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Clinical Outcomes of Micropulsed Transcleral Cyclophotocoagulation in Moderate to Severe Glaucoma
摘要： Purpose: The purpose of this study is to evaluate the safety and effectiveness of a new micropulsed transcleral continuous wave diode laser in a clinical setting of patients diagnosed with open angle glaucoma, ranging from mild glaucoma to severe. Methods: Twenty-six eyes of thirteen patients were treated by a single surgeon at a single private practice center. Results were reviewed retrospectively. Each subject was treated with preset MP3 setting according to recommended treatment guidelines. Results: At baseline, patients were on an average of 3.3 topical glaucoma medications with an average IOP of 25.6 mmHg. At POD1 IOP was reduced by 20%, by 34% at POD7, 8% at POD28 and decreased 30% from baseline at the final postop visit 6-12 months after the procedure. Average medication use decreased from 3.3 to 1.8 from baseline to final post op visit. There were no serious adverse events. Conclusion: Micropulsed transcleral diode laser is a safe and effective alternative for glaucoma therapy for patients with open angle glaucoma. Patients can expect significant IOP lowering along with reduction in number of topical glaucoma medications required for IOP control.
关键词： Transcleral cyclophotocoagulation,Micropulse diode laser MP3 laser,Glaucoma
更新于2025-09-10 09:29:36
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Effects of Cataract Extraction on the Outcomes of Automated Perimetry and Retinal Nerve Fiber Layer Thickness Measurements by Optical Coherence Tomography in Primary Angle Closure Glaucoma
摘要： Objective: To evaluate the effect of cataract extraction on both visual field and retinal nerve fiber layer thickness measurements in primary angle closure glaucoma (PACG) eyes. Methods: Retrospective cohort study on 30 PACG eyes underwent cataract extraction. Changes in RNFL thickness and visual field parameters including mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) were analyzed within 6 months before and after cataract extraction. Results: Overall, MD (p=0.003) and VFI (p=0.004) improved significantly after cataract extraction, whereas PSD showed no significant change (p=0.6). In the 10 eyes with MD worse than -20 dB, mean MD improved by 3.4 ± 3.56 dB (from -24.36 ± 3.06 dB to -20.96 ± 5.06 dB, p=0.01) and mean VFI improved by 16.25 ± 15.66% (from 23.38 ± 9.65% to 39.63 ± 20.83%, p=0.02). PSD showed no significant change after cataract extraction (p=0.07). In the 20 eyes with MD better than -20 dB, MD and VFI also improved postoperatively, but the changes did not reach statistical significance: mean MD improved by 1.64 ± 3.65 dB (from -11.57 ± 5.57 dB to -9.92 ± 5.36 dB, p=0.05) whilst mean VFI improved by 4.57 ± 12.29% (from 74.95 ± 17.95% to 79.52 ± 17.26%, p=0.07). RNFL thickness did not show any significant changes after cataract extraction (p=0.13). Conclusions: Both MD and VFI improved after cataract extraction, especially in eyes with pre-operative MD worse than -20 dB. PSD and RNFL thickness showed no significant change after cataract extraction.
关键词： Perimetry,Visual field,Extraction,Retinal nerve fiber layer thickness,Optical coherence tomography,Primary angle closure glaucoma,Cataract
更新于2025-09-10 09:29:36
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Comparison of variation of intraocular pressure in noncontact tonometry in patients subjected to phacoemulsification and trabeculectomy with phacoemulsification
摘要： Objective: Evaluate the pattern of intraocular pressure (IOP) variations through the pneumatic tonometer, between two specific surgical techniques, and the possible variables that may influence the behavior of this pressure. Methods: Retrospective cross-sectional study carried out through the review of electronic medical records of a private ophthalmological reference hospital in the city of Goiania, Goiás, Brazil, from 2012 to 2016, comprising of a sample of 550 eyes. The analyzed variables were, age, gender, IOP, axis, pachymetry, anterior chamber depth, and axial length. Results: In the end, the study consisted of 231 eyes, represented by 179 patients. Of these, 182 eyes were operated on by isolated cataract surgery, with a mean age of 72.0±9.5 years. The combined surgery represented a total of 49 eyes, 34 patients with a mean age of 71.9±8.14 years. There was statistical significance (P,0.05) in correlating the pre- and postoperative IOP values in the 24-hour, 7-, 15-day, and 12-month postoperative periods. Conclusion: A standard of variation of IOP was found through the pneumatic tonometer in both surgical techniques, but a more significant reduction was observed in combined surgery than in isolated cataract surgery, and further studies with a greater epidemiological impact are required for confirmation of this conclusion.
关键词： pneumatic tonometer,cataract,glaucoma,intraocular pressure
更新于2025-09-10 09:29:36
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Pilot study for three-dimensional assessment of laminar pore structure in patients with glaucoma, as measured with swept source optical coherence tomography
摘要： Purpose To develop a method to quantify, based on swept-source optical coherence tomography (OCT), the 3D structure of the laminar pores in patients with glaucoma. Methods This retrospective study examined 160 laminar pores from 8 eyes of 8 cases: 4 normal subjects and 4 open-angle glaucoma (OAG) patients. We reconstructed 3D volume data for a 3 x 3 mm disc, using a method similar to OCT angiography, and segmented the structure of the lamina cribrosa. Then, we manually segmented each laminar pore in sequential C-scan images (>90 slices at 2.6-micron intervals) with VCAT5 (RIKEN, Japan). We compared the control and OAG subjects with the Mann-Whitney U test. Differences were considered significant at p < 0.05. Results We found that the laminar pores of the OAG patients had a significantly smaller average cross-sectional area, smaller 3D volume (adjusted to the average thickness of the lamina cribrosa), and higher true sphericity, and lower principal value (P1, 2, 3) of the 3D structure data (all: p < 0.0001). The topographic distribution of damaged laminar pores was consistent with the damaged area of the macular map. Conclusion We successfully developed a method to quantify the 3D structure of the laminar pores; providing a useful tool to assess lamina cribrosa-associated risk factors for glaucoma. These findings promise to benefit future investigations into the pathomechanisms of glaucoma.
关键词： swept-source optical coherence tomography,glaucoma,lamina cribrosa,laminar pores,3D structure
更新于2025-09-10 09:29:36
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Iris Morphological Features in Patients with 360° Angle-Closure Neovascular Glaucoma: An Anterior Segment Optical Coherence Tomography Study
摘要： Purpose: To investigate iris morphological features in 360° angle-closure neovascular glaucoma (NVG) by swept-source anterior segment optical coherence tomography (ASOCT). Patients and Methods: In this retrospective, clinic-based, comparative study, 14 patients with 360° angle-closure NVG and 14 healthy age-matched control subjects were enrolled. All patients enrolled had no prior glaucoma surgery but underwent cataract surgery with intraocular lens implantation. Horizontal scanning images of swept-source ASOCT were analyzed using software calipers in temporal and nasal angle areas. The iris thickness at 1 and 2 mm from the pupil edge, iris length, trabecular meshwork length, peripheral anterior synechia (PAS) length, PAS height ratio (PAS length/trabecular meshwork length), and pupil diameter were measured. Results: Between the groups, there were no statistically significant differences in iris length, trabecular meshwork length, and pupil diameter (p > 0.05). However, the iris thickness was significantly reduced in the NVG group compared with the control group in the temporal and nasal areas (0.306 vs. 0.563 mm/0.326 vs. 0.645 mm at 1 mm, 0.278 vs. 0.523 mm/0.282 vs. 0.546 mm at 2 mm, respectively) (mean, all p < 0.001). In the NVG group, PAS height ratios were 1.55 ± 0.45 (mean ± standard deviation) (range, 0.58–2.30) and 1.55 ± 0.78 (range, 0.68–3.68) at the temporal and nasal angles, respectively. Conclusions: In patients with 360° angle-closure NVG, the iris thickness decreased to about 50% of that in healthy subjects, and the PAS length exceeded the trabecular meshwork length by about 1.5 times.
关键词： Neovascular glaucoma,Angle closure,Peripheral anterior synechia,Anterior segment optical coherence tomography
更新于2025-09-10 09:29:36
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A new device to noninvasively estimate the intraocular pressure produced during ocular compression
摘要： To describe a noninvasive instrument that estimates intraocular pressure during episodes of external globe compression and to demonstrate the accuracy and reliability of this device by comparing it to the intraocular pressures simultaneously and manometrically measured in cannulated eyes. A thin fluid-filled bladder was constructed from flexible and inelastic plastic sheeting and was connected to a pressure transducer with high pressure tubing. The output of the pressure transducer was sent to an amplifier and recorded. This device was validated by measuring induced pressure in the fluid-filled bladder while digital pressure was applied to one surface, and the other surface was placed directly against a human cadaver eye or in vivo pig eye. The human cadaver and in vivo pig eyes were each cannulated to provide a manometric intraocular pressure control. The measurements obtained with the newly described device were within ～5% of simultaneously measured manometric intraocular pressures in both a human cadaver and in vivo pig eye model for a pressure range of ～15–100 mmHg. This novel noninvasive device is useful for estimating the intraocular pressure transients induced during any form of external globe compression; this is a clinical setting where no other devices can be used to estimate intraocular pressure.
关键词： ocular compression,tonometer,glaucoma,intraocular pressure
更新于2025-09-10 09:29:36
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The Result of Photorefractive Keratectomy Treated with 0.1% Fluorometholone and Tranilast Eye Drops
摘要： ??: ????????????(photorefractive keratectomy) ? 0.1% ??????? ???? ?? ??? ??? ??, ??????(0.5% tranilast, Krix?, JW pharmaceutical, Seoul, Korea) ??? ?? ??? ???? ??? ?? ?? ??? ??? ??? ????? ???. ??? ??: 2014? 5??? 2015? 5??? ???? ????????????? ?? 0.1% ??????? ??? ?? ?, ? ? 1??? ?? ???? ?????? ?????? ???? ??? ?? 49?(49?)? 2012? 12??? 2013? 10??? ??? ??? ?? ?????? ???? ???? ?? 71?(71?)? ??? ?????. ??: ? ? 6?? ? ??? ?????? ???? ????? ?? logMAR -0.08 ± 0.05, logMAR -0.08 ± 0.04? ? ? ?? ??? ???. 0.1% ??????? ?? ??? ?????? ????? 17.7 ± 3.3?, ????? 20.5 ± 3.7???(p＜0.01). ?????? ?? ??? ?????? ????? ? ? 18.4 ± 3.2?, ????? 20.9 ± 3.7???(p＜0.01). ??: ???????????? ? 0.1% ???????? ?? ?? ??? ??? ??, ?????? ??? ?? ??? ????? ????? 0.1% ???????? ?? ??? ??? ????? ??? ???? ? ?? ????.
关键词： Fluorometholone,Tranilast,Intraocular pressure,Photorefractive keratectomy,Steroid-induced glaucoma
更新于2025-09-10 09:29:36
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Glaucoma Increases Retinal Surface Contour Variability as Measured by Optical Coherence Tomography
摘要： We investigated the feasibility of glaucoma detection by measuring retinal surface contour variability (RSCV) using optical coherence tomography (OCT). The peripapillary region in one eye of each participant was scanned over an 8 3 8 mm area with a swept source OCT prototype. The retinal surface contour was sampled at approximately 1.5- to 3.5-mm radius circles centered on the optic nerve head. The RSCV is defined as the average log value within a middle spatial frequency band of the Fourier transform to the elevation profile of the inner retinal surface. The spatial frequency band was optimized to distinguish glaucoma from normal. Nerve fiber layer thickness (NFLT) was sampled around a 1.7-mm radius circle. Glaucoma severity was assessed by automated static perimetry. We enrolled 17 glaucomatous eyes and 17 healthy eyes. A great majority of the glaucoma group were in the early stage (visual field mean deviation average (cid:2)2.48 6 3.73 dB). Significant differences were found for RSCV between glaucoma and control eyes (P < 0.003) at all radii. The area under the receiver operating characteristic curve (AROC ? 0.90) of RSCV was best at the 3.5-mm radius. This was not significantly better than NFLT (AROC ? 0.84). With the 99% specificity, the glaucoma detection sensitivity was 53% for RSCV and 29% for NFLT (P ? 0.13). Retinal surface contour variability was significantly increased in glaucoma patients. The diagnostic accuracy of RSCV was equal to NFLT in early glaucoma. Since the RSCV detects small-scale focal damage and the average NFLT measures global damage, they provide different diagnostic information that may be synergistic.
关键词： optical coherence tomography,glaucoma,nerve fiber layer,retinal surface contour variability
更新于2025-09-10 09:29:36
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Localization and segmentation of optic disc in retinal images using Circular Hough transform and Grow Cut algorithm
摘要： Automated retinal image analysis has been emerging as an important diagnostic tool for early detection of eye-related diseases such as glaucoma and diabetic retinopathy. In this paper, we have presented a robust methodology for optic disc detection and boundary segmentation, which can be seen as the preliminary step in the development of a computer-assisted diagnostic system for glaucoma in retinal images. The proposed method is based on morphological operations, the circular Hough transform and the grow-cut algorithm. The morphological operators are used to enhance the optic disc and remove the retinal vasculature and other pathologies. The optic disc center is approximated using the circular Hough transform, and the grow-cut algorithm is employed to precisely segment the optic disc boundary. The method is quantitatively evaluated on five publicly available retinal image databases DRIVE, DIARETDB1, CHASE_DB1, DRIONS-DB, Messidor and one local Shifa Hospital Database. The method achieves an optic disc detection success rate of 100% for these databases with the exception of 99.09% and 99.25% for the DRIONS-DB, Messidor, and ONHSD databases, respectively. The optic disc boundary detection achieved an average spatial overlap of 78.6%, 85.12%, 83.23%, 85.1%, 87.93%, 80.1%, and 86.1%, respectively, for these databases. This unique method has shown significant improvement over existing methods in terms of detection and boundary extraction of the optic disc.
关键词： Optic disc,Image analysis,Glaucoma detection,Retinal image analysis,Growcut algorithm
更新于2025-09-10 09:29:36
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[Advances in Intelligent Systems and Computing] Intelligent Computing Volume 857 (Proceedings of the 2018 Computing Conference, Volume 2) || Automated Inner Limiting Membrane Segmentation in OCT Retinal Images for Glaucoma Detection
摘要： This paper proposes an automated algorithm to segment inner limiting membrane, i.e., the top most retinal layer in spectral domain optical coherence tomography (SD-OCT) scan. Its segmentation enables ophthalmologist to diagnose retinal diseases like macular edema and glaucoma as they affect ILM layer. The foremost purpose behind this segmentation is to correctly detect and diagnose glaucoma. Glaucoma is declared as the second common cause of blindness by World Health Organization, and can cause severe damage if not treated earlier. Optic-nerve-head (ONH) centered OCT scans are considered for glaucoma. Glaucoma can be described as cupping of optic nerve head, i.e. increase in the diameter of optic cup, and ends up in increasing cup to disc diameters (CDR) ratio. ILM is steeper in central-cup section in glaucoma images than normal images. Therefore, ILM is used to extract cup from macula or ONH centered OCT image volumes and then classify them further as glaucoma-tic or normal eye.
关键词： Cup to disc diameters (CDR),Spectral domain optical coherence tomography (SD-OCT),ILM,Segmentation,Glaucoma
更新于2025-09-10 09:29:36