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Journal of Glaucoma Dec 2022The choroidal vascularity index (CVI) is a new marker for the choroid. The decrease in CVI following latanoprost use can provide a better understanding of the...
PRCIS
The choroidal vascularity index (CVI) is a new marker for the choroid. The decrease in CVI following latanoprost use can provide a better understanding of the pathogenesis of the posterior segment side effects of latanoprost such as cystoid macular edema and central serous choroidopathy.
PURPOSE
The purpose of this paper is to evaluate the changes in the CVI, total choroidal area (TCA), stromal area (SA), luminal area (LA), and choroidal thickness (CT) following latanoprost therapy in patients with primary open angle glaucoma and ocular hypertension.
MATERIALS AND METHODS
Patients with newly diagnosed primary open angle glaucoma or ocular hypertension who had never received antiglaucoma therapy were included. Each patient received latanoprost 0.005% once daily. Enhanced depth imaging mode of spectral-domain optical coherence tomography scans was taken before the start of latanoprost therapy and in the first and third months. Subfoveal CT, CVI, TCA, LA, and SA for the submacular area, and 4 quadrants of the peripapillary area were calculated from the scans.
RESULTS
A total of 36 eyes of 18 patients were analyzed. Subfoveal CT increased significantly ( P =0.007). Mean TCA ( P =0.008) and SA ( P <0.001) in the first and third months were higher than baseline in the submacular regions. Mean CVI was lower in the first and third months ( P <0.001). There was an increase in the mean TCA and SA in the peripapillary temporal ( P =0.001 and 0.028) and inferior ( P =0.002 and <0.001) quadrants and a decrease in mean CVI in the temporal ( P =0.027) and inferior ( P =0.003) peripapillary quadrants. A negative correlation was found between the rate of decrease in intraocular pressure and the macular region CVI.
CONCLUSIONS
Following latanoprost use for several months, the CVI was significantly decreased in newly treated patients with glaucoma or ocular hypertension, among other changes to the choroid. These findings may contribute to a better understanding of the effects of prostaglandins on the posterior segment of the eye.
Topics: Humans; Latanoprost; Glaucoma, Open-Angle; Intraocular Pressure; Choroid; Tomography, Optical Coherence; Ocular Hypertension
PubMed: 35980849
DOI: 10.1097/IJG.0000000000002097 -
Revista de Chirurgie, Oncologie,... 1989Are the ocular hypertension and glaucoma two different clinical entities? Recent researches show that ocular hypertension can have an evolution period, of about five... (Review)
Review
Are the ocular hypertension and glaucoma two different clinical entities? Recent researches show that ocular hypertension can have an evolution period, of about five years, without clinical manifestations of glaucoma. In ocular hypertension, the atrophy of the retinal nerve precedes with many years the appearance of the perimetric deficits. Retinographies in non-erythro light show a destruction, up to 40%, of the nerve fibres of the retina without evident perimetric modifications. The conclusion is reached that intraocular hypertension is only an incipient stage of a glaucoma not yet detected by the clinical means available.
Topics: Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Optic Atrophy; Time Factors
PubMed: 2529600
DOI: No ID Found -
American Journal of Ophthalmology Apr 2022To determine the change in intraocular pressure (IOP) and ocular hypotensive medication use after cataract extraction in the Medication Group of the Ocular Hypertension... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To determine the change in intraocular pressure (IOP) and ocular hypotensive medication use after cataract extraction in the Medication Group of the Ocular Hypertension Treatment Study.
DESIGN
Secondary analysis of randomized clinical trial data.
METHODS
We included 92 participants (n = 149 eyes) of the Medication Group of the Ocular Hypertension Treatment Study who underwent cataract surgery in at least 1 eye during the study and 531 participants (n = 1004 eyes) of the Medication Group who did not undergo cataract surgery. We defined the "split date" as the first study visit that cataract surgery was reported for the cataract surgery group and the 15th visit in the control group to equalize the median number of visits. We then compared the 2 groups at visits relative to this split date.
MAIN OUTCOME MEASURES
Difference in preoperative and postoperative IOP, and number of classes of ocular hypotensive medications between the cataract and control group over a 72-month period.
RESULTS
Cataract surgery significantly decreased the number of ocular hypotensive medications at all postoperative visits (mean, -0.4 medications; P ≤ .005) through the 48-month postoperative visit when compared with the control group. At the split date, approximately 23% of eyes were medication free and 41% had a reduced medication burden. Cataract surgery resulted in a decrease in IOP (P < .001), but the difference in IOP between the groups reduced over time and became nonsignificant after 12 months.
CONCLUSIONS
Cataract surgery in patients with ocular hypertension produced sustained reductions in the average number of ocular hypotensive medications and transient reductions in IOP.
Topics: Antihypertensive Agents; Cataract; Cataract Extraction; Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Phacoemulsification; Tonometry, Ocular; Visual Acuity
PubMed: 34280363
DOI: 10.1016/j.ajo.2021.07.008 -
JAMA Ophthalmology Oct 2021
Topics: Glaucoma; Humans; Ocular Hypertension
PubMed: 34383028
DOI: 10.1001/jamaophthalmol.2021.3038 -
Seminars in Ophthalmology Dec 1994The routine surgical use of viscoelastic substances has revolutionized many anterior segment procedures. All of the currently available agents may be responsible for... (Review)
Review
The routine surgical use of viscoelastic substances has revolutionized many anterior segment procedures. All of the currently available agents may be responsible for causing or exacerbating a transient, but occasionally significant, postoperative IOP elevation. In spite of differences in physical properties such as molecular weight, concentration, and viscosity, none of the various viscoelastics has consistently shown a decreased likelihood of producing ocular hypertension. Moreover, any newly introduced product must be evaluated carefully for this potential complication. Lavage of viscomaterial from the anterior chamber and administration of ocular antihypertensives may be helpful in averting or controlling the increased IOP. The surgeon should be cognizant of any pre-existing optic nerve damage and adjust the aggressiveness of postoperative glaucoma therapy accordingly. In the future, the development of new substances or simultaneous use of degrading enzymes may reduce or eliminate the incidence of viscoelastic-induced ocular hypertension.
Topics: Animals; Anterior Eye Segment; Chondroitin; Glaucoma; Humans; Hyaluronic Acid; Intraocular Pressure; Ocular Hypertension; Postoperative Complications
PubMed: 10155642
DOI: 10.3109/08820539409060020 -
Cell Death & Disease Nov 2022Ocular hypertension is a significant risk factor for vision loss in glaucoma due to the death of retinal ganglion cells (RGCs). This study investigated the effects of...
Ocular hypertension is a significant risk factor for vision loss in glaucoma due to the death of retinal ganglion cells (RGCs). This study investigated the effects of the antiapoptotic peptides peptain-1 and peptain-3a on RGC death in vitro in rat primary RGCs and in mouse models of ocular hypertension. Apoptosis was induced in primary rat RGCs by trophic factor deprivation for 48 h in the presence or absence of peptains. The effects of intravitreally injected peptains on RGC death were investigated in mice subjected to retinal ischemic/reperfusion (I/R) injury and elevated intraocular pressure (IOP). I/R injury was induced in mice by elevating the IOP to 120 mm Hg for 1 h, followed by rapid reperfusion. Ocular hypertension was induced in mice by injecting microbeads (MB) or silicone oil (SO) into the anterior chamber of the eye. Retinal flatmounts were immunostained with RGC and activated glial markers. Effects on anterograde axonal transport were determined by intravitreal injection of cholera toxin-B. Peptain-1 and peptain-3a inhibited neurotrophic factor deprivation-mediated RGC apoptosis by 29% and 35%, respectively. I/R injury caused 52% RGC loss, but peptain-1 and peptain-3a restricted RGC loss to 13% and 16%, respectively. MB and SO injections resulted in 31% and 36% loss in RGCs following 6 weeks and 4 weeks of IOP elevation, respectively. Peptain-1 and peptain-3a inhibited RGC death; the loss was only 4% and 12% in MB-injected eyes and 16% and 15% in SO-injected eyes, respectively. Anterograde transport was defective in eyes with ocular hypertension, but this defect was substantially ameliorated in peptain-injected eyes. Peptains suppressed ocular hypertension-mediated retinal glial activation. In summary, our results showed that peptains block RGC somal and axonal damage and neuroinflammation in animal models of glaucoma. We propose that peptains have the potential to be developed as therapeutics against neurodegeneration in glaucoma.
Topics: Rats; Mice; Animals; Retinal Ganglion Cells; Neuroprotection; Intraocular Pressure; Ocular Hypertension; Glaucoma; Disease Models, Animal
PubMed: 36379926
DOI: 10.1038/s41419-022-05407-2 -
Journal of Glaucoma Dec 2022
Topics: United States; Humans; Metabolic Syndrome; Intraocular Pressure; Ocular Hypertension; Glaucoma
PubMed: 36223292
DOI: 10.1097/IJG.0000000000002128 -
Journal of Glaucoma Mar 2023Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas. (Meta-Analysis)
Meta-Analysis
PRCIS
Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas.
PURPOSE
To comprehensively identify the corneal biomechanical differences of patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT) using the Ocular Response Analyzer or the Corvis ST.
METHODS
The electronic databases PubMed, Embase, and Web of Science were comprehensively searched for studies comparing corneal biomechanical differences between POAG and OHT patients with normal controls by Ocular Response Analyzer or Corvis ST. The weighted mean differences and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to the subtypes of POAG, including high-tension glaucoma (HTG) and normal tension glaucoma (NTG).
RESULTS
Thirty-one case-control studies were ultimately included, with 2462 POAG patients, 345 OHT patients, and 3281 normal controls. The corneal hysteresis (CH), corneal resistance factor (CRF), and highest concavity time (HC-t) were all lower in POAG patients than in normal controls. The CH, time at the second applanation (A2t), HC-t, highest concavity radius (HC-R), and deformation amplitude at the highest concavity (HC-DA) were lower in OHT patients, while the CRF, time at the first applanation (A1t), and stiffness parameter at the first applanation (SP-A1) were greater in OHT patients than in normal controls. The subgroup analyses showed that the CH, A2t, length at the second applanation (A2L), and HC-DA were lower in HTG, and the CH, CRF, A1t, and HC-t were lower in NTG patients than in normal controls.
CONCLUSION
The corneas of NTG patients are more deformable than normal controls, whereas the corneas of HTG and OHT patients are stiffer.
Topics: Humans; Low Tension Glaucoma; Glaucoma, Open-Angle; Intraocular Pressure; Biomechanical Phenomena; Tonometry, Ocular; Glaucoma; Ocular Hypertension; Cornea
PubMed: 36583701
DOI: 10.1097/IJG.0000000000002170 -
Methods and Findings in Experimental... Oct 1997The effect of subconjunctivally injected betamethasone on intraocular pressure (IOP) was studied in 85 albino New Zealand rabbits. IOP was measured with a Mentor Model...
The effect of subconjunctivally injected betamethasone on intraocular pressure (IOP) was studied in 85 albino New Zealand rabbits. IOP was measured with a Mentor Model 30 classic pneumatonograph that was manometrically calibrated to the rabbit eye. Ocular hypertension was induced by weekly subconjunctival injections of a betamethasone suspension into the left eye. In one experiment, 70 rabbits were given betamethasone for 4 weeks, while a second group of 10 rabbits received betamethasone for 11 weeks. The short-term effects of subconjunctival injections of betamethasone on IOP were also recorded in a third group of 5 rabbits. Weekly injections over 4 weeks resulted in an increase in IOP in the treated eye, which was prolonged to 11 weeks by repeated weekly injections. A sustained increase in IOP was observed in the treated eye for a period of 7 weeks. During the early hours after betamethasone injection, a transient decrease in IOP was registered in both eyes. The results show that weekly subconjunctival injections of betamethasone cause a predictable increase in IOP in the treated eye which may be suitable for testing the short- and long-term effects of antiglaucoma drugs. Evidence suggesting that endogenous glucocorticoids may play a role in the development of ocular hypertension in humans strengthens the potential value of this glaucoma model.
Topics: Animals; Betamethasone; Conjunctiva; Disease Models, Animal; Glucocorticoids; Injections; Intraocular Pressure; Ocular Hypertension; Rabbits; Time Factors
PubMed: 9442479
DOI: No ID Found -
The British Journal of Ophthalmology Sep 2016To assess the efficiency of alternative monitoring services for people with ocular hypertension (OHT), a glaucoma risk factor.
OBJECTIVE
To assess the efficiency of alternative monitoring services for people with ocular hypertension (OHT), a glaucoma risk factor.
DESIGN
Discrete event simulation model comparing five alternative care pathways: treatment at OHT diagnosis with minimal monitoring; biennial monitoring (primary and secondary care) with treatment if baseline predicted 5-year glaucoma risk is ≥6%; monitoring and treatment aligned to National Institute for Health and Care Excellence (NICE) glaucoma guidance (conservative and intensive).
SETTING
UK health services perspective.
PARTICIPANTS
Simulated cohort of 10 000 adults with OHT (mean intraocular pressure (IOP) 24.9 mm Hg (SD 2.4).
MAIN OUTCOME MEASURES
Costs, glaucoma detected, quality-adjusted life years (QALYs).
RESULTS
Treating at diagnosis was the least costly and least effective in avoiding glaucoma and progression. Intensive monitoring following NICE guidance was the most costly and effective. However, considering a wider cost-utility perspective, biennial monitoring was less costly and provided more QALYs than NICE pathways, but was unlikely to be cost-effective compared with treating at diagnosis (£86 717 per additional QALY gained). The findings were robust to risk thresholds for initiating monitoring but were sensitive to treatment threshold, National Health Service costs and treatment adherence.
CONCLUSIONS
For confirmed OHT, glaucoma monitoring more frequently than every 2 years is unlikely to be efficient. Primary treatment and minimal monitoring (assessing treatment responsiveness (IOP)) could be considered; however, further data to refine glaucoma risk prediction models and value patient preferences for treatment are needed. Consideration to innovative and affordable service redesign focused on treatment responsiveness rather than more glaucoma testing is recommended.
Topics: Adult; Costs and Cost Analysis; Disease Progression; Female; Health Care Costs; Humans; Intraocular Pressure; Male; Middle Aged; Monitoring, Physiologic; Ocular Hypertension; Tonometry, Ocular; United Kingdom
PubMed: 26659710
DOI: 10.1136/bjophthalmol-2015-306757