Ocular Causes of Headache in Patients Presenting to a Sub-urban Eye Hospital

Abstract Background: Headache one of the most frequent complaints for which the patients visit the medical practitioners. The current study was planned to determine the aetiology of headache in patients seen for an ocular examination in ophthalmology outpatient clinics in a sub urban Eye hospital.Methods: This is a cross-sectional study conducted in Reiyukai Eiko Masunaga eye hospital, Banepa, Nepal over a period of 3 months from 1st March 2020 to 1st June 2020. 200 patients with headache with or without ocular pain were enrolled in the study. The patients were assessed for any ocular cause of headache.Results: Of the 200 patients, 115(57.5%) were female and 85(42.5%) were male. The overall mean age was 37.19 years (range: 11-65 years). 69 of 200 patients had refractive error (34.5%).Most common error was astigmatism (69.5%) followed by myopia (17.3%) and hyperopia (13.05%). 58(29%) patients were above the age of 40 years and hence were presbyopic.14% had convergence insufficiency, 4.2% had accommodation insufficiency and 3.5% had fusional insufficiency Various ocular morbidities that were noted were, Corneal ulcer , disciform keratitis, epithelial defect, primary angle closure glaucoma, phacomorphic glaucoma, primary angle closure suspect,Chronic angle closure, ocular hypertension, anterior uveitis , posterior scleritis, optic neuritis, intracranial space occupying lesion indicated by papilledema , acute dacryocystitis, herpes zoster ophthalmicus , preseptal cellulitis and painful internal hordeolumConclusion: A detailed evaluation of patient with headache is necessary to properly identify and treat the cause of headache. The role of ophthalmologist in assessing the patients with headache has been emphasized by this study.

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Evaluation of spontaneous retinal venous pulsation in primary open-angle and primary angle-closure glaucoma patients

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v2i1.100 ◽

2020 ◽

Vol 2 (1) ◽

pp. 27-41

Author(s):

Sylves Patrick ◽

Chan Hui Tze ◽

Rasdi Abdul Rashid ◽

Liza Sharmini Ahmad Tajudin

Keyword(s):

Cross Sectional Study ◽

Angle Closure ◽

Control Group ◽

Sectional Study ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Venous Pulsation ◽

Primary Glaucoma

Introduction: Spontaneous retinal venous pulsation (SRVP) is a rhythmic variation in the calibre of one or more retinal veins. The incidence of SRVP was reduced in glaucoma patients. It was also reduced in people with raised intracranial pressure compared to a healthy population. Purpose: The main objective was to report the frequency and rate of SRVP in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) patients and to associate these with the severity of glaucoma in Malay patients. Design of study: A comparative cross-sectional study. Materials and methods: A comparative cross-sectional study involving primary glaucoma patients attending the eye clinic at Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia, was performed between December 2015 and June 2017. The main outcomes measured were the presence and rate of SRVP using a confocalscanning laser ophthalmoscope (Spectralis High-Resolution Optical Coherence Tomography Angiography, Heidelberg Engineering GmbH, Heidelberg, Germany). In the presence of SRVP, the rate of SRVP in one minute was counted manually based on the real-time fundus movie recorded using the confocal scanning laser ophthalmoscope. Results: Thirty-eight POAG, 14 PACG, and 51 control group subjects were included. There was a significantly lower incidence of SRVP in primary glaucoma patients than in the control group (p = 0.003). The presence of SRVP was significantly lower in POAG than PACG (p = 0.04). There was no significant difference in the rate ofSRVP between primary glaucoma patients and the control group (p = 0.873) or between the POAG group and PACG group (p = 0.511). There was no association of incidence (p = 0.574) and rate (p = 0.167) of SRVP according to the severity of glaucoma. Systolic blood pressure (95% CI: 0.95–1.00, p = 0.038) and retinal nervefibre layer thickness (95% CI: 1.01–1.09, p = 0.008) showed a significant association with the presence of SRVP. Conclusions: SRVP is a potential predictive factor for detection of primary glaucoma. The role of SRVP in the severity of glaucoma is still unclear. The role of SRVP in PACG patients warrants further studies in the future.

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Inflammatory cytokine profiles in eyes with primary angle-closure glaucoma

Bioscience Reports ◽

10.1042/bsr20181411 ◽

2018 ◽

Vol 38 (6) ◽

Cited By ~ 7

Author(s):

Yayi Wang ◽

Shida Chen ◽

Yaoming Liu ◽

Wenbin Huang ◽

Xinyi Li ◽

...

Keyword(s):

Inflammatory Cytokines ◽

Aqueous Humor ◽

Clinical Information ◽

Cross Sectional Study ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Inflammatory Protein

Acute primary angle-closure (APAC) eyes show an early ‘acute inflammatory’ condition, while the inflammation condition has not been fully elucidated in the development of primary angle-closure glaucoma (PACG). To evaluate the roles of inflammatory cytokines in the pathogenesis of PACG, this cross-sectional study involved 40 eyes of 32 PACG patients who required trabeculectomy and 24 eyes of 24 patients who required cataract surgery. The aqueous humor samples were collected at the time of surgery. Fifteen inflammatory cytokines were detected using the multiplex bead immunoassay technique, and the clinical information was recorded for the correlation analysis. Eight of the 15 cytokines were all detectable in both groups, including granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-6, IL-8, monocyte chemotactic protein (MCP)-1, MCP-3, macrophage-derived chemokine (MDC), macrophage inflammatory protein (MIP)-1β, and vascular endothelial growth factor (VEGF). When compared with the cataract patients, the MCP-3, MDC, and VEGF levels were elevated in the PACG patients, while the MCP-1 and MIP-1β levels were decreased. However, the G-CSF, IL-6, and IL-8 levels were similar between the two groups. The MCP-1 concentration was elevated accordingly as the disease progressed in the PACG patients. Our results suggest the PACG eyes retained a ‘mild inflammation’ condition in the aqueous humor, and MCP-1 may play an important role in the progression of this disease.

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Glaucoma Profile at the Tertiary Ophthalmic Centers in Ankara, Turkey

10.21203/rs.3.rs-307295/v1 ◽

2021 ◽

Author(s):

Atilla Bayer ◽

Ufuk Elgin ◽

Oya Tekeli ◽

Tamer Takmaz ◽

Ümit Ekşioğlu ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Cross Sectional Study ◽

Clinical Findings ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Predominant Type ◽

Exfoliative Glaucoma

Abstract Purpose: This study aimed to investigate the demographic and clinical characteristics of the patients with glaucoma, who presented at the tertiary ophthalmology clinics in Ankara, Turkey.Patients and Methods: This cross-sectional study included all of the consecutive glaucoma patients or glaucoma suspects who presented at ten different tertiary ophthalmology clinics in Ankara between March 2015 and May 2015. The demographic characteristics and clinical findings of the patients were evaluated. Glaucoma was diagnosed according to the International Society for Geographical and Epidemiological Ophthalmology Classification. In the patients with binocular glaucoma, only the data of the worse eye was included for statistical analyses. Results: A total of 4604 eyes of 2541 patients fulfilled the inclusion criteria and were classified as having glaucoma. Binocular involvement was present in 2063 (81.2%) patients. Primary open angle glaucoma (POAG) was the most common glaucoma type (38.8%), followed by exfoliative glaucoma (XFG; 26.2%), and primary angle-closure glaucoma (PACG; 7.7%). The distribution of the sexes was significantly different among the diagnosis groups (P < 0.001). The cup/disk ratio was the highest among the patients with secondary angle-closure glaucoma (SACG; P < 0.001). The visual field MD parameter was significantly higher in the patients with SACG and XFG (P < 0.001). Monocular and binocular blindness ratios were 21% and 2.8%, respectively.Conclusions: The predominant type of glaucoma in Turkish clinic patients was found to be POAG, followed by XFG and PACG.

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The Impact of Adherence and Instillation Proficiency of Topical Glaucoma Medications on Intraocular Pressure

Journal of Ophthalmology ◽

10.1155/2017/1683430 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Tesfay Mehari Atey ◽

Workineh Shibeshi ◽

Abeba T. Giorgis ◽

Solomon Weldegebreal Asgedom

Keyword(s):

Intraocular Pressure ◽

Cross Sectional Study ◽

Angle Closure ◽

Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Unit Increase ◽

The Impact

Background. The possible sequel of poorly controlled intraocular pressure (IOP) includes treatment failure, unnecessary medication use, and economic burden on patients with glaucoma. Objective. To assess the impact of adherence and instillation technique on IOP control. Methods. A cross-sectional study was conducted on 359 glaucoma patients in Menelik II Hospital from June 1 to July 31, 2015. After conducting a Q-Q analysis, multiple binary logistic analyses, linear regression analyses, and two-tailed paired t-test were conducted to compare IOP in the baseline versus current measurements. Results. Intraocular pressure was controlled in 59.6% of the patients and was relatively well controlled during the study period (mean (M) = 17.911 mmHg, standard deviation (S) = 0.323) compared to the baseline (M=20.866 mmHg, S=0.383, t (358) = −6.70, p<0.0001). A unit increase in the administration technique score resulted in a 0.272 mmHg decrease in IOP (p=0.03). Moreover, primary angle-closure glaucoma (adjusted odds ratio (AOR) = 0.347, 95% confidence interval (CI): 0.144–0.836) and two medications (AOR = 1.869, 95% CI: 1.259–9.379) were factors affecting IOP. Conclusion. Good instillation technique of the medications was correlated with a reduction in IOP. Consequently, regular assessment of the instillation technique and IOP should be done for better management of the disease.

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A community based study of scenario of glaucoma in Aligarh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20194024 ◽

2019 ◽

Vol 6 (9) ◽

pp. 4098

Author(s):

Syed Zulfequar Ahmad ◽

Anees Ahmad ◽

Najam Khalique ◽

Yasir Alvi

Keyword(s):

Open Angle Glaucoma ◽

Cross Sectional Study ◽

Applanation Tonometry ◽

Angle Closure ◽

Cross Sectional ◽

Medical College ◽

Primary Angle Closure Glaucoma ◽

Study Population ◽

Eye Examination ◽

One Year

Background: Glaucoma is the leading cause of irreversible blindness worldwide and is second only to cataracts as the most common cause of blindness overall. In the developing world, the prevalence of glaucoma is expected to rise even more dramatically as the population of adults has doubled within a span of few decades. So this study was done with an objective of finding out the prevalence of glaucoma among adults aged 40 years and above in the field practice area of the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.Methods: A cross-sectional study was carried out for the duration of one year. A total of 680 persons were interviewed and examined by a trained ophthalmologist for detailed eye examination including visual acuity, refraction and slit-lamp bio-microscopy, intraocular pressure (IOP) by Keeler Pulsair non-contact tonometer confirm by applanation tonometry, gonioscopy, and dilated fundus examination after ruling out the risk of angle closure. Anderson criteria were used to diagnose glaucomatous visual field defect.Results: In our study population, the IOP of the majority of population lied in 11-15 mm Hg with a mean IOP of 13.42±4.09 mmHg. In regard to optic disc examination, a cup to disc ratio of >0.6 was found in 35 eyes. According to the predefined criteria, a total of 31 subjects were diagnosed as glaucoma in either one or both eyes. The overall prevalence of glaucoma was found to be 4.6% (31/680), with the prevalence of primary open angle glaucoma, primary angle closure glaucoma, normotensive glaucoma and secondary glaucoma as 1.3%, 1.2%, 1.2% and 0.9% respectively.Conclusions: The prevalence of glaucoma is quite high in an elder population of Aligarh. This should warrant more intensive activities, focusing not only on early diagnosis and management of glaucoma but also include strengthening preventive ophthalmic care.

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Peripheral Anterior Chamber Depth and Screening Techniques for Primary Angle Closure Disease in Community Elderly Chinese

10.21203/rs.2.23915/v1 ◽

2020 ◽

Author(s):

Wenwen Xue ◽

Qin Luo ◽

Yin Yuan ◽

Chaowei Fu ◽

Jiangnan He ◽

...

Keyword(s):

Anterior Chamber ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Multivariate Logistic Regression Analysis ◽

Population Based ◽

Cross Sectional Study ◽

Angle Closure ◽

Cross Sectional ◽

Primary Angle Closure ◽

Elderly Chinese

Abstract Purpose To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters (peripheral ACD, spherical equivalent [SE], intraocular pressure [IOP]) for primary angle closure disease (PACD) screening in an elderly Chinese community. Methods Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results 2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD. Conclusions Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.

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Association Between Serum Lipid Levels and Patients With Primary Angle-Closure Glaucoma in China: A Cross Sectional, Case–Control Study

Frontiers in Medicine ◽

10.3389/fmed.2021.618970 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mingxi Shao ◽

Yingzhu Li ◽

Jisen Teng ◽

Shengjie Li ◽

Wenjun Cao

Keyword(s):

Serum Lipid ◽

Density Lipoprotein ◽

High Serum ◽

Angle Closure ◽

Lipid Levels ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Serum Lipid Levels ◽

Control Study

Objective: To evaluate the serum lipid levels of patients with primary angle-closure glaucoma (PACG) and to investigate the relationship between serum lipid levels and PACG.Methods: In this cross-sectional, case–control study, a total of 320 PACG subjects and 242 age- and sex-matched control subjects were recruited. Serum high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (SDLDL-C), triglyceride (TRIG), and cholesterol (CHOL) levels were measured using enzymatic colorimetry. Serum apolipoprotein A (APOA), apolipoprotein B (APOB), apolipoprotein E (APOE), and lipoprotein(a) (LPa) levels were measured by immunoturbidimetry.Results: The serum LDL-C, TRIG, HDL-C, APOE, LPa, CHOL, APOB, and APOA levels were significantly higher (p < 0.05) in the PACG group than in the control group. Multiple liner regression analyses revealed that there was a statistically correlation between HDL-C levels and mean deviation MD (B = 0.389, P = 0.002, 95% confidence interval [CI] = −1.249 to −0.624); LDL-C levels and MD (B = 0.190, P = 0.019, 95% CI = −5.632 to −1.306); and CHOL levels and MD (B = 0.364, P = 0.27, 95% CI = −7.727 to −1.839). Logistic regression analyses showed that high serum HDL-C (odds ratio [OR] = 11.01, 95% CI = 5.616–21.587), LDL-C (OR = 1.330, 95% CI = 1.079–1.640), SDLDL-C (OR = 1.007, 95% CI = 1.005–1.008), APOA (OR = 13.621, 95% CI = 7.251–25.591), APOB (OR = 2.243, 95% CI = 1.060–4.732), LPa (OR = 0.999, 95% CI = 0.998–1.00), and CHOL (OR = 1.131, 95% CI = 1.005–1.326) levels were significantly associated with PACG.Conclusions: High serum HDL-C, LDL-C, APOA, APOB, LPa, and CHOL levels were associated with PACG.

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Prevalence of Primary Angle Closure Glaucoma in the Last 20 Years: A Meta-Analysis and Systematic Review

Frontiers in Medicine ◽

10.3389/fmed.2020.624179 ◽

2021 ◽

Vol 7 ◽

Author(s):

Nan Zhang ◽

Jiaxing Wang ◽

Biyue Chen ◽

Ying Li ◽

Bing Jiang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Population Based ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Pooled Prevalence

Purpose: This meta-analysis aims to investigate the worldwide prevalence of primary angle-closure glaucoma (PACG) and its risk factors in the last 20 years.Methods: We conducted a systematic review and meta-analysis of 37 population-based studies and 144,354 subjects. PubMed, Embase, and Web of Science databases were searched for cross-sectional or cohort studies published in the last 20 years (2000–2020) that reported the prevalence of PACG. The prevalence of PACG was analyzed according to various risk factors. A random-effects model was used for the meta-analysis.Results: The global pooled prevalence of PACG was 0.6% [95% confidence interval (CI) = 0.5–0.8%] for the last 20 years. The prevalence of PACG increases with age. Men are found less likely to have PACG than women (risk ratio = 0.71, 95% CI = 0.53–0.93, p < 0.01). Asia is found to have the highest prevalence of PACG (0.7%, 95% CI = 0.6–1.0%). The current estimated population with PACG is 17.14 million (95% CI = 14.28–22.85) for people older than 40 years old worldwide, with 12.30 million (95% CI = 10.54–17.57) in Asia. It is estimated that by 2050, the global population with PACG will be 26.26 million, with 18.47 million in Asia.Conclusion: PACG affects more than 17 million people worldwide, especially leading a huge burden to Asia. The prevalence of PACG varies widely across different ages, sex, and population geographic variation. Asian, female sex, and age are risk factors of PACG.

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Association between axial length of the eye and primary angle closure glaucoma

Kathmandu University Medical Journal ◽

10.3126/kumj.v6i3.1712 ◽

1970 ◽

Vol 6 (3) ◽

pp. 361-363 ◽

Cited By ~ 3

Author(s):

D Sherpa ◽

BP Badhu

Keyword(s):

Risk Factor ◽

Axial Length ◽

Simple Random Sampling ◽

Normal Subjects ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Control Group ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma

Background: Angle closure glaucoma is emerging as a leading cause of blindness in Asia. Objective: To compare the ocular axial length of normal individuals and the subjects with primary angle closure glaucoma. This study has been conducted to determine axial length of eye as a risk factor of primary angle closure glaucoma. Materials and Methods: A cross-sectional comparative study was carried out in Mechi Eye Care Centre, Jhapa, Nepal including forty eyes of 20 diagnosed cases of primary angle closure glaucoma (40 eyes) and 40 eyes of 20 normal subjects selected by simple random sampling. A complete ocular examination of all the subjects was carried out. Axial length measurement was done using ultrasound A scan. Results: Out of 80 eyes, there were 40 eyes of 20 diagnosed primary angle closure subjects and 40 eyes of 20 normal subjects. The mean axial length and standard deviation of primary angle closure glaucoma were 21.93 ± 1.16 mm (95% CI = 21.41 - 22.45) and those of control group were 23.01 ± 0.49 (95% CI = 22.79 - 23.23). The axial length of less than 23 mm was found as a risk factor for angle closure glaucoma (Relative risk =3.40; p = 0.0032). Conclusion: This study showed that patients with the axial length of less than 23 mm are at risk to develop primary angle closure glaucoma. This result can be confirmed by doing population based study in a larger sample size. Keywords: Axial length, Primary angle closure glaucoma, Nepal doi: 10.3126/kumj.v6i3.1712 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 361-363

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Correlation between Intraocular Pressure and Visual Field Loss in Primary Open Angle and Primary Angle Closure Glaucoma: A Cross-Sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48317.14943 ◽

2021 ◽

Author(s):

VR Raji ◽

Susan Philip ◽

Ambily S

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Pearson Correlation ◽

Visual Field Loss ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Open Angle ◽

Cross Sectional ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma

Introduction: Glaucoma is characterised by structural damage to optic nerve head with corresponding visual field defects and often associated with increased Intraocular Pressure (IOP). It may be broadly classified as Primary Angle Closure Glaucoma (PACG) and Primary Open Angle Glaucoma (POAG). It is one of the leading causes of global blindness, and a major proportion occurs in Indian population. Aim: To study the correlation between pretreatment IOP and extent of visual field loss in PACG and POAG. Materials and Methods: A cross-sectional observational study was carried out in Regional Institute of Ophthalmology, Trivandrum, Kerala, India from April 2016 to May 2017. Newly diagnosed cases of PACG (25 patients-13 males, 12 females, mean age 58.72±10.07 years) and POAG (85 patients- 45 males, 40 females, mean age 60.28±10.42 years) underwent a detailed glaucoma evaluation which included IOP measurement with Goldmann applanation tonometer and visual field testing using Humphrey Field Analysis (HFA) 24-2 pattern. Mean Deviation (MD), Pattern Standard Deviation (PSD) and Advanced Glaucoma Intervention Score (AGIS) score was calculated from reliable visual field test result. All data were coded and entered in to statistical software, Statistical Package for Social Sciences (SPSS) version 16.0 for analysis. The correlation between pretreatment IOP and visual field loss in patients with PACG and POAG was determined by Pearson Correlation of Coefficient. Results: Amongst the total 110 patients of this study, 25 patients were of PACG while POAG were in 85 patients. A significant correlation between pre treatment IOP and the extent of visual field loss in PACG was noted. There was no significant correlation in POAG. Linear regression analysis demonstrated a significant positive correlation between IOP and AGIS score in PACG (Pearson correlation coefficient(r)=0.805, p<0.001), not in POAG (r=0.026, p=0.816). Correlation between IOP and MD is statistically significant in PACG (r=0.812, p<0.001) but not in POAG (r=0.058, p=0.597). The correlation between IOP and PSD is not statistically significant in both groups (p-value >0.450). Conclusion: A significant correlation between IOP and visual field loss in PACG indicates that extent of visual field damage can be controlled by controlling IOP alone in PACG. The correlation between the pretreatment IOP and visual field loss in POAG is not statistically significant which agrees with the current proposed pathophysiology of optic neuropathy in which multiple factors influence in addition to IOP.

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