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  1 / 11889 MEDLINE  
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PMID:29482497
Autor:Ashworth Briggs EL; Toh T; Eri R; Hewitt AW; Cook AL
Endereço:School of Health Sciences, University of Tasmania, Launceston, Australia.
Título:Uteroglobin and FLRG concentrations in aqueous humor are associated with age in primary open angle glaucoma patients.
Fonte:BMC Ophthalmol; 18(1):57, 2018 Feb 27.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: The pathophysiological changes occurring in the trabecular meshwork in primary open angle glaucoma are poorly understood, but are thought to include increased extracellular matrix deposition, trabecular meshwork cell apoptosis, inflammation, trabecular meshwork calcification and altered protein composition of the aqueous humor. Although many proteins are present in aqueous humor, relatively few have been studied extensively, and their potential roles in primary open angle glaucoma are unknown. METHODS: Analyte concentrations in aqueous humor from 19 primary open angle glaucoma and 18 cataract patients were measured using a multiplex immunoassay. Fisher's exact test was used to assess statistical significance between groups, and correlations of analyte concentrations with age, intraocular pressure, pattern standard deviation, mean deviation, cup-to-disc ratio and disease duration since commencing treatment were tested by Spearman's method. RESULTS: CHI3L1, FLRG, HGF, MIF, P-selectin and Uteroglobin were detected in more than 50% of samples of one or both patient groups, some of which have not previously been quantified in aqueous humor. In the glaucoma but not the cataract group, significant correlations were determined with age for Uteroglobin/SCGB1A1 (r = 0.805, p < 0.0001) and FLRG (r = 0.706, p = 0.0007). Furthermore, HGF correlated significantly with disease duration (r = - 0.723, p = 0.0007). There were no differences in analyte concentrations between groups, and no other significant associations with clinical descriptors that passed correction for multiple testing. CONCLUSIONS: The correlations of uteroglobin and FLRG with age in primary open angle glaucoma but not cataract may suggest a heightened requirement for anti-inflammatory (uteroglobin) or anti-calcification (FLRG) activity in the ageing glaucomatous trabecular meshwork.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Follistatin-Related Proteins); 9060-09-7 (Uteroglobin)


  2 / 11889 MEDLINE  
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PMID:29329338
Autor:Frech S; Kreft D; Guthoff RF; Doblhammer G
Endereço:Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.
Título:Pharmacoepidemiological assessment of adherence and influencing co-factors among primary open-angle glaucoma patients-An observational cohort study.
Fonte:PLoS One; 13(1):e0191185, 2018.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:The goal of this study was to assess the adherence of primary open-angle glaucoma (POAG) patients to medication, and to determine co-factors influencing adherence, using a representative sample of members of the largest German public health insurer. The observational cohort study was based on a longitudinal data set from 2010-2013 and included 250,000 insured persons aged 50 and older with 10,120 diagnosed POAG patients. Uni- and multivariate analysis was performed to investigate several aspects of glaucoma, such as prevalence, adherence, and co-factors influencing adherence. The main outcome measured adherence with prescriptions filled within a year. Multivariate panel regression analysis was used to determine the co-factors influencing this adherence. Prevalence of POAG was 3.36% [CI: 3.28-3.43%], with 2.91% [CI: 2.81-3.01%] for males and 3.71% [CI: 3.61-3.81%] for females, increasing with age. The mean level of adherence in terms of prescriptions filled was 66.5% [CI: 65.50-67.60%]. The results of this analysis revealed a significant influence of age, duration of the disease, care need, distance to death, and multimorbidity as co-factors of non-adherence, whereas gender had no influence. The analysis provided detailed information about POAG health care aspects concerning prevalence and adherence. The most endangered risk groups for non-adherence were patients aged 50-59, patients older than 80 years, patients with a longer duration of POAG, patients with care needs, and patients with three or more severe diseases in addition to glaucoma. To know the predictors responsible for an increased risk to develop POAG is of importance for all persons involved in health care management. Therefore effective strategies to increase awareness of patients and medical care personnel about non-adherence and the importance of a regular and continuous medication to avoid further nerve fiber damage and possible blindness have to be developed.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T


  3 / 11889 MEDLINE  
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PMID:29256897
Autor:Yook E; Vinod K; Panarelli JF
Endereço:Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Título:Complications of micro-invasive glaucoma surgery.
Fonte:Curr Opin Ophthalmol; 29(2):147-154, 2018 Mar.
ISSN:1531-7021
País de publicação:United States
Idioma:eng
Resumo:PURPOSE OF REVIEW: Micro-invasive glaucoma surgery (MIGS) is gaining favor with both comprehensive ophthalmologists and glaucoma specialists due in part to its improved safety profile when compared to traditional incisional glaucoma surgery. Despite a micro-invasive approach and minimal induced tissue trauma, each MIGS procedure is associated with unique complications. The present article summarizes evidence from the 2016 to 2017 review period regarding the safety profiles of Schlemm's canal-based, suprachoroidal, and subconjunctival microstents. RECENT FINDINGS: Ab-interno microstents are subject to intraoperative malpositioning, which can result in luminal obstruction and decreased efficacy. Acutely elevated intraocular pressure (IOP) has been observed with the iStent (Glaukos Corp., Laguna Hills, CA, USA; 2-4.3%), Hydrus Microstent (Ivantis Inc., Irvine, CA, USA; 6%), Cypass Microstent (Alcon, Fort Worth, TX, USA; 3-10.8%), and Xen Gel Stent (Allergan Plc, Dublin, Ireland; 21.5%). Meanwhile, most cases of hypotony (IOP < 6 mmHg) occurred within the first postoperative month, resolved with conservative treatment and without further surgical intervention, and were not associated with vision-threatening sequelae. SUMMARY: Interest in MIGS continues to grow as these procedures allow surgeons to intervene earlier in the disease course for patients with milder stages of glaucoma. Complications associated with MIGS, albeit infrequent and mostly transient, do occur despite a less invasive approach than trabeculectomy and tube shunt surgery.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  4 / 11889 MEDLINE  
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PMID:29206652
Autor:Vinod K
Endereço:Department of Ophthalmology, Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Título:Suprachoroidal shunts.
Fonte:Curr Opin Ophthalmol; 29(2):155-161, 2018 Mar.
ISSN:1531-7021
País de publicação:United States
Idioma:eng
Resumo:PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and safety of ab externo and ab interno suprachoroidal shunts designed to augment uveoscleral outflow in patients with open angle glaucoma. RECENT FINDINGS: The Gold Shunt and STARflo are placed into the suprachoroidal space via an ab externo approach, while the CyPass Micro-Stent and iStent Supra are inserted ab interno through a clear corneal incision. A small randomized clinical trial suggested similar efficacy among two different models of the Gold Shunt and the Ahmed glaucoma valve. The pivotal multicenter, randomized COMPASS trial showed that the CyPass Micro-Stent combined with cataract surgery is more effective than cataract surgery alone through 2 years. Study results suggest a favorable safety profile for each suprachoroidal device and intraocular pressure-lowering to the mid-to-high teens with an associated reduction in medication burden. Given the relative novelty of these procedures, it is currently unknown whether fibroblastic proliferation within the suprachoroidal space may limit their long-term success. SUMMARY: Renewed interest in the suprachoroidal space has led to the development of new biocompatible glaucoma implants. Ab interno devices are easily combined with cataract surgery and preserve conjunctiva for future incisional glaucoma surgery. Additional data regarding the long-term efficacy and late complications of suprachoroidal shunts are needed.
Tipo de publicação: JOURNAL ARTICLE; REVIEW
Nome de substância:0 (Biocompatible Materials)


  5 / 11889 MEDLINE  
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PMID:29433472
Autor:Adachi S; Yuki K; Awano-Tanabe S; Ono T; Shiba D; Murata H; Asaoka R; Tsubota K
Endereço:Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, Japan.
Título:Factors associated with developing a fear of falling in subjects with primary open-angle glaucoma.
Fonte:BMC Ophthalmol; 18(1):39, 2018 Feb 13.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: To investigate the relationship between clinical risk factors, including visual field (VF) defects and visual acuity, and a fear of falling, among patients with primary open-angle glaucoma (POAG). METHODS: All participants answered the following question at a baseline ophthalmic examination: Are you afraid of falling? The same question was then answered every 12 months for 3 years. A binocular integrated visual field was calculated by merging a patient's monocular Humphrey field analyzer VFs, using the 'best sensitivity' method. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral VFs were calculated. The relationship between these mean VF measurements, and various clinical factors, against patients' baseline fear of falling and future fear of falling was analyzed using multiple logistic regression. RESULTS: Among 392 POAG subjects, 342 patients (87.2%) responded to the fear of falling question at least twice in the 3 years study period. The optimal regression model for patients' baseline fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. The optimal regression equation for future fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. CONCLUSION: Defects in the inferior peripheral VF area are significantly related to the development of a fear of falling.
Tipo de publicação: JOURNAL ARTICLE


  6 / 11889 MEDLINE  
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PMID:29390457
Autor:Xu X; Xiao H; Guo X; Chen X; Hao L; Luo J; Liu X
Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Título:Diagnostic ability of macular ganglion cell-inner plexiform layer thickness in glaucoma suspects.
Fonte:Medicine (Baltimore); 96(51):e9182, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:The purpose is to assess the diagnostic ability for early glaucoma of macular ganglion cell-inner plexiform layer (GCIPL) thickness in a Chinese population including glaucoma suspects.A total of 367 eyes with primary open-angle glaucoma (168 early glaucoma, 78 moderate glaucoma, and 121 advanced glaucoma), 52 eyes with ocular hypertension (OHT), 59 eyes with enlarged cup-to-disc ratio (C/D), and 225 normal eyes were included. GCIPL thickness (average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal), retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured using Cirrus high-definition optical coherence tomography (OCT) and compared. The diagnostic ability of OCT parameters was assessed by area under receiver operating characteristic curve (AUROC) in 3 distinguishing groups: normal eyes and eyes with early glaucoma, normal eyes and eyes with glaucoma regardless of disease stage, and nonglaucomatous eyes (normal eyes, eyes with OHT, and enlarged C/D) and early glaucomatous eyes.Glaucomatous eyes showed a significant reduction in GCIPL thickness compared with nonglaucomatous eyes. In all 3 distinguishing groups, best-performing parameters of GCIPL thickness, RNFL thickness, and ONH parameters were minimum GCIPL thickness (expressed in AUROC, 0.899, 0.952, and 0.900, respectively), average RNFL thickness (0.904, 0.953, and 0.892, respectively), and rim area (0.861, 0.925, and 0.824, respectively). There was no statistical significance of AUROC between minimum GCIPL thickness and average RNFL thickness (all P > .05).GCIPL thickness could discriminate early glaucoma from normal and glaucoma suspects with good sensitivity and specificity. The glaucoma diagnostic ability of GCIPL thickness was comparable to that of RNFL thickness.
Tipo de publicação: JOURNAL ARTICLE


  7 / 11889 MEDLINE  
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PMID:29260410
Autor:Szurman P; Januschowski K; Boden KT; Seuthe AM
Endereço:Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Saar, Germany.
Título:Suprachoroidal drainage with collagen sheet implant- a novel technique for non-penetrating glaucoma surgery.
Fonte:Graefes Arch Clin Exp Ophthalmol; 256(2):381-385, 2018 Feb.
ISSN:1435-702X
País de publicação:Germany
Idioma:eng
Resumo:PURPOSE: Our purpose was both to introduce the new technique of suprachoroidal drainage with collagen sheet implantation as a novel technique of non-penetrating glaucoma surgery and to present first results of a prospective pilot study. METHODS: A superficial rectangular sclera flap of half-scleral thickness sized 4 × 4.5 mm is dissected anteriorly until clear cornea. Then, a second scleral flap is created underneath the first one sized 3.5x4mm and is cut down full-thickness to the choroid exposing the suprachoroidal space. The flap is then bluntly prepared until the scleral spur is reached. Sharp dissection above the sclera spur exposes Schlemm's canal, which is located directly anteriorly. Schlemm's canal is unroofed, juxtacanalicular meshwork is peeled and the deep flap is cut off at its base. An absorbable collagen sheet (Ologen®, Dahlhausen, Cologne, Germany) is placed into the suprachoroidal space at the level of the ciliary body, and the superficial sclera flap is sutured tightly to prevent leakage. RESULTS: We prospectively analyzed 65 eyes that underwent suprachoroidal drainage with collagen sheet implantation. Mean reduction of intraocular pressure after 3 months was 35.1% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.4 mmHg)(p < 0.01) and after 12 months 35.6% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.0  mmHg)(p < 0.01). The number of topical IOP-reducing medication decreased significantly from 3.5 ± 0.7 to 0.6 ± 0.9 and to 0.9 ± 1.1 after 3 and 12 months, respectively (p < 0.01). No serious complications occurred. CONCLUSION: Suprachoroidal drainage with collagen sheet implantation seems to be a safe and effective surgical technique for non-penetrating glaucoma surgery that yields the opportunity of a sufficient IOP reduction for eyes unsuitable for canaloplasty.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Coated Materials, Biocompatible); 9007-34-5 (Collagen)


  8 / 11889 MEDLINE  
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PMID:29350499
Autor:Janicijevic K; Kocic S; Pajovic S; Zdravkovic N; Sarenac-Vulovic T; Janicijevic-Petrovic M
Título:The importance of developing atherosclerosis in pseudoexfoliation glaucoma.
Fonte:Vojnosanit Pregl; 74(1):8-12, 2017 Jan.
ISSN:0042-8450
País de publicação:Serbia
Idioma:eng
Resumo:Background/Aim: Pseudoexfoliation syndrome (XPS) is an age-related systemic disorder characterized by increased production and accumulation of elastic microfibrillar material in different tissues of the body: skin, connective tissue portions of visceral organs, periphery blood vessels and the eye, as well. The aim of our study was to determine the significance of atherosclerotic changes in the carotid arteries in the development of XFS and pseudoexfoliation glaucoma (XFG). Methods: The study included 120 patients ­ 40 patients per each of the three defined groups: XFS group, XFG group and age- and sex-matched control subjects (control group) without XFG. Blood samples were collected from the patients before cataract surgery. Serum levels of total cholesterol, low-density lipoprotein ­ LDL, high density lipoprotein ­ HDL and triglycerides were analyzed by standard laboratory techniques. Standard ultrasonography of the carotid blood vessels was performed in all the participants. Results: Lipid's profile was disturbed in the patients with XFS and XFG with statistical significance p control group (p < 0.01). Systolic and diastolic pressure was elevated in the patients with XFS and XFG (p < 0.01). Resistance index was increased in the patients with XFG (p < 0.01). Intima-media thickness was prolonged in patients with XFG (p < 0.01). Conclusion: A disturbed lipid profile with elevated resistancy index and intima-media thickness and increased systolic and diastolic pressure were compulsory findings in patients with developed XFG. So, these factors could be considered as risk. It seems to be difficult to inhibit the process of pseudoexfolation production in the whole body, but it appears that with proper therapy (antihypertnesive, cardiotoncs, etc.) and adequate nourishing, the process of XFG development could be interrupted.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Biomarkers); 0 (Lipids)


  9 / 11889 MEDLINE  
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PMID:29314792
Autor:Trenkic-Bozinovic M; Zlatanovic G; Jovanovic P; Veselinovic D; Dordevic-Jocic J; Radenkovic M; Resan M
Título:Optical coherence tomography in the evaluation of structural changes in primary open-angle glaucoma with and without elevated intraocular pressure.
Fonte:Vojnosanit Pregl; 73(7):618-25, 2016 Jul.
ISSN:0042-8450
País de publicação:Serbia
Idioma:eng
Resumo:Background/Aim: Glaucoma is a progressive optic neuropathy characterized by damage of the retinal ganglion cells and their axons and glial cells. The aim of this study was to evaluate the differences and connections between changes in the visual field and the thickness of the peripapillary retinal nerve fiber layer (RNFL), using optical coherence tomography (OCT) in patients with primary open-angle glaucoma with normal and elevated intraocular pressure (IOP). Methods: This prospective study included 38 patients (38 eyes) with primary open-angle glaucoma with normal intraocular pressure (NTG) and 50 patients (50 eyes) with primary open-angle glaucoma with elevated intraocular pressure (HTG), paired by the same degree of structural glaucomatous changes in the optic nerve head and by age. OCT protocols 'fast RNFL thickness' and 'fast optic disc' were used for testing. The patients' age, gender, best corrected visual acuity (BCVA), IOP, stereometric and functional parameters were compared. Results: The average age of the examined population was 65.49 ± 9.36 (range 44-83) years. There was no statistically significant difference by age and by gender between the two study groups (p = 0.795 and p = 0.807, respectively). BCVA was higher in patients with NTG but there was no statistically significant difference compared to HTG patients (p = 0.160). IOP was statistically significantly higher in patients with HTG compared to NTG patients (17.40 ± 2.77 mmHg vs 14.95 ± 3.01 mmHg, p = 0.009). The cup/disc (C/D) (p = 0.258), mean deviation (MD) (p = 0.477), corrected patern standard deviation (CPSD) (p = 0.943), disk area (p = 0.515), rim area (p = 0.294), rim volume (p = 0.118), C/D area R (p = 0.103), RNFL Average (p = 0.632), RNFL Superior (p = 0.283) and RNFL Inferior (p = 0.488) were not statistically significantly different between the groups. Conclusion: OCT measurements of the RNFL thickness provide clinically significant information in monitoring of glaucomatous changes. There are no differences in the patterns of RNFL defects per sectors and quadrants between NTG and HTG, measured by OCT.
Tipo de publicação: JOURNAL ARTICLE


  10 / 11889 MEDLINE  
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PMID:28449300
Autor:Seuthe AM; Januschowski K; Mariacher S; Ebner M; Opitz N; Szurman P; Boden K
Endereço:Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany.
Título:The effect of canaloplasty with suprachoroidal drainage combined with cataract surgery - 1-year results.
Fonte:Acta Ophthalmol; 96(1):e74-e78, 2018 Feb.
ISSN:1755-3768
País de publicação:England
Idioma:eng
Resumo:PURPOSE: The purpose of this study was to investigate the safety and efficacy of phacocanaloplasty with suprachoroidal drainage (PCscD) and to compare its intraocular pressure (IOP)-lowering and drug-sparing effect to canaloplasty with suprachoroidal drainage (CscD). METHODS: The study retrospective interventional study included patients with open-angle glaucoma or secondary forms of glaucoma who underwent either CscD or PCscD between the year 2011 and 2014 in Knappschaft Eye Clinic Sulzbach. Primary end-points were IOP reduction and the number of IOP-lowering medication after 12 months. Secondary end-points were intraoperative and postoperative complications. RESULTS: A total of 328 eyes were included, 193 were treated with CscD and 135 underwent PCscD. Canaloplasty with scD achieved an IOP reduction of 37.0% (from 20.9 ± 3.6 mmHg to 13.2 ± 2.6 mmHg) after 1 year, whereas PCscD showed a significant higher reduction of 47.4% (from 23.2 ± 5.1 mmHg to 12.2 ± 1.7 mmHg). Reduction in IOP-lowering medication was higher after PCscD (from 3.6 ± 0.6 to 0.2 ± 0.5) than after CscD (from 3.5 ± 0.8 to 0.7 ± 1.0). Twelve months after surgery 55.5% in the CscD group and 80.2% in the PCscD group were free of IOP-lowering medication. In both groups, no severe or sight-threatening complications occurred. CONCLUSION: Combining cataract surgery and CscD achieves a higher IOP reduction, and patients postoperatively need less IOP-lowering medication than after CscD alone.
Tipo de publicação: CLINICAL STUDY; JOURNAL ARTICLE



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