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Zhang Y, Lin MM. Ocular Hypertension and Glaucoma After Open Globe Injury. Int Ophthalmol Clin 2024; 64:63-73. [PMID: 38525982 DOI: 10.1097/iio.0000000000000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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Gong H, Lin M. Posttraumatic glaucoma in southern China: A ten-year retrospective study. Eur J Ophthalmol 2024:11206721241236918. [PMID: 38425295 DOI: 10.1177/11206721241236918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE To analyze posttraumatic glaucoma regarding its demographics, presentations, different causes, surgical modalities, and hospitalization burden among patients in southern China. METHODS This retrospective study investigated all individuals with posttraumatic glaucoma admitted to the Zhongshan Ophthalmic Center of Sun Yat-Sen University from January 2012 through December 2021. RESULTS Out of 2211 cases, 64.82% had closed globe injury (CGI), 28.22% had open globe injury (OGI), and 6.96% had chemical injury (CI). The mean age of all patients was 44.45 ± 19.45 years old. Males (83.36%), rural patients (56.17%), and farmers (27.14%) predominantly had posttraumatic glaucoma. The most common external injury mechanism was blunt objects (37.82%). Compared with the other two groups, the majority of surgical modalities were cataract extraction (27.12%) in the CGI group, combined anterior-posterior surgery (34.79%) in the OGI group, and cyclocryotherapy/cyclophotoagulation (49.1%) in the CI group. The CI group had higher times of hospitalization (3.542 ± 0.242) and hospitalization duration (8.373 ± 0.743 days), whereas the OGI group had more operation expense ($ 1476.729 ± 11.047) and medical consumables expense per head ($ 962.578 ± 25.801). CONCLUSION Blunt injury, males, adults, farmers, and rural patients were high-risk factors for posttraumatic glaucoma. Chemical-induced glaucoma management requires a longer hospitalization period, while OGI requires more medical expenditure. This knowledge provides a new reference for clinicians to accurately diagnose and intervene in posttraumatic glaucoma. It also suggests that more education and long-term surveillance are needed regarding the presence of glaucoma after ocular trauma.
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Affiliation(s)
- Haijun Gong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingkai Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
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Reis LS, Arancibia AEL, Prata TS, Kanadani FN. Ab-interno trabeculotomy with Kahook dual blade in secondary traumatic glaucoma in a child. Am J Ophthalmol Case Rep 2022; 25:101354. [PMID: 35146206 PMCID: PMC8818491 DOI: 10.1016/j.ajoc.2022.101354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/17/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To report a successful ab-interno trabeculotomy with Kahook Dual Blade (KDB) in secondary traumatic angle recession glaucoma in a child and discuss the possible mechanisms of action. Observations A 7 years-old boy presented, after a blunt trauma in the left eye, with angular recess surroundings 110° and concomitant intra-ocular pressure (IOP) elevation around 35 mmHg, despite the maximum topical and systemic ocular hypotensive therapy. As there was no glaucomatous neuropathy yet, a KDB ab-interno trabeculotomy was performed. After KDB's surgery, oral and topical hypotensive medications were gradually withdrawn until complete suspension with IOP levels around 11 mmHg, which has remained the same in the last 2 years. Both functional and structural assessment of glaucoma have maintained stable throughout the follow-up until the present moment. Conclusion and Importance The KDB has demonstrating a favorable safety profile and a useful surgical technique that should be considered mainly in trabecular glaucomas, as well as those secondary to trauma. Studies are still needed to define which patient and glaucoma profile are the most suitable for the procedure and for how long it is effective.
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Shabbir A, Rasheed A, Shehraz H, Saleem A, Zafar B, Sajid M, Ali N, Dar SH, Shehryar T. Detection of glaucoma using retinal fundus images: A comprehensive review. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2021; 18:2033-2076. [PMID: 33892536 DOI: 10.3934/mbe.2021106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Content-based image analysis and computer vision techniques are used in various health-care systems to detect the diseases. The abnormalities in a human eye are detected through fundus images captured through a fundus camera. Among eye diseases, glaucoma is considered as the second leading case that can result in neurodegeneration illness. The inappropriate intraocular pressure within the human eye is reported as the main cause of this disease. There are no symptoms of glaucoma at earlier stages and if the disease remains unrectified then it can lead to complete blindness. The early diagnosis of glaucoma can prevent permanent loss of vision. Manual examination of human eye is a possible solution however it is dependant on human efforts. The automatic detection of glaucoma by using a combination of image processing, artificial intelligence and computer vision can help to prevent and detect this disease. In this review article, we aim to present a comprehensive review about the various types of glaucoma, causes of glaucoma, the details about the possible treatment, details about the publicly available image benchmarks, performance metrics, and various approaches based on digital image processing, computer vision, and deep learning. The review article presents a detailed study of various published research models that aim to detect glaucoma from low-level feature extraction to recent trends based on deep learning. The pros and cons of each approach are discussed in detail and tabular representations are used to summarize the results of each category. We report our findings and provide possible future research directions to detect glaucoma in conclusion.
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Affiliation(s)
- Amsa Shabbir
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Aqsa Rasheed
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Huma Shehraz
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Aliya Saleem
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Bushra Zafar
- Department of Computer Science, Government College University, Faisalabad 38000, Pakistan
| | - Muhammad Sajid
- Department of Electrical Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Nouman Ali
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Saadat Hanif Dar
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
| | - Tehmina Shehryar
- Department of Software Engineering, Mirpur University of Science and Technology (MUST), Mirpur- AJK 10250, Pakistan
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Steroid-induced glaucoma: Epidemiology, pathophysiology, and clinical management. Surv Ophthalmol 2020; 65:458-472. [PMID: 32057761 DOI: 10.1016/j.survophthal.2020.01.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
Abstract
Glucocorticoids are a class of anti-inflammatory drugs commonly used to treat various ocular and systemic conditions. Although the role of glucocorticoids in the treatment of numerous serious inflammatory diseases is pivotal, their prolonged use may increase intraocular pressure resulting in steroid-induced glaucoma. We provide a detailed update on steroid-induced glaucoma as a preventable cause of blindness in the adult and pediatric population and describe its epidemiology, social impact, and risk factors. Furthermore, we explore the propensity of different steroids to increase the intraocular pressure, the role of different routes of steroid administration, dosage and duration of treatment, as well as the clinical features, genetics, and management of steroid-induced glaucoma.
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Lee KM, Seery C, Khouri AS. Traumatic glaucoma due to paintball injuries: A case series. J Curr Ophthalmol 2017; 29:318-320. [PMID: 29270481 PMCID: PMC5735233 DOI: 10.1016/j.joco.2017.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To study the management and outcomes of patients with paintball injuries resulting in traumatic glaucoma. Methods A retrospective review was performed, identifying four patients with a confirmed diagnosis of traumatic glaucoma secondary to paintball sports. Results Four male patients with paintball gun injuries presented with a mean follow-up time of 51 months after the date of injury. The mean age was 23.5 ± 18.6 years. Three patients presented with blunt trauma, while one patient had a ruptured globe. Presenting visual acuity (VA) was hand motions in three of the patients and no light perception in the fourth patient. All patients were diagnosed with traumatic glaucoma and treated with glaucoma medications during their follow-up. Two patients received tube shunts to control intraocular pressures (IOPs). At the time of most recent follow-up, three patients had elevated IOPs and were not on any medications. VA at the last follow-up was 20/400 or worse. Conclusions Traumatic glaucoma can be managed with surgical and medical interventions, while VA usually does not return to baseline levels prior to the injury. Prognostic predictors can be used to guide treatment and identify patients who should be closely followed. Because the presentation and onset is widely variable, follow-up and screening is crucial even years after the injury.
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Abstract
BACKGROUND An ocular injury can lead to secondary glaucoma in the traumatized eye in 3% to 20% of cases. Literature on the risk of developing elevated intraocular pressure in the nontraumatized fellow eye is scant. Clinicians treating ocular traumas should also bear in mind sympathetic ophthalmia, a rare bilateral granulomatous panuveitis following accidental or surgical trauma to 1 eye. CASE REPORT We report a case of high-pressure glaucoma of the fellow eye without any signs of uveitis. The left eye of a 24-year-old man was injured in an inadvertent movement during a free-time table-tennis match. The eye was severely crushed, leading to blindness. His right eye developed medically uncontrolled high-pressure glaucoma only 1 month after the injury. CONCLUSION To the best of our knowledge, there are no previous reports of post-traumatic glaucoma in the nontraumatized eye after open-globe injury.
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Affiliation(s)
- Anu Vaajanen
- Tays Eye Centre, Tampere University Hospital
- Department of Ophthalmology, School of Medicine, University of Tampere, Tampere, Finland
- Correspondence: Anu Vaajanen, Tampere, Finland (e-mail: )
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Glaucoma After Open-globe Injury at a Tertiary Care University Hospital: Cumulative Causes and Management. J Glaucoma 2016; 25:e170-4. [PMID: 25265009 DOI: 10.1097/ijg.0000000000000162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate causes and treatment modalities of traumatic glaucoma after open-globe injury (OGI). MATERIALS AND METHODS The medical records of all patients with postrepair follow-up of OGI at a tertiary care university hospital from January 1996 to December 2010 were reviewed. These patients had persistent elevated intraocular pressure (IOP) of >21 mm Hg at 2 consecutive visits, with or without optic disc damages. RESULTS Over the 14-year study period, 41 eyes of 41 patients with repaired OGI that developed glaucoma were identified. In the early stage (within 1 mo), high IOP levels occurred owing to the presence of unremoved lens particles in 11 patients (26.8%), inflammation in 6 patients (14.6%), and hyphema in 3 patients (7.3%). In the intermediate stage (2 to 6 mo), the IOP increased owing to the presence of synechial angle closure in 9 patients (21.9%) and ghost cells in 3 patients (7.3%). In the late stage (>6 mo), the IOP rose owing to the presence of unremoved lens particles in 2 patients (4.8%), angle recession in 4 patients (9.7%), and synechial angle closure in 3 patients (7.3%). Surgical interventions included trabeculectomy in 9 eyes (22%), lens aspiration in 9 eyes (22%), cyclophotocoagulation (CPC) in 5 eyes (12.2%), anterior chamber washout in 3 eyes (7.3%), and tube surgery in 2 eyes (4.9%). CONCLUSIONS Traumatic glaucoma is not uncommon long-term complication after OGI. It is important to inspect the association between the initial cause and achieving a successful treatment. Surgical intervention may be crucial in the majority of cases.
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Bojikian KD, Stein AL, Slabaugh MA, Chen PP. Incidence and risk factors for traumatic intraocular pressure elevation and traumatic glaucoma after open-globe injury. Eye (Lond) 2015; 29:1579-84. [PMID: 26381097 DOI: 10.1038/eye.2015.173] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/15/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To examine traumatic intraocular pressure (IOP) elevation and glaucoma after open-globe injury. DESIGN Retrospective, observational case series. METHODS Review of patients with open-globe repair at the University of Washington from May 1997 through July 2010. Traumatic IOP elevation and glaucoma were defined respectively as intraocular pressure (IOP) ≥22 mm Hg at >1 visit or need for glaucoma medication, and long-term (at least 3 months) glaucoma medication use or glaucoma surgery. RESULTS We included 515 eyes (515 patients). The mean follow-up was 12.6±20.1 months. One hundred twenty eyes (23.3%) developed traumatic IOP elevation, of which 32 (6.2%) developed glaucoma; six eyes (1.2%) required glaucoma surgery. The mean time to development of traumatic IOP elevation was 1.5±3.4 months (range 1 day to 2 years). Kaplan-Meier 6- and 12-month estimates for development of traumatic IOP elevation were 27.2 and 32.4%, respectively, and for development of traumatic glaucoma were 7.1 and 11.0%, respectively. Multivariate regression revealed associations between traumatic IOP elevation and older age, and traumatic glaucoma and prior penetrating keratoplasty, initial vitreous hemorrhage, Zone II injury, and penetrating keratoplasty after open-globe repair. Traumatic glaucoma was controlled (IOP <22 mm Hg) in 78.1% of eyes at final follow-up, with mean IOP of 18.2 mm Hg on 1.7 medications. CONCLUSIONS Traumatic IOP elevation and glaucoma were common after visually salvageable open-globe injury. Most cases developed within 6 months, although longer follow-up remains important for case detection. Penetrating keratoplasty before or after repair, and vitreous hemorrhage were notable risk factors.
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Affiliation(s)
- K D Bojikian
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - A L Stein
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - M A Slabaugh
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - P P Chen
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Kang YS, Park SW. Risk Factors and Clinical Manifestations of Ocular Hypertension after Primary Repair of Open Globe Injury. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.8.1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yeon Soo Kang
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
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Osman EA. Glaucoma after open globe injury. Saudi J Ophthalmol 2014; 29:222-4. [PMID: 26155083 PMCID: PMC4487842 DOI: 10.1016/j.sjopt.2014.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 11/12/2022] Open
Abstract
Ocular trauma remains a core root of avoidable blindness worldwide. Corneal scarring, lens injury, glaucoma, vitreous hemorrhage, retinal or choroidal detachment and endophthalmitis are sequel to ocular trauma that can lead to blindness. Very few studies have been published to tackle the risk of developing post-traumatic glaucoma after open globe injuries (OGI), however, there are many articles discussing closed eye injury. This review article aims to cover the incidence, risk factors, causes and treatment of glaucoma after open globe injury.
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Affiliation(s)
- Essam A Osman
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
PURPOSE Evaluate predictors and outcomes of ocular hypertension after open-globe injury. PATIENTS AND METHODS This is a retrospective, case-control study reviewing records of consecutive patients with open-globe injuries treated at Massachusetts Eye and Ear Infirmary between February 1999 and January 2007. Of 658 patients treated, 382 had at least 2 months of follow-up and sufficient data to be included. Main outcome measures are visual acuity, intraocular pressure (IOP), and type of glaucoma intervention employed. RESULTS Sixty-five (17%) patients developed ocular hypertension defined as IOP≥22 mm Hg at >1 visit or requiring treatment. Increased age (P<0.001), hyphema (0.025), lens injury (P<0.0001), and zone II injury (P=0.0254) are risk factors for developing ocular hypertension after open-globe injury. Forty-eight (74%) patients with ocular hypertension were treated medically, 8 (12%) underwent filtering or glaucoma drainage device surgery, 5 (8%) had IOP normalization with observation, while 4 (6%) required anterior chamber washout with no other glaucoma surgery. Patients with ocular hypertension had an average maximum IOP=33.4 mm Hg at a median follow-up of 21 days, with most patients maintaining normal IOP at all follow-up time points. Visual acuity improved over time with median acuity of hand motions preoperatively, and 20/60 at 12 and 36 months. CONCLUSIONS Ocular hypertension is a significant complication after open-globe injury that sometimes requires surgical intervention. Predictive factors can alert physicians to monitor for elevated IOP in the first month after trauma. Most patients with traumatic ocular hypertension had improved visual acuity and IOP normalization over time.
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