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  1. Singh M, Kaur B
    Int Ophthalmol, 1992 May;16(3):163-6.
    PMID: 1452420
    Postural behaviour of intraocular pressure (IOP) was studied in 29 glaucomatous eyes before and after argon laser trabeculoplasty (ALT) and compared with that of 60 normal eyes. Although argon laser trabeculoplasty was successful in lowering the IOP below 21 mm Hg, it produced little effect on the postural behaviour of the IOP. No significant change was observed in the amplitude of postural rise of IOP in ALT treated eyes.
    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  2. Teoh SL, Allan D, Dutton GN, Foulds WS
    Br J Ophthalmol, 1990 Apr;74(4):215-9.
    PMID: 2186795
    The visual acuity, the difference in sensitivity of the two eyes to light (brightness ratio), and contrast sensitivity were assessed in 28 patients with chronic open angle glaucoma and compared with those of 41 normal controls of similar ages and visual acuity. The results obtained were related to the results of Tübingen visual field analysis in patients with glaucoma. Twenty-four of the 28 glaucoma patients (86%) had a significant disparity in brightness ratio between the two eyes. This was found to match the frequency of visual field loss. Moreover, there was a significant relationship between the interocular differences in brightness sense and the difference in the degree of visual field loss between the two eyes. Of the glaucoma patients 39% had sum contrast sensitivities outside the normal range for age-matched normal controls. No significant correlation was found between the interocular difference in brightness sense and the visual acuity or the interocular difference in sum contrast sensitivity. It is concluded that, in the presence of a normal visual acuity, the brightness ratio test warrants evaluation as a potential screening test for chronic open angle glaucoma.
    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  3. Tajunisah I, Reddy SC, Fathilah J
    Graefes Arch Clin Exp Ophthalmol, 2007 Dec;245(12):1851-7.
    PMID: 17901971
    BACKGROUND: A case-controlled prospective study was conducted to evaluate the diurnal variation of intraocular pressure (IOP); the mean, the amplitude of variation and the peak and trough times of pressure readings in the suspected open-angle glaucoma patients as compared with a control group. We also looked at the outcome of these suspects after diurnal variation of IOP measurements.

    METHODS: Diurnal variation of intraocular pressure was measured in 202 eyes of suspected open-angle glaucoma patients and 100 control eyes, at 4-hourly intervals for 24 hours (phasing). Based on the phasing results, optic disc changes and visual field defects, the patients were diagnosed as primary open angle glaucoma (POAG), normal tension glaucoma (NTG), ocular hypertension (OHT), or physiologic cup (PC), or still remained as glaucoma suspects due to inconclusive diagnosis. The last group (glaucoma suspects) was then followed up 6-monthly for their eventual outcome.

    RESULTS: The highest percentage of suspected glaucoma patients had peak (maximum) readings in the mid-morning (10-11 A.M.) and trough (minimum) readings after midnight (2-3 A.M.); the highest percentage of control group had peak readings in the late evening (6-7 P.M.) and trough readings after midnight (2-3 A.M.). The mean amplitude of variance was 6 mm Hg in suspected glaucoma group and 4 mm Hg in the control group. After 'phasing', 18.8% of the suspected glaucoma patients were diagnosed as POAG, 16.8% as NTG, 5% as OHT, and 28.7% as physiologic cup; 30.9% remained as glaucoma suspects. After 4 years follow-up, 70% of the glaucoma suspects still remained as glaucoma suspects, 6.7% developed NTG and another 6.7% POAG; 16.6% were normal.

    CONCLUSIONS: Serial measurement of IOP ( phasing) in a 24-hour period is still needed, in order not to miss the peak and the trough IOP readings in suspected open-angle glaucoma patients, which helps in better management of glaucoma. Among 30.9% of patients who remained as glaucoma suspects after the initial phasing, 13.4% developed NTG/POAG over a period of 4 years.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  4. Abdullah SN, Sanderson GF, Husni MA, Maddess T
    PMID: 32034583 DOI: 10.1007/s10633-020-09750-7
    PURPOSE: To compare two forms of perimetry that use large contrast-modulated grating stimuli in terms of: their relative diagnostic power, their independent diagnostic information about glaucoma and their utility for mfVEPs. We evaluated a contrast-threshold mfVEP in normal controls using the same stimuli as one of the tests.

    METHODS: We measured psychophysical contrast thresholds in one eye of 16 control subjects and 19 patients aged 67.8 ± 5.65 and 71.9 ± 7.15, respectively, (mean ± SD). Patients ranged in disease severity from suspects to severe glaucoma. We used the 17-region FDT-perimeter C20-threshold program and a custom 9-region test (R9) with similar visual field coverage. The R9 stimuli scaled their spatial frequencies with eccentricity and were modulated at lower temporal frequencies than C20 and thus did not display a clear spatial frequency-doubling (FD) appearance. Based on the overlapping areas of the stimuli, we transformed the C20 results to 9 measures for direct comparison with R9. We also compared mfVEP-based and psychophysical contrast thresholds in 26 younger (26.6 ± 7.3 y, mean ± SD) and 20 older normal control subjects (66.5 ± 7.3 y) control subjects using the R9 stimuli.

    RESULTS: The best intraclass correlations between R9/C20 thresholds were for the central and outer regions: 0.82 ± 0.05 (mean ± SD, p ≤ 0.0001). The areas under receiver operator characteristic plots for C20 and R9 were as high as 0.99 ± 0.012 (mean ± SE). Canonical correlation analysis (CCA) showed significant correlation (r = 0.638, p = 0.029) with 1 dimension of the C20 and R9 data, suggesting that the lower and higher temporal frequency tests probed the same neural mechanism(s). Low signal quality made the contrast-threshold mfVEPs non-viable. The resulting mfVEP thresholds were limited by noise to artificially high contrasts, which unlike the psychophysical versions, were not correlated with age.

    CONCLUSION: The lower temporal frequency R9 stimuli had similar diagnostic power to the FDT-C20 stimuli. CCA indicated the both stimuli drove similar neural mechanisms, possibly suggesting no advantage of FD stimuli for mfVEPs. Given that the contrast-threshold mfVEPs were non-viable, we used the present and published results to make recommendations for future mfVEP tests.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  5. Tan HK, Ahmad Tajuddin LS, Lee MY, Ismail S, Wan-Hitam WH
    PMID: 26065503 DOI: 10.1097/APO.0000000000000058
    PURPOSE: To determine the mean central corneal thickness (CCT) and the relationship between the CCT and visual field progression in primary angle closure (PAC) and primary angle closure glaucoma (PACG).

    DESIGN: A combined cross-sectional and prospective study on PAC and PACG.

    METHODS: A total of 35 eyes were included in the study for each group of normal control, PAC, and PACG patients from eye clinics in Kota Bharu, state of Kelantan, Malaysia, from January 2007 to November 2009. The PAC and PACG patients were divided into thin and thick CCT groups. They were followed up for 12 to 18 months for visual field progression assessment with their mean Advanced Glaucoma Intervention Study (AGIS) score.

    RESULTS: The CCT was 516.8 ± 26.0 µm for PAC and 509.7 ± 27.4 µm for PACG. Both were significantly thinner compared with the control group with CCT of 540 ± 27.8 µm (P < 0.001). There was a statistically significant increase in the mean AGIS score after 12.9 ± 1.7 months of follow-up in the thin CCT group for PACG (P = 0.002). However, no significant increase in the mean AGIS score was found for the thick CCT group in PACG and for both thin and thick CCT in PAC.

    CONCLUSIONS: The PAC and PACG had statistically significant thinner CCT compared with the controls. Thin CCT was associated with visual field progression based on the mean AGIS score in PACG.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology
  6. Zhao D, Kim MH, Pastor-Barriuso R, Chang Y, Ryu S, Zhang Y, et al.
    Invest Ophthalmol Vis Sci, 2014 Oct;55(10):6244-50.
    PMID: 25183763 DOI: 10.1167/iovs.14-14151
    To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women.
    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  7. Shin HC, Subrayan V, Tajunisah I
    J Cataract Refract Surg, 2010 Aug;36(8):1289-95.
    PMID: 20656150 DOI: 10.1016/j.jcrs.2010.02.024
    PURPOSE: To evaluate changes in anterior chamber depth (ACD) and intraocular pressure (IOP) after phacoemulsification in eyes with occludable angles and compare the results with those in eyes with normal open angles.
    SETTING: Eye Clinic, Ipoh General Hospital, Ipoh, Perak, Malaysia.
    METHODS: Patients with nonglaucomatous eyes with open angles or with occludable angles were recruited. Ocular biometric measurements (ACD, axial length [AL], lens thickness and position) and IOP (tonometry) were performed preoperatively and 1 day and 1, 4, 9, and 12 weeks postoperatively.
    RESULTS: The open-angle group and occludable-angle group each comprised 35 patients. The occludable-angle group had a shallower ACD, shorter AL, thicker and relatively anterior lens position, and higher IOP preoperatively; postoperatively, there was a significant increase in ACD and a significant reduction in IOP (Popen-angle group (14.52 +/- 2.65 mm Hg) (Popen-angle group. The IOP decrease in the occludable-angle group was inversely related to the preoperative IOP (P
    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology
  8. Yip VCH, Wong HT, Yong VKY, Lim BA, Hee OK, Cheng J, et al.
    J Glaucoma, 2019 01;28(1):80-87.
    PMID: 30461553 DOI: 10.1097/IJG.0000000000001125
    AIM: To study the microvascular density of the macular and optic nerve head in healthy and glaucoma subjects using optical coherence tomography angiography.

    METHODOLOGY: We performed a cross-sectional cohort study on healthy subjects and patients with glaucoma. The AngioVue Enhanced Microvascular Imaging System was used to capture the optic nerve head and macula images during one visit. En face segment images of the macular and optic disc were studied in layers. Microvascular density of the optic nerve head and macula were quantified by the number of pixels measured by a novel in-house developed software. Areas under the receiver operating characteristic curves (AUROC) were used to determine the accuracy of differentiating between glaucoma and healthy subjects.

    RESULTS: A total of 24 (32 eyes) glaucoma subjects (57.5±9.5-y old) and 29 (58 eyes) age-matched controls (51.17±13.5-y old) were recruited. Optic disc and macula scans were performed showing a greater mean vessel density (VD) in healthy compared with glaucoma subjects. The control group had higher VD than the glaucoma group at the en face segmented layers of the optic disc (optic nerve head: 0.209±0.05 vs. 0.110±0.048, P<0.001; vitreoretinal interface: 0.086±0.045 vs. 0.052±0.034, P=0.001; radial peripapillary capillary: 0.146±0.040 vs. 0.053±0.036, P<0.001; and choroid: 0.228±0.074 vs. 0.165±0.062, P<0.001). Similarly, the VD at the macula was also greater in controls than glaucoma patients (superficial retina capillary plexus: 0.115±0.016 vs. 0.088±0.027, P<0.001; deep retina capillary plexus: 0.233±0.027 vs. 0.136±0.073, P<0.001; outer retinal capillary plexus: 0.190±0.057 vs. 0.136±0.105, P=0.036; and choriocapillaris: 0.225±0.053 vs. 0.153±0.068, P<0.001. The AUROC was highest for optic disc radial peripapillary capillary (0.96), followed by nerve head (0.92) and optic disc choroid (0.76). At the macula, the AUROC was highest for deep retina (0.86), followed by choroid (0.84), superficial retina (0.81), and outer retina (0.72).

    CONCLUSIONS: Microvascular density of the optic disc and macula in glaucoma patients was reduced compared with healthy controls. VD of both optic disc and macula had a high diagnostic ability in differentiating healthy and glaucoma eyes.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology*
  9. Kashiwagi K, Chono E, Koesters S, Yap PS
    BMC Ophthalmol, 2020 Jun 10;20(1):223.
    PMID: 32522181 DOI: 10.1186/s12886-020-01508-8
    BACKGROUND: Poor persistence with glaucoma therapy can lead to disease progression and subsequent blindness. Persistence with second-line glaucoma combination treatment in a Japanese real-world setting and whether it differed from fixed and unfixed combination drugs was investigated.

    METHODS: This was a retrospective, non-interventional, cohort study using data from a Japanese medical claims database. Patients with glaucoma aged ≥20 years with a first drug claim for glaucoma treatment between 01 July 2005 and 30 October 2014 and with data for > 6 months before and after this first prescription were included. The primary endpoint was duration of drug persistence among glaucoma patients with and without the use of fixed combination drugs in the year following initiation of second-line combination treatment.

    RESULTS: Of 1403 patients included in the analysis, 364 (25.94%) received fixed combination drugs and 1039 (74.06%) received unfixed combination drugs as second-line treatment. Baseline characteristics were generally comparable between the groups. A total of 39.01% of patients on fixed combination drugs, compared with 41.67% of patients on unfixed combination drugs, persisted on their glaucoma drugs 12 months post second-index date. Median persistence durations for the fixed combination drugs and unfixed combination drugs groups were 6 (95% confidence interval [CI]: 5-8) and 7 months (95% CI 6-9), respectively. Patients who received prostaglandin analogs (PGAs) were the most persistent with their treatment (n = 99, 12.84%). Patients diagnosed with primary open-angle glaucoma were less likely to experience treatment modification (hazard ratio [HR]: 0.800, 95% CI 0.649-0.986, P = 0.036), while those diagnosed with secondary glaucoma were more likely to experience treatment modification (HR: 1.678, 95% CI 1.231-2.288, P = 0.001) compared with glaucoma suspects.

    CONCLUSIONS: In this retrospective claims database study, the persistence rate of second-line glaucoma combination treatment was low, with no difference in persistence between glaucoma patients receiving unfixed combination drugs compared with fixed combination drugs. Patients on PGA showed greater persistence rates compared with other treatments.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology
  10. Subramaniam S, Jeoung JW, Lee WJ, Kim YK, Park KH
    Jpn. J. Ophthalmol., 2018 Nov;62(6):634-642.
    PMID: 30229404 DOI: 10.1007/s10384-018-0620-7
    PURPOSE: To compare the diagnostic capability of three-dimensional (3D) neuro-retinal rim thickness (NRR) with existing optic nerve head and retinal nerve fiber layer (RNFL) scan parameters using high-definition optical coherence tomography (HD-OCT).

    DESIGN: Retrospective study.

    METHODS: Based on the mean deviation (MD) of the Humphrey Field Analyzer (HFA), the 152 subjects were categorized into mild (MD > - 6 dB, 100), moderate (MD - 6 to - 12 dB, 26), and severe (MD glaucoma. The HD-OCT values of NRR, RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses, along with those of other parameters (rim area, disc area) were obtained, and the average NRR thickness was calculated.

    RESULTS: For all of the HD-OCT parameters, RNFL thickness showed a higher area under the ROC (AUROC) curve (range: 0.937-1.000) than did NRR thickness (range: 0.827-1.000). There were significant RNFL, NRR, and GCIPL AUROC curve differences among the mild, moderate and severe glaucoma groups. RNFL thickness for mild glaucoma showed a significantly larger area than did NRR thickness [area difference: 0.110 (± 0.025); p value glaucoma.

    CONCLUSION: RNFL thickness remains significantly better than 3D NRR thickness in terms of glaucoma-diagnostic capability in HD-OCT.

    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology
  11. Mimivati Z, Nurliza K, Marini M, Liza-Sharmini A
    Mol Vis, 2014;20:714-23.
    PMID: 24883016
    PURPOSE:
    To screen for mutations in the coding region of the myocilin (MYOC) gene in a large Malay family with juvenile-onset open angle glaucoma (JOAG).

    METHODS:
    A total of 122 family members were thoroughly examined and screened for JOAG. Venipuncture was conducted. Genomic DNA was extracted from peripheral blood leukocytes. The presence of a mutation and a polymorphism was ascertained with PCR amplification followed by the direct sequencing technique.

    RESULTS:
    Thirty-two of the 122 screened family members were identified to have JOAG (11 new cases and 21 known cases). An autosomal dominant inheritance pattern with incomplete penetrance was observed. A C→A substitution at position 1440 in exon 3 that changes asparagine (AAC) to lysine (AAA) was identified in affected family members except two probands (III:5 and IV:6). Six probands were identified as having the Asn480Lys mutation but have not developed the disease yet. An intronic polymorphism IVS2 730 +35 G>A was also identified. There was a significant association between Asn480Lys (p<0.001) and IVS2 730+35G>A (p<0.001) in the affected and unaffected probands in this family.

    CONCLUSIONS:
    The Asn480Lys mutation and the IVS2 730+35 G>A polymorphism increased susceptibility to JOAG in this large Malay pedigree. Identifying the MYOC mutations and polymorphisms is important for providing presymptomatic molecular diagnosis.
    Matched MeSH terms: Glaucoma, Open-Angle/physiopathology
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