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Journal of Glaucoma Sep 2009
Topics: Chronic Disease; Female; Glaucoma, Angle-Closure; Gonioscopy; Headache; Humans; Intraocular Pressure; Iridectomy; Lasers, Gas; Middle Aged; Recurrence; Tonometry, Ocular; Visual Acuity
PubMed: 19745673
DOI: 10.1097/IJG.0b013e31819aa50a -
Ophthalmology. Glaucoma 2022To study and compare factors contributing to the differentiation between diagnosed and undiagnosed primary angle-closure glaucoma (PACG) and primary open-angle glaucoma...
PURPOSE
To study and compare factors contributing to the differentiation between diagnosed and undiagnosed primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the same population.
DESIGN
Population-based survey.
PARTICIPANTS
All residents 40 years of age and older in Kumejima, Japan.
METHODS
Primary angle-closure glaucoma and POAG were diagnosed according to the criteria of the International Society of Geographical and Epidemiological Ophthalmology. Factors contributing significantly to the differentiation between diagnosed and undiagnosed PACG and POAG were selected from various systemic, ocular, visual function, and fundus planimetric parameters using multivariate logistic regression analysis and were compared between the two diseases.
MAIN OUTCOME MEASURES
Factors contributing significantly to the differentiation between diagnosed and undiagnosed PACG and POAG.
RESULTS
The prevalence rates of PACG and POAG were 2.2% and 4.0%, respectively. A greater proportion of patients with PACG (34.1%) received a diagnosis previously compared with patients with POAG (17.2%; P = 0.004). Worse mean deviation on visual field (VF) testing (odds ratio, 0.869; 95% confidence interval, 0.788-0.959; P = 0.006) and the presence of signs suggestive of previous acute angle closure (odds ratio, 4.35; range, 1.66-11.36; P = 0.003) contributed to a established diagnosis of PACG at the time of screening. A greater vertical cup-to-disc ratio (3.74; range, 1.38-10.17; P = 0.012) contributed with marginal significance to an established diagnosis of POAG at the time of screening.
CONCLUSIONS
Primary angle-closure glaucoma was more likely to have been diagnosed previously than POAG during a screening examination. Examination of the anterior segment and VF may contribute more to the detection of PACG, and disc examination may contribute more to the detection of POAG.
Topics: Cross-Sectional Studies; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Gonioscopy; Humans; Intraocular Pressure
PubMed: 34339876
DOI: 10.1016/j.ogla.2021.07.010 -
The Journal of International Medical... May 2023Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease that causes multi-system damage. It is rarely associated with angle-closure glaucoma, especially...
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease that causes multi-system damage. It is rarely associated with angle-closure glaucoma, especially in pediatric patients. We herein report a case of unilateral chronic angle-closure glaucoma in a patient with NF1. A 5-year-old girl with a large subcutaneous soft mass and multiple scattered coffee-milk spots presented with low vision, increased intraocular pressure, and angle closure in her right eye. Lisch nodules were seen in both eyes. In her right eye, ectropion uveae was observed at the top and bottom margins of the pupil. Magnetic resonance imaging of the skull and orbit revealed no abnormalities. Finally, trabeculectomy was performed on the right eye, after which the right eye showed a stable intraocular pressure. NF1 combined with angle-closure glaucoma is rare and easily missed in the clinical setting. Early diagnosis and treatment may achieve good results.
Topics: Humans; Child; Female; Child, Preschool; Glaucoma, Angle-Closure; Neurofibromatosis 1; Intraocular Pressure
PubMed: 37203383
DOI: 10.1177/03000605231173828 -
Nigerian Journal of Clinical Practice 2014The aim of this study was to report the characteristics of angle closure glaucoma (ACG) in eye clinic patients of University College Hospital (UCH), Ibadan, Nigeria. (Comparative Study)
Comparative Study
PURPOSE
The aim of this study was to report the characteristics of angle closure glaucoma (ACG) in eye clinic patients of University College Hospital (UCH), Ibadan, Nigeria.
MATERIALS AND METHODS
A total of 336 consecutive new glaucoma patients of all age groups who presented to the glaucoma clinic of UCH over a 1 year period between December 2009 and November 2010 were evaluated. Each patient had a complete ophthalmic evaluation, including relevant history, visual acuity testing, slit-lamp examination, applanation tonometry, gonioscopy with a Posner lens and standard automated perimetry. Patients with previous incisional surgery and corneal opacities precluding gonioscopy were excluded.
RESULTS
Of the 336 patients, 60 eyes of 31 patients (9.2%) had angle closure with or without glaucoma. The mean age was 59.0 ± 15.4 years and there was a female predilection (58.1%). Forty eight eyes (80%) had primary angle closure glaucoma, eight eyes (13.4%) had primary angle closure, two eyes (3.3%) had plateau iris syndrome and two eyes (3.3%) had secondary ACG (post uveitis). Also, 45.2% of the patients presented with at least one blind eye (<3/60). The mean intraocular pressure (IOP) at presentation was 28.7 ± 12.7 mmHg. A total of 54.8% presented with advanced glaucoma (mean deviation >12 dB). Twelve eyes underwent laser iridotomy or surgical iridotomy and others had trabeculectomy or antiglaucoma medications. Mean IOP post intervention was 17.4 ± 6.9 mmHg.
CONCLUSION
ACG is not an uncommon disease. Early and effective diagnosis is important to prevent blindness.
Topics: Diagnosis, Differential; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Male; Middle Aged; Nigeria; Prevalence; Retrospective Studies; Trabeculectomy; Visual Acuity
PubMed: 24553024
DOI: 10.4103/1119-3077.127425 -
Clinical & Experimental Ophthalmology May 2020
Topics: Acute Disease; Bradycardia; Glaucoma, Angle-Closure; Humans; Intraocular Pressure
PubMed: 31975522
DOI: 10.1111/ceo.13718 -
Ceska a Slovenska Oftalmologie :... 2019To report a case of patient with Miller Fisher syndrome, complicated by simultaneous bilateral acute angle-closure glaucoma in her slightly (+1.5) hyperopic eyes.
PURPOSE
To report a case of patient with Miller Fisher syndrome, complicated by simultaneous bilateral acute angle-closure glaucoma in her slightly (+1.5) hyperopic eyes.
METHODS
We present a case report of a 71-year-old female patient presenting with total ophthalmoplegia, areflexia, ataxia and bilateral acute angle-closure glaucoma.
RESULTS
The initial ocular examination revealed hand motion in the both eyes and oedematic corneas. Initial intraocular pressure was immeasurable high (measurment by Tonopen Avia). Measurement was possible after intravenous Mannitol 20 % infusion on both eyes as 54 and 56 mm Hg, respectively. Local medical therapy of pilocarpine, timolol, dorsolamide and dexamethasone improve intraocular pressure into normal limits within several hours. Prophylactic peripheral Nd-YAG laser iridotomy was performed on a both eyes two days later. Systemic treatment involved plasma exchange and rehabilitation program. Subsequent cataract surgery on both eyes with posterior capsule lens implantation improve the best corrected visual acuity on right eye from 0.5 to 1.0 and the left eye from 0.5 to 0.8, respectively. Intraocular pressure is within normal limits without any glaucoma therapy. Follow up period is three years.
CONCLUSIONS
This is the second reported case of patient with Miller Fisher syndrome and simultaneous bilateral acute angle-closure glaucoma and the fifth reported case of Miller Fisher syndrome and acute angle-closure glaucoma. Treatment for both conditions made a very good recovery.
Topics: Aged; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Laser Therapy; Miller Fisher Syndrome; Tonometry, Ocular
PubMed: 32397723
DOI: 10.31348/2019/4/5 -
Vestnik Oftalmologii 2022Analysis of the effectiveness of preventative phacoemulsification (PE) in anatomically short eyes with an increased risk of an acute glaucoma attack in thickened lens...
UNLABELLED
Analysis of the effectiveness of preventative phacoemulsification (PE) in anatomically short eyes with an increased risk of an acute glaucoma attack in thickened lens can help in choosing the optimal management tactics for these patients.
PURPOSE
To study the changes in morphometric parameters of the anterior segment of anatomically short eyes with an increased risk of acute glaucoma attack before and after preventative PE.
MATERIAL AND METHODS
The study included 70 patients (70 eyes) with a high risk of acute glaucoma attack in short anatomical axial length and thickened lens, with posterior and middle positions of the ciliary body. They were divided into 2 groups: the main group consisted of 45 patients who agreed to undergo PE; the comparison group consisted of 25 patients who refused to undergo PE due to good visual functions and no complaints about vision. B-mode ultrasound examination of the anterior segment of the eye was used to evaluate the cross-sectional surface area of the lens (CSAL) and the cross-sectional surface area of the anterior chamber (CSAAC).
RESULTS
In the main group, on day 2-3 after PE the anterior chamber depth increased in all eyes, the CSAAC index increased, the anterior chamber angle (ACA) widened to Schaffer grade to II-III. After 1-3 years and 4-5 years, the anterior chamber depth, the CSAAC index and the width of the ACA remained stable. In the comparison group, after 1-3 years the anterior chamber depth and the CSAAC index significantly decreased, the ACA narrowed, and the intraocular pressure increased; after 4-5 years, there was a progressive increase in the CSAL index, the ACA was completely closed (0°).
CONCLUSION
In all cases of timely performed preventative PE, already on days 2-3 after surgery there was a statistically significant improvement in the main morphometric parameters of the eye, which remained stable for 4-5 years.
Topics: Cataract Extraction; Cross-Sectional Studies; Glaucoma, Angle-Closure; Humans; Phacoemulsification; Tonometry, Ocular
PubMed: 35488561
DOI: 10.17116/oftalma202213802137 -
Ophthalmology May 2007
Topics: Adult; Anterior Eye Segment; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Iris; Lens, Crystalline; Microscopy, Acoustic
PubMed: 17467540
DOI: 10.1016/j.ophtha.2006.11.020 -
Current Opinion in Ophthalmology Mar 2015Lens extraction for primary angle-closure glaucoma (PACG) is a subject of increased interest recently, with advocates promoting its benefits of anatomical opening of the... (Review)
Review
PURPOSE OF REVIEW
Lens extraction for primary angle-closure glaucoma (PACG) is a subject of increased interest recently, with advocates promoting its benefits of anatomical opening of the angle, intraocular pressure (IOP) reduction and improved vision. The present review seeks to evaluate recent available evidence to provide clarity on this potential intervention within the armamentarium of approaches for PACG.
RECENT FINDINGS
The emergence of recent case-control studies, cohort studies and randomized controlled trials has provided a stronger evidence base to equip ophthalmic surgeons with the necessary information to utilize lens extraction in the management of PACG, and to consider whether this should be combined with trabeculectomy or goniosynechialysis. Imaging modalities such as anterior segment optical coherence tomography have yielded new insights into the mechanical features of the lens in angle closure, with the lens thickness and lens vault now quantifiable. A trend is emerging regarding the improvement in IOP control, reduced complication rates and reduced need for IOP-lowering medications in patients who undergo lens extraction for PACG. These issues are discussed, along with aspects of preoperative assessment and surgical techniques.
SUMMARY
Good outcomes in terms of long-term IOP control have been found following lens extraction for PACG. Lens extraction should be considered in patients with PACG, especially with hyperopia, or a thick and anteriorly vaulted lens.
Topics: Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Lens, Crystalline; Phacoemulsification; Trabeculectomy
PubMed: 25565368
DOI: 10.1097/ICU.0000000000000128 -
[Zhonghua Yan Ke Za Zhi] Chinese... Oct 2011Primary angle-closure glaucoma (PACG) is an independent and complex disease. According to International Society Geographical & Epidemiological Ophthalmology (ISGEO) PACG... (Review)
Review
Primary angle-closure glaucoma (PACG) is an independent and complex disease. According to International Society Geographical & Epidemiological Ophthalmology (ISGEO) PACG is defined as primary angle closure (PAC) with glaucomatous neuropathy, whereas a diagnosis of PAC will be given to patients without a neuropathy. This classification is simple and very useful in survey. In contrast, conventional classification of PACG by Chinese Glaucoma Association is based on anatomical predisposition, such as peripheral iridocorneal apposition/adhesions, and functional sub-stages, which is more clinical usefulness. The difference of PACG classification system between Chinese Glaucoma Association and ISGEO appears to hinder the communication and cooperation between Chinese and international colleague. In this article, we attempted to review classifications and analyze the epidemiological characteristics of PACG under these two systems. It is obvious that the continuing effects to establish a rational and standardized classification system of PACG will greatly promote and benefit glaucoma research and clinical practice for both international and domestic ophthalmic community.
Topics: China; Glaucoma, Angle-Closure; Humans
PubMed: 22321507
DOI: No ID Found