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Related Concept Videos

Glaucoma: Overview01:25

Glaucoma: Overview

621
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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Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

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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.
Drugs such as carbonic anhydrase inhibitors, α2- and...
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Identifying Rapid Glaucoma Progression Using Hemifield Rates of Progression.

Ari Leshno1,2, Johnny X Li1, Carlos Gustavo De Moraes1

  • 1Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY.

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Summary

Glaucoma progression is better detected using hemifield rates of progression (ROP) than global rates. This approach enhances the identification of rapidly progressing eyes, aiding in personalized treatment strategies.

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Area of Science:

  • Ophthalmology
  • Glaucoma research
  • Visual field analysis

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide.
  • Early detection and monitoring of glaucoma progression are crucial for effective management.
  • Global visual field (VF) metrics may not fully capture localized or asymmetric disease progression.

Purpose of the Study:

  • To evaluate if hemifield rate of progression (ROP) in the 24-2 visual field (VF) test aids in detecting rapidly progressing glaucoma eyes.
  • To compare the sensitivity of hemifield ROP versus global ROP in identifying faster disease progression.

Main Methods:

  • Retrospective longitudinal study of 1658 glaucoma patients with 3+ years of follow-up and at least 8 VF tests.
  • Calculated ROP (dB/year) for global, superior hemifield, and inferior hemifield mean deviation (MD).
  • Determined worst hemifield ROP (ROPworst) and hemifield ROP absolute difference (ROPdiff) to assess asymmetry and focal progression.

Main Results:

  • Worst hemifield ROP (ROPworst) was significantly faster than global ROP (ROPglobal) by 0.25 dB/year on average.
  • 25% of eyes were classified as progressing faster based on ROPworst compared to ROPglobal.
  • Over 40% of eyes identified as rapid progressors by ROPglobal were reclassified as very rapid or catastrophic progressors using ROPworst.

Conclusions:

  • Hemifield ROP is more sensitive to focal or faster progression than global ROP.
  • Analyzing hemifield ROP can improve the detection of rapidly progressing glaucoma.
  • This detailed analysis aids in tailoring patient management and treatment decisions.