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PubMedDate not supplied

[A variant of glaucoma surgery].

The suggested variant of surgery provides an enhanced outflow of aqueous fluid from the anterior chamber of the eye into the suprachoroidal and subconjunctival spaces, this resulting in a reliable and stable hypotensive effect. In 53 of the 56 eyes with various forms, stages, and compensation degree of primary glaucoma, operated on, ophthalmic tone after surgery was within 18-20 mm Hg, in 3 cases it was within 15-17 mm Hg, and when the patients were discharged from hospital it was 18-21 mm Hg in all the eyes operated on. No cases of ciliochoroidal detachment, hyphema, or other complications were recorded in the postoperative period, that ran a smooth course with the minimal recovery inflammation reaction of the eye and was shorter by 3.5 bed-days, on an average. The technique is simple and available for ophthalmic surgeons, low traumatic and highly effective in patients with various stages of primary glaucoma, this recommending it for wide practice.

Aged↗
PubMed1991

Argon laser pretreatment 4 to 6 weeks before Nd:YAG laser iridotomy.

Argon laser pretreatment followed by Nd:YAG laser iridotomy 4 to 6 weeks later was performed in the right eye of 10 patients. Primary Nd:YAG laser iridotomy was performed in the left eye. Significantly more Nd:YAG laser energy was needed to produce an iridotomy in pretreated eyes (P less than .001). Pretreated eyes developed a significantly larger pigment epithelium defect around the iridotomy site and a greater degree of pigmentation of the inferior part of the trabecular meshwork 6 months following treatment. Argon laser pretreatment followed by Nd:YAG laser iridotomy 4 to 6 weeks later appears to offer no advantages over primary Nd:YAG laser iridotomy.

Aged↗
PubMed1992

[Inner nuclear layer of the retina in eyes with secondary angle-block glaucoma].

Glaucomatous changes have been known to occur in the inner retinal layer all over the fundus and in the deep retinal layer and retinal pigment epithelium close at the optic disc border. This study was conducted to address the question as to whether the middle retinal layers are altered by the glaucomatous process. The study included histological slides of 23 eyes enucleated due to painful secondary traumatic angle-closure glaucoma and 14 nonglaucomatous eyes removed because of a malignant choroidal melanoma. We evaluated the cell count and thickness of the inner nuclear layer via histomorphometry. The inner nuclear layer contained significantly fewer cells and was thinner (P < 0.05) in the glaucoma group compared to the control group. Since this study contains eyes with possible secondary changes due to the initial trauma, further investigations on eyes with primary open-angle glaucoma are necessary to confirm the results. This could be important for psychophysical testing in glaucoma.

Adult↗
PubMed2026

Migraine is not a risk factor for glaucoma: Evidence from a bidirectional Mendelian randomization study.

Numerous compelling observational studies have indicated that migraine is a risk factor for the development of glaucoma. Nevertheless, some studies have observed entirely opposite results. The objective of our research is to evaluate the potential relationship between migraine and glaucoma by employing a bidirectional Mendelian Randomization (MR) approach. This method enables us to rigorously assess the causal links between these 2 conditions, thereby addressing the discrepancies in existing literature. Independent genetic variants associated with glaucoma and migraine at the genome-wide significance level were selected as instrumental variables. All summary data were obtained from the genome-wide association study database. The primary method employed in the bidirectional MR analysis was the inverse variance weighted method, while sensitivity analyses utilized the leave-one-out method, MR-Egger method, and MR-Pleiotropy RESidual Sum and Outlier&#x200c; method. When migraine and its subtypes (specifically migraine with aura and migraine without aura) were evaluated as exposure factors, we found no evidence of a causal relationship with glaucoma and its subtypes (namely angle-closure glaucoma and open-angle glaucoma). Subsequently, in the reverse MR analysis, when glaucoma and its subtypes (angle-closure glaucoma and open-angle glaucoma) were assessed as exposure factors, there was no substantial evidence to support a causal relationship with migraine or its subtypes (migraine with aura and migraine without aura). Furthermore, sensitivity analyses also reinforced the robustness of our bidirectional MR findings. Our bidirectional MR analysis mitigates the biases associated with traditional observational studies, highlighting that there is no direct causal relationship between migraine and the risk of glaucoma.

Humans↗
PubMedDate not supplied

Trabeculectomy: a reevaluation after three years and a comparison with Scheie's procedure.

Seventy-one patients with glaucoma needing surgical correction had either a peripheral iridectomy with a thermal sclerostomy or a trabeculectomy utilizing a modification of Watson's technique in which the scleral flap was closed tightly with sutures. Results of surgery were analyzed at intervals up to an including three years following the surgical procedure. The success of the operations was judged both in terms of the effect on intraocular pressure as well as on the visual ability of the eye. Since the surgeon's aim is to lower intraocular pressure to a particular level, not simply to an arbitrary level that facilitates statistical analysis, the control of the disease was graded in terms of how completely the operative procedure fulfilled the goal set by the surgeon at the time the decision to operate was made. While this method of grading success introduces a subjective element, a more valid assessment of the true value of the surgery may be obtained. The results suggest that the Scheie procedure lowers pressure to a lower level and for a longer duration than does the trabeculectomy (mean intraocular pressure three years postoperatively was 12.3 mm Hg in patients with primary glaucoma treated with a Scheie procedure and 16.6 mm Hg in those with trabeculectomy with a sutured scleral flap). In this study the long-term visual result was apparently no different with the Scheie procedure and trabeculectomy. Trabeculectomy causes fewer flat anterior chambers than the Scheie procedure. The degree of pressure lowering in trabeculectomy is directly related to the amount of postoperative filtration. The relative indications for trabeculectomy include: (1) malignant glaucoma in the other eye, (2) chronic angle-closure glaucoma where an iridectomy is considered insufficient, (3) "high pressure glaucoma" where pressure below 20 mm Hg is not essential, (4) low inflow glaucoma in which persistent flat anterior chambers may be expected following routine filtration surgery, and (5) patients where endophthalmitis is a real concern, as in the young, those remote from medical care and those with poor personal hygiene. Trabeculectomy gives such poor results in secondary glaucoma that the procedure is probably relatively contraindicated. Trabeculectomy is a valuable operation, but not the final solution to glaucoma surgery. It should be chosen with full recognition of its specific advantages and disadvantages.

Adolescent↗
PubMed2023

The Use of ChatGPT to Assist in Diagnosing Glaucoma Based on Clinical Case Reports.

INTRODUCTION: The purpose of this study was to evaluate the capabilities of large language models such as Chat Generative Pretrained Transformer (ChatGPT) to diagnose glaucoma based on specific clinical case descriptions with comparison to the performance of senior ophthalmology resident trainees. METHODS: We selected 11 cases with primary and secondary glaucoma from a publicly accessible online database of case reports. A total of four cases had primary glaucoma including open-angle, juvenile, normal-tension, and angle-closure glaucoma, while seven cases had secondary glaucoma including pseudo-exfoliation, pigment dispersion glaucoma, glaucomatocyclitic crisis, aphakic, neovascular, aqueous misdirection, and inflammatory glaucoma. We input the text of each case detail into ChatGPT and asked for provisional and differential diagnoses. We then presented the details of 11 cases to three senior ophthalmology residents and recorded their provisional and differential diagnoses. We finally evaluated the responses based on the correct diagnoses and evaluated agreements. RESULTS: The provisional diagnosis based on ChatGPT was correct in eight out of 11 (72.7%) cases and three ophthalmology residents were correct in six (54.5%), eight (72.7%), and eight (72.7%) cases, respectively. The agreement between ChatGPT and the first, second, and third ophthalmology residents were 9, 7, and 7, respectively. CONCLUSIONS: The accuracy of ChatGPT in diagnosing patients with primary and secondary glaucoma, using specific case examples, was similar or better than senior ophthalmology residents. With further development, ChatGPT may have the potential to be used in clinical care settings, such as primary care offices, for triaging and in eye care clinical practices to provide objective and quick diagnoses of patients with glaucoma.

Artificial intelligence (AI)↗
PubMed1978

Lack of association of histocompatibility antigens with primary open-angle glaucoma.

Eighty-seven patients (35 with primary open-angle glaucoma, 20 with angle-closure glaucoma, and 32 controls) underwent HLA typing of peripheral lymphocytes. Sixteen specificities were detected at the A locus, 19 at the B locus, and four at the C locus. No significant differences were found between patients with either type of glaucoma and control patients.

Ethnicity↗
PubMed1991

The oval pupil.

The dynamics of pupillary dilation induced by Phenylephrine 10% and Cyclopentolate 1% have been examined by flash photography. A correlation between anterior chamber depth and the pupil shape on dilation with Phenylephrine Hydrochloride 10% is described. It is postulated that these pupillary dilation dynamics support a sympathetic abnormality as a trigger for acute primary angle closure glaucoma.

Adolescent↗
PubMed1991

Trabeculectomy with 5-fluorouracil.

The effect of subconjunctival injection of 5-fluorouracil (5-FU) after trabeculectomy was studied retrospectively in 205 eyes of 168 patients. A life table analysis of the surgical outcome was based on the type of glaucoma and age related differences, and a comparison was made with patients who had trabeculectomy without subconjunctival 5-FU. The success rate at 30 months after trabeculectomy with 5-FU therapy was considerably higher in primary open-angle glaucoma at 93.6% (72.7%), secondary glaucoma at 88.9% (72.4%), and refractory glaucoma at 72.2% (32.5%) with (or without) the use of ocular hypotensive drops when compared with historical control groups treated without 5-FU (60.0% (41.7%), 35.5% (24.0%), and 18.0% (8.0%), respectively). In patients aged over 70 years, no statistically significant improvement could be demonstrated with the use of 5-FU after trabeculectomy in primary open-angle glaucoma. Our study may provide data on the appropriate dosage and indications for the use of this drug after glaucoma surgery.

Aged↗
PubMed1990

Soap gets in your eyes.

We present a previously unreported series of five cases of acute angle closure glaucoma associated with watching the Australia soap opera "Neighbours". Two cases were bilateral and associated with watching two episodes of "Neighbours" on the same day. The pathogenesis, and possible role of watching soap operas in the causation of primary angle closure glaucoma is discussed.

Aged↗
PubMed1992

[YAG laser treatment in anterior segment disease of the eye].

Three hundred and fifty-two eyes (230 patients) with various diseases were treated with the first China-made YAG laser therapy instruments. The success rate was 100%. Two hundred and seventy-six eyes with primary angle closed glaucoma were treated by peripheral iridotomy. Postoperatively, the IOP was lowered by 0.267 kPa (2.43 mmHg). The dose and frequency of medication could then be lowered. The closed chamber angle index improved. Forty-nine eyes with membranous cataract were treated by posterior capsulotomy: Visual acuity was improved by 95%. The main complications during or immediately after operation were as follows: transient elevation of IOP, hyphema, anterior uveitis and corneal edema. All of these were well controlled.

Adult↗
PubMed1992

The selective effects of elevated intraocular pressure on temporal resolution.

Twenty-seven eyes of 27 patients with normal tension glaucoma (NTG), 68 eyes of 68 patients with primary open-angle glaucoma (POAG), and 11 eyes of 11 patients with special forms of high-tension glaucoma (SHTG) including (pigmentary glaucoma, angle-closure glaucoma, secondary glaucoma, etc.), were examined by automated light-sense and temporal resolution perimetry. Light-sense perimetry was performed with the Humphrey Field Analyzer, using program 30-2. Temporal resolution perimetry was conducted with a system developed by Lachenmayr. Global field indices were calculated for all visual fields and modalities: mean defect (MD) for light-sense perimetry and mean flicker defect (FD) for flicker perimetry. For each of the three glaucoma groups there was a significant linear correlation of FD over MD. The slope of the regression line (regression coefficient a) increased with increasing maximal pressure level of the glaucomatous group: for NTG a = 0.6671, for POAG a = -1.2413, and for SHTG a = -2.235. The differences of the regression coefficients between NTG and POAG and between NTG and SHTG were statistically significant (P = 0.0366 and P = 0.0046, respectively). The results of the present study provide evidence that the relative amount of damage to flicker compared to light-sense perimetry increases with increasing maximal pressure level of a glaucomatous population. Thus, flicker perimetry may be a tool for the identification of eyes with pressure-produced damage.

Adult↗
PubMedDate not supplied

[Effectiveness of laser treatment of narrow-angle glaucoma].

Forty-eight patients with narrow-angle glaucoma were treated with M-900 argon laser (Coherent Radiation, USA). Reduction of intraocular pressure as low as 20 +/- 1.82 mm Hg on an average was achieved. Fluid discharge efficacy coefficient has improved. The authors claim that laser cyclotrabeculospasis a sufficiently effective method for the treatment of primary narrow-angle glaucoma.

Adult↗
PubMedDate not supplied

[Clinical evaluation of the hypotensive effectiveness of Betoptic preparation].

Clinical trials of the hypotensive effect of 0.5% betoptic, an antiglaucoma drug manufactured by Alcon (USA), were carried out at three ophthalmologic hospitals. Similar results obtained in all the trials permit a conclusion on a high hypotensive efficacy of this drug in patients with primary open-angle glaucoma. The drug was well tolerated by the patients.

Aged↗
PubMed1991

Awan's syndrome (primary orbital hypertelorism, narrow-angle glaucoma and lean physique) in two women.

Awan's syndrome, characterized by a lean physique, orbital hypertelorism and angle-closure glaucoma, is a distinct clinical entity which should be more widely recognized. The patients, usually women in their sixth decade, may suffer several self-limiting and misdiagnosed episodes of angle-closure before a definite diagnosis is made. The general physical appearance and hypertelorism in two women, one aged 56 and the other 59 years, with Awan's syndrome aroused the suspicion of angle-closure glaucoma. The timely confirmation of diagnosis and proper management prevented further visual loss in both patients. Some patients with Awan's syndrome may show advanced damage to the optic nerve without ever having had an acute attack of glaucoma or any other symptoms, which makes it important that all patients with orbital hypertelorism and suspected glaucomatous optic discs should undergo gonioscopic evaluation to rule out glaucoma.

Body Constitution↗
PubMedDate not supplied

Argon laser iridoplasty: a primary mode of therapy in primary angle closure glaucoma.

Argon laser iridoplasty was performed in 40 eyes of 33 patients of primary angle closure glaucoma. There were 12 male and 21 female patients. The mean ages of the male and female patients were 51 years and 48.4 years respectively. Forty eyes were divided into two groups. Group I consisted of ten eyes of subacute angle closure glaucoma and group II included thirty eyes of chronic angle closure glaucoma. Argon laser iridoplasty was performed with Coherent 9000 model using laser settings of spot size 200 micron, duration 0.2 second and power 0.7 watt. A total of 80 spots were applied over 360 degree circumference. The intraocular pressure control (below 22 mm Hg) was achieved after iridoplasty in all the eyes (100%) in group I, where as in group II the intraocular pressure was controlled in 70% eyes. The follow up period varied from 3 months to one year with a mean of eight months. The success rate with iridoplasty was directly related to the extent of peripheral anterior synechiae, optic disc cupping and presence of visual field changes.

Acute Disease↗
PubMed1991

A preliminary study of short-term efficacy of Nd:YAG laser peripheral iridotomy in patients with primary angle closed glaucoma.

Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases (80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5 (1-127 shots), and the average shot energy is 2.5 mJ (0.9-5.6 mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2 mm2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy present as transient IOP elevation and iris bleeding. Increase in IOP most occurs within two hours after the laser therapy. The iris bleeding was seen in about 39% of the patients, but this iris bleeding is slight and very minor and tend to stop spontaneously. On the other hand, no correlation was found among the IOP elevation, laser shot, and laser shot energy. The causes and management of the IOP elevation after Nd:YAG laser iridotomy was discussed in detail. The authors believe that this newer treatment has immediate benefit for the patients with narrow-angle or angle-closure glaucoma, but many problems still remain to be investigated.

Female↗