scholarly journals Correlation of Structural and Functional Changes in Ocular Hypertension and Early Glaucoma

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W O Noureldin ◽  
H M Ebiary ◽  
R G Zaki
Keyword(s):  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Automated Perimetry ◽  
Fiber Layer ◽  
Temporal Area ◽  
Early Glaucoma ◽  
Functional Changes ◽  
Rnfl Thickness ◽  
Group I

Abstract Purpose To estimate the link between the thickness of retinal nerve fiber layer (RNFL); utilizing optical coherence tomography (OCT) and corresponding retinal sensitivity changes; utilizing visual field (VF) perimetry, in cases of ocular hypertension and early glaucoma. Methods Thirty patients (60 eyes) were gathered for this prospective, cross-sectional study. They were categorized into two groups. Group I comprised 30 eyes (15 patients) having ocular hypertension. Group II comprised 30 eyes (15 patients) early recognized as primary open angle glaucoma. Each patient underwent a thorough ophthalmologic examination, OCT for RNFL thickness estimation using quick RNFL thickness protocol and VF testing using automated perimetry (G2 program, central 30–2 threshold protocol). Pearson’s correlation was premediated between thickness of RNFL and VF indices. Results Significant connections between the thickness of temporal area of RNFL and mean sensitivity (MS), mean defect (MD) and loss of variance (LV) indices of VF (r = 0.533, -0.431, -0.388; P < 0.01, respectively) were noticed in patients having ocular hypertension. Additionally, a significant link between the thickness of the temporal area of RNFL and MS index of VF (0.441; P < 0.05) was noticed in patients with early POAG. Otherwise, there were no significant links between indices of VF and other areas of RNFL thickness in both groups. Conclusion Average RNFL thickness is certifiably not a dependable index for early determination of glaucoma or for the follow-up of ocular hypertension and POAG. Segmental RNFL thickness (especially temporal) appears to be a more dependable index. Profound structural modification with OCT test comprises an imperative sign of early utilitarian changes, regardless of whether they are not yet recognized with perimetry. The MS index of VF is by all accounts sensitive for the follow-up of ocular hypertension.

scholarly journals Applying a New Automated Perimetry Pattern Based on the Stimulus Distribution of the Multifocal ERG to Improve Structure-Function Investigation in Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Lívia M. Brandão ◽  
Matthias Monhart ◽  
Andreas Schötzau ◽  
Anna A. Ledolter ◽  
Anja M. Palmowski-Wolfe
Keyword(s):  
Optical Coherence Tomography ◽  
Structure Function ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Significant Difference ◽  
Retinal Structure ◽  
One Year

Purpose. To validate a new automated perimetry pattern (mf103 pattern) for the investigation of retinal structure-function relationships in glaucoma in comparison to the standard G2 pattern and to relate either field’s performance to optical coherence tomography (OCT). Methods. Automated perimetry data from the mfERG103 pattern were compared with the standard G2 pattern in glaucoma patients (18) and controls (15). The results of both (mean defect (MD) and mean sensitivity (MS)) were compared with optical coherence tomography (OCT): retinal nerve fiber layer (RNFL) thickness, macular thickness (mT), and ganglion cell analysis (GCIPL). Nine patients were followed up after one year. Results. G2 pattern and mf103 pattern did not differ significantly in MD or MS. The mf103 pattern associated significantly with more RNFL sectors in both MD and MS (p<0.01 and p<0.05, resp.). GCIPL thickness was not significantly associated with either SAP protocols. Both protocols remained comparable after one-year follow-up. Conclusions. G2 and mf103 pattern can both differentiate patients from controls with no significant difference in performance. RNFL thickness defects correlated better with mf103 than G2 with POAG. The mfERG-103 perimetry pattern can be used to establish structure-function correlations in glaucoma and may enable a more direct comparison with objective electrophysiological data.

scholarly journals The Assessment of Morphological and Functional Changes in the Detection of the Initial Stage of Primary Glaucoma

2021 ◽  
Vol 18 (4) ◽  
pp. 857-865
Author(s):  
N. I. Kurysheva ◽  
L. V. Lepeshkina
Keyword(s):  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Glaucoma Progression ◽  
Functional Changes ◽  
Primary Glaucoma ◽  
Sd Oct

Purpose — to study morphological and functional changes in the detection of primary glaucoma progression.Patients and methods. 128 patients (128 eyes, among them — 64 eyes with primary open angle glaucoma (POAG) and 64 with primary angle closure glaucoma (PACG)) with the initial MD of –6.0 dB were examined at the Ophthalmology Center of the FMBA of Russia from May 2016 to November 2019. The values of corneal-compensated IOP were also considered: minimal (IOPmin), peak (IOPmax) and its fluctuations (IOPfluct). The progression was measured using standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). During the observation period, each patient received the average of 8.42 ± 2.08 SAP and SD-OCT. Progressive thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated using SD-OCT. If RNFL and/or GCC had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The correlation between the rate of progression detected by SAP (ROP1) using thinning of RNFL (ROP2) and GCC (ROP3) with other clinical parameters was analyzed.Results and discussion. Glaucoma progression was detected in 73 eyes. While the isolated use of SAP did not allow detecting progression, it was possible to detect it in 39 % cases by SD-OCT. The combination of both methods allowed detecting progression in 57 %. In both forms, ROP1 correlated with IOPmin: in PACG r = 0.41, p = 0.023 and in POAG r = 0.43, p = 0.016. In PACG, ROP2 and ROP3 correlated with the foveal choroid thickness: r = 0.46, p = 0.019 and r = 0.47, p = 0.009, respectively. At the same time, ROP3 was associated with peak IOP (r = –0.402, p = 0.025); the correlation of peak IOP with its fluctuations amounted to 0.7 (p < 0.001).Conclusion. SD-OCT is more informative than SAP in determining the progression of the initial primary glaucoma. The combination of these two methods 1.5 times increases the possibility of detecting progression in comparison with the isolated use of SD-OCT. The choroid thickness, associated with the IOP fluctuations, plays an important role in the progression of PACG.

Topical Bimatoprost Insert for Primary Open-Angle Glaucoma and Ocular Hypertension Treatment - A Phase II Controlled Study

2021 ◽  
Vol 18 ◽  
Author(s):  
Francine Rubião ◽  
Alan Cezar Faria Araújo ◽  
João Bernardo Sancio ◽  
Bárbara Silva Nogueira ◽  
Juçara Ribeiro Franca ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
T Test ◽  
Controlled Study ◽  
Therapeutic Drug ◽  
Eye Drops ◽  
Open Angle ◽  
Drug Concentrations

Background: The most common treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Sustained-release drug delivery systems have been developed to improve patient adherence by achieving prolonged therapeutic drug concentrations in ocular target tissues while limiting systemic exposure. The purpose of this study is to compare the efficacy and safety of bimatoprost inserts with bimatoprost eye drops in patients with POAG and ocular hypertension (OH). Methods: We include OH and POAG patients aged between 40 and 75 years-old. Both OH and POAG patients had intraocular pressure (IOP) greater than 21 and ≤30 mmHg at 9:00 am without glaucoma medication and normal biomicroscopy. Five normal patients with IOP≤14 mmHg constitute the control group. A chitosan-based insert of bimatoprost was placed at the upper conjunctival fornix of the right eye. In the left eye, patients used one drop of LumiganTM daily at 10:00 pm. For statistical analysis, we used a two-way analysis of variance (ANOVA), Student t-test, and paired t-test. Results: Sixteen POAG and 13 OH patients with a mean age of 61 years were assessed. In both eyes, IOP reduction was similar during three weeks of follow-up (19.5±2.2 mmHg and 16.9±3.1 mmHg), insert, and eye drop, respectively; P=0.165). The percentage of IOP reduction in the third week was 30% for insert and 35% for eye drops (P=0.165). No intolerance or discomfort with the insert was reported. Among the research participants, 58% preferred the use of the insert while 25% preferred eye drops, and 17% reported no preference. Conclusions: Bimatoprost-loaded inserts showed similar efficacy to daily bimatoprost eye drops during three weeks of follow up, without major side effects. This might suggest a possible change in the daily therapeutic regimen for the treatment of POAG and OH.

scholarly journals Ganglion cell complex scan in the early prediction of glaucoma

2012 ◽  
Vol 4 (2) ◽  
pp. 236-241
Author(s):  
S Ganekal
Keyword(s):  
Ganglion Cell ◽  
Cell Complex ◽  
P Value ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Color Code ◽  
Rnfl Thickness ◽  
Significant Difference

Objective: To compare the macular ganglion cell complex (GCC) with peripapillary retinal fiber layer (RNFL) thickness map in glaucoma suspects and patients. Subjects and methods: Forty participants (20 glaucoma suspects and 20 glaucoma patients) were enrolled. Macular GCC and RNFL thickness maps were performed in both eyes of each participant in the same visit. The sensitivity and specificity of a color code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Standard Automated Perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Statistics: The statistical analysis was performed with the SPSS 10.1 (SPSS Inc. Chicago, IL, EUA). Results were expressed as mean ± standard deviation and a p value of 0.05 or less was considered significant. Results: Provide absolute numbers of these findings with their units of measurement. There was a statistically significant difference in average RNFL thickness (p=0.004), superior RNFL thickness (p=0.006), inferior RNFL thickness (p=0.0005) and average GCC (p=0.03) between the suspects and glaucoma patients. There was no difference in optic disc area (p=0.35) and vertical cup/disc ratio (p=0.234) in both groups. While 38% eyes had an abnormal GCC and 13% had an abnormal RNFL thickness in the glaucoma suspect group, 98% had an abnormal GCC and 90% had an abnormal RNFL thickness in the glaucoma group.Conclusion: The ability to diagnose glaucoma with macular GCC thickness is comparable to that with peripapillary RNFL thickness. Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6538 Nepal J Ophthalmol 2012; 4 (2): 236-241 

scholarly journals A simplified combined index of structure and function for detecting and staging glaucomatous damage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhichao Wu ◽  
Felipe A. Medeiros
Keyword(s):  
Clinical Utility ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Measurement Scales ◽  
Empirical Formulas ◽  
Fiber Layer ◽  
Glaucomatous Damage ◽  
Functional Changes ◽  
Cell Counts ◽  
Better Than

AbstractGlaucomatous damage results in characteristics structural and functional changes on optical coherence tomography (OCT) imaging and standard automated perimetry (SAP) testing. The clinical utility of these measures differs based on disease severity, as they are evaluated along different measurement scales. This study therefore sought to examine if a simplified combined structure–function index (sCSFI) could improve the detection and staging of glaucomatous damage, compared to the use of average retinal nerve fiber layer thickness (RNFL) measurements from OCT and mean deviation (MD) values from SAP alone, and also an estimated retinal ganglion cell counts (eRGC) measure derived using empirical formulas described previously. Examining 577 eyes from 354 participants with perimetric glaucoma and 241 normal eyes from 138 healthy participants, we found that the sCSFI performed significantly better than average RNFL, MD and eRGC count for discriminating between glaucoma and healthy eyes (P ≤ 0.008 for all). The sCSFI also performed significantly better than RNFL and eRGC count at discriminating between different levels of visual field damage in glaucoma eyes (P < 0.001 for both). These findings highlight the clinical utility of combining structural and functional information for detecting and staging glaucomatous damage using the simplified index developed in this study.

Vitrectomy does not increase the risk of open-angle glaucoma or ocular hypertension—a 5-year follow-up

2010 ◽  
Vol 248 (10) ◽  
pp. 1407-1414 ◽  
Author(s):  
Alice L. Yu ◽  
Wolfgang Brummeisl ◽  
Markus Schaumberger ◽  
Anselm Kampik ◽  
Ulrich Welge-Lussen
Keyword(s):  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Open Angle

Evaluation of dynamic thiol–disulfide homeostasis in glaucoma patients and the correlation with retinal nerve fiber layer analysis

2019 ◽  
Vol 30 (4) ◽  
pp. 690-699 ◽  
Author(s):  
Bayram Gulpamuk ◽  
Ufuk Elgin ◽  
Emine Sen ◽  
Pelin Yilmazbas ◽  
Salim Neselioglu ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Total Thiol ◽  
Retinal Nerve Fiber

Purpose: The aim of this study was to evaluate thiol/disulfide homeostasis and ischemia-modified albumin levels with primary open-angle glaucoma, ocular hypertension, and control group; also to interpret the correlation between these biochemical parameters and retinal nerve fiber layer analysis. Material and methods: In a prospective cross-sectional study, 30 primary open-angle glaucoma cases, 30 ocular hypertension cases, and 30 control subjects were included in the study. Native thiol, total thiol, and disulfide measurements and disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were evaluated as thiol–disulfide homeostasis. Albumin and ischemia-modified albumin parameters were also evaluated. All cases underwent detailed ophthalmologic examination including visual acuity, retinal nerve fiber layer via optical coherence tomography, intraocular pressure, and central corneal thickness measurements and visual field analysis by 24-2 Swedish Interactive Threshold Algorithm (SITA) Standard visual field test. Results: Primary open-angle glaucoma group had significantly higher ischemia-modified albumin values than ocular hypertension and control group (p < 0.001). Native thiol and total thiol values of control group were statistically higher than those of primary open-angle glaucoma and ocular hypertension groups. The correlation between the temporal retinal nerve fiber layer value and ischemia-modified albumin, disulfide/native thiol, and disulfide/total thiol values of the primary open-angle glaucoma patients included in the study was moderate correlation in negative direction (r = –0.46, r = –0.39, r = –0.39, respectively), whereas there was a statistically significant moderate correlation in positive direction between the native thiol/total thiol values (r = 0.39) (p < 0.05). Conclusion: These findings have reinforced the role of oxidative stress in the etiopathogenesis of primary open-angle glaucoma, suggesting that the thinning retinal nerve fiber layer may be associated with oxidative stress in favor of prooxidant shift.

Long-term Follow-up of Diode Laser Trabeculoplasty for Primary Open-angle Glaucoma and Ocular Hypertension

Ophthalmology ◽  
1993 ◽  
Vol 100 (11) ◽  
pp. 1614-1618 ◽  
Author(s):  
Anthony P. Moriarty ◽  
J. Dominic A. McHugh ◽  
Timothy J. ffytche ◽  
John Marshall ◽  
A.M. Peter Hamilton
Keyword(s):  
Ocular Hypertension ◽  
Diode Laser ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Laser Trabeculoplasty ◽  
Long Term Follow Up

scholarly journals An Ex-Press implant versus trabeculectomy in a fibrotic bleb with late failure after previous trabeculectomy

2021 ◽  
Vol 14 (3) ◽  
pp. 383-387
Author(s):  
Faried Wagdy ◽  
◽  
Hisham Elsorogy ◽  
Ahmed Alnagdy ◽  
Dina Abd Elfattah ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Open Angle Glaucoma ◽  
Implant Surgery ◽  
Late Failure ◽  
Group I ◽  
The Mean ◽  
The Difference ◽  
One Year ◽  
Age Range

AIM: To compare the outcome of an Ex-Press implant and subscleral trabeculectomy (SST) in the management of glaucoma after previous trabeculectomy on a fibrotic bleb. METHODS: This randomized prospective study included 28 eyes from 28 patients (age range: 42-55y) with primary open angle glaucoma (POAG) presented with elevated intraocular pressure (IOP) with fibrotic bleb despite previous SST for more than 4mo. The eyes enrolled in the study were divided into two groups: group I (subjected to Ex-Press implant surgery) and group II [subjected to SST with mitomycin C (MMC)]. The follow-up continued one year after surgery to evaluate IOP, visual acuity (VA), visual field (VF), and postoperative complications. RESULTS: A significant decrease in IOP was found in both groups with a higher reduction in Ex-Press implant surgery with the mean IOP of 14.50 mm Hg (P=0.001), while the SST group recorded the mean IOP of 16.50 mm Hg (P=0.001) after one year. However, the difference between the two groups in terms of the decrease in IOP was insignificant. Fewer postoperative complications were recorded in the Ex-Press implant surgery and more cases requiring further anti-glaucomatous medications were seen in the SST group. Both groups showed stability in terms of VA and VF. CONCLUSION: Ex-Press implant surgery and SST with MMC are two surgical alternatives for controlling IOP in late failure that occurs more than 4mo after previous SST with a fibrotic bleb. However, Ex-Press shunt is a safer surgery with fewer complications.

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