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

The author presents the up-to-date opinions on the problem of "normal" intraocular pressure connecting it with another hydro- and haemodynamic parameters of the eye. Subsequently he discusses the contradictory opinions whether one has to distinguish two clinical conditions: intraocular hypertension and the initial period of open angle glaucoma. According to the author the initiation of the ++anti-glaucoma treatment should be considered individually in each particular case but before the onset of changes at the fundus and before the impairment of the visual field.
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PMID:[Problems of intraocular pressure and the early period of primary open-angle glaucoma]. 187 Feb 97

Values of plasma free cortisol (not bound to plasma proteins), total plasma cortisol, and percent free cortisol were determined in normal, ocular hypertensive, and open angle glaucomatous subjects. Median total plasma, plasma free, and percent free cortisol levels were higher in ocular hypertensive and glaucomatous individuals. The most significant differences occurred with percent free cortisol values between normal and glaucomatous subjects. There was a significant positive correlation between percent free cortisol and total cortisol levels in normal subjects only. For subjects with glaucoma and hypertension, the percent free cortisol values were independent of the total cortisol values. Multilinear regression analysis also indicated that besides diagnosis and level of total plasma cortisol, male sex, blood sampling late in the day, and increased diastolic blood pressure were the only variables significantly related to increased values of plasma free cortisol and percent free cortisol. Ocular medication for glaucoma and use of beta-blockers were not found to be significant independent variables in the regression models for either plasma free cortisol or percent free cortisol. These observations further suggest that a disorder of the pituitary adrenal axis and/or a binding of plasma cortisol is associated with ocular hypertension and open angle glaucoma.
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PMID:Increased plasma free cortisol in ocular hypertension and open angle glaucoma. 288 54

Levobunolol is a potent non-selective beta-adrenoceptor blocking agent used for the topical treatment of increased intraocular pressure in patients with chronic open angle glaucoma or ocular hypertension. In comparative studies of up to 2 years' duration levobunolol 0.5 to 1% reduced intraocular pressures by about 30% and adequately controlled intraocular hypertension in 50 to 85% of those treated. These results were significantly superior to those produced by placebo and comparable to the responses achieved with ocular timolol in double-blind controlled trials. Levobunolol has been well tolerated, producing only minor changes in objective and subjective ophthalmic and systemic parameters. Adverse reactions resulted in approximately 5% of patients withdrawing from treatment with levobunolol which was equivalent to that observed with timolol. Thus, ocular levobunolol is a well-tolerated and effective therapy for the management of raised intraocular pressure, and is a suitable alternative to ocular timolol in patients with chronic open angle glaucoma or ocular hypertension.
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PMID:Ocular levobunolol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. 289 62

Argon laser trabeculoplasty (ALT) has recently become one of the most popular procedures in the treatment of chronic open angle glaucoma. Although ALT is quite efficient, its mode of action is far from understood and the rate of complications or side effects is not negligible. In 1981 we began exploring a different procedure that we have called argon laser gonioretraction (ALG) with reference to the Cairns surgical goniospasis. While the corneo-scleral trabeculum is the target for argon laser beams in ALT, in ALG the beams are directed toward the ciliary band in an attempt to get the scar to pull the scleral spur backwards and stretch the trabeculum. The procedure may also act through the uveal trabeculum. The procedure was first utilized from 1981 to 1983 in 43 chronic open angle glaucoma eyes with: 1/ a high rate of success in decreasing the intraocular pressure on a long term basis, 2/ an acceptable rate of complications. 18 months after laser surgery, intraocular pressure was fully controlled without any medical treatment in 19 cases (44%). 18 additional cases (42%) were controlled with the help of less medical treatment than before. In 4 cases (8%) the failure was complete including one case with significant prolonged and non-responsive post-op hypertension which has induced a slight alteration of the visual field. One case was lost to follow-up. Supposed advantages of ALG over ALT are: integrity of the corneo-scleral trabeculum is maintained, goniosynechiae are more peripheral, and there is less propensity to induce proliferation of endothelial cells.
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PMID:[Gonioretraction using argon laser]. 399 5

The prevalence of glaucoma and ocular hypertension was investigated in an epidemiological study of diabetics traced by registration of prescriptions on insulin and oral hypoglycaemic agents (OHA) on the island of Falster (inhabitants 44 498), Denmark. Among 533 diabetics (227 insulin- and 306 OHA-treated) the prevalence rate of primary open angle glaucoma and ocular hypertension was 6.0% and 3.0%, respectively. Neovascular glaucoma occurred in 2.1% of all diabetics and in 21.3% of diabetics with proliferative retinopathy. Open angle glaucoma was more prevalent (P less than 0.01) in type 2 diabetes mellitus compared with type 1 diabetes mellitus. No difference in the prevalence of neovascular glaucoma was found between type 1 and type 2 diabetics. The occurrence of open angle glaucoma correlated positively (P less than 0.01) to the current age (greater than 65 years) in both groups and the diabetes onset age (greater than 40 years) in insulin-treated diabetics. Neovascular glaucoma correlated positively (P less than 0.05) with diabetic macrovascular complications in total (myocardial infarction, ischemic heart disease, arterial hypertension, cerebrovascular stroke, gangrene/amputation), neuropathy and severe microvascular complications (proliferative retinopathy, retinovascular occlusion). Diabetics with open angle glaucoma and ocular hypertension showed a higher frequency (P less than 0.05) of ischemic heart disease, arterial hypertension and retinovascular occlusion compared with diabetics without glaucoma or ocular hypertension.
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PMID:The prevalence of glaucoma and ocular hypertension in type 1 and 2 diabetes mellitus. An epidemiological study of diabetes mellitus on the island of Falster, Denmark. 663 28

It is the object of this paper to familiarize the ophthalmologist with some modern epidemiological techniques and to present examples of their application to a consideration of the influence of the level of intraocular pressure on the development of the type of visual field loss characteristic of primary open angle glaucoma. Epidemiological methods are particularly required in chronic multifactorial diseases such as primary open angle glaucoma and arterial hypertension to obtain reliable guidance on practical measures for their treatment or control. Two basic requirements are reliable uniform data suitable for computer manipulation and epidemiological methods to exploit the data and yield conclusions as free of bias and confounding as possible. An example of a glaucoma data base is described and types of enquiry and the importance of standardising prevalence estimations are discussed. Analyses by the four-fold table, risk ratios, the effect of stratification, sensitivity, specifity and the decision curve are described. Attributable risk (potential for prevention) is indicated as yielding information suitable for public health programmes. The life table method is described when relating initial observations to subsequent progressive visual field loss. The factors to be considered in epidemiological work generally and the inferences concerning the early diagnosis of primary open angle glaucoma are discussed.
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PMID:[Intraocular pressure and primary open-angle glaucoma. Epidemiologic technics in practice]. 672 50

Fifty-eight patients with intraocular hypertension or primary open angle glaucoma participated in a double masked randomized study. Timolol in concentrations 0.25% and 0.5% was compared with 1, 2, or 4% pilocarpine Acetazolamide (250 mg x 3) was added if intraocular pressure (IOP) was uncontrolled with the highest concentrations tested. No statistical difference was found in hypotensive effect between pilocarpine and timolol neither on ocular hypertensions nor glaucomas. The additive hypotensive effect of acetazolamide was the same for both substances. Once a day by administration of timolol was sufficient in 17 of 20 cases controlled merely by topical administration.
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PMID:Timolol versus pilocarpine separately or combined with acetazolamide-effects on intraocular pressure. 701 Aug 86

Transient and steady state VER's before and after artificial IOP elevation were recorded from 16 eyes (9 persons) with untreated intraocular hypertension observed for several years without signs of functional loss or optic disc changes. Four eyes (two patients) demonstrated a pathological transient VER amplitude drop after pressure increase. One eye with an ophthalmoscopically atypical disc presented a grossly deformed transient VER at the habitual pressure level; the fellow eye was lost from trauma. Another eye presented an abnormal VER pattern and showed as yet normal function and ophthalmoscopy, the fellow eye had developed open angle glaucoma and showed identical VER changes. The prognostic and diagnostic implications are briefly discussed.
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PMID:VER in intraocular hypertension. Short communication. 733 78

The effects of the angiotensin converting enzyme (ACE) inhibitor captopril (SQ 14225) on intraocular pressure (IOP) were studied. Four groups were analyzed: group A, ten control subjects; group B, ten hypertensive patients with normal IOP; group C, ten normotensive patients with primary open angle glaucoma (POAG); and group D, ten hypertensive patients with POAG. Systolic and diastolic blood pressure, heart rate, pupil diameter, IOP and total outflow facility were recorded at baseline and at 1-h intervals up to 3h after an oral dose of 25 mg captopril or placebo, given in a randomized, double-blind cross-over fashion. The alternative treatment was given a week later. Captopril significantly lowered IOP in all patients, with no effects on heart rate and pupil diameter. Blood pressure changed only in patients with hypertension (groups B and D). Total outflow facility, measured by conventional tonography, increased significantly in all groups. These findings indicate that oral captopril could represent a new antiglaucomatous compound.
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PMID:Effect of oral captopril (SQ 14225) on intraocular pressure in man. 779 97

Open angle glaucoma is an optic neuropathy, the etiology of which is still unknown and which has not yet satisfactory therapy. Intraocular hypertension due to a decrease in trabecular out flow facility, is a risk factor. The side effects caused by ocular hypotensive treatments justify the search for better-tolerated drugs. A survey of the new approaches is reported: carbonic anhydrase inhibition, renin-angiotensin system inhibition, glucocorticoid antagonism, the use of prostaglandins etc. are evoked, as well as other more speculative ways: antioxidant treatments. Glaucoma which is characterized by ganglion cell degeneration probably related to a vascular defect, deserves to be studied from this point of view. Recent data on vascular and haemorheological abnormalities and the possible involvement of excitotoxic neurotransmitters in pathological process open a novel way for really innovative pharmacological research.
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PMID:[New perspectives in the pharmacological treatment of glaucoma]. 809 41


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