Biomedical subjects

H C Agarwal

Publications and source records attributed to H C Agarwal.

At least 19 recordsLinked to original sources

PubMed2006

Prospective, long-term evaluation of steroid-induced glaucoma.

PURPOSE: To evaluate the intraocular pressure (IOP) after cessation of steroid use in steroid-induced glaucoma and its control with medication or surgery. METHODS: Thirty-four eyes of 34 patients having steroid-induced glaucoma were prospectively evaluated after cessation of steroid for IOP, visual acuity, and optic disc status at 3 months, and every 3 months for 18 months. RESULTS: Topical steroid use (73.5%) was the most frequent cause for glaucoma. The baseline IOP was 35.47+/-12.59 mmHg. The baseline vertical cup-disc ratio correlated with duration of steroid use (P=0.014) and the baseline IOP (P<0.0001). In 25 patients (73.5%), IOP could be controlled by topical medications alone, whereas nine patients (26.5%) required surgery. The mean baseline IOP in eyes requiring surgery was 49.67+/-13.28 mmHg and in eyes managed medically, 30.36+/-7.51 mmHg (P=0.002). The vertical cup-disc ratio in surgically treated patient was 0.87+/-0.13:1 as compared to 0.71+/-0.15:1 (P=0.012) in the medically treated group. At 6, 12, and 18 months follow-up, 22 (64.7%), 33 (97.1%), and all 34 (100%) patients were off treatment, respectively. CONCLUSIONS: Patients with steroid-induced glaucoma, who were <or=20 years old, with a higher IOP, and greater glaucomatous optic neuropathy, were more likely to need surgery. After cessation of steroid therapy, all eyes were off treatment at 18 months.

Adolescent↗

PubMed2006

Evaluation of efficacy and safety of daunorubicin in glaucoma filtering surgery.

PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect and ocular side effects of daunorubicin (DNR) in drug-modulated trabeculectomy. METHODS: A prospective pilot study was conducted in which 21 Asian patients of Indian origin with high risk factors for failure of trabeculectomy were recruited. An approval from research ethics committee and an informed consent from every patient included in the study were obtained. DNR, an antimetabolite with known antifibroblastic action was used intraoperatively. A limbus-based conjunctival flap followed by conventional trabeculectomy was performed in all eyes. During trabeculectomy, a cellulose sponge soaked in 0.2 mg/ml DNR was applied for 3 min at the proposed site of trabeculectomy before preparation of the partial thickness scleral flap. A regular follow-up was carried out for 1 year where parameters including visual acuity, IOP by applanation tonometry, and slit lamp examination were performed on each visit. An IOP of 21 mmHg or less was taken as criteria for success. RESULTS: Following DNR trabeculectomy, the IOP was lowered from baseline preoperative value of 36.19+/-5.9 to 16.05+/-2.52 mmHg at the end of 1 year. Success rate of 81% (17 out of 21 patients) was noted. None of the patients developed corneal epithelial toxicity, hypotony maculopathy, or choroidal detachment. CONCLUSION: The authors feel that intraoperative daunorubicin is safe and effective in lowering IOP in high-risk surgical cases of glaucoma. However, a much larger cohort study over a considerable number of years will eventually demonstrate its safety.

Adolescent↗

PubMed2006

Dissipation and leaching of (14)C-monocrotophos in Soil Columns under subtropical climate.

Dissipation and leaching behavior of 14C-monocrotophos was studied for 365 days under field conditions using PVC cylinders. The first set (24 cylinders) was spiked with 1.0 microCi 14C-labeled monocrotophos along with 1.06 mg unlabeled monocrotophos to give a concentration of 2 mg kg -1 in the soil up to 15 cm depth. The second set (24 cylinders) received 14C-labeled monocrotophos along with other non-labeled insecticides viz., dimethoate @ 300 g a.i ha-1, deltamethrin @ 12.5 g a.i ha-1, endosulfan @ 750 g a.i ha-1, cypermethrin @ 60 g a.i ha-1, and triazophos @ 600 g a.i ha-1 at an interval of 15 days each as recommended for the cotton crop. 14C-monocrotophos dissipated faster, up to 45% in first 90 days in columns treated with only monocrotophos compared to 25% in columns that received monocrotophos along with other insecticides. However, both the columns showed similar residues 180 days onward. After 180 days of treatment, 46% radiolabeled residues were observed, which reduced up to 39.6% after 365 days. Leaching of 14C-monocrotophos to 15-30 cm soil layer was observed in both the experimental setups. In the 15-30 cm soil layer of both soil columns, up to 0.19 mg 14C-monocrotophos kg-1d. wt. soil was detected after 270 days.

Adsorption↗

PubMed2005

Comparative evaluation of diode laser trabeculoplasty vs frequency doubled Nd : YAG laser trabeculoplasty in primary open angle glaucoma.

AIMS: To evaluate the efficacy of diode laser trabeculoplasty (DLT) and frequency doubled Nd : YAG laser trabeculoplasty (YLT) in primary open angle glaucoma (POAG). METHODS: A total of 52 eyes of 35 patients with POAG were included. In all, 25 eyes underwent DLT (Group I) and 27 eyes underwent YLT (Group II). IOP, gonioscopy and visual fields were evaluated before and 3, 6, and 9 months and 1 year after the laser. An IOP<21 mmHg without medications or a decrease in the number of glaucoma medications with no progression of disc and field changes was considered a success. RESULTS: The mean age of patients in Group I was 57.72+/-8.1 years and the patients in Group II had a mean age of 59.85+/-7.76 years. The mean prelaser IOP was 24.93+/-1.49 mmHg and 25.36+/-1.57 mmHg. The mean IOP after DLT at 12 months follow-up was 18.0+/-0.93 mmHg and after YLT was 18.6+/-1.52 mmHg. The reduction of IOP was statistically significant in both the groups at 3, 6, 9, and 12 months (P<0.001), however there was no significant difference between the two groups. Success rates in both groups were similar, 92% in Group I and 92.6% in Group II. CONCLUSIONS: DLT and Fd YLT are equally effective in controlling IOP in eyes with POAG.

Adult↗

PubMed2004

Crossover comparison of timolol and latanoprost in chronic primary angle-closure glaucoma.

OBJECTIVE: To compare latanoprost and timolol maleate as primary therapy in 60 eyes with chronic primary angle-closure glaucoma after a laser iridotomy. METHODS: We performed a prospective, randomized, crossover study of 60 eyes of 30 patients with chronic primary angle-closure glaucoma after laser iridotomy. Patients were randomized to 2 groups: those taking latanoprost once daily or those taking timolol twice daily. Three months after treatment with the first drug, the second drug was substituted. The circadian rhythm of intraocular pressure (IOP) was recorded before the start of therapy, at 3 months, and at 7 months. The fourth month was the washout period for the first drug. RESULTS: The mean baseline IOP was 23.5 +/- 2.1 mm Hg, which decreased by 8.2 +/- 2.0 mm Hg with latanoprost (P<.001) and by 6.1 +/- 1.7 mm Hg with timolol (P =.01). The decrease in IOP was greater for patients taking latanoprost (P<.001). Latanoprost was significantly more effective in eyes having morning and afternoon peaks of IOP. A total of 43 eyes (72%) of patients taking latanoprost and 26 (43%) on timolol achieved a reduction of more than 30% from baseline IOP. CONCLUSION: There were greater mean and peak IOP reductions achieved with 0.005% latanoprost once daily compared with 0.5% timolol twice daily.

Aged↗

PubMed2003

Correlation between confocal scanning laser ophthalmoscopy and scanning laser polarimetry in open angle glaucoma.

PURPOSE: To correlate the findings of confocal scanning laser ophthalmoscopy and scanning laser polarimetry in diagnosed cases of glaucoma with established visual field defects. METHODS: A total of 53 diagnosed cases of primary open angle glaucoma that had at least two recorded of IOP more than 21 mm Hg on Goldmann applanation tonometry, open angles on gonioscopy and glaucomatous visual field defects on automated perimetry, were examined by confocal scanning laser ophthalmoscopy (HRT-II) and scanning laser polarimetry (GDx-NFA), in random order. RESULTS: The number on GDx advanced analysis had a significant (p < 0.05) correlation with the rim area (r = -0.279; p = 0.043), cup area (r = 0.311; p = 0.023) and the vertical cup: disc ratio (r = 0.376; p = 0.006). The correlation between HRT-II stereometric parameters and GDx advanced analysis parameters was significant (p < 0.05) for more parameters targeting the inferior pole of the disc than the superior pole. Numerically, the worst values of GDx parameters were associated with a worse result on Moorfields regression analysis, but there was poor agreement between the diagnostic labels like within or outside normal limits as obtained on GDx and HRT-II. CONCLUSIONS: Nerve fiber loss as detected on GDx correlates well with topographic optic nerve head changes as measured with the HRT-II. However, automated diagnosis on the two machines showed poor agreement.

Female↗

PubMed2003

Peak pressures: crossover study of timolol and latanoprost.

PURPOSE: To compare the diurnal efficacy and action on peak intraocular pressures (IOP) of 0.005% latanoprost and 0.5% timolol as primary therapy in 60 eyes having dark brown irides with primary open angle glaucoma (POAG). METHODS: A prospective, comparative, observer-masked, crossover, interventional trial including the mean of both eyes of 30 patients with POAG who were randomly started on either latanoprost once daily or timolol twice daily. Three months after treatment with one drug, the second drug was substituted. A masked observer carried out diurnal assessments of IOP before the start of therapy and at 3 and 7 months. The fourth month was the washout period for the first drug. RESULTS: The average baseline IOP was 23.36 +/- 2.14 mm Hg, which was reduced by 8.8 +/- 2.2 mmHg with latanoprost (p < 0.01) and by 6.75 +/- 1.9 mm Hg with timolol (p = 0.01). The reduction was greater for latanoprost (p < 0.005). The average peak IOP at baseline was 27.6 +/- 2.22 mmHg. The effective fall in IOP at the time of new peaks in subsequent diurnal recordings of IOP compared to the baseline diurnal curve was 8.9 mm Hg with latanoprost (p < 0.005) and 5.77 mm Hg with timolol (p < 0.01). This difference in IOP reduction between the two drugs was statistically significant (p < 0.01). Latanoprost had a lower efficacy in peak IOP reduction in eyes with evening peak of IOP than in those with morning peak (p < 0.005). The efficacy of timolol was lower overall compared to latanoprost, but was similar in all circadian rhythms. The shift in timing of IOP peak was greater with latanoprost compared to timolol (4.34 hours vs -0.72 hours, p < .01). A total of 90% of patients on latanoprost and 33.3% on timolol achieved a reduction of > 30% in baseline mean IOP. The average of the trough IOP recorded in each of the individual baseline IOP curves was 19.05 +/- 2.05 mm Hg. CONCLUSIONS: Greater mean and peak IOP reduction was achieved with latanoprost compared to timolol. Dampening of the circadian rhythm was better with latanoprost. Latanoprost appears to be more effective than timolol at all points in time with greater efficacy in eyes with morning peaks compared to evening peaks.

Administration, Topical↗

PubMed2002

Persistence and degradation of coumaphos in model cattle dipping vats.

The stability of coumaphos [O,O-diethyl O-(3-chloro-4-methyl-2-oxo-2H-1-benzopyran-7 yl)phosphorothioatel was studied in model dipping vats under field conditions using 14C-labelled and unlabelled coumaphos, with or without additives. The stability of coumaphos in model vats increased significantly by maintaining a pH of 5 by addition of superphosphate. Copper sulphate amendment did not seem to have any additional effect on stability. Potasan was the major metabolite in addition to chlorferon and 4-methylumbelliferone. Coumaphos concentration was doubled in the sediment of vat treated with copper sulphate as compared to the control vat as a result of emulsion breakdown. Chlorferon was the only metabolite detected in the sediment of the former vat indicating inhibition of the anaerobic degradation.

Animals↗

PubMed2002

Role of argon laser trabeculoplasty as primary and secondary therapy in open angle glaucoma in Indian patients.

AIMS: To study the efficacy of argon laser trabeculoplasty (ALT) as a primary and secondary therapy in Indian patients with primary open angle glaucoma (POAG). METHODS: ALT was performed as a primary therapy in 40 eyes of 21 patients newly diagnosed with POAG (group I) and as a secondary therapy in 39 eyes of 21 patients who had been taking topical antiglaucoma medications for more than 1 year. The best corrected visual acuity, baseline intraocular pressure (IOP), diurnal variation of IOP, anterior chamber angles, and visual fields were the various parameters evaluated before and after performing ALT. Follow up visits were scheduled at 24 hours, 1 week, 1 month, 3 months, 6 months, and 1 year after the surgery. The patients were recalled at the end of 5 years for the final follow up examination. Success of ALT was defined as IOP </=21 mm Hg without any medication with no progression of disc or visual field changes. RESULTS: The prelaser mean IOP was 25.8 (SD 3.4) mm Hg in group I and 26.1 (3.2) mm Hg in group II. The mean post-laser IOP at 5 year follow up was 18.1 (3.2) mm Hg in group I and 22.7 (3.9) mm Hg in group II (p= 0.002) while the mean reduction in IOP was 5.7 (1.8) mm Hg in group I and 3.2 (0.8) mm Hg in group II (p<0.001). The diurnal variation reduced from a preoperative value of 7.9 (1.4) mm Hg to 3.6 (1.3) mm Hg in group I and from 7.7 (1.4) mm Hg to 5.8 (1.8) mm Hg in group II (p<0.001). The success rate of ALT was 75% at 1 year and 65% at 5 years in group I and 35% at 1 year and 10% at 5 years in group II. CONCLUSION: ALT can be used as a primary therapy in pigmented eyes with POAG. ALT is less effective as a secondary therapy in controlling the IOP in eyes of patients on long term topical antiglaucoma treatment.

Follow-Up Studies↗

PubMed2002

Protein mediated cholesterol absorption in locusts Schistocerca gregaria (Forskal) and Locusta migratoria (Linn).

Absorption and transport of 3H cholesterol from the midgut to hemolymph and other tissues was studied in the locusts Schistocerca gregaria and Locusta migratoria. S. gregaria are able to absorb dietary cholesterol in the midgut and release into the hemolymph in vivo and into the incubation medium in virto. Certain proteins of midgut origin are involved in the absorption and release of cholesterol. The proteins designated as cholesterol binding proteins (CBP's) were fractionated by gel filtration chromatography using Sepharose CL-6B-200 column. Presence of a protein and its binding with cholesterol is confirmed by TCA precipitation after subsequent incubation of midgut in the incubation medium. Cholesterol binding with the proteins was also confirmed in native polyacrylamide gel electrophoresis. Biosynthesis of this protein takes place in the midgut which is inhibited by a protein synthesis inhibitor, cycloheximide. It also inhibits absorption and release of cholesterol from the midgut. The cholesterol binding activity was associated with a peak containing proteins ranging from molecular weights of 17-32 kDa in SDS-PAGE gels. Treatment of midgut with cycloheximide resulted in reduced cholesterol binding activity. Dilipidation of mucin and transport in presence of bile salts yielded a higher cholesterol binding activity. Although the absorption and release of cholesterol was observed in the hemolymph of both sexes, the ovary exhibited higher cholesterol binding as compared to testis.

Animals↗

PubMed2001

Insecticide residues in cotton crop soil.

Dimethoate, monocrotophos, triazophos, deltamethrin, cypermethrin and endosulfan were applied to a cotton crop soil located at Nurpur village, Punjab, India. The insecticides were applied sequentially at recommended dosages in cotton fields by foliar application in 1995, 1996 and 1998. Soil samples were collected from the cotton crop farms and extracted with acetone. The extracted material was analysed by a gas liquid chromatograph (GLC) equipped with an 63Ni electron-capture detector (ECD-63Ni). Recovery data was obtained by fortifying soil with insecticide. The average recoveries from the fortified soil samples were 76-92% for organophosphorous compounds and 90-98% for synthetic pyrethroids and organochlorines. The results showed that the insecticide residues under study were present in the range of 1.16 to 41.97 ng g(-1) d.wt.soil. The pattern of dissipation of the insecticides used was similar for the duration of the crop. Half lives of the insecticides ranged from 7 to 22 days. Except endosulfan none of the other insecticides used were leached below 15 cm. Endosulfan was found to be rapidly degraded in the soil and formed a sulfate metabolite. Persistence and dissipation pattern in soils with history of exposure to the insecticide compared to non-history soils were similar.

Chromatography, Gas↗

PubMed2001

Inhibitory effect of 1-benzyl-5[(C)-2,6-dimethyl-1,5-heptadienyl] imidazole (KK-42) on desert locust, Schistocerca gregaria forsk.

Imidazole compound KK-42 was tested for its inhibitory effect on Schistocerca gregaria. The compound caused 80% mortality after 19 days of treatment with 100 microg of KK-42/insect. It also caused the production of deformed adults at even lower doses. Ecdysteroid content, when estimated by RIA, declined due to KK-42 treatment in both haemolymph and ovaries of the insect. Reduction in ecdysteroid titer was maximum at 100 microg of KK-42/insect. The value estimated by RIA was 0.34 ng/pL haemolymph as compared to 0.97 ng/microL in case of controls. Similarly,ecdysteroid content of ovaries detected was 0.48 ng/mg in treated ones as compared to 0.61 ng/mg in controls. Histological studies, however, revealed no alteration in the ovarian tissues due to KK-42 treatment.

Animals↗

PubMed2001

The trabecular meshwork in acute and chronic angle closure glaucoma.

PURPOSE: To determine the effect of acute and chronic primary angle closure glaucoma (PACG) on the trabecular meshwork. METHODS: Trabecular specimens of 16 consecutive patients with primary angle closure glaucoma (PACG)--6 acute PACG eyes, and 10 chronic PACG eyes without an acute attack--were studied by light and electron microscopy. RESULTS: Acute PACG: The trabecular meshwork revealed a generalised oedema and an accumulation of pigment in the widened trabecular spaces and Schlemm's canal. Attenuated trabecular endothelial cells appeared to be devoid of subcellular components. Chronic PACG: In chronic PACG eyes the trabecular architecture had lost its regular arrangement, with fewer and narrower trabecular spaces and fusion of the trabecular beams in areas. There were numerous electron-dense bodies in the trabecular tissues, both within the trabecular beams and in the extracellular spaces, which had a banded fibrillar structure. An overall loss of endothelial cells was noted; the remaining cells were crowded together and were polymorphic. Melanin pigment was present both within the stroma and in the endothelial cells. CONCLUSIONS: Pigment accumulation in the trabecular spaces and within the cells and a noninflammatory degeneration appeared to be the primary changes in the trabecular meshwork after acute angle closure glaucoma. In chronic PACG eyes, there was evidence of loss of endothelial cells and reactive repair processes. These changes were present in areas away from visible peripheral anterior synechiae. A gonioscopic evaluation of the extent of peripheral anterior synechiae alone may not reflect the extent of trabecular meshwork damage in acute and chronic PACG. Patients experiencing an acute attack of PACG require a long-term follow up, because the intraocular pressure (IOP) may rise later, due to ongoing changes compromising the outflow facility, or due to the effects of aging in the trabecular meshwork.

Acute Disease↗

PubMed2001

Assessing the role of subconjunctival versus intrascleral application of mitomycin C in high-risk trabeculectomies.

PURPOSE: To compare the efficacy and safety of subconjunctival and intrascleral applications of mitomycin C (MMC) in trabeculectomy for high-risk glaucomas. METHODOLOGY: A randomized prospective clinical study was conducted on 41 consecutive eyes with a high risk of glaucoma surgery failure. Patients were randomized to trabeculectomy and application of subconjunctival MMC or to trabeculectomy and application of intrascleral MMC. MMC solution 0.2 mg/ml was applied for 3 minutes under the conjunctival flap overlying the proposed site of trabeculectomy in Group I (n=21), or intrasclerally under the superficial scleral flap in Group II (n=20) RESULTS: After a follow-up of one year, the intraocular pressure (IOP) decreased from a mean basal IOP of 33.0 +/- 8.4 mm Hg to 12.56 +/- 2.54 mm Hg in Group I and from 30.9 +/- 6.6 mm Hg to 11.6 +/- 2.21 mm Hg in Group II. The IOP was 6-21 mmHg, without medication, in 90.5 % of the eyes in Group I and 75 % of the eyes Group II. Ocular hypotony, hypotony maculopathy, choroidal detachment and a shallow anterior chamber were more frequent with the intrascleral application of MMC during trabeculectomy, but the difference was not statistically significant. The overall success of the surgery at one year, i.e., achieving an IOP of 6-21 mmHg and a stable vision, (reduction in visual acuity of < or = 2 lines), was 90.5% in Group I and 75 % in Group II. CONCLUSION: No significant difference was seen in overall success or complication between subconjunctival and intrascleral application of MMC-augmented trabeculectomies in glaucomatous eyes at high risk of surgical failure.

Adolescent↗

PubMed2000

Ocular parameters in the subgroups of angle closure glaucoma.

PURPOSE: This study was conducted to compare anatomical parameters, thought to be responsible for causing angle closure glaucoma (ACG), among eyes having acute, subacute or chronic ACG. METHODS: Ninety consecutive patients diagnosed with a subgroup of ACG, and 30 age, sex and refraction matched controls, provided a total of 240 eyes for a prospective study. The refractive error, corneal diameter, keratometry, pachymetry, lens thickness and axial length were measured and the relative lens position was calculated. The data were analysed by paired t-test, ANOVA, signed rank test and multivariate analysis. RESULTS: Acute ACG eyes were mildly hyperopic. All the ACG subgroups had similarly short eyeballs and a steeper corneal curvature compared to control eyes. Acute ACG lenses were thicker than all the other groups (P < 0.001), but all ACG eyes had thicker lenses than the controls. Corneal diameters and anterior chamber depths were decreased in acute and chronic ACG eyes compared with subacute ACG and controls (P < 0.001). The uninvolved fellow eyes in each subgroup differed from affected eyes only in having more posteriorly positioned lenses. CONCLUSIONS: There was a spectrum of anatomical variations seen in the subgroups of ACG. Acute ACG eyes expressed an extreme shift of anatomical features away from normal, especially, smaller corneal diameters, leading to a large mobile lens in an already crowded anterior segment. This predisposed them to a severe relative pupillary block, and to a form of ciliary block glaucoma. Chronic ACG eyes were less divergent from normal and therefore could have suffered a milder form of the same kind of angle closure, but over a more prolonged period. Subacute ACG eyes deviated least from controls, and therefore exhibited mild signs and spontaneous resolution. Further work is required to elucidate completely the pathophysiology that leads to ACG.

Acute Disease↗

PubMed2000

Persistence, degradation and leaching of coumaphos in soil.

Dissipation, degradation and leaching of fresh 14C coumaphos, alkylated 14C coumaphos and aged residues of 14C coumaphos from vats were studied in alkaline sandy loam soil in soil columns in the field under subtropical conditions in Delhi for a year. Dissipation, degradation and bound residue formation was more in case of alkali treated coumaphos than fresh coumaphos. After 365 days total residues of fresh coumaphos accounted for 33.25% while that of alkali treated coumaphos was 19.12%. Bound residue formation was almost double in case of alkali treated coumaphos (18.95%) than fresh coumaphos (9.53%) after 150 days followed by release of bound residue in both the cases. The proportion of metabolites 4-methylumbelliferone, chlorferon and potasan collectively was 86.05% in fresh coumaphos extractable residues while the same was 91.74% in alkali treated coumaphos after 365 days. Aged residues from vats containing copper sulphate and buffer were found to be more persistent in soil as total residues remained were 95.58% in comparison with 83.09% total residues of aged residues from vats containing only buffer after 150 days of treatment. Copper sulphate seems to inhibit the degradatiion of coumaphos in soil by microorganisms. Chlorferon was the major metabolite in generally all the samples. Coumaphos did not leach below 10 cm in all the cases.

Biodegradation, Environmental↗

PubMed2000

Comparison of symptomatic and asymptomatic, chronic, primary angle-closure glaucoma, open-angle glaucoma, and controls.

PURPOSE: To determine the clinical features and anatomic parameters in asymptomatic (creeping) and symptomatic, chronic, primary angle-closure glaucoma (PACG) as compared with open-angle glaucoma (OAG) and with control subjects with normal eyes. METHODS: Forty consecutive patients with each of the following four types of eyes were studied (N = 160): eyes with symptomatic PACG, eyes with asymptomatic PACG, eyes with OAG, and the eyes of age-, sex-, and refraction-matched control subjects. The refractive status, keratometry, pachymetry, corneal diameter, anterior chamber depth, lens thickness, axial length, and relative lens position were noted. The groups were compared using a paired t test and analysis of variance. RESULTS: Patients with asymptomatic chronic PACG were older than patients in the symptomatic group, were more often men, and were more likely to have either diabetes mellitus or hypertension. Symptomatic chronic PACG eyes were more hypermetropic. Asymptomatic eyes had more iridotrabecular synechiae and minimal pupillary ruff atrophy as compared with the symptomatic eyes that had largely iridocorneal synechiae and large areas where the ruff was absent. All other clinical and anatomic parameters were statistically similar in the two groups, but differed significantly from OAG and control eyes. CONCLUSIONS: The ocular parameters of asymptomatic or creeping angle closure eyes show that these are significantly different from eyes having POAG. Asymptomatic and symptomatic chronic PACG eyes are structurally similar. Open-angle glaucoma eyes and normal eyes were comparable, but differed from both the chronic angle-closure glaucoma groups in having a larger corneal diameter, deeper anterior chamber, thinner lens, and a longer axial length. The symptomatic chronic PACG eyes showed more evidence of ischemic damage to the iris, and this could account for the symptoms reported by these patients.

Aged↗

PubMed2000

Conjunctival dysfunction and mitomycin C-induced hypotony.

PURPOSE: To determine the role of a physically intact conjunctiva in the development of chronic hypotony after mitomycin C-enhanced trabeculectomy. METHOD: Three patients with mitomycin C-related hypotonic maculopathy, but without a leak on Siedel test, had a thorough evaluation of the bleb area and an anterior segment fluorescein angiography. The bleb was excised and a pedicle flap, rotated from the temporal conjunctiva, was sutured to cover the defect superiorly. The scleral flap and its sutures were not disturbed. The excised bleb was subjected to light and electron microscopy. RESULTS: The Seidel test result was negative in all patients, but late phases of the anterior segment angiography showed a generalized seepage of aqueous from the bleb. After revision of the bleb, there was a gradual increase in the intraocular pressure, a reversal of the hypotonic maculopathy, and consequent improvement in visual acuity in all three patients, stable up to a minimum follow-up of 18 months. On histopathologic examination, the basement membrane was thickest under thin areas of the epithelium and thinnest below thicker epithelial layers. CONCLUSION: A dysfunctional conjunctival barrier, as evidenced by the "sweating" of the bleb and histopathologic alterations in the epithelial barrier, could be responsible for the hypotonic maculopathy in these patients. Excision of the conjunctiva alone and replacement by a pedicle conjunctival graft offers a safe and effective method of treating chronic hypotony after mitomycin C-augmented trabeculectomy in such patients.

Adolescent↗