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Ophthalmology Jul 1995Late-onset glaucoma can occur after pediatric cataract surgery. However, no large prospective study of the prevalence of ocular hypertension and glaucoma after pediatric...
BACKGROUND
Late-onset glaucoma can occur after pediatric cataract surgery. However, no large prospective study of the prevalence of ocular hypertension and glaucoma after pediatric cataract surgery has been performed.
METHODS
A prospective glaucoma evaluation was offered to all eligible subjects at least 5 years after automated lensectomy and vitrectomy for pediatric cataracts.
RESULTS
Sixty-two (58%) of 107 eligible subjects received a glaucoma evaluation. One (4.5%) of 22 patients with bilateral cataracts had glaucoma, and a much higher percentage (45%) had ocular hypertension. Five (12.5%) of 40 patients with unilateral cataracts had glaucoma, and an additional 32.5% had ocular hypertension. For patients with monocular cataracts, the age and corneal diameter at the time of cataract surgery were related to the subsequent development of ocular hypertension or glaucoma. The majority of subjects were able to cooperate with a comprehensive glaucoma examination that included cycloplegic refraction, determination of intraocular pressure, examination of the optic nerve, and fundus photography, without requiring sedation.
CONCLUSIONS
There is a high prevalence of ocular hypertension after pediatric cataract surgery. Children who are 5 years of age and older usually are able to cooperate with a glaucoma evaluation. The natural history of ocular hypertension after pediatric cataract surgery will be determined with longitudinal studies in the future.
Topics: Aphakia, Postcataract; Cataract Extraction; Child; Child, Preschool; Glaucoma; Humans; Infant; Intraocular Pressure; Minnesota; Ocular Hypertension; Prevalence; Prospective Studies
PubMed: 9121758
DOI: 10.1016/s0161-6420(95)30906-2 -
Indian Journal of Ophthalmology Jun 2022Angle-based surgeries for the treatment of open-angle glaucoma have gained popularity in recent years. This study aimed to evaluate the efficacy of combined...
Six-month outcomes of combined conventional needle goniotomy and phacoemulsification in eyes with early to moderate primary open-angle and pseudoexfoliation glaucoma and ocular hypertension.
PURPOSE
Angle-based surgeries for the treatment of open-angle glaucoma have gained popularity in recent years. This study aimed to evaluate the efficacy of combined phacoemulsification and goniotomy in primary open-angle and pseudoexfoliation glaucoma (POAG and PXG) and ocular hypertension (OHTN).
METHODS
In this interventional case series in the setting of the Glaucoma Service at the Farabi Eye Hospital, 32 eyes of 30 patients with early-to-moderate POAG and PXG and OHTN were enrolled. All eyes underwent combined phacoemulsification and needle goniotomy. Intraocular pressure (IOP) and the number of antiglaucoma medications as well as demographic data were recorded at baseline and one day, one week, one month, three months, and six months after the surgery. Generalized Estimating Equation (GEE) was used to compare the values of IOP and the number of medications at different time points. Kaplan-Meier graph was used to demonstrate the survival status of the eyes.
RESULTS
Mean IOP at baseline was 21.8 ± 4.6 mmHg on mean 1.2 ± 1.5 topical medications. There was a 25.2% (16.3 ± 4.5 mmHg) and 32.1% (14.8 ± 3.9 mmHg) reduction in IOP at three and six months after procedure, respectively (P < 0.001). Meanwhile, the decline in medications was 66.7% (0.4 ± 0.9) and 50.0% (0.6 ± 1.1) at the same time points (P = 0.002 and P = 0.048, respectively). Post-operative complications were clot hyphema (n = 1, 3.1%), fibrinous inflammation (n = 1, 3.1%) and distorted pupil (n = 2, 6.3%).
CONCLUSION
Combined phacoemulsification and needle goniotomy as a procedure for mild and moderate POAG and PXG and OHTN is as effective as other modified goniotomies in the setting of minimally invasive glaucoma surgeries (MIGS).
Topics: Exfoliation Syndrome; Glaucoma; Glaucoma, Open-Angle; Humans; Ocular Hypertension; Phacoemulsification; Trabeculectomy
PubMed: 35647975
DOI: 10.4103/ijo.IJO_2969_21 -
Ophthalmology Mar 2005To compare glaucoma conversion rates in patients with ocular hypertension (OH) with and without pseudoexfoliation. (Comparative Study)
Comparative Study
PURPOSE
To compare glaucoma conversion rates in patients with ocular hypertension (OH) with and without pseudoexfoliation.
DESIGN
Cohort study, based on 32,918 screening participants.
PARTICIPANTS AND CONTROLS
Ninety-eight patients with OH and pseudoexfoliation and 98 matched controls.
MAIN OUTCOME MEASURE
Perimetric glaucoma conversion.
METHODS
A population-based glaucoma screening of elderly citizens of Malmö, Sweden, was conducted between 1992 and 1997 to recruit participants for the Early Manifest Glaucoma Trial. Screening participants with intraocular pressure (IOP) between 24 and 32 mmHg and pseudoexfoliation were compared to controls among other screening participants without pseudoexfoliation but matched for baseline IOP, age, and gender, and the 2 groups were invited to a reexamination. Computerized visual field tests were performed to identify persons with manifest glaucoma. Visual acuity, refraction, IOP, and central corneal thickness were also measured.
RESULTS
After a mean of 8.7 years (range: 6.3-11.4), 54 of 98 patients (55.1%) with pseudoexfoliation at the baseline examination and 27 of 98 patients (27.6%) without pseudoexfoliation had developed glaucoma. The risk ratio was 2.0 (P<0.0001).
CONCLUSION
The glaucoma conversion rate was twice as high in patients with OH and pseudoexfoliation as in control patients matched for IOP, age, and gender. Thus, pseudoexfoliation was a strong independent risk factor for glaucoma in patients with OH.
Topics: Aged; Cohort Studies; Exfoliation Syndrome; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Ocular Hypertension; Odds Ratio; Optic Nerve Diseases; Refraction, Ocular; Risk Factors; Sweden; Visual Acuity; Visual Field Tests; Visual Fields
PubMed: 15745763
DOI: 10.1016/j.ophtha.2004.09.024 -
Acta Ophthalmologica Dec 1987In a prospective study of 41 persons with ocular hypertension followed for 20 years, 14 individuals (34 per cent) developed glaucoma. Of 38 persons who 20 years ago were...
In a prospective study of 41 persons with ocular hypertension followed for 20 years, 14 individuals (34 per cent) developed glaucoma. Of 38 persons who 20 years ago were normotensive, 2 (5 per cent), developed glaucoma. This difference is significant. The mean IOP of the remaining untreated ocular hypertensives was about 7 mmHg higher than the mean tension in the control group.
Topics: Aged; Female; Follow-Up Studies; Glaucoma; Humans; Male; Ocular Hypertension; Prospective Studies
PubMed: 3434236
DOI: 10.1111/j.1755-3768.1987.tb07067.x -
Graefe's Archive For Clinical and... Dec 2020To characterise longitudinal structural and functional changes in albino Sprague-Dawley rats following circumlimbal suture ocular hypertension (OHT) induction.
PURPOSE
To characterise longitudinal structural and functional changes in albino Sprague-Dawley rats following circumlimbal suture ocular hypertension (OHT) induction.
METHODS
Ten-week-old rats (n = 24) underwent suture implantation around the limbal region in both eyes. On the next day, the suture was removed from one eye (control eyes) and left intact in the other eye (OHT eyes) of each animal. Intraocular pressure (IOP) was monitored weekly twice for the next 15 weeks. Optical coherence tomography (OCT) and electroretinogram (ERG) were measured at baseline and weeks 4, 8, 12, and 15, and eyes were then collected for histological assessment.
RESULTS
Sutured eyes (n = 12) developed IOP elevation of ~ 50% in the first 2 weeks that was sustained at ~ 25% above the control eye up to week 15 (p = 0.001). Animals with insufficient IOP elevation (n = 6), corneal changes (n = 3), and attrition (n = 3) were excluded from the analysis. OHT eyes developed significant retinal nerve fibre layer (RNFL) thinning (week 4: - 19 ± 14%, p = 0.10; week 8: - 17 ± 12%, p = 0.04; week 12: - 16 ± 10%, p = 0.04, relative to baseline) and reduction in retinal ganglion cell (RGC) density (- 32 ± 26%, p = 0.02). At week 15, both inner (9 ± 7%, p = 0.01) and outer retinal layer thicknesses (6.0 ± 5%, p = 0.001) showed a mild increase in thicknesses. The positive scotopic threshold response (- 28 ± 25%, p = 0.04) and a-wave were significantly reduced at week 12 (- 35 ± 21%; p = 0.04), whereas b-wave was not significantly affected (week 12: - 18 ± 27%, p = 0.24).
CONCLUSION
The circumlimbal suture model produced a chronic, moderate IOP elevation in an albino strain that led to RNFL thinning and reduced RGC density along with the reductions in ganglion and photoreceptoral cell functions. There was a small thickening in both outer and inner retinal layers.
Topics: Animals; Disease Models, Animal; Glaucoma; Intraocular Pressure; Ocular Hypertension; Rats; Rats, Sprague-Dawley; Sutures
PubMed: 32623578
DOI: 10.1007/s00417-020-04820-7 -
Journal of Glaucoma Jun 2024Gonioscopy-assisted transluminal trabeculotomy (GATT) may be an effective first-line surgery for decreasing intraocular pressure (IOP) and medication burden in patients...
PRCIS
Gonioscopy-assisted transluminal trabeculotomy (GATT) may be an effective first-line surgery for decreasing intraocular pressure (IOP) and medication burden in patients with uveitis-related ocular hypertension (OHT) or glaucoma.
OBJECTIVE
The purpose of the study is to determine the efficacy of GATT in lowering IOP in uveitis-related OHT or glaucoma.
METHODS
Retrospective case series that included patients with uveitis-related OHT or glaucoma who underwent GATT with or without concomitant cataract extraction and intraocular lens implantation at 2 Canadian academic centres from July 2018 to May 2022. Primary outcomes were: complete (no medications) and qualified success (with medication), and failure defined as (1) IOP >21 mm Hg with maximal medical therapy, (2) the need for additional glaucoma procedure, (3) loss of light perception secondary to glaucoma, and (4) IOP <6 mm Hg for 3 months.
RESULTS
Twenty-one eyes from 18 patients were included with a mean preoperative IOP of 26.2 ± 7.3 mm Hg on 4.3 ± 0.7 classes of glaucoma drops. The average follow-up was 29.2 ± 17.6 months and 76% of eyes (n = 16) had reached at least 12 months of follow-up. At the 12-month follow-up visit, there was a significant decrease in average IOP by 9.9 ± 7.9 mm Hg (38%, P = 0.005) and a decrease of 1.9 in glaucoma medication classes ( P = 0.002). Of eyes, 14% achieved complete success, whereas 80% of eyes achieved qualified success. Six eyes failed (29%) and 5 patients (24%) required additional glaucoma surgery. The most common postoperative complication was hyphema (n = 9; 43%).
CONCLUSION
This small case series suggests that GATT may be an effective first-line surgery for decreasing IOP and medication burden in patients with uveitis-related OHT or glaucoma. Further studies with longer follow-ups should be conducted to assess its long-term outcomes.
Topics: Humans; Trabeculectomy; Intraocular Pressure; Retrospective Studies; Female; Male; Gonioscopy; Middle Aged; Ocular Hypertension; Uveitis; Aged; Adult; Tonometry, Ocular; Visual Acuity; Glaucoma; Treatment Outcome; Follow-Up Studies
PubMed: 38506842
DOI: 10.1097/IJG.0000000000002376 -
Journal of Glaucoma Feb 2004
Topics: Aged; Corneal Topography; Diabetes Mellitus, Type 2; Female; Humans; Intraocular Pressure; Lasers, Excimer; Ocular Hypertension; Photorefractive Keratectomy; Postoperative Period
PubMed: 14704549
DOI: 10.1097/00061198-200402000-00015 -
Current Opinion in Investigational... Jan 2005The potential utility of naturally occurring nucleotide compounds in the treatment of ocular hypertension and glaucoma is described. Nucleotides are compounds that can... (Review)
Review
The potential utility of naturally occurring nucleotide compounds in the treatment of ocular hypertension and glaucoma is described. Nucleotides are compounds that can modify the hydrodynamics of the aqueous humor by modulating the activity of nerve terminals that control the drainage and production of aqueous humor in the eye. Their mechanisms of action are focused on reducing intraocular pressure, thereby preventing optic nerve damage. These agents are candidates for the treatment of ocular hypertension and glaucoma.
Topics: Adenine Nucleotides; Animals; Dinucleoside Phosphates; Glaucoma; Humans; Intraocular Pressure; Ocular Hypertension; Receptors, Purinergic P2; Receptors, Purinergic P2X
PubMed: 15675606
DOI: No ID Found -
Survey of Ophthalmology Dec 1983Ocular hypertension (intraocular pressure greater than or equal to 21 mm Hg, normal visual fields, normal optic discs, open angles, and the absence of any contributing...
Ocular hypertension (intraocular pressure greater than or equal to 21 mm Hg, normal visual fields, normal optic discs, open angles, and the absence of any contributing ocular disease) occurs in 4-10% of the population over age 40. The question of whether to treat ocular hypertensive patients remains controversial. The author recommends prophylactic treatment for selected ocular hypertensive individuals who are at high risk of developing primary open angle glaucoma. The primary risk factors are high intraocular pressure, optic disc abnormality, increasing age, a family history of glaucoma, and systemic vascular disease. In addition, certain features of the patient's personality or medical condition favor treatment; for instance, treatment would probably be indicated in (1) a young patient, (2) a one-eyed patient, (3) an unreliable patient, (4) a patient who cannot do reliable visual fields or in whom the optic disc cannot be visualized, (5) a patient who prefers to be treated, and (6) a patient who has suffered a retinal vascular occlusion.
Topics: Age Factors; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ocular Hypertension; Optic Disk; Probability; Risk
PubMed: 6665700
DOI: 10.1016/0039-6257(83)90136-4 -
Journal of AAPOS : the Official... Feb 2006We sought to define the prevalence and natural history of ocular hypertension and glaucoma for at least a 10-year period after pediatric cataract surgery. (Comparative Study)
Comparative Study
INTRODUCTION
We sought to define the prevalence and natural history of ocular hypertension and glaucoma for at least a 10-year period after pediatric cataract surgery.
METHODS
We conducted a prospective observational study of patients who received pediatric cataract surgery. Inclusion criteria included 2 directed ophthalmologic examinations performed at a minimum of 5 and 10 years after surgery.
RESULTS
A total of 63 patients (22 with bilateral cataracts and 41 with unilateral cataracts) were examined at a median of 15.1 year (range, 10.3-21.3 years) after surgery. A majority of the subjects had glaucoma or ocular hypertension (ie, 59%; 37/63). Nineteen percent (12/63) had glaucoma (5/22 with bilateral cataracts and 7/41 with unilateral cataracts). Approximately half (7/12) had developed glaucoma during the first 5-year observational period and the remainder (5/12) developed it during the following observational period. Forty percent (25/63) of the patients had ocular hypertension in at least one aphakic eye (9/23 with bilateral cataracts and 16/40 with unilateral cataracts). The rate of progression from ocular hypertension to glaucoma over a mean observational period of 7.2 years (range, 6.2-8.1 years) was 23% (5/22).
DISCUSSION
Patients who receive surgery for pediatric cataracts are at very high risk of developing ocular hypertension and glaucoma. Patients can develop late-onset glaucoma and ocular hypertension more than 10 years after surgery. Years of ocular hypertension may precede the diagnosis of late-onset glaucoma.
Topics: Adolescent; Cataract Extraction; Child; Follow-Up Studies; Glaucoma; Humans; Incidence; Intraocular Pressure; Minnesota; Ocular Hypertension; Prognosis; Prospective Studies; Retrospective Studies; Risk Factors; Time Factors
PubMed: 16527681
DOI: 10.1016/j.jaapos.2005.07.002