Comparison of Latanoprost/Timolol with Carbonic Anhydrase Inhibitor and Dorzolamide/Timolol with Prostaglandin Analog in the Treatment of Glaucoma

Purpose.We retrospectively reviewed medical records of glaucoma patients to investigate how switching medications may affect intraocular pressure (IOP) management. Three concomitant medications were changed to two medications: one combination drop and one single-action drop. Associated adverse effects were also examined.Subjects and Methods.A total of 112 patients with primary open-angle glaucoma or ocular hypertension were examined. All patients were concomitantly using a prostaglandin (PG) analog, aβ-blocker, and a carbonic anhydrate inhibitor (CAI). Fifty-five patients began using latanoprost (PG analog)/timolol (β-blocker) fixed-combination (LTFC) drops and a CAI (group 1), and 57 patients began using dorzolamide (CAI)/timolol fixed-combination (DTFC) drops and a PG analog (group 2). The IOP was measured every 6 months for 2 years following medication changes. Changes in visual field mean deviation (MD) and medication discontinuations were also examined.Results.There were no significant differences in IOP or MD values before and after medication changes in either group. The proportion of medication discontinuations, uncontrolled IOP, and adverse reactions was similar in both groups.Conclusion.Switching patients from multiple single-action medications to combination medications was not associated with changes in IOP, visual field testing results, or adverse event frequency.

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The Effect of Contact Lens–spectacle Reversed Galilean Telescope on the Visual Field of Patients with Open-angle Glaucoma

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i4.7779 ◽

2020 ◽

Author(s):

Mohammadreza Moniritilaki ◽

Maryam Badakhsh ◽

Asieh Ehsaei ◽

Ramin Daneshvar

Keyword(s):

Visual Field ◽

Contact Lens ◽

Open Angle Glaucoma ◽

Field Measurements ◽

Visual Field Defects ◽

Mean Deviation ◽

Open Angle ◽

A Value ◽

Before And After ◽

The Mean

Purpose: Glaucoma causes irreversible visual field defects. This study aims to evaluate the effect of a reversed Galilean telescope on the visual field of patients with open-angle glaucoma. Methods: Fifty-two glaucoma patients with a restricted visual field were recruited for this study. Central 30° visual field measurements were performed using a Humphrey visual field analyzer before and after applying the reversed Galilean telescope. To be more cosmetically acceptable, a combination of contact lens–spectacle was used as the reversed Galilean telescope. Results: Our data analysis showed that the reversed Galilean telescope had a significant effect on all measured perimetric indices. Visual field index (VFI) improved from a basic value of 44.38 ± 26.96 percent to 49.30 ± 29.83 percent by using the reversed telescope (P < 0.001). Moreover, the mean deviation (MD) was significantly improved from the initial value of –19.91 ± 7.19 dB to a value of –18.69 ± 7.73 dB (P < 0.001). However, our results showed a significant reduction in the pattern standard deviation (PSD) comparing before (9.83 ± 2.82) and after (8.51 ± 3.30) values using the reversed Galilean telescope (P < 0.001). Conclusion: The contact lens–spectacle combination reversed Galilean telescope significantly improved the central 30° visual field of glaucoma patients with the restricted visual field.

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Comparing the usefulness of a new algorithm to measure visual field using the variational Bayes linear regression in glaucoma patients, in comparison to the Swedish interactive thresholding algorithm

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318304 ◽

2021 ◽

pp. bjophthalmol-2020-318304

Author(s):

Hiroshi Murata ◽

Ryo Asaoka ◽

Yuri Fujino ◽

Masato Matsuura ◽

Kazunori Hirasawa ◽

...

Keyword(s):

Visual Field ◽

Linear Regression ◽

Open Angle Glaucoma ◽

Variational Bayes ◽

Mean Deviation ◽

Test Duration ◽

Field Analyser ◽

Measurement Duration ◽

Measurement Algorithm ◽

Thresholding Algorithm

Background/aimsWe previously reported that the visual field (VF) prediction model using the variational Bayes linear regression (VBLR) is useful for accurately predicting VF progression in glaucoma (Invest Ophthalmol Vis Sci. 2014, 2018). We constructed a VF measurement algorithm using VBLR, and the purpose of this study was to investigate its usefulness.Method122 eyes of 73 patients with open-angle glaucoma were included in the current study. VF measurement was performed using the currently proposed VBLR programme with AP-7700 perimetry (KOWA). VF measurements were also conducted using the Swedish interactive thresholding algorithm (SITA) standard programme with Humphrey field analyser. VF measurements were performed using the 24–2 test grid. Visual sensitivities, test–retest reproducibility and measurement duration were compared between the two algorithms.ResultMean mean deviation (MD) values with SITA standard were −7.9 and −8.7 dB (first and second measurements), whereas those with VBLR-VF were −8.2 and −8.0 dB, respectively. There were no significant differences across these values. The correlation coefficient of MD values between the 2 algorithms was 0.97 or 0.98. Test–retest reproducibility did not differ between the two algorithms. Mean measurement duration with SITA standard was 6 min and 02 s or 6 min and 00 s (first or second measurement), whereas a significantly shorter duration was associated with VBLR-VF (5 min and 23 s or 5 min and 30 s).ConclusionVBLR-VF reduced test duration while maintaining the same accuracy as the SITA-standard.

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A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1039 ◽

2012 ◽

Vol 46 (4) ◽

pp. 172-176

Author(s):

Sukhsagar Ratol ◽

Rani Walia ◽

Mridu Chaudhry

Keyword(s):

Ocular Hypertension ◽

Primary Open Angle Glaucoma ◽

Fixed Combination ◽

Open Angle Glaucoma ◽

Eye Drops ◽

Open Angle ◽

Once Daily ◽

Group 2 ◽

Diurnal Iop ◽

Group 1

ABSTRACT Background Glaucoma is a leading cause of irreversible blindness. The fundamental problem in medical management of glaucoma is of patient compliance. An ideal drug or a drug combination is needed to slow the progression of this majorly symptomless disease. Aim To compare the efficacy and tolerability of the fixed combination latanoprost and timolol instilled once daily in the evening vs fixed combination of dorzolamide and timolol instilled twice daily in primary open angle glaucoma or ocular hypertension. Materials and methods A 12-week, randomized, open, parallel group study including 50 patients with primary open angle glaucoma or ocular hypertension was conducted at a tertiary care hospital. Patients were randomized to group 1, (fixed combination (FC) latanoprost and timolol eye drops, once daily in evening) and group 2, (FC dorzolamide and timolol eye drops, twice daily). At baseline, 2, 4 and 12 weeks, IOP was recorded at 9 AM and 12 noon. The difference in IOP reduction in two treatment groups from baseline to 12 weeks was the main outcome measure. Results Mean diurnal IOP was similar at baseline for both groups. Mean reduction in IOP from baseline to 12 weeks was 9.92 mm Hg (p = 0.001) in group 1 and 9.22 (p = 0.001) in group 2. The reduction in IOP in both groups 1 and 2 was statistically significant at all time intervals. There was a statistically significant advantage for group 1 at 12 weeks for both time readings (p = 0.013 and 0.002 respectively) as compared to group 2. Conclusion The fixed combination of latanoprost and timolol was more effective than that of dorzolamide and timolol in reducing mean diurnal IOP and both treatments were well tolerated. To confirm further such studies are required. How to cite this article Ratol S, Walia R, Chaudhry M. A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension. J Postgrad Med Edu Res 2012;46(4):172-176.

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Role of Central Corneal Thickness on Baseline Parameters and Progression of Visual Fields in Open Angle Glaucoma

European Journal of Ophthalmology ◽

10.1177/112067210701700411 ◽

2007 ◽

Vol 17 (4) ◽

pp. 545-549 ◽

Cited By ~ 14

Author(s):

H. Shah ◽

C. Kniestedt ◽

A. Bostrom ◽

R. Stamper ◽

S. Lin

Keyword(s):

Visual Field ◽

Central Corneal Thickness ◽

Open Angle Glaucoma ◽

Corneal Thickness ◽

Visual Fields ◽

Negative Relationship ◽

Significant Risk ◽

Mean Deviation ◽

Open Angle ◽

Visual Field Progression

Purpose To evaluate the relationship of central corneal thickness (CCT) to baseline visual field parameters and visual field progression in patients with primary open-angle glaucoma (POAG). Methods Charts of consecutive patients with POAG were reviewed to obtain visual field data. Visual field was measured by standard threshold static perimetry. Variables analyzed included mean deviation (MD) and pattern standard deviation (PSD). Results A total of 121 eyes examined over 4 years were evaluated. A significant negative relationship between CCT and PSD (correlation coefficient: −0.02, p<0.05) was found. Analyses comparing CCT to change in PSD and MD (visual field progression) were statistically not significant. Conclusions Patients with thinner corneas initially present with a greater visual field defect, indicating that thin corneas may contribute to advanced glaucomatous damage at the time of diagnosis. However, CCT does not seem to be a significant risk factor for progression of the disease.

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Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

Journal of Ophthalmology ◽

10.1155/2019/1583260 ◽

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.

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Relationship between consecutive deterioration of mean deviation value and progression of visual field defect in open-angle glaucoma

Clinical Ophthalmology ◽

10.2147/opth.s94497 ◽

2015 ◽

pp. 2217 ◽

Cited By ~ 2

Author(s):

Tomoko Naito ◽

Keiji Yoshikawa ◽

Shiro Mizoue ◽

Mami Nanno ◽

Tairo Kimura ◽

...

Keyword(s):

Visual Field ◽

Visual Field Defect ◽

Open Angle Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Field Defect

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Impact of Visual Field Testing on Intraocular Pressure Change Trends in Healthy People and Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2020/7936205 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mengwei Li ◽

Bingxin Zheng ◽

Qi Wang ◽

Xinghuai Sun

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Repeated Measures ◽

Healthy Subjects ◽

Open Angle Glaucoma ◽

Field Testing ◽

Automated Perimetry ◽

Open Angle ◽

Standard Automated Perimetry ◽

The Impact

Purpose. To compare the impact of visual field (VF) testing on intraocular pressure (IOP) change trends between healthy subjects and glaucoma patients. Methods. We recruited healthy volunteer subjects who did not have previous ocular diseases and open-angle glaucoma patients who were medically controlled well. IOP in both eyes of each participant was measured by using a noncontact tonometer at five time points: before, immediately after (0 minute), and 10, 30, and 60 minutes after the standard automated perimetry. Repeated measures ANOVA was used to analyze the effect of VF testing on IOP change trends in healthy and glaucoma eyes. Results. Forty healthy subjects (80 eyes) and 31 open-angle glaucoma patients (62 eyes) were included for the study. The baseline IOP of healthy and glaucoma eyes was 16.11 ± 3.01 mmHg and 15.78 ± 3.57 mmHg, respectively. After the VF testing, the IOP in healthy eyes was decreased by 1.5% at 0 minute, 6.5% at 10 minutes (P<0.001), 6.6% at 30 minutes (P<0.001), and 7.0% at 1 hour (P<0.001), indicating that this reduction was sustained for at least 1 hour. However, the IOP in glaucoma eyes was increased by 12.7% at 0 minute (P<0.001) and, then, returned towards initial values 1 hour after the VF testing. Conclusions. IOP change trends after VF field testing between healthy subjects and glaucoma patients were quite different. VF testing led to a mild and relatively sustained IOP decrease in healthy subjects, whereas IOP in open-angle glaucoma patients tended to significantly increase immediately after VF testing and, then, returned to pretest values after 1 hour. These findings indicate that the factors of VF testing should be considered in the clinical IOP measurements.

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Chiasmal herniation following treatment of pituitary macroadenoma

Pituitary ◽

10.1007/s11102-020-01088-2 ◽

2020 ◽

Author(s):

Marjolein Tabak ◽

Iris C. M. Pelsma ◽

Mark C. Kruit ◽

Wouter R. van Furth ◽

Nienke R. Biermasz ◽

...

Keyword(s):

Tumour Size ◽

Severity Index ◽

Optic Chiasm ◽

Added Value ◽

Control Group ◽

Mean Deviation ◽

Pituitary Macroadenoma ◽

Mri Findings ◽

Before And After ◽

Group 2

Abstract Purpose To evaluate whether the occurrence of chiasmal herniation coincides with visual field (VF) deterioration and to compare the course of VF defects in patients with and without radiological chiasmal herniation following treatment of pituitary adenoma. Methods This retrospective cohort study included 48 pituitary macroadenoma patients with chiasm compression, divided into three groups: Group 1 (N = 12), downward displaced optic chiasm and deteriorated VFs; Group 2 (N = 16), downward displaced optic chiasm; Group 3 (N = 20), control-group matched for tumour size and follow-up VFs, in mean deviation (dB). VFs were compared over time and a severity index, Chiasm Herniation Scale (CHS), for herniation based on radiological parameters was designed. Results After treatment, all groups showed improvement of VFs (Gr1: 2.97 dB p = 0.097, Gr2: 4.52 dB p = 0.001 and Gr3: 5.16 dB p = 0.000), followed by long-term gradual deterioration. The course of VFs between patients with and without herniation was not significantly different (p = 0.143), neither was there a difference in the course before and after herniation (p = 0.297). The median time till onset of herniation was 40 months (IQR 6 month-10 years) and did not significantly differ (p = 0.172) between the groups. There was no relation between VFs and the degree of herniation (p = 0.729). Conclusion Herniation does not appear to have clinical relevance with respect to VF outcome. The newly designed CHS is the first scoring system to quantify the severity of herniation and, in the absence of alternatives, may be useful to describe MRI findings to serve future added value in larger sized outcome studies.

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Relationship between visual field changes and optical coherence tomography measurements in advanced open-angle glaucoma

Folia Medica ◽

10.1515/folmed-2016-0027 ◽

2016 ◽

Vol 58 (3) ◽

pp. 174-181 ◽

Cited By ~ 2

Author(s):

Snezhina S. Kostianeva ◽

Marieta I. Konareva-Kostianeva ◽

Marin A. Atanassov

Keyword(s):

Optical Coherence Tomography ◽

Visual Field ◽

Structural Changes ◽

Open Angle Glaucoma ◽

Mean Deviation ◽

Ganglion Cell Complex ◽

Automated Perimetry ◽

Optical Coherence ◽

Open Angle ◽

Sd Oct

Abstract Aim: To assess relationships between functional changes in visual field and structural changes in advanced open-angle glaucoma (OAG) found using spectral-domain optical coherence tomography (SD-OCT). Methods: Thirty-one eyes of 25 patients with OAG were included in this study. Besides the routine ophthalmological exam the patients underwent standard automated perimetry (SAP) (Humphrey Field Analyzer) and SD-OCT (RTVue–100) performed within 6 months. The global perimetric indices in the study group were as follows: mean deviation (MD) 12.33±6.18 dB and pattern standard deviation (PSD) 9.17±3.41 dB. The relationship between OCT measurements and MD and PSD was evaluated by correlation analysis (Pearson’s correlation coefficient) and regression analysis (linear and nonlinear regression models). Results: Thickness measurements of the lower halves of ganglion cell complex (GCC) and retinal nerve fiber layer by two scanning protocols (ONH and 3.45) showed these to be thinner than the upper halves, but the difference failed to reach statistical significance. The correlations between global indices MD/PSD and most of the analysed quantitative OCT measurements were moderate (r in the range between 0.3 and 0.6). The correlation between MD and GCC showed nonlinear cubic regression (R2=0.417, P=0.004). Good correlation was found between MD and GLV (R2=0.383; P=0.008). Linear regression (P<0.05) was found only between MD and Cup area (R2=0.175, P=0.024) and between MD and RNFL by 3.45 protocol (R2=0.131, P=0.045). Conclusion: Nonlinear regressive models appear to be more appropriate in the assessment of the correlations between functional and structural changes in eyes with advanced glaucoma. The correlations we found were moderate.

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