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 Visual field indices and optic disc parameters in a 24-month follow-up of primary open angle glaucoma patients

1999 ◽  
Vol 77 (S229) ◽  
pp. 20-21
Author(s):  
Angelo Macrì ◽  
Maurizio Rolando ◽  
Guido Corallo ◽  
Michele Iester ◽  
Giuseppe Verrastro ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Visual Field Indices

scholarly journals Efficacy and Safety of Timolol-Dorzolamide Fixed-Combination Three Times a Day Versus Two Times a Day in Newly Diagnosed Open Angle Glaucoma

2018 ◽  
Author(s):  
Mohammad Pakravan ◽  
Afsaneh Naderi Beni ◽  
Shahin Yazdani ◽  
Hamed Esfandiari
Keyword(s):  
Blood Pressure ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
The Mean

Purpose: To compare the therapeutic efficacy and safety of dorzolamide/timolol fixed-combination in newly diagnosed primary open angle glaucoma patients. Methods: In this prospective, interventional case series, newly diagnosed primary open angle glaucoma (POAG) patients that had not been treated for glaucoma were included. Patients were started on Cosopt twice a day (BID) for 1 month and then switched to three times a day (TDS) for additional 1 month. Patients underwent comprehensive ophthalmic examination, diurnal intraocular pressure (IOP), blood pressure (BP) and 24-hours heart rate (HR) measurements at baseline, month 1( BID), and month 2( TDS). IOP, systolic and diastolic pressures were measured at 8:00 AM,12:00 AM, 4:00 PM, 8:00 PM and 12:00 PM. Throughout the study, all adverse events were recorded and monitored by the investigators. Results: In 31 POAG patients that completed the study ,mean baseline IOP was 23.1&plusmn;3.15 mmHg . IOP was decreased significantly 16.5 &plusmn; 2.21 at 1 month (P &lt; 0.0001) and 13.9 &plusmn; 2.23 mmHg at 1 and 2 month follow up. (P &lt; 0.0001) IOP was significantly lower in month 2 compared to month 1 (P = 0.0004). While Cosopt BID significantly reduced the mean 24-hour systolic BP and mean 24-hour HR from baseline (P &lt; 0.0001), the mean 24-hour systolic BP and HR remained unchanged 2ith Cosopt TDS compared to BID (P = 0.62). Conclusions: Cosopt TDS has a superior IOP-lowering effect than Cosopt BID in POAG patients with comparable safety profile.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;

scholarly journals Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden.

2020 ◽  
Author(s):  
Marcelo Ayala
Keyword(s):  
Visual Field ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
T Test ◽  
Open Angle ◽  
Visual Field Progression ◽  
Exfoliation Glaucoma ◽  
The Difference ◽  
Glaucoma Group

Abstract Background: The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients. Methods: Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for three years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24-2 of the Humphrey Field Analysis. Outcomes: Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA). Results: The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (-3.17 dB) than in the primary open-angle (-1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p=<0.001). The difference in VFI was calculated for the three years follow-up period. The difference was higher in the exfoliation (-7.65%) than in the primary open (-1.90%) glaucoma group (t-test, p=<0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p=<0.001). Conclusion: The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.

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 Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Marcelo Ayala
Keyword(s):  
Visual Field ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
T Test ◽  
Open Angle ◽  
Visual Field Progression ◽  
Exfoliation Glaucoma ◽  
The Difference ◽  
Glaucoma Group

Abstract Background The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients. Methods Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for 3 years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24–2 of the Humphrey Field Analysis. Outcomes: Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA). Results The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (− 3.17 dB) than in the primary open-angle (− 1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p = < 0.001). The difference in VFI was calculated for the 3 years follow-up period. The difference was higher in the exfoliation (− 7.65%) than in the primary open (− 1.90%) glaucoma group (t-test, p = < 0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p = < 0.001). Conclusion The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.

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 A comparative study of computerised visual field testing and optic disc morphometric parameters in the follow-up of primary open angle glaucoma

Eye ◽  
1998 ◽  
Vol 12 (6) ◽  
pp. 916-920 ◽  
Author(s):  
Angelo Macri ◽  
Maurizio Rolando ◽  
Guido Corallo ◽  
Michele Iester ◽  
Giuseppe Verrastro ◽  
...  
Keyword(s):  
Visual Field ◽  
Comparative Study ◽  
Optic Disc ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Field Testing ◽  
Morphometric Parameters ◽  
Open Angle ◽  
Visual Field Testing

scholarly journals Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Soosan Jacob ◽  
Michele Figus ◽  
Dhivya Ashok Kumar ◽  
Ashvin Agarwal ◽  
Amar Agarwal ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Single Step ◽  
Visual Field Defects ◽  
Open Angle ◽  
Filtration Surgery ◽  
Stab Incision

Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS), for primary open angle glaucoma (POAG).Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects). After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5–1 mm into cornea and anterior chamber (AC) was entered. Kelly Descemet’s punch (1 mm) was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured.Results. Mean preoperative IOP was27.41±5.54 mmHg and mean postoperative IOP was16.47±4.81 mmHg (n=17). Mean reduction in IOP was38.81±16.55%. There was significant reduction of IOP (p<0.000). 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered.Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18±1.88months).

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.

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