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Related Concept Videos

Glaucoma: Overview01:25

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: Jan 19, 2026

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Structural evaluation of perimetrically normal and affected hemifields in open angle glaucoma.

Gunjan Deshpande1, Prashant Bawankule2, Dhananjay Raje1

  • 1Department of Glaucoma, Sarakshi Netralaya, Nagpur, Maharashtra, India.

Indian Journal of Ophthalmology
|September 25, 2019
PubMed
Summary

Spectral domain optical coherence tomography (SD-OCT) can detect early structural changes in glaucoma. Even seemingly normal visual fields may show damage, highlighting the need for comprehensive glaucoma management.

Keywords:
Ganglion cell layer--inner plexiform layerinferior hemifieldretinal nerve fiber layersuperior hemifield

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Glaucoma Research

Background:

  • Glaucoma is a progressive optic neuropathy characterized by visual field defects.
  • Early detection of structural changes is crucial for managing glaucoma and preventing vision loss.
  • Macular ganglion cell layer--inner plexiform layer complex (GCL + IPL) and peripapillary retinal nerve fiber layer (RNFL) are key indicators of glaucomatous damage.

Purpose of the Study:

  • To investigate the relationship between GCL + IPL and peripapillary RNFL in glaucomatous eyes with superior or inferior hemifield defects (HD).
  • To assess the structural configuration of apparently normal hemifields in patients with localized visual field defects.
  • To evaluate the diagnostic utility of SD-OCT for detecting early structural changes in glaucoma.

Main Methods:

  • Observational, cross-sectional study involving 45 superior HD and 50 inferior HD eyes.
  • Detailed ocular examination, standard automated perimetry, and spectral domain optical coherence tomography (SD-OCT) were performed.
  • Area under receiver operating characteristic curve (AUC) analysis was used to determine the diagnostic ability of GCL + IPL and RNFL parameters after adjusting for covariates.

Main Results:

  • In superior HD glaucoma, inferotemporal GCL + IPL (AUC 0.935) and inferior quadrant RNFL (AUC 0.971) were best discriminators.
  • In inferior HD glaucoma, average GCL + IPL (AUC 0.877) and average RNFL (AUC 0.950) showed the highest diagnostic ability.
  • Apparently normal hemifields demonstrated significant structural differences in specific sectors (e.g., inferior GCL + IPL and RNFL in IHD; superonasal GCL + IPL and superior RNFL in SHD).

Conclusions:

  • SD-OCT is a valuable tool for identifying early macular and circumpapillary structural changes in glaucoma with localized visual field defects.
  • Apparently normal hemifields in glaucoma patients exhibit structural damage, necessitating their consideration in overall management strategies.
  • These findings support the use of SD-OCT as an ancillary diagnostic method for glaucoma evaluation.