scholarly journals Morphofunctional Studies in the Early Diagnosis of Primary Open-Angle Glaucoma

2018 ◽  
Vol 15 (3) ◽  
pp. 280-286
Author(s):  
E. E. Kazaryan ◽  
I. A. Ronzina ◽  
V. M. Sheludchenko ◽  
T. V. Smirnova ◽  
D. M. Safonova ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Early Diagnosis ◽  
Structural Changes ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Nerve Fibers ◽  
Control Group ◽  
Retinal Layer ◽  
Open Angle ◽  
Confocal Scanning Laser

Purpose:to study the relationship between the optic nerve structural changes and the electrophysiological parameters of visual analyzer in the early diagnosis of primary open-angle glaucoma (POAG).Patients and methods.68 people took part in the study. 48 patients (56 eyes) were diagnosed with ophthalmic hypertension, suspected glaucoma (age ranged from 35 to 67 years, the average age was 51 years) and 20 healthy subjects (40 eyes) who entered the control group (age 32 up to 63 years, the average age is 47 years). All patients underwent standard ophthalmologic examination, multifocal electroretinography (mEPHRG), confocal scanning laser ophthalmoscopy (KSLO), electrophosphhenes and CFCs. For all types of analysis of mEPHR indices (by rings, quadrants and 3D), normal topography and density of the biopotential of the central region of the retina were recorded in patients with suspected glaucoma. The indices of the electrosensitivity of the inner layers of the retina, the conductivity of the axial fasciculus of the optic nerve, and CFSC also corresponded to normal values. Analysis of CCEA results showed a significant decrease of NRF volume of and the thickness of the retinal layer of nerve fibers compared to the control group, while in the group of patients with suspected glaucoma in 71 % of cases, the decrease of indicators correlated with the abnormalities in the static perimetry that was carried out earlier. Conducted morphometric studies confirm the fact that the decrease in the volume of IUU and SNV begins at the early, preclinical stage of glaucoma, and this in patients with ophthalmic hypertension can provide valuable information on the early diagnosis of POAG.

Efficiency evaluation of the neuromidin in complex treatment of the patients with primary glaucoma

10.12737/5480 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Сурнин ◽  
S. Surnin ◽  
Захарова ◽  
Irina Zaharova ◽  
Приставка ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Nerve Fibers ◽  
Field Of View ◽  
Control Group ◽  
Advanced Stage ◽  
Open Angle ◽  
Complex Treatment ◽  
Severe Degree

The authors studied the efficiency of the Neuromidin in complex treatment of the patients with primary open-angle glaucoma. 65 patients (130 eyes), of which 44 advanced stage, 76 - with severe and 10 eyes with a terminal stage of primary open-angle glaucoma (POAG) were examined. These patients received the Neuromidin in the dose of 1 ml (15 mg) intramuscularly, №10, with complete therapy (the Emoxipin in/m, the Piracetam in/in, the medication parabulbarno). Then, the patients received 1 tablet 2 times daily (20 mg) within 25 days as the monotherapy with local hypotensive drops (timolol, azopt, azarga, fotil, cosopt, alphagan P). Intraocular pressure compensation was achieved by timolol 0,5% dropping (45 eyes), azopt dropping (28 eyes), alphagan P dropping (6 eyes) and by means of combination drugs: azarga (32 eyes), cosopt (15 eyes) and fotil (4 eyes). Of them, in 52 eyes surgical treatment was made. The control group consisted of 30 patients (60 eyes), who received the treatment without the Neuromidin. In work the authors used the standard methods of ophthalmic research. The increase of visual acuity and expansion of field of view in both groups was revealed, but in the patients treated by means of the Neuromidin the visual acuity increased in advanced 0.13, in patients with severe degree of disease – in 0.12, in the control group – in 0.06 and 0,05, respectively . Field of view has expanded in an advanced stage of 55 degrees, and in severe – 35 degrees higher than in the control group. The Neuromidin effect on the state of the outflow of aqueous humor was revealed. This effect can be explained by the fact that the drug stimulates the impulse conduction in nerve fibers and synapses, blocks of cholinesterase, stimulates the ciliary muscle and activation of the outflow watery moisture. The achieved effect gradually decreases to the initial indicators within 6 months in 2/3 patients.

scholarly journals Treatment of patients with primary open angle glaucoma with the use of myotherapy

2012 ◽  
Vol 93 (4) ◽  
pp. 590-594
Author(s):  
A N Korobitsin
Keyword(s):  
Optic Nerve ◽  
Visual Function ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Control Group ◽  
Upper Cervical Spine ◽  
Morphological Parameters ◽  
Open Angle ◽  
Upper Cervical ◽  
Regional Hemodynamics

Aim. To evaluate the effectiveness of myotherapy, which is conducted to stabilize the glaucoma optic neuropathy in patients with primary open-angle glaucoma. Methods. Treatment with the use of myotherapy was performed in 50 patients (94 eyes) with open-angle glaucoma of the I-II stage with decompensation of intraocular pressure b-c, at the age of 45 to 67 years. The control group consisted of 50 patients (100 eyes) with similar stages of glaucoma, at the age of 47 to 60 years who were treated with vascular drugs. The complex ophthalmologic examination included visometry, auto-refractometry, biomicroscopy, gonioscopy, direct ophthalmoscopy with medical mydriasis, the Heidelberg retinal tomography of the optic disc, computer static perimetry, 24-hour tonometry, tonography, Doppler ultrasound. Repeated complex examination of all patients was performed 6-12 months after treatment. Results. In the first group stabilization of the visual function and morphological parameters of the optic nerve disc was registered in 19.1% of cases (18 eyes), a positive dynamic was registered in 74.4% of cases (70 eyes). In the second (control) group stabilization was achieved in 16% of cases (16 eyes), a positive dynamic was achieved only in 8% of cases (8 eyes), while a negative dynamic was noted in 76% of cases (76 eyes) compared with 6.4% in the first group. Conclusion. Treatment of the reflex spasm of the ciliary muscle after removal of the muscle blocks of the upper cervical spine leads to stabilization of the visual function, morphological parameters of the optic nerve and visual field expansion due to restoration of the hydrodynamic parameters as well as the cerebral and regional hemodynamics of the eye.

scholarly journals Contribution and significance of Heidelberg retinal tomography II in diagnostics of ocular hypertension and its conversion into primary open-angle glaucoma

2009 ◽  
Vol 66 (4) ◽  
pp. 283-289
Author(s):  
Vujica Markovic ◽  
Djordje Kontic ◽  
Paraskeva Hentova-Sencanic ◽  
Marija Bozic ◽  
Ivan Marjanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optic Nerve ◽  
Ocular Hypertension ◽  
Optic Nerve Head ◽  
Structural Changes ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Significant Loss ◽  
Open Angle

Background/Aim. A term 'ocular hypertension' is used when IOP is found to be > 21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II) results that show very early, subtle changes in retinal neurofibre layers (RNFL) in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio), but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. Methods. During a 5-year study period (2002-2007), 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT), central corneal thickness (CCT) determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nervi optici (PNO) examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D) ratio, which was followed during the control examination by each segment, as well as PNO in global. Results. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413) comparing to the last one. Conclusion. In diagnosing ocular hypertension and its conversion to glaucoma, HRT II is used for quantitative evaluation of retinal topography and for quantitative monitoring of topographical changes, especially regarding the increase of C/D ratio and loss of rim volume tissue, which enables to see and register subtle structural changes in optic nerve head and RNFL that are so characteristic for glaucoma, which cannot be seen by an ophthalmoscope. With these results, according to risk factors for glaucoma, one can confirm the diagnosis of ocular hypertension and its conversion to primary open-angle glaucoma. In this study HRT II revealed conversion of ocular hypertension into glaucoma in 10% of the patients.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

2020 ◽  
pp. 97-105
Author(s):  
E. N. Simakova ◽  
O. V. Stenkova
Keyword(s):  
Intraocular Pressure ◽  
Drug Therapy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Main Group ◽  
Control Group ◽  
Open Angle ◽  
Complex Treatment ◽  
Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

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.

scholarly journals Comparison of Ocular Biometry between Primary Open Angle Glaucoma Patients and Normal subjects

2021 ◽  
Vol 13 (2) ◽  
pp. 62-68
Author(s):  
Nisha Manandhar ◽  
Chandni Pradhan ◽  
Purushottam Joshi ◽  
Prabha Subedi ◽  
Pranav Shrestha
Keyword(s):  
Anterior Chamber ◽  
Axial Length ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Chamber Depth ◽  
Control Group ◽  
Open Angle ◽  
K Value ◽  
The Difference ◽  
Glaucoma Group

Introduction: Glaucoma is one of the major causes of irreversible blindness. In Nepal, the most common type of Glaucoma seen is Primary Open Angle Glaucoma. There are many risk factors associated with Primary Open Angle Glaucoma. The main objective of the study was to compare ocular biometric parameters in patients diagnosed with Primary Open Angle Glaucoma and age matched controls. Material and methods: This is a hospital based cross sectional study done at Mechi Eye Hospital. The study included 137 cases of Primary Open Angle Glaucoma and 75 normal individuals as control.  Axial length (AL), anterior chamber depth (ACD), Keratometry ‘K’ value and Central Corneal Thickness (CCT) were measured. Mann – Whitney U test was used for statistical analysis. Results: Mean age in Primary Open Angle Glaucoma group was (55.25 ± 10.16 years) and in the control group was (60.96 ± 10.91 years). Axial length  in the Primary Open Angle Glaucoma group (23.16 ±1.19 mm) was deeper as compared to the control group (22.69 ±0.89 mm), the difference was statistically significant (p<0.001). Anterior chamber depth (ACD) was statistically deeper in the Primary Open Angle Glaucoma group (3.05 ±0.51 mm) as compared to the control group (2.86 ±0.46 mm), (p<0.01). Central corneal thickness (CCT) was thinner in the Primary Open Angle Glaucoma group (519.5 ±36.25 um) as compared to the control group (525.40 ±37.77 um) but the difference was not found to be statistically significant (p<0.19). K value in Primary Open Angle Glaucoma (7.54 ±0.41mm) was higher than age-matched controls (7.58 ± 0.33mm) but the difference was not statistically significant (p<0.79). Conclusion: Patients with Primary Open Angle Glaucoma had longer Axial length (AL) and deeper Anterior chamber depth (ACD) as compared to normal individuals.

scholarly journals The association between primary open-angle glaucoma and helicobacter pylori infection

2021 ◽  
pp. 036-042
Author(s):  
Raji Mohammad Mehdi
Keyword(s):  
Helicobacter Pylori ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Helicobacter Pylori Infection ◽  
Control Group ◽  
Case Group ◽  
Open Angle ◽  
Practical Applications ◽  
Ocular Pressure ◽  
H Pylori

Background: Primary Open-Angle Glaucoma (POAG) the most common form of glaucoma is a neurodegenerative disease, which is the third most common cause of blindness worldwide. It is estimated that 60 million people in the world are affected by this disease and 8.4 million are bilaterally blind. Among the various factors that have been implicated in the pathophysiology of this disease is infection with Helicobacter pylori (HP), a Gram-negative bacterium that is commonly found in stomach and present in approximately one-half of the world’s population. Establishment of such a causal correlation will probably have important practical applications as the eradication of H. pylori might lead to developments in the treatment of glaucoma. Objectives: To investigate the association between Primary Open-Angle Glaucoma (POAG) and Helicobacter Pylori infection and to observe fluctuations in intra ocular pressure after Helicobacter Pylori infection eradication. Design: Duration based, prospective observational study. Participants: 50 patients with documented Primary Open-Angle Glaucoma (POAG) as case group and 50 non-glaucoma participants as control group. Methods: Upper gastrointestinal endoscopy was performed to evaluate macroscopic abnormalities, and gastric mucosal biopsy specimens were obtained for the presence of H. pylori infection tested by Rapid Urease Test (RUT). All subjects underwent detailed ocular examinations including visual acuity, slit-lamp examination, fundoscopy, intra-ocular pressure recording, gonioscopy, GHT to assess visual fields and OCT of optic nerve head. Results: In 90% of POAG patients of case group and in 68% of non-glaucoma participants of control group Helicobacter pylori infection was detected by RUT (P-Value=0.007). Conclusion: H. pylori infection is more frequent in glaucoma patients, perhaps more so in those of Indian ethnicity. It may play a role as a secondary aggravating factor or even may be the primary cause. The establishment of such a causal relationship will probably have important practical applications as the eradication of H. pylori might lead to developments in the treatment of glaucoma.

scholarly journals Association between Platelet Parameters and Glaucoma Severity in Primary Open-Angle Glaucoma

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yi Ma ◽  
Jianping Han ◽  
Shengjie Li ◽  
Aiping Zhang ◽  
Wenjun Cao ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Clinical Laboratory ◽  
Open Angle Glaucoma ◽  
Large Cell ◽  
Control Group ◽  
Mean Deviation ◽  
Open Angle ◽  
Regression Analyses ◽  
Distribution Width ◽  
Department Of Ophthalmology

Purpose. To evaluate platelet parameters in primary open-angle glaucoma (POAG) patients and to explore the association between platelet parameters and POAG severity. Methods. A total of 402 consecutive POAG patients and 408 healthy control subjects from the Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Fudan University, were consecutively recruited between January 2016 and October 2018. Detailed ophthalmological and systematic examinations were performed. Blood samples for platelet parameters, including platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR), were analyzed using an automated hematology analyzer in the department of clinical laboratory science of the hospital. The POAG subgroups were classified according to age (<50, ≥50), gender, and visual field mean deviation (MD): mild (MD ≤ 6 dB), moderate (6 dB < MD ≤ 12 dB), and severe (MD > 12 dB). Results. In POAG patients, PLT counts (207.08 ± 54.70 ∗ 109/L) were significantly lower p=0.001 than those of the control group (220.46 ± 55.85 ∗ 109/L). In the POAG group, PDW (13.76 ± 3.16 fL) and MPV (10.46 ± 1.32 fL) values were significantly higher (all p<0.001) than those of the control group (PDW 11.82 ± 2.44 fL, MPV 10.13 ± 1.10 fL). PDW and MPV values were highest in the severe POAG group (PDW 14.49 ± 2.99 fL; MPV 10.74 ± 1.39 fL), followed by the moderate group (PDW 12.50 ± 3.14 fL; MPV 10.02 ± 1.08 fL) and then the mild group (PDW 11.82 ± 2.44 fL; MPV 9.92 ± 0.76 fL), with statistically significant differences observed between mild-severe POAG and moderate-severe POAG groups by LSD post hoc test. Multiple linear regression analyses showed a significant association between PDW and MD (β = 0.430, p<0.001) and MPV and MD (β = 0.363, p=0.001). Logistic regression analyses revealed that PDW (OR = 1.297, 95% CI = 1.011–1.663) was associated with the severity of POAG. Conclusions. PDW and MPV values were significantly elevated in POAG patients, and PDW was positively associated with disease severity, which suggested the possibility that platelet activation be involved in pathomechanisms of POAG.

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