Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:2.6.1.2 (alanine aminotransferase)
26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using the now well established technique ALT is a safe and effective means of lowering IOP in eyes with POAG, pigmentary glaucoma, and exfoliative glaucoma though the effect diminishes with time. Pressure reduction with ALT is seldom greater than 30% and eyes with an IOP of more than 28 mm Hg are unlikely to be controlled for any length of time without additional treatment. ALT is probably most suitable either for older patients whose glaucoma is not well controlled on medical treatment, or for patients with newly diagnosed open angle glaucoma, but without advanced field loss, as a primary treatment or in combination with a non-miotic topical medication. In many it will defer surgery, in some indefinitely.
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PMID:Laser trabeculoplasty. 142 46

In group of 202 eyes in 125 patients with primary open-angle glaucoma with an observation period from 12 to 66 months (32.6 z 4.8 months) the effectiveness of ALT was analyzed in relation to the time factor. The reduction of the intraocular pressure was statistically significant and treatment was successful when the intraocular pressure was reduced beneath 2.66 kPa (20 mm Hg) in 64.4%. Changes of the visual field developed in 23.3% and the efflux rate increased by 28.6%. The authors compared also the effectiveness of two methods, 180 degrees ALT 1.0 W and 180 degrees ALT 0.5 W which did not differ significantly.
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PMID:[Argon laser trabeculoplasty--5 years' experience]. 152 94

This study demonstrates that ALT can provide a 5-year benefit to around one third of patients with glaucoma sufficiently severe and uncontrolled that filtration surgery is considered advisable. Whether or not this conclusion can be generalized to patients with earlier stages of glaucoma or better IOP control cannot be stated.
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PMID:Argon laser trabeculoplasty controls one third of patients with progressive, uncontrolled open-angle glaucoma for five years. 180 15

The role of repeat argon laser trabeculoplasty (RALT) in the management of open-angle glaucoma is controversial. To determine the long-term efficacy of RALT, the authors reviewed case records of 44 patients (50 eyes) who received RALT for uncontrolled glaucoma at the Wills Eye Hospital before 1986. Success was defined as a 3 mmHg or greater decrease in intraocular pressure (IOP) to less than 22 mmHg, and no further surgical intervention. By life table analysis, RALT was successful in 35% of eyes at 6 months, in 21% at 12 months, in 11% at 24 months, and in 5% at 48 months. Thirty-three percent of eyes in which primary ALT was successful for 1 year were successful 12 months after RALT. Complications included IOP spikes in 12%. In conclusion, RALT was generally not effective for long-term control of open-angle glaucoma, but may be useful as a temporizing measure. However, this use of RALT must be weighed against the risks of complications and the additional progression of disease before more definitive surgical intervention.
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PMID:Long-term efficacy of repeat argon laser trabeculoplasty. 189 Dec 14

A review of the relevant literature strongly suggests that several medical and laser treatments presently used in glaucoma therapy, and other potential treatments under investigation, reduce IOP, at least, in part, by stimulating endogenous PG synthesis. There are four lines of evidence leading to this conclusion. (1) PGs are potent ocular hypotensive agents. (2) Adrenergic and cholinergic agonists stimulate PG synthesis by ocular tissues in vitro. (3) Epinephrine and ALT cause elevation of PG levels in the aqueous humor in vivo. (4) PG synthesis inhibitors such as indomethacin or flurbiprofen block, or partially inhibit, the reduction of IOP produced by epinephrine, para-aminoclonidine, forskolin, vanadate, verapamil, arachidonic acid, and ALT in rabbits, cats, monkeys, and/or humans. This last finding has great clinical importance with regard to the efficacy of such treatment modalities as epinephrine and ALT, since it indicates that these modalities may be less effective in reducing IOP in glaucoma patients who are taking systemic PG synthesis inhibitors - such as aspirin or indomethacin - for arthritis, cerebrovascular disease, arteriosclerotic coronary vascular disease, headache, or the common cold. Other surgical procedures for glaucoma such as cyclocryotherapy or other cyclodestructive procedures may also reduce IOP in part by stimulating local PG synthesis. Since PGs are produced in various ocular tissues and some of these PGs are highly potent ocular hypotensive agents, their potential role in mediating the reduction of IOP produced by medical or surgical modalities of glaucoma therapy must always be considered. Furthermore, these considerations support the concept that topical application of an appropriately selected PG, or its derivative, may provide a more direct means of lowering IOP than some of the currently used procedures or therapeutic agents.
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PMID:The role of endogenous prostaglandins in clinically-used and investigational glaucoma therapy. 250 30

Authors refer one-year-results of their original modification of the partial trabeculoplasty using the argon laser Britt 152 in the treatment of the primary open-angle glaucoma. In 48 eyes of 35 patients the laser trabeculoplasty (ALT) was performed, using parameters 50 microns, 750-100 mW, 0.1 sec, 120 degrees of circumference of the anterior chamber angle. Influence of ALT on the compensation of the intraocular pressure and visual functions were followed in week intervals (1.5, 6-15, 16-25, 25-35, 36-45, 46-55, 56-70) after the performed ALT. The mean decrease of the intraocular pressure was 8.4 mmHg (1.12 kPa), the mean success was in 87%.
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PMID:[Partial trabeculoplasty using the argon laser in the microsurgery of glaucoma]. 271 14

Long-term follow-up findings after argon laser trabeculoplasty are communicated. The coagulation technique employed was that described by Wise and Witter (1979). The circumference of the chamber angle was coagulated over 360 degrees. The indications were chronic open-angle glaucoma, pseudoexfoliation glaucoma, pigmentdispersion glaucoma, glaucoma in aphakia, and glaucoma after ALT or fistulizing surgery with uncontrolled IOP. Glaucoma cases in which IOP exceeded 35 mm Hg were not treated by this method. Therapy was considered successful if a decrease in IOP to below 20 mm Hg was achieved. The difficulties of finding appropriate parameters for the success of glaucoma therapy are discussed. The percentages of normotonic eyes after ALT with a follow-up period of one to four years are reported and compared with results obtained by other authors. After one year, IOP was normal in 89.9% of 881 eyes (chronic open-angle glaucoma 94%, pigment-dispersion glaucoma 91%, pseudoexfoliation glaucoma 86%, glaucoma in aphakia 88%). After two years, it was normal in 72.6% of 237 eyes (chronic open-angle glaucoma 82%, pigment-dispersion glaucoma 50%, pseudoexfoliation glaucoma 53%, glaucoma in aphakia 75%). After three years, it was normal in 60.5% of 76 eyes (chronic open-angle glaucoma 72%, pigment-dispersion glaucoma 25%, pseudoexfoliation glaucoma 37%, glaucoma in aphakia 66%). After four years, it was normal in 95.4% of 128 eyes (chronic open-angle glaucoma 82%, pseudoexfoliation glaucoma 50%). The results of ALT therapy reported by other authors are similar. A decrease in efficiency, initially of 5% to 10% per year, is seen in eyes thus treated, which may necessitate fistulizing surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Long-term results following argon laser trabeculoplasty]. 322 53

Argon laser trabeculoplasty was performed in 71 eyes with complicated forms of open-angle glaucoma and insufficiently regulated intraocular pressure. The follow-up time was 18 +/- 6 months. The success rate was 35% in the group with secondary forms of glaucoma (37 treated eyes). Depending on the special indication a great difference in the subgroups was noted: the ALT failed in 4 cases of glaucoma after trauma, but was successful in 45% of all cases of aphakic glaucoma. Thirty-four eyes were treated by ALT after trabeculectomy had failed. The success rate in this group was 71%.
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PMID:[Argon laser trabeculoplasty in special forms of open-angle glaucoma]. 365 12

We have compared long-term intraocular pressure control in patients with open angle glaucoma, cupping and atrophy of the optic nerve head and visual field loss as well as cataract after: trabeculectomy posterior to the scleral spur and cataract extraction without implantation in 108 patients. guarded posterior lip sclerectomy, cataract extraction and Mark VIII or Mark IX anterior chamber implantation in 28 patients. argon laser trabeculoplasty followed by lens extraction and implantation in 27 patients. Approximately 75 per cent of patients achieve intraocular pressures of 18 mm Hg or less without medication after (a), and approximately 40 per cent of patients achieve similar control without medication after (b). Approximately 25 per cent of these glaucoma patients have intraocular pressure levels of less than or equal to 18 mm Hg on topical medication three months after ALT, and none achieve this control without medication. Cataract surgery with anterior or posterior chamber implantation caused loss of topical control in four of the seven patients benefiting from ALT. These data imply that combined surgery with or without implantation produces better and more significant intraocular pressure control than the presently utilized techniques of ALT subsequently followed by lens extraction and implantation.
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PMID:Laser trabeculoplasty and cataract surgery. 385 41

On 210 glaucomatous patients (119 men, 91 women), 390 eyes with open angle chronic glaucoma, we have performed an argon laser trabeculoplasty according to Wise technique (360 degrees in one time). ALT was presented as an alternative to surgery. Therefore results were appreciated so that ALT allowed or not to avoid surgery. After one year, the rate of failures was: on all the 390 eyes: 15 p. cent on O.A.C.G. simplex: 6.7 p. cent on myopic glaucoma: 7 p. cent on pigmentary glaucoma: 29.5 p. cent on capsular glaucoma: 6 p. cent after trabeculectomy: 62 p. cent on aphakic glaucoma: 50 p. cent on secondary glaucoma: 33 p. cent on combined glaucoma: 0 p. cent In the group of successful results, ALT allowed to lower medical treatment in at less 70 p. cent after one year of follow-up except for pigmentary glaucoma where, in almost all cases, medication before ALT had to be continued.
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PMID:[Results 1 year after trabeculoretraction by 360 degree argon laser in the treatment of open-angle glaucoma]. 399 4


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