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Primary Open Angle Glaucoma (primary + open_angle_glaucoma)

Distribution by Scientific Domains

Medical Sciences	89%
Life Sciences	10%

Selected Abstracts

Postural stability in primary open angle glaucoma

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2005
Noor Shabana MB BS
Abstract Background:, This study evaluated the visual contribution to postural steadiness in primary open angle glaucoma (POAG), in correlation with the mean deviation (MD) measured through conventional perimetry, and with the Advanced Glaucoma Intervention Study (AGIS) score, which quantifies the extent of losses in the visual field. Methods:, In 35 POAG patients and 21 age-matched normal subjects, the sway of the centre of pressure of the feet, on a firm or foam support, was recorded. The subjects stood on a force-plate with eyes closed, or with one or two eyes open. Results:, For all subjects, the sway velocity was lower with vision than without vision, indicating the existence of a visual contribution to posture at all stages of glaucoma. This contribution was significantly lower for POAG patients than for normals in monocular and binocular vision, and decreased with the MD, or as the AGIS score increased. Among the maximum, minimum and average values of the two monocular MD, the MD of the worse eye presented the most significant negative correlation with the visual contribution to posture. The somatosensory contribution to postural steadiness was larger in POAG patients, as compared to normals, in monocular or binocular vision. Conclusion:, Primary open angle glaucoma induces a deficit in the visual contribution to postural steadiness, which should be taken into account for the prevention of falls. [source]

Novel mutations in the MYOC/GLC1A gene in a large group of glaucoma patients,,

HUMAN MUTATION, Issue 6 2002
Karin Michels-Rautenstrauss
Abstract Mutations at the myocilin (MYOC) gene within the GLC1A locus have been revealed in 2-4% of patients suffering primary open angle glaucoma (POAG) worldwide. In our ongoing glaucoma study sixhundred eighty two persons have been screend for MYOC mutations. The first group consisted of 453 patients from a long-term clinical study diagnosed either with juvenile OAG (JOAG), POAG, ocular hypertension (OHT) or normal tension glaucoma (NTG) plus 22 cases of secondary glaucoma. This group, and additional 83 healthy controls, is part of a long term study with repeated clinical examinations at the University of Erlangen-Nurnberg. An additional sample of 124 glaucoma patients or at risk persons referred from other sources were included in the mutation screening. Five novel mutations, namely Gly434Ser, Asn450Asp, Val251Ala, Ile345Met and Ser393Asn, could be identified as cause of preperimetric POAG, JOAG, normal tension POAG and POAG. Myocilin mutations were identified similar with previous reports with other ethnic populations at the rate of 11/341 (3.2%) probands. © 2002 Wiley-Liss, Inc. [source]

4121: Combined OCT retinal nerve fibre layer analysis and VEP in neuro-ophthalmic disease

ACTA OPHTHALMOLOGICA, Issue 2010
P GOOD
Purpose Ocular Coherence Tomography (OCT) has become a valuable tool in assessing retinal nerve fibre layer thickness (RNFL) in Patients with optic nerve disease. This study is designed to compare RNFL thickness n with Visual Evoked Cortical Potentials (VECP)in patients with known optic nerve disease and comparing these to a group of patients with primary open angle glaucoma (POAG). Methods Twenty Patients (37 eyes) with clinically determined optic nerve disease underwent pattern reversal VECP and also OCT using a Spectralis OCT system. Assessment of global and segmental RNFL was made. Six Patients were diagnosed as Dominant Optic atrophy, 3 with Lebers Optic Neuropathy (LHON), 6 with Nutritional amblyopia, 3 with Anterior Ischaemic Optic Neuropathy (AION), and 2 with Demyelinating disease. These Patients were also compared to a group of 10 patients (20 eyes) with Primary Open Angle Glaucoma POAG. Results Pattern reversal VECP were abnormal in 32/37 eyes (86%): 26/32 (81%) of these being of reduced amplitude, and 20/32 (62%) being delayed. Amongst the patients with POAG only 4/20 eyes (20%) had abnormal VECP, and none were delayed. Thinning of the RNFL occurred in 36/37 eyes (97%) with optic nerve disease; 24 (65%) had global thinning, and the remainder segmental thinning only. All of the eyes with POAG had RNFL thinning but only 6/20 eyes (30%) had global thinning. Bipolar cell thinning of the central retina was noted in 6 eyes with optic nerve disease. Conclusion OCT is a valuable tool in the assessment of patients with optic nerve disease. Thinning of the RNFL was a more consistent finding than delay of the VECP in optic nerve disease, and a combination of VECP and OCT is helpful in the differential diagnosis of low tension glaucoma and optic nerve disease. [source]

2356: Diurnal variation of ocular pulse amplitude in primary open angle glaucoma patients

ACTA OPHTHALMOLOGICA, Issue 2010
LA PINTO
Purpose (1) to determine the diurnal behaviour of the ocular pulse amplitude (OPA) in primary open angle glaucoma (POAG) patients. (2) To identify any variables modulating OPA. Methods In this prospective study we included 22 POAG patients under topical intraocular pressure (IOP)-lowering treatment, who underwent contour dynamic tonometry measurements every three hours from 9am to 6pm for IOP and OPA readings. Heart rate (HR) and blood pressure (BP) were simultaneously recorded during the ocular measurements. Only the eye with greater glaucomatous damage was selected per patient. Results Both IOP and OPA did not change during the day (OPA: 3.0±1.3, 3.2±1.4, 2.9±1.5, 3.0±1.3; IOP: 19.3±2.9, 20.0±3.0, 19.1±3.0, 19.8±2.6; multiple comparisons p=0.21, p=0.27 respectively). Systolic, diastolic and did not present significant diurnal variation (p<0.05 all measurements). OPA was significantly correlated at all time-measurements with arterial pulse pressure, but not by IOP, median ocular pulse pressure(MOPP) nor median arterial pressure (p<0.05). Univariate analysis revealed HR to negatively correlate OPA at the 15h and 18h measurements (r= -0,42, p=0.049; r= -0,53, p=0.01; respectively). Multiple linear regression analysis identified blood pressure amplitude as an independent factor contributing to OPA (p<0.05 at all measurements). These observations were more pronounced in patients with high blood pressures. Conclusion OPA readings seem to be influenced by blood pressure amplitude in POAG patients. High blood pressure amplitude values may overcome the eye self-regulation mechanisms, resulting in the OPA becoming dependent on the blood pressure amplitude rather than of the IOP. [source]

Systemic disease associations of familial and sporadic glaucoma: the Glaucoma Inheritance Study in Tasmania

ACTA OPHTHALMOLOGICA, Issue 1 2010
Alex W. Hewitt
Abstract. Background:, This aim of this study was to compare the prevalence of various disease-associated and potentially modifiable risk factors between people with familial and sporadic forms of primary open angle glaucoma (OAG). Methods:, A cross-sectional, retrospective study design was utilized. A detailed questionnaire enquiring about knowledge of family history, demographic data, current medications, and medical history of systemic disorders was administered. Where possible, living relatives were examined for signs of OAG. Results:, A total of 3,800 potential patients with OAG were identified, of whom 2062 were examined. One thousand twelve (59.5%) subjects were found to have familial OAG, and 688 (40.5%) subjects had no known or identified relative with OAG (sporadic glaucoma). One thousand forty-two unaffected family members examined. A past history of migraine was found more often with familial OAG (OR: 1.67 95% CI: 1.15,2.42). This effect was primarily driven by patients who had a first-degree relative also affected by OAG. Following adjustment for male gender and the age at review, the presence of atherosclerosis was also found to be more common in patients with familial glaucoma than in people with sporadic disease (OR: 1.42 95% CI: 1.05,1.92). No significant difference in the prevalence of hypertension, Raynaud's phenomenon, diabetes mellitus or thyroid disease was identified. Conclusions:, Patients with a known relative affected by OAG were statistically significantly more likely to have a past history for migraine or presence of atherosclerosis compared to people with no known affected relative. An understanding of such differences and systemic comorbidities will be useful for further work investigating the underlying molecular mechanisms of this disease. [source]

Ocular rigidity and ocular response analyzer

ACTA OPHTHALMOLOGICA, Issue 2009
E IOMDINA
Purpose To study ocular rigidity and sclera crosslinking level at diferent stages of primary open angle glaucoma (POAG). Methods Biomechanical parameters of the eye especially corneal hysteresis (CH, mm Hg) were measured in 238 patients (311 eyes) aged 40-84 (median age 67.4 yrs) at various stages of compensated primary open-angle glaucoma using Reichert Ocular Response Analyzer (ORA). Besides, scleral samples obtained during sinus trabeculectomy combined with sclera trephination in the inferio-exterior quadrant of 28 patients (28 eyes) with various stages of POAG were studied using differential scanning calorimetry (Mettler TA 4000 with DSC20 cell). Results Average value (median) of CH gradually decreased from 10.1 mm Hg in the initial glaucoma stage (I) to 9.1 mm Hg in the developed (II) and 8.6 mm Hg in the advanced (III) glaucoma stage. The decrease of this clinical parameter is caused by structural and biochemical damage of the corneoscleral coat. In stage I, endothermic scleral collagen transition occurred at the median thermal peak Tm=60.3 grad.C, while in stages II and III the median peaks of scleral collagen melting emerge at higher temperatures: Tm=62.0 grad.C and Tm=64.5 grad.C, respectively (p<0,05). This testifies to a significant increase of scleral cross-linking and ocular rigidity during glaucoma development. Conclusion Biomechanical and biochemical disorders of glaucomatous sclera may cause clinical changes of ocular rigidity of eyes with POAG. This may be an important link of POAG pathogenesis requiring special therapy. [source]

Evidence for altered ocular rigidity in glaucoma

ACTA OPHTHALMOLOGICA, Issue 2009
L SCHMETTERER
Purpose Based on theoretical models and animal studies altered biomechanical properties of the optic nerve head and the sclera have been implicated in the pathophysiology of glaucoma. Only few data have, however, demonstrated such biomechanical alterations in vivo. We tested the hypothesis that patients with primary open angle glaucoma (POAG) have an abnormal structural stiffness based on measurements of intraocular pressure amplitude and ocular fundus pulsation amplitude. Methods Seventy patients with POAG and 70 healthy control subjects matched for age, gender, intraocular pressure and systemic blood pressure were included in this study. The ocular pulse amplitude (PA) was assessed with pneumotonometry. The fundus pulsation amplitude (FPA) was measured using laser interferometry. Based on the Friedenwald equation a coefficient of structural stiffness (E1) was calculated relating PA to FPA. Results Systemic blood pressure, intraocular pressure, and ocular perfusion pressure was comparable between glaucoma patients and healthy control subjects. FPA as well as PA was lower in patients with glaucoma than in healthy controls. The calculated factor E1 was significantly higher in patients with POAG (0.0454 ± 0.0085 a.u.) than in healthy control subjects (0.0427 ± 0.0058 a.u., p = 0.03). Conclusion This study is indicative of increased structural stiffness of the sclera in patients with POAG. This is in agreement with a number of previous animal experiments and supports the idea that the biomechanical properties of ocular tissues play a role in the process of glaucomatous ONH damage. [source]

Effects of moxaverine on ocular blood flow in patients with age-related macular degeneration, patients with primary open angle glaucoma and in healthy controls

ACTA OPHTHALMOLOGICA, Issue 2009
B PEMP
Purpose Several common eye diseases including age-related macular degeneration (AMD) and primary open angle glaucoma (POAG) are associated with ocular perfusion abnormalities. Moxaverine has been shown to increase ocular blood flow in young, healthy volunteers after intravenous administration. The present study investigated whether moxaverine alters ocular blood flow in elderly patients with AMD or POAG and in healthy control subjects. Methods 20 patients with AMD, 20 patients with POAG and 20 age-matched healthy subjects were included in this trial. 150 mg moxaverine (Ursapharm, Saarbrücken, Germany) was administered intravenously over 30 minutes. Systemic haemodynamics, retinal vessel diameters, choroidal, optic nerve head and retrobulbar blood flow were measured before and up to 90 minutes after drug administration. Results Administration of moxaverine increased choroidal blood flow by 8.7 ± 21.8% (p=0.012) and optic nerve head blood flow by 12.9 ± 33.3% (p=0.021). Additionally, an increase in the mean flow velocities of posterior ciliary arteries (24.8 ± 34.7%, p<0.001) and in the ophthalmic artery (23.3 ± 33.5%, p<0.001) was found after administration of moxaverine. However, no differences were found between the 3 study groups. No significant change of retinal vessel diameters was observed. Conclusion The present study indicates an increase of ocular blood flow after systemic administration of a single dose of moxaverine in patients with POAG, patients with AMD and in age-matched healthy controls. Further studies are needed to investigate possible beneficial effects after long-term treatment in patients with ocular diseases associated with hypoperfusion. [source]

Effect of glaucoma and glaucoma risk factors on choroidal hemodynamics

ACTA OPHTHALMOLOGICA, Issue 2009
W ABOU SAMRA
Purpose a) to determine subfoveal choroidal hemodynamics in patients with primary open angle glaucoma (POAG) and patients with ocular hypertension (OH); b) to assess the effects of diabetes (DM), systemic hypertension (SHT) and myopia on subfoveal choroidal hemodynamics Methods Laser Doppler flowmetry (LDF) was used to determine the subfoveal choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBF) in 1) patients with POAG (n=85) and patients with OHT (n=25); 2) patients with glaucoma risk factors which were further subdivided into three subgroups; DM (n=93), SHT (n=57) and myopia (n=29) respectively. Subjects with each risk factor were further subdivided into two subgroups (without and with POAG), 3) age matched healthy controls (n=100). Results All LDF parameters were significantly reduced in all groups of patients compared with age matched controls. No statistically significant differences in the LDF parameters among HTG, NTG and OHT subgroups were detected. No significant difference in the LDF parameters between the two subgroup of each risk factor (without and with POAG) was noted. The LDF data of glaucomatous patients with risk factors demonstrated a significant reduction of ChBF and an increase in resistance in comparison to glaucomatous patients without risk factors Conclusion Subfoveal choroidal LDF parameters are reduced in subjects with POAG, OHT and patients with glaucoma risk factors, such as DM, SHT (under antihypertensive therapy) and myopia when compared with age matched healthy controls. However, the role of these choroidal circulatory alterations in the development or progression of the glaucomatous optic neuropathy remains to be clarified. [source]

Association between optic nerve head blood flow as assessed with Laser Doppler Flowmetry and mean arterial blood pressure in glaucoma, ocular hypertension and healthy control subjects

ACTA OPHTHALMOLOGICA, Issue 2009
D SCHMIDL
Purpose It has been implicated that vascular dysregulation plays a role in the pathogenesis of primary open angle glaucoma (POAG). In the present study the association between optic nerve head blood flow as measured with laser Doppler flowmetry and ocular perfusion pressure in patients with treated and untreated POAG, patients with ocular hypertension and healthy control subjects was compared. Methods 136 patients with treated POAG, 116 patients with untreated POAG, 138 patients with ocular hypertension and 160 control subjects were included in the study. Optic nerve head blood flow was assessed using laser Doppler flowmetry. Ocular perfusion pressure was calculated based on measurement of IOP and systemic hemodynamics. Results Optic nerve head blood flow was significantly reduced in patients with glaucoma compared to patients with ocular hypertension and healthy subjects (p<0.01). However, no difference in optic nerve head blood flow between treated and untreated glaucoma patients was detected. The highest association between ocular perfusion pressure and optic nerve head blood flow was found in untreated glaucoma patients followed by ocular hypertensives and treated glaucoma patients. Conclusion The present study confirms evidence that optic nerve head blood flow is reduced in patients with POAG and patients with ocular hypertension. Correlation coefficients in the glaucoma groups and in the ocular hypertensives indicate a vascular dysregulation in these patients compared to healthy control subjects. [source]

Effect of phacoemulsification on the primary open angle glaucoma control after trabeculectomy: a case-control study

ACTA OPHTHALMOLOGICA, Issue 2009
S AZIZ
Purpose In this retrospective and comparative study, we analyzed the influence of phacoemulsification (PE) on the glaucoma control in case patients (trabeculectomy-phacoemulsification [CE]) compared with the control that underwent trabeculectomy (T) alone in eyes with primary open angle glaucoma (POAG). Methods Twenty one patients who underwent PE subsequent to T were identified, and 41 who underwent T alone were matched. Visual acuity (VA), intraocular pressure (IOP), bleb appearance, vertical cup disc ratio (VCDR), visual field (VF), glaucoma medications, iris manipulation and complications were documented. Mean follow up was 12 months. Success was defined when IOP , 21 mmHg with the abscense of glaucoma medication and/or further surgical intervention. Results Patients in CE group had no significant change in IOP from pre-operative measures to 12 months post-operative (p=0.001). The mean IOP reduced from 15.3 mm Hg to 14.7 mmHg postoperatively. The control group showed an average IOP reduction of 6 mm Hg in the last visit. In CE group, 19% required 1 or 2 glaucoma medications at one year fellow-up vs 19.5% in the control group. In CE group 9.5% showed flattening of previously formed bleb in the last visit (P<0.001), 9.7 % ended with flat bleb in the T group. The increase in VCDR for the CE group was statistically significant when compared to the control group (p<0.001). Patients in CE group were more likely to exhibit a change in VF (47.6% versus 7.3% respectively). The study is limited by the small number of cases available. Conclusion Corneal PE in eyes with filtering blebs does not adversely affect long-term glaucoma control in patients with POAG. [source]

Optic nerve head parameters of an indigenous population living within Central Australia

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 9 2006
John A Landers MBBS MPH
Abstract Purpose:, Clinical examination of the optic disc is an essential element in the assessment of its health. Previous work has described normal optic disc appearance among different races. No such description of optic discs exists for indigenous Australians, who are at low risk of developing glaucoma. This study was designed to evaluate optic disc parameters of indigenous Australians. Methods: A sample of 208 indigenous Australians were recruited as they presented to remote clinics in Central Australia. Each subject underwent optic disc photography using a Topcon TRC-NW100 digital fundus camera. Optic discs were measured and analysed with Topcon ImageNet 2000 software. Results: Among other parameters, mean vertical disc diameter and disc area were 2.13 ± 0.21 mm (mean ± SD) and 3.13 ± 0.57 mm2, respectively, for right eyes and 2.14 ± 0.21 mm and 3.16 ± 0.58 mm2 for left eyes. When compared with published studies, these parameters were significantly larger than Caucasians, but similar to African individuals. Conclusion:, Our results suggest that indigenous Australians have optic discs that are larger than those of Caucasians, but similar to those of Africans who are considered to at a greater risk of glaucoma. Factors other than optic disc area are likely to underlie the higher prevalence of primary open angle glaucoma among African individuals. [source]

Postural stability in primary open angle glaucoma

Carotid artery ectasia coexistent with primary open angle glaucoma

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2001
Mark F Ellis FRACO
ABSTRACT A 60-year-old smoker presented with high intraocular pressure in the right eye with a right afferent pupil defect and visual field suggestive of primary open angle glaucoma in the right eye only, when an examination 2 years earlier had revealed no hint of ocular pathology. Radiological investigations demonstrated prominent ectasia of the internal carotid arteries extending into the proximal middle cerebral arteries. The changes in the carotids extended throughout the cavernous sinus regions, encroached on the under surface of the optic chiasm and were closely related to the internal aspects of both optic canals. In primary open angle glaucoma management, neural imaging is not normally recommended; however, neural imaging investigations should be considered if the presentation is not typical of a chronic bilateral optic neuropathy. [source]

A rare complication from prostaglandin analogue therapy

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 2 2009
Rajarshi Mukhopadhyay
This case describes a rare complication of prostaglandin analogue eye drops used for treatment of primary open angle glaucoma. Though increase in the number, size and pigmentation of eyelashes is well-known, this case shows extensive hair growth in malar region, which can be unacceptable. This complication can be one of the causes of discontinuation of prostaglandin analogue therapy. [source]

Myocilin gene implicated in primary congenital glaucoma

CLINICAL GENETICS, Issue 4 2005
K Kaur
Primary congenital glaucoma (PCG) has been associated with CYP1B1 gene (2p21), with a predominantly autosomal recessive mode of inheritance. Our earlier studies attributed CYP1B1 mutations to only 40% of Indian PCG cases. In this study, we included 72 such PCG cases where CYP1B1 mutations were detected in only 12 patients in heterozygous condition, implying involvement of other gene(s). On screening these patients for mutations in myocilin (MYOC), another glaucoma-associated gene, using denaturing high-performance liquid chromatography followed by sequencing, we identified a patient who was double heterozygous at CYP1B1 (c.1103G>A; Arg368His) and MYOC (c.144G>T; Gln48His) loci, suggesting a digenic mode of inheritance of PCG. In addition, we identified the same MYOC mutation, implicated for primary open angle glaucoma, in three additional PCG patients who did not harbor any mutation in CYP1B1. These observations suggest a possible role of MYOC in PCG, which might be mediated via digenic interaction with CYP1B1 and/or an yet unidentified locus associated with the disease. [source]