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1
Thompson, H. Stanley, and E. Michael Van Buskirk. "Becker-Shaffer's Diagnosis and Therapy of the Glaucomas." American Journal of Ophthalmology 107, no. 6 (June 1989): 688. http://dx.doi.org/10.1016/0002-9394(89)90282-1.
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Geanon, John D. "Glaucoma: Diagnosis and Therapy." Archives of Ophthalmology 112, no. 12 (December 1, 1994): 1517. http://dx.doi.org/10.1001/archopht.1994.01090240023014.
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Chen, Philip P. "Clinical Glaucoma Management: Critical Signs in Diagnosis and Therapy." Journal of Glaucoma 10, no. 6 (December 2001): 502–3. http://dx.doi.org/10.1097/00061198-200112000-00013.
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Robinson, James C. "Clinical Glaucoma Management: Critical Signs in Diagnosis and Therapy." Archives of Ophthalmology 120, no. 2 (February 1, 2002): 238. http://dx.doi.org/10.1001/archopht.120.2.238.
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Harasymowycz, Paul. "CLINICAL GLAUCOMA MANAGEMENT: CRITICAL SIGNS IN DIAGNOSIS AND THERAPY." Ophthalmic Surgery, Lasers and Imaging Retina 33, no. 3 (May 2002): 264. http://dx.doi.org/10.3928/1542-8877-20020501-22.
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Fingeret, Murray. "Glaucoma, Vol. 1: Medical Diagnosis and Therapy, and Vol. 2: Surgical Management." Optometry and Vision Science 88, no. 1 (January 2011): E173. http://dx.doi.org/10.1097/opx.0b013e318205feab.
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Vora, Gargi Khare, and Kathryn A. Colby. "Management of Glaucoma Following Boston Keratoprosthesis." European Ophthalmic Review 06, no. 04 (2012): 214. http://dx.doi.org/10.17925/eor.2012.06.04.214.
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Boston keratoprosthesis (KPro) surgery has revolutionised the treatment of corneal and ocular surface disease. At present, glaucoma is the most important vision-threatening complication following KPro surgery. Diagnosis of glaucoma in KPro patients is difficult since the current method of determining intraocular pressure (IOP) by digital palpation is subjective and dependent upon the skill of the examiner. Optic nerve evaluation and visual field testing are important tools to follow glaucoma progression. Management of glaucoma following Boston KPro consists of medical therapy and surgical options. Glaucoma drainage devices are useful in this population but can have a variety of complications. Cyclophotocoagulation, either the non-invasive transscleral method or endocyclophotocoagulation, is also useful as an adjunctive measure in glaucoma management. Appropriate diagnosis and management of glaucoma is essential after KPro surgery to reduce the chance of vision loss.
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Gupta, P., A. Sharma, and P. Ichhpujani. "Post penetrating keratoplasty glaucoma – A review." Nepalese Journal of Ophthalmology 6, no. 1 (July 22, 2014): 80–90. http://dx.doi.org/10.3126/nepjoph.v6i1.10776.
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Glaucoma following penetrating keratoplasty remains a challenge for the treating ophthalmologist. Its frequent occurrence, difficult diagnosis and recalcitrant nature coupled with the propensity to cause irreversible visual loss makes it essential to identify the problem early and manage it effectively.A careful pre-operative assessment along with appropriate intra-operative measures can help to reduce the chances of developing glaucoma in the post-operative period. Wherever indicated, prompt therapy should be initiated to lower intraocular pressure and salvage vision. Effective management of post-operative keratoplasty glaucoma remains an enigma with no single therapy being suited for all cases. One has to weigh the risks and benefits of the anti-glaucoma drugs on the corneal graft. However, it should be kept in mind that although there is a potential option for a graft exchange, vision lost from glaucomatous optic nerve damage cannot be recovered.This review aims at highlighting the magnitude of the problem, assessing the risk factors that predispose to post-penetrating keratoplasty glaucoma along with the methodology for its diagnosis and management. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10776 Nepal J Ophthalmol 2014; 6 (2): 80-90
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Simakova, I. L., A. N. Kulikov, I. A. Tikhonovskay, M. V. Sukhinin, R. D. Berezin, and T. G. Babakhanov. "Features of Diagnosis and Treatment of the Drug-Induced Glaucoma Clinical Case." Ophthalmology in Russia 16, no. 3 (October 2, 2019): 399–407. http://dx.doi.org/10.18008/1816-5095-2019-3-399-407.
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Purpose: To describe the interesting and fairly rare due to its features clinical case of secondary glaucoma caused by prolonged use of corticosteroids in the composition of ocular drops and ointments for the treatment of chronic blepharitis. Key points: The features of this case are the young age of the patient, as well as late diagnosis of steroid glaucoma and concomitant systemic disease in the form of psoriatic spondylitis, despite regular examinations of the patient by ophthalmologists from various medical institutions over the past two years in connection with the treatment of chronic blepharitis with frequent exacerbations in both eyes. The abolition of corticosteroid drugs, complex treatment in combination with immunocorrection, systemic therapy of psoriatic spondylitis and surgical treatment of glaucoma in both eyes led to long-term remission of chronic blepharitis, stabilization of the glaucomatous process and improvement of the patient’s quality of life. Conclusion: Ophthalmologists should monitor the level of intraocular pressure in all patients who are treated with drugs containing corticosteroids
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M Rossi, Gemma C. "Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma." European Ophthalmic Review 08, no. 01 (2014): 40. http://dx.doi.org/10.17925/eor.2014.08.01.40.
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Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.
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Krieglstein, Guenter K. "Becker–Shaffer’s Diagnosis and Therapy of the Glaucomas (8th Edition) Eds: Robert L Stamper, Marc F Lieberman and Michael V Drake 2009 568pp., Hardcover ISBN: 9780323023948 Mosby Elsevier." Graefe's Archive for Clinical and Experimental Ophthalmology 249, no. 8 (October 8, 2010): 1271–72. http://dx.doi.org/10.1007/s00417-010-1517-4.
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Zhuravleva, Anastasiia N., Maria O. Kirillova, Marina V. Zueva, and Vitaliy V. Kadyshev. "The role of genetic factors in the pathogenesis of primary open-angle glaucoma. Part 1. Connective tissue." Ophthalmology Journal 14, no. 1 (June 9, 2021): 89–100. http://dx.doi.org/10.17816/ov52972.
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The article presents an analytical review of works devoted to molecular and genetic studies in primary open-angle glaucoma from the perspective of the concept of hereditary inferiority of the connective tissue of the eye (scleral component), and the entire body as a whole, as triggers in the development of the disease. The relationship between the main theories of the pathogenesis of glaucoma optical neuropathy and the determining role of molecular and genetic mechanisms of specific changes in the eye tissue is shown. The clinical features of primary open-angle glaucoma in patients with a family history are analyzed. Potentially new directions for preclinical diagnosis of glaucoma and pathogenetically oriented therapy are proposed.
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Whelan, K., A. Mertens, R. Castleberry, P. Mitby, T. Kawashima, C. Sklar, R. Packer, J. Waterbor, J. Blatt, and L. Robison. "Visual complications in childhood cancer survivors: A Childhood Cancer Survivor Study report." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 9006. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.9006.
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9006 Background: The Childhood Cancer Survivor Study (CCSS) is an NIH funded project (U01-CA 55727) designed to study the effects of childhood cancer treatment on long- term survivors. Previous studies have found associations between certain cancer therapies and visual complications. Methods: The CCSS is a retrospective cohort study investigating health outcomes of long-term survivors (> 5 years) diagnosed and treated between 1970 and 1986 compared to a randomly selected sibling cohort. Questionnaires were completed by 14,362 survivors of childhood cancer and 3,901 sibling controls. Analysis determined the first occurrence of 8 visual conditions in 3 time periods: during therapy, end of therapy to 5 years post diagnosis, and greater than or equal to 5 years post diagnosis. Multivariate analyses, adjusting for current age and gender, determined the relative risks (RR) and 95% confidence interval (CI) of visual conditions by treatment exposure. Results: Survivors had statistically significant increases in the RR of cataracts, glaucoma, legal blindness, double vision, retinal condition, and dry eyes, across all time periods, when compared to siblings. During the time period of 5 or more years post-diagnosis, statistically significant positive associations were present for cataracts and other head radiation, craniospinal radiation, total body radiation, and prednisone; glaucoma and craniospinal radiation; double vision and craniospinal radiation; legally blind and other head radiation and craniospinal radiation; and dry eyes and other head radiation, total body radiation, and dexamethasone. There were no statistically significant associations between treatment factors and retinal conditions. Conclusions: Childhood cancer survivors are at risk of developing visual complications and treatment related factors are important determinants of this risk. Follow-up is needed to evaluate the impact of visual conditions on quality of life. [Table: see text] No significant financial relationships to disclose.
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Guerriero, Silvana, Ermete Giancipoli, Lorenza Ciracì, Giuseppe Ingravallo, Marcella Prete, Elisabetta Di Leo, Antonietta Cimmino, and Nicola Cardascia. "Masquerade Syndrome of Multicentre Primary Central Nervous System Lymphoma." Case Reports in Ophthalmological Medicine 2011 (2011): 1–4. http://dx.doi.org/10.1155/2011/329857.
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Purpose. In Italy we say that the most unlucky things can happen to physicians when they get sick, despite the attention of colleagues. To confirm this rumor, we report the sad story of a surgeon with bilateral vitreitis and glaucoma unresponsive to traditional therapies.Methods/Design. Case report.Results. After one year of steroidal and immunosuppressive therapy, a vitrectomy, and a trabeculectomy for unresponsive bilateral vitreitis and glaucoma, MRI showed a multicentre primary central nervous system lymphoma, which was the underlying cause of the masquerade syndrome.Conclusions. All ophthalmologists and clinicians must be aware of masquerade syndromes, in order to avoid delays in diagnosis.
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Apostolova, A. S., A. V. Malyshev, K. M. Gurdzhijan, V. A. Shipilov, and N. N. Ponomareva. "Features of Monitoring Patients with Primary and Advanced Stages of Glaucoma in Krasnodar Territory." Ophthalmology in Russia 17, no. 1 (April 3, 2020): 142–51. http://dx.doi.org/10.18008/1816-5095-2020-1-142-151.
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Purpose: to analyze the monitoring of patients with primary and advanced stages of glaucoma, who applied to the private clinic “Tri-Z” (Krasnodar).Patients and Methods. A total of 3 524 patients underwent screening with a diagnosis of glaucoma for all over 2018 at the clinic, of which 55.6 % were diagnosed with primary and advanced glaucoma. The criterion for inclusion in the study was primary glaucoma of the initial and advanced stages, elimination criteria: high degree of refraction errors, retinal detachment in anamnesis, proliferative diabetic retinopathy, AMD exudative forms, congenital forms of glaucoma, secondary types of glaucoma.Results: The average age of patients was 68.44 ± 8.142 years, women were 71 %, men — 29 %. The average duration of glaucomatous history was 3.48 ± 3.525 years. POAG was found in 85.3 % of cases, PACG in 14.7 % of cases. Glaucoma without concomitant PEX was observed in 44.7 % cases, with signs of PEX in 55.3 % cases. In stage I of glaucoma, the majority of patients (42.7 %) received APG and in 27.1 % cases a fixed combination of ICA + BB. In stage II glaucoma, the majority of patients (26.5 %) received a fixed combination of ICA + BB, in 18.8 % of cases, the combination of APG + ICA + BB and in 17.7 % — APG. The share of laser interventions: LTP — 14.7 %, SLT — 4.1 %, peripheral iridectomy — 10 %, YAG-GP — 0.8 %, SLT + YAG-GP — 0.8 %, peripheral iridectomy + SLT — 0.5 %. The share of surgical interventions: at glaucoma stage I non-penetrating deep sclerectomy (NPDS) — 3.4 %; at stage II NPDS — 10.9 %, repeated NPDS — 0.5 %, deepsclerectomy — 2.2 %; phacoemulsification + IOL — 21.9 % of cases.Conclusion: In the study, we noted the following features: use, including as a starting therapy, effective drugs or their combinations; the preferred use of fixed combinations; prioritization of non-preservative therapy; high frequency of laser interventions in the anterior eye segment; use of peripheral laser iridectomy in the overwhelming majority of cases when PACG is detected; early transition to surgical treatment.
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Jelic-Vukovic, Marija, Suzana Matic, Josip Barac, Tomislav Novinscak, Mirna Belovari, and Hrvoje Baric. "Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation." Srpski arhiv za celokupno lekarstvo 145, no. 9-10 (2017): 513–15. http://dx.doi.org/10.2298/sarh160907075j.
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Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL) were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.
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Neroev, V. V., M. V. Zueva, A. N. Zhuravleva, and I. V. Tsapenko. "Structural and Functional Disorders in Glaucoma: the Prospects for Preclinical Diagnosis. Part 1. Is the Search for what Comes First Relevant?" Ophthalmology in Russia 17, no. 3 (September 24, 2020): 336–43. http://dx.doi.org/10.18008/1816-5095-2020-3-336-343.
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The review analyzes the capabilities of modern technologies of structural neuroimaging of the retina, standard perimetry, and studies of ocular blood flow in the early diagnosis and management of glaucoma. The relevance of the search for those structural and functional changes that are primary in the development of glaucomatous optical neuropathy (GON) and the diagnostic method that has the greatest clinical significance is discussed. Progress in understanding the pathogenesis of glaucoma and the expansion of scientific understanding of key risk factors for the development and progression of the disease, including genetic factors, can be crucially important to substantiate new strategies for preclinical diagnosis and the development of radically new approaches to personalized and preventive glaucoma therapy. However, the search for what arises most early with in primary open-angle glaucoma — changes in structure or function — will not have clinical relevance unless you take into account the capabilities of specific methods of structural and functional neuroimaging that represent information at various levels of organization of the visual system. The search for a single primary factor in the pathogenesis of GON can lead to an erroneous exaggeration of the close relationship between the variables being studied, which in reality either does not exist as a causal relationship or is significantly less than what is supposed — the phenomenon called “illusory correlation”. The reliable diagnosis of early changes that occur before the clinical manifestation of glaucoma is most likely to be based on a combination of structural, functional, and hemodynamic indicators, aimed not only to increase the sensitivity of diagnosis in detecting the earliest events in the development of GON, but rather to dramatically improve the understanding and quality of interpretation of those markers that we own.
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Gazepov, Strahil, Marija Hubreva, Radmila Zendelska, Elena Lichkova, and Verica Stojmenova. "FIXED COMBINATIONS IN THE TREATMENT OF GLAUCOMA." Knowledge International Journal 28, no. 2 (December 10, 2018): 613–18. http://dx.doi.org/10.35120/kij2802613g.
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Glaucoma is a slowly progressive neuropathy with changes in the optic nerve, the retinal neurofibrillar layer, and the field of vision.The aim of the paper is to present the significance of detecting elevated intra ocular pressure in early glaucoma detection.Glaucoma is one of the leading causes of blindness in the world. According to the latest WHO estimates, as a challenge to global level resolution - carcinomas are in the first place, cardiovascular diseases in second, and blindness in third place. The glaucoma accounts for about 9-12% of all blind people in the world, that is, this disease is diagnosed in about 2.5 million people each year. WHO predicts that the percentage will increase to 30% by 2020.The definition of the 2014 European Glaucoma Association (EEC 2014) reads: "Glaucoma is a chronic progressive optic neuropathy with characteristic morphological changes on the optic nerve disc and the retinal neurofibrillar layer as well as the progressive death of ganglia cells with visual field loss in the absence other eye diseases and congenital anomalies. " Hence, in addition to the standard methods available to us, such as measuring the height of the intraocular pressure (IOP), gonioscopy, eyelid examination, as well as determining and monitoring visual acuity, the necessity of the standard computerized perimetry and optic coherent tomography of back eye segment.Timely diagnosis of glaucoma is the only mechanism to combat this disease. The new methods offer a variety of new possibilities for investigating the earliest changes in the optic nerve disc and the retinal neurofibrillar layer. Their use should be combined with the classic glaucoma testing methods, such as standard computerized perimeter. But the basis is the early detection of an increased IOP by means of mass measurements with screening programs in risky or general groups. According to modern ophthalmic protocols, all patients with an increased IOP must be computed perimetrically once a year. In patients with significant changes in the field of vision, more often, for six months, the findings of the visible fields are compared. The new methods provide a quick, precise and timely diagnosis of this severe disease, which, if not detected, leads to safe blindness in time. Early combination therapy may be appropriate in patients with advanced glaucoma, patients with a high progression rate in patients with high IOP and / or severe visual field impairment, as well as in younger patients. Fixed combination therapy should be considered when patients fail to achieve their individualized IOP targets with monotherapy when 2 special applications of drops are preferred.
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Burya, R. A., and E. L. Sorokin. "A clinical case of newly detected far-advanced primary open-angle glaucoma against the background of optic disc drusen." Reflection 10, no. 1 (December 25, 2020): 52–57. http://dx.doi.org/10.25276/2686-6986-2020-1-52-57.
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Aim. To present a clinical case of glaucoma development against the background of optic disc drusen (ODD), demonstrating the difficulties of differential diagnosis between such nosologies as glaucomatous optic neuropathy, optic disc swelling, and chronic optic neuropathy caused by ODD. Methods. Patient S., 72 years old, was referred to clinic with suspected optic disc swelling, initial senile cataract of both eyes. The patient underwent additional investigations: Maklakov tonometry registered an increase of intraocular pressure level exceeding permissible norm; perimetry which has revealed narrowing of visual field boundaries in both eyes; ß-scan ultrasonography has visualized morphological changes with highly reflective drusen in both eyes; optical coherence tomography of optic nerve and ganglion cell layer revealed decrease in nerve fiber layer thickness on nasal side. For differential diagnosis, the patient underwent magnetic resonance imaging (MRI) of the brain, according to which intracranial pathology was excluded. Results. Using modern diagnostic methods it was possible to establish clinical diagnosis: newly detected primary open-angle glaucoma (POAG) III b, explicit ODD, initial senile cataract, pseudoexfoliation syndrome grade 2. Hypotensive regimen did not result in target pressure; therefore, the patient was prescribed surgical treatment (microinvasive non-penetrating deep sclerectomy on both eyes). Conclusion. The presented clinical case showed that against the background of ODD creating the picture of pseudo-swelling and masking the changes in optic nerve because of glaucoma process, the patient had POAG in far-advanced stage. MRI of the brain, as well as additional ophthalmological investigations using modern technologies, made it possible to establish correct diagnosis and prescribe the necessary therapy for this nosology. Key words: optic disc drusen; primary open-angle glaucoma; perimetry; optical coherence tomography.
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Yurieva, T. N., and S. I. Zhukova. "OCT angiography in a comprehensive assessment of hypotensive therapy effectiveness in patients with primary open-angle glaucoma." Russian Ophthalmological Journal 12, no. 3 (August 31, 2019): 43–49. http://dx.doi.org/10.21516/2072-0076-2019-12-3-43-49.
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Degenerative changes in the retina of primary open-angle glaucoma (POAG) patients are developing as response to ischemia and chronic hypoxia accompanied by intolerant IOP. For this reason, the analysis of ocular blood flow changes in glaucoma monitoring, as well as the basic tests, should be considered an integral part of comprehensive examination of such patients.The purpose is to identify the most informative markers of the disease and to assess the effectiveness of its antihypertensive therapy by the fixed combination Dorzolamide / Timolol (Dorzopt Plus). Material and methods. 34 patients aged 68.44 ± 4.26 years with an advanced POAG stage and sub- or decompensated IOP were examined. The examination included optical coherence tomography in the angiography mode.Results. A stable average reduction in IOP by 35.1 % (by 8.6 ± 0.7 mm Hg, p < 0.05) as compared with the baseline was achieved. IOP normalization was accompanied by a stable increase in corneal hysteresis and perfusion pressure, a decrease in the average depth of the perimetric defect, and changes in chorioretinal blood flow.Conclusion. Changes in the choroid thickness and capillary density of the retinal peripapillary layer may be considered as the most informative biomarkers in the diagnosis of glaucoma and the evaluation of antihypertensive therapy effectiveness.
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Evans, Naomi, Katherine Paton, Harinder Kaur Gill, and Juliette Hukin. "RARE-25. RETINAL ASTROCYTOMA mTOR INHIBITOR THERAPY IN TUBEROUS SCLEROSIS MOSAICISM." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii447. http://dx.doi.org/10.1093/neuonc/noaa222.736.
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Abstract INTRODUCTION Everolimus is an inhibitor of mTORC1 (mammalian target of rapamycin complex 1), it is Health Canada and FDA approved for SEGA and renal angiomyolipoma in the setting of tuberous sclerosis complex (TSC). There is little data available in regards to this treatment of TSC associated retinal astrocytoma (RA). Although the behaviour of RA is often indolent or slowly progressive, aggressive behaviour with retinal detachment and neovascular glaucoma requiring enucleation has been reported in several patients. Definite TSC diagnosis is established when either two major features or one major and two minor features are present. Probable TSC diagnosis is established when one major plus one minor feature is present. METHODS We report a child with probable TSC mosaicism, with negative serum NGS for TSC but RA and retinal achromic patch on the left. A left retinal peripapillary astrocytoma around optic nerve and very close to fovea was noted. There was concern that if it grew or there were to be any leakage it would cause visual impairment. This lead to therapy with everolimus 4.5 mg/m2/d aiming for level between 5 and 10 mcg/L. RESULTS This boy has had a gradual reduction of the RA over the last 29 months, with healthy retina in the region no longer occupied by the lesion and preserved vision. He has tolerated therapy well with occasional mouth ulcers. CONCLUSION mTORC1 inhibition is effective therapy to preserve vision in the setting of retinal astrocytoma and tuberous sclerosis mosaicism.
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Valueva, I. V., and O. Yu Kirgizova. "EFFECT OF ACUPUNCTURE ON THE FUNCTION OF THE VISUAL SYSTEM IN PATIENTS OF GLAUCOMA." Acta Biomedica Scientifica 3, no. 5 (October 29, 2018): 72–75. http://dx.doi.org/10.29413/abs.2018-3.5.11.
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At present, significant advances have been made in the surgical and conservative treatment of glaucoma. However, in patients with a prolonged course of the disease, even against the background of normalized intraocular pressure, progressive deterioration of visual functions occurs with the transition of the disease to a more severe stage. Effects directed solely at lowering the intraocular pressure are not able to fully ensure the preservation of visual functions, so its normalization cannot ensure the stabilization of the glaucoma process. Dysfunction of the nervous system and vascular disorders play a significant role in the pathogenesis of glaucoma. In this regard, the treatment of this disease should be comprehensive and include neuroprotective therapy aimed at correction of metabolic disorders that occur in glaucoma in the optic nerve head, improvement of local microcirculation and trophism of tissues, normalization the rheological properties of the blood. Conventional conservative therapy does not provide adequate blood supply to the optic nerve and prevent the deterioration of visual functions in more than half of patients. The purpose of this study was to study the effectiveness of reflexotherapy in patients with glaucoma after surgery and normalization of intraocular pressure. In the study, 18 patients with a diagnosis of primary open-angle glaucoma were treated. It has been established that reflexotherapy improves significantly the functions of the visual system and the general condition, normalizes arterial pressure and psycho-emotional state of patients.
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Kaufman, Paul L., B'Ann Gabelt, Baohe Tian, and Xuyang Liu. "Advances in Glaucoma Diagnosis and Therapy for the Next Millennium: New Drugs for Trabecular and Uveoscleral Outflow." Seminars in Ophthalmology 14, no. 3 (January 1999): 130–43. http://dx.doi.org/10.3109/08820539909061466.
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Kobelt, Gisela, and Linus Jönsson. "MODELING COST OF TREATMENT WITH NEW TOPICAL TREATMENTS FOR GLAUCOMA." International Journal of Technology Assessment in Health Care 15, no. 1 (January 1999): 207–19. http://dx.doi.org/10.1017/s0266462399015299.
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Several new topical agents have been introduced recently and it can be expected that the treatment of glaucoma will change, depending on how effectively these agents control intraocular pressure (IOP). IOP is considered the major risk factor in the development of glaucomatous damage. In order to estimate the impact of these new agents on the cost of treating glaucoma, a simulation model was created to estimate the cost of treating patients with a recent diagnosis of primary open-angle glaucoma or ocular hypertension in different countries. The Markov model is based on retrospective chart reviews in different countries and calculates only cost, not outcome. Results are presented for France and the United Kingdom, where current treatment appeared to be comparable. Average one-year costs per patient with current treatment were FF2,389 (US $389) and £380 (US $627), respectively. Costs with the new treatments were lower than with current therapy.
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RITCH, R. "DIRECTED THERAPY FOR SPECIFIC GLAUCOMAS." Ophthalmology Clinics of North America 13, no. 3 (September 1, 2000): 429–41. http://dx.doi.org/10.1016/s0896-1549(05)70204-2.
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Pilipenko, A. D., R. A. Burya, and A. V. Romanova. "Relationship between duration of antihypertensive regimen and incidence of dry eye syndrome in patients with primary open-angle glaucoma." Modern technologies in ophtalmology, no. 1 (May 29, 2021): 75–78. http://dx.doi.org/10.25276/2312-4911-2021-1-75-78.
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Purpose. To study the incidence of dry eye syndrome (DES) in patients with primary open-angle glaucoma (POAG), depending on the duration of the use of local antihypertensive therapy. Material and methods. The material for the study was patients who were examined in the treatment and diagnostic department of the Khabarovsk branch the S. Fyodorov Eye Microsurgery Federal State Institution with a confirmed clinical diagnosis of POAG. The main group included 45 patients with a duration of antihypertensive therapy of 1 month or more. The comparison group consisted of 15 patients with newly diagnosed POAG. The period of use of antihypertensive therapy in them did not exceed one month. Depending on the experience of using antihypertensive therapy, the patients of the main group were divided into 3 subgroups. All were questioned using the DEQ-5 dry eye questionnaire, Schirmer I, II and Norn's tests, objective examination of the anterior segment of the eyes. The analysis of the detection and severity of DES among patients with POAG was carried out, taking into account the experience of using the antihypertensive regimen. Results. According to the questionnaire, 26 patients (58%) of the main group presented complaints typical of DES, while in the comparison group only 3 patients (20%) presented them (p<0.05). There was also a tendency towards a decrease in the total and main type of tear production in the main group according to the results of Schirmer's tests I and II – 10.9±1.04 mm and 7.7±0.48 mm versus 13.9±2.5 mm and 10, 2±2.1 mm in the comparison group (p>0.05). The stability of the tear film, according to Norn's test, also differed: 8.2±0.35 sec. and 9.5±1.8 sec. in the main and comparison group, respectively (p> 0.05). Conclusion. The initial symptoms of xerosis of the ocular surface are recorded in the period from 1 to 3 years from the beginning of the use of antihypertensive drugs and increase in proportion to the increase in the length of the disease. Key words: dry eye syndrome, glaucoma, antihypertensive therapy.
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Harasymowycz, Paul, Catherine Birt, Patrick Gooi, Lisa Heckler, Cindy Hutnik, Delan Jinapriya, Lesya Shuba, David Yan, and Radmila Day. "Medical Management of Glaucoma in the 21st Century from a Canadian Perspective." Journal of Ophthalmology 2016 (2016): 1–22. http://dx.doi.org/10.1155/2016/6509809.
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Glaucoma is a medical term describing a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and retinal nerve fibre layer and resulting in changes in the optic nerve head. Glaucoma is a leading cause of irreversible vision loss worldwide. With the aging population it is expected that the prevalence of glaucoma will continue to increase. Despite recent advances in imaging and visual field testing techniques that allow establishment of earlier diagnosis and treatment initiation, significant numbers of glaucoma patients are undiagnosed and present late in the course of their disease. This can lead to irreversible vision loss, reduced quality of life, and a higher socioeconomic burden. Selection of therapeutic approaches for glaucoma should be based on careful ocular examination, patient medical history, presence of comorbidities, and awareness of concomitant systemic therapies. Therapy should also be individualized to patients’ needs and preferences. Recent developments in this therapeutic field require revisiting treatment algorithms and integration of traditional and novel approaches in order to ensure optimal visual outcomes. This article provides an overview of recent developments and practice trends in the medical management of glaucoma in Canada. A discussion of the surgical management is beyond the scope of this paper.
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Cherednichenko, Nina L., Sergey M. Karpov, Vladimir A. Baturin, and Yuliana A. Barbos. "Antibodies to myelin basic protein as a diagnostic marker of primary open-angle glaucoma." Ophthalmology journal 11, no. 1 (March 15, 2018): 19–24. http://dx.doi.org/10.17816/ov11119-24.
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Recently, many authors resort to immunomolecular diagnostics of glaucoma. We found conflicting information about the concentration of antibodies to the myelin basic protein (AB to MBP) in primary open-angle glaucoma in the literature. Aim: to determine the concentration of antibodies to the myelin basic protein in the serum of patients with primary open-angle glaucoma to assess the diagnostic significance of the test. Materials and methods. We included 48 people aged from 42 to 79 years: fourteen people had the diagnosis of the first stage of primary open-angle glaucoma (POAG), 10 people had the second (advanced) stage of POAG, 8 people had the III (far-gone) stage of POAG, and 16 subjects made the control group. Exclusion criteria: mature or almost mature cataract, age-related macular degeneration, severe concomitant ophthalmologic, neurological pathology, oncological and autoimmune diseases, glucocorticoid or immunosuppressive therapy, exacerbation of any acute and subacute respiratory infection, chronic inflammatory processes and craniocerebral trauma. The serum level of AB to MBP was determined by enzyme immunoassay method (ELISA). Results. The concentration of AB to MBP was significantly higher in patients with first and second stages of POAG (177.5 ± 63.93 μg/ml and 262.63 ± 34.78 μg/ml, respectively) than in the control group (38.69 ± 11.77 micron/ml, p < 0.05). To establish the diagnosis of POAG in at risk patients it is appropriate to use the level of IgG to MBP > 60 μg/ml; the sensitivity of the method is 78% and its specificity is 87%. (For citation: Cherednichenko NL, Karpov SM, Baturin VA, Barbos YuA. Antibodies to myelin basic protein as a diagnostic marker of primary open-angle glaucoma. Ophthalmology Journal. 2018;11(1):19-24. doi: 10.17816/OV11119-24).
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Sudovskaya, Tatyana Viktorovna, Yu A. Bobrovskaya, A. A. Makarova, N. Sh Kokoeva, and Ya O. Veklich. "The influence of the central corneal thickness on the characteristics of the ophthalmic tone in the children presenting with congenital microphthalmia." Russian Pediatric Ophthalmology 11, no. 4 (December 15, 2016): 196–99. http://dx.doi.org/10.18821/1993-1859-2016-11-4-196-199.
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Objective. To evaluate the influence of the central corneal thickness on the characteristics of the ophthalmic tone in the children presenting with congenital microphthalmia of different severity and to describe its clinical significance for diagnostics of glaucoma and prescription of hypotensive therapy. Materials and methods. A total of 40 children (80 eyes) at the age from 5 to 17 years presenting with congenital microphthalmia of different severity were available for the examination. The children remained under the examination during 10 and more years. They were divided into three groups in terms of severity of microphthalmia. Thirteen children were admitted with the diagnosis of “glaucoma”. The comprehensive ophthalmological examination was supplemented by the measurement of the central corneal thickness. Results. The analysis of the results of the examination gave evidence of the increased central corneal thickness in all the patients with grade 1 - III microphthalmia included in the study. The measurement of the central corneal thickness is important for the establishment of the diagnosis of “glaucoma” because it exerts the direct influence on the characteristics of the ophthalmic tone in the children presenting with congenital microphthalmia. Conclusion. The present study has demonstrated the fairly well apparent relationship between the central corneal thickness, the severity of microphthalmia and intraocular pressure (IOP) in the children presenting with congenital microphthalmia. The higher the severity of microphthalmia the greater the central corneal thickness and the intraocular pressure.
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M. Ali, Khaled. "Bilateral Panophthalmia as a Late Sequel of Leishmaniasis in Dogs." Pakistan Veterinary Journal 41, no. 01 (March 1, 2021): 13–18. http://dx.doi.org/10.29261/pakvetj/2021.006.
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Fifteen dogs were presented with complete blindness that progressed over 2-4 months. Diagnosis was confirmed that dogs had leishmaniasis through direct observation of the amastigotes within the blood cells, PCR testing and phylogenetic analysis. Gross pathologic and histopathologic examinations were performed for two dogs that were severely debilitated and humanely euthanized. Systemic involvement including decreased appetite (n=8), generalized weight loss (n=4), generalized lymphadenopathy (n=3), icterus (n=3), polyuria and polydepsia (n=2), lethargy (n=5) and four dogs were presented without any systemic involvement. All dogs had bilateral panophthalmia (n=30 eyes) manifested by cataract, anterior uveitis, posterior uveitis, retinal detachment, peri-ocular alopecia, conjunctivitis, blepharitis, keratoconjunctivitis and glaucoma. Detailed ultrasonographic ocular lesions were described; histopathological examination confirmed the ongoing changes within the eye. Leishmaniasis should be considered in the differential diagnosis of dogs with bilateral ocular involvement especially those not responding to symptomatic medicinal therapy.
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Kerber, Juliana Maria, Juliana Dias de Mello, Karolinny Borinelli de Aquino Moura, Gustavo Cardoso da Silva, Iuri Christmann Wawrzeniak, and Tatiana Helena Rech. "Acetazolamide Intoxication in an Elderly Patient with Diabetes and Chronic Renal Failure after Cataract Surgery." Case Reports in Critical Care 2020 (February 1, 2020): 1–3. http://dx.doi.org/10.1155/2020/3764972.
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Carbonic anhydrase inhibitors, such as acetazolamide, are widely used in the treatment of open-angle glaucoma. Severe metabolic acidosis is a rare complication of acetazolamide use, and life-threatening acidosis occurs most commonly in elderly patients, in patients with advanced renal failure, and in patients with diabetes. We describe an unusual case of an elderly patient with diabetic nephropathy and chronic renal failure who presented to the emergency department with severe metabolic acidosis and coma after exposure to high doses of acetazolamide in the postoperative period of ophthalmic surgery. As symptoms of acetazolamide intoxication and uremia are similar, high suspicion is required to detect excessive plasma drug concentrations and intoxication in patients presenting with concomitant uremia. Clinical symptoms are potentially reversible with prompt diagnosis and treatment, including supportive treatment, bicarbonate therapy, and renal replacement therapy. Hemodialysis is particularly helpful in the management of acetazolamide overdose as the medication is dialyzable.
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Matsubayashi, Hiroyuki, Hirotoshi Ishiwatari, Kenichiro Imai, Yoshihiro Kishida, Sayo Ito, Kinichi Hotta, Yohei Yabuuchi, et al. "Steroid Therapy and Steroid Response in Autoimmune Pancreatitis." International Journal of Molecular Sciences 21, no. 1 (December 30, 2019): 257. http://dx.doi.org/10.3390/ijms21010257.
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Autoimmune pancreatitis (AIP), a unique subtype of pancreatitis, is often accompanied by systemic inflammatory disorders. AIP is classified into two distinct subtypes on the basis of the histological subtype: immunoglobulin G4 (IgG4)-related lymphoplasmacytic sclerosing pancreatitis (type 1) and idiopathic duct-centric pancreatitis (type 2). Type 1 AIP is often accompanied by systemic lesions, biliary strictures, hepatic inflammatory pseudotumors, interstitial pneumonia and nephritis, dacryoadenitis, and sialadenitis. Type 2 AIP is associated with inflammatory bowel diseases in approximately 30% of cases. Standard therapy for AIP is oral corticosteroid administration. Steroid treatment is generally indicated for symptomatic cases and is exceptionally applied for cases with diagnostic difficulty (diagnostic steroid trial) after a negative workup for malignancy. More than 90% of patients respond to steroid treatment within 1 month, and most within 2 weeks. The steroid response can be confirmed on clinical images (computed tomography, ultrasonography, endoscopic ultrasonography, magnetic resonance imaging, and 18F-fluorodeoxyglucose-positron emission tomography). Hence, the steroid response is included as an optional diagnostic item of AIP. Steroid treatment results in normalization of serological markers, including IgG4. Short- and long-term corticosteroid treatment may induce adverse events, including chronic glycometabolism, obesity, an immunocompromised status against infection, cataracts, glaucoma, osteoporosis, and myopathy. AIP is common in old age and is often associated with diabetes mellitus (33–78%). Thus, there is an argument for corticosteroid therapy in diabetes patients with no symptoms. With low-dose steroid treatment or treatment withdrawal, there is a high incidence of AIP recurrence (24–52%). Therefore, there is a need for long-term steroid maintenance therapy and/or steroid-sparing agents (immunomodulators and rituximab). Corticosteroids play a critical role in the diagnosis and treatment of AIP.
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TELLO, C., R. ROTHMAN, H. ISHIKAWA, and R. RITCH. "DIFFERENTIAL DIAGNOSIS OF THE ANGLE-CLOSURE GLAUCOMAS." Ophthalmology Clinics of North America 13, no. 3 (September 1, 2000): 443–53. http://dx.doi.org/10.1016/s0896-1549(05)70205-4.
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Scuderi, Gianluca, Peng T. Khaw, Felipe A. Medeiros, and Gianluca Manni. "Challenging Glaucomas: Update on Diagnosis and Management." Journal of Ophthalmology 2016 (2016): 1–2. http://dx.doi.org/10.1155/2016/6935086.
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Leblanc, Alice, Livia Lumbroso-Le Rouic, Laurence Desjardins, Rémi Dendale, and Nathalie Cassoux. "Diffuse Iris Melanoma: Conservative Treatment with Proton Beam Therapy after Limbal Stem Cell Preservation or Enucleation?" Ocular Oncology and Pathology 5, no. 6 (2019): 396–401. http://dx.doi.org/10.1159/000496847.
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Objectives: Iris melanomas represent 2–3% of uveal melanomas; the diffuse variant accounts for approximately 10% of all iris melanomas. Different treatment modalities for diffuse iris melanomas (DIM) have been proposed depending on the local status as well as the age and general condition of the patient. Methods: This study is a single-centre retrospective case series describing the diagnosis, treatments and outcomes of DIM. Treatment consisted of enucleation or proton beam therapy (PT) of the whole anterior segment. Patients who were treated with PT benefitted from limbal stem cell preservation before irradiation. Results: Between 1996 and 2016, a total of 14 patients with DIM presented to our institution and were included in the database. The global survival was 86%. The median follow-up was 4.6 years (range 4 months to 15 years). Only 1 patient (7%) developed metastatic disease of the DIM (gastric location). No patient developed liver metastasis. Seven patients were treated by enucleation and 7 by PT after limbal stem cell preservation. After a conservative attempt, local tumour recurrence occurred in 2 patients at 2 years, requiring enucleation. The cornea was clear after irradiation in all patients. Cataract (n = 6) and glaucoma (n = 4) were the main complications after irradiation. Conclusions: DIM is a very rare tumour. The global survival is excellent. Conservative treatment with PT is an efficient alternative to enucleation and allows good local tumour control. Cataract and glaucoma are the main radiation-related complications, but the corneal status was excellent due to the stem cell harvest prior to radiotherapy.
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Pinazo-Durán, María D., Vicente Zanón-Moreno, José J. García-Medina, J. Fernando Arévalo, Roberto Gallego-Pinazo, and Carlo Nucci. "Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review." BioMed Research International 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/6215745.
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Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients.
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Soboka, Jibat Gemida, Abeba T. Giorgis, Abiye M. Alemu, W. G. Hodge, and Karim F. Damji. "Efficacy and Safety of Selective Laser Trabeculoplasty among Ethiopian Glaucoma Patients." Journal of Ophthalmology 2020 (September 16, 2020): 1–6. http://dx.doi.org/10.1155/2020/7620706.
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Background. Selective laser trabeculoplasty (SLT) is a safe and effective treatment modality for lowering intraocular pressure (IOP). Purpose. To determine the efficacy and safety of SLT among Ethiopian patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and ocular hypertension (OHT). Method. A prospective, nonrandomized interventional study was conducted at Menelik II Hospital, Ethiopia. Patients on antiglaucoma medication with uncontrolled IOP and those patients treated for the first time with 360 degrees of SLT were included. Success was defined as an IOP lowering of > 20% from baseline without repeat treatment. Result. A total of 95 eyes of 61 patients with a diagnosis of OAG and OHT were enrolled. The diagnosis was POAG in 55 (57.9%) eyes, PXG in 22 (23.2%) eyes, and OHT in 18 (18.9%) eyes. Seventy (73.7%) eyes were on medications, and 25 (26.3%) eyes were treated with laser as primary therapy. The mean (SD) baseline IOP and medication were 24.3 ± 2.5 mmHg and 1.29 ± 1.01, respectively. The one-year mean (SD) IOP reduction was 6.7 ± 4.2 mmHg and medication reduction was 0.26 ± 1.34. The overall IOP reduction at 12 months was 27.6%, and the success rate was 60%. The mean IOP (SD) reduction for patients who were treated for the first time with laser and on antiglaucoma medication was 6.5 ± 3.1 mmHg and 6.8 ± 2.8 mmHg, respectively. Post-SLT, patients experienced transient ocular pain, brow ache, headache, and/or blurring of vision in 31.6%, anterior chamber reaction in 36.8%, and IOP spike ≥ 6 mmHg in 11.6%. Conclusion. SLT is an effective and safe treatment modality for OHT, POAG, and PXG among Ethiopian patients either as a first-line treatment or as an adjunct to topical glaucoma treatment.
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Rossi, Claudia, Ilaria Cicalini, Maria Concetta Cufaro, Luca Agnifili, Leonardo Mastropasqua, Paola Lanuti, Marco Marchisio, Vincenzo De Laurenzi, Piero Del Boccio, and Damiana Pieragostino. "Multi-Omics Approach for Studying Tears in Treatment-Naïve Glaucoma Patients." International Journal of Molecular Sciences 20, no. 16 (August 18, 2019): 4029. http://dx.doi.org/10.3390/ijms20164029.
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Primary open-angle glaucoma (POAG) represents the leading cause of irreversible blindness worldwide and is a multifactorial, chronic neurodegenerative disease characterized by retinal ganglion cell and visual field loss. There are many factors that are associated with the risk of developing POAG, with increased intraocular pressure being one of the most prevalent. Due to the asymptomatic nature of the disease, the diagnosis of POAG often occurs too late, which necessitates development of new effective screening strategies for early diagnosis of the disease. However, this task still remains unfulfilled. In order to provide further insights into the pathophysiology of POAG, we applied a targeted metabolomics strategy based on a high-throughput screening method for the determination of tear amino acids, free carnitine, acylcarnitines, succinylacetone, nucleosides, and lysophospholipids in naïve to therapy glaucomatous patients and normal controls. Also, we conducted proteomic analyses of the whole lacrimal fluid and purified extracellular vesicles obtained from POAG patients and healthy subjects. This multi-omics approach allowed us to conclude that POAG patients had lower levels of certain tear amino acids and lysophospholipids compared with controls. These targeted analyses also highlighted the low amount of acetylcarnitine (C2) in POAG patient which correlated well with proteomics data. Moreover, POAG tear proteins seemed to derive from extracellular vesicles, which carried a specific pro-inflammatory protein cargo.
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Tigrak, S. N., Ş. Çekiç, O. Yalcinbayir, and S. S. Kilic. "AB0751 JUVENILE UVEİTİS: THE 3RD LEVEL EXPERIENCE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1404.1–1404. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3933.
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Background:Uveitis is the inflammation of the uveal components of the eye (iris, choroid and retina) and is the third leading cause of blindness in the world. It is less common in children than adults. Young children are usually diagnosed late, as they cannot express their complaints.Objectives:With this work; We aimed to contribute to the literature by determining the underlying primary diagnosis and evaluating the treatment response in patients who were followed up in our clinic with a diagnosis of non-infectious uveitis, mostly juvenile idiopathic arthritis.Methods:93 patients under 18 years of age who were followed up with a diagnosis of non-infectious uveitis were included in the study. The data of the patients were scanned retrospectively. According to the last biomicroscopic examinations, the patients were classified as remission, inactive period and active disease. Clinical characteristics, laboratory findings, family history, drugs used during the disease and duration of treatment were examined.Results:The male to female ratio was 1,06 (48/45). The mean age at diagnosis of childhood uveitis was found to be 10±4.02. 49 Patients (52.6%) were diagnosed with idiopathic uveitis, 33 (33.5%)with juvenile idiopathic arthritis, 11 (11.7%) with Behçet’s, 2 (2.2%) with FMF. Juvenile idiopathic arthritis was the most common systemic disease in the patient group. The mean age of patients with uveitis to be diagnosed with rheumatological disease was 10.1±5.32. ANA test was positive in 30 (32.2%) patients. 23 (69.7%) of juvenile idiopathic arthritis patients were oligoartricular type. Anterior uveitis was present in 37 (39.8%) of the patients. Anterior uveitis was most common in the juvenile idiopathic arthritis cases. Of the patients with uveitis, 24 (25.8%) were intermediate, 11 (11.8%) were posterior, 21 (22.6%) were panuveitis. Anti-TNFα agents were administered to patients with unresponsiveness to immunosuppressive therapy and high risk of vision loss. Most used anti-TNFα agents were infliximab and adalimumab. Glaucoma, cataract, and posterior synechiae were common complications in the patients during follow-up.Conclusion:The most common systemic disease that cause noninfectious uveitis in children is juvenile idiopathic arthritis. In juvenile idiopathic arthritis, the most common involvement of the eye was the anterior segment, and it was thought that the location of the eye involvement could be useful in determining the underlying systemic disease. It is important to ensure regular eye examination in patients with rheumatologic symptoms.Disclosure of Interests:None declared
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Frolov, M. A., K. A. Kazakova, G. N. Dushina, A. M. Frolov, and P. A. Gonchar. "Intolerance of preservative-containing eye drops in a glaucoma patient: diagnostic and therapeutic challenges." Bulletin of Russian State Medical University, no. (1)2020 (January 26, 2020): 89–92. http://dx.doi.org/10.24075/brsmu.2020.005.
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A patient presented to our clinic with stage Ia open-angle glaucoma of the right eye and stage IIa surgically corrected open-angle glaucoma of the left eye. The condition of the ocular surface was interpreted as toxic/allergic conjunctivitis provoked by brimonidine 0.15 %. Brimonidine was substituted with non-selective 0.5%; additionally, topical steroids were prescribed. After steroids were discontinued, some of the symptoms came back, including moderate hyperemia and conjunctival edema, which was interpreted as intolerance to a preservative contained in the eye drops. A decision was made to switch from the β-blocker to its preservative-free formulation; regular IOP monitoring was continued. IOP measured during the next visit was above tolerated, so a preservative-free form of the ocular hypotensive combination drug (an analog of prostaglandin 0.005% with non-selective β-blocker 0.5%) was introduced to the regimen, with further IOP monitoring. Because the initial diagnosis was wrong, damage to the ocular surface had been aggravated by inadequate therapy. Preservative-free hypotensive eye drops are beneficial for the corneal surface and have a positive effect on a patient’s adherence to the regimen.
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Kaufman, Paul L., William W.-G. Jia, Jiren Tan, Zheng Chen, B’Ann T. Gabelt, Virginia Booth, Frank Tufaro, and Max Cynader. "A Perspective of Gene Therapy in the Glaucomas." Survey of Ophthalmology 43 (June 1999): S91—S97. http://dx.doi.org/10.1016/s0039-6257(99)00028-4.
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Miller, Paul E., and Ellison Bentley. "Clinical Signs and Diagnosis of the Canine Primary Glaucomas." Veterinary Clinics of North America: Small Animal Practice 45, no. 6 (November 2015): 1183–212. http://dx.doi.org/10.1016/j.cvsm.2015.06.006.
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Chukhraev, A. M., N. M. Agarkov, K. I. Proschayev, A. N. Ilnitskiy, A. S. Kulabukhov, and A. V. Ivanov. "Features Local Interlacing Status of Elderly Patients with Primary Angle-Closure Glaucoma." Ophthalmology in Russia 18, no. 1 (April 4, 2021): 123–28. http://dx.doi.org/10.18008/1816-5095-2021-1-123-128.
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An increased share of the elderly in the structure of modern society, along with other causes and risk factors, is accompanied by the growing the incidence of glaucoma. According to international research in the world by 2020 it is predicted that glaucoma patients will increase to 80 million. Among the elderly, glaucoma is a common pathology, the development of which is associated with local disorders of the interleukin profile. However, the features of the latter in patients with primary closed-angle glaucoma in the elderly have not been studied. The purpose of this work is to identify the features and informativeness of local interleukin profile indicators in elderly patients with primary angle — closure glaucoma. The study included 58 patients with primary angle-closure glaucoma of stage II, who made up the main group, aged 60–74 years with a median of 70.1 ± 2.5 years. All patients underwent a comprehensive ophthalmological examination. The diagnosis of primary angle-closure glaucoma was established in accordance with the requirements of the National glaucoma guidelines. The control group consisted of 27 elderly people aged 60 to 74 years with a median of 68.7 ± 2.1 years without signs and manifestations of primary angle-closure glaucoma, who also underwent a comprehensive ophthalmological examination. Changes in proinflammatory interleukins at the local level in the development of primary angle-closure glaucoma are accompanied by a significant increase in their content in all cases. On the contrary, changes in anti-inflammatory interleukins in the lacrimal fluid in patients with the considered ophthalmological pathology are characterized by a significant inhibition of their production. IL-10 are characterized by the most significant decrease at the local level and it is less related to IL-4. Local interlacing profile of patients with primary angle-closure glaucoma elderly are characterized by increased level in the tear fluid of anti-inflammatory IL-2, IL-17, IL-8 and lower production of anti-inflammatory IL-10. These local interleukins have the greatest informative value, which is of scientific and practical significance for identifying new mechanisms of development, diagnostics and justification of selective immunotropic therapy of the pathology in question.
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Batool, Aqsa, Iqra Nehal, Areej Riaz, Muzna Javed, Tahir Hussain, Abdul Hameed Talpur, and Shua Azam. "To evaluate the retinal nerve fiber layer thickness in different types of glaucoma." Advances in Ophthalmology & Visual System 11, no. 1 (February 25, 2021): 5–9. http://dx.doi.org/10.15406/aovs.2021.11.00400.
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Objective: Glaucoma is a multifaceted eye disease which is classified as physical damage of retinal ganglion cells which may effect in loss of vision and permanent blindness. While physical damage of glaucoma can be clinically evaluated the optic nerve head and peripapillary retinal nerve fiber layer (RNFL). Our objective is to evaluate the mean RNFL thickness in all types of glaucoma. Methodology: This prospective and cross sectional study was conducted in Glaucoma Clinic of Al Ibrahim Eye Hospital (AIEH), Karachi, for the period from May 2019 to October 2019, after ethical approval from Institutional Research Committee. A total of 64 glaucoma patients were chosen by using non-probability purposive sampling technique. The participant comprised, no known eye disease, no visual impairment, IOP below 22 mmHg, and no obvious retinal disease or defect were included while individuals having a history of ocular diseases or pathology with residual visual impairment, retinal diseases, amblyopia, and history of intraocular surgery or laser therapy were excluded from the study. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: 64 patients of both genders with mean age of 55.54±15.58 years. The mean intraocular pressure of right eye and left eye was 16.46±8.06 and 16.75±7.82 mmHg, respectively. The mean RNFL thickness in superior, inferior, temporal and nasal quadrant of the right eye was measured 68.23±25.44, 66.79±27.50, 51.75±12.58 and 47.73±18.82 microns, respectively while the mean RNFL thickness in superior, inferior, temporal and nasal quadrant of the left eye was measured 76.01±22.72, 67.42±21.25, 54.37±13.0 and 49.62±11.57 microns, respectively. Conclusion: Our study showed that analysis of retinal nerve fiber layer thickness with optical coherence tomography is the best tool for the diagnosis of glaucoma. It has also been observed in our study that frequency of changes in retinal nerve fiber layer thickness was mostly found in primary open angle glaucoma patients
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Shahraki, Kourosh, Alireza Khosravi, Shiva Kaffashipour, Kianoush Shahraki, and Masoud Sadeghi. "Evaluation of the optic nerve head and peripapillary retinal nerve fiber layer thickness in patients receiving Electro-Convulsive Therapy." Biomedical Research and Therapy 4, no. 12 (December 27, 2017): 1885–97. http://dx.doi.org/10.15419/bmrat.v4i12.399.
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Background: Electroconvulsive therapy (ECT) is a method commonly used in the treatment of psychiatric disorders. As ocular side effects from OCT are less studied and discussed, the aim of this study was to evaluate the profile of the peripapillary retinal nerve fiber layer thickness in patients receiving ECT.
Method: This study was performed on 30 patients who had indication for ECT. After recording demographic data, retinal nerve fiber layer thickness was measured by using spectral domain optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany) of optic nerve head and peripapillary retinal nerve fiber layer.
Results: Our results showed that for most of the studied variables, the normal range was observed in less than 85% of patients receiving ECT. Variables which were outside the normal range were: cup disk (C/D) ratio (right and left eyes were 50% and 46.7%, respectively), vertical C/D ratio (right and left eyes were 53.3% and 46.7%, respectively), and cup volume (right and left eyes were 53.3% and 33.3%, respectively).
Conclusion: This study showed that a high percentage of patients receiving ECT had changes in the optic nerve head while intra-ocular pressure in these patients was normal. It is warranted for examiners to pay attention to diagnosis of normal tension glaucoma in patients receiving ECT.
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Accorinti, Massimo, Giovanni Spinucci, Maria Pia Pirraglia, Simone Bruschi, Francesca Romana Pesci, and Ludovico Iannetti. "Fuchs’ Heterochromic Iridocyclitis in an Italian Tertiary Referral Centre: Epidemiology, Clinical Features, and Prognosis." Journal of Ophthalmology 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/1458624.
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Purpose. To study epidemiology, clinical findings and visual prognosis of patients with Fuchs’ Heterochromic Iridocyclitis (FHI).Methods. A retrospective analysis was performed on 158 patients with FHI. Thirty-five patients were observed only once; the remaining 123 had a mean follow-up of 30.7 months (50 of them had a mean follow-up of 63.5 months) and in those we assessed complications, medical and surgical treatment, and long-term visual prognosis.Results. Average age at uveitis diagnosis was 27.2 years and 18.3% of patients were children. Blurred vision (54.5%) and floaters (40.5%) were the most frequent presenting symptoms. Small to medium-sized keratic precipitates (95.6%), iris atrophy (86.8%), and vitreous opacities (91.2%) were the most common signs; the prevalence of cataract and IOP increase was 63.5% and 20.1%, respectively, and their incidence was 0.1 and 0.06 eye/year. Significant risk factor for visual loss was IOP increase at presentation (p=0.02). At final examination 98% of the eye had a visual acuity ≥ 0.6, and topical (p<0.001) and systemic (p<0.001) corticosteroids therapy were used less frequently than before referral.Conclusions. FHI has a good visual prognosis, despite the significant incidence of cataract and glaucoma. A correct and prompt diagnosis might avoid unnecessary therapies and provide excellent visual outcomes.
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Сагинбаев, У. Р., С. А. Рукавишникова, В. В. Потемкин, А. С. Пушкин, and Т. А. Ахмедов. "LABORATORY PREDICTORS OF GLAUCOMA IN PATIENTS WITH MIDDLE AND OLD AGE - A TOOL TO IMPROVE THE QUALITY OF LIFE (LITERATURE REVIEW)." Успехи геронтологии, no. 2 (June 10, 2020): 339–45. http://dx.doi.org/10.34922/ae.2020.33.2.017.
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В мире насчитывается около 1,3 млрд человек с такими нарушениями зрительного анализатора, как катаракта и глаукома, распространенность которых значимо выше у лиц пожилого возраста. Заболевания глаз остаются глобальной медикосоциальной и экономической проблемой, что связано как с прогрессированием болезни вплоть до слепоты, так и с отсутствием методов патогенетической терапии. Вторичной профилактикой глаукомы остается своевременное выявление патологии. В настоящее время разработан ряд диагностических приемов, включающих, в основном, инструментальные методики. Несомненно, в качестве скрининговых методов донозологической диагностики могут выступать лабораторные показатели. Сегодня выявлена группа биомаркеров, обладающих разной степенью чувствительности и специфичности. Однако широкое использование индикации данных маркеров затруднено, в том числе и по организационным причинам. Встает вопрос поиска следов присутствия патологии в таких рутинных исследованиях, как общий анализ крови. Глаукома признана системным заболеванием, что может найти отражение в изменении морфофункциональных свойств форменных элементов крови. There are about 1,3 billion people worldwide with visual disorders such as cataract and glaucoma, the prevalence of which is significantly higher in elder persons. Eye diseases remain a global medical, social and economic problem, associated with both the progression of the disease up to blindness and the lack of pathogenetic therapy methods. Timely detection of pathology is secondary prevention of glaucoma. At present, a number of diagnostic techniques have been developed, including mainly instrumental techniques. Undoubtedly, laboratory indicators should be used as screening methods of early diagnosis. Today, a group of biomarkers with different degrees of sensitivity and specificity has been identified. However, these markers have some difficulty in indicating. Finding signs of glaucoma in complete blood count is an important task. Glaucoma is recognized as a systemic disease, which should be reflected in the change in morphofunctional properties of blood elements.
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Song, Xinmao, Huanyu He, Yi Zhu, Shengzi Wang, Jie Wang, Weifang Wang, and Yi Li. "Treatment outcomes after definitive radio(chemo)therapy for 17 lacrimal sac squamous cell carcinoma." British Journal of Radiology 93, no. 1115 (November 1, 2020): 20190633. http://dx.doi.org/10.1259/bjr.20190633.
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Objectives: Tumors of the lacrimal sac are rare and life-threatening. Because of their rarity, no extensive clinical data on their management and prognosis exist. We investigated the application of definitive radiation therapy and its outcome in patients with lacrimal sac squamous cell carcinoma (LSSCC). Methods: We retrospectively studied 17 patients with LSSCC at a single institution between 2003 and 2017. All the patients were treated with definitive radiotherapy, and 11 patients were delivered with cisplatin-based chemotherapy. The patients’ clinical records were reviewed for symptoms, pathological types, the volume and dosimetry of the tumors and their adjacent structures, radiation coverage of lymph node drainage areas, treatment outcomes, and complications from definitive radiotherapy. Results: Median follow-up was 38.9 months, and age at diagnosis was 48 years.The 2-year and 5-year overall survival, progression-free survival, locoregional control, and disease metastasis-free survival rates were 94.1 and 84.7%, 88.2 and 73.5%, 93.8%, 94.1, and 78.4%, respectively. A total dose of 6600–7000 cGy was prescribed to the tumor. Levels Ⅰb, Ⅶa, Ⅷ, and Ⅸ were covered with the clinical target volume regardless of lymph involvement. Acute Grade 3 radiation dermatitis occurred in seven patients (17.6%), but no acute Grade 4 or Grade 5 toxicity of any type occurred. Seven (41.2%, 7/17) of the treated eyes had moderated vision impairments; 17.6% (3/17) of patients developed cataracts, and glaucoma and radiation retinopathy were found in 5.9% (1/17) of patients. Conclusions: Definitive radiotherapy could be a treatment option for those who refuse surgery or have unresectable LSSCC. Advances in knowledge: Radiation alone is a treatment option for LSSCC.
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Ramazanova, L. S., E. Y. Yazykova, O. A. Napylova, and R. Z. Shamratov. "Tear replacement therapy for newly diagnosed glaucoma." GlaucomaNews, no. 1 (January 20, 2020): 35–36. http://dx.doi.org/10.25276/2227-8281-1-35-36.
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Цель. Оценка эффективности слезозаместительной терапии у пациентов с впервые выявленной первичной глаукомой. Материал и методы. В исследование было включено 20 пациентов с впервые выявленной ПОУГ I-II стадии, которым в качестве монотерапии были назначены простагландины или неселективные β-адреноблокаторы. Из них 12 мужчин и 8 женщин в возрасте от 60 до 70 лет. 30% пациентов имели сопутствующую глазную патологию (катаракта, хронические заболевания век и глазной поверхности), 50% – патологию системного характера (эндокринные заболевания, артериальная гипертензия, менопауза) с постоянной заместительной терапией, у 20% в анамнезе различного рода хирургические и лазерные операции глаз (ФЭК с ИОЛ, фокальная лазеркоагуляция сетчатки). После первичного обследования пациенты были разделены на 2 группы. Первой группе пациентов на ряду с гипотензивным препаратом был назначен лубрикант, восстанавливающий недостаток липидного и муцинового слоя по 1 капле 3 раза в день. Вторая группа пациентов не использовала слезозаменители. Результаты. Стандартное офтальмологическое обследование, позволило выявить синдром «сухого глаза» (ССГ) легкой степени. У 27% (5 чел.) ССГ был обусловлен хроническими заболеваниями придаточного аппарата глаза, дисфункцией мейбомиевых желез и у 73% (15 чел.) смешанного генеза (эндокринная патология, артериальная гипертензия , системный прием β-адреноблокаторов, гормональная заместительная терапия). Через 1 месяц на контрольном осмотре у всех пациентов 1-й группы, получавших слезозаменитель, уменьшились жалобы на чувство дискомфорта, жжения, затуманивания зрения в сравнении с группой, не получавшей слезозаменитель. Через 3 месяца субъективные жалобы у пациентов 1 группы практически отсутствовали, в то время как у пациентов 2-й группы отмечалось повышение степени выраженности жалоб. Выводы. Слезозаместительная терапия улучшает качество жизни пациентов, способствует приверженности лечению глаукомы, так как купирует жалобы и предотвращает осложнения, связанные с синдромом ССГ. Синдромом сухого глаза у пациентов с глаукомой индуцирован как входящими в состав гипотензивных капель консервантами, обладающими токсическим действием [4], так и наличием сопутствующей патологии глазного и системного характера. Ранее перенесенные хирургические операции переднего отрезка глаза предполагают нарушение стабильности слезной пленки.
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Doolan, Emer, and Colm O’Brien. "Abnormal corneal properties in osteogenesis imperfecta and glaucoma: a case series." BMJ Open Ophthalmology 6, no. 1 (April 2021): e000684. http://dx.doi.org/10.1136/bmjophth-2020-000684.
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ObjectiveWe aimed to carry out ocular examination and genetic studies in a family in which some members are affected with osteogenesis imperfecta (OI) and primary open-angle glaucoma (POAG). We compared the corneal properties of affected and unaffected members (ie, cases and controls).MethodsEight family members from two generations, both affected and unaffected, were examined. Corneal hysteresis (CH), intraocular pressure (IOP) measured with Goldmann applanation tonometer, central corneal thickness (CCT) and cornea-corrected IOP (IOPcc) were recorded. Blood samples were obtained from seven family members, both affected and unaffected, and tested for a panel of genes associated with OI.ResultsFamily members affected with OI (n=6) had a heterozygous splice site mutation in intron 26 of the COL1A1 gene. The family members affected with OI had reduced CCT (476.5±24.6 µm) and CH (7.9 ±1.4 mmHg) compared with the unaffected controls (CCT, 575.8±10.8 µm; CH, 12.3±0.8 mmHg). Two of the six patients affected with OI had a glaucoma diagnosis and were on topical therapy and under regular clinical review.ConclusionsPatients affected with OI have a significant risk of developing POAG due to the effects of abnormal collagen on various ocular structures. Two of these effects which place them at risk are reduced CCT and CH. They should be screened and monitored for glaucoma from a young age, and the examination should include corneal biomechanical measurements and CCT to identify those most at risk. IOPcc may be a more accurate way to monitor IOP in the presence of abnormal corneal properties.