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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Alterations of the retinal nerve fiber layer occur as a result of diseases affecting the anterior visual pathway. Optimal viewing conditions, familiarity with the appearance of the normal nerve fiber layer, precise focus, and a high index of suspicion are necessary for the ophthalmoscopic observation of pathologic alteration in the nerve fiber layer. The observer must learn to differentiate pseudodefects (reflexes) from true defects (areas of nerve fiber layer atrophy). Nerve fiber layer changes appear ophthalmoscopically as generalized attrition, slit defects, sector defects (all types of atrophic change), or changes in the appearance of the nerve fiber layer itself. These alterations, which occur in numerous conditions including congenital hemianopia, ocular hypertension and glaucoma, multiple sclerosis, acute Leber optic neuropathy, trauma, severe hypertension, congenital and heredity optic atrophy, toxic amblyopia, papilledema, retinochoroiditis, and following photocoagulation, may be of critical diagnostic importance.
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PMID:Ophthalmoscopic observation of the retinal nerve fiber layer. 92 96

A retrospective study of 45 patients with low-tension glaucoma revealed the mean age at diagnosis to be 66 years. Seventeen patients had follow-up visual field examinations, the average follow-up period being 6.4 years. There was no significant difference in prognosis of the ocular course between patients with Po/C equal to or greater than 100 and those with Po/C less than 100. The presence of splinter hemorrhages at the optic disk (10% of affected eyes) or of systemic arterial hypertension (diastolic blood pressure greater than 100 mm Hg) was associated with progression of visual field defects. Patients with sudden visual loss or associated hemodynamic events (33% of the total patients) had a more favorable prognosis regarding stability (lack of progression) of visual field defects than those without such an event. Extension of visual field defects across the macula was a common finding (25% of affected eyes). No firm evidence was obtained to indicate that treatment of the low-tension glaucoma improved the prognosis of the ocular course.
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PMID:Low-tension glaucoma. 93 30

Intraocular lesions occurred in 55 of 70 sarcoidosis patients (78.6%) and their intraocular findings were biomicroscopically analyzed. Intraocular lesions were observed bilaterally in 54 of 55 patients (98.0%) and these various lesions occurred simultaneously or within a short period in almost all tissues of the eyeball. From these characteristics a new attempt was made to correlate the presence of sarcoidosis with intraocular findings. A gross positive correlation was revealed between the number of active intraocular lesions and the presence of sarcoidosis. Four to six active, bilateral intraocular lesions were found only in sarcoidosis. Although the correlation was not statistically tested, it should be clinically very useful in managing patients with suspicious intraocular lesions. Among the causes of visual disturbances secondary glaucoma was the most frequent. In 41 (37.2%) eyes various degrees of intraocular hypertension were observed. Impairment of aqueous outflow due to nodular infiltration of trabeculae was the fundamental mechanism in the rise of intraocular pressure. It should be emphasized that this peculiar trabecular finding can be identified only by a trained ophthalmologist and is very frequent in and characteristic of ocular sarcoidosis.
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PMID:Ocular sarcoidosis: evaluation of intraocular findings. 106 30

For up to one year, 22 patients with occular hypertension or glaucoma wore a seven-day sustained release device (Ocusert) containing pilocarpine with acceptable retention and no important side-effects. Comparison of prestudy medical regimens using eye drops with those defined as minimum controlling concentrations indicated a high rate of over-medication. The hypotensive effect of two Ocusert strengths was compared to four pilocarpine drop concentrations. Concurrent administration of epinephrine drops did not interfere with Ocusert action and had the anticipated additive effect. Further study indicated the need for continuous wearing and delimited the effective duration of action for single Ocuserts to seven days.
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PMID:Pilocarpine ocuserts. Long-term clinical trials and selected pharmacodynamics. 123 81

The decays in the applanation pressures of both eyes, after a reduction of the aqueous secretion by means of intravenous acetazolamide, are studied with respect to shape and steepness by comparison with reference curves calculated from different values of the facility of aqueous outflow. The pressure decays in three out of four eyes with narrow-angle glaucoma exhibited "breaks" possibly resulting from a stepwise reopening of the chamber angle during the decompression. Twenty patients with intraocular hypertension and open angles could be divided into two groups according to the facility of aqueous outflow (in mul mmHg-1 min-1), estimated from approximately matching reference curves: Nine patients with facilities above 0.15 had normal visual fields and nearly indentical pressure curves of the two eyes. Out of 11 patients with facilities below 0.15, seven patients had glaucomatous visual field defects and excavated optic discs. The pressure curves of eye pairs in this low facility group showed asymmetry, and breaks were seen in approximately half of the curves. These might be caused by changes in the outflow facility due to a decompression of collapsed outflow channels. However, the morphological basis for such an interpretation is not as well founded as in the case of narrow-angle glaucoma.
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PMID:The immediate response in applanation pressure to intravenous acetazolamide in primary glaucomas and glaucoma suspects. 124 76

Pattern electroretinogram (PERG) combined with visual evoked potential (VEP) has become increasingly useful in clinical assessment of the anterior visual pathways. In regard to the PERG dependence on ganglion cell activity, we studied monocular PERG in 36 patients (71 eyes) with intraocular hypertension (6 eyes under topical beta-blockers) and in 10 patients (18 eyes) with advanced glaucoma, to estimate the potential effect of increased IOP on ganglion cells. We recorded simultaneous VEP to evaluate the retino-cortical conduction time. Referring to normal values obtained from 19 eyes (12 subjects), we found clear-cut PERG abnormalities in 20 eyes among ocular hypertensive patients with increased IOP. They were more altered in the advanced glaucomatous group. Two or three control exams were performed in 10 patients every 6 months: however such a short-time follow-up seems too limited to define the ERG prognosis value in this pathology. Comparing the PERG with the clinical routine assessments, we discuss its place in the diagnosis and in the follow-up of patients with ocular hypertension.
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PMID:Contribution of pattern electroretinogram and pattern visual evoked potential in early diagnosis of primary open angle glaucoma. 129 20

Expulsive choroidal haemorrhage is a dramatic and serious complication of cataract surgery that occurred in five patients out of ten thousand consecutive cataract surgeries performed by the author during the year 1989 and 1990. Report about this dreaded complication after cataract surgery are scanty and as far as I can remember I have not seen any report in Indian ophthalmic literature recently. Since cataract surgery forms the major part of intra ocular surgeries performed in our country, I thought it would be appropriate to report about this rare complication which may occur to all of us. Out of five cases 3 were males and 2 were females in the age group ranging between 45-72 years. Two eyes regained vision up to 6/12 after intra operative expulsive haemorrhage. All the eyes were salvaged by doing anterior sclerotomy. Diabetes, hypertension, glaucoma and myopia are the commonest predisposing factors.
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PMID:Expulsive choroidal haemorrhage. 130 Feb 98

To investigate the risk factors for glaucoma, we reviewed the clinical record of 361 primary open-angle glaucoma (POAG) patients, 178 ocular hypertensives (OH), and 927 controls without POAG or OH, randomly selected from an urban medical center eye clinic. Old age defined as > or = 55 year, (odds ratio ratio (OR) = 3.13 95% confidence interval (CI): 2.06-4.76, P < .0001), black race (OR = 2.58, 95% CI: 1.79-3.74, p < .0001), hypertension (OR = 1.709, 95% CI: 1.15-2.51, P < .0108), and diabetes mellitus (OR = 1.83, 95% CI: 1.08-3.09, P = .0308) were identified as significant risk factors in POAG compared to OH. Old Age (OR = 4.94, 95% CI: 3.62-6.76, p < .0001), and black race (OR = 2.04, 95% CI: 1.59-2.61, P < .0001), HTN (OR = 1.63, 95% CI: 1.26-2.11, P = .0002), and DM (OR = 1.40 95% CI: 1.02-1.92 P = .0450) were also significant risk factors when compared to normal controls. However, when the 361 POAG patients were compared to 361 controls matched with respect to age, race, and sex, hypertension and diabetes mellitus did not appear to be independent risk factors. Family history of glaucoma was found to be a risk factors more significantly for OH (OR = 6.79, 95% CI: 4.39-10.50, P < .0001) than for POAG (OR = 2.83, 95% CI: 1.90-4.21, P < .0001) compared to the matched control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Glaucoma risk factors in primary open-angle glaucoma patients compared to ocular hypertensives and control subjects. 130 52

Since some authors have considered useless a differentiation between hemicentral retinal vein occlusion (HCRVO) and hemispheric retinal vein occlusion (HSRVO), we have conducted a prospective research in order to evaluate the clinical and prognostic features of these diseases. We have followed prospectively 26 cases of HCRVO and 25 cases of HSRVO. The most important risk factors were hypertension, diabetes mellitus and glaucoma in HCRVO, and hypertension in HSRVO. In the HCRVO group 20 cases (76.9%) were of the non-ischemic type and six cases (23.1%) were ischemic-type, whereas in the HSRVO seven (28%) were non-ischemic type and 18 cases (72%) were ischemic-type. Our results demonstrate that the two retinal vein occlusions are quite different with regards to pathogenesis, clinical evolution and visual outcome and point out the necessity to achieve a precise diagnosis.
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PMID:Hemicentral and hemispheric retinal vein occlusions. 130 8

Aqueous humor flow was calculated during day-time in 148 healthy volunteers and 75 older patients using the Fluorotron Master II anterior chamber protocol (Coherent, Palo Alto, USA). Healthy volunteers as well as patients had no history of ocular pathology, surgery or laser treatment. Slitlamp examination revealed no ocular pathology. Hypertension, diabetes, local and systemic drug therapy, neoplasia, kidney or liver disease, contact lens and ocular trauma were excluded. Mean age of volunteers was 26.5 +/- 3.8 years; age of patients: 65.5 +/- 10.5 years. Aqueous humor flow during day-time in healthy volunteers in the OD: (mean +/- s.d.) 2.26 +/- 1.0 microliters/min, in the OS: 2.17 +/- 1.0 microliters/min, OS: 1.86 +/- 1.1 Ml/min. Correlation coefficient: r = 0.8. The mean aqueous humor flow in the older patients during day-time: OD: 1.91 +/- 1.1 microliters/min. Correlation coefficient: r = 0.54. The Mann-Whitney-U-test revealed a significant difference when comparing the right eyes of healthy volunteers with the right eyes of patients (p < 0.01). When comparing all left eyes the difference is also significant (p = 0.01). The results of the study underline, that the mean aqueous humor secretion does significantly decrease with age. However, the data show that there is only a slight decrease of flow of approximately 2.5% per decade. From the clinical point of view it should be concluded, that although the aqueous humor secretion does decrease with age, this is not of clinical importance, even in cases of glaucoma surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does aqueous humor secretion decrease with age? 142 63


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