scholarly journals Secondary glaucoma due to thrombosis of sigmoid and transverse sinus

2020 ◽  
Vol 17 (2) ◽  
pp. 142-146
Author(s):  
Vijaya Pai H. ◽  
Matta Rudhira Reddy

An 88-year-old female presented with redness in the left eye of one-month duration. On examination, the left eye showed 3 mm of proptosis with dilated and tortuous episcleral vessels and relative afferent pupillary defect. Intraocular pressure was 60 mmHg and showed open angles on gonioscopy with cup disc ratio of 0.8 in OS. A diagnosis of secondary open-angle glaucoma due to elevated episcleral venous pressure (EVP) was made. Magnetic resonance venogram revealed thrombosis of transverse and sigmoid sinus on the left side. This is the first case report of secondary open-angle glaucoma due to elevated EVP following thrombosis of transverse and sigmoid sinus.

2020 ◽  
pp. 112067212091423 ◽  
Author(s):  
Oya Tekeli ◽  
Helin Ceren Köse

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.


2011 ◽  
Vol 22 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Gábor Holló ◽  
Péter Kóthy ◽  
Anastasios G.P. Konstas

Purpose To present a case with co-existence of Cogan-Reese syndrome and exfoliation syndrome. Case report A 72-year-old Caucasian woman presented for consultation due to uncontrolled intraocular pressure (IOP) of the right eye. Clinical examination revealed the presence of Cogan-Reese syndrome and exfoliation syndrome OD. This eye exhibited elevated IOP, open anterior chamber angle, advanced glaucomatous optic nerve head damage, and severe glaucomatous visual field loss. The left eye was completely normal without IOP elevation or visual field damage. To our knowledge this is the first case report demonstrating the coexistence of the Cogan-Reese syndrome, exfoliation syndrome, and secondary open-angle glaucoma. Since both syndromes frequently lead to secondary open-angle glaucoma, it is not feasible to determine with certainty which condition was the cause of secondary open-angle glaucoma in our case. It is conceivable that both conditions contributed to glaucoma development. Conclusions Cogan-Reese syndrome, exfoliation syndrome and secondary open-angle glaucoma may present on the same eye.


2019 ◽  
Vol 81 (3) ◽  
pp. 29-38
Author(s):  
Andrew J. Rixon ◽  
Rebecca A. Wenig ◽  
Brittany N. Rigdon

This is a case report demonstrating appropriate diagnosis and management of PSS and its possible sequelae. Posner-Schlossman Syndrome is characterized by recurrent, unilateral attacks of significantly increased intraocular pressure. The etiology and pathophysiology of this condition remains unclear. Duration of this chronic condition and the risk of developing secondary open angle glaucoma are directly proportional. The patient and managing optometrist must be aware of the necessity of timely intervention during acute attacks, as well as adherent longitudinal care to preserve function and quality of life. The ensuing case report and review underscores the impact of this disease.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Handan Akil ◽  
Vikas Chopra ◽  
Alex S. Huang ◽  
Ramya Swamy ◽  
Brian A. Francis

Purpose. To assess the safety and efficacy of Trabectome procedure in patients with preoperative intraocular pressure (IOP) of 30 mmHg or higher. Methods. All patients who had underwent Trabectome stand-alone or Trabectome combined with phacoemulsification were included. Survival analysis was performed by using Kaplan-Meier, and success was defined as IOP ≤ 21 mmHg, 20% or more IOP reduction from baseline for any two consecutive visits after 3 months, and no secondary glaucoma surgery. Results. A total of 49 cases were included with an average age of 66 (range: 13–91). 28 cases had Trabectome stand-alone and 21 cases had Trabectome combined with phacoemulsification. Mean IOP was reduced from a baseline of 35.6 ± 6.3 mmHg to 16.8 ± 3.8 mmHg at 12 months (p<0.01∗), while the number of medications was reduced from 3.1 ± 1.3 to 1.8 ± 1.4 (p<0.01∗). Survival rate at 12 months was 80%. 9 cases required secondary glaucoma surgery, and 1 case was reported with hypotony at day one, but resolved within one week. Conclusion. Trabectome seems to be safe and effective in patients with preoperative IOP of 30 mmHg or greater. Even in this cohort with high preoperative IOP, the end result is a mean IOP in the physiologic range.


Author(s):  
Richard Stodtmeister ◽  
Wiebke Koch ◽  
Sylvana Georgii ◽  
Karin R. Pillunat ◽  
Eberhard Spörl ◽  
...  

Abstract Introduction Until now, venous pressure within the eye has widely been equated with intraocular pressure (IOP). Measurements with dynamometers calibrated in instrument units or in force showed that the retinal venous pressure (RVP) may be higher than the IOP in glaucoma patients. In this study, the RVP was measured with a contact lens dynamometer calibrated in mmHg. Methods Study type: cross-sectional. Subjects: Fifty consecutive patients with primary open-angle glaucoma (POAG) who underwent diurnal curve measurement under medication. Age: 69 ± 8 years. Measurement of RVP: contact lens dynamometry. IOP measurement: dynamic contour tonometry. Results Pressures are given in mmHg. In all 50 patients, the IOP was 15.9 (13.6; 17.1) [median (Q1; Q3)], and the RVP was 17.4 (14.8; 27.2). The distribution of the IOP was normal and that of the RVP was right skewed. In the subgroup of 34 patients with spontaneous pulsation of the central retinal vein (SVP), the IOP and therefore, by definition, the RVP was 16.5 (13.7; 17.4). In the subgroup of 16 patients without SVP, the IOP was 14.8 (13.3; 16.4), and the RVP was 31.3 (26.2; 38.8) (p ≤ 0.001). In systemic treatment, the prescribed drugs were (the number of patients is given in parentheses): ACE inhibitors (20), β-blockers (17), angiotensin II-receptor blockers (13), calcium channel blockers (12), diuretics (7). No difference in RVP was observed between patients receiving these drugs and not receiving them, except in the β-blocker group. Here, the 17 patients with systemic β-blockers had a median RVP of 15.6 mmHg and without 20.2 mmHg (p = 0.003). In the 16 patients with a higher RVP than IOP, only one patient received a systemic β-blocker. The median IOP was 15.7 mmHg with systemic β-blockers and 16.1 mmHg without (p = 0.85). Conclusion In a subgroup of 16 of the 50 patients studied, the RVP was greater than the IOP by a highly statistically and clinically significant degree. According to the widely accepted thinking on the pathophysiology of retinal and optic nerve head circulation, the blood flow in these tissues may be much more compromised in this group of patients than has been assumed. They may be identified by a missing SVP. Topical and systemic medications showed no statistically significant influence on the RVP, except for the systemic β-blockers, in which the RVP was lower by 4.6 mmHg than for the patients who did not receive these drugs (p = 0.003).


2013 ◽  
Vol 07 (01) ◽  
pp. 10 ◽  
Author(s):  
Pedro Arriola-Villalobos ◽  
Laura Morales-Fernández ◽  
José M Martínez-de-la-Casa ◽  
Julián García-Feijoó ◽  
◽  
...  

Micro-invasive glaucoma surgery (MIGS) is gaining interest in very recent years, due to a better safety profile and good tensional results, often associated to cataract surgery. Glaukos iStent® is the only FDA-approved device for micro-invasive glaucoma surgery. It connects the anterior chamber to Schlemm´s canal by bypassing the trabecular meshwork, increasing the outflow facility. The Glaukos iStent is indicated for use in conjunction with cataract surgery for the reduction of intraocular pressure (IOP) in adult patients with mild to moderate open-angle glaucoma currently treated with ocular hypotensive medication. This article summarises the results of all the clinical and experimental studies published regarding iStent effectiveness and safety. Glaukos iStent, in conjunction with cataract surgery, is a safe and effective option in the treatment of open angle glaucoma, with a significant but modest IOP drop and a significant and more clinically relevant decrease in glaucoma medications, with no serious adverse events. Some aspects concerning the number of iStent used or other indications like ocular hypertension or secondary glaucoma remain under study, although good results in both clinical situations have been published. A new model of iStent has just been developed and its first clinical results are near to be published.


Author(s):  
E. N. Simakova ◽  
O. V. Stenkova

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.


Sign in / Sign up

Export Citation Format

Share Document