Choroidal vascularity index in pseudoexfoliative glaucoma

Introduction: Primary open-angle glaucoma (POAG) is one of the most prevalent causes of irreversible blindness and is associated with endothelial dysfunction and arterial stiffness. Pseudoexfoliative glaucoma (PEG) is another type of glaucoma observed in pseudoexfoliation syndrome. It is characterized by the deposition of pseudoexfoliative material not only to the anterior segment of the eye, but also to the vessels, heart and other organs. Hypothesis: Endothelial function and arterial stiffness are impaired in patients with POAG and PEG supporting the significant role of vascular function impairment in the progression of the disease. Methods: Forty four POAG patients, 22 PEG and 38 healthy subjects (Cl) were included in this study. All subjects were free of cardiovascular or inflammatory diseases. Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections Results: Between the three study groups CL, POAG, PEG there was no difference in age (67±10years vs. 70±9years vs. 66±12yeras, p=0.12) or prevalence of male sex (70% vs. 57% vs. 50%, p=0.21). Importantly, there was a linear impairment of FMD (7.35±2.77% vs. 6.58±3.18% vs. 4.88±3.29%, p=0.006), PWV (7.98±1.56m/sec vs. 9.20±1.84m/sec vs. 9.22±2.16m/sec, p=0.004) and AIx (21.29±8.77% vs. 25.14±5.71% vs. 28.20±8.75%, p=0.002) from CL to POAG and PEG. Interestingly post hoc test after Scheffe correction revealed also that PEG subjects had not only significantly impaired FMD, compared to control subjects, but also compared to POAG subjects (4.88±3.29% vs. 6.58±3.18%, p=0.02). Conclusions: Endothelial function and arterial stiffness are significantly impaired in patients with pseudoexfoliative glaucoma. These findings shed some light in the pathophysiology of pseudoexfoliative glaucoma and support the theory that pseudoexfoliative fibrils may also accumulate and damage the arterial wall.

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Intraocular pressure control after trabeculectomy in the patients with primary open angle glaucoma and pseudoexfoliative glaucoma followed up for 3 to 5 years

Vojnosanitetski pregled ◽

10.2298/vsp161228178m ◽

2019 ◽

Vol 76 (8) ◽

pp. 822-829

Author(s):

Vesna Maric ◽

Vujica Markovic ◽

Marija Bozic ◽

Ivan Marjanovic ◽

Paraskeva Hentova-Sencanic ◽

...

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Survival Curve ◽

Pressure Control ◽

Safe Procedure ◽

Open Angle ◽

Success Rates ◽

Pseudoexfoliative Glaucoma ◽

Significant Difference

Background/Aim. Trabeculectomy is a safe procedure which effectively reduces the intraocular pressure (IOP). IOP is the most frequent indicator of success after glaucoma surgery. The aim of this work was to evaluate the long-term pressure control in primary open-angle glaucoma (POAG) and in pseudoexfoliative glaucoma (XFG) after primary trabeculectomy without the use of mitomycin-C (MMC), 3 to 5 years after trabeculectomy. Methods. This study involved a retrospective evaluation of 332 consecutive patients (352 eyes), 174 patients (188 eyes) with POAG (mean age of 64.0 ? 8.6 years) and 158 patients (164 eyes) with XFG (mean age of 70.7 ? 8.9 years) who underwent primary trabeculectomy between January 2007 and December 2009 at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade. A successful control of IOP was defined as achieving IOP ? 21 mmHg without medication (complete success), or with a single topical medication (qualified success). Results. According to the type of glaucoma POAG/XFG preoperative IOP was 28.4 ? 6.3/30.4 ? 8.4 mmHg, respectively (p = 0.311) and last postoperative IOP was 16.9 ? 5.2/18.7 ? 5.9 mmHg, respectively (p = 0.681). According to the Kaplan-Meier survival curve, the complete success in the group with POAG in 1, 3 and 5 years were 85%, 75% and 58% and in the group with XFG were 82%, 70% and 56%, respectively. There was no statistically significant difference in the complete success rates between the patients with POAG and XFG. Conclusion. The primary goal of surgery was to achieve a sufficiently low IOP without additional medication, thus preventing progression of glaucomatous damage. In our study, the complete success in the group with POAG was achieved in 75% and 58% of the patients in the period of 3 and 5 years after surgery, respectively and in the group with XFG complete success was achieved in 70% and 56% of the patients respectively.

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Evaluation of Anterior Segment Parameters in Pseudoexfoliative Glaucoma, Primary Angle-Closure Glaucoma, and Healthy Eyes

Turkish Journal of Ophthalmology ◽

10.4274/tjo.03271 ◽

2018 ◽

Vol 48 (5) ◽

pp. 227-231

Author(s):

Nilgün Özkan Aksoy ◽

Burçin Çakır ◽

Emine Doğan ◽

Gürsoy Alagöz

Keyword(s):

Anterior Segment ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Pseudoexfoliative Glaucoma ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Anterior Segment Parameters ◽

Healthy Eyes

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Morphological features of the corneal endothelium in patients with pseudoexfoliative glaucoma

Ophthalmology journal ◽

10.17816/ov11431-44 ◽

2018 ◽

Vol 11 (4) ◽

pp. 31-44 ◽

Cited By ~ 2

Author(s):

Inessa S. Beletskaya ◽

Sergey Yu. Astakhov ◽

Natalya V. Tkachenko

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Corneal Endothelium ◽

Morphological Changes ◽

Open Angle Glaucoma ◽

Morphological Features ◽

Endothelial Cell Density ◽

Control Group ◽

Eye Drops ◽

Pseudoexfoliative Glaucoma

Purpose. To study the main morphological features of the corneal endothelium in patients with pseudoexfoliative glaucoma (PEG). Methods. We included 193 subjects aged from 55 to 75 years. The main study group (PEG) included 96 patients (192 eyes), the primary open angle glaucoma (POAG) group included 36 patients (72 eyes) with POAG, the PEX group included 31 patients (62 eyes) with pseudoexfoliation syndrome without glaucoma. The control group consisted of 30 healthy subjects (60 eyes). Main corneal endothelium parameters were evaluated using a non-contact endothelial microscope EM-935 (Haag Streit, Switzerland). Data were analyzed by STATISTICA 9 software for Windows. Results. The patients with PEG had lower endothelial cell density (ECD) in comparison to the control group (p < 0.01), and PEX group (p < 0.05). The polymegatism level in patients with PEG and POAG was higher than in the control group (p < 0.001, and p < 0.01, correspondingly). In patients with moderate and advanced PEG, the ECD was significantly lower (p < 0.01), and the polymegatism level was significantly higher (p < 0.01) than the same parameters in patients with early PEG. The lowest ECD and the highest polymegatism percentage were observed in PEG patients with more pronounced PEX manifestations, p < 0.05. No effect of IOP-lowering eye drops on the corneal endothelium parameters was revealed, p < 0.05. Conclusions. Significant morphological changes of the corneal endothelium (decreased endothelial cell density, increased polymegatism percentage) were revealed in patients with PEG. It was established that the severity of these changes is associated with the PEG and PEX severity. No effect of IOP-lowering eye drops on the corneal endothelium parameters was detected.

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Analysis of Peripapillary and Macular Choroidal Thickness in Eyes with Pseudoexfoliative Glaucoma and Fellow Eyes

Journal of Ophthalmology ◽

10.1155/2020/9634543 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Fan Li ◽

Qingli Shang ◽

Guangxian Tang ◽

Hengli Zhang ◽

Xiaowei Yan ◽

...

Keyword(s):

Choroidal Thickness ◽

Enhanced Depth Imaging ◽

Average Volume ◽

Depth Imaging ◽

Pseudoexfoliative Glaucoma ◽

Group A ◽

Imaging Optical Coherence Tomography ◽

Group B ◽

Control Study ◽

Fellow Eyes

Purpose. To compare differences in peripapillary and macular choroidal thickness in pseudoexfoliative glaucoma (PXG) eyes, nonexfoliative fellow eyes, and normal eyes. Methods. This case-control study included 37 PXG patients (group A: 37 PXG eyes; group B: 37 nonexfoliative fellow eyes) and 37 sex-, age-, and axial length-matched healthy volunteer eyes (group C). Peripapillary and macular choroidal thickness and volume were measured in all subjects via enhanced-depth imaging-optical coherence tomography. Results. The average peripapillary (AP) choroidal thickness was (130.10 ± 46.14) μm, (131.43 ± 46.00) μm, and (147.89 ± 53.32) μm; average macular (AM) choroidal thickness was (191.72 ± 68.07) μm, (204.62 ± 69.54) μm, and (215.10 ± 45.40) μm; and average volume was (0.59 ± 0.21) μm3, (0.63 ± 0.21) μm3, and (0.65 ± 0.14) μm3 in groups A, B, and C, respectively. NIP choroidal thickness was significantly lower in groups A and B than in group C (P<0.05). TIM and TOM choroidal thickness and volume were significantly lower in group A than in group C (P<0.05). NIM, SIM, NOM, IOM, AM choroidal thickness and volume, and CSM choroidal thickness were significantly lower in group A than in group B (P<0.05). CSM, TIM, and TOM in group A and TIM, TOM choroidal thickness, and volume in group B were significantly lower than in group C (P<0.05). Conclusions. NIP choroidal thickness in PXG eyes and nonexfoliative fellow eyes and temporal macular choroidal thickness in PXG eyes were significantly lower than in normal eyes. Macular choroidal thickness (except in temporal regions) was significantly lower in PXG eyes than in nonexfoliative fellow eyes. Changes in peripapillary and macula choroidal thickness further elucidate the choroid’s role in PXG development and progression.

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