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At least 55 records · Page 3Linked to original sources
PubMed2005

Chromosomal abnormalities and glaucoma: a case of congenital glaucoma with trisomy 8q22-qter/ monosomy 9p23-pter.

PURPOSE: To present a case of congenital glaucoma with an unbalanced translocation trisomy 8q22-qter/monosomy 9p23-pter, resulting in trisomy of the GLC1D locus. To perform a literature review of chromosomal abnormalities associated with glaucoma. METHOD: A case report of a family with balanced translocation without glaucoma and unbalanced translocation with congenital glaucoma. PubMed and OMIM databases were searched for reports of chromosomal abnormalities and glaucoma. RESULTS: Other case reports of congenital glaucoma with chromosomal abnormalities in this region were identified. A review of cytogenetics in southeastern Australia found nine cases involving the loss of 9p23 and 10 cases involving mosaicism for trisomy 8, but none had congenital glaucoma. A review of the literature identified reports of glaucoma and chromosomal abnormalities in regions with glaucoma loci mapped by conventional linkage analysis. These include the loci GLC1B, GLC1C, GLC1D, GLC1F, GPDS1, and RIEG2. CONCLUSION: The study of patients with glaucoma and chromosomal abnormalities may help to identify new glaucoma genes. Ophthalmologists can assist with this by requesting cytogenetic studies on congenital and developmental glaucoma cases and interacting with ophthalmic genetics researchers.

Adolescent↗
PubMed1989

Glaucoma prevalence in the Nordic countries. Estimates based on glaucoma drug consumption.

Glaucoma prevalences in the 5 Nordic countries are estimated on basis of a) wholesale of glaucoma medicaments (Denmark, Iceland, Norway, and Sweden) and b) registered glaucoma patients receiving free medication (Finland). Prevalences are compared nationally and internationally. The estimated glaucoma prevalence is highest in Norway (2.19% related to the population greater than 40 years), lowest in Denmark (0.76% in the same age group). The prevalence in Iceland, Finland, and Sweden are 2.0, 1.94, and 1.55%, respectively. We suggest that the relatively large differences in glaucoma prevalence between the countries may be explained by geographical differences in occurrence of capsular glaucoma. The sources of error concerning prevalence estimates based on glaucoma drug consumption are discussed. Pre-supposing a balance numerically between undetected glaucoma cases and patients receiving glaucoma medication without really having glaucoma, the glaucoma drug sales statistics may be taken as fair indicators of glaucoma prevalence.

Adult↗
PubMed2004

[Prevalance of open angle glaucoma and ocular hypertension as a risk factor for primary open angle glaucoma in Wroclaw population. Wroclaw Epidemiology Study].

OBJECTIVE: The purpose of the study is to assess the prevalence of various types of open angle glaucoma (OAG) and ocular hypertension (OH) as a risk factor for AOG. The second aim of the study was to determine the detection level of glaucoma in the population of Wroclaw inhabitants aged 40-79. MATERIAL AND METHODS: The population based cross-sectional sample of 4853 Wroclaw inhabitants aged 40-79 years underwent two stage examination. First stage of the study included medical history interview and five screening tests: tonometry, peripheric anterior chamber depth assessment by Van Herick technique, ocular nerve head (ONH) assessment by stereoscopic ophthalmoscopy, Heidelberg Retina Tomograph (HRT) and Nerve Fiber Analyzer (GDx) investigation. Second stage included complete ophthalmological examination with gonioscopy, static perimetry and 24 hours monitoring of intraocular pressure (IOP), and pachymetry in OH group. RESULTS: The prevalence of glaucoma in Wroclaw population aged 40-79 years was 1.6%. Open angle glaucoma (OAG) that includes primary open angle glaucoma (POAG), normal pressure glaucoma (NPG) and capsular glaucoma (PEX-glaucoma) was found in 1.53% of the population. Glaucoma detection level was low: 71% of all cases of glaucoma were diagnosed for the first time. The percentage of OH detected in Wrodaw population was 1.9%. Following the criteria of Ocular Hypertension Treatment Study (OHTS) we found that the pachymetric value of central corneal thickness (CCT) in OH group was less than 555 microm (thin cornea) in 12.5%, from 555 microm to 588 microm (normal thickness of central cornea) in 26.14% and more than 588 microm (thick cornea) in 61.36% of the subjects. CONCLUSIONS: The Wroclaw Epidemiological Study revealed OAG as 91% of overall glaucoma cases. The relatively high percentage of glaucoma cases was diagnosed for the first time. This number is higher than reported by other authors of population studies in white communities. In the OH group the 26.14% of the eyes with normal CCT has increased risk, and the 12.5% eyes with thin cornea has highly increased risk of POAG, according to OHTS results.

Adult↗
PubMed1999

Management of uveitic glaucoma with Ahmed glaucoma valve implantation.

OBJECTIVE: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for the management of glaucoma associated with chronic uveitis. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Nineteen patients (21 eyes) with chronic uveitis underwent Ahmed glaucoma valve implantation for uncontrolled glaucoma between 1995 and 1998. INTERVENTION: All patients had their uveitis controlled before surgery via immunomodulatory therapy. Ahmed glaucoma valve implantation was performed. Immunosuppression was continued in the early postoperative period for strict control of inflammation. MAIN OUTCOME MEASURES: Control of intraocular pressure (IOP). A secondary outcome measure was the number of antiglaucoma medications required to achieve the desired IOP. Visual acuity and complications associated with the surgery were monitored. RESULTS: The postoperative follow-up averaged 24.5 months. At the most recent visit, all 21 eyes had IOPs between 5 and 18 mmHg. The average pressure reduction after Ahmed glaucoma valve implantation was 23.7 mmHg. The average number of antiglaucoma medicines required to achieve the desired IOP was reduced from 3.5 before surgery to 0.6 after surgery. No eye lost even a single line of Snellen acuity at the most recent postoperative visit. Two eyes developed hypotony in the course of follow-up. One resolved without specific intervention, and the other eye required two autologous blood injections and tube ligature to correct the hypotony. One eye underwent Ahmed glaucoma valve replacement for abrupt valve failure. Two eyes underwent penetrating keratoplasty for reasons believed to be unrelated to the glaucoma surgery. Kaplan-Meier life-table analysis showed a cumulative probability of success after Ahmed glaucoma valve implantation of 94% at 1 year. CONCLUSIONS: Ahmed glaucoma valve implantation can be an effective and safe method in the management of uveitic glaucoma. The authors hypothesize that control of the patients' uveitis, through preoperative and long-term postoperative immunomodulatory therapy, may have contributed to the success rate reported herein.

Adolescent↗
PubMedDate not supplied

The relationship between intraocular pressure and glaucoma in a defined population. Data from the Egna-Neumarkt Glaucoma Study.

PURPOSE: To provide data on the prevalence of ocular hypertension and glaucoma and on the diagnostic validity of tonometry. METHODS: In this cross-sectional, population-based study, 4,927 subjects over 40 years of age were examined. Each subject underwent a complete ocular examination as part of the Egna-Neumarkt Glaucoma Study. These examinations were carried out by trained, quality-controlled ophthalmologists, according to a predetermined standard protocol that included a medical interview, applanation tonometry, computerized perimetry, optic nerve head examination and other ocular measurements. The following data were recorded: mean IOP, prevalence of ocular hypertension, primary open-angle glaucoma and normal tension glaucoma. Sensitivity, specificity and the predictive value of the tonometric test, as well as the distribution of IOP in the different groups were also determined. RESULTS: The overall prevalence of ocular hypertension, hypertensive primary open-angle glaucoma and normal tension glaucoma corresponded to 2.1, 1.4 and 0.6%, respectively. Other types of glaucoma accounted for a further 0.9%. The sensitivity and specificity of the tonometric test in recognizing glaucoma (cut-off between 21 and 22 mm Hg) were, respectively, 80.1 and 97.8%. The predictive values of the positivity and negativity of the test were 52.1 and 99.4%, respectively. CONCLUSIONS: The prevalence of ocular hypertension and glaucoma was similar to that found in several recent epidemiological studies. Tonometry alone is obviously not sufficient to ascertain or to exclude the presence of glaucoma; its diagnostic validity however is high and should never be underestimated. An elevated IOP is the main risk factor for glaucoma, with the degree of risk increasing as the level of IOP increases.

Adult↗
PubMed1998

Differentiating patients with glaucoma from glaucoma suspects and normal subjects by nerve fiber layer assessment with scanning laser polarimetry.

PURPOSE: A study was conducted to determine normative data for nerve fiber layer measurements as obtained by scanning laser polarimetry with the Laser Diagnostic Technologies Nerve Fiber Analyzer II, identify factors affecting the measurements, and identify parameters capable of differentiating normal subjects from patients with glaucoma and patients suspected of having glaucoma because of ocular hypertension or because of a large cup-to-disc ratio (GS-disc). DESIGN: A case series. PARTICIPANTS: Four hundred normal subjects, 35 patients with ocular hypertension, 42 patients with glaucoma, and 17 glaucoma suspects based on optic disc appearance participated. METHODS: Nerve fiber layer thickness assessments were determined in normal subjects (with normal-appearing optic nerves and normal visual fields). The results were compared to measurements from samples of age-matched patients with ocular hypertension (with normal visual fields), patients suspected of having glaucoma based on enlarged cup-to-disc ratios, and patients with open-angle glaucoma who had visual field loss. RESULTS: The majority of the parameters derived from the measurements showed no significant relationship to age, although some parameters tended to decrease with increasing age. Multiple parameters showed statistically significant differences between normal subjects and patients with glaucoma. In particular, the intraellipse sector variability, an indirect measure of the shape of the nerve fiber layer in an ellipse surrounding the nerve head, showed statistically significant differences between normal subjects and patients with glaucoma as well as between glaucoma suspects and normal subjects. Similar results were seen with the superior maxima, the average thickness assessment value of the 1500 thickest points in the superior bundle. CONCLUSIONS: Assessments of nerve fiber layer thickness as determined by scanning laser polarimetry can differentiate patients with glaucoma from normal subjects and may identify otherwise undetected damage in glaucoma suspects.

Diagnostic Techniques, Ophthalmological↗
PubMed1998

Comparison of mitomycin C trabeculectomy, glaucoma drainage device implantation, and laser neodymium:YAG cyclophotocoagulation in the management of intractable glaucoma after penetrating keratoplasty.

PURPOSE: This study aimed to compare the surgical outcomes of mitomycin C trabeculectomy glaucoma drainage device (GDD) surgery and laser neodymium:YAG (Nd:YAG) cyclophotocoagulation (CPC) in the management of intractable glaucoma after penetrating keratoplasty (PKP) in a retrospective study. DESIGN: Interventional case series. PARTICIPANTS/METHODS: The medical charts of consecutive patients who had pre-existing glaucoma or who developed glaucoma after PKP and underwent a surgical procedure to control the glaucoma at the University Eye Associates of Boston University Medical Center, New England Eye Center, and Massachusetts Eye and Ear Infirmary between January 1991 and July 1995 were reviewed. Follow-up ranged from 6 months to 4 years after the glaucoma procedure. A total of 38 patients were included consisting of 17 patients who underwent mitomycin C, 10 patients who underwent GDD surgery, and 11 patients who had CPC. INTERVENTION: Mitomycin C trabeculectomy, GDDs, or Nd:YAG CPC to control glaucoma after PKP was performed, MAIN OUTCOME MEASURES: Graft status, postoperative intraocular pressure (IOP), and visual acuity were the main outcome measures. RESULTS: There were no differences among the three groups with respect to the follow-up time after the corneal graft operation (P = 0.15) or after the glaucoma operation (P = 0.98). At the final follow-up, the average decrease in the IOP was 17 mmHg (P < 0.001) after mitomycin C, 15 mmHg (P = 0.003) after GDD surgery, and 14.4 mmHg (P = 0.001) after CPC. There were no differences in the proportion of patients who developed postoperative IOP above 20 mmHg (P = 0.50) and in the proportion who developed hypotony (P = 0.10) among the three groups. Two grafts failed after mitomycin C and one failed after CPC. Among the three procedures, there were no differences in the proportion of patients who experienced either an improvement (P = 0.14) or a decrease (P = 0.22) in the visual acuity by more than one line after the glaucoma procedure. One patient each in the GDD group and the CPC group lost light perception after the procedure. The risk of graft failure was almost three times higher for each additional PKP (odds ratio = 2.80, P = 0.02). CONCLUSIONS: No differences were found among the three glaucoma procedures with respect to controlling IOP and graft failure. There was a trend for patients treated with CPC to have a higher incidence of graft failure, glaucoma failure, hypotony, and visual loss by more than one line, although this was not statistically significant. The number of PKPs was associated with graft failure, independent of the surgical procedure.

Adolescent↗
PubMed2004

Trends in glaucoma surgery before and after the introduction of new topical glaucoma pharmacotherapies.

OBJECTIVE: Recent advances in pharmacotherapy that have improved the ability to effect sustained reductions in intraocular pressure may delay or obviate the need for surgery for open-angle glaucoma. This analysis explored this possibility by evaluating the frequency of surgeries for open-angle glaucoma in the US Medicare population before and after the 1996 introduction of latanoprost, a topical prostaglandin analogue with potent ocular antihypertensive efficacy and a better safety profile than older topical glaucoma medications. METHODS: Data from the Medicare 5% Standard Analytical File were used to develop national estimates of the frequency of glaucoma surgeries in the US yearly from 1994 through 1999. RESULTS: While the number of US Medicare patients with a diagnosis of glaucoma remained constant from 1994 through 1999, the number of inpatient and outpatient glaucoma surgeries declined with a particularly sharp drop between 1996 and 1997. In 1999 relative to 1994, the number of annual glaucoma surgeries among unique patients with a diagnosis of glaucoma was reduced by 72% for inpatient procedures and 42% for outpatient procedures. CONCLUSIONS: The number of glaucoma surgeries among US Medicare patients markedly decreased from 1994 to 1999, during which time the prevalence of glaucoma remained stable in this population. The decrease in surgeries coincided with the introduction of improved topical pharmacotherapies for the management of glaucoma. Although the ability to infer a causal relationship between introduction of new pharmacotherapy and the decrease in surgeries is limited, the consistency of these data with those of several other studies renders the findings compelling.

Administration, Topical↗
PubMed2006

Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients.

PURPOSE: This study evaluates the change in intraocular pressure (IOP) and glaucoma medication requirements after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients at 3 years and last follow-up (mean 5 y). PATIENTS AND METHODS: This study represents a retrospective analysis of patients who had clear corneal phacoemulsification and at least 3 years of follow-up. The patients were classified into 3 groups: glaucoma (G), glaucoma suspects (GS), and no glaucoma (NG). No patient had a history of previous intraocular surgery. Single factor analysis of variance, Fisher exact tests, 2-tailed paired Student t tests and Kaplan-Meier analysis were applied. RESULTS: Forty-eight patients (55 eyes) in the glaucoma group, 41 patients (44 eyes) in the GS group, and 59 patients (59 eyes) in the NG group met the above criteria. At 3 years follow-up IOP was significantly decreased in all groups; (G) group decreased 1.4+/-3.3 mm Hg (P = 0.0025), GS 1.4+/-4.2 mm Hg (P = 0.004), and NG 1.7+/-3.1 mm Hg (P = 0.0005). At the final follow-up visit (mean near 5 y for all groups) the IOP was significantly decreased in all groups, (G) group 1.8+/-3.5 mm Hg (P = 0.005), GS 1.3+/-3.7 mm Hg (P = 0.025), and NG 1.5+/-2.5 mm Hg (P < 0.0001). The number of preoperative and postoperative glaucoma medications in the (G) group did not show any significant change at 3 and 5 years (P = 0.36, P = 0.87). Kaplan-Meier analysis shows that at 3 years, 85% of the (G) group, 81% of GS, and 90% of the NG had IOPs less than or equal to their preoperative IOP, with the same number of glaucoma medications or less. At 5 years the percentages were 76%, 79%, and 85%, respectively. CONCLUSIONS: This study demonstrates that cataract removal by clear cornea phacoemulsification in glaucoma patients, glaucoma suspects, and normal patients results in a small but significant decrease in IOP that is sustained at 3 years and a mean of 5 years in all groups. This study does not imply that cataract removal by phacoemulsification is a substitute for a combined procedure but may be an appropriate procedure for certain patients based on medication requirements and extent of optic nerve damage.

Aged↗
PubMed1999

Mid-peripheral pattern electrical retinal responses in normals, glaucoma suspects, and glaucoma patients.

AIMS: Reliance on intraocular pressure, optic nerve cupping changes, nerve fibre layer integrity, and visual field changes may delay treatment of glaucoma since irreversible changes may have already occurred at the time of diagnosis. Abnormal pattern electrical retinal responses (PERR or PERG) have been demonstrated in patients with ocular hypertension (no visual field changes) and glaucoma when visual stimulation was presented to the central field. Since glaucomatous visual field changes tend to occur first in the mid-periphery, the use of PERR outside of the central field may offer an earlier indication of glaucomatous involvement. METHODS: Glaucoma suspects and glaucoma patients were derived from a university practice. Normal subjects were recruited from non-patient volunteers. Alternating bar gratings were presented in the supranasal, supratemporal, infratemporal, and infranasal visual field. Six spatial frequencies, from 0.25 to 6.0 cycles per degree, were used for normal volunteers; three spatial frequencies, from 0.38 to 1.5 cycles per degree, were presented to suspects and glaucoma patients. Time of onset of the first negative (N35) and first positive peak (P50) and the amplitude consisting of the absolute difference between the first negative peak and first positive peak (P50 amplitude) are reported. Age corrected values were determined for normals, suspects, and glaucoma patients for each spatial frequency and for each quadrant in the visual field. RESULTS: Mean P50 amplitudes from normal subjects showed spatial tuning in all quadrants with reduced low frequency attenuation. Normals demonstrated a small decline in amplitude with age. Glaucoma patients demonstrated an age corrected reduction in amplitude and early implicit times. Glaucoma suspects had values between those of normal and glaucoma subjects. P50 amplitudes were weakly correlated with increasing cup to disc diameter ratio. A glaucoma patient with asymmetric visual field loss demonstrated significant diminution of the PERR bilaterally. CONCLUSION: The PERR, using mid-peripheral stimulation, may be a sensitive tool for the early detection of glaucoma. Further refinements can speed clinical data acquisition and enhance signal to noise ratio.

Adolescent↗
PubMed1993

Characteristics of frequency-of-seeing curves in normal subjects, patients with suspected glaucoma, and patients with glaucoma.

PURPOSE: The authors performed this study to determine factors that affect the characteristics of frequency-of-seeing curves in normal subjects, patients with suspected glaucoma, and patients with glaucoma. METHODS: The sample consisted of 70 subjects (22 normal subjects, 12 patients with suspected glaucoma, and 36 patients with glaucoma). A program was written to interface with the Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA) to measure frequency-of-seeing curves. The authors presented stimuli 8 dB either side of the estimated threshold in 1-dB intervals with five repetitions at each stimulus intensity. The authors tested four to six locations in each subject, with randomization of the stimulus intensity and location. Fixation was monitored with the Heijl-Krakau method. Using a probit program, the authors calculated the threshold and slope (estimated by the interquartile range) of each curve. RESULTS: The authors obtained 124 curves from the normal subjects, 71 from the patients with suspected glaucoma, and 183 from the patients with glaucoma. In all three groups, the slope of the frequency-of-seeing curve was correlated highly with the threshold or threshold deviation, although the correlation was significantly higher in the normal subjects compared with the patients with suspected glaucoma and patients with glaucoma, even after controlling for the range of the threshold and threshold deviation. For this reason, the authors found considerably different frequency-of-seeing curves, between subject groups and also within the group of patients with glaucoma, in locations with the same threshold. CONCLUSIONS: There may be fundamental differences in areas of normal subjects and patients with glaucoma with similar thresholds or threshold deviations. These differences also may exist within patients with glaucoma.

Adult↗
PubMed2004

Surgical outcomes of combined phacoemulsification and glaucoma drainage implant surgery for Asian patients with refractory glaucoma with cataract.

PURPOSE: To examine the safety and efficacy of combined phacoemulsification and glaucoma drainage implant surgery in providing reduction of intraocular pressure (IOP) and visual rehabilitation in eyes with refractory glaucoma and cataract. DESIGN: Interventional case series. METHODS: A retrospective chart review was performed on all subjects who underwent combined phacoemulsification with intraocular lens implantation and glaucoma drainage implant surgery by a single surgeon at the National University Hospital, Singapore. The implants used were the 185 mm2 Ahmed glaucoma valve and the 350 mm2 Baerveldt glaucoma implant. In terms of IOP, a complete success was defined as IOP of between 6 to 21 mm Hg without medication, qualified success as IOP between 6 to 21 mm Hg with one or more medication, and failure as a sustained IOP of >21 mm Hg or <6 mm Hg with or without one or more medication on two or more visits. RESULTS: A total of 32 combined phacoemulsification and glaucoma implant surgeries in 32 patients was performed. All patients were of Asian origin, and the mean age was 58 +/- 16 years (range, 20-78 years). The Baerveldt glaucoma implant and Ahmed glaucoma valve implant were inserted in 16 eyes each. With a mean follow-up of 13 +/- 5 months (range 6 to 22 months), IOP was reduced from a mean of 28.0 +/- 11.5 mm Hg to 15.2 +/- 6.0 mm Hg postoperatively (P <.0001), whereas the number of antiglaucoma medications decreased from a mean of 2.4 +/- 1.4 to.3 +/-.7 (P <.0001) at last follow-up. Overall, there were 24 eyes (75%) that were classified as complete successes, 4 eyes (12.5%) that were qualified successes, and 4 eyes that failed (12.5%). Twenty-three eyes (72%) had improvement of visual acuity, while only one eye had a loss of more than 1 line of Snellen acuity. There was no case that encountered an intraoperative complication, and postoperative complications occurred in 12 eyes (38%), the most common of which was hypotony (in six eyes, 19%). CONCLUSION: For subjects with refractory glaucoma and cataract, combined phacoemulsification and glaucoma drainage implant surgery provide good visual rehabilitation and control of IOP, with low incidence of complications.

Adult↗
PubMed1992

Clinical features of capsular glaucoma in comparison with primary open-angle glaucoma in Japan.

Clinical features of capsular glaucoma during a recent 15-year period were compared with those of primary open-angle glaucoma (POAG). Out of 1623 new glaucoma patients, 263 patients (16.2%) were capsular glaucoma and 268 (16.5%) were POAG. The patients with capsular glaucoma were older than the patients with POAG. The former had higher intraocular pressure, lower visual acuity, more advanced visual field change and heavier trabecular pigmentation than POAG patients at the time of initial examination. These findings suggest that capsular glaucoma is more difficult to manage than POAG and that the prognosis is poorer than for POAG. Pseudoexfoliative material was found on the pupillary border in 98.3%, on the central lens surface in 46.1%, and on the peripheral lens surface in 72.3%. Though 190 of 263 patients with capsular glaucoma (73.9%) were unilateral cases, 38.9% of the fellow eyes had some abnormalities related to glaucoma. Phakodonesis was found in 10% of patients with capsular glaucoma. This finding suggests that the presence of capsular glaucoma might be a risk factor in cataract surgery.

Adult↗
PubMed1999

Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients.

PURPOSE: To compare the effects of clear corneal phacoemulsification on intraocular pressure (IOP) in patients without glaucoma, glaucoma suspects, and patients with glaucoma. SETTING: Urban, multisubspecialty private practice. METHODS: A retrospective analysis of patients who had clear corneal phacoemulsification with a minimum of 12 months follow-up was performed. The patients were divided into 3 groups: no glaucoma (NG), glaucoma suspects (GS), and glaucoma (GG). None had a history of prior surgery. Glaucoma suspects included patients with elevated IOPs, abnormal discs, pseudoexfoliation syndrome, or pigment dispersion syndrome on no medications and with no field defects. Glaucoma patients had received only medical treatment. Two-tailed, homoscedastic t tests were used for statistical analysis. RESULTS: There were 143 patients (164 eyes) in the NG group, 65 (75) in the GS group, and 61 (71) in the GG group. The mean preoperative IOP was 16.42 mm Hg +/- 2.77 (SD), 17.59 +/- 4.15 mm Hg, and 16.97 +/- 4.86 mm Hg in the 3 groups, respectively. At 1 year, the mean IOP was lower in all groups: 14.37 +/- 2.97 mm Hg, 15.68 +/- 3.38 mm Hg, and 15.86 +/- 4.00 mm Hg, respectively. The change was statistically significant in the NG and GS groups. Glaucoma patients showed a statistically significant reduction in the number of glaucoma medications postoperatively. CONCLUSION: Clear corneal phacoemulsification was associated with a statistically significant long-term reduction in IOP.

Aged↗
PubMed2005

Glaucoma in aphakia and pseudophakia in the Chennai Glaucoma Study.

AIM: To determine the prevalence of glaucoma among aphakes and pseudophakes in a rural population of southern India. METHODS: 3924 subjects aged 40 years or above underwent complete ophthalmic examination. Glaucoma in aphakia/pseudophakia was diagnosed using International Society of Geographical and Epidemiological Ophthalmology criteria in aphakic/pseudophakic people. RESULTS: 54 subjects (37 aphakes, 17 pseudophakes) (1.38% of 3924 subjects, 11.2% of 482 aphakes/pseudophakes) had glaucoma in aphakia/pseudophakia. Aphakia, age, intraocular pressure (IOP), pseudoexfoliation, and peripheral anterior synechiae greater than or equal to 180 degrees of the angle were risk factors for glaucoma on univariate analysis. On multivariate analysis, IOP and aphakia were independent risk factors for glaucoma. 39 people (72.22%) with glaucoma had normal IOP at presentation. None of the people with glaucoma were aware of the disease. Blindness in one or both eyes was seen in 12 subjects (10 unilateral and two bilateral)-that is, 22.22% of people with glaucoma in aphakia/pseudophakia. CONCLUSIONS: Glaucoma is an important cause of ocular morbidity among aphakes and pseudophakes in this rural population of south India. This glaucoma, responsible for unilateral or bilateral blindness in 22.2% of those affected, was entirely undetected in this study population.

Adult↗
PubMed2000

Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients.

AIMS: To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients. METHODS: 141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the chi(2) test. RESULTS: Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 mm Hg and 4.1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management. CONCLUSIONS: Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical beta blocker therapy to control their glaucoma.

Adrenergic alpha-Agonists↗
PubMed1996

Treatment of the fellow eye in acute angle-closure glaucoma: a case report and survey of members of the American Glaucoma Society.

PURPOSE: A survey of members of the American Glaucoma Society was compiled to determine the treatment practices of subspecialty-trained glaucoma specialists regarding the treatment of the fellow eye in acute angle-closure glaucoma. METHODS: We surveyed 200 members of the American Glaucoma Society regarding treatment options for the fellow eye of a patient with acute angle-closure glaucoma. The survey was mailed and was preceded by a case of a patient who had acute angle-closure glaucoma and in whom definitive prophylactic laser iridotomy was temporarily deferred; her eye developed acute angle-closure glaucoma despite treatment with pilocarpine. RESULTS: One hundred fifty-five of the 200 mailed surveys were answered and returned. Pilocarpine alone was the most common response category (50.3% of respondents), followed by observe/close follow-up (32.9%). Other response categories were selected by < 5% of the respondents. CONCLUSION: Pilocarpine is well supported by the literature and by subspecialty-trained glaucoma specialists as the treatment of the fellow eye in cases of acute angle-closure glaucoma when laser iridotomy is temporarily deferred. The present case reminds us that the fellow eye is highly susceptible to acute angle closure glaucoma and that prophylactic laser iridotomy should be performed at the earliest possible juncture.

Acute Disease↗