Journal of Current Glaucoma Practice

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2014 | January-April | Volume 8 | Issue 1

EDITORIAL

Shibal Bhartiya, Tarek Shaarawy, Tanuj Dada

Editorial

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jocgp-8-1-v  |  Open Access |  How to cite  | 

ORIGINAL RESEARCH

James Chiung Yoong Leong, Jeremy O'Connor, Ghee Soon Ang, Anthony P Wells

Anterior Segment Optical Coherence Tomography Changes to the Anterior Chamber Angle in the Short-term following Laser Peripheral Iridoplasty

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Optical coherence tomography, Angle closure glaucoma, Laser peripheral iridoplasty

PDF  |  DOI: 10.5005/jp-journals-10008-1152  |  Open Access |  How to cite  | 

Abstract

Purpose: To evaluate, by anterior segment optical coherence tomography (AS-OCT), the changes in the anterior chamber angle during the short-term postoperative period after diode laser peripheral iridoplasty (LPI). Methods: Retrospective, observational study of consecutive primary angle closure suspect, primary angle closure, or primary angle closure glaucoma patients who underwent LPI. These patients had persistent iridotrabecular contact despite the presence of a patent peripheral iridotomy. The AS-OCT images of the temporal and nasal anterior chamber angles in dark conditions before and after LPI were ana lyzed. The main outcome measures were changed in AS-OCT parameters such as trabecular-iris angle (TIA), angle opening distance (AOD), trabecular-iris space area (TISA), trabecular-iris contact length (TICL), iris thickness (IT), and maximum iris bow height (MIBH). Secondary outcome para meters included intraocular pressure (IOP) and postlaser complications. Results: Images of 14 eyes of 14 patients were assessed. The mean time from LPI to the follow-up AS-OCT scan was 6 ± 3 weeks. The IT did not alter significantly after LPI, but there were significant increases in the TIA, AOD and TISA, as well as a significant decrease in TICL and MIBH. There were no significant postlaser complications. There was a small decrease in mean IOP from 17.1 ± 4.0 mm Hg to 14.8 ± 4.6 mm Hg (p = 0.014). Conclusion: Based on AS-OCT imaging, LPI resulted in significant angle widening and iris profile fattening during the short-term postoperative period in eyes with persistent angle closure despite the presence of a patent peripheral iridotomy.

ORIGINAL RESEARCH

Nguyen Thi Ha Thanh

Comparison of Treated Mean Intraocular Pressure in Stable Glaucoma with Different Severity in Vietnam

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:3] [Pages No:7 - 9]

Keywords: Intraocular pressure, Stable glaucoma, Stage, Medication

PDF  |  DOI: 10.5005/jp-journals-10008-1153  |  Open Access |  How to cite  | 

Abstract

Purpose: To compare stable glaucoma with different severity in a Vietnamese population in regard to mean intraocular pressure (IOP) and number of medications used. Materials and methods: A total of 116 eyes from 68 patients with medically treated glaucoma were prospectively enrolled at a single center and subjected to automated perimetry every 3 months for at least 9 months. Glaucoma progression was identifed according to early manifest glaucoma trial criterion using glaucoma progression analysis software. Eyes in which no progression was identifed were staged for glaucoma severity using field criteria (mild MD ≥ 6 dB, moderate MD –6 to –12 dB, advanced MD ≥ 12 dB, end-stage central island only). Groups were compared in terms of mean IOP and number of medications used. Statistical analysis was performed using SPSS v16.0. Results: A total of 109 eyes displayed no evidence of pro gres-sion during the study period. Pretreatment mean IOP for mild, moderate, severe and end-stage glaucoma was 28.2 ± 1.4, 28.8 ± 1.6, 29.1 ± 1.8, and 28.6 ± 0.8 mm Hg. The mean IOP of all 109 eyes during follow-up was 16.8 ± 1.4 mm Hg (95% conf dence interval = 15.4 ± 18.2 mm Hg). Mild, moderate, advan ced, and end-stage glaucoma had mean IOP of 17.5 ± 1.2, 16.9 ± 1.3, 15.8 ± 0.9 and 15.5 ± 1.1 mm Hg. The mean IOP of mild stage was significantly higher than advanced and end-stage (t-test, p < 0.001). Also, the mean IOP of moderate glaucoma was significantly higher than advanced and end-stage glaucoma (t-test, p < 0.05). Number of medications had no signi ficant difference among these glaucoma stages (chi-square test, p > 0.05). Conclusion: Reached IOP lowering contributes to glaucoma stabilization especially in late stages. To maintain stable glaucoma, there was no difference in medical procedure of glaucoma stages.

ORIGINAL RESEARCH

Anjali Sharma, Prakashchand Agarwal, P Sathyan, VK Saini

Macular Thickness Variability in Primary Open Angle Glaucoma Patients using Optical Coherence Tomography

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:5] [Pages No:10 - 14]

Keywords: Macular thickness, Glaucoma, Optical coherence tomography

PDF  |  DOI: 10.5005/jp-journals-10008-1154  |  Open Access |  How to cite  | 

Abstract

Aim: To compare the difference of retinal macular thickness and macular volume using optical coherence tomography (OCT) in primary open angle glaucoma (POAG) patients with the normal subjects. Materials and methods: This observational case control study included primary open angle glaucoma (POAG) patients (n = 124 eyes) and healthy subjects in the control group (n = 124 eyes). All subjects underwent detailed history, general and systemic exami -nation. Complete ocular examination included best corrected visual acuity (BCVA), slit lamp examination, intraocular pressure (IOP), central corneal thickness, gonioscopy, dilated fundus biomicroscopy. Field analysis was done by white on white Humphrey Field Analyzer (Carl Zeiss). Optical coherence tomography imaging of macular area was performed using Stratus OCT (OCT 3, Version 4, Carl Zeiss Inc, Dublin, California, USA). In both these groups, parameters analyzed were macular thickness, inner macular thicknesses (IMT), outer macular thicknesses (OMT), central macular thick ness (CMT) and total macular volume (TMV). Results: The POAG group had significantly decreased values of TMV, OMT and IMT, compared to control group, while there was no difference in CMT, presumably due to absence of ganglion cells in the central part. Thus, macular thickness and volume parameters may be used for making the diagnosis of glaucoma especially in patients with abnormalities of disc. Conclusion: Macular thickness parameters correlated well with the diagnosis of glaucoma.

ORIGINAL RESEARCH

Sunil Ganekal, Syril Dorairaj, Vishal Jhanji, Krishnaprasad Kudlu

Effect of Topical Calcium Channel Blockers on Intraocular Pressure in Steroid-induced Glaucoma

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:5] [Pages No:15 - 19]

Keywords: Calcium channel blockers, Intraocular pressure, Steroid-induced glaucoma

PDF  |  DOI: 10.5005/jp-journals-10008-1155  |  Open Access |  How to cite  | 

Abstract

Purpose: To evaluate the effect of 0.125% verapamil and 0.5% diltiazem eye drops on intraocular pressure (IOP) in steroid-induced glaucoma in rabbit eyes. Methods: A total of 18 rabbits with steroid-induced glaucoma were divided into three groups (A, B and C; n = 6 each). Right eyes in groups A, B and C received 0.5% diltiazem, 0.125% verapamil and 0.5% timolol eye drops twice daily for 12 days, respectively; whereas, left eyes received distilled water. IOP was measured with Tono-pen XL at baseline, day 4, day 8, and day 12 of treatment. Results: Both 0.5% diltiazem and 0.125% verapamil eye drops significantly reduced IOP compared to control eyes (p < 0.05). Reduction of IOP by 0.5% diltiazem, 0.125% verapamil eye drops were comparable to 0.5% timolol. No surface toxicity or systemic side effects were noted during the study period. Conclusion: Calcium channel blockers, verapamil, and diltia-zem significantly reduced IOP in rabbiteyes. This group of drugs may have a potential role in treatment of glaucoma

ORIGINAL RESEARCH

Jacky WY Lee, Jonathan CH Chan, Li Qing, Jimmy SM Lai

Early Postoperative Results and Complications of using the EX-PRESS Shunt in uncontrolled Uveitic Glaucoma: A Case Series of Preliminary Results

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:5] [Pages No:20 - 24]

Keywords: EX-PRESS, Uveitic glaucoma, Intraocular pressure, Success, Complications, Medication

PDF  |  DOI: 10.5005/jp-journals-10008-1156  |  Open Access |  How to cite  | 

Abstract

Purpose: The purpose of this case series is to describe the efficacy of the EX-PRESS shunt in uveitic glaucoma. Methods: This prospective case series sequentially recruited uveitic glaucoma subjects with intraocular pressure (IOP) > 21 mm Hg despite maximal topical antiglaucoma medications from July 2012 to July 2013 in Hong Kong. All subjects received a trabeculectomy with mitomycin C (MMC) and EX-PRESS shunt implantation. The primary outcome measures included preope-rative IOP and postoperative IOP on day 1, 1 week, 1 month, and every 3 months thereafter. The secondary outcome measures included postoperative complications and follow-up procedures, pre- and postoperative Snellen best corrected visual acuity and cup-disc ratio, as well as the number of antiglaucoma medication required. Results: In a case series of five subjects with uncontrolled uveitic glaucoma, two had inactive anterior uveitis, and three had active panuveitis. The mean preoperative IOP was 35.4 ± 12.6 mm Hg on 3.8 ± 0.5 antiglaucoma eye drops. The mean day 1, 1 week and 1 month IOP\'s were 6.6 ± 3.7 mm Hg, 7.2 ± 3.2 mm Hg, and 12.6 ± 8.2 mm Hg, respectively. One case required subconjunctival MMC injections postoperatively; two required conjunctival resuture for leakage; and two had early postoperative hypotony that resolved after oral prednisolone. At 6 months, the mean IOP was 13.2 ± 4.6 mm Hg. Four out of five subjects had IOP < 21 mm Hg without medication, and all had IOP < 21 mm Hg with antiglaucoma medication. Conclusion: The EX-PRESS shunt demonstrates good IOP control with a propensity for hypotony in the early postoperative period in this small uveitic glaucoma series.

REVIEW ARTICLE

Annadurai Parivadhini, Vijaya Lingam

Management of Secondary Angle Closure Glaucoma

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:8] [Pages No:25 - 32]

Keywords: Pupillary block, Neovascular glaucoma, Iridocorneal endothelial syndrome, Aqueous misdirection syndrome, Ciliary body swelling

PDF  |  DOI: 10.5005/jp-journals-10008-1157  |  Open Access |  How to cite  | 

Abstract

Secondary angle closure glaucomas are a distinct entity from primary angle closure glaucoma (PACG). Unlike PACG, secondary angle closure glaucoma\'s have an identifable contributory factor/s for angle closure and obstruction of aqueous fow which is usually unrelieved by iridotomy. The treatment of each type of secondary angle closure glaucoma is varied, so identification of the primary cause aids in its effective management.

CASE REPORT

Sushmita Kaushik, Parul Ichhpujani, Savleen Kaur, Surinder Singh Pandav

Optic Disk Pit and Iridociliary Cyst Precipitating Angle Closure Glaucoma

[Year:2014] [Month:January-April] [Volume:8] [Number:1] [Pages:3] [Pages No:33 - 35]

Keywords: Optic disk, Pit, Angle closure glaucoma

PDF  |  DOI: 10.5005/jp-journals-10008-1158  |  Open Access |  How to cite  | 

Abstract

Primary angle closure glaucoma is usually a bilateral disease, though it may be asymmetrical. However, it is unusual to see advanced glaucoma in one eye and no disk damage in the other. We present a case of unilateral angle closure glaucoma complicated by an optic disk pit and iridociliary cysts.

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