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Canadian Journal of Ophthalmology.... Dec 2014Ocular hypertension is a common and important problem seen by eye care providers. This review presents a practical approach to individuals with ocular hypertension. It... (Review)
Review
Ocular hypertension is a common and important problem seen by eye care providers. This review presents a practical approach to individuals with ocular hypertension. It describes the common functional and structural investigations used in evaluation, as well as the advantages and disadvantages of each test. This review also discusses several landmark studies on ocular hypertension and provides a practical guide to the management of this problem.
Topics: Glaucoma, Open-Angle; Humans; Nerve Fibers; Ocular Hypertension; Ophthalmoscopy; Optic Disk; Optic Nerve Diseases; Retinal Ganglion Cells; Risk Assessment; Scanning Laser Polarimetry; Tomography, Optical Coherence; Visual Field Tests
PubMed: 25433737
DOI: 10.1016/j.jcjo.2014.06.013 -
Seminars in Ophthalmology 2014Glaucoma is the leading cause of irreversible vision loss post-keratoplasty and an important cause of graft failure. With newer techniques, such as lamellar,... (Review)
Review
Glaucoma is the leading cause of irreversible vision loss post-keratoplasty and an important cause of graft failure. With newer techniques, such as lamellar, endothelial, and laser-assisted keratoplasty as well as keratoprosthesis gaining popularity, clinicians will need to consider the incidence, risks, evaluation, and management of glaucoma for each type of keratoplasty when determining which type of transplant may be most appropriate. A comprehensive literature search of glaucoma in the setting of corneal transplantation was performed and serves as the basis for this review. Preexisting glaucoma and aphakia are notable risk factors. Patients that are candidates for deep anterior lamellar keratoplasty may benefit from reduced rates of post-keratoplasty glaucoma. Although glaucoma also complicates eyes with Descemet stripping endothelial keratoplasty, the severity is less and the intraocular pressure is more easily controlled when compared to penetrating keratoplasty. Endothelial keratoplasty creates unique perioperative issues mostly related to management of anterior chamber air bubbles.
Topics: Corneal Diseases; Glaucoma; Humans; Incidence; Keratoplasty, Penetrating; Ocular Hypertension; Risk Factors
PubMed: 25325864
DOI: 10.3109/08820538.2014.959201 -
Survey of Ophthalmology 2023Glaucoma is a chronic, progressive disease leading to irreversible blindness if left untreated; however, since reducing intraocular pressure has proven to be successful... (Review)
Review
Glaucoma is a chronic, progressive disease leading to irreversible blindness if left untreated; however, since reducing intraocular pressure has proven to be successful in slowing disease progression, little is known about the natural history of untreated glaucoma. This knowledge can be valuable in guiding management decisions in the era of personalized medicine. A systematic search was performed in Medline (PubMed), Embase, and Web of Science in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRIMSA) guidelines. The rate of structural and/or functional progression and conversion to glaucoma or to a more advanced stage of glaucoma are discussed for ocular hypertension and different types of open-angle glaucoma. Forty-three studies were included. Different rates of progression were found both among and within the different diagnostic groups that belong to the open-angle glaucoma spectrum. The highest rate was found in pseudoexfoliation glaucoma, followed by high tension glaucoma, normal tension glaucoma, and ocular hypertension, in decreasing order. The lowest rate was observed in glaucoma suspects. The known rates of progression provide valuable prognostic information for ophthalmologists and patients. Nonetheless, due to high variability among patients, individual progression cannot be accurately predicted and repeated follow-up examinations are required to estimate individual progression.
Topics: Humans; Glaucoma, Open-Angle; Glaucoma; Ocular Hypertension; Intraocular Pressure; Eye
PubMed: 36563707
DOI: 10.1016/j.survophthal.2022.12.001 -
American Journal of Ophthalmology May 2018To identify results from the Ocular Hypertension Study that can aid patients and clinicians to make evidence-based decisions about the management of ocular hypertension. (Review)
Review
PURPOSE
To identify results from the Ocular Hypertension Study that can aid patients and clinicians to make evidence-based decisions about the management of ocular hypertension.
DESIGN
Perspective.
RESULTS
At 60 months, the cumulative frequency of developing primary open-angle glaucoma (POAG) was 4.4% in the medication group and 9.5% in the observation group (hazard ratio for medication, 0.40; 95% confidence interval [CI], 0.27-0.59; P < .0001). At 13 years the cumulative proportion of participants who developed POAG was 0.22 (95% CI 0.19-0.25) in the original observation group and 0.16 (95% CI 0.13-0.19) in the original medication group (complementary log-log xP = .009). A 5-factor model (older age, higher IOP, thinner central corneal thickness, larger cup-to-disc ratio, and higher visual field pattern standard deviation) separated participants at high and low risk of developing POAG.
CONCLUSIONS
Clinicians and patients can make evidence-based decisions about the management of ocular hypertension using the risk model and considering patient age, medical status, life expectancy, and personal preference.
Topics: Age Factors; Antihypertensive Agents; Disease Progression; Evidence-Based Medicine; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Life Expectancy; Ocular Hypertension; Proportional Hazards Models; Randomized Controlled Trials as Topic; Risk Factors; Secondary Prevention; Vision Disorders; Visual Fields
PubMed: 29501371
DOI: 10.1016/j.ajo.2018.02.016 -
Indian Journal of Ophthalmology Feb 2021To determine the effect of commonly used intravitreal agents on immediate and long-term IOP elevations and their association, if any, with glaucoma. Literature searches... (Review)
Review
To determine the effect of commonly used intravitreal agents on immediate and long-term IOP elevations and their association, if any, with glaucoma. Literature searches in PubMed and the Cochrane databased in January 2020 yielded 407 individual articles. Of these, 87 were selected for review based on our inclusion criteria. Based on the evidence provided, 20 were assigned level I, 27 level II, and 22 level III. Eight articles were rejected because of poor quality, insufficient clarity, or irrelevance based on standardized protocols set out by the American Academy of Ophthalmology. The studies that reported on short-term IOP elevation (i.e., between 0 and 60 min) showed that an immediate increase in IOP is seen in all patients who receive anti-VEGF agents or triamcinolone acetonide when measured between 0 and 30 min of intravitreal injection and that the IOP elevation decreases over time. The data on long-term IOP elevation were mixed; Pretreatment with glaucoma medications, anterior chamber tap, vitreous reflux, longer intervals between injections, and longer axial lengths were associated with lower IOP elevations after injection of anti-VEGF agents, while the position of the implant vis-à-vis, the anterior chamber was important for steroid therapy. Data were mixed on the relationship between IOP increase and the type of intravitreal injection, number of intravitreal injections, preexisting glaucoma, and globe decompression before injection. There were no data on the onset or progression of glaucoma in the studies reviewed in this assessment. However, some studies demonstrated RNFL thinning in patients receiving chronic anti-VEGF therapy. Most, if not all, intravitreal agents cause ocular hypertension, both in the short term and long term. The functional consequences of these observations are not very clear.
Topics: Angiogenesis Inhibitors; Bevacizumab; Glaucoma; Humans; Intraocular Pressure; Intravitreal Injections; Ocular Hypertension; Ranibizumab; Vascular Endothelial Growth Factor A
PubMed: 33463565
DOI: 10.4103/ijo.IJO_1028_20 -
[Zhonghua Yan Ke Za Zhi] Chinese... Jul 2016Ocular hypertension is popular among people, with a prevalence of 3% to 10% in those older than 40 years old. Without proper intervention, over 10% of the patients with... (Review)
Review
Ocular hypertension is popular among people, with a prevalence of 3% to 10% in those older than 40 years old. Without proper intervention, over 10% of the patients with ocular hypertension would develop glaucoma in the following 5 to 10 years. Glaucoma has become one of the leading causes of blindness all over the world, which makes it essential for us to pay enough attention to the prevention and treatment of ocular hypertension. However, it is not cost-effective to treat all the patients with ocular hypertension. Certain side effects may also be caused with long-term medical treatment. Therefore, it is of great importance for ophthalmologists to identify the right time and use appropriate therapeutic methods. To introduce the knowledge of ocular hypertension, the definition, epidemiology, diagnosis, risk factors and treatment of ocular hypertension are reviewed in this article. (Chin J Ophthalmol, 2016, 52: 542-546).
Topics: Adult; Blindness; Cost-Benefit Analysis; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Middle Aged; Ocular Hypertension; Risk Factors
PubMed: 27531115
DOI: 10.3760/cma.j.issn.0412-4081.2016.07.016 -
Survey of Ophthalmology 2021Pigment dispersion syndrome (PDS) represents a clinical spectrum of a relatively common and usually underdiagnosed phenomenon produced by spontaneous pigment dispersion... (Review)
Review
Pigment dispersion syndrome (PDS) represents a clinical spectrum of a relatively common and usually underdiagnosed phenomenon produced by spontaneous pigment dispersion from the iris into the anterior segment. PDS is often bilateral, has no gender predisposition, and presents at a young age, particularly in myopes. Although most patients experiencing an episode of pigment dispersion are asymptomatic, extreme photophobia, ocular pain, redness, and blurred vision may occur. Other characteristic signs are iridolenticular contact, concave iris configuration, 360° peripheral iris transillumination, and pigment deposition on the anterior chamber angle or the corneal endothelium (Krukenberg spindle). Early PDS diagnosis is crucial to detect patients with pigment-related ocular hypertension (POHT) that can eventually lead to pigmentary glaucoma (PG). The latter represents a sight-threatening condition in which mechanical, environmental, and genetic factors contribute to optic nerve damage. In this review, we update the pathogenic mechanisms involved in the clinical spectrum of the disease. We describe its clinical presentation, ophthalmologic manifestations, and complications, including the factors influencing the development of POHT and PG. Because PDS has variable clinical presentations that lead to misdiagnoses, we emphasize the differential diagnosis and the actual therapeutic strategies according to disease status.
Topics: Anterior Chamber; Endothelium, Corneal; Glaucoma; Glaucoma, Open-Angle; Humans; Iris
PubMed: 33444629
DOI: 10.1016/j.survophthal.2021.01.002 -
Methods in Molecular Biology (Clifton,... 2023Viral transduction of the mouse trabecular meshwork using a variety of transgenes associated with glaucoma generates an inducible and reproducible method for generating...
Viral transduction of the mouse trabecular meshwork using a variety of transgenes associated with glaucoma generates an inducible and reproducible method for generating ocular hypertension due to increased aqueous humor outflow resistance of the conventional outflow pathway. Both adenovirus serotype 5 (Ad5) and lentiviruses have selective tropism for the mouse trabecular meshwork with intraocular injections. Accurate intraocular pressures are easily measured using a rebound tonometer, and aqueous humor outflow facilities can be measured in anesthetized live mice.
Topics: Mice; Animals; Glaucoma; Ocular Hypertension; Intraocular Pressure; Trabecular Meshwork; Aqueous Humor
PubMed: 37558962
DOI: 10.1007/978-1-0716-3409-7_9 -
Asia-Pacific Journal of Ophthalmology... 2016Selective laser trabeculoplasty (SLT) is an effective treatment option for the reduction of intraocular pressure (IOP) in patients with ocular hypertension or open-angle... (Review)
Review
Selective laser trabeculoplasty (SLT) is an effective treatment option for the reduction of intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma. The mechanism by which SLT lowers IOP is not completely understood and is likely multifactorial. Published studies indicate that SLT is at least as effective as argon laser trabeculoplasty or medications at lowering IOP in many forms of glaucoma. In addition to IOP reduction, SLT may decrease IOP fluctuation and can be successfully used as primary or adjunctive therapy for the management of both early and advanced glaucoma. However, SLT may not be effective in certain forms of glaucoma, and the IOP-lowering effect seems to wane with time. High pretreatment IOP is the strongest predictor of treatment success, even in patients with normal-tension glaucoma. Repeatability of SLT has been controversial, but recent evidence suggests that it can be successfully repeated to achieve additional or recurrent IOP reduction, even in eyes that only had a modest response to initial treatment. Adverse events are uncommon after SLT, and the most common complications such as discomfort and inflammation are typically mild and transient. Further investigation is required to determine the optimal treatment parameters for SLT treatment. Limited evidence suggests that SLT is cost-effective as primary therapy for patients with glaucoma.
Topics: Glaucoma, Open-Angle; Humans; Intraocular Pressure; Laser Therapy; Ocular Hypertension; Trabeculectomy
PubMed: 26886122
DOI: 10.1097/APO.0000000000000175 -
Ophthalmology Mar 2021
Topics: Glaucoma; Humans; Hypertension; Ocular Hypertension
PubMed: 33612165
DOI: 10.1016/j.ophtha.2020.10.020