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At least 343 records · Page 19Linked to original sources
PubMed2000

Glaucoma surgery with or without adjunctive antiproliferatives in normal tension glaucoma: 1 intraocular pressure control and complications.

BACKGROUND: Reduction of intraocular pressure (IOP) by 20-30% with glaucoma drainage surgery slows disease progression in normal tension glaucoma (NTG). It is not clear whether adjunctive antiproliferative agents are necessary or safe in eyes at low risk for scarring. METHOD: 86 eyes of 73 white NTG patients who had undergone a primary guarded fistulising procedure were reviewed. 25 eyes had no antiproliferatives, 36 had peroperative 5-fluorouracil (5-FU) and 25 had peroperative mitomycin C (MMC). Their postoperative IOPs, complications, and changes in visual acuity were recorded. RESULTS: Eyes that had no adjunctive antiproliferative less commonly maintained a 20-30% reduction in IOP (47.4% at 2 years) compared with either the 5-FU group (69.4%at 2 years, p=0.01) or the MMC group (64.9% at 2 years, p=0.04). Eyes that had adjunctive MMC more often had late hypotony (28%, p=0.02) and late bleb leak (12%, p<0.001). Eyes that had adjunctive MMC also more often had a two lines loss of Snellen visual acuity (39.8% by 2 years) compared with those that had adjunctive 5-FU (14.7% by 2 years), p=0.06. CONCLUSION: For NTG patients at low risk of scarring trabeculectomy with adjunctive peroperative 5-FU should maintain a suitable target IOP without the additional sight threatening complications seen with adjunctive MMC.

Aged↗
PubMed2001

Glaucoma surgery with or without adjunctive antiproliferatives in normal tension glaucoma: 2 Visual field progression.

BACKGROUND: Reduction of intraocular pressure by 20-30% with glaucoma drainage surgery slows disease progression in normal tension glaucoma (NTG). It is not clear whether adjunctive antiproliferative agents are necessary or safe in eyes at low risk for scarring. METHOD: 61 eyes of 61 white patients with NTG who had undergone a primary guarded fistulising procedure were reviewed. 20 eyes had no antiproliferatives (nil), 29 had peroperative 5-fluorouracil (5-FU), and 12 had peroperative mitomycin C (MMC). Pointwise linear regression analysis (PROGRESSOR for Windows software) was applied to their visual field series starting with the first visual field following surgery and adding subsequent visual fields one at a time. Progression of visual field loss was defined as the appearance of a regression slope 1 dB per year or more with a significance of p<0.01 at one or more visual field locations which remained consistent with the addition of two of three successive visual fields. Time updated covariate analysis was used to determine the relation between variables that changed with time, such as IOP, and the risk of progression. RESULTS: The median percentage IOP reduction was 24.4 for the nil group, 38.0 for the 5-FU group, and 47.5 for the MMC group (p=0.001). There was a statistically significant relation between percentage change in IOP and risk of visual field progression in the subsequent 6 month period for all patients analysed as one group, hazard ratio = -0.021 (p=0.002). There was a statistically significantly increase in the risk of visual field progression for the MMC group compared with the 5-FU group, hazard ratio = 1.51 (p=0.02). CONCLUSION: In NTG patients, the IOP reduction produced by drainage surgery reduces the risk that visual field progression may be reduced after drainage surgery; this is related to the level of IOP reduction. The percentage drop in IOP during a given time is related to the risk of subsequent visual field progression. However, the use of MMC is associated with a greater risk of visual field progression despite a greater fall in IOP. This visual field deterioration may be related to the functional loss produced by late postoperative complications which have been reported at a higher rate in this group. The use of adjunctive perioperative 5-FU should maintain a suitable target IOP with preservation of visual function without the additional complications and associated visual deterioration seen with adjunctive MMC.

Aged↗
PubMed2003

Agreement between frequency doubling perimetry and static perimetry in eyes with high tension glaucoma and normal tension glaucoma.

AIMS: To investigate the agreement in results between frequency doubling technology (FDT) and the conventional automated static perimeter in eyes with normal tension glaucoma (NTG) and high tension glaucoma (HTG). METHODS: 72 eyes of 36 patients, who had two or more experiences with the Humphrey field analyser (HFA) program C30-2, were examined with the screening C-20-1 program of FDT. The result of FDT at each of the 17 stimulus points was graded as one of four categories. 58 out of 76 test points of HFA were assigned to one of the 17 clusters corresponding to FDT test points. Each cluster was represented as the lowest (scotoma of HFA) or the highest (threshold of HFA) probability symbol of total deviation (TD) of the HFA test points included in the cluster. The agreement between scotoma/threshold of HFA and FDT results was evaluated for NTG and HTG. RESULTS: In a total of 65 eyes, the Spearman coefficients between the FDT and HFA (threshold/scotoma of HFA) were 0.599 and 0.515 (p<0.0001), respectively. In the HFA mean deviation matched 20 HTG eyes and 20 NTG eyes, the number of points with abnormal FDT results were 102 and 62 in eyes with HTG and NTG, respectively. The eyes with HTG had more abnormal FDT results than NTG eyes (p=0.0014, Mann-Whitney U test). The kappa coefficient between FDT and threshold of HFA in eyes with HTG and NTG was 0.288 and 0.520, respectively, and the agreement between FDT and scotoma of HFA was 0.480 and 0.439, respectively. CONCLUSIONS: The best agreement of the results of FDT and HFA was observed in eyes with NTG using threshold of HFA. The eyes with HTG showed lower agreement with more abnormal points in FDT results, which suggests enough sensitivity of FDT in eyes with NTG, and higher sensitivity of FDT in eyes with HTG.

Adult↗
PubMed2003

Comparison of localised nerve fibre layer defects in normal tension glaucoma and primary open angle glaucoma.

AIM: To compare the pattern of localised nerve fibre layer (NFL) defects in normal tension glaucoma (NTG) and primary open angle glaucoma (POAG). METHODS: 50 NTG eyes and 36 POAG eyes, all with localised NFL defects, were enrolled. On retinal NFL photography, the proximity of the defect to the centre of the fovea (angle alpha) and the sum of the angular width of the defects (angle beta) were determined. Angle alpha was the angle made by a line from the centre of the fovea to the disc centre and a line from the disc centre to the disc margin, where the nearest border of the defect met. The patterns of localised NFL defects in NTG and POAG were compared with angles alpha and beta. Independent t test was used for statistical analysis. RESULTS: Angle alpha in NTG (35.1 (SD 20.0) degrees ) was significantly smaller than that of POAG (45.9 (21.9) degrees ) (p=0.02), while angle beta in NTG (49.0 (31.9) degrees ) was significantly larger than that of POAG (33.1 (23.9) degrees ) (p=0.01). CONCLUSIONS: The pattern of NFL defects in NTG was different from that in POAG. Localised NFL defects in NTG were closer to the fovea and wider in width than those in POAG.

Adult↗
PubMedDate not supplied

Comparative study of retinal nerve fiber layer loss in normal-tension glaucoma and chronic open-angle glaucoma.

PURPOSE: To clarify whether loss of the retinal nerve fiber layer in normal-tension glaucoma (NTG) differs from that in chronic open-angle glaucoma (COAG). METHODS: Using a scanning laser polarimeter, retinal nerve fiber layer thickness (RNFLT) was measured in 21 patients with NTG, 21 patients with COAG and 21 normal controls. The three groups were matched for age, and the NTG and COAG groups were matched for visual field loss. RESULTS: The mean RNFLT was significantly less in the NTG than in the control group and less in the COAG than in the controls and NTG group. Although the correlations between the parameters of RNFLT and homotopic visual field measurements were significant in COAG, none of the correlations were significant in NTG. CONCLUSIONS: The present results suggest that loss of the retinal nerve fiber layer in NTG differs from that in COAG.

Chronic Disease↗
PubMedDate not supplied

Intraocular pressure response of capsular glaucoma and primary open-angle glaucoma to selective Nd:YAG laser trabeculoplasty: a prospective, comparative clinical trial.

PURPOSE: To compare the intraocular pressure (IOP) response of uncontrolled capsular glaucoma (CG) and primary open-angle glaucoma (POAG) to selective laser trabeculoplasty (SLT) in a prospective clinical trial. METHODS: Ten eyes often patients suffering from uncontrolled CG (CG Group) and ten eyes of ten patients with uncontrolled POAG (POAG Group) were treated with a frequency-doubled, Q-switched Nd:YAG laser (532 nm). The baseline characteristics were similar in both groups. IOP was measured before and 1 day, 1 week, 1 month and 3, 6, 9, 12, 15 and 18 months after treatment. Success was defined as IOP more than 20% lower than before treatment. Any change of hypotensive medication led to the subjects' exclusion from the study. The two groups were compared using the independent-sample t test for continuous variables and the log-rank test for survival analysis. A value of p<0.05 was considered significant. RESULTS: The mean follow-up was 12.0 months (SD 5.5) for the CG group and 13.5 months (SD 4.3) for POAG (n.s.). No significant difference was found between the two groups for mean pretreatment IOP (23.6 mmHg +/- 5.70 in the CG group and 22.8 mmHg +/- 2.44 in the POAG group) or for mean IOP and mean IOP reductions during the follow-up. At all follow-up visits, IOP was reduced less in the CG group than in the POAG group (24.8% +/- 11.15 vs. 27.7% +/- 9.91 at 6 months, 22.0% +/- 6.66 vs. 30.6% +/- 6.35 at 12 months, and 31.4% +/- 5.55 vs. 35.1% +/- 1.75 at 18 months), but the difference was significant only at 12 months. Kaplan-Meier survival analysis gave an 18-month success rate of 64% in the CG group and 78% in the POAG group, with no significant differences between the groups. CONCLUSIONS: SLTis an effective procedure forlowering IOP in CG and POAG eyes, although the effect seems to last less in CG eyes.

Aged↗
PubMed1997

A comparison of optic nerve head topography in primary open-angle glaucoma and normal-tension glaucoma in Korean.

We investigated whether there is any difference in optic nerve head topography between primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG) in Koreans. Twenty-three eyes of 23 POAG and 20 eyes of 20 NTG Korean patients closely matched for mean deviation of automated static threshold perimetry (Humphrey Field Analyzer, program C30-2) were enrolled. The patients' mean age was 51.5 +/- 11.7 years in POAG and 55.1 +/- 10.6 years in NTG; the average mean deviation was -5.47 +/- 1.84 dB in POAG and -6.45 +/- 3.69 dB in NTG. Mean age and mean deviation were not statistically different between the two groups. Heidelberg Retina Tomograph was used to obtain topographic measurements of disc area, rim area, cup volume, cup-to-disc area ratio, mean cup depth, maximum cup depth, and cup shape measure. Disc area and cup volume were significantly larger in NTG than in POAG (p < 0.01, p = 0.03, respectively, Wilcoxon rank sum test). Other variables were not significantly different between the two groups. There was significant negative correlation between cup volume and rim area only in POAG (r = -0.725, p < 0.01, Spearman correlation analysis). These results suggest that the larger cup volume in NTG than in POAG may be influenced rather by larger optic disc in NTG not by smaller neuroretinal rim.

Adult↗
PubMedDate not supplied

Glaucoma and findings simulating glaucoma in the Rubinstein-Taybi syndrome.

Information is reviewed on the ophthalmologic findings in 614 individuals with Rubinstein-Taybi syndrome (RTS). The data were collected from the world literature, from communication with colleagues and with families of individuals with RTS, and from personal observations. Particular emphasis is given in this article to the association of RTS with glaucoma and five other findings that may be confused with glaucoma (corneal lesions, megalocornea, colobomatous or cystic optic nerve, excavation of papilla, and large cup-to-disc ratio). A case report is presented including autopsy results on a 5-year-old black female with RTS, corneal lesions, colobomas of the optic nerves, and normal intraocular pressure.

Coloboma↗
PubMed2000

[Mitomycin C in open angle glaucoma surgery with previous failed glaucoma surgery].

PURPOSE: This study investigates the results of trabeculectomy with peroperative topical application of mitomycin-C performed on eyes with previous failed glaucoma filtering surgery. METHODS: The study includes 34 eyes of 26 patients operated on open angle glaucoma between March 1992 and October 1996, with a minimum of 6 months follow-up (mean 28.1 months). All the eyes had undergone prior one (27) o two (7) filtering surgeries. We evaluated intraocular pressure (IOP) and treatment reduction after surgery. Success was defined as IOP <20 mmHg, without deterioration of the visual field and/or papilla and without oral carbonic anhydrase inhibitors (OCAI) treatment. RESULTS: Average IOP decrease (p<0,001) from 21.06+/-3.70 mmHg to 13.88+/-2.42 mmHg after surgery and the number of medications dropped from 2.44+/-0.69 to 0.68+/-1.02 (p<0.01). The success rate was 88.2%. The major complication was hypotony maculopathy in 3 eyes (8.8%). CONCLUSIONS: Trabeculectomy with mitomycin-C decreases IOP and postoperative medications in eyes with previous unsuccessful filtering surgery.

Adult↗
PubMed1992

Clinical results of glaucoma surgery using the White glaucoma pump shunt.

The findings are reported in 37 patients with refractory glaucoma who were treated with the White glaucoma pump shunt for 6 months to 2 years (average follow-up, 14 months). Thirty-three patients (89%) had an intraocular pressure 22mmHg after six months and beyond, with or without medications. The decrease in intraocular pressure ranged from 24 to 33mmHg. Visual acuity improved in 12 patients, remained the same in 18 patients, and decreased in seven patients (all decreases were caused by progression of unrelated ocular disease).

Aqueous Humor↗
PubMed1992

[Fluorescein fundus angiography of optic nerve head in primary open angle glaucoma and low tension glaucoma].

Fluorescein fundus angiography was performed at angle of 20 degrees in the 58 low tension glaucoma (LTG) eyes (30 cases) and 77 primary open angle glaucoma (POAG) eyes (41 cases) and the relation of the optic nerve head fluorescein changes to visual field disturbances (stage classification of Kosaki) was compared between POAG and LTG groups. The filling defect of fluorescein in the deep area and the decrease in number of superficial capillaries were observed in the optic nerve head. The filling defect area of fluorescein in the optic nerve head corresponding to Bjerrum scotoma was recognized even in the mild visual field disturbance cases of both LTG and POAG. The following findings were noted in both LTG and POAG cases; expansion of the filling defect area and the decrease in number of superficial capillaries in the same area with progression of visual field disturbances. Filling defect area of fluorescein of the optic nerve head accorded with visual field disturbance area in 19 LTG eyes (32.8%) and 61 POAG eyes (79.2%). On the contrary, the filling defect area of the optic nerve head was wider than the visual disturbance area in 37 LTG eyes (63.8%) and 16 POAG eyes (20.8%). These findings suggest that blood circulatory disorders of the optic nerve head occurred earlier in LTG than in POAG and that the development of LTG might be closely associated with the blood circulatory disorders.

Aged↗
PubMed2004

[Papillary blood flow and morphological parameters of the optic nerve head in patients with normal tension glaucoma, primary open angle glaucoma and in healthy volunteers].

The aim of the present study was to compare selected morphological parameters of the optic nerve head and papillary blood flow in patients with NTG, POAG and in healthy volunteers, as well as to find any possible correlation between selected morphological parameters and papillary blood flow. 21 glaucomatous and 31 normal eyes were diagnosed using HRT and HRF. Statistically significant differences within many morphological parameters like cup area, cup to disc, cup shape measure, rim volume, RFNL thickness, RFNL cross section and neuroretinal rim blood flow appeared. Nevertheless, in glaucoma patients no statistically significant differences between morphology and flow were found. The conclusion is that blood flow impairment within the neuroretinal rim is connected with glaucoma neuropathy development, nevertheless it is affected by other factors.

Case-Control Studies↗
PubMed2006

[Evolution of secondary pseudoexfoliative glaucoma after cataract surgery in patients with cataract-glaucoma combination].

PURPOSE: To assess the effects of the cataract surgery on the evolution of the secondary open angle glaucoma (SOAG) in patients with pseudoexfoliative syndrome (PEX) that present the association cataract--SOAG. METHODS: A prospective study on 2 years on a group of 12 eyes with PEX syndrome presenting the association cataract-secondary open angle glaucoma, that have been operated by phacoemulsification + PC IOL, without intra-operator complications. We have monitored the effects of the cataract surgery on the evolution of the glaucomatous disease, evaluated by: monitoring of the IOP dynamics, the analysis of the visual field defects and the aspect of the FO, the evolution of the visual acuity and the morphology of the specific changes of PEX. The analysed group has been compared with a control group (5 eyes) presenting the association cataract--POAG, operated by phacoemulsification by the same surgeon. We have used the SPSS programme for statistical analysis. RESULTS: In the follow-up period we have observed almost similar evolutions of the IOP dynamic, but we obtained in PEX group statistically significant lowering of the IOP than in the control group. In PEX group the papillo-perimetric results have presented significantly different characteristics than in the control group, without having an influence on the visual acuity. CONCLUSIONS: Although the cataract extraction has produced in both groups, on a medium follow-up, an IOP decrease from the pre-operator values, the glaucomatous disease in PEX patients, probably because of other specific risk factors, continues to progress.

Adrenergic beta-Antagonists↗
PubMed1990

The Glaucoma Laser Trial (GLT). 2. Results of argon laser trabeculoplasty versus topical medicines. The Glaucoma Laser Trial Research Group.

The Glaucoma Laser Trial, a multicenter, randomized clinical trial involving 271 patients, was designed to assess the efficacy and safety of argon laser trabeculoplasty (ALT) as an alternative treatment with topical medication for controlling intraocular pressure (IOP) in patients with newly diagnosed, previously, untreated primary open-angle glaucoma (POAG). Each patient had one eye randomly assigned to ALT (the laser first [LF] eye) and the other eye assigned to timolol maleate 0.5% (the medication first [MF] eye). Medication was initiated or changed for either eye according to the same stepped regimen if the IOP was not controlled. Throughout the 2-year follow-up, LF eyes had lower mean IOPs than MF eyes (1-2 mmHg), and fewer LF eyes than MF eyes required simultaneous prescription of two or more medications to control IOP (P less than 0.001). After 2 years of follow-up, 44% of LF eyes were controlled by ALT, 70% were controlled by ALT or ALT and timolol, and 89% were controlled within the stepped medication regimen. After 2 years, 30% of MF eyes remained controlled by timolol, and 66% were controlled within the stepped regimen. There were no major differences between the two treatment approaches with respect to changes in visual acuity or visual field over the 2 years of follow-up.

Adult↗
PubMed1989

The Glaucoma Laser Trial. I. Acute effects of argon laser trabeculoplasty on intraocular pressure. Glaucoma Laser Trial Research Group.

The Glaucoma Laser Trial Research Group has examined the acute effects of argon laser trabeculoplasty on immediate change in intraocular pressure and the formation of peripheral anterior synechiae among the 271 eyes assigned to argon laser trabeculoplasty as initial treatment for primary open angle glaucoma. Argon laser trabeculoplasty was administered in two sessions. Intraocular pressure rises of greater than 5 mm Hg occurred in 34% of eyes after one or both of the treatment sessions; intraocular pressure rises of greater than 10 mm Hg occurred in 12%. Eyes that had an intraocular pressure rise after the first session were more likely to have a rise after the second session than eyes with no rise after the first session. Among the many patient, eye, and treatment characteristics examined, only pigmentation of the trabecular meshwork was strongly associated with intraocular pressure rises. Forty-six percent of eyes developed greater than or equal to 1 degree of peripheral anterior synechiae. Brown iris color and posterior placement of laser burns were associated with higher rates of peripheral anterior synechiae formation.

Adult↗
PubMed1989

[Surgical results in congenital glaucoma and in glaucoma in young persons].

The paper analyses results after observation over 38 patients (52 eyes operated on) divided into 2 groups: group I included 19 patients (29 eyes) with primary congenital glaucoma (hydrophthalmos) and group II consisting of 19 patients (23 eyes) with glaucoma associated with congenital anomalies. Trabeculotomy ab externo was made in 16 eyes, sinusotrabeculectomy after Kernz--in 9 cases. Trabeculotomy after Grusha and Sokolovskiĭ was made in 10 eyes, valvar trabeculotomy after Nesterov--in 17 eyes. It is pointed out that as a result of microsurgical operations hypotensive effect was achieved in 90.4% of cases both in immediate and remote terms. The obtained results once again confirm that early diagnosis and timely surgical treatment of hydrophthalmos is a necessary condition for a favourable prognosis of the disease.

Adolescent↗
PubMed1978

Glaucoma implants. Their use in difficult cases of glaucoma.

Implants with a regime of fibrosis suppression (prednisolone 30 mg daily plus fluphenamic acid 200 mg three times a day for 6 to 8 weeks) controlled the intraocular pressure (applanation tonometry (AT) less than 21 mm Hg) in seven out of ten patients with different types of glaucoma. One implant was removed after erosion of the conjunctiva and sclera; there were no other serious complications. Use of the implant is indicated after failed drainage operations or as a primary procedure in glaucoma associated with aphakia, chronic uveitis, vitreous in the anterior chamber, and scarring of the conjunctiva.

Adult↗