-
Survey of Ophthalmology 2020Ocular trauma is a significant cause of blindness worldwide, particularly if associated with glaucoma. Direct damage from blunt or penetrating trauma, bleeding,... (Review)
Review
Ocular trauma is a significant cause of blindness worldwide, particularly if associated with glaucoma. Direct damage from blunt or penetrating trauma, bleeding, inflammation, lens-related problems, orbital and brain vascular pathologies related to trauma, and chemical injuries may increase intraocular pressure and lead to traumatic glaucoma. Treatment may be as simple as eliminating the underlying cause in some conditions or management can be challenging, depending on the mechanism of damage. If proper management is not undertaken, visual outcomes can be poor. We discuss a broad spectrum of trauma-related mechanisms of intraocular pressure elevation, as well as their management.
Topics: Disease Management; Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Wounds and Injuries
PubMed: 32057763
DOI: 10.1016/j.survophthal.2020.02.003 -
Retina (Philadelphia, Pa.) May 2018Pars plana vitrectomy has been reported to increase the risk of ocular hypertension and open-angle glaucoma. The authors conducted a systematic review of randomized and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Pars plana vitrectomy has been reported to increase the risk of ocular hypertension and open-angle glaucoma. The authors conducted a systematic review of randomized and nonrandomized studies to compare the incidence of open-angle glaucoma and ocular hypertension in vitrectomized versus nonvitrectomized eyes.
METHODS
A literature search was performed using MEDLINE and EMBASE until August 2016. Data on ocular hypertension and open-angle glaucoma incidence and mean intraocular pressure after at least 1 year were pooled using random-effects metaanalysis models. Because only nonrandomized studies were retrieved, ROBINS-I tool was used to assess risk of bias in the review.
RESULTS
Seven included studies had a paired design to compare the outcomes of vitrectomized versus fellow eyes, with mean follow-up of least 12 months. Four studies (851 patients) provided data on open-angle glaucoma: incidence in vitrectomized versus non-vitrectomized eyes was 7.8% and 4.8%, respectively, yielding a metaanalytic odds ratio of 1.67 (95% CI: 1.08-2.57). Six studies (1,060 patients) reported on the occurrence of ocular hypertension, which was 5.8% in vitrectomized eyes versus 3.1% in fellow eyes (odds ratio: 2.03, 95% CI: 0.97-4.22), without significant differences in the mean postoperative intraocular pressure (mean difference 0.31 mmHg, 95% CI: -0.26 to 0.89).
CONCLUSION
Although the review found increased risk of open-angle glaucoma with pars plana vitrectomy, the studies were heterogenous or inconsistent regarding ocular hypertension and intraocular pressure increase. Larger studies should be conducted in homogenous cohorts of patients undergoing macular surgery, excluding complex conditions such as retinal detachment or diabetic retinopathy.
Topics: Glaucoma, Open-Angle; Humans; Incidence; Intraocular Pressure; Nerve Fibers; Ocular Hypertension; Retina; Vitrectomy
PubMed: 28426628
DOI: 10.1097/IAE.0000000000001651 -
Survey of Ophthalmology 2020Glaucoma secondary to ocular inflammation is potentially blinding and requires aggressive multifaceted management. The pathogenesis is related to the intraocular... (Review)
Review
Glaucoma secondary to ocular inflammation is potentially blinding and requires aggressive multifaceted management. The pathogenesis is related to the intraocular pressure elevation secondary to compromised aqueous humor outflow by inflammatory cells, chemical mediators released into the aqueous, and to the uveitic therapy itself (corticosteroid induced). The management of uveitic glaucoma needs a careful combination between anti-inflammatory therapy and appropriate intraocular pressure-lowering drugs to prevent worsening of condition and long-term visual loss. Although there have been novel medications that have emerged in the management of glaucoma and uveitis, around 30% of uveitic glaucoma eyes do not respond to maximal medical therapy and require surgical intervention. Studied procedures include laser therapy, filtration surgery, and glaucoma drainage devices, as well as recent surgical techniques for intraocular pressure control such as minimally invasive glaucoma surgery and angle-based procedures. We review and update the medical and surgical management of uveitic glaucoma.
Topics: Disease Management; Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Uveitis
PubMed: 31816329
DOI: 10.1016/j.survophthal.2019.12.003 -
Ocular Immunology and Inflammation Dec 2017
Topics: Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Prevalence; Risk Factors; Uveitis
PubMed: 29265966
DOI: 10.1080/09273948.2017.1415077 -
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 -
Current Opinion in Ophthalmology Apr 2003To summarize the major findings of the Ocular Hypertension Treatment Study (OHTS). (Review)
Review
PURPOSE OF REVIEW
To summarize the major findings of the Ocular Hypertension Treatment Study (OHTS).
RECENT FINDINGS
Ocular hypertensive subjects who received topical glaucoma medication experienced conversion to glaucoma at less than half the rate of subjects who were monitored without treatment. Risk factors for converting to glaucoma included older age, higher intraocular pressure, larger cup-disc ratio, higher pattern SD, and thinner central corneal thickness.
SUMMARY
The OHTS clearly established that medically treating ocular hypertension is efficacious in delaying or preventing the onset of glaucoma. Further, the results may assist in providing useful guidelines for determining who with ocular hypertension should be offered medical treatment.
Topics: Administration, Topical; Adult; Aged; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Multicenter Studies as Topic; Ocular Hypertension; Ophthalmic Solutions; Randomized Controlled Trials as Topic; Risk Factors; Visual Fields
PubMed: 12698045
DOI: 10.1097/00055735-200304000-00003 -
European Journal of Pharmacology Sep 2016The projected number of people who will develop age-related macular degeneration in estimated at 2020 is 196 million and is expected to reach 288 million in 2040. Also,... (Review)
Review
The projected number of people who will develop age-related macular degeneration in estimated at 2020 is 196 million and is expected to reach 288 million in 2040. Also, the number of people with Diabetic retinopathy will grow from 126.6 million in 2010 to 191.0 million by 2030. In addition, it is estimated that there are 2.3 million people suffering from uveitis worldwide. Because of the anti-inflammatory properties of glucocorticoids (GCs), they are often used topically and/or intravitreally to treat ocular inflammation conditions or edema associated with macular degeneration and diabetic retinopathy. Unfortunately, ocular GC therapy can lead to severe side effects. Serious and sometimes irreversible eye damage can occur as a result of the development of GC-induced ocular hypertension causing secondary open-angle glaucoma. According to the world health organization, glaucoma is the second leading cause of blindness in the world and it is estimated that 80 million will suffer from glaucoma by 2020. In the current review, mechanisms of GC-induced damage in ocular tissue, GC-resistance, and enhancing GC therapy will be discussed.
Topics: Aging; Animals; Glucocorticoids; Humans; Intraocular Pressure; Ocular Hypertension; Receptors, Glucocorticoid
PubMed: 27388141
DOI: 10.1016/j.ejphar.2016.06.018 -
Journal of Glaucoma Sep 2020Glaucoma remains the world's leading cause of irreversible blindness and though intraocular pressure (IOP) is the most prevalent risk factor and only reliable... (Review)
Review
Glaucoma remains the world's leading cause of irreversible blindness and though intraocular pressure (IOP) is the most prevalent risk factor and only reliable therapeutic target, a number of systemic disease associations have been reported. Metabolic syndrome (MetS) is a constellation of findings that includes systemic hypertension, abdominal obesity, glucose intolerance, and dyslipidemia. MetS is becoming increasingly common worldwide, with prevalence up to 40% in some countries. Not only is MetS a significant cause of morbidity, but it is also associated with an increase in all-cause mortality. Reports have been conflicting regarding the association of individual components of MetS, including systemic hypertension and diabetes, with elevated IOP or glaucoma. However, though limitations in the existing literature are present, current evidence suggests that MetS is associated with IOP as well as glaucoma. Additional studies are needed to clarify this association by incorporating additional metrics including assessment of central corneal thickness as well as optic nerve structure and function. Future studies are also needed to determine whether lifestyle modification or systemic treatment of MetS could reduce the incidence or progression of glaucoma.
Topics: Glaucoma; Humans; Intraocular Pressure; Metabolic Syndrome; Ocular Hypertension; Risk Factors; Tonometry, Ocular
PubMed: 32618805
DOI: 10.1097/IJG.0000000000001593 -
Indian Journal of Ophthalmology Sep 2004
Topics: Circadian Rhythm; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ocular Hypertension
PubMed: 15510475
DOI: No ID Found -
Romanian Journal of Ophthalmology 2020to describe a clinical case of ocular hypertension (OHT) in Axenfeld-Rieger Syndrome (ARS). Observational case report of a 43-year-old woman with background of OHT....
to describe a clinical case of ocular hypertension (OHT) in Axenfeld-Rieger Syndrome (ARS). Observational case report of a 43-year-old woman with background of OHT. The data was collected originally with a standardized electronic medical record. A complete ophthalmologic examination was performed. In the biomicroscopy, a posterior embryotoxon, iris atrophy with absence of crypts and irregularity of pigmentation, and discoria in OU were observed. Gonioscopy revealed an open angle with a prominent and anterior displaced Schwalbe line. Ocular fundus (OF) demonstrated small and oblique papillae, with normal neurorretinal ring. Functional tests were normal. The patient did not present systemic pathologies, so the diagnosis of Rieger anomaly was made. The IOP control was achieved with aqueous humor suppressants. Glaucoma is the main cause of visual morbidity in patients with ARS, therefore a complete periodic ophthalmological exam is a priority. :ARS = Axenfeld-Rieger Syndrome, RP = retinitis pigmentosa, IOP = Intraocular Pressure, BCVA = Best Corrected Visual Acuity, OR = right eye, OS = left eye, OU = both eyes, OF = ocular fundus, OCT = optical coherence tomography, VF = visual field, TBC = trabeculectomy.
Topics: Adult; Anterior Chamber; Anterior Eye Segment; Eye Abnormalities; Eye Diseases, Hereditary; Female; Gonioscopy; Humans; Intraocular Pressure; Ocular Hypertension
PubMed: 33367186
DOI: 10.22336/rjo.2020.70