Iridotomy to slow progression of visual field loss in angle-closure glaucoma

Lê, Jimmy T.; Rouse, Benjamin; Gazzard, Gus

doi:10.1002/14651858.cd012270.pub2

Cited by 13 publications

(7 citation statements)

References 44 publications

(53 reference statements)

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“…22 Le et al, reported a lack of conclusive evidence of the role of PI in slowing the progression of visual field defects in PACG. 23 Iris pigments also result in suboptimal outcomes after laser iridotomy for PACG. Hence, de Silva et al, recommended a two-stage application of argon and YAG laser iridotomy in Asian and African PACG patients.…”

Section: Discussionmentioning

confidence: 99%

Chronic angle closure glaucoma: presentation and outcomes at a tertiary eye hospital of Saudi Arabia

Alzuhairy

2018

Int Surg J

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Background: Detection and management of chronic angle closure glaucoma (CACG) differ from primary open angle glaucoma (POAG). For general ophthalmologists in institutions with limited resources, timely detection and standard management of primary angle closure glaucoma (PACG) remains challenging.Methods: A retrospective chart review was performed of patients with CACG who presented to an eye unit in a hospital in central Saudi Arabia. Data were analyzed over a 5-year period regarding presentation, determinants and management outcomes of clinically diagnosed CACG cases.Results: The study sample was comprised of 102 eyes of 53 CACG patients. Bilateral disease at presentation was diagnosed in 92.4% patients. Nearly half of these patients were hypertensive, and more than one-fourth had diabetes or ocular comorbidities. Eighty eyes (78.4%) had a history of ocular surgery. A closed anterior chamber angle was detected in all eyes. The mean intraocular pressure (IOP) was 18.1±6.0mmHg, with or without medications. IOP greater than 22mmHg was detected in 26 (25.5%) eyes. The median cup-to-disk (CD) ratio was 0.6 [intraquartile range (IQR), 0.4; 0.7]. Laser peripheral iridotomy (PI) was performed in 61 eyes, trabeculectomy in 7 eyes, cataract extraction in 1 eye and combinations glaucoma surgeries in 7 eyes. Ninety-eight eyes had best-corrected visual acuity ≥20/200. The number of glaucoma medications declined significantly following surgery (χ2=32, P< 0.001).Conclusions: Laser PI was the main management modality for CACG in the study area. Goal of preventing blindness in eyes with CACG seems to be achieved.

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Section: Discussionmentioning

confidence: 99%

Chronic angle closure glaucoma: presentation and outcomes at a tertiary eye hospital of Saudi Arabia

Alzuhairy

2018

Int Surg J

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“…In this study, despite the increases in aqueous humor production in the wide-angle and narrow-angle groups, the compensatory capacity of the aqueous humor drainage pathway was relatively high, aqueous humor production and drainage were in equilibrium, and fluctuations in IOP during 4 Disease Markers and after hemodialysis were not significant. However, aqueous humor drainage is low in patients with a shallow anterior chamber and a narrow anterior chamber angle [23,24]. As plasma osmotic pressure decreases after hemodialysis, increased aqueous humor secretion may lead to an increase in IOP and may even cause acute angle-closure glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Effects of Hemodialysis on Intraocular Pressure and Ocular Biological Parameters in Different Angle Structures

Wang

et al. 2022

Disease Markers

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Purpose. This study is aimed at evaluating the effects of hemodialysis on intraocular pressure (IOP) and exploring the possible factors affecting IOP. Methods. Fifty-two patients with hemodialysis (HD) that were diagnosed with chronic renal failure by nephrology were divided into four groups: wide angle, narrow angle, extremely narrow angle, and closed angle. IOP, central anterior chamber depth (ACD), lens thickness (LT), angle opening distance (AOD), trabecular-iris angle (TIA), iris thickness (IT), and ciliary body thickness (CBT) were recorded before and after HD. The Pearson coefficient test was used to determine correlations among changes in IOP and AOD, ACD, TIA, IT, CBT, and LT. Results. The IOP in the extremely narrow angle group had significant difference compared with that in the wide angle group and narrow angle group ( P < 0.05 , P < 0.01 ). In the narrow angle group, change in LT was positively correlated with change in IOP ( P < 0.05 ). In the extremely narrow angle group, change in LT was positively correlated with change in IOP (P<0.01), whereas changes in AOD and TIA were negatively correlated with change in IOP ( P < 0.01 ; P < 0.05 ). Conclusion. The effect of HD on IOP varies with the structure of the anterior chamber. The increasing of IOP in the extremely narrow-angle group is related with the changes of structure of anterior chamber.

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“…Notably, fewer than 1% of the study participants progressed to PACG, and the authors advised against widespread prophylactic LPI in resource-limited populations. Whether our study patients benefited from LPI or whether a different treatment should have been considered (e.g., phacoemulsification) [ 26 ] is beyond the scope of our study, and more longitudinal studies with different ethnic backgrounds are needed [ 27 ]. Of note, these studies were published more recently than our study period.…”

Section: Discussionmentioning

confidence: 99%

Predictors of narrow angle detection rate—a longitudinal study of Massachusetts residents over 1.7 million person years

Lee

Yanagihara

et al. 2020

Eye

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Background/Objectives To determine the predictors of narrow angle detection in a United States population-based cohort. Materials and methods This was a retrospective cohort study using the Massachusetts All-Payer Claims Database. Demographic information of all patients and eye care provider information during the years 2011–2015 were extracted from Massachusetts All Payers Claims Data. All payers who received eye care during 1/1/2012–12/31/2015 without any previous eye visit during 2011 were included in the analyses. Laser peripheral iridotomy was identified by Current Procedural Terminology code 66761. Narrow angle detection was defined as the diagnosis of narrow angles by diagnosis code followed by a laser peripheral iridotomy procedure. Different predictors of narrow angle detection were evaluated using Kaplan–Meier curves with the log rank and Cox regression modeling. Results A total of 1,082,144 patients were included. The hazard ratio of narrow angle detection increased with age compared to the reference group of 0–10 years: 21–30 years of age (hazard ratio = 4.5), 31–40 (10.5), 41–50 (27.9), 51–60 (46.1), 61–70 (68.4), 71–80 (56.8) (all p < 0.0002), was 1.47 times higher in women and 1.85 times higher if evaluated by ophthalmologists compared to optometrists, after controlling for provider × time interaction. Conclusion Older age and female sex are associated with narrow angles. The rate of narrow angle detection was significantly higher if patients are seen by ophthalmologists compared to optometrists only. Evaluation with an ophthalmologist may be important for patients at high risks for developing primary angle closure glaucoma.

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Iridotomy to slow progression of visual field loss in angle-closure glaucoma

Cited by 13 publications

References 44 publications

Chronic angle closure glaucoma: presentation and outcomes at a tertiary eye hospital of Saudi Arabia

Chronic angle closure glaucoma: presentation and outcomes at a tertiary eye hospital of Saudi Arabia

Effects of Hemodialysis on Intraocular Pressure and Ocular Biological Parameters in Different Angle Structures

Predictors of narrow angle detection rate—a longitudinal study of Massachusetts residents over 1.7 million person years

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