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PubMed1979

[Clinical experiences with timolol eye drops].

Three groups of chronic simple glaucoma (group I: newly adjusted patients; group II: previously satisfactorily pressure-regulated patients; group III: previously notsatisfactorily pressure-regulated patients) received treatment with Timolol eye drops for 4 months. In 34 eyes the intra-ocular pressure could be lowered below 22 mm Hg by Timolol alone, whereas 10 eyes additionally had to be treated with 1% epinephrine. The higher the initial pressure effect, the more pronounced the pressure-lowering properties of Timolol became. Especially in the first 2 weeks, less in the following 14 weeks, Timolol showed a loss in effectiveness. The application of Timolol instead of carbonic anhydrase inhibitors with acute angle-closure glaucoma and secondary glaucoma was successful. Timolol eye drops were tolerated very well. There were no local or systemic side effects.

Adult↗
PubMed2023

The Use of ChatGPT to Assist in Diagnosing Glaucoma Based on Clinical Case Reports.

INTRODUCTION: The purpose of this study was to evaluate the capabilities of large language models such as Chat Generative Pretrained Transformer (ChatGPT) to diagnose glaucoma based on specific clinical case descriptions with comparison to the performance of senior ophthalmology resident trainees. METHODS: We selected 11 cases with primary and secondary glaucoma from a publicly accessible online database of case reports. A total of four cases had primary glaucoma including open-angle, juvenile, normal-tension, and angle-closure glaucoma, while seven cases had secondary glaucoma including pseudo-exfoliation, pigment dispersion glaucoma, glaucomatocyclitic crisis, aphakic, neovascular, aqueous misdirection, and inflammatory glaucoma. We input the text of each case detail into ChatGPT and asked for provisional and differential diagnoses. We then presented the details of 11 cases to three senior ophthalmology residents and recorded their provisional and differential diagnoses. We finally evaluated the responses based on the correct diagnoses and evaluated agreements. RESULTS: The provisional diagnosis based on ChatGPT was correct in eight out of 11 (72.7%) cases and three ophthalmology residents were correct in six (54.5%), eight (72.7%), and eight (72.7%) cases, respectively. The agreement between ChatGPT and the first, second, and third ophthalmology residents were 9, 7, and 7, respectively. CONCLUSIONS: The accuracy of ChatGPT in diagnosing patients with primary and secondary glaucoma, using specific case examples, was similar or better than senior ophthalmology residents. With further development, ChatGPT may have the potential to be used in clinical care settings, such as primary care offices, for triaging and in eye care clinical practices to provide objective and quick diagnoses of patients with glaucoma.

Artificial intelligence (AI)↗
PubMed1979

Mydriatic effect of anticholinergic drugs used during reversal of nondepolarizing muscle relaxants.

Large doses of anticholinergic drugs (atropine, glycopyrrolate) produced mydriasis in a group of adults with no eye abnormalities except strabismus, though the usual intramuscular and intravenous doses of these drugs do not have this tendency. Such large doses are often given intravenously during general anesthesia to prevent the side effects of neostigmine methylsulfate, which is used to reverse the effect of nondepolarizing muscle relaxants. Neostigmine methylsulfate (Prostigmin) reduced the mydriatic effect when given intravenously in conjunction with atropine or glycopyrrolate. Mydriasis was more likely to occur in lightly pigmented eyes than in eyes with dark irides. Pilocarpine eyedrops instilled at the beginning of anesthesia caused miosis that persisted after the large intravenous doses of atropine or glycopyrrolate were given. To prevent an attack of acute angle-closure glaucoma in any patient who is to receive large doses of anticholinergic drugs during general anesthesia, miotic drug therapy should be continued before, during, and after anesthesia at the same frequency as when awake.

Adolescent↗
PubMed1979

Clinical experiences with the use of an automated perimeter (Octopus) in the diagnosis and management of patients with glaucoma and neurologic diseases.

This is a study of 59 patients, 42 with glaucoma and 17 with neurological disease, to compare the Octopus automated perimeter with the conventional Goldmann and Tubinger perimeters for detection and assessment of visual field defects. We believe the Octopus automated perimeter is an excellent method for screening patients suspected of glaucoma and can be expected to identify over 90% of the patients actually having visual field loss due to glaucoma. In patients with neurological disease, the Goldmann perimeter was superior to either the Octopus or Tubinger perimeters in providing clinically useful information.

Adolescent↗
PubMed1979

Anterior segment abnormalities in cicatricial retinopathy of prematurity.

Abnormalities that occur in the anterior segments of patients with retinopathy of prematurity have been studied in 72 eyes of 36 patients. The anterior chamber depth, the placido disc image on the cornea, the distortion of polarized light by corneal stress, and keratometry readings were recorded. There was a highly significant correlation between anterior chamber depth, retinopathy of prematurity, and keratometry readings (p less than .001). These findings emphasize the importance of careful follow-up examinations of the anterior segment in retinopathy of prematurity because cataracts, band keratopathy, acute hydrops, and angle-closure glaucoma can progressively occur as complications.

Adolescent↗
PubMed1977

Variation and heritability of ocular dimensions. A population study among adult Greenland Eskimos.

Adult Greenland Eskimos from Umanaq town (age 15+) and villages (age 40+) were examined. Optical pachymetry, ultrasonic oculometry, corneal diameter and curvature measurements, and subjective refraction were performed in 5-600 persons. Frequent occurrence of primary angle-closure glaucoma motivated the survey. Age-, sex- and family-variations were studied by linear regression analyses. Conspicuous age effect was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to corneoscleral size, i. e. axial length, corneal size and corneal radius of curvature. Conspicuous heritability (h2=0.6-0.8) was found in corneoscleral size parameters as well as lens position, while refractive error showed a much smaller genetic influence.

Adolescent↗
PubMed1977

Ultrasonographic study of the effect of different miotics on the eye components.

The effect of topical instillations of carbachol 3%, pilocarpine 2%, aceclidine 2%, aceclidine 2%-adrenaline 1%, and of the Ocusert delivery system was determined and compared in 151 eyes. The depth of the anterior chamber, the thickness and the position of the lens, the length of the vitreous and the refraction were studied. Aceclidine has negligible side effects on the ocular components (maximal change of the anterior chamber 0.20 mm; maximal change of the lens thickness 0.14 mm; maximal myopisation: -1.5 delta. Carbachol has the strongest side effects (maximal change of the anterior chamber 0.80 mm; maximal change of the lens thickness 0.80 mm; maximal myopisation -11.50 delta). Carbachol and pilocarpine may cause an important forward displacement of the lens with the risk of an angle-closure glaucoma in an eye with shallow anterior chamber.

Administration, Topical↗
PubMed1978

[Irisangiography of rubeosis iridis].

In 66 patients with a rubeosis iridis due to diabetes mellitus (25), old central retinal vein occlusion (22), long-standing secondary angle-closure glaucoma (6), total old retinal detachment (3) and chronic uveitis (10), iris angiography was performed. Typical angiographical findings were found in some of the cases. One can differentiate the different modes of formation of the new vessels; angiographically, rubeosis iridis is never a congestion of preexisting vessels but rather an active vascular proliferation which is always permeable to fluorescein.

Aged↗
PubMed1978

[Contusion and permeability of the hemato-aqueous barrier to fluorescein. Effect of a pretreatment by local indometacine (author's transl].

An experimental study, by angiography of the anterior segment of rabbit's eye, estimates the permeability of the hemato-aqueous barrier, using fluorescein. A trauma of the eye (contusion) leads to a rapid and significant increase in this permeability. However, local pretreatment, using an ophthalmic solution of 0,33% indometacine, almost completely stabilizes the hemato-aqueous barrier, even for elements as diffusible as fluorescein. These results suggest that application of a similar preparation to the human eye could be useful in the treatment of ocular contusions, chemical burns and angle-closure glaucoma. But the best perspective could be the application of the indometacine solution to the eye, before an operation, to reduce the sideeffects of surgery relative to the surgical break of the hemato-aqueous barrier.

Animals↗
PubMed1979

Blindness due to illicit use of topical cocaine.

A drug abuser developed simultaneous bilateral corneal ulcerations after the use of topical cocaine. One eye was enucleated because of secondary angle-closure glaucoma and the other developed a dense central corneal scar.

Administration, Topical↗
PubMed1978

[Trabeculectomy-iridencleisis combined with cataract extraction].

On 31 eyes (23 patients, average age 74 years) with cataract and primary open-angle or chronic angle-closure glaucoma modified trabeculectomy with lobelike iridencleisis was performed combined with cataract-extraction. They were followed up for periods between 6 months and 3 years. In 84% of cases the i.o. pressure continued to be normalized without further antiglaucomatous therapy, in 16% additional treatment with drugs achieved sufficient lowering of i.o. pressure. In nearly all of the cases I observed a diffuse, very flat filtering bleb. Gonioscopy shows, that filtering channels stay open along the margin of the imbedded iris flap. Complications were rare and demanded no further surgery.

Aged↗
PubMedDate not supplied

Visual field changes following acute elevation of intraocular pressure.

Visual field, acuity, and optic nerve head were evaluated in 24 patients with transient but marked elevations in intraocular pressure. The patient population consisted of 16 patients with angle-closure glaucoma and 7 with high tensions following cataract surgery. In all cases, duration and extent of pressure elevation is documented as well as subsequent visual field, acuity, and fundus examinations. In selected cases, visual field determinations were made during the acute pressure elevation. Previous reports of patients with acute pressure elevation are reviewed. The general absence of glaucomatous field defects in this patient population is discussed with respect to the possible pathogenesis of field loss seen in chronic simple glaucoma.

Acute Disease↗
PubMed1976

Immediate fundus complications after retinal scatter photocoagulation. I. Clinical picture and pathogenesis.

Fifty diabetics with severe background retinopathy or early proliferative retinopathy underwent retinal scatter photocoagulation with either the argon laser or the xenon arc photocoagulators. Choroidal detachment, exudative retinal detachment, shallowing of the anterior chamber, and secondary angle-closure glaucoma were observed. Exudative retinal detachment and choroidal detachment subsided in two days to 2-1/2 weeks. Glaucoma secondary to choroidal detachment with angle closure was observed in 11 eyes, three of which required medical treatment, although surgical therapy was not needed. This secondary glaucoma was detected in the first two days and subsided in subsequent days, with intraocular pressure reaching pretreatment values at the fifth day. No long-term sequelae were observed in these complications, except in one eye that developed macular edema that lasted for four months with decreased visual acuity; nevertheless, vision returned to the pretreatment level one year after photocoagulation.

Adult↗
PubMed1978

Argon laser iridotomy in the treatment of patients with primary angle-closure or pupillary block glaucoma: a clinicopathologic study.

A "pulsed" argon laser was successful in 48 of 64 (75%) attempted laser iridotomies. Scanning and transmission electron microscopy performed on specimens taken at varying intervals following laser treatment revealed progressive scarring of iris tissue. The complications appear minimal at this time, but longer follow-up is required before it can be stated that laser and surgical peripheral iridectomies are comparable. However, the laser's simplicity and ease of administration appear to warrant its continued use at this time.

Argon↗
PubMed1979

Combined thermotrabeculocanalotomy cataract extraction.

The results of combined thermotrabeculocanalotomy-cataract extraction are reported on 9 cases, 7 of which are glaucoma cases controlled by medical therapy, one secondary glaucoma following chronic angle-closure, and one secondary glaucoma following trauma. The results were satisfactory both in terms of visual acuity and lessening reliance on medical therapy of the glaucoma following surgery. More importantly, the safety of the procedure is emphasized, which further indicates that the combined procedure should be considered as the procedure of choice when a cataract must be extracted in a patient with glaucoma.

Acetazolamide↗
PubMed1977

Trabeculectomy: long-term follow-up.

The postoperative course of 309 eyes subjected to trabeculectomy has been studied over a 7-year period. The results have been compiled with regard to effectiveness to maintain a normal range of intraocular pressure with and without postoperative medication. The figures have been assessed in toto and for 3 groups of glaucoma, namely, open angle, chronic angle-closure, and acute angle-closure. Results support those of other reports to show that trabeculectomy gives satisfactory control over the years in a reasonably high proportion of eyes and with relatively few postoperative complications. There is also a small group of combined trabeculectomy with cataract extraction.

Cataract Extraction↗
PubMed1976

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↗