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European Journal of Medical Research Jun 2024Glaucoma is the most common cause of irreversible blindness in the world. It is associated with elevated intraocular pressure (IOP). Fluctuations in tonometer readings...
Glaucoma is the most common cause of irreversible blindness in the world. It is associated with elevated intraocular pressure (IOP). Fluctuations in tonometer readings have implications for glaucoma research, where accurate IOP measurements are vital for evaluating disease progression and treatment efficacy. Researchers should carefully select the appropriate tonometer and consider biases associated with different tonometers. Validation against standard measurements can improve IOP measurement accuracy in rat models. In conclusion, this systematic review will emphasize on the importance of selecting the appropriate tonometer for IOP measurement in rat models, considering potential biases and their implications for glaucoma research. Accurate and consistent IOP measurement in rat models is crucial for understanding glaucoma pathophysiology and developing effective treatments. This systematic review aims to assess agreement among tonometers used for measuring IOP in Wistar rat models primarily focusing on TonoLab, TonoVet, and Tono-pen. The review was conducted using PRISMA guidelines. Two articles were included for qualitative synthesis. The studies compared manometric IOP with TonoLab, rebound tonometer, and Tono-pen XL readings. It was observed that TonoLab consistently underestimated IOP, while Tono-pen XL tended to overestimate IOP compared to manometric measurements. The study's findings will help researchers in making decisions about tonometer selection, leading to more reliable outcomes in glaucoma research using rat models. Further research, specifically RCT's (randomized controlled trial) is needed to confirm the results and enhance IOP measurement precision in rat models.
Topics: Animals; Intraocular Pressure; Tonometry, Ocular; Rats; Rats, Wistar; Glaucoma; Disease Models, Animal
PubMed: 38880889
DOI: 10.1186/s40001-024-01927-z -
Actas Espanolas de Psiquiatria Jun 2024Glaucoma is a chronic disease with an insidious onset that often brings severe psychological burden to patients. Therefore, based on a systematic review and... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Glaucoma is a chronic disease with an insidious onset that often brings severe psychological burden to patients. Therefore, based on a systematic review and meta-analysis, we explore the prevalence and severity of depression and anxiety in glaucoma patients, and provide clinically valuable information for medical staff.
METHODS
Computer searches were conducted for relevant studies in PubMed, Embase, ProQuest PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure, Wanfang Database, and China VIP Database. The search date range was from the establishment of the database to December 2023. Literature was screened and data were extracted. The Cochrane risk of bias assessment tool was used to evaluate the quality of the literature, and RevMan5.4 was used for meta-analysis.
RESULTS
The total sample size of the 15 included studies was 24,334 cases. All included studies were of high quality. The results of the meta-analysis revealed that, compared with control patients without glaucoma, patients with glaucoma were more likely to experience depression and to have more severe depressive symptoms [RR (Relative Risk) = 5.92, 95% CI (Confidence Interva) (3.29, 10.66), p < 0.01]; they were also more likely to experience anxiety and to have more severe anxiety symptoms [RR = 2.99, 95% CI (1.93, 4.64), p < 0.01]. The results of the sensitivity analysis showed that the two studies by Cumurcu E. 2005 and Yochim 2012 were the sources of heterogeneity in the meta-analysis of depression; and the three studies by Mabuchi 2012, Otori 2017, and Yochim 2012 were the sources of heterogeneity in the meta-analysis of anxiety disorders.
CONCLUSION
People with glaucoma are more likely to experience depression and anxiety than people without glaucoma. Medical staff should pay greater attention to patients' emotional problems and help patients improve their quality of life.
Topics: Humans; Glaucoma; Prevalence; Cross-Sectional Studies; Anxiety Disorders; Depression; Depressive Disorder
PubMed: 38863056
DOI: 10.62641/aep.v52i3.1561 -
Genes Apr 2024Normal tension glaucoma (NTG) is becoming a more and more serious problem, especially in Asia. But the pathological mechanisms are still not illustrated clearly. We... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Normal tension glaucoma (NTG) is becoming a more and more serious problem, especially in Asia. But the pathological mechanisms are still not illustrated clearly. We carried out this research to uncover the gene polymorphisms with NTG.
METHODS
We searched in Web of Science, Embase, Pubmed and Cochrane databases for qualified case-control studies investigating the association between single nucleotide polymorphisms (SNPs) and NTG risk. Odds ratios (ORs) and 95% confidence intervals (CIs) for each SNP were estimated by fixed- or random-effect models. Sensitivity analysis was also performed to strengthen the reliability of the results.
RESULTS
Fifty-six studies involving 33 candidate SNPs in 14 genetic loci were verified to be eligible for our meta-analysis. Significant associations were found between 16 SNPs (rs166850 of ; rs10451941 of ; rs735860 of ; rs678350 of ; c.603T>A/Met98Lys of ; c.412G>A/Thr34Thr of ; rs10759930 of ; rs1927914 of ; rs1927911 of ; c.*70C>G of ; rs1042522/-Arg72Pro of ; rs10483727 of ; rs33912345 of ; rs2033008 of ; rs3213787 of and c.231G>A of ) with increased or decreased risk of NTG.
CONCLUSIONS
In this study, we confirmed 16 genetic polymorphisms in 10 genes (, , , , , , , , and ) were associated with NTG.
Topics: Humans; Case-Control Studies; Genetic Predisposition to Disease; Low Tension Glaucoma; Polymorphism, Single Nucleotide
PubMed: 38674425
DOI: 10.3390/genes15040491 -
Indian Journal of Ophthalmology May 2024Age is an important risk factor for both glaucoma and cataract. As global life expectancy continues to rise, the prevalence of concomitant open-angle glaucoma (OAG) and... (Comparative Study)
Comparative Study
Age is an important risk factor for both glaucoma and cataract. As global life expectancy continues to rise, the prevalence of concomitant open-angle glaucoma (OAG) and cataracts is increasing. Currently, there is a lack of definitive consensus on the optimal management approach for such individuals. Conventionally, trabeculectomy (Trab) in combination with phacoemulsification is the preferred method. Recent developments in microinvasive glaucoma surgery (MIGS), which offer similar results with fewer complications, provide a new possible approach to this condition. This study aimed to assess the current knowledge of combination surgery in patients with cataract and OAG to provide a comprehensive understanding and help its implementation in clinical settings. A comprehensive systematic search was conducted in May 2021 on five databases (MEDLINE, Embase, SCOPUS, Proquest, EBSCO, and Cochrane Library). The results were filtered for English and human studies but not publication year. All studies published up to May 2021 were reviewed. Newcastle-Ottawa Scale and PEDro scale were used to screen studies for risk of bias where appropriate. Four studies satisfied the inclusion criteria and were subsequently added in this review. Study designs consisted of one RCT and three descriptive studies. Appropriate assessment tools were used; these studies demonstrated moderate to good quality. Postoperative mean IOP, IOP reduction, and qualified success rates were comparable in the Phaco-MIGS (Phaco-endoscopic cyclophotocoagulation (ECP), Phaco-ab interno trabeculectomy (AIT)) and Phaco-Trab group. Severe complication was reported only in the latter. Phaco-MIGS (in particular, trabectome) shows excellent promise as an option for individuals with OAG and concomitant cataract; further research through RCT is required to validate these findings.
Topics: Humans; Glaucoma, Open-Angle; Trabeculectomy; Cataract; Intraocular Pressure; Visual Acuity
PubMed: 38648451
DOI: 10.4103/IJO.IJO_1322_23 -
Turkish Journal of Ophthalmology Apr 2024To review the current literature related to the correlation between translaminar pressure difference (TLPD) and glaucoma. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To review the current literature related to the correlation between translaminar pressure difference (TLPD) and glaucoma.
MATERIALS AND METHODS
In this article, we conducted a literature review using MEDLINE via PubMed, Cochrane Eyes and Vision, and Google Scholar from 01/01/2010 to 31/12/2022. Search terms included "glaucoma", "intraocular pressure", "translaminar cribrosa pressure gradient/difference", "intracranial pressure", and "cerebrospinal fluid pressure". Of 471 results, 8 articles were selected for the meta-analysis.
RESULTS
Our meta-analysis demonstrated significantly higher intraocular pressure, lower cerebrospinal fluid pressure (CSFp), and greater TLPD in high-tension and normal-tension glaucoma groups compared to healthy groups.
CONCLUSION
The differences in CSFp and TLPD between glaucoma and healthy people detected in current studies suggests a potential relationship between TLPD and glaucoma.
Topics: Humans; Intraocular Pressure; Optic Nerve Diseases; Cerebrospinal Fluid Pressure; Glaucoma; Tonometry, Ocular; Low Tension Glaucoma
PubMed: 38645613
DOI: 10.4274/tjo.galenos.2024.66267 -
BMC Ophthalmology Apr 2024Corneal biomechanics has been implicated in a variety of ocular diseases. The purpose of this study was to evaluate the relationship between the glaucoma and corneal... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Corneal biomechanics has been implicated in a variety of ocular diseases. The purpose of this study was to evaluate the relationship between the glaucoma and corneal biomechanical properties, and exploring the value of corneal biomechanics in the diagnosis and follow-up of glaucoma diseases.
METHODS
We searched studies in PubMed, EMBASE, Web of Science and clinicaltrials.gov., as of October 8, 2022. Only English studies were included, without publication time limit. We also searched the reference lists of published reviews. This meta-analysis was conducted with random-effects models, we used mean difference(MD) to evaluate the outcome, and the heterogeneity was assessed with the I statistic. Subgroup analyses were performed under the appearance of high heterogeneity. We used 11 items to describe the characteristics of included studies, publication bias was performed through the Egger's test. The quality assessment were evaluated by Newcastle-Ottawa Scale(NOS) items.
RESULTS
A total of 27 eligible studies were identified for data synthesis and assessment. The result of meta-analysis showed that in the comparison of included indicators, the corneal biomechanics values of glaucoma patients were statistically lower than those of normal subjects in a similar age range. The covered indicators included central corneal thickness(CCT) (MD = -8.34, 95% CI: [-11.74, -4.94]; P < 0.001), corneal hysteresis(CH)(MD = -1.54, 95% CI: [-1.88, -1.20]; P < 0.001), corneal resistance factor(CRF)( MD = -0.82, 95% CI: [-1.21, -0.44]; P < 0.001), and intraocular pressure(IOP)( corneal-compensated intraocular pressure (IOPcc): MD = 2.45, 95% CI: [1.51, 3.38]; P < 0.001); Goldmann-correlated intraocular pressure (IOPg): MD = 1.30, 95% CI: [0.41, 2.20]; P = 0.004), they all showed statistical difference. While the value of axial length(AL) did not show statistically different(MD = 0.13, 95% CI: [-0.24, 0.50]; P = 0.48).
CONCLUSION
Corneal biomechanics are associated with glaucoma. The findings can be useful for the design of glaucoma screening, treatment and prognosis.
Topics: Humans; Biomechanical Phenomena; Glaucoma; Intraocular Pressure; Cornea; Tonometry, Ocular
PubMed: 38622519
DOI: 10.1186/s12886-024-03443-4 -
International Journal of Molecular... Apr 2024Melatonin's cytoprotective properties may have therapeutic implications in treating ocular diseases like glaucoma and age-related macular degeneration. Literature data... (Review)
Review
Melatonin's cytoprotective properties may have therapeutic implications in treating ocular diseases like glaucoma and age-related macular degeneration. Literature data suggest that melatonin could potentially protect ocular tissues by decreasing the production of free radicals and pro-inflammatory mediators. This study aims to summarize the screened articles on melatonin's clinical, pharmacological, and formulation evaluation in treating ocular disorders. The identification of relevant studies on the topic in focus was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. The studies were searched in the following databases and web search engines: Pubmed, Scopus, Science Direct, Web of Science, Reaxys, Google Scholar, Google Patents, Espacenet, and Patentscope. The search time interval was 2013-2023, with the following keywords: melatonin AND ocular OR ophthalmic AND formulation OR insert AND disease. Our key conclusion was that using melatonin-loaded nano-delivery systems enabled the improved permeation of the molecule into intraocular tissues and assured controlled release profiles. Although preclinical studies have demonstrated the efficacy of developed formulations, a considerable gap has been observed in the clinical translation of the results. To overcome this failure, revising the preclinical experimental phase might be useful by selecting endpoints close to clinical ones.
Topics: Humans; Melatonin; Eye; Glaucoma; Face; Databases, Factual
PubMed: 38612812
DOI: 10.3390/ijms25073999 -
Annals of Cardiac Anaesthesia Apr 2024Postoperative visual loss (POVL) is an infrequent yet consequential complication that can follow cardiac surgical interventions. This systematic review aims to provide a...
Postoperative visual loss (POVL) is an infrequent yet consequential complication that can follow cardiac surgical interventions. This systematic review aims to provide a comprehensive analysis of the incidence of POVL after cardiac surgery and to delineate the associated risk factors. A comprehensive search was conducted in major medical databases for relevant studies published up to September 2022. Eligible studies reporting on the incidence of POVL and identifying risk factors in patients undergoing cardiac surgery were included. Data extraction was performed independently by two reviewers. The pooled incidence rates and the identified risk factors were synthesized qualitatively. POVL after cardiac surgery has an overall incidence of 0.015%, that is, 15 cases per 100,000 cardiac surgical procedures. Risk factors for POVL include patient characteristics (advanced age, diabetes, hypertension, and preexisting ocular conditions), procedural factors (prolonged surgery duration, cardiopulmonary bypass time, and aortic cross-clamping), anesthetic considerations (hypotension, blood pressure fluctuations, and specific techniques), and postoperative complications (stroke, hypotension, and systemic hypoperfusion). Ischemic optic neuropathy (ION) is an uncommon complication, associated with factors like prolonged cardiopulmonary bypass, low hematocrit levels, excessive body weight gain, specific medications, hypothermia, anemia, raised intraocular pressure, and micro-embolization. Diabetic patients with severe postoperative anemia are at increased risk for anterior ischemic optic neuropathy (AION). Posterior ischemic optic neuropathy (PION) can occur with factors like hypertension, postoperative edema, prolonged mechanical ventilation, micro-embolization, inflammation, hemodilution, and hypothermia.While the overall incidence of POVL postcardiac surgery remains modest, its potential impact is substantial, necessitating meticulous consideration of modifiable risk factors. Notably, prolonged surgical duration, intraoperative hypotension, anemia, and reduced hematocrit levels remain salient contributors. Vigilance is indispensable to promptly detect this infrequent yet visually debilitating phenomenon in the context of postcardiac surgical care.
Topics: Humans; Incidence; Hypothermia; Risk Factors; Hypertension; Hypotension; Anemia
PubMed: 38607873
DOI: 10.4103/aca.aca_85_23 -
PloS One 2024Intraocular pressure is the only modifiable risk factor for the development and progression of glaucoma. Raised intraocular pressure could cause progressive visual field... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intraocular pressure is the only modifiable risk factor for the development and progression of glaucoma. Raised intraocular pressure could cause progressive visual field loss and blindness if left uncontrolled. Adherence to ocular hypotensive medications is vital to prevent optic nerve damage and its consequences. This study was conducted to systematically summarize the magnitude of glaucoma medication adherence and factors influencing adherence to glaucoma medications among adult glaucoma patients in Ethiopia.
METHODS
Database searches to identify research articles were conducted on PubMed, EMBASE, Cochrane, AJOL, SCOPUS, and Google Scholar without restriction on the date of publication. Data extraction was done using a data extraction Excel sheet. Analysis was performed using STATA version 16. Heterogeneity was assessed using I2 statistics. Pooled prevalence and pooled odds ratio with a 95% confidence interval using a random effect model were computed.
RESULT
We included six studies with a total of 2101 participants for meta-analysis. The magnitude of adherence to glaucoma medication was found to be 49.46% (95% CI [41.27-57.66]). Urban residents (OR = 1.89, 95% CI; 1.29-2.49) and those with normal visual acuity (OR = 2.82, 95% CI; 0.85-4.80) had higher odds of adherence to glaucoma medications. Patients who pay for the medications themselves (OR = 0.22, 95% CI; 0.09-0.34) were found to have 78% lower odds of adherence than their counterparts.
CONCLUSION
The magnitude of glaucoma medication adherence is lower than expected. Place of residence, visual acuity, and payment means had statistically significant associations with glaucoma medication adherence. Tailored health education on medication adherence and subsidization of glaucoma medication is recommended.
Topics: Adult; Humans; Ethiopia; Glaucoma; Antihypertensive Agents; Intraocular Pressure; Medication Adherence
PubMed: 38478513
DOI: 10.1371/journal.pone.0293047 -
BMJ Open Mar 2024To compare the efficacy and safety of different anti-vascular endothelial growth factor (VEGF) agents combined with different delivery methods for neovascular glaucoma... (Meta-Analysis)
Meta-Analysis
Comparative efficacy and safety of different anti-VEGF agents combined with different delivery methods for neovascular glaucoma: a systematic review and Bayesian network meta-analysis.
OBJECTIVE
To compare the efficacy and safety of different anti-vascular endothelial growth factor (VEGF) agents combined with different delivery methods for neovascular glaucoma (NVG).
DESIGN
Systematic review and Bayesian network meta-analysis (NMA).
DATA SOURCES
PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, ISRCTN and Chinese databases including the China National Knowledge Infrastructure, China Science Periodical Database (Wanfang Database), VIP Journal Integration Platform and China Biology Medicine Database were searched from inception to 5 September 2022.
ELIGIBILITY CRITERIA
We included randomised controlled trials (RCTs) that investigated the treatment of NVG using different anti-VEGF agents combined with various methods of drug administration, without any language limitations. All patients included underwent panretinal laser photocoagulation and there were no restrictions on prior glaucoma surgery.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers extracted data and assessed the risk of bias. Random-effect Bayesian NMA was conducted to compare the efficacy and safety and rank priority of anti-VEGF regimens. The source of heterogeneity and the related factors affecting the stability of the results were also explored. CINeMA (Confidence in Network Meta-Analysis) was used to assess the certainty of evidence.
RESULTS
Our analysis included 17 RCTs involving a total of 1311 eyes from 1228 patients. We examined five different treatment regimens, which used three different anti-VEGF drugs. The following treatments showed a significant decrease in intraocular pressure (IOP) compared with the control group at 1 month after glaucoma surgery: simultaneous intravitreal and intracameral injection of conbercept (ICCIVC) (mean difference (MD)=-11.56, 95% credible interval (CrI) -20.8 to -2.24), intravitreal injection of conbercept (MD=-8.88, 95% CrI -13.93 to -3.78), intravitreal injection of ranibizumab (MD=-7.62, 95% CrI -10.91 to -4.33) and intravitreal injection of bevacizumab IVB) (MD=-5.51, 95% CrI -10.79 to -0.35). The surface under the cumulative ranking curve (SUCRA) analysis indicated that ICCIVC (82.0%) may be the most effective regimen in reducing IOP. In terms of safety, there were no statistically significant differences among the interventions. According to the SUCRA analysis, ICCIVC (68.0%) was considered the safest choice with the fewest complications. Subgroup and meta-regression analyses showed that mean age was the main source of heterogeneity. Sensitivity analysis demonstrated the robustness of the study results.
CONCLUSION
ICCIVC was more effective and safer than other anti-VEGF regimens for NVG. Simultaneous intravitreal and intracameral injection was found to be the best route of administration, and conbercept was found to be the superior drug selection when compared with ranibizumab and bevacizumab.
PROSPERO REGISTRATION NUMBER
CRD42022309676.
Topics: Humans; Glaucoma, Neovascular; Bevacizumab; Network Meta-Analysis; Ranibizumab; Vascular Endothelial Growth Factors; Glaucoma
PubMed: 38443085
DOI: 10.1136/bmjopen-2023-080103