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Effects of combined phacoemulsification and viscogoniosynechialysis versus trabeculectomy in patients with primary angle-closure glaucoma and coexisting cataract.

AIMS: To compare the effectiveness of combined phacoemulsification and viscogoniosynechialysis versus trabeculectomy alone in primary angle-closure glaucoma (PACG) with a coexisting cataract. METHODS: Thirty-nine Chinese patients (39 eyes) were retrospectively analyzed: 19 patients underwent combined phacoemulsification and viscogoniosynechialysis (group 1), and 20 underwent trabeculectomy (group 2). In both groups, the intraocular pressure (IOP), the number of antiglaucoma medications, the best corrected visual acuity (BCVA), the central anterior chamber depth (ACD), the synechial/apposition

Detection of glaucoma progression by population and individual derived variability criteria.

PURPOSE: Ocular imaging devices provide quantitative structural information that might improve glaucoma progression detection. This study examined scanning laser polarimetry (SLP) population-derived versus individual-derived cut-off criteria for detecting progression. METHODS: Forty-eight healthy, glaucoma suspect and glaucoma subjects, providing 76 eyes were used. All subjects had reliable visual field (VF) and SLP scans acquired at the same visits from ≥4 visits. VF progression was defined by guided progression analysis (GPA) and by the VF index. SLP measurements were analysed by fast mode

Benefit from bevacizumab for macular edema in central retinal vein occlusion: twelve-month results of a prospective, randomized study.

PURPOSE: To evaluate the efficacy of intraocular injections with bevacizumab over 12 months in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). DESIGN: A prospective study including a randomized 6-month, sham injection-controlled, double-masked clinical trial followed by a 6-month open-label extension. PARTICIPANTS: Sixty patients with ME secondary to CRVO. METHODS: At baseline, patients were randomized 1:1 to receive intraocular injections of bevacizumab or sham injections every 6 weeks for 6 months. From month 6, all patients received intraocular inject

Postoperative microhyphema as a positive prognostic indicator in canaloplasty.

PURPOSE: To assess risk factors for failure in canaloplasty. METHODS: Nonrandomized prospective study involving 51 eyes of 51 patients with medically uncontrolled primary open-angle glaucoma undergoing canaloplasty. Visual acuity, intraocular pressure (IOP) and slit-lamp examinations were performed before and after surgery at 1 and 7 days, and at 1 month and every 3 months thereafter. Factors like age, gender, preoperative IOP and microhyphema on day 1 were evaluated. RESULTS: The mean follow-up was 20.6 (SD 8.3) months. The mean preoperative IOP was 26.8 (SD 5.2) mmHg; the mean postoperativ

Clinical Practice: A Proposed Standardized Ophthalmological Assessment for Patients with Cystinosis.

Cystinosis is a rare autosomal recessive disease with an incidence of approximately 1 case per 100,000-200,000 live births. Over the years, gaining in-depth knowledge of the disease has led to vast improvement in patient life expectancy. However, debilitating, extra-renal manifestations such as eye disease, in particular corneal crystal deposition and its associated photophobia, still occur frequently, regardless of patient age and notwithstanding the increased implementation of systemic therapy. Ophthalmological assessment has not yet been standardized. The aim of this article was to provide

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… These included visual acuity measurements, slit-lamp photography, IOP measurement, corneal pachymetry, corneal sensation, specular microscopy, gonioscopy, ultrasound biomicroscopy, dilated fundus exams, as well as technical examinations (ERG, ICVM, OCT, perimetry, corneal pachymetry). … In patients with narrow angles or those with obvious iris crystals [ 37 ], the risk of angle-closure glaucoma should be assessed by gonioscopy prior to installing dilating drops. …

Association of Plasma Complement C3 Levels With Primary Angle-Closure Glaucoma in Older Women.

PURPOSE: The plasma complement component (C)3 concentration and clinical characteristics of primary angle-closure glaucoma (PACG) subjects were analyzed to evaluate whether C3 levels were correlated with PACG severity. METHODS: Peripheral blood samples from subjects with PACG (n = 237) and normal controls (n = 158) were collected. The plasma levels of C3 were measured by immunoturbidimetry. The assessments of intraocular pressure; vertical cup/disc ratio (VCDR); central corneal thickness; axial length; anterior chamber depth; visual field-derived mean deviation; and mean sensitivity were perf

Five-year incidence of angle closure among glaucoma health examination participants.

BACKGROUND AND AIM: To investigate incidence of angle closure (AC) and its associated factors through a community-based longitudinal study over a 5-year period. METHODS: Japanese residents aged 40 years or over who underwent two glaucoma health examinations held in 2005 and 2010 were enrolled. Of the participants of the first glaucoma health examination (first examination), those who satisfied exclusion criteria such as having eyes with angle closure, glaucoma, incisional ocular surgery, or other conditions that could influence the results were eliminated from the second glaucoma health exami

Blindness and long-term progression of visual field defects in chinese patients with primary angle-closure glaucoma.

PURPOSE: To investigate the long-term rates of blindness and visual field (VF) progression in treated primary angle-closure glaucoma (PACG) patients. DESIGN: Retrospective observational case series. METHODS: PACG patients with ≥10 years of follow-up were analyzed. All VFs (static automated perimetry, central 24-2 threshold test) performed were reviewed and reliable VFs (fixation losses <20%, false positives and false negatives <33%) were scored using the Advanced Glaucoma Intervention Study (AGIS) system. Progression of a VF defect was defined as a change of ≥4 from baseline on 2 consecutive

Progression in primary angle closure eyes.

PURPOSE: To study the long-term course of primary angle closure (PAC) eyes after iridotomy. METHODS: Seventy-two eyes of 72 patients diagnosed as PAC, having occludable angles with evidence of closure, but no ocular hypertension, were studied. Laser iridotomy was carried out in all eyes at baseline. Standard achromatic perimetry and tonometry were recorded at baseline and serially every 6 months, for at least 4 years. Changes on perimetry and the intraocular pressure (IOP) were analyzed. RESULTS: At 1 year, 10 eyes and at final review, 26 eyes had developed ocular hypertension and required t

Correlation between photopic negative response and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes.

PURPOSE: To investigate whether there is a significant correlation between the photopic negative response (PhNR) of the electroretinogram (ERG) and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes. METHODS: Ninety-nine eyes of 53 patients with open-angle glaucoma (OAG) and 30 eyes of 28 normal volunteers were studied. Photopic ERGs were elicited by red stimuli (644 nm, 1600 cd/m(2)) on a blue background (470 nm, 40 cd/m(2)). The mean deviation (MD) of the visual field was obtained by static visual field analyses. The topography of the optic nerve head was det

Surgical results of secondary glaucomas in childhood.

OBJECTIVE: This study aimed to describe results of glaucoma surgeries performed at one institution over the past 20 years in children with aphakia, aniridia, anterior segment dysgenesis, and other secondary glaucomas. DESIGN: The study design was a retrospective review. PARTICIPANTS: Fifty-eight eyes of 40 patients were studied. INTERVENTION: Trabeculectomy with or without mitomycin C, Molteno implantation, goniotomy, sclerostomy, endolaser cyclophotocoagulation, and cyclocryotherapy were performed. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) control, defined as complete success (IOP

Glaucoma in Mongolia. A population-based survey in Hövsgöl province, northern Mongolia.

OBJECTIVES: To determine the prevalence of glaucoma and suspect glaucoma, and to classify the cases detected according to mechanism. DESIGN: A population-based prevalence study. SETTING: Rural and urban locations in Hövsgöl province, northern Mongolia. PARTICIPANTS: Nine hundred forty-two (94.2%) of 1000 individuals 40 years of age and older were examined. MAIN OUTCOME MEASURE: Primary angle-closure glaucoma was diagnosed in subjects with previous acute or intermittent symptoms of angle closure and in individuals with an occludable angle and an intraocular pressure greater than 19 mm Hg or

Efficacy of selective laser trabeculoplasty in primary angle-closure glaucoma: a randomized clinical trial.

IMPORTANCE: Selective laser trabeculoplasty (SLT) should be explored as a therapeutic option in eyes with angle closure. OBJECTIVE: To assess the intraocular pressure (IOP)-lowering efficacy of SLT in eyes with primary angle closure (PAC) and PAC glaucoma (PACG). DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial at tertiary eye care institutions of 100 patients diagnosed as having PAC or PAC glaucoma in which the angles had opened at least 180° (visible posterior trabecular meshwork on gonioscopy) after laser iridotomy. Recruitment and baseline were completed from June 2009 to Apr…

One-Year Outcomes of Gonio Scratch as a Minimally Invasive Glaucoma Surgery With Cataract Removal.

PRÉCIS: This study evaluated the 1-year efficacy and safety of a novel minimally invasive glaucoma surgery, gonio scratch, in reducing intraocular pressure of eyes with open angle glaucoma and cataracts. PURPOSE: To evaluate the 1-year efficacy and safety of phacoemulsification cataract extraction combined with gonio scratch (GS-Phaco), a novel minimally invasive glaucoma surgery, in patients with open angle glaucoma and cataracts. PATIENTS AND METHODS: This prospective multicenter clinical trial was conducted at Hiroshima University, Yokoyama Retina Clinic, Kusatsu Eye Clinic, and Miyoshi E

Optic Disc Margin Anatomic Features in Myopic Eyes with Glaucoma with Spectral-Domain OCT.

PURPOSE: To investigate optic disc margin anatomic features in myopic eyes with open-angle glaucoma (OAG) using spectral-domain (SD) OCT. DESIGN: Cross-sectional study. PARTICIPANTS: Two hundred four eyes of 102 participants with OAG and 106 eyes of 53 participants without glaucoma with axial length of 24 mm or more. METHODS: Radial SD OCT B-scans centered on the optic discs were acquired in each eye, and the SD OCT data were colocalized with the optic disc stereophotographs. Optic disc margin anatomic features were evaluated as (1) SD OCT structure coinciding with the disc margin identifie

Does the intraocular pressure-lowering effect of prostaglandin analogues continue over the long term?

The purpose of the study is to assess the changes in the long-term effects of prostaglandin analogues (PGAs) on intraocular pressure (IOP) reduction in patients with primary open-angle glaucoma (POAG). Data of POAG patients treated with latanoprost (0.005 %), travoprost (0.004 %), or bimatoprost (0.03 %) as the first line treatment for 5 years or more were retrospectively evaluated. Baseline ophthalmic assessment values were recorded together with the IOP at the 6th month, 1st year, and then annually. The 79 patients included 33 (41.8 %) men and 46 (58.2 %) women. There were 34 (43.0 %) patien

Diagnostic Accuracy of the Spectralis and Cirrus Reference Databases in Differentiating between Healthy and Early Glaucoma Eyes.

PURPOSE: To evaluate and compare the diagnostic accuracy of global and sector analyses for detection of early visual field (VF) damage using the retinal nerve fiber layer (RNFL) reference databases of the Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Cirrus (Carl Zeiss Meditec, Dublin, CA) spectral-domain optical coherence tomography (SD OCT) devices. METHODS: Healthy subjects and glaucoma suspects from the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES) with at least 2 years of follow-up were included. Global and secto

Open-angle glaucoma in Filipino and white Americans: a comparative study.

BACKGROUND: To compare the frequency of open-angle glaucoma (OAG) subtypes between Filipino and white Americans in a general ophthalmology clinic population. PATIENTS AND METHODS: In this retrospective cross-sectional epidemiologic study with prospective sampling, medical charts of 1113 patients aged 40 years or older (513 Filipinos, 600 whites) seen in 2008 were randomly sampled from 2 private comprehensive ophthalmology clinics. Glaucoma was diagnosed based on optic nerve appearance, visual field defects, and other ocular findings using the International Society of Geographical and Epidemio

Effects of the timolol-dorzolamide fixed combination and latanoprost on circadian diastolic ocular perfusion pressure in glaucoma.

PURPOSE: To evaluate the effect of the timolol-dorzolamide fixed combination (TDFC) and latanoprost 0.005% on 24-hour intraocular pressure (IOP), systolic (SBP) and diastolic (DBP) blood pressure, and diastolic ocular perfusion pressure (DOPP) in patients with primary open-angle glaucoma (POAG). METHODS: This was an institutional, randomized clinical trial. After a 24-hour assessment without treatment, 27 previously untreated patients with POAG were randomized to 6 weeks' treatment with twice-daily TDFC (8 AM and 8 PM) followed by once-daily latanoprost 0.005% (8 PM), or vice versa. One eye w

Axenfeld-Rieger syndrome: a theory of mechanism and distinctions from the iridocorneal endothelial syndrome.

Twenty-four patients with the diagnosis of Axenfeld's anomaly or Rieger's anomaly or syndrome were the subjects of a clinical study, which included specular microscopy of the corneal endothelium in 16 cases and fluorescein angiography of the iris in 5. Histopathologic material was obtained from ten eyes of eight of these patients (one enucleated eye and nine trabeculectomy specimens) and was studied by light and electron microscopy. The overlapping of ocular and nonocular defects in these patients prevented subclassification according to traditional criteria. Any attempted subdivision appears