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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is currently a general consensus to perform argon laser trabeculoplasty (ALT) onto the 360 degrees of the trabecular ring to obtain the best long term results; but in two sessions a month apart with, during each session, 50 burns of a true 50 mu laser spot on 180 degrees, a 0.1 sec exposure time and a power high enough to create a tiny but visible trabecular reaction on the anterior edge of the posterior trabecular meshwork. During the first three hours after treatment, the main complication is raised intraocular pressure (IOP) which occurs in between 14% and 33% of the cases with a 10 mmHg rise above the initial IOP. In end stage glaucomas, a very close monitoring is mandatory during these first hours. Pretreatment with apraclonidine drops can dramatically reduce this complication. Our results and those of the literature with the same follow-up show that ALT seems effective in phakic chronic open-angle glaucomas (COAG) in half of the cases for about five years with a 10% new failure rate per year. The youngest patients, the aphakic patients and all the cases with trabecular severe disorganisation display the worst results. ALT must be considered to be a physical treatment - initially powerful but with decreasing efficacy in the long term. It should be used in presurgical glaucomas when IOP does not exceed 30 mmHg with intensive medical treatment and in intermediate stages of the disease where it is more effective.
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PMID:[Argon laser trabeculoplasty]. 179 Dec 82

The authors investigated visual field changes in 28 eyes of 28 adult patients with early-to-moderate chronic open-angle glaucoma (COAG) in whom reversal of glaucomatous disc cupping was documented by computerized image analysis (Rodenstock Optic Nerve Head Analyzer) after intraocular pressure (IOP) reduction from 29.3 (+/- 5.9) to 19.4 (+/- 4.3) mmHg over 34.8 (+/- 24.8) weeks. Humphrey Statpac global indices (mean deviation and pattern standard deviation) improved in direct proportion to the magnitude of IOP reduction even after controlling for the possible influences of learning effect, short-term fluctuation, reliability, duration of IOP reduction, age, and pupil size. The mean visual field global indices (mean deviation and pattern standard deviation) improved in patients with IOP reduction of 40% or greater, in statistically significant contrast to no improvement of mean global indices with IOP reduction less than 35%. The beneficial effect of IOP reduction is apparent in COAG patients with topographical evidence of reversal of cupping.
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PMID:Visual field global indices in patients with reversal of glaucomatous cupping after intraocular pressure reduction. 194 18

The pulsatile ocular blood flow (POBF) has been recorded in 15 patients with chronic open angle glaucoma. Measurements were performed during regular treatment with timolol 0.25% eyedrops, two weeks after withdrawal of this treatment, and then a further two weeks after its reinstitution. Readings were taken with subjects in both the erect and supine positions by means of a pneumotonometric probe to measure intraocular pressure (IOP), linked to a Langham ocular blood flow system. Assumption of the supine posture was associated with a significant increase in IOP in all phases of the study. Treatment with timolol lowered the mean IOP in comparison with the untreated phase (-4.4 (SEM 0.6) mmHg, p less than 0.001) but had no effect on the postural change. A significant reduction in POBF was recorded on assumption of the supine posture (-66 (SEM 18) microliters/min, p less than 0.001), representing a mean decrement of 19%. However, there were no significant differences in POBF between treated and untreated phases of the study. Comparison of the values obtained in patients with glaucoma (COAG) after withdrawal of treatment with those in subjects with ocular hypertension revealed that there was no significant difference in intraocular pressure between the two groups. However, both POBF (-68 (SEM 29) microliters/min) and the pulse amplitude of the intraocular pressure (ocular pulse: -0.45 (SEM) 0.14 mmHg) were significantly lower in the COAG patients. Pulsatile ocular blood flow is significantly lower in patients with chronic open angle glaucoma. Furthermore, the POBF and the postural response of these patients is not improved by the use of topical timolol therapy.
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PMID:Postural studies in pulsatile ocular blood flow: II. Chronic open angle glaucoma. 199 46

A series of 474 mixed cases of glaucoma was assessed to determine whether there were any genetic differences between different types of glaucoma. A careful distinction was made between chronic open angle glaucoma (COAG), acute and chronic angle closure glaucoma, ocular hypertension, low tension glaucoma, patients with large cup disc ratios, and various types of secondary glaucoma including pseudoexfoliation of the lens capsule, uveitic and traumatic glaucoma. Using ABO blood groups, Rhesus groups, ABH secretion or non-secretion, and phenylthiourea tasting we identified certain differences. The differences from normal were significant decrease in Rh-negative patients in chronic closed angle glaucoma (p less than 0.05), a decrease in ABH secretors in ocular hypertension (p less than 0.01), and fewer HB secretors in patients with COAG (p less than 0.02). There was a significant decrease in AH secretors and increase in HB secretors in both pseudoexfoliation with raised intraocular pressure compared with COAG (p less than 0.01) and in secondary glaucomas as a group compared with COAG (p less than 0.01). Tasters of phenylthiourea were more common in traumatic and uveitic glaucoma than in normal controls (p less than 0.05). These results suggest that secondary glaucoma develops in different subjects from COAG, while patients who develop a rise in intraocular pressure proceed to cupping and field loss if they have a certain genetic constitution. The groups of patients are too small for the differences to be of great prognostic value.
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PMID:Blood groups as genetic markers in glaucoma. 313 1

A quantitative measure of visual field loss associated with kinetic perimetry in chronic open-angle glaucoma (COAG) is discussed. With this new technique an analysis of covariance is applied to a retrospective study of 41 COAG patients. It suggests that reduction of intraocular pressure may not be uniformly effective in controlling the progression of the disease.
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PMID:Some observations on the relation between intraocular pressure reduction and the progression of glaucomatous visual loss. 365 60

Forty-six eyes with chronic open-angle glaucoma (COAG) and 24 eyes which had previously undergone trabeculectomy for COAG were studied and the postural response of the intraocular pressure compared with that of 70 normal eyes. In all three groups the greatest rise in intraocular pressure (IOP) occurred when the subject changed from the sitting to the lying position. In the control group this was never more than 2 mmHg in any subject. The rise was greater than 2 mmHg in 93% of the patients suffering from COAG who were treated medically and in 100% of the eyes of those on which trabeculectomy had been performed. The well recognised abnormal postural response of intraocular pressure in COAG appears both to be retained and to be unaffected in those eyes which have undergone trabeculectomy.
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PMID:Postural response of intraocular pressure in chronic open-angle glaucoma following trabeculectomy. 365 61

In a retrospective study in a consecutive series of operations performed by the author, 13 eyes in 10 patients underwent combined extracapsular cataract extraction, posterior chamber intraocular lens (IOL) implantation and trabeculectomy. All had significant cataract and chronic open-angle glaucoma with field loss, uncontrolled or marginally controlled on maximum tolerable medical treatment. All had a postoperative reduction in intraocular pressure. Significant complications included malignant glaucoma (in two eyes) and a late choroidal detachment (in one eye). The indications for and the advantages of the combined procedure are discussed, emphasising the advantages of extracapsular cataract extraction (ECCE) and posterior chamber lens implantation, in patients with chronic open-angle glaucoma (COAG).
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PMID:Combined extracapsular cataract extraction and posterior chamber intraocular lens implantation and trabeculectomy. 367 12

One hundred and thirty-three eyes with raised intraocular pressure treated by argon laser trabeculoplasty were studied to determine the factors predicting a fall in pressure with treatment. The two main predictive factors were: (i) initial pressure--a higher initial pressure was associated with a greater fall in pressure (p less than 0.001); and (ii) diagnosis (type of glaucoma)--pseudoexfoliative glaucoma (PXFG) and chronic open-angle glaucoma (COAG) had the greatest fall (p less than 0.05). Aphakic glaucoma was associated with the worst results. Of the other factors studied, only the degree of pigmentation of the angle was a significant predictor: the greatest fall in pressure occurred in eyes with moderately pigmented angles (p = 0.05). Complications of treatment were pigment scatter in the angle with depigmentation (41% of eyes), peripheral anterior synechiae (7.5%), immediate postoperative rise in pressure of 10 mmHg or more (7%), moderately severe iritis (3%) and hyphaema (2%). Medication was able to be ceased in only five patients after laser trabeculoplasty; even if a small fall in pressure is achieved, a large fall to the bottom of the normal range is unlikely.
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PMID:Do any factors predict a favourable response to laser trabeculoplasty? 648 85

Three hundred and eighty eyes of 300 patients which were treated with argon laser trabeculoplasty for medically uncontrolled open angle glaucoma were studied retrospectively. Among the 334 eyes having at least six weeks follow up, the mean overall pressure drop was 8.1 mm Hg. In 19.2 per cent of eyes, pressure was inadequately controlled by laser treatment and subsequent glaucoma surgery was required. Phakic primary chronic open angle glaucoma (COAG), aphakic COAG, pseudoexfoliation, pigmentary, and low tension glaucoma eyes all had a significant drop in pressure. Eyes with juvenile glaucoma or inflammatory glaucoma had a much poorer response in terms of mean pressure drop and number requiring later operation. There was no statistically significant difference in response between aphakic and phakic coag eyes, between pseudoexfoliation and phakic COAG eyes, or between eyes treated over the full 360 degrees and eyes treated over half the angle with treatment over the second half later if needed. A higher initial pressure usually resulted in a greater lowering of pressure. Medication was reduced after treatment in 28.7 per cent of eyes. The data suggest that the effect of laser trabeculoplasty generally persists for at least one year. Complications were few, the most serious being elevated intraocular pressure, which rose 10 mm Hg or more in 2.1 per cent of all eyes.
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PMID:Argon laser trabeculoplasty for open angle glaucoma. A retrospective study of 380 eyes. 658 72

The efficacy of 0.5% timolol was compared with that of the prostaglandin derivative unoprostone in maintaining control of intraocular pressure (IOP) in subjects with chronic open angle glaucoma (COAG) or ocular hypertension (OH) already responding satisfactorily to beta-blocker monotherapy. In a two-centre, double-masked, randomised parallel group study, 40 subjects were placed on 0.5% timolol eyedrops twice daily for two weeks. They were then randomised either to continue with 0.5% timolol or to switch to 0.12% unoprostone, applied twice daily for six weeks. IOP was measured at two-weekly intervals. The status of the conjunctiva, iris, cornea and anterior chamber was kept under observation. Ocular safety was monitored by measurements of visual acuity, and any systemic adverse events were recorded. After six weeks' treatment, there were no statistically significant differences in mean change from baseline IOP within or between treatment groups. For the subjects treated with unoprostone, mean IOP increased by 0.69 mm Hg (p = 0.368) while that of the timolol-treated subjects fell by 0.47 mm Hg (p = 0.287). The difference in mean IOP between groups was 1.16 mm Hg (p = 0.211, 95% confidence interval [CI] -0.69 to 3.02). The most common complaint was a mild and transient burning sensation on instillation which occurred more frequently in the unoprostone group. In conclusion, an aqueous solution of 0.12% unoprostone isopropyl, applied topically to the eye twice daily for six weeks, was as effective as 0.5% timolol in maintaining control of IOP in subjects with chronic open angle glaucoma or ocular hypertension. Both treatments were safe and well tolerated.
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PMID:A comparison of the intraocular pressure-lowering effect of 0.5% timolol maleate and the docosanoid derivative of a PGF2 alpha metabolite, 0.12% unoprostone, in subjects with chronic open-angle glaucoma or ocular hypertension. 1049 91


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