Primary Open-Angle Glaucoma

Kwon, Young H.; Fingert, John H.; Kuehn, Markus H.; Alward, Wallace L.M.

doi:10.1056/nejmra0804630

Cited by 760 publications

(661 citation statements)

References 92 publications

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“…[37][38][39][40] Accumulation of abnormal myocilin protein may be toxic to trabecular meshwork cells and may lead to their dysfunction or death, which may ultimately produce decreased aqueous outflow, elevated IOP, and glaucoma. 41,42 Animal models harboring myocilin mutations have been developed and are beginning to reveal the specific molecular steps that lead from mutations in myocilin to the elevated IOP that is characteristic of myocilin-related glaucoma. [43][44][45] Optineurin (OPTN, OMIM #602432)…”

Section: Myocilin (Myoc Omim #601652)mentioning

confidence: 99%

Primary open-angle glaucoma genes

Fingert

2011

Eye

191

175

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A substantial fraction of glaucoma has a genetic basis. About 5% of primary open angle glaucoma (POAG) is currently attributed to single-gene or Mendelian forms of glaucoma (ie glaucoma caused by mutations in myocilin or optineurin). Mutations in these genes have a high likelihood of leading to glaucoma and are rarely seen in normal subjects. Other cases of POAG have a more complex genetic basis and are caused by the combined effects of many genetic and environmental risk factors, each of which do not act alone to cause glaucoma. These factors are more frequently detected in patients with POAG, but are also commonly observed in normal subjects. Additional genes that may be important in glaucoma pathogenesis have been investigated using quantitative traits approaches. Such studies have begun to identify genes that control the magnitude of important quantitative features of glaucoma that may also be important risk factors for POAG, such as central corneal thickness. Each of these different approaches to study glaucoma genetics is providing new insights into the pathogenesis of POAG.

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Section: Myocilin (Myoc Omim #601652)mentioning

confidence: 99%

Primary open-angle glaucoma genes

Fingert

2011

Eye

191

175

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“…Glaucoma can be classified based on the iridocorneal angle into open‐angle, closed‐angle and developmental glaucoma, which are further divided into primary and secondary types (Kwon et al. 2009). Primary open‐angle glaucoma (POAG) is the predominant form of glaucoma in western countries and has the highest incidence rate in people of African descent and the lowest rate in people of Asian descent (Tielsch et al.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of different regimens for primary open‐angle glaucoma or ocular hypertension: a systematic review and network meta‐analysis

Huang

Zhang

2017

Acta Ophthalmologica

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PurposeTo assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open‐angle glaucoma (POAG) or ocular hypertension.MethodsWe searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta‐analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra‐ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed‐comparison analysis.ResultsThis study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta‐blockers (BB) showed relatively weaker ability to lower IOP, followed by α2‐adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non‐PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia.ConclusionOur network meta‐analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non‐PGA drug may have less ocular side‐effects than PGA alone.

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“…1 Both types of glaucoma are characterized by progressive and irreversible destruction of optic nerve axons and degeneration of the retinal ganglion cells (RGCs), frequently in association with increased intraocular pressure (IOP). 2 There are 15.7 million cases of PACG reported worldwide. 3,4 The number of PACG cases is projected to reach 21 million by 2020, and it is estimated that 5.3 million bilaterally will be blind from this condition.…”

Section: Introductionmentioning

confidence: 99%

The genetic mechanisms of primary angle closure glaucoma

Ahram

Alward

Kuehn

2015

Eye

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Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma affecting over 15 million individuals worldwide. Family history and ethnicity are strongly associated with the development of the disease, suggesting that one or more genetic factors contribute to PACG. Although strictly heritable disease-causing mutations have not been identified, a number of recent association studies have pointed out genetic factors that appear to contribute to an individual's risk to develop PACG. In addition, genetic factors have been identified that modify PACG endophenotypes for example, axial length. Herein we review the current literature on this important topic.

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Primary Open-Angle Glaucoma

Cited by 760 publications

References 92 publications

Primary open-angle glaucoma genes

Primary open-angle glaucoma genes

Efficacy and safety of different regimens for primary open‐angle glaucoma or ocular hypertension: a systematic review and network meta‐analysis

The genetic mechanisms of primary angle closure glaucoma

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