scholarly journals Traumatic glaucoma mimicking primary open angle glaucoma

2019 ◽  
Author(s):  
Xiaoming Duan

Abstract Backgrounds To retrospectively analyze the clinical and ocular features in eyes with traumatic glaucoma misdiagnosed as primary open angle glaucoma (POAG). Methods We reviewed nineteen eyes with traumatic glaucoma misdiagnosed and collected their ocular and supplementary examination results. Results The outpatient age was 47.1±12.8 years old. The traumatic history was from 1 to 40 years. The history of hand or stone was present about 21.1% of patients, followed by balls (15.8%) and wooden stick (15.8%). The peak IOPs were 33.0±10.6mmHg. Iridodialysis was seen in 2 patients. Trabecular pigmentation grade more than 3 was noticed in 15 patients. Angle recession was found in all patients. No patient was found lens location and fundus damage. Conclusions Patients with long traumatic history, mild ocular signs and insidious symptoms were more likely to be misdiagnosed. It might be more prudent to diagnose as POAG while there was significant difference in the condition of both eyes.

2019 ◽  
Vol 76 (8) ◽  
pp. 822-829
Author(s):  
Vesna Maric ◽  
Vujica Markovic ◽  
Marija Bozic ◽  
Ivan Marjanovic ◽  
Paraskeva Hentova-Sencanic ◽  
...  

Background/Aim. Trabeculectomy is a safe procedure which effectively reduces the intraocular pressure (IOP). IOP is the most frequent indicator of success after glaucoma surgery. The aim of this work was to evaluate the long-term pressure control in primary open-angle glaucoma (POAG) and in pseudoexfoliative glaucoma (XFG) after primary trabeculectomy without the use of mitomycin-C (MMC), 3 to 5 years after trabeculectomy. Methods. This study involved a retrospective evaluation of 332 consecutive patients (352 eyes), 174 patients (188 eyes) with POAG (mean age of 64.0 ? 8.6 years) and 158 patients (164 eyes) with XFG (mean age of 70.7 ? 8.9 years) who underwent primary trabeculectomy between January 2007 and December 2009 at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade. A successful control of IOP was defined as achieving IOP ? 21 mmHg without medication (complete success), or with a single topical medication (qualified success). Results. According to the type of glaucoma POAG/XFG preoperative IOP was 28.4 ? 6.3/30.4 ? 8.4 mmHg, respectively (p = 0.311) and last postoperative IOP was 16.9 ? 5.2/18.7 ? 5.9 mmHg, respectively (p = 0.681). According to the Kaplan-Meier survival curve, the complete success in the group with POAG in 1, 3 and 5 years were 85%, 75% and 58% and in the group with XFG were 82%, 70% and 56%, respectively. There was no statistically significant difference in the complete success rates between the patients with POAG and XFG. Conclusion. The primary goal of surgery was to achieve a sufficiently low IOP without additional medication, thus preventing progression of glaucomatous damage. In our study, the complete success in the group with POAG was achieved in 75% and 58% of the patients in the period of 3 and 5 years after surgery, respectively and in the group with XFG complete success was achieved in 70% and 56% of the patients respectively.


2021 ◽  
Author(s):  
Giorgia Demaria ◽  
Azzurra Invernizzi ◽  
Daniel Ombelet ◽  
Joana Carvalho ◽  
Remco Renken ◽  
...  

Recent brain imaging studies have shown that the degenerative eye damage generally observed in the clinical setting, also extends intracranially. Both structural and functional brain changes have been observed in glaucoma participants, but we still lack an understanding of whether these changes also affect the integrity of cortical functional networks. This is relevant, as functional network integrity may affect the applicability of future treatments, as well as the options for rehabilitation or training. Here, we compare global and local functional connectivity between glaucoma and controls. Moreover, we study the relationship between functional connectivity and visual field (VF) loss. For our study, 20 subjects with primary open angle glaucoma (POAG) and 24 age similar healthy participants were recruited to undergo a complete ophthalmic assessment followed by two resting state (RS) (f)MRI scans. For each scan and for each group, the ROIs with EC values higher than the 95th percentile were considered the most central brain regions (hubs). Hubs for which we found a significant difference in EC in both scans between glaucoma and healthy were considered to provide evidence for network changes. In addition, for each participant, behavioural scores were derived based on the notion that a brain regions hub function might relate to the: 1) sensitivity of the worse eye, indicating disease severity, 2) sensitivity of both eyes combined, with one eye potentially compensating for loss in the other, or 3) difference in eye sensitivity, requiring additional network interactions. By correlating each of these VF scores and the EC values, we assessed whether VF defects could be associated with centrality alterations in POAG. Our results show that no functional connectivity disruptions were found at the global brain level in POAG participants. This indicates that in glaucoma global brain network communication is preserved. Furthermore, a positive correlation was found between the EC value of the Lingual Gyrus, identified as a brain hub, and the behavioral score for the VF sensitivity of both eyes combined. The fact that reduced local network functioning is associated with reduced binocular VF sensitivity suggests the presence of local brain reorganization that has a bearing on functional visual abilities.


2019 ◽  
Author(s):  
Anh Van Bui ◽  
Tung Thanh Hoang ◽  
Ngoc Bich Nguyen ◽  
Anh Kim Le ◽  
Jennifer L. Patnaik

Abstract Purpose: To identify risk factors for primary open-angle glaucoma (POAG) in a Vietnamese population. Methods: A matched case-control study was conducted at Vietnam National Institute of Ophthalmology. Cases were patients clinically diagnosed with POAG. Controls were caregivers of patients with other eye diseases, free from any ocular and systemic abnormalities, and were selected and then matched with the cases by gender and age. Cases and controls were examined by a glaucoma specialist to confirm presence or absence of POAG. Data on demographic, ophthalmic and medical conditions were collected via interview at time of examination. Associations between POAG and potential factors were examined by univariate conditional logistic regression analysis (OR – Odd Ratios) and multivariate conditional logistic regression (AOR – Adjusted Odd Ratios) with level of significance is 0.05. Results: In total, 128 cases with POAG and 128 controls were recruited. Multivariate conditional (fixed-effects) logistic regression analysis resulted in several significant risk factors, including hypertension AOR =4.7 (95% CI: 1.8–12.0; p=0.002); family history of glaucoma AOR = 6.4 (95% CI: 1.3 – 32.2; p = 0.026); over–the–counter eye medication AOR = 3.1 (95% CI: 1.5 – 6.5; p = 0.006), and a protective role for marriage AOR = 0.2 (95% CI: 0.1 – 0.7; p = 0.006) and weekly exercise AOR = 0.3 (95% CI: 0.1 – 0.8; p = 0.021). Conclusions: Hypertension, family history of glaucoma and over–the–counter eye medication were risk factors while marriage and weekly exercise were protective factors for POAG in Vietnamese population.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Remi Takeuchi ◽  
Nobuko Enomoto ◽  
Kyoko Ishida ◽  
Ayako Anraku ◽  
Goji Tomita

Purpose. We aimed to investigate factors related to superior and inferior hemifield defects in primary open-angle glaucoma (POAG). Methods. Sixty-seven subjects with newly diagnosed, untreated POAG underwent optical coherence tomography (OCT) of the disc area, macular ganglion cell complex (mGCC), and circumpapillary retinal nerve fiber layer (cpRNFL) thickness within 6 months of the visual field (VF) test. Based on the VF and OCT results, 40 subjects had a superior and 27 an inferior hemifield defect. Clinical data including visual acuity, refractive error, disc hemorrhage, VF indexes, and medical history were recorded. Results. Average mGCC thickness corresponding to the defective hemifields was thinner in the superior VF defect group than in the inferior VF defect group (P=0.003). Average total deviation (TD) was comparable between the two groups. However, the superior VF defect group had a higher prevalence of defects (P=0.001) and lower TD (P=0.002) within central 5 degrees of VF than the inferior VF defect group. In multivariate regression analyses, the temporal-lower and inferior-temporal cpRNFL thicknesses were significant contributing factors to the inferior mGCC thickness in the superior VF defect group. In the inferior VF defect group, the disc area, family history of glaucoma, and temporal-upper cpRNFL thickness contributed to the superior mGCC thickness. Conclusion. The inferior mGCC thickness corresponding to the superior hemifield defect group was significantly thinner than the superior mGCC thickness corresponding to the inferior hemifield defect group. The factors related to the reduction of the corresponding mGCC thickness may differ between superior VF defect and inferior VF defect groups.


Author(s):  
Olha V. Levytska ◽  
Igor Ya. Novytskyy

Hypotensive effect of endotrabeculectomy was compared with that of selective laser trabeculoplasty in patients with primary open-angle glaucoma (POAG). We evaluated 44 patients (44 eyes) with POAG. In the first group (23 patients), endotrabeculectomy (trabecular ablation through the angle of anterior chamber) was performed, and in the second group (21 patients) the patients underwent selective laser trabeculoplasty. When comparing the intraocular pressure (IOP), it was found that the difference between preoperative and postoperative IOP was significant up to 6 months of follow-up in both groups (p < 0.05), however, hypotensive effect in the first group was more pronounced (7.58 vs. 1.55 mmHg, respectively). When comparing the number of hypotensive medications used before and after glaucoma surgery, it was found that the difference in patients of the first group was significant throughout the observation period (p = 0.028), while in patients of the second group there was no significant difference from the 3rd month of observation. The number of topical drugs to reduce IOP decreased by 1.44 in the first group (p < 0.05) and by 0.33 in the second group (p = 0.109). Endotrabeculectomy, as well as selective laser trabeculoplasty, showed significant hypotensive effect in patients with POAG within 6 months of observation, however, hypotensive effect of endotrabeculectomy significantly overweighted that of SLT. Keywords: endotrabeculectomy, selective laser trabeculoplasty, intraocular pressure, primary open-angle glaucoma.


2013 ◽  
Vol 33 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Mohammad Najafi ◽  
Morteza Nouruzi Yeganeh ◽  
Arezoo Miraftabi ◽  
Reza Zarei ◽  
Isa Noormohammadi

Summary Background Glaucoma is a highly prevalent eye disease related to optic nerve lesions and visual field defects. Primary Open-Angle Glaucoma (POAG) is a type of glaucoma that occurs frequently with unknown etiology. In this study, we investigated the serum levels of selenium, selenoprotein P1, glutathione, hemolysate glutathione peroxidase1 (GPx1) activity and aqueous humour selenium in POAG patients. Methods Ninety sex- and age-matched subjects (POAG patients; n=45 and, controls; n=45) with the controlled confounders (smoking, hypertension and alcohol beverages) were recruited on clinical histories and exams. The serum and aqueous humour selenium levels were measured using GFAAS technique. The serum selenoprotein P1 level was assayed with the ELISA method. The hemolysate GPx1 activity and serum reduced glutathione level were also measured using known colorimetric techniques. Results The serum selenium (P=0.01) and selenoprotein P1 (P<0.001) levels were significantly high in POAG patients. Furthermore, the aqueous humour selenium level was significantly high among patients as compared to controls (64.68±13.07 vs. 58.36±13.76 ng/mL, P=0.02). The results did not show a significant difference (P=0.36) in the hemolysate GPx1 activity between the groups. The cutoff points for intraocular pressure (IOP) and serum selenoprotein P1 parameters were estimated to be 39 mmHg (sensitivity 97.5%; 1-specificity 6.5%) and 188 mg/mL (sensitivity 93.5%; 1-specificity 14%), respectively.


2018 ◽  
Vol 243 (13) ◽  
pp. 1083-1091 ◽  
Author(s):  
Mariana B Oliveira ◽  
José Paulo C de Vasconcellos ◽  
Galina Ananina ◽  
Vital P Costa ◽  
Mônica B de Melo

The aim of this study was to investigate the association of five polymorphisms in the IL1A and IL1B genes in Brazilian patients with primary open angle glaucoma (POAG). A case–control study, including 214 unrelated POAG patients and 187 healthy individuals, was conducted to evaluate the frequency of polymorphisms in the IL1A and IL1B genes. Ophthalmic evaluation was performed and genomic DNA was obtained from all participants. Five single nucleotide polymorphisms (SNPs): IL1A (–889C/T: rs1800587:C > T, +4845G/T:rs17561G>T) and IL1B (–31C/T:rs1143627:T > C, –511C/T:rs16944C>T and +3954C/T:rs1143634:C > T) were genotyped through direct sequencing. The association of individual SNPs was tested using logistic regression. There was an association between the –31C/T and –511 C/T polymorphisms in the IL1B gene with POAG (p = 0.002 and p = 0.009, respectively). High linkage disequilibrium was observed between the –31C/T and –511C/T polymorphisms. The statistical analysis showed that the T/C haplotype (–31/–511) in the IL1B gene is more frequent in controls (p = 0.011) and the C/T haplotype (–31/–511) is more common in POAG patients (p = 0.018). Among POAG cases, the genotypic distribution of the –31C/T and –511 C/T SNPs was significantly different in patients who underwent anti-glaucomatous surgery compared to patients without surgery (p = 0.016 and 0.023, respectively). There was no statistically significant difference for the remaining SNPs between POAG patients and controls. In conclusion, the C allele of the –31C/T and the T allele of the –511C/T polymorphisms in the IL1B gene may represent a “risk haplotype” for the development of POAG in Brazilian individuals. Further studies with larger cohorts of patients are necessary to substantiate these findings. Impact statement This study is the first, according to our knowledge, to show the association between glaucoma and the functional –31C/T single nucleotide polymorphism. We provide evidence indicating that homozygotes CC at –31C/T and TT at –511 C/T of IL1B are at risk for glaucoma. We also demonstrated that these polymorphisms are in strong linkage disequilibrium (LD). Increasing evidence support the role of inflammation in glaucoma and this study is an important result that reinforces these findings. How IL-1 signaling influences the triggering and pathogenesis of glaucoma remains to be investigated. Greater understanding of the mechanisms leading to glaucoma will provide the development of new management strategies that target the primary disease lesion and maybe the discovery of new treatments.


2014 ◽  
Vol 7 (1) ◽  
pp. 19-27 ◽  
Author(s):  
R. V. Avdeyev ◽  
A. S. Aleksandrov ◽  
A. S. Basinskiy ◽  
Ye. A. Blyum ◽  
A. Yu. Brezhnev ◽  
...  

A study of cross-impact degree and morpho-functional correlation characteristics of primary open angle glaucoma and age-related macular degeneration was performed at 25 clinical sites in Russia and some CIS countries from January through May 2013. The study final protocol included 87 patients (108 eyes) divided into two groups, mean age of patients was 66.6 ± 5.65 years (min 55; max 81). Intragroup and intergroup variance analysis did not establish any significant difference in the macular area between the «glaucoma» group and the «glaucoma + AMD» group depending on the disease stage. The findings suggest that macular degeneration develops subsequent to a preexisting glaucomatous state.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ojasvi Sharma ◽  
Didar Abdulla ◽  
Anthony King ◽  
Monali Chakrabarti ◽  
Tarun Sharma

AbstractTo compare the safety and efficacy of phacoemulsification combined with ab-interno trabeculectomy (Trabectome) and phacoemulsification combined with I-Stent inject in patients with medically uncontrolled primary open-angle glaucoma (POAG). A retrospective comparative case series. 70 eyes of 66 patients completed 2 years follow up after these treatments performed in 2017–2018. 35 eyes of 33 patients underwent combined Phaco-Trabectome (PT); and 35 eyes of 33 patients underwent combined Phaco-I-Stent inject (Pi). Patient demographics and preoperative characteristics are comparable. A 20% drop in IOP was achieved in 27 eyes (77.14%) in PT group and 28 eyes (80%) in Pi group (p = 0.77). Success rate (target IOP achieved and maintained for 2 years) in advance glaucoma was 25% in PT group and 30.7% in Pi group (p = 0.90). In mild to moderate glaucoma, success rate was 85.71% in PT group and 90% in Pi group (p = 0.67). There was no significant difference between two groups with regards to mean reduction in glaucoma medications and complication rates. Trabectome and I-Stent combined with phacoemulsification are equally efficacious and safe for treating patients with medically uncontrolled mild and moderate primary open-angle glaucoma (POAG). However, they are not an effective treatment for patients with advanced glaucoma.


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