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Zhu Z, Waxman S, Wang B, Wallace J, Schmitt SE, Tyler-Kabara E, Ishikawa H, Schuman JS, Smith MA, Wollstein G, Sigal IA. In vivo Modulation of Intraocular and Intracranial Pressures Causes Nonlinear and Non-monotonic Deformations of the Lamina Cribrosa and Scleral Canal. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.29.526113. [PMID: 36778255 PMCID: PMC9915473 DOI: 10.1101/2023.01.29.526113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose To evaluate changes in monkey optic nerve head (ONH) morphology under acutely controlled intraocular pressure (IOP) and intracranial pressure (ICP). Methods Seven ONHs from six monkeys were imaged via optical coherence tomography while IOP and ICP were maintained at one of 16 conditions. These conditions were defined by 4 levels for each pressure: low, baseline, high and very high. Images were processed to determine scleral canal area, aspect ratio, and planarity and anterior lamina cribrosa (ALC) shape index and curvature. Linear mixed effect models were utilized to investigate the effects of IOP, ICP and their interactions on ONH morphological features. The IOP-ICP interaction model was compared with one based on translaminar pressure difference (TLPD). Results We observed complex, eye-specific, non-linear patterns of ONH morphological changes with changes in IOP and ICP. For all ONH morphological features, linear mixed effects models demonstrated significant interactions between IOP and ICP that were unaccounted for by TLPD. Interactions indicate that the effects of IOP and ICP depend on the other pressure. The IOP-ICP interaction model was a higher quality predictor of ONH features than a TLPD model. Conclusions In vivo modulation of IOP and ICP causes nonlinear and non-monotonic changes in monkey ONH morphology that depend on both pressures and is not accounted for by a simplistic TLPD. These results support and extend prior findings. Translational Relevance A better understanding of ICP's influence on the effects of IOP can help inform the highly variable presentations of glaucoma and effective treatment strategies.
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Affiliation(s)
- Ziyi Zhu
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susannah Waxman
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bo Wang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob Wallace
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samantha E. Schmitt
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Elizabeth Tyler-Kabara
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurosurgery, University of Texas-Austin, Austin, TX, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Medical Informatics and Clinical Epidemiology (DMICE), Oregon Health & Science University, Portland, OR, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU School of Medicine, New York, NY, USA
| | - Matthew A. Smith
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU School of Medicine, New York, NY, USA
| | - Ian A. Sigal
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
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Wang T, Wang R, Su Y, Li N. Ultrasound cyclo plasty for the management of refractory glaucoma in chinese patients: a before-after study. Int Ophthalmol 2020; 41:549-558. [PMID: 33070270 DOI: 10.1007/s10792-020-01606-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cyclocryotherapy and transscleral cyclophotocoagulation are commonly used procedures for the treatment of refractory glaucoma, but still with many complications. Ultrasound cyclo plasty (UCP) is a novel technique that determines a selective and more precise coagulation necrosis of the ciliary body to reduce intraocular pressure (IOP), but its efficacy and safety have been less investigated in Chinese population. This study aimed to evaluate the clinical efficacy and safety of UCP in Chinese patients with refractory glaucoma. METHODS We designed a prospective, before-after study involving 36 eyes of 36 patients with refractory glaucoma that underwent uneventful UCP. Mean IOP, mean IOP reduction and subjective pain scale scores before and after UCP were compared to evaluate the efficacy of UCP in these patients. Procedural success defined as no abnormality of the treatment sites, and complications were recorded, along with confirmation of the safety of UCP. RESULTS The 36 UCP patients had a mean IOP of 53.61 ± 12.4 mmHg and a mean VAS score of 5.69 ± 3.02 preoperatively. Successful operation was achieved in 28 patients, with a success rate of 77.8%. In the follow-up observation at day 1, day 7, and month 1, 2, 3 and 6 postoperatively, both mean IOP and mean VAS score were significantly lower than those before operation (both P < 0.0001). The median baseline IOP reduction ranged from 22 to 36%. The mean reduction was 42.5% in 36 patients when taking IOP at the last follow-up visit as the last. No significant changes in visual acuity were achieved in 4 patients after UCP, and no adverse outcomes were present in other patients after timely treatment of complications such as conjunctival hyperemia, subconjunctival hemorrhage, or hyphema. CONCLUSIONS UCP is a novel yet reliable option for Chinese patients with refractory glaucoma since its high efficacy and safety.
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Affiliation(s)
- Tao Wang
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Meishan Road, Shushan District, Hefei, 230022, Anhui Province, China
| | - Ruixue Wang
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Meishan Road, Shushan District, Hefei, 230022, Anhui Province, China
| | - Yu Su
- Department of Ophthalmology, Anhui Provincial Children's Hospital, Hefei, 230022, Anhui Province, China
| | - Ning Li
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Meishan Road, Shushan District, Hefei, 230022, Anhui Province, China.
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Ayat NR, Sun Z, Sun D, Yin M, Hall RC, Vaidya AM, Liu X, Schilb AL, Scheidt JH, Lu ZR. Formulation of Biocompatible Targeted ECO/siRNA Nanoparticles with Long-Term Stability for Clinical Translation of RNAi. Nucleic Acid Ther 2019; 29:195-207. [PMID: 31140918 PMCID: PMC6686697 DOI: 10.1089/nat.2019.0784] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/29/2019] [Indexed: 12/22/2022] Open
Abstract
Nanoparticle based siRNA formulations often suffer from aggregation and loss of function during storage. We in this study report a frozen targeted RGD-polyethylene glycol (PEG)-ECO/siβ3 nanoparticle formulation with a prolonged shelf life and preserved nanoparticle functionality. The targeted RGD-PEG-ECO/siβ3 nanoparticles are formed by step-wised self-assembly of RGD-PEG-maleimide, ECO, and siRNA. The nanoparticles have a diameter of 224.5 ± 9.41 nm and a zeta potential to 45.96 ± 3.67 mV in water and a size of 234.34 ± 3.01 nm and a near neutral zeta potential in saline solution. The addition of sucrose does not affect their size and zeta potential and substantially preserves the integrity and biological activities of frozen and lyophilized formulations of the targeted nanoparticles. The frozen formulation with as low as 5% sucrose retains nanoparticle integrity (90% siRNA encapsulation), size distribution (polydispersity index [PDI] ≤20%), and functionality (at least 75% silencing efficiency) at -80°C for at least 1 year. The frozen RGD-PEG-ECO/siβ3 nanoparticle formulation exhibits excellent biocompatibility, with no adverse effects on hemocompatibility and minimal immunogenicity. As RNAi holds the promise in treating the previously untreatable diseases, the frozen nanoparticle formulation with the low sucrose concentration has the potential to be a delivery platform for clinical translation of RNAi therapeutics.
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Affiliation(s)
- Nadia R. Ayat
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Zhanhu Sun
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Da Sun
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Michelle Yin
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Ryan C. Hall
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Amita M. Vaidya
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Xujie Liu
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Andrew L. Schilb
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Josef H. Scheidt
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Zheng-Rong Lu
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
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Tang W, Zhang F, Liu K, Duan X. Efficacy and safety of prostaglandin analogues in primary open-angle glaucoma or ocular hypertension patients: A meta-analysis. Medicine (Baltimore) 2019; 98:e16597. [PMID: 31348303 PMCID: PMC6709278 DOI: 10.1097/md.0000000000016597] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To evaluated and compared the efficacy and safety of 3 prostaglandin analogues (0.005% latanoprost, 0.004% travoprost, and 0.03% bimatoprost) in treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT). METHODS PubMed, Embase, Cochrane library, Web of science, CNKI, Wanfang, and Vip database, published between January 1, 2000 and June 1, 2018, were systematically examined for randomized controlled trials (RCT) based on prostaglandin analogues for POAG or OHT treatment. Statistical analyses including weighted mean difference (WMD) calculation and odds ratio (OR) were performed using Review Manager Software version 5.3. RESULT The 17 studies were included in this analysis (N = 2433 participants) with 1∼12 months' follow-ups. The difference of intraocular pressure (IOP) reduction between latanoprost and travoprost group had not significant; there was significant difference of IOP reduction between latanoprost and bimatoprost group in the third month and sixth month; Travoprost was significantly different from bimatoprost in reducing IOP in the third month. Travoprost revealed an elevated risk of conjunctival hyperemia compared with latanoprost. An elevated risk of conjunctival hyperemia and growth of lashes compared with latanoprost. Bimatoprost shows lower ocular tolerability with higher incidence of side effects such as conjunctival hyperemia. CONCLUSIONS 0.03% bimatoprost appears more effective following long time use (3 and 6 month post-treatment) for IOP control compared to 0.005% latanoprost, and is more effective compared to 0.004% travoprost after being used for a certain period of time (3 months post-treatment); nevertheless, 0.005% latanoprost is better tolerated in patients with POAG or OHT.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University
- Department of Ophthalmology, Hunan Province Children’ Hospital
| | - Feng Zhang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University
| | - Ke Liu
- Department of Ophthalmology, Second Xiangya Hospital, Central South University
| | - Xuanchu Duan
- Department of Ophthalmology, Second Xiangya Hospital, Central South University
- Aier School of Ophthalmology, Central South University
- Changsha Aier Eye Hospital, Changsha, Hunan, China
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Malishevskaya TN, Yusupov AR, Shatskikh SV, Antipina NA, Klindyuk TS, Bogdanova DS. [Efficacy and safety of neuroprotection in patients with primary open-angle glaucoma]. Vestn Oftalmol 2019; 135:83-92. [PMID: 31215538 DOI: 10.17116/oftalma201913502183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Elevated intraocular pressure (IOP) is considered one of the main factors in the development and progression of primary open-angle glaucoma (POAG). The main schemes of drug treatment and cell protection from glaucomatous damage are aimed particularly at reducing IOP. However, it is possible for the disease to progress with normalized IOP. This determines the need to search for drugs that would affect other pathogenetic links of the progression of POAG. PURPOSE To study the effect of 'Cytoflavin' drug on the stabilization of glaucomatous optic neuropathy in patients with POAG. MATERIAL AND METHODS The study included 103 patients with initial or developed POAG. Patients were randomized into two groups using random numbers: the control group patients (n=50) receiving standard conservative treatment, and the main group (n=53), where patients received the combined drug with metabolic action 'Cytoflavin'. In addition to standard ophthalmological studies, all patients underwent biological, electrophysiological, perimetric, structural topographic, laboratory and sociological examinations before and after the treatment. RESULTS By the end of the 3rd month of the treatment, the patients of the main group showed positive dynamics of the amplitude and phase characteristics of bioelectric activity of the retina, improvement in the total sensitivity of the retina for central field of view. Cytoflavin contributed to reducing the rate of progression of glaucoma according to optical coherence tomography: stabilization of the thickness of the nerve fiber layer, reduction of the rate of global and focal loss of retinal ganglion cells. In patients of the main group, by the end of the 3rd month, the severity of oxidative stress has significantly reduced and the antioxidant defense improved. On the background of stabilized glaucomatous process, a subjective improvement in general and psycho-emotional health, increased confidence in the success of the therapy and thus the improved the quality of life was observed in comorbid patients of the main group. CONCLUSION Cytoflavin acts on the mechanisms that enhance the protection of the retina against the effects of reperfusion injury and oxidative stress, contributes to the metabolic adaptation of neurons and leads to a more favorable variant of POAG.
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Affiliation(s)
- T N Malishevskaya
- Regional Ophthalmologic Dispensary, 118/1 Kholodilnaja St., Tyumen, Russian Federation, 625048; West-Siberian Institute of Postgraduate Medical Education, 5/11 Prokopiya Artamonova St., Tyumen, Russian Federation, 625051
| | - A R Yusupov
- Hospital for war veterans, 47/1 Volodarsky St., Tyumen, Russian Federation, 625000
| | - S V Shatskikh
- Regional Ophthalmologic Dispensary, 118/1 Kholodilnaja St., Tyumen, Russian Federation, 625048
| | - N A Antipina
- Regional Ophthalmologic Dispensary, 118/1 Kholodilnaja St., Tyumen, Russian Federation, 625048
| | - T S Klindyuk
- Regional Ophthalmologic Dispensary, 118/1 Kholodilnaja St., Tyumen, Russian Federation, 625048
| | - D S Bogdanova
- Tyumen State Medical University, 54 Odesskaya St., Tyumen, Russian Federation, 625023
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Dang YL, Wang X, Dai WW, Huang P, Loewen NA, Zhang C. Two-year outcomes of ab interno trabeculectomy with the Trabectome for Chinese primary open angle glaucoma: a retrospective multicenter study. Int J Ophthalmol 2018; 11:945-950. [PMID: 29977805 DOI: 10.18240/ijo.2018.06.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/28/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma (POAG) patients. METHODS This was a multicenter, retrospective, observational study and included POAG patients with or without visually-significant cataracts. The Chinese patients were enrolled from three glaucoma centers and a group of comparable Japanese POAG patients was analyzed from our international Trabectome database. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2y. Success was defined as: 1) IOP≤21 mm Hg and at least 20% IOP reduction from baseline after 3mo at any two consecutive visits; 2) no additional glaucoma surgery required. RESULTS A total of 42 Chinese POAG patients from three glaucoma centers were enrolled. Twelve patients underwent Trabectome surgery combined with phacoemulsification and intraocular lens implantation while the remainder underwent Trabectome surgery alone. Thirteen patients had a history of failed glaucoma surgery and were considered as complicated cases. In China data, the mean preoperative IOP was 21.4±1.23 mm Hg. The Trabectome lowered IOP to 17.9±1.8 mm Hg at 2y (P=0.05). The number of glaucoma medications also decreased significantly from a baseline of 2.0±0.9 to 1.1±0.8 at 2y post-surgery (P=0.04). The overall 2-year success rate was 78%, with patients undergoing combined surgery having a higher success rate compared with those undergoing Trabectome surgery alone (100% vs 76%). In Japan data, the mean preoperative IOP was 20.8±7.7 mm Hg. The Trabectome lowered IOP to 12.20±2.0 mm Hg at 2y. The number of glaucoma medications also decreased significantly from a baseline of 2.1±0.9 to 3.4±0.6 at 2y post-surgery. In all patients, no major complications were seen. CONCLUSION Surgery with the Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.
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Affiliation(s)
- Ya-Long Dang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Optic Nerve, Peking University Third Hospital, Beijing 100191, China.,Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.,Department of Ophthalmology, Sanmenxia Central Hospital, Sanmenxia 472000, Henan Province, China
| | - Xiao Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Wan-Wei Dai
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Optic Nerve, Peking University Third Hospital, Beijing 100191, China.,Institution of Population Research, Peking University, Beijing 100191, China
| | - Ping Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Nils A Loewen
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Optic Nerve, Peking University Third Hospital, Beijing 100191, China
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Dang YL, Cen YJ, Hong Y, Huang P, Wang NL, Wang C, Zhang C. Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients: A Two-year, Retrospective, Multicentre Study. Chin Med J (Engl) 2018; 131:420-425. [PMID: 29451146 PMCID: PMC5830826 DOI: 10.4103/0366-6999.225050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate the long-term safety and efficacy of the Trabectome for Chinese glaucoma patients. METHODS This was a multicenter, retrospective, observational study. Glaucoma patients, except those with neovascular glaucoma, with/without a visually significant cataract were enrolled. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome evaluation was a reduction in intraocular pressure (IOP), and the secondary outcomes were a reduction in glaucoma medication, the 2-year success percentages, and complications. Success was defined as an IOP <21 mmHg and at least a 20% IOP reduction from baseline after 3 months for any two consecutive visits, without additional glaucoma surgery. The data were processed using the R Stats Package version 3.0.0. The Wilcoxon test was used to compare the postoperative IOP and the number of glaucoma medications with baselines. The Kaplan-Meier test was used to calculate the 2-year success percentage. The risk factors related to Trabectome failure were determined by logistic regression. RESULTS A total of 120 glaucoma patients were enrolled. The Trabectome efficiently reduced the IOP from a baseline of 22.8 ± 1.34 mmHg to 17.6 ± 0.96 mmHg, and the use of glaucoma medications from 2.2 ± 0.17 mmHg to 1.4 ± 0.21 in a 2-year follow-up (both, P < 0.01). The overall success percentage was 80%. No risk factor related to Trabectome failure was identified. No vision-threatening complication was observed. Ten patients, who required secondary glaucoma surgery, all reached the target IOP. CONCLUSIONS In a 2-year follow-up, Trabectome was an efficient and safe procedure for Chinese glaucoma patients.
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Affiliation(s)
- Ya-Long Dang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Yu-Jie Cen
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Ying Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Ping Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Ning-Li Wang
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Chao Wang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
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Milla E, Gamundi MJ, Duch S, Rios J, Carballo M, Study Group EMEIGG. Phenotypic Description of the Spanish Multicentre Genetic Glaucoma Group Cohort. J Ophthalmol 2017; 2017:1907454. [PMID: 29082038 PMCID: PMC5634567 DOI: 10.1155/2017/1907454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/02/2017] [Accepted: 03/15/2017] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The aim of the study was to make a phenotypic description of the Spanish multicentre glaucoma group cohort of patients. DESIGN Retrospective, observational, multicentre, cohort study. MATERIAL AND METHODS The clinical charts of 152 patients with hereditary glaucoma from18 Spanish eye centres were reviewed in order to make an epidemiologic description of the type of glaucoma and associated factors. True hereditary cases were compared with familiar cases according to the Gong et al. criteria. RESULTS 61% were true hereditary cases and 39% familiar cases. Ocular comorbidity, optic disc damage, and visual field mean defect were significantly more severe in hereditary patients, who required significantly more first-line hypotensive drugs and surgical interventions to control intraocular pressure than familiar patients. CONCLUSIONS The strength of the hereditary component of glaucoma seems to worsen the clinical course, causing more structural and functional damage and requiring more intense glaucoma treatment. The family history of glaucoma should be carefully investigated and taken into consideration when making treatment decisions or intensifying previous treatment.
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Affiliation(s)
- Elena Milla
- Unidad de Glaucoma, Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain
- Unidad de Glaucoma y Genética, Institut Comtal d'Oftalmologia, Barcelona, Spain
| | | | - Susana Duch
- Unidad de Glaucoma y Genética, Institut Comtal d'Oftalmologia, Barcelona, Spain
| | - Jose Rios
- Servicio de Estadística, Hospital Clinic, Barcelona, Spain
| | - Miguel Carballo
- Servicio de Laboratorio, Hospital de Terrassa, Barcelona, Spain
| | - EMEIGG Study Group
- EMEIGG, Spanish Multicentre Glaucoma Group (Estudio Multicéntrico Español de Investigaciones Genéticas en Glaucoma), Spain
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