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Paul T K Chew - One of the best experts on this subject based on the ideXlab platform.
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acute primary angle closure long term Intraocular pressure outcome in asian eyes
American Journal of Ophthalmology, 2001Co-Authors: Tin Aung, Leonard P K Ang, Siew Pang Chan, Paul T K ChewAbstract:Abstract PURPOSE: To report the long-term outcome of Intraocular pressure after laser peripheral iridotomy in Asian eyes with acute primary angle-closure. METHODS: Retrospective study of 111 eyes of 96 consecutive patients with acute primary angle-closure, presenting at the National University Hospital, Singapore, from 1990 to 1994. The presenting features of the affected eye and the treatment instituted were recorded. The subsequent long-term Intraocular pressure outcome was analyzed. An increase in Intraocular pressure on follow-up was defined as increase in Intraocular pressure greater than 21 mm Hg and requiring treatment by medication or surgery. RESULTS: The mean follow-up period was 50.3 months (range, 9 to 107 months). The mean presenting Intraocular pressure was 52.8 mm Hg (range, 28 to 80 mm Hg). One hundred ten eyes were treated with laser peripheral iridotomy, with resolution of the acute episode and Intraocular pressure less than 21 mm Hg in all eyes after laser peripheral iridotomy. Of these, only 46 eyes (41.8%) were successfully treated with laser peripheral iridotomy alone in the long term. Sixty-four eyes (58.1%) developed an increase in Intraocular pressure (requiring treatment) on follow-up, of which 49 eyes developed an increase in Intraocular pressure within the first 6 months after acute primary angle-closure. Thirty-six eyes (32.7%) eventually underwent trabeculectomy because of uncontrolled Intraocular pressure despite laser and medical therapy. CONCLUSIONS: In this study of Asian eyes, a high proportion (58.1%) of eyes with acute primary angle-closure developed an increase in Intraocular pressure on long-term follow-up after resolution of the acute attack, despite the presence of a patent laser peripheral iridotomy. These results suggest a racial difference in the outcome of laser peripheral iridotomy after acute primary angle-closure in Asians, compared with Caucasians. Because a majority of eyes that develop an increase in Intraocular pressure do so within the first 6 months of presentation, close monitoring of Intraocular pressure is advised in the follow-up of patients with acute primary angle-closure.
Arturo Chayet - One of the best experts on this subject based on the ideXlab platform.
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refractory Intraocular pressure increase after phakic posterior chamber Intraocular lens implantation
American Journal of Ophthalmology, 2002Co-Authors: Cesar A Sanchezgaleana, David Zadok, Miguel Montes, Marco A Cortes, Arturo ChayetAbstract:Abstract PURPOSE: To describe a complication resulting from the implantation of a posterior chamber Intraocular lens in a phakic eye. DESIGN: Interventional case report. METHODS: We examined a 37-year-old woman with severe myopia who had implantation of a phakic posterior chamber Intraocular lens. RESULTS: The patient developed pigmentary glaucoma with refractory increase in Intraocular pressure, despitemedical therapy and Intraocular lens removal. Trabeculectomy was required to reduce the pressure. CONCLUSION: This case demonstrates that pigmentary glaucoma secondary to implantation of a phakic posterior chamber Intraocular lens can lead to filtering surgery to decrease Intraocular pressure.
Jimmy S M Lai - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of immediate anterior chamber paracentesis in the treatment of acute primary angle closure glaucoma a pilot study
Ophthalmology, 2002Co-Authors: Dennis S C Lam, John K H Chua, Clement C Y Tham, Jimmy S M LaiAbstract:Abstract Objective To study the safety and effectiveness of immediate anterior chamber paracentesis, combined with antiglaucomatous medications, in the Intraocular pressure control and relief of symptoms of acute primary angle-closure glaucoma (PACG). Design Prospective noncomparative case series. Participants Eight consecutive patients with their first attack of acute PACG, with Intraocular pressure ≥50 mmHg, were recruited into the study. Intervention On presentation, each patient received topical pilocarpine (4%) and timolol (0.5%), immediate anterior chamber paracentesis, and systemic acetazolamide and mannitol as primary treatment. The Intraocular pressures at 15 and 30 minutes, and then at 1, 2, 3, 12, and 24 hours, were documented by applanation tonometry. Main outcome measures Symptoms, visual acuity, Intraocular pressure, corneal edema, angle status on gonioscopy, pupillary size, and reaction. Results Ten eyes of eight patients seen with acute PACG were recruited. The mean Intraocular pressure was reduced from 66.6 ± 9.1 mmHg to 15.1 ± 3.5 mmHg immediately after paracentesis, and then to 17.1 ± 7.0 mmHg at 15 minutes, 21.7 ± 10.2 mmHg at 30 minutes, 22.7 ± 11.0 mmHg at 1 hour, and 20.1 ± 14.6 mmHg at 2 hours after paracentesis. The mean Intraocular pressure was less than 21 mmHg at 2 hours and beyond. There was instant symptomatic relief for all patients. No complications from the paracentesis were encountered. Conclusions From this preliminary study, immediate paracentesis seems to be safe and effective in controlling the Intraocular pressure and eliminating symptoms in acute PACG.
Kaori Kobayashi - One of the best experts on this subject based on the ideXlab platform.
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a correlation between latanoprost induced conjunctival hyperemia and Intraocular pressure lowering effect
Journal of Glaucoma, 2011Co-Authors: Hiroshi Kobayashi, Kaori KobayashiAbstract:PURPOSE To study any correlation between a short-term change in conjunctival hyperemia severity and the Intraocular pressure-lowering effect induced by latanoprost. PATIENTS AND METHODS A 114 patients (56 females and 58 males) with open-angle glaucoma or ocular hypertension were studied. Their mean age was 60.9±15.0 years (range, 25 to 87 y). The primary outcome measure was the change in conjunctival hyperemia grade at 2 days and the change in Intraocular pressure at 6 months after the start of latanoprost administration. RESULTS Mean Intraocular pressure before and 6 months after latanoprost administration was 22.5±3.8 mm Hg and 16.5±2.9 mm Hg, respectively (P<0.0001). Mean conjunctival hyperemia grade before and 2 days after the administration of latanoprost was 0.32±0.58 and 1.74±1.11, respectively (P<0.0001). Mean change in Intraocular pressure was -1.7±1.2 mm Hg (-6.6±5.1%) in eyes with no hyperemia grade change, -5.2±2.2 mm Hg (-21.5±7.6%) in eyes with a hyperemia grade change of 1, -7.3±2.8 mm Hg (-32.0±8.9%) in eyes with a change of 2, and -10.8±2.7 mm Hg (-46.1±8.6%) in eyes with a change of 3 or 4 (P<0.0001). There was a significant correlation between Intraocular pressure change and hyperemia grade change (Intraocular pressure: r=0.535, P=0.0001; percent of Intraocular pressure: r=0.755, P=0.0001). CONCLUSION A statistically significant correlation was found between a change in Intraocular pressure and conjunctival hyperemia severity induced by latanoprost.
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a comparison of Intraocular pressure lowering effect of prostaglandin f2 alpha analogues latanoprost and unoprostone isopropyl
Journal of Glaucoma, 2001Co-Authors: Hiroshi Kobayashi, Kaori Kobayashi, Satoshi OkinamiAbstract:PURPOSE To compare the Intraocular pressure-lowering effect of unoprostone isopropyl (unoprostone) 0.12% and latanoprost 0.005%. A correlation between the Intraocular pressure-lowering effect of unoprostone and latanoprost was also evaluated. METHODS A single-masked randomized study included 18 patients between 49 and 68 years (mean, 60.7 +/- 5.1 years) with an Intraocular pressure of both eyes from 21 to 27 mm Hg. The patients were prospectively randomized to receive latanoprost in the right eye and unoprostone in the left eye, or unoprostone in the right eye and latanoprost in the left eye. The patients were followed up for 8 weeks. This study evaluated the Intraocular pressure-lowering effect and incidence of drug-related side effects. RESULTS Mean baseline Intraocular pressure was 22.8 +/- 1.2 mm Hg in latanoprost-treated eyes and 22.4 +/- 1.0 mm Hg in unoprostone-treated eyes; there was no statistically significant difference between these groups. Mean Intraocular pressure at 8 weeks after the start of the administration was 16.7 +/- 2.0 mm Hg in latanoprost-treated eyes and 19.0 +/- 1.5 mm Hg in unoprostone-treated eyes. Patients in the latanoprost-treated group showed a greater Intraocular pressure reduction compared with those in the unoprostone-treated group. Mean Intraocular pressure changes in latanoprost-treated eyes were significantly greater at every visit (P < 0.0001). A change of Intraocular pressure at 8 weeks in the latanoprost-treated eyes was significantly correlated with that in the contralateral unoprostone-treated eyes (r = 0.665, P = 0.0013) (Figure). There was no significant difference in the rate of ocular side effects between latanoprost- and unoprostone-treated eyes. CONCLUSIONS Latanoprost appears to have a more beneficial effect for Intraocular pressure control compared with unoprostone. An Intraocular pressure reduction in the latanoprost-treated eyes was significantly correlated with that in the contralateral unoprostone-treated eyes. There was no significant difference in the incidence of ocular side effects between both drugs. Further investigation using more cases and longer follow-up periods are needed.
Robert N. Weinreb - One of the best experts on this subject based on the ideXlab platform.
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optic disk topography after medical treatment to reduce Intraocular pressure
American Journal of Ophthalmology, 2000Co-Authors: Christopher Bowd, Robert N. Weinreb, Brian L Lee, Alireza Emdadi, Linda M. ZangwillAbstract:Abstract PURPOSE: We examined changes in optic disk topography using confocal scanning laser ophthalmoscopy after reducing Intraocular pressure with administration of latanoprost. METHODS: Twenty-nine patients with glaucoma or ocular hypertension were imaged using the Heidelberg Retina Tomograph before and after the administration of latanoprost to decrease Intraocular pressure. Average time between pretreatment and posttreatment imaging was 2.7 ± 1.8 weeks. Heidelberg Retina Tomograph software–measured parameters were mean height of contour, cup area, cup volume, mean cup depth, maximum cup depth, cup shape, rim area, rim volume, cup-to-disk ratio, and retinal nerve fiber thickness. RESULTS: Average Intraocular pressure decreased significantly (mean ± SD) by 7.2 ± 5.4 mm Hg (25 ± 16% decrease). No statistically significant changes in measured topographic parameters were found. When data from patients with decreases in Intraocular pressure of 7 mm Hg or greater were analyzed separately (mean Intraocular pressure decrease=10.79 ± 4.32 mm Hg, 36 ± 8% decrease), cup area ( P = .005), cup volume ( P = .002), and cup-to-disk ratio ( P = .005) decreased significantly, and rim area ( P = .005) increased significantly. Linear regression analysis of the data from all subjects showed that a change in Intraocular pressure after latanoprost administration accounted for 12% or more of the variance in two measured topographic parameters (mean cup depth and cup shape). CONCLUSIONS: These results suggest that, in some patients, moderate decreases in Intraocular pressure may affect disk topography, as measured by Heidelberg Retina Tomograph. Intraocular pressure should be considered when analyzing consecutive confocal scanning laser ophthalmoscopy images for glaucomatous progression.
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change in optic disk topography after trabeculectomy
American Journal of Ophthalmology, 1996Co-Authors: Inci Irak, Linda M. Zangwill, Valerie Garden, Sima Shakiba, Robert N. WeinrebAbstract:Purpose To investigate the relationship between optic disk topography and Intraocular pressure before and after trabeculectomy with confocal scanning laser ophthalmoscopy. Methods The eyes of 49 consecutive patients undergoing trabeculectomy at a university-based glaucoma practice underwent preoperative and postoperative imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph). Three images of one eye of each patient were obtained with a 15-degree field of view. Preoperative images were obtained approximately 2 months before surgery (mean ± SD, 2.4 ±1.6 months). Postoperative images were obtained at least 3 months after surgery (mean, 4.5 ± 2.6 months). Results Mean preoperative Intraocular pressure, postoperative Intraocular pressure, and percent change in Intraocular pressure respectively were 23.1 ± 6.8 mm Hg, 12.7 ± 7.1 mm Hg, and 43.8% ± 29.9%. A significant association (P 2 ) in these parameters was explained by the percent change in Intraocular pressure. Topography changes were more strongly associated with percent change than with mean change in Intraocular pressure. We found no association between percent decrease in Intraocular pressure and reference plane height or maximum cup depth. Conclusions Changes in optic nerve topography were associated with reduction in Intraocular pressure after trabeculectomy.
