Confidence Intervals ; Probability ; Population

Instilling glaucoma eye drops has been the mainstay in glaucoma management for many years, be it as initial treatment or as adjunct to laser or filtering surgeries. There are different classes of glaucoma eye drops, with different mechanisms of action to lower the intraocular pressure (IOP), either by improving the outflow facility or by suppressing the aqueous production, singly or as combination therapy. Many of these eye drops can lower the IOP by as much as 35% when given either once or twice a day. Successful treatment outcomes for chronic diseases such as glaucoma, however, require daily use of glaucoma eye drops to minimize disease progression.

OBJECTIVE: This study determined the risk of postoperative visual loss and the factors affecting the decrease in visual acuity in patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery. METHODS: Charts of patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery were reviewed for the following parameters: visual acuity (VA), intraocular pressure (IOP), and visual-field indices of the Humphrey perimetry. Eyes that lost 2 or more Snellen lines or worsened one category two months after surgery were identified. Central vision was lost (wipeout) when best corrected VA was less than 20/200, characterized as a sudden, permanent, and unexplained visual loss within 2 months post-operatively. Analysis of variance (ANOVA) determined the differences between groups and logistic regression analyzed the factors affecting the decrease in visual acuity postoperatively. RESULTS: Ninety-eight eyes of 92 patients aged 18 years and older were included in the study. The incidence of postoperative visual loss 2 months after surgery was 20 percent (20/98), of which 3 percent (3/98) was considered "wipeout." Factors affecting the decrease in VA postoperatively include the presence of surgical complications (p = 0.04) and increase in postoperative IOP at two months (p = 0.05). CONCLUSION: The incidence of wipeout among patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery is low and generally occurs in patients with central-splitting fixation. Surgical complications play a major role in causing postoperative decrease in VA.
Human ; Young Adult ; Adolescent ; GLAUCOMA ; TRABECULECTOMY ; CATARACT ; SURGERY ; RISK FACTORS ; VISUAL ACUITY ; EYE DISEASES ; CATARACT EXTRACTION

Human ; Adult ; GLAUCOMA-OPEN-ANGLE ; GLAUCOMA,SIMPLEX ; GLAUCOMA, COMPENSATED ; IRIDOCORNEAL ENDOTHELIAL SYNDROME ; FILTERING SURGERY ; GLAUCOMA ; SCLEROSTOMY ; TRABECULECTOMY

PURPOSE:To determine the cup and disc areas using computer-aided imaging. METHODOLOGY:Case-control study using the computer-aided imaging as a screening test in a given population. RESULTS:There is a wide variability in cup and disc areas among glaucoma suspects and normal. CONCLUSION:C:D alone has a poor predictive value for diagnosing glaucoma.Optic disc size with C:D is just as sensitive and specific in screening for glaucoma.Cup and disc areas are positively correlated for normal and glaucoma suspects.
Human ; Aged ; Middle Aged ; Adult ; GLAUCOMA

Purpose: To determine the proportion of glaucoma suspects with abnormal nerve fiber layer measurement using GDx nerve fiber analyzer Methodology: The study population consisted of glaucoma suspects between ages 30-70 years, who underwent glaucoma workup including retinal nerve fiber layer measurement (GDx NFA) Results: 35 eyes of glaucoma suspects were analyzed. 28/35 were found to have normal NFL thickness; 5/35 have 1 abnormal GDx parameters; 1/35 with 3 abnormal GDx parameters; 1/35 with 3 GDx abnormal parameters. Linear regression analysis showed no correlation between C:D and GDx parameters Conclusion: This study confirms that superior maximum is useful to the other parameters but there is a need to collect more samples. (Author)
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; RETINA/ANATOMY & HISTOLOGY ; NERVE FIBERS ; GLAUCOMA ; HUMAN ; OPTIC DISK ; SCANNING LASER POLARIMETRY ; LASER/DIAGNOSTIC USE

Methods: Patients with and without glaucoma underwent a complete eye evaluation, automated perimetry, scanning laser polarimetry with the GDx 400, and opticdisc photography. Two glaucoma experts graded each study eye. Two-by-two tables were constructed for 5 GDx parameters (average thickness, superior average, inferior average, ellipse average, and ellipse modulation) and the CDx number. Receiver operating characteristic (ROC) curves were generated. Results: The study included 355 patients (171 normal, 184 glaucoma). The mean values of the 5 GDx parameters were lower for the glaucoma than for the normal group. The sensitivity and specificity of the GDx 400 were 45.4 percent and 91.9 percent if the cut off level of the GDx number was 71. Ellipse modulation (EM) measures have the best ROC curve with area under the curve of 0.725. Conclusion: The GDx 400 nerve-fiber analyzer is primarily used as a screening tool to detect the presence or absence of glaucoma. Its accuracy can be improved with use of continuous corneal compensator.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; GLAUCOMA ; RETINA ; NERVE FIBERS ; SCANNING LASER POLARIMETRY ;

Human ; Male ; Female ; INTRAOCULAR PRESSURE ; GLAUCOMA ; OCULAR HYPERTENSION ;