Glaucoma Research Today is a free monthly online journal that collates and summarizes the latest research about Glaucoma, including details on cataracts, surgery, treatment, blindness.

Glaucoma surgery decreases the rates of localized and global visual field progression.

Folgar FA, de Moraes CG, Prata TS, Teng CC, Tello C, Ritch R, Liebmann JM

New York University School of Medicine, New York, NY, USA.

PURPOSE: Incisional glaucoma surgical procedures produce greater intraocular pressure (IOP) reduction and less IOP variability than medical treatment. We sought to determine the efficacy of glaucoma surgery in decreasing localized and global rates of visual field (VF) progression. DESIGN: Retrospective, interventional case series. METHODS: Subjects in the New York Glaucoma Progression Study with glaucomatous optic neuropathy, repeatable VF loss, and 10 or more Swedish interactive threshold algorithm standard VF examinations were assessed for eligibility. Patients who underwent successful glaucoma surgery (not requiring further surgical intervention and IOP < 18 mm Hg) in either eye and who were followed up for at least 2 years before and after surgery were enrolled. Automated pointwise linear regression analysis was used to calculate global and localized rates of progression before and after surgery. Eyes with other ocular conditions likely to affect the VF and an insufficient number of VF to create a slope before and after surgery were excluded. Comparisons were performed within the same eyes before and after surgery (Student paired t test). RESULTS: We enrolled 28 eyes of 28 patients (mean age, 61.2 +/- 14.5 years). The mean number +/- standard deviation of VF was 13.4 +/- 2.3, spanning 7.1 +/- 1.2 years (range, 4 to 9 years). Mean IOP +/- standard deviation decreased from 19.0 +/- 3.9 mm Hg before surgery to 11.3 +/- 3.7 mm Hg after surgery (40% reduction; P < .01). Mean global progression rates decreased from -1.48 +/- 1.4 dB/year before surgery to -0.43 +/- 0.8 dB/year after surgery (70% reduction; P = .01). Twelve eyes (42.8%) had at least 1 significantly progressing point before surgery, whereas only 2 (7.1%) had at least 1 progressing point after surgery. Each 1 mm Hg of IOP reduction after surgery resulted in a 0.1 dB/year decrease in the global rate of progression. CONCLUSIONS: Successful IOP reduction after glaucoma surgery greatly reduces both the number of progressing points and the localized and general rates of VF progression.

Published 27 January 2010 in Am J Ophthalmol, 149(2): 258-264.e2.
Full-text of this article is available online (may require subscription).

Articles on Glaucoma published 27 January 2010:

Sequential glaucoma implants in refractory glaucoma.   Am J Ophthalmol, 149(1): 95-101.

PURPOSE: To evaluate the efficacy of a second glaucoma implant in eyes with prior glaucoma implant surgery and inadequate intraocular pressure (IOP) control. DESIGN: Retrospective observational cohort study. METHODS: Patients undergoing a second glaucoma implant surgery from 1996 to 2008 were included. Outcome measures included visual acuity, IOP, glaucoma medication use, and complications. Success was defined as IOP < 21 mm Hg (criterion 1) and IOP < 17 mm Hg (criterion 2), with at least ... [Abstract] [Full-text]

Pulsar perimetry in the diagnosis of early glaucoma.   Am J Ophthalmol, 149(1): 102-12.

PURPOSE: To assess the ability of Pulsar perimetry (Pulsar) in detecting early glaucomatous visual field (VF) damage in comparison with Frequency Doubling Technology (FDT), Scanning Laser Polarimetry (SLP, GDx VCC), and Heidelberg Retina Tomography (HRT). DESIGN: Prospective observational cross-sectional case study. METHODS: This multicenter study included: 87 ocular hypertensives (OHT); 67 glaucomatous optic neuropathy (GON) patients; 75 primary open-angle glaucoma (POAG) patients; and 90 ... [Abstract] [Full-text]

Articles on Glaucoma published 21 January 2010:

Rho-kinase inhibitors as therapeutics: from pan inhibition to isoform selectivity.   Cell Mol Life Sci, 67(2): 171-7.

The emerging critical implications of Rho/Rho-kinase (ROCK) signaling in neurodegenerative diseases, glaucoma, renoprotection, diabetes and cancer have sparked growing interest in the pharmacological potential of ROCK inhibitors beyond their current application in cardiovascular disease. This article discusses the therapeutic benefits of novel ROCK inhibitors in development, and highlights the recent advances in the current understanding of disease-dependent and isoform-specific functions of ... [Abstract] [Full-text]

Articles on Glaucoma published 5 January 2010:

Estimating normative limits of Heidelberg Retina Tomograph optic disc rim area with quantile regression.   Invest Ophthalmol Vis Sci, 51(1): 355-61.

PURPOSE: To investigate why the specificity of the Moorfields Regression Analysis (MRA) of the Heidelberg Retina Tomograph (HRT) varies with disc size, and to derive accurate normative limits for neuroretinal rim area to address this problem. METHODS: Two datasets from healthy subjects (Manchester, UK, n = 88; Halifax, Nova Scotia, Canada, n = 75) were used to investigate the physiological relationship between the optic disc and neuroretinal rim area. Normative limits for rim area were derived ... [Abstract] [Full-text]

Cirrus high-definition optical coherence tomography compared with Stratus optical coherence tomography in glaucoma diagnosis.   Invest Ophthalmol Vis Sci, 51(1): 335-43.

PURPOSE: To compare the retinal nerve fiber layer (RNFL) evaluation using Cirrus optical coherence tomography (OCT) and Stratus OCT in glaucoma diagnosis. METHODS: One hundred thirty normal and 86 patients with glaucoma were included in this prospective study. The signal strengths of the OCTs were evaluated. The sensitivities and specificities of global RNFL average thickness were compared in the four quadrants and in each clock hour sector. Receiver operating characteristic (ROC) curves, areas ... [Abstract] [Full-text]

Silent substitution stimulation of S-cone pathway and L- and M-cone pathway in glaucoma.   Invest Ophthalmol Vis Sci, 51(1): 319-26.

PURPOSE: The study aimed for objective detection of primary open-angle glaucoma with selective color channel stimulation based on the silent substitution technique. In addition, an objective was analysis of the characteristics of individual color channels based on visual evoked potentials. METHODS: Visual evoked potentials were recorded in 141 subjects (39 patients with glaucoma, 71 healthy subjects, and 31 age-matched healthy subjects) with two scalp electrodes after cone-specific flash ... [Abstract] [Full-text]

Involvement of platelet coagulation and inflammation in the endothelium of Schlemm's canal.   Invest Ophthalmol Vis Sci, 51(1): 277-83.

PURPOSE: To investigate whether the endothelial cells of Schlemm's canal (ECSCs) are connected to lymphatic vessels or are involved in platelet coagulation and inflammation, by comparing them to lung tissue cells. METHODS: Three normal eyes, trabeculectomy specimens of 6 early-onset primary open-angle glaucoma (POAG), 15 late-onset POAG, and 6 normal-tension glaucoma (NTG), and lung tissues from 10 normal autopsy cases were used. The specimens were processed for light microscopy of ... [Abstract] [Full-text]

Peripheral vascular endothelial dysfunction in glaucomatocyclitic crisis: a preliminary study.   Invest Ophthalmol Vis Sci, 51(1): 272-6.

PURPOSE: Glaucomatocyclitic crisis (GCC) is a syndrome of recurrent unilateral increased intraocular pressure associated with mild cyclitis and few clinical symptoms. This study was undertaken to assess brachial artery endothelium-dependent flow-mediated vasodilation (FMD) as an indicator of vascular endothelial function, to describe the association between GCC and endothelial dysfunction excluding age effects. METHODS: This prospective study was conducted from January 2007 to April 2009 and ... [Abstract] [Full-text]

© 2005-2010 Glaucoma Research Today. All Rights Reserved.