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Wang YM, Shen R, Lin TP, Chan PP, Wong MO, Chan NC, Tang F, Lam AK, Leung DY, Tham CC, Cheung CY. Optical coherence tomography angiography metrics predict normal tension glaucoma progression. Acta Ophthalmol 2022; 100:e1455-e1462. [PMID: 35261173 DOI: 10.1111/aos.15117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 01/25/2022] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Yu Meng Wang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Ruyue Shen
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Timothy P.H. Lin
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Poemen P. Chan
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Hong Kong Eye Hospital Hong Kong SAR China
- Lam Kin Chung, Jet King‐Shing Ho Glaucoma Treatment and Research Centre The Chinese University of Hong Kong Hong Kong SAR China
| | - Mandy O.M. Wong
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Hong Kong Eye Hospital Hong Kong SAR China
| | - Noel C.Y. Chan
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China
| | - Fangyao Tang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Alexander K.N. Lam
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Dexter Y.L. Leung
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Department of Ophthalmology Hong Kong Sanatorium and Hospital Hong Kong SAR China
| | - Clement C.Y. Tham
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Hong Kong Eye Hospital Hong Kong SAR China
- Lam Kin Chung, Jet King‐Shing Ho Glaucoma Treatment and Research Centre The Chinese University of Hong Kong Hong Kong SAR China
| | - Carol Y. Cheung
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
- Lam Kin Chung, Jet King‐Shing Ho Glaucoma Treatment and Research Centre The Chinese University of Hong Kong Hong Kong SAR China
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Therapeutic and preventive eff ect of physical exercises in primary open-angle glaucoma. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.6-1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The review assesses physical exercises as an additional non-pharmacological mean of combating the progression of primary open-angle glaucoma. The ophthalmic hypotensive effect is determined by the type of exercise, its duration and intensity. Moderate aerobic activity is preferred. Among dynamic exercises, jogging has the greatest hypotensive effect. Upper body isometric resistance training provides a more lasting decrease in ophthalmotonus. The decrease in intraocular pressure (IOP) in patients with glaucoma is several times more pronounced in comparison with healthy people and occurs regardless of the nature of the local drug antihypertensive therapy. After the termination of classes IOP returns to the previous level on average within a month. An increase in ocular perfusion pressure associated with physical activity dictates the appropriateness of physical exercise for patients with pseudo-normal pressure glaucoma. The combination of hypotensive, vascular, neuroprotective effects of physical activity with a high level of physical fi tness does not exclude a decrease in the risk of development and progression of primary open-angle glaucoma. The development of indications for the use of physical activity by patients with advanced glaucoma, including those who have undergone hypotensive surgery, remains relevant. The type, intensity, dosage and mode of performing the recommended physical exercises require an individual choice.
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Berdahl JP, Ferguson TJ, Samuelson TW. Periodic normalization of the translaminar pressure gradient prevents glaucomatous damage. Med Hypotheses 2020; 144:110258. [PMID: 33254565 DOI: 10.1016/j.mehy.2020.110258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/30/2020] [Accepted: 09/05/2020] [Indexed: 01/02/2023]
Abstract
The 24-hour intraocular pressure (IOP) rhythm is of interest to clinicians but its overall impact on glaucomatous progression remains unclear. Recent evidence has implicated the translaminar pressure gradient (TLPG), or imbalance between IOP and intracranial pressure, in the development of glaucoma. Evidence suggests that retinal ganglion cell death occurs as a result of decreased axonal transport only after a sustained, elevated TLPG. We hypothesize that periodic normalization of the TLPG prevents glaucomatous damage by enabling temporary resumption of axonal transport. Temporary resumption of axonal transport allows for delivery of critical metabolic cargoes with concomitant removal of metabolic waste which prevents apoptosis of the retinal ganglion cell.
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Lin TPH, Wang YM, Ho K, Wong CYK, Chan PP, Wong MOM, Chan NCY, Tang F, Lam A, Leung DYL, Wong TY, Cheng CY, Cheung CY, Tham CC. Global assessment of arteriolar, venular and capillary changes in normal tension glaucoma. Sci Rep 2020; 10:19222. [PMID: 33154407 PMCID: PMC7644687 DOI: 10.1038/s41598-020-75784-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/12/2020] [Indexed: 01/31/2023] Open
Abstract
Microcirculatory insufficiency has been hypothesized in glaucoma pathogenesis. There is a scarcity of data to comprehensively examine the changes in retinal microvasculature and its role in normal tension glaucoma (NTG). We conducted a cross-sectional case-control study and included 168 eyes from 100 NTG patients and 68 healthy subjects. Quantitative retinal arteriolar and venular metrics were measured from retinal photographs using a computer-assisted program. Radial peripapillary capillary network was imaged with OCT-A and quantitative capillary metrics (circumpapillary vessel density (cpVD) and circumpapillary fractal dimension (cpFD)) were measured with a customized MATLAB program. We found that NTG was associated with decreased arteriolar and venular tortuosity, arteriolar branching angle, cpVD and cpFD. Decreased venular caliber, arteriolar and venular branching angles, cpVD and cpFD were associated with thinner average RNFL thickness. Decreased arteriolar and venular branching angles, cpVD and cpFD were also associated with worse standard automated perimetry measurements (mean deviation and visual field index). Compared with retinal arteriolar and venular metrics, regression models based on OCT-A capillary metrics consistently showed stronger associations with NTG and structural and functional measurements in NTG. We concluded that NTG eyes showed generalized microvascular attenuations, in which OCT-A capillary metrics attenuations were more prominent and strongly associated with NTG.
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Affiliation(s)
- Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Kevin Ho
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Cherie Y K Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China
| | - Poemen P Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China
| | - Mandy O M Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China
| | - Noel C Y Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology, Prince of Wales Hospital, Hong Kong, China
| | - Fangyao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Alexander Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Dexter Y L Leung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China
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