scholarly journals Evaluation of Cerebrospinal Fluid Pressure by a Formula and Its Role in the Pathogenesis of Glaucoma

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Landi ◽  
Federica Casciaro ◽  
Serena Telani ◽  
Carlo E. Traverso ◽  
Alon Harris ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Visual Field ◽  
Healthy Subjects ◽  
Diastolic Pressure ◽  
Open Angle Glaucoma ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Mean Deviation ◽  
Fiber Layer ◽  
Rnfl Thickness

Purpose. To investigate potential associations between intraocular pressure (IOP) and cerebrospinal fluid pressure (CSFP) in patients with primary open-angle glaucoma (POAG) and healthy subjects. Methods. Forty-three subjects were recruited. Weight and height were measured to calculate body mass index (BMI), along with blood pressure, heart rate, visual acuity, and IOP. Biometrics exam, corneal pachymetry, peripapillary retinal nerve fiber layer (RNFL) thickness, and macular thickness were assessed. The visual field exam was performed on all patients, and both pattern standard deviation (PSD) and mean deviation (MD) were considered. CSFP was estimated indirectly by using the mathematical formula CSFP = 0.44 × BMI + 0.16 × diastolic pressure − 0.18 × age − 1.91, based on the previous scientific studies. The TLCPD was calculated as follows: IOP−CSFP. Results. A significant (p<0.05) difference was found between the two groups for several parameters. Specifically, the CSFP was lower in patients with POAG than in healthy subjects (8.14 ± 4.52 and 7.43 ± 2.06, p<0.001, respectively). Anamnestic TLCPD was found to be significantly (p<0.001) higher in patients with POAG compared to healthy subjects. A significant (p<0.05) correlation was found between anamnestic TLCPD and MD (r = −0.31), inferior RNFL thickness (r = −0.29), superior RNFL thickness (r = −0.27), IOP (r = 0.22), and CSFP (r = −0.46). Conclusion. The CSFP was lower in glaucomatous patients compared to healthy subjects, whereas the TLCPD was higher in glaucomatous patients compared to healthy subjects, even though this difference was not statistically significant. A higher TLCPD may damage the RNFL, resulting in functional visual field impairment.

The effect of mirtogenol towards the changes in retinal nerve fiber layer thickness and visual field in primary open angle glaucoma

2019 ◽  
Vol 43 (1) ◽  
pp. 28
Author(s):  
Astriviani Widyakusuma ◽  
Widya Artini ◽  
Virna Dwi Oktariana ◽  
Joedo Prihartono
Keyword(s):  
Visual Field ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Open Angle Glaucoma ◽  
Visual Fields ◽  
Mean Deviation ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness ◽  
Retinal Nerve Fiber

Objective: To evaluate the effect of Mirtogenol towards the changes in retinal nerve fiber layer (RNFL) thickness and visual field in patients with primary open angle glaucoma (POAG) with controlled IOP. Methods: This is a prospective, double blind, randomized study. Forty one POAG patients with IOP ≤ 18 mmHg were randomly assigned to receive either Mirtogenol or placebo. Changes in RNFL thickness and mean deviation of visual fields were evaluated before the treatment, as well as 4 weeks and 8 weeks after the treatment. Patients were asked for any side effects during the treatment period. Result: The average RNFL thickness in the Mirtogenol group decreased -0.70±1.63 μm from 87.29±19.39 μm before the treatment to 86.58±19.43 μm after 8 weeks of treatment, however the change was not significant (p=0.121). The average RNFL thickness in the placebo group decreased -1.74±1.79 μm from 97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks of treatment, the change was statistically significant (p< 0.001). The average MD of visual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks of treatment while the MD of visual field in the placebo group decreased -0.083±1.36 dB after 8 weeks of treatment. Hoewever the changes in MD of visual field was not significant (p>0.05). No side effect was found throughout the study. Conclusion: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields.

scholarly journals Change of Retinal Vessels in Different Sectors of the Parapapillary Area in Primary Open-Angle Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Jingyi Cheng ◽  
Hongmei Zhao ◽  
Chunhui Jiang ◽  
Xiangmei Kong ◽  
Xinghuai Sun
Keyword(s):  
Visual Field ◽  
Healthy Subjects ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Visual Field Defects ◽  
Mean Deviation ◽  
Retinal Vessels ◽  
Open Angle ◽  
Fiber Layer ◽  
Nerve Fiber Layer Thickness

Purpose: To investigate the changes in the retinal vessels (RVs) in different sectors in patients with primary open-angle glaucoma (POAG), and their possible correlations with retinal nerve fiber layer thickness (RNFLT) and visual-field defects in the temporal parapapillary region.Methods: The RV diameters, RNFLTs, and visual-field parameters were measured. The temporal parapapillary region was divided into the temporal (T, 315°-45°), temporal superior (TS, 45°-90°), and temporal inferior sectors (TI, 270°-315°). The changes in the RV diameters in each sector were determined, and their relationships with RNFLT, the mean deviation (MD), and visual field sensitivity (VFS) were examined.Results: Fifty POAG patients (50 eyes) and 50 healthy subjects (50 eyes) were included. Compared with the healthy subjects, the POAG group had a significantly smaller accumulated parapapillary RV diameter (P &lt; 0.001), which was positively correlated with the MD and RNFLT. When the different temporal sectors were examined, the accumulated RV diameters were significantly smaller in the POAG group than in the healthy controls in the TI and T sectors, but not in the TS sector. The accumulated diameters in the TI and T sectors were correlated with the corresponding RNFLTs (all P &lt; 0.05), but only the accumulated diameter in the TI sector was correlated with the VFS.Conclusions: In POAG, the changes in the RVs differed between different temporal sectors, with the most prominent changes occurring in the TI and T sectors.

scholarly journals Peripapillary retinal nerve fibre thickness in patients with primary open-angle glaucoma

2019 ◽  
Author(s):  
Aleksandar Miljkovic ◽  
Nikola Babic ◽  
Davidovic Sofija ◽  
Sava Barisic ◽  
Jelena Ljikar ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Open Angle Glaucoma ◽  
Statistical Processing ◽  
Healthy Population ◽  
Ophthalmological Examination ◽  
Open Angle ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Preperimetric Glaucoma ◽  
The Difference

Abstract Background The purpose of this study was to determine the difference in peripapillary retinal nerve fiber layer (RNFL) thickness in patients with preperimetric glaucoma and open angle glaucoma (POAG) in comparison to healthy population, as well as to determine the difference in thickness of peripapillary RNFL according to progression of the disease.Methods In this study, 120 patients were included . On the basis of clinical finding four groups of patients were formed: group without glaucoma, early POAG group, moderate POAG group and group with preperimetric glaucoma. Complete ophthalmological examination, visual field and optic coherent tomography of peripapillar region of RNFL were performed. The collected data was entered into a specially created database on a personal account, and the statistical processing was done using the SPSS for Windows. Results are displayed through charts and tables.Results The results showed that the thickness of peripapillary RNFL in patients with mild POAG is lesser than in healthy subjects, and thickness in patients with moderate POAG is lesser than in patients with mild POAG, as well as in healthy subjects (59.69±10.63 μm vs 73.44±12.16 μm vs 105.57±11.34 μm). Thickness of peripapillary RNFL in patients with preperimetric glaucoma is significantly lesser than in healthy subjects (83.65±9.24 μm vs 105.57±11. 34 μm). Parameter S together with mean value of peripapillary RNFL thickness (AvgThic) is the best predictors of appearance and progression of preperimetric glaucoma. There is positive correlation between progression of glaucoma (MD value) and AvgThic. The best predictors of appearance and progression of glaucomatous disease are: AvgThic, RNFL thickness in quadrants- S, I, N; and parameters RNFL- Smax, Savg, Iavg. ROC curve has shown that the following parameters are bad markers for progression of the disease: RNFL thickness in quadrant T and Imax.Conclusions We concluded that the determination of thickness of peripapillary RNFL in patients with glaucoma using optical coherent tomography represents the method which distinguishes between patients with POAG, preperimetric glaucoma and healthy population hence it can be used in glaucoma diagnostics and follow-up.

scholarly journals Three-Decade Evaluation of Cerebrospinal Fluid Pressure in Open-Angle Glaucoma at a Tertiary Care Center

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Catherine G. Knier ◽  
David Fleischman ◽  
David O. Hodge ◽  
John P. Berdahl ◽  
Michael P. Fautsch
Keyword(s):  
Cerebrospinal Fluid ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Care Center ◽  
Tertiary Care ◽  
Fluid Pressure ◽  
Normal Tension Glaucoma ◽  
Cerebrospinal Fluid Pressure ◽  
Open Angle ◽  
Study Results

Elevated intraocular pressure (IOP) is the most prevalent risk factor for primary open-angle glaucoma. However, IOP alone does not fully describe a mechanical basis for disease in patients with normal tension glaucoma or primary open-angle glaucoma. The translaminar pressure difference (TLPD) theory proposes that the pressure gradient generated by the difference of IOP and cerebrospinal fluid pressure (CSFp) acting at the level of the optic nerve can lead to cupping and glaucoma when IOP is higher than normal and/or CSFp is lower than normal. The study results to date have generally supported the TLPD theory; however, varying methods, populations, and sample sizes make it difficult to compare results. To further assess whether there is an association between low CSFp and open-angle glaucoma, 30 years of clinical data that assess 96,543 lumbar punctures were analyzed. Patients with open-angle glaucoma showed a significantly lower CSFp than randomly selected normal control patients (9.9 ± 3 mm·Hg (n = 86) versus 12.1 ± 3.6 mm·Hg (n = 114), p < 0.001 ) following adjustment for age and sex. This retrospective study provides strong evidence for an association between open-angle glaucoma and low CSFp.

Detection of serum uric acid in primary open angle glaucoma: A pilot study

2020 ◽  
pp. 112067212094401
Author(s):  
Rita Serra ◽  
Florence Coscas ◽  
Antonio Pinna ◽  
Marcella Peri ◽  
Ignazio Zucca ◽  
...  
Keyword(s):  
Uric Acid ◽  
Pilot Study ◽  
Visual Field ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Serum Levels ◽  
Mean Deviation ◽  
Ophthalmological Examination ◽  
Open Angle ◽  
Rnfl Thickness

Purpose: To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG). Methods: In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement. Results: IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls ( p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes ( p < 0.05). Conclusion: Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.

scholarly journals Changes in peripapillary retinal nerve fiber layer thickness in chronic glaucoma and non-glaucoma patients after phacoemulsification cataract surgery

2015 ◽  
Vol 24 (4) ◽  
pp. 221-7
Author(s):  
Olivia P. Perdana ◽  
Andi A. Victor ◽  
Virna D. Oktarina ◽  
Joedo Prihartono
Keyword(s):  
Visual Field ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
T Test ◽  
Mean Deviation ◽  
Fiber Layer ◽  
Chronic Glaucoma ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness ◽  
Glaucoma Group

Background: Phacoemulsification is a common cataract operation nowadays. During phacoemulsification, variation in intraocular pressure (IOP) may occur, which might change the retinal nerve fiber layer (RNFL) thickness. This study was aimed to evaluate the change in peripapillary RNFL thickness and mean deviation (MD) of visual field after phacoemulsification in chronic primary glaucoma and non-glaucoma patients. Methods: Cohort prospective study was done on 26 patients (13 chronic glaucoma eyes and 13 non-glaucoma eyes) who underwent phacoemulsification. The changes in peripapillary RNFL thickness and MD of visual field were measured as the primary outcome. Comparison between pre- and post-surgery was analyzed with paired t-test, while unpaired t-test was used for comparison between groups.Results: There were no significant changes in RNFL thickness on both groups. Average RNFL thickness in glaucoma group before and after phacoemulsification were 94.9±20.0 μm and 99.1±21.3 μm, respectively (p>0.05). Average RNFL thickness in non-glaucoma group were 100.2±11.1 μm and 101.7±6.8 μm, respectively (p>0.05). Glaucoma patients yielded decreasing mean deviation (MD) of visual field, but it was not statistically significant (p=0.071). In contrast, the MD of visual field after surgery was significantly increased in non-glaucoma group (p=0.005).Conclusion: Phacoemulsification tended to increase peripapillary RNFL thickness in glaucoma or non-glaucoma patients. The visual field tended to decrease in glaucoma patients, but was significantly increased in non-glaucoma patients.

scholarly journals Glaucoma Progression after Delivery in Patients with Open-Angle Glaucoma Who Discontinued Glaucoma Medication during Pregnancy

2021 ◽  
Vol 10 (10) ◽  
pp. 2190
Author(s):  
Duri Seo ◽  
Taekjune Lee ◽  
Joo Yeon Kim ◽  
Gong Je Seong ◽  
Wungrak Choi ◽  
...  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Field Tests ◽  
Mean Deviation ◽  
Close Monitoring ◽  
Open Angle ◽  
Fiber Layer ◽  
Glaucoma Progression

In this retrospective study, clinical characteristics and glaucoma progression of open-angle glaucoma (OAG) patients who discontinued intraocular pressure (IOP)-lowering medication during pregnancy were investigated. Glaucoma progression was determined using either serial visual field tests or optic disc/retinal nerve fiber layer (RNFL) photographs. Age, number of previous pregnancies, diagnosis, average IOP, IOP fluctuation, visual field mean deviation, pattern standard deviation, and RNFL thickness were examined, and their association with glaucoma progression was determined using linear regression analysis. Among 67 eyes (37 patients), 19 eyes (28.4%) exhibited glaucoma progression 13.95 ± 2.42 months after delivery. The progression group showed significantly higher mean IOP than the nonprogression group in the first, second, and third trimesters (p = 0.02, 0.001, and 0.04, respectively). The average IOP in the second, and third trimesters and IOP fluctuation during the entire pregnancy were significantly associated with glaucoma progression according to a univariate analysis (p = 0.04, 0.031, and 0.026, respectively). In conclusion, IOP elevation during pregnancy is associated with glaucoma progression after delivery in patients who had discontinued medication during pregnancy. Therefore, close monitoring of glaucoma is necessary, particularly if patients discontinue medication during pregnancy, and appropriate intervention should be considered in case of increased IOP.

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