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JAYPEE JOURNALS
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1.  ORIGINAL REASEARCH
Assessment of Retinal Nerve Fiber Layer Changes by Cirrus High-definition Optical Coherence Tomography in Myopia
Divya Singh, Sanjay K Mishra, Esha Agarwal, Reetika Sharma, Shibal Bhartiya, Tanuj Dada
[Year:2017] [Month:May-August] [Volume:11 ] [Number:2] [Pages:40] [Pages No:52-57] [No of Hits : 1868]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1223 | FREE

ABSTRACT

Introduction: To evaluate the relationship between retinal nerve fiber layer (RNFL) thickness measured by Cirrus highdefinition (HD) optical coherence tomography (OCT) and the axial length and refractive error of the eye.

Materials and methods: A total of 100 eyes of 100 healthy subjects (age 20-34 years with M/F ratio of 57/43), comprising 50 eyes with emmetropia [spherical equivalent (SE) 0 D], 25 eyes with moderate myopia (SE between -4 D and -8 D), and 25 eyes with high myopia (SE between -8 D and -12 D) were analyzed in this cross-sectional study. Average and mean clock hour RNFL thicknesses were measured by cirrus HD-OCT and compared between the three groups. Associations between RNFL measurements and axial length and SE were evaluated by linear regression analysis.

Results: The average RNFL measurements were significantly lower in high myopia (78.68 +/- 5.67) and moderate myopia (83.76 +/- 3.44) group compared with emmetropia group (91.26 +/- 2.99), also in the superior and inferior mean clock hours. Significant correlations were evident between RNFL measurements and the SE and axial length. The average RNFL thickness decreased with increasing axial length (r = -0.8115) and negative refractive power (r = 0.8397). Myopia also affected the RNFL thickness distribution. As the axial length increased and the SE decreased, the thickness of the superior, inferior, and nasal peripapillary RNFL decreased.

Conclusion: The axial length/refractive error of the eye affected the average RNFL thickness and the RNFL thickness distribution. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status. When interpreting the RNFL thickness of highly myopic patients by OCT, careful attention must be given to the inherently thinner RNFL to avoid a false diagnosis of glaucoma.

Keywords: Emmetropia, Retinal Ner ve Fiber Layer, Spearman’s rho.

How to cite this article: Singh D , Mishra S K, Agarwal E, Sharma R, Bhartiya S, Dada T. Assessment of Retinal Nerve Fiber Layer Changes by Cirrus High-definition Optical Coherence Tomography in Myopia. J Curr Glaucoma Pract 2017;11(2):52-57.

Source of support: Nil

Conflict of interest: None

 
2.  INVITED EDITORIAL
Optical Coherence Tomography Angiography to Better understand Glaucoma
Gábor Holló
[Year:2017] [Month:May-August] [Volume:11 ] [Number:2] [Pages:40] [Pages No:35-37] [No of Hits : 1380]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1219 | FREE

ABSTRACT

The term optical coherence tomography angiography (OCTA) comprises different OCT-based technologies which all allow noninvasive assessment of retinal perfusion, based on moving red blood cells. The main areas where OCTA is currently used are investigation of perfusion and vascular structure of the macular retina (e.g., in macular degenerations and diabetic macular diseases) and the disk and peripapillary retina (in glaucoma and other optic disk diseases). The current editorial provides a brief overview on the potential of OCTA and its use to measure perfusion in the peripapillary retina in glaucoma.

Keywords: Glaucoma, Optical coherence tomography angiography, Optic nerve head, Perfusion, Peripapillary retina.

How to cite this article: Holló G. Optical Coherence Tomography Angiography to Better understand Glaucoma. J Curr Glaucoma Pract 2017;11(2):35-37.

Source of support: Nil

Conflict of interest: None

 
3.  INVITED EDITORIAL
Relationship between Glaucoma Drainage Device Size and Intraocular Pressure Control: Does Size Matter?
Cooper D Rodgers, Alissa M Meyer, Mark B Sherwood
[Year:2017] [Month:January-April] [Volume:11 ] [Number:1] [Pages:34] [Pages No:1-2] [No of Hits : 927]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10008-1212 | FREE

ABSTRACT

There is ambiguity in the literature regarding whether a larger glaucoma drainage device (GDD) achieves a lower long-term intraocular pressure (IOP). There is some evidence on both sides, but overall there seems to be an optimal surface area of approximately 200–250 mm2 beyond which there may be little advantage to increasing the plate size for most patients.

Keywords: Baerveldt, Glaucoma, Glaucoma drainage device, Intraocular pressure, Molteno, Retrospective study, Visual acuity.

How to cite this article: Rodgers CD, Meyer AM, Sherwood MB. Relationship between Glaucoma Drainage Device Size and Intraocular Pressure Control: Does Size Matter? J Curr Glaucoma Pract 2017;11(1):1-2.

Source of support: Nil

Conflict of interest: None

 
4.  ORIGINAL ARTICLE
Incidence of Intraocular Pressure Elevation following Intravitreal Ranibizumab (Lucentis) for Age-related Macular Degeneration
Gustavo MSM Reis, John Grigg, Brian Chua, Anne Lee, Ridia Lim, Ralph Higgins Alessandra Martins, Ivan Goldberg, Colin I Clement
[Year:2017] [Month:January-April] [Volume:11 ] [Number:1] [Pages:34] [Pages No:3-7] [No of Hits : 917]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10008-1213 | FREE

ABSTRACT

Aim: The aim of this article is to evaluate the rate of patients developing sustained elevated intraocular pressure (IOP) after ranibizumab (Lucentis) intravitreal (IVT) injections.

Design: This is a retrospective study.

Participants: Charts of 192 consecutive patients receiving Lucentis for age-related macular degeneration (AMD) were retrospectively reviewed.

Materials and methods: We enrolled patients with at least two IOP measurements between injections. Elevated IOP was defined as >21 mm Hg with an increase of at least 20% from baseline. Noninjected contralateral eyes of the same patient cohort were used as control.

Main outcome measures: Primary outcome was defined as elevated IOP. Secondary outcomes were presence and type of glaucoma, number of injections, and time to IOP elevation.

Results: Elevated IOP occurred at a significantly higher rate in eyes receiving IVT ranibizumab (7.47%; n = 9) compared with control (0.93%; n = 1). Patients with preexisting glaucoma or ocular hypertension (OHT) were more likely to develop elevated IOP after IVT ranibizumab injection.

Conclusion: Intravitreal ranibizumab injections are associated with sustained IOP elevation in some eyes.

Keywords: Age-related macular degeneration, Intraocular pressure, Ranibizumab.

How to cite this article: Reis GMSM, Grigg J, Chua B, Lee A, Lim R, Higgins R, Martins A, Goldberg I, Clement CI. The Incidence of Intraocular Pressure Elevation following Intravitreal Ranibizumab (Lucentis) for Age-related Macular Degeneration. J Curr Glaucoma Pract 2017;11(1):3-7.

Source of support: Nil

Conflict of interest: None

 
5.  ORIGINAL ARTICLE
Racial Differences in Selective Laser Trabeculoplasty Efficacy
Emil Goosen, Kate Coleman, Linda Visser, William E Sponsel
[Year:2017] [Month:January-April] [Volume:11 ] [Number:1] [Pages:34] [Pages No:22-27] [No of Hits : 776]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10008-1216 | FREE

ABSTRACT

Aim: Sub-Saharan Africa has a population of 1 billion, with one ophthalmologist per million people. Basic ophthalmic support services are virtually absent for all but a few urban populations. Minimally invasive laser treatment may help. This study reports our initial experience using selective laser trabeculoplasty (SLT) in a mixed-racial population of adult glaucoma patients in Durban, South Africa.

Study design: Institution Review Board approved the 5-year chart review.

Materials and methods: Consecutive glaucomatous adults underwent SLT (Lumenis Selecta) on one or both eyes applying 360° treatment of 120 to 140 closely spaced burns (400 μm spot size for 3 ns; range 1.1?1.4 mJ). Significance of change in intraocuar pressure (IOP) from baseline at 1, 3, 6, and 12 months was assessed by two-tailed paired t-test.

Results: Among 148 eyes of 84 patients (60 African, 21 Indian, 3 Caucasian), 69 had already undergone glaucoma therapy, and 15 untreated (de novo). Among all eyes, mean IOP was reduced by >32% with mean IOP < 15 mm Hg from baseline at all four study intervals (p < 0.0001). A 20% reduction in IOP was sustained at 12 months in 90% of African eyes but in only 50% of Indian eyes.

Conclusion: Selective laser trabeculoplasty was effective in producing clinically significant IOP reduction among South African adults with or without prior medical or surgical antiglaucoma therapy. Socioeconomically comparable individuals of Indian ancestry showed good therapeutic responses, but significantly less efficacious than those observed among Black subjects. Programs to provide first-line SLT management of glaucoma in Africa, where 90% of patients are unable to sustain prescribed medical therapy, appear to be a very appropriate option.

Keywords: Ethnicity, Glaucoma, Intraocular pressure, Selective laser trabeculoplasty.

How to cite this article: Goosen E, Coleman K, Visser L, Sponsel WE. Racial Differences in Selective Laser Trabeculoplasty Efficacy. J Curr Glaucoma Pract 2017;11(1):22-27.

Source of support: Nil

Conflict of interest: None

 
6.  EDITORIAL
Is Glaucoma a Neurodegeneration caused by Central Insulin Resistance: Diabetes Type IV?
Tanuj Dada
[Year:2017] [Month:September-December] [Volume:11 ] [Number:3] [Pages:47] [Pages No:77-79] [No of Hits : 693]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1228 | FREE

ABSTRACT

Glaucoma is an acquired multifactorial progressive neurodegenerative syndrome with complex pathogenesis. It is characterized by accelerated retinal ganglion cell (RGC) apoptosis and leads to optic neuropathy with visual field defects, the intraocular pressure (IOP) being a major risk factor.

How to cite this ar ticle: Dada T. Is Glaucoma a Neurodegeneration caused by Central Insulin Resistance: Diabetes Type 4? J Curr Glaucoma Pract 2017;11(3):77-79.

Source of support: Nil

Conflict of interest: None

 
7.  ORIGINAL ARTICLE
Incidence and Risk Factors of Early-onset Glaucoma following Pediatric Cataract Surgery in Egyptian Children: One-year Study
Ghada I Gawdat, Maha M Youssef, Nermeen M Bahgat, Dina M Elfayoumi, Mohamed AS Eddin
[Year:2017] [Month:September-December] [Volume:11 ] [Number:3] [Pages:47] [Pages No:80-85] [No of Hits : 663]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1229 | FREE

ABSTRACT

Aim: To study the incidence and risk factors of glaucoma occurring within 1 year following pediatric cataract surgery in Egyptian children.

Materials and methods: This is a prospective nonrandomized study conducted at Aburich Children’s Hospital, over a period of 1 year on a cohort of Egyptian patients with congenital and infantile cataract. One hundred and fifty eyes of 88 patients were enrolled in this study. All the patients underwent anterior approach removal of lens matter, whereas primary intraocular lens (IOL) implantation was carried at the age of 1 and 2 years for unilateral and bilateral cases respectively. Intraocular pressure (IOP) was measured at 1 week, 1 month, 3 months, 6 months, 9 months, and 1 year. For those who developed glaucoma, time of diagnosis and associated risk factors were reported.

Results: The incidence of glaucoma was 11.33% (17 of 150 eyes), while incidence of glaucoma suspect was 0.67% (1 of 150 eyes) in the first year following cataract surgery. The majority of the cases (66.7%) were discovered in the first 3 months postcataract surgery. Age at time of cataract surgery, the state of aphakia/pseudophakia, persistent fetal vasculature (PFV), and microphthalmia were not found to be significant predictors of early-onset glaucoma in our study.

Conclusion: Aphakic glaucoma continues to be a devastating condition with high incidence during first year following cataract surgery.

Clinical significance: Regular follow-up should start as early as possible following cataract surgery. Further prospective studies with larger study population are required.

Keywords: Aphakic glaucoma, Congenital cataract, Incidence, Prospective, Risk factors.

How to cite this article: Gawdat GI, Youssef MM, Bahgat NM, Elfayoumi DM, Eddin MAS. Incidence and Risk Factors of Early-onset Glaucoma following Pediatric Cataract Surgery in Egyptian Children: One-year Study. J Curr Glaucoma Pract 2017;11(3):80-85.

Source of support: Nil

Conflict of interest: None

 
8.  ORIGINAL ARTICLE
Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy
Tarannum Mansoori, Nagalla Balakrishna
[Year:2017] [Month:September-December] [Volume:11 ] [Number:3] [Pages:47] [Pages No:86-91] [No of Hits : 636]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1230 | FREE

ABSTRACT

Aim: To evaluate the configuration of the anterior chamber angle quantitatively and study the morphological changes in the eye with ultrasound biomicroscopy (UBM) in primary angle closure glaucoma (PACG) patients after laser peripheral iridotomy (LPI).

Materials and methods: A total of 185 eyes of 185 PACG patients post-LPI and 126 eyes of 126 normal subjects were included in this prospective study. All subjects underwent complete ophthalmic evaluation, A-scan biometry, and UBM. The anterior segment and angle parameters were measured quantitatively and compared in both groups using Student’s t-test.

Results: The PACG patients had shorter axial length, shallower central anterior chamber depth anterior chamber depth (ACD), and anteriorly located lens when compared with normal subjects. Trabecular iris angle (TIA) was significantly narrow (5.73 ± 7.76°) in patients with PACG when compared with normal subjects (23.75 ± 9.38°). The angle opening distance at 500 μm from scleral spur (AOD 500), trabecular-ciliary process distance (TCPD), iris-ciliary process distance (ICPD), and iris-zonule distance (IZD) were significantly shorter in patients with PACG than in normal subjects (p < 0.0001). The iris lens angle (ILA), scleral-iris angle (SIA), and scleral-ciliary process angle (SCPA) were significantly narrower in patients with PACG than in normal subjects (p < 0.0001). The iris-lens contact distance (ILCD) was greater in PACG group than in normal (p = 0.001). Plateau iris was seen in 57/185 (30.8%) of the eyes. Anterior positioned ciliary processes were seen in 130/185 eyes (70.3%) of eyes.

Conclusion: In PACG patients, persistent apposition angle closure is common even after LPI, which could be due to anterior rotation of ciliary body and plateau iris and overcrowding of anterior segment due to shorter axial length and relative anterior lens position.

Keywords: Anterior chamber angle, A-scan biometry, Primary angle closure glaucoma, Ultrasound biomicroscopy.

How to cite this article: Mansoori T, Balakrishna N. Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2017;11(3):86-91.

Source of support: Nil

Conflict of interest: None

 
9.  ORIGINAL ARTICLE
Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma
Arkadiy Yadgarov, Dan Liu, Elliot S Crane, Albert S Khouri
[Year:2017] [Month:January-April] [Volume:11 ] [Number:1] [Pages:34] [Pages No:16-21] [No of Hits : 611]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10008-1215 | FREE

ABSTRACT

Aim: To describe postoperative surgical success of either Ahmed or Baerveldt tube shunt implantation for eyes with medically uncontrolled traumatic glaucoma.

Materials and methods: A review was carried out to identify patients with traumatic glaucoma that required tube shunt implantation between 2009 and 2015 at Rutgers University in Newark, New Jersey, USA. Seventeen eyes from 17 patients met inclusion criteria, including at least 3-month postoperative follow-up. The main outcome measure was surgical success at 1-year follow-up after tube implantation.

Results: Mean preoperative intraocular pressure (IOP) was 34.1 ± 8.2 mm Hg on 3.1 ± 1.6 ocular hypotensive medications. Nine eyes (53%) sustained closed globe injury. Ten eyes (59%) received an Ahmed valve shunt and seven eyes (41%) received a Baerveldt tube shunt. Surgical success rate at 1 year postoperatively was 83%. Compared to preoperative, the mean postoperative IOP was significantly lower (16.1 ± 3.5 mm Hg, p < 0.001) on significantly fewer ocular hypertensive medications (1.3 ± 1.6, p = 0.001) at a mean follow-up of 10 months. Mean IOP reduction at last follow-up was 49%. There were three cases of surgical failures: One case of hypotony, one case of tube extrusion with subsequent explantation, and one case requiring second tube insertion for IOP control.

Conclusion: Implantation of an Ahmed or Baerveldt tube shunt provided successful control of IOP in patients with medically uncontrollable traumatic glaucoma.

Keywords: Cohort study, Glaucoma, Glaucoma drainage device, Intraocular pressure, Trauma, Tube.

How to cite this article: Yadgarov A, Liu D, Crane ES, Khouri AS. Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma. J Curr Glaucoma Pract 2017;11(1):16-21.

Source of support: Nil

Conflict of interest: None

 
10.  CASE REPORT
Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique
Ian AS Rodrigues, Brinda Shah, Saurabh Goyal, K Sheng Lim
[Year:2017] [Month:January-April] [Volume:11 ] [Number:1] [Pages:34] [Pages No:31-34] [No of Hits : 563]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10008-1218 | FREE

ABSTRACT

Aim: We present a novel surgical technique for repair of persistent and symptomatic cyclodialysis clefts refractory to conservative or minimally invasive treatment.

Background: Numerous surgical techniques have been described to close cyclodialysis clefts. The current standard approach involves intraocular repair of cyclodialysis clefts underneath a full-thickness scleral flap.

Technique: Our technique employs intraoperative use of a direct gonioscope to guide a nonpenetrating surgical repair. Subsequently, a significantly less invasive, nonpenetrating technique utilizing a partial-thickness scleral flap can be performed that reduces potential risks associated with intraocular surgery. The direct gonioscope is also used for confirmation of adequate surgical closure of the cyclodialysis cleft prior to completion of surgery. This technique has been successfully carried out to repair traumatic chronic cyclodialysis clefts associated with hypotony in two patients. There were no significant adverse events as a result of using this technique.

Conclusion: The novel technique described increases the likelihood of successful and permanent repair of cyclodialysis clefts with resolution of symptoms associated with hypotony, through direct intraoperative visualization of the cleft.

Clinical significance: Gonioscopically guided nonpenetrating cyclodialysis cleft repair offers significant benefits over previously described techniques. Advantages of our technique include gonioscopic cleft visualization, enabling accurate localization of the area requiring repair, and subsequent confirmation of adequate closure of the cleft. Using a partial-thickness scleral flap is also less invasive and reduces risks associated with treatment of this potentially challenging complication of ocular trauma.

Keywords: Cyclodialysis cleft, Direct gonioscope, Hypotony, Ocular trauma.

How to cite this article: Rodrigues IAS, Shah B, Goyal S, Lim S. Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique. J Curr Glaucoma Pract 2017;11(1):31-34.

Source of support: Nil

Conflict of interest: None

 
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