scholarly journals Population-based associations between progression of normal-tension glaucoma and Yang-deficient constitution among Chinese persons

2021 ◽  
pp. bjophthalmol-2021-319210
Author(s):  
Lewei Tang ◽  
Liang Chen ◽  
Cong Ye ◽  
Jingwei Zheng ◽  
Yi Zhou ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Chinese Medicine ◽  
Visual Field ◽  
Traditional Chinese Medicine ◽  
Normal Tension Glaucoma ◽  
Population Based ◽  
The Body ◽  
Mean Deviation ◽  
Visual Field Progression

PurposeTo explore the association between constitution types as defined by traditional Chinese medicine (TCM) and risk for normal-tension glaucoma (NTG).DesignPopulation-based cohort study.MethodsPersons were identified in a population cohort aged ≥30 years with NTG, defined as having an untreated mean intraocular pressure measurement ≤21 mm Hg over six separate occasions, with no single reading >24 mm Hg (as in the Collaborative Normal Tension Glaucoma Study). The Body Constitution in Traditional Chinese Medicine Questionnaire was used to assess each participant’s TCM constitution types. The association between various constitutions and visual field progression according to Early Manifest Glaucoma Trial criteria was assessed using Cox regression HR models.ResultsAmong 142 participants (245 eyes), 23 persons (17.6%) and 25 eyes (10.2%) progressed, over a mean (SD) follow-up duration of 3.49 (0.99) years. Progression rates were highest in participants with Yang-deficient constitution (n=19, 13.4%), among whom 7 (36.8%) exhibited worsening fields. After adjusting for sex, age, central corneal thickness, retinal nerve fibre layer thickness and mean deviation on visual field testing, Yang-deficient constitution (HR 4.63, 95% CI 1.77 to 12.1, p=0.002) and higher mean intraocular pressure during follow-up (HR 1.25, 95% CI 1.01 to 1.56, p=0.044) were associated with field progression.ConclusionsYang-deficient constitution and higher intraocular pressure are risk factors for visual field progression in NTG patients. Yang deficiency is characterised by abnormal vasoregulation, and these results may be consistent with prior studies linking NTG progression to Raynaud’s phenomenon and migraine.

Impact of myopia on the association of long-term intraocular pressure fluctuation with the rate of progression in normal-tension glaucoma

2020 ◽  
pp. bjophthalmol-2019-315441
Author(s):  
Jinho Lee ◽  
Eun Jung Ahn ◽  
Yong Woo Kim ◽  
Ahnul Ha ◽  
Young Kook Kim ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Linear Regression Models ◽  
Risk Effect ◽  
Rate Of Progression ◽  
Topical Medications

Background/AimsTo investigate whether the association of long-term intraocular pressure (IOP) fluctuation with the rate of progression of normal-tension glaucoma (NTG) differs between myopia and non-myopia.MethodsThe medical records of 65 myopic NTG (axial length (AL) > 24.0 mm) and 64 non-myopic NTG eyes (AL < 24.0 mm), who had been treated with topical medications for more than 5 years, were reviewed. Multiple linear regression models were fitted to analyse the relationships of the slope of mean deviation (MD) or visual field index (VFI) with the clinical factors, including the interactions with myopia.ResultsThe average follow-up period was 8.3 years. Twenty-two (22) non-myopic eyes (34.4%) and 27 myopic eyes (41.5%) showed NTG progression (p=0.511). The interaction of myopia with IOP fluctuation was a significant factor regarding both MD and VFI slope (p=0.002, 0.024, respectively); stratified analyses suggested that the risk effect of IOP fluctuation was significant only in myopic NTG in terms of both MD (β= −1.27, p=0.003) and VFI slope (β=−2.32, p=0.011).ConclusionLong-term IOP fluctuation was significantly related to faster visual field progression in myopic NTG eyes, compared with non-myopic NTG eyes.

Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines

2020 ◽  
pp. bjophthalmol-2020-317406
Author(s):  
Bruna Melchior ◽  
Carlos Gustavo De Moraes ◽  
Jayter S Paula ◽  
George A Cioffi ◽  
Christopher A Girkin ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Treatment Guidelines ◽  
Evaluation Study ◽  
Mean Deviation ◽  
Racial Groups ◽  
Current Guideline ◽  
Registration Number ◽  
The Mean

AimsTo investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.MethodsA total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.ResultsFor stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.ConclusionIn a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.Trial registration numberclinicaltrials.gov Identifier: NCT00221923.

scholarly journals Surgery for normal tension glaucoma. Target intraocular pressure and visual field progression

2009 ◽  
Vol 75 (S224) ◽  
pp. 43-44 ◽  
Author(s):  
L. Fontana ◽  
A. C. Viswanathan ◽  
D. Poinooswamy ◽  
R. A. Hitchings ◽  
L. Scullica
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Visual Field Progression

scholarly journals Arteriovenous Passage Times and Visual Field Progression in Normal Tension Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Eva Charlotte Koch ◽  
Kay Oliver Arend ◽  
Marion Bienert ◽  
Andreas Remky ◽  
Niklas Plange
Keyword(s):  
Visual Field ◽  
Field Tests ◽  
Normal Tension Glaucoma ◽  
Retinal Blood Flow ◽  
Visual Field Progression ◽  
Confocal Scanning Laser Ophthalmoscope ◽  
Confocal Scanning ◽  
Confocal Scanning Laser ◽  
Passage Times

Purpose. Fluorescein angiographic studies revealed prolonged arteriovenous passage (AVP) times and increased fluorescein filling defects in normal tension glaucoma (NTG) compared to healthy controls. The purpose of this study was to correlate baseline AVP and fluorescein filling defects with visual field progression in patients with NTG.Patients and Methods. Patients with a follow-up period of at least 3 years and at least 4 visual field examinations were included in this retrospective study. Fluorescein angiography was performed at baseline using a confocal scanning laser ophthalmoscope (SLO, Rodenstock Instr.); fluorescein filling defects and AVP were measured by digital image analysis and dye dilution curves (25 Hz). Visual field progression was evaluated using regression analysis of the MD (Humphrey-Zeiss, SITA-24-2, MD progression per year (dB/year)). 72 patients with NTG were included, 44 patients in study 1 (fluorescein filling defects) and 28 patients in study 2 (AVP).Results. In study 1 (mean follow-up years, visual field tests), MD progression per year ( dB/year) was significantly correlated to the age (, ) but not to fluorescein filling defects, IOP, or MD at baseline. In study 2 (mean follow-up years, visual field tests), MD progression per year ( dB/year) was significantly correlated to AVP (, ) but not to age, IOP, or MD at baseline.Conclusion. Longer AVP times at baseline are correlated to visual field progression in NTG. Impaired retinal blood flow seems to be an important factor for glaucoma progression.

scholarly journals Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Cristiana Valente ◽  
Elisa D’Alessandro ◽  
Michele Iester
Keyword(s):  
Statistical Analysis ◽  
Standard Deviation ◽  
Visual Field ◽  
Trend Analysis ◽  
Open Angle Glaucoma ◽  
Mean Deviation ◽  
Threshold Strategy ◽  
Visual Field Progression ◽  
The Mean

Aim. To evaluate the agreement between different methods in detection of glaucomatous visual field progression using two classification-based methods and four statistical approaches based on trend analysis. Methods. This is a retrospective and longitudinal study. Twenty Caucasian patients (mean age 73.8 ± 13.43 years) with open-angle glaucoma were recruited in the study. Each visual field was assessed by Humphrey Field Analyzer, program SITA standard 30-2 or 24-2 (Carl Zeiss Meditec, Inc., Dublin, CA). Full threshold strategy was also accepted for baseline tests. Progression was analyzed by using Hodapp–Parrish–Anderson classification and the Advanced Glaucoma Intervention Study visual field defect score. For the statistical analysis, linear regression (r2) was calculated for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), and when it was significant, each series of visual field was considered progressive. We also used Progressor to look for a significant progression of each visual field series. The agreement between methods, based on statistical analysis and classification, was evaluated using a weighted kappa statistic. Results. Thirty-eight visual field series were analyzed. The mean follow-up time was 6.2 ± 1.53 years (mean ± standard deviation). At baseline, the mean MD was −7.34 ± 7.18 dB; at the end of the follow-up, the mean MD was −9.25 ± 8.65 dB; this difference was statistically significant (p<0.001). The agreement to detect progression was fair between all methods based on statistical analysis and classification except for PSD r2. A substantial agreement (κ = 0.698 ± 0.126) was found between MD r2 and VFI r2. With the use of all the statistical analysis, there was a better time-saving. Conclusions. The best agreement to detect progression was found between MD r2 and VFI r2. VFI r2 showed the best agreement with all the other methods. GPA2 can help ophthalmologists to detect glaucoma progression and to help in treatment decisions. PSD r2 was the worse method to detect progression.

Long-term follow-up of visual field progression after trabeculectomy in progressive normal-tension glaucoma

Ophthalmology ◽  
2002 ◽  
Vol 109 (4) ◽  
pp. 766-770 ◽  
Author(s):  
Takashi Shigeeda ◽  
Atsuo Tomidokoro ◽  
Makoto Araie ◽  
Nobuyuki Koseki ◽  
Seiichiro Yamamoto
Keyword(s):  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Visual Field Progression ◽  
Long Term Follow Up

scholarly journals Acupuncture Application in Seconder amenorrhea Obese female Patient

2021 ◽  
Vol 5 (04) ◽  
pp. 01-02
Author(s):  
Hayriye Alp
Keyword(s):  
Chinese Medicine ◽  
Energy Balance ◽  
Traditional Chinese Medicine ◽  
Female Patient ◽  
The Body ◽  
Secondary Amenorrhea ◽  
Balance Problem ◽  
The Third ◽  
Obese Female

Obesity is a disease caused by excessive fat storage in the body. It is an energy balance problem. Obesity can prepare the ground for many diseases. Secondary amenorrhea is the condition of not having menstruation for 6 months. In Traditional Chinese Medicine, it is thought to be caused by Qi and blood deficiency. The 43-year-old nurse applied due to obesity, inability to have menstruation, edema and nodules in goiter. TSH was 4.25, T3 2.87, T4 1.07mU/L. The 78.6 kg 150cm tall TA was 100/70 mmHg.Ten sessions of acupuncture were performed. Yin-tan, DU-20,21, LU-9, H-7, PC-6, SI-3, ST-24,25, REN-7,9, KID-3-6, SP -6.9 uterus, zero, jerome, shen-men hunger, kidney, points were pinned with disposable acupuncture needles. The patient, whose edema was resolved in the second session, started to have menstruation in the third session and lost 9kg in total. The patient had regular periods during the 1-year follow-up. TSH fell to 3.18mU/L.

scholarly journals Relationship between peripheral vasospasm and visual field progression rates in patients with normal-tension glaucoma with low-teen intraocular pressure

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250085
Author(s):  
Do Young Park ◽  
Jong Chul Han ◽  
Eun Jung Lee ◽  
Changwon Kee
Keyword(s):  
Regression Analysis ◽  
Intraocular Pressure ◽  
Visual Field ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Normal Tension Glaucoma ◽  
Progression Rate ◽  
Finger Temperature ◽  
Ice Water

Purpose To investigate the association between peripheral vasospasm and the visual field (VF) progression rate in patients with normal-tension glaucoma (NTG) with low-teen intraocular pressure (IOP). Methods The finger temperature of 113 NTG patients was measured before and after exposure to ice water using a Temperature gun (cold pressor test). These patients had confirmed VF progression, despite a low-teen IOP during a follow-up period of >5 years. VF progression rates were calculated as the slope of the visual field index (VFI) and mean deviation (MD) over time. Demographic, systemic, and ocular factors and VF progression rates were compared, based on the cold pressor test results. A regression analysis was used to investigate the factors affecting VF progression rates. Results Mean age, initial IOP, mean IOP during the follow-up period, and initial VF MD were 57.1 years, 15.8 mmHg, 12.0 mmHg, and -5.2 dB, respectively. When patients were divided into two groups (less vasospasm and more vasospasm) according to changes in temperature after exposure to ice water, the VF progression rate was significantly faster in the group with more vasospasm. In a multiple regression analysis, older age, worse initial VF MD, and greater decrease in finger temperature after ice water exposure were significantly associated with faster VF progression rates. Conclusion An excessive drop in finger temperature after exposure to ice water was significantly associated with faster VF progression in patients with low-teen NTG. This suggests that the blood flow in the optic nerve head may also be disturbed by peripheral vasospasm, accelerating glaucomatous damage regardless of IOP.

scholarly journals Visual field progression 8 years after trabeculectomy in Asian eyes: results from The Singapore 5-Fluorouracil Study

2020 ◽  
Vol 104 (12) ◽  
pp. 1690-1696
Author(s):  
Bryan C H Ang ◽  
Sophia Seen ◽  
Arjunan Kumaran ◽  
John Mark Sim De Leon ◽  
Steve Kah Leng Seah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Intraocular Pressure ◽  
Visual Field ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Multivariate Regression ◽  
Mean Deviation ◽  
Regression Analyses

Background/AimsThis work aimed to study the effect of long-term intraocular pressure (IOP) fluctuation on visual field (VF) progression 8 years post-trabeculectomy in Asian eyes.MethodsThis was a retrospective analysis of 8-year post-trabeculectomy data from The Singapore 5-Fluorouracil (5-FU) Study. VFs were analysed using Progressor software (Medisoft, Leeds, UK). Outcome measures included mean slope for VF per year, number of progressing points and mean slope for progressing points per year. Multivariate regression analyses were performed adjusting for age, gender, ethnicity, glaucoma type, intraoperative 5-FU, diabetes mellitus, hypertension, best pre-trabeculectomy VF mean deviation, post-trabeculectomy mean IOP, IOP reduction and IOP fluctuation (SD of IOPs at 6-monthly timepoints).Results127 (52.3%) subjects completed 8-year follow-up with ≥5 reliable VFs and ≥8 6-monthly IOP measurements. Mean age was 61.8±9.6 years. Post-operatively, mean IOP was 14.2±2.8 mm Hg and mean IOP fluctuation was 2.53±1.20 mm Hg. Higher IOP fluctuation was associated with greater mean slope for field (B=−0.071; p=0.013), number of progressing points (B=0.963; p=0.014) and VF progression as defined by ≥1 progressing point (OR=1.585; p=0.029). There was also a trend towards eyes with higher IOP fluctuation having ≥3 adjacent progressing points in the same hemifield (OR=1.489; p=0.055). Greater mean IOP reduction post-trabeculectomy was associated only with a lower mean slope for progressing points per year (B=−0.026; p=0.028). There was no significant effect of intra-operative 5-FU compared with placebo for all outcome measures.ConclusionIn post-trabeculectomy Asian eyes with well-controlled IOP, higher long-term IOP fluctuation may be associated with greater VF progression.

scholarly journals Retrobulbar Hemodynamics and Visual Field Progression in Normal Tension Glaucoma: A Long-Term Follow-Up Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
D. Kuerten ◽  
M. Fuest ◽  
E. C. Koch ◽  
A. Koutsonas ◽  
N. Plange
Keyword(s):  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Doppler Imaging ◽  
Progression Rate ◽  
Visual Field Progression ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Retrobulbar Hemodynamics

Purpose. Vascular risk factors are important factors in the pathogenesis of glaucoma. The purpose of this research was to investigate retrobulbar hemodynamics and visual field progression in patients with normal tension glaucoma (NTG).Patients and Methods. 31 eyes of 16 patients with NTG were included in a retrospective long-term follow-up study. Colour Doppler imaging was performed at baseline to determine various CDI parameters in the different retrobulbar vessels. The rate of visual field progression was determined using the Visual Field Index (VFI) progression rate per year (in %). To be included in the analysis, patients had at least 4 visual field examinations with a follow-up of at least 2 years.Results. Mean follow-up was 7.6 ± 4.1 years with an average of 10 ± 5 visual field tests. The mean MD (mean defect) at baseline was −7.61 ± 7.49 dB. The overall VFI progression was −1.14 ± 1.40% per year. A statistical significant correlation between VFI progression and the RI of the NPCA and PSV of the CRA was found.Conclusion. Long-term visual field progression may be linked to impaired retrobulbar hemodynamics in patients with NTG only to a limited degree. Interpretation of the data for an individual patient seems to be limited due to the variability of parameters.

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