scholarly journals Anterior segment imaging-based subdivision of subjects with primary angle-closure glaucoma

Eye ◽  
2016 ◽  
Vol 31 (4) ◽  
pp. 572-577 ◽  
Author(s):  
M E Nongpiur ◽  
E Atalay ◽  
T Gong ◽  
M Loh ◽  
H K Lee ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Anterior Segment Imaging

scholarly journals Case Report: The efficacy of early phacoemulsification in the intraocular pressure control in primary angle closure glaucoma associated with cataract in a young female

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 372
Author(s):  
Carmen-Ecaterina Leferman ◽  
Madalina Cazacut ◽  
Alin Dumitru Ciubotaru
Keyword(s):  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
The Elderly ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Caucasian Woman ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Initial Symptoms

Glaucoma is a leading cause of irreversible blindness worldwide. Among different types of glaucoma, irreversible bilateral visual impairment is more common in primary angle closure glaucoma (PACG) patients. PACG and cataract often coexist and are both more prevalent among the elderly population, being rare in children and young adults. Here, we discuss the case of a 39-year-old Caucasian woman with unilateral PACG associated with cataract. The patient presented with a several-day history of left sided headache, decreased and blurred vision as well as pain and redness of the left eye (LE). She reported similar episodes in the previous year. Visual acuity (VA) of the LE was limited to counting fingers and intra-ocular pressure (IOP) of the LE was 42 mmHg. Anterior segment examination of the LE revealed: edematous cornea, a peripheral anterior chamber depth corresponding to Van Herick’s grade 0, mid-dilated pupil and lens opacities with visible glaukomflecken. Gonioscopic evaluation revealed iridotrabecular contact for 360º, no visible angle structures and a flat–mild convex iris contour. Spectral domain optical coherence tomography suggested only a thinning of neuro-retinal rim at the lower pole. Following treatment of the initial symptoms, phacoemulsification with intra-ocular lens implant was performed. IOP improved and no IOP-lowering medication was required. The patient was monitored for VA, IOP, field of vision changes, and optic disc evaluation every six months for 2 years and no glaucomatous change occurred. The patient also denied ocular symptoms during this period. This case supports the effectiveness of early phacoemulsification in the IOP control in patients with PACG.

scholarly journals Combined Phacoemulsification and Goniosynechialysis under an Endoscope for Chronic Primary Angle-Closure Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Li Nie ◽  
Weihua Pan ◽  
Aiwu Fang ◽  
Zhangliang Li ◽  
Zhenbin Qian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
The Mean

Purpose. To investigate the clinical efficacy and safety of combined phacoemulsification with goniosynechialysis (GSL) under an ophthalmic endoscope for chronic primary angle-closure glaucoma and coexisting cataract. Methods. This is a retrospective study. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), and number of glaucoma medications at baseline and each postoperative follow-up visit were recorded. Other measurements included supraciliochoroidal fluid measured by anterior segment optical coherence tomography, corneal endothelial cell density (ECD), and peripheral anterior synechia (PAS). All patients were followed for more than a year. Results. Thirty-eight eyes of 31 patients were included. The mean follow-up duration was 16.3 ± 3.9 months. The IOP decreased from 22.2 ± 9.3 mmHg at baseline to 15.4 ± 4.2 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications (0.1 ± 0.6) at the last follow-up was significantly lower than the preoperative number (2.3 ± 1.1) (P<0.001). All patients achieved improved or stable visual acuity after surgery. All patients achieved a complete opened angle after GSL. The postoperative complications included hyphema (7.9%), exudation (5.3%), transiently elevated IOP (55.3%), and supraciliochoroidal fluid (40%). Conclusions. Combined phacoemulsification and GSL under an endoscope can completely reopen PAS and is an effective and safe method for patients with chronic primary angle-closure glaucoma and coexisting cataract.

scholarly journals Case Report: The efficacy of early phacoemulsification in the intraocular pressure control in primary angle closure glaucoma associated with cataract in a young female

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 372
Author(s):  
Carmen-Ecaterina Leferman ◽  
Madalina Cazacut ◽  
Alin Dumitru Ciubotaru
Keyword(s):  
Optic Disc ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Caucasian Woman ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Initial Symptoms

Glaucoma is a leading cause of irreversible blindness in the world, second only to cataract. Among different types of glaucoma, irreversible bilateral visual impairment is more common in primary angle closure glaucoma (PACG) patients. PACG and cataract often coexist and are both more prevalent among the elderly population, being rare in children and young adults. Here, we discuss the case of a 39-year-old Caucasian woman with unilateral PACG associated with cataract. The patient presented with a several-day history of left sided headache, decreased and blurred vision as well as pain and redness of the left eye (LE). She reported similar episodes in the previous year. Visual acuity (VA) of the LE was limited to counting fingers and intra-ocular pressure (IOP) of the LE was 42 mmHg. Anterior segment examination of the LE revealed: edematous cornea, a peripheral anterior chamber depth corresponding to Van Herick’s grade 0, mid-dilated pupil and lens opacities with visible glaukomflecken. Gonioscopic evaluation revealed iridotrabecular contact for 360º, no visible angle structures and a flat–mild convex iris contour. The digital image of the optic disc suggested only a thinning of neuro-retinal rim at the lower pole. Following treatment of the initial symptoms, phacoemulsification with intra-ocular lens implant was performed. IOP improved and no IOP-lowering medication was required. The patient was monitored for VA, IOP, field of vision changes, and optic disc evaluation every six months for 2 years and no glaucomatous change occurred. The patient also denied ocular symptoms during this period. This case supports the effectiveness of early phacoemulsification in the IOP control in patients with PACG.

scholarly journals Ultrasound Biomicroscopy Might Predict the Outcome of Phacoemulsification-Visco Dissection in Medically Controlled Primary Angle-Closure Glaucoma Eye With Extensive Peripheral Anterior Synechia

2021 ◽  
Vol 8 ◽  
Author(s):  
Haijun Gong ◽  
Xu Dong ◽  
Bingru Zheng ◽  
Xinbo Gao ◽  
Liming Chen ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
One Year

Objective: The treatment procedures of primary angle-closure glaucoma (PACG) with extensive peripheral anterior synechia (PAS) is a subject of debate. This study is to investigate the clinical features of phacoemulsification (Phaco)-visco dissection in medically controlled PACG patients with PAS &gt; 180° and evaluate the predictability of Ultrasound Biomicroscopy (UBM) parameters on postoperative intraocular pressure (IOP).Methods: 48 eyes (48 patients) with acute angle-closure glaucoma (AACG) and 30 eyes (30 patients) with chronic angle-closure glaucoma (CACG) were prospectively included. All patients underwent phaco-viscogoniolysis and foldable lens implantation and were followed for 1 year after surgery. We analyzed preoperative and postoperative IOP, the numbers of anti-glaucoma medicine, the visual field value, the extent of PAS, and UBM parameters alterations, and evaluated the correlation between preoperative UBM parameters and one-year postoperative IOP.Results: IOP reduced significantly from 16.24 ± 4.33 to 14.49 ± 3.69 mmHg in AACG group and from 16.16 ± 3.69 mmHg to 14.31 ± 4.12 mmHg in CACG group, and PAS decreased significantly from 270 ± 60.33 to 171 ± 56.44° in AACG group and from 285 ± 70.46 to 168 ± 61.32° in CACG group, and the number of anti-glaucoma drugs decreased significantly in both groups. Several UBM parameters, including anterior chamber depth, trabecular iris angle, and peripheral iris thickness 500 increased while iris convex reduced considerably in the two groups, and angle opening distance 500 and trabecular-meshwork ciliary process angle increased significantly only in AACG group. One-year postoperative IOP correlated with preoperative angle opening distance 500 and trabecular iris angle negatively and iris convex positively.Conclusion: Phaco-visco dissection can effectively reduce IOP, the numbers of glaucomatous medications, and PAS in medically controlled PACG patients with extensive PAS. UBM parameters might be valuable for analyzing postoperative anterior segment structure and predicting postoperative IOP of Phaco-visco dissection in PACG patients with extensive PAS.

Biallelic variants in CPAMD8 are associated with primary open-angle glaucoma and primary angle-closure glaucoma

2021 ◽  
pp. bjophthalmol-2020-318668
Author(s):  
Xueqing Li ◽  
Wenmin Sun ◽  
Xueshan Xiao ◽  
Lei Fang ◽  
Shiqiang Li ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Congenital Glaucoma ◽  
Angle Closure ◽  
Open Angle ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Background/AimsThis study aims to assess the contribution of biallelic CPAMD8 variants in patients with different forms of glaucoma, especially primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), based on a systematic analysis of exome sequencing (ES).MethodsPotentially pathogenic CPAMD8 variants were selected from the ES data of 5307 subjects with various eye conditions through multiple bioinformatics analyses. Of the 5307 subjects, 1221 probands had different forms of primary glaucoma. The genotype–phenotype correlation was assessed by a systematic review of biallelic CPAMD8 variants that including our data and data from the literature. The expression profile of CPAMD8 in human tissues was determined at the mRNA and protein levels.ResultsBiallelic CPAMD8 variants, including one frameshift and six missense variants, were exclusively present and significantly enriched in patients with glaucoma (one with juvenile open-angle glaucoma (JOAG), two with POAG and two with PACG) compared with none of the 4086 probands with other eye conditions in this cohort (p=4.1E-07). The effect of variants in these patients is relatively mild compared with that reported in patients with anterior segment dysgenesis or primary congenital glaucoma. CPAMD8 mRNA was highly expressed in the optic nerve, ciliary body, retina and iris, whereas the CPAMD8 protein was mainly detected in the nonpigmented epithelium of the iris and ciliary process, determined by immunohistochemistry.ConclusionsThe data from this study not only provide further evidence to support the association of biallelic CPAMD8 variants with JOAG but also suggest that biallelic CPAMD8 variants might be associated with POAG and PACG.

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