The Association Between Primary Open Angle Glaucoma and Clustered Components of Metabolic Syndrome

Purpose : There is conflicting evidence whether components of metabolic syndrome (MetS) increase or decrease the risk of primary open-angle glaucoma (POAG). The aim of the present study was to determine the association between metabolic syndrome and primary open-angle glaucoma. Methods : A total of 200 participants comprising 100 controls and 100 patients with POAG documented by clinical tests and examined by an experienced ophthalmologist using standard ophthalmologic equipment were included in the study. MetS was defined and based on ATP III criteria and POAG was defined by the criteria of the International Society of Geographic and Epidemiological Ophthalmology (ISGEO). The data were entered into the SPSS software and analyzed. Results : The prevalence of MetS in the glaucoma group was 53% in comparison to 38% in the control group (p=0.037). MetS was associated with an increased odds ratio for an IOP higher than 21 mmHg (OR: 1.72; 95% CI 1.03-2.79; p=0.034). The mean IOP was 24.91±4.29 mmHg in the patients without MetS, and 27.23±4.81 mmHg in those with MetS (p=0.027). The mean values of CCT were 603.64±63.16 µm in MetS patients and 579.27±72.87 µm in controls (p=0.018). Conclusion : Data showed an increased prevalence of components of metabolic syndrome in patients with glaucoma. The mechanisms underlying these associations need to be established in future studies. Our results support the recommendation that patients with metabolic syndrome undergo regular ophthalmological exams to monitor for the onset or progression of glaucoma.

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i2.34048 ◽

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.

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Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672120914231 ◽

2020 ◽

pp. 112067212091423 ◽

Cited By ~ 1

Author(s):

Oya Tekeli ◽

Helin Ceren Köse

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Pseudoexfoliation Glaucoma ◽

Transscleral Cyclophotocoagulation ◽

The Mean ◽

Glaucoma Group

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C). Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05). Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

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Effect of mean ocular perfusion pressure on primary open angle glaucoma

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v11i4.38618 ◽

2018 ◽

Vol 11 (4) ◽

pp. 286-290

Author(s):

Pallab Kumar Sen ◽

Nazneen Khan ◽

Md. Shafiqul Islam

Keyword(s):

Odds Ratio ◽

Primary Open Angle Glaucoma ◽

Perfusion Pressure ◽

Open Angle Glaucoma ◽

Control Group ◽

Open Angle ◽

Ocular Perfusion Pressure ◽

Ocular Perfusion ◽

The Mean ◽

The Right

Primary open angle glaucoma is the most common form of glaucoma and it remains asymptomatic until the late stage of the disease. The purpose of this study is to compare the mean ocular perfusion pressure with the primary open angle glaucoma. A total of 60 study subjects were divided into two following groups: a) newly diagnosed patients with primary open angle glaucoma (case) and b) age and sex-matched healthy volunteers (control). The intraocular pressure and blood pressure were measured 3 hourly from 8:00 am to 11:00 pm. The mean ocular perfusion pressure of the right eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg whereas it was 47.7 ± 7.7 mm Hg in the control. The odds ratio was 6.6 (95% CI, 2.1-20.5; p=0.002). The right eyes of untreated primary open angle glaucoma had 6.6 times more risk compared to the control group. The mean ocular perfusion pressure of left eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg and 48.6 ± 4.0 mm Hg in the control group. The odds ratio was 5.7 (95% CI, 1.8-17.5; p=0.004). The left eyes of untreated primary open angle glaucoma had 5.7 times more risk compared to control group. The findings revealed the evidence of vascular mechanism in glaucoma pathogenesis: Reduction of mean ocular perfusion pressure ≤48 mm Hg, may lead to daily repetitive ischemic insult to the optic nerve.

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Clinical Analysis of Macular Choroidal Thickness in Pseudoexfoliative Glaucoma and Primary Open-Angle Glaucoma

Journal of Ophthalmology ◽

10.1155/2021/3897952 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Fan Li ◽

Yiming Huo ◽

Lihua Ma ◽

Qing Zhang ◽

Hengli Zhang ◽

...

Keyword(s):

Axial Length ◽

Choroidal Thickness ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Control Group ◽

Open Angle ◽

Healthy Individuals ◽

Pseudoexfoliative Glaucoma ◽

The Mean ◽

Choroidal Volume

Purpose. To evaluate the differences in macular choroidal thickness and volume among patients with pseudoexfoliative glaucoma (PXG), patients with primary open-angle glaucoma (POAG), and controls. Methods. A total of 50 PXG patients (50 eyes) and 56 POAG patients (56 eyes) were selected as the PXG group and the POAG group, respectively, in this case-control study. A total of 54 age-, gender-, IOP-, and axial length-matched healthy individuals (54 eyes) were selected as the control group. Enhanced-depth imaging-optical coherence tomography (EDI-OCT) was used to measure and analyze the choroidal thicknesses and volumes in 9 macular regions of all subjects. Results. The choroidal thicknesses in the central subfield (CSM), temporal inner macula (TIM), inferior inner macula (IIM), and temporal outer macula (TOM) and the mean macular choroidal thickness were significantly thinner in the PXG group than in the control group (all P < 0.05 ). The choroidal volumes in the TIM, IIM, and TOM and the mean macular choroidal volume were significantly smaller in the PXG group than in the control group (all P < 0.05 ). The choroidal thicknesses in the CSM and IIM and the mean macular choroidal thickness were significantly thinner in the PXG group than in the POAG group (all P < 0.05 ). The choroidal volumes in the IIM and TOM and the mean macular choroidal volume were significantly smaller in the PXG group than in the POAG group (all P < 0.05 ). Multivariable linear regression analysis showed that the mean macular choroidal thickness was significantly thinner in association with older subjects and longer axial length eyes. There was no association between the macular choroidal thickness of various macular regions and visual field mean defect (MD) in groups PXG and POAG (all P > 0.05 ). Conclusions. The macular choroidal thicknesses and volumes (inferior and temporal) in PXG patients were thinner and smaller than those in POAG patients and healthy individuals. The role of choroidal thickness changes in the course of PXG remains unclear. A future prospective study is needed to better define these changes in PXG patients.

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Progression of Corneal Endothelial Insult by Chronic Elevation of intraocular Pressure: A prospective Observational Comparative Study Among Primary Open Angle Glaucoma Patients

10.21203/rs.3.rs-190994/v1 ◽

2021 ◽

Author(s):

Elshimaa A.Mateen ◽

Hatem Gamal Ammar ◽

Khulood Muhammad Sayed

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Significant Negative Correlation ◽

Control Group ◽

P Value ◽

Open Angle ◽

Advanced Stages ◽

Iop Elevation ◽

Glaucoma Group

Abstract Purpose: To evaluate specular microscopic changes of corneal endothelial cells (CEC) count and morphology in correlation to retinal nerve fiber layer RNFL changes detected by visual field (VF) and OCT in early and advanced primary open-angle glaucoma (POAG).Methods: A prospective observational comparative study was conducted on patients with POAG versus non-glaucomatous patients of the same age group. Specular microscopy, VF test, OCT scans of RNFL, and macular ganglion cell complex (GCC) were performed. Glaucoma group was further subdivided into early and advanced stages.Results: The study included 130 eyes of 130 subjects, 70 were eyes with POAG (glaucoma group), 60 were healthy eyes (control group). Both groups were comparable regarding mean age and sex.In the early glaucoma group, a significant negative correlation was found between the coefficient of variation (CV%) and superior PRNFL thickness (r=-0.5, p-value=0.018). A significant negative correlation was also found between percentage of cellular hexagonality (HEX%) and vertical cup/disc (C/D) ratio (r=-0.43, p-value= 0.035). A significant positive correlation was found between HEX% and (superior, inferior) PRNFL thickness (r=0.53, 0.5 and p-value= 0.008, 0.015) respectively.Mean CEC count was significantly lower in the advanced glaucoma group than in the control group (2958.7±371.2 vs 3085±172.5, p value=0.043). Conclusions: CEC is affected by chronic intraocular pressure (IOP) elevation just like the PRNFL and macular GCC. CEC morphology is insulted in the early stages of POAG while the count can withstand chronic IOP elevation till advanced stages were both are affected.

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Topographic correlation between juxtapapillary choroidal thickness and parapapillary deep-layer microvasculature dropout in primary open-angle glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311136 ◽

2017 ◽

Vol 102 (8) ◽

pp. 1134-1140 ◽

Cited By ~ 11

Author(s):

Seung Hyen Lee ◽

Eun Ji Lee ◽

Tae-Woo Kim

Keyword(s):

Choroidal Thickness ◽

Primary Open Angle Glaucoma ◽

Deep Layer ◽

Open Angle Glaucoma ◽

Control Group ◽

Open Angle ◽

Swept Source ◽

En Face ◽

Swept Source Oct ◽

The Mean

PurposeTo investigate the topographic relationship between parapapillary deep-layer microvasculature dropout (MvD) as assessed by optical coherence tomography (OCT) angiography (OCTA) and the juxtapapillary choroidal thickness (JPCT) in primary open-angle glaucoma (POAG).MethodsA total of 194 eyes (138 POAG and 56 control eyes) having parapapillary atrophy (PPA) were imaged using the swept-source OCT and OCTA to examine the microstructure of PPA and measure the JPCT, and to determine the presence of the MvD. MvD was defined as a focal sectoral capillary dropout without any visible microvascular network identified in the parapapillary deep-layer in the en face OCTA images.ResultsJPCT was smaller in the POAG group than control group at 6-, 6.5-, 7- and 7.5-o’clock meridians (all p≤0.002). When POAG eyes were classified into those with parapapillary γ-zone and those with only β-zone without γ-zone, the mean JPCT was significantly smaller in the latter (p=0.027). The JPCT differed between with and without MvD only in eyes with a γ-zone: the JPCT was smaller in the eyes having MvD at 7- and 7.5-o’clock meridians (both p=0.001), where MvD was detected most frequently. However, such a difference was not observed in the eyes with only β-zone without the γ-zone at any of the meridians.ConclusionsLocalised reductions in JPCT were observed at the location of MvD in POAG eyes with parapapillary γ-zone. Such a correlation was not observed in the POAG eyes with only β-zone, but the mean JPCT was significantly smaller in this group.

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Correlation Analysis between Macular Choroidal Thickness and Visual Field Mean Defect in Primary Open-Angle Glaucoma

Journal of Ophthalmology ◽

10.1155/2021/5574950 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Fan Li ◽

Yiming Huo ◽

Lihua Ma ◽

Guangxian Tang

Keyword(s):

Visual Field ◽

Choroidal Thickness ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Enhanced Depth Imaging ◽

Control Group ◽

Open Angle ◽

Imaging Optical Coherence Tomography ◽

The Mean

Purpose. To evaluate the differences in macular choroidal thickness and volume between patients with primary open-angle glaucoma (POAG) and healthy controls to assess the correlation between macular choroidal thickness and visual field mean defect (MD). Methods. Case-control study. A total of 101 patients (101 eyes) with POAG who were hospitalized in our hospital and 102 healthy subjects (102 eyes) matched by age, sex, and axial length were consecutively selected as the POAG group and the control group, respectively. The macular choroidal thickness and volume in nine regions were measured in all subjects by enhanced-depth imaging optical coherence tomography (EDI-OCT). Results. The mean thicknesses of the choroid in the macular area in the POAG group and healthy group were 207.97 ± 62.83 µm and 208.24 ± 47.97 µm, and the mean volumes were 0.63 ± 0.19 µm3 and 0.64 ± 0.14 µm3. There were no significant differences in macular choroidal thickness, volumes of various macular regions, or mean choroidal thickness or volume between the POAG and healthy groups (all p > 0.05 ). The macular choroidal thickness of various macular regions was not correlated with visual field MD in the POAG group (all p > 0.05 ). Conclusion. The macular choroidal thicknesses and volumes in POAG patients were not significantly different from those in healthy individuals. The macular choroidal thickness was not correlated with MD in POAG patients. Therefore, macular choroidal thickness is not an appropriate parameter to evaluate damage caused by POAG, and the role of the macular choroid thickness in POAG needs to be further investigated.

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Evaluation of depth perception and association of severity in Glaucoma patients and suspects

BMC Ophthalmology ◽

10.1186/s12886-021-02198-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pragati Gautam Adhikari ◽

Madhu Thapa ◽

Manisha Dahal

Keyword(s):

Depth Perception ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Corneal Thickness ◽

Control Group ◽

Open Angle ◽

Female Ratio ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Background To evaluate depth perception in Primary open angle glaucoma (POAG), glaucoma suspects compared to controls and to determine the association between depth perception and severity of glaucoma. Methods This was a hospital based, comparative, cross-sectional study. The ethical clearance was taken from institutional review committee of Institute of Medicine [Reference no.399 (6–11) E2 077-078]. Agematched, equal number of participants in each group (N=20) were evaluated with both Titmus and Frisby stereoacuity tests to measure depth perception as stereopsis threshold in seconds of arc. The participants were selected using the purposive sampling technique. Results There was no differences in age, sex, or best corrected visual acuity, intraocular pressure, central corneal thickness (CCT), found among the three groups (POAG, Glaucoma Suspects and Control) respectively. However, there was significant difference in cup disc ratio (CDR) between the groups. Equal number of male and female were there in each group, while in POAG group male to female ratio was 3:2. The mean stereoacuity threshold in control group was 53.5±23.23 seconds of arc with Titmus test and 38.75±18.83 seconds of arc with Frisby stereoacuity test. The difference in threshold was significant between control and glaucoma suspect with Titmus (t=1.991, p=0.05) and with Frisby (t=2.114, p=0.04). The difference was also significant in POAG group by Titmus (t=3.135, p=0.0033) and by Frisby (t=3.014, p=0.004). More so, with increasing severity of glaucoma, the mean threshold of stereopsis increased as seen with both Titmus and Frisby Tests (ANOVA, p < 0.001) Conclusion Primary open angle glaucoma patients and glaucoma suspects, showed significant reduction in depth perception. Decreased stereoacuity was associated with greater glaucomatous visual field loss.

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Micro-Bypass Implantation for Primary Open-Angle Glaucoma Combined with Phacoemulsification: 4-Year Follow-Up

Journal of Ophthalmology ◽

10.1155/2015/795357 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 25

Author(s):

Antonio Maria Fea ◽

Giulia Consolandi ◽

Marta Zola ◽

Giulia Pignata ◽

Paola Cannizzo ◽

...

Keyword(s):

Cataract Surgery ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Control Group ◽

Open Angle ◽

Long Term Follow Up ◽

Baseline Values ◽

The Mean

Purpose. To report the long-term follow-up results in patients with cataract and primary open-angle glaucoma (POAG) randomly assigned to cataract surgery combined with micro-bypass stent implantation or phacoemulsification alone.Methods. 36 subjects with cataract and POAG were randomized in a 1 : 2 ratio to either iStent implantation and cataract surgery (combined group) or cataract surgery alone (control group). 24 subjects agreed to be evaluated again 48 months after surgery. Patients returned one month later for unmedicated washout assessment.Results. At the long-term follow-up visit we reported a mean IOP of 15,9 ± 2,3 mmHg in the iStent group and 17 ± 2,5 mmHg in the control group (p=NS). After washout, a 14,2% between group difference in favour of the combined group was statistically significant (p=0,02) for mean IOP reduction. A significant reduction in the mean number of medications was observed in both groups compared to baseline values (p=0,005in the combined group andp=0,01in the control group).Conclusion. Patients in the combined group maintained low IOP levels after long-term follow-up. Cataract surgery alone showed a loss of efficacy in controlling IOP over time. Both treatments reduced the number of ocular hypotensive medications prescribed. This trial is registered with:NCT00847158.

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

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-97-105 ◽

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.

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