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At least 19 recordsLinked to original sources
PubMed1978

Thymoxamine test. Differentiating angle-closure glaucoma form open-angle glaucoma with narrow angles.

To help differentiate mild angle-closure glaucoma from open-angle glaucoma in patients with elevated intraocular pressure (IOP) and angles so narrow that the structures cannot be seen adequately, we used a thymoxamine hydrochloride eyedrop that induces miosis and tends to widen the angle. Thymoxamine does not contract the ciliary muscle and does not alter the IOP or facility of outflow in open-angle glaucoma, but it can relieve angle-closure glaucoma. A test with thymoxamine was performed in 26 patients because of this differential diagnostic dilemma. When gonioscopic, tonometric, and tonographic findings appeared to indicate a diagnosis of angle-closure glaucoma, a peripheral iridectomy was done. Subsequent (one to 27 months) observations have substantiated that testing with thymoxamine is a helpful aid in this differential diagnosis, and merits more widespread evaluation.

Adult↗
PubMed1977

Cycloscopy of angle-closure glaucoma.

Cycloscopy was performed in eyes with primary angle-closure glaucoma and non-glaucomatous wide-angle. In all eyes of primary angle-closure glaucoma, the ciliary processes were accessible through the small pupil by cycloscopy with minimal or no indentation. In fellow eyes of the previously acute-attack eyes, the ciliary processes were visualized through the small pupil without indentation. On the contrary, in primary angle-closure glaucoma eyes the significant shallow chamber depth was seen in 66%, and the positive prone-position test in 41%. The results obtained seem to suggest that morphological changes of the ciliary processes might be causally related to the manifestation of primary angle-closure glaucoma, and that cycloscopy is a reliable diagnostic method.

Acute Disease↗
PubMed1977

Value of prophylactic peripheral iridectomy on the second eye in angle-closure glaucoma.

In a group of 250 patients with gonioscopically proved angle-closure glaucoma, 72 who did not have prophylactic peripheral iridectomy were reviewed and the adverse effects suffered by these patients were analysed. Comparison was made with 63 patients from the same group who did have peripheral iridectomy. All these patients were drawn from the Glaucoma Clinic, University Department of Ophthalmology, Manchester Royal Eye Hospital.

Adult↗
PubMed1979

Angle-closure glaucoma in nanophthalmos.

Two patients had nanophthalmos with uveal effusion and angle-closure glaucoma. They were treated with a method based on the use of the laser, not only to perform iridotomy but to shrink the iris stroma, which appears to open the anterior chamber angle even without iridotomy. Additionally, we introduced three factors that may be diagnostic of nanophthalmos.

Choroid↗
PubMed2026

Genome-wide discovery reveals 30 loci for choroidal thickness and uncovers potential causal links with angle-closure glaucoma.

The choroid is critical for maintaining vision and implicated in several ocular diseases, being the sole source of nutrients and waste removal for the outer retina. Genetic discovery can help elucidate the pathways through which choroidal features influence disease risk. Our meta-analysis of genome-wide association studies (n= 78,682 participants) identified 30 genomic regions, including 20 novel loci, associated with choroidal thickness. Findings suggest inflammatory and vascular processes drive choroidal thickness, with overlapping mechanisms shared with refractive error. Genome-wide independently significant SNPs accounted for 18.7% of the genetic variance in choroidal thickness. Mendelian randomisation analyses showed a causal effect of age-related macular degeneration on choroidal thickness, and suggest a bidirectional causal effect between choroidal thickness and primary angle-closure glaucoma. These findings provide insight into the shared genetic architecture and biological pathways linking choroidal thickness and related diseases.

Canadian Longitudinal Study on Aging↗
PubMed1976

Primary angle-closure glaucoma. Oculometry, epidemiology, and genetics in a high risk population.

The ocular dimensions in patients suffering from primary angle-closure glaucoma (a.c.g.) have been studied in several clinical series, chiefly in Caucasians. The epidemiology and aetiology of a.c.g. are less well known although genetic factors seem to be involved. Eskimos have recently been shown to constitute a high risk population with respect to a.c.g. Consequently, a series of oculometric, epidemiologic, and genetic studies among Greenland Eskimos was undertaken. Besides the immediate purpose, prevention of blindness in this population, the survey had important general aspects and the following main results were obtained: 1a) Ocular dimensions, as well as clinical symptoms, in Eskimo a.c.g. patients correspond closely to those of a.c.g. reports from other ethnic groups and 1b) ocular dimensions of the anterior segment in the general Eskimo population deviate conspicuously towards the low level characteristic of all samples of a.c.g. patients. 2) A.c.g. prevalence rates were estimated at 1.6% in males and 5.1% in females of the general population aged 40 years or more. The epidemiology of a.c.g. seems to reflect closely the variations of axial anterior chamber depth (ACD) according to race (Eskimo, Caucasian), sex and age. Empirical a.c.g. risk estimates, depending on the ACD value, were obtained in elderly females. 3) A relatively shallow chamber was found in 1st and 2nd degree relatives of a.c.g. patients, in close agreement with an earlier study in Caucasians (Törnquist 1953). However, also in the general Eskimo population a pronounced familial resemblance with respect to ACD and corneal diameter was found. Thus the family studies indicate that the size of the anterior chamber shows a mainly genetic determination, which probably constitutes the genetic basis of a.c.g. as well. With this background a hypothesis is discussed, which interprets the small anterior chambers in Eskimos as a result of genetic adaptation to arctic environment. Corneal protection may have been the significant advantage and the a.c.g. load in elderly persons a relatively less important cost.

Adolescent↗
PubMed2026

Migraine is not a risk factor for glaucoma: Evidence from a bidirectional Mendelian randomization study.

Numerous compelling observational studies have indicated that migraine is a risk factor for the development of glaucoma. Nevertheless, some studies have observed entirely opposite results. The objective of our research is to evaluate the potential relationship between migraine and glaucoma by employing a bidirectional Mendelian Randomization (MR) approach. This method enables us to rigorously assess the causal links between these 2 conditions, thereby addressing the discrepancies in existing literature. Independent genetic variants associated with glaucoma and migraine at the genome-wide significance level were selected as instrumental variables. All summary data were obtained from the genome-wide association study database. The primary method employed in the bidirectional MR analysis was the inverse variance weighted method, while sensitivity analyses utilized the leave-one-out method, MR-Egger method, and MR-Pleiotropy RESidual Sum and Outlier‌ method. When migraine and its subtypes (specifically migraine with aura and migraine without aura) were evaluated as exposure factors, we found no evidence of a causal relationship with glaucoma and its subtypes (namely angle-closure glaucoma and open-angle glaucoma). Subsequently, in the reverse MR analysis, when glaucoma and its subtypes (angle-closure glaucoma and open-angle glaucoma) were assessed as exposure factors, there was no substantial evidence to support a causal relationship with migraine or its subtypes (migraine with aura and migraine without aura). Furthermore, sensitivity analyses also reinforced the robustness of our bidirectional MR findings. Our bidirectional MR analysis mitigates the biases associated with traditional observational studies, highlighting that there is no direct causal relationship between migraine and the risk of glaucoma.

Humans↗
PubMed1977

[Biometry of the malignant glaucoma (author's transl)].

The survey of a population of 7 patients with malignant glaucoma, whose 3 were bilateral, showed that the total length of these eyes was weaker, the corneal radius shorter, the anterior chamber more shallow and the insertion of the lens more anterior than that of eyeballs with angle-closure glaucoma on the whole. These latter, we must remind, are already smaller than normal eyes. But this lessening of size does not affect the corneal diameter which remains always normal. And the lens, which is greater than normally in the angle-closure glaucoma, in the contrary is normal or smaller in the malignant glaucoma. The authors think that this little size of the lens allows it to be dislocated anteriorly through the limbal ring after the operation, and so is the cause of the post-surgical malignant glaucoma.

Biometry↗
PubMed1979

Anterior chamber volume. Its measurement and clinical application.

Measurement of anterior chamber volume is discussed and attention drawn to a new, convenient slit-image method, which was used to study anterior chamber depth and volume before and after prophylactic peripheral iridectomy in the fellow eyes of patients presenting with unilateral acute angle-closure glaucoma. There was no significant change in depth after iridectomy but the mean anterior chamber volume increased significantly (P less than 0.01), by nearly 3 per cent. This increase was due to elimination of peripheral iris bombé which was not present in two control groups of normal eyes, one matched for anterior chamber depth and the other for age and refraction. Peripheral iris bombé may be a quantifiable factor predisposing to the development of acute angle-closure glaucoma.

Adult↗
PubMed2026

Incidence patterns and genetic validation of primary glaucoma subtypes among 1 million adults in China and the UK.

BACKGROUND/AIMS: Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct diseases, yet many glaucoma cases in population-based datasets lack subtype specification. We assessed incidence patterns of glaucoma subtypes in China and the UK and used genetic evidence to infer the likely subtype composition of cases recorded as unspecified glaucoma. METHODS: Incident primary glaucoma was identified from linked inpatient records in the prospective China Kadoorie Biobank (CKB; n=512 504) and UK Biobank (UKB; n=492 329) studies. Cohort-specific phenotyping algorithms defined POAG, PACG and unspecified glaucoma. Adjusted incidence rates were estimated by direct standardisation. To support subtype inference, polygenic risk scores (PRSs) were constructed using ancestry-specific genome-wide association studies, including a new East Asian PACG meta-analysis, and tested for association with glaucoma phenotypes using multivariable logistic regression. RESULTS: Over 12 years of follow-up, 1658 primary glaucoma cases were identified in CKB and 7643 in UKB. Most (>68%) cases lacked subtype specification. Incidence increased with age and was twofold higher among women for PACG in both cohorts and for unspecified glaucoma in CKB. In UKB, POAG incidence was fivefold higher among Black than White participants, with a similar but attenuated pattern for unspecified glaucoma. PRS analyses indicated that unspecified glaucoma closely aligned with PACG in CKB but was more heterogeneous in UKB. CONCLUSION: Healthcare-recorded incidence patterns for POAG and PACG were consistent with established demographic risk factors, whereas unspecified glaucoma showed differences in subtype composition between populations. Integrating epidemiological and genetic evidence improves interpretation of glaucoma phenotypes when detailed clinical information is unavailable.

Epidemiology↗
PubMed1976

Thymoxamine hydrochloride: effects on the facility of outflow and intraocular pressure.

Eleven subjects with normal eyes and sixteen subjects with open-angle glaucoma had a selective alpha-adrenergic blocking agent, thymoxamine hydrochloride 0.5 per cent eyedrop, applied to one of their eyes. This consistently produced miosis, but did not significantly alter the intraocular pressure or the tonographically determined facility of aqueous outflow. Because we find that thymoxamine can selectively induce miosis without significant accompanying effect on the ciliary muscle or facility of outflow, we expect that this drug may prove to be a useful diagnostic adjunct to gonioscopy in distinguishing between angle-closure glaucoma and open-angle glaucoma with narrow angle. It seems worthwhile proceeding with clinical evaluation of this possibility.

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

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↗
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

[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↗