Glaucoma and Aging

Guedes, Guilherme; Tsai, James C.; Loewen, Nils A.

doi:10.2174/1874609811104020110

Cited by 73 publications

(47 citation statements)

References 84 publications

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“…Due to an increasing human lifespan, chronic diseases that manifest later in life, such as glaucoma and cataracts, have an increasing incidence and often occur in the same individuals 1 . In addition, medications used to treat glaucoma 2 or interventions to reduce intraocular pressure (IOP) 3 can cause cataracts or accelerate their occurrence.…”

Section: Introductionmentioning

confidence: 99%

Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity

et al. 2016

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Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.

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Section: Introductionmentioning

confidence: 99%

Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity

et al. 2016

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“…In contrast, Prior and colleagues found that those with a positive family history of glaucoma were less likely to present late than those with no family history whilst a third study found patients with a positive family history of glaucoma were more likely to present with advanced disease [17,25]. The association between family history and late presentation therefore seems somewhat variable and the risk of late presentation probably depends more on patient awareness of glaucoma risk and on other parameters such age, education and socioeconomic status [10,17,18].…”

Section: Discussionmentioning

confidence: 95%

“…Also the current system of free eye examinations in Scotland was only introduced 10 years ago and the effects of this initiative may take longer to manifest. Older patients presenting with advanced disease now, may have missed out on eye examinations at an earlier age [25].…”

Section: Discussionmentioning

confidence: 99%

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Severity of Glaucoma at First Presentation to Hospital Eye Services

El-Medany¹,

Jeganathan²,

Tatham³

2017

IJOAO

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Context/Background: To identify the proportion of patients with glaucoma presenting to hospital eye services with advanced disease and determine risk factors for late presentation. Methods:A retrospective study was conducted including100 consecutive patients newly referred from community optometrists to the glaucoma clinic at the Princess Alexandra Eye Pavilion, Edinburgh, Scotland. All subjects underwent slit lamp examination, intraocular pressure (IOP), central corneal thickness (CCT), fundus examination and standard automated perimetry (SAP). 84 patients with glaucoma were categorised according to SAP mean deviation (MD) in the worse eye as 'late presenters' if MD was ≤ -6dB; and 'very late presenters' if MD was ≤ -10dB.Logistic regression analysis identified factors associated with late presentation.Results: Mean age was 73.2 ± 10.2 years. 36 patients (42.9%) were female and 28 (33.3%) had a family history of glaucoma. 41 of 84 (48.8%) had an MD in the worse eye ≤ -6dB and 23 of 84 (27.4%) had an MD in the worse eye ≤ -10dB. Older age (p = 0.004) was a significant risk factor for late presentation. Gender (p = 0.660), IOP (p = 0.712), CCT (p = 0.968), and family history (p = 0.108) were not associated with late presentation. Conclusions:Half of patients presenting to hospital eye services for the first time with newly diagnosed glaucoma had a MD ≤ -6dB in at least one eye. Older patients were more likely to present with advanced disease. Increasing awareness of glaucoma in the elderly population may allow earlier diagnosis and reduce vision related morbidity.

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“…We showed that 6 months use of HRT has a decreasing effect on IOP in postmenopausal population concordance as shown previously in the literature. Primary open-angle glaucoma is an age-dependent disease which can be defined as aging of the optic nerve related with IOP (22). Identification of modifiable risk factors is important in preventing glaucoma.…”

Section: Discussionmentioning

confidence: 99%