Displaying publications 1 - 20 of 114 in total

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  1. Michael NDB, Hussein A, Abd Halim S, Ab Hamid SA
    Cureus, 2019 May 04;11(5):e4599.
    PMID: 31309023 DOI: 10.7759/cureus.4599
    Background Neurovascular changes occur during the migraine is believed to cause alteration in cerebral and retinal circulation that possible result in damage to the brain and even retina or optic nerve. Retinal nerve fiber layer (RNFL) thickness measurement can be used as an index to assess ganglion cell and retinal nerve fiber damages. The aim of this study was to evaluate the optic nerve head (ONH) parameters, RNFL thickness, and ocular perfusion pressure (OPP) in migraine patients. Methods This was a cross-sectional study, conducted in Hospital Universiti Sains Malaysia, Kelantan from July 2016 to November 2018, involving patients with a confirmed diagnosis of migraine and controls. Ninety-four eyes of 47 migraine patients and 94 eyes of 47 healthy subjects were included in this study. Blood pressure and intraocular pressure were measured and OPP was calculated. ONH parameters and RNFL thickness were measured using optical coherence tomography (OCT) after pupillary dilatation. Statistical analysis was done using Statistical Package for the Social Science (SPSS Inc Version 24). Results With respect to all means values of ONH parameters, there was no statistically significant difference between migraine patients and controls. For RNFL, there were significant reductions in average and superior RNFL thickness on both eyes with adjustment of age and gender (P-value: right eye (RE) average = 0.027; RE superior = 0.034; left eye (LE) average = 0.037; LE superior = 0.031). In view of OPP, there was no significant difference between migraine patients and controls (P-value = 0.172). Weak correlations were found between the ONH parameters and RNFL thickness with OPP, respectively, in migraine patients. Conclusion This study showed no difference in ONH parameters between migraine patients and healthy subjects. There was significant thinning in average and superior RNFL for migraine patients. No difference found in OPP between both groups. ONH parameters and RNFL thickness had a weak correlation with OPP in migraine patients.
    Matched MeSH terms: Intraocular Pressure
  2. Mohidin N, Abd Wahab N
    Sains Malaysiana, 2010;39(2):333-336.
    A retrospective study was carried out to determine the distribution of intraocular pressure in normal patients who came for vision problems at the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM) Kuala Lumpur Campus, and to determine the differences in intraocular pressure with respect to age, gender and race. The cohort consisted of 148 subjects divided into five groups with age ranged from 10 to 59 years. The inclusion criteria were, subjects had no sistemic or ocular disease, subjects were not taking any medication, visual acuity was 6/6 or better, refractive errors < ±6.00D, astigmatism < 2.00D, anisometropia <2.00D, and mean intraocular pressure measured using the X-PERT tonometer and taken between 9 am to 2 pm. Statistical analysis (ANOVA) showed the mean intraocular pressure without consideration for age, race or gender was 12.6 mmHg (SD ±2.5). There was no significant differences in intraocular pressure between right and left eyes, between different age groups and between different genders. However, the intraocular pressuse for the Chinese was found to be significantly higher than the Malays. It was found that the intraocular pressure of patients who came for vision problems at the Optometry Clinic UKM follows a normal distribution and there was no significant diference found between right and left eyes, between different age groups and genders. Race seemed to contribute to the differences in intraocular pressure. Keywords: Age; clinic population; genders; pressure; intraocular pressure; race
    Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Intraocular Pressure*
  3. Agarwal R, Agarwal P
    Ophthalmic Res, 2010;43(1):1-10.
    PMID: 19829006 DOI: 10.1159/000246571
    Glaucoma, a leading cause of irreversible blindness, is often associated with increased resistance to aqueous outflow in trabecular tissue. Increased outflow resistance has been attributed to increased extracellular matrix (ECM) deposition in trabecular tissue. A critical balance between the synthesis and breakdown of the components of extracellular tissue is important in keeping the intraocular pressure within the normal range. Multiple mechanisms have been shown to affect ECM turnover in trabecular tissue. In this review, we examine the related literature to understand the role of TGF-beta in ECM turnover, in the development and progression of glaucoma, and in possible therapeutic strategies that can be devised by targeting the TGF-beta signaling pathways.
    Matched MeSH terms: Intraocular Pressure/drug effects
  4. Agarwal R, Agarwal P
    Expert Opin Ther Targets, 2014 May;18(5):527-39.
    PMID: 24579961 DOI: 10.1517/14728222.2014.888416
    The homeostatic role of adenosine in regulating intraocular pressure (IOP) is now widely recognized, and hence, the drugs targeting adenosine receptors have become the focus of investigation. In this review, we summarize the adenosine receptor signaling pathways, which could be potential therapeutic targets for the management of glaucoma.
    Matched MeSH terms: Intraocular Pressure/drug effects*; Intraocular Pressure/physiology
  5. Agarwal P, Agarwal R
    Expert Opin Ther Targets, 2018 07;22(7):629-638.
    PMID: 29883239 DOI: 10.1080/14728222.2018.1486822
    INTRODUCTION: Disturbances of extracellular matrix (ECM) homeostasis in trabecular meshwork (TM) cause increased aqueous outflow resistance leading to elevated intraocular pressure (IOP) in glaucomatous eyes. Therefore, restoration of ECM homeostasis is a rational approach to prevent disease progression. Since renin-angiotensin system (RAS) inhibition positively alters ECM homeostasis in cardiovascular pathologies involving pressure and volume overload, it is likely that RAS inhibitors reduce IOP primarily by restoring ECM homeostasis. Areas covered: Current evidence showing the presence of RAS components in ocular tissue and its role in regulating aqueous humor dynamics is briefly summarized. The role of RAS in ECM remodeling is discussed both in terms of its effects on ECM synthesis and its breakdown. The mechanisms of ECM remodeling involving interactions of RAS with transforming growth factor-β, Wnt/β-catenin signaling, bone morphogenic proteins, connective tissue growth factor, and matrix metalloproteinases in ocular tissue are discussed. Expert opinion: Current literature strongly indicates a significant role of RAS in ECM remodeling in TM of hypertensive eyes. Hence, IOP-lowering effect of RAS inhibitors may primarily be attributed to restoration of ECM homeostasis in aqueous outflow pathways rather than its vascular effects. However, the mechanistic targets for RAS inhibitors have much wider distribution and consequences, which remain relatively unexplored in TM.
    Matched MeSH terms: Intraocular Pressure/drug effects
  6. Agarwal R
    Medical Health Reviews, 2009;2009(1):75-93.
    MyJurnal
    Glaucoma, recognized as optic neuropathy is the second largest cause of blindness worldwide. The disease is characterized by progressive loss of retinal ganglion cells and visual field defects. The pathophysiological factors involved in the onset and progression of glaucoma are not fully understood. However, it is now well accepted that elevated intraocular pressure is not the only causative factor. The pathophysiology of glaucoma involves multiple factors that interact in a highly complex manner to favor development of glaucomatous optic neuropathy. As the knowledge of molecular mechanisms involved is expanding, more and more therapeutic targets are being recognized for the development of safe and effective pharmacotherapy of glaucoma. Although at present the intraocular pressure lowering drugs are still the first line of treatment, the prospect of introducing neuroprotective therapies that can directly protect and perhaps stimulate regeneration of dying and dead retinal ganglion cells, shows considerable promise. This review presents recent developments in the pathophysiology and pharmacotherapy of glaucoma.
    Matched MeSH terms: Intraocular Pressure
  7. Agarwal P, Daher AM, Agarwal R
    Mol Vis, 2015;21:612-20.
    PMID: 26019480
    Elevated intraocular pressure (IOP) in glaucomatous eyes is often due to increased resistance to aqueous outflow. Previous studies have shown that increased extracellular material deposition in outflow pathways leads to increased resistance to aqueous outflow, and transforming growth factor (TGF)-β seems to play a role in the deposition of extracellular material. TGF-β2 is the predominant isoform in ocular tissue. Hence, comparison of the aqueous humor TGF-β2 level between patients with open-angle glaucoma (OAG) and controls would provide direct evidence for the role of TGF-β2 in the etiology of OAG. Hence, we performed this meta-analysis to develop an accurate estimate of the changes in aqueous humor TGF-β2 levels among OAG patients.
    Matched MeSH terms: Intraocular Pressure
  8. Hassan MDS, Razali N, Abu Bakar AS, Abu Hanipah NF, Agarwal R
    Exp Biol Med (Maywood), 2023 Aug;248(16):1425-1436.
    PMID: 37873757 DOI: 10.1177/15353702231199466
    Connective tissue growth factor (CTGF) is a distinct signaling molecule modulating many physiological and pathophysiological processes. This protein is upregulated in numerous fibrotic diseases that involve extracellular matrix (ECM) remodeling. It mediates the downstream effects of transforming growth factor beta (TGF-β) and is regulated via TGF-β SMAD-dependent and SMAD-independent signaling routes. Targeting CTGF instead of its upstream regulator TGF-β avoids the consequences of interfering with the pleotropic effects of TGF-β. Both CTGF and its upstream mediator, TGF-β, have been linked with the pathophysiology of glaucomatous optic neuropathy due to their involvement in the regulation of ECM homeostasis. The excessive expression of these growth factors is associated with glaucoma pathogenesis via elevation of the intraocular pressure (IOP), the most important risk factor for glaucoma. The raised in the IOP is due to dysregulation of ECM turnover resulting in excessive ECM deposition at the site of aqueous humor outflow. It is therefore believed that CTGF could be a potential therapeutic target in glaucoma therapy. This review highlights the CTGF biology and structure, its regulation and signaling, its association with the pathophysiology of glaucoma, and its potential role as a therapeutic target in glaucoma management.
    Matched MeSH terms: Intraocular Pressure
  9. Abdul Rahim A, Ismail S, Ahmad Tajudin LS, Ahmad MS
    Med J Malaysia, 2013 Aug;68(4):338-42.
    PMID: 24145263 MyJurnal
    There are limited data in the literature on the optic disc topography in normal tension glaucoma (NTG) patients in Asian countries, especially in Southeast Asia. This study is aimed at comparing optic disc topography in NTG patients and a control group in Malaysia, and we discuss the literature on NTG studies in other Asian populations. A comparative cross-sectional study was conducted in two hospitals with glaucoma services in Malaysia from November 2010 to February 2012. A total of 109 eyes of 109 Malay patients were included in this study: 32 NTG patients and 77 subjects in the control group. All participants underwent a thorough ocular examination, including visual acuity, subjective refraction, anterior segment and fundus examinations, Humphrey visual field 24-2, intraocular pressure measurement, gonioscopy examination and fundus photography. Optic disc topography was assessed using the Heidelberg Retinal Tomograph III by an identified masked investigator in each hospital. NTG patients had a notably larger disc area (2.65 (0.41) vs 2.19 (0.43) mm(2), respectively), larger cupping (1.54 (0.43) vs 0.63 (0.40) mm(2), respectively), smaller retinal rim areas (1.12 (0.41) vs 1.56 (0.33) mm(2), respectively), higher cup volume (0.47 (0.28) vs 0.11 (0.19) mm(3), respectively), reduced rim volume (0.23 (0.13) vs 0.41 (0.16) mm(3), respectively), higher cup to disc area ratio (0.58 (0.14) vs 0.27 (0.15), respectively), higher linear cup to disc ratio (0.76 (0.09) vs 0.49 (0.17) mm(2), respectively), higher mean cup depth (0.37 (0.09) vs 0.22 (0.09) mm, respectively), higher maximum cup depth (0.77 (0.16) vs 0.59 (0.20) mm, respectively), higher mean of cup shape measure (-0.04 (0.06) vs -0.16 (0.07), respectively), and thinner mean retinal nerve fibre layer thickness (0.15 (0.15) vs 0.24 (0.07) mm, respectively) compared to the control group (p<0.05). In conclusion, most of the optic disc parameters were significantly different in NTG patients compared to healthy individuals in Malaysia. Our findings are comparable to those reported in NTG studies in other Asian countries.
    Matched MeSH terms: Intraocular Pressure
  10. Diymitra, K. G., Mushawiahti, M., Aida Zairani, M. Z.
    MyJurnal
    Orbital cellulitis is a relatively common disease affecting predominantly the paediatric population. Most cases occur as a result of spread from the nearby sinuses. Other causes include penetrating trauma or extension from infected adjacent structures.If left untreated, this condition may result in devastating sequelae such as orbital apex syndrome, cavernous sinus thrombosis, meningitis, cranial nerve palsies, intracranial abscess formation and even death. A 47 year old immunocompetent Burmese lady presented with left eyelid swelling of 2 days duration associated with eye redness, blurring of vision and diplopia. Previously, there was history of right maxillary sinusitis and parapharyngeal abscess 9 months prior to presentation. On examination, she was afebrile with vision of 1/60 for the left eye with positiverelative afferent pupillary defect (RAPD). The eye was proptosed and swollen with restricted extraocular movements in all gazes. Conjunctiva was injected with chemosis and there was corneal epithelial bedewing. Otherwise anterior chamber was quiet and intraocular pressure was 51mmHg. Bilateral fundus examination was normal. Computed tomography (CT) scan of the orbit and paranasal sinus showed dense sinusitis and periosteal abscess at the lateral orbital wall.She was started on intravenous (IV) Cefuroxime and Metronidazole and underwent Functional Endoscopic Sinus Surgery (FESS) and orbital decompression. Intra-operatively there was pus and debris at the left anterior ethmoid, maxillary and sphenoid air sinuses and cultures revealed Klebsiella pneumoniae which was sensitive to Cefuroxime. Despite medical and surgical treatment, left orbital swelling only reduced minimally. However after starting intravenous Dexamethasone the swelling dramatically improved. She completed 10 days of intravenous Dexamethasone. Upon discharge, she was given oral Dexamethasone 2mg daily for 2 weeks and completed 2 weeks of oral Cefuroxime and Metronidazole. Intraocular pressure normalised and vision recovered to 6/9. A repeat CT orbit 3 weeks later showed resolving preseptal and periorbital collection.
    Matched MeSH terms: Intraocular Pressure
  11. Noorlaila B., Zunaina E., Raja Norliza R.O., Nor Fadzillah A.J., Alice, G.K.C.
    MyJurnal
    We report a case of dural carotid cavernous fistula (CCF) pose a diagnostic dilemma with initial symptoms of the arteriovenous shunt. A 56 year-old man presented with right eye diplopia, thensubsequently developed ptosis, congestion of conjunctiva, dilated episcleral vessels, and gradual rise in intraocular pressure. Initial diagnosis of pseudotumour was made based on negative finding of CCF by computed tomography angiography (CTA). In view of persistent clinical manifestations in spite of steroid therapy, and with the presence of new ocular signs; cock-screw conjunctival vessels, dilated retinal veins, and proptosis, digital subtraction angiography (DSA) was performed and confirmed the diagnosis of dural CCF.The ocular symptoms resolved completely post embolization of the fistula.
    Matched MeSH terms: Intraocular Pressure
  12. Vassiliev P, Iezhitsa I, Agarwal R, Marcus AJ, Spasov A, Zhukovskaya O, et al.
    Data Brief, 2018 Jun;18:340-347.
    PMID: 29896521 DOI: 10.1016/j.dib.2018.02.067
    This article contains data that relate to the study carried out in the work of Marcus et al. (2018) [1]. Data represent an information about pharmacophore analysis of imidazo[1,2-a]benzimidazole and pyrimido[1,2-a]benzimidazole derivatives and results of construction of the relationship between intraocular pressure (IOP) lowering activity and hypotensive activity of imidazo[1,2-a]benzimidazole and pyrimido[1,2-a]benzimidazole derivatives using a multilayer perceptron artificial neural network. In particular, they include the ones listed in this article: 1) table of all pharmacophores of imidazo[1,2-a]benzimidazole and pyrimido[1,2-a]benzimidazole derivatives that showed IOP lowering activity; 2) table of all pharmacophores of the compounds that showed absence of IOP lowering activity; 3) table of initial data for artificial neural network analysis of relationship between IOP activity and hypotensive activity of this chemical series; 4) graphical representation of the best neural network model of this dependence; 5) original txt-file of results of pharmacophore analysis; 6) xls-file of initial data for neural network modeling; 7) original stw-file of results of neural network modeling; 8) original xml-file of the best neural network model of dependence between IOP lowering activity and hypotensive activity of these azole derivatives. The data may be useful for researchers interested in designing new drug substances and will contribute to understanding of the mechanisms of IOP lowering activity.
    Matched MeSH terms: Intraocular Pressure
  13. Liza-Sharmini AT, Ng GF, Nor-Sharina Y, Khairil Anuar MI, Nik Azlan Z, Azhany Y
    Med J Malaysia, 2014 Dec;69(6):245-51.
    PMID: 25934953 MyJurnal
    OBJECTIVE: To compare the clinical presentation, severity and progression of primary angle closure between Chinese and Malays residing in Malaysia.

    METHODS: A comparative retrospective record review study was conducted involving one hundred (200 eyes) Malay and fifty eight (116 eyes) Chinese patients. They were selected from medical records of Hospital Universiti Sains Malaysia, Kelantan and Hospital Pulau Pinang, Penang, Malaysia. The selected patients were re-diagnosed based on the International Society of Geographical and Epidemiological classification. The clinical data on presentation including the presence of systemic diseases were documented. Progression of the disease was based on available reliable visual fields and optic disc changes of patients who have been on follow-up for at least five years.

    RESULTS: Malay patients presented at older age (61.4 years SD 8.4) compared to Chinese (60.6 years SD 8.3). There was significant higher baseline Intraocular Pressure (IOP) among Malays (34.7 SD 18.5mmHg) compared to Chinese (30.3 SD 16.7mmHg) (p=0.032). The Chinese patients presented with significantly better visual acuity (p<0.001) and less advanced cup to disc changes (p=0.001) compared to Malays. Malay patients progressed faster than the Chinese. Majority progressed within 1 year of diagnosis. Malays without laser peripheral iridotomy (LPI) have a 4 fold (95% CI 1.4, 10.9) risk of progression. Higher baseline IOP, more advanced visual field defect and absence of LPI was identified as significant predictors associated with progression.

    CONCLUSION: The Malays presented with more advanced angle closure glaucoma as compared to the Chinese in Malaysia. Aggressive disease progression was observed in Malays with the onset of optic neuropathy. Effective public awareness and aggressive management is important to prevent blindness in the Malaysian population.
    Matched MeSH terms: Intraocular Pressure
  14. Norhayaty S., Nurul Dalila M.S., Tai, Evelyn L.M., Liza Sharmini A.T., Zunaina E., Azhany Y.
    MyJurnal
    Tunnel vision is a classic sign among patients with advanced glaucoma. However, other conditions such as retinitis pigmentosa, optic neuritis and rod-cone dystrophy may be characterized by similar visual field defects. A 52-year-old lady with a family history of glaucoma presented with bilateral gradual loss of peripheral vision for two years. She claimed to have poor night vision about 20 years prior to this presentation. Her visual acuity was 6/7.5 in both eyes. The anterior chamber depth was moderate bilaterally, with Schaffer grading on gonioscopy of grade I to II. The intraocular pressure was 14 mmHg in both eyes. The optic discs appeared normal. Fundus examination showed scattered hypopigmented changes sparing the fovea. Humphrey visual field test revealed bilateral constricted visual fields. She was diagnosed with retinitis punctata albescens (RPA) based on her symptom of poor night vision, supported by the diffuse hypopigmented changes in her fundi. The management of this condition involves careful counselling regarding the genetic nature of the disease and its progressive course. We discuss this case to illustrate the importance of a thorough history taking and careful fundus examination in the workup of patients presenting with tunnel vision.
    Matched MeSH terms: Intraocular Pressure
  15. Chua PY, Day AC, Lai KL, Hall N, Tan LL, Khan K, et al.
    Br J Ophthalmol, 2018 Apr;102(4):539-543.
    PMID: 28794074 DOI: 10.1136/bjophthalmol-2017-310725
    PURPOSE: To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC).

    METHODS: Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up.

    RESULTS: There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP.

    CONCLUSION: The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.

    Matched MeSH terms: Intraocular Pressure
  16. Ong LB, Liza-Sharmini AT, Chieng LL, Cheong MT, Vengadasalam SR, Shin HC, et al.
    J Ocul Pharmacol Ther, 2005 Oct;21(5):388-94.
    PMID: 16245965
    The aim of this study was to determine the effectiveness of timolol gel-forming solution as a monotherapy and to compare the efficacy of timolol gel-forming solution morning instillation versus at night application in Asians with newly diagnosed open-angle glaucoma.
    Matched MeSH terms: Intraocular Pressure/drug effects
  17. Lam CS, Umi Kalthum MN, Norshamsiah MD, Bastion M
    Malays Fam Physician, 2018;13(3):32-37.
    PMID: 30800232
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Intraocular Pressure
  18. Chow JY, Wan Norliza WM, Bastion MC
    Med J Malaysia, 2021 03;76(2):236-240.
    PMID: 33742635
    BACKGROUND: Subliminal transscleral cyclophotocoagulation (SL-TSCPC) is a new alternative therapy to reduce intraocular pressure (IOP) safely and effectively. However, there are few studies regarding SL-TSCPC by Supra 810 laser machine and limited data regarding its effectiveness in moderate severity glaucoma that still has good preservation of vision. This study was conducted to evaluate the outcome of SL-TSPCPC in various types of glaucoma including patients with good vision.

    METHODS: A retrospective, non-comparative, analytical case series of all patients who received SL-TSCPC treatment from October 2018 to April 2019 at Hospital Tengku Ampuan Afzan, Pahang, Malaysia. Data was collected during the second week, sixth week, third month and sixth month follow-up. The primary outcome measure gave success rate at six months post-treatment. Secondary measures were changes in visual acuity, mean IOP reduction, mean number of IOP lowering medications reduced and ocular side effects noted during follow-up.

    RESULTS: The success rate was 43.8% (seven eyes out of sixteen eyes) at six months post-treatment. The mean IOP reduced from 43.0mmHg±14.8mmHg pre-treatment to 24.7mmHg±12.0mmHg at two weeks post treatment with 42.6% reduction. Subsequently, mean IOP at sixth week, third month and sixth month were 33.8mmHg±16.9mmHg, 35.2mmHg±14.9mmHg, and 29.0mmHg±16.2mmHg respectively. Vision maintained in 13 patients, two patients had improvement in vision however, five patients had deterioration in vision. No serious ocular side effects were noted.

    CONCLUSION: Subliminal TSCPC is a safe and alternative method of lowering IOP in moderate to advanced glaucoma over 6 months duration of follow-up. As it has good safety profile and repeatability, it is a good treatment option for patients with uncontrolled glaucoma.

    Matched MeSH terms: Intraocular Pressure
  19. Azmi NA, Ahem A, Mustapha M, Bastion MC
    BMJ Case Rep, 2016 Sep 28;2016.
    PMID: 27681348 DOI: 10.1136/bcr-2016-215987
    We report a case of enucleation for painful blind eye secondary to recurrent bleeding from choroidal neovascularisation in an eye that was irradiated following presumed metastatic breast carcinoma to the choroid. A 58-year-old woman with a history of treated breast malignancy presented with haemophthalmus and intractable glaucoma in the right eye. One year previously she had presented with right vitreous haemorrhage with subretinal mass that had been irradiated given her history of breast carcinoma. Following irradiation, vitrectomy was performed to clear the blood. Intraoperative and postoperative angiography findings suggested a diagnosis of breakthrough bleeding secondary to polypoidal choroidal vasculopathy. At this presentation, however, the intraocular bleeding was recurrent resulting in elevated intraocular pressure and pain. Despite repeat surgery and medical therapy, the eye had to be enucleated. Histopathology showed choroidal neovascularisation.
    Matched MeSH terms: Intraocular Pressure
  20. Lam, C.S., Umi Kalthum, M.N., Norshamsiah, M.D., Bastion, M.L.C.
    Malaysian Family Physician, 2018;13(3):32-37.
    MyJurnal
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids,
    particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent,
    and children are commonly being prescribed topical anti-inflammatories, including topical steroids,
    by general practitioners. Furthermore, topical steroids are also available over the counter, and this
    availability contributes to overuse without proper monitoring by an ophthalmologist. We present
    a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids
    among children for vernal keratoconjunctivitis. The medications were prescribed initially by general
    ophthalmologists and were continually bought over the counter by parents. At the presentation to
    our center, these patients were already compromised visually, exhibiting glaucomatous optic disc
    changes and high intraocular pressure. The series highlights the optic nerve damage resulting in
    irreversible visual compromises among children on long-term, topical steroids and the importance
    of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Intraocular Pressure
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