Longitudinal follow up of glaucoma suspects tested with pattern electroretinogram.
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Adrenergic beta-Antagonists↗
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Results for “Glaucoma, Open-Angle”
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[Epithelial basement membrane MDF dystrophy of the cornea].
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Adult↗
Treatment of encapsulated blebs with 30-gauge needling and injection of low-dose 5-fluorouracil.
We describe a simplified needling procedure, performed at the slit-lamp, with injection of low-dose 5-fluorouracil to treat encapsulated filtering blebs. Between August 1989 and December 1990 we treated 17 eyes of 14 patients with this procedure. At 2 months 13 of the eyes had needed only one needling procedure. Risk factors for reencapsulation of the bleb were a history of three or more previous surgical procedures (p less than 0.05) and prolonged preoperative use of topical adrenergic drugs (p less than 0.05). At 1 year all but one eye had an intraocular pressure below 21 mm Hg (median 15 mm Hg). Twelve of the eyes had needed more than one needling procedure. There were no serious complications of the 32 procedures performed. The incidence rate of minor complications (wound leaks, corneal erosion and small hyphemas) was 38%.
Adult↗
Comparison of computer-assisted versus manual optic nerve head pallor measurement.
Computerized methods of examining the optic nerve head offer the possibility of providing consistent, reliable, and accurate measurements of the nerve head. The reliability and accuracy of such instruments must be examined to confirm this. This research was undertaken to gain an insight into the accuracy of such a system, which takes its measurements by tracking the luminance boundaries of the pallor area and the optic nerve head after an observer marks the starting points. Measurements made using the computer-tracked boundary were compared with those made using a boundary tracked by an image-processing system of greater sophistication, the human visual system. The comparison was made with images from one eye from each of 30 subjects (10 normal, 10 ocular hypertensive, and 10 glaucomatous). The measurements were made by two observers. Each observer made each set of measurements twice, and the results were analyzed with a five-factor analysis of variance. The measurements made using the computerized method did not differ significantly from those made using the manual boundary tracking for the two observers, and they were highly correlated (r = 0.99 for the area pallor-disc ratio). Significant differences (P < 0.05) were found between the two observers in both the manual and computerized boundary tracking. The computerized method, however, did not find differences between the two sets of measurements made by each observer; the manual method did show such differences. The computerized method appeared to trace the luminance boundaries successfully in the image, and it might reduce errors related to the observer marking the starting points on different occasions.(ABSTRACT TRUNCATED AT 250 WORDS)
Analysis of Variance↗
Trabeculectomy with 5-fluorouracil subsequent to circular buckling operation and cataract extraction.
Six patients, each with one eye that had previously undergone circular buckling surgery for the repair of retinal detachment before or followed by cataract extraction with or without intraocular lens implantation, underwent trabeculectomy with 5-fluorouracil (5-FU) for intractable glaucoma. Surgery was done through scarred subconjunctival tissues that were excised partially. The total doses of 5-FU ranged from 65 to 100mg (mean +/- standard deviation, 84.2 +/- 13.2mg) Eight to 47 months later, intraocular pressures were 18mmHg in five eyes, two of which were not receiving hypotensive medications. In the sixth eye, the intraocular pressure was 26mmHg with maximum hypotensive treatment. Intraocular pressures in the six eyes were significantly lower postoperatively than preoperatively (P < .05). This preliminary study suggests that filtering surgery with 5-FU may be beneficial after intraocular operations even in eyes where it is done through postoperative scarred subconjunctival tissues.
Adult↗
Comparative results of limbal based versus fornix based conjunctival flaps for trabeculectomy.
Among 100 cases of primary glaucomas, 50 cases were operated for trabeculectomy by making fornix based flap and 50 cases were operated by fashioning limbal based conjunctival flap. Operative and post operative complications were studied thoroughly in the two groups. All the cases were followed up for six months to one year to assess control of intra ocular pressure, nature and functioning of filtering bleb, field changes and visual status in the two groups. It was found that the fornix based flap is much superior and carries various advantages over the limbal based flap. The operative and post operative complications are minimum in the fornix based flap as compared to the limbal based flap.
Adult↗
The pigmentary dispersion disorder in USAF aviators.
The pigmentary dispersion syndrome (PDS) can have serious ocular consequences. Visual changes due to glaucoma and the treatment required can threaten the high level of visual function necessary in military aviation. We reviewed the records of 50 aviators with PDS who were evaluated at the Aeromedical Consultation Service (formerly the USAF School of Aerospace Medicine) over the past 10 years. At last evaluation, 48 were still qualified to fly. Only two aviators were permanently removed from flying duties due to glaucoma. Initial intraocular pressures, cup-to-disc ratios, and refractions were not statistically correlated with progression to glaucoma, but sample sizes were small. At final evaluation, 20 of the 34 aviators with follow-up had glaucoma and required medication. Thirteen eyes underwent laser trabeculoplasty. With appropriate management, the majority of aviators with PDS were able to safely continue their flying careers.
Adult↗
Use of beta radiation to control I.O.P.
The use of ophthalmic applicator containing Strontium-90 beta ray was used to bring about a change in I.O.P. by its effect on the ciliary body. The change in I.O.P. depends on the degree of damage done to the ciliary body. The study showed that the change in I.O.P. was directly proportional to the intensity of beta rays application - higher the dose of beta radiation more was the damage and more the reduction in I.O.P.
Aged↗
[How is simplex glaucoma diagnosed?].
Although glaucoma has traditionally been regarded as a disease affecting people over 60 years of age, improved diagnostic methods now enable glaucoma-related changes to be detected already in the 35-40-year-old age group, long before any functional visual changes are present. Since there is no treatment capable of restoring lost visual capacity, the diagnosis should be made and treatment initiated at an early stage before visual deterioration has become manifest. Measurements of intra-ocular pressure and visual acuity provide insufficient guidance, whereas periodic photography of the nerve fibre layer yields early diagnostic information and an indication of the appropriate individual level of intra-ocular pressure to prevent progression of the disease.
Glaucoma, Open-Angle↗
Value of trabeculectomy specimens in glaucoma.
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Adolescent↗
Peripheral nasal field defects in glaucoma.
One hundred fifty-one eyes of 101 consecutive patients with chronic open-angle and low tension glaucoma showed typical visual field changes. Sixty of the eyes had a nasal step, either alone or in combination with other defects. In 17 of these eyes, it was possible to demonstrate an isolated scotoma in the nasal periphery. It was concluded that the peripheral nasal step is a nerve fiber bundle defect that in its earliest phase produces a scotoma. In this sense, it behaves similar to the more central defects, rather than simply as a depression of isopters nasally.
Adult↗
Diathermo-trabeculotomy ab externo: indications and long-term results.
The authors present the results of 2 years' observation of 47 eyes operated with diathermo-trabeculotomy ab externo. This technique, based on a diathermic effect in association with trabeculotomy ab externo, allows an ample opening of Schlemm's canal and of the trabecular meshwork, with normalisation of intraocular pressure and outflow facility, for a period of up to 2 years, in open-angle and congenital glaucoma.
Electrocoagulation↗
Combined cyclodialysis and cataract extraction.
Combined cyclodialysis and cataract extraction was performed on 78 eyes in a consecutive series of 26 years duration. This operation was performed on eyes with severe glaucoma, inadequately controlled on maximum medical therapy, and with a cataract needing extraction. Glaucoma types included open-angle, angle-closure with peripheral anterior synechias, combined open-angle and angle-closure, and secondary to uveitis. Seventy of the 78 eyes had follow-up of six months or more and the results in these 70 eyes were analyzed. In thirteen percent of the eyes in this study the postoperative intraocular pressure was the same or higher than the preoperative level, or reductions of intraocular pressure were not clinically significant. Eighty-seven percent (61 eyes) had a clinically significant lowering of intraocular pressure following the combined procedure. Thirty-nine percent (27 eyes) of the 70 eyes in this study had a tension of 0-14 mm Hg, and 44% (31 eyes) had a tension of 15-20 mm Hg. Intraocular pressure was improved significantly more often in patients over 60 years of age. Resulting intraocular pressures of 14 mm Hg or less were more likely when the cyclodialysis was performed in the lower quadrant. The results of the combined procedure were not significantly influenced by the type of glaucoma involved or by a history of previous glaucoma surgery. Bleeding was a frequent complication, but was not related to resulting intraocular pressure. Other complications were rare. We conclude that combining cyclodialysis with cataract extraction is safe and effective, and is a suitable procedure when there is need for surgery to relieve severe glaucoma, along with a need for cataract extraction.
Adolescent↗
[Topical oxpernolol in the treatment of various forms of glaucoma (author's transl)].
Oxprenolol is a new beta-adrenergic blocking drug, whose effectiveness in the treatment of various forms of glaucoma has been evaluated. The drug was administered topically as 0.5% -1%-2% solution. The results of the investigation may be summarized as follows: The instillation of the drug produces a transient and slight conjunctival hyperaemia and a not significant miosis. A significnat ocular hypotensive action has been observed in the treatment of chronic open-angle, hemorrhagic and congenital glaumiosis. A significnat ocular hypotensive action has been observed in the treatment of chronic open-angle, hemorrhagic and congenital glaucoma. The concentration of 0.5% Oxprenolol seems to be as effective as topical 1% Propranolol. At the same concentration (0.5%), Oxprenolol produces no significnat change of the systemic blood pressure or of the heart rate. Topical pre-treatment with 1% Oxprenolol inhibits the systemic side-effects (tachycardia) produced by topical Isoproterenol, a wellknown ocular hypotensive drug. The authors conclude the investigation affirming that Oxprenolol may represent a new effective means for the medical treatment of glaucoma.
Chronic Disease↗
Pilocarpine therapy in glaucoma: effects on anterior chamber depth and lens thickness in patients receiving long-term therapy.
The effect of pilocarpine hydrochloride on the anterior chamber depth and lens thickness was measured in 20 eyes of patients with chronic open-angle glucoma who were receiving long-term glaucoma therapy with pilocarpine. Measurements were made with high-resolution ultrasonic biometry. This study demonstrated that regardless of their age (58.4 years, average) and the fact that they had been regularly using pilocarpine from two to four times a day, 85% of these patients demonstrated narrowing of the anterior chamber (AC) depth (average, 0.19 mm) and thickening of the lens (average, 0.21 mm) with each instillation of pilocarpine. In approximately 15% of eyes, a repeatable deepening of the AC depth and flattening of the lens was noted.
Administration, Topical↗
The histopathology of pigmentary dispersion syndrome with glaucoma.
Iris tissue and trabecular meshwork, obtained at time of trabeculectomy, was studied using the light and electron microscope in a 54-year-old woman with pigmentary dispersion syndrome with glaucoma. The specific defect was a loss of the outer epithelial cells of the iris with marked thinning of the remaining outer layers so that the two-cell architecture of the iris epithelium was maintained. In addition, the radial muscle layer was increased in both number and size of muscle fiber. It would appear that the pigmentary dispersion syndrome may represent a congenital or developmental abnormality of the iris epithelium, or both, and that the glaucoma which occasionally occurs in conjunction with this syndrome is of the usual open-angle type.
Atrophy↗
Glucocorticoid responsiveness associated with HLA-B12.
Primary open-angle galucoma (POAG) patients are more responsive to glucocorticoids, and have increased prevalences of the histocompatibility antigens HLA-B7 and HLA-B12. We report herein a comparison of in vitro cellular responsiveness to glucocorticoids and HLA classification for 25 POAG patients, and 25 individuals who respond to topical dexamethasone with intraocular pressure is greater than 31 mm. HG. (GG responders). Within both the POAG and GG groups, significantly greater responsiveness to prednisolone occurs in patients with HLA-B12 antigen. No such association occurs for patients with HLA-B7.
Aged↗