ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Topical carbonic anhydrase inhibitors are a novel addition to the armamentarium of medical glaucoma treatment; dorzolamide has been available since 1995 and brinzolamide since 1998. They lower intraocular pressure by inhibiting carbonic anhydrase, a key enzyme for aqueous humor formation. Intraocular pressure–lowering activity of the substances appears to be the same and is similar to that of most other agents, but it does not reach the activity of the unselective β-blocker timolol or the prostaglandin latanoprost. On concomitant treatment, additivity is reached with all other topical agents. A possible improvement of blood flow may offer an additional benefit, but its significance for the long-term outcome for human glaucoma remains to be shown. Side effects are mostly local. A more physiologic pH of brinzolamide appears to be advantageous.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The aqueous humor supplies nutrients to the nonvascularized cornea, lens, and trabecular meshwork. A number of tissue growth factors have been detected in this fluid. The composition of these proteins changes dramatically with different ocular conditions, such as inflammation and glaucoma. In this review, an overview of new findings regarding effects of aqueous humor growth factors is given. Our main emphasis is on the regulation of the avascular anterior eye compartment, the possible role of growth factors in the pathogenesis of glaucoma, and the importance of growth factors for the special immunosuppressive status of the anterior chamber.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

In the last decade, new imaging techniques have been added to conventional fundus photography and have been evaluated for use in early glaucoma. They all measure the loss of neuroretinal rim or retinal nerve fiber layer as a correlate to glaucomatous ganglion cell and axon loss. The value of optic disc photography, planimetry, laser scanning tomography, laser scanning polarimetry, and optical coherence tomography for the diagnosis of glaucomatous eyes in a preperimetric or early perimetric stage is analyzed on the basis of sensitivity, specificity, and receiver operating characteristics (ROC) curves. It becomes clear that all these techniques allow a more or less semi-automated evaluation of the optic disc and retinal nerve fiber layer but still have their limitations in the diagnosis of a very early, preperimetric stage of the glaucoma disease.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

For social and economic reasons, glaucoma screening is a useful and necessary task, with possible benefits for individuals and the health care system arising from the early diagnosis and early therapy of patients with glaucoma. Early treatment of patients with glaucoma decreases the probability that those patients will become blind and lowers the direct and indirect costs for patients with glaucoma. Most of the reported studies dealing with glaucoma screening used only one parameter (eg, intraocular pressure) to detect and to discriminate glaucoma patients from healthy subjects. Glaucoma screening devices might be combined to obtain the best specificity and sensitivity. Because the diagnosis of glaucoma is very closely associated with a morphologic change in the optic nerve head, one screening parameter should be the morphology of the papilla. To increase specificity and sensitivity, a combination of morphologic and functional testing might be useful. In this review, we report the context of glaucoma screening in terms of health economics, the testing quality of devices for functional and morphologic screening, and the results of a pilot study.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Morphologic studies to date show that prostanoid-induced iris color change is not associated with any major pathologic process in the tissue. There is no evidence of melanocyte proliferation. The most likely mechanism for iris color darkening is increased melanogenesis, but this is not so marked as to cause any extensive release of melanin granules that might cause iris inflammation or even a pigmentary-type of glaucoma. Some patients, but not all, with color darkening have an apparent thickening of the anterior border zone; it remains to be established whether this is true thickening or merely if the anterior border is emphasized because of increased pigmentation.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The concept of cycloablation has been present for several decades, but the inability to titrate a predictable and reproducible response has been its drawback. However, cycloablation still plays an important role in our paradigm of glaucoma therapy, since it can be the treatment of last resort for a small group of patients who have exhausted all other treatment modalities. Experience with argon or diode endolaser cyclophotocoagulation holds promise for these and other patients because it appears to demonstrate a safer side-effect profile, while providing good results. Better results may be partially due to visualization of the ciliary processes before applying laser energy, which allows for targeted destruction of tissue and limits the amount of inflammation. Additional experience will better define the indications and scope of these newer modalities.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Exfoliation syndrome (XFS) is an age-related disorder of the extracellular matrix characterized by production and progressive accumulation of small, white deposits of a fibrillar extracellular material in many ocular tissues, most commonly seen on the pupillary border and anterior lens capsule. Characteristic signs of pigment liberation and deposition throughout the anterior segment aid in the diagnosis. Exfoliation syndrome predisposes to both open-angle and angle-closure glaucoma, and to capsular rupture, zonular dehiscence, and vitreous loss during cataract extraction. Exfoliation syndrome is associated with ocular and perhaps systemic ischemia. The exact chemical composition of exfoliation material remains unknown. Medical, laser, and surgical therapy are similar to treatment of primary open-angle glaucoma.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Whereas intraocular pressure is considered a major risk factor in glaucoma, growing evidence now indicates that ocular ischemia plays a major role too. By virtue of this and because many existing medications are able to interact with vasculature, altering ocular blood flow, it is essential that current and future medications for glaucoma be evaluated for their effect on ocular circulation. The authors review published papers examining the effect of topical and some systemic medications on ocular blood flow, focusing mostly on data from the human eye. The authors provide a comprehensive review on the effect of subclasses of medications (eg, carbonic anhydrase inhibitors, β-blockers, &agr;-adrenergic agonists, and prostaglandin analogues on optic nerve head, and on retinal, choroidal, and retrobulbar circulation. The various claims for enhancements or reduction of ocular circulation within each class of medication are reviewed and evaluated.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID