Evaluation of Intraocular Pressure (IOP) and optic disc in primary angle closure disease

2016 ◽  
Vol 4 (3) ◽  
pp. 146
Author(s):  
Srihari Atti ◽  
Venkataratnam Peram ◽  
Sufia Shaik
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.


2019 ◽  
Vol 104 (5) ◽  
pp. 629-635
Author(s):  
Carol Y Cheung ◽  
Sophia L Li ◽  
Poemen Pui Chan ◽  
Noel C Y Chan ◽  
Shaoying Tan ◽  
...  

PurposeTo determine the relationship of intraocular pressure (IOP) control with subsequent visual field (VF) deterioration in patients with primary angle closure disease (PACD).Methods419 PACD eyes from 240 Chinese patients were included. Mean IOP and IOP fluctuation were calculated as the average and SD divided by mean IOP, respectively, of all the IOP measured in the initial 18 months for assessment of IOP control. The relationship between IOP control and subsequent VF parameters over time was examined using linear mixed models. VF deterioration was defined as IOP control associated with decreased VF parameters over time with a p value <0.05. We calculated the average of the mean IOPs and IOP fluctuations in the cohort and used these two average values as a cut-off point to define high-threshold (≥average value) or low-threshold (<average value) for mean IOP and IOP fluctuation for each PACD eye, respectively.ResultsGreater IOP fluctuation was significantly associated with VF deterioration, independent of mean IOP (mean deviation (MD) β=−6.36, p=0.03; VF index β=−16.41, p=0.04; and cataract-adjusted MD β=−6.96, p=0.02). In the categorical analysis, those with both high-threshold mean IOP and high-threshold IOP fluctuation had the most rapid VF deterioration, compared with eyes with low-threshold IOP fluctuation (p<0.05). Among eyes with high-threshold mean IOP, eyes with high-threshold IOP fluctuation had faster rate of VF deterioration compared with eyes with low-threshold IOP fluctuation (p=0.01).ConclusionsIOP fluctuation was a significant and independent predictor for subsequent VF deterioration in eyes with PACD.


Ophthalmology ◽  
2008 ◽  
Vol 115 (7) ◽  
pp. 1134-1140 ◽  
Author(s):  
Dennis S.C. Lam ◽  
Dexter Y.L. Leung ◽  
Clement C.Y. Tham ◽  
Felix C.H. Li ◽  
Yolanda Y.Y. Kwong ◽  
...  

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