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 Correlation between functional staging and DDLS in primary open angle glaucoma patients in Vietnam

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Anh Van Thi Bui ◽  
Thom Thi Vu ◽  
Tung Thanh Hoang
Keyword(s):  
Visual Field ◽  
Intervention Study ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Mean Deviation ◽  
Fisher Exact Test ◽  
Open Angle ◽  
Chi Square ◽  
Exact Test ◽  
Chi Square Test

Background: Clinically, there are many systems of visual field staging parallel exist. The agreement between glaucoma function and appearance is still uncertain. This study was to compare visual field staging classifications (as function staging) with disc damage likelihood scale (DDLS as appearance staging) in primary open angle glaucoma (POAG).Methods: Cross-section study on 55 patients (90 eyes) examined and treated in Vietnam National Institute of Ophthalmology from 9/2016 – 9/2017. The MD (mean deviation), PSD (pattern standard deviation), VFI (visual field index) indexes were recorded and were used to classify glaucoma staging according to categories of eGSS (enhance glaucoma severity staging), mGSS (modified glaucoma severity staging), HPA (Hoddaps – Palmela – Adersons), AGIS (advance glaucoma intervention study) and DDLS. Using SPSS 16.0 software, statistically significance was tested with proper tests as Chi – square test, Fisher exact test, Kappa (to assess the agreement - disagreement), Spearman Rank (to assess the level of correlation).Results: Mean visual field indexes were -11.49 dB (MD), 5.85 dB (PSD), 74.2% (VFI). Compared to the DDLS, all systems had slight agreement (K < 0.2). The disagreement percentage was highest in eGSS (70%) then followed by mGSS (50%) and HPA (48.9%). In terms of definitive diagnosis, HPA and mGSS showed a substantial agreement (K > 0.6) with AGIS which is higher than that between eGSS and AGIS (retrospectively 0.773 and 0.75 vs 0.399) with p < 0.001. In terms of staging detection, the agreement between HPA &mGSS and AGIS was substantial (K > 0.6) while that between eGSS and AGIS was fair (K < 0.4).Conclusion: mGSS and HPA tend to show the stronger agreement with standard classifications than eGSS. mGSS should be used in clinical practice and research.

scholarly journals Association between lateral decubitus sleeping position and asymmetric visual field loss and its progression in primary open-angle glaucoma patients

2019 ◽  
Author(s):  
Zhong Lin ◽  
Xiafei Pan ◽  
Xing Wang ◽  
Cong Ye ◽  
Shaodan Zhang ◽  
...  
Keyword(s):  
Visual Field ◽  
Primary Open Angle Glaucoma ◽  
Screening Program ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Open Angle ◽  
Sleeping Position ◽  
Lateral Decubitus ◽  
Fellow Eyes

Abstract Background: To investigate the association between lateral decubitus sleeping position (LDSP) and asymmetric visual field (VF) loss and progression in primary open-angle glaucoma (POAG) patients. Methods: This was a prospective, cohort study. Sixty-eight POAG (53 normal tension glaucoma, NTG) patients with asymmetric VF loss were included from the Wenzhou Glaucoma Screening Program (WGSP) and followed up. A questionnaire was used to determine the LDSP. Asymmetric VF loss was defined as at least 2-dB difference in mean deviation (MD) between the 2 eyes at baseline. According to these values, the better eye and worse eye were defined. The number of those preferring the worse eye LDSP versus the better eye LDSP was compared. The number of progressive eyes with LDSP and fellow eyes of LDSP were also compared. Results: Forty-five (66.2%) POAG and 34 (64.2%) NTG patients preferred the LDSP. Of these, 24 (53.3%, p=0.66) and 16 (47.1%, p=0.73) preferred the worse eye LDSP, respectively. Twenty-six eyes of the 45 POAG patients with both asymmetric VF loss and LDSP were judged as progression until the last follow-up (24.7 ± 9.5 months). Among which, there were 12 (46.2%) eyes with LDSP and 14 (53.8%) fellow eyes of LDSP (p=0.70). Conclusions: Approximately two thirds of the POAG/NTG patients preferred the LDSP. However, we could not draw the conclusion that lateral decubitus sleeping position is associated with asymmetric VF loss or glaucoma progression. Keywords: primary open-angle glaucoma; normal tension glaucoma; preferred sleeping position; asymmetric visual field defect

scholarly journals Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls

2019 ◽  
Vol 104 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Riccardo Vinciguerra ◽  
Salwah Rehman ◽  
Neeru A Vallabh ◽  
Mark Batterbury ◽  
Gabriela Czanner ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Biomechanics ◽  
Mean Deviation ◽  
Open Angle ◽  
Corvis St ◽  
Significant Difference

AimsTo compare the biomechanically corrected intraocular pressure (IOP) estimate (bIOP) provided by the Corvis-ST with Goldmann applanation tonometry (GAT-IOP) in patients with high-tension and normal-tension primary open-angle glaucoma (POAG; HTG and NTG), ocular hypertension (OHT) and controls. Moreover, we compared dynamic corneal response parameters (DCRs) of the Corvis-ST in POAG, OHT and controls, evaluated the correlation between global visual field parameters mean deviation and pattern SD (MD and PSD) and DCRs in the POAG group.Methods156 eyes of 156 patients were included in this prospective, single-centre, observational study, namely 41 HTG and 33 NTG, 45 OHT cases and 37 controls. Central corneal thickness (CCT), GAT-IOP and bIOP were measured, GAT-IOP was also adjusted for CCT (GATAdj). DCRs provided by Corvis-ST were evaluated, MD and PSD were recorded by 24–2 full-threshold visual field. To evaluate the difference in DCRs between OHT, HTG and NTG, a general linear model was used with sex, medications and group as fixed factors and bIOP and age as covariates.ResultsThere was a significant difference between GAT-IOP, GATAdj and bIOP in NTG and HTG, OHT and controls. NTG corneas were significantly softer and more deformable compared with controls, OHT and HTG as demonstrated by significantly lower values of stiffness parameters A1 and highest concavity and higher values of inverse concave radius (all p<0.05). There was a significant correlation (p<0.05) between MD, PSD and many DCRs with POAG patients with softer or more compliant corneas more likely to show visual field defects.ConclusionsCorneal biomechanics might be a significant confounding factor for IOP measurement that should be considered in clinical decision-making. The abnormality of corneal biomechanics in NTG and the significant correlation with visual field parameters might suggest a new risk factor for the development or progression of NTG.

scholarly journals 5-year outcomes of single iStent (G1) trabecular microbypass implantation with phacoemulsification in moderately advanced primary open angle glaucoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257015
Author(s):  
Ejaz Ansari
Keyword(s):  
Visual Field ◽  
Outcome Measures ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Secondary Outcome ◽  
Mean Deviation ◽  
Open Angle ◽  
Severe Stage

Purpose To evaluate the safety and efficacy of combined phacoemulsification and single iStent (G1) (iStent, Glaukos Corp. San Clemente, USA), implantation in moderately advanced primary open angle glaucoma (POAG) with 5-years follow-up. Methods Retrospective, interventional case series. All subjects had POAG and underwent single iStent implantation+ phaco+IOL by a single surgeon, with 5 years follow-up. Primary outcome measures: reduction in intraocular pressure (IOP) and proportion of eyes achieving at least 20% reduction of IOP at 5 years. Secondary outcome measures: number of glaucoma drops at 1 through to 5 years; change in visual field mean deviation (MD) at year 5 compared to baseline. Results 35 eyes of 26 patients were included. Mean (sd) medicated pre-op IOP was 18.5 (3.2) mm Hg on mean (sd) 2.3 (1.0) medications. Mean IOP was reduced to 15.9 (4.5) mm Hg on 2.2 (0.9) drops, 15.0mm (4.5) mm Hg on 2.3 (0.9) drops, 15.6 (3.6) mm Hg on 2.5 (1.0) drops, 15.7 (4.43) mmHg on 2.6 (1.0) drops and 14.7 (3.02) mmHg (P<0.001) on 2.7 (1.14) drops (P = 0.06) from 1 through to 5 years. At year 5, 62% of eyes had achieved at least 20% reduction in IOP. MD reduced from -8 (8.1) dB to -10.7 (13.4) dB over 5 years (p = 0.8) at 0.54dB/ annum. One eye required filtering surgery. There were no sight-threatening complications. Conclusion This study showed sustained IOP reduction and excellent safety profile for single iStent implantation. Uniquely it provides data for a more severe stage of glaucoma, and also visual field data, which indicated no significant change through 5 years.

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.

Surgical resection of the sclera is a non-penetrating operation for the treatment of patients with primary open-angle and secondary glaucoma

GlaucomaNews ◽  
2020 ◽  
pp. 62-65
Author(s):  
А.Y. Kazantseva ◽  
◽  
O.A. Rumyantseva ◽  
Keyword(s):  
Surgical Resection ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Secondary Glaucoma ◽  
Ophthalmological Examination ◽  
Open Angle ◽  
Visual Functions ◽  
Dynamic Observation ◽  
Uveoscleral Outflow ◽  
Outflow Pathway

Purpose. To evaluate the effectiveness of surgical resection of the sclera in patients with primary open-angle and secondary glaucoma. Materials and methods. The study included 84 patients with POAG and SG stages III-IV and decompensated IOP level (not higher than 32 mm Hg). In order to normalize the increased ophthalmotonus, a non - penetrating operation was performed-surgical resection of the sclera (SRS). The patients underwent complex ophthalmological examination and dynamic observation. Result. In the studied groups of patients after surgical treatment there was a decrease in elevated IOP levels by 33.42%, an improvement in the coefficient of ease of outflow and a weakening of the hypotensive regime. Stabilization of visual functions was observed in all patients. Summary. The proposed new SRS technique provides a smooth decrease in IOP, preservation of visual functions and is not accompanied by intra-and postoperative complications. Key words: primary open-angle glaucoma, surgical resection of sclera, secondary glaucoma, uveoscleral outflow pathway (USPO), intraocular pressure, EO coefficient .

Effectiveness of Ayurvedic intervention in Primary Open Angle Glaucoma (Kaphaja Adhimantha) - A Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Ratheesh P. ◽  
Dr. Abhayadev A. ◽  
Dr. Varsha Sumedhan ◽  
Dr. Meghna P P. ◽  
Dr. Srinivasan M ◽  
...  
Keyword(s):  
Visual Field ◽  
Structural Changes ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Treatment Protocol ◽  
Clinical Findings ◽  
Field Analysis ◽  
Open Angle ◽  
Remarkable Change ◽  
Related Disorder

Glaucoma is a diverse group of disorders affecting the eye with a common characteristic potentially progressive optic neuropathy that is determined by both structural changes and functional deficit in which IOP is a key modifiable factor. In Primary Open Angle Glaucoma (POAG), IOP independent mechanisms of glaucomatous nerve damage and visual field loss with unobstructed angle of anterior chamber is observed. The patient has reported gradual diminution of peripheral aspect of visual field (Rt. eye - 6/12 and Lt. eye - 6/12 on Snellen’s distant vision chart) in both eyes for 2 years. There was marked peripheral field defect on both confrontation test and perimetry visual field analysis test. The disease shows clinical similarity with Kaphaja Adhimantha, a disease affecting the whole eye mentioned in Susruta Samhita and Ashtanga Hrudaya. It is a chronic disease comes under life style related disorder. Dukhena Roopam Pasyathi (distorted image or constricted visual field), Sirodukha (headache), Srava (watering), Kandu (itching), Pamsupoornatha (foreign body sensation), Aviladarsana (diminished vision) and Gourava (heaviness of eye and head) are the clinical findings explained in the context of Kaphaja Adhimantha. These clinical finding mentioned in classical literature shows resemblance with POAG. The meticulous deployment of kaphaja Abhisyandha- Adhimantha treatment protocol can be used to prevent the progression of ganglionic damage and preservation of eye sight. The logical interpretation on the basis of both subjective and objective clinical findings concluded the diagnosis as Kaphaja Adhimantha and treatment principle adopted was Apatharpana, Kaphahara, Abhisyandhahara and Srothovisodhana. After treatment his vision has improved as 6/6 (Rt. Eye) and 6/6 (Lt. Eye) and remarkable change in field analysis. The study discusses about the effectiveness of Ayurvedic management in POAG.

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