PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Glaucoma”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1995

The Tübingen Glaucoma Study. Glaucoma filtering surgery--a retrospective long-term follow-up of 254 eyes with glaucoma.

A major focus of our study was the ability to predict the long-term success of filtering surgery. The results of glaucoma filtering surgery (trabeculectomy) as performed by the staff of the University Eye Hospital of Tübingen from 1988 through 1994 on 254 eyes of 214 patients are presented, with particular emphasis being placed not only on intraocular pressure (IOP) control but also the progression of glaucomatous damage (visual field loss or disc damage) and the etiology of visual acuity losses. There was an overall success rate of 64%. Rigid criteria for success included an IOP of less than 30 mmHg, no further visual field loss or disc damage, and no glaucomatous etiology for a decrease in visual acuity. A total of 35 eyes (13.8%) showed a loss of visual acuity after 6 months amounting to 2 or more Snellen lines, caused mainly by lens opacification, hypotony maculopathy, and "wipeout" (loss of the central visual field in the absence of another explanation). We found that there is a considerable risk for sudden loss of visual acuity after operation on older patients with small residual visual fields and severe hypotony on the 1st postoperative day. There was a 13% incidence of failure of blebs. A total of 34 eyes had an early IOP rise of more than 30 mmHg after surgery. A postoperative hypotony of less than 3 mmHg was more significantly seen in patients treated with 5-fluorouracil. Moreover, the results show that in some instances, a long-term use of topically applied glaucoma medication can adversely affect the results of fistulizing surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

Peripapillary atrophy in primary angle-closure glaucoma: a comparative study with primary open-angle glaucoma.

PURPOSE: To investigate the characteristics of peripapillary atrophy in primary angle-closure glaucoma and to compare peripapillary atrophy in primary angle-closure glaucoma with that in primary open-angle glaucoma. METHODS: Twenty-one eyes (of 21 patients) with chronic primary angle-closure glaucoma that had no evidence of an acute attack or combined-mechanism glaucoma and 31 eyes (31 patients) with primary open-angle glaucoma were enrolled in this study. The cup-to-disk area ratio and the visual field mean deviation were matched in both groups. The prevalence of peripapillary atrophy and peripapillary atrophy-to-disk area ratio of eyes with primary angle-closure glaucoma and eyes with primary open-angle glaucoma were compared. The correlation between the peripapillary atrophy area and the cup-to-disk area ratio or the mean deviation was also evaluated. RESULTS: Eight (38%) of 21 eyes with primary angle-closure glaucoma and 21 (68%) of 31 eyes with primary open-angle glaucoma had peripapillary atrophy. The peripapillary atrophy-to-disk area ratio averaged 0.16 in primary angle-closure glaucoma and 0.41 in primary open-angle glaucoma. There were statistically significant differences regarding the prevalence of peripapillary atrophy (P = .048) and peripapillary atrophy-to-disk area ratio (P = .005) between the two groups. There was no significant correlation between the peripapillary atrophy area and the cup-to-disk area ratio or the mean deviation in primary angle-closure glaucoma. In contrast, the peripapillary atrophy-to-disk area ratio significantly correlated with the cup-to-disk area ratio (P = .003) and the mean deviation (P = .0001) in primary open-angle glaucoma. CONCLUSIONS: The peripapillary atrophy in primary angle-closure glaucoma has a different relationship to the structural and functional optic disk changes than that in primary open-angle glaucoma. Different mechanisms seem to be involved in the development of the optic disk damage in the two types of glaucoma.

Adult↗
PubMed1999

Family history of glaucoma in the primary and secondary open-angle glaucomas.

BACKGROUND: A study was carried out to evaluate the frequency of a positive family history in the primary and secondary open-angle glaucomas. PATIENTS AND METHODS: The study included 1176 patients with chronic open-angle glaucoma who were differentiated into secondary open-angle glaucoma [pseudoexfoliative glaucoma (n=144) and pigmentary glaucoma (n=61)], and primary open-angle glaucoma (POAG; n=971). The POAG group was divided into non-highly-myopic patients without ("non-highly-myopic POAG"; n=662) or with circular parapapillary atrophy ("age-related atrophic POAG"; n=168), highly myopic POAG (n=35), and focal normal-pressure glaucoma (n=106). All patients were asked whether family members had glaucoma. RESULTS: In the POAG group, frequency of a positive family history of glaucoma (overall frequency 24.5%) decreased significantly with age from 35.8% in patients (n=240) younger than 50 years, to 25% in patients (n=501) aged between 51 and 70 years and to 11.7% in patients (n=230) older than 70 years. The overall frequencies of a positive family history of glaucoma did not vary significantly between age-related atrophic POAG, focal normal-pressure glaucoma, pseudoexfoliative glaucoma, and pigmentary glaucoma, compared with age-matched groups of non-highly-myopic POAG. Highly myopic POAG had a lower, but not significantly lower, frequency of a positive family history of glaucoma (17.1% vs 26.9%). CONCLUSIONS: In POAG, frequency of a known positive family history of glaucoma decreases with increasing age. Apart from juvenile-onset POAG with a relatively high, and highly myopic POAG with a relatively low frequency of known heredity, other primary and secondary open-angle glaucomas do not show pronounced differences in this variable when adjusted for age.

Age Factors↗
PubMed1997

A comparison of retinal and choroidal hemodynamics in patients with primary open-angle glaucoma and normal-pressure glaucoma.

PURPOSE: To quantify, compare, and assess differences between retinal and choroidal hemodynamics in normal control subjects and patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma. METHODS: Video fluorescein angiograms were made in 20 normal subjects, 11 patients with ocular hypertension, 45 patients with primary open-angle glaucoma, and 43 patients with normal-pressure glaucoma. Choroidal dye build-up curves were analyzed using an exponential model. The model time constant tau reflected the local blood refreshment time, the time needed to replace the blood volume in a tissue volume. Retinal arteriovenous passage time was estimated from the time lapse between retinal arterial and venous dye curves. RESULTS: The retinal arteriovenous passage time was longer in patients with primary open-angle glaucoma compared with normal subjects and patients with normal-pressure glaucoma; the average arteriovenous passage times (+/-SEM) in normal subjects and in patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma were, respectively, 2.44 +/- 0.19, 2.90 +/- 0.37, 3.02 +/- 0.17, and 2.55 +/- 0.15 seconds. Choroidal tau was longest in the normal-pressure glaucoma group but not as long in the primary open-angle glaucoma group; tau values in normal subjects and patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma were, respectively, 4.6 +/- 0.29, 5.6 +/- 0.69, 6.2 +/- 0.39, and 7.1 +/- 0.33 seconds. CONCLUSIONS: Whereas choroidal circulation is especially slower in patients with normal-pressure glaucoma, retinal circulation is delayed in patients with primary open-angle glaucoma. The choroidal and retinal vascular systems behave differently in primary open-angle and normal-pressure glaucoma, which may be important in the management of glaucoma.

Aged↗
PubMed1999

[Morphology of the optic papilla in glaucoma. II. Secondary chronic open angle glaucoma].

UNLABELLED: Previous studies have shown that the chronic open-angle glaucomas form a heterogeneous spectrum of diseases which have in common an open anterior chamber angle and glaucomatous optic nerve damage. Purpose of this study was to evaluate whether the appearance of the optic disc shows specific features among various types of secondary chronic open-angle glaucoma. METHODS: Clinical data and color-stereo optic disc photographs of 126 patients with pseudoexfoliative glaucoma and 47 patients with pigmentary glaucoma were compared with those of 501 patients with primary open-angle glaucoma (POAG) and of 481 normal subjects. The glaucoma groups did not differ in neuroretinal rim nor in perimetric mean defect. RESULTS: Mean optic disc area was significantly smaller in the pseudoexfoliative glaucoma eyes (2.54 +/- 0.51 mm2 vs. 2.71 +/- 0.63 mm2, p = 0.03) than in the primary open-angle glaucoma eyes. The pigmentary glaucoma group did not vary significantly from the primary open-angle glaucoma group in size of the optic disc. No significant differences were found for neuroretinal rim area, configuration of neuroretinal rim, depth of optic cup and diameters of the retinal arterioles and venules at the disc border between the secondary glaucoma groups and the POAG group respectively. Size of zone beta of the parapapillary atrophy was slightly, but not significantly smaller in the secondary glaucoma groups than in POAG. In the secondary glaucoma groups, the maximal intraocular pressure measurements were significantly (p < 0.001) higher than in the group with POAG. All glaucoma groups had a significantly smaller neuroretinal rim, significantly smaller retinal arterioles, and significantly larger parapapillary atrophy compared to the normal group. CONCLUSIONS: Except of a slightly smaller optic disc in eyes with pseudoexfoliative glaucoma, eyes with secondary glaucoma due to pseudoexfoliation or due to pigmentary dispersion do not vary significantly in their optic disc morphology compared to POAG and do not show pathognomonic features of the optic disc despite marked changes in the anterior segment of the eye.

Adult↗
PubMed1996

Probable exclusion of GLC1A as a candidate glaucoma gene in a family with middle-age-onset primary open-angle glaucoma.

PURPOSE: To determine whether an adult-onset variety of primary open-angle glaucoma in family UM:POAG1 is linked to the previously mapped GLC1A juvenile-onset primary open-angle glaucoma locus on chromosome 1q or whether linkage can be excluded. METHODS: Microsatellite repeat markers from the 9 cM D1S196 to D1S218 interval containing the GLC1A gene were amplified by polymerase chain reaction from DNA samples collected from 11 members of one sibship in family UM:POAG1. Haplotype analysis was carried out, including calculation of the probability that the observed data would have been obtained if the underlying cause of primary open-angle glaucoma in this family were a defect in a gene located in the tested interval. Linkage analysis was carried out under an autosomal dominant model for GLC1A glaucoma. RESULTS: In family UM:POAG1, primary open-angle glaucoma was diagnosed in six surviving and one deceased member of a sibship of 13 individuals during the fifth or sixth decade of life. Glaucoma in this family has a later average age at diagnosis and significantly less elevation in intraocular pressure than GLC1A glaucoma so far described. Haplotype analysis, using a population prevalence up to 0.9%, shows that it is unlikely that the reported data would have been observed if primary open-angle glaucoma in this pedigree were due to the GLC1A locus on chromosome 1q21-q31. Linkage analysis under the juvenile glaucoma autosomal dominant model allowed exclusion of linkage across the entire GLC1A genetic inclusion interval, with a maximum lod score in the interval of -3.28. CONCLUSION: The most likely interpretation of these observations is that a defect in the GLC1A glaucoma gene is not responsible for adult-onset primary open-angle glaucoma in family UM:POAG1. This suggests the existence of at least two primary open-angle glaucoma genes, the previously reported GLC1A gene on chromosome 1q and another gene located elsewhere in the genome. Diagnosis of UM:POAG1 glaucoma between 42 and 57 years of age also raises questions regarding the relation of the glaucoma present in this family to the common later-age-onset form of the disease.

Adult↗
PubMed1996

Comparative optic disc analysis in normal pressure glaucoma, primary open-angle glaucoma, and ocular hypertension.

PURPOSE: The authors wished to determine whether characteristics of optic disc and parapapillary atrophy differ between eyes with ocular hypertension, primary open-angle glaucoma (POAG) and those with normal-pressure glaucoma, including a subset of patients with normal-pressure glaucoma with evidence of serum abnormalities of humoral autoimmunity. METHODS: Three hundred ninety-two eyes of 196 patients with ocular hypertension, 394 eyes of 197 patients with POAG, and 135 eyes of 68 patients with normal-pressure glaucoma were analyzed. Nerve fiber layer hemorrhage in the optic disc region, retinal arteriolar narrowing, and morphometric parameters of optic disc and parapapillary atrophy were investigated in these groups. Parapapillary atrophy was differentiated in two different zones (alpha and beta). RESULTS: Nerve fiber layer hemorrhage and arteriolar narrowing were found more frequently in patients with normal-pressure glaucoma than in patients with POAG (P = 0.014, P = 0.004) and ocular hypertension (P < 0.0001, P < 0.0001). Zone beta was detected more often in patients with normal-pressure glaucoma than in those with ocular hypertension (P < 0.001) and POAG (P = 0.013). Although patients with normal-pressure glaucoma had more advanced neural rim loss and larger parapapillary atrophy, there were similar correlations between neural rim area and the area and extension of parapapillary atrophy in patients with normal-pressure glaucoma and POAG. Parapapillary atrophy parameters also were similar in different stages of neural rim damage in patients with normal-pressure glaucoma and POAG (P > 0.05). Optic disc characteristics were not different (P > 0.05) between the subgroups of patients with normal-pressure glaucoma. CONCLUSION: The authors' findings support the idea that besides the enlargement of the area and extension of parapapillary atrophy that accompanies neural damage in glaucoma, the severity of the parapapillary atrophy also increases as assessed by the increase in zone beta in more damaged eyes. Furthermore, the final clinical appearance of optic nerve damage is similar among patients with POAG, normal-pressure glaucoma, and the subgroups of normal-pressure glaucoma, regardless of their possibly different mechanisms of neuropathy.

Aged↗
PubMed2006

Comparison of delayed-onset glaucoma and early-onset glaucoma after infantile cataract surgery.

PURPOSE: To investigate the causes and characteristics of glaucoma in children following cataract surgery. METHODS: Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in one case). RESULTS: There was a bimodal onset of glaucoma after cataract surgery. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayed-onset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (p = 0.018) more likely to be due to angle closure than delayed-onset glaucoma. With delayed-onset glaucoma, the filtration angle was open in 86% of eyes and significantly (p = 0.006) more eyes in the delayed-onset group had microcornea. Medical treatment was sufficient to control intraocular pressure in the delayed-onset group while the early-onset group required surgical treatment (P < 0.001). CONCLUSIONS: The onset of glaucoma after cataract surgery during infancy follows a bimodal pattern that is correlated with the configuration of the filtration angle. The early-onset glaucoma group had high incidence of angle closure requiring surgical treatment, while in the delayed-onset group non-surgical treatment was sufficient to control intraocular pressure. Prophylactic iridectomy in eyes at risk for pupillary block is recommended. Eyes with delayed-onset glaucoma have open filtration angles yet also have findings of incomplete development of filtration structures. Microcornea is a risk factor for delayed-onset glaucoma.

Adolescent↗
PubMed1999

Glaucoma awareness and screening uptake in relatives of people with glaucoma.

PURPOSE: To assess glaucoma awareness and screening uptake in relatives of people with glaucoma. METHODS: A questionnaire was administered to 52 patients with primary open-angle glaucoma. They were asked about their awareness of glaucoma clustering within families, and the need for glaucoma screening in relatives of glaucoma patients. Patients were asked to identify one or more first-degree relatives, aged over 40 years and thus eligible for free glaucoma screening in the United Kingdom. These relatives were mailed a similar questionnaire. In performing the statistical analysis we corrected for possible clustering within families. The study was approved in advance by our local ethics committee, and all participants were informed of the United Kingdom's free screening service afterwards. RESULTS: Ninety relatives were identified, of whom 70 (78%) returned questionnaires. Only 53% of responding relatives thought they were at increased lifetime risk of developing glaucoma. Though 81% of relatives had been screened, many were screened infrequently. We compared the responses of patients' siblings and patients' offspring. Perceived lifetime glaucoma risk was similar in the two groups, but the (older) siblings had a significantly lower awareness of the free screening service (p = 0.03) and attended for screening less frequently (p = 0.07). Uptake of regular, free glaucoma screening at least every 2 years was 57% among offspring and 30% among siblings (p = 0.005). Because of selection bias (good communicators were more likely to be invited to participate) the true rates of glaucoma awareness and screening uptake are almost certainly lower than this. CONCLUSIONS: Relatives of people with glaucoma should be made more aware of the need for glaucoma screening and encouraged to use the free screening service. Older relatives should be particularly targeted.

Aged↗
PubMedDate not supplied

Nerve fiber layer assessment with scanning laser polarimetry in glaucoma patients and glaucoma suspects.

PURPOSE: To investigate whether scanning laser polarimeter can differentiate glaucoma and suspected glaucoma patients from normals. METHODS: Polarimetric measurements were obtained using the nerve fiber analyzer (NFA)-I from 80 eyes of patients with glaucoma with mostly moderate glaucomatous optic nerve damage (37 eyes with primary open angle glaucoma, 21 with normal tension glaucoma, 17 with pseudoexfoliative glaucoma, 3 with angle closure glaucoma, and 2 with juvenile glaucoma), 53 eyes of patients suspected of glaucoma based on disc appearance, and from age-matched healthy volunteers as control groups. Ratios (superior/nasal, inferior/nasal, superior/inferior) were used for assessing nerve fiber layer (NFL) thickness. Student's t-test and linear regression analysis were used for statistical analysis. RESULTS: Both the glaucoma patients and glaucoma suspects had significantly lower NFL ratios (mean S/N 2.34 +/- 0.47, I/N 2.46 +/- 0.52, S/I 0.94 +/- 0.18) than the control groups (respectively 2.88 +/- 0.48, 2.88 +/- 0.48, 1.00 +/- 0.13) (p<0.05). There was an ample overlap between the patient groups and the normals. The superior and inferior NFL ratios in glaucoma patients gradually decreased as the mean defect in visual field increased (linear regression analysis, p<0.05). CONCLUSIONS: The NFL of glaucomatous eyes and eyes suspected of glaucoma based on disc appearance was significantly less thick than normals. NFA-I detects pathological abnormalities in some patients with glaucomatous optic nerve damage and normal visual fields as measured by conventional achromatic computerized perimetry. NFA-I, however, is unable to distinguish these patients from normals, at least using these parameters, because of the considerable overlap.

Diagnostic Techniques, Ophthalmological↗
PubMed2004

[Phacotrabeculectomy in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation glaucoma].

PURPOSE: To compare the results obtained after phacotrabeculectomy followed by implantation of an intracapsular lens in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation open angle glaucoma. MATERIAL AND METHODS: The retrospective study covered 55 eyes with cataract and glaucoma. In 28 eyes, chronic open angle glaucoma was diagnosed, and in 27--pseudoexfoliation glaucoma. In all cases, phacoemulsification of the opacified lens was carried out, a foldable intraocular lens was implanted in the capsule, and the trabeculum was removed by means of a punch. Visual acuity, intraocular pressure and the ratio of applied anti-glaucoma drugs were subject to the assessment. RESULTS: The observation period was 12 months. Within the COAG patient group, the average visual acuity prior to the surgery was 0.2+/-0.24, and after one year from the surgery it increased to 0.82+/-0.22. For PEX glaucoma patients, the values were respectively 0.3+/-0.25 before the surgery and 0.75+/-0.29 a year after it. Considerable reduction of the intraocular pressure was also achieved: in the COAG patients--from 19.51+/-3.8 mm Hg to 16.6+/-1.6 mm Hg, and in PEX glaucoma patients--from 22.28+/-5.18 mm Hg to 17.6+/-2.33 mm Hg one year after the surgery. Also, the quantity of anti-glaucoma drugs applied in the study groups was significantly reduced. The anti-glaucoma drug ratio in the COAG patients dropped from 1.8 to 0 after the surgery, and in the PEX glaucoma patients--from 2.3 to 0.3. CONCLUSIONS: Phacotrabeculectomy is an efficient and safe surgical method, to be recommended for patients both with primary open angle glaucoma and with pseudoexfoliation glaucoma.

Cataract↗
PubMed2000

[The Ahmed glaucoma valve implantation for refractory glaucoma].

OBJECTIVE: To evaluate the efficacy of the Ahmed Glaucoma Valve implant in the treatment of refractory glaucoma. METHODS: 28 cases(29 eyes) of refractory glacucoma were treated by the Ahmed glaucoma Valve implant, including 10 cases (10 eyes) of neovascula glaucoma, 5 cases (6 eyes) of juvenile glaucoma and 13 cases (13 eyes) of other causes glaucoma. RESULTS: Post-operative follow-up time was 3-12 months. The intraocular pressure (IOP) was lowered from preoperative 40.9 +/- 7.32 mmHg (1 mmHg = 0.133 kPa) to postoperative 20.63 +/- 2.75 mmHg in Neovascular glaucoma; from preoperative 41 +/- 5.66 to postoperative 18.00 +/- 2.12 mmHg in glaucoma after IOL implant combined with vitrectomy operation; from preoperative 33.65 +/- 5.28 to postoperative 16.45 +/- 1.48 mmHg in juvenile glaucoma; from preoperative 31.43 +/- 4.13 to postoperative 18.13 +/- 1.25 mmHg in the failure conventional filtering surgery of glaucoma. The postoperative complicatons were flat anterior chamber, hyphema, anterior iritis and so on. CONCLUSION: The Ahmed glaucoma valve implant is a useful method in lowing IOP of refractory glaucoma.

Female↗
PubMed1990

Pseudoexfoliative glaucoma in patients with open-angle glaucoma in the northwest of Spain.

A prospective study of pseudoexfoliative (PSX) glaucoma was carried out in the Northwest of Spain. In 546 examined eyes with open-angle glaucoma, PSX glaucoma was found in 243 (44.5%). The mean age in eyes with PSX glaucoma was 72.4 years as opposed to 68.2 of the glaucomas without PSX. Intraocular pressure (IOP) and visual field defects were higher in the PSX glaucomas than in the non-PSX (P less than 0.0001), and within PSX glaucomas was higher in males than in females (P less than 0.001). We found no relation between the IOP of one eye and the contralateral in the bilateral PSX glaucomas, while there was a certain relation to the rest of bilateral glaucomas. In 83.9% of the unilateral glaucomas there was PSX. In 68.4% of the eyes with alteration of the field defect degree 3-4, PSX-glaucomas were observed. Finally, 59.6% of the eyes with glaucoma and cataract showed PSX.

Adult↗
PubMed1998

Primary glaucoma triple procedure in patients with primary open-angle glaucoma: the effect of mitomycin C in patients with and without prognostic factors for filtration failure.

PURPOSE: To investigate the effect of adjunctive mitomycin C on primary glaucoma triple procedure in patients with primary open-angle glaucoma with and without one or more of the prognostic factors for filtration failure of primary glaucoma triple procedure. Those factors include being of African-American race, having a preoperative intraocular pressure of 20 mm Hg or more on maximum tolerated medications, and being on two or more medications preoperatively. METHODS: Study patients consisted of 197 consecutive patients with primary open-angle glaucoma who were randomly assigned to receive either no adjunctive mitomycin C (101 eyes of 101 patients) or to receive adjunctive subconjunctival mitomycin C (96 eyes of 96 patients) during the primary glaucoma triple procedure. Kaplan-Meier survival analysis comparisons were made between respective subgroups with and without prognostic indicators for filtration failures using a relatively stringent set of criteria for filtration success of primary glaucoma triple procedure. RESULTS: There was no statistically significant (P = .117) difference in filtration success of primary glaucoma triple procedure between the control and mitomycin C groups. Adjunctive mitomycin C significantly (P < .05) improved the filtration outcome of the primary glaucoma triple procedure in the subgroups with each of the three prognostic factors for filtration failure of primary glaucoma triple procedure. On the other hand, in the subgroups without the prognostic factors, adjunctive mitomycin C did not significantly (P > .05) change the filtration outcome of the primary glaucoma triple procedure. CONCLUSION: These findings establish the basis for selective use of mitomycin C in patients with primary open-angle glaucoma undergoing primary glaucoma triple procedure.

Aged↗
PubMed2000

Optic nerve head appearance in juvenile-onset chronic high-pressure glaucoma and normal-pressure glaucoma.

OBJECTIVE: To evaluate the appearance of the optic nerve head in chronic high-pressure glaucoma and normal-pressure glaucoma. DESIGN: Clinic-based cross-sectional study. PARTICIPANTS: The study included 52 eyes with normal-pressure glaucoma and 28 eyes with juvenile-onset primary open-angle glaucoma that served as models for chronic high-pressure glaucoma. METHODS: Color stereo optic disc photographs and wide-angle retinal nerve fiber layer photographs were morphometrically examined. MAIN OUTCOME MEASURES: Localized retinal nerve fiber layer defects; parapapillary chorioretinal atrophy; disc hemorrhages; optic cup shape; retinal arteriole narrowing. RESULTS: Both study groups did not vary significantly in count of localized retinal nerve fiber layer defects, size of parapapillary atrophy, optic cup depth, steepness of disc cupping, rim/disc area ratio, diameter of retinal arterioles, and frequency and degree of focal retinal arteriole narrowing. In normal-pressure glaucoma versus juvenile open-angle glaucoma, localized retinal nerve fiber layer defects were significantly broader, disc hemorrhages were found significantly more often and were larger, and neuroretinal rim notches were present more frequently and were deeper. CONCLUSIONS: Chronic high-pressure glaucoma and normal-pressure glaucoma show morphologic similarities in the appearance of the optic nerve head. The lower frequencies of detected disc hemorrhages and rim notches in high-pressure glaucoma may be due to a smaller size of hemorrhages and localized retinal nerve fiber layer defects in high-pressure glaucoma. Both glaucoma types have morphologic features in common, suggesting that they may possibly belong to a spectrum of the same pathologic process.

Adolescent↗