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At least 577 records · Page 32Linked to original sources
PubMed2003

[Efficacy of selective laser trabeculoplasty in the treatment of primary open-angle glaucoma].

BACKGROUND: Our aim was to investigate the efficacy of selective laser trabeculoplasty (SLT) for the treatment of primary open-angle glaucoma (POAG) in a prospective clinical study. PATIENTS AND METHODS: In 36 eyes of 36 patients suffering from uncontrolled POAG, treatment was carried out with a frequency-doubled, Q-switched Nd:YAG laser (532 nm). The intraocular pressure (IOP) was measured before the treatment and one day, one week, one month and 3, 6, 12, 18, 24, 30, 36, 42 and 48 months after. A failure was defined as an IOP reduction of less than 20% from pretreatment IOP, or a progression of visual field or optic disc damage requiring filtering surgery. The hypotensive medication during the study period remained unchanged. RESULTS: The mean follow-up time was 34 months (SD 12.9). The mean pretreatment IOP was 22.9 mm Hg (SD 2.1). At one month of follow-up, the mean IOP reduction was 5.3 mm Hg (SD 2.1) or 23.1% and at 6 months 5.6 mm Hg (SD 2.6) or 24.5%. At 12 months of follow-up, the mean IOP reduction was 5.6 mm Hg (SD 2.3) or 24.5% and at 24 months 6.2 mm Hg (SD 2.5) or 27%. At 36 months of follow-up, the mean IOP reduction was 6.4 mm Hg (SD 2.1) or 27.4% and at the end of 48 months of follow-up, the mean IOP reduction was 5.9 mm Hg (SD 2.0) or 25.4%. The success rate after 12 months determined from the Kaplan-Meier survival analysis was 97%, after 24 months 88%, after 36 months 76% and after 48 months 71%. CONCLUSION: SLT is an effective procedure for the treatment of POAG.

Aged↗
PubMed2006

[Long-term follow-up of selective laser trabeculoplasty in primary open-angle glaucoma].

BACKGROUND: Our aim was to investigate the outcomes of selective laser trabeculoplasty (SLT) for the treatment of primary open-angle glaucoma (POAG) in a prospective clinical study. PATIENTS AND METHODS: In 90 eyes suffering from POAG, treatment was carried out with a frequency-doubled, Q-switched Nd:YAG laser (532 nm). The intraocular pressure (IOP) was measured before the treatment and 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, 60, 66 and 72 months after. A failure was defined as an IOP reduction of less than 20 % of the pretreatment IOP, or a progression of visual field or optic disc damage requiring filtering surgery. The hypotensive medication during the study period remained unchanged. RESULTS: The mean follow-up time was 41.2 months (SD 20.0). The mean pretreatment IOP was 22.4 mmHg (SD 2.3). At one month of follow-up, the mean IOP reduction was 5.0 mmHg (SD 2.3) or 22.3 % and at 6 months 5.2 mmHg (SD 2.4) or 23.2 %. At 12 months of follow-up, the mean IOP reduction was 5.4 mmHg (SD 2.4) or 24.0 % and at 24 months 5.8 mmHg (SD 2.3) or 25.5 %. At 36 months of follow-up, the mean IOP reduction was 5.7 mmHg (SD 2.1) or 25.1 % and at 48 months of follow-up, the mean IOP reduction was 5.2 mmHg (SD 1.9) or 23.1 %. At 60 months of follow-up, the mean IOP reduction was 5.2 mmHg (SD 2.0) or 22.6 % and at the end of 72 months of follow-up, the mean IOP reduction was 5.4 mmHg (SD 2.3) or 22.8 %. The success rate after 12 months determined by Kaplan-Meier survival analysis was 94 %, after 24 months 85 %, after 36 months 74 %, after 48 months 68 % and after 72 months 59 %. CONCLUSION: SLT is an effective procedure offering an additional therapy option for the treatment of POAG, but the effect diminishes over time.

Female↗
PubMed1982

[Immunopathogenesis of primary open-angle glaucoma].

By means of direct immunofluorescence technique the trabecular meshwork of patients with primary open-angle glaucoma, obtained at the time of filtering surgery, and the trabecular meshwork of controls were investigated for the presence of immunoglobulins and the complement component C3. In neither group were such deposits found; this indicates a lack of immunogenic mechanisms in primary open-angle glaucoma.

Fluorescent Antibody Technique↗
PubMed1998

OPC-15161 suppresses the proliferation of Tenon's capsule fibroblasts and the production of type I collagen and fibronectin stimulated by TGF-beta1 in vitro.

PURPOSE: We investigated the effects of OPC-15161 on the growth of cultured human Tenon's capsule fibroblasts (TCFs), as well as on the production of type I procollagen, fibronectin, and laminin. These effects were examined in the presence or absence of TGF-beta1. METHODS: Cell proliferation was assayed by counting cell number and assay of DNA synthesis. Cytotoxicity was determined by the MTT method. Matrix components were assayed by enzyme immunoassay of material in the medium and in the cell lysate with or without OPC-15161. Total protein content was determined. Cellular ultrastructure was also evaluated. RESULTS: Treatment with OPC-15161 (up to 100.0 microg ml(-1)) significantly reduced the proliferation and DNA synthesis of TCFs. No significant decrease in MTT values was observed in confluent TCF cultures with OPC-15161 (up to 100.0 microg ml(-1)). TGF-beta1 enhanced the TCF production of procollagen I and fibronectin. OPC-15161 significantly decreased the procollagen I content in both the medium, in the cell lysate of TGF-beta1-stimulated cells, and fibronectin content in the lysate. OPC-15161 did not affect the laminin or total protein content, either with or without TGF-beta1. No ultrastructural evidence of cytotoxicity was observed. CONCLUSIONS: OPC-15161 inhibited the proliferation of TCFs, and reduced their production of procollagen I and fibronectin in the presence of TGF-beta1 without evidence of cytotoxicity. OPC-15161 may be useful in inhibiting the excessive fibrosis produced in the wound in response to filtering surgery.

Adult↗
PubMed2003

Effect of growth factors on the activation of human Tenon's capsule fibroblasts.

PURPOSE: To investigate stimulatory effects of PDGF-AA, PDGF-AB, PDGF-BB, bFGF, IL-1beta, TGF-beta1 and TGF-beta2 on the proliferation and myofibroblast transformation of cultured human Tenon's capsule fibroblasts and to characterize expression of PDGF- and TGF-beta-receptors in these cells. METHODS: To determine cell proliferation, cell number of 2nd passage cultured human Tenon's capsule fibroblasts was measured before and after addition of growth factors using a computer-based cell counter system. Immunoblotting was used to detect and quantitate alpha-smooth-muscle actin (alpha-SMA) expression. Expression of PDGF- and TGF-beta-receptor mRNA was detected by RT-PCR, expression of the corresponding protein was demonstrated using Western blot. RESULTS: A significant increase in proliferation (p < or = 0.05) was detected after exogenous stimulation with PDGF-AA (10 ng/ml and 100 ng/ml), PDGF-AB (10 ng/ml and 100 ng/ml), PDGF-BB (10 ng/ml and 100 ng/ml), bFGF (100 ng/ml), IL-1beta (1 ng/ml and 10 ng/ml), TGF-beta1 (0.5 ng/ml) and TGF-beta2 (0.5 ng/ml). Both TGF-beta1 and TGF-beta2 stimulated expression of alpha-SMA in a dose dependent manner with peak activity at a concentration of 50 ng/ml (TGF-beta1) and 500 ng/ml (TGF-beta2). Protein and mRNA of PDGF-receptor type alpha and type beta and TGF-beta-receptors type I, II and III are expressed in cultured human Tenon's capsule fibroblasts. CONCLUSIONS: The present investigation strongly supports the hypothesis that PDGF-isoforms are major stimulators of proliferation of Tenon's capsule fibroblasts after glaucoma filtering surgery while TGF-beta-isoforms are essential for the transformation of Tenon's capsule fibroblasts into myofibroblasts.

Actins↗
PubMed1999

Childhood-onset primary open angle glaucoma in a Canadian kindred: clinical and molecular genetic features.

OBJECTIVE: To describe the clinical features and identify the molecular etiology of childhood-onset primary open angle glaucoma (POAG) in a Canadian kindred. METHODS: Members of a Canadian Caucasian family with POAG were examined and DNA obtained. Single-strand conformation polymorphism analysis was performed using reported primers from exon 3 of the myocilin gene. A single-stranded conformation polymorphism was characterized by polymerase chain reaction-based sequencing. RESULTS: Two affected half-sibs had onset of severe glaucoma at age 3 and 9. Their mother had lost vision in one eye from glaucoma by age 17. All three affected subjects had undergone bilateral glaucoma filtering surgery. Both fathers were unaffected. A single-stranded conformation polymorphism was identified in the mother and the two affected daughters and was absent in one father. A single base change from C-->T at nucleotide position 1109 was identified in the affected members of the family by direct sequencing. This mutation, which causes a nonconservative amino acid change (Pro370Leu), was not found on 192 normal chromosomes from Caucasian individuals. CONCLUSION: We report a Canadian family with childhood-onset, severe POAG due to a mutation in the myocilin gene.

Adult↗
PubMed1991

Glaucoma. A primer for primary care physicians.

Glaucoma is best detected by examination of the optic disk, since intraocular pressure is not always elevated in patients with the condition. A large, vertically oval cup within the optic disk is strong evidence for glaucoma. Open-angle glaucoma, the most common form of the disorder, often is not detected until the disease is advanced. It can usually be treated successfully with topical medications, but systemic absorption of these can result in serious side effects. If medical treatment fails, laser therapy or filtering surgery may be helpful. Acute angle-closure glaucoma has a sudden onset marked by alarming elevations in intraocular pressure. It is treated immediately with topical pilocarpine and systemic osmotic agents, and an iridectomy should be performed as soon as possible. Congenital glaucoma can be cured with goniotomy.

Family Practice↗
PubMed1991

Inhibition of rabbit ocular fibroblast proliferation by 5-fluorouracil and cytosine arabinoside.

Inhibition of rabbit subconjunctival fibroblast attachment and proliferation by the antimetabolites 5-fluorouracil (5-FU) and cytosine arabinoside (ara-C) was determined by radionucleotide uptake, cell counting, and colorimetric assays for the concentration range of 1000 to 0.0001 micrograms/ml over an 11-day period. The mean 50% inhibitory doses (ID50s) against proliferation were calculated for each assay. Rabbit fibroblast attachment was not inhibited at any drug concentration by either 5-FU or ara-C. Ara-C was a 10 to 100 times more potent inhibitor of rabbit fibroblast proliferation than 5-FU. The mean ID50s for rabbit subconjunctival fibroblasts were compared with the mean ID50s from a similar series of experiments conducted in our laboratory on human subconjunctival fibroblasts. Unpaired t-test analysis showed a significant difference between the inhibitory effects of 5-FU on rabbit and human fibroblast proliferation. An ID50 against rabbit fibroblasts was detectable after 24 hours of incubation with 5-FU by the 3H-thymidine uptake assay, whereas the ID50 against human fibroblasts was detectable after 48 hours of incubation. Once inhibition of proliferation occurred, however, human fibroblasts were up to six times more sensitive to the antiproliferative effects of 5-FU than rabbit fibroblasts as measured by the 3H-thymidine uptake assay (p = 0.0005). Unpaired t-test analysis showed no statistical difference between the ID50s of ara-C on rabbit and human fibroblasts. Starting on day 3, however, doses greater than 1 micrograms/ml of ara-C were cytotoxic to rabbit fibroblasts but only cytostatic to human fibroblasts as determined by trypan blue uptake assay microscopically. Rabbit ocular fibroblasts may be useful in modelling the proliferation of human ocular fibroblasts in vitro to a limited degree. This tissue culture system may be useful for predicting optimal drug dosages for in vivo rabbit and human glaucoma filtering surgery.

Animals↗
PubMed1996

Antiproliferative activity of a liposomal delivery system of mitoxantrone on rabbit subconjunctival fibroblasts in an ex-vivo model.

Wound healing is the main cause of the failure of filtering surgery in glaucoma. We developed a liposomal delivery system of mitoxantrone (MITX), an anthracyclin derivative, to allow a single adjuvant administration and to lessen ocular side-effects of the drug. In order to evaluate the antiproliferative activity of liposomal MITX, an ex vivo model consisting in the culture of subconjunctival tissue explants from rabbits pretreated with subconjunctival injections of free or liposomal MITX was used. We found that both forms of MITX decreased the growth rate as well as the explant proliferation surfaces 15 days or 1 month after a single administration of the drug in vivo. A morphometric analysis of the cells showed that the surface of the fibroblasts exposed to both forms of MITX was from 10 to 12 times as important as that of the control cells exposed to the empty liposomes and to the control buffer. A radioautographic study showed that more than 95% of the fibroblasts exposed to both forms of MITX were in the G1 phase of the cell cycle, while the control cell population was equally distributed among the different phases of the cell cycle.

Animals↗
PubMed1997

Effects of pilocarpine and other antiglaucoma drugs on cultured human Tenon's fibroblast cells.

It has been found that long-term therapy with topical antiglaucoma drugs may decrease the success of glaucoma filtering surgery. In this study, various antiglaucoma drugs, including carteolol, betaxolol, levobunolol, pilocarpine, and timolol, were investigated for their proliferative effect on cultured human Tenon's fibroblast cells. It was found that the 3H-thymidine uptake of cultured fibroblast cells was inhibited by commercial antiglaucoma drugs, including carteolol of 0.1% concentration (13%), 0.01% (50%) and 0.001% (53%), betaxolol of 0.05% concentration (14%), 0.005% (42%) and 0.0005% (62%), levobunolol of 0.05% concentration (2%), 0.005% (32%) and 0.0005% (55%), and timolol of 0.025% concentration (4%), 0.0025% (47%) and 0.00025% (55%), whereas the 3H-thymidine uptake was increased by commercial pilocarpine eyedrop from 103% (0.2% of concentration), 170% (0.02% of concentration) to 171% (0.002% of concentration), when cells were treated with commercial drugs for 100 min. Meanwhile, the proliferations of cultured fibroblast cells were stimulated by simultaneously combining 0.2%, 0.02% and 0.002% concentrations of pilocarpine eyedrops with other antiglaucoma drugs, such as carteolol of 0.1% concentration (50%), 0.01% (113%) and 0.001% (138%), betaxolol of 0.05% concentration (24%), 0.005% (128%) and 0.0005% (142%), levobunolol of 0.05% concentration (32%), 0.005% (87%) and 0.0005% (119%), and timolol of 0.025% concentration (15%), 0.0025% (94%) and 0.00025% (118%). Following incubation with pure pilocarpine, the proliferation of Tenon's fibroblast cells was inhibited for 84% (0.2% concentration), 84% (0.02% concentration) and 90% (0.002% concentration). When fibroblast cells were treated with commercial pilocarpine eyedrops for 24 hours, the 3H-thymidine uptake was increased to 160% (0.02% concentration) and 172% (0.002% concentration). This result shows that the commercial pilocarpine may play a crucial role for the proliferation of cultured human Tenon's fibroblast cells.

Adrenergic beta-Antagonists↗
PubMed2000

Wound modulation after trabeculectomy by different formulations of antimetabolites in rabbits.

A prospective, randomized study was performed to examine the effects of subconjunctival retention of 5-fluorouracil (5-FU) microparticles or 5-FU microparticles combined with mitomycin-C (MMC) on the success of trabeculectomy procedure in 32 New Zealand white rabbits. Drug-loaded microparticles were prepared using a biodegradable polymer, 50:50 ploy (D,L-lactide-co-glycolide) (50:50, PLG, MW 9000), by an oil-in-oil emulsification/solvent extraction technique. Each rabbit underwent trabeculectomy on both eyes, then one of the 5-FU and/or MMC preparations was placed at the site of the filtering surgery intraoperatively in the right eye, while the left eye was used as a control. The rabbits were randomly allocated to one of four treatment groups: group 1 rabbits received 5% 5-FU microparticles 10 mg; group 2 rabbits received 10% 5-FU microparticles 10 mg; group 3 rabbits received 10% 5-FU microparticles 5 mg and MMC 0.01 mg (5-FU/MMC); and group 4 rabbits received MMC 0.02 mg. Postoperatively, intraocularpressure (IOP), bleb survival, complications and IOP dynamics were compared during a follow-up period of 42 days. The results showed that IOPs were significantly lower in the eyes that received groups 3 and 4 treatments, while the eyes that received low concentrations of 5-FU microparticles resulted in no difference in IOPs as compared with those of controls. At 42 days, blebs were present in 100% of the eyes treated with 5-FU/MMC and MMC, but 0% of the eyes treated with 5-FU microparticles. The blebs in the eyes treated with MMC 0.02 mg were thinner, and significant complications (endophthalmitis, transient corneal opacification and neovascularization) occurred. In addition, the IOP dynamics study revealed that the eyes treated with 5-FU/MMC and MMC resulted in less IOP spikings after intravenous infusion of 0.9% NaCl solution. Our study suggested that the use of 5-FU microparticles in promoting the success of trabeculectomy in rabbits is dose-dependent, and its effect is less potent than a single intraoperative application of MMC.

Animals↗
PubMed2000

Excisional bleb revision to correct overfiltration or leakage.

OBJECTIVES: To evaluate the effectiveness of excisional revision of filtering blebs for hypotony or leakage when more conservative measures have failed. PATIENTS AND METHODS: Retrospective review of all patients who underwent excisional revision of a filtering bleb for hypotony (intraocular pressure [IOP] < 5 mm Hg) or leakage during a 3 year period. The revision consisted of excision of the avascular bleb, mobilization of the surrounding conjunctiva, and suturing of the conjunctiva at the limbus. RESULTS: Sixteen patients were included in the study. The average age was 66.3 +/- 14.8 years (range, 39-83). Revision followed trabeculectomy in 11 cases, combined phacoemulsification-trabeculectomy in three cases, and inadvertent blebs in two cases. Five cases had bleb leaks without hypotony, four cases had hypotony alone, and seven cases had both hypotony and a bleb leak. Average follow-up after bleb revision was 25 +/- 11 months (range, 9-43). Average IOP increased from 3.8 +/- 5.6 mm Hg (range, 0-22) to 11.9 +/- 4.1 mm Hg (range, 3-18), with an average of 1.1 +/- 1.1 medication (range, 0-3). The IOP at the last visit was < 15 mm Hg in all but two patients, with 10 of the 16 patients requiring medications. At the last follow-up examination, visual acuity had improved > or = two lines in nine patients and was reduced two lines in one patient. Five patients had early postoperative limbal wound leaks; resuturing was required in one case. CONCLUSIONS: Excisional bleb revision is an effective technique to correct hypotony or leakage after filtering surgery when other methods have failed. Intraocular pressure control is often maintained with the use of medications.

Adult↗
PubMed2003

Optic disc hemorrhage in Asian glaucoma patients.

PURPOSE: To assess the prevalence of optic disc hemorrhage in Asian patients with established glaucoma using a recently described, highly sensitive detection method. MATERIALS AND METHODS: Patients entering a trial of glaucoma filtering surgery in Southeast Asia (The Singapore 5FU Study) were assessed for the presence or absence of optic disc hemorrhage using stereo flicker chronoscopy of stereophotograph pairs. RESULTS: A total of 167 patients (117 males and 50 females) were assessed, of whom 128 were Chinese. Primary open-angle glaucoma was diagnosed in 90 patients, primary angle-closure glaucoma in 69 patients, and pseudoexfoliative or pigment dispersion glaucoma in 7 patients. Five eyes of 5 patients had disc hemorrhage at enrollment (5/167), a rate of 2.99%. Four patients with disc hemorrhage had primary open-angle glaucoma and 1 had primary angle-closure glaucoma. There were no significant differences in global visual field indices, AGIS scores, or intraocular pressures between eyes with and without disc hemorrhage. All disc hemorrhages were seen in eyes prior to trabeculectomy. CONCLUSIONS: The prevalence of disc hemorrhage in the current study was comparable to that seen in primary open-angle glaucoma in clinic-based studies of white patients, but far less than that reported in normal-tension glaucoma studies. Hemorrhages were more common in primary open-angle glaucoma than primary angle-closure glaucoma.

Ethnicity↗
PubMed2004

Aspirin use in advanced uncontrolled glaucoma.

PURPOSE: To evaluate if aspirin use affects progression of primary open angle glaucoma (POAG). METHODS: A retrospective review of patients with uncontrolled glaucoma was performed. Incidence of aspirin use was noted by a one-time self-reporting survey. Controls were medically stable patients diagnosed with POAG. The primary outcome measure studied was a comparison of percentages of aspirin use in patients who have and have not undergone glaucoma filtering surgery (trabeculectomy). RESULTS: Forty-one percent (26/64) of the patients in the trabeculectomy group and 23% (17/74) of controls were using aspirin. Patients undergoing trabeculectomy were twice as likely to take aspirin (O.R., 2.29; 95% C.I., 1.10-4.79). Subgroup analyses demonstrated increased aspirin use in those operative patients who are current or former smokers (O.R., 3.71; 95% C.I., 1.10-12.56), have systemic hypertension (O.R., 3.30; 95% C.I., 1.02-22.58), or have joint disease (O.R., 4.60; 95% C.I., 1.34-15.82). CONCLUSION: A higher concurrence of aspirin use was observed in patients with POAG who required surgical management compared with patients having relatively medically stable glaucoma. This may be secondary to a higher rate of glaucoma surgery performed on patients with greater systemic illnesses, more of whom use aspirin.

Aged↗
PubMed2005

Implantation of a miniature glaucoma device under a scleral flap.

PURPOSE: To test the safety and efficacy of the Ex-PRESS miniature glaucoma device when it is implanted under a scleral flap instead of under the conjunctiva as it was originally suggested. PATIENTS AND METHODS: Between November 2000 and February 2003, the Ex-PRESS implant was inserted in 24 eyes of 23 patients with severe open angle glaucoma. Sixteen eyes of the 24 (66%) had had previous failed filtering surgery. The remaining 8 eyes (33%) were high risk for failures cases. A 5 x 5 mm limbal-based, 50% depth, scleral flap was raised into clear cornea. The Ex-PRESS implant was inserted into the anterior chamber under the scleral flap at the limbus. The scleral flap was securely sutured back, as is done in trabeculectomy operations. RESULTS: The intraocular pressure was significantly reduced from 27.2 +/- 7.1 mm Hg pre-operatively to 14.5 +/- 5.0 mm Hg at 12 months (n = 21) and 14.2 +/- 4.2 mm Hg at 24 months (n = 8). Postoperatively, only two patients needed anti-glaucoma medications to keep the IOP below 21 mm Hg. CONCLUSIONS: The Ex-PRESS device was found to be safe and effective with few complications when it is implanted under a scleral flap even in the high-risk patients studied.

Adult↗
PubMed2006

Selective laser trabeculoplasty for intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

PURPOSE: Intravitreal injection of triamcinolone acetonide has increasingly become a therapeutic option for neovascular, inflammatory, and edematous intraocular diseases. A common side effect of this treatment is a steroid-induced elevation of intraocular pressure. In most of these patients, the rise in intraocular pressure can be treated topically. Those cases that cannot be treated medically have been treated with filtering surgery. This report presents a case of intraocular pressure elevation after intravitreal triamcinolone acetonide injection that was successfully treated with selective laser trabeculoplasty. CASE REPORT: A 63-year-old white man presented with brow ache on the right side approximately 3 months after undergoing intravitreal injection of triamcinolone acetonide for diabetic macular edema in the right eye. Applanation tonometry revealed an intraocular pressure of 45 mm Hg in the involved eye. After initial treatment with topical medications, the patient underwent selective laser trabeculoplasty. Now, 6 months postlaser treatment, the intraocular pressure in the involved eye is stable at 15 mm Hg without topical medications. CONCLUSIONS: A steroid-induced elevation of intraocular pressure is a common and widely reported side effect of treatment with intravitreal triamcinolone acetonide. This case report suggests that selective laser trabeculoplasty has potential as first- or second-line therapy for intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

Diabetic Retinopathy↗
PubMed1993

Cryotherapy to close a corneal subepithelial aqueous track after trabeculectomy.

After filtering surgery for primary open-angle glaucoma in a 64-year-old man, a persistent wound leak was encountered from the fornix-based conjunctival flap. Cyanoacrylate adhesive was applied but was unsuccessful in sealing the leak. The limbal margin was sutured with 10/0 nylon. One week later a corneal subepithelial fistulous track developed from the edge of the bleb and extended across the cornea towards the inferonasal limbus. The inferior end of the track leaked aqueous. Further surgery was performed to refashion the conjunctival bleb, ablate the fistula at its origin and re-form the anterior chamber. The track recurred 16 days later. The upper cornea was then treated with cryotherapy, which successfully closed the track with maintenance of a functional bleb (ocular pressure 6 mmHg). A faint asymptomatic subepithelial scar persisted.

Aged↗
PubMed2005

Iris ischaemic changes and visual outcome after acute primary angle closure.

BACKGROUND: Ischaemic changes in the iris occur frequently after an episode of acute primary angle closure (APAC). The aim of this study was to investigate the significance of such changes with regards to visual outcome. METHODS: Acute primary angle closure cases were treated with medical therapy followed by laser peripheral iridotomy after resolution of the acute episode. Subjects were examined at 1, 4, 8, 12 and 16 weeks post laser peripheral iridotomy. Eyes were examined for signs of iris ischaemic changes (IIC), defined as the presence of iris whorling or stromal atrophy. Iris photographs were also taken at weeks 1, 8 and 16. Subjects requiring glaucoma medication or filtering surgery during the follow-up period were excluded. The visual acuity and visual field (using automated white-on-white threshold perimetry) at week 16 were used in the assessment of visual outcome. RESULTS: Sixty-one subjects with APAC completed the study. The majority of subjects were female (82%) and Chinese (92%), and the mean age was 59 +/- 8.8 years. More than half the subjects (52.5%) were found to have developed IIC during the study, 65% of whom already had signs of IIC by the first week. Only 13 subjects (41%) with IIC and 6 subjects (21%) without IIC had an abnormal visual field defect at week 16 (P = 0.09). There was also no difference in visual acuity at week 16, the majority of subjects in both groups having visual acuity of 6/12 or better. CONCLUSIONS: The development of iris ischaemic changes after a single episode of APAC may not be associated with an adverse visual outcome.

Acute Disease↗