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At least 289 records · Page 16Linked to original sources
PubMed2000

[Assessment of the retinal blood flow by DRG retina Doppler in primary open angle glaucoma and normal tension glaucoma].

PURPOSE: The aim of the study was to evaluate the blood flow in central retinal artery (CRA) in primary open angle glaucoma (POAG) and normal tension glaucoma (NTG). MATERIAL AND METHODS: Two groups of patients were examined: I group consisted of 15 patients (19 eyes) with POAG, II group of 16 patients (32 eyes) with NTG. The controls were age-matched healthy persons. Blood flow velocities and resistance index in central retinal artery were measured by DRG Retina-Doppler. RESULTS: We found decreased blood flow velocity in CRA in most of the patients with NTG and in part of the patients with POAG. Significant increase of resistance index was found only in NTG group. CONCLUSION: Our study confirmed that assessment of the blood flow in central retinal artery appears to be a valuable method in diagnosis of neuropathy mechanism in glaucoma.

Female↗
PubMedDate not supplied

Diode laser cyclophotocoagulation in refractory glaucoma: comparison between pediatric and adult glaucomas.

OBJECTIVE: To evaluate the outcome of contact transscleral diode laser cyclophotocoagulation (CTDC) in eyes with advanced glaucoma and to compare the efficacy in pediatric and adult patients. PATIENTS AND METHODS: Included in the study were 41 eyes (39 patients) with advanced glaucoma (15 eyes of 13 pediatric patients and 26 eyes of 26 adult patients). The patients were followed at least for six months or until failure of the procedure, if shorter than 6 months. The mean follow-up of all patients was 10 months (median 8 months, range 3-24 months); the mean pretreatment intraocular pressure (IOP) was 34.5+/-10.9 mm Hg for all cases, 36.2+/-12.6 mm Hg in adult cases and 31.6+/-6.5 mm Hg in pediatric cases. RESULTS: At last follow-up after first treatment, there was significant decrease in IOP and the mean reduction in IOP was 12.11+/-10.5 mm Hg for all eyes. The mean reduction in IOP adult (13.6+/-11.8 mm Hg) and (9.9+/-6.8 mm Hg) patients. While the success rate after the first diode laser therapy was 59%, it increased to 75% after retreatments. The most common complications were conjunctival hyperemia and anterior chamber reaction. There was no difference in the complication rate between the pediatric and adult cases. CONCLUSION: CTDC is a safe and effective therapy in eyes with advanced refractory glaucoma in the short term. But multiple applications may be needed in the long term. The results in adult and pediatric patients were found to be similar in efficacy and safety.

Adolescent↗
PubMed2001

The Advanced Glaucoma Intervention Study (AGIS): 10. Variability among academic glaucoma subspecialists in assessing optic disc notching.

PURPOSE: An analysis of data from the Advanced Glaucoma Intervention Study (AGIS) has found eyes reported to have partial optic disc rim notching (not to the edge) at baseline to have less risk of subsequent visual field loss than eyes with no notching. Because this is counterintuitive and because classification of notching had not been defined in the AGIS protocol, we have assessed AGIS ophthalmologists interobserver and intraobserver agreement on notching. METHODS: Fourteen glaucoma subspecialists classified notching in 26 pairs of stereoscopic disc photographs of eyes with mild to severe glaucomatous optic neuropathy. They classified images as showing either no notching, notching not to the edge, or notching to the edge. Several hours later, 10 of them classified the same images a second time. RESULTS: In an analysis of interobserver agreement, of 26 stereoscopic images, a plurality of ophthalmologists classified notching as absent in 9 (35%), as present but not to the edge in 7 (27%), and as present and not to the edge in 10 (38%). All 14 ophthalmologists (100%) agreed on the classification of 7 (27%) of the images, and 13 of the 14 ophthalmologists (93%) agreed on the classification of 4 additional images (15%). Of these 11 images with at least 93% agreement, notching was reported as absent in 3 (27%) and to the edge in 8 (73%). In the remaining 15 images, there was substantial disagreement about whether notching was present and, if so, whether it was to the edge. In an analysis of intraobserver agreement, none of the 10 ophthalmologists who completed the viewing a second time classified all eyes exactly the same as the first time, though 5 ophthalmologists made 4 or fewer reclassifications. Overall, 80% of the original classifications were reproduced on second reading. Of the initial classifications that were not reproduced, slightly more than half were first classified as having notching not to the edge. CONCLUSION: Without definitions or examples of optic disc rim notching, the glaucoma subspecialists had relatively high intraobserver agreement but were likely to disagree with each other in characterizing the degree of disc rim notching. We recommend development of a standard photographic classification of disc rim notching. The classification should be tested for inter- and intra-observer agreement.

Academic Medical Centers↗
PubMedDate not supplied

[Closed angle glaucoma induced by phospholine iodide and epinephrine in a case of open angle glaucoma].

A patient suffering from open angle glaucoma was treated with topical phospholine iodide and epinephrine. Before treatment the anterior chamber was deep and the angle wide open in both eyes. Two weeks after beginning treatment there was an acute elevation of pressure to 52 mm hg in the right eye accompanied by myopia, shallowing of the anterior chamber and closure of the angle. These findings were dramatically reversed by the instillation of one drop of tropicamide and one drop of cyclopentolate. Simultaneous contraction of the dilator and sphincter muscles of the iris in this case probably caused pupillary block and closure of the anterior chamber angle, in spite of the initially wide open angle. Phospholine iodide may also have caused a spasm of the ciliary muscle and a forward movement of the lens, in a manner similar to that thought to occur in malignant glaucoma. Strong miotics together with epinephrine should be used cautiously in the treatment of glaucoma even when the initial examination shows a wide open angle.

Adult↗
PubMed2005

[A comparative study of optic nerve damage between primary open angle glaucoma and normal tension glaucoma].

OBJECTIVE: To investigate the differences in the characteristics of optic nerve damage in patients with primary open angle glaucoma (POAG)and normal tension glaucoma (NTG). METHOD: The optic disc parameters and retinal nerve fiber layer (RNFL) of 47 eyes of 39 subjects with POAG (IOP > 24 mmHg) and 38 eyes of 32 subjects with NTG (IOP < 21 mmHg) were measured by using a Heidelberg retina tomograph II, color stereo-optic disc photographs, and an Octopus automated perimetry. RESULTS: (1) Rim area, rim/disc area ratios and three sectors except temporal quadrant of optic disc were significantly smaller, whereas C/D was significantly larger in patients with NTG than those of POAG. The mean RNFL thickness and RNFL cross-sectional areas at temporal/interior and temporal/superior in those with NTG were significantly (P < 0.05) smaller than those of POAG. The rim volume was significantly (P < 0.05) smaller and mean cup depth was significantly (P < 0.05) larger in patients with NTG than POAG. (2) The defect types of RNFL: RNFL diffuse loss and local defect ratio were 53.19% and 4.26% in POAG, respectively; while were 21.05% and 55.26% in NTG, respectively. The difference between the proportions of the defect type of RNFL in patients with POAG and those of NTG is statistically significant (P < 0.01). CONCLUSIONS: Our results demonstrate that the varieties of C/D area ratio, rim area, RNFL thickness, and defect types of RNFL with NTG and POAG indicate that the different mechanisms are involved in optic nerve damage in the two types of glaucoma.

Adult↗
PubMed1991

Referrals for suspected glaucoma: an International Glaucoma Association survey.

In a survey covering 275,600 eye examinations by optometrists, 0.55% resulted in a referral to a medical practitioner for suspected glaucoma. Some 85-90% of the referred patients subsequently attended for examination by a consultant ophthalmologist. Of these, rather more than a third were confirmed as having glaucoma, almost a third were discharged as not having the disease, and the diagnosis was borderline for the remainder. The survey's results imply that optometrists detect about 20,000 cases of glaucoma in England and Wales each year.

Aged↗
PubMed1990

[The functional characteristics of the eye vessels in glaucoma and suspect glaucoma].

The paper analyses results after examination of the functional state of eye vessels in 92 patients (117 eyes) with initial stage of glaucoma and 44 persons (55 eyes) with suspected glaucoma. A control group included 31 patients (41 eyes) without any eye pathology. For assessment of the functional state of eye vessels, cryorheographic test was used. Main types and variants of neurovascular reactions of the eye were determined. Reduced vascular tonus was recorded in most of the subjects. Glaucomatous, patients showed predominantly organic changes in the vascular bed of the eye. In persons with suspected glaucoma, the incidence of functional and organic changes of the vessels was approximately the same. In healthy persons, functional changes were observed more frequently. A conclusion is made that the functional state of the vascular bed of the eye should be considered when prescribing medicamentous treatment for glaucomatous patients.

Aged↗
PubMed1998

Glaucoma drops control intraocular pressure and protect optic nerves in a rat model of glaucoma.

PURPOSE: To determine whether chronic topical glaucoma therapy can control intraocular pressure (IOP) and protect nerve fibers in a rat model of pressure-induced optic nerve damage. METHODS: Sixteen adult Brown Norway rats were-administered unilateral episcleral vein injections of hypertonic saline to produce scarring of the aqueous humor outflow pathways. Twice daily applications of either artificial tears (n = 6), 0.5% betaxolol (n = 5), or 0.5% apraclonidine (n = 5) were delivered to both eyes, and awake pressures were monitored with a TonoPen XL tonometer for 17 days before the rats were killed. RESULTS: For animals administered artificial tears, the mean IOP of the experimental eyes was 39 +/- 2 mm Hg compared with 29 +/- 1 mm Hg for the control eyes. This difference was statistically significant (P < 0.001). Mean IOPs in the experimental eyes of animals administered betaxolol and apraclonidine were 29 +/- 7 and 29 +/- 4 mm Hg, respectively, whereas the mean IOP in the control eyes was 28 +/- 1 mm Hg for both groups. There was no statistically significant difference among these values. The mean IOP for the experimental eyes in the betaxolol and apraclonidine groups was lower than that in animals administered artificial tears (P = 0.003). Quantitative histologic analysis of optic nerve damage in experimental eyes showed that four of the six animals administered artificial tears had damage involving 100% of the neural area. This degree of damage appeared in only 3 of 10 animals administered glaucoma therapy. Optic nerve protection was closely correlated with IOP history because damage was limited to less than 10% of the cross-sectional area in all animals in which the maximal IOP was less than or equal to 39 mm Hg, more than 2 SD below the mean value for eyes administered artificial tears. CONCLUSIONS: Topical glaucoma therapy in this model can prevent IOP elevation and protect optic nerve fibers.

Adrenergic alpha-Agonists↗
PubMed2003

Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial.

OBJECTIVE: To assess factors for progression in the Early Manifest Glaucoma Trial (EMGT), including the effect of EMGT treatment. SETTING/PARTICIPANTS: Two hundred fifty-five open-angle glaucoma patients randomized to argon laser trabeculoplasty plus topical betaxolol or no immediate treatment (129 treated; 126 controls) and followed up every 3 months. METHODS: Progression was determined by perimetric and photographic optic disc criteria. Patient-based risk of progression was evaluated using Cox proportional hazard regression models and was expressed as hazard ratios (HR) with 95% confidence intervals (95% CI). RESULTS: After 6 years, 53% of patients progressed. In multivariate analyses, progression risk was halved by treatment (HR = 0.50; 95% CI, 0.35-0.71). Predictive baseline factors were higher intraocular pressure (IOP) (ie, the higher the baseline IOP, the higher the risk), exfoliation, and having both eyes eligible (each of the latter 2 factors doubled the risk), as well as worse mean deviation and older age. Progression risk decreased by about 10% with each millimeter of mercury of IOP reduction from baseline to the first follow-up visit (HR = 0.90 per millimeter of mercury decrease; 95% CI, 0.86-0.94). The first IOP at that visit (3 months' follow-up) was also related to progression (HR = 1.11 per millimeter of mercury higher; 95% CI, 1.06-1.17), as was the mean IOP at follow-up (HR = 1.13 per millimeter of mercury higher; 95% CI, 1.07-1.19). The percent of patient follow-up visits with disc hemorrhages was also related to progression (HR = 1.02 per percent higher; 95% CI, 1.01-1.03). No other factors were identified. CONCLUSIONS: Patients treated in the EMGT had half of the progression risk of control patients. The magnitude of initial IOP reduction was a major factor influencing outcome. Progression was also increased with higher baseline IOP, exfoliation, bilateral disease, worse mean deviation, and older age, as well as frequent disc hemorrhages during follow-up. Each higher (or lower) millimeter of mercury of IOP on follow-up was associated with an approximate 10% increased (or decreased) risk of progression.

Adrenergic beta-Antagonists↗
PubMed1982

Open angle glaucoma, ocular hypertension, low-tension glaucoma, and refraction.

An analysis of the refractions of patients with primary open angle glaucoma, ocular hypertension (OH), and low-tension glaucoma showed that myopia occurred more frequently in each group than would be expected in a normal population of similar age. One in three of the myopes with OH had glaucomatous field defects on follow-up examination, whereas the defects developed in only one in 20 of the emmetropes and in one in 40 of the hypermetropes. These results suggest that myopic eyes are more susceptible to the effects of raised intraocular pressure than are nonmyopic eyes and that myopes with OH have a particularly high risk of the development of field defects.

Adolescent↗
PubMed1984

Neuroretinal rim area in suspected glaucoma and early chronic open-angle glaucoma. Correlation with parameters of visual function.

The cup-disc ratio is an indirect measure of the amount of neural tissue present at the optic nerve head. A large cup-disc ratio in a large disc may be accompanied by a normal neuroretinal rim. The area of the neuroretinal rim is relatively constant in normal persons and should relate to visual function. In 39 eyes of patients with suspected glaucoma, normal subjects, and patients with early open-angle glaucoma, biometric findings, psychophysical functions, and optic nerve measurements were studied. The area of the neuroretinal rim was determined from stereophotographs and corrected for the magnification by the optical components of the eye. A statistically significant relation between this neuroretinal area and parameters of visual function was found. The cup-disc ratio correlated more weakly with visual function. Covariant analysis showed the neuroretinal area to be the only parameter capable in our sample of discriminating among the three clinical groups.

Adolescent↗
PubMed1995

Efficacy of apraclonidine ophthalmic solution (Iopidine) in presumed silicon oil-induced glaucoma and primary open-angle glaucoma.

BACKGROUND: This pilot study evaluated the acute effects of topical ocular apraclonidine 1% (Iopidine) in 10 patients with presumed silicone oil-induced secondary glaucoma (SOIG) and in 10 patients with high-pressure primary open-angle glaucoma (POAG) despite maximum tolerated medical therapy. METHODS: Intraocular pressure (IOP) measurements were carried out before and 1, 2 and 3 h after a single drop of apraclonidine. RESULTS: Patients with SIOG presented with a mean IOP of 30.0 +/- 2.8 mmHg, which was reduced to 21.7 +/- 2.9 mmHg (P < 0.001) after 1 h, to 20.4 +/- 2.3 mmHg (P < 0.001) after 2 h and to 20.0 +/- 2.5 mmHg (P < 0.001) after 3 h. In the POAG group, IOP was reduced from 25.9 +/- 1.9 mmHg before treatment to 18.9 +/- 1.4 mmHg after 1 h (P < 0.001), 17.7 +/- 1.2 mmHg after 2 h (P < 0.001) and 16.9 +/- 0.9 mmHg after 3 h (P < 0.001). There were no significant changes in blood pressure or pulse rate. CONCLUSION: This study confirmed the activity of apraclonidine as an IOP suppressant.

Adolescent↗
PubMed2001

[Innovative glaucoma therapy. Glaucoma therapy with topical carbonic anhydrase inhibitors].

Topical carbonic anhydrase inhibitors have been used since 1995 for medical glaucoma therapy, when dorzolamide was approved. In 2000, a second carbonic anhydrase inhibitor, brinzolamide, has become available in most of Europe. Both substances exhibit a comparable intraocular pressure-lowering activity, however, the side-effects are somewhat different. In the five years since its introduction, dorzolamide has had a positive risk-benefit-profile. In combination with any other topical agent, carbonic anhydrase inhibitors have an additive effect on the reduction of the intraocular pressure. Animal studies suggest that dorzolamide may improve ocular blood flow independent of the intraocular pressure; however, the significance for human glaucoma remains to be established.

Administration, Topical↗
PubMed2003

A comparison of optic disc topographic parameters in patients with primary open angle glaucoma, normal tension glaucoma, and ocular hypertension.

BACKGROUND: Heidelberg Retina Tomograph (HRT) findings have been employed to quantitatively assess the topography of optic discs. We measured topographic parameters of optic discs in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and ocular hypertension (OH) using an HRT in order to determine whether HRT topographic parameters can be used to differentiate those conditions. METHODS: Seventeen eyes in 17 patients with POAG, 23 eyes in 23 patients with NTG, and 15 eyes in 15 patients with OH were examined using an HRT, and the results were analyzed by age, refractive error, and topographic parameters. RESULTS: Among the HRT parameters, the mean values for rim area, rim volume, cup disk area ratio, and classification showed significant differences among POAG, NTG, and OH eyes. The mean values for cup area, cup volume, mean RNFL thickness, and RNFL cross section area showed significant differences between POAG and NTG eyes, and NTG and OH eyes, however, not between POAG and OH eyes. Cup shape measure showed significant differences between POAG and OH, and NTG and OH eyes, but not between POAG and NTG eyes. CONCLUSIONS: Our results suggest that POAG is distinguishable from NTG and OH based on evaluations of rim area and rim volume. Patients with NTG tend to have larger cupping, smaller rims, and thinner retinal nerve fiber layers as compared to POAG and OH patients. Thus, HRT topographic parameters are useful to differentiate patients with POAG, NTG, and OH.

Aged↗
PubMed2004

Results of the use of the Ex-PRESS miniature glaucoma implant in technically challenging, advanced glaucoma cases: a clinical pilot study.

PURPOSE: To report results of implantation of the Ex-PRESS Miniature Glaucoma Implant (Optonol, Neve Ilan, Israel) shunt directly under the conjunctiva in advanced glaucoma. DESIGN: Noncomparative case series. METHODS: Chart review of eleven cases of Ex-PRESS implantation. Outcome measures included intraocular pressure (IOP), complications, visual acuity, and additional interventions. Failure was defined as unacceptably high IOP requiring revision or explantation. RESULTS: Four patients (36%) failed. Ten (91%) experienced hypotony during postoperative week one. In the seven nonfailures, mean pre and postoperative IOPs were 30.3 +/- 9.3 mm Hg and 13.6 +/- 4.4 mm Hg, respectively (P = .006). The logMAR visual acuity did not change significantly from baseline to follow up (logMAR 1.1 +/- 0.9 and 1.4 +/- 0.9, respectively, P = .13). There were no intraoperative complications. Postoperative complications in the 11 eyes included choroidal detachment in 3 (27%) and suprachoroidal hemorrhage in 2 (18%). Of the 7 successful cases, additional interventions were required in 4 (57%). CONCLUSIONS: Despite significant IOP reduction, the incidence of complications following Ex-PRESS implantation directly under the conjunctiva was unacceptably high in this group of patients.

Conjunctiva↗
PubMed2006

Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European Glaucoma Prevention Study.

OBJECTIVE: To evaluate the predictive factors of open-angle glaucoma (OAG) in patients affected by ocular hypertension enrolled in the European Glaucoma Prevention Study (EGPS). DESIGN: Randomized, double-masked, controlled clinical trial. PARTICIPANTS: One thousand seventy-seven patients, > or =30 years old, were enrolled at 18 European centers. The patients met inclusion criteria: intraocular pressure, 22 to 29 mmHg; 2 normal and reliable visual fields (VFs) (on the basis of mean deviation and corrected pattern standard deviation [PSD]); and a normal optic disc, as determined by an optic disc reading center. INTERVENTION: Treatment with dorzolamide or a placebo (the vehicle of dorzolamide) in one or both eyes. MAIN OUTCOME MEASURES: Efficacy end points were VF and/or optic disc changes. Baseline demographic and clinical data were collected before randomization, except for corneal thickness measurements, which were determined during follow-up. Proportional hazards models were used to identify factors that predicted which participants in the EGPS had developed OAG. RESULTS: In multivariate analyses, factors that predicted the development of OAG included older age (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.04-1.69), larger vertical cup-to-disc (C/D) ratio (HR, 1.34; 95% CI, 1.14-1.58), larger vertical C/D ratio asymmetry (HR, 1.46; 95% CI, 1.11-1.93), higher PSD (HR, 1.66; 95% CI, 1.15-2.38), and lesser central corneal thickness (HR, 1.32; 95% CI, 1.05-1.67). CONCLUSIONS: Baseline age, vertical C/D ratio, vertical C/D ratio asymmetry, and PSD were good predictors of the onset of OAG in the EGPS. Central corneal thickness was found to be a powerful predictor of the development of OAG. The EGPS results agree with the findings of the Ocular Hypertension Treatment Study and support the need for a thorough evaluation of patients with ocular hypertension.

Antihypertensive Agents↗
PubMed2004

Interocular asymmetry of visual field defects in primary open angle glaucoma and primary angle-closure glaucoma.

AIM: To compare the interocular asymmetry in visual field loss of patients with primary open-angle (POAG) and primary angle-closure glaucoma (PACG). METHODS: Subjects entering a prospective, randomised, controlled trial of intraoperative 5-fluorouracil in glaucoma surgery in Singapore were included. Preoperative visual field testing was performed using automated white-on-white perimetry (24-2 test pattern, threshold program, Mk II, Model 750, Zeiss-Humphrey, San Leandro, CA, USA). A minimum of two tests were required with mean deviation within 2 dB on two tests, fixation losses <20%, false positives <33%, and false negatives <33%. The second field was scored using AGIS II criteria and the 'mean asymmetry score' defined as the mean difference between eyes for both AGIS scores and global indices. RESULTS: In 230 subjects assessed (128 POAG, 102 PACG), mean interocular asymmetry of visual field loss was greater for the PACG group. The mean AGIS asymmetry scores for total (PACG=9.21+/-6.87 vs POAG=6.48+/-5.58, P=0.001), superior (PACG=4.31+/-3.39 vs POAG=3.35+/-3.13, P=0.035), and inferior (PACG=4.43+/-3.31 vs POAG=2.64+/-2.77, P<0.0001) areas and mean deviation (MD) asymmetry scores (PACG=6.89+/-13.22 vs POAG=1.66+/-16.97, P=0.012) were all significantly different. Interocular correlation of visual field loss for POAG was significant; total AGIS, r=0.27 (P=0.003), superior field AGIS, r=0.24 (P=0.008), inferior field AGIS, r=0.34 (P=0.0001), and MD, r=0.27 (P=0.003). In PACG, there was no significant correlation between eyes; total AGIS, r=-0.02 (P=0.85), superior field AGIS, r=-0.02 (P=0.82), inferior field AGIS, r=-0.17 (P=0.87), and MD, r=0.015 (P=0.89). CONCLUSION: There was a greater asymmetry of visual field loss between eyes, as measured by AGIS scores and MD, in PACG than that in POAG.

Aged↗
PubMed2005

Long-term results of Ahmed glaucoma valve and Molteno implant in neovascular glaucoma.

AIMS: To evaluate the surgical success results of Ahmed glaucoma valve (AGV) and Molteno single-plate implant (MSPI) in cases of neovascular glaucoma (NVG). METHODS: Between May 1997 and May 2002, 38 of 38 NVG patients that underwent implantation of AGV and 27 eyes of 27 NVG patients that underwent MSPI (a total 65 eyes of 65 patients) included to the study. RESULTS: The cumulative probabilities of success were 63.2% at 1 year, 56.2% at 2 years, 43.2% at 3 years, 37.8% at 4 years, and 25.2% at 5 years in AGV group whereas the cumulative probabilities of success were 37.0% at 1 year, 29.6% at 2 years, 29.6% at 3 years, 29.6% at 4 years, and 29.6% at 5 years in MSPI group (P=0.141). Preoperative visual acuity <2/200 (P=0.003), diagnosis of diabetes mellitius (P=0.050), and preoperative IOP>or=35 mmHg (P=0.038) were found to be poor prognostic factors for surgical success. CONCLUSIONS: Both AGV and single plate MSPI were successful for early and intermediate-term of IOP control but in long term both implants were failed to achieve control of IOP in patients with NVG.

Adolescent↗