with a categorical outcome variable was used. Potential participants/caregivers were questioned regarding glaucoma diagnosis and treatment. Those denying glaucoma or treatment qualified for free screening. Participants (n = 103) were 75% African American (75 females, 28 males, average age 75 +/- 7.59). Thirty-three had dementia. Referral rate with dementia was significantly higher than without dementia (54% vs. 27%, chi(2) = 7.32, p = 0.0007) (95% CI = 0.304-0.816), affirming the study hypothesis. Lack of glaucoma screening and treatment follow-up by a majority of primary care physicians treating geriatric patients demonstrates a need for medical professionals to address function, particularly mobility, to discuss glaucoma's effects with patients/caregivers, and to consider measuring intraocular pressure.

  7. A novel algorithm to detect glaucoma risk using texton and local configuration pattern features extracted from fundus images.

    Science.gov (United States)

    Acharya, U Rajendra; Bhat, Shreya; Koh, Joel E W; Bhandary, Sulatha V; Adeli, Hojjat

    2017-09-01

    Glaucoma is an optic neuropathy defined by characteristic damage to the optic nerve and accompanying visual field deficits. Early diagnosis and treatment are critical to prevent irreversible vision loss and ultimate blindness. Current techniques for computer-aided analysis of the optic nerve and retinal nerve fiber layer (RNFL) are expensive and require keen interpretation by trained specialists. Hence, an automated system is highly desirable for a cost-effective and accurate screening for the diagnosis of glaucoma. This paper presents a new methodology and a computerized diagnostic system. Adaptive histogram equalization is used to convert color images to grayscale images followed by convolution of these images with Leung-Malik (LM), Schmid (S), and maximum response (MR4 and MR8) filter banks. The basic microstructures in typical images are called textons. The convolution process produces textons. Local configuration pattern (LCP) features are extracted from these textons. The significant features are selected using a sequential floating forward search (SFFS) method and ranked using the statistical t-test. Finally, various classifiers are used for classification of images into normal and glaucomatous classes. A high classification accuracy of 95.8% is achieved using six features obtained from the LM filter bank and the k-nearest neighbor (kNN) classifier. A glaucoma integrative index (GRI) is also formulated to obtain a reliable and effective system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. 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.

  9. 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.

  10. [General substance classification and pharmacology of glaucoma].

    Science.gov (United States)

    Thieme, H; Renieri, G; Schuart, C

    2013-12-01

    The pharmaceutical therapy of glaucoma dates back to 1875 when Weber introduced pilocarpine into the medicinal treatment of glaucoma. Since then there has been a continuous development of topical antiglaucoma therapy whereby the main developments date back to the 1980s and 1990s. All forms of medicinal therapy aim at lowering the intraocular pressure and achieve this either by inhibiting aqueous humor secretion into the ciliary body or by enhancing physiological drainage routes along Schlemm's canal. This article gives an overview over the most important classes of antiglaucoma drugs, the indications and contraindications as well as pharmacological characteristics. The focus lies on the market of combination and generic drug preparations that is currently rapidly developing and therefore needs to be discussed in detail.

  11. Anesthetic Preconditioning as Endogenous Neuroprotection in Glaucoma

    Directory of Open Access Journals (Sweden)

    Tsung-Han Chou

    2018-01-01

    Full Text Available Blindness in glaucoma is the result of death of Retinal Ganglion Cells (RGCs and their axons. RGC death is generally preceded by a stage of reversible dysfunction and structural remodeling. Current treatments aimed at reducing intraocular pressure (IOP are ineffective or incompletely effective in management of the disease. IOP-independent neuroprotection or neuroprotection as adjuvant to IOP lowering in glaucoma remains a challenge as effective agents without side effects have not been identified yet. We show in DBA/2J mice with spontaneous IOP elevation and glaucoma that the lifespan of functional RGCs can be extended by preconditioning RGCs with retrobulbar lidocaine in one eye at four months of age that temporary blocks RGC axonal transport. The contralateral, PBS-injected eye served as control. Lidocaine-induced impairment of axonal transport to superior colliculi was assessed by intravitreal injection of cholera toxin B. Long-term (nine months effect of lidocaine were assessed on RGC electrical responsiveness (PERG, IOP, expression of relevant protein (BDNF, TrkB, PSD95, GFAP, Synaptophysin, and GAPDH and RGC density. While lidocaine treatment did not alter the age-related increase of IOP, TrkB expression was elevated, GFAP expression was decreased, RGC survival was improved by 35%, and PERG function was preserved. Results suggest that the lifespan of functional RGCs in mouse glaucoma can be extended by preconditioning RGCs in early stages of the disease using a minimally invasive treatment with retrobulbar lidocaine, a common ophthalmologic procedure. Lidocaine is inexpensive, safe and is approved by Food and Drug Administration (FDA to be administered intravenously.

  12. Acute lens-induced glaucomas: A review

    Directory of Open Access Journals (Sweden)

    Syed Shoeb Ahmad

    2017-02-01

    Full Text Available Lens-induced factors are important and common mechanisms causing acute elevation of intraocular pressure. While in most cases, the diagnosis and management are straight-forward, in others it is difficult and can lead to improper procedures, complications and poor visual outcomes. This review was done with the aim of studying the various types of lens-induced glaucomas, classifying them in an easy way to understand manner, their clinical features, current management and future possibilities.

  13. 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.

  14. MEASUREMENT OF RNFL THICKNESS USING OCT IMAGES FOR GLAUCOMA DETECTION

    Directory of Open Access Journals (Sweden)

    Dhivyabharathi

    2013-08-01

    Full Text Available The thickness of retinal nerve fiber layer (RNFL is one of the pompous parameters for assessing the disease, Glaucoma. A substantial amount of vision can be lost before the patient becomes aware of any defect. Optical Coherence Tomography (OCT provides enhanced depth and clarity of viewing tissues with high resolution compared with other medical imaging devices. It examines the living tissue non-invasively. This paper presents an automatic method to find the thickness of RNFL using OCT images. The proposed algorithm first extracts all the layers present in the OCT image by texture segmentation using Gabor filter method and an algorithm is then developed to segment the RNFL. The thickness measurement of RNFL is automatically displayed based on pixel calculation. The calculated thickness values are compared with the original values obtained from hospital. The result shows that the proposed algorithm is efficient in segmenting the region of interest without manual intervention. The effectiveness of the proposed method is proved statistically by the performance analysis.

  15. 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.

  16. 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.

  17. Cluster headache or narrow angle glaucoma?

    Directory of Open Access Journals (Sweden)

    Prasad Palimar

    1991-01-01

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

  18. 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

  19. Automatic CDR Estimation for Early Glaucoma Diagnosis

    Directory of Open Access Journals (Sweden)

    M. A. Fernandez-Granero

    2017-01-01

    Full Text Available Glaucoma is a degenerative disease that constitutes the second cause of blindness in developed countries. Although it cannot be cured, its progression can be prevented through early diagnosis. In this paper, we propose a new algorithm for automatic glaucoma diagnosis based on retinal colour images. We focus on capturing the inherent colour changes of optic disc (OD and cup borders by computing several colour derivatives in CIE L∗a∗b∗ colour space with CIE94 colour distance. In addition, we consider spatial information retaining these colour derivatives and the original CIE L∗a∗b∗ values of the pixel and adding other characteristics such as its distance to the OD centre. The proposed strategy is robust due to a simple structure that does not need neither initial segmentation nor removal of the vascular tree or detection of vessel bends. The method has been extensively validated with two datasets (one public and one private, each one comprising 60 images of high variability of appearances. Achieved class-wise-averaged accuracy of 95.02% and 81.19% demonstrates that this automated approach could support physicians in the diagnosis of glaucoma in its early stage, and therefore, it could be seen as an opportunity for developing low-cost solutions for mass screening programs.

  20. Cyclodialysis ab interno as a surgical approach to intractable glaucoma.

    Science.gov (United States)

    Jordan, Jens F; Dietlein, Thomas S; Dinslage, Sven; Lüke, Christoph; Konen, Walter; Krieglstein, Günter K

    2007-08-01

    In glaucoma filtration surgery, the problem of subconjunctival scarring has still not been satisfactorily solved. Suprachoroidal drainage of aqueous humour offers a promising, alternative option for intractable glaucoma. We here present a clinical study on the surgical approach of gonioscopic cyclodialysis ab interno. Twenty-eight eyes of 20 patients with intractable glaucoma were included in this prospective, consecutive, case-control study. The eyes had had a mean of 4.4 +/- 2.4 previous antiglaucomatous interventions. Baseline intraocular pressure (IOP) was 34.3 +/- 10.5 mmHg despite maximum therapy. Under gonioscopic control, cyclodialysis ab interno was performed over two clock times to gain access to the suprachoroidal space. No additional trabecular meshwork surgery was performed. Success was defined as a lowering of IOP to below 21 mmHg without the need for further medication or intervention. Mean postoperative IOP was 14.6 +/- 12.4 mmHg. Mean follow-up (FU) for all eyes was 121.8 days. After a mean of 60 days, 21 eyes (75%) needed further surgical intervention. Qualified success was seen in four eyes (14.3%), with a mean FU of 383.6 days. Three eyes (10.7%) showed absolute success after a mean FU period of 202.7 days. In our series, we obtained the best results for phakic eyes, followed by pseudophakic and aphakic eyes. The results of this study do not provide convincing evidence of the functional efficacy of cyclodialysis ab interno. Nevertheless, the technique is easy to perform and offers safe and atraumatic access to the resorptive capability of the choroid. Conjunctival manipulation is avoided. Contrary to reports in the current literature, in our series, the best results were obtained for phakic eyes, though the small number of eyes included does not allow reliable statistics. Further studies will need to focus on the use of different space-retaining substances or a widening of the cyclodialysis cleft to improve surgical outcome.

  1. 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

  2. Generalised Filtering

    Directory of Open Access Journals (Sweden)

    Karl Friston

    2010-01-01

    Full Text Available We describe a Bayesian filtering scheme for nonlinear state-space models in continuous time. This scheme is called Generalised Filtering and furnishes posterior (conditional densities on hidden states and unknown parameters generating observed data. Crucially, the scheme operates online, assimilating data to optimize the conditional density on time-varying states and time-invariant parameters. In contrast to Kalman and Particle smoothing, Generalised Filtering does not require a backwards pass. In contrast to variational schemes, it does not assume conditional independence between the states and parameters. Generalised Filtering optimises the conditional density with respect to a free-energy bound on the model's log-evidence. This optimisation uses the generalised motion of hidden states and parameters, under the prior assumption that the motion of the parameters is small. We describe the scheme, present comparative evaluations with a fixed-form variational version, and conclude with an illustrative application to a nonlinear state-space model of brain imaging time-series.

  3. Effect of glaucoma tube shunt parameters on cornea endothelial cells in patients with Ahmed valve implants.

    Science.gov (United States)

    Koo, Euna B; Hou, Jing; Han, Ying; Keenan, Jeremy D; Stamper, Robert L; Jeng, Bennie H

    2015-01-01

    The aim of this study was to assess the effect of various tube parameters on corneal endothelial cell density (ECD) after insertion of Ahmed valves. Thirty-nine eyes of 33 patients with previous superotemporal (ST) Ahmed valve implantation and 20 eyes of 13 participants with previous uncomplicated phacoemulsification and intraocular lens implantation but no history of glaucoma surgery were evaluated. Various tube parameters were measured with anterior segment optical coherence tomography. ST, central, and inferonasal (IN) ECD and pachymetry were measured. Endothelial cell loss and corneal thickness in the ST cornea was compared with those in the IN cornea. The mean age of the operated patients was 58 ± 22 years, and the mean time since glaucoma surgery was 2.5 ± 2.6 years. Thirty-two of the 39 study eyes were pseudophakic. The ECD was significantly lower in the ST endothelium than in the IN endothelium in eyes with glaucoma tube surgery (P cornea and distance from the tip of the tube to the cornea were significant risk factors for decreased ST endothelial cell loss when assessed relative to the IN ECD (P = 0.01 and P = 0.02, respectively). In multivariate analysis, only the distance of the tube tip to the cornea remained significantly associated with ST endothelial cell loss. Although this was a retrospective study with inherent limitations, tubes that are closer to the cornea seem to lead to increased loss of adjacent endothelial cells.

  4. ipRGCs: possible causation accounts for the higher prevalence of sleep disorders in glaucoma patients

    Directory of Open Access Journals (Sweden)

    Zhen-Zhen Guo

    2017-07-01

    Full Text Available Sleep accounts for a third of one’s lifetime, partial or complete deprivation of sleep could elicit sever disorders of body function. Previous studies have reported the higher prevalence of sleep disorders in glaucoma patients, but the definite mechanism for this phenomenon is unknown. On the other hand, it is well known by us that the intrinsically photosensitive retinal ganglion cells (ipRGCs serve additional ocular functions, called non-image-forming (NIF functions, in the regulation of circadian rhythm, melatonin secretion, sleep, mood and others. Specifically, ipRGCs can directly or indirectly innervate the central areas such as suprachiasmatic nucleus (SCN, downstream pineal gland (the origin of melatonin, sleep and wake-inducing centers and mood regulation areas, making NIF functions of ipRGCs relate to sleep. The more interesting thing is that previous research showed glaucoma not only affected visual functions such as the degeneration of classical retinal ganglion cells (RGCs, but also affected ipRGCs. Therefore, we hypothesize that higher prevalence of sleep disorders in glaucoma patients maybe result from the underlying glaucomatous injuries of ipRGCs leading to the abnormalities of diverse NIF functions corresponding to sleep.

  5. Patterns of functional vision loss in glaucoma determined with archetypal analysis

    Science.gov (United States)

    Elze, Tobias; Pasquale, Louis R.; Shen, Lucy Q.; Chen, Teresa C.; Wiggs, Janey L.; Bex, Peter J.

    2015-01-01

    Glaucoma is an optic neuropathy accompanied by vision loss which can be mapped by visual field (VF) testing revealing characteristic patterns related to the retinal nerve fibre layer anatomy. While detailed knowledge about these patterns is important to understand the anatomic and genetic aspects of glaucoma, current classification schemes are typically predominantly derived qualitatively. Here, we classify glaucomatous vision loss quantitatively by statistically learning prototypical patterns on the convex hull of the data space. In contrast to component-based approaches, this method emphasizes distinct aspects of the data and provides patterns that are easier to interpret for clinicians. Based on 13 231 reliable Humphrey VFs from a large clinical glaucoma practice, we identify an optimal solution with 17 glaucomatous vision loss prototypes which fit well with previously described qualitative patterns from a large clinical study. We illustrate relations of our patterns to retinal structure by a previously developed mathematical model. In contrast to the qualitative clinical approaches, our results can serve as a framework to quantify the various subtypes of glaucomatous visual field loss. PMID:25505132

  6. Caracterización del glaucoma juvenil

    Directory of Open Access Journals (Sweden)

    Silvia Roche Caso

    2011-03-01

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

  7. 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.

  8. Pigment Dispersion Syndrome Progression to Pigmentary Glaucoma in a Latin American Population.

    Science.gov (United States)

    Gomez Goyeneche, Hector Fernando; Hernandez-Mendieta, Diana Patricia; Rodriguez, Diego Andres; Sepulveda, Ana Irene; Toledo, Jose Daniel

    2015-01-01

    To determine the progression of pigment dispersion syndrome (PDS) into pigmentary glaucoma (PG) in a population at the Central Military Hospital in Bogotá, Colombia. A retrospective study was conducted, based on a review of medical records of patients with PDS evaluated in the Glaucoma Clinic. Data were collected in a database in excel and subsequently analyzed with the software Statistical Package for the Social Sciences (SPSS), performing Chi-square test analysis and Spearman's rho test. Forty-eight eyes of 24 patients were included. Forty-two percent were women and 58% were men. Pigmentation of the trabecular meshwork was the most frequent clinical sign (100%), followed by Krukenberg's spindle (91.7%), the least frequent were the iris concavity and iris heterochromia (4.2%), the average of the spherical equivalent was of - 1.33 (SD 2.07). The rate of conversion of PDS to PG was 37.5%, after an average follow-up of 50.7 months. Having an intraocular pressure (IOP) greater than 21 mm Hg was statistically the only significant risk factor for conversion. We found several differences in frequency and clinical signs in these patients in contrast to previous data, probably due to different racial characteristics. The rate of progression is similar to previous reports despite of heterogeneity of these. Having IOP > 21 mm Hg was the only risk factor associated with progression in this sample. How to cite this article: Gomez Goyeneche HF, Hernandez-Mendieta DP, Rodriguez DA, Sepulveda AI, Toledo JD. Pigment Dispersion Syndrome Progression to Pigmentary Glaucoma in a Latin American Population. J Curr Glaucoma Pract 2015;9(3):69-72.

  9. Glaucoma: a brief update for 2017 | Schellack | South African Family ...

    African Journals Online (AJOL)

    Glaucoma is a complex condition of the eye and the second leading cause of blindness around the globe. It is an ophthalmic neurodegenerative condition and is characterised by a raised intra-ocular pressure (IOP). The latter also constitutes the only modifiable risk factor in glaucoma management. When left untreated ...

  10. glaucoma transactions of the ophthalmological society of nigeria

    African Journals Online (AJOL)

    Glaucoma was defined as IOP >21 mmHg with a vertical cup-to-disc ratio (VCDR) ≥0.5. Those with binocular difference in VCDR of >0.2 ± IOP >21 mmHg were considered glaucoma suspects. Those who had evidence of eye infection or inflammation, corneal scar or disease (pterygium, dystrophy, or ectasia), contact lens ...

  11. Should Glaucoma be Publicly Funded in Arguments for Funding ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... Glaucoma adversely affects the visual function, impacting negatively on the individual with glaucoma (IWG),s flourishing life. ... function, especially its adverse effects on their daily activities, health, education, work, economy and overall harm to Nigerian nation. ..... capable manpower for food production.

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

    African Journals Online (AJOL)

    Background: Glaucoma is one of the main causes of blindness worldwide that has been considered as a major public health issue. Raising awareness about glaucoma among the general public, ophthalmic patients and health professionals would be key instrument for early case identification and prevention of blindness.

  13. Clinical Features Of Primary Glaucoma In Ibadan | Ashaye | Nigerian ...

    African Journals Online (AJOL)

    Severe cupping and atrophy of optic nerve heads, severe field loss and high intraocular pressure were the typical presentations. Eyes examined with a gonioscope revealed that 15% had closed, 26.2% had narrow and 58.8% had wide open angle glaucomas. Angle closure glaucoma did not present with acute features in ...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. 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 ...

  16. Comparison of Primary Open Angle Glaucoma Patients in Rural and ...

    African Journals Online (AJOL)

    Purpose: To compare the clinical features of glaucoma patients who present at a rural hospital in North Eastern Ghana and an urban hospital in the capital city of Accra. Methods: This is a multi-center retrospective case series involving records of newly diagnosed glaucoma patients with emphasis on primary open angle ...

  17. 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

  18. Micro-trephination Glaucoma Surgery In Nigerians: 10 Years Outcome

    African Journals Online (AJOL)

    The aim of this study was to show the effectiveness of microtrephination glaucoma surgery in Nigerians followed up for up to 10 years. Eight eyes of 5 Nigerian patients who had microtrephination glaucoma surgery at DDS Eye Surgery, Benin City and the University of Benin Teaching Hospital Benin City were followed up for ...

  19. Glaucomas in Africans | Murdoch | Nigerian Journal of Ophthalmology

    African Journals Online (AJOL)

    It is with great pleasure I accept the task to produce a series of thought windows on a subject that challenges me daily ... the glaucomas! I thought a series of short pieces might be more digestible, so if, for example, you feel frustrated that I have not amplified on disc diagnosis for the glaucomas or classification of the ...

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

    Science.gov (United States)

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

    2010-06-23

    Ocular abnormalities are common in Patau syndrome (trisomy 13), but only a few cases with congenital glaucoma have been reported, some of which were associated with other ocular defects. This report describes a case of primary congenital glaucoma in an 11-year-old patient with full trisomy 13. Copyright 2010, SLACK Incorporated.

  1. 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

  2. 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

  3. Monochromatic pupillometry in unilateral glaucoma discloses noadaptive changes subserved by the ipRGCs

    Directory of Open Access Journals (Sweden)

    Claus eNissen

    2014-02-01

    Full Text Available Purpose: to detect signs of a possible adaptive mechanism of the intrinsic photosensitive ganglion cells in unilateral glaucoma. Method: 11 patients with unilateral glaucoma, classified by automated perimetry (glaucoma: MDKeywords: unilateral glaucoma, melanopsin, intrinsically photosensitive retinal ganglion cells, pupillary light reflex.

  4. 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.

  5. 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.

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

    DEFF Research Database (Denmark)

    Kolko, Miriam

    2015-01-01

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

  7. 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.

  8. Clinical efficacy analysis of Ahmed glaucoma valve implantation in neovascular glaucoma and influencing factors: A STROBE-compliant article.

    Science.gov (United States)

    He, Ye; Tian, Ying; Song, Weitao; Su, Ting; Jiang, Haibo; Xia, Xiaobo

    2017-10-01

    This study aimed to evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation in treating neovascular glaucoma (NVG) and to analyze the factors influencing the surgical success rate.This is a retrospective review of 40 eyes of 40 NVG patients who underwent AGV implantation at Xiangya Hospital of Central South University, China, between January 2014 and December 2016. Pre- and postoperative intraocular pressure (IOP), visual acuity, surgical success rate, medications, and complications were observed. Surgical success criteria were defined as IOP ≤21 and >6 mm Hg with or without additional medications. Kaplan-Meier survival curves and Multivariate cox regression analysis were used to examine success rates and risk factors for surgical outcomes.The mean follow-up period was 8.88 ± 3.12 months (range: 3-17). IOP declined at each visit postoperatively and it was statistically significant (P < .001). An average of 3.55 ± 0.86 drugs was applied preoperatively, while an average of 0.64 ± 0.90 drugs was used postoperatively, with the difference being of statistical significance (P < .05). The complete surgical success rate of 3, 6, and 12 months after the operation was 85%, 75%, and 65%, respectively. Meanwhile, the qualified success rate of 3, 6, and 12 months after the operation was 85%, 80%, and 77.5%, respectively. The multivariate cox regression analysis showed that age (hazard ratio: 3.717, 7.246; 95% confidence interval: 1.149-12.048, 1.349-38.461; P = .028, .021) was influencing factors for complete success rate and qualified success rate among all NVG patients. Gender, previous operation history, primary disease, and preoperative IOP were found to be not significant.AGV implantation is an effective and safe surgical method to treat NVG. Age is an important factor influencing the surgical success rate.

  9. Particle Kalman Filtering: A Nonlinear Framework for Ensemble Kalman Filters

    KAUST Repository

    Hoteit, Ibrahim

    2010-09-19

    Optimal nonlinear filtering consists of sequentially determining the conditional probability distribution functions (pdf) of the system state, given the information of the dynamical and measurement processes and the previous measurements. Once the pdfs are obtained, one can determine different estimates, for instance, the minimum variance estimate, or the maximum a posteriori estimate, of the system state. It can be shown that, many filters, including the Kalman filter (KF) and the particle filter (PF), can be derived based on this sequential Bayesian estimation framework. In this contribution, we present a Gaussian mixture‐based framework, called the particle Kalman filter (PKF), and discuss how the different EnKF methods can be derived as simplified variants of the PKF. We also discuss approaches to reducing the computational burden of the PKF in order to make it suitable for complex geosciences applications. We use the strongly nonlinear Lorenz‐96 model to illustrate the performance of the PKF.

  10. Practice preferences for glaucoma surgery: a survey of the American Glaucoma Society in 2008.

    Science.gov (United States)

    Desai, Manishi A; Gedde, Steven J; Feuer, William J; Shi, Wei; Chen, Philip P; Parrish, Richard K

    2011-01-01

    To evaluate glaucoma surgical practice patterns among members of the American Glaucoma Society (AGS). An anonymous web-based survey was sent to AGS members to determine their preferred surgical approach in ten clinical settings. Survey results were compared with those from 1996 and 2002. A total of 125 (22%) AGS members responded to the survey. Mean glaucoma drainage device (GDD) usage increased from 17.5% (range: 5% to 37%; standard deviation [SD]: 10.9%) in 1996 to 50.8% (range: 15% to 76%; SD: 17.3%) in 2008, and mean trabeculectomy usage decreased from 80.8% (range: 62% to 93%; SD: 11.3%) in 1996 to 45.5% (range: 16% to 80%; SD: 17.9) in 2008. GDD was most popular in none of 8 clinical settings in 1996, and 5 of 8 clinical settings in 2008. Mitomycin C was selected as an adjunctive antifibrotic agent to trabeculectomy in 85% to 99% of cases. Glaucoma surgical practice patterns have changed since 1996. The use of a GDD has progressively increased, and the popularity of trabeculectomy decreased between 1996 and 2008. Mitomycin C remains the most frequently selected antifibrotic agent used as an adjunct to trabeculectomy. Copyright 2011, SLACK Incorporated.

  11. Minimally invasive glaucoma surgery as primary stand-alone surgery for glaucoma.

    Science.gov (United States)

    Kerr, Nathan M; Wang, Jing; Barton, Keith

    2017-05-01

    Recently, many new devices and procedures have been developed to lower intraocular pressure in a less invasive and purportedly safer manner than traditional glaucoma surgery. These new devices might encourage an earlier transition to surgery and reduce the long-term commitment to topical glaucoma medications with their associated compliance and intolerance issues. Although often seen as an adjunct to cataract surgery, a growing body of evidence suggests that primary minimally invasive glaucoma surgery may be a viable initial treatment option. New studies have shown that primary ab interno trabeculectomy (Trabectome, NeoMedix Inc., Tustin, CA, USA), trabecular micro-bypass stent insertion (iStent and iStent Inject, Glaukos Corporation, Laguna Hills, CA, USA), canalicular scaffolding (Hydrus, Invantis Inc., Irvine CA, USA), the ab interno gel Implant (XEN, Allergan, Dublin, Ireland) or supraciliary stenting (CyPass Micro-Stent, Alcon, Fort Worth, TX, USA) may lower the lowering intraocular pressure and/or topical medication burden in phakic or pseudophakic patients with glaucoma. This effect seems to last at least 12 months but reliable cost-effectiveness and quality of life indicators have not yet been established by investigator-initiated randomized trials of sufficient size and duration. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  12. 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.

  13. Eyeglass Filters

    Science.gov (United States)

    1987-01-01

    Biomedical Optical Company of America's suntiger lenses eliminate more than 99% of harmful light wavelengths. NASA derived lenses make scenes more vivid in color and also increase the wearer's visual acuity. Distant objects, even on hazy days, appear crisp and clear; mountains seem closer, glare is greatly reduced, clouds stand out. Daytime use protects the retina from bleaching in bright light, thus improving night vision. Filtering helps prevent a variety of eye disorders, in particular cataracts and age related macular degeneration.

  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. The impact of educational workshops on individuals at risk for glaucoma in the Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Johnson, Deiana M; Stratford, Shayla; Shyu, Andrew P; Sembhi, Harjeet; Molineaux, Jeanne; Reamer, Courtney; Spaeth, George L; Myers, Jonathan S; Hark, Lisa A; Katz, L Jay; Waisbourd, Michael

    2016-04-01

    The purpose of this study was to investigate the impact of educational workshops, led by community health educators, on the level of knowledge, perceived risk of glaucoma, and rate of attendance in a subsequent glaucoma detection examination. Participants attended an educational workshop about glaucoma and completed an 8-question pre- and post-test to assess knowledge. A paired samples t-test assessed mean differences in composite pre- and post-test scores, correct responses for each question, and perceived risk of glaucoma after the workshop. Seven hundred and seven (707) pre- and post-test surveys were completed. There was a significant increase in the level of knowledge about glaucoma as reflected in the pre- and post-test composite scores (M=3.86, SD=1.95 vs. M=4.97, SD=1.82, P<0.001). In the 5 largest community sites, 44% (n=221/480) of the participants who attended an educational workshop scheduled a glaucoma detection examination appointment and 76% (n=160/211) of these participants completed this eye examination in the community setting. Educational workshops increased knowledge and awareness about glaucoma and were helpful in recruiting patients for community-based glaucoma detection examinations. We recommend including educational workshops when conducting community-based outreach programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. 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

  17. Life Experiences of Patients With Glaucoma: A Phenomenological Study.

    Science.gov (United States)

    Iyigun, Emine; Tastan, Sevinc; Ayhan, Hatice; Coskun, Halise; Kose, Gulsah; Mumcuoglu, Tarkan

    2017-10-01

    Studies that describe the experiences of patients with glaucoma from different cultures may help health professionals gain a broader perspective on this issue. Currently, few qualitative studies describe how patients with glaucoma in Turkey cope with daily life. The aim of this study was to explore the experiences of patients with glaucoma. This descriptive phenomenological study used purposive sampling to enroll 20 patients with glaucoma. A qualitative, in-depth, face-to-face interview technique was used to collect data during January and February 2014. The data were analyzed using to the Van Kaam method. Seven themes were identified, including confirming the diagnosis by acute symptoms or unrelated symptoms, grateful to God for having a non-life-threatening disease, feeling happy after receiving more accurate information, coping with the disease by using eye drops and attending follow-up examinations regularly, managing daily life to avoid further damage to eyesight, emotional reactions related to going blind, and urging family members or friends to attend regular glaucoma checkups. Patients with glaucoma experience physiological and psychological problems throughout the course of their disease. Being informed and cultural practices such as "praising God" and "resignation" helped patients cope with the disease. Furthermore, because of the cultural characteristic of social collectivism, participants acted to protect the health of others by informing them about glaucoma. Understanding the experiences of patients with glaucoma is important for nursing practice. Nurses should be encouraged to take a greater role in the care of patients with glaucoma by becoming the primary source of glaucoma disease, treatment, and care-related information.

  18. 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.

  19. Cognitive functions and normal tension glaucoma

    Directory of Open Access Journals (Sweden)

    Akvile Daveckaite

    2017-01-01

    Full Text Available Purpose: Only a few studies have analyzed the potential link between glaucoma and cognitive function impairment. They have found controversial results. This study aims to perform quick cognitive function assessment with clock drawing test (CDT using two different scoring systems and compare between normal tension glaucoma (NTG and cataract patients. Methods: Totally, 30 NTG and 30 patients with cataracts were included in a prospective, pilot study. The predrawn circle was given, and patients were asked to draw the clock showing a time of 11:10. The test was evaluated using two methods – Freund method using a 7-point scoring scale (optimal cutoff ≤4 and Rakusa using a 4-point scoring scale (optimal cutoff ≤3. The level of significance was set at P < 0.05. Results: CDT result was significantly better in cataract group than in NTG group: 3.5 (2 versus 2 (2 by Freund, (P = 0.003 and 6.5 (1 versus 4.5 (2.75 by Rakusa, respectively (P = 0.004. Sixty percent (n = 18 of NTG group and 10% (n = 3 of cataract group patients completed the CDT in the specific picture manner (the short hand on 11 and the long hand between 11 and 12, (P = 0.001. Conclusions: Lower CDT results were seen in NTG patients according to two different scoring systems. NTG patients showed a specific manner of drawing. Further prospective studies are needed to investigate the CDT reliability as fast screening test of cognitive function impairment in glaucoma patients.

  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. Impact of the clinical use of ROCK inhibitor on the pathogenesis and treatment of glaucoma.

    Science.gov (United States)

    Honjo, Megumi; Tanihara, Hidenobu

    2018-03-01

    Rho-associated protein kinase (ROCK), a ubiquitously expressed signaling messenger and downstream effector of Rho, is activated by several bioactive factors in the aqueous humor (AH). Rho-ROCK signaling regulates a wide spectrum of fundamental cellular events, including cell adhesion, motility, proliferation, differentiation, and apoptosis. Previous studies, including our own, found that ROCK inhibitor lowers intraocular pressure (IOP) via a direct effect on the conventional AH outflow pathway, by regulation of contractile properties, fibrotic activity, and permeability of the trabecular meshwork (TM) and Schlemm's canal (SC) tissues, influencing extracellular matrix (ECM) production. Recently, a novel ROCK inhibitor, ripasudil, has been introduced in Japan. Other ROCK inhibitors are now in clinical trials as new IOP-lowering drugs for glaucoma patients. To date, ripasudil, administered together with other glaucoma medications, has proved safe and efficient in lowering IOP as well as additional effects such as prostaglandin analogs, beta-blockers, and carbonic anhydrase inhibitors, all of which help lower IOP by different mechanisms. In addition, we found that long-term treatment with ripasudil exerted an additional IOP-lowering effect, especially in eyes with high IOP, suggesting that late-onset remodeling of the ECM in glaucomatous eyes may elicit mild and delayed changes in IOP levels. ROCK inhibitors have also shown several additional effects, including increased retinal blood flow, direct protection of neurons against various types of stress, and regulation of wound healing; these benefits may potentially be useful in glaucoma treatment.

  2. Predicting Vision-Related Disability in Glaucoma.

    Science.gov (United States)

    Abe, Ricardo Y; Diniz-Filho, Alberto; Costa, Vital P; Wu, Zhichao; Medeiros, Felipe A

    2018-01-01

    To present a new methodology for investigating predictive factors associated with development of vision-related disability in glaucoma. Prospective, observational cohort study. Two hundred thirty-six patients with glaucoma followed up for an average of 4.3±1.5 years. Vision-related disability was assessed by the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) at baseline and at the end of follow-up. A latent transition analysis model was used to categorize NEI VFQ-25 results and to estimate the probability of developing vision-related disability during follow-up. Patients were tested with standard automated perimetry (SAP) at 6-month intervals, and evaluation of rates of visual field change was performed using mean sensitivity (MS) of the integrated binocular visual field. Baseline disease severity, rate of visual field loss, and duration of follow-up were investigated as predictive factors for development of disability during follow-up. The relationship between baseline and rates of visual field deterioration and the probability of vision-related disability developing during follow-up. At baseline, 67 of 236 (28%) glaucoma patients were classified as disabled based on NEI VFQ-25 results, whereas 169 (72%) were classified as nondisabled. Patients classified as nondisabled at baseline had 14.2% probability of disability developing during follow-up. Rates of visual field loss as estimated by integrated binocular MS were almost 4 times faster for those in whom disability developed versus those in whom it did not (-0.78±1.00 dB/year vs. -0.20±0.47 dB/year, respectively; P disability developing over time (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.06-1.70; P = 0.013). In addition, each 0.5-dB/year faster rate of loss of binocular MS during follow-up was associated with a more than 3.5 times increase in the risk of disability developing (OR, 3.58; 95% CI, 1.56-8.23; P = 0.003). A new methodology for classification and analysis

  3. Challenges in the clinical measurement of ocular surface disease in glaucoma patients

    Directory of Open Access Journals (Sweden)

    Pflugfelder SC

    2011-11-01

    Full Text Available Stephen C Pflugfelder1, Christophe Baudouin2,3 1Ophthalmology-Ocular Surface Center, Baylor College of Medicine, Houston, TX, USA; 2Department of Ophthalmology, Quinze-Vingts Hospital, Paris, France; 3Vision Institute, Paris, France Abstract: Ocular surface disease (OSD is common among glaucoma patients. Clinical assessment of OSD can be challenging. This review focuses on some of the limitations relating to both subjective and objective measures of OSD, including dry eye. A survey of the literature was conducted to identify the caveats associated with different methods of assessing OSD. The effect of preservatives on the ocular surface, with respect to glaucoma patients in particular, was also reviewed. Objective methods for assessing ocular surface health and disease include the Schirmer test, tear break-up time, fluorescein turnover, corneal and conjunctival staining, tear osmolarity, and vital dyes. These measures all have limitations in terms of their ability to grade the severity of OSD. Previous studies using the OSD Index showed a mild-to-moderate correlation to dry eye disease severity. Other scoring systems for dry eye have shown a relationship to patient symptom scores or quality of life. Due to the challenges clinicians face concerning both subjective and objective ocular surface health assessments, discerning clinical improvement in ocular surface disease can be a challenge. Further research is needed in order to optimize existing clinical methods and/or identify alternative techniques for assessing OSD in the glaucoma population. Keywords: dry eye, glaucoma, ocular surface disease, ocular surface disease index, preservatives, tear break-up time

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  7. A comparative study of trabeculectomy and the new clear-cornea filtering procedure, intrastromal diathermal keratostomy (IDK)

    DEFF Research Database (Denmark)

    Bach-Holm, Daniella; Storr-Paulsen, Allan; Norregaard, Jens Christian

    2012-01-01

    -established primary open-angle glaucoma referred for filtering operation. We compared the change in intraocular pressure (IOP), number of anti-glaucomatous medication, complications and reoperations after 1 year. Seventy-four eyes were operated with trabeculectomy, and 25 with IDK. Complete success was defined as IOP...

  8. Digital filters

    CERN Document Server

    Hamming, Richard W

    1997-01-01

    Digital signals occur in an increasing number of applications: in telephone communications; in radio, television, and stereo sound systems; and in spacecraft transmissions, to name just a few. This introductory text examines digital filtering, the processes of smoothing, predicting, differentiating, integrating, and separating signals, as well as the removal of noise from a signal. The processes bear particular relevance to computer applications, one of the focuses of this book.Readers will find Hamming's analysis accessible and engaging, in recognition of the fact that many people with the s

  9. Stochastic processes and filtering theory

    CERN Document Server

    Jazwinski, Andrew H

    1970-01-01

    This unified treatment of linear and nonlinear filtering theory presents material previously available only in journals, and in terms accessible to engineering students. Its sole prerequisites are advanced calculus, the theory of ordinary differential equations, and matrix analysis. Although theory is emphasized, the text discusses numerous practical applications as well.Taking the state-space approach to filtering, this text models dynamical systems by finite-dimensional Markov processes, outputs of stochastic difference, and differential equations. Starting with background material on probab

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

    Directory of Open Access Journals (Sweden)

    Hassan Sabit

    2005-10-01

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

  11. Topical treatment of glaucoma: established and emerging pharmacology.

    Science.gov (United States)

    Dikopf, Mark S; Vajaranant, Thasarat S; Edward, Deepak P

    2017-06-01

    Glaucoma is a collection of optic neuropathies consisting of retinal ganglion cell death and corresponding visual field loss. Glaucoma is the leading cause of irreversible vision loss worldwide and is forecasted to precipitously increase in prevalence in the coming decades. Current treatment options aim to lower intraocular pressure (IOP) via topical or oral therapy, laser treatment to the trabecular meshwork or ciliary body, and incisional surgery. Despite increasing use of trabecular laser therapy, topical therapy remains first-line in the treatment of most forms of glaucoma. Areas covered: Novel glaucoma therapies are a long-standing focus of investigational study. More than two decades have passed since the last United States Food and Drug Administration (FDA) approval of a topical glaucoma drug. Here, the authors review established topical glaucoma drops as well as those currently in FDA phase 2 and 3 clinical trial, nearing clinical use. Expert opinion: Current investigational glaucoma drugs lower IOP, mainly through enhanced trabecular meshwork outflow. Although few emerging therapies show evidence of retinal ganglion cell and optic nerve neuroprotection in animal models, emerging drugs are focused on lowering IOP, similar to established medicines.

  12. 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

  13. Difficulty with out-loud and silent reading in glaucoma.

    Science.gov (United States)

    Ramulu, Pradeep Y; Swenor, Bonnielin K; Jefferys, Joan L; Friedman, David S; Rubin, Gary S

    2013-01-23

    We evaluated the impact of glaucoma on out-loud and silent reading. METHODS. Glaucoma patients with bilateral visual field (VF) loss and normally-sighted controls had the following parameters measured: speed reading an International Reading Speed Text (IReST) passage out loud, maximum out-loud MNRead chart reading speed, sustained (30 minutes) silent reading speed, and change in reading speed during sustained silent reading. Glaucoma subjects read slower than controls on the IReST (147 vs. 163 words per minute [wpm], P reading speeds were 12 wpm (6%-7%) slower among glaucoma subjects compared to controls (P reading speed was 16% slower (95% confidence interval [CI] = -24 to -6%, P = 0.002). Each 5 decibel (dB) decrement in better-eye VF mean deviation was associated with 6 wpm slower IReST reading (95% CI = -9 to -3%, P reading (95% CI = -7 to -2%, P reading (95% CI = -13 to -6%, P reading speed decline of 0.5 wpm/min or more over the sustained silent reading period was more common among glaucoma subjects than controls (odds ratio [OR] = 2.2, 95% CI = 1.0-4.9, P Reading speed is slower among glaucoma patients with bilateral VF loss, with the greatest impact present during sustained silent reading. Persons with glaucoma fatigue during silent reading, resulting in slower reading over time.

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

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    Salim S

    2012-06-01

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

  15. Retinal nerve fiber layer reflectance for early glaucoma diagnosis.

    Science.gov (United States)

    Liu, Shuang; Wang, Bingqing; Yin, Biwei; Milner, Thomas E; Markey, Mia K; McKinnon, Stuart J; Rylander, Henry G

    2014-01-01

    Compare performance of normalized reflectance index (NRI) and retinal nerve fiber layer thickness (RNFLT) parameters determined from optical coherence tomography (OCT) images for glaucoma and glaucoma suspect diagnosis. Seventy-five eyes from 71 human subjects were studied: 33 controls, 24 glaucomatous, and 18 glaucoma-suspects. RNFLT and NRI maps were measured using 2 custom-built OCT systems and the commercial instrument RTVue. Using area under the receiver operating characteristic curve, RNFLT and NRI measured in 7 RNFL locations were analyzed to distinguish between control, glaucomatous, and glaucoma-suspect eyes. The mean NRI of the control group was significantly larger than the means of glaucomatous and glaucoma-suspect groups in most RNFL locations for all 3 OCT systems (PNRI performs significantly better than RNFLT at distinguishing between glaucoma-suspect and control eyes using RTVue OCT (P=0.008). The performances of NRI and RNFLT for classifying glaucoma-suspect versus control eyes were statistically indistinguishable for PS-OCT-EIA (P=0.101) and PS-OCT-DEC (P=0.227). The performances of NRI and RNFLT for classifying glaucomatous versus control eyes were statistically indistinguishable (PS-OCT-EIA: P=0.379; PS-OCT-DEC: P=0.338; RTVue OCT: P=0.877). NRI is a promising measure for distinguishing between glaucoma-suspect and control eyes and may indicate disease in the preperimetric stage. Results of this pilot clinical study warrant a larger study to confirm the diagnostic power of NRI for diagnosing preperimetric glaucoma.

  16. The Risk of glaucoma after early bilateral oophorectomy

    Science.gov (United States)

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

    2013-01-01

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

  17. Simulasi Filter Pasif Dan Perbandingan Unjuk Kerjanya Dengan Filter Aktif Dan Filter Aktif Hibrid Dalam Meredam Harmonisa Pada Induction Furnace

    OpenAIRE

    Tanoto, Yusak; Limantara, Limboto; Khandy Lestanto, Khristian

    2005-01-01

    This paper describe about simulation of Passive Filter in analysis to reduce harmonics that happened in a load such as vacuum casting induction furnace 9 kW, 13.8 kVA, 200V, 3 Ph, 50/60 Hz, also gives comparison with Hybrid Active Filter and Active Filter which made satisfaction result on the previous research. The best result achieved on the use of Hybrid Active Filter on %ITHD for 4.27 % and %VTHD for 3.83%, while Active Filter gave on %ITHD for 5.14 % and %VTHD for 3.82%. There ...

  18. Nimodipine Ophthalmic Formulations for Management of Glaucoma.

    Science.gov (United States)

    Maria, Doaa Nabih; Abd-Elgawad, Abd-Elgawad Helmy; Soliman, Osama Abd-Elazeem; El-Dahan, Marwa Salah; Jablonski, Monica M

    2017-04-01

    Preparation and evaluation of topical ophthalmic formulations containing nimodipine-CD complexes prepared using HP-β-CD, SBE-β-CD and M-β-CD for the management of glaucoma. Nimodipine-CD complexes were prepared using a freeze-drying method. Two different molar ratios (NMD:CD) were used for each cyclodextrin. The inclusion complexes were characterized using DSC, FTIR, yield (%), drug content and in vitro release characteristics. NMD-CD complexes incorporated into chitosan eye drops and a temperature-triggered in situ gelling system were evaluated for their pH, viscosity and in vitro release characteristics. We determined the intraocular pressure (IOP) lowering effect of NMD-hydroxypropylmethylcellulose (HPMC) eye drops through a single dose response design using C57BL/6J mice. The minimum effective concentration (MEC) of nimodipine was further applied to mice that vary in the parental allele of Cacna1s, the drug target of nimodipine. Cytotoxicity was also evaluated. Our ophthalmic formulations possessed pH and viscosity values that are compatible with the eye. In vitro release of nimodipine was significantly increased from chitosan eye drops containing NMD-CD complexes compared to uncomplexed drug. Administration of nimodipine can lower IOP significantly after a single drop of drug HPMC suspension. The IOP-lowering response of the MEC (0.6%) was significantly influenced by the parental allele of Cacna1s. Nimodipine can be used as a promising topical drug for management of glaucoma through ocular delivery.

  19. Combined surgical intervention at terminal glaucoma

    Directory of Open Access Journals (Sweden)

    O. A. Kiseleva

    2012-01-01

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

  20. 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.

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

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    Marcos Balbino

    2013-12-01

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

  2. Automated diagnosis of diabetic retinopathy and glaucoma using fundus and OCT images

    Directory of Open Access Journals (Sweden)

    Pachiyappan Arulmozhivarman

    2012-06-01

    Full Text Available Abstract We describe a system for the automated diagnosis of diabetic retinopathy and glaucoma using fundus and optical coherence tomography (OCT images. Automatic screening will help the doctors to quickly identify the condition of the patient in a more accurate way. The macular abnormalities caused due to diabetic retinopathy can be detected by applying morphological operations, filters and thresholds on the fundus images of the patient. Early detection of glaucoma is done by estimating the Retinal Nerve Fiber Layer (RNFL thickness from the OCT images of the patient. The RNFL thickness estimation involves the use of active contours based deformable snake algorithm for segmentation of the anterior and posterior boundaries of the retinal nerve fiber layer. The algorithm was tested on a set of 89 fundus images of which 85 were found to have at least mild retinopathy and OCT images of 31 patients out of which 13 were found to be glaucomatous. The accuracy for optical disk detection is found to be 97.75%. The proposed system therefore is accurate, reliable and robust and can be realized.

  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. Optic nerve head morphologic characteristics in chronic angle-closure glaucoma and normal-tension glaucoma.

    Science.gov (United States)

    Zhao, Lin; Wu, Lingling; Wang, Xin

    2009-08-01

    To determine whether the morphometric features of the optic disk in eyes with chronic angle-closure glaucoma (CACG) are different from those with normal-tension glaucoma (NTG). This is a retrospective, case-matched study. Patients with CACG or NTG in an early or moderate stage were recruited. On the basis of age, sex, and visual field mean defect, patients with CACG were matched to those with NTG on a case-by-case basis. Heidelberg retina tomography was used to evaluate the optic disk, and parameters were compared between the 2 groups. Sixty-three patients were recruited for the study. Twenty cases (eyes) with CACG were matched to 20 cases (eyes) with NTG. The total, temporal/inferior, nasal/superior, and nasal/inferior rim area of the optic disk were significantly larger (Pmorphometric features of the optic disk in eyes with CACG are different from those with NTG.

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

    OpenAIRE

    Molleda-Carbonell José Mª; Martín-Suárez, Eva Mª

    2009-01-01

    ResumenEl diagnóstico precoz del glaucoma es un problema en oftalmologíaveterinaria. Basándose en los síntomas clínicos habituales el diagnóstico suele hacerse en un punto en el que la visión ha sufrido un importante deterioro. Basados en el hecho de que el glaucoma es una enfermedad neurodegenerativa del nervio óptico y que sus primeras manifestaciones son degeneración y muerte de las células ganglionares de la retina, degeneración de axones del nervio óptico y por tanto disminución de la ca...

  6. Comparison of digital and film stereo photography of the optic nerve in the evaluation of patients with glaucoma.

    Science.gov (United States)

    Khouri, Albert S; Szirth, Bernard; Realini, Tony; Fechtner, Robert D

    2006-12-01

    The aim of this study was to validate a digital simultaneous stereo photography system against film in the assessment of optic nerve head features in patients with glaucoma. Fifteen digital and 15 corresponding film simultaneous stereo photographs (SSP) of the optic nerve from patients with glaucoma were graded by two glaucoma specialists. Assessed parameters included the vertical and horizontal cup-to-disc ratios (VCD and HCD, respectively), and the image quality score (1 = worse, 5 = best) for each image. Digital and film SSP were presented in random order, two times to each grader. A total of 60 evaluations (30 digital and 30 film) per grader were collected. A Nidek 3-Dx simultaneous stereo disc camera (Gamagori, Japan) was used with both a standard 35-mm-film camera back, and with a 6.1 mega pixel camera (Nikon D1x, Tokyo, Japan) for capture of digital images. All digital images were stored on a computer and reviewed using the Navis Screener software (proprietary software from Nidek). Digital image pairs were evaluated directly on an ADVAN 27-inch Liquid Crystal Display computer monitor (Taipei, Taiwan) with resolution comparable to that of the digital camera, using the screen-vu stereo viewer held at a fixed angle to the monitor. Film image pairs were evaluated using a Pentax stereo slide viewer (Asahi Optical Co., Tokyo, Japan) illuminated by a light box over a neutral density filter to match the luminance between the computer screen and the light box. The mean difference between digital and film was near zero for all three evaluated outcomes (VCD, HCD, and quality score), and there was no significant grader effect for any of the outcomes. Digital images correlated well with film for SSP of the optic nerve in glaucoma.

  7. Topical medication instillation techniques for glaucoma.

    Science.gov (United States)

    Xu, Li; Wang, Xuemei; Wu, Meijing

    2017-02-20

    Glaucoma is a leading cause of irreversible blindness worldwide and the second most common cause of blindness after cataracts. The primary treatment for glaucoma aims to lower intraocular pressure (IOP) with the use of topical medicines. Topical medication instillation techniques, such as eyelid closure and nasolacrimal occlusion when instilling drops, have been proposed as potential methods to increase ocular absorption and decrease systemic absorption of the drops. To investigate the effectiveness of topical medication instillation techniques compared with usual care or another method of instillation of topical medication in the management of glaucoma or ocular hypertension. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1947 to 8 December 2016), PubMed (1948 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), International Pharmaceutical Abstracts Database (1970 to 8 December 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 13 May 2013), ClinicalTrials.gov (www.clinicaltrials.gov) (searched 8 December 2016) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) (searched 8 December 2016). We did not use any date or language restrictions in the electronic searches for trials. We included randomized controlled trials which had compared any topical medication instillation technique with usual care or a different method of instillation of topical medication. Two review authors independently screened records from the searches for eligibility, assessed the risk of bias, and extracted data. We followed methods recommended by Cochrane. We identified two trials (122 eyes of 61 participants) that had evaluated a topical medication instillation technique. We

  8. Neuroprotection for treatment of glaucoma in adults.

    Science.gov (United States)

    Sena, Dayse F; Lindsley, Kristina

    2017-01-25

    Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells, and ultimately visual field loss. It is a leading cause of blindness worldwide. Open angle glaucoma (OAG), the most common form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. The objective of this review was to systematically examine the evidence regarding the effectiveness of neuroprotective agents for slowing the progression of OAG in adults compared with no neuroprotective agent, placebo, or other glaucoma treatment. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 7), Ovid MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily (January 1946 to August 2016), Embase (January 1980 to August 2016), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2016), 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 16 August 2016. We included randomised controlled trials (RCTs) in which topical or oral treatments were used for neuroprotection in adults with OAG. Minimum follow-up time was four years. Two review authors independently reviewed titles and abstracts from the literature searches. We obtained full-text copies of potentially relevant studies and re-evaluated for inclusion. Two review authors independently extracted data related to study characteristics, risk of bias, and outcomes. We identified one trial for this review, thus we

  9. Clinical observation of needle revision and 5-fluorouracil subconjunctive injection for the dysfunctional filtering blebs

    Directory of Open Access Journals (Sweden)

    Yan-Hua Gao

    2016-07-01

    Full Text Available AIM:To investigate the efficacy and safety of needle revision with 5-fluorouracil(5-FUon the dysfunctional filtering blebs after trabeculectomy and to assess the factors that may impact the success. METHODS:Eighty-three eyes in 76 patients underwent the needle revision and 5-FU subconjunctive injection for the dysfunctional blebs after trabeculectomy and were followed up for 12mo. The intraocular pressure(IOP, the number of drugs, corneal endothclium, bleb morphology and complications were observed and recorded. RESULTS:IOP decreased significantly from 35.3±5.8mmHg(1kPa=7.5mmHgof pre-needling to 17.0±4.3mmHg of post-needling(PPCI: 10.3-11.6. Statistically, there were no significant difference on needling effect with reference to the types of glaucoma, the use of mitomycin C(MMCduring the previous filtration surgery, the ages of patients, the intervals of needling operation from previous trabeculectomy, while there were significant difference on needling effect with reference to bleb appearance before needling, and the mean number of needling in patients that had surgery within 3mo were less than those who had surgery for more than 3mo. CONCLUSION: The needle revision combined with 5-FU is a safe, effective and simple method. Dysfunctional blebs should be treated early after trabeculectomy.

  10. Experimental Contact Lens to Prevent Glaucoma-Induced Blindness

    Science.gov (United States)

    ... a month. Its construction offers numerous potential clinical advantages over the standard glaucoma treatment and may have ... Media Links Bookmark & Share Free Subscriptions Twitter Facebook Instagram YouTube RSS Feeds Page Footer NIGMS Home Site ...

  11. 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.

  12. Changes to the Aqueous Humor Proteome during Glaucoma.

    Directory of Open Access Journals (Sweden)

    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.

  13. Modelling Goldmann applanation tonometry to improve accuracy of glaucoma screening

    CSIR Research Space (South Africa)

    Botha, N

    2012-10-01

    Full Text Available This presentation outlines how the intraocular pressure inside the human eye can be estimated using numerical techniques. This can be used as a risk indicator in the diagnosis of glaucoma....

  14. Watch Out for Glaucoma | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... get glaucoma, but people at higher risk include African Americans age 40 and older, everyone over 60, especially Hispanic Americans, and those with a family history of the disease. "Studies show that at least half of all persons ...

  15. Shared Cared for Stable Glaucoma Patients: Economic Benefits and Patient-centered Outcomes of a Feasibility Trial.

    Science.gov (United States)

    Goh, David; de Korne, Dirk F; Ho, Henrietta; Mathur, Ranjana; Chakraborty, Bibhas; Van Hai, Nguyen; Wai, Charity; Perera, Shamira; Aung, Tin; Wong, Tien Y; Lamoureux, Ecosse L

    2018-02-01

    The purpose of this article is to assess the quality of care and economic benefits of a shared care model managing patients with stable glaucoma in a primary eye care (PEC) clinic compared with a tertiary specialist outpatient clinic (SOC) in Singapore. A randomized equivalence feasibility trial was preformed comparing the PEC with SOC models. Participants recruited from the SOC had no visual field progression or change in management for at least 3 years, were on a maximum of a single glaucoma medication, had no previous tube-shunt implant and were at least 3-year posttrabeculectomy surgery.Primary outcomes were clinical assessment and management, economic benefits, and patient satisfaction. Differences were analyzed using equivalence testing and generalized odds ratios. The trial included 233 patients, consisting of 42.1% glaucoma disc suspects (PEC: 47.4%; SOC: 36.8%), 27.5% primary angle closure suspects (PEC: 25.0%; SOC: 29.9%), 13.7% with ocular hypertension (PEC: 13.8%; SOC: 13.7%), 3.9% with primary angle closure glaucoma (PEC: 4.3%; SOC: 3.4%), and 3.0% with primary open angle glaucoma (PEC: 1.7%; SOC: 4.3%). Glaucoma clinical care for patients at PEC was as good as SOC [rate difference, 6.83%; 95% confidence interval (CI), 2.84-11.12) and management (rate difference, 7.69%; 95% CI, 3.21-12.17). In 23 cases (9.9%), 5.2% at PEC and 14.5% at SOC, there was disconcordance with the gold standard of senior consultant. Patient satisfaction at the PEC was equally high when compared with SOC (generalized odds ratio, 1.43; CI, 0.50-2.00). Direct costs per patient visit were 43% lower at PEC compared with SOC. Managing stable glaucoma patients at a primary care setting is a cost saving, safe, and effective shared care while enhancing professional collaboration between hospital and community settings.

  16. Awareness and knowledge of glaucoma and associated factors among adults: a cross sectional study in Gondar Town, Northwest Ethiopia.

    Science.gov (United States)

    Alemu, Destaye Shiferaw; Gudeta, Alemayehu Desalegn; Gebreselassie, Kbrom Legesse

    2017-08-24

    Raising public awareness and knowledge about glaucoma is a key for early case identification and prevention of blindness. However, awareness and knowledge about glaucoma is unknown at community level, making provision of interventions difficult. This study was intended to assess the awareness and knowledge of adults about glaucoma and the factors affecting it in Gondar town, Northwest Ethiopia. Community based cross - sectional study was conducted on 701 adults 35 and above years in Gondar from April 12-30, 2016. Multistage sampling technique was used to select study participants. Interviewer administered pretested structured questionnaire was used to collect data after verbal informed consent. Data were entered into EpiData version 3.1 and analyzed by Statistical Package for Social Sciences version 20. Bivariate and multivariate logistic regression models and Odds ratio with 95% interval were used to identify factors. P-value glaucoma aware participants. Education (primary [AOR: 3.21; 1.73, 5.95], secondary [AOR: 4.34; 2.30, 8.22]; college and above [AOR: 9.82; 4.27, 22.60]) and having eye examination [AOR: 2.78; 1.86, 4.15] were positively associated with awareness of glaucoma whereas older age (65 -74 years [AOR: 0.31(0.21, 0.76]) was inversely related. Level of Education (primary[AOR:2.83;1.04,7.71],secondary[AOR:3.45;1.33,9.41],college and above [AOR: 4.86;1.82,12,99] and having eye examination [AOR: 2.61;1.53,4.45] were significantly associated with knowledge. The study has indicated higher level of awareness and knowledge about glaucoma in urban communities than previous studies. It has also identified educational status, eye examination at least once in life are related with better awareness and knowledge. The present awareness and knowledge should be enhanced through public oriented glaucoma education via mass media and incorporating eye check up as a routine in older people.

  17. Nerve Fiber Layer Thickness and Characteristics Associated with Glaucoma in Community Living Older Adults: Prelude to a Screening Trial?

    Science.gov (United States)

    Klein, Barbara E K; Johnson, Chris A; Meuer, Stacy M; Lee, Kyungmoo; Wahle, Andreas; Lee, Kristine E; Kulkarni, Amruta; Sonka, Milan; Abràmoff, Michael D; Klein, Ronald

    2017-04-01

    To examine the associations of nerve fiber layer (NFL) thickness with other ocular characteristics in older adults. Participants in the Beaver Dam Eye Study (2008-2010) underwent spectral domain optical coherence tomography (SD-OCT) scans of the optic nerve head, imaging of optic discs, frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP), and an interview concerning their history of glaucoma and use of drops to lower eye pressure. Self-reported histories of glaucoma and the use of drops to lower eye pressure were obtained at follow-up examinations (2014-2016). NFL thickness measured on OCTs varied by location around the optic nerve. Age was associated with mean NFL thickness. Mean NFL was thinnest in eyes with larger cup/disc (C/D) ratios. Horizontal hemifield defects or other optic nerve-field defects were associated with thinner NFL. NFL in persons who reported taking eye drops for high intraocular pressure was thinner compared to those not taking drops. After accounting for the presence of high intraocular pressure, large C/D ratios or hemifield defects, eyes with thinner NFL in the arcades were more likely (OR = 2.3 for 30 micron thinner NFL, p = 0.04) to have incident glaucoma at examination 5 years later. Retinal NFL thickness was associated with a new history of self-reported glaucoma 5 years later. A trial testing the usefulness of NFL as part of a screening battery for predicting glaucoma in those previously undiagnosed might lead to improved case finding and, ultimately, to diminishing the risk of visual field loss.

  18. Uteroglobin and FLRG concentrations in aqueous humor are associated with age in primary open angle glaucoma patients.

    Science.gov (United States)

    Ashworth Briggs, Esther L; Toh, Tze'Yo; Eri, Rajaraman; Hewitt, Alex W; Cook, Anthony L

    2018-02-27

    The pathophysiological changes occurring in the trabecular meshwork in primary open angle glaucoma are poorly understood, but are thought to include increased extracellular matrix deposition, trabecular meshwork cell apoptosis, inflammation, trabecular meshwork calcification and altered protein composition of the aqueous humor. Although many proteins are present in aqueous humor, relatively few have been studied extensively, and their potential roles in primary open angle glaucoma are unknown. Analyte concentrations in aqueous humor from 19 primary open angle glaucoma and 18 cataract patients were measured using a multiplex immunoassay. Fisher's exact test was used to assess statistical significance between groups, and correlations of analyte concentrations with age, intraocular pressure, pattern standard deviation, mean deviation, cup-to-disc ratio and disease duration since commencing treatment were tested by Spearman's method. CHI3L1, FLRG, HGF, MIF, P-selectin and Uteroglobin were detected in more than 50% of samples of one or both patient groups, some of which have not previously been quantified in aqueous humor. In the glaucoma but not the cataract group, significant correlations were determined with age for Uteroglobin/SCGB1A1 (r s  = 0.805, p < 0.0001) and FLRG (r s  = 0.706, p = 0.0007). Furthermore, HGF correlated significantly with disease duration (r s  = - 0.723, p = 0.0007). There were no differences in analyte concentrations between groups, and no other significant associations with clinical descriptors that passed correction for multiple testing. The correlations of uteroglobin and FLRG with age in primary open angle glaucoma but not cataract may suggest a heightened requirement for anti-inflammatory (uteroglobin) or anti-calcification (FLRG) activity in the ageing glaucomatous trabecular meshwork.

  19. 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...

  20. 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

  1. 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

  2. The next step: detailed assessment of an adult glaucoma patient

    Directory of Open Access Journals (Sweden)

    Matthew Burton

    2012-01-01

    Full Text Available The glaucomas are a group of progressive optic neuropathies associated with characteristic structural changes at the optic nerve head (cupping and corresponding visual field defects. The main modifiable risk factor for glaucomatous optic neuropathy is increased intraocular pressure (IOP. The aims of assessment are:accurate diagnosisidentification of the cause of increased IOP, if applicablequantification of the level of glaucoma damage and functional impairment.

  3. Confocal scanning laser ophthalmoscopy in glaucoma diagnosis and management.

    Science.gov (United States)

    Alexandrescu, C; Dascalu, A M; Panca, A; Sescioreanu, A; Mitulescu, C; Ciuluvica, R; Voinea, L; Celea, C

    2010-01-01

    The early diagnosis and detection of progression are two key-elements in the actual management of glaucoma. The current opinion in clinical practice is to quantify the structural damage for a better follow-up of the patient and the standardization of the results. The present review is a concise survey of literature covering the period of 1990-2010, documenting the evidence-based role of confocal scanning laser ophthalmoscopy in glaucoma diagnosis and management.

  4. Atypical Intrapapillary Hemorrhage in a Patient with Glaucoma

    Directory of Open Access Journals (Sweden)

    Sirel Gür Güngör

    2015-04-01

    Full Text Available A 73-year-old man presented for routine follow-up. There were primary open-angle glaucoma, diabetes mellitus, and usage of acetylsalicylic acid in patient’s history. Dilated fundus examination demonstrated cup hemorrhage in the right eye. Because of the progression of the superotemporal retinal nerve fiber layer defect in the last seven months, we think that the disk hemorrhage could be associated with glaucoma. (Turk J Ophthalmol 2015; 45: 77-8

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

    Directory of Open Access Journals (Sweden)

    Shcherbinina I.V.

    2010-12-01

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

  6. The STARflo glaucoma implant: preliminary 12 months results.

    Science.gov (United States)

    Fili, Sofia; Wölfelschneider, Peter; Kohlhaas, Markus

    2018-04-01

    The STARflo glaucoma implant is a drainage-free system designed for the operative treatment of refractory open-angle glaucoma. The purpose of this study is to investigate the safety and efficacy of the STARflo implant. The results of 12 months follow-up are presented in patients with open-angle glaucoma, PEX-glaucoma, and congenital glaucoma. A prospective study with a total of over 29 patients (36 eyes), in which the suprachoroidal implantation of the STARflo was indicated for long-term intraocular pressure reduction, is still in process and evaluation. The reduction of intraocular pressure was satisfying after 12 months with an average intraocular pressure of 15.0 (± 2.5) mmHg in comparison to 21.08 (± 7.29) mmHg preoperatively. There was a significant 66.7% reduction in local glaucoma drops 12 months postoperatively (p < 0.001). Twenty-five percent of the eyes needed further surgery to regulate the intraocular pressure. No intraoperative complications have been reported after the implantation of STARflo. Postoperative complications include hyphema and fibrin formation in the anterior chamber, which were completely resorbed after the first postoperative month. A postoperative intraocular pressure (IOP) elevation was the most common complication after the first 3 months. The STARflo implant appears to be a safe and effective alternative treatment method for patients with refractory open-angle glaucoma compared to conventional glaucoma surgery.

  7. Teleglaucoma: Improving access and efficiency for glaucoma care

    OpenAIRE

    Faazil Kassam; Kanagasingam Yogesan; Enitan Sogbesan; Louis R Pasquale; Karim F Damji

    2013-01-01

    Teleglaucoma is the application of telemedicine for glaucoma. We review and present the current literature on teleglaucoma; present our experience with teleglaucoma programs in Alberta, Canada and Western Australia; and discuss the challenges and opportunities in this emerging field. Teleglaucoma is a novel area that was first explored a little over a decade ago and early studies highlighted the technical challenges of delivering glaucoma care remotely. Advanced technologies have since emerge...

  8. Presence and Risk Factors for Glaucoma in Patients with Diabetes

    OpenAIRE

    Song, Brian J.; Aiello, Lloyd Paul; Pasquale, Louis R.

    2016-01-01

    Diabetes mellitus represents a growing international public health issue with a near quadrupling in its worldwide prevalence since 1980. Though it has many known microvascular complications, vision loss from diabetic retinopathy is one of the most devastating for affected individuals. In addition, there is increasing evidence to suggest that diabetic patients have a greater risk for glaucoma as well. Though the pathophysiology of glaucoma is not completely understood, both diabetes and glauco...

  9. Infected Baerveldt Glaucoma Drainage Device by Aspergillus niger

    Directory of Open Access Journals (Sweden)

    Nurul-Laila Salim

    2015-01-01

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

  10. Dimensional reduction in nonlinear filtering

    Science.gov (United States)

    Park, J. H.; Sowers, R. B.; Sri Namachchivaya, N.

    2010-02-01

    The theory of nonlinear filtering forms the framework of many data assimilation problems. When the rates of change of different variables differ by orders of magnitude, efficient data assimilation can be accomplished by constructing nonlinear filtering equations for the coarse-grained signal. We consider the conditional law of a signal given the observations in a multi-scale context. In particular, we study how scaling interacts with filtering via stochastic averaging. This is an extension of our previous work (Park et al 2008 Stoch. Dyn. 8 543-60) where the observation process depended only on the fast variable, so the filter became independent of the observation in the limit. Here, we investigate a more realistic setting in which the observation depends on both the slow and the fast variables. Paper dedicated to Professor Manfred Denker on the occasion of his 65th birthday.

  11. 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

  12. Diagnostic Capability of Peripapillary Retinal Volume Measurements in Glaucoma.

    Science.gov (United States)

    Simavli, Huseyin; Poon, Linda Yi-Chieh; Que, Christian J; Liu, Yingna; Akduman, Mustafa; Tsikata, Edem; de Boer, Johannes F; Chen, Teresa C

    2017-06-01

    To determine the diagnostic capability of spectral domain optical coherence tomography peripapillary retinal volume (RV) measurements. A total of 156 patients, 89 primary open-angle glaucoma and 67 normal subjects, were recruited. Spectral domain optical coherence tomography peripapillary RV was calculated for 4 quadrants using 3 annuli of varying scan circle diameters: outer circumpapillary annuli of circular grids 1, 2, and 3 (OCA1, OCA2, OCA3). Area under the receiver operating characteristic curves and pairwise comparisons of receiver operating characteristic (ROC) curves were performed to determine which quadrants were best for diagnosing primary open-angle glaucoma. The pairwise comparisons of the best ROC curves for RV and retinal nerve fiber layer (RNFL) were performed. The artifact rates were analyzed. Pairwise comparisons showed that the smaller annuli OCA1 and OCA2 had better diagnostic performance than the largest annulus OCA3 (Pglaucoma patients but also a subset of early glaucoma patients. The inferior quadrant of peripapillary annulus OCA1 demonstrated the best diagnostic capability for both glaucoma and early glaucoma. The diagnostic ability of RV is comparable with that of RNFL parameters in glaucoma but with lower artifact rates.

  13. 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.

  14. 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.

  15. Discovery of novel inhibitors for the treatment of glaucoma

    Science.gov (United States)

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

    2015-01-01

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

  16. Presence and Risk Factors for Glaucoma in Patients with Diabetes.

    Science.gov (United States)

    Song, Brian J; Aiello, Lloyd Paul; Pasquale, Louis R

    2016-12-01

    Diabetes mellitus represents a growing international public health issue with a near quadrupling in its worldwide prevalence since 1980. Though it has many known microvascular complications, vision loss from diabetic retinopathy is one of the most devastating for affected individuals. In addition, there is increasing evidence to suggest that diabetic patients have a greater risk for glaucoma as well. Though the pathophysiology of glaucoma is not completely understood, both diabetes and glaucoma appear to share some common risk factors and pathophysiologic similarities with studies also reporting that the presence of diabetes and elevated fasting glucose levels are associated with elevated intraocular pressure-the primary risk factor for glaucomatous optic neuropathy. While no study has completely addressed the possibility of detection bias, most recent epidemiologic evidence suggests that diabetic populations are likely enriched with glaucoma patients. As the association between diabetes and glaucoma becomes better defined, routine evaluation for glaucoma in diabetic patients, particularly in the telemedicine setting, may become a reasonable consideration to reduce the risk of vision loss in these patients.

  17. Complementary and Alternate Management of Glaucoma: The Verdict so Far

    Science.gov (United States)

    Ichhpujani, Parul

    2014-01-01

    ABSTRACT Complementary and alternative medicine deserves scientific scrutiny as patients with glaucoma often lose vision despite adequate medical or surgical treatment. Most glaucomatologists abstain from recommending alternative medicine as there is little evidence to support most of the recommendations for complementary and alternate management (CAM) use in glaucoma. Megavitamin supplementation has not been shown to have a long-term beneficial effect on glaucoma. In a glaucomatous eye, a very modest benefit of IOP-lowering may be offset by the temporary elevation in IOP that accompanies exercise. There is little evidence to support the use of special diets, acupuncture, relaxation techniques, or therapeutic touch for the treatment of glaucoma. Marijuana can have a profound lowering of IOP, but the low response rate, short half-life, and significant toxicity are strong indicators that it is not an appropriate therapeutic agent. Future research must be carried out to document the effect of CAM not only on IOP, but also on perimetric tests or other objective parameters, such as ocular blood fow and nerve fiber layer thickness. How to cite this article: Bhartiya S, Ichhpujani P. Complementary and Alternate Management of Glaucoma: The Verdict so Far. J Curr Glaucoma Pract 2014;8(2):54-57. PMID:26997809

  18. Lgr4 in Ocular Development and Glaucoma

    Directory of Open Access Journals (Sweden)

    Stefan Siwko

    2013-01-01

    Full Text Available The leucine-rich repeat-containing G protein-coupled receptor 4 (LGR4, also called GPR48 plays a key role in multiple developmental processes, and mice lacking Lgr4 display anterior segment dysgenesis leading to early-onset glaucomatous retinal ganglion cell loss as well as defective eyelid formation. This paper will review Lgr4 signaling and its regulation of the Axenfeld-Rieger syndrome gene Pitx2, a crucial developmental transcription factor. In addition, Wnt signaling plays an important role in eye development, with Norrin functioning to activate the Wnt receptor Frizzled 4 required for proper retinal vascularization. Recent discoveries identifying Lgr4 as a receptor for Norrin highlight the potential for Lgr4 function in retinal vascularization. Finally, several unanswered questions impeding a full understanding of Lgr4 in glaucoma are considered as avenues for further research.

  19. Glaucoma pigmentario y ultrabiomicroscopía

    OpenAIRE

    Moreno Londoño, María Victoria; Cristina González González, Ma.; Takane Imay, Mariana; Koga Nakamura, Wilson; Rodríguez López, Luz María; Islas de la Vega, Gilberto

    2014-01-01

    Introducción: El síndrome de dispersión pigmentaria se da por la liberación de pigmento del epitelio pigmentado del iris y depósito de gránulos de este en el iris y en las estructuras del segmento anterior, incluyendo el endotelio corneal y la malla trabecular, con posterior aumento de la presión intraocular y glaucoma. Presentación del caso: Paciente masculino de 66 años con historia de disminución de la agudeza visual en ojo derecho (3/200; PIO ojo derecho: 20 mmHg); a la biomicroscopía ...

  20. Improving patient satisfaction in glaucoma care

    Directory of Open Access Journals (Sweden)

    Islam S

    2017-12-01

    Full Text Available Samsul Islam, Ahmad Salha, Saeed Azizi Faculty of Medicine, St George’s Hospital Medical School, London, UKWe read the article by Foo et al1 with great interest. We were intrigued by the factors influencing satisfaction rates among glaucoma patients. It made us question what changes could be made in the future attempting to improve patient satisfaction.\tSimilar to Foo et al,1 we were also surprised to find a lower end-point intraocular pressure was linked with increased patient dissatisfaction. As stated by Foo et al,1 other studies exploring clinical outcomes and patient satisfaction found that a positive clinical state was linked to higher patient satisfaction. Prakash2 proposes a three-way association between patient satisfaction, increased compliance, and better clinical outcomes. Hence, in attempting to investigate patient satisfaction, it would be appropriate to assess patient compliance and clinical outcomes.View the original paper by Foo and colleagues.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Ocular pulse amplitude in different types of glaucoma using dynamic contour tonometry: Diagnosis and follow-up of glaucoma.

    Science.gov (United States)

    Cheng, Lingyan; Ding, Yuzhi; Duan, Xuanchu; Wu, Zhifeng

    2017-11-01

    The aim of the present study was to compare the ocular pulse amplitude (OPA) in patients with different types of glaucoma using dynamic contour tonometry (DCT), to evaluate ocular and systemic factors associated with the OPA and to verify whether OPA measured by DCT is an independent predictor for glaucoma diagnosis. A total of 217 eyes of 217 participants in the following five groups were included in this cross-sectional study: Chronic angle closure glaucoma (CACG), primary open angle glaucoma, normal tension glaucoma (NTG), suspected open angle glaucoma (SOAG) and normal control (NC). The following tests were simultaneously performed during a single visit: Intra-ocular pressure (IOP), OPA, cup-to-disk (C/D) ratio, mean damage (MD) and loss variance (LV). OPAs were compared in each group. The association between OPA and IOP, age, C/D ratio, MD and LV was detected. OPA analysis prior to and after trabeculectomy was also performed to assess its prognostic value. Among the 217 individuals, the OPA was consistent with the IOP, both measured by DCT, along with the MD and LV. Patients with CACG and SOAG had higher OPA values than those with NTG and normal controls. Compared with patients aged >30 years, the OPA was significantly lower in younger patients, while they may not have been affected by different C/D ratios. After trabeculectomy, the OPA had significantly decreased compared with the values prior to surgery. In conclusion, the present study showed that the OPA is correlated with the IOP determined by DCT. CACG and SOAG patients had higher OPA values than patients with other types of glaucoma. OPA measured by DCT may be a predictor for glaucoma diagnosis and prognosis.

  3. Autotaxin-Lysophosphatidic Acid Pathway in Intraocular Pressure Regulation and Glaucoma Subtypes.

    Science.gov (United States)

    Honjo, Megumi; Igarashi, Nozomi; Kurano, Makoto; Yatomi, Yutaka; Igarashi, Koji; Kano, Kuniyuki; Aoki, Junken; Weinreb, Robert N; Aihara, Makoto

    2018-02-01

    To compare the levels of autotaxin (ATX), lysophosphatidic acid (LPA), and lysophosphatidylcholine (LPC) in the aqueous humor (AH) of healthy control subjects with those of patients with different subtypes of glaucoma, and also to investigate the relationship of the ATX-LPA pathway with IOP and subtype of glaucoma. This study included 164 eyes of 164 consecutive cases of cataract and glaucoma surgery (37 healthy, 31 normal tension glaucoma, 49 primary open angle glaucoma, 28 secondary open angle glaucoma, and 19 exfoliation glaucoma). Aqueous levels of LPA, LPC, and ATX were quantified using liquid chromatography-tandem mass spectrometry and a two-site immunoenzymetric assay. The association between aqueous levels of ATX/LPA/LPC and IOP elevation in different glaucoma subtypes was investigated. The diagnostic values of indices of the ATX-LPA pathway were compared using receiver operating characteristic curve analysis. Notable increases in ATX/LPA/LPC levels in glaucoma patients were observed. The ATX-LPA pathway was significantly related to IOP elevation and the subtype of glaucoma, especially in SOAG and XFG patients, and the area under the curve was significant for discriminating glaucoma eyes from healthy eyes. Bioactive ATX/LPA/LPC concentrations were present in aqueous humor, and higher ATX and LPA concentrations were significantly correlated with IOP in all study subjects. Furthermore, the ATX-LPA pathway was significantly related to glaucoma subtype. These results reveal the potentially important role of the ATX-LPA pathway for IOP regulation in healthy subjects and glaucoma patients.

  4. Kidnapping Detection and Recognition in Previous Unknown Environment

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    Yang Tian

    2017-01-01

    Full Text Available An unaware event referred to as kidnapping makes the estimation result of localization incorrect. In a previous unknown environment, incorrect localization result causes incorrect mapping result in Simultaneous Localization and Mapping (SLAM by kidnapping. In this situation, the explored area and unexplored area are divided to make the kidnapping recovery difficult. To provide sufficient information on kidnapping, a framework to judge whether kidnapping has occurred and to identify the type of kidnapping with filter-based SLAM is proposed. The framework is called double kidnapping detection and recognition (DKDR by performing two checks before and after the “update” process with different metrics in real time. To explain one of the principles of DKDR, we describe a property of filter-based SLAM that corrects the mapping result of the environment using the current observations after the “update” process. Two classical filter-based SLAM algorithms, Extend Kalman Filter (EKF SLAM and Particle Filter (PF SLAM, are modified to show that DKDR can be simply and widely applied in existing filter-based SLAM algorithms. Furthermore, a technique to determine the adapted thresholds of metrics in real time without previous data is presented. Both simulated and experimental results demonstrate the validity and accuracy of the proposed method.

  5. Concurrent computation of attribute filters on shared memory parallel machines

    NARCIS (Netherlands)

    Wilkinson, Michael H.F.; Gao, Hui; Hesselink, Wim H.; Jonker, Jan-Eppo; Meijster, Arnold

    2008-01-01

    Morphological attribute filters have not previously been parallelized mainly because they are both global and nonseparable. We propose a parallel algorithm that achieves efficient parallelism for a large class of attribute filters, including attribute openings, closings, thinnings, and thickenings,

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

    Directory of Open Access Journals (Sweden)

    Megan Ulmer Carnes

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

  8. Presenting features of primary angle-closure glaucoma in patients of ...

    African Journals Online (AJOL)

    closure glaucoma depends on their ethnic background. In order to examine the presenting features and effects of primary angle-closure glaucoma in people of mixed ethnicity, we reviewed all 'coloured' patients who presented to Groote Schuur ...

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

    Directory of Open Access Journals (Sweden)

    Anton M Kolomeyer

    2012-01-01

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

  10. The treatment of open- and narrow-angle glaucoma | Sevel | South ...

    African Journals Online (AJOL)

    Abstract. A review of the presentation and diagnosis of acute narrow- angle glaucoma and open-angle glaucoma is presented. Both medical and surgical treatment are discllssed with anevaluation of operative techniques.

  11. 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.

  12. Socioeconomics of long-term glaucoma therapy in India

    Directory of Open Access Journals (Sweden)

    Bhagabat Nayak

    2015-01-01

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

  13. 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.

  14. Reading ability and reading engagement in older adults with glaucoma.

    Science.gov (United States)

    Nguyen, Angeline M; van Landingham, Suzanne W; Massof, Robert W; Rubin, Gary S; Ramulu, Pradeep Y

    2014-07-22

    We evaluated the impact of glaucoma-related vision loss on reading ability and reading engagement in 10 reading activities. A total of 63 glaucoma patients and 59 glaucoma suspect controls self-rated their level of reading difficulty for 10 reading items, and responses were analyzed using Rasch analysis to determine reading ability. Reading engagement was assessed by asking subjects to report the number of days per week they engaged in each reading activity. Reading restriction was determined as a decrement in engagement. Glaucoma subjects more often described greater reading difficulty than controls for all tasks except puzzles (P reading tasks involved puzzles, books, and finances, while the least difficult reading tasks involved notes, bills, and mail. In multivariable weighted least squares regression models of Rasch-estimated person measures of reading ability, less reading ability was found for glaucoma patients compared to controls (β = -1.60 logits, P reading ability was associated with more severe visual field (VF) loss (β = -0.68 logits per 5-dB decrement in better-eye VF mean deviation [MD], P reading on 18% fewer days (P = 0.003) and newspaper reading on 10% fewer days (P = 0.008). No statistically significant reading restriction was observed for other reading activities (P > 0.05). Glaucoma patients have less reading ability and engage less in a variety of different reading activities, particularly those requiring sustained reading. Future work should evaluate the mechanisms underlying reading disability in glaucoma to determine how patients can maintain reading ability and engagement. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Vijaya K Gothwal

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

  18. 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

  19. Two-year results of microcatheter-assisted trabeculotomy in paediatric glaucoma: a randomized controlled study.

    Science.gov (United States)

    El Sayed, Yasmine; Gawdat, Ghada

    2017-12-01

    To compare the outcomes of microcatheter-assisted circumferential trabeculotomy to standard rigid probe trabeculotomy in childhood glaucomas. Eyes of children requiring trabeculotomy for primary congenital or secondary paediatric glaucoma were randomized to undergo either trabeculotomy using the Glaucolight illuminated microcatheter, or a rigid probe trabeculotomy. Complete success was defined as an intraocular pressure (IOP) of glaucoma. The need for reoperation for glaucoma was significantly lower in the microcatheter group. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Glaucoma as a Neurodegenerative Disease: Why We Must 'Look for the Protein'.

    Science.gov (United States)

    Johnson, Lenworth N

    2016-06-01

    For years, clinicians and scientists interested in glaucoma have focused on the anterior segment of the eye and lowering of the intraocular pressure with respect to glaucoma causes and therapies. Yet glaucoma progresses in many individuals despite lowering the intraocular pressure. Herein, the concept of glaucoma as a neurodegenerative disease is presented. [Full article available at http://rimed.org/rimedicaljournal-2016-06.asp, free with no login].

  1. Aortitis requiring aortic repair associated with glaucoma, thyroiditis, glaucoma, and neuropathy: case report

    Directory of Open Access Journals (Sweden)

    Bayer Günther

    2011-05-01

    Full Text Available Abstract Aortitis may be due to infectious and non-infectious causes. We observed aortitis, associated with glaucoma, thyroiditis, pericarditis, pleural effusion and neuropathy in a 63-years old woman. Despite antibiotic therapy, inflammatory signs persisted and resolved only after initiation of glucocorticoid therapy. Increasing aortic ectasia necessitated resection of the ascending aorta and implantation of a Vascutek 30 mm prosthesis. Histologically a granulomatous aortitis was diagnosed. Since all other possible causes were excluded, an immunological mechanism of the aortitis is suspected and possible triggering factors are discussed.

  2. Personality assessment based on the five-factor model of personality structure in patients with primary open-angle glaucoma.

    Science.gov (United States)

    Mabuchi, Fumihiko; Yoshimura, Kimio; Kashiwagi, Kenji; Shioe, Kunihiko; Kanba, Shigenobu; Iijima, Hiroyuki; Tsukahara, Shigeo

    2005-01-01

    Several characteristic personality types have been reported for glaucoma patients in previous studies. However, none of the previous studies used a common structural theory of personality. In this study, we conducted a multicenter cross-sectional case-control study using the recently established five-factor model of personality structure. Personality was evaluated using the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), which is a questionnaire specifically designed to test the five-factor model of personality: neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Eligible questionnaires were obtained from 196 patients with primary open-angle glaucoma (POAG) (99 men, 97 women) and 223 reference subjects with no ocular disease except cataract (87 men, 136 women). The mean score of each NEO-FFI factor for POAG patients was compared to the scores for the reference subjects. Compared with the reference subjects, the mean N score was significantly higher (P = 0.013), the mean scores for A and C were significantly lower (P = 0.007 and P = 0.001, respectively), and the mean E score tended to be lower (P = 0.055) in male POAG patients. The mean E score was significantly lower (P = 0.023) in female POAG patients. Characteristic personality traits were noted in POAG patients, and a more significant relationship was found between personality and glaucoma in men than in women.

  3. Device-modified trabeculectomy for glaucoma.

    Science.gov (United States)

    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

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

    NARCIS (Netherlands)

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

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

  5. The efficacy of NHIS-listed anti-glaucoma drugs in the management ...

    African Journals Online (AJOL)

    Ghana is the most affected country in Africa as far as glaucoma is concerned. This study therefore aims at determining the efficacy of the National Health Insurance Scheme listed anti-glaucoma drugs in the management of primary open-angle glaucoma in Ghana. This retrospective survey was carried out at the Golden ...

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  7. Confusion over and consideration about classification and definition of primary angle-closure glaucoma

    Directory of Open Access Journals (Sweden)

    You-Qin Sun

    2013-12-01

    Full Text Available This paper reflected upon the clinical confusion over the classification and definition of primary angle-closure glaucoma proposed by International Society of Geographical and Epidemiological Ophthalmology(ISGEO. It is pointed out that lack of unified standards for glaucoma is the root of the confusion, and a preliminary discussion is made on the definition of glaucoma.

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

    Directory of Open Access Journals (Sweden)

    Bharathi

    2015-05-01

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

  9. Types of Glaucoma in a University Health Centre in Al‑Ahsa, Saudi ...

    African Journals Online (AJOL)

    Worldwide, glaucoma is the leading cause of irreversible blindness, affecting more than 60 million people which is projected to increase to 76.0 million by 2020 and 111.8 million by 2040.[3] Glaucoma disproportionally affects people residing in Asia and Africa.[3] The prevalence and the type of glaucoma vary in different ...

  10. 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...

  11. 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) <22 mmHg, without anti-glaucoma medications or additional surgery. Qualified success was IOP <22 mmHg regardless of number of anti-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.

  12. Modelling the lifetime economic consequences of glaucoma in France.

    Science.gov (United States)

    Philippe Nordmann, Jean; Lafuma, Antoine; Berdeaux, Gilles

    2009-03-01

    To estimate the lifetime economic consequences of glaucoma in France. A Markov model estimated the average discounted outcome and cost of glaucoma treatment over a patient's lifetime. Clinical states were defined as first- to fourth-line drugs, no treatment, laser therapy, surgery, blindness and death. After each failure (always after the fourth-line drug) patients could receive either laser treatment or surgery followed by no treatment, or a new treatment. A societal perspective was adopted. Sensitivity analyses were performed. Discounted medical costs were euro 7,322 for ocular hypertension treatment (OHT) and euro 8,488 for a glaucoma patient. Social costs of OHT and glaucoma patients exceeded medical costs. First-line use of the most effective drug would reduce medical and social costs. Societal willingness to pay for the vision benefit would equal the medical costs. Treatment initiated with the most effective drug is a cost saving strategy. Public health decisions in glaucoma treatment should take a broad economic view embracing the lifetime duration of the disease. There is still a place both within and outside the healthcare system for therapeutic innovations with important economic consequences that bring high added value to patients.

  13. 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.

  14. Glaucoma and Cytochrome P4501B1 Gene Mutations

    Directory of Open Access Journals (Sweden)

    Mukesh Tanwar

    2010-01-01

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

  15. Clinical effect of neovascular glaucoma treated by vitrectomy and cyclophotocoagulation

    Directory of Open Access Journals (Sweden)

    Yi-Xuan Jin

    2014-07-01

    Full Text Available AIM: To observe the postoperative intraocular pressure(IOPand operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time. METHODS: A total of 12 neovascular glaucoma cases(14 eyessecondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0.1-0.2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the IOP and complications. RESULTS: IOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average IOP at 1wk was 16.7±14.4mmHg, 15.7±8.8mmHg at 1mo and 12.9±4.5mmHg at 6mo, which compared with untreatment(39.6 ±10.0mmHgwas statistically significant different(PCONCLUSION: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

  16. [Structure-function correlation in early diagnosis of glaucoma progression].

    Science.gov (United States)

    Dascălu, Ana-Maria; Alexandrescu, Cristina; Popa-Cherecheanu, Alina; Stana, Daniela; Panca, Aida; Pascu, Ruxandra; Voinea, Liliana

    2011-01-01

    The study investigates the correlations between structure and function in early detection of glaucoma progression. A prospective study was carried on 204 patients diagnosed with POAG and a follow-up period of 4 years. All the patients underwent complex ophthalmological examination, C/D ratio, Disk Damage Likelyhood Scale (DDLS), automated perimetry and Heidelberg retina tomography The relations between structure and function were investigated for all patients, but also according to clinical stage of glaucomatous damage. Structural progression was more frequently associated with perimetric progression for patients with moderate advanced glaucoma. For patients with preperimetric glaucoma and early glaucoma, the progression was present more often for structural test (19,04% and 29,3%), while perimetric progression was less frequent objectivated and weak correlated with structural progression (16,66%). For the 15 cases diagosed with both structural and functional progression, the locations of the structural lesion and functional defect were better correlated in cases involving the poles of the optic disc. Structure-function relation depends on clinical stage of glaucoma and the location of the glaucomatous defects. In early stages, structural investigations can detect progression before perimetry, while in advanced stages, the functional tests are more useful for early detection of progression.

  17. 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.

  18. Canine glaucoma and Helicobacter spp. infection: a possible relationship

    Directory of Open Access Journals (Sweden)

    Ademir Zacarias Junior

    2014-09-01

    Full Text Available The ocular system in domestic animals is very complex and delicate, and composed for the eyeball and ocular adnexal. Disorders that affect the balance between production and outflow of aqueous humor can result in variations in intraocular pressure and glaucoma. Syndrome glaucomatous presents approximately 0.5% incidence in dogs and is a leading cause of blindness, eye pain and surgeries for enucleation. The secondary glaucoma are frequent and result of uveitis by bacteria of the genus Brucella, Leptospira, Ehrlichia, and other etiologic agents. In humans, the bacteria of the genus Helicobacter has attracted the attention of ophthalmologists because potentially operate in the pathogenesis of several eye problems, including glaucoma. In dogs, there are no studies that correlate the origin of glaucoma or secondary uveitis to bacteria of the genus Helicobacter. Whereas uveitis with unknown cause in dogs is very common and proven association between bacteria of the genus Helicobacter and this condition in humans, increases the importance of studies that evaluate these aspects also in pets, helping the understanding of pathogenesis and resulting in proposing therapeutic protocols most effective for glaucoma patients.

  19. Glaucoma screening: analysis of conventional and telemedicine-friendly devices.

    Science.gov (United States)

    Kumar, Sajeesh; Giubilato, Antonio; Morgan, William; Jitskaia, Ludmila; Barry, Chris; Bulsara, Max; Constable, Ian J; Yogesan, Kanagasingam

    2007-04-01

    Portable, telemedicine-friendly devices offer novel opportunity for screening and monitoring glaucoma in the remote and rural regions of the world. This study examines the effective combination of telemedicine-friendly screening devices for detection of glaucoma in relation with conventional, hospital-based devices. A total of 399 eyes were screened with telemedicine-friendly devices and conventional, hospital-based devices such as ophthalmoscope, tonometer and perimeter. Combination of age and family history of glaucoma alone has a sensitivity of 35.6% (specificity 94.2%, area under the curve 0.81, correctly classified 81.1%) and an addition of telemedicine-friendly or conventional visual field tests optimized the sensitivity to 91.1% (specificity 93.6%, area under the curve 0.95, correctly classified 93%). Analysis indicates good agreement between vertical cup-to-disc ratio by ophthalmoscopy and digital image reading. An addition of intraocular pressure test does not change sensitivity (35.6%) and specificity (94.2%). This study indicates that evaluations of cup-to-disc ratio and visual field, using telemedicine-friendly devices, are most useful tools in screening for glaucoma. When used together these devices may be an alternative for conventional glaucoma screenings.

  20. The papilla as screening parameter for early diagnosis of glaucoma.

    Science.gov (United States)

    Michelson, Georg; Wärntges, Simone; Hornegger, Joachim; Lausen, Berthold

    2008-08-01

    In the industrialized countries 67 million people suffer from glaucoma, which represents the third most common cause of blindness and thus has a high economic impact. Early diagnosis of glaucoma, which does not necessarily involve raised intraocular pressure, is essential because by the time the patient notices functional impairment the damage is irreversible. Early treatment can decrease the rate of blindness 20 years later by about 50%. Selective literature review and clinical investigation of early glaucoma detection and of screening methods. Currently, no evidence-based recommendations for glaucoma screening can be found in the literature. No single method or combination of screening procedures can be recommended unambiguously on economic grounds. From the clinical perspective sensitive, specific, and cost-effective glaucoma screening seems feasible. The high-risk group would need to be defined on the basis of age and family history. A two-stage screening process would then have to be established with initial computer-supported telemedical sorting followed by telemedical ophthalmological diagnosis of cases selected for clarification.