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At least 199 records · Page 11Linked to original sources
PubMed2004

Long-term evaluation of trabeculectomy in primary open angle glaucoma and chronic primary angle closure glaucoma in an Asian population.

PURPOSE: A retrospective cohort study was undertaken to evaluate and compare the long-term results of trabeculectomy in primary open angle glaucoma (POAG) and chronic primary angle closure glaucoma (CPACG) in an Asian population. METHODS: Yearly diurnal measurements of intraocular pressure (IOP), best-corrected visual acuity, optic disc and visual field records of patients having primary adult glaucomas who had undergone trabeculectomy, without anti-mitotic agents, with a minimum of 5 years follow up were evaluated. Only one eye of each patient was studied. The success rates for IOP control in POAG and CPACG were statistically analysed. RESULTS: Sixty-four eyes of 64 patients were studied. The overall probability of success of trabeculectomy in controlling IOP to < or = 21 mmHg with or without additional topical antiglaucoma medication was 0.94 and 0.88 at 5 and 10 years, respectively. There was no statistically significant difference in the qualified and absolute success rates for IOP control between POAG and CPACG eyes (log rank test P= 0.6, 0.88, respectively). Twelve of 38 CPACG eyes had a two-line decrease in visual acuity as compared to four of 26 POAG eyes (P = 0.17). Progression or development of a cataract was the most common cause of visual decline. CONCLUSIONS: Trabeculectomy without antimetabolite use appears to be efficacious in lowering IOP and in visual field preservation over a period of 10 years in both POAG and CPACG. Development/progression of cataract especially in eyes with chronic angle closure glaucoma after trabeculectomy must be considered an important issue.

Aged↗
PubMed1997

Familial glaucoma iridogoniodysplasia maps to a 6p25 region implicated in primary congenital glaucoma and iridogoniodysgenesis anomaly.

Familial glaucoma iridogoniodysplasia (FGI) is a form of open-angle glaucoma in which developmental anomalies of the iris and irido-corneal angle are associated with a juvenile-onset glaucoma transmitted as an autosomal dominant trait. A single large family with this disorder was examined for genetic linkage to microsatellite markers. A peak LOD score of 11.63 at a recombination fraction of 0 was obtained with marker D6S967 mapping to chromosome 6p25. Haplotype analysis places the disease gene in a 6.4-cM interval between the markers D6S1713 and D6S1600. Two novel clinical appearances extend the phenotypic range and provide evidence of variable expressivity. The chromosome 6p25 region is now implicated in FGI, primary congenital glaucoma, and iridogoniodysgenesis anomaly. This may indicate the presence of a common causative gene or, alternatively, a cluster of genes involved in eye development/function.

Chromosome Mapping↗
PubMed2003

Graft survival and glaucoma outcome after simultaneous penetrating keratoplasty and ahmed glaucoma valve implant.

PURPOSE: To investigate the success of corneal graft and intraocular pressure (IOP) control after simultaneous penetrating keratoplasty (PKP) and Ahmed glaucoma valve implant in patients with coexisting corneal opacity and glaucoma. METHODS: A retrospective review was undertaken of adult patients at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, who underwent simultaneous PKP and Ahmed glaucoma valve implant between January 1994 and September 1999. RESULTS: Twenty-five eyes of 25 patients were included in the study. Cumulative probabilities of success by Kaplan-Meier analysis showed 92% and 50% graft success and 92% and 86% IOP control at 1 and 3 years, respectively. The main postoperative complication was graft failure in 10 of 25 cases, and the majority of those failures resulted from immunologic graft rejection and tube endothelial touch. CONCLUSION: Ahmed glaucoma valve implant is effective in controlling IOP in a majority of eyes during a 3-year time span. However, corneal graft success continues to pose challenges.

Adult↗
PubMed2000

Comparison of symptomatic and asymptomatic, chronic, primary angle-closure glaucoma, open-angle glaucoma, and controls.

PURPOSE: To determine the clinical features and anatomic parameters in asymptomatic (creeping) and symptomatic, chronic, primary angle-closure glaucoma (PACG) as compared with open-angle glaucoma (OAG) and with control subjects with normal eyes. METHODS: Forty consecutive patients with each of the following four types of eyes were studied (N = 160): eyes with symptomatic PACG, eyes with asymptomatic PACG, eyes with OAG, and the eyes of age-, sex-, and refraction-matched control subjects. The refractive status, keratometry, pachymetry, corneal diameter, anterior chamber depth, lens thickness, axial length, and relative lens position were noted. The groups were compared using a paired t test and analysis of variance. RESULTS: Patients with asymptomatic chronic PACG were older than patients in the symptomatic group, were more often men, and were more likely to have either diabetes mellitus or hypertension. Symptomatic chronic PACG eyes were more hypermetropic. Asymptomatic eyes had more iridotrabecular synechiae and minimal pupillary ruff atrophy as compared with the symptomatic eyes that had largely iridocorneal synechiae and large areas where the ruff was absent. All other clinical and anatomic parameters were statistically similar in the two groups, but differed significantly from OAG and control eyes. CONCLUSIONS: The ocular parameters of asymptomatic or creeping angle closure eyes show that these are significantly different from eyes having POAG. Asymptomatic and symptomatic chronic PACG eyes are structurally similar. Open-angle glaucoma eyes and normal eyes were comparable, but differed from both the chronic angle-closure glaucoma groups in having a larger corneal diameter, deeper anterior chamber, thinner lens, and a longer axial length. The symptomatic chronic PACG eyes showed more evidence of ischemic damage to the iris, and this could account for the symptoms reported by these patients.

Aged↗
PubMed2006

Pars plana insertion of glaucoma drainage devices for refractory glaucoma.

BACKGROUND: Glaucoma drainage devices are more commonly inserted into the anterior chamber because of the relative ease of this method of insertion. However, in certain cases, posterior placement of the tube may be necessary or may be more desirable. The outcome of a series of patients with glaucoma drainage devices inserted into the pars plana was examined. METHODS: Retrospective chart review of patients who underwent pars plana implantation of Molteno and Baerveldt glaucoma drainage devices at the Sydney Eye Hospital. RESULTS: There were 33 cases reviewed. The mean follow-up period was 30.2 months. The mean final postoperative intraocular pressure was reduced to 13.4 +/- 4.4 mmHg (SD) from 33.06 +/- 8.47 mmHg preoperatively. The mean number of intraocular pressure-lowering medications in use postoperatively was 0.6 +/- 0.8, reduced from 3.6 +/- 1.27 medications in use preoperatively. Sixteen (48.5%) eyes were classified as complete successes, 14 (42.4%) eyes as qualified successes and three eyes (9%) as failures. Kaplan-Meier survival analysis for cumulative success (absence of failure) predicted 61.1% survival at 60 months. Complications included five cases of decompensation of corneas or corneal grafts, one case each of conjunctival wound dehiscence, large choroidal effusion, epiretinal membrane, Molteno plate extrusion and intraocular pressure unresponsive to medical therapy, and three cases of tube blockage. CONCLUSIONS: In this series of patients, pars plana insertion of glaucoma drainage devices has been shown to be an effective alternative for selected cases where anterior chamber tube insertion is not possible or is not ideal.

Adult↗
PubMed1988

Glaucoma capsulare in patients with open-angle glaucoma in Hungary.

The data of 403 inpatients with open-angle glaucoma were selected between 1977-1986, 155 had glaucoma capsulare (GC) and 248 suffered from primary open-angle glaucoma (POAG). The incidence rate of GC was 38.4% in the total material. In the GC group, the peak of age distribution was between the ages 70-79 (45.8%). The male/female ratio of the total GC material was 1.67, that in POAG was 0.85. The difference between the two glaucoma groups was significant.

Age Factors↗
PubMed1994

Optic nerve head blood flow using a laser Doppler velocimeter and haemorheology in primary open angle glaucoma and normal pressure glaucoma.

Optic disc blood flow velocity was measured in healthy patients, those with primary open angle glaucoma (POAG), and patients with normal pressure glaucoma (NPG). The velocity of the red blood cells (RBCs) in the capillaries of the optic nerve head (ONH) has been measured with a laser Doppler velocimeter (LDV), and blood viscosity has been evaluated notably by determining the aggregability of the RBCs with an erythroaggregameter. Our results in POAG patients and NPG patients showed that their optic nerve blood flow velocity was reduced and that the aggregability of the RBCs was increased. The hyperaggregability of the erythrocytes is responsible for the increase of the local viscosity in the papillary capillary network. These haemodynamic modifications observed in patients with glaucoma support the hypothesis of a vasogenic mechanism that could impair the optic nerve in glaucoma patients.

Adult↗
PubMed1984

A comparison of visual field loss in primary open-angle glaucoma and the secondary glaucomas.

We compared the pattern of visual field loss in 148 patients with primary open-angle glaucoma and 63 patients with secondary glaucoma. The frequency with which each location in the visual field was defective was similar in the two conditions. The most common visual field defects in both varieties of glaucoma were superior arcuate scotomas and superior nasal steps. The similar distribution of visual field defects in primary and secondary glaucomas is consistent with a common mechanism for optic disc damage.

Computers↗
PubMedDate not supplied

Clinical results of Ahmed glaucoma valve implantation in refractory glaucoma with adjunctive mitomycin C.

OBJECTIVE: To study the surgical outcome and complications of Ahmed glaucoma valve (AGV) implantation with mitomycin C (MMC) in refractory glaucoma. PATIENTS AND METHODS: The authors retrospectively reviewed the records of 40 eyes in 37 consecutive patients who underwent combined AGV with MMC (0.4 mg/mL; 5 minutes). All patients had a minimum of 6 months of follow-up. Outcome measures were best corrected visual acuity, intraocular pressure (IOP), the number of medications, success rates, and the incidence of complications. RESULTS: The Kaplan-Meier life table analysis revealed that the probabilities of surgical success based on our success criteria at 1 year and 2 years postoperatively were 80% and 77%, respectively. Postoperative IOP was significantly lower at all follow-up intervals. At the final visit fewer glaucoma medications were used (2.5 vs 0.7, preoperative vs postoperative). The most frequent complication was hypotony (17%). CONCLUSION: In this retrospective case series with relatively short follow-ups, AGV implantation with mitomycin C in refractory glaucoma appears to be effective without increased complication rates.

Adolescent↗
PubMed2002

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

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

Adult↗
PubMedDate not supplied

Ahmed glaucoma valve implant for childhood glaucoma in Sturge-Weber syndrome with choroidal hemangioma.

We present our experience with implantation of an Ahmed glaucoma valve in a 9-year-old girl with Sturge-Weber syndrome with choroidal hemangioma. In this case of childhood glaucoma, the choice of surgical procedure should be based on the efficacy and elimination of intra-and post-operative complications. An Ahmed glaucoma valve offered safety and efficacy in controlling glaucoma. This technique avoided sudden drops in intraocular pressure and decreases the risk of intraoperative and postoperative choroidal effusion and hemorrhage. The surgical procedure was not complicated: a one-staged implant was satisfactory and a prophylactic sclerostomy was not required.

Child↗
PubMed1989

[Comparison between the optic nerve heads in low tension glaucoma and primary open angle glaucoma].

The optic nerve heads of 52 eyes of 42 patients with low tension glaucoma (LTG) were compared with those of 67 eyes of 47 patients with primary open angle glaucoma (POAG). The mean of the highest intraocular pressure was 2.43 +/- 0.03 kPa (18.3 +/- 0.2 mmHg) in the LTG group, and 3.90 +/- 0.09 kPa (29.3 +/- 0.7 mmHg) in the POAG group, the difference being significant (P less than 0.001). The visual field loss was similar in the two groups, only the temporal optic disc rim in LTG was narrower than in POAG, the rim to disc ratios in other meridians and the cup to disc ratios were not significantly different between the two groups. Deep cups, striate openings on the lamina cribrosa and blood vessel overpasses were significantly more seen in POAG than in LTG Hemorrhages on the disc were more frequent in LTG than in POAG. All these findings may serve as complementary indicators in differential diagnosis between these two types of glaucoma, and support the belief that different mechanisms exist for optic nerve damage in glaucoma.

Diagnosis, Differential↗
PubMedDate not supplied

[Variations in intraocular pressure in normal-pressure glaucoma and in hypertensive open-angle glaucoma].

The comparative study of the intraocular pressure variations at patients with low-tension glaucoma and hypertensive open-angle glaucoma reveals some common modifications regarding the aspect of the nictemeral levels of intraocular tension (the maximal variation of the nictemeral curve, the time of maximal intraocular pressure, variability) and the aspect of the provocative testes. The nictemeral curves and the provocative testes are used at the patients suspects of low-tension glaucoma both for diagnose and to eliminate the incipient open-angle glaucoma with one tensional pick.

Disease Progression↗
PubMed2006

The prevalence of open-angle glaucoma among blacks and whites 73 years and older: the Salisbury Eye Evaluation Glaucoma Study.

OBJECTIVE: To determine the prevalence of glaucoma among black and white persons 73 years and older. DESIGN: Participants in the fourth round of a population-based study, the Salisbury Eye Evaluation, were examined. The main outcome measure was glaucoma, based on optic nerve damage and visual field loss or obvious glaucomatous optic neuropathy without an available, reliable, reproducible visual field. RESULTS: A total of 1250 individuals (95.9% of those eligible) participated, 1233 (98.6%) of whom agreed to screening and an eye examination. The prevalence (95% confidence interval) of open-angle glaucoma was 3.4% (0.5%-6.4%) for white individuals aged 73 and 74 years, increasing to 9.4% (7.4%-11.5%) for those 75 years and older. There was no increasing prevalence in those older than 75 years. Among black persons, the prevalence (95% confidence interval) was 5.7% (0%-11.9%) in those aged 73 and 74 years and 23.2% (17.8%-28.5%) in those 75 years and older. CONCLUSIONS: Many older individuals have open-angle glaucoma, and black persons 75 years and older have substantially higher rates than whites. These findings have important implications for public health initiatives, in which screening programs may be of benefit.

Aged↗
PubMed2006

Disease severity of familial glaucoma compared with sporadic glaucoma.

OBJECTIVE: To determine whether there is a difference in disease severity between familial and sporadic primary open-angle glaucoma (POAG). METHODS: A cross-sectional study design compared the distribution of Glaucoma Inheritance Study in Tasmania (GIST) severity scores of patients with genealogically confirmed familial POAG and those with sporadic POAG. The GIST severity scores provide a combined weighting of glaucoma severity based on findings from visual field defects and optic disc analysis, with and without intraocular pressure. A Poisson regression analysis, t test, and chi(2) tests were performed. RESULTS: One thousand twelve (59.5%) of 1700 subjects had familial glaucoma. The mean +/- SD age at examination was greater in the sporadic POAG group compared with the familial group (72.6 +/- 10.3 years vs 70.6 +/- 12.6 years; P = .001). The family group was significantly younger at diagnosis than the sporadic group (mean +/- SD, 61.4 +/- 13.0 years vs 64.0 +/- 12.6 years; P<.001). The GIST severity scores were significantly skewed toward greater disease severity in the familial group compared with the sporadic group (P<.001). CONCLUSION: Identifying individuals at risk of severe POAG will be more successful if screening programs are developed with appropriate weighting toward those with a positive family history of the disease.

Aged↗
PubMed1982

Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy.

The number and distribution of human optic nerve axons were compared with clinical measurements available the same eyes, including visual acuity, disc appearance, and visual field studies. Definite loss of axons occurs prior to reproducible visual field defects in some patients suspected of having glaucoma. In glaucoma, the superior and inferior poles of the nerve lose nerve fibers at a selectively greater rate, leading to an hourglass-shaped atrophy. Cavernous degeneration of the retrobulbar optic nerve is rarely observed in chronic glaucoma. The pattern of atrophy in examples of toxic amblyopia, ischemic optic neuropathy and chronic papilledema differ from that of glaucoma, suggesting different mechanisms of damage in these conditions.

Adult↗
PubMed1984

Differential light threshold. Short- and long-term fluctuation in patients with glaucoma, normal controls, and patients with suspected glaucoma.

In the diagnosis and evaluation of progression of chronic open-angle glaucoma, a quantitative comparison of visual fields is important for which a knowledge of the spontaneous fluctuation of the visual field is essential. This study shows that in patients with glaucoma, the components of the short- and long-term fluctuation are substantially greater than in patients without the disease. Patients with suspected glaucoma show fluctuation in between, and all components of the fluctuation are greater in them than in normals and smaller than in patients with open-angle glaucoma.

Differential Threshold↗
PubMed1992

Platelet aggregation, disc haemorrhage and progressive loss of visual fields in glaucoma. A seven year follow-up study on glaucoma.

Platelet aggregation in vitro, deterioration of visual field defects (VFD) and the prevalence of disc haemorrhages (DH) were assessed in 49 patients with primary open angle glaucoma (POAG) and compared with the findings for 67 individuals with suspected glaucoma (GS) in a seven-year follow-up study (range 5.8 to 8.2 years). The percentage patients with spontaneous platelet aggregation (SPA) was higher for POAG patients with visual field deterioration (60%) than both POAG patients without progressive loss of visual fields (12.5%; P less than 0.005) and those with suspected glaucoma (22.4%; P less than 0.005). The occurrence of DH was higher among POAG patients with progressive loss of visual field (28%) compared to the GS group (8.4%; P less than 0.025) and the group of patients consisting of POAG patients without deterioration of VFD and GS (9.9%; P less than 0.05). DH also occurred more often in patients with low tension glaucoma (41.6%) than in the remaining POAG patients (13.5%; P less than 0.05). No relation between the patients with SPA and the patients with DH was observed.

Adult↗