The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma

Abstract Neovascular Glaucoma (NVG) is a severe form of glaucoma characterized by neovascularization and the proliferation of fibrovascular tissue in the anterior chamber angle. Patients with NVG generally present with elevated intraocular pressure (IOP) and may experience severe pain. Ocular surface is affected by high IOP and can lead from moderated to marked conjunctival congestion that is frequently associated with edematous cornea. The aim of the study is to show how the high IOP can affect the ocular surface of the NVG patients and how we can treat and prevent the suffering. Materials and methods: We took in the study a number of 38 eyes from 35 patients with NVG in stage 3 with angle closure glaucoma, that presented high IOP and impaired ocular surface. Results and discussions: The ocular surface was damaged in patients that presented IOP between a minimum of 38 mmHg and maximum of 89 mmHg. The symptoms that patients presented were: conjunctival congestion in particular perikeratic, epithelial and stromal corneal edema, epithelial bubble, corneal ulcerations. Treatment followed rapid drop in IOP and the restoration and protection of ocular surface. The management of neovascular eye with high IOP was medical, laser and surgical. The restoration of ocular surface was made with lubricating hyperosmotic ophthalmic solutions, regenerative and protective agents. In all cases after the treatment was performed the ocular surface was restored. Conclusions: NVG is a very difficult pathology and is very hard to manage. The uncontrolled IOP in NVG patients affect the ocular surface and leads to complications. Long-term maintenance of normal intraocular pressure is important in NVG management but also in protecting the ocular surface.

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Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma

Journal of Ophthalmology ◽

10.1155/2016/1205895 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Satoko Nakano ◽

Takako Nakamuro ◽

Katsuhiko Yokoyama ◽

Kunihiro Kiyosaki ◽

Toshiaki Kubota

Keyword(s):

Intraocular Pressure ◽

Neovascular Glaucoma ◽

Angle Closure ◽

Vein Occlusion ◽

Anti Vegf ◽

Long Term Prognosis ◽

Endothelial Growth Factor ◽

Ischemic Syndrome

Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections.Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration.Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP.Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.

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The Long-term Effect of Nd:YAG Laser Iridotomy on Intraocular Pressure in Taiwanese Eyes with Primary Angle-closure Glaucoma

Journal of the Chinese Medical Association ◽

10.1016/s1726-4901(08)70126-6 ◽

2008 ◽

Vol 71 (6) ◽

pp. 300-304 ◽

Cited By ~ 13

Author(s):

Mei-Ju Chen ◽

Ching-Yu Cheng ◽

Ching-Kuang Chou ◽

Catherine J.L. Liu ◽

Wen-Ming Hsu

Keyword(s):

Intraocular Pressure ◽

Nd:Yag Laser ◽

Term Effect ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Laser Iridotomy ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Long Term Effect

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Iridoplasty for plateau iris syndrome: a systematic review

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000340 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000340

Author(s):

Hugo Bourdon ◽

Vittoria Aragno ◽

Christophe Baudouin ◽

Antoine Labbé

Keyword(s):

Systematic Review ◽

Intraocular Pressure ◽

Retrospective Studies ◽

Scientific Evidence ◽

Argon Laser ◽

Angle Closure ◽

Current Evidence ◽

Iridocorneal Angle

Plateau iris syndrome (PIS) is a frequent cause of angle closure. Argon laser peripheral iridoplasty (ALPI) has been proposed in PIS to widen the iridocorneal angle. The objective of the present study was to perform a systematic review of the available studies evaluating the efficacy of ALPI on intraocular pressure (IOP), iridocorneal angle opening and the number of medications in patients with chronic angle-closure associated with PIS. One prospective and seven retrospective studies with a minimum 1 month of follow-up were included. Although ALPI seemed to lower IOP, to decrease the number of topical antiglaucoma medications and widen the iridocorneal angle shortly after the procedure, there is no current evidence of long-term efficacy. To date, there is no robust scientific evidence to advocate ALPI as a treatment for chronic angle-closure caused by PIS.

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Long-term Intraocular Pressure Elevation after Primary Angle Closure Treated with Early Phacoemulsification

Korean Journal of Ophthalmology ◽

10.3341/kjo.2017.0077 ◽

2018 ◽

Vol 32 (2) ◽

pp. 108

Author(s):

Sung Uk Baek ◽

Kwang Hyun Kim ◽

Joo Yeon Lee ◽

Kyung Wha Lee

Keyword(s):

Intraocular Pressure ◽

Angle Closure ◽

Primary Angle Closure ◽

Pressure Elevation ◽

Intraocular Pressure Elevation

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Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

BioMed Research International ◽

10.1155/2013/603782 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Martina Tomić ◽

Snježana Kaštelan ◽

Kata Metež Soldo ◽

Jasminka Salopek-Rabatić

Keyword(s):

Intraocular Pressure ◽

Ocular Surface ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Final Visit ◽

Open Angle ◽

Newly Diagnosed ◽

Prostaglandin Analog ◽

Ocular Surface Health

Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG.Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%.Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg;P<0.001). Mean TBUT decreased from11.70±1.86seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P<0.001).Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

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Long-term Effect of BAK-free Travoprost on Ocular Surface and Intraocular Pressure in Glaucoma Patients After Transition From Latanoprost

Journal of Glaucoma ◽

10.1097/ijg.0b013e3181fc8129 ◽

2012 ◽

Vol 21 (1) ◽

pp. 60-64 ◽

Cited By ~ 22

Author(s):

Makoto Aihara ◽

Shin-ichiro Otani ◽

Jun Kozaki ◽

Kazuhiko Unoki ◽

Masamitsu Takeuchi ◽

...

Keyword(s):

Intraocular Pressure ◽

Ocular Surface ◽

Term Effect ◽

Long Term Effect

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Long-term perimetric stabilization with a management algorithm of set target intraocular pressure in different severities of primary angle-closure glaucoma

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_329_21 ◽

2021 ◽

Vol 69 (10) ◽

pp. 2721

Author(s):

Ramanjit Sihota ◽

Jyoti Shakrawal ◽

AjayK Sharma ◽

Amisha Gupta ◽

Tanuj Dada ◽

...

Keyword(s):

Intraocular Pressure ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Management Algorithm

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Determinants of Long-term Intraocular Pressure After Phacoemulsification in Primary Angle-closure Glaucoma

Journal of Glaucoma ◽

10.1097/ijg.0b013e3181efe1e9 ◽

2011 ◽

Vol 20 (9) ◽

pp. 566-570 ◽

Cited By ~ 29

Author(s):

Catherine Jui-ling Liu ◽

Ching-Yu Cheng ◽

Yu-Chieh Ko ◽

Ling-Ing Lau

Keyword(s):

Intraocular Pressure ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma

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Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

10.21203/rs.2.17700/v2 ◽

2020 ◽

Author(s):

Lin Fu ◽

Yau Kei Chan ◽

Junhua Li ◽

Li Nie ◽

Na Li ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Final Visual Acuity ◽

Angle Closure ◽

Mean Deviation ◽

Primary Angle Closure Glaucoma ◽

The Mean ◽

End Stage

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end stage glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors.Methods: A retrospective study of primary angle closure glaucoma patients was conducted on who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Sixteen patients (19 eyes) were included. The mean age was 64.89 ± 11.68 years and the mean followed up duration was 21.89 ± 7.85 months. The final visual acuity was significantly improved from 0.69 ± 0.55 to 0.46 ± 0.52 logMAR , within 12 (63.2%) eyes improved, 4 (21.1%) eyes kept unchanged, and 3 (15.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with better final visual acuity (r = -0.511, r = -0.493, r = 0.537 respectively). Moreover, the final number of medications were reduced from 1.26 ± 0.99 to 0.26 ± 0.56 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 14.48 ± 3.74 mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was decreased to 6 (31.6%) eyes compared to 10 (52.6%) eyes at baseline. Moreover, the number of eyes free of medications was increased from 4 (21.1%) preoperatively to 15 (78.9%) eyes postoperatively.Conclusions: Final visual acuity was significantly improved in the severe and end stage primary angle closure glaucoma patients and the number of eyes came off medications increased by 57.8% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the final visual acuity after cataract surgery.

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