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At least 235 records · Page 13Linked to original sources
PubMed2001

Syndroma: glaucoma pigmentatum primarium--pigmented glaucoma.

In this study pigmented glaucoma was diagnosed in 29 out of 4350 patients suffering from glaucoma. In clinical analysis of those cases main attention was put on Krukenberg spindle with emphasis on the process and reason of its development. In all cases of Krukenberg spindle moderate myopia and myopic astigmatism were present. The main axis of the spindle lies in the principal meridian of corneal astigmatism. The principal meridian of the anterior cornea surface corresponds with the axis of the principal meridian of the posterior corneal surface. The higher degree of astigmatism more pronounced Krukenberg spindle. This corresponds to a number of cases in which the spindle is hardly recognisable in the astigmatism, of only +/- 0.25 to +/- 0.50 Dcyl. The axis of meridian corresponds to direct astigmatism (from 110 degrees to 70 degrees). The authors conclude that there is no pigmented Krukenberg spindle without myopic astigmatism. It is for this reason and because of the inheritance factor that this type of glaucoma should be considered primary glaucoma and a separate clinical entity.

Adult↗
PubMedDate not supplied

Comparison of double-plate Molteno and Ahmed glaucoma valve in patients with advanced uncontrolled glaucoma.

BACKGROUND AND OBJECTIVE: To compare double-plate Molteno (DPM) with the Ahmed glaucoma valve (AGV) in the treatment of eyes with complicated glaucoma. PATIENTS AND METHODS: This matched, retrospective, case-control study was based on diagnosis, number of previous operations, and age. There were 30 patients in each group and only patients with a minimum of 6 months follow up were included. Double-plate Molteno or Ahmed glaucoma valve insertion was performed on each patient to control intractable glaucoma. Success was defined as IOP <22 mm Hg and >4 mm Hg on the last two visits, a decrease of no more than 2 lines in the visual acuity, and no additional surgical intervention to control IOP. RESULTS: The Kaplan-Meier estimated probability of success at 12 and 24 months was 73% and 56% with DPM and 60% and 50% for AGV (P = 0.72). Mean IOP measured 13.36 +/- 5.2 mm Hg following DPM and 16.7 +/- 5.6 mm Hg following AGV at 12 months (P = 0.026) and 13.3 +/- 5.1 mm Hg with DPM and 19 +/- 5.8 mm Hg with AGV at 24 months (P = 0.009). Of the patients involved in the study, 83.5% exhibited hypertensive phase (HP) of AGV vs 43.5% of DPM (P = 0.04). AGV had a tendency to fail earlier (5 months +/- 7 following AGV vs 13 months +/- 13 following DPM, P = 0.07, t-test). Patients with either a second valve insertion or valve removal were 7/30 of AGV vs 1/30 in DPM (P = 0.05). Stent removal was needed by 10/30 DPM and 8/30 AGV had needling/5-FU. CONCLUSIONS: The percentage of patients free from failure was similar between the two groups at 36 months. DPM is associated with lower mean IOP in the long term compared to AGV.

Adolescent↗
PubMed2006

[Effect of topical glaucoma medications on optic disc topography in normal tension glaucoma].

PURPOSE: To investigate the effects of topical glaucoma medications on optic disc topography in patients with normal tension glaucoma (NTG) using confocal scanning laser ophthalmoscopy. SUBJECTS AND METHODS: We enrolled 39 NTG patients (39 eyes) who had not been treated for glaucoma. A combined medication of 0.005% latanoprost and 0.5% timolol gel was administered. Optic disc parameters were measured before and after the treatment using the Heidelberg Retina Tomograph (HRT). The treatment period was 20.2 +/- 6.4 days (mean +/- SD). RESULTS: Administration of these two drugs significantly decreased the intraocular pressure (IOP) from 16.7 +/- 1.9 mmHg to 12.3 +/- 1.9 mmHg (26.7 +/- 8.7% decrease). Cup area, cup/disk area ratio and cup volume decreased significantly, while the rim area increased significantly. Linear progression analysis showed a significant correlation between the percent decrease in the IOP and the topographic changes in the cup area, cup/disk area ratio, rim area, cup volume, rim volume, and height variation contour. When the subjects were divided into two groups: patients with high baseline IOP of more than 16 mmHg (HNTG group) and those with low baseline IOP below 15 mmHg (LNTG group), significant changes in several parameters were observed only in the HNTG group. CONCLUSIONS: These results suggest that the topographic changes in the optic disc were induced by the short-term topical glaucoma medications prescribed for the NTG patients, and the changes in several HRT parameters correlated with the percent decrease in the IOP.

Administration, Topical↗
PubMed1990

Neodymium: YAG laser therapy in aphakic pupillary block glaucoma and aphakic malignant (ciliovitreal block) glaucoma.

Aphakic pupillary block glaucoma and malignant glaucoma (ciliovitreal block) are severe complications of the intracapsular cataract extraction, presenting clinically as elevated intraocular pressure, persistent shallow anterior chamber and severe vitreal hernia. Six eyes (four women and two men) with aphakic pupillary block glaucoma and aphakic malignant glaucoma were resolved by Neodymium: YAG laser iridotomy and hyaloidotomy. The laser therapy resulted in immediate deepening of the anterior chamber and reducing of intraocular pressure. No side effect was observed. Neodymium: YAG laser iridotomy and hyaloidotomy may be more effective and simple than penetrating surgery in such cases.

Aged↗
PubMedDate not supplied

[True tolerant intraocular pressure in glaucoma, ocular hypertension and low-tension glaucoma].

Measurements of the true tolerant intraocular pressure (IOP) in 500 eyes of 384 patients with primary glaucoma and in 26 eyes of 13 patients with ophthalmic hypertension have demonstrated that the value of the true tolerant 10P is close to the lowest border of the mean statistical range of normal ophthalmic tone values, this value being, on an average, 13.4 mm Hg in primary glaucoma and 10.2 mm Hg in low-pressure glaucoma, whereas in ophthalmic hypertension it has been much higher - 24.8 mm Hg. The intolerance index in stabilized glaucoma does not surpass 4 mm Hg with both the true and the tonometric 10P.

Glaucoma↗
PubMed1977

Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma.

A detailed analysis of 101 eyes of 76 patients with advanced glaucomatous visual field loss but with retention of good visual acuity is presented. Patients were followed for a minimum of 4 years with an average duration of follow-up of 7.1 years. Loss of central vision, defined by permanent reduction of visual acuity to less than or equal to 20/200, occurred with equal frequency in eyes treated medically (15.8%) or surgically (13.6%) for glaucoma. Sudden loss of central vision also occurred following cataract extraction (8.7%). No patient lost central vision suddenly following surgery when central vision was spared at the time of operation. In addition, all cases that eventually lost central vision, either medically or surgically, demonstrated field defects which split fixation prior to its loss. Loss of central vision is seen rarely when medical therapy maintains the average intraocular pressure below 18 mm Hg, but increases markedly with higher pressures, reaching approximately 30% when average intraocular pressure is above 22 mm Hg. Progression in field loss is rare after successful glaucoma surgery, although cataracts develop in about 32% of such eyes. Cataracts also develop in 21% of medically treated eyes. In addition, about 50% of unoperated eyes demonstrate further field loss even when central vision is maintained. In spite of very definite risks, serious consideration should be given to glaucoma filtering surgery when the intraocular pressure is consistently over 22 mm Hg in patients on medical therapy with advanced glaucoma.

Adolescent↗
PubMed2000

Ahmed glaucoma valve implant vs trabeculectomy in the surgical treatment of glaucoma: a randomized clinical trial.

PURPOSE: To compare the short- and intermediate-term results of two commonly used glaucoma surgical procedures, trabeculectomy and Ahmed glaucoma valve implant. METHODS: A randomized clinical trial was performed at two international centers. One eye each of consecutive patients requiring glaucoma surgery for intraocular pressure control was randomized to receive either trabeculectomy or the Ahmed implant. RESULTS: Of the 117 patients, 62 were randomized to trabeculectomy and 55 to the Ahmed implant. With a mean follow-up of 9.7 months, the trabeculectomy group had statistically lower intraocular pressures at weeks 6 to 15 (12.6 mm Hg vs 16.4 mm Hg) and months 11 to 13 (11.4 mm Hg vs 17.2 mm Hg) than the Ahmed implant group. Compared with preoperative status, no statistically significant differences between groups were noted for visual acuity, visual field, lens status, and final anterior chamber depth. The cumulative probabilities of success (intraocular pressure <21 mm Hg and at least 15% reduction in intraocular pressure from preoperative level) were 83.6% for trabeculectomy and 88.1% for Ahmed implant (P =.43). However, the Ahmed implant group had a greater adjunctive medication requirement. On the last visit, 10 of the trabeculectomy eyes and 19 of the Ahmed implant eyes required at least one topical medication (P =.01). There was no statistically significant difference in the rate of complications between the two groups. CONCLUSIONS: Lower mean intraocular pressures were noted for the trabeculectomy group. All other results, including success (as defined in this study) and frequency of complications, were comparable between the two groups.

Female↗
PubMed2003

Long-term follow-up of primary glaucoma surgery with Ahmed glaucoma valve implant versus trabeculectomy.

PURPOSE: To compare the long-term results of trabeculectomy and Ahmed glaucoma valve implant in the initial surgical management of primary open- and closed-angle glaucoma. DESIGN: Randomized controlled clinical trial. METHODS: One eye each of consecutive patients with primary glaucoma and without prior intraocular surgery was randomized to receive either trabeculectomy or the Ahmed implant. Large university-affiliated eye hospital in Columbo, Sri Lanka. RESULTS: Of 123 patients, 64 were randomized to trabeculectomy and 59 to the Ahmed implant. With a mean follow-up of 31 months, the trabeculectomy group had statistically lower intraocular pressures (IOP) during the first postoperative year. After the first year, the IOPs were comparable. No statistically significant differences between groups were noted for postoperative visual acuity, visual field, anterior chamber depth, and short-term or long-term complications. Adjunctive medication requirement was comparable for both groups. The cumulative probabilities of success (IOP <21 mm Hg and at least 15% reduction in IOP from preoperative levels) at the final follow-up period (months, 41-52) were 68.1% for trabeculectomy and 69.8% for Ahmed implant (P =.86). CONCLUSIONS: Lower IOPs were noted for the trabeculectomy group during the first year. With longer follow-up, the IOPs and the cumulative probabilities of success were comparable between the two groups.

Adolescent↗
PubMed2000

A Case Report of Neovascular Glaucoma Due to Carotid Artery Occlusive Disease. Diagnosis of Neovascular Glaucoma and Histological Characteristics.

Purpose: The methods of diagnosing neovascular glaucoma were evaluated in a case with carotid artery occlusive disease. A trabeculectomy specimen taken from this patient was examined histologically to find the characteristic picture of this slowly progressive neovascular glaucoma.Materials and Methods: The left eye of a 48-year old man with neovascular glaucoma due to carotid artery occlusive disease had been previously diagnosed as uveitis with ocular hypertension. His left eye was examined by fluorescein fundus and gonioangiography. Trabeculectomy was performed because of uncontrolled intraocular pressure and the trabeculectomy specimen was examined histologically including immunohistochemistry with antibodies against von Willebrand factor antigen.Results: The characteristic picture of fluorescein fundus angiography was filling delay in the choroid and stained walls of the retinal arteries and veins. Fluorescein gonioangiography using a fundus camera clearly demonstrated new vessels in the pupil and angle with intense fluorescein leak in spite of faint neovascularization in those areas when observed by slit lamp with gonioscopy. Histological examination of the trabeculectomy specimen revealed proliferation of new vessels in the spaces of the trabecular meshwork and focal occlusion of Schlemm's canal.Conclusion: Fluorescein fundus angiography and gonioangiography by fundus camera is very useful for diagnosis of neovascular glaucoma due to carotid artery occlusive disease. Neovascular proliferation in the trabecular meshwork with slight of peripheral anterior synechia and focal occlusion of Schlemm's canal may be peculiar to such slowly progressive neovascular glaucoma.

Journal Article↗
PubMedDate not supplied

Phacotrabeculectomy in treatment of primary angle-closure glaucoma and primary open-angle glaucoma.

PURPOSE: To evaluate the surgical outcome of combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy (phacotrabeculectomy) in patients with primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG). METHODS: The records of 57 consecutive patients (65 eyes) with PACG or POAG that were treated with phacotrabeculectomy were reviewed retrospectively. There were 31 eyes with PACG and 34 with POAG. The mean follow-up period was 21.0 +/- 8.3 months. The visual acuity, intraocular pressure (IOP), number of medications, and complications were evaluated. RESULTS: The mean IOP and the number of glaucoma medications decreased significantly after phacotrabeculectomy in both groups. The mean IOP reduction was significantly greater in eyes with PACG (P < 0.05). The absolute success rates were 87.1% and 70.6% in PACG and POAG, respectively. The difference in the success rates was not significant (P = 0.297). The early postoperative complication rates were similar in both groups. CONCLUSIONS: Phacotrabeculectomy results in greater IOP reduction in eyes with PACG than in those with POAG, but the overall success rates were not significantly different.

Aged↗
PubMed2001

Pars plana tube insertion of glaucoma drainage implants and penetrating keratoplasty in patients with coexisting glaucoma and corneal disease.

PURPOSE: To determine the efficacy and associated complications of glaucoma drainage implant (GDI) surgery with pars plana tube insertion and penetrating keratoplasty (PK) in eyes with glaucoma and corneal disease. DESIGN: Retrospective, interventional case series. PARTICIPANTS: All patients who underwent both GDI surgery with pars plana tube insertion and PK before September 1997 were included. METHODS: The medical records of 34 consecutive patients (34 eyes) who had undergone GDI (Baerveldt, Pharmacia & Upjohn, Kalamazoo, MI; Molteno, IOP INC:, Costa Mesa, CA; Krupin, Hood Laboratories, Pembroke, MA; or Ahmed, New World Medical, Rancho Cucamonga, CA) insertion before, concurrent with, or after PK were reviewed retrospectively. All corneal grafts were clear before GDI surgery for patients who underwent glaucoma surgery after PK. Outcomes were evaluated using Kaplan-Meier life-table analysis. MAIN OUTCOME MEASURES: Clinical outcome assessment included corneal graft clarity, intraocular pressure (IOP), visual acuity, and identification of complications. RESULTS: Mean follow-up after completion of both GDI surgery and PK was 12.1 +/- 8.4 months (range, 0-31.8 months). Twelve- and 24-month life-table rates for complete success after both GDI and PK were 63% and 33%, respectively. Twelve- and 24-month life-table success rates for IOP control and corneal graft clarity were 85% and 62%, and 64% and 41%, respectively. Final postoperative visual acuity was the same as or better than (> or =2 Snellen lines) the preoperative level in 29 patients (85%). One or more posterior segment complications occurred in 15 (44%) patients. CONCLUSIONS: Pars plana tube insertion of GDIs is a reasonable option for patients who have undergone PK or in whom PK is anticipated, despite the need for a complete pars plana vitrectomy. Although complications related to limbal tube placement are avoided, the incidence of posterior segment complications may be higher for pars plana insertion. The potential for enhanced corneal graft survival with pars plana versus anterior segment tube placement warrants further investigation.

Adult↗
PubMed2006

Heidelberg Retinal Tomograph (HRT 2) parameters in primary open angle glaucoma and primary angle closure glaucoma: a comparative study in an Indian population.

AIMS: To compare the Heidelberg Retinal Tomograph (HRT 2) parameters in patients with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in an Indian population. MATERIALS AND METHODS: Two groups of patients were recruited: group I comprised 78 eyes (78 patients) with POAG and group II 58 eyes (58 patients) with PACG. Based on visual field defects detected by automated perimetry, the groups were further classified into early, moderate, and severe glaucoma. All patients underwent a complete ophthalmic examination as well as an HRT 2 examination. The HRT parameters for the two groups were compared and the sensitivity and specificity of the parameters calculated. RESULTS: All HRT parameters were similar in both groups: 85.9% (95% CI: 78.2, 93.6) of POAG and 81% (95% CI: 72.3, 89.3) of PACG had a positive F. S. Mikeleberg (FSM) discriminant function. Considering outside normal limits and borderline as abnormal, the Moorefield regression analysis had 83.3% (95% CI: 75, 91.6) sensitivity in POAG and 75.9% (95% CI: 64.9, 86.9) in PACG. In early POAG, the FSM discriminant function had a sensitivity of 74.3% (95% CI: 59.8, 88.8) compared to 58.3% (95% CI: 38.9, 77.7) for early PACG. The cup shape measure (p = 0.018) and the Moorfield regression analysis (p = 0.011) had significantly higher sensitivity for early POAG than for early PACG: cup shape measure sensitivity 62.9% (95% CI 46.9, 78.9) for early POAG versus 33.3% (95% CI: 14.4, 52.2) for early PACG and Moorefield regression analysis 74.3% (95% CI: 59.8, 88.8) versus 45.8% (95% CI: 39.9, 65.7). CONCLUSIONS: HRT has moderate sensitivity in the detection of damage leading to glaucomatous field defects. The sensitivity of HRT for early PACG appears to be less than that for early POAG. This may indicate a difference in pathophysiology.

Developing Countries↗
PubMed1983

Laser trabeculoplasty II in secondary glaucoma and after failed trabeculectomy in primary open angle glaucoma.

Thirteen eyes of 12 patients with secondary glaucoma and 18 eyes of 18 patients with failed trabeculectomy were retrospectively followed at least for 12 months. The success rate in secondary glaucoma was 23% (3 of 13 eyes). Six eyes were operated, and 2 eyes were re-lasered without success. In the eyes with failed trabeculectomy the success rate was 83% (15 of 18 eyes) with a 37% reduction of the mean intraocular pressure at one year. Medication could be tapered in 9 eyes and no eyes had to be re-operated. Laser trabeculoplasty (LTP) seems to be highly effective in eyes with failed trabeculectomy while eyes with secondary glaucoma have a poor response.

Adolescent↗
PubMed1984

Congenital glaucoma and incomplete congenital glaucoma in two siblings.

The case histories and eye findings of 2 siblings of a non-sanguinous marriage are reported. The first child, a girl, had the typical findings of a unilateral congenital glaucoma. Her brother had an enlarged unilateral cornea (13 mm) without Descemet breaks, and normal intraocular pressure on repeated follow-up examination over 4 years. Gonioscopy showed numerous iris processes covering the iridocorneal angle. Fundus examination revealed a cup-disc ratio of 0.4 in the affected eye and 0.1 in the normal eye. Patients whose clinical picture resembles that of our second patient should be classified as having incomplete or abortive congenital glaucoma; such patients may develop raised intraocular pressure at a later stage. The term megalocornea should be reserved for eyes with enlarged cornea, normal intraocular pressure, normal iridocorneal angles, no cup-disc asymmetry and no family history of congenital glaucoma.

Cornea↗
PubMed2006

Meta-analysis of randomised controlled trials comparing latanoprost with brimonidine in the treatment of open-angle glaucoma, ocular hypertension or normal-tension glaucoma.

AIM: To compare the efficacy and tolerability of latanoprost versus brimonidine in the treatment of open-angle glaucoma, ocular hypertension or normal-tension glaucoma. METHOD: Systematic review of randomised controlled trials comparing latanoprost and brimondine, identified by searches including Medline, Embase and Cochrane Controlled Trials Register. Two reviewers independently assessed trials for eligibility and quality and extracted data. Data were synthesised (random effects model) and expressed as the absolute mean intraocular pressure (IOP) reduction difference from baseline to end point for efficacy and relative risk for adverse events. Subgroup analysis and regression were used to explore heterogeneity according to patient characteristics, trial design and quality. RESULTS: 15 publications reporting on 14 trials (1784 participants) were included for meta-analysis. IOP reduction favoured latanoprost (weighted mean difference (WMD) = 1.10 mm Hg (95% confidence interval (CI) 0.57 to 1.63)). Significant heterogeneity was present (chi(2)(13) = 38.29, p = 0.001, I(2) = 66.0%). Subgroup analysis showed greater WMD for studies where data were analysed from end points >6 months duration, cross-over design, open-angle glaucoma or ocular hypertension and monotherapy. Multiple regression showed no significant association of WMD with trial duration (t(9) = 1.92, p = 0.09), trial design (t(9) = 1.79, p = 0.11), trial quality (t(9) = -0.46, p = 0.66), or monotherapy or adjunctive therapy (t(9) = -2.14, p = 0.06). Fatigue was less commonly associated with latanoprost (RR = 0.27, 95% CI 0.08 to 0.88). Publication bias was not evident on visual inspection of a funnel plot. CONCLUSION: Latanoprost is more effective than brimonidine as monotherapy in lowering IOP. Brimonidine is associated with a higher rate of fatigue.

Administration, Topical↗
PubMed1984

Postural change of IOP in normal persons and in patients with primary wide open-angle glaucoma and low-tension glaucoma.

The values of intraocular pressure (IOP) measurements by an Alcon pneumatic tonometer and a Goldmann applanation tonometer were found to be close, with a correlation coefficient of 0.92. Measured by the pneumatonograph the IOP after 30 minutes in the supine position was highest in normal persons, in patients with primary wide open-angle glaucoma and low-tension glaucoma. The greatest difference in IOP between subjects sitting and supine was observed in patients with low-tension glaucoma.

Aged↗
PubMed2001

Comparison of visual field defects between primary open-angle glaucoma and chronic primary angle-closure glaucoma in the early or moderate stage of the disease.

The visual field data (Humphrey C24-2) of early to moderate stage glaucoma between primary open-angle glaucoma (POAG) and chronic primary angle-closure glaucoma (PACG) patients was compared. Eleven POAG (11 eyes) and 14 chronic PACG patients (14 eyes) were matched with respect to age, sex, and disease severity. Although the mean deviation, pattern standard deviation, and short-term fluctuation were similar between the two groups, the mean corrected pattern standard deviation was higher in the POAG patients (p=0.048). When the numeric pattern deviation data (STATPAC II) was used for point-wise between-group comparisons, more depressed paracentral points were found in POAG patients. Different patterns were identified in visual field damages between the chronic PACG and POAG patients. The chronic PACG patients showed more generalized field loss than the POAG patients.

Aged↗