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

Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. Central retinal artery occlusion and branch retinal artery occlusion are most often caused by emboli. The mean age of patients with retinal artery occlusion and branch retinal artery occlusion is 62 and 58 years, respectively. The most common risk factors are arterial hypertension (65%), diabetes mellitus (25%), valvular diseases of the heart (25%), and carotid artery stenosis or plaques (45%). Rare causes are arteritis and vascular spasm. The pathogenesis of retinal branch vein occlusion and central retinal vein occlusion remains speculative. Two different mechanisms have been postulated, i.e. thrombosis in the vein due to a compression by atherosclerotic changes in the adjacent artery and a local alteration of the blood flow due to unfavourable physiologic factors. Retinal vein occlusion manifests at a mean age of 65 years. The most common risk factors are arterial hypertension in 34-75% and primary open angle glaucoma in 2.1-82%. In 5.6% of the patients with retinal branch vein occlusion retinal vasculitis is present.
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PMID:[Risk factors for retinal occlusive diseases]. 944 8

The authors report the conclusions of their analysis of 308 operated eyes for primary open-angle glaucoma with Cairns trabeculectomy procedure. The analysed period is 1991-1995--and the patients have been operated in the Ophthalmology Clinic of the University Hospital of Bucharest. The work contains: 1) General epidemiologic characters: number of eyes, number of patients, sex, age. 2) The analysis of the surgical intervention's efficiency by the following parametres (TIO, visual acuity, field loss, fundus oculi changes) after 6 months, 12 months, 24 months ... to 5 years. 3) The repartition of the cases clinical forms of glaucoma: primary glaucoma, pigmentary glaucoma, myopic glaucoma > 6D, exfoliative glaucoma, glaucoma with normal pressure. 4) The efficiency of the trabeculectomy depending on the moment of the surgical intervention: first stadium, second stadium, advanced stadium. 5) The analysis of the risk factors: familial antecedents of glaucoma, hypertension, hypercholesterolemia, thrombosis of the central retinal vein, myopia > 6D. 6) The cataractogen effect of the trabeculectomy.
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PMID:[The efficacy of Cairns trabeculectomy in open-angle glaucoma]. 971 1

Glaucoma, the third leading cause of blindness in the western world, is characterized by painless, gradual loss of visual fields which may lead to severe visual impairment or even blindness. In 4 years of operation of a mobile glaucoma unit for screening and early diagnosis of glaucoma, 10,037 subjects aged 18-95 years were screened (4504 women, 45%); 55% were under 50 years (Graph 1). Ocular hypertension was diagnosed in 8.0%; primary open angle glaucoma (POAG) in 0.8%, with 2/3 already under treatment, the rest newly diagnosed. Pseudo-exfoliative glaucoma was diagnosed in 0.2%; only 2 cases had closed angle glaucoma; 91% of those screened were normal (Fig. 4; age stratification, Graph 3). POAG increased with age, from 0.2% in those under 40 years to 10% in those over 80; POAG was more common in men, but OHT was similar in both sexes (6.0% vs. 5.3%). There was no correlation between incidence of POAG and place of work except in the Sorek Nuclear Center (1.9% vs. 0.8%, p = 0.11). Other conditions significantly more frequent in POAG than normals were diabetes mellitus (x 2.5), systemic hypertension (x 4), myopia (x 2) and history of intraocular surgery (x 6).
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PMID:[Early detection of glaucoma by a mobile unit--results from 10,000 examinees]. 1088 8

The effects of the type 1 angiotensin II receptor antagonist Losartan potassium on intraocular pressure (IOP) were studied. Four groups of subjects were analysed: group A, ten controls; group B, ten patients with essential arterial hypertension and with IOP within the normal range; group C, ten patients with primary open angle glaucoma (POAG), but without essential arterial hypertension; group D, ten patients with arterial hypertension and POAG. The study design was held in a randomized crossover double-blind fashion. Systolic and diastolic arterial pressure, heart rate, pupil diameter, IOP and total outflow facility were recorded at baseline and at 1 hr intervals up to 6 hr, following the oral administration of 50 mg of Losartan potassium and/or placebo. The alternative treatment was given a week later. Drug administration significantly reduced IOP in all subjects. No variation in heart rate and pupil diameter was observed during the follow-up period. Blood pressure dropped only in arterial hypertensive patients (groups B and D). Total outflow facility increased significantly in all groups. Placebo did not induce any variation in all groups. These findings demonstrate that the mechanism by which Losartan potassium reduces intraocular pressure is not mediated by a decrease in blood pressure, but rather it is more specific, confirming the role of the renin-angiotensin system also in the regulation of intraocular pressure in man.
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PMID:Effect of oral losartan potassium administration on intraocular pressure in normotensive and glaucomatous human subjects. 1093 Mar 21

Malignant glaucoma is a rare and dramatic complication that occurs more frequently after glaucoma filtration surgery for angle closure glaucoma and rarely for open angle glaucoma. We report a case of a highly myopic monocular 38-year-old woman, with a primary open angle glaucoma who developed malignant glaucoma in the first postoperative days of a trabeculectomy. Treatment consisted of extracapsular cataract extraction and vitrectomy, with the removal of the anterior hyaloid and preventive circular buckling. Late postoperative events have been marked by the occurrence of anterior synechiae and residual hypertension. We discuss the pathogenesis of malignant glaucoma, its management and the results of the different therapeutic procedures.
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PMID:[Malignant glaucoma and severe myopia. Report of a case]. 1191 39

An 80-year-old male patient experienced recently diagnosed swelling of the limbal conjunctiva. In his clinical history were found cataract surgery on the right eye 3 months before, chronic open angle glaucoma effectively treated by local eye drops, treated systemic hypertension and hypercholesterolemia. On ophthalmic examination, a conjunctival mass was present in the inferior lateral conjunctival quadrant next to the limbus, with numerous vessels visible at its top. Treatment with topical corticosteroids failed to obtain regression, but decreased the local inflammatory signs. The persistence of the mass led to its surgical excision under local anesthesia. Histopathology found a subepithelial accumulation of modified collagen bundles typical of elastotic degeneration. Capillary vessels were seen in the superficial subepithelial area, attesting to the high degree of vascularization observed clinically. The final diagnosis was a pinguecula, which was not exactly located on the horizontal meridian area as it is usual.
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PMID:[Inflammation of an ectopic pinguecula]. 1251 50

According to a recent epidemiological study done in Japan, 2 or 3 million Japanese people are thought to be suffering from glaucoma, and 70-80% of them have not been examined or diagnosed by ophthalmologists. Therefore, the problem is how to find these untreated and undiagnosed people. At present, treatment of glaucoma continues to be directed at lowering intraocular pressure to prevent progression of glaucomatous optic neuropathy. However, theoretically, there are three stages in the prevention of progression of glaucoma. In the first stage, diagnosis of glaucoma can be done by genetic examination, before occurrence of glaucoma. The MYOCILIN/trabecular meshwork-inducible glucocorticoid response gene and the optineurin gene were identified as the genes that cause open angle glaucoma. Although some Japanese patients have sequence changes in the myocilin gene, there are no apparent specific mutations in Japanese glaucoma patients, in the MYOCILIN/TIGR and optineurin genes. Secondary glaucoma such as steroid glaucoma, induced by allergic diseases, and neovascular glaucoma, induced by retinal circulatory insufficiency, are preventable by improving the causal diseases, diabetes and hypertension. The education of doctors and laymen is important to reduce the occurrence of diabetes, and hypertension to prevent diabetic retinopathy, and retinal vessel occlusion. The second stage in preventing progression of glaucoma is to find the disease as early as possible. In Japan, a physical examination system is in place for everybody over 40 years old, in companies and local districts. Therefore, ocular examination, specially non-mydriatic fundus photographs should be taken in these examinations, and the film should be evaluated by an ophthalmologist, to search for retinal and optic disc abnormalities. Primary open angle glaucoma can be detected through this system in early stages. In primary angle closure glaucoma, instruments for estimating anterior chamber rapidly and accurately are necessary for the diagnosis. There is a special machine which can be handled easily, safely, and economically for detecting angle closure glaucoma, has been developed by Yamanashi University. This machine might help to reduce the number of angle closure glaucoma patients in the world. In the near future, a glaucoma network system should be put in place all over Japan. This organization consists of central headquarter and local central office. Most hospitals and private offices will belong to a local central office, and several glaucoma specialists will work in central and local offices. All glaucoma patients will be registered in local glaucoma office. The information on glaucoma patients will be communicated in the system the through light fiber cables or a satellite system. The patients can ask about their own disease through this glaucoma center system. In the third stage of glaucoma prevention, progression of glaucomatous optic neuropathy is retarded by conventional IOP lowering treatment or neuroprotective drugs. This stage compromises rehabilitation of visual function, implant of artificial visual systems, and regeneration of retinal ganglion cells(RGC). The disturbances of axonal flow in guinea pig optic nerve fibers was demonstrated electromicroscopically by quick-freeze, deep-etching method and, the decrease in numbers of motor proteins like "Kinesin" "Dynein" and "MAP-1" was shown in guinea pig eyes with elevated intraocular pressure by immunohistochemistry. Retinal glanglion cells have been isolated and new findings have been reported using this RGC culture system. Therefore, new neuroprotective drugs will be developed through this culture system.
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PMID:[21st century management of glaucoma]. 1473 29

To obtain epidemiological data on the prevalence and risk factors for open angle glaucoma in hospital workers of African origin, and investigate appropriate methods of a rapid, cost-effective screening procedure for glaucoma. A cross-sectional study of workers in the University College Hospital (UCH) Ibadan, using a structured questionnaire for data collection. The variables available for data analysis include workers demographic characteristics, visual acuity, pupil status, intraocular pressure, cup-disc ratio, central visual fields, family history of glaucoma, chronic diseases such as hypertension and diabetes. The data was analysed with EPI-INFO version 6.02 for simple analysis, while the SPSS package was used for multivariate analysis. A total of two thousand, one hundred and nine (2,109) UCH workers participated in the screening exercise for glaucoma. A high majority of the workers 1794 (85.1%) were negative to the diagnosis of glaucoma, while the remaining 315 (14.9%) were suspected to have glaucoma out of which 57 (2.7%) were confirmed as definite glaucoma cases. The prevalence of glaucoma among UCH workers was 27 per 1000, 95%, confidence interval = 20 per 1000, 35 per 1000. Factors associated with glaucoma were relative afferent pupillary defect, cup-disc ratio greater than 0.7, intraocular pressure, family history of glaucoma and the presence of chronic diseases such as diabetes. The left eye appears to have a higher probability of ocular problems compared with the right eye. The prevalence of glaucoma among hospital workers was 2.7% The cup-disc ratio appears to be a better diagnostic tool for glaucoma since it gives the best positive predictive value (with a cut-off point of 0.7) than all other variables.
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PMID:The Ibadan glaucoma study. 1525 20

Prolonged exposure to stress and the resulting over-stimulation of the HPA system are often detrimental to the homeostasis of an organism. In fact, chronic stress is believed to affect the pathology of several disease states including coronary heart disease and hypertension, diabetes and obesity. In humans, mutations in the GLC1A gene have been associated with primary open angle glaucoma. Previous studies on this gene have suggested that its expression is also affected by the same factors that mediate the stress response. With the ultimate goal of using the nematode, Caenorhabditis elegans, as an invertebrate model for glaucoma, we have measured the stress responsiveness of the cof-2 gene, one of two C. elegans proteins with significant homology to the myocilin olfactomedin domain. We show that both cof-2 mRNA and protein expression are developmentally regulated and that both are affected by heat shock stress.
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PMID:Glaucoma studies in the eyeless worm: stress responsiveness and temporal expression of the Caenorhabditis elegans myocilin-like gene, cof-2. 1564 Nov 63

Diabetes mellitus develops spontaneously in middle-aged, obese rhesus monkeys, thus making them a good model for examining the effects of co-morbid factors on the development of end-organ damage. Changes in structure and function in the eyes of one monkey who spontaneously developed type 2 diabetes are reported here. This animal had concomitant hypertension, high levels of triglycerides and serum cholesterol, and a low fraction of high-density lipoprotein. The eyes showed intraretinal hemorrhages and large areas of retinal capillary nonperfusion. Indo-cyanin green (ICG) angiography revealed a large area of non- or poorly perfused choriocapillaris in one eye, and immunohistochemistry showed loss of viable choriocapillaries in this region. Both basal laminar deposits and hard drusen were present on areas of Bruch's membrane adjacent to nonviable choriocapillaris. Blood flow via the nasal posterior ciliary arteries to this section of choroid was not detectable by color duplex Doppler ultrasound, indicating contribution of extraocular vascular disease to ischemia in this eye. There was a severe decline in number of photoreceptor inner and outer segments, and corresponding reductions in the multifocal electroretinogram (ERG), in the areas of choriocapillaris loss. The ganzfeld ERG indicated loss in both inner and outer retinal function. Much of the ganglion cell layer was absent throughout the retina, possibly reflecting the effect of diabetes as well as chronic open angle glaucoma; the latter diagnosis supported by elevated intraocular pressures and excavated optic disks. In summary, high resolution, enzyme histochemical and histopathological analyses of a diabetic hypertensive monkey retina and choroid after serial functional in vivo analyses have demonstrated the relationship between vascular dysfunction and visual function loss. Choroidal vascular dysfunction in both large and small vessels was associated with age-related macular degeneration-like changes in Bruch's membrane and photoreceptor degeneration.
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PMID:Ocular structure and function in an aged monkey with spontaneous diabetes mellitus. 1565 24


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