Pathophysiology and management of glaucoma and ocular hypertension related to trauma

Razeghinejad, Reza; Lin, Michael; Lee, Daniel; Katz, L. Jay; Myers, Jonathan S.

doi:10.1016/j.survophthal.2020.02.003

Cited by 45 publications

(52 citation statements)

References 119 publications

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“…However, no cases presented with hypotony in our study, and the mean preoperative IOP was 8.91 ± 1.77 mmHg (range: 5.2 to 10.5 mmHg). These results may be due to additional ocular damage, including inflammation, intraocular haemorrhaging, angle damage, and lens-related injury, which may lead to the presence of white or red blood cells in the anterior chamber or direct injury to the trabecular meshwork or synechial angle-closure [ 18 ]. Additionally, despite the additional drainage pathway of the aqueous humour, these changes could hinder the aqueous outflow pathways and lead to no presentation of hypotony.…”

Section: Discussionmentioning

confidence: 99%

“…However, successful cleft reattachment often does not correspond with a normal IOP, especially in patients with traumatic cyclodialysis. IOP is associated with aqueous humour circulation; traumatic changes in the function of the ciliary body, the presence of direct injury of the trabecular meshwork, angle recession, or PAS will induce abnormalities of the aqueous humour dynamics, which will affect IOP [ 17 , 18 ]. Ocular hypertension and hypotony are also common after vitrectomy surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular hypertension after ocular trauma and vitrectomy is common. It likely occurs due to a shallower anterior chamber [ 22 ], PAS [ 22 ], or trabecular meshwork damage [ 10 , 18 ]. In our study, ocular hypertension likely occurred in Patient 5 due to 360°-PAS.…”

Section: Discussionmentioning

confidence: 99%

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Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Wang

Zhao

2020

Journal of Ophthalmology

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Background. Various techniques have been described for repairing cyclodialysis clefts, but there is no consensus regarding the optimal treatment. This study investigated the clinical efficacy of a novel surgical approach that is used to manage traumatic cyclodialysis. Methods. We prospectively enrolled 7 patients (7 eyes) with traumatic cyclodialysis of the concomitant lens and other vitreous diseases. Ultrasound biomicroscopy was used to diagnose cyclodialysis, and all eyes underwent pars plana vitrectomy with air endotamponade. The main outcome measures were postoperative anatomical success rates, best-corrected visual acuity (BCVA), and intraocular pressure (IOP). Results. All patients were male, and their age ranged from 46 to 64 years (mean: 54.3 years). After the surgical intervention, the extent of the cyclodialysis cleft ranged from 1 to 4 clock hours (mean: 2.3 clock hours) and the detached ciliary body of all cases was completely restored; the anatomical success rate was 100%. The BCVA significantly increased from 1.40 ± 0.49 to 0.42 ± 0.31 (P = 0.002). The IOP increased from 8.91 ± 1.77 to 14.67 ± 6.38, but the difference was not significant (P = 0.056). The postoperative IOP of most patients was temporarily elevated or lowered after surgery. At the last follow-up, there were still two abnormal cases, including one with ocular hypertension and one with hypotony. Conclusions. This study revealed that vitrectomy with air endotamponade is an effective and minimally invasive alternative surgical approach for small traumatic cyclodialysis clefts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Wang

Zhao

2020

Journal of Ophthalmology

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“…Kebutaan yang diakibatkan oleh glaukoma bersifat permanen atau tidak dapat kembali seperti semula (ireversibel) sehingga menjadi tantangan tersendiri dalam upaya pencegahan dan penanganan kasus glaukoma (8) . Menurut World Health Organization (WHO) diperkirakan sebanyak 5,9 dan 5,3 juta orang akan mengalami kebutaan sekunder akibat dari glaukoma sudut terbuka dan glaukoma sudut tertutup pada tahun 2020 (9) . Menurut hasil Riset Kesehatan Dasar (RISKESDAS) tahun 2013, prevalensi kebutaan di Indonesia adalah sebanyak 0,9%.…”

Section: Latar Belakangunclassified

“…Klasifikasi dalam menentukan sudut bilik mata depan menggunakan gonioskopi sehingga nantinya dapat ditentukan glaukoma sudut terbuka atau glaukoma sudut tertutup (9) . Glaukoma primer sudut terbuka biasanya bersifat asimtomatis, meskipun terkadang disertai keluhan berupa nyeri kepala, kesulitan melihat dalam gelap ataupun sering berganti-ganti kacamata baca.…”

Section: Diskusiunclassified

Penatalaksanaan Glaukoma Akut Primer Sudut Terbuka

Sari¹

2018

JKS

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Abstrak. Glaukoma merupakan penyebab kebutaan kedua terbanyak di seluruh dunia setelah katarak. Glaukoma sudut terbuka primer biasanya terjadi pada pasien dewasa yaitu di atas usia 40 tahun. Laporan kasus ini memaparkan seorang pria berusia 46 tahun datang ke Poliklinik Mata Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh dengan keluhan pandangan kabur pada mata kanan. Pada pemeriksaan fisik didapatkan keadaam umum tampak sakit sedang, composmentis, TD 130/80 mmHg, Nadi 82 x/menit, RR 19 x/menit, T 36,7oC. Pemeriksaan tajam penglihatan mata kanan VOD 6/60, TIO mata kanan 21,7 mmHg dan mata kiri 17,3 mmHg. Pada pemeriksaan segmen anterior mata kanan dan kiri dalam batas normal dengan kedalaman bilik mata depan keduanya von Herick derajat II. Pada pemeriksaan gonioskopi pada mata kanan dan kiri kedua sudut bilik mata depan terbuka. Pemeriksaan perimetri dijumpai hasil yaitu pada mata kanan terdapat nasal step dan enlargement blind spot sedangkan pada mata kiri dijumpai enlargement blind spot. Pasien didiagnosa dengan glaukoma sudut terbuka primer OD. Penatalaksanaan yang dilakukan ialah dengan menggunakan obat tetes mata timolol maleat 0,5%, dan artificial tears.Kata Kunci: Glaukoma sudut primer terbuka, penatalaksanaan Abstract. Glaucoma is the second leading cause of blindness worldwide after cataracts. Primary open-angle glaucoma usually occurs in adult patients over the age of 40 years. This case report describes a 46-year-old man who came to the Eye Clinic at Dr. Zainoel Abidin Banda Aceh Regional General Hospital with complaints of blurred vision in the right eye. On physical examination showed that the general condition appeared to be moderately pain, composmentis, TD 130/80 mmHg, pulse 82 x / min, RR 19 x / min, T 36.7 ° C. Examination visual acuity of right eye was 6/60, and left eyes was 6/9. Intra ocular pressure of right eye was 21.7 mmHg and left eye was 17.3 mmHg. Anterior segment examination was normal on both eyes with anterior chamber depth was von Herick grade II of both eyes. Perimetry examination showed nasal step and enlargement of the blind spot on right eye, enlargement of the blind spot on left eye. Posterior segment examination was 0,6 with minimal cupping disc on right eye and 0,5 on left eye. This patient was diagnosed as primary open angle glaucoma OD and treated with timolol maleate 0.5% eye drops and artificial tears.Primary open angle glaucoma, managementKeywords: Primary open angle glaucoma, management

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Insights into CD154‐mediated pathways in ocular hypertensive glaucoma: The role of Müller cells and P2X7 in retinal neuroprotection and therapeutic potential

Liu

Nie

et al. 2023

Cell Biology International

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An elevation of pathologic intraocular pressure (IOP) is the greatest risk factor for glaucoma. CD154 has been reported to bind to CD40 expressed by orbital fibroblasts and be involved in immune and inflammatory responses. However, the function and mechanism of CD154 in ocular hypertensive glaucoma (OHG) are not fully understood. We isolated and characterized Müller cells and subsequently examined the effect of CD154 on ATP release from those cells. After being cocultured with CD154-pretreated Müller cells, retinal ganglion cells (RGCs) were treated with P2X7 siRNAs or a P2X7 inhibitor. Furthermore, mouse models of glaucoma (GC) were injected with P2X7 shRNA. p21, p53, and P2X7 expression were examined, and cellular senescence and apoptosis were detected by β-Gal and TUNEL staining, retinal pathology was examined by H&E staining, and CD154 and β-Gal expression were detected by ELISA. CD154 induced ATP release from Müller cells and accelerated the senescence and apoptosis of RGCs that had been cocultured with Müller cells. We also found that treatment with P2X7 could attenuate the senescence and apoptosis of RGCs mediated by Müller cells pretreated with CD154. In vivo studies in GC model mice verified that P2X7 silencing attenuated pathological damage and prevented the senescence and apoptosis of retinal tissue. The study demonstrates how CD154 accelerates the aging and apoptosis of RGCs by co-cultivating Müller cells pretreated with CD154 in OHG. The research implies that CD154 has the potential to become a new therapeutic target for ocular hypertension glaucoma, providing a new research direction for its treatment.

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Pathophysiology and management of glaucoma and ocular hypertension related to trauma

Cited by 45 publications

References 119 publications

Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Penatalaksanaan Glaukoma Akut Primer Sudut Terbuka

Insights into CD154‐mediated pathways in ocular hypertensive glaucoma: The role of Müller cells and P2X7 in retinal neuroprotection and therapeutic potential

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