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Sample records for experimental glaucoma filtration

  1. Cellular proliferation after experimental glaucoma filtration surgery

    SciTech Connect

    Jampel, H.D.; McGuigan, L.J.; Dunkelberger, G.R.; L'Hernault, N.L.; Quigley, H.A.

    1988-01-01

    We used light microscopic autoradiography to determine the time course of cellular incorporation of tritiated thymidine (a correlate of cell division) following glaucoma filtration surgery in seven eyes of four cynomolgus monkeys with experimental glaucoma. Incorporation of tritiated thymidine was detected as early as 24 hours postoperatively. Peak incorporation occurred five days postoperatively and had returned to baseline levels by day 11. Cells incorporating tritiated thymidine included keratocytes, episcleral cells, corneal and capillary endothelial cells, and conjunctival and corneal epithelial cells. Transmission electron microscopy was correlated with the autoradiographic results to demonstrate that fibroblasts were dividing on the corneoscleral margin. These findings have potential clinical implications for the use of antiproliferative agents after filtration surgery.

  2. Modulation of postoperative scarring with tacrolimus and octreotide in experimental glaucoma filtration surgery.

    PubMed

    Arslan, Sermal; Aydemir, Orhan; Güler, Mete; Dağlı, Adile Ferda

    2012-03-01

    The purposes of this study were to investigate the effects of topically administrated Tacrolimus and Octreotide on modulation of postoperative scarring in experimental glaucoma filtration surgery and to compare the antifibrotic properties of these agents with mitomycin-C (MMC). A total of 28 New Zealand rabbits weighing 2.5-3 kg were randomly divided into a surgical control (SC) group and three experimental groups. Standard filtration surgeries were performed on the right eyes of all the rabbits. The rabbits in the SC group received only vehicle after the surgeries, whereas the rabbits in the three experimental groups were treated either with 0.4 mg/mL MMC during the surgery (MMC group) or with 0.3 mg/mL Tacrolimus drop four times a day (TT group) or with 10 µg/mL Octreotide drop three times a day (OT group) for 14 days. The animals were killed on day 14, eyes were enucleated and histologically and immunohistochemically analyzed. In SC group mean fibroblast, mononuclear cell number and fibroblast growth factor-β (FGF-β), transforming growth factor-β (TGF-β) immunostaining intensity was higher than all treatment groups. In OT group mean fibroblast number was lesser than MMC (p < 0.01) and TT (p < 0.05) group. In TT group mean fibroblast number was lesser than MMC group (p < 0.05). Mean mononuclear cell number was similar between MMC, OT and TT groups (p > 0.05). In MMC, OT and TT groups mean TGF-β and FGF-β immunostaining intensity was similar (p > 0.05). Topically administration of Tacrolimus and Octreotide effectively reduced the subconjuntival scarring response 2 weeks after experimental glaucoma filtration surgery.

  3. Bevacizumab-loaded polyurethane subconjunctival implants: effects on experimental glaucoma filtration surgery.

    PubMed

    Paula, Jayter Silva; Ribeiro, Vanessa Raquel Coimbra; Chahud, Fernando; Cannellini, Roberta; Monteiro, Tassia Cristina; Gomes, Elionai Cassiana de Lima; Reinach, Peter Sol; Rodrigues, Maria de Lourdes Veronese; Silva-Cunha, Armando

    2013-01-01

    Vascular endothelial growth factor (VEGF) may contribute to the scarring process resulting from glaucoma filtration surgery, since this cytokine may stimulate fibroblast proliferation. The aim of this study was to describe a new bevacizumab-loaded polyurethane implant (BPUI) and to evaluate its effectiveness as a new drug delivery system of anti-VEGF antibody in a rabbit model of glaucoma filtration surgery. An aqueous dispersion of polyurethane was obtained via the conventional process. Bevacizumab (1.5 mg) was then incorporated into the dispersion and was subsequently dried to form the polymeric films. Films with dimensions of 3×3×1 mm that either did (group BPUI, n=10) or did not contain bevacizumab (group PUI, n=10) were implanted in the subconjunctival space, at the surgical site in 1 eye of each rabbit. The in vitro bevacizumab release was evaluated using size-exclusion high-performance liquid chromatography (HPLC), and the in vivo effects of the drug were investigated in a rabbit experimental trabeculectomy model by examining the bleb characteristics and collagen accumulation, and by performing immunohistological analyses of VEGF expression. HPLC showed that only 10% of the bevacizumab in the implants had been released by postoperative day 5. In vivo studies demonstrated that the drug had no adverse effects; however, no significant differences in either the bleb area score or the collagen deposit intensity between the group PUI and the group that BPUI were observed. Moreover, the group BPUI presented a significantly lower proportion of VEGF-expressing fibroblasts than group PUI (0.17±0.03 vs. 0.35±0.05 cells/field, P=0.005). This study demonstrated that bevacizumab release from the BPUIs only occurred for a short time probably from the surface of the films. Nevertheless, they were well tolerated in rabbit eyes and reduced the number of VEGF-expressing fibroblasts.

  4. Bevacizumab-Loaded Polyurethane Subconjunctival Implants: Effects on Experimental Glaucoma Filtration Surgery

    PubMed Central

    Ribeiro, Vanessa Raquel Coimbra; Chahud, Fernando; Cannellini, Roberta; Monteiro, Tassia Cristina; de Lima Gomes, Elionai Cassiana; Reinach, Peter Sol; Veronese Rodrigues, Maria de Lourdes; Silva-Cunha, Armando

    2013-01-01

    Abstract Purpose Vascular endothelial growth factor (VEGF) may contribute to the scarring process resulting from glaucoma filtration surgery, since this cytokine may stimulate fibroblast proliferation. The aim of this study was to describe a new bevacizumab-loaded polyurethane implant (BPUI) and to evaluate its effectiveness as a new drug delivery system of anti-VEGF antibody in a rabbit model of glaucoma filtration surgery. Methods An aqueous dispersion of polyurethane was obtained via the conventional process. Bevacizumab (1.5 mg) was then incorporated into the dispersion and was subsequently dried to form the polymeric films. Films with dimensions of 3×3×1 mm that either did (group BPUI, n=10) or did not contain bevacizumab (group PUI, n=10) were implanted in the subconjunctival space, at the surgical site in 1 eye of each rabbit. The in vitro bevacizumab release was evaluated using size-exclusion high-performance liquid chromatography (HPLC), and the in vivo effects of the drug were investigated in a rabbit experimental trabeculectomy model by examining the bleb characteristics and collagen accumulation, and by performing immunohistological analyses of VEGF expression. Results HPLC showed that only 10% of the bevacizumab in the implants had been released by postoperative day 5. In vivo studies demonstrated that the drug had no adverse effects; however, no significant differences in either the bleb area score or the collagen deposit intensity between the group PUI and the group that BPUI were observed. Moreover, the group BPUI presented a significantly lower proportion of VEGF-expressing fibroblasts than group PUI (0.17±0.03 vs. 0.35±0.05 cells/field, P=0.005). Conclusions This study demonstrated that bevacizumab release from the BPUIs only occurred for a short time probably from the surface of the films. Nevertheless, they were well tolerated in rabbit eyes and reduced the number of VEGF-expressing fibroblasts. PMID:23391327

  5. Topical infliximab for the suppression of wound healing following experimental glaucoma filtration surgery

    PubMed Central

    Turgut, Burak; Eren, Kenan; Akın, Mehmet Mustafa; Demir, Tamer; Kobat, Sabiha

    2014-01-01

    Background The purpose of this work was to look into the effects of infliximab on wound healing in experimental glaucoma filtration surgery and to compare the antifibrotic effects of this agent to that of mitomycin-C (MMC). Methods Twenty-eight male New Zealand White rabbits were randomly assigned to four groups, each including seven rabbits: control group, sham group, MMC group, and infliximab group. The rabbits in the control group were not operated on and did not receive any treatment. The rabbits in the sham group underwent trabeculectomy and had one drop of saline instilled four times a day for 14 days. The rabbits in the MMC treatment group underwent trabeculectomy, and a sponge soaked in 0.4 mg/mL MMC was applied intraoperatively to the scleral surgical site for three minutes. The rabbits in the infliximab treatment group underwent trabeculectomy and one drop of 10 mg/mL infliximab was instilled four times a day for 14 days after surgery. On day 14 of the experiment, the operated and control eyes were enucleated and histologically and immunohistochemically analyzed. Results The mean fibroblast and mononuclear cell (MNC) numbers and the mean immunostaining intensities of transforming growth factor-β (TGF-β), fibroblast growth factor-β (FGF-β), and platelet-derived growth factor (PDGF) in the sham group were higher than those of the control group (P<0.01). The mean fibroblast and MNC numbers and the mean immunostaining intensities of TGF-β, FGF-β, and PDGF in the MMC and infliximab groups were statistically significantly lower than those of the sham group (P<0.01). The mean fibroblast and MNC numbers and the mean TGF-β, FGF-β, and PDGF immunostaining intensities of the MMC and infliximab groups were similar (P>0.05). Conclusion Our study suggests that topical infliximab effectively suppresses the subconjunctival wound healing response after experimental glaucoma filtration surgery, reducing the MNC and fibroblast numbers and immunostaining intensities

  6. Safety of Using Matrix Metalloproteinase Inhibitor in Experimental Glaucoma Filtration Surgery.

    PubMed

    Suh, Wool; Han, Kyung Eun; Han, Jae Ryong

    2017-04-01

    We evaluated the safety of matrix metalloproteinase (MMP) inhibitor in experimental glaucoma filtration surgery in an animal model. Fifteen New Zealand white rabbits underwent an experimental trabeculectomy and were randomly allocated into 3 groups according to the adjuvant agent: no treatment group (n = 5), 0.02% mitomycin C (MMC) soaking group (n = 5), and MMP inhibitor (ilomastat) subconjunctival injection group (n = 5). Slit lamp examination with Seidel testing, pachymetry, and specular microscopy was performed preoperatively and postoperatively. The conjunctiva and ciliary body toxicity were evaluated with scores according to the pathologic grading systems. Electron microscopy was used to examine the structural changes in cornea, conjunctiva, and ciliary body. In the ilomastat-treated group, there was no statistically significant change in central corneal thickness preoperatively and at 28 days postoperatively (P = 0.655). There were also no significant changes in specular microscopy findings over the duration of the study in the ilomastat-treated group. The conjunctival toxicity score was 1 in the control group, 1.5 in the ilomastat-treated group, and 2 in the MMC-treated group. When assessing ciliary body toxicity scores, the ilomastat-treated group score was 0.5 and the MMC-treated group score was 1.5. Transmission electron microscopy did not show structural changes in the cornea and ciliary body whereas the structural changes were noticed in MMC group. A single subconjunctival injection of MMP inhibitor during the experimental trabeculectomy showed a less toxic affect in the rabbit cornea, conjunctiva, and ciliary body compared to MMC. © 2017 The Korean Academy of Medical Sciences.

  7. Safety of Using Matrix Metalloproteinase Inhibitor in Experimental Glaucoma Filtration Surgery

    PubMed Central

    2017-01-01

    We evaluated the safety of matrix metalloproteinase (MMP) inhibitor in experimental glaucoma filtration surgery in an animal model. Fifteen New Zealand white rabbits underwent an experimental trabeculectomy and were randomly allocated into 3 groups according to the adjuvant agent: no treatment group (n = 5), 0.02% mitomycin C (MMC) soaking group (n = 5), and MMP inhibitor (ilomastat) subconjunctival injection group (n = 5). Slit lamp examination with Seidel testing, pachymetry, and specular microscopy was performed preoperatively and postoperatively. The conjunctiva and ciliary body toxicity were evaluated with scores according to the pathologic grading systems. Electron microscopy was used to examine the structural changes in cornea, conjunctiva, and ciliary body. In the ilomastat-treated group, there was no statistically significant change in central corneal thickness preoperatively and at 28 days postoperatively (P = 0.655). There were also no significant changes in specular microscopy findings over the duration of the study in the ilomastat-treated group. The conjunctival toxicity score was 1 in the control group, 1.5 in the ilomastat-treated group, and 2 in the MMC-treated group. When assessing ciliary body toxicity scores, the ilomastat-treated group score was 0.5 and the MMC-treated group score was 1.5. Transmission electron microscopy did not show structural changes in the cornea and ciliary body whereas the structural changes were noticed in MMC group. A single subconjunctival injection of MMP inhibitor during the experimental trabeculectomy showed a less toxic affect in the rabbit cornea, conjunctiva, and ciliary body compared to MMC. PMID:28244295

  8. Overexpression of CDKN1B inhibits fibroblast proliferation in a rabbit model of experimental glaucoma filtration surgery.

    PubMed

    Yang, Jian-gang; Deng, Ying; Zhou, Ling-xiao; Li, Xiao-yan; Sun, Peng-rui; Sun, Nai-xue

    2013-01-14

    To investigate the potential antiproliferative effect of cyclin-dependent kinase inhibitor 1B (CDKN1B) overexpression in a rabbit model of glaucoma filtration surgery (GFS). The recombinant adenovector expressing exogenous CDKN1B was delivered to Tenon's capsule by subconjunctival injection during unilateral filtration surgery. The time course of CDKN1B expression was monitored by immunohistochemistry and Western blot analysis. Evaluation of proliferating activity was performed by proliferating cell nuclear antigen (PCNA), argyrophilic nucleolar organizing region (AgNOR) staining, and fibroblast-specific protein 1 (FSP-1). Cyclin-dependent kinase 2 (Cdk2) and Cdk4 expression were detected with immunohistochemical analysis. The overexpression of CDKN1B in Tenon's capsule was monitored throughout the experimental period. Immunoreactivity to CDKN1B was mainly observed in the nucleus of fibroblasts. The increased expression of CDKN1B in sclera was detected up to 21 days after viral infection, whereas the level of CDKN1B protein in corneal stroma was not significantly increased. The overexpression of CDKN1B induced a significant decrease in AgNOR number/nucleus and area/nucleus, PCNA staining, FSP-1 positive cells, and the decreased expressions of Cdk2 and Cdk4, as evidenced by nuclear and cytoplasmic immunoreactivity to Cdk2 and Cdk4 antibodies in positive fibroblasts. The persistent overexpression of CDKN1B mediated by the recombinant adenovector expressing exogenous CDKN1B in Tenon's fibroblasts after GFS may lead to the inhibition of fibroblast proliferation and the downregulation of Cdk2 and Cdk4 activity, thereby reducing the severity of scar formation and the surgical outcome.

  9. EX-PRESS Glaucoma Filtration Device: efficacy, safety, and predictability.

    PubMed

    Chan, Jessica E; Netland, Peter A

    2015-01-01

    Trabeculectomy has been the traditional primary surgical therapy for open-angle glaucoma. While trabeculectomy is effective in lowering intraocular pressure, complications associated with the procedure have motivated the development of alternative techniques and devices, including the EX-PRESS Glaucoma Filtration Device. This review describes the efficacy, safety, complication rates, and potential advantages and disadvantages of the EX-PRESS Glaucoma Filtration Device. EX-PRESS implantation is technically simpler compared with that of trabeculectomy, with fewer surgical steps. Vision recovery has been more rapid after EX-PRESS implantation compared with trabeculectomy. Intraocular pressure variation is lower during the early postoperative period, indicating a more predictable procedure. While efficacy of the EX-PRESS implant has been comparable to trabeculectomy, postoperative complications appear less common after EX-PRESS implantation compared with trabeculectomy. The EX-PRESS Glaucoma Filtration Device appears to be safe and effective in the surgical management of open-angle glaucoma.

  10. Vision-related quality of life following glaucoma filtration surgery.

    PubMed

    Hirooka, Kazuyuki; Nitta, Eri; Ukegawa, Kaori; Tsujikawa, Akitaka

    2017-05-12

    To evaluate vision-related quality of life (VR-QOL) following glaucoma filtration surgery. A total of 103 glaucoma patients scheduled to undergo glaucoma filtration surgery. Prior to and at three months after glaucoma filtration surgery, trabeculectomy or EX-PRESS, all patients completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). A total of 48 patients underwent combined cataract and filtration surgery. The clinical data collected pre- and postoperatively included best-corrected visual acuity (BCVA) and intraocular pressure (IOP). The IOP decreased significantly from 19.0 ± 8.1 mmHg to 9.7 ± 3.9 mmHg (P < 0.001). Preoperative VFQ-25 composite score (65.8 ± 15.6) was similar to the postoperative score (67.8 ± 16.6). A significantly improved VFQ-25 composite score (pre: 63.2 ± 17.1, post: 67.7 ± 17.8; P = 0.001) was observed in the patients who underwent combined cataract and filtration surgery. There was a significant association between the BCVA changes in the operated eye and the changes in the VFQ-25 composite score (r = -0.315, P = 0.003). Although glaucoma filtration surgery by itself did not decrease the VR-QOL in glaucoma patients, there was significant improvement in the VR-QOL after the patients underwent combined cataract and glaucoma filtration surgery.

  11. [Evaluation of preoperative anxiety in patients requiring glaucoma filtration surgery].

    PubMed

    Lemaitre, S; Blumen-Ohana, E; Akesbi, J; Laplace, O; Nordmann, J-P

    2014-01-01

    Preoperative anxiety is often expressed by patients requiring filtration surgery for their glaucoma. So far, there has been no scale for screening this group of patients for preoperative anxiety. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-evaluation questionnaire which has been used in specialties other than ophthalmology and which makes it possible to identify the adult patients with a high level of preoperative anxiety over an upcoming surgical procedure. The purpose of this study is to estimate the preoperative anxiety in glaucoma patients requiring filtration surgery. We performed a prospective study of 36 adult patients with chronic glaucoma not responding to medical treatment and who were about to undergo filtration surgery (trabeculectomy or deep sclerectomy). The APAIS questionnaire was given to the patients after discussing the indication for surgery. A global anxiety score (ranging from 4 to 20) above 10 defined patients with a high level of preoperative anxiety. We attempted to identify among these patients the factors related to filtration surgery which caused them anxiety (lack of control of intraocular pressure, risk of blindness, presence of the filtering bleb). In our sample of patients, we found that glaucoma was a source of anxiety. That was also true for the surgical procedure, though most patients believe that once the decision had been made, their psychological status was not modified by the upcoming procedure. The patient-clinician relationship is important in any chronic disease, all the more so in glaucoma, since this disease remains asymptomatic for a long time. When filtration surgery is necessary, the patients are going to express less preoperative anxiety if they trust their physician and if individualized information has been given to them The French version of the APAIS is a quick scale, easily completed, that can be recommended for evaluating anxiety and patients' need for information prior to filtering

  12. Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma.

    PubMed

    Angmo, Dewang; Sharma, Reetika; Temkar, Shreyas; Dada, Tanuj

    2015-05-01

    ExPress glaucoma filtration device (GFD) has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs) not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications) was achieved in eight cases (66.7%) and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications) in two cases (16.7%) at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37). ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma's, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.

  13. Experimental data filtration algorithm

    NASA Astrophysics Data System (ADS)

    Oanta, E.; Tamas, R.; Danisor, A.

    2017-08-01

    Experimental data reduction is an important topic because the resulting information is used to calibrate the theoretical models and to verify the accuracy of their results. The paper presents some ideas used to extract a subset of points from the initial set of points which defines an experimentally acquired curve. The objective is to get a subset with significantly fewer points as the initial data set and which accurately defines a smooth curve that preserves the shape of the initial curve. Being a general study we used only data filtering criteria based geometric features that at a later stage may be related to upper level conditions specific to the phenomenon under investigation. Five algorithms were conceived and implemented in an original software consisting of more than 1800 computer code lines which has a flexible structure that allows us to easily update it using new algorithms. The software instrument was used to process the data of several case studies. Conclusions are drawn regarding the values of the parameters used in the algorithms to decide if a series of points may be considered either noise, or a relevant part of the curve. Being a general analysis, the result is a computer based trial-and-error method that efficiently solves this kind of problems.

  14. Experimental Contact Lens to Prevent Glaucoma-Induced Blindness

    MedlinePlus

    ... Articles | Inside Life Science Home Page An Experimental Contact Lens to Prevent Glaucoma-Induced Blindness By Sharon Reynolds Posted January 23, 2014 An experimental contact lens design releases a glaucoma medicine at a ...

  15. Glaucoma

    MedlinePlus

    ... closure glaucoma; Acute glaucoma; Secondary glaucoma; Congenital glaucoma; Vision loss - glaucoma ... the optic nerve causes blind spots in your vision. Open-angle glaucoma tends to run in families. ...

  16. Glaucoma

    MedlinePlus

    ... version of this page please turn Javascript on. Glaucoma What is Glaucoma? Glaucoma is a group of diseases that can ... is much greater for people over 60. How Glaucoma Develops There are several different types of glaucoma. ...

  17. EX-PRESS glaucoma filtration device: Review of clinical experience and comparison with trabeculectomy.

    PubMed

    Shaarawy, Tarek; Goldberg, Ivan; Fechtner, Robert

    2015-01-01

    Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, the most widely utilized procedure for glaucoma filtration surgery has been trabeculectomy. Although this approach reliably provides long-term IOP reduction in many patients, the postoperative complication rate is high. This has driven the development of alternative approaches to reduce IOP surgically. The EX-PRESS glaucoma filtration device was developed to mimic IOP control by trabeculectomy and to have a better safety profile. This non-valved, medical-grade stainless steel device diverts aqueous humor from the anterior chamber to an intrascleral space. Despite the widespread use of the EX-PRESS device, only a few studies compare its efficacy and safety with that of trabeculectomy. We analyze available data regarding the safety and efficacy of the EX-PRESS device, particularly in comparison with trabeculectomy.

  18. Experimentally Induced Mammalian Models of Glaucoma

    PubMed Central

    Yoshitomi, Takeshi; Zorumski, Charles F.; Izumi, Yukitoshi

    2015-01-01

    A wide variety of animal models have been used to study glaucoma. Although these models provide valuable information about the disease, there is still no ideal model for studying glaucoma due to its complex pathogenesis. Animal models for glaucoma are pivotal for clarifying glaucoma etiology and for developing novel therapeutic strategies to halt disease progression. In this review paper, we summarize some of the major findings obtained in various glaucoma models and examine the strengths and limitations of these models. PMID:26064891

  19. Five-year extension of a clinical trial comparing the EX-PRESS glaucoma filtration device and trabeculectomy in primary open-angle glaucoma.

    PubMed

    de Jong, Leo; Lafuma, Antoine; Aguadé, Anne-Sophie; Berdeaux, Gilles

    2011-01-01

    This study compared the efficacy of the EX-PRESS(®) glaucoma filtration device and trabeculectomy in primary open-angle glaucoma up to five years after surgery. Patients from a previously reported randomized, open-label, parallel-arm clinical trial in which 78 patients received either the EX-PRESS glaucoma filtration device or underwent a trabeculectomy were followed for up to an additional four years (five total) beyond the original study (39 eyes per treatment group). Risk-benefit data were obtained for up to five years after glaucoma surgery. Outcome variables were intraocular pressures and intraocular pressure medications. Complete success was denoted by intraocular pressure values ≤ 18 mmHg without medication. The EX-PRESS glaucoma filtration device controlled intraocular pressure more effectively without medication for more patients from year 1 (86.8% versus 61.5%, P = 0.01) to year 3 (66.7% versus 41.0%, P = 0.02) than trabeculectomy. At year 1, only 12.8% of patients required intraocular pressure medication after EX-PRESS implantation, compared with 35.9% after trabeculectomy. The proportions became closer at year 5 (41% versus 53.9%). The responder rate was higher with EX-PRESS and time to failure was longer. In addition, surgical interventions for complications were fewer after EX-PRESS implantation. This five-year analysis confirmed and extended the results reported after one year. Compared with trabeculectomy, EX-PRESS provided better intraocular pressure control in the first three years, and patients required fewer intraocular pressure medications and fewer surgical interventions during the five-year study period. For patients with primary open-angle glaucoma, the EX-PRESS glaucoma filtration device, implanted under a superficial scleral flap, produced significantly higher success rates than trabeculectomy. EX-PRESS is an effective device for long-term treatment of primary open-angle glaucoma.

  20. Rho kinase inhibitor AMA0526 improves surgical outcome in a rabbit model of glaucoma filtration surgery.

    PubMed

    Van de Velde, Sarah; Van Bergen, Tine; Vandewalle, Evelien; Kindt, Nele; Castermans, Karolien; Moons, Lieve; Stalmans, Ingeborg

    2015-01-01

    First, to elucidate the effect of Rho kinase inhibitor, AMA0526, on Human Tenon Fibroblast (HTF) proliferation and transdifferentiation to myofibroblasts. Second, the effects of ROCK inhibition on the wound healing process and surgical outcome were investigated in a rabbit model of glaucoma filtration surgery. After exposure of HTF to AMA0526 (0.1-25 μM), a water-soluble tetrazolium salt-1 assay and caspase 3/7 activity assay were used to assess its effect on cell proliferation and to elucidate any toxic effects, respectively. Immunohistochemistry of α-smooth muscle actin expression was used to investigate fibroblast-to-myofibroblast differentiation induced by transforming growth factor-beta 1 (TGF-β1) in the presence or absence of the ROCK inhibitor. The effect of topical treatment was studied in a rabbit model of glaucoma filtration surgery. Treatment outcome was studied by performing intraocular pressure (IOP) measurements and clinical investigation of the bleb area and survival. Immunohistological analysis for inflammation (CD45), angiogenesis (CD31), and collagen I was performed at day 8, 14, and 30 after surgery (n=5/time point). Separate control groups treated with vehicle were used as control. In vitro results showed that AMA0526 dose dependently inhibited proliferation of HTF (P<0.05) without the induction of caspase 3/7 activity. Incubation of HTF with the AMA0526 inhibited TGF-β1 induced fibroblast-to-myofibroblast differentiation. In the rabbit model, topical treatment significantly improved surgical outcome. Compared to vehicle-treated eyes, AMA0526 resulted in increased bleb area (P<0.0001) and prolonged survival (P=0.0025). IOP remained significantly lower throughout the course of the experiment in the AMA0526 group (P<0.0001). Histological evaluation revealed that blebs treated with the ROCK inhibitor were characterized by reduced inflammation, angiogenesis, and collagen deposition at the site of filtration surgery (P<0.05). AMA0526 had profound

  1. Scleral fibroblast response to experimental glaucoma in mice

    PubMed Central

    Tezel, Gülgün; Cone-Kimball, Elizabeth; Steinhart, Matthew R.; Jefferys, Joan; Pease, Mary E.; Quigley, Harry A.

    2016-01-01

    Purpose To study the detailed cellular and molecular changes in the mouse sclera subjected to experimental glaucoma. Methods Three strains of mice underwent experimental bead-injection glaucoma and were euthanized at 3 days and 1, 3, and 6 weeks. Scleral protein expression was analyzed with liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) using 16O/18O labeling for quantification in 1- and 6-week tissues. Sclera protein samples were also analyzed with immunoblotting with specific antibodies to selected proteins. The proportion of proliferating scleral fibroblasts was quantified with Ki67 and 4’,6-diamidino-2-phenylindole (DAPI) labeling, and selected proteins were studied with immunohistochemistry. Results Proteomic analysis showed increases in molecules involved in integrin-linked kinase signaling and actin cytoskeleton signaling pathways at 1 and 6 weeks after experimental glaucoma. The peripapillary scleral region had more fibroblasts than equatorial sclera (p=0.001, n=217, multivariable regression models). There was a sixfold increase in proliferating fibroblasts in the experimental glaucoma sclera at 1 week and a threefold rise at 3 and 6 weeks (p=0.0005, univariate regression). Immunoblots confirmed increases for myosin, spectrin, and actinin at 1 week after glaucoma. Thrombospondin-1 (TSP-1), HINT1, vimentin, actinin, and α-smooth muscle actin were increased according to immunohistochemistry. Conclusions Scleral fibroblasts in experimental mouse glaucoma show increases in actin cytoskeleton and integrin-related signaling, increases in cell division, and features compatible with myofibroblast transition. PMID:26900327

  2. Management of hypotony and flat anterior chamber associated with glaucoma filtration surgery

    PubMed Central

    Tunç, Yavuz; Tetikoglu, Mehmet; Kara, Necip; Sagdık, Haci Murat; Özarpaci, Selahattin; Elçioğlu, Mustafa Nuri

    2015-01-01

    AIM To determine the effectiveness of pharmacological and interventional treatment of hypotony and flat anterior chamber (FAC) resulting from glaucoma filtration surgery. METHODS We retrospectively examined the medical records of fifty-two trabeculectomy patients (52 eyes) who developed postoperative hypotony and FAC. The management and associated complications of hypotony, changing intraocular pressure (IOP) and best corrected visual acuity (BCVA) were evaluated. RESULT Of the 52 patients with hypotony, 29 (56%) had a grade 1 FAC, 21 (40%) had a grade 2 FAC, and only 2 had a grade 3 FAC. There was no significant difference between the mean preoperative IOP and the mean IOP at three and six months after surgery. Thirteen eyes (25%) required antiglaucomatous medication three months after surgery. The mean BCVA at 6mo after surgery was significantly reduced as compared with the mean preoperative BCVA. CONCLUSION Hypotonia and FAC following trabeculectomy are associated with troublesome complications that require pharmacological and/or surgical treatment. Thus, close follow-up is essential for affected patients. PMID:26558207

  3. Glaucoma

    MedlinePlus

    ... 60, especially Mexican Americans People with a family history of glaucoma There is no cure, but glaucoma can usually be controlled. Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and/or surgery. NIH: National Eye Institute

  4. Epigenetic Modification Prevents Excessive Wound Healing and Scar Formation After Glaucoma Filtration Surgery.

    PubMed

    Sharma, Ajay; Anumanthan, Govindaraj; Reyes, Marcos; Chen, Huiyi; Brubaker, Jacob W; Siddiqui, Saad; Gupta, Suneel; Rieger, Frank G; Mohan, Rajiv R

    2016-06-01

    The purpose of this study was to determine the efficacy of suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor (HDACi), in prevention of excessive wound healing and scar formation in a rabbit model of glaucoma filtration surgery (GFS). A rabbit model of GFS was used. Rabbits that underwent GFS received balanced salt solution, or SAHA (50 μM), or mitomycin C (0.02%). Clinical scores of IOP, bleb vascularity, and slit-lamp examination were performed. On postoperative day 14, rabbits were killed and the bleb tissues were collected for evaluation of tissue fibrosis with hematoxylin and eosin, Masson trichrome, α-smooth muscle actin (αSMA), and F-actin staining. Furthermore, SAHA-mediated acetylation of histones in corneal fibroblasts and conjunctiva were determined by Western blot analysis. Suberoylanilide hydroxamic acid treatment after GFS showed no signs of edema, corneal opacity, endophthalmitis, or cataract formation. Morphometric analysis of SAHA-treated eyes showed higher bleb length (P < 0.001), bleb area (P < 0.05), lower IOP (P < 0.01), and decreased vascularity compared to control. Furthermore, SAHA treatment showed significantly reduced levels of αSMA (P < 0.001), F-actin (P < 0.01), and collagen deposition (P < 0.05) at the sclerotomy site. In addition, SAHA treatment increased the acetylation status of H3 and H4 histones in corneal fibroblasts and conjunctiva. This study demonstrates that HDAC inhibition is an attractive pharmacologic target to modulate GFS wound healing, and SAHA, an HDACi, can be a useful adjunct to improve the GFS outcome.

  5. Withaferin A Effectively Targets Soluble Vimentin in the Glaucoma Filtration Surgical Model of Fibrosis

    PubMed Central

    Bargagna-Mohan, Paola; Deokule, Sunil P.; Thompson, Kyle; Wizeman, John; Srinivasan, Cidambi; Vooturi, Sunil; Kompella, Uday B.; Mohan, Royce

    2013-01-01

    Withaferin A (WFA) is a natural product that binds to soluble forms of the type III intermediate filament (IF) vimentin. Currently, it is unknown under what pathophysiological contexts vimentin is druggable, as cytoskeltal vimentin-IFs are abundantly expressed. To investigate druggability of vimentin, we exploited rabbit Tenon's capsule fibroblast (RbTCF) cell cultures and the rabbit glaucoma filtration surgical (GFS) model of fibrosis. WFA potently caused G0/G1 cell cycle inhibition (IC50 25 nM) in RbTCFs, downregulating ubiquitin E3 ligase skp2 and inducing p27Kip1 expression. Transforming growth factor (TGF)-ß-induced myofibroblast transformation caused development of cell spheroids with numerous elongated invadopodia, which WFA blocked potently by downregulating soluble vimentin and α-smooth muscle actin (SMA) expression. In the pilot proof-of-concept study using the GFS model, subconjunctival injections of a low WFA dose reduced skp2 expression in Tenon's capsule and increased p27Kip1 expression without significant alteration to vimentin-IFs. This treatment maintains significant nanomolar WFA concentrations in anterior segment tissues that correspond to WFA's cell cycle targeting activity. A ten-fold higher WFA dose caused potent downregulation of soluble vimentin and skp2 expression, but as found in cell cultures, no further increase in p27Kip1 expression was observed. Instead, this high WFA dose potently induced vimentin-IF disruption and downregulated α-SMA expression that mimicked WFA activity in TGF-ß-treated RbTCFs that blocked cell contractile activity at submicromolar concentrations. These findings illuminate that localized WFA injection to ocular tissues exerts pharmacological control over the skp2-p27Kip1 pathway by targeting of soluble vimentin in a model of surgical fibrosis. PMID:23667686

  6. Effect of Lovastatin on Wound-Healing Modulation After Glaucoma Filtration Surgery in a Rabbit Model.

    PubMed

    Park, Ji-Hye; Yoo, Chungkwon; Kim, Yong Yeon

    2016-04-01

    To investigate the efficacy of lovastatin as an antifibrotic agent after glaucoma filtration surgery (GFS) in a rabbit model. Thirty New Zealand white rabbits underwent GFS on the right eye. The rabbits were randomly assigned to one of three groups: (1) the mitomycin-C (MMC) group, which received 0.2 mg/mL MMC-soaked Weck-Cel under the conjunctival flap; (2) the control group, which received postoperative subconjunctival injections with 0.1 mL balanced salt solution (BSS); and (3) the lovastatin group, which received postoperative subconjunctival injection with 0.1 mL lovastatin (10 μM). Intraocular pressure (IOP), bleb survival, and bleb morphology were examined until blebs showed evidence of failure. Three rabbits in each group were killed on postoperative day (POD) 5, and analyzed for histology and immunohistochemistry. Lovastatin significantly improved bleb survival compared with that in the control group (P = 0.002); however, no significant difference in bleb survival was observed between the MMC and lovastatin groups (P = 0.097). The lovastatin group showed significantly larger and higher blebs than did the control group. Further, the IOPs of the lovastatin and MMC groups were significantly lower than that of the control group (8.0 ± 1.4 mm Hg, 7.9 ± 3.2 mm Hg, and 11.1 ± 2.9 mm Hg, respectively; P = 0.016) on POD 5. Histologic analyses revealed decreased inflammatory response and reduced fibrosis in the lovastatin group than in the control group. Postoperative injection of lovastatin improved bleb survival in the rabbit model of GFS. Therefore, lovastatin may have potential as a novel wound-modulating agent after GFS.

  7. [Glaucoma].

    PubMed

    Funk, Jens

    2009-03-01

    Glaucoma is one of the most frequent causes of blindness in the world. Although there are several different subforms of glaucoma, their final common pathway is an atrophy of the optic disc leading to progressive visual field defects and finally total blindness. The loss of function in glaucoma is irreversible, i.e. early detection of the disease is the most important part of its therapy. Early detection, however, requires improved knowledge about the disease in the general population and the active help of all general practitioners, explaining their patients the insidious nature of the disease.

  8. Evaluation of pirfenidone as a new postoperative antiscarring agent in experimental glaucoma surgery.

    PubMed

    Zhong, Hua; Sun, Guoying; Lin, Xianchai; Wu, Kaili; Yu, Minbin

    2011-05-16

    To investigate whether topical administration of pirfenidone eye drops could be used to prevent postoperative scarring in a rabbit model of experimental glaucoma filtration surgery. In a randomized, controlled, masked-observer study, 40 rabbits underwent trabeculectomy in the right eyes and randomly received postoperative administration of 0.1% or 0.5% pirfenidone, perioperative mitomycin C (0.25 mg/mL), or no treatment. Bleb characteristics and functions were evaluated over a period of 4 weeks. The animals were killed on days 7, 14, and 28. Histopathology and immunohistochemistry were performed to determine the amount of scarring and fibrosis. Ocular toxicity was assessed by the Draize test, histopathology, and electron microscope. The four treatment groups were similar with respect to intraocular pressure and anterior chamber depth. Pirfenidone 0.5% significantly prolonged bleb survival, and the blebs were larger and higher than those in the control group (P < 0.05); the 0.1% pirfenidone concentration was less effective. Furthermore, the histology and immunohistology results showed that the 0.5% pirfenidone and mitomycin C groups had less scarring at days 7 to 28 than did the controls. Toxicity assessments showed that pirfenidone did not damage the rabbit eyes. Postoperative use of 0.5% pirfenidone eye drops was associated with improved trabeculectomy bleb survival in a rabbit model. Pirfenidone eye drops may be a safe and effective antiscarring agent in glaucoma filtration surgery.

  9. Glaucoma.

    PubMed

    Mantravadi, Anand V; Vadhar, Neil

    2015-09-01

    Glaucoma is a multifactorial degenerative optic neuropathy that can progress at variable rates and afflict all age groups. It is the second leading cause of blindness worldwide. The disease is commonly divided into 2 major subtypes, open angle and angle closure. Diagnosis of glaucoma is made by a combination of identifying characteristic changes of the optic nerve, functional testing such as visual fields, and structural imaging of the optic nerve. Management is aimed at reducing intraocular pressure (IOP). Patients with known risk factors should be referred to an ophthalmologist for complete evaluation.

  10. The Non-Human Primate Experimental Glaucoma Model

    PubMed Central

    Burgoyne, Claude F.

    2015-01-01

    The purpose of this report is to summarize the current strengths and weaknesses of the non-human primate (NHP) experimental glaucoma (EG) model through sections devoted to its history, methods, important findings, alternative optic neuropathy models and future directions. NHP EG has become well established for studying human glaucoma in part because the NHP optic nerve head (ONH) shares a close anatomic association with the human ONH and because it provides the only means of systematically studying the very earliest visual system responses to chronic IOP elevation, i.e. the conversion from ocular hypertension to glaucomatous damage. However, NHPs are impractical for studies that require large animal numbers, demonstrate spontaneous glaucoma only rarely, do not currently provide a model of the neuropathy at normal levels of IOP, and cannot easily be genetically manipulated, except through tissue-specific, viral vectors. The goal of this summary is to direct NHP EG and non-NHP EG investigators to the previous, current and future accomplishment of clinically relevant knowledge in this model. PMID:26070984

  11. FTY720 protects retinal ganglion cells in experimental glaucoma.

    PubMed

    You, Yuyi; Gupta, Vivek K; Li, Jonathan C; Al-Adawy, Nadia; Klistorner, Alexander; Graham, Stuart L

    2014-04-17

    To investigate the neuroprotective effects of sphingosine-1-phosphate (S1P) analogue fingolimod (FTY720) in experimental glaucoma in rats. A unilateral chronic ocular hypertensive model was established by injections of microbeads into the anterior eye chamber of adult Sprague-Dawley rats. Fingolimod was administered to one group of rats intraperitoneally every week for 3 months. The scotopic threshold response (STR) was recorded to assess the function of the inner retina. Changes in cell density in the ganglion cell layer (GCL) were evaluated by hematoxylin and eosin staining on retinal sections and axonal count of the optic nerve was performed using Bielschowsky's silver staining. Effects of drug treatment on activation of Akt and Erk1/2 were evaluated using Western blotting by assessing phosphorylation levels of these proteins. The expression of S1P receptors in the optic nerve head region was also evaluated using Western blotting and immunohistochemistry. Administration of FTY720 reduced the loss of STR amplitude in glaucomatous eyes (P < 0.05). Counting and plotting the cell numbers/axonal density showed significant neural preservation in the GCL and the optic nerve (P < 0.05). An increased phosphorylation level of Akt and Erk1/2 following FTY720 administration was observed. Both S1P1 and S1P5 receptors were found to be expressed in the retina and the expression of S1P1R was upregulated in experimentally-induced glaucoma. This study demonstrates, for the first time, that FTY720 could act as a neuroprotective agent to protect retinal ganglion cells in experimental glaucoma. Administration of this drug significantly reduces the structural and functional loss of the inner retina elicited indicating that it may potentially be used to attenuate neuronal loss and optic nerve damage in glaucomatous patients. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  12. Lamina Cribrosa Microarchitecture in Monkey Early Experimental Glaucoma: Global Change

    PubMed Central

    Reynaud, Juan; Lockwood, Howard; Gardiner, Stuart K.; Williams, Galen; Yang, Hongli; Burgoyne, Claude F.

    2016-01-01

    Purpose The purpose of this study was to characterize experimental glaucoma (EG) versus control eye differences in lamina cribrosa (LC), beam diameter (BD), pore diameter (PD), connective tissue volume fraction (CTVF), connective tissue volume (CTV), and LC volume (LV) in monkey early EG. Methods Optic nerve heads (ONHs) of 14 unilateral EG and 6 bilateral normal (BN) monkeys underwent three-dimensional reconstruction and LC beam segmentation. Each beam and pore voxel was assigned a diameter based on the largest sphere that contained it before transformation to a common cylinder with inner, middle, and outer layers. Full-thickness and layer averages for BD, PD, CTVF, CTV, and LV were calculated for each ONH. Beam diameter and PD distributions for each ONH were fit to a gamma distribution and summarized by scale and shape parameters. Experimental glaucoma and depth effects were assessed for each parameter by linear mixed-effects (LME) modeling. Animal-specific EG versus control eye differences that exceeded the maximum intereye difference among the six BN animals were considered significant. Results Overall EG eye mean PD was 12.8% larger (28.2 ± 5.6 vs. 25.0 ± 3.3 μm), CTV was 26.5% larger (100.06 ± 47.98 vs. 79.12 ± 28.35 × 106 μm3), and LV was 40% larger (229.29 ± 98.19 vs. 163.63 ± 39.87 × 106 μm3) than control eyes (P ≤ 0.05, LME). Experimental glaucoma effects were significantly different by layer for PD (P = 0.0097) and CTVF (P < 0.0001). Pore diameter expanded consistently across all PDs. Experimental glaucoma eye-specific parameter change was variable in magnitude and direction. Conclusions Pore diameter, CTV, and LV increase in monkey early EG; however, EG eye-specific change is variable and includes both increases and decreases in BD and CTVF. PMID:27362781

  13. Trabeculectomy Versus Ex-Press Glaucoma Filtration Device in Silicomacrophagocytic Open Angle Glaucoma Secondary to Silicone Oil Emulsification

    PubMed Central

    Errico, Donato; Scrimieri, Francesca Luigia; Riccardi, Roberta; Iarossi, Giancarlo

    2016-01-01

    Purpose: To compare the outcomes of Ex-PRESS device implantation versus trabeculectomy in patients with ocular hypertension after pars plana vitrectomy and silicone oil injection (SOI). Materials and Methods: Twenty-six consecutive eyes with ocular hypertension after pars plana vitrectomy and SOI were included in this study and randomized to one of two groups: A group treated with Ex-PRESS (model P50) placed under a scleral flap (Ex-PRESS group), and a group treated with trabeculectomy (trabeculectomy group). Complete success (intraocular pressure [IOP] <21 mmHg without medication) and qualified success rates (IOP <21 mmHg with one or two glaucoma medications) at 2 years postoperatively were analyzed. Between-groups comparison was performed with the Mann-Whitney U-test for continuous variables, and Fischer exact test for categorical data. Success rates between groups were compared using Kaplan-Meier life analysis and the log-rank test. P < 0.05 was considered statistically significant. Results: In the Ex-PRESS group, complete success was achieved in 73% eyes and qualified success in 81.8% of eyes. In the trabeculectomy group, complete success was achieved in 40% and qualified success was achieved in 60% of eyes. The difference in mean IOP between groups was statistically significant from the 3rd postoperative month onward (P = 0.007 at 3 months, P = 0.003 at 6 months, and P = 0.03 at 24 months). Conclusion: Ex-PRESS implantation was more effective than trabeculectomy in controlling IOP in ocular hypertensives after pars plana vitrectomy and SOI, but the surgical technique may require improvement. PMID:27162449

  14. Depot effect of bioactive components in experimental membrane filtrations

    NASA Astrophysics Data System (ADS)

    Mitev, D.; Peshev, D.; Peev, G.; Peeva, L.

    2017-01-01

    Depot effects were found to be accompanying phenomena of membrane separation processes. Accumulation of target species in the membrane matrix during feasibility tests can hamper proper conclusions or compromise the filtration results. Therefore, we investigated the effects of delayed membrane release of chlorogenic acid and caffeine, considered as key compounds of interest in spent coffee products’ recovery treatment. Permeate fluxes and key components release were studied in course of 24 hours via nanofiltration of pure solvent, both immediately after the mock solution filtration and after idle stay. Conclusions are drawn and recommendations advised for proper analysis of experimental data on membrane screening.

  15. Changes in Inflammatory Activity after Glaucoma Filtration Surgery in Children with Chronic Anterior Uveitis.

    PubMed

    Wiese, Christina; Heiligenhaus, Arnd; Heinz, Carsten

    2016-08-01

    To evaluate changes in inflammatory activity over time in patients with juvenile idiopathic arthritis (JIA)-associated anterior uveitis after two different types of glaucoma surgery. Retrospective analysis of 32 patients with JIA who had trabeculectomy (TE, 21 eyes) or Ahmed glaucoma valve implantation (AGV, 11 eyes). Inflammatory activity and use of anti-inflammatory medication were evaluated 1 year prior to surgery and in the first, third, and fifth years after surgery. In both groups IOP decreased significantly from pre-surgery to 2 years after surgery (TE, 31.1 ± 6.7 to 12.8 ± 6.1 mmHg, p<0.0001; AGV, 28.5 ± 8.5 to 14.9 ± 6.6 mmHg, p<0.001). In the TE group flare, anterior chamber cells, and uveitis activity decreased significantly after surgery, whereas with AGV there was no sustained reduction of flare. The degree of inflammation in JIA-associated uveitis is significantly reduced after trabeculectomy.

  16. Retinal Ganglion Cell Morphology after Optic Nerve Crush and Experimental Glaucoma

    PubMed Central

    Kalesnykas, Giedrius; Oglesby, Ericka N.; Zack, Donald J.; Cone, Frances E.; Steinhart, Matthew R.; Tian, Jing; Pease, Mary E.; Quigley, Harry A.

    2012-01-01

    Purpose. To study sequential changes in retinal ganglion cell (RGC) morphology in mice after optic nerve crush and after induction of experimental glaucoma. Methods. Nerve crush or experimental glaucoma was induced in mice that selectively express yellow fluorescent protein (YFP) in RGCs. Mice were euthanized 1, 4, and 9 days after crush and 1, 3, and 6 weeks after induction of glaucoma by bead injection. All YFP-RGCs were identified in retinal whole mounts. Then confocal images of randomly selected RGCs were quantified for somal fluorescence brightness, soma size, neurite outgrowth, and dendritic complexity (Sholl analysis). Results. By 9 days after crush, 98% of RGC axons died and YFP-RGCs decreased by 64%. After 6 weeks of glaucoma, 31% of axons died, but there was no loss of YFP-RGC bodies. All crush retinas combined had significant decreases in neurite outgrowth parameters (P ≤ 0.036, generalized estimating equation [GEE] model) and dendritic complexity was lower than controls (P = 0.017, GEE model). There was no change in RGC soma area after crush. In combined glaucoma data, the RGC soma area was larger than control (P = 0.04, GEE model). At 3 weeks, glaucoma RGCs had significantly larger values for dendritic structure and complexity than controls (P = 0.044, GEE model), but no statistical difference was found at 6 weeks. Conclusions. After nerve crush, RGCs and axons died rapidly, and dendritic structure decreased moderately in remaining RGCs. Glaucoma caused an increase in RGC dendrite structure and soma size at 3 weeks. PMID:22589442

  17. Experimental study of dynamic vs. static filtration rates in drilling muds

    SciTech Connect

    Nasar, M.S.

    1983-01-01

    Four clay-water base drilling muds treated with increasing concentrations of different water loss additives were used in this study. The water-loss additives are sodium carboxymethylcellulose (CMC), starch, sodium polyacrylate (Cypan), and oil. The first drilling mud is composed of 3.2% by volume sand and 2% clay; the second is composed only of 2% clay. These two muds were used to study the effect of cuttings such as sand or silt on both static and dynamic filtration rates and on the performance of water loss additives. The third and the fourth drilling muds, composed of clay and barite, have 12% and 27% solids contents, respectively. The results from measuring the API filtrate losses and dynamic filtration rates of all four muds were used to investigate the possibility of correlating API filtrate losses with stabilized dynamic filtration. Experimental results indicate that the presence of sand in the drilling mud decreases the API filtrate losses, while it increases the dynamic filtration rates. From the experimental results, different relationships were found between API filtrate losses and stabilized dynamic filtration rates depending on the mud or the additive used. Therefore, it was concluded that no general correlation exists between API filtrate losses and stabilized dynamic filtration rates.

  18. Is there a change in the quality of life comparing the micro-invasive glaucoma surgery (MIGS) and the filtration technique trabeculectomy in glaucoma patients?

    PubMed

    Pahlitzsch, Milena; Klamann, Matthias K J; Pahlitzsch, Marie-Luise; Gonnermann, Johannes; Torun, Necip; Bertelmann, Eckart

    2017-02-01

    This study was conducted to assess the impact on the Quality of Life (QOL) of micro-invasive glaucoma surgery (MIGS: iStent, Trabectome) and a penetrating technique such as Trabeculectomy (TE). This study evaluated 88 eyes of 88 open angle glaucoma patients undergoing glaucoma surgery: 43 (mean age 72.8 ± 8.8y, female 59.5 %, male 40.5 %) Trabectome (NeoMedix, Inc., Tustin, CA, USA), 20 (mean age 68.6 ± 16.4y, female 60 %, male 40 %) iStent (Glaucos Corporation, Laguna Hills, CA, USA), and 25 TE patients (mean age 74.2 ± 9.1y female 58.3 %, male 41.7 %). The National Eye Institute-Visual Functioning Questionnaire (VFQ-25) survey was used to assess the QOL at 6 months post surgery. The following 12 QOL parameters were evaluated: general health, ocular pain, general vision, near and distance activities, mental health, social functioning, role difficulties, dependency, driving, color vision, and peripheral vision. Intraocular pressure (IOP), number of topical medications, and visual acuity (VA) were examined preoperatively, 1 day, 6 weeks, 3 months, and 6 months post surgery. Statistical data were calculated using SPSS (v20.0, SPSS, Inc.). There was no significant difference between TE and MIGS in the quality of life 6 months postoperatively. IOP was significantly lower in TE compared to MIGS at 6 weeks and 3 months postoperatively (p = 0.046 and p = 0.046). Number of medications was significantly decreased in TE compared to MIGS (p < 0.001). A significant difference in VA between TE and MIGS could be assessed at day 1 post-op (p = 0.011). In this study cohort, the QOL can be maintained by all three surgical techniques. Patients, however, need lower numbers of topical medication in TE, which would impact QOL even though it is not included in the NEI-VFQ-25. The decision of the most appropriate surgical technique should be made by including single QOL categories, IOP and glaucoma medication outcome.

  19. Effect of CNTF on Retinal Ganglion Cell Survival in Experimental Glaucoma

    PubMed Central

    Pease, Mary Ellen; Zack, Donald J; Berlinicke, Cynthia; Bloom, Kristen; Cone, Frances; Wang, Yuxia; Klein, Ronald L.; Hauswirth, William W.; Quigley, Harry A.

    2009-01-01

    Purpose To assess the neuroprotective effect of virally-mediated over-expression of ciliary derived neurotrophic factor (CNTF) and brain-derived neurotrophic factor (BDNF) in experimental rat glaucoma. Methods Laser-induced glaucoma was produced in one eye of 224 Wistar rats after injection of adeno-associated viral vectors (type 2) containing either CNTF, BDNF or both, using saline injected eyes and uninjected glaucoma eyes as controls. IOP was measured with the TonoLab and semi-automated optic nerve axon counts were performed by masked observers. IOP exposure over time was adjusted in multivariate regression analysis to calculate the effect of CNTF and BDNF. Results By multivariate regression, CNTF had a significant protective effect, with 15% less RGC axon death (p < 0.01). Both combined CNTF—BDNF and BDNF over-expression alone had no statistically significant improvement in RGC axon survival. By Western blot, there was a quantitative increase in CNTF and BDNF expression in retinas exposed to single viral vectors carrying each gene, but no increase with sequential injection of both vectors. Conclusion These data confirm that CNTF can exert a protective effect in experimental glaucoma. The reason for a lack of observed effect with the BDNF overexpression groups is unclear, but may be a function of the level of neurotrophin expression achieved. PMID:19060281

  20. Effect of experimental glaucoma on the non-image forming visual system.

    PubMed

    de Zavalía, Nuria; Plano, Santiago A; Fernandez, Diego C; Lanzani, María Florencia; Salido, Ezequiel; Belforte, Nicolás; Sarmiento, María I Keller; Golombek, Diego A; Rosenstein, Ruth E

    2011-06-01

    Glaucoma is a leading cause of blindness worldwide, characterized by retinal ganglion cell degeneration and damage to the optic nerve. We investigated the non-image forming visual system in an experimental model of glaucoma in rats induced by weekly injections of chondroitin sulphate (CS) in the eye anterior chamber. Animals were unilaterally or bilaterally injected with CS or vehicle for 6 or 10 weeks. In the retinas from eyes injected with CS, a similar decrease in melanopsin and Thy-1 levels was observed. CS injections induced a similar decrease in the number of melanopsin-containing cells and superior collicular retinal ganglion cells. Experimental glaucoma induced a significant decrease in the afferent pupil light reflex. White light significantly decreased nocturnal pineal melatonin content in control and glaucomatous animals, whereas blue light decreased this parameter in vehicle- but not in CS-injected animals. A significant decrease in light-induced c-Fos expression in the suprachiasmatic nuclei was observed in glaucomatous animals. General rhythmicity and gross entrainment appear to be conserved, but glaucomatous animals exhibited a delayed phase angle with respect to lights off and a significant increase in the percentage of diurnal activity. These results indicate the glaucoma induced significant alterations in the non-image forming visual system. © 2011 The Authors. Journal of Neurochemistry © 2011 International Society for Neurochemistry.

  1. Pressure filtration of ceramic pastes. 4: Treatment of experimental data

    NASA Technical Reports Server (NTRS)

    Torrecillas, A. S.; Polo, J. F.; Perez, A. A.

    1984-01-01

    The use of data processing method based on the algorithm proposed by Kalman and its application to the filtration process at constant pressure are described, as well as the advantages of this method. This technique is compared to the least squares method. The operation allows the precise parameter adjustment of the equation in direct relationship to the specific resistance of the cake.

  2. Experimental scleral cross-linking increases glaucoma damage in a mouse model

    PubMed Central

    Kimball, Elizabeth C.; Nguyen, Cathy; Steinhart, Matthew R.; Nguyen, Thao D.; Pease, Mary E.; Oglesby, Ericka N.; Oveson, Brian C.; Quigley, Harry A.

    2014-01-01

    The purpose of this study was to assess the effect of a scleral cross-linking agent on susceptibility to glaucoma damage in a mouse model. CD1 mice underwent 3 subconjunctival injections of 0.5 M glyceraldehyde (GA) in 1 week, then had elevated intraocular pressure (IOP) induced by bead injection. Degree of cross-linking was measured by enzyme-linked immunosorbent assay (ELISA), scleral permeability was measured by fluorescence recovery after photobleaching (FRAP), and the mechanical effects of GA exposure were measured by inflation testing. Control mice had buffer injection or no injection in 2 separate glaucoma experiments. IOP was monitored by Tonolab and retinal ganglion cell (RGC) loss was measured by histological axon counting. To rule out undesirable effects of GA, we performed electroretinography and detailed histology of the retina. GA exposure had no detectable effects on RGC number, retinal structure or function either histologically or electrophysiologically. GA increased cross-linking of sclera by 37% in an ELISA assay, decreased scleral permeability (FRAP, p = 0.001), and produced a steeper pressure—strain behavior by in vitro inflation testing. In two experimental glaucoma experiments, GA-treated eyes had greater RGC axon loss from elevated IOP than either buffer-injected or control eyes, controlling for level of IOP exposure over time (p = 0.01, and 0.049, multivariable regression analyses). This is the first report that experimental alteration of the sclera, by cross-linking, increases susceptibility to RGC damage in mice. PMID:25285424

  3. Neuroprotective and antioxidant effects of ghrelin in an experimental glaucoma model

    PubMed Central

    Can, Nagehan; Catak, Onur; Turgut, Burak; Demir, Tamer; Ilhan, Nevin; Kuloglu, Tuncay; Ozercan, Ibrahim Hanifi

    2015-01-01

    Damage to retinal ganglion cells due to elevation of intraocular pressure (IOP) is responsible for vision loss in glaucoma. Given that loss of these cells is irreversible, neuroprotection is crucial in the treatment of glaucoma. In this study, we investigated the possible antioxidant and neuroprotective effects of ghrelin on the retina in an experimental glaucoma model. Twenty-one Sprague–Dawley rats were randomly assigned to three groups comprising seven rats each. The rats in the control group were not operated on and did not receive any treatment. In all rats in the other groups, IOP was increased by cauterization of the limbal veins. After creation of the IOP increase, saline 1 mL/kg or ghrelin 40 μg/kg was administered intraperitoneally every day for 14 days in the vehicle control group and ghrelin groups, respectively. On day 14 of the study, the eyes were enucleated. Levels of malondialdehyde (MDA), nitric oxide (NO), and nitric oxide synthase-2 (NOS2) in anterior chamber fluid were measured. The retinas were subjected to immunohistochemistry staining for glial fibrillary acidic protein (GFAP), S-100, and vimentin expression. Mean levels of MDA, NO, and NOS2 in the aqueous humor were higher in the vehicle control group than in the control group (P<0.05). Mean levels of MDA, NO, and NOS2 in the ghrelin group did not show a significant increase compared with levels in the control group (P>0.05). Retinal TUNEL and immunohistochemistry staining in the vehicle control group showed an increase in apoptosis and expression of GFAP, S-100, and vimentin compared with the control group (P<0.05). In the ghrelin group, apoptosis and expression of GFAP, S-100, and vimentin was significantly lower than in the vehicle control group (P<0.05). This study suggests that ghrelin has antioxidant and neuroprotective effects on the retina in an experimental glaucoma model. PMID:26082612

  4. Assessment of Filtration Bleb and Endplate Positioning Using Magnetic Resonance Imaging in Eyes Implanted with Long-Tube Glaucoma Drainage Devices

    PubMed Central

    Sano, Ichiya; Tanito, Masaki; Uchida, Koji; Katsube, Takashi; Kitagaki, Hajime; Ohira, Akihiro

    2015-01-01

    Background To evaluate ocular fluid filtration and endplate positioning in glaucomatous eyes with long-tube glaucoma drainage devices (GDDs) using magnetic resonance imaging (MRI) and the effects of various factors on postoperative intraocular pressure (IOP). Methods This observational case series included 27 consecutive glaucomatous eyes (18 men, 7 women; mean age ± standard error, 63.0±2.0 years) who underwent GDD implantation (n = 8 Ahmed Glaucoma Valves [AGV] and n = 19 Baerveldt Glaucoma Implants [BGI]). Tubes were inserted into the pars plana in 23 eyes and anterior chamber in 4 eyes. Six months postoperatively, high-resolution orbital images were obtained using 3-Tesla MRI with head-array coils, and the filtering bleb volume, bleb height, and distances between the anterior endplate edge and corneal center or limbus or between the endplate and orbital wall were measured. Results In MR images obtained by three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequences, the shunt endplate was identified as low-intensity signal, and the filtering bleb was identified as high-intensity signals above and below the endplate in all eyes. The 6-month-postoperative IOP level was correlated negatively with bleb volume (r = -0.4510, P = 0.0182) and bleb height (r = -0.3954, P = 0.0412). The postoperative IOP was significantly (P = 0.0026) lower in BGI-implanted eyes (12.2±0.7 mmHg) than AGV-implanted eyes (16.7±1.2 mmHg); bleb volume was significantly (P = 0.0093) larger in BGI-implanted eyes (478.8±84.2 mm3) than AGV-implanted eyes (161.1±52.3 mm3). Other parameters did not differ. Conclusions The presence of intraorbital/periocular accumulation of ocular fluid affects postoperative IOP levels in eyes implanted with long-tube GDDs. Larger filtering blebs after BGI than AGI implantations explain lower postoperative IOP levels achieved with BGI than AGV. The findings will contribute to better understanding of IOP reducing mechanism of long

  5. Regional Choroidal Blood Flow and Multifocal Electroretinography in Experimental Glaucoma in Rhesus Macaques

    PubMed Central

    Nork, T. Michael; Kim, Charlene B. Y.; Munsey, Kaitlyn M.; Dashek, Ryan J.; Hoeve, James N. Ver

    2014-01-01

    Purpose. To test a hypothesis of regional variation in the effect of experimental glaucoma on choroidal blood flow (ChBF) and retinal function. Methods. Five rhesus macaques underwent laser trabecular destruction (LTD) to induce elevated intraocular pressure (IOP). Intraocular pressures were elevated for 56 to 57 weeks. Multifocal electroretinographic (mfERG) and multifocal visual evoked cortical potential (mfVEP) testing were performed at regular intervals before and during the period of IOP elevation. At euthanasia, the IOP was manometrically controlled at 35 (experimentally glaucomatous eye) and 15 (fellow control eye) mm Hg. Fluorescent microspheres were injected into the left ventricle. Regional ChBF was determined. Results. All of the experimentally glaucomatous eyes exhibited supranormal first-order kernel (K1) root mean square (RMS) early portions of the mfERG waveforms and decreased amplitudes of the late waveforms. The supranormality was somewhat greater in the central macula. Second-order kernel, first slice (K2.1) RMS mfVEP response was inversely correlated (R2 = 0.97) with axonal loss. Total ChBF was reduced in the experimentally glaucomatous eyes. The mean blood flow was 893 ± 123 and 481 ± 37 μL/min in the control and glaucomatous eyes, respectively. The ChBF showed regional variability with the greatest proportional decrement most often found in the central macula. Conclusions. This is the first demonstration of globally reduced ChBF in chronic experimental glaucoma in the nonhuman primate. Both the alteration of mfERG waveform components associated with outer retinal function and the reduction in ChBF were greatest in the macula, suggesting that there may be a spatial colocalization between ChBF and some outer retinal effects in glaucoma. PMID:25370515

  6. Losartan Treatment Protects Retinal Ganglion Cells and Alters Scleral Remodeling in Experimental Glaucoma

    PubMed Central

    Pitha, Ian F.; Nguyen, Cathy; Steinhart, Matthew R.; Nguyen, Thao D.; Pease, Mary Ellen; Oglesby, Ericka N.; Berlinicke, Cynthia A.; Mitchell, Katherine L.; Kim, Jessica; Jefferys, Joan J.

    2015-01-01

    Purpose To determine if oral losartan treatment decreases the retinal ganglion cell (RGC) death caused by experimental intraocular pressure (IOP) elevation in mice. Methods We produced IOP increase in CD1 mice and performed unilateral optic nerve crush. Mice received oral losartan, spironolactone, enalapril, or no drug to test effects of inhibiting angiotensin receptors. IOP was monitored by Tonolab, and blood pressure was monitored by tail cuff device. RGC loss was measured in masked axon counts and RGC bodies by β-tubulin labeling. Scleral changes that could modulate RGC injury were measured including axial length, scleral thickness, and retinal layer thicknesses, pressure-strain behavior in inflation testing, and study of angiotensin receptors and pathways by reverse transcription polymerase chain reaction, Western blot, and immunohistochemistry. Results Losartan treatment prevented significant RGC loss (median loss = 2.5%, p = 0.13), while median loss with water, spironolactone, and enalapril treatments were 26%, 28% and 43%; p < 0.0001). The lower RGC loss with losartan was significantly less than the loss with spironolactone or enalapril (regression model p = 0.001; drug treatment group term p = 0.01). Both losartan and enalapril significantly lowered blood pressure (p< 0.001), but losartan was protective, while enalapril led to worse than water-treated RGC loss. RGC loss after crush injury was unaffected by losartan treatment (difference from control p = 0.9). Survival of RGC in cell culture was not prolonged by sartan treatment. Axonal transport blockade after 3 day IOP elevations was less in losartan-treated than in control glaucoma eyes (p = 0.007). Losartan inhibited effects of glaucoma, including reduction in extracellular signal-related kinase activity and modification of glaucoma-related changes in scleral thickness and creep under controlled IOP. Conclusions The neuroprotective effect of losartan in mouse glaucoma is associated with adaptive changes

  7. Losartan Treatment Protects Retinal Ganglion Cells and Alters Scleral Remodeling in Experimental Glaucoma.

    PubMed

    Quigley, Harry A; Pitha, Ian F; Welsbie, Derek S; Nguyen, Cathy; Steinhart, Matthew R; Nguyen, Thao D; Pease, Mary Ellen; Oglesby, Ericka N; Berlinicke, Cynthia A; Mitchell, Katherine L; Kim, Jessica; Jefferys, Joan J; Kimball, Elizabeth C

    2015-01-01

    To determine if oral losartan treatment decreases the retinal ganglion cell (RGC) death caused by experimental intraocular pressure (IOP) elevation in mice. We produced IOP increase in CD1 mice and performed unilateral optic nerve crush. Mice received oral losartan, spironolactone, enalapril, or no drug to test effects of inhibiting angiotensin receptors. IOP was monitored by Tonolab, and blood pressure was monitored by tail cuff device. RGC loss was measured in masked axon counts and RGC bodies by β-tubulin labeling. Scleral changes that could modulate RGC injury were measured including axial length, scleral thickness, and retinal layer thicknesses, pressure-strain behavior in inflation testing, and study of angiotensin receptors and pathways by reverse transcription polymerase chain reaction, Western blot, and immunohistochemistry. Losartan treatment prevented significant RGC loss (median loss = 2.5%, p = 0.13), while median loss with water, spironolactone, and enalapril treatments were 26%, 28% and 43%; p < 0.0001). The lower RGC loss with losartan was significantly less than the loss with spironolactone or enalapril (regression model p = 0.001; drug treatment group term p = 0.01). Both losartan and enalapril significantly lowered blood pressure (p< 0.001), but losartan was protective, while enalapril led to worse than water-treated RGC loss. RGC loss after crush injury was unaffected by losartan treatment (difference from control p = 0.9). Survival of RGC in cell culture was not prolonged by sartan treatment. Axonal transport blockade after 3 day IOP elevations was less in losartan-treated than in control glaucoma eyes (p = 0.007). Losartan inhibited effects of glaucoma, including reduction in extracellular signal-related kinase activity and modification of glaucoma-related changes in scleral thickness and creep under controlled IOP. The neuroprotective effect of losartan in mouse glaucoma is associated with adaptive changes in the sclera expressed at the

  8. Experimental study of head loss and filtration for LOCA debris

    SciTech Connect

    Rao, D.V.; Souto, F.J.

    1996-02-01

    A series of controlled experiments were conducted to obtain head loss and filtration characteristics of debris beds formed of NUKON{trademark} fibrous fragments, and obtain data to validate the semi-theoretical head loss model developed in NUREG/CR-6224. A thermally insulated closed-loop test set-up was used to conduct experiments using beds formed of fibers only and fibers intermixed with particulate debris. A total of three particulate mixes were used to simulate the particulate debris. The head loss data were obtained for theoretical fiber bed thicknesses of 0.125 inches to 4.0 inches; approach velocities of 0.15 to 1.5 ft/s; temperatures of 75 F and 125 F; and sludge-to-fiber nominal concentration ratios of 0 to 60. Concentration measurements obtained during the first flushing cycle were used to estimate the filtration efficiencies of the debris beds. For test conditions where the beds are fairly uniform, the head loss data were predictable within an acceptable accuracy range by the semi-theoretical model. The model was equally applicable for both pure fiber beds and the mixed beds. Typically the model over-predicted the head losses for very thin beds and for thin beds at high sludge-to-fiber mass ratios. This is attributable to the non-uniformity of such debris beds. In this range the correlation can be interpreted to provide upper bound estimates of head loss. This is pertinent for loss of coolant accidents in boiling water reactors.

  9. Retinal glutamate transporter changes in experimental glaucoma and after optic nerve transection in the rat.

    PubMed

    Martin, Keith R G; Levkovitch-Verbin, Hana; Valenta, Danielle; Baumrind, Lisa; Pease, Mary Ellen; Quigley, Harry A

    2002-07-01

    High levels of glutamate can be toxic to retinal ganglion cells. Effective buffering of extracellular glutamate by retinal glutamate transporters is therefore important. This study was conducted to investigate whether glutamate transporter changes occur with two models of optic nerve injury in the rat. Glaucoma was induced in one eye of 35 adult Wistar rats by translimbal diode laser treatment to the trabecular meshwork. Twenty-five more rats underwent unilateral optic nerve transection. Two glutamate transporters, GLAST (EAAT-1) and GLT-1 (EAAT-2), were studied by immunohistochemistry and quantitative Western blot analysis. Treated and control eyes were compared 3 days and 1, 4, and 6 weeks after injury. Optic nerve damage was assessed semiquantitatively in epoxy-embedded optic nerve cross sections. Trabecular laser treatment resulted in moderate intraocular pressure (IOP) elevation in all animals. After 1 to 6 weeks of experimental glaucoma, all treated eyes had significant optic nerve damage. Glutamate transporter changes were not detected by immunohistochemistry. Western blot analysis demonstrated significantly reduced GLT-1 in glaucomatous eyes compared with control eyes at 3 days (29.3% +/- 6.7%, P = 0.01), 1 week (55.5% +/- 13.6%, P = 0.02), 4 weeks (27.2% +/- 10.1%, P = 0.05), and 6 weeks (38.1% +/- 7.9%, P = 0.01; mean reduction +/- SEM, paired t-tests, n = 5 animals per group, four duplicate Western blot analyses per eye). The magnitude of the reduction in GLT-1 correlated significantly with mean IOP in the glaucomatous eye (r(2) = 0.31, P = 0.01, linear regression). GLAST was significantly reduced (33.8% +/- 8.1%, mean +/- SEM) after 4 weeks of elevated IOP (P = 0.01, paired t-test, n = 5 animals per group). In contrast to glaucoma, optic nerve transection resulted in an increase in GLT-1 compared with the control eye (P = 0.01, paired t-test, n = 15 animals). There was no significant change in GLAST after transection. GLT-1 and GLAST were significantly

  10. Pretreatment chemistry for dual media filtration: model simulations and experimental studies.

    PubMed

    Shin, J Y; O'Melia, C R

    2006-01-01

    Laboratory dual media filtration experiments were conducted (a) in direct filtration mode using model raw water moderate in turbidity and low in DOC, and (b) in conventional filtration mode treating water moderate in turbidity and high in DOC. Model simulations of filter performance for the removal of particles provided hypotheses for the experimental studies of dual media filtration. An increase in alum dose in direct filtration mode, while improving filter performance, also showed some disadvantages, including rapid development of head loss. Suboptimal dose in direct filtration significantly impaired the filter performance. In conventional mode, the effect of alum dose on the filter performance, while obvious, was not as dramatic as in direct filtration. Ripening indicated by particle counts occurred earlier than by turbidity and breakthrough of particle counts started earlier than breakthrough of turbidity, suggesting that turbidity can be used as a more conservative monitor of filter performance during the ripening period to minimise the risk of passage of small particles, while particle counts can be considered a more sensitive indicator of deteriorating filter performance during the breakthrough period. The lower sand layer served as a multiple barrier for particle when the performance of the anthracite layer was not effective.

  11. In Vivo Detection of Laminar and Peripapillary Scleral Hypercompliance in Early Monkey Experimental Glaucoma

    PubMed Central

    Ivers, Kevin M.; Yang, Hongli; Gardiner, Stuart K.; Qin, Lirong; Reyes, Luke; Fortune, Brad; Burgoyne, Claude F.

    2016-01-01

    Purpose To compare optical coherence tomography (OCT) detected, optic nerve head (ONH) compliance within control and experimental glaucoma (EG) eyes of 15 monkeys at EG onset. Methods Intraocular pressure (IOP) was chronically elevated in one eye of each animal using a laser. Experimental glaucoma onset was identified using confocal scanning laser tomography (CSLT). Optical coherence tomography ONH imaging (40 radial B-scans) was performed at 10 mm Hg before and after laser. At EG onset, OCT scans were obtained at IOP 10 and 30 mm Hg. Optical coherence tomography landmarks within the IOP 10/30 images were delineated to quantify IOP 10/30 differences (compliance) for anterior lamina cribrosa surface depth (ALCSD) relative to Bruch's membrane opening (BMO) (ALCSD-BMO), ALCSD relative to peripheral BM (ALCSD-BM), and BMO depth relative to peripheral BM (BMOD-BM). A linear mixed effects model assessed for acute IOP elevation effects, control versus EG eye effects, and their interaction Results Effects of IOP elevation were greater in EG versus control eyes for ALCSD-BMO (−46 ± 45 vs. −8 ± 13 μm, P = 0.0042) and ALCSD-BM (−92 ± 64 vs. −42 ± 22 μm, P = 0.0075). Experimental glaucoma eye-specific ALCSD-BMO and ALCSD-BM compliance exceeded the range of control eye compliance in 9 and 8 of the 15 EG eyes, respectively. Post-laser peak IOP (R2 = 0.798, P < 0.0001) and post-laser mean IOP (R2 = 0.634, P < 0.0004) most strongly correlated to EG versus control eye differences in ALCSD-BMO compliance. Conclusions Laminar (ALCSD-BMO) and peripapillary scleral (ALCSD-BM) hypercompliance are present in most monkey eyes at the onset of EG. PMID:27409498

  12. Studies of Scleral Biomechanical Behavior Related to Susceptibility for Retinal Ganglion Cell Loss in Experimental Mouse Glaucoma

    PubMed Central

    Nguyen, Cathy; Cone, Frances E.; Nguyen, Thao D.; Coudrillier, Baptiste; Pease, Mary E.; Steinhart, Matthew R.; Oglesby, Ericka N.; Jefferys, Joan L.; Quigley, Harry A.

    2013-01-01

    Purpose. To study anatomical changes and mechanical behavior of the sclera in mice with experimental glaucoma by comparing CD1 to B6 mice. Methods. Chronic experimental glaucoma for 6 weeks was produced in 2- to 4-month-old CD1 (43 eyes) and B6 mice (42 eyes) using polystyrene bead injection into the anterior chamber with 126 control CD1 and 128 control B6 eyes. Intraocular pressure (IOP) measurements were made with the TonoLab at baseline and after bead injection. Axial length and scleral thickness were measured after sacrifice in the CD1 and B6 animals and compared to length data from 78 eyes of DBA/2J mice. Inflation testing of posterior sclera was conducted, and circumferential and meridional strain components were determined from the displacement response. Results. Experimental glaucoma led to increases in axial length and width by comparison to fellow eyes (6% in CD1 and 10% in B6; all P < 0.03). While the peripapillary sclera became thinner in both mouse types with glaucoma, the remainder of the sclera uniformly thinned in CD1, but thickened in B6. Peripapillary sclera in CD1 controls had significantly greater temporal meridional strain than B6 and had differences in the ratios of meridional to effective circumferential strain from B6 mice. In both CD1 and B6 mice, exposure to chronic IOP elevation resulted in stiffer pressure–strain responses for both the effective circumferential and meridional strains (multivariable regression model, P = 0.01–0.03). Conclusions. Longer eyes, greater scleral strain in some directions at baseline, and generalized scleral thinning after glaucoma were characteristic of CD1 mice that have greater tendency to retinal ganglion cell damage than B6 mice. Increased scleral stiffness after glaucoma exposure in mice mimics findings in monkey and human glaucoma eyes. PMID:23404116

  13. DBA/2J mouse model for experimental glaucoma: pitfalls and problems.

    PubMed

    Turner, Anita J; Vander Wall, Roshana; Gupta, Vivek; Klistorner, Alex; Graham, Stuart L

    2017-05-18

    The DBA/2J mouse has been described as a model for congenital experimental glaucoma. It develops anterior segment anomalies with synechiae and pigment dispersion leading to raised intraocular pressure and glaucomatous damage. However, there are serious practical considerations when using this model in longitudinal studies. We followed 118 mice from 12-48 weeks of age in a pharmaceutical trial. Here we report on the findings in control animals (n = 37). Intraocular pressure was measured weekly, electrophysiology and optical coherence tomography every 6 weeks. A subset also had invasive intraocular pressure measurements performed prior to euthanasia. Although intraocular pressure eventually rose by 9 months in most animals, tonometry was complicated by corneal calcification in the majority of animals rendering intraocular pressure measurement unreliable. Invasive intraocular pressure did not correlate with non-invasive measures. Loss of scotopic threshold response and thinning of inner retinal layers on optical coherence tomography was observed over time, suggesting glaucomatous damage, but this occurred in some animals without raised intraocular pressure. Poor pupil dilation significantly affected electrophysiology, optical coherence tomography and fundus imaging; 22% of animals developed major systemic complications leading to high dropout rate. The DBA/2J experimental glaucoma model shows variability in expression, and its pathological changes cause major difficulties in assessing disease progression. From our experience, the model presents significant challenges for drug studies in glaucoma, as there are many confounding factors: difficulty with accurate intraocular pressure measurement, in vivo imaging, and electrophysiology recording and a high dropout rate. In addition, there may be an underlying neurodegenerative process independent of intraocular pressure. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  14. Experimental study on non-woven filamentous fibre micro-filter with high filtration speed.

    PubMed

    Niu, Siping; Park, Kisoo; Guerra, Heidi B; Kim, Youngchul

    2015-01-01

    A laboratory study was undertaken to pursue the filter performance of a micro-filter module employing highly porous fibre media under a high filtration rate (≥1,500 m/day), faster than that of any conventional filter process. The effects of filtration rate, head loss, raw water turbidity, and filter aid chemicals on filter performance were analysed. In spite of the extremely high filtration rate, the filter achieved an attractive efficiency, reducing the raw water turbidity by over 80%. As with other filter systems, the filter aid used ((polyaluminium chloride (PAC)) greatly affected the performance of this particular fibre filter. Long-term repetitive runs were additionally carried out to confirm the reproducibility of the filter performance. Also, a comparison was carried out with other high-rate filter systems which are either being tested for use in experimental studies, or are already commercially available. This study reveals that the filter performance under a high filtration speed is still attractive especially as PAC is used. Due to the high porosity of the fibre, the filter had small head loss even though the filtration rate was high. These results ascertain that it is possible to operate the filters with high filtration rate achieving reliable treatment performance.

  15. Size exclusion deep bed filtration: Experimental and modelling uncertainties

    SciTech Connect

    Badalyan, Alexander You, Zhenjiang; Aji, Kaiser; Bedrikovetsky, Pavel; Carageorgos, Themis; Zeinijahromi, Abbas

    2014-01-15

    A detailed uncertainty analysis associated with carboxyl-modified latex particle capture in glass bead-formed porous media enabled verification of the two theoretical stochastic models for prediction of particle retention due to size exclusion. At the beginning of this analysis it is established that size exclusion is a dominant particle capture mechanism in the present study: calculated significant repulsive Derjaguin-Landau-Verwey-Overbeek potential between latex particles and glass beads is an indication of their mutual repulsion, thus, fulfilling the necessary condition for size exclusion. Applying linear uncertainty propagation method in the form of truncated Taylor's series expansion, combined standard uncertainties (CSUs) in normalised suspended particle concentrations are calculated using CSUs in experimentally determined parameters such as: an inlet volumetric flowrate of suspension, particle number in suspensions, particle concentrations in inlet and outlet streams, particle and pore throat size distributions. Weathering of glass beads in high alkaline solutions does not appreciably change particle size distribution, and, therefore, is not considered as an additional contributor to the weighted mean particle radius and corresponded weighted mean standard deviation. Weighted mean particle radius and LogNormal mean pore throat radius are characterised by the highest CSUs among all experimental parameters translating to high CSU in the jamming ratio factor (dimensionless particle size). Normalised suspended particle concentrations calculated via two theoretical models are characterised by higher CSUs than those for experimental data. The model accounting the fraction of inaccessible flow as a function of latex particle radius excellently predicts normalised suspended particle concentrations for the whole range of jamming ratios. The presented uncertainty analysis can be also used for comparison of intra- and inter-laboratory particle size exclusion data.

  16. Size exclusion deep bed filtration: Experimental and modelling uncertainties

    NASA Astrophysics Data System (ADS)

    Badalyan, Alexander; You, Zhenjiang; Aji, Kaiser; Bedrikovetsky, Pavel; Carageorgos, Themis; Zeinijahromi, Abbas

    2014-01-01

    A detailed uncertainty analysis associated with carboxyl-modified latex particle capture in glass bead-formed porous media enabled verification of the two theoretical stochastic models for prediction of particle retention due to size exclusion. At the beginning of this analysis it is established that size exclusion is a dominant particle capture mechanism in the present study: calculated significant repulsive Derjaguin-Landau-Verwey-Overbeek potential between latex particles and glass beads is an indication of their mutual repulsion, thus, fulfilling the necessary condition for size exclusion. Applying linear uncertainty propagation method in the form of truncated Taylor's series expansion, combined standard uncertainties (CSUs) in normalised suspended particle concentrations are calculated using CSUs in experimentally determined parameters such as: an inlet volumetric flowrate of suspension, particle number in suspensions, particle concentrations in inlet and outlet streams, particle and pore throat size distributions. Weathering of glass beads in high alkaline solutions does not appreciably change particle size distribution, and, therefore, is not considered as an additional contributor to the weighted mean particle radius and corresponded weighted mean standard deviation. Weighted mean particle radius and LogNormal mean pore throat radius are characterised by the highest CSUs among all experimental parameters translating to high CSU in the jamming ratio factor (dimensionless particle size). Normalised suspended particle concentrations calculated via two theoretical models are characterised by higher CSUs than those for experimental data. The model accounting the fraction of inaccessible flow as a function of latex particle radius excellently predicts normalised suspended particle concentrations for the whole range of jamming ratios. The presented uncertainty analysis can be also used for comparison of intra- and inter-laboratory particle size exclusion data.

  17. Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

    PubMed Central

    Kelher, Marguerite R.; Khan, Samina Y.; LaSarre, Monica; West, F. Bernadette; Land, Kevin J.; Mish, Barbara; Ceriano, Linda; Sowemimo-Coker, Samuel

    2014-01-01

    Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusion-related mortality with red cell transfusion. We hypothesize that prestorage filtration may reduce proinflammatory activity in the red blood cell (RBC) supernatant and prevent TRALI. Filters were manufactured for both small volumes and RBC units. Plasma containing antibodies to human lymphocyte antigen (HLA)-A2 or human neutrophil antigen (HNA)-3a was filtered, and immunoglobulins and specific HNA-3a and HLA-2a neutrophil (PMN) priming activity were measured. Antibodies to OX27 were added to plasma, and filtration was evaluated in a 2-event animal model of TRALI. RBC units from 31 donors known to have antibodies against HLA antigens and from 16 antibody-negative controls were filtered. Furthermore, 4 RBC units were drawn and underwent standard leukoreduction. Immunoglobulins, HLA antibodies, PMN priming activity, and the ability to induce TRALI in an animal model were measured. Small-volume filtration of plasma removed >96% of IgG, antibodies to HLA-A2 and HNA-3a, and their respective priming activity, as well as mitigating antibody-mediated in vivo TRALI. In RBC units, experimental filtration removed antibodies to HLA antigens and inhibited the accumulation of lipid priming activity and lipid-mediated TRALI. We conclude that filtration removes proinflammatory activity and the ability to induce TRALI from RBCs and may represent a TRALI mitigation step. PMID:24747436

  18. Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo.

    PubMed

    Silliman, Christopher C; Kelher, Marguerite R; Khan, Samina Y; LaSarre, Monica; West, F Bernadette; Land, Kevin J; Mish, Barbara; Ceriano, Linda; Sowemimo-Coker, Samuel

    2014-05-29

    Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusion-related mortality with red cell transfusion. We hypothesize that prestorage filtration may reduce proinflammatory activity in the red blood cell (RBC) supernatant and prevent TRALI. Filters were manufactured for both small volumes and RBC units. Plasma containing antibodies to human lymphocyte antigen (HLA)-A2 or human neutrophil antigen (HNA)-3a was filtered, and immunoglobulins and specific HNA-3a and HLA-2a neutrophil (PMN) priming activity were measured. Antibodies to OX27 were added to plasma, and filtration was evaluated in a 2-event animal model of TRALI. RBC units from 31 donors known to have antibodies against HLA antigens and from 16 antibody-negative controls were filtered. Furthermore, 4 RBC units were drawn and underwent standard leukoreduction. Immunoglobulins, HLA antibodies, PMN priming activity, and the ability to induce TRALI in an animal model were measured. Small-volume filtration of plasma removed >96% of IgG, antibodies to HLA-A2 and HNA-3a, and their respective priming activity, as well as mitigating antibody-mediated in vivo TRALI. In RBC units, experimental filtration removed antibodies to HLA antigens and inhibited the accumulation of lipid priming activity and lipid-mediated TRALI. We conclude that filtration removes proinflammatory activity and the ability to induce TRALI from RBCs and may represent a TRALI mitigation step.

  19. BDNF impairment is associated with age-related changes in the inner retina and exacerbates experimental glaucoma.

    PubMed

    Gupta, Vivek; You, Yuyi; Li, Jonathan; Gupta, Veer; Golzan, Mojtaba; Klistorner, Alexander; van den Buuse, Maarten; Graham, Stuart

    2014-09-01

    Brain-derived neurotrophic factor (BDNF) stimulation of its high-affinity receptor TrkB results in activation of pro-survival cell-signalling pathways that can afford neuroprotection to the retina. Reduction in retrograde axonal transport of neurotrophic factors such as BDNF from the brain to the neuronal cell bodies in the retina has been suggested as a critical factor underlying progressive and selective degeneration of ganglion cell layer and optic nerve in glaucoma. We investigated the role of BDNF in preserving inner retinal homeostasis in normal and glaucoma states using BDNF(+/-) mice and compared it with wild type controls. This study demonstrated that BDNF(+/-) animals were more susceptible to functional, morphological and molecular degenerative changes in the inner retina caused by age as well as upon exposure to experimental glaucoma caused by increased intraocular pressure. Glaucoma induced a down regulation of BDNF/TrkB signalling and an increase in levels of neurotoxic amyloid β 1-42 in the optic nerve head which were exacerbated in BDNF(+/-) mice. Similar results were obtained upon analysing the human optic nerve head tissues. Our data highlighted the role of BDNF in maintaining the inner retinal integrity under normal conditions and the detrimental effects of its insufficiency on the retina and optic nerve in glaucoma. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Comparison of Modeling and Experimental Approaches for Improved Modeling of Filtration in Granular and Consolidated Media

    NASA Astrophysics Data System (ADS)

    Mirabolghasemi, M.; Prodanovic, M.; DiCarlo, D. A.

    2014-12-01

    Filtration is relevant to many disciplines from colloid transport in environmental engineering to formation damage in petroleum engineering. In this study we compare the results of the novel numerical modeling of filtration phenomenon on pore scale with the complementary experimental observations on laboratory scale and discuss how the results of comparison can be used to improve macroscale filtration models for different porous media. The water suspension contained glass beads of 200 micron diameter and flows through a packing of 1mm diameter glass beads, and thus the main filtration mechanism is straining and jamming of particles. The numerical model simulates the flow of suspension through a realistic 3D structure of an imaged, disordered sphere pack, which acts as the filter medium. Particle capture through size exclusion and jamming is modeled via a coupled Discrete Element Method (DEM) and Computational Fluid Dynamics (CFD) approach. The coupled CFD-DEM approach is capable of modeling the majority of particle-particle, particle-wall, and particle-fluid interactions. Note that most of traditional approaches require spherical particles both in suspension and the filtration medium. We adapted the interface between the pore space and the spherical grains to be represented as a triangulated surface and this allows extensions to any imaged media. The numerical and experimental results show that the filtration coefficient of the sphere pack is a function of the flow rate and concentration of the suspension, even for constant total particle flow rate. An increase in the suspension flow rate results in a decrease in the filtration coefficient, which suggests that the hydrodynamic drag force plays the key role in hindering the particle capture in random sphere packs. Further, similar simulations of suspension flow through a sandstone sample, which has a tighter pore space, show that filtration coefficient remains almost constant at different suspension flow rates. This

  1. Experimental study of the effect of polyanionic cellulose on process of filtrate loss of low-solids drilling fluid

    NASA Astrophysics Data System (ADS)

    yang, P.

    2013-12-01

    Experimental study of the effect of polyanionic cellulose on process of filtrate loss of low-solids drilling fluid Ping Yang 1,2, Min-hui Wu2, Xue-wen Zhu2, Tao Deng2, Xue-qing Sun2 1. Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092,China 2. Department of Geotechnical Engineering,Tongji University,Shanghai 200092,China Abstract The process of filtrate loss of low-solids drilling fluid was tested by changing the polyanionic cellulose content in low-solids drilling fluid. The effect of polyanionic cellulose on process of filtrate loss of low-solids drilling fluid was analyzed. The test results showed that when time of filtration is same, the volume of filtrate loss decreases linearly with increasing polyanionic cellulose content. When polyanionic cellulose content is same, the rate of filtrate loss decreases nonlinearly with increasing time and the rate of filtrate loss will reach a stable value.The volume of filtrate loss in 7 to 8 minutes can reaches half of the total volume of filtrate loss. At the same time, the rate of filtrate loss of drilling fluid decreases nonlinearly with increasing viscosity.When the apparent viscosity is between 3.5~4.15 MPa.s, decrease speed of rate of filtrate loss of drilling fluid is quick. The results are helpful for characteristics evaluation of filtrate loss of drilling fluid and control of filtrate loss. Keyword Polyanionic Cellulose,Drilling Fluid,Process of Filtrate Loss Acknowledgments This investigation was supported by the National Natural Science Foundation of China (projects No. 41002093 and 41072205); the Fundamental Research Funds for the Central Universities; the Shanghai Leading Academic Discipline Project (project No. B308), Tongji University; and the Program for Young Excellent Talents, Tongji University. The authors are extremely grateful for the financial support from these five organizations.

  2. In Vivo Changes in Lamina Cribrosa Microarchitecture and Optic Nerve Head Structure in Early Experimental Glaucoma

    PubMed Central

    Ivers, Kevin M.; Sredar, Nripun; Patel, Nimesh B.; Rajagopalan, Lakshmi; Queener, Hope M.; Twa, Michael D.; Harwerth, Ronald S.; Porter, Jason

    2015-01-01

    The lamina cribrosa likely plays an important role in retinal ganglion cell axon injury in glaucoma. We sought to (1) better understand optic nerve head (ONH) structure and anterior lamina cribrosa surface (ALCS) microarchitecture between fellow eyes of living, normal non-human primates and (2) characterize the time-course of in vivo structural changes in the ONH, ALCS microarchitecture, and retinal nerve fiber layer thickness (RNFLT) in non-human primate eyes with early experimental glaucoma (EG). Spectral domain optical coherence tomography (SDOCT) images of the ONH were acquired cross-sectionally in six bilaterally normal rhesus monkeys, and before and approximately every two weeks after inducing unilateral EG in seven rhesus monkeys. ONH parameters and RNFLT were quantified from segmented SDOCT images. Mean ALCS pore area, elongation and nearest neighbor distance (NND) were quantified globally, in sectors and regionally from adaptive optics scanning laser ophthalmoscope images. In bilaterally normal monkeys, ONH parameters were similar between fellow eyes with few inter-eye differences in ALCS pore parameters. In EG monkeys, an increase in mean ALCS Depth (ALCSD) was the first structural change measured in 6 of 7 EG eyes. A decrease in mean minimum rim width (MRW) simultaneously accompanied this early change in 4 of 6 EG eyes and was the first structural change in the 7th EG eye. Mean ALCS pore parameters were among the first or second changes measured in 4 EG eyes. Mean ALCS pore area and NND increased in superotemporal and temporal sectors and in central and peripheral regions at the first time-point of change in ALCS pore geometry. RNFLT and/or mean ALCS radius of curvature were typically the last parameters to initially change. Survival analyses found mean ALCSD was the only parameter to significantly show an initial change prior to the first measured loss in RNFLT across EG eyes. PMID:26230993

  3. Scleral Permeability Varies by Mouse Strain and Is Decreased by Chronic Experimental Glaucoma

    PubMed Central

    Pease, Mary E.; Oglesby, Ericka N.; Cone-Kimball, Elizabeth; Jefferys, Joan L.; Steinhart, Matthew R.; Kim, Anthony J.; Hanes, Justin; Quigley, Harry A.

    2014-01-01

    Purpose. To determine differences in scleral permeability, as measured by diffusion of macromolecules, by using fluorescence recovery after photobleaching (FRAP), with reference to differences by mouse strain, scleral region, and the effect of experimental glaucoma. Methods. In three mouse strains (B6, CD1, and B6 mice with mutation in collagen 8α2 [Aca23]), we used FRAP to measure the diffusion of fluorescein isothiocyanate–dextran, molecular weight 40 kDa, into a photobleached zone of sclera. Scleral regions near the optic nerve head (peripapillary) and two successively more anterior regions were compared. Sclera from mouse eyes subjected to chronically elevated intraocular pressure after bead injection into the anterior chamber were compared to fellow eye controls. FRAP data were compared against estimated retinal ganglion cell axon loss in glaucomatous eyes. Results. Diffusion rates of dextran molecules in the sclera were significantly greater in Aca23 and B6 mice than in CD1 mice in a multivariate model adjusted for region and axial length (P < 0.0001). Dextran diffusion significantly decreased in glaucomatous eyes, and the decline increased with greater axon loss (P = 0.0003, multivariable model). Peripapillary scleral permeability was higher in CD1 than B6 and Aca23 mice (P < 0.05, multivariable model, adjusted by Bonferroni). Conclusions. Measurement of the diffusion rates of dextran molecules in the sclera showed that glaucoma leads to decreased scleral permeability in all three mouse strains tested. Among mouse strains tested, those that were more susceptible to glaucomatous loss of retinal ganglion cells had a lower scleral permeability at baseline. PMID:24557355

  4. Changes in optic nerve head circulation in response to vasoactive agents: intereye comparison in monkeys with experimental unilateral glaucoma.

    PubMed

    Mayama, Chihiro; Ishii, Kiyoshi; Ota, Takashi; Tomidokoro, Atsuo; Araie, Makoto

    2012-08-22

    To investigate circulatory changes in the optic nerve head (ONH) in response to vasoactive agents including calcium antagonists, a substrate of nitric oxide (NO), and an inhibitor of NO synthase (NOS) in monkeys with unilateral experimental glaucoma. Argon laser cautery to the trabecular meshwork was used to create experimental unilateral glaucoma in nine monkeys. The effects of systemic lomerizine or nilvadipine (calcium-antagonists), L-arginine (a substrate of NO), and NG-nitro-L-arginine methyl ester (L-NAME, a NOS inhibitor) on the ONH tissue blood velocity (NB(ONH)) was studied by the laser speckle method. Lomerizine and nilvadipine significantly increased NB(ONH) in the untreated normal eyes (P = 0.039 and 0.008, respectively), while significant, less increases were found in the laser-treated experimental glaucomatous eyes with significant intereye differences (P = 0.036 and 0.011, respectively). L-arginine significantly increased NB(ONH) in both eyes without intereye difference (P = 0.71). L-NAME had no significant effects on NB(ONH) in the experimental glaucoma eyes; however, it produced a significant decrease in the nonlaser treated eyes (P = 0.036). In experimental glaucomatous eyes, the reactivity of ONH vessels to calcium antagonists was preserved, but was significantly reduced. The response to a NOS inhibitor was lost; however, reactivity to a substrate of NO was normal. These data indicate that in experimental glaucoma, vasodilator reactivity in the peripheral vasculature of the ONH is preserved, but functional alterations are likely to affect reactivity to the NO system.

  5. Experimental study of two-phase filtration regimes of methane-n-pentane mixture

    NASA Astrophysics Data System (ADS)

    Zaichenko, V. M.; Molchanov, D. A.; Torchinskiy, V. M.

    2016-11-01

    The results of experimental studies of methane-n-pentane mixture filtration in a porous medium under isothermal conditions in pressure range typical for gas-condensate reservoirs are presented. Interest in the filtration problem of such mixtures is aroused by the need to intensify production of heavy fractions of gas-condensate-valuable hydrocarbons, consisting of methane and its higher homologues. Different flow regimes including oscillatory one are observed during gas-condensate extraction under natural conditions. Our studies have shown that there are multiple flow regimes including self-oscillating one under isothermal conditions for this type of mixtures depending on the initial pressure, the kind of the mixture's phase diagram and the permeability coefficients of the liquid and gas phases in the porous medium.

  6. Morphological and morphometric changes in rat optic nerve microvessels in a glaucoma experimental model.

    PubMed

    Moreno, M; Ríos, M C; Alba, C; Díaz, F; Villena, A; Figueroa-Ortiz, L C; García-Campos, J

    2014-12-01

    To study the morphological and morphometric changes produced in the capillaries of the optic nerve (ON) head and initial portion after the experimental increase in intraocular pressure (IOP). Wistar rats underwent cauterization of three episcleral veins, which produced an immediate increase in the IOP, and was maintained for 3 months. Sagittal sections of the eyeball were studied with immunohistochemical techniques, using a primary antibody to GLUT-1. The GLUT-1 positive capillaries were counted, and measurements were made of the area, perimeter and mean diameter. Microscopic examination of sections of the ON of control rats revealed a lower density and larger caliber of capillaries in the prelaminar region as compared with the other regions of the ON (P<.05). Comparison between the control and the experimental groups showed a reduction in capillary density (except in the prelaminar region) and a smaller size in all the areas of the ON studied, but less evident in the initial portion (P<.05). The increase in IOP was associated with significant qualitative and quantitative changes in the capillaries of the laminar and poslaminar regions of the ON head. These changes appear to return towards parameters compatible with normality in the initial portion of the ON, an area where the vascular collapse was less evident. These findings might explain the significant reduction in ocular blood flow seen in patients with primary open-angle glaucoma. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  7. Colloid filtration in surface dense vegetation: experimental results and theoretical predictions.

    PubMed

    Wu, Lei; Muñoz-Carpena, Rafael; Gao, Bin; Yang, Wen; Pachepsky, Yakov A

    2014-04-01

    Understanding colloid and colloid-facilitated contaminant transport in overland flow through dense vegetation is important to protect water quality in the environment, especially for water bodies receiving agricultural and urban runoff. In previous studies, a single-stem efficiency theory for rigid and clean stem systems was developed to predict colloid filtration by plant stems of vegetation in laminar overland flow. Hence, in order to improve the accuracy of the single-stem efficiency theory to real dense vegetation system, we incorporated the effect of natural organic matter (NOM) on the filtration of colloids by stems. Laboratory dense vegetation flow chamber experiments and model simulations were used to determine the kinetic deposition (filtration) rate of colloids under various conditions. The results show that, in addition to flow hydrodynamics and solution chemistry, steric repulsion afforded by NOM layer on the plants stem surface also plays a significant role in controlling colloid deposition on vegetation in overland flow. For the first time, a refined single-stem efficiency theory with considerations of the NOM effect is developed that describes the experimental data with good accuracy. This theory can be used to not only help construct and refine mathematical models of colloid transport in real vegetation systems in overland flow, but also inform the development of theories of colloid deposition on NOM-coated surfaces in natural, engineered, and biomedical systems.

  8. Benzalkonium Chloride and Glaucoma

    PubMed Central

    Kaufman, Paul L.; Kiland, Julie A.

    2014-01-01

    Abstract Glaucoma patients routinely take multiple medications, with multiple daily doses, for years or even decades. Benzalkonium chloride (BAK) is the most common preservative in glaucoma medications. BAK has been detected in the trabecular meshwork (TM), corneal endothelium, lens, and retina after topical drop installation and may accumulate in those tissues. There is evidence that BAK causes corneal and conjunctival toxicity, including cell loss, disruption of tight junctions, apoptosis and preapoptosis, cytoskeleton changes, and immunoinflammatory reactions. These same effects have been reported in cultured human TM cells exposed to concentrations of BAK found in common glaucoma drugs and in the TM of primary open-angle glaucoma donor eyes. It is possible that a relationship exists between chronic exposure to BAK and glaucoma. The hypothesis that BAK causes/worsens glaucoma is being tested experimentally in an animal model that closely reflects human physiology. PMID:24205938

  9. Benzalkonium chloride and glaucoma.

    PubMed

    Rasmussen, Carol A; Kaufman, Paul L; Kiland, Julie A

    2014-01-01

    Glaucoma patients routinely take multiple medications, with multiple daily doses, for years or even decades. Benzalkonium chloride (BAK) is the most common preservative in glaucoma medications. BAK has been detected in the trabecular meshwork (TM), corneal endothelium, lens, and retina after topical drop installation and may accumulate in those tissues. There is evidence that BAK causes corneal and conjunctival toxicity, including cell loss, disruption of tight junctions, apoptosis and preapoptosis, cytoskeleton changes, and immunoinflammatory reactions. These same effects have been reported in cultured human TM cells exposed to concentrations of BAK found in common glaucoma drugs and in the TM of primary open-angle glaucoma donor eyes. It is possible that a relationship exists between chronic exposure to BAK and glaucoma. The hypothesis that BAK causes/worsens glaucoma is being tested experimentally in an animal model that closely reflects human physiology.

  10. Investigational and experimental drugs for intraocular pressure reduction in ocular hypertension and glaucoma.

    PubMed

    Lusthaus, Jed Asher; Goldberg, Ivan

    2016-10-01

    Intraocular pressure (IOP) is the most significant modifiable risk factor to prevent onset or progression of glaucoma. Glaucoma prevalence continues to increase, emphasizing the need for improved ocular hypotensive treatment options. To try to improve on both tolerance and IOP control of currently available therapies, different receptors or mechanisms are being explored to reduce IOP more effectively and to improve tolerance. We review synthetic topical and oral drugs in early development for the management of ocular hypertension and glaucoma. New therapeutic agents for IOP control have been discovered; some appear to be reasonably tolerated. IOP reduction may be limited with some agents, but other benefits although unproven may compensate for this, such as less ocular surface disease, enhanced neuro-protection or increased ocular blood flow. Further product development promises improved treatment options for ocular hypertensives and glaucoma sufferers.

  11. [The structure of the optic nerve in experimental glaucoma and in the means for its treatment].

    PubMed

    Ivanova, V F; Mikheeva, E A; Karelina, V E; Alekseev, V N

    2000-01-01

    Using light and electron microscopy disorders of structure of the optic nerve were studied in rabbits with adrenaline induced glaucoma and after the action of antioxidants (Emoxipine, Erisode) used for preventive and medical purposes. Changes in glaucoma and after administration of drugs in axons and their myelinated sheath were similar but differently pronounced in right and left eye of the same animal. Positive effect of Erisode used for preventive and medical purposes was noted. Emoxipine enhanced the disturbances in optic nerve structure.

  12. The Role of the Immune System in Glaucoma: Bridging the Divide Between Immune Mechanisms in Experimental Glaucoma and the Human Disease.

    PubMed

    Kamat, Shivani S; Gregory, Meredith S; Pasquale, Louis R

    2016-01-01

    Glaucoma is one of the leading causes of visual impairment worldwide. Classically, clinicians have evaluated patients through a full ophthalmological examination including gonioscopy, measurement of intraocular pressure (IOP), and assessment of the optic nerve. New imaging modalities have further enhanced our ability to evaluate glaucoma; however, our treatments have not evolved as much. Whether one uses medical treatment with topical ocular antihypertensives, laser trabeculoplasty, or filtering surgery, the mainstay of treatment is to lower IOP. However, as our understanding of the disease evolves, mechanisms other than elevated IOP have been implicated in glaucoma pathogenesis. Recent animal model studies have shown a possible role of the immune system in the pathophysiology of glaucoma. This article explores the current understanding of immune reactions in glaucoma, which could lead to a new paradigm of treatment for human disease.

  13. Delivery of antifibroblast agents as adjuncts to filtration surgery. Part I--Periocular clearance of cobalt-57 bleomycin in experimental drug delivery: pilot study in the rabbit

    SciTech Connect

    Kay, J.S.; Litin, B.S.; Woolfenden, J.M.; Chvapil, M.; Herschler, J.

    1986-10-01

    Antitumor and antifibroblast agents show promise as adjuncts after glaucoma filtration surgery in reducing postoperative scarring and failure. We used nuclear imaging in rabbits to investigate periocular clearance of one such agent (/sup 57/Co-bleomycin). Sub-Tenon injection was compared to other delivery techniques. Our results showed that a collagen sponge and a silastic disc implant with a microhole prolonged drug delivery when compared to sub-Tenon injection alone or injection with a viscosity enhancing agent (0.5% sodium hyaluronate). We theorize that if an antifibroblast agent can be delivered in small and sustained amounts after filtration surgery, this may prolong bleb longevity and avoid unnecessary drug toxicity.

  14. Cataract Surgery in the Glaucoma Patient

    PubMed Central

    Kung, Jennifer S.; Choi, Daniel Y.; Cheema, Anjum S.; Singh, Kuldev

    2015-01-01

    To summarize the role of cataract surgery in the glaucoma patient, in terms of the effect on intraocular pressure (IOP) as well as diagnostic and therapeutic considerations for those with both conditions. Recent evidence suggests that cataract extraction may produce a significant and sustained IOP reduction in individuals with open-angle glaucoma, ocular hypertension, and angle-closure glaucoma. Cataract removal may improve the practitioner's ability to interpret perimetric testing, and re-establishing perimetric and optic nerve imaging baselines is recommended after cataract surgery. The sequence of cataract surgery relative to glaucoma surgery impacts the likelihood of complications and surgical success. There are multiple benefits to perform cataract surgery prior to glaucoma surgery while cataract surgery after trabeculectomy increases the risk of subsequent filtration failure. As “minimally invasive glaucoma surgeries” continue to improve in terms of efficacy, there is an evolving role for combined cataract and glaucoma surgery in patients with early to moderate stages of glaucoma. PMID:25624668

  15. A rat experimental model of glaucoma incorporating rapid-onset elevation of intraocular pressure

    PubMed Central

    Smedowski, Adrian; Pietrucha-Dutczak, Marita; Kaarniranta, Kai; Lewin-Kowalik, Joanna

    2014-01-01

    Glaucoma is a chronic disease that causes structural and functional damage to retinal ganglion cells (RGC). The currently employed therapeutic options are not sufficient to prevent vision loss in patients with glaucoma; therefore, there is a need to develop novel therapies, which requires the creation of functional, repeatable and easy-to-utilize animal models for use in pre-clinical studies. The currently available models ensure only low to moderate damage in optic nerves, with high variation in the outcomes and poor repeatability. We have developed an effective and reproducible rat glaucoma model based on a previous idea for a “Bead Model” in mice, which could be useful in future glaucoma research. Additionally, in an attempt to achieve rapid elevation of Intraocular Pressure (IOP), we included an initial “high-pressure injury” as part of this method, which serves as the equivalent of a severe glaucoma attack. These modifications made it possible to achieve longer lasting IOP elevation with chronic damage of retinal ganglion cells. PMID:25081302

  16. Structure/Function Studies and the Effects of Memantine in Monkeys with Experimental Glaucoma

    PubMed Central

    Gabelt, B'Ann T.; Rasmussen, Carol A.; Tektas, Ozan Y.; Kim, Charlene B. Y.; Peterson, John C.; Nork, T. Michael; Hoeve, James N. Ver; Lütjen-Drecoll, Elke; Kaufman, Paul L.

    2012-01-01

    Purpose. The scanning laser polarimetry with variable corneal compensation (GDx VCC) methodology was established and verified in monkeys with experimental glaucoma (ExpG). Terminal GDx parameters were correlated with axon counts and electrophysiologic measures. The effects of memantine on these parameters were investigated. Methods. ExpG was induced in monkeys and intraocular pressure monitored weekly. Some monkeys received memantine in their diet before and after ExpG induction (1–10 months). GDx VCC scans, stereophotographs, and multifocal visual evoked potential (mfVEP) data were collected at baseline and every 6 to 8 weeks until euthanasia. Optic nerves were prepared for axon counting and other morphologic analysis. Results. There was no difference in IOP elevation exposure between memantine-treated and no-memantine–treated monkeys. The percentage of the optic nerve area composed of connective tissue septa was significantly greater in ExpG eyes than in Fellow eyes. There was a strong positive correlation between axon counts and terminal GDx parameter measures. Animals not receiving memantine exhibited significantly lower mfVEP amplitudes in ExpG eyes compared with the ipsilateral baseline or the final value in the Fellow eye. ExpG eyes from memantine-treated animals had higher overall mean amplitudes that were not significantly different relative to the ipsilateral baseline and final amplitudes in the Fellow eye. Conclusions. The authors' studies confirm that GDx VCC can be utilized in monkey ExpG studies to detect early retinal structural changes and that these changes are highly correlated with optic nerve axon counts. These structural changes may or may not lead to central functional changes as shown by the mfVEP in response to investigational therapies. PMID:22427549

  17. African Americans and Glaucoma

    MedlinePlus

    ... Latinos at Increased Glaucoma Risk Glaucoma Facts and Stats Glaucoma Risk Increases in Families: Spread the Word ... Anatomy Five Common Glaucoma Tests Glaucoma Facts and Stats Glossary Symptoms of Open-Angle Glaucoma Types of ...

  18. Intravitreal administration of erythropoietin and preservation of retinal ganglion cells in an experimental rat model of glaucoma.

    PubMed

    Tsai, James C; Wu, Li; Worgul, Basil; Forbes, Max; Cao, Jingtai

    2005-11-01

    The aim of this pilot study was to evaluate the potential neuroprotective effect of an intravitreal injection of erythropoietin (EPO) on retinal ganglion cell (RGC) preservation in an episcleral vessel cautery-induced rat model of glaucoma. The animals were randomly assigned into an unoperated control group (n = 11) and three experimental groups: episcleral vessel cautery only (EVC: n = 4), episcleral vessel cautery with intravitreal normal saline injection (EVC-NS; n = 5), and episcleral vessel cautery with intravitreal EPO treatment (EVC-EPO; n = 9). The intravitreal injections were limited to 5 mul containing either normal saline alone or 200 ng of EPO in normal saline administered immediately after the cautery procedure. RGCs were labeled retrogradely by FluoroGold neuron tracer 5 to 7 days prior to the collection of eyes at day 21 and counted in whole flat-mounted retinas with fluorescence microscopy. Compared to the RGC counts in retinal specimens from unoperated control rats (12,619 +/- 310), the corresponding RGC counts were significantly decreased in both the EVC (9116 +/- 273; p < 0.005) and EVC-NS (9489 +/- 293; p < 0.005) groups but not significantly decreased in the EVC-EPO (11,212 +/- 414; p = 0.051) treated retinas. A single intravitreal 200 ng dose of EPO appears to have a protective effect on RGC viability in an in vivo rat model of glaucoma. Further experimental studies are needed to confirm these preliminary results and to optimize the appropriate dose and frequency of EPO delivery in animal models of glaucoma.

  19. Glaucoma (image)

    MedlinePlus

    Glaucoma is a condition of increased fluid pressure inside the eye. The increased pressure causes compression of ... nerve which can eventually lead to nerve damage. Glaucoma can cause partial vision loss, with blindness as ...

  20. Experimental investigation of air pressure affecting filtration performance of fibrous filter sheet.

    PubMed

    Xu, Bin; Yu, Xiao; Wu, Ya; Lin, Zhongping

    2017-03-01

    Understanding the effect of air pressure on their filtration performance is important for assessing the effectiveness of fibrous filters under different practical circumstances. The effectiveness of three classes of air filter sheets were investigated in laboratory-based measurements at a wide range of air pressures (60-130 KPa). The filtration efficiency was found most sensitive to the air pressure change at smaller particle sizes. As the air pressure increased from 60 to 130 KPa, significant decrease in filtration efficiency (up to 15%) and increase in pressure drop (up to 90 Pa) were observed. The filtration efficiency of the filter sheet with largest fiber diameter and smallest solid volume fraction was affected most, while the pressure drop of the filter sheet with smallest fiber diameter and largest solid volume fraction was affected most. The effect of air pressure on the filtration efficiency was slightly larger at greater filter face air velocity. However, the effect of air pressure on the pressure drop was negligible. The filtration efficiency and pressure drop were explicitly expressed as functions of the air pressure. Two coefficients were empirically derived and successfully accounted for the effects of air pressure on filtration efficiency and pressure drop.

  1. Elevated intraocular pressure decreases response sensitivity of inner retinal neurons in experimental glaucoma mice

    PubMed Central

    Pang, Ji-Jie; Frankfort, Benjamin J.; Gross, Ronald L.; Wu, Samuel M.

    2015-01-01

    Glaucoma is the second leading cause of blindness in the United States and the world, characterized by progressive degeneration of the optic nerve and retinal ganglion cells (RGCs). Glaucoma patients exhibit an early diffuse loss of retinal sensitivity followed by focal loss of RGCs in sectored patterns. Recent evidence has suggested that this early sensitivity loss may be associated with dysfunctions in the inner retina, but detailed cellular and synaptic mechanisms underlying such sensitivity changes are largely unknown. In this study, we use whole-cell voltage-clamp techniques to analyze light responses of individual bipolar cells (BCs), AII amacrine cells (AIIACs), and ON and sustained OFF alpha-ganglion cells (ONαGCs and sOFFαGCs) in dark-adapted mouse retinas with elevated intraocular pressure (IOP). We present evidence showing that elevated IOP suppresses the rod ON BC inputs to AIIACs, resulting in less sensitive AIIACs, which alter AIIAC inputs to ONαGCs via the AIIAC→cone ON BC→ONαGC pathway, resulting in lower ONαGC sensitivity. The altered AIIAC response also reduces sOFFαGC sensitivity via the AIIAC→sOFFαGC chemical synapses. These sensitivity decreases in αGCs and AIIACs were found in mice with elevated IOP for 3–7 wk, a stage when little RGC or optic nerve degeneration was observed. Our finding that elevated IOP alters neuronal function in the inner retina before irreversible structural damage occurs provides useful information for developing new diagnostic tools and treatments for glaucoma in human patients. PMID:25675503

  2. Experimental microendoscopic photoablative laser goniotomy as a surgical model for the treatment of dysgenetic glaucoma.

    PubMed

    Jacobi, P C; Dietlein, T S; Krieglstein, G K

    1996-11-01

    The aim of this study was to investigate the feasibility of photoablative Er:YAG laser goniotomy under microendoscopic control in a surgical cloudy corneal model of primary infantile glaucoma. Pectinate ligaments of 12 freshly enucleated cadaver porcine eyes were treated by ab interno single-pulse (5 mJ, 200 microseconds) Er:YAG laser (2.94 microns) photoablation. Through a clear corneal incision near the limbus an ophthalmic microendoscope (18 and 20 gauge) was inserted into the anterior chamber. Internal structures were observed and photoablative laser goniotomy was conducted under video guidance. Following treatment all eyes were prepared for light and scanning electron microscopy. Anterior chamber angle structures and tissue photoablation were clearly visualized on the videoscreen using ophthalmic microendoscopy. Energy settings of 5 mJ per pulse proved to be sufficient for reproducible photoablation of pectinate ligaments, accompanied by the root of the iris falling back and exposing trabecular meshwork. This was confirmed histopathologically. Scatter thermal damage was less than 30 microns. This new therapeutic modality, which combines endoscopic visualization of the internal structures with photoablative laser goniotomy, can be effective in the management of dysgenetic glaucoma in the presence of a cloudy cornea. High reproducibility of contact laser photoablation enabled sufficient control of incision depth and was not accompanied by inadvertent tissue damage to adjacent intraocular structures.

  3. Neuroprotection in Glaucoma

    PubMed Central

    Doozandeh, Azadeh; Yazdani, Shahin

    2016-01-01

    Glaucoma is a degenerative optic neuropathy characterized by retinal ganglion cell (RGC) loss and visual field defects. It is known that in some glaucoma patients, death of RGCs continues despite intraocular pressure (IOP) reduction. Neuroprotection in the field of glaucoma is defined as any treatment, independent of IOP reduction, which prevents RGC death. Glutamate antagonists, ginkgo biloba extract, neurotrophic factors, antioxidants, calcium channel blockers, brimonidine, glaucoma medications with blood regulatory effect and nitric oxide synthase inhibitors are among compounds with possible neuroprotective activity in preclinical studies. A few agents (such as brimonidine or memantine) with neuroprotective effects in experimental studies have advanced to clinical trials; however the results of clinical trials for these agents have not been conclusive. Nevertheless, lack of compelling clinical evidence has not prevented the off-label use of some of these compounds in glaucoma practice. Stem cell transplantation has been reported to halt experimental neurodegenerative disease processes in the absence of cell replacement. It has been hypothesized that transplantation of some types of stem cells activates multiple neuroprotective pathways via secretion of various factors. The advantage of this approach is a prolonged and targeted effect. Important concerns in this field include the secretion of unwanted harmful mediators, graft survival issues and tumorigenesis. Neuroprotection in glaucoma, pharmacologically or by stem cell transplantation, is an interesting subject waiting for broad and multidisciplinary collaborative studies to better clarify its role in clinical practice. PMID:27413504

  4. The Connective Tissue Components of Optic Nerve Head Cupping in Monkey Experimental Glaucoma Part 1: Global Change

    PubMed Central

    Yang, Hongli; Ren, Ruojin; Lockwood, Howard; Williams, Galen; Libertiaux, Vincent; Downs, Crawford; Gardiner, Stuart K.; Burgoyne, Claude F.

    2015-01-01

    Purpose To characterize optic nerve head (ONH) connective tissue change within 21 monkey experimental glaucoma (EG) eyes, so as to identify its principal components. Methods Animals were imaged three to five times at baseline then every 2 weeks following chronic unilateral IOP elevation, and euthanized early through end-stage confocal scanning laser tomographic change. Optic nerve heads were serial-sectioned, three-dimensionally (3D) reconstructed, delineated, and quantified. Overall EG versus control eye differences were assessed by general estimating equations (GEE). Significant, animal-specific, EG eye change was required to exceed the maximum physiologic intereye differences in six healthy animals. Results Overall EG eye change was significant (P < 0.0026) and animal-specific EG eye change most frequent, for five phenomena (number of EG eyes and range of animal-specific change): posterior laminar deformation (21, −29 to −437 μm), laminar thickening (11, 20–73 μm) and thinning (3, −23 to −31 μm), scleral canal expansion (17, 20–139 μm), outward anterior (16, −16 to −124 μm) and posterior (17, −22 to −279 μm) laminar insertion migration, and peripapillary scleral bowing (11, 21–77 μm). Experimental glaucoma versus control eye laminar thickness differences were bimodal in behavior, being thickened in most EG eyes demonstrating the least deformation and less thickened or thinned in most EG eyes demonstrating the greatest deformation. Conclusions Our postmortem studies retrospectively identify five connective tissue components of ONH “cupping” in monkey EG which serve as targets for longitudinally staging and phenotyping ONH connective tissue alteration within all forms of monkey and human optic neuropathy. PMID:26641545

  5. Towards axonal regeneration and neuroprotection in glaucoma: Rho kinase inhibitors as promising therapeutics.

    PubMed

    Van de Velde, Sarah; De Groef, Lies; Stalmans, Ingeborg; Moons, Lieve; Van Hove, Inge

    2015-08-01

    Due to a prolonged life expectancy worldwide, the incidence of age-related neurodegenerative disorders such as glaucoma is increasing. Glaucoma is the second cause of blindness, resulting from a slow and progressive loss of retinal ganglion cells (RGCs) and their axons. Up to now, intraocular pressure (IOP) reduction is the only treatment modality by which ophthalmologists attempt to control disease progression. However, not all patients benefit from this therapy, and the pathophysiology of glaucoma is not always associated with an elevated IOP. These limitations, together with the multifactorial etiology of glaucoma, urge the pressing medical need for novel and alternative treatment strategies. Such new therapies should focus on preventing or retarding RGC death, but also on repair of injured axons, to ultimately preserve or improve structural and functional connectivity. In this respect, Rho-associated coiled-coil forming protein kinase (ROCK) inhibitors hold a promising potential to become very prominent drugs for future glaucoma treatment. Their field of action in the eye does not seem to be restricted to IOP reduction by targeting the trabecular meshwork or improving filtration surgery outcome. Indeed, over the past years, important progress has been made in elucidating their ability to improve ocular blood flow, to prevent RGC death/increase RGC survival and to retard axonal degeneration or induce proper axonal regeneration. Within this review, we aim to highlight the currently known capacity of ROCK inhibition to promote neuroprotection and regeneration in several in vitro, ex vivo and in vivo experimental glaucoma models.

  6. Movement of retinal vessels toward the optic nerve head after increasing intraocular pressure in monkey eyes with experimental glaucoma.

    PubMed

    Kuroda, Atsumi; Enomoto, Nobuko; Ishida, Kyoko; Shimazawa, Masamitsu; Noguchi, Tetsuro; Horai, Naoto; Onoe, Hirotaka; Hara, Hideaki; Tomita, Goji

    2017-09-01

    A shift or displacement of the retinal blood vessels (RBVs) with neuroretinal rim thinning indicates the progression of glaucomatous optic neuropathy. In chronic open angle glaucoma, individuals with RBV positional shifts exhibit more rapid visual field loss than those without RBV shifts. The retinal vessels reportedly move onto the optic nerve head (ONH) in response to glaucoma damage, suggesting that RBVs are pulled toward the ONH in response to increased cupping. Whether this phenomenon only applies to RVBs located in the vicinity or inside the ONH or, more generally, to RBVs also located far from the ONH, however, is unclear. The aim of this study was to evaluate the movement of RBVs located relatively far from the ONH edge after increasing intraocular pressure (IOP) in an experimental monkey model of glaucoma. Fundus photographs were obtained in 17 monkeys. High IOP was induced in the monkeys by laser photocoagulation burns applied uniformly with 360° irradiation around the trabecular meshwork of the left eye. The right eye was left intact and used as a non-treated control. Considering the circadian rhythm of IOP, it was measured in both eyes of each animal at around the same time-points. Then, fundus photographs were obtained. Using Image J image analysis software, an examiner (N.E.) measured the fundus photographs at two time-points, i.e. before laser treatment (time 1) and the last fundus photography after IOP elevation (time 2). The following parameters were measured (in pixels): 1) vertical diameter of the ONH (DD), 2) distance from the ONH edge to the first bifurcation point of the superior branch of the central retinal vein (UV), 3) distance from the ONH edge to the first bifurcation point of the inferior branch of the central retinal vein (LV), 4) ONH area, and 5) surface area of the cup of the ONH. We calculated the ratios of UV to DD (UV/DD), LV to DD (LV/DD), and the cup area to disc area ratio (C/D). The mean UV/DD at time 1 (0.656 ± 0.233) was

  7. A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations.

    PubMed

    Riva, Ivano; Roberti, Gloria; Katsanos, Andreas; Oddone, Francesco; Quaranta, Luciano

    2017-04-01

    The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

  8. Colloid filtration in surface dense vegetation: Experimental results and theoretical predictions

    USDA-ARS?s Scientific Manuscript database

    Understanding colloid and colloid-facilitated contaminant transport in overland flow through dense vegetation is essential to protect water quality for the environment. In previous studies, a single-stem efficiency theory for rigid and clean stem systems has been developed to predict colloid filtrat...

  9. Experimental development of advanced air filtration media based on electrospun polymer fibers

    NASA Astrophysics Data System (ADS)

    Ghochaghi, Negar

    Electrospinning is a process by which polymer fibers can be produced using an electrostatically driven fluid jet. Electrospun fibers can be produced at the micro- or nano-scale and are, therefore, very promising for air filtration applications. However, because electrospun fibers are electrically charged, it is difficult to control the morphology of filtration media. Fiber size, alignment and uniformity are very important factors that affect filter performance. The focus of this project is to understand the relationship between filter morphology and performance and to develop new methods to create filtration media with optimum morphology. This study is divided into three focus areas: unimodal and bimodal microscale fibrous media with aligned, orthogonal and random fiber orientations; unimodal and bimodal nanoscale fibers in random orientations; bimodal micrometer and nanometer fiber media with orthogonally aligned orientations. The results indicate that the most efficient filters, which are those with the highest ratio of particle collection efficiency divided by pressure drop, can be obtained through fabricating filters in orthogonal layers of aligned fibers with two different fiber diameters. Moreover, our results show that increasing the number of layers increases the performance of orthogonally layered fibers. Also, controlling fiber spacing in orthogonally layered micrometer fiber media can be an alternative way to study the filtration performance. Finally, such coatings presented throughout this research study can be designed and placed up-stream, down-stream, and/or in between conventional filters.

  10. Long-term glial reactivity in rat retinas ipsilateral and contralateral to experimental glaucoma.

    PubMed

    Kanamori, Akiyasu; Nakamura, Makoto; Nakanishi, Yoriko; Yamada, Yuko; Negi, Akira

    2005-07-01

    Although glaucoma is known to alter glial reactivity, the long-term effect of elevated intraocular pressure (IOP) on glial change has not been fully elucidated. This study aimed to examine how chronically elevated IOP induced by episcleral vein cauterization (EVC) in unilateral eyes affect reactivities of astrocytes and Müller cells of rats in the treated as well as contralateral eyes over time. EVC in unilateral eyes of Sprague-Dawley rats were performed to produce chronically elevated IOP. Flat mounted retina preparations were made at several points until 6 months, which were subjected to immunostaining for glial fibrillary acidic protein (GFAP). Retinal homogenates were one- or two-dimensionally electrophoresed, followed by GFAP immunoblotting. EVC significantly increased IOPs up to 27.8 from 13.1 mmHg, which gradually decreased over time. In flat mounted retinas, astrocytes lost but Müller cells gained GFAP immunoreactivity at 3 days after cauterization. The glial changes were partially reversed over time but last even after IOP normalization. In the contralateral eyes, similar glial changes gradually appeared at 1 month after EVC and thereafter. Immunoblotting demonstrated not only molecular size shifts but also alteration of isoelectric focusing of GFAP both in treated and contralateral retina as compared with age-matched control retina. EVC led to opposite reactions in astrocytes and Müller cells in terms of GFAP immunoreactivity. Late-onset glial reactivity also occurred in the contralateral retina.

  11. Inflammatory glaucoma

    PubMed Central

    Bodh, Sonam A.; Kumar, Vasu; Raina, Usha K.; Ghosh, B.; Thakar, Meenakshi

    2011-01-01

    Glaucoma is seen in about 20% of the patients with uveitis. Anterior uveitis may be acute, subacute, or chronic. The mechanisms by which iridocyclitis leads to obstruction of aqueous outflow include acute, usually reversible forms (e.g., accumulation of inflammatory elements in the intertrabecular spaces, edema of the trabecular lamellae, or angle closure due to ciliary body swelling) and chronic forms (e.g., scar formation or membrane overgrowth in the anterior chamber angle). Careful history and follow-up helps distinguish steroid-induced glaucoma from uveitic glaucoma. Treatment of combined iridocyclitis and glaucoma involves steroidal and nonsteroidal antiinflammatory agents and antiglaucoma drugs. However, glaucoma drugs can often have an unpredictable effect on intraocular pressure (IOP) in the setting of uveitis. Surgical intervention is required in case of medical failure. Method of Literature Search: Literature on the Medline database was searched using the PubMed interface. PMID:21713239

  12. Screening for Glaucoma

    MedlinePlus

    ... vision. Glaucoma can lead to vision problems and blindness. Facts About Glaucoma Glaucoma is a serious disease ... rise in eye pressure. Glaucoma can lead to blindness, but we don’t know which people with ...

  13. Feline Glaucoma.

    PubMed

    McLellan, Gillian J; Teixeira, Leandro B C

    2015-11-01

    Feline glaucoma is often insidious in onset and slowly progressive with very subtle clinical signs. As a consequence, it is likely that the disease in cats is underdiagnosed. As cats typically present late in the course of disease, prognosis for long-term maintenance of vision is poor. Patient and owner compliance with frequent application of topical medications can be a limiting factor, and represents a serious clinical challenge. This review outlines the clinical features, classification, and pathophysiology of the feline glaucomas and provides current evidence on which to base the selection of appropriate treatment strategies for cats with glaucoma.

  14. Safety and Efficacy of Microinvasive Glaucoma Surgery

    PubMed Central

    Chen, David Z.

    2017-01-01

    Microinvasive glaucoma surgery (MIGS) is emerging as a new therapeutic option for glaucoma patients who wish to reduce their medication burden and avoid the postoperative complications of conventional glaucoma filtration surgery. These devices differ in terms of their efficacy and safety profile. Schlemm's canal devices have the most favorable safety profile at the compromise of modest efficacy, while subconjunctival and suprachoroidal devices are potentially more effective at lowering the intraocular pressure at the expense of a higher rate of complications. This review consolidates the latest evidence on the efficacy and safety of the MIGS devices in clinical use and provides an overview on upcoming devices which would likely also become viable treatment options in the near future. These clinical data would assist a glaucoma surgeon in selecting the most appropriate MIGS device for each patient based on the glaucoma severity and patient expectations. PMID:28512578

  15. Paclitaxel Associated With Lipid Nanoparticles as a New Antiscarring Agent in Experimental Glaucoma Surgery.

    PubMed

    Occhiutto, Marcelo L; Freitas, Fatima R; Lima, Patrícia P; Maranhão, Raul C; Costa, Vital P

    2016-03-01

    To investigate the effects of paclitaxel associated with lipid nanoemulsions (LDE-PTX) on postoperative scarring in rabbits undergoing trabeculectomy. Thirty-four rabbits that underwent trabeculectomy were allocated to four groups: LDE-PTX/SC (n = 9), treated with LDE-PTX (1.5 mg, intraoperative subconjunctival injection); LDE-PTX/IV (n = 9), treated with LDE-PTX (4 mg/kg per day intravenously) at the end of the surgery and once per week for 3 weeks; MMC (n = 9), treated with intraoperative 0.4 mg/mL mitomycin-C for 3 minutes; and control group (CTL, n = 7), without treatment. Bleb characteristics and IOP were evaluated over 4 weeks. Animals were killed on day 28. Histologic analyses were performed to assess the amount of scarring and toxicity to the conjunctiva and ciliary body. Groups were similar with respect to IOP and anterior chamber depth during the 28-day observation period. The LDE-PTX/SC, LDE-PTX/IV, and MMC groups showed greater bleb height than CTL on days 14 and 21 (P < 0.001). The LDE-PTX/SC, LDE-PTX/IV, and MMC groups showed longer bleb survival time than CTL (P < 0.001). The LDE-PTX/SC, LDE-PTX/IV, and MMC groups were equally effective in reducing fibrosis (P < 0.001), number of blood vessels (P < 0.001), and chronic inflammatory cells (P < 0.01) at the surgical site. However, LDE-PTX/SC and LDE-PTX/IV treatments had lower conjunctival (P < 0.001) and ciliary body toxicity (P < 0.01), compared with MMC. The LDE-PTX/SC was effective in reducing the scarring process following trabeculectomy to the same extent as MMC, but with considerably less toxicity to the conjunctiva and ciliary body. The LDE-PTX/IV was somewhat less effective than LDE-PTX/SC or MMC, but could have potential as a postoperative adjuvant treatment. Therefore, the LDE-PTX preparation in both administration routes may offer promising options for wound-healing modulation in the surgical treatment of glaucoma.

  16. Glaucoma medications.

    PubMed

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi

    2013-01-01

    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates.

  17. Experimental and Numerical Investigations on Flue Gas Purification during Hot Gas Filtration

    SciTech Connect

    Thulfaut, C.; Renz, U.

    2002-09-19

    The aim of the actual investigations is to integrate the catalytic reduction of carbon monoxide and particularly nitric oxides into the hot gas filtration process with ceramic filter elements of fluidized bed combustors which mainly represent an important N2O-source. According to Klein (Klein 1994) worldwide approx. 260 coal-fired power plants with fluidized bed combustors in the power range > 50 MWel existed in 1994, to which approx. 1% of the global coal dissipation corresponds. These emitted dinitrogen oxide with 70 kt/a, however, 20% of the entire N2O amounts from stationary firing plants. After Kleins calculations an increase of coal-fired fluidized bed combustors only by 10% triples the N2O emission.

  18. Filtration of triazine herbicides by polymer-clay sorbents: coupling an experimental mechanistic approach with empirical modeling.

    PubMed

    Gardi, Ido; Nir, Shlomo; Mishael, Yael G

    2015-03-01

    Triazine herbicides detected in surface and groundwater pose environmental and health risks. Removal of triazine herbicides (simazine, atrazine and terbuthylazine) by polymer-clay composites was studied and modeled. Their binding by a poly 4-vinyl pyridine co styrene-montmorillonite (HPVP-CoS-MMT) composite was especially high due to specific interactions between the herbicides and polymer, mainly hydrogen bonds and π-π stacking. The binding kinetics to the composite was in the order of simazine > atrazine > terbuthylazine, which was in accord with their equilibrium Langmuir binding coefficients; 44,000, 17,500 and 16,500 M(-1), respectively, which correlated with herbicide accessibility to form specific interaction with the polymer. Simazine binding kinetics to the composite was significantly faster than to granulated activated carbon (GAC), reaching 93% vs 38% of the maximal adsorption within 10 min, respectively. Herbicide filtration by composite columns was adequately fitted by a model which considers convection and employs Langmuir formalism for kinetics of adsorption/desorption. Filtration of simazine (10 μg L(-1)) by composite columns (40 cm long, which included 26 g composite mixed with sand 1:40 (weight ratio)), was well predicted by the model with nearly 120 L purified, i.e., effluent concentrations were below regulation limit (3 μg L(-1)). Effluent concentrations from GAC columns exceeded the limit after filtering 5 L. Experimental results and model predictions suggest that while GAC has a high capacity for simazine binding, the composite has higher affinity towards the herbicide and its adsorption is faster, which yields more efficient filtration by composite columns.

  19. Glaucoma diagnostics.

    PubMed

    Geimer, Sabina Andersson

    2013-02-01

    This thesis addresses several aspects of glaucoma diagnostics from both a clinical and a screening perspective. New instruments for diagnosing glaucoma have been developed over the past years, but little information is available regarding their performance as screening methods and their usefulness in ordinary clinical practice. PURPOSE OF THE RESEARCH UNDERLYING THIS THESIS:  The objectives of this research were as follows: to compare the accuracy of results of analysis of the optic nerve head (ONH) achieved by computerized imaging using the Heidelberg Retina Tomograph (HRT) and by subjective assessment performed by physicians with different degrees of experience of glaucoma (paper III); to evaluate the effect of a continuous medical education (CME) lecture on subjective assessment of the ONH for diagnosis of glaucoma (paper II); to investigate subjective assessment of perimetric test results by physicians with varying knowledge of glaucoma with a trained artificial neural network (ANN) and to compare the certainty of the classifications (paper IV); and to compare the diagnostic performance of time-domain Stratus optical coherence tomography (OCT) with that of spectral-domain Cirrus OCT (paper I), frequency doubling technology (FDT) screening perimetry and scanning laser polarimetry with the GDx variable corneal compensator (VCC) in a random population-based sample and in patients with glaucoma of varying disease severity.   In evaluation of the ONH, use of the HRT statistical tools, Moorfields regression analysis (MRA) and the Glaucoma Probability Score (GPS) was compared with subjective assessment performed by 45 physicians. Optic nerve head images and photographs from 138 healthy and 97 glaucoma subjects were included. The sensitivity of MRA was higher (87-94%) than that of the average physician (62-82%), considerably greater than that of ophthalmologists with subspecialties other than glaucoma (53-77%) and non-significantly better than that of glaucoma

  20. Glaucoma database.

    PubMed

    K, Rangachari; M, Dhivya; Pj, Eswari Pandaranayaka; N, Prasanthi; P, Sundaresan; Sr, Krishnadas; S, Krishnaswamy

    2011-02-07

    Glaucoma, a complex heterogenous disease, is the leading cause for optic nerve-related blindness worldwide. Primary open angle glaucoma (POAG) is the most common subset and by the year 2020 it is estimated that approximately 60 million people will be affected. MYOC, OPTN, CYP1B1 and WDR36 are the important candidate genes. Nearly 4% of the glaucoma patients have mutation in any one of these genes. Mutation in any of these genes causes disease either directly or indirectly and the severity of the disease varies according to position of the genes. We have compiled all the related mutations and SNPs in the above genes and developed a database, to help access statistical and clinical information of particular mutation. This database is available online at http:bicmku.in:8081/glaucoma The database, constructed using SQL, contains data pertaining to the SNPs and mutation information involved in the above genes and relevant study data. The database is available for free at http:bicmku.in:8081/glaucoma.

  1. Age-Related Differences in Longitudinal Structural Change by Spectral-Domain Optical Coherence Tomography in Early Experimental Glaucoma

    PubMed Central

    Yang, Hongli; He, Lin; Gardiner, Stuart K.; Reynaud, Juan; Williams, Galen; Hardin, Christy; Strouthidis, Nicholas G.; Downs, J. Crawford; Fortune, Brad; Burgoyne, Claude F.

    2014-01-01

    Purpose. To characterize age-related differences in the magnitude of spectral-domain optical coherence tomography (SD-OCT) structural change in early experimental glaucoma (EG). Methods. Both eyes from four young (1.4–2.6 years) and four old (18.6–21.9 years) rhesus monkeys were imaged at least three times at baseline, and then every 2 weeks after laser-induced, chronic, unilateral IOP elevation until the onset of EG (confocal scanning laser tomographic surface change confirmed twice). Two to 20 weeks after EG onset, animals were euthanized and optic nerve axon counts for all eyes were performed. Masked operators delineated retinal and ONH landmarks in 40 radial B-scans from each eye and imaging session to quantify change from baseline in five SD-OCT neural and connective tissue parameters. The effects of EG, age, and EG × age interactions on the magnitude, rate (magnitude per postlaser time), and IOP responsiveness (magnitude per cumulative IOP insult) of postlaser parameter change were individually assessed using general estimating equation models. Results. Presac SD-OCT RNFLT and minimum rim width change and postmortem axon loss was not significantly different in old compared with young EG eyes. The rate of change and IOP responsiveness of the parameters anterior lamina cribrosa surface depth relative to Bruch's membrane opening (BMO) and BMO depth relative to peripheral Bruch's membrane were significantly lower (P < 0.05) in the old compared with the young EG eyes. Conclusions. At similar postlaser times, levels of cumulative IOP insult and axonal damage, SD-OCT–detected ONH connective tissue structural change is greater in young compared with old monkey EG eyes. PMID:25190652

  2. The dark phase intraocular pressure elevation and retinal ganglion cell degeneration in a rat model of experimental glaucoma.

    PubMed

    Kwong, Jacky M K; Vo, Nancy; Quan, Ann; Nam, Michael; Kyung, Haksu; Yu, Fei; Piri, Natik; Caprioli, Joseph

    2013-07-01

    analysis showed statistical significance for the relationships between the total cumulative IOP elevation and RGC body loss (P = 0.009), and axonal injury (P = 0.016). To examine the role of light and dark IOP elevation in RGC body loss and axonal injury, analyses for the association between different light/dark IOP factors and percentage of RGC body loss/axonal injury grading were performed and only the association between the cumulative dark IOP elevation and axonal injury showed statistical significance (P = 0.033). The findings demonstrated that the cumulative total (light and dark) IOP elevation is a risk factor to RGC degeneration in a rat model of experimental glaucoma using modified partial laser photocoagulation at 330° trabecular meshwork. Further investigations are required to understand the role of longer term light and dark phase IOP elevation contributing to the progression of degeneration in different compartments of RGCs.

  3. An experimental model of affinity filtration for the isolation of egg white Lysozyme using Cibacron Blue immobilized to yeast cells.

    PubMed

    Ferraris, María del Pilar; Gonzalez, Ulises A; Aguilar, Carlos F; Rodríguez, Jorge A

    2016-05-01

    An experimental model of affinity filtration process was designed using a macroligand composed by Cibacron Blue F3GA immobilized to yeast cells. Its performance was evaluated, at bench scale, through the recovery of egg white Lysozyme. The selective and reversible binding between the Cibacron ligand molecule and the enzyme is described. The separation of Lysozyme from the protein mixture included the application of stages such as affinity adsorption, concentration, diafiltration and elution. A tangential microfiltration system with an inorganic membrane was designed. The main finding was the development of the diafiltration operation, key stage in the enzyme isolation. The macroligand particle kept its integrity along the whole process and the degree of purity of the isolated Lysozyme was significant.

  4. The prediction of filter belt press dewatering efficiency for activated sludge by experimentation on filtration compression cells.

    PubMed

    Olivier, J; Vaxelaire, J

    2004-12-01

    The filter belt press is commonly used to dewater activated sludge. However, little research has been done on this process and the prediction of its efficiency. Experimentation has been carried out in a filtration compression cell (FCC) and in a pilot scale filter belt press. It offers a way of determining filter belt press efficiency thanks to simple laboratory research. The pressure distribution around the pressing roller was measured inside the pilot scale filter belt press. It showed progressive increase (up to a certain maximum value: plateau), which was followed by a rapid decrease. The impact of the progressive increase of applied pressure onto the dry solid sludge content was observed in FCC. Similar dry solid contents were obtained from both the above laboratory devices when the application of the pressure is comparable (in time and increasing rate).

  5. Filtration Fundamentals.

    ERIC Educational Resources Information Center

    Ward, Ken; Hunsaker, Scot

    1997-01-01

    Examines how choice of commercial swimming-pool filtration systems is driven by the project-specific needs of the pools. Also highlighted are definitions of specific terms used when discussing filtration systems. Questions that pool designers can answer to make filtration-system purchasing decisions are listed. (GR)

  6. Water Filtration

    ERIC Educational Resources Information Center

    Jacobsen, Erica K.

    2004-01-01

    A water filtration column is devised by students using a two-liter plastic bottle containing gravel, sand, and activated charcoal, to test the filtration potential of the column. Results indicate that the filtration column eliminates many of the contaminating materials, but does not kill bacteria.

  7. Water Filtration

    ERIC Educational Resources Information Center

    Jacobsen, Erica K.

    2004-01-01

    A water filtration column is devised by students using a two-liter plastic bottle containing gravel, sand, and activated charcoal, to test the filtration potential of the column. Results indicate that the filtration column eliminates many of the contaminating materials, but does not kill bacteria.

  8. UBM-guided chamber angle surgery for glaucoma management: an experimental study.

    PubMed

    Dietlein, T S; Engels, B F; Jacobi, P C; Krieglstein, G K

    2003-04-01

    The aim of this experimental study was to investigate the potential of ultrasound bimicroscopy (UBM)-guided chamber angle surgery as an alternative or supplement to gonioscopy and intraocular microendoscopy for intraoperative control. In 15 porcine cadaver eyes, mechanical goniopuncture or punctual Er:YAG laser trabecular ablation was performed without operating microscope or gonioscopy, but with real-life ultrasound biomicroscopy monitoring with a 50 MHz transducer. Intraoperative localization of the microsurgical instruments and tissue-instrument contact were qualitatively evaluated. The instruments could be clearly visualized within the chamber angle and disturbing artefacts were only minimal when using mechanically fixed instruments in slow motion. Topographic localization, tissue contact, and penetration depth of the instruments entering the scleral were well illustrated as far as the technical resolution limits of UBM would allow. UBM can be used intraoperatively to monitor the correct manoeuvring of microsurgical instruments in selected ab interno procedures. Some adaptations and further modifications of the technique presented here will be necessary before UBM-guided surgery can be considered for clinical use in humans.

  9. Androgen receptor and NFkB expression in human normal and glaucomatous optic nerve head astrocytes in vitro and in experimental glaucoma.

    PubMed

    Agapova, Olga A; Kaufman, Paul L; Hernandez, M Rosario

    2006-06-01

    For several decades, clinical and experimental observations suggested a relationship between steroids and glaucoma; however, the possibility that androgens are also involved in the glaucomatous changes in the optic nerve heads (ONH) has not been explored. Our previous findings that glaucomatous ONH astrocytes synthesize androgen-metabolising enzymes and overproduce a neuroactive androgen, 5alpha-androstane-3alpha, 17beta-diol (3alpha-diol) led us to propose that ONH astrocytes are androgen target cells. Androgens modulate different cellular processes through androgen receptor (AR). NFkB is a transcription factor that positively regulates AR transcription. Here, we analysed AR and NFkB expression in normal and glaucomatous ONH astrocytes in vitro, and in vivo in a monkey model of experimental glaucoma (ExpG) by quantitative real time RT-PCR, Western blotting and immunohistochemistry. We demonstrated that in vitro human glaucomatous ONH astrocytes express AR mRNA and protein at higher levels than normal astrocytes and that in vivo ONH astrocytes from eyes with ExpG showed increased nuclear and cytoplasmic AR immunostaining compared to control eyes. In the retina, retinal ganglion cells (RGC) demonstrated cytoplasmic staining both in control and in ExpG eyes. NFkB mRNA expression was higher in glaucomatous ONH astrocytes than in normal and more nuclear NFkB protein was detected in glaucomatous ONH astrocytes. In vivo immunopositive NFkB nuclear staining of ONH astrocytes in ONH and in RGC in retina was detected both in control and in ExpG eyes. We conclude that in addition to our published data, increase of AR and NFkB expression in glaucomatous ONH astrocytes provides strong evidence that androgens play a significant role in the pathophysiology of glaucoma.

  10. Experimental Glaucoma Causes Optic Nerve Head Neural Rim Tissue Compression: A Potentially Important Mechanism of Axon Injury

    PubMed Central

    Fortune, Brad; Reynaud, Juan; Hardin, Christy; Wang, Lin; Sigal, Ian A.; Burgoyne, Claude F.

    2016-01-01

    Purpose We tested the hypothesis that experimental glaucoma (EG) results in greater thinning of the optic nerve head (ONH) neural rim tissue than the peripapillary retinal nerve fiber layer (RNFL) tissue. Methods Longitudinal spectral-domain optical coherence tomography (SDOCT) imaging of the ONH and peripapillary RNFL was performed every other week under manometric IOP control (10 mm Hg) in 51 nonhuman primates (NHP) during baseline and after induction of unilateral EG. The ONH parameter minimum rim area (MRA) was derived from 80 radial B-scans centered on the ONH; RNFL cross-sectional area (RNFLA) from a peripapillary circular B-scan with 12° diameter. Results In control eyes, MRA was 1.00 ± 0.19 mm2 at baseline and 1.00 ± 0.19 mm2 at the final session (P = 0.77), while RNFLA was 0.95 ± 0.09 and 0.95 ± 0.10 mm2, respectively (P = 0.96). In EG eyes, MRA decreased from 1.00 ± 0.19 mm2 at baseline to 0.63 ± 0.21 mm2 at the final session (P < 0.0001), while RNFLA decreased from 0.95 ± 0.09 to 0.74 ± 0.19 mm2, respectively (P < 0.0001). Thus, MRA decreased by 36.4 ± 20.6% in EG eyes, significantly more than the decrease in RNFLA (21.7 ± 19.4%, P < 0.0001). Other significant changes in EG eyes included increased Bruch's membrane opening (BMO) nonplanarity (P < 0.05), decreased BMO aspect ratio (P < 0.0001), and decreased MRA angle (P < 0.001). Bruch's membrane opening area did not change from baseline in either control or EG eyes (P = 0.27, P = 0.15, respectively). Conclusions Optic nerve head neural rim tissue thinning exceeded peripapillary RNFL thinning in NHP EG. These results support the hypothesis that axon bundles are compressed transversely within the ONH rim along with glaucomatous deformation of connective tissues. PMID:27564522

  11. Simultaneous Complement Response via Lectin Pathway in Retina and Optic Nerve in an Experimental Autoimmune Glaucoma Model

    PubMed Central

    Reinehr, Sabrina; Reinhard, Jacqueline; Gandej, Marcel; Kuehn, Sandra; Noristani, Rozina; Faissner, Andreas; Burkhard Dick, H.; Joachim, Stephanie C.

    2016-01-01

    Glaucoma is a multifactorial disease and especially mechanisms occurring independently from an elevated intraocular pressure (IOP) are still unknown. Likely, the immune system contributes to the glaucoma pathogenesis. Previously, IgG antibody depositions and retinal ganglion cell (RGC) loss were found in an IOP-independent autoimmune glaucoma model. Therefore, we investigated the possible participation of the complement system in this model. Here, rats were immunized with bovine optic nerve homogenate antigen (ONA), while controls (Co) received sodium chloride (n = 5–6/group). After 14 days, RGC density was quantified on flatmounts. No changes in the number of RGCs could be observed at this point in time. Longitudinal optic nerve sections were stained against the myelin basic protein (MBP). We could note few signs of degeneration processes. In order to detect distinct complement components, retinas and optic nerves were labeled with complement markers at 3, 7, 14, and 28 days and analyzed. Significantly more C3 and MAC depositions were found in retinas and optic nerves of the ONA group. These were already present at day 7, before RGC loss and demyelination occurred. Additionally, an upregulation of C3 protein was noted via Western Blot at this time. After 14 days, quantitative real-time PCR revealed significantly more C3 mRNA in the ONA retinas. An upregulation of the lectin pathway-associated mannose-serine-protease-2 (MASP2) was observed in the retinas as well as in the optic nerves of the ONA group after 7 days. Significantly more MASP2 in retinas could also be observed via Western Blot analyses at this point in time. No effect was noted in regard to C1q. Therefore, we assume that the immunization led to an activation of the complement system via the lectin pathway in retinas and optic nerves at an early stage in this glaucoma model. This activation seems to be an early response, which then triggers degeneration. These findings can help to develop novel

  12. Neuroprotection in glaucoma

    PubMed Central

    Vasudevan, Sushil K; Gupta, Viney; Crowston, Jonathan G

    2011-01-01

    Glaucoma is a neurodegenerative disease characterized by loss of retinal ganglion cells and their axons. Recent evidence suggests that intraocular pressure (IOP) is only one of the many risk factors for this disease. Current treatment options for this disease have been limited to the reduction of IOP; however, it is clear now that the disease progression continues in many patients despite effective lowering of IOP. In the search for newer modalities in treating this disease, much data have emerged from experimental research the world over, suggesting various pathological processes involved in this disease and newer possible strategies to treat it. This review article looks into the current understanding of the pathophysiology of glaucoma, the importance of neuroprotection, the various possible pharmacological approaches for neuroprotection and evidence of current available medications. PMID:21150020

  13. Determinants of glomerular filtration and plasma flow in experimental diabetic rats.

    PubMed

    Michels, L D; Davidman, M; Keane, W F

    1981-12-01

    GFR and, to a lesser extent, RPF are elevated soon after the onset of human diabetes mellitus. The mechanisms involved in these functional changes are unknown. Since the experimental diabetic rat has renal morphological changes similar to those observed in man, we investigated whole-kidney and superficial-nephron glomerular function in this animal model early during the course of the disease. Alloxan-induced diabetes (50 mg/kg BW) is frequently characterized by severe hyperglycemia and retarded body growth. Supplemental insulin administration (6 U of NPH insulin daily) results in normal body growth, although hyperglycemia persists. As a result, we studied four groups of diabetic rats (1) after 1 month of untreated diabetes, (2) after 3 months of untreated diabetes, (3) after 3 months of untreated diabetes followed by 1 month of insulin supplementation, and (4) after 3 months of insulin-supplemented diabetes. After 1 month of untreated diabetes, GFR and SNGFR each declined by 20% compared to age-matched control rats. RPF and SNGFR were both reduced by 33% as a consequence of a 41% increase in RT. Reduced SNGPF together with a 7 mm Hg reduction in PGC caused the fall in GFR and SNGFR. KWs were not significantly different from those of control rats. The functional changes that occurred after 1 month of untreated diabetes did not significantly deteriorate after 3 months of the disease. Insulin supplementation, when instituted for 1 month after 3 months of untreated diabetes, produced no significant improvement in either whole-kidney or superficial-nephron hemodynamics even though body and kidney growth were stimulated. In contrast, insulin supplementation initiated at the onset of diabetes increased both SNGFR and SNGFR to 23% above control values. GFR and RPF each increased in proportion to the 18% increment in kidney size. RT was reduced in these rats, and the pressures that govern glomerular ultrafiltration were not altered from control values. We conclude that in

  14. Experimental investigation of the formaldehyde removal mechanisms in a dynamic botanical filtration system for indoor air purification.

    PubMed

    Wang, Zhiqiang; Pei, Jingjing; Zhang, Jensen S

    2014-09-15

    Botanical filtration has been proved to be effective for indoor gas pollutant removal. To understand the roles of different transport, storage and removal mechanism by a dynamic botanical air filter, a series of experimental investigations were designed and conducted in this paper. Golden Pothos (Epipremnum aureum) plants was selected for test, and its original soil or activated/pebbles root bed was used in different test cases. It was found that flowing air through the root bed with microbes dynamically was essential to obtain meaningful formaldehyde removal efficiency. For static potted plant as normally place in rooms, the clean air delivery rate (CADR), which is often used to quantify the air cleaning ability of portable air cleaners, was only ∼ 5.1m(3)/h per m(2) bed, while when dynamically with air flow through the bed, the CADR increased to ∼ 233 m(3)/h per m(2) bed. The calculated CADR due to microbial activity is ∼ 108 m(3)/h per m(2) bed. Moisture in the root bed also played an important role, both for maintaining a favorable living condition for microbes and for absorbing water-soluble compounds such as formaldehyde. The role of the plant was to introduce and maintain a favorable microbe community which effectively degraded the volatile organic compounds adsorbed or absorbed by the root bed. The presence of the plant increased the removal efficiency by a factor of two based on the results from the bench-scale root bed experiments.

  15. Magnetic-seeding filtration

    SciTech Connect

    Ying, T.Y.; Chin, C.J.; Lu, S.C.; Yiacoumi, S.

    1997-10-01

    Magnetic-seeding filtration consists of two steps: heterogeneous particle flocculation of magnetic and nonmagnetic particles in a stirred tank and high-gradient magnetic filtration (HGMF). The effects of various parameters affecting magnetic-seeding filtration (HGMF). The effects of various parameters affecting magnetic seeding filtration are theoretically and experimentally investigated. A trajectory model that includes hydrodynamic resistance, van der Waals, and electrostatic forces is developed to calculate the flocculation frequency in a turbulent-shear regime. Fractal dimension is introduced to simulate the open structure of aggregates. A magnetic-filtration model that consists of trajectory analysis, a particle build-up model, a breakthrough model, and a bivariate population-balance model is developed to predict the breakthrough curve of magnetic-seeding filtration. A good agreement between modeling results and experimental data is obtained. The results show that the model developed in this study can be used to predict the performance of magnetic-seeding filtration without using empirical coefficients or fitting parameters. 35 refs., 7 figs., 1 tab.

  16. IOP induces upregulation of GFAP and MHC-II and microglia reactivity in mice retina contralateral to experimental glaucoma

    PubMed Central

    2012-01-01

    Background Ocular hypertension is a major risk factor for glaucoma, a neurodegenerative disease characterized by an irreversible decrease in ganglion cells and their axons. Macroglial and microglial cells appear to play an important role in the pathogenic mechanisms of the disease. Here, we study the effects of laser-induced ocular hypertension (OHT) in the macroglia, microglia and retinal ganglion cells (RGCs) of eyes with OHT (OHT-eyes) and contralateral eyes two weeks after lasering. Methods Two groups of adult Swiss mice were used: age-matched control (naïve, n = 9); and lasered (n = 9). In the lasered animals, both OHT-eyes and contralateral eyes were analyzed. Retinal whole-mounts were immunostained with antibodies against glial fibrillary acid protein (GFAP), neurofilament of 200kD (NF-200), ionized calcium binding adaptor molecule (Iba-1) and major histocompatibility complex class II molecule (MHC-II). The GFAP-labeled retinal area (GFAP-RA), the intensity of GFAP immunoreaction (GFAP-IR), and the number of astrocytes and NF-200 + RGCs were quantified. Results In comparison with naïve: i) astrocytes were more robust in contralateral eyes. In OHT-eyes, the astrocyte population was not homogeneous, given that astrocytes displaying only primary processes coexisted with astrocytes in which primary and secondary processes could be recognized, the former having less intense GFAP-IR (P < 0.001); ii) GFAP-RA was increased in contralateral (P <0.05) and decreased in OHT-eyes (P <0.001); iii) the mean intensity of GFAP-IR was higher in OHT-eyes (P < 0.01), and the percentage of the retinal area occupied by GFAP+ cells with higher intensity levels was increased in contralateral (P = 0.05) and in OHT-eyes (P < 0.01); iv) both in contralateral and in OHT-eyes, GFAP was upregulated in Müller cells and microglia was activated; v) MHC-II was upregulated on macroglia and microglia. In microglia, it was similarly expressed in contralateral

  17. Minimally invasive glaucoma surgery: current status and future prospects

    PubMed Central

    Richter, Grace M; Coleman, Anne L

    2016-01-01

    Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy); suprachoroidal shunts (Cypass micro-stent); reducing aqueous production (endocyclophotocoagulation); and subconjunctival filtration (XEN gel stent). The data on each surgical procedure for each of these approaches are reviewed in this article, patient selection pearls learned to date are discussed, and expectations for the future are examined. PMID:26869753

  18. Filtration principles and practices

    SciTech Connect

    Matteson, M.J.; Orr, C.

    1986-01-01

    This book provides theoretical and practical data on filtration of gases and liquids. Topics covered include the following: gas filtration theory; liquid filtration theory; filter media; industrial gas filtration; filtration pretreatment; filtration in the chemical process industry; ultrafiltration; filtration in the mineral industry; filtration in heating, ventilating, and air conditioning; cartridge filtration; high-efficiency air filtration; analytical applications of filtration; and filter evaluation and testing.

  19. Electromagnetically Modified Filtration of Aluminum Melts—Part I: Electromagnetic Theory and 30 PPI Ceramic Foam Filter Experimental Results

    NASA Astrophysics Data System (ADS)

    Kennedy, Mark William; Akhtar, Shahid; Bakken, Jon Arne; Aune, Ragnhild E.

    2013-06-01

    In the present work, laboratory-scale continuous filtration tests of liquid A356 aluminum alloy have been performed. The tests were conducted using standard 30 PPI (pores per inch) ceramic foam filters combined with magnetic flux densities (~0.1 and 0.2 T), produced using two different induction coils operated at 50 Hz AC. A reference filtration test was also carried out under gravity conditions, i.e., without an applied magnetic field. The obtained results clearly prove that the magnetic field has a significant affect on the distribution of SiC particles. The influence of the electromagnetic Lorentz forces and induced bulk metal flow on the obtained filtration efficiencies and on the wetting behavior of the filter media by liquid aluminum is discussed. The magnitudes of the Lorentz forces produced by the induction coils are quantified based on analytical and COMSOL 4.2® finite element modeling.

  20. Experimental study on filtration and continuous regeneration of a particulate filter system for heavy-duty diesel engines.

    PubMed

    Tang, Tao; Zhang, Jun; Cao, Dongxiao; Shuai, Shijin; Zhao, Yanguang

    2014-12-01

    This study investigated the filtration and continuous regeneration of a particulate filter system on an engine test bench, consisting of a diesel oxidation catalyst (DOC) and a catalyzed diesel particulate filter (CDPF). Both the DOC and the CDPF led to a high conversion of NO to NO2 for continuous regeneration. The filtration efficiency on solid particle number (SPN) was close to 100%. The post-CDPF particles were mainly in accumulation mode. The downstream SPN was sensitively influenced by the variation of the soot loading. This phenomenon provides a method for determining the balance point temperature by measuring the trend of SPN concentration.

  1. Daily Life with Glaucoma

    MedlinePlus

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  2. Glaucoma in Asian Populations

    MedlinePlus

    ... Us Donate In This Section Glaucoma In Asian Populations email Send this article to a friend by ... an even more serious problem as the world population and longevity increases. The other major glaucoma type ...

  3. Types of Glaucoma

    MedlinePlus

    ... Support Groups For more information about area support groups, please click here . NEWSWORTHY WORLD GLAUCOMA WEEK - GET INVOLVED! click for info © Copyright 2017 The Glaucoma Foundation. All Rights Reserved. | Site Map Web design by Integra Strategic Technologies

  4. Microglia in mouse retina contralateral to experimental glaucoma exhibit multiple signs of activation in all retinal layers

    PubMed Central

    2014-01-01

    Background Glaucomatous optic neuropathy, a leading cause of blindness, can progress despite control of intraocular pressure - currently the main risk factor and target for treatment. Glaucoma progression shares mechanisms with neurodegenerative disease, including microglia activation. In the present model of ocular hypertension (OHT), we have recently described morphological signs of retinal microglia activation and MHC-II upregulation in both the untreated contralateral eyes and OHT eyes. By using immunostaining, we sought to analyze and quantify additional signs of microglia activation and differences depending on the retinal layer. Methods Two groups of adult Swiss mice were used: age-matched control (naïve, n = 12), and lasered (n = 12). In the lasered animals, both OHT eyes and contralateral eyes were analyzed. Retinal whole-mounts were immunostained with antibodies against Iba-1, MHC-II, CD68, CD86, and Ym1. The Iba-1+ cell number in the plexiform layers (PL) and the photoreceptor outer segment (OS), Iba-1+ arbor area in the PL, and area of the retina occupied by Iba-1+ cells in the nerve fiber layer-ganglion cell layer (NFL-GCL) were quantified. Results The main findings in contralateral eyes and OHT eyes were: i) ameboid microglia in the NFL-GCL and OS; ii) the retraction of processes in all retinal layers; iii) a higher level of branching in PL and in the OS; iv) soma displacement to the nearest cell layers in the PL and OS; v) the reorientation of processes in the OS; vi) MHC-II upregulation in all retinal layers; vii) increased CD68 immunostaining; and viii) CD86 immunolabeling in ameboid cells. In comparison with the control group, a significant increase in the microglial number in the PL, OS, and in the area occupied by Iba-1+ cells in the NFL-GCL, and significant reduction of the arbor area in the PL. In addition, rounded Iba-1+ CD86+ cells in the NFL-GCL, OS and Ym1+ cells, and rod-like microglia in the NFL-GCL were restricted to OHT eyes

  5. Cost analysis of glaucoma medications.

    PubMed

    Rylander, Nathan R; Vold, Steven D

    2008-01-01

    To provide patients and health care providers with calculated yearly costs of topical glaucoma medications. Prospective, experimental, laboratory study. Using the average wholesale price and common dosing patterns, we calculated the theoretical yearly cost of glaucoma medications. Calculated yearly cost ranged from $150.81 for generic timolol maleate 0.5% (Falcon Pharmaceuticals, Ltd, Fort Worth, Texas, USA) to $697.42 for Cosopt (Merck & Co, West Point, Pennsylvania, USA), and as high as $873.98 for a three-times-daily dose of Alphagan P 0.15% (Allergan, Inc, Irvine, California, USA). Among brand name beta-blockers, yearly cost ranged between $203.47 for Timoptic 0.5% (Merck & Co) and $657.24 for Betoptic S (Alcon Laboratories, Fort Worth, Texas, USA). Generic beta-blockers consistently were more economical than their brand-name counterparts. Yearly cost of prostaglandin analogs ranged from $427.69 for Travatan (Alcon) to $577.62 for Lumigan (Allergan). The two carbonic anhydrase inhibitors Azopt (Alcon) and Trusopt (Merck & Co), yielded similar economic profiles. Alphagan P 0.15% had yearly calculated costs of $559.08 for twice daily dosing per eye. The generic selective alpha(2)-agonist brimonidine tartrate 0.2% (Bausch & Lomb Pharmaceuticals, Tampa, Florida, USA) costs approximately $352.89 and $529.34 per year for the respective two and three drops daily per eye regimens. Nonselective beta-blockers remain the most inexpensive class of glaucoma medications. Bottle size may impact yearly glaucoma medication expenditures. Costs of glaucoma medications may impact decision making in the medical management of glaucoma.

  6. Glaucoma - Multiple Languages

    MedlinePlus

    ... Section Glaucoma - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section Glaucoma - ... Chinese, Simplified (Mandarin dialect)) Bilingual PDF ... Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Glaucoma - ...

  7. Pediatric Glaucoma: Pharmacotherapeutic Options.

    PubMed

    Samant, Monica; Medsinge, Anagha; Nischal, Ken K

    2016-06-01

    Childhood glaucoma is a major therapeutic challenge for pediatric ophthalmologists and glaucoma specialists worldwide. Management depends on the etiology and age at presentation. A variety of drugs are available for the control of intraocular pressure in children; however, none of these drugs have been licensed by the regulatory agencies for use in children. Furthermore, evidence gained from randomized controlled trials in the pediatric population is sparse, and little is known regarding the use of newer anti-glaucoma preparations. This evidence-based review aims to discuss the available pharmacotherapeutic options for glaucoma in children. Topical adrenoceptor blockers, topical and systemic carbonic anhydrase inhibitors, prostaglandin (PG) analogs, adrenoceptor agonists, parasympathomimetics, and combined preparations are available for use in children, but usually as an off-label indication. Therefore, it is important to recognize that serious side effects have been reported, even with topical drops, and measures to reduce systemic absorption should be taken. Most drugs have been shown to have comparable ocular hypotensive effects, with the lowest occurrence of systemic side effects with PG analogs. Whereas a newly introduced prostaglandin analog, tafluprost, and some other preservative-free preparations have shown promising results in adult glaucoma patients, no pediatric reports are available as yet. Future studies may describe their role in treating pediatric glaucoma. This review also shares some suggested treatment pathways for primary congenital glaucoma (PCG), juvenile open angle glaucoma (JOAG), developmental glaucoma, aphakic/pseudophakic glaucoma, and uveitic glaucoma.

  8. Filtration by eyelashes

    NASA Astrophysics Data System (ADS)

    Vistarakula, Krishna; Bergin, Mike; Hu, David

    2010-11-01

    Nearly every mammalian and avian eye is rimmed with lashes. We investigate experimentally the ability of lashes to reduce airborne particle deposition in the eye. We hypothesize that there is an optimum eyelash length that maximizes both filtration ability and extent of peripheral vision. This hypothesis is tested using a dual approach. Using preserved heads from 36 species of animals at the American Museum of Natural History, we determine the relationship between eye size and eyelash geometry (length and spacing). We test the filtration efficacy of these geometries by deploying outdoor manikins and measuring particle deposition rate as a function of eyelash length.

  9. Effectiveness of Membrane Filtration to Improve Drinking Water: A Quasi-Experimental Study from Rural Southern India

    PubMed Central

    Francis, Mark Rohit; Sarkar, Rajiv; Roy, Sheela; Jaffar, Shabbar; Mohan, Venkata Raghava; Kang, Gagandeep; Balraj, Vinohar

    2016-01-01

    Since point-of-use methods of water filtration have shown limited acceptance in Vellore, southern India, this study evaluated the effectiveness of decentralized membrane filtration 1) with safe storage, 2) without safe storage, versus 3) no intervention, consisting of central chlorination as per government guidelines, in improving the microbiological quality of drinking water and preventing childhood diarrhea. Periodic testing of water sources, pre-/postfiltration samples, and household water, and a biweekly follow up of children less than 2 years of age was done for 1 year. The membrane filters achieved a log reduction of 0.86 (0.69–1.06), 1.14 (0.99–1.30), and 0.79 (0.67–0.94) for total coliforms, fecal coliforms, and Escherichia coli, respectively, in field conditions. A 24% (incidence rate ratio, IRR [95% confidence interval, CI] = 0.76 [0.51–1.13]; P = 0.178) reduction in diarrheal incidence in the intervention village with safe storage and a 14% (IRR [95% CI] = 1.14 [0.75–1.77]; P = 0.530) increase in incidence for the intervention village without safe storage versus no intervention village was observed, although not statistically significant. Microbiologically, the membrane filters decreased fecal contamination; however, provision of decentralized membrane-filtered water with or without safe storage was not protective against childhood diarrhea. PMID:27601525

  10. Detection of rare circulating breast cancer cells by filtration cytometry and identification by DNA content: sensitivity in an experimental model.

    PubMed

    Rostagno, P; Moll, J L; Bisconte, J C; Caldani, C

    1997-01-01

    Current methods of detecting micrometastases in breast cancer fail in a large proportion of patients. Therefore an improved method for detection of metastases in blood samples could be of great clinical interest both for prognosis and selection of patients for adjuvant systemic therapy. We have developed a new non-invasive method which associates immuno-magnetic separation and filtration cytometry. The sensitivity of our procedure was evaluated in a model system using a mixture from a human breast cancer cell line (MCF-7) and a normal human blood sample. The identification of tumoral cells was achieved by measuring DNA content in comparison with standard cells. The lowest concentration of MCF-7 detected was 1 tumoral cell in 500,000 white blood cells. In addition, filtration cytometry provides a visual control of nuclei permitting the elimination of all doubtful cases and an automatic count of tumoral cells directly per ml of blood, which may be an independent predictor of early relapse. This new method may avoid unnecessary axillary lymph node dissection in patients with negative nodes. Our procedure seems suitable for the detection of rare circulating cells in routine laboratory testing and could be used in other applications.

  11. Effectiveness of Membrane Filtration to Improve Drinking Water: A Quasi-Experimental Study from Rural Southern India.

    PubMed

    Francis, Mark Rohit; Sarkar, Rajiv; Roy, Sheela; Jaffar, Shabbar; Mohan, Venkata Raghava; Kang, Gagandeep; Balraj, Vinohar

    2016-11-02

    Since point-of-use methods of water filtration have shown limited acceptance in Vellore, southern India, this study evaluated the effectiveness of decentralized membrane filtration 1) with safe storage, 2) without safe storage, versus 3) no intervention, consisting of central chlorination as per government guidelines, in improving the microbiological quality of drinking water and preventing childhood diarrhea. Periodic testing of water sources, pre-/postfiltration samples, and household water, and a biweekly follow up of children less than 2 years of age was done for 1 year. The membrane filters achieved a log reduction of 0.86 (0.69-1.06), 1.14 (0.99-1.30), and 0.79 (0.67-0.94) for total coliforms, fecal coliforms, and Escherichia coli, respectively, in field conditions. A 24% (incidence rate ratio, IRR [95% confidence interval, CI] = 0.76 [0.51-1.13]; P = 0.178) reduction in diarrheal incidence in the intervention village with safe storage and a 14% (IRR [95% CI] = 1.14 [0.75-1.77]; P = 0.530) increase in incidence for the intervention village without safe storage versus no intervention village was observed, although not statistically significant. Microbiologically, the membrane filters decreased fecal contamination; however, provision of decentralized membrane-filtered water with or without safe storage was not protective against childhood diarrhea.

  12. Does Marijuana Help Treat Glaucoma?

    MedlinePlus

    ... Ophthalmologist Patient Stories Español Eye Health / Tips & Prevention Marijuana Sections Does Marijuana Help Treat Glaucoma? Why Eye ... Don't Recommend Marijuana for Glaucoma Infographic Does Marijuana Help Treat Glaucoma? Written by: David Turbert , contributing ...

  13. Closed angle glaucoma detection in RetCam images.

    PubMed

    Cheng, Jun; Liu, Jiang; Lee, Beng Hai; Wong, Damon Wing Kee; Yin, Fengshou; Aung, Tin; Baskaran, Mani; Shamira, Perera; Wong, Tien Yin

    2010-01-01

    Closed/Open angle glaucoma classification is important for glaucoma diagnosis. RetCam is a new imaging modality that captures the image of iridocorneal angle for the classification. However, manual grading and analysis of the RetCam image is subjective and time consuming. In this paper, we propose a system for intelligent analysis of iridocorneal angle images, which can differentiate closed angle glaucoma from open angle glaucoma automatically. Two approaches are proposed for the classification and their performances are compared. The experimental results show promising results.

  14. [Neuroprotection in glaucoma].

    PubMed

    Kuprjanowicz, Leszek; Karczewicz, Danuta

    2007-01-01

    The aim of this research is to describe one of the most frequent ophthalmology disease-glaucoma and to look at their neurodegenerative nature and methods to stop disease. We use neuroprotection in glaucoma from a short time but despite of ethiological reasons neuroprotection seems to be one of the main mechanism to slow their progression. This research is talking about new opinions about neuroprotection in glaucoma and their epidemiology and etiology.

  15. The Suprachoroidal Route in Glaucoma Surgery

    PubMed Central

    Shaarawy, Tarek

    2016-01-01

    ABSTRACT Glaucoma surgeries targeting the uveoscleral drainage pathways have been drawing more attention lately. Among all the available techniques, procedures focusing on the supra-choroidal space seem particularly promising, by making use of a presumably efficient and secure outflow route and avoiding subconjunctival filtration blebs. The purpose of this review is to assess the efficacy and the security of the different suprachoroidal drainage implants, namely the CyPass Micro-Stent, the iStent Supra, the SOLX Gold Shunt, the Aquashunt, and the STARflo Glaucoma Implant. Most clinical studies seem to currently point toward the direction that there are actual benefits in suprachoroidal surgeries by avoiding bleb-related complications. Nevertheless, even suprachoroidal implants may be subject to scarring and failure. More data are still needed, especially concerning long-term effects, although the approach does seem appealing. How to cite this article: Gigon A, Shaarawy T. The Suprachoroidal Route in Glaucoma Surgery. J Curr Glaucoma Pract 2016;10(1): 13-20. PMID:27231415

  16. The choroid in glaucoma.

    PubMed

    Banitt, Michael

    2013-03-01

    Prior studies have not conclusively established a relationship between the choroid and glaucoma. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting the changes in the choroid as they relate to glaucoma. When applied to the SD-OCT, the technique of enhanced depth imaging allows for reproducible measurements of choroidal thickness. Nine reports have been published about choroidal thickness within the macula, as measured by OCT, in eyes with glaucoma. In six publications, there was no significant difference between the macular choroidal thicknesses of patients with glaucoma compared with those without glaucoma. Additional five studies have reported on peripapillary choroidal thickness in glaucoma patients. Although three of the studies determined that the peripapillary choroid is thinner in glaucoma patients, two others failed to establish this relationship. The SD-OCT is capable of reproducibly measuring choroidal thickness in the peripapillary and macular areas. In those with glaucoma, choroidal thickness does not change within the macula. In a few subsets of glaucoma, the peripapillary choroid is thinner when compared with normals.

  17. [Sport and Glaucoma].

    PubMed

    Rüfer, F

    2017-02-01

    Traumatic changes in the iridocorneal angle, e.g. in ball sports, can lead to secondary glaucoma. High intensity resistance exercise or yoga exercises - such as the headstand - can increase IOP, and deterioration in the visual field and acute narrow angle glaucoma attacks have been described in some case reports. Glaucoma therapy of professional athletes with steroids, carbonic anhydrase inhibitors and beta-blockers can result in positive doping tests. In manifest glaucoma, moderate aerobic exercise is presumably of use because of the IOP lowering effect, improved retinal perfusion and reduction in oxidative stress. Georg Thieme Verlag KG Stuttgart · New York.

  18. Comparing Optic Nerve Head Rim Width, Rim Area, and Peripapillary Retinal Nerve Fiber Layer Thickness to Axon Count in Experimental Glaucoma

    PubMed Central

    Fortune, Brad; Hardin, Christy; Reynaud, Juan; Cull, Grant; Yang, Hongli; Wang, Lin; Burgoyne, Claude F.

    2016-01-01

    Purpose We compare spectral-domain optical coherence tomography (SDOCT) measurements of minimum rim width (MRW), minimum rim area (MRA), and peripapillary retinal nerve fiber layer thickness (RNFLT) to complete orbital optic nerve axon counts in nonhuman primates (NHP) with unilateral experimental glaucoma (EG). Methods Biweekly SDOCT measurements of MRW, MRA, and RNFLT were acquired under manometric IOP control (10 mm Hg) in 51 NHP during baseline (mean ± SD, 5.0 ± 1.6 sessions) and after laser photocoagulation was applied to the trabecular meshwork of one eye to induce chronic IOP elevation. At the study endpoint (predefined for each NHP), 100% axon counts were obtained from each optic nerve. Results For SDOCT parameters at baseline, the correlation between the two eyes of each animal was strongest for RNFLT (R = 0.97) and MRW (R = 0.97), but lower for MRA (R = 0.85). At the final time point, average values in EG eyes relative to control eyes were: −22% for RNFLT, −38% for MRW, −36% for MRA, and −36% for optic nerve axons. The correlation with axon counts was strongest for RNFLT (R = 0.81), compared to MRW (R = 0.72, P = 0.001) or MRA (R = 0.70, P = 0.001). Diagnostic sensitivity was 75% for RNFLT, 90% for MRW, and 88% for MRA; all had 100% specificity. Conclusions Peripapillary RNFLT was correlated more closely with total orbital optic nerve axon count than were the ONH parameters MRW or MRA. This is likely because glaucomatous deformation (beyond axon loss alone) has a greater influence on the ONH parameters MRW and MRA than on RNFLT. PMID:27409499

  19. A Period of Controlled Elevation of IOP (CEI) Produces the Specific Gene Expression Responses and Focal Injury Pattern of Experimental Rat Glaucoma

    PubMed Central

    Morrison, John C.; Cepurna, William O.; Tehrani, Shandiz; Choe, Tiffany E.; Jayaram, Hari; Lozano, Diana C.; Fortune, Brad; Johnson, Elaine C.

    2016-01-01

    Purpose We determine if several hours of controlled elevation of IOP (CEI) will produce the optic nerve head (ONH) gene expression changes and optic nerve (ON) damage pattern associated with early experimental glaucoma in rats. Methods The anterior chambers of anesthetized rats were cannulated and connected to a reservoir to elevate IOP. Physiologic parameters were monitored. Following CEI at various recovery times, ON cross-sections were graded for axonal injury. Anterior ONHs were collected at 0 hours to 10 days following CEI and RNA extracted for quantitative PCR measurement of selected messages. The functional impact of CEI was assessed by electroretinography (ERG). Results During CEI, mean arterial pressure (99 ± 6 mm Hg) and other physiologic parameters remained stable. An 8-hour CEI at 60 mm Hg produced significant focal axonal degeneration 10 days after exposure, with superior lesions in 83% of ON. Message analysis in CEI ONH demonstrated expression responses previously identified in minimally injured ONH following chronic IOP elevation, as well as their sequential patterns. Anesthesia with cannulation at 20 mm Hg did not alter these message levels. Electroretinographic A- and B-waves, following a significant reduction at 2 days after CEI, were fully recovered at 2 weeks, while peak scotopic threshold response (pSTR) remained mildly but significantly depressed. Conclusions A single CEI reproduces ONH message changes and patterns of ON injury previously observed with chronic IOP elevation. Controlled elevation of IOP can allow detailed determination of ONH cellular and functional responses to an injurious IOP insult and provide a platform for developing future therapeutic interventions. PMID:27942722

  20. Single half-wavelength ultrasonic particle filter: predictions of the transfer matrix multilayer resonator model and experimental filtration results.

    PubMed

    Hawkes, Jeremy J; Coakley, W Terence; Gröschl, Martin; Benes, Ewald; Armstrong, Sian; Tasker, Paul J; Nowotny, Helmut

    2002-03-01

    The quantitative performance of a "single half-wavelength" acoustic resonator operated at frequencies around 3 MHz as a continuous flow microparticle filter has been investigated. Standing wave acoustic radiation pressure on suspended particles (5-microm latex) drives them towards the center of the half-wavelength separation channel. Clarified suspending phase from the region closest to the filter wall is drawn away through a downstream outlet. The filtration efficiency of the device was established from continuous turbidity measurements at the filter outlet. The frequency dependence of the acoustic energy density in the aqueous particle suspension layer of the filter system was obtained by application of the transfer matrix model [H. Nowotny and E. Benes, J. Acoust. Soc. Am. 82, 513-521 (1987)]. Both the measured clearances and the calculated energy density distributions showed a maximum at the fundamental of the piezoceramic transducer and a second, significantly larger, maximum at another system's resonance not coinciding with any of the transducer or empty chamber resonances. The calculated frequency of this principal energy density maximum was in excellent agreement with the optimal clearance frequency for the four tested channel widths. The high-resolution measurements of filter performance provide, for the first time, direct verification of the matrix model predictions of the frequency dependence of acoustic energy density in the water layer.

  1. Effect of filtration by activated charcoal on the toxicological activity of cigarette mainstream smoke from experimental cigarettes.

    PubMed

    Gaworski, Charles L; Schramke, Heike; Diekmann, Joerg; Meisgen, Thomas J; Tewes, Franz J; Veltel, Detlef J; Vanscheeuwijck, Patrick M; Rajendran, Narayanan; Muzzio, Miguel; Haussmann, Hans-Juergen

    2009-07-01

    Activated charcoal (AC) filtration reportedly decreases the yields of smoke vapor phase constituents including some identified as human carcinogens and respiratory irritants. Non-clinical studies including chemical smoke analysis, in vitro cytotoxicity and mutagenicity (bacterial and mammalian cells), and in vivo subchronic rat inhalation studies were carried out using machine smoking at ISO conditions with lit-end research cigarettes containing AC filters. The objective was to assess whether AC filter technology would alter the established toxicity profile of mainstream smoke by increasing or decreasing any known toxicological properties, or elicit new ones. The reduced yield of vapor phase irritants from AC filter cigarettes correlated with markedly decreased in vitro cytotoxicity and in vivo morphology of the nose and lower respiratory tract. Increased yields of particulate phase constituents (e.g. polycyclic aromatic hydrocarbons) in AC filtered smoke were noted in comparison to controls in some studies. The in vitro bacterial mutagenicity of AC filtered smoke particulate preparations was occasionally increased over control levels. Laryngeal epithelial thickness was increased in some rats inhaling AC filtered smoke in comparison to controls, an effect perhaps related to higher inspiratory flow. When tested under more intense Massachusetts Department of Public Health smoking conditions, AC filter associated reductions in vapor phase constituent yields were smaller than those seen with ISO conditions, but the effect on in vitro cytotoxicity remained.

  2. [Music and Glaucoma].

    PubMed

    Plange, N

    2017-02-01

    Music may have multiple influences on the human organism. A possible therapeutic effect for patients with glaucoma has been postulated, aside from the known impact of music on the cardiovascular system, psychogenic effects and a short-term improvement in mental performance (Mozart effect). The higher level of mental stress in patients with glaucoma and type-A personality behaviour may be related to higher intraocular pressure in patients with glaucoma. Relaxing music may have a positive impact in these patients, related to a reduction in intraocular pressure or its fluctuations. However, only limited data exist on the effects of music on intraocular pressure. No clinical studies have yet been performed to investigate the effect of music or music therapy on glaucoma progression. The music of Mozart may influence visual field examinations, possibly due to a positive short term effect on mental performance. This factor needs to be addressed in studies dealing with the effect of music in glaucoma. The relevance of intraocular pressure increases in professional wind instrument players is controversial. An increased level of care might be advisable in patients with advanced glaucoma. The influences of music on humans, altered personality profiles in patients with glaucoma and the studies showing some effect of stress on intraocular pressure stress the relevance of psychological support for glaucoma patients, who are confronted with a disease with a high longterm risk of blindness.

  3. Educating the glaucoma patient.

    PubMed Central

    Rosenthal, A. R.; Zimmerman, J. F.; Tanner, J.

    1983-01-01

    Forty-nine patients with open-angle glaucoma and 32 controls were studied at each of 2 medical centres, one in California and one in England. A 12-point questionnaire was answered before, immediately after, and 6 months after viewing a 6 minute video film about glaucoma. The English glaucoma patients and controls showed lower initial knowledge than their American counterparts. Immediately after the film all groups had substantially improved their knowledge by answering 78-88% of the questions correctly. Recall study showed that both American groups had retained more than their British counterparts and that glaucoma patients retained more knowledge of their disease than did controls. The use of an educational video film in an outpatient setting is a simple and economical method of patient education applicable to both American and British subjects with open-angle glaucoma. PMID:6671096

  4. Nanotechnology Applications for Glaucoma.

    PubMed

    Cetinel, Sibel; Montemagno, Carlo

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide, and the antiglaucoma treatments currently available suffer from various complications. Nanotechnology-based treatments show a great deal of promise in overcoming these complications and form the basis for next-generation glaucoma treatment strategies, with the help of applications such as controlled release, targeted delivery, increased bioavailability, diffusion limitations, and biocompatibility. Significant progress has been made in nanomedicine in the efficiency of antiglaucoma medications, nanofabrication systems such as microelectromechanical systems that remove the limitations of nanodevices, and tissue regeneration vesicles for developing glaucoma treatments not based on intraocular pressure. With the use of these advanced technologies, the prevention of glaucoma-induced blindness will be possible in the near future. Herein, we reviewed the recent advances in nanotechnology-based treatment strategies for glaucoma.

  5. [Vascular factors in glaucoma].

    PubMed

    Mottet, B; Aptel, F; Geiser, M; Romanet, J P; Chiquet, C

    2015-12-01

    The exact pathophysiology of glaucoma is not fully understood. Understanding of the vascular pathophysiology of glaucoma requires: knowing the techniques for measuring ocular blood flow and characterizing the topography of vascular disease and the mechanisms involved in this neuropathy. A decreased mean ocular perfusion pressure and a loss of vascular autoregulation are implicated in glaucomatous disease. Early decrease in ocular blood flow has been identified in primary open-angle glaucoma and normal pressure glaucoma, contributing to the progression of optic neuropathy. The vascular damage associated with glaucoma is present in various vascular territories within the eye (from the ophthalmic artery to the retina) and is characterized by a decrease in basal blood flow associated with a dysfunction of vasoregulation.

  6. [Micro-trephination of the limbus in neovascular glaucoma].

    PubMed

    Sergienko, N M; Torchinskaia, N V

    2001-01-01

    Microtrephination of the limb was carried out for neovascular glaucoma on 112 eyes. The technique of the operation is described and its results are analyzed. Electric microtrephine (0.6 mm) allows making perforations in the limb as oblique microchannels connecting the anterior chamber and the subconjunctival space. Mitomycin C, an antimetabolic drug, was used for neovascularization control near the channels and filtration pad. High efficiency, low invasiveness, and low incidence of postoperative complications recommend this operation as an alternative method for the treatment of neovascular glaucoma.

  7. Perioperative pharmacological management in patients with glaucoma.

    PubMed

    Rodríguez Uña, I; Martínez-de-la-Casa, J M; Pablo Júlvez, L; Martínez Compadre, J A; García Feijoo, J; Belda Sanchís, J I; Canut Jordana, M I; Hernández-Barahona Palma, J; Muñoz Negrete, F J; Urcelay Segura, J L

    2015-06-01

    REVIEẂS AIM: When a phacoemulsification, a filtration surgery or a combined surgery are necessary, questions about the convenience of continuing certain antiglaucomatous drugs could appear. The aim of this review article is to unify criteria that will guide daily clinical practice and including the developing algorithms of action in the preoperative and postoperative periods of filtration surgery and/or cataract surgery. In the preoperative period of cataract surgery, the use of non-steroidal anti-inflammatory drugs is at the discretion of the surgeon, with the monodose presentation being recommended. The suspension of prostaglandines a fewdays before the surgery should be considered. Preservative-free drugs ensure a better recovery of the ocular surface (OS) after cataract surgery. Once all modifying factors of the intraocular pressure (IOP) have been removed, baseline IOP should be evaluated again, choosing preservative-free antiglaucomatous drugs when needed. The use of preservative-free ocular antihypertensive drugs and steroids in the preoperative period of glaucoma surgery reduces the risk of surgical failure. The interruption of prostaglandines is recommended. In the postoperative period of glaucoma surgery, steroids are the anti-inflammatory treatment of choice, the preservative-free ones being preferred. When reintroducing antiglaucomatous treatment, preservatives should be avoided to prevent scarring. The appropriate perioperative management of patients with glaucoma is essential to obtain a correct control of IOP, improve the situation of the OS, prevent complications and improve the result of the filtration surgery and cataract surgery. this protocol aims to unify the different lines of action in order to decrease the incidence of adverse events and maximize the surgical outcome. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Ahmed glaucoma valve implant: surgical technique and complications

    PubMed Central

    Riva, Ivano; Roberti, Gloria; Oddone, Francesco; Konstas, Anastasios GP; Quaranta, Luciano

    2017-01-01

    Implantation of Ahmed glaucoma valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed glaucoma valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the valve mechanism embedded in the Ahmed glaucoma valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed glaucoma valve implantation and to report related complications. PMID:28255226

  9. Cake Filtration in Viscoelastic Polymer Solutions

    NASA Astrophysics Data System (ADS)

    Surý, Alexander; Machač, Ivan

    2009-07-01

    In this contribution, the filtration equations for a cake filtration in viscoelastic fluids are presented. They are based on a capillary hybrid model for the flow of a power law fluid. In order to express the elastic pressure drop excess in the flow of viscoelastic filtrate through the filter cake and filter screen, modified Deborah number correction functions are included into these equations. Their validity was examined experimentally. Filtration experiments with suspensions of hardened polystyrene particles (Krasten) in viscoelastic aqueous solutions of polyacryl amides (0.4% and 0.6%wt. Kerafloc) were carried out at a constant pressure on a cylindrical filtration unit using filter screens of different resistance.

  10. Evaluation of post-treatment filter, Part I: Experimental study of DMMP and DIMP filtration at high temperature and high dew point using activated carbon. Final report, November 1994-September 1995

    SciTech Connect

    Mahle, J.J.; Buettner, L.C.; Mauer, S.

    1996-08-01

    A series of experimental results are reported for breakthrough of the agent simulants DMMP and DIMP on coconut carbon. This adsorbent is used in filters for the Chemical Demiliterization program. The conditions were appropriate for a post treatment stack gas filter. Results indicate that high capacity and long filtration times are achievable under moderate humidity conditions up to 180 degrees F.

  11. Glaucoma Research Foundation

    MedlinePlus

    ... find a cure for glaucoma. The Biomarker Initiative Catalyst for a Cure Applying for a Grant Photos ... Gala The Annual Gala showcases the visionaries and catalysts who believe in our mission. The Gala took ...

  12. Facts about Glaucoma

    MedlinePlus

    ... several evenly spaced burns that stretch the drainage holes in the meshwork. This allows the fluid to ... who may be at high risk for glaucoma-African Americans over age 40; everyone over age 60, especially ...

  13. Five Common Glaucoma Tests

    MedlinePlus

    ... pressure Tonometry The shape and color of the optic nerve Ophthalmoscopy (dilated eye exam) The complete field ... This diagnostic procedure helps the doctor examine your optic nerve for glaucoma damage. Eye drops are used ...

  14. Surgical Treatment of Canine Glaucoma: Filtering and End-Stage Glaucoma Procedures.

    PubMed

    Maggio, Federica; Bras, Dineli

    2015-11-01

    Canine glaucoma is a common cause of vision loss associated with raised intraocular pressure, and leads to damage of the retina and optic nerve head. In most cases, medical treatment alone cannot provide long-term management of intraocular pressure control and preservation of vision. Surgical intervention is usually recommended to either decrease aqueous humor production, or increase its outflow. Among the current available procedures, filtering techniques are aimed at increasing aqueous humor outflow. Proper surgical timing and a combination of cyclodestructive and filtering procedures have been recently suggested to improve the long-term success of surgical treatment in dogs. Bleb fibrosis and surgical failure are still common occurrences in filtration surgery with relapse of glaucoma and vision loss. End stage procedures, such as enucleation, evisceration with intrascleral prosthesis, and chemical ablation of the ciliary bodies are then recommended to address chronic discomfort in buphthalmic and blind eyes.

  15. Objective perimetry in glaucoma.

    PubMed

    Klistorner, A; Graham, S L

    2000-12-01

    Objective perimetry in glaucoma is described using the multifocal pattern visually evoked potential (VEP). A multichannel recording technique was used to improve signal detection in healthy volunteers and assess its ability to detect glaucoma and early changes in patients with suspected glaucoma. Prospective, case-control study. Thirty healthy volunteers, 30 patients with suspected glaucoma, and 30 patients with glaucomatous visual field defects were tested. The VEP was recorded using cortically scaled, multifocal, pseudorandomly alternated pattern stimuli with the VERIS system (Electro-Diagnostic Imaging, Inc., San Francisco, CA). An array of four bipolar occipital electrodes provided four differently oriented channels for simultaneous recording. Signals were compared for different locations within the field up to 26 degrees of eccentricity. Healthy volunteers, patients with suspected glaucoma, and glaucoma patients with established visual field defects were tested, and results were compared with Humphrey visual fields (Humphrey Systems, Dublin, CA) performed on the same day. For reproducibility, five healthy volunteers were each tested on four separate days. The patients with suspected glaucoma and the established glaucoma patients were analyzed for intereye asymmetry of signals, and these data were compared with the asymmetry values of the healthy volunteers. Multiple recording channels significantly enhanced the recording of signals from parts of the visual field not reliably sampled with a single channel technique in all healthy volunteers, particularly along the horizontal meridian (P: < 0.001). Signal amplitude did not decline with age in healthy volunteers. Recordings showed good reproducibility within individuals. In all 30 glaucoma patients, the Humphrey visual field defects were well demonstrated by the VEP, and topographic location was strongly correlated (r(s) = 0.79). Despite large interindividual variations in amplitude, scotomas were well

  16. Clinical Metabolomics and Glaucoma.

    PubMed

    Barbosa-Breda, João; Himmelreich, Uwe; Ghesquière, Bart; Rocha-Sousa, Amândio; Stalmans, Ingeborg

    2017-09-01

    Glaucoma is one of the leading causes of irreversible blindness worldwide. However, there are no biomarkers that accurately help clinicians perform an early diagnosis or detect patients with a high risk of progression. Metabolomics is the study of all metabolites in an organism, and it has the potential to provide a biomarker. This review summarizes the findings of metabolomics in glaucoma patients and explains why this field is promising for new research. We identified published studies that focused on metabolomics and ophthalmology. After providing an overview of metabolomics in ophthalmology, we focused on human glaucoma studies. Five studies have been conducted in glaucoma patients and all compared patients to healthy controls. Using mass spectrometry, significant differences were found in blood plasma in the metabolic pathways that involve palmitoylcarnitine, sphingolipids, vitamin D-related compounds, and steroid precursors. For nuclear magnetic resonance spectroscopy, a high glutamine-glutamate/creatine ratio was found in the vitreous and lateral geniculate body; no differences were detected in the optic radiations, and a lower N-acetylaspartate/choline ratio was observed in the geniculocalcarine and striate areas. Metabolomics can move glaucoma care towards a personalized approach and provide new knowledge concerning the pathophysiology of glaucoma, which can lead to new therapeutic options. © 2017 S. Karger AG, Basel.

  17. Bacterial, viral and turbidity removal by intermittent slow sand filtration for household use in developing countries: experimental investigation and modeling.

    PubMed

    Jenkins, Marion W; Tiwari, Sangam K; Darby, Jeannie

    2011-11-15

    A two-factor three-block experimental design was developed to permit rigorous evaluation and modeling of the main effects and interactions of sand size (d(10) of 0.17 and 0.52 mm) and hydraulic head (10, 20, and 30 cm) on removal of fecal coliform (FC) bacteria, MS2 bacteriophage virus, and turbidity, under two batch operating modes ('long' and 'short') in intermittent slow sand filters (ISSFs). Long operation involved an overnight pause time between feeding of two successive 20 L batches (16 h average batch residence time (RT)). Short operation involved no pause between two 20 L batch feeds (5h average batch RT). Conditions tested were representative of those encountered in developing country field settings. Over a ten week period, the 18 experimental filters were fed river water augmented with wastewater (influent turbidity of 5.4-58.6 NTU) and maintained with the wet harrowing method. Linear mixed modeling allowed systematic estimates of the independent marginal effects of each independent variable on each performance outcome of interest while controlling for the effects of variations in a batch's actual residence time, days since maintenance, and influent turbidity. This is the first study in which simultaneous measurement of bacteria, viruses and turbidity removal at the batch level over an extended duration has been undertaken with a large number of replicate units to permit rigorous modeling of ISSF performance variability within and across a range of likely filter design configurations and operating conditions. On average, the experimental filters removed 1.40 log fecal coliform CFU (SD 0.40 log, N=249), 0.54 log MS2 PFU (SD 0.42 log, N=245) and 89.0 percent turbidity (SD 6.9 percent, N=263). Effluent turbidity averaged 1.24 NTU (SD 0.53 NTU, N=263) and always remained below 3 NTU. Under the best performing design configuration and operating mode (fine sand, 10 cm head, long operation, initial HLR of 0.01-0.03 m/h), mean 1.82 log removal of bacteria (98

  18. Nonwoven filtration mat production by electrospinning method

    NASA Astrophysics Data System (ADS)

    Lackowski, M.; Krupa, A.; Jaworek, A.

    2011-06-01

    The filtration of nanoparticles and submicron particles is an important problem in industry and health protection. One of the methods which can be used to solve this problem is to use nonwoven nanofibrous filters. The process of producing filtration mats of different thickness by electrospinning is presented in the paper. The experimental results on filtration properties of nanofibrous filter mat, including the efficiency of removal of cigarette smoke particles from a gas are also presented.

  19. New Tool to Predict Glaucoma

    MedlinePlus

    ... News About Us Donate In This Section A New Tool to Predict Glaucoma email Send this article ... determine if a patient has glaucoma. Recently, a new tool has become available to eye care specialists ...

  20. Does Your Child Have Glaucoma?

    MedlinePlus

    ... Donate In This Section Does Your Child Have Glaucoma? email Send this article to a friend by ... a pediatric ophthalmologist. Signs and Symptoms of Childhood Glaucoma What to watch for in children under the ...

  1. Vérification expérimentale de la relation de réciprocité d'Onsager pour l'électro-osmose et l'électro-filtration dans une argile naturelleExperimental verification of the Onsager's reciprocal relations for electro-osmosis and electro-filtration phenomena on a saturated clay

    NASA Astrophysics Data System (ADS)

    Beddiar, Karim; Berthaud, Yves; Dupas, André

    2002-12-01

    This Note is devoted to the experimental verification of the Onsager's reciprocal relations in the particular case of electro-osmosis and electro-filtration. A special set up has been designed to carry out the measurements of both the electro-osmotic permeability and the streaming potential. This has been performed by using a natural material i.e., saturated kaolinite. To cite this article: K. Beddiar et al., C. R. Mecanique 330 (2002) 893-898.

  2. Relating Retinal Ganglion Cell Function and Retinal Nerve Fiber Layer (RNFL) Retardance to Progressive Loss of RNFL Thickness and Optic Nerve Axons in Experimental Glaucoma

    PubMed Central

    Fortune, Brad; Cull, Grant; Reynaud, Juan; Wang, Lin; Burgoyne, Claude F.

    2015-01-01

    Purpose. To relate changes in retinal function and retinal nerve fiber layer (RNFL) retardance to loss of RNFL thickness and optic nerve axon counts in a nonhuman primate (NHP) model of experimental glaucoma (EG). Methods. Bilateral longitudinal measurements of peripapillary RNFL thickness (spectral-domain optical coherence tomography, SDOCT; Spectralis), retardance (GDxVCC), and multifocal electroretinography (mfERG; VERIS) were performed in 39 NHP at baseline (BL; median, 5 recordings; range, 3–10) and weekly after induction of unilateral EG by laser photocoagulation of the trabecular meshwork. Multifocal ERG responses were high-pass filtered (>75 Hz) to measure high- and low-frequency component (HFC and LFC) amplitudes, including LFC features N1, P1, and N2. High-frequency component amplitudes are known to specifically reflect retinal ganglion cell (RGC) function. Complete (100%) axon counts of orbital optic nerves were obtained in 31/39 NHP. Results. Postlaser follow-up was 10.4 ± 7.9 months; mean and peak IOP were 18 ± 5 and 41 ± 11 mm Hg in EG eyes, 11 ± 2 and 18 ± 6 mm Hg in control (CTL) eyes. At the final available time point, RNFL thickness had decreased from BL by 14 ± 14%, retardance by 20 ± 11%, and the mfERG HFC by 30 ± 17% (P < 0.0001 each). Longitudinal changes in retardance and HFC were linearly related to RNFL thickness change (R2 = 0.51, P < 0.0001 and R2 = 0.22, P = 0.002, respectively); LFC N2 was weakly related but N1 or P2 (N1: R2 = 0.07, P = 0.11; P1: R2 = 0.04, P = 0.24; N2: R2 = 0.13, P = 0.02). At zero change from BL for RNFL thickness (Y-intercept), retardance was reduced by 11% (95% confidence interval [CI]: −15.3% to −6.8%) and HFC by 21.5% (95% CI: −28.7% to −14.3%). Relative loss of RNFL thickness, retardance, and HFC (EG:CTL) were each related to axon loss (R2 = 0.66, P < 0.0001; R2 = 0.42, P < 0.0001; R2 = 0.42, P < 0.0001, respectively), but only retardance and HFC were significantly reduced at zero relative axon

  3. [Glaucoma in the melanoderm patient].

    PubMed

    Denis, P

    2004-06-01

    Much less marginal in France than believed, glaucoma in the melanoderm patient comes early in life, with a more aggressive progression leading to blindness twice as often as in the Caucasian patient. Generally open-angle glaucoma, it may be related to anatomical ocular characteristics of the Black population. Its management is not very different from that of glaucoma in the Caucasian patient.

  4. A New Safety Concern for Glaucoma Treatment Demonstrated by Mass Spectrometry Imaging of Benzalkonium Chloride Distribution in the Eye, an Experimental Study in Rabbits

    PubMed Central

    Brignole-Baudouin, Françoise; Desbenoit, Nicolas; Hamm, Gregory; Liang, Hong; Both, Jean-Pierre; Brunelle, Alain; Fournier, Isabelle; Guerineau, Vincent; Legouffe, Raphael; Stauber, Jonathan; Touboul, David; Wisztorski, Maxence; Salzet, Michel; Laprevote, Olivier; Baudouin, Christophe

    2012-01-01

    We investigated in a rabbit model, the eye distribution of topically instilled benzalkonium_(BAK) chloride a commonly used preservative in eye drops using mass spectrometry imaging. Three groups of three New Zealand rabbits each were used: a control one without instillation, one receiving 0.01%BAK twice a day for 5 months and one with 0.2%BAK one drop a day for 1 month. After sacrifice, eyes were embedded and frozen in tragacanth gum. Serial cryosections were alternately deposited on glass slides for histological (hematoxylin-eosin staining) and immunohistological controls (CD45, RLA-DR and vimentin for inflammatory cell infiltration as well as vimentin for Müller glial cell activation) and ITO or stainless steel plates for MSI experiments using Matrix-assisted laser desorption ionization time-of-flight. The MSI results were confirmed by a round-robin study on several adjacent sections conducted in two different laboratories using different sample preparation methods, mass spectrometers and data analysis softwares. BAK was shown to penetrate healthy eyes even after a short duration and was not only detected on the ocular surface structures, but also in deeper tissues, especially in sensitive areas involved in glaucoma pathophysiology, such as the trabecular meshwork and the optic nerve areas, as confirmed by images with histological stainings. CD45-, RLA-DR- and vimentin-positive cells increased in treated eyes. Vimentin was found only in the inner layer of retina in normal eyes and increased in all retinal layers in treated eyes, confirming an activation response to a cell stress. This ocular toxicological study confirms the presence of BAK preservative in ocular surface structures as well as in deeper structures involved in glaucoma disease. The inflammatory cell infiltration and Müller glial cell activation confirmed the deleterious effect of BAK. Although these results were obtained in animals, they highlight the importance of the safety-first principle for

  5. A new safety concern for glaucoma treatment demonstrated by mass spectrometry imaging of benzalkonium chloride distribution in the eye, an experimental study in rabbits.

    PubMed

    Brignole-Baudouin, Françoise; Desbenoit, Nicolas; Hamm, Gregory; Liang, Hong; Both, Jean-Pierre; Brunelle, Alain; Fournier, Isabelle; Guerineau, Vincent; Legouffe, Raphael; Stauber, Jonathan; Touboul, David; Wisztorski, Maxence; Salzet, Michel; Laprevote, Olivier; Baudouin, Christophe

    2012-01-01

    We investigated in a rabbit model, the eye distribution of topically instilled benzalkonium_(BAK) chloride a commonly used preservative in eye drops using mass spectrometry imaging. Three groups of three New Zealand rabbits each were used: a control one without instillation, one receiving 0.01%BAK twice a day for 5 months and one with 0.2%BAK one drop a day for 1 month. After sacrifice, eyes were embedded and frozen in tragacanth gum. Serial cryosections were alternately deposited on glass slides for histological (hematoxylin-eosin staining) and immunohistological controls (CD45, RLA-DR and vimentin for inflammatory cell infiltration as well as vimentin for Müller glial cell activation) and ITO or stainless steel plates for MSI experiments using Matrix-assisted laser desorption ionization time-of-flight. The MSI results were confirmed by a round-robin study on several adjacent sections conducted in two different laboratories using different sample preparation methods, mass spectrometers and data analysis softwares. BAK was shown to penetrate healthy eyes even after a short duration and was not only detected on the ocular surface structures, but also in deeper tissues, especially in sensitive areas involved in glaucoma pathophysiology, such as the trabecular meshwork and the optic nerve areas, as confirmed by images with histological stainings. CD45-, RLA-DR- and vimentin-positive cells increased in treated eyes. Vimentin was found only in the inner layer of retina in normal eyes and increased in all retinal layers in treated eyes, confirming an activation response to a cell stress. This ocular toxicological study confirms the presence of BAK preservative in ocular surface structures as well as in deeper structures involved in glaucoma disease. The inflammatory cell infiltration and Müller glial cell activation confirmed the deleterious effect of BAK. Although these results were obtained in animals, they highlight the importance of the safety-first principle for

  6. Selective laser trabeculoplasty (SLT): 1-year results in early and advanced open angle glaucoma.

    PubMed

    Schlote, Torsten; Kynigopoulos, Myron

    2016-02-01

    The purpose of this study was to examine the efficacy of selective laser trabeculoplasty (SLT) in eyes with early and more advanced stages of open angle glaucoma within 1 year of follow-up. Retrospective chart review in a consecutive series of patients treated by SLT to reduce intraocular pressure (IOP) or decrease number of topical medications in cases of discomfort and allergy. The cup-to-disc ratio of the optic nerve and the GSS 2 (glaucoma staging system 2) was used to differentiate between early (group 1) and more advanced (group 2) stages of glaucoma. At the time of SLT treatment, no new signs of glaucoma progression were seen. Only the first treated eye of every patient was included in the analysis. In group 1 (early glaucoma), 27 eyes were included. IOP reduction <21 mmHg/>20 % of the preoperative IOP-value and reduction of medication were achieved in 17 eyes (62.96 %). Successful re-treatment was necessary in 2 eyes (7.4 %). In group 2 (advanced glaucoma), 44 eyes underwent SLT. In eight eyes (18.18 %), filtrating surgery was necessary after initial SLT. In the remaining 36 eyes, IOP reduction <21 mmHg/>20 % of the baseline IOP was achieved in 26 eyes (59.09 % of 44 eyes) and IOP reduction <18 mmHg/> 30 % of the baseline IOP in 22 eyes (50 % of 44 eyes). SLT was safe and effective in nearly 2/3 of early glaucoma patients and also in 50 % of advanced glaucoma patients using stronger criteria of success. Failure of SLT in advanced glaucoma should lead to immediate filtrating surgery, which seems not to be associated with higher risk of fibrosis.

  7. Severe vernal keratoconjunctivitis requiring trabeculectomy with mitomycin C for corticosteroid-induced glaucoma.

    PubMed

    Ang, Marcus; Ho, Ching-Lin; Tan, Donald; Chan, Cordelia

    2012-01-01

    To describe clinical features of severe vernal keratoconjunctivitis with steroid response in Asian children and risk factors for glaucoma filtration surgery. Retrospective non-controlled, comparative case series. Patients with severe vernal keratoconjunctivitis seen at a single centre over 6 years. Clinical features, symptoms and treatment modalities were recorded for patients (i) diagnosed with severe VKC (clinical grade ≥ 3); (ii) had >2 recordings of increased intraocular pressures of >21 mmHg; (iii) and a minimum follow-up period of 1 year post-presentation. Corticosteroid-induced glaucoma requiring trabeculectomy with mitomycin-C. Six patients (eight eyes) of 36 patients required trabeculectomy/mitomycin-C. All were male. Mean age of disease onset was 9.3 ± 4.5 years for a mean duration of 6.08 ± 3.5 years. Mean intraocular pressures increase from baseline was 29.0 ± 8.2 mmHg and all required >2 anti-glaucoma medications. The main risk factor for trabeculectomy was a greater increase in intraocular pressures from baseline (odds ratio 1.3; 95% confidence interval, 1.0-1.5; P = 0.011), which was independent of potential confounders such as type and duration of corticosteroid use. Comparing eyes pre- and post-trabeculectomy, all improved in clinical severity of vernal keratoconjunctivitis (mean clinical grade improvement 2.1; 95% confidence interval, 1.3-3.0; P < 0.001) and reduced dependence on topical corticosteroids for mean duration of 22.5 ± 15.3 months. In our study, patients with a 'greater steroid response', that is, higher increase in intraocular pressures from baseline are associated with a 30% higher risk toftrabeculectomy. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  8. [Perspectives in glaucoma surgery].

    PubMed

    Dietlein, T S

    2002-02-01

    Trabeculectomy is still considered to be the gold standard in the surgical treatment of the open-angle glaucomas. The additional application of local antimetabolites has reduced the rate of early filtering bled fibrosis, but increased the rate of essential late-postoperative complications. Growth factor inhibition and photodynamic therapy may be an alternative local treatment to enhance the results in filtering surgery. Non-penetrating glaucoma surgery and ab-interno trabecular surgery have several conceptual advantages, e.g. the lack of overfiltration or the untouched conjunctiva in the ab-interno approach. Clinical studies of these and other new procedures including antiglaucomatous retinectomy and subchoroidal shunt systems are currently performed in order to evaluate their potential and limits in the clinical management of glaucoma.

  9. Update on congenital glaucoma

    PubMed Central

    Mandal, Anil K; Chakrabarti, Debasis

    2011-01-01

    Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy–trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must. PMID:21150027

  10. Exciting Directions in Glaucoma

    PubMed Central

    Rasmussen, Carol A; Kaufman, Paul L

    2014-01-01

    Glaucoma is a complex, life-long disease that requires an individualized, multifaceted approach to treatment. Most patients will be started on topical ocular hypotensive eyedrop therapy and over time, multiple classes of drugs will be needed to control their intraocular pressure (IOP). The search for drugs with novel mechanisms of action, to treat those who do not achieve adequate IOP control with, or become refractory to, current therapeutics, is ongoing, as is the search for more efficient, targeted drug delivery methods. Gene transfer and stem cell applications for glaucoma therapeutics are moving forward. Advances in imaging technologies improve our understanding of glaucoma pathophysiology and enable more refined patient evaluation and monitoring, improving patient outcomes. PMID:25433744

  11. Pars plana vitrectomy for malignant glaucoma in nonglaucomatous and in filtered glaucomatous eyes

    PubMed Central

    Matlach, Juliane; Slobodda, Joerg; Grehn, Franz; Klink, Thomas

    2012-01-01

    Purpose To assess the outcomes of pars plana vitrectomy for the treatment of malignant glaucoma in patients with and without previous filtration surgery. Patients and methods Data of 15 patients developing malignant glaucoma after trabeculectomy (60%) or following ophthalmic interventions other than filtration surgery (40%) were recorded retrospectively. Pars plana vitrectomy was performed in case of failed medical or laser treatment recreating the normal pathway of aqueous humor. The main outcome measures were the postoperative intraocular pressure (IOP), the frequency of complications, and success rate based on the following criteria: IOP reduction by ≥20% and to ≤21 mmHg (definition one) or an IOP < 18 mmHg (definition two) with (qualified success) and without (complete success) glaucoma medication. Results Vitrectomy reduced IOP from baseline in eyes with and without previous trabeculectomy during a median follow-up of 16.4 months (range 7 days to 58 months); although the majority of patients required glaucoma medication to reach desired IOP. The complete success rates were 11% (both definitions) for patients with filtering blebs and none of the patients without previous trabeculectomy had complete success at the 12-month visit. Complications were few and included transient shallowing of the anterior chamber, choroidal detachment, corneal decompensation, filtering bleb failure, and need for further IOP-lowering procedures. Conclusion Pars plana vitrectomy is equally effective for malignant glaucoma caused by trabeculectomy or interventions other than filtration surgery, although IOP-lowering medication is necessary in nearly all cases to maintain target IOP. PMID:23226000

  12. Gene therapy for retinal ganglion cell neuroprotection in glaucoma.

    PubMed

    Wilson, A M; Di Polo, A

    2012-02-01

    Glaucoma is the leading cause of irreversible blindness worldwide. The primary cause of glaucoma is not known, but several risk factors have been identified, including elevated intraocular pressure and age. Loss of vision in glaucoma is caused by the death of retinal ganglion cells (RGCs), the neurons that convey visual information from the retina to the brain. Therapeutic strategies aimed at delaying or halting RGC loss, known as neuroprotection, would be valuable to save vision in glaucoma. In this review, we discuss the significant progress that has been made in the use of gene therapy to understand mechanisms underlying RGC degeneration and to promote the survival of these neurons in experimental models of optic nerve injury.

  13. Ganglion cell death in glaucoma: from mice to men.

    PubMed

    Nickells, Robert W

    2007-01-01

    Glaucoma results from the degeneration of retinal ganglion cells and their axons. Over the last 20 years several important advancements have been made in our understanding of the molecular pathology of this disease, particularly through the development of rat models of experimental glaucoma and the characterization of a spontaneous secondary form of glaucoma in DBA/2 substrains of inbred mice. One of these advances is the observation that ganglion cells die by apoptosis, an intrinsic molecular pathway of programmed cell death. An important aspect of this cell death process is the concept that these cells actually undergo compartmentalized self-destruction. Importantly, genetic evidence now suggests that axons die independently of the apoptotic program that executes the cell body or soma. This review briefly summarizes some of the most significant developments in glaucoma research, with respect to the process of ganglion cell degeneration.

  14. Pharmacotherapy of Glaucoma

    PubMed Central

    Schmidl, Doreen; Garhöfer, Gerhard; Popa-Cherecheanu, Alina

    2015-01-01

    Abstract Glaucoma is a group of diseases involving the optic nerve and associated structures, which is characterized by progressive visual field loss and typical changes of the optic nerve head (ONH). The only known treatment of the disease is reduction of intraocular pressure (IOP), which has been shown to reduce glaucoma progression in a variety of large-scale clinical trials. Nowadays, a relatively wide array of topical antiglaucoma drugs is available, including prostaglandin analogues, carbonic anhydrase inhibitors, beta-receptor antagonists, adrenergic agonists, and parasympathomimetics. In clinical routine, this allows for individualized treatment taking risk factors, efficacy, and safety into account. A major challenge is related to adherence to therapy. Sustained release devices may help minimize this problem but are not yet available for clinical routine use. Another hope arises from non-IOP-related treatment concepts. In recent years, much knowledge has been gained regarding the molecular mechanisms that underlie the disease process in glaucoma. This also strengthens the hope that glaucoma therapy beyond IOP lowering will become available. Implementing this concept with clinical trials remains, however, a challenge. PMID:25587905

  15. OCT Imaging in Glaucoma

    NASA Astrophysics Data System (ADS)

    Nevins, Jessica E.; Wollstein, Gadi; Schuman, Joel S.

    The precise micron scale quantification of ocular structures provided by OCT turn this technology to be a valuable tool in clinical evaluation of glaucoma patients. This chapter describes the clinical utility of OCT from choosing the scan pattern and scan location to the interpretation of the test outcome.

  16. Diplopia after glaucoma surgery.

    PubMed

    Christiansen, Stephen P

    2012-01-01

    The occurrence of strabismus and symptomatic diplopia following glaucoma surgery is becoming more common as the use of implanted setons increases. Understanding the factors contributing to the diplopia is critical to the development of treatment strategies to alleviate the patient's symptoms.

  17. [Corneal endothelium in glaucoma].

    PubMed

    Stefan, C; Nicolae, Miruna; Pop, Adina

    2012-01-01

    It is a clinical, observational, retrospective, randomised study, performed on 34 eyes with hipertensive primary open angle glaucoma (POAG) drug equilibrated and 18 eyes with normotensive POAG. We have evaluated the endothelial cells number variation in the hypertensive POAG and normotensive POAG.

  18. Get Tested for Glaucoma!

    MedlinePlus

    ... m afraid. What is your message to our readers? Get screened! Glaucoma is a silent blinder. Fortunately, most people are never going to get it. But everyone needs to be tested. Especially if they have a family history of it—a parent or grandparent, brother or ...

  19. Rotary filtration system

    DOEpatents

    Herman, David T [Aiken, SC; Maxwell, David N [Aiken, SC

    2011-04-19

    A rotary filtration apparatus for filtering a feed fluid into permeate is provided. The rotary filtration apparatus includes a container that has a feed fluid inlet. A shaft is at least partially disposed in the container and has a passageway for the transport of permeate. A disk stack made of a plurality of filtration disks is mounted onto the shaft so that rotation of the shaft causes rotation of the filtration disks. The filtration disks may be made of steel components and may be welded together. The shaft may penetrate a filtering section of the container at a single location. The rotary filtration apparatus may also incorporate a bellows seal to prevent leakage along the shaft, and an around the shaft union rotary joint to allow for removal of permeate. Various components of the rotary filtration apparatus may be removed as a single assembly.

  20. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    MedlinePlus

    ... Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms ... patients may need to keep taking drugs. Latest Research Researchers are studying the causes of glaucoma, looking ...

  1. The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery

    PubMed Central

    Bikbov, Mukharram Mukhtaramovich

    2015-01-01

    ABSTRACT The treatment of refractory glaucoma (RG) is challenging. The commonly adopted strategy in RG treatment is a glaucoma drainage device (GDD) implantation, which despite its radical nature may not always provide the desired intraocular pressure (IOP) levels for a long term. This review is based on the scientific literature on Ahmed glaucoma valve (AGV) implantation for refractory glaucoma. The technique of AGV implantation is described and data for both the types, FP7 and FP8 performance are presented. The outcome with adjunct antimetabolite and anti-VEGF drugs are also highlighted. An insight is given about experimental and histological examinations of the filtering bleb encapsulation. The article also describes various complications and measures to prevent them. How to cite this article: Bikbov MM, Khusnitdinov II. The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery. J Curr Glaucoma Pract 2015;9(3):86-91. PMID:26997843

  2. ITP Filtrate Benzene Removal Alternatives

    SciTech Connect

    Dworjanyn, L.O.

    1993-05-21

    Existing ITP filtrate hold tanks may provide sufficient capacity and residence time to strip dissolved benzene from the incoming filtrate using nitrogen sparging in the bottom of the old tanks. This is based on equilibrium supported by late Wash test data using aged washed slurry. Theoretical considerations indicate that benzene stripping will be more difficult from the ITP unwashed high salt filtrates due to reduced mass transfer. Therefore experimental sparging data is needed to quantify the theoretical effects.Foaming limits which dictate allowable sparging rate will also have to be established. Sparging in the hold tanks will require installation of sintered metal spargers, and possibly stirrers and foam monitoring/disengagement equipment. The most critical sparging needs are at the start of the precipitation/concentration cycle, when the filtrate flux rate is the highest,and at the end of wash cycle where Henry`s equilibrium constant falls off,requiring more gas to sparge the dissolved benzene. With adequate recycle (for proper distribution) or sparging in the old tanks, the 30 inch column could be used for the complete ITP process. A courser packing would reduce back pressure while enabling benzene stripping. The Late Wash Tests indicate adequate benzene stripping even at reduced gas flow. This will require experimental verification under ITP conditions. Using the 30 in. column vs 18 in. during the wash cycle will enhance stripping without need for additional sparging provided the minimum flow requirements are met.

  3. Is topical haloperidol a useful glaucoma treatment?

    PubMed Central

    Lavin, M. J.; Andrews, V.

    1986-01-01

    A randomised, double blind, single dose study of topical haloperidol, a dopamine receptor blocking drug, was performed on 20 healthy volunteers. After its administration a modest reduction in intraocular pressure was recorded over the six-hour study period, but the difference was not significant at the p less than 0.05 level. Although dopamine blocking agents are effective in reducing intraocular pressure in experimental animals, topical haloperidol appears unlikely to be clinically useful in the treatment of glaucoma. PMID:3718908

  4. A retrospective survey of childhood glaucoma prevalence according to Childhood Glaucoma Research Network classification.

    PubMed

    Hoguet, Ambika; Grajewski, Alana; Hodapp, Elizabeth; Chang, Ta Chen Peter

    2016-02-01

    To evaluate the Childhood Glaucoma Research Network (CGRN) classification system and describe the prevalence of each subtype according to this classification. Retrospectively, the medical records of 205 consecutive childhood glaucoma and glaucoma suspect patients at an urban tertiary care center were reviewed. The initial diagnosis and new diagnosis according to CGRN classification were recorded. All patients fit one of the seven categories of the new classification. Seventy-one percent of diagnoses were changed upon reclassification. Twenty-three percent of patients had primary glaucoma (juvenile open-angle glaucoma and primary congenital glaucoma [PCG]); 36% had secondary glaucoma (glaucoma associated with nonacquired ocular anomalies; glaucoma associated with nonacquired systemic disease or syndrome; glaucoma associated with acquired condition; and glaucoma following cataract surgery); and 39% were glaucoma suspect. Of the patients diagnosed with glaucoma, PCG was the most common diagnosis, seen in 32% of patients. The CGRN classification provides a useful method of classifying childhood glaucoma.

  5. American Glaucoma Society position statement: glaucoma surgery by surgeons.

    PubMed

    Mattox, Cynthia; Tsai, James C

    2013-08-01

    The American Glaucoma Society seeks to ensure the highest quality care for patients with glaucoma. The surgical care of the glaucoma patient requires the skills and judgment of physicians who have graduated from the rigorous training and hands-on experience provided by a complete curriculum in allopathic or osteopathic medicine with subsequent subspecialty training in Ophthalmology. Surgery for glaucoma includes the use of laser, incisional surgery with and without devices, injections into or around the eye, and should be performed only by physicians who have been licensed and credentialed in allopathic (MD) or osteopathic (DO) medicine.

  6. Glaucoma and Corneal Transplant Procedures

    PubMed Central

    Al-Mahmood, Ammar M.; Al-Swailem, Samar A.; Edward, Deepak P.

    2012-01-01

    Glaucoma after corneal transplantation is a leading cause of ocular morbidity after penetrating keratoplasty. The incidence reported is highly variable and a number of etiologic factors have been identified. A number of treatment options are available; surgical intervention for IOP control is associated with a high incidence of graft failure. IOP elevation is less frequently seen following deep anterior lamellar keratoplasty. Descemet's striping-automated endothelial keratoplasty is also associated with postprocedure intraocular pressure elevation and secondary glaucoma and presents unique surgical challenges in patients with preexisting glaucoma surgeries. Glaucoma exists in up to three-quarters of patients who undergo keratoprosthesis surgery and the management if often challenging. The aim of this paper is to highlight the incidence, etiology, and management of glaucoma following different corneal transplant procedures. It also focuses on the challenges in the diagnosis of glaucoma and intraocular pressure monitoring in this group of patients. PMID:22315661

  7. [Current concepts in malignant glaucoma].

    PubMed

    Călugăru, M; Marin, C

    1990-01-01

    The paper reports on the main pathogenic types of anatomical blocking of the aqueous humor circulation in malignant glaucoma: pupillary, secondary iridolenticular, ciliovitreolenticular, iridociliovitreous blocks and in suprachoroidal effusion. The paper also presents some of the entities correlated with malignant glaucoma: glaucoma with blocked angle following the administration of miotics, traumatisms, the operations of scleral obstruction for retina detachment, panretinal photocoagulation and thrombosis of the retina central vein.

  8. The management of complicated glaucoma

    PubMed Central

    Clement, C I; Goldberg, Ivan

    2011-01-01

    Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management. PMID:21150026

  9. PDF-based heterogeneous multiscale filtration model.

    PubMed

    Gong, Jian; Rutland, Christopher J

    2015-04-21

    Motivated by modeling of gasoline particulate filters (GPFs), a probability density function (PDF) based heterogeneous multiscale filtration (HMF) model is developed to calculate filtration efficiency of clean particulate filters. A new methodology based on statistical theory and classic filtration theory is developed in the HMF model. Based on the analysis of experimental porosimetry data, a pore size probability density function is introduced to represent heterogeneity and multiscale characteristics of the porous wall. The filtration efficiency of a filter can be calculated as the sum of the contributions of individual collectors. The resulting HMF model overcomes the limitations of classic mean filtration models which rely on tuning of the mean collector size. Sensitivity analysis shows that the HMF model recovers the classical mean model when the pore size variance is very small. The HMF model is validated by fundamental filtration experimental data from different scales of filter samples. The model shows a good agreement with experimental data at various operating conditions. The effects of the microstructure of filters on filtration efficiency as well as the most penetrating particle size are correctly predicted by the model.

  10. Tertiary filtration in small wastewater treatment plants.

    PubMed

    Naddeo, V; Belgiorno, V

    2007-01-01

    Tertiary filtration can be proposed in small wastewater treatment plants with impact on protected water bodies. Rotating disk filters may be adopted, in respect to conventional sand filters, when low availability of space and low investment costs are the prevailing conditions. The overall objective of this research was to evaluate the filtration efficiency of rotating disk filters; to compare effectiveness with traditional sand filters; to analyse thoroughly the importance of particle size distribution in wastewater tertiary filtration. In the experimental activity, conventional wastewater quality parameters were investigated and particle size distribution (PSD) was characterized to discuss the filter effectiveness. The effect of design and operation parameters of tertiary filters were discussed related to particle removal curves derived from particles counts. Analysis of particle size distribution can be very useful to help comprehension of filtration processes, design of filtration treatments and to decide the best measures to improve filter performance.

  11. Cambridge community Optometry Glaucoma Scheme.

    PubMed

    Keenan, Jonathan; Shahid, Humma; Bourne, Rupert R; White, Andrew J; Martin, Keith R

    2015-04-01

    With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom. The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma. 1733 patients were evaluated by this scheme between 2010 and 2013. Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist. The number of false positive referrals from initial referral into the scheme. Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit. The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

  12. Building a glaucoma interaction network using a text mining approach.

    PubMed

    Soliman, Maha; Nasraoui, Olfa; Cooper, Nigel G F

    2016-01-01

    The volume of biomedical literature and its underlying knowledge base is rapidly expanding, making it beyond the ability of a single human being to read through all the literature. Several automated methods have been developed to help make sense of this dilemma. The present study reports on the results of a text mining approach to extract gene interactions from the data warehouse of published experimental results which are then used to benchmark an interaction network associated with glaucoma. To the best of our knowledge, there is, as yet, no glaucoma interaction network derived solely from text mining approaches. The presence of such a network could provide a useful summative knowledge base to complement other forms of clinical information related to this disease. A glaucoma corpus was constructed from PubMed Central and a text mining approach was applied to extract genes and their relations from this corpus. The extracted relations between genes were checked using reference interaction databases and classified generally as known or new relations. The extracted genes and relations were then used to construct a glaucoma interaction network. Analysis of the resulting network indicated that it bears the characteristics of a small world interaction network. Our analysis showed the presence of seven glaucoma linked genes that defined the network modularity. A web-based system for browsing and visualizing the extracted glaucoma related interaction networks is made available at http://neurogene.spd.louisville.edu/GlaucomaINViewer/Form1.aspx. This study has reported the first version of a glaucoma interaction network using a text mining approach. The power of such an approach is in its ability to cover a wide range of glaucoma related studies published over many years. Hence, a bigger picture of the disease can be established. To the best of our knowledge, this is the first glaucoma interaction network to summarize the known literature. The major findings were a set of

  13. Awareness, knowledge and self-care practices toward glaucoma among final year health science university students in Ghana.

    PubMed

    Boadi-Kusi, Samuel B; Kyei, Samuel; Mashige, Khathutshelo P; Hansraj, Rekha; Abraham, Carl Halladay; Ocansey, Stephen; Agbedzie, Elvis L

    2015-03-01

    In the absence of adequate services, patients have to rely on the few health professionals that they do come into contact with to advise them on their treatment options. The aim of this study was to determine the level of awareness and knowledge of glaucoma, and the association between these factors and self-care practices among final year health science university students in Ghana. A cross-sectional survey involving the use of a structured questionnaire was conducted among 273 final year students (67 per cent) studying at any one of eight health science programs in three selected public universities in Ghana. All 273 respondents were aware of glaucoma but only 37.7 per cent had knowledge of it. The majority (65.9 per cent) defined glaucoma as raised intraocular pressure, and confused glaucoma with ocular hypertension. Over half (56.8 per cent) had acquired their knowledge of glaucoma during the course of their training. The media also played a major role in glaucoma awareness; however, it played a limited role in impacting on the knowledge of glaucoma. Only 28.6 per cent of respondents had previously undergone glaucoma screening. Although all respondents were aware of glaucoma, their level of knowledge of glaucoma was low. Self-care practices were also generally poor among the respondents. This information may be useful for glaucoma health education in Ghana. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometry Australia.

  14. 7. OBLIQUE INTERIOR VIEW OF FILTRATION ROOM IN FILTRATION PLANT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. OBLIQUE INTERIOR VIEW OF FILTRATION ROOM IN FILTRATION PLANT (#1773), LOOKING NORTHEAST, SHOWING PUMP NO. 1 AND METERING EQUIPMENT - Presidio Water Treatment Plant, Filtration Plant, East of Lobos Creek at Baker Beach, San Francisco, San Francisco County, CA

  15. 8. OBLIQUE INTERIOR VIEW OF FILTRATION ROOM IN FILTRATION PLANT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. OBLIQUE INTERIOR VIEW OF FILTRATION ROOM IN FILTRATION PLANT (#1773), LOOKING SOUTHWEST, SHOWING MEZZANINE WITH FILTER TANKS AT REAR - Presidio Water Treatment Plant, Filtration Plant, East of Lobos Creek at Baker Beach, San Francisco, San Francisco County, CA

  16. Aggravation of glaucoma with fluvoxamine.

    PubMed

    Jiménez-Jiménez, F J; Ortí-Pareja, M; Zurdo, J M

    2001-12-01

    To report a case of aggravation of glaucoma associated with the use of fluvoxamine. A 66-year-old while woman diagnosed with narrow-angle glaucoma showed an increase in intraocular pressure and experienced orbital pain and blurred vision after the initiation of fluvoxamine for tension-type headache. These symptoms disappeared and intraocular pressure normalized after withdrawal of this drug. Aggravation of narrow-angle glaucoma is a well-known adverse effect of tricyclic antidepressants. Because this adverse effect had been rarely reported to date with selective serotonin-reuptake inhibitors (paroxetine and fluoxetine), we used fluvoxamine in our patient. The disappearance of ocular symptoms and the normalization of intraocular pressure two days after stopping fluvoxamine suggest a possible relationship between fluvoxamine and aggravation of glaucoma. Fluvoxamine should be considered as a drug that can induce or aggravate narrow-angle glaucoma.

  17. Glaucoma Surgery: Taking the Sub-Conjunctival Route

    PubMed Central

    Shaarawy, Tarek

    2015-01-01

    We are currently in the midst of a surge in interest in glaucoma surgery. Novel pathways for reducing intraocular pressure (IOP) have been tried with various levels of success over the last few years. While the trabecular bypass and suprachoroidal approaches have captured much of the attention, filtering aqueous into the sub-conjunctival space remains the gold standard for lowering IOP. This review attempts to focus on current research in surgical methods to enhance filtration by potentially improving on tried and tested methods like the trabeculectomy, deep sclerectomy, and tube surgeries. PMID:25624674

  18. Glaucoma in atomic bomb survivors.

    PubMed

    Kiuchi, Yoshiaki; Yokoyama, Tomoko; Takamatsu, Michiya; Tsuiki, Eiko; Uematsu, Masafumi; Kinoshita, Hirofumi; Kumagami, Takeshi; Kitaoka, Takashi; Minamoto, Atsushi; Neriishi, Kazuo; Nakashima, Eiji; Khattree, Ravindra; Hida, Ayumi; Fujiwara, Saeko; Akahoshi, Masazumi

    2013-10-01

    Radiation has been associated with increases in noncancerous diseases. An effect of low-dose radiation on the prevalence of clinically detected glaucoma has not been previously reported. We therefore investigated the prevalence of glaucoma in A-bomb survivors and its possible association with radiation dose. A total of 1,589 people who participated in the clinical examination program for A-bomb survivors at the Radiation Effects Research Foundation (RERF) between October 2006 and September 2008 and who had reconstructed radiation doses, were recruited into this cross-sectional screening study. The prevalence of glaucoma and its dose-response relationship to A-bomb radiation were measured. Each subject underwent an initial screening consisting of an interview and ophthalmological examination. Questionable cases with any indication of ocular disease, including glaucoma, were referred to local hospitals for more comprehensive evaluation. A diagnosis of glaucoma was made based on specific optic disc appearance, perimetric results and other ocular findings. Of 1,589 eligible people, we detected 284 (17.9%) cases of glaucoma overall, including 36 (2.3%) cases of primary open-angle glaucoma with intraocular pressure levels greater than 21 mmHg, 226 (14.2%) cases of normal-tension glaucoma and 25 (1.6%) cases of primary angle-closure glaucoma. Seven glaucoma risk factors were examined as potential confounders but only two needed to be included in the final model. Binary regression using a generalized estimating equation method, with adjustment for gender, age, city, cataract surgery or diabetes mellitus, revealed an odds ratio at 1 Gy of 1.31 (95% confidence interval 1.11-1.53, P = 0.001) in the case of normal-tension glaucoma, but no association for other types of glaucoma. The prevalence of normal-tension glaucoma may increase with A-bomb radiation dose, but uncertainties associated with nonparticipation (59% participation) suggest caution in the interpretation of these

  19. Advanced Glaucoma: Management Pearls

    PubMed Central

    Gessesse, Girum W.; Damji, Karim F.

    2013-01-01

    A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient's perspective. The physician may also feel that they are in a difficult position managing the patient's disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ‘biopsychosociospiritual’ (BPSS) profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health), psychological considerations (e.g., fear, depression), socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s) what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite), and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life. PMID:23741132

  20. Neuroprotective therapies for glaucoma

    PubMed Central

    Song, Wei; Huang, Ping; Zhang, Chun

    2015-01-01

    Glaucoma is the second leading cause for blindness worldwide. It is mainly caused by glaucomatous optic neuropathy (GON) characterized by retinal ganglion cell loss, which leads to visual field defect and blindness. Up to now, the main purpose of antiglaucomatous therapies has been to lower intraocular pressure (IOP) through surgeries and medications. However, it has been found that progressive GON is still present in some patients with effective IOP decrease. Therefore, risk factors other than IOP elevation, like neurotrophin deprivation and excitotoxicity, contribute to progressive GON. Novel approaches of neuroprotection may be more effective for preserving the function of the optic nerve. PMID:25792807

  1. Physicochemical interaction and its influence on deep bed filtration process.

    PubMed

    Guo, Jin-long; Meng, Jun; Li, Gui-ping; Luan, Zhao-kun; Tang, Hong-xiao

    2004-01-01

    The capillary model was used to analyze the hydraulic conditions in the deep bed filtration process. The physicochemical interaction forces between the filter media and suspended particles and their influence on deep bed filtration process were also studied theoretically. Through the comparison of the hydraulic and physicochemical forces, the key influencing factors on the filtration process were proposed and investigated. Pilot study of the microflocculation deep bed filtration was carried out in the No. 9 Potable Water Treatment Plant of Beijing, and the experimental results of hydraulic head loss, particle distribution and entrapment were presented. The theoretical prediction was reasonably consistent with the experimental results under different conditions, which indicated that the regulation and control of micro-flocculation and deep bed filtration could be realized by the evaluation of the physicochemical interactions. Further theoretical and experimental research should be carried out to investigate the interaction mechanism and its application in the deep bed filtration and other cases.

  2. Aqueous shunts for glaucoma.

    PubMed

    Tseng, Victoria L; Coleman, Anne L; Chang, Melinda Y; Caprioli, Joseph

    2017-07-28

    Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase.com (1947 to August 2016), PubMed (1948 to August 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to August 2016), ClinicalTrials.gov (www.clinicaltrials.gov); searched 15 August 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 15 August 2016. We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 15 August 2016. We also searched the reference lists of identified trial reports and the Science Citation Index to find additional trials. We included randomized controlled trials that compared various types of aqueous shunts with standard surgery or to each other in eyes with glaucoma. Two review authors independently screened search results for eligibility, assessed the risk of bias, and extracted data from included trials. We contacted trial investigators when data were unclear or not reported. We graded the certainty of the evidence using the GRADE approach. We followed standard methods as recommended by Cochrane. We included 27 trials with a total of 2099 participants with mixed diagnoses and comparisons of interventions. Seventeen studies reported adequate methods of randomization, and seven reported adequate allocation concealment. Data collection and follow-up times varied.Four trials compared an aqueous shunt (Ahmed or Baerveldt) with trabeculectomy, of which

  3. Global rates of glaucoma surgery.

    PubMed

    Mansouri, Kaweh; Medeiros, Felipe A; Weinreb, Robert N

    2013-11-01

    To estimate global rates of glaucoma surgery. National glaucoma and national ophthalmology societies were contacted to obtain rates of glaucoma surgery for the preceding 5 years. In countries without a professional society, leading ophthalmologists or non-governmental organizations (NGO) were approached. When available, published literature was used for the estimates. Three levels of evidence were assigned: published data from central government or insurance registries (level I), estimates provided by a national professional society based on survey of members (level II), and estimates based on data from individual glaucoma surgeons (level III). Glaucoma surgical rate (GSR) was defined as the annual number of total glaucoma surgeries performed per million population. Linear regression analysis was performed between GSR and the following parameters: population per ophthalmologist, per capita gross domestic product (GDP), and per capita health expenditures. Seventy-three glaucoma societies, 35 ophthalmology societies, as well as six NGOs and 37 leading ophthalmologists (11 other countries) were contacted. Data were obtained from 38 countries (10 level I, 23 level II, and 5 lev el III) with a total population of 1.723 billion. The average GSR was 139.2 ± 113.1 (range, 2.9-500.0). There was a positive correlation between GSR and GDP (r(2) = 0.309, P = 0.0004) and GSR and the number of ophthalmologists (r(2) = 0.476, P < 0.0001). There is a paucity of data on rates of glaucoma surgery, particularly from developing countries. The new metric GSR may be useful for the allocation of healthcare resources, as well as for planning and monitoring public health interventions in glaucoma.

  4. Management of neovascular glaucoma.

    PubMed

    Ajvazi, Halil; Goranci, Ilhami; Lutaj, Pajtim

    2013-01-01

    Neovascular glaucoma is an atrophic optic neuropathy resulting from the neovascularization of the iridocorneal angle increasing the intraocular pressure. To show the incidence of NVG in comparison to the other types of glaucoma and to compare with the relevant literature data and other referent clinics. In this study were included 116 patients with NVG, of whom 75 or 64.7% male and 41 or 35.3% female, treated from January 2003 until February 2013. Visual acuity damages from NVG, were classified as big damages with 84.7% of cases and minor damages with 15.3% of cases. Cases with heavy damages were the cases with blindness, L+P+/- up to V = 0.3 and cases with slightly damages with V = 0.4-1.0. NVG caused by PDR with 52 cases or 44.8% and CRVO with 12 cases or 10.3%. We should be focused on prevention of diabetic retinopathy which requires interdisciplinary cooperation. In cases when diabetic retinopathy is present, we have to advise patients to undergo PRP as soon as possible, since it is the only way to prevent NVG and heavy consequences.

  5. Water sample filtration unit

    USGS Publications Warehouse

    Skougstad, M.W.; Scarbro, G.F.

    1968-01-01

    A readily portable, all plastic, pressure filtration unit is described which greatly facilitates rapid micropore membrane field filtration of up to several liters of water with a minimum risk of inorganic chemical alteration or contamination of the sample. The unit accommodates standard 10.2-cm. (4-inch) diameter filters. The storage and carrying case serves as a convenient filter stand for both field and laboratory use.

  6. Water Filtration Products

    NASA Technical Reports Server (NTRS)

    1986-01-01

    American Water Corporation manufactures water filtration products which incorporate technology originally developed for manned space operations. The formula involves granular activated charcoal and other ingredients, and removes substances by catalytic reactions, mechanical filtration, and absorption. Details are proprietary. A NASA literature search contributed to development of the compound. The technology is being extended to a deodorizing compound called Biofresh which traps gas and moisture inside the unit. Further applications are anticipated.

  7. Acupuncture for glaucoma

    PubMed Central

    Law, Simon K; Li, Tianjing

    2013-01-01

    Background Glaucoma is a multifactorial optic neuropathy in which there is an acquired loss of retinal ganglion cells at levels beyond normal age-related loss and corresponding atrophy of the optic nerve. Although there are many existing treatments, glaucoma is a chronic condition. Some patients may seek complementary or alternative medicine such as acupuncture to supplement their regular treatment. The underlying plausibility of acupuncture is that disorders related to the flow of Chi (the traditional Chinese concept translated as vital force or energy) can be prevented or treated by stimulating the relevant points on the body surface. Objectives The objective of this review was to assess the effectiveness and safety of acupuncture in people with glaucoma. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 3), MEDLINE (January 1950 to March 2010), EMBASE (January 1980 to March 2010), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2010), ZETOC (January 1993 to March 2010), Allied and Complementary Medicine Database (AMED) (January 1985 to March 2010), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the National Center for Complementary and Alternative Medicine web site (NCCAM) (http://nccam.nih.gov). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 23 March 2010 with the exception of NCCAM which was last searched on 14 July 2010. We also handsearched Chinese medical journals at Peking Union Medical College Library in April 2007. Although the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Chinese Acupuncture Trials Register, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), and the Chinese

  8. Hot gas filtration technical issues

    SciTech Connect

    Pontius, D.H.

    1995-11-01

    The primary objective of this research has been to provide an understanding of factors pertinent to the development of an effective filtration system for removing particles from high-temperature, high-pressure gas streams in advanced power generation systems under development by the Department of Energy. Information used to define the filtration system issues was compiled from the Morgantown Energy Technology Center (METC) Contractors Conferences, specific tasks assigned to Southern Research Institute, meetings with METC personnel and contractors, and other conferences and workshops organized by METC. Initial research and pilot scale installations have shown that there are some potential problem areas. Thick ash deposits have formed, bridging from passive surfaces to the filter material and between filter candles. A great number of ceramic filters have broken in various experimental and demonstration devices, especially during long-term testing. This paper reviews particulate characteristics (effects on filtration processes, conventional fly ash, gasifier char, PFBC ash, and detailed studies of PFBC ash) and ceramic filter materials (general issues, thermal stress, clay-bonded SiC filter materials, and monolithic ceramic materials).

  9. Experimental proof of contamination of blood components by (1-->3)-beta-D-glucan caused by filtration with cellulose filters in the manufacturing process.

    PubMed

    Nagasawa, Koichi; Yano, Tatsuyuki; Kitabayashi, Go; Morimoto, Hiroaki; Yamada, Yuji; Ohata, Atsushi; Usami, Makoto; Horiuchi, Takashi

    2003-01-01

    The level of (1-->3)-beta-D-glucan in blood is a diagnostic index of fungal infection because it is released from the fungal cell wall. However, high levels of plasma (1-->3)-beta-D-glucan in patients administered blood components may give false positive results. High levels of (1-->3)-beta-D-glucan have been detected in blood components. We suspected that (1-->3)-beta-D-glucan from cellulose filters had been eluted into blood components by filtration in the manufacturing process. To investigate the contamination of blood components by (1-->3)-beta-D-glucan from cellulose filters, in vitro experiments were performed by using six cellulose filters and a nylon filter. Human serum albumin (HSA) solution (100 ml) was flowed through each filter after rinsing with 100 ml of distilled water, and (1-->3)-beta-D-glucan in each fraction was determined by Fungitec G test MK. The concentration of (1-->3)-beta-D-glucan eluted from cellulose filters in 100-ml distilled water fractions ranged from 6 to 207 pg/ml, and that of HSA fractions ranged from 33 to 20,784 pg/ml. These data showed that remarkably higher (1-->3)-beta-D-glucan levels were detected in HSA fractions flowed through cellulose filters in spite of advance rinsing with 100 ml of distilled water. In the case of a nylon filter, (1-->3)-beta-D-glucan was not eluted in either fraction. These results indicate that (1-->3)-beta-D-glucan contamination in blood components is caused by filtration with cellulose filters in the manufacturing process.

  10. The molecular basis of retinal ganglion cell death in glaucoma.

    PubMed

    Almasieh, Mohammadali; Wilson, Ariel M; Morquette, Barbara; Cueva Vargas, Jorge Luis; Di Polo, Adriana

    2012-03-01

    Glaucoma is a group of diseases characterized by progressive optic nerve degeneration that results in visual field loss and irreversible blindness. A crucial element in the pathophysiology of all forms of glaucoma is the death of retinal ganglion cells (RGCs), a population of CNS neurons with their soma in the inner retina and axons in the optic nerve. Strategies that delay or halt RGC loss have been recognized as potentially beneficial to preserve vision in glaucoma; however, the success of these approaches depends on an in-depth understanding of the mechanisms that lead to RGC dysfunction and death. In recent years, there has been an exponential increase in valuable information regarding the molecular basis of RGC death stemming from animal models of acute and chronic optic nerve injury as well as experimental glaucoma. The emerging landscape is complex and points at a variety of molecular signals - acting alone or in cooperation - to promote RGC death. These include: axonal transport failure, neurotrophic factor deprivation, toxic pro-neurotrophins, activation of intrinsic and extrinsic apoptotic signals, mitochondrial dysfunction, excitotoxic damage, oxidative stress, misbehaving reactive glia and loss of synaptic connectivity. Collectively, this body of work has considerably updated and expanded our view of how RGCs might die in glaucoma and has revealed novel, potential targets for neuroprotection. Copyright © 2011. Published by Elsevier Ltd.

  11. Glaucoma risk index: automated glaucoma detection from color fundus images.

    PubMed

    Bock, Rüdiger; Meier, Jörg; Nyúl, László G; Hornegger, Joachim; Michelson, Georg

    2010-06-01

    Glaucoma as a neurodegeneration of the optic nerve is one of the most common causes of blindness. Because revitalization of the degenerated nerve fibers of the optic nerve is impossible early detection of the disease is essential. This can be supported by a robust and automated mass-screening. We propose a novel automated glaucoma detection system that operates on inexpensive to acquire and widely used digital color fundus images. After a glaucoma specific preprocessing, different generic feature types are compressed by an appearance-based dimension reduction technique. Subsequently, a probabilistic two-stage classification scheme combines these features types to extract the novel Glaucoma Risk Index (GRI) that shows a reasonable glaucoma detection performance. On a sample set of 575 fundus images a classification accuracy of 80% has been achieved in a 5-fold cross-validation setup. The GRI gains a competitive area under ROC (AUC) of 88% compared to the established topography-based glaucoma probability score of scanning laser tomography with AUC of 87%. The proposed color fundus image-based GRI achieves a competitive and reliable detection performance on a low-priced modality by the statistical analysis of entire images of the optic nerve head. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  12. Combination therapy as initial treatment in glaucoma and suspected glaucoma.

    PubMed

    Mikelberg, Frederick S; Etminan, Mahyar

    2012-06-01

    We hypothesize that there may be an inappropriate overuse of initial combination therapy in patients with glaucoma and in those who are glaucoma suspects. To test this hypothesis, we examined the British Columbia Population DataBase to determine the frequency of prescription of combination eye drops as initial therapy in glaucoma patients or glaucoma suspects. Cohort study. The study cohort included all those who visited an ophthalmologist's office between 2004 and 2007. Within the cohort we identified all those who were newly prescribed any ocular hypotensive eye drop. Specifically, we identified those who had been newly prescribed any ocular hypotensive eye drop within 60 days of receiving diagnoses of glaucoma, as defined by having received an international classification for disease code ICD-9 for glaucoma 365. We used the Population Data British Columbia (POP Data BC) as the main data source for this study. POP Data BC is a provincially linkable database that captures the physician visits (including inpatient procedures); hospital admissions; demographics; and prescription drug use of 4.5 million residents of British Columbia. Between 2004 and 2007, the percentage of combination therapy as the first ocular hypotensive prescription rose from 12.29% to 18.63%. The high percentage of combination therapy as initial therapy suggests that ophthalmologists either require additional education in principles of pharmacologic therapy or are unduly influenced by their interaction with the pharmaceutical industry. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  13. Implants for draining neovascular glaucoma.

    PubMed Central

    Molteno, A C; Van Rooyen, M M; Bartholomew, R S

    1977-01-01

    The implant design, surgical technique, and pharmacological methods of controlling bleb fibrosis, used to treat neovascular glaucoma, are described, together with the results of 14 operations performed on 12 eyes. Images PMID:843508

  14. Scanning laser polarimetry in glaucoma

    PubMed Central

    Dada, Tanuj; Sharma, Reetika; Angmo, Dewang; Sinha, Gautam; Bhartiya, Shibal; Mishra, Sanjay K; Panda, Anita; Sihota, Ramanjit

    2014-01-01

    Glaucoma is an acquired progressive optic neuropathy which is characterized by changes in the optic nerve head and retinal nerve fiber layer (RNFL). White-on-white perimetry is the gold standard for the diagnosis of glaucoma. However, it can detect defects in the visual field only after the loss of as many as 40% of the ganglion cells. Hence, the measurement of RNFL thickness has come up. Optical coherence tomography and scanning laser polarimetry (SLP) are the techniques that utilize the evaluation of RNFL for the evaluation of glaucoma. SLP provides RNFL thickness measurements based upon the birefringence of the retinal ganglion cell axons. We have reviewed the published literature on the use of SLP in glaucoma. This review elucidates the technological principles, recent developments and the role of SLP in the diagnosis and monitoring of glaucomatous optic neuropathy, in the light of scientific evidence so far. PMID:25494244

  15. Scanning laser polarimetry in glaucoma.

    PubMed

    Dada, Tanuj; Sharma, Reetika; Angmo, Dewang; Sinha, Gautam; Bhartiya, Shibal; Mishra, Sanjay K; Panda, Anita; Sihota, Ramanjit

    2014-11-01

    Glaucoma is an acquired progressive optic neuropathy which is characterized by changes in the optic nerve head and retinal nerve fiber layer (RNFL). White-on-white perimetry is the gold standard for the diagnosis of glaucoma. However, it can detect defects in the visual field only after the loss of as many as 40% of the ganglion cells. Hence, the measurement of RNFL thickness has come up. Optical coherence tomography and scanning laser polarimetry (SLP) are the techniques that utilize the evaluation of RNFL for the evaluation of glaucoma. SLP provides RNFL thickness measurements based upon the birefringence of the retinal ganglion cell axons. We have reviewed the published literature on the use of SLP in glaucoma. This review elucidates the technological principles, recent developments and the role of SLP in the diagnosis and monitoring of glaucomatous optic neuropathy, in the light of scientific evidence so far.

  16. Primary open-angle glaucoma.

    PubMed

    Weinreb, Robert N; Khaw, Peng Tee

    2004-05-22

    Primary open-angle glaucoma is a progressive optic neuropathy and, perhaps, the most common form of glaucoma. Because the disease is treatable, and because the visual impairment caused by glaucoma is irreversible, early detection is essential. Early diagnosis depends on examination of the optic disc, retinal nerve fibre layer, and visual field. New imaging and psychophysical tests can improve both detection and monitoring of the progression of the disease. Recently completed long-term clinical trials provide convincing evidence that lowering intraocular pressure prevents progression at both the early and late stages of the disease. The degree of protection is related to the degree to which intraocular pressure is lowered. Improvements in therapy consist of more effective and better-tolerated drugs to lower intraocular pressure, and more effective surgical procedures. New treatments to directly treat and protect the retinal ganglion cells that are damaged in glaucoma are also in development.

  17. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-05-21

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case.

  18. Visualization of water flow during filtration using flat filtration materials

    NASA Astrophysics Data System (ADS)

    Bílek, Petr; Šidlof, Petr; Hrůza, Jakub

    2012-04-01

    Filtration materials are very important elements of some industrial appliances. Water filtration is a separation of solid materials from fluid. Solid particles are captured on the frontal area of the filtration textile and only liquid passes through it. It is important to know the filtration process in a detailed way to be able to develop filtration materials. Visualization of filtration process enables a better view of the filtration. This method also enables to determine efficiency and homogeneity of filtration using image analysis. For this purpose, a new waterfiltration measuring setup was proposed and constructed. Filtration material is mounted into the optically transparent place in the setup. Laser sheet is directed into this place as in the case of Particle Image Velocimetry measuring method. Monochrome and sensitive camera records the light scattered by seeding particles in water. The seeding particles passing through the filter serve for measuring filtration efficiency, and also for visualization of filtration process. Filtration setup enables to measure also the pressure drop and a flow. The signals are processed by National Instruments compactDAQ system and UMA software. Microfibrous and nanofibrous filtration materials are tested by this measuring method. In the case of nanofibrous filtration, appropriate size of seeding particles is needed to be used to perform a process of filtration.

  19. Feline Glaucoma – A Comprehensive Review

    PubMed Central

    McLellan, Gillian J; Miller, Paul E

    2012-01-01

    Cats with glaucoma typically present late in the course of disease. It is likely that glaucoma in cats is under-diagnosed due to its insidious onset and gradual progression, as well as limitations of some commonly used tonometers in this species. Treatment of glaucoma in feline patients presents a clinical challenge, particularly as glaucoma is often secondary to other disease processes in cats. In this review, we consider the clinical features, patho-physiology and classification of the feline glaucomas and provide current evidence to direct selection of appropriate treatment strategies for feline glaucoma patients. PMID:21923820

  20. Smoking and incidence of glaucoma

    PubMed Central

    Pérez-de-Arcelus, Mónica; Toledo, Estefanía; Martínez-González, Miguel Á.; Martín-Calvo, Nerea; Fernández-Montero, Alejandro; Moreno-Montañés, Javier

    2017-01-01

    Abstract Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma. In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis. During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26–2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88–1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose–response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10–2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37–1.21]; P = 0.189). Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers. PMID:28072720

  1. Glaucoma history and risk factors.

    PubMed

    McMonnies, Charles W

    Apart from the risk of developing glaucoma there is also the risk that it is not detected and irreversible loss of vision ensues. Some studies of methods of glaucoma diagnosis have examined the results of instrument-based examinations with great if not complete reliance on objective findings in arriving at a diagnosis. The very valuable advances in glaucoma detection instrument technologies, and apparent increasing dependence on them, may have led to reduced consideration of information available from a patient history in those studies. Dependence on objective evidence of glaucomatous pathology may reduce the possibility of detecting glaucoma suspects or patients at risk for becoming glaucoma suspects. A valid positive family history of glaucoma is very valuable information. However, negative family histories can often be unreliable due to large numbers of glaucoma cases being undiagnosed. No evidence of family history is appropriate rather than no family history. In addition the unreliability of a negative family history is increased when patients with glaucoma fail to inform their family members. A finding of no family history can only be stated as no known family history. In examining the potential diagnostic contribution from a patient history, this review considers, age, frailty, race, type and degree of refractive error, systemic hyper- and hypotension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication interactions and side effects, the degree of exposure to intraocular and intracranial pressure elevations and fluctuations, smoking, and symptoms in addition to genetics and family history of the disease. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  2. Wound healing and glaucoma surgery: modulating the scarring process with conventional antimetabolites and new molecules.

    PubMed

    Holló, Gábor

    2012-01-01

    Subconjunctival absorption of aqueous humor is an essential part of glaucoma filtration surgery. Mitomycin C (MMC) and 5-fluorouracil have been used to reduce postoperative episcleral fibrosis and scar formation in the filtering bleb area for more than two decades. Both antimetabolites have also been frequently injected before needling revision of failing filtering blebs. Recently, MMC was tried also in tube surgery and nonpenetrating filtering surgery, but its usefulness in these applications has not yet been determined. The main complications and side effects of antimetabolite-enhanced filtration surgery comprise development of thin-walled cystic blebs, late bleb leaks, bleb infections, endophthalmitis, chronic hypotony, hypotony maculopathy and corneal epithelial toxicity. Besides MMC and 5-fluorouracil, several other agents were proposed for decreasing episcleral healing after glaucoma filtering surgery. Only few were evaluated in randomized clinical trials, and none became generally accepted or widely used. Copyright © 2012 S. Karger AG, Basel.

  3. Wound Healing and Glaucoma Surgery: Modulating the Scarring Process with Conventional Antimetabolites and New Molecules.

    PubMed

    Holló, Gábor

    2017-01-01

    Subconjunctival absorption of aqueous humor is an essential part of glaucoma filtration surgery. Mitomycin C (MMC) and 5-fluorouracil have been used to reduce postoperative episcleral fibrosis and scar formation in the filtering bleb area for more than 2 decades. Both antimetabolites have also been frequently injected before needling revision of failing filtering blebs. Recently, MMC was also tried in tube surgery and nonpenetrating filtering surgery, but its usefulness in these applications has not yet been determined. The main complications and side effects of antimetabolite-enhanced filtration surgery comprise the development of thin-walled cystic blebs, late bleb leaks, bleb infections, endophthalmitis, chronic hypotony, hypotony maculopathy and corneal epithelial toxicity. Besides MMC and 5-fluorouracil, several other agents were proposed for decreasing episcleral healing after glaucoma filtering surgery. Only a few were evaluated in randomized clinical trials, and none became generally accepted or widely used. © 2017 S. Karger AG, Basel.

  4. A nanopore membrane regulator device for laser modulated flow after glaucoma surgery.

    PubMed

    Olson, Jeffrey L; Bhandari, Ramanath; Groman-Lupa, Sergio; Velez-Montoya, Raul

    2015-10-01

    Glaucoma, the second most common cause of blindness in the world, is a multifactorial disease with several risk factors, of which intraocular pressure (IOP) is a primary contributing factor. Filtration surgery is one of the most effective means to significantly lower IOP compared to medical or laser treatments, and it is typically reserved for advanced disease. However, there are high rates of postoperative complications associated with the procedure, often from over- or under-filtration. To address these problems, the glaucoma drainage device regulator (GDDR) implant was developed to allow post-operative control of aqueous flow and IOP. The device, a tube with a nanopore membrane, is placed beneath the scleral flap. Postoperatively, the membrane surface can be ruptured with a laser to augment flow through the system. This feature allows adjustable control of aqueous flow and diminishes the risk of hypotony in the early postoperative period.

  5. Waste water filtration enhancement

    SciTech Connect

    Martin, H.L.

    1989-01-01

    Removal of submicron particles from process solutions and waste water is now economically achievable using a new Tyvek{reg sign} media in conventional filtration equipment. This new product greatly enhances filtration and allows use of the much improved filter aids and polymers which were recently developed. It has reduced operating costs and ensures a clean effluent discharge to the environment. This significant technical development is especially important to those who discharge to a small stream with low 7Q10 flow and must soon routinely pass the Toxicity tests that are being required by many States for NPDES permit renewal. The Savannah River Plant produces special nuclear materials for the US Government. Aluminum forming and metal finishing operations in M-Area, that manufacture fuel and target assemblies for the nuclear reactors, discharge to a waste water treatment facility using BAT hydroxide precipitation and filtration. The new Tyvek{reg sign} media and filter aids have achieved 55% less solids in the filtrate discharged to Tims Branch Creek, 15% less hazardous waste (dry filter cake), 150%-370% more filtration capacity, 74% lower materials purchase cost, 10% lower total M-Area manufacturing cost, and have improved safety. Performance with the improved polymers is now being evaluated.

  6. Microfluidic colloid filtration

    NASA Astrophysics Data System (ADS)

    Linkhorst, John; Beckmann, Torsten; Go, Dennis; Kuehne, Alexander J. C.; Wessling, Matthias

    2016-03-01

    Filtration of natural and colloidal matter is an essential process in today’s water treatment processes. The colloidal matter is retained with the help of micro- and nanoporous synthetic membranes. Colloids are retained in a “cake layer” - often coined fouling layer. Membrane fouling is the most substantial problem in membrane filtration: colloidal and natural matter build-up leads to an increasing resistance and thus decreasing water transport rate through the membrane. Theoretical models exist to describe macroscopically the hydrodynamic resistance of such transport and rejection phenomena; however, visualization of the various phenomena occurring during colloid retention is extremely demanding. Here we present a microfluidics based methodology to follow filter cake build up as well as transport phenomena occuring inside of the fouling layer. The microfluidic colloidal filtration methodology enables the study of complex colloidal jamming, crystallization and melting processes as well as translocation at the single particle level.

  7. CENTRIFUGAL MEMBRANE FILTRATION

    SciTech Connect

    Daniel J. Stepan; Bradley G. Stevens; Melanie D. Hetland

    1999-10-01

    The overall project consists of several integrated research phases related to the applicability, continued development, demonstration, and commercialization of the SpinTek centrifugal membrane filtration process. Work performed during this reporting period consisted of Phase 2 evaluation of the SpinTek centrifugal membrane filtration technology and Phase 3, Technology Partnering. During Phase 1 testing conducted at the EERC using the SpinTek ST-IIL unit operating on a surrogate tank waste, a solids cake developed on the membrane surface. The solids cake was observed where linear membrane velocities were less than 17.5 ft/s and reduced the unobstructed membrane surface area up to 25%, reducing overall filtration performance. The primary goal of the Phase 2 research effort was to enhance filtration performance through the development and testing of alternative turbulence promoter designs. The turbulence promoters were designed to generate a shear force across the entire membrane surface sufficient to maintain a self-cleaning membrane capability and improve filtration efficiency and long-term performance. Specific Phase 2 research activities included the following: System modifications to accommodate an 11-in.-diameter, two-disk rotating membrane assembly; Development and fabrication of alternative turbulence promoter designs; Testing and evaluation of the existing and alternative turbulence promoters under selected operating conditions using a statistically designed test matrix; and Data reduction and analysis; The objective of Phase 3 research was to demonstrate the effectiveness of SpinTek's centrifugal membrane filtration as a pretreatment to remove suspended solids from a liquid waste upstream of 3M's WWL cartridge technology for the selective removal of technetium (Tc).

  8. Glaucoma: Screening Can Save Your Sight!

    MedlinePlus

    ... turn Javascript on. Feature: Glaucoma Glaucoma: Screening Can Save Your Sight! Past Issues / Fall 2009 Table of ... be restored. However, there are treatments that may save remaining sight. That is why early diagnosis is ...

  9. Magnetic-seeding filtration

    SciTech Connect

    Depaoli, D.

    1996-10-01

    This task will investigate the capabilities of magnetic-seeding filtration for the enhanced removal of magnetic and nonmagnetic particulates from liquids. This technology appies to a wide range of liquid wastes, including groundwater, process waters, and tank supernatant. Magnetic-seeding filtration can be used in several aspects of treatment, such as (1) removal of solids, particularly those in the colloidal-size range that are difficult to remove by conventional means; (2) removal of contaminants by precipitation processes; and (3) removal of contaminants by sorption processes.

  10. Novel surgical procedures in glaucoma: advances in penetrating glaucoma surgery.

    PubMed

    Filippopoulos, Theodoros; Rhee, Douglas J

    2008-03-01

    Despite late modifications and enhancements, traditional penetrating glaucoma surgery is not without complications and is reserved for patients in whom pharmacologic treatment and/or laser trabeculoplasty do not suffice to control the intraocular pressure. This article critically reviews recent advances in penetrating glaucoma surgery with particular attention paid to two novel surgical approaches: ab interno trabeculectomy with the Trabectome and implantation of the Ex-PRESS shunt. Ab interno trabeculectomy (Trabectome) achieves a sustained 30% reduction in intraocular pressure by focally ablating and cauterizing the trabecular meshwork/inner wall of Schlemm's canal. It has a remarkable safety profile with respect to early hypotonous or infectious complications as it does not generate a bleb, but it can be associated with early postoperative intraocular pressure spikes that may necessitate additional glaucoma surgery. The Ex-PRESS shunt is more commonly implanted under a partial thickness scleral flap, and appears to have similar efficacy to standard trabeculectomy offering some advantages with respect to the rate of early complications related to hypotony. Penetrating glaucoma surgery will continue to evolve. As prospective randomized clinical trials become available, we will determine the exact role of these surgical techniques in the glaucoma surgical armamentarium.

  11. Simulation on combined rapid gravity filtration and backwash models.

    PubMed

    Han, S J; Fitzpatrick, C S B; Wetherill, A

    2009-01-01

    Combined rapid gravity filtration and backwash models have been applied to simulate filtration and backwash cycles. The simulated results from the backwash model suggest that an optimum air flow rate exists to maximise particle removal efficiency in the backwash operation for a certain backwash system. The simulation of combined rapid gravity filtration and backwash models suggests that the filter should not be completely cleaned up in the backwash and a certain amount of particles retained on filter grains after backwash can be beneficial for subsequent filtration runs. This is consistent with the experimental results in the literature.

  12. Water Treatment Technology - Filtration.

    ERIC Educational Resources Information Center

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on filtration provides instructional materials for six competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: purposes of sedimentation basins and flocculation…

  13. Water Treatment Technology - Filtration.

    ERIC Educational Resources Information Center

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on filtration provides instructional materials for six competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: purposes of sedimentation basins and flocculation…

  14. Difference in glaucoma progression between the first and second eye after consecutive bilateral glaucoma surgery in patients with bilateral uveitic glaucoma.

    PubMed

    Din, Norshamsiah Md; Talat, Lazha; Isa, Hazlita; Tomkins-Netzer, Oren; Barton, Keith; Lightman, Sue

    2016-12-01

    To determine whether the second eyes (SE) of patients with bilateral uveitic glaucoma undergoing filtration surgery have more glaucomatous progression in terms of visual acuity, visual field (VF) and optic nerve changes compared to the first eyes (FE). This retrospective study analysed data of 60 eyes from 30 patients with bilateral uveitic glaucoma who had undergone glaucoma surgery in both eyes on separate occasions. Humphrey VF progression was assessed using the Progressor software. The pre-operative IOP between the FE (43.1 ± 7.7 mmHg) and SE (40 ± 8.7 mmHg) was not statistically significant (p = 0.15). IOP reduction was greater in the FE (64 %) than SE (59.7 %) post-operatively, but the mean IOP at the final visit in the FE (12.3 ± 3.9 mmHg) and SE (14.5 ± 7 mmHg) was not statistically different (p = 0.2). There was no significant change in mean logMAR readings pre and post-operatively (0.45 ± 0.6 vs 0.37 ± 0.6, p = 0.4) or between the FE and SE. The number of SE with CDR > 0.7 increased by 23 % compared to the FE. From 23 available VFs, five SE (21.7 %) progressed at a median of five locations (range 1-11 points) with a mean local slope reduction of 1.74 ± 0.45 dB/year (range -2.39 to -1.26), whereas only one FE progressed. However, there was no significant difference between mean global rate of progression between the FE (-0.9 ± 1.6 dB/year) and SE (-0.76 ± 2.1 dB/year, p = 0.17) in the Humphrey VF. In eyes with bilateral uveitic glaucoma requiring glaucoma surgery, the SEs had more progressed points on VF and glaucomatous disc progression compared to FEs at the final visit.

  15. Glaucoma: the retina and beyond.

    PubMed

    Davis, Benjamin Michael; Crawley, Laura; Pahlitzsch, Milena; Javaid, Fatimah; Cordeiro, Maria Francesca

    2016-12-01

    Over 60 million people worldwide are diagnosed with glaucomatous optic neuropathy, which is estimated to be responsible for 8.4 million cases of irreversible blindness globally. Glaucoma is associated with characteristic damage to the optic nerve and patterns of visual field loss which principally involves the loss of retinal ganglion cells (RGCs). At present, intraocular pressure (IOP) presents the only modifiable risk factor for glaucoma, although RGC and vision loss can continue in patients despite well-controlled IOP. This, coupled with the present inability to diagnose glaucoma until relatively late in the disease process, has led to intense investigations towards the development of novel techniques for the early diagnosis of disease. This review outlines our current understanding of the potential mechanisms underlying RGC and axonal loss in glaucoma. Similarities between glaucoma and other neurodegenerative diseases of the central nervous system are drawn before an overview of recent developments in techniques for monitoring RGC health is provided, including recent progress towards the development of RGC specific contrast agents. The review concludes by discussing techniques to assess glaucomatous changes in the brain using MRI and the clinical relevance of glaucomatous-associated changes in the visual centres of the brain.

  16. Internal filtration, filtration fraction, and blood flow resistance in high- and low-flux dialyzers.

    PubMed

    Schneditz, Daniel; Zierler, Edda; Vanholder, Raymond; Eloot, Sunny

    2014-01-01

    It was the aim to examine the fluid flow in blood and dialysate compartments of highly permeable hollow fiber dialyzers where internal filtration contributes to solute removal but where excessive filtration bears a risk of cell activation and damage. Flow characteristics of high- (HF) and low-flux (LF) dialyzers were studied in lab-bench experiments using whole bovine blood. Measurements obtained under different operating conditions and under zero net ultrafiltration were compared to theoretical calculations obtained from a mathematical model. Experimental resistances in the blood compartment were within ±2% of those calculated from the model when dialysate was used as a test fluid. With whole blood, the experimental resistances in the blood compartment were only 81.8 ± 2.8% and 83.7 ± 4.3% of those calculated for the LF and HF dialyzer, respectively. Surprisingly, measured blood flow resistance slightly but significantly decreased with increasing flow rate (p < 0.001). Mathematical modeling confirmed this decrease both in LF and HF dialyzers which was accompanied by a concomitant decrease in internal filtration fraction, while overall internal filtration increased. The increase in internal filtration when increasing blood flow is associated with a beneficial reduction in internal filtration fraction. Concerns of increased hemoconcentration when increasing blood flow therefore appear to be unwarranted.

  17. Glaucoma drops control intraocular pressure and protect optic nerves in a rat model of glaucoma.

    PubMed

    Morrison, J C; Nylander, K B; Lauer, A K; Cepurna, W O; Johnson, E

    1998-03-01

    To determine whether chronic topical glaucoma therapy can control intraocular pressure (IOP) and protect nerve fibers in a rat model of pressure-induced optic nerve damage. Sixteen adult Brown Norway rats were-administered unilateral episcleral vein injections of hypertonic saline to produce scarring of the aqueous humor outflow pathways. Twice daily applications of either artificial tears (n = 6), 0.5% betaxolol (n = 5), or 0.5% apraclonidine (n = 5) were delivered to both eyes, and awake pressures were monitored with a TonoPen XL tonometer for 17 days before the rats were killed. For animals administered artificial tears, the mean IOP of the experimental eyes was 39 +/- 2 mm Hg compared with 29 +/- 1 mm Hg for the control eyes. This difference was statistically significant (P < 0.001). Mean IOPs in the experimental eyes of animals administered betaxolol and apraclonidine were 29 +/- 7 and 29 +/- 4 mm Hg, respectively, whereas the mean IOP in the control eyes was 28 +/- 1 mm Hg for both groups. There was no statistically significant difference among these values. The mean IOP for the experimental eyes in the betaxolol and apraclonidine groups was lower than that in animals administered artificial tears (P = 0.003). Quantitative histologic analysis of optic nerve damage in experimental eyes showed that four of the six animals administered artificial tears had damage involving 100% of the neural area. This degree of damage appeared in only 3 of 10 animals administered glaucoma therapy. Optic nerve protection was closely correlated with IOP history because damage was limited to less than 10% of the cross-sectional area in all animals in which the maximal IOP was less than or equal to 39 mm Hg, more than 2 SD below the mean value for eyes administered artificial tears. Topical glaucoma therapy in this model can prevent IOP elevation and protect optic nerve fibers.

  18. Management of Secondary Angle Closure Glaucoma.

    PubMed

    Parivadhini, Annadurai; Lingam, Vijaya

    2014-01-01

    Secondary angle closure glaucomas are a distinct entity from primary angle closure glaucoma (PACG). Unlike PACG, secondary angle closure glaucoma's have an identifable contributory factor/s for angle closure and obstruction of aqueous fow which is usually unrelieved by iridotomy. The treatment of each type of secondary angle closure glaucoma is varied, so identification of the primary cause aids in its effective management. How to cite this article: Annadurai P, Vijaya L. Management of Secondary Angle Closure Glaucoma. J Current Glau Prac 2014;8(1):25-32.

  19. Pediatric genetic diseases causing glaucoma

    PubMed Central

    Ichhpujani, Parul; Singh, Rohan B.

    2014-01-01

    Glaucomatous optic neuropathy may be considered as an endpoint of multiple systemic factors. Genetic conditions commonly causing glaucoma in children and adolescents include Axenfeld-Reiger syndrome, aniridia, Marfan syndrome, Weill-Marchessani syndrome, Sturge-Weber syndrome, Rubinstein-Taybi syndrome, nevus of Ota, congenital rubella and neurofibromatosis type 1. In the recent years, with the advancements in genetic research our understanding of the fundamental causes of glaucoma associated with inherited disorders has improved. In addition to intraocular pressure reduction, it is important for the clinician to be familiar with the multiple systemic associations with glaucoma, to re-evaluate treatment frequently, and to target the underlying disease process, if present. PMID:27625878

  20. Differential gene expression in glaucoma.

    PubMed

    Jakobs, Tatjana C

    2014-07-01

    In glaucoma, regardless of its etiology, retinal ganglion cells degenerate and eventually die. Although age and elevated intraocular pressure (IOP) are the main risk factors, there are still many mysteries in the pathogenesis of glaucoma. The advent of genome-wide microarray expression screening together with the availability of animal models of the disease has allowed analysis of differential gene expression in all parts of the eye in glaucoma. This review will outline the findings of recent genome-wide expression studies and discuss their commonalities and differences. A common finding was the differential regulation of genes involved in inflammation and immunity, including the complement system and the cytokines transforming growth factor β (TGFβ) and tumor necrosis factor α (TNFα). Other genes of interest have roles in the extracellular matrix, cell-matrix interactions and adhesion, the cell cycle, and the endothelin system.

  1. Differential Gene Expression in Glaucoma

    PubMed Central

    Jakobs, Tatjana C.

    2014-01-01

    In glaucoma, regardless of its etiology, retinal ganglion cells degenerate and eventually die. Although age and elevated intraocular pressure (IOP) are the main risk factors, there are still many mysteries in the pathogenesis of glaucoma. The advent of genome-wide microarray expression screening together with the availability of animal models of the disease has allowed analysis of differential gene expression in all parts of the eye in glaucoma. This review will outline the findings of recent genome-wide expression studies and discuss their commonalities and differences. A common finding was the differential regulation of genes involved in inflammation and immunity, including the complement system and the cytokines transforming growth factor β (TGFβ) and tumor necrosis factor α (TNFα). Other genes of interest have roles in the extracellular matrix, cell–matrix interactions and adhesion, the cell cycle, and the endothelin system. PMID:24985133

  2. Clinical Management of Malignant Glaucoma

    PubMed Central

    Foreman-Larkin, Julie; Netland, Peter A.; Salim, Sarwat

    2015-01-01

    Malignant glaucoma remains one of the most challenging complications of ocular surgery. Although it has been reported to occur spontaneously or after any ophthalmic procedure, it is most commonly encountered after glaucoma surgery in eyes with prior chronic angle closure. The clinical diagnosis is made in the setting of a patent peripheral iridotomy and axial flattening of the anterior chamber. Intraocular pressure is usually elevated, but it may be normal in some cases. Although the exact etiology of this condition is not fully understood, several mechanisms have been proposed and it is thought to result from posterior misdirection of aqueous humor into or behind the vitreous. This review discusses pathophysiology, differential diagnosis, imaging modalities, and current treatment strategies for this rare form of secondary glaucoma. PMID:26819754

  3. A retrospective survey of childhood glaucoma prevalence according to Childhood Glaucoma Research Network classification

    PubMed Central

    Hoguet, Ambika; Grajewski, Alana; Hodapp, Elizabeth; Chang, Ta Chen Peter

    2016-01-01

    Purpose: To evaluate the Childhood Glaucoma Research Network (CGRN) classification system and describe the prevalence of each subtype according to this classification. Materials and Methods: Retrospectively, the medical records of 205 consecutive childhood glaucoma and glaucoma suspect patients at an urban tertiary care center were reviewed. The initial diagnosis and new diagnosis according to CGRN classification were recorded. Results: All patients fit one of the seven categories of the new classification. Seventy-one percent of diagnoses were changed upon reclassification. Twenty-three percent of patients had primary glaucoma (juvenile open-angle glaucoma and primary congenital glaucoma [PCG]); 36% had secondary glaucoma (glaucoma associated with nonacquired ocular anomalies; glaucoma associated with nonacquired systemic disease or syndrome; glaucoma associated with acquired condition; and glaucoma following cataract surgery); and 39% were glaucoma suspect. Of the patients diagnosed with glaucoma, PCG was the most common diagnosis, seen in 32% of patients. Conclusion: The CGRN classification provides a useful method of classifying childhood glaucoma. PMID:27050345

  4. Blood groups as genetic markers in glaucoma.

    PubMed

    Brooks, A M; Gillies, W E

    1988-04-01

    A series of 474 mixed cases of glaucoma was assessed to determine whether there were any genetic differences between different types of glaucoma. A careful distinction was made between chronic open angle glaucoma (COAG), acute and chronic angle closure glaucoma, ocular hypertension, low tension glaucoma, patients with large cup disc ratios, and various types of secondary glaucoma including pseudoexfoliation of the lens capsule, uveitic and traumatic glaucoma. Using ABO blood groups, Rhesus groups, ABH secretion or non-secretion, and phenylthiourea tasting we identified certain differences. The differences from normal were significant decrease in Rh-negative patients in chronic closed angle glaucoma (p less than 0.05), a decrease in ABH secretors in ocular hypertension (p less than 0.01), and fewer HB secretors in patients with COAG (p less than 0.02). There was a significant decrease in AH secretors and increase in HB secretors in both pseudoexfoliation with raised intraocular pressure compared with COAG (p less than 0.01) and in secondary glaucomas as a group compared with COAG (p less than 0.01). Tasters of phenylthiourea were more common in traumatic and uveitic glaucoma than in normal controls (p less than 0.05). These results suggest that secondary glaucoma develops in different subjects from COAG, while patients who develop a rise in intraocular pressure proceed to cupping and field loss if they have a certain genetic constitution. The groups of patients are too small for the differences to be of great prognostic value.

  5. Liquid filtration simulation

    SciTech Connect

    Corey, I.; Bergman, W.

    1996-06-01

    We have a developed a computer code that simulates 3-D filtration of suspended particles in fluids in realistic filter structures. This code, being the most advanced filtration simulation package developed to date, provides LLNL and DOE with new capabilities to address problems in cleaning liquid wastes, medical fluid cleaning, and recycling liquids. The code is an integrated system of commercially available and LLNL-developed software; the most critical are the computational fluid dynamics (CFD) solver and the particle transport program. For the CFD solver, we used a commercial package based on Navier-Stokes equations and a LLNL-developed package based on Boltzman-lattice gas equations. For the particle transport program, we developed a cod based on the 3-D Langevin equation of motion and the DLVO theory of electrical interactions. A number of additional supporting packages were purchased or developed to integrate the simulation tasks and to provide visualization output.

  6. Melt Purification via Filtration

    DTIC Science & Technology

    1981-06-01

    function of melt flow rate . This work was extended to encompass variations in deep bed filter characteristics such as porosity, length of bed...of a, which is the concentration of entrapped inclusions, as well as a function of the melt physical properties, melt flow rates and the shape and...filtration runs at different flow rates . Measurement of thfe inclusion (Al^O,) concentration in the inlet and filtered melt at different flowrate allows one

  7. Persistence of glaucoma medical therapy in the Glasgow Glaucoma Database.

    PubMed

    Rahman, M Q; Abeysinghe, S S; Kelly, S; Roskell, N S; Shannon, P R; Abdlseaed, A A; Montgomery, D M I

    2011-07-01

    To report the persistence of glaucoma medical therapy in a database of 1006 patients with ocular hypertension (OHT), normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG) attending the Glaucoma Clinic at Glasgow Royal Infirmary, Glasgow, UK. Analyses have been carried out using specially written queries to generate reports relating to initial treatment choice and persistence for individual drugs. Queries were investigated in the database time period from 16 February 1982 to 11 February 2009. When investigating drug persistence, the results from the database were split into two distinct time periods from 1997 to 2001 and from 2002 to 2009 to reflect the available treatment options used. The number of patients with each diagnosis was as follows: POAG 608; OHT 246; NTG 152. The Kaplan-Meier estimate for mean persistence from 1997 to 2001 (time to treatment discontinuation) of latanoprost was 58.8 ± 1.95 months, timolol was 41.8 ± 3.94 months, brimonidine was 24.1 ± 3.05 months, and betaxolol was 22.9 ± 2.04 months. The Kaplan-Meier estimate for mean persistence from 2002 to 2009 of latanoprost (time to treatment discontinuation) was 52.0 ± 2.26 months, bimatoprost was 25.8 ± 2.89 months, and travoprost was 23.0 ± 1.27 months. The Kaplan-Meier estimate for mean persistence of latanoprost (time to treatment change) was 37.5 ± 2.47 months, travoprost was 30.2 ± 2.70 months, and bimatoprost was 17.5 ± 2.88 months. The introduction of the first prostaglandin analogue, latanoprost, dramatically improved treatment persistence for glaucoma patients. In the current prostaglandin-rich treatment environment, these data do not show any significant differences between prostaglandins with respect to treatment persistence.

  8. [Basic and clinical studies of pressure-independent damaging factors of open angle glaucoma].

    PubMed

    Araie, Makoto

    2011-03-01

    Pathogenesis of open-angle glaucoma involves both pressure-dependent damaging factors and pressure-independent damaging factors. The high prevalence of open-angle glaucoma with normal pressure (normal-tension glaucoma) in Japan implies that treatment of pressure-independent damaging factors in Japanese open-angle glaucoma patients is of importance. In an attempt to investigate the roles of pressure-independent damaging factors in open-angle glaucoma, we carried out basic and clinical studies and obtained the following results. 1. The rate of deterioration of visual field after trabeculectomy in normal tension glaucoma patients with post-operative intraocular pressure (IOP) of 10 mmHg was found to be -0.25 dB/year of mean deviation (MD), suggesting that contribution of pressure-independent damaging factors to the deterioration of MD in open-angle glaucoma is around -0.25 dB/year of mean deviation (MD). 2. Experiments using isolated purified cultured retinal ganglion cells (RGCs) indicated that calcium-channel blockers and some of antiglaucoma drugs showed neuroprotective effects on RGCs at concentrations of 0.01 microM or higher. 3. In mice, damage to RGCs resulted in secondary degeneration of neurons and activation of glial cells in the lateral geniculate nucleous (LGN) and superior colliculus, and these secondary changes in the central nervous system (CNS) due to RGC damage was partly ameliorated by systemic administration of memantine. 4. Mice experimental high IOP glaucoma models could be established using laser irradiation of the limbal area, and the usefulness of Tonolab in IOP measurements of mice eye was confirmed. 5. Monkey experimental high IOP glaucoma models revealed that in the glaucomatous optic nerve head vaso-constrictive reactions to an alpha-1 agonist was abolished, while vasodilative reaction to a prostaglandin FP receptor agonist was retained. 6. In monkeys with experimental high IOP glaucoma, secondary damage to neurons in the LGN and the glial

  9. Optical Coherence Tomography in Glaucoma

    NASA Astrophysics Data System (ADS)

    Berisha, Fatmire; Hoffmann, Esther M.; Pfeiffer, Norbert

    Retinal nerve fiber layer (RNFL) thinning and optic nerve head cupping are key diagnostic features of glaucomatous optic neuropathy. The higher resolution of the recently introduced SD-OCT offers enhanced visualization and improved segmentation of the retinal layers, providing a higher accuracy in identification of subtle changes of the optic disc and RNFL thinning associated with glaucoma.

  10. Prevention of Blindness: Chronic Glaucoma

    ERIC Educational Resources Information Center

    Richardson, Kenneth T.

    1970-01-01

    An evaluation of present screening procedures for chronic open-angle glaucoma includes suggestions for improvement: greater distribution of screening and education, conversion from monophasic to multiphasic screen, and examination of visual fields, optic nerve, and medical history in addition to the tonometry currently done. (KW)

  11. Prevention of Blindness: Chronic Glaucoma

    ERIC Educational Resources Information Center

    Richardson, Kenneth T.

    1970-01-01

    An evaluation of present screening procedures for chronic open-angle glaucoma includes suggestions for improvement: greater distribution of screening and education, conversion from monophasic to multiphasic screen, and examination of visual fields, optic nerve, and medical history in addition to the tonometry currently done. (KW)

  12. Managing advanced unilateral pseudoexfoliative glaucoma

    PubMed Central

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the “wipe-out phenomenon” in this case. PMID:24850557

  13. Functional analysis of glaucoma data.

    PubMed

    Hosseini-Nasab, Mohammad; Mirzaei K, Zahra

    2014-05-30

    We refer glaucoma to a category of eye disorders often associated with a dangerous buildup of intraocular pressure (IOP), which can damage the eyes' optic nerve that transmits visual information to the brain. Because IOP changes over time, it is a function of time, and it is an advantage that we analyze the phenomenon using functional data analysis. In this paper, we treat the data related to the IOP of 35 patients with right eye glaucoma, collected in Rasul-e-Akram Hospital at Tehran, Iran, over the years 2007–2011. We shall explore the structure of the data in search of the features that describe them, and find the characteristics that give a comprehensible presentation of the structure of the variability in the data.We extract patterns of variation in the data by using a generalization of the smoothed functional principal component analysis to obtain the main factors causing glaucoma and then determine their importance. We also explore the correlation patterns between the IOP of right and left eyes, and then model the left eye IOP of the glaucoma patients at each time on the basis of their right eye IOP in a previous interval of time.We can use the model to predict the values of the former variable by using the latter one in a previous time interval.

  14. Peripapillary Retinoschisis in Glaucoma Patients

    PubMed Central

    Bayraktar, Serife; Cebeci, Zafer; Kabaalioglu, Melis; Ciloglu, Serife; Kir, Nur; Izgi, Belgin

    2016-01-01

    Purpose. To investigate peripapillary retinoschisis and its effect on retinal nerve fiber layer (RNFL) thickness measurements by using spectral-domain optical coherence tomography (SD-OCT) in glaucomatous eyes. Methods. Circumpapillary RNFL (cpRNFL) B-scan images of 940 glaucoma patients (Group 1) and 801 glaucoma-suspect patients (Group 2) obtained by SD-OCT were reviewed. The structural and clinical characteristics of the retinoschisis were investigated. The RNFL thickness measurements taken at the time of retinoschisis diagnosis and at the follow-up visits were also compared. Results. Twenty-nine retinoschisis areas were found in 26 of the 940 glaucoma patients (3.1%) in Group 1 and seven areas were found in 801 patients (0.87%) in Group 2. In glaucomatous eyes, the retinoschisis was attached to the optic disc and overlapped with the RNFL defect. At the time of retinoschisis, the RNFL thickness was statistically greater in the inferior temporal quadrant when compared with the follow-up scans (p < 0.001). No macular involvement or retinal detachment was observed. Conclusion. The present study investigated 33 peripapillary retinoschisis patients. Increase in RNFL thickness measurements was observed at the time of retinoschisis. It is important to examine the cpRNFL B-scan images of glaucoma patients so that the RNFL thickness is not overestimated. PMID:27069674

  15. Solute partitioning and filtration by extracellular matrices

    PubMed Central

    Hofmann, Christina L.; Ferrell, Nicholas; Schnell, Lisa; Dubnisheva, Anna; Zydney, Andrew L.; Yurchenco, Peter D.; Roy, Shuvo

    2009-01-01

    The physiology of glomerular filtration remains mechanistically obscure despite its importance in disease. The correspondence between proteinuria and foot process effacement suggests podocytes as the locus of the filtration barrier. If so, retained macromolecules ought to accumulate at the filtration barrier, an effect called concentration polarization. Literature data indicate macromolecule concentrations decrease from subendothelial to subepithelial glomerular basement membrane (GBM), as would be expected if the GBM were itself the filter. The objective of this study was to obtain insights into the possible role of the GBM in protein retention by performing fundamental experimental and theoretical studies on the properties of three model gels. Solute partitioning and filtration through thin gels of a commercially available laminin-rich extracellular matrix, Matrigel, were measured using a polydisperse polysaccharide tracer molecule, Ficoll 70. Solute partitioning into laminin gels and lens basement membrane (LBM) were measured using Ficoll 70. A novel model of a laminin gel was numerically simulated, as well as a mixed structure-random-fiber model for LBM. Experimental partitioning was predicted by numerical simulations. Sieving coefficients through thin gels of Matrigel were size dependent and strongly flux dependent. The observed flux dependence arose from compression of the gel in response to the applied pressure. Gel compression may alter solute partitioning into extracellular matrix at physiologic pressures present in the glomerular capillary. This suggests a physical mechanism coupling podocyte structure to permeability characteristics of the GBM. PMID:19587146

  16. Corneal hysteresis and its relevance to glaucoma

    PubMed Central

    Deol, Madhvi; Taylor, David A.; Radcliffe, Nathan M.

    2015-01-01

    Purpose of review Glaucoma is a leading cause of irreversible blindness worldwide. It is estimated that roughly 60.5 million people had glaucoma in 2010 and that this number is increasing. Many patients continue to lose vision despite apparent disease control according to traditional risk factors. The purpose of this review is to discuss the recent findings with regard to corneal hysteresis, a variable that is thought to be associated with the risk and progression of glaucoma. Recent findings Low corneal hysteresis is associated with optic nerve and visual field damage in glaucoma and the risk of structural and functional glaucoma progression. In addition, hysteresis may enhance intraocular pressure (IOP) interpretation: low corneal hysteresis is associated with a larger magnitude of IOP reduction following various glaucoma therapies. Corneal hysteresis is dynamic and may increase in eyes after IOP-lowering interventions are implemented. Summary It is widely accepted that central corneal thickness is a predictive factor for the risk of glaucoma progression. Recent evidence shows that corneal hysteresis also provides valuable information for several aspects of glaucoma management. In fact, corneal hysteresis may be more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than central corneal thickness. PMID:25611166

  17. Altered aquaporin expression in glaucoma eyes.

    PubMed

    Tran, Thuy Linh; Bek, Toke; la Cour, Morten; Nielsen, Søren; Prause, Jan Ulrik; Hamann, Steffen; Heegaard, Steffen

    2014-09-01

    Aquaporins (AQP) are channels in the cell membrane that mainly facilitate a passive transport of water. In the eye, AQPs are expressed in the ciliary body and retina and may contribute to the pathogenesis of glaucoma and optic neuropathy. We investigated the expression of AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9 in human glaucoma eyes compared with normal eyes. Nine glaucoma eyes were examined. Of these, three eyes were diagnosed with primary open angle glaucoma; three eyes had neovascular glaucoma; and three eyes had chronic angle-closure glaucoma. Six eyes with normal intraocular pressure and without glaucoma were used as control. Immunohistochemistry was performed using antibodies against AQP1, AQP3, AQP4, AQP5, AQP7 and AQP9. For each specimen, optical densities of immunoprecipitates were measured using Photoshop and the staining intensities were calculated. Immunostaining showed labelling of AQP7 and AQP9 in the nonpigmented ciliary epithelium and the staining intensities were significantly decreased in glaucoma eyes (p = 0.003; p = 0.018). AQP7 expression in the Müller cell endfeet was increased (p = 0.046), and AQP9 labelling of the retinal ganglion cells (RGC) showed decreased intensity (p = 0.037). No difference in AQP1, AQP4 and AQP9 expression was found in the optic nerve fibres. This study is the first investigating AQPs in human glaucoma eyes. We found a reduced expression of AQP9 in the retinal ganglion cells of glaucoma eyes. Glaucoma also induced increased AQP7 expression in the Müller cell endfeet. In the ciliary body of glaucoma eyes, the expression of AQP7 and AQP9 was reduced. Therefore, the expression of AQPs seems to play a role in glaucoma.

  18. Preliminary results of CO2 laser-assisted sclerectomy surgery (CLASS) in the treatment of advanced glaucoma in a Chinese population

    PubMed Central

    Yick, Doris W.F.; Lee, Jacky W.Y.; Tsang, Susanna; Yeung, Barry Y.M.; Yuen, Can Y.F.

    2016-01-01

    Abstract To evaluate the efficacy and safety of CO2 laser-assisted sclerectomy surgery (CLASS) in Chinese patients with advanced glaucoma. Patients with advanced glaucoma who were candidates for glaucoma filtration surgery were included. The intraocular pressure (IOP) and number of antiglaucoma medications were documented before surgery and at all postoperative clinic visits. All intra- and postoperative complications were documented. The primary outcome measures were the changes in IOP and medication use before and after the procedure as well as complications from the procedure. The secondary outcome measure included the CLASS success rate. Twenty patients (23 eyes) underwent CLASS between November 2014 and September 2015. Nineteen eyes had primary open-angle glaucoma, 2 eyes had primary angle-closure glaucoma, and 2 eyes had uveitic glaucoma. One patient was lost to follow-up. The mean age of subjects was 68.1 ± 11.9 years. IOP was significantly reduced at 1 day and 1 week after CLASS. At 6 months, the IOP and number of medications were significantly reduced by 19.0% and 38.2%, respectively (both P < 0.0001). One patient had intraoperative trabeculo-Descemet membrane perforation. Two patients required laser goniopuncture and 2 required needling between 3 and 6 months postoperatively. The overall success rate was 81.8% at 6 months. CLASS achieved a modest IOP reduction in the early postoperative period and was overall a safe procedure for advanced glaucoma. PMID:27828849

  19. Preliminary results of CO2 laser-assisted sclerectomy surgery (CLASS) in the treatment of advanced glaucoma in a Chinese population.

    PubMed

    Yick, Doris W F; Lee, Jacky W Y; Tsang, Susanna; Yeung, Barry Y M; Yuen, Can Y F

    2016-11-01

    To evaluate the efficacy and safety of CO2 laser-assisted sclerectomy surgery (CLASS) in Chinese patients with advanced glaucoma.Patients with advanced glaucoma who were candidates for glaucoma filtration surgery were included. The intraocular pressure (IOP) and number of antiglaucoma medications were documented before surgery and at all postoperative clinic visits. All intra- and postoperative complications were documented. The primary outcome measures were the changes in IOP and medication use before and after the procedure as well as complications from the procedure. The secondary outcome measure included the CLASS success rate.Twenty patients (23 eyes) underwent CLASS between November 2014 and September 2015. Nineteen eyes had primary open-angle glaucoma, 2 eyes had primary angle-closure glaucoma, and 2 eyes had uveitic glaucoma. One patient was lost to follow-up. The mean age of subjects was 68.1 ± 11.9 years. IOP was significantly reduced at 1 day and 1 week after CLASS. At 6 months, the IOP and number of medications were significantly reduced by 19.0% and 38.2%, respectively (both P < 0.0001). One patient had intraoperative trabeculo-Descemet membrane perforation. Two patients required laser goniopuncture and 2 required needling between 3 and 6 months postoperatively. The overall success rate was 81.8% at 6 months.CLASS achieved a modest IOP reduction in the early postoperative period and was overall a safe procedure for advanced glaucoma.

  20. Dynamic optical filtration

    NASA Technical Reports Server (NTRS)

    Chretien, Jean-Loup (Inventor); Lu, Edward T. (Inventor)

    2005-01-01

    A dynamic optical filtration system and method effectively blocks bright light sources without impairing view of the remainder of the scene. A sensor measures light intensity and position so that selected cells of a shading matrix may interrupt the view of the bright light source by a receptor. A beamsplitter may be used so that the sensor may be located away from the receptor. The shading matrix may also be replaced by a digital micromirror device, which selectively sends image data to the receptor.

  1. Melt Purification via Filtration.

    DTIC Science & Technology

    1980-04-01

    to determine the melt flow - rate through the filter. A filtration run consists of first stirring the melt rigorously in order to prevent settling of...as an on/off valve to regulate melt flow through the filter. The filter bed preparation consists of heating the SiC tube to 970-1070*K and adding to it...the initial P1020 infiltrant aluminum has been purged out of the filter and the contaminated melt is flowing through the bed inlet and filtered

  2. Dynamic Optical Filtration

    NASA Technical Reports Server (NTRS)

    Chretien, Jean-Loup (Inventor); Lu, Edward T. (Inventor)

    2005-01-01

    A dynamic optical filtration system and method effectively blocks bright light sources without impairing view of the remainder of the scene. A sensor measures light intensity and position so that selected cells of a shading matrix may interrupt the view of the bright light source by a receptor. A beamsplitter may be used so that the sensor may be located away from the receptor. The shading matrix may also be replaced by a digital micromirror device, which selectively sends image data to the receptor.

  3. Dynamic Optical Filtration

    NASA Technical Reports Server (NTRS)

    Chretien, Jean-Loup (Inventor); Lu, Edward T. (Inventor)

    2005-01-01

    A dynamic optical filtration system and method effectively blocks bright light sources without impairing view of the remainder of the scene. A sensor measures light intensity and position so that selected cells of a shading matrix may interrupt the view of the bright light source by a receptor. A beamsplitter may be used so that the sensor may be located away from the receptor. The shading matrix may also be replaced by a digital micromirror device, which selectively sends image data to the receptor.

  4. Abrasive Particle Trajectories and Material Removal Non-Uniformity during CMP and Filtration Characteristics of CMP Slurries - A Simulation and Experimental Study

    NASA Astrophysics Data System (ADS)

    Rastegar, Vahid

    Nanoscale finishing and planarization are integral process steps in multilevel metallization designs for integrated circuit (IC) manufacturing since it is necessary to ensure local and global surface planarization at each metal layer before depositing the next layer. Chemical mechanical planarization (CMP) has been widely recognized as the most promising technology to eliminate topographic variation and has allowed the construction of multilevel interconnection structures with a more regularly stacked sequence, resulting in better device performance [1]. Understanding fundamental of the CMP mechanisms can offer guidance to the control and optimization of the polishing processes. CMP kinematics based on slurry distribution and particle trajectories have a significant impact on MRR profiles. In this work a mathematical model to describe particle trajectories during chemical mechanical polishing was developed and extended to account for the effect of larger particles, particle location changes due to slurry dispensing and in-situ conditioning. Material removal rate (MRR) and within wafer non-uniformity (WIWNU) were determined based on the calculated particle trajectory densities. Rotary dynamics and reciprocating motion were optimized to obtain best MRR uniformity. Edge-fast MRR profile was discussed based on mechanical aspect of CMP. Using the model, we also investigated the effect of variable rotational speeds of wafer and pad, and of large particles on WIWNU and scratch growth. It was shown that the presence of even a small portion of large particles can deteriorate the WIWNU significantly and also lead to more scratches. Furthermore, it was shown that the in-situ conditioning improves the uniformity of the polished wafers. Furthermore, a combined experimental and computational study of fibrous filters for removal of larger abrasive particles from aqueous dispersions, essential to minimize defects during chemical mechanical polishing, was performed. Dilute aqueous

  5. Non-steroidal drug-induced glaucoma

    PubMed Central

    Razeghinejad, M R; Pro, M J; Katz, L J

    2011-01-01

    Numerous systemically used drugs are involved in drug-induced glaucoma. Most reported cases of non-steroidal drug-induced glaucoma are closed-angle glaucoma (CAG). Indeed, many routinely used drugs that have sympathomimetic or parasympatholytic properties can cause pupillary block CAG in individuals with narrow iridocorneal angle. The resulting acute glaucoma occurs much more commonly unilaterally and only rarely bilaterally. CAG secondary to sulfa drugs is a bilateral non-pupillary block type and is due to forward movement of iris–lens diaphragm, which occurs in individuals with narrow or open iridocorneal angle. A few agents, including antineoplastics, may induce open-angle glaucoma. In conclusion, the majority of cases with glaucoma secondary to non-steroidal medications are of the pupillary block closed-angle type and preventable if the at-risk patients are recognized and treated prophylactically. PMID:21637303

  6. [Neovascular glaucoma--etipathogeny and diagnosis].

    PubMed

    Călugăru, D; Călugăru, M

    2012-01-01

    Neovascular glaucoma is defined as an iris and/or anterior chamber angle neovascularization associated with increased intraocular presure. It is a secondary glaucoma most frequently determined by a severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion and ocular ischemic syndrome; the uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and probably predominant agent in the pathogenesis of both intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis as well as neovacular glaucoma is divided into four grades that is prerubeotic, preglaucomatous, open-angle and angle closure glaucoma stages.

  7. Ab interno approach to the subconjunctival space using a collagen glaucoma stent.

    PubMed

    Lewis, Richard A

    2014-08-01

    This review considers a minimally invasive ab interno approach to glaucoma filtration surgery. Glaucoma filtration surgery can be defined as an attempt to lower intraocular pressure (IOP) by the surgical formation of an artificial drainage pathway from the anterior chamber to the subconjunctival space. Subconjunctival drainage of aqueous fluid has been a cornerstone of glaucoma surgery for more than a century. Varying techniques have been deployed to provide access to this space. Yet, despite numerous innovations in filtering surgery to achieve safe IOP reduction, too many short-term and long-term complications are associated with this surgery. This article describes the development of a new, soft, and permanent ab interno collagen implant (XEN gel stent) to optimize aqueous drainage to the subconjunctival space. Specific characteristics are critical in designing such an implant. Determining the optimum size of the device lumen to avoid hypotony while maximizing long-term outflow is crucial. Other topics discussed include material, length, diameter, flexibility, stability, and biocompatibility of the implant. Preclinical and human eye testing shows that the implant does not seem to occlude inside the lumen and the implant material does not appear to cause tissue reaction in the eye. The ab interno placement of the stent offers an alternative for lowering IOP with a minimally invasive procedure, minimum conjunctival tissue disruption, restricted flow to avoid hypotony, and long-term safety. Dr. Lewis received financial support from Aquesys, Inc. as a consultant. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Laser-induced primate glaucoma. II. Histopathology.

    PubMed

    Radius, R L; Pederson, J E

    1984-11-01

    A sustained, moderate pressure elevation was produced in 15 nonhuman primate eyes by application of laser energy to the trabecular meshwork. By light and electron microscopy, the trabecular beams were blunted, and scattered synechiae were present. Backward bowing of the lamina cribrosa, partial loss of the myelin sheath surrounding axonal segments just posterior to the lamina, and diffuse axonal loss involving the entire nerve cross section were noted. A quantitative analysis of this axonal loss revealed that eyes with moderate nerve head damage (cup-disc ratio, 0.6 to 0.8) had only 38% to 69% of the expected normal axonal count. The eyes with nearly total cupping (cup-disc ratio, 0.9 to 1.0) maintained between 10% and 36% of the normal axonal count. The disc changes in these experimental eyes are similar to those previously described in human eyes with glaucoma.

  9. Peripheral iridotomy for pigmentary glaucoma.

    PubMed

    Michelessi, Manuele; Lindsley, Kristina

    2016-02-12

    Glaucoma is a chronic optic neuropathy characterized by retinal ganglion cell death resulting in damage to the optic nerve head and the retinal nerve fiber layer. Pigment dispersion syndrome is characterized by a structural disturbance in the iris pigment epithelium (the densely pigmented posterior surface of the iris) that leads to dispersion of the pigment and its deposition on various structures within the eye. Pigmentary glaucoma is a specific form of open-angle glaucoma found in patients with pigment dispersion syndrome.Topcial medical therapy is usually the first-line treatment; however, peripheral laser iridotomy has been proposed as an alternate treatment. Peripheral laser iridotomy involves creating an opening in the iris tissue to allow drainage of fluid from the posterior chamber to the anterior chamber and vice versa. Equalizing the pressure within the eye may help to alleviate the friction that leads to pigment dispersion and prevent visual field deterioration. However, the effectiveness of peripheral laser iridotomy in reducing the development or progression of pigmentary glaucoma is unknown. The objective of this review was to assess the effects of peripheral laser iridotomy compared with other interventions, including medication, trabeculoplasty, and trabeculectomy, or no treatment, for pigment dispersion syndrome and pigmentary glaucoma. We searched a number of electronic databases including CENTRAL, MEDLINE and EMBASE and clinical trials websites such as (mRCT) and ClinicalTrials.gov. We last searched the electronic databases on 2 November 2015. We included randomized controlled trials (RCTs) that had compared peripheral laser iridotomy versus no treatment or other treatments for pigment dispersion syndrome and pigmentary glaucoma. We used standard methodological procedures for systematic reviews. Two review authors independently screened articles for eligibility, extracted data, and assessed included trials for risk of bias. We did not perform a

  10. Peripheral iridotomy for pigmentary glaucoma

    PubMed Central

    Michelessi, Manuele; Lindsley, Kristina

    2016-01-01

    Background Glaucoma is a chronic optic neuropathy characterized by retinal ganglion cell death resulting in damage to the optic nerve head and the retinal nerve fiber layer. Pigment dispersion syndrome is characterized by a structural disturbance in the iris pigment epithelium (the densely pigmented posterior surface of the iris) that leads to dispersion of the pigment and its deposition on various structures within the eye. Pigmentary glaucoma is a specific form of open-angle glaucoma found in patients with pigment dispersion syndrome. Topcial medical therapy is usually the first-line treatment; however, peripheral laser iridotomy has been proposed as an alternate treatment. Peripheral laser iridotomy involves creating an opening in the iris tissue to allow drainage of fluid from the posterior chamber to the anterior chamber and vice versa. Equalizing the pressure within the eye may help to alleviate the friction that leads to pigment dispersion and prevent visual field deterioration. However, the effectiveness of peripheral laser iridotomy in reducing the development or progression of pigmentary glaucoma is unknown. Objectives The objective of this review was to assess the effects of peripheral laser iridotomy compared with other interventions, including medication, trabeculoplasty, and trabeculectomy, or no treatment, for pigment dispersion syndrome and pigmentary glaucoma. Search methods We searched a number of electronic databases including CENTRAL, MEDLINE and EMBASE and clinical trials websites such as (mRCT) and ClinicalTrials.gov. We last searched the electronic databases on 2 November 2015. Selection criteria We included randomized controlled trials (RCTs) that had compared peripheral laser iridotomy versus no treatment or other treatments for pigment dispersion syndrome and pigmentary glaucoma. Data collection and analysis We used standard methodological procedures for systematic reviews. Two review authors independently screened articles for eligibility

  11. Magnetic-seeding filtration

    SciTech Connect

    DePaoli, D.W.; Tsouris, C.; Yiacoumi, Sotira

    1997-10-01

    Magnetic-seeding filtration is a technology under development for the enhanced removal of magnetic and non-magnetic particulates from liquids. This process involves the addition of a small amount of magnetic seed particles (such as naturally occurring iron oxide) to a waste suspension, followed by treatment with a magnetic filter. Non-magnetic and weakly magnetic particles are made to undergo nonhomogeneous flocculation with the seed particles, forming flocs of high magnetic susceptibility that are readily removed by a conventional high-gradient magnetic filter. This technology is applicable to a wide range of liquid wastes, including groundwater, process waters, and tank supernatants. Magnetic-seeding filtration may be used in several aspects of treatment, such as (1) removal of solids, particularly those in the colloidal size range that are difficult to remove by conventional means; (2) removal of contaminants by precipitation processes; and (3) removal of contaminants by sorption processes. Waste stream characteristics for which the technology may be applicable include (1) particle sizes ranging from relatively coarse (several microns) to colloidal particles, (2) high or low radiation levels, (3) broad-ranging flow rates, (4) low to moderate solids concentration, (5) cases requiring high decontamination factors, and (6) aqueous or non-aqueous liquids. At this point, the technology is at the bench-scale stage of development; laboratory studies and fundamental modeling are currently being employed to determine the capabilities of the process.

  12. Outcomes of Sequential Glaucoma Drainage Implants in Refractory Glaucoma.

    PubMed

    Hu, Wanda D; Moster, Marlene R; Zheng, Cindy X; Sabherwal, Naryan; Pequignot, Edward; Cvintal, Victor; Ekici, Feyzahan; Waisbourd, Michael

    2016-04-01

    To describe the outcomes of eyes that have undergone a second glaucoma drainage implant (GDI) surgery. A retrospective review of eyes that underwent a second GDI surgery from 2006 to 2013 was conducted. Primary outcome measures included intraocular pressure (IOP) reduction and success rates. Secondary outcome measures included glaucoma medication use, visual acuity, and number of reoperations. Success was defined as 6 ≤ IOP ≤ 21 with at least 20% IOP reduction, and no increase in the number of glaucoma medications from baseline at 3 months of follow-up or more. Sixty-five eyes (63 patients) had a mean follow-up of 22.4 ± 19.9 months. The most frequently placed second GDIs were an Ahmed FP7 (49%) or a Baerveldt 250 (26%) in the inferotemporal (46%) or inferonasal (35%) quadrant. At 3-year follow-up, IOP was reduced from 25.8 ± 7.7 to 17.4 ± 9.9 mm Hg (P = 0.004) and the number of glaucoma medications decreased from 3.6 ± 1.2 to 2.5 ± 1.4 (P = 0.01) compared with baseline. The median time to failure was 24.7 ± 5.8 months. There was no significant difference in failure rates for type of sequential GDI (P = 0.80) or plate location (P = 0.34). There was no significant difference in visual acuity between baseline and 3-year follow-up (P = 1.0). The most common postoperative complication was corneal edema (n = 9, 14%). Most eyes undergoing a second GDI achieve adequate IOP control with fewer antiglaucoma medications. Failure rates were similar regardless of quadrant selection or GDI type.

  13. The Philadelphia Glaucoma Detection and Treatment Project

    PubMed Central

    Waisbourd, Michael; Pruzan, Noelle L.; Johnson, Deiana; Ugorets, Angela; Crews, John E.; Saaddine, Jinan B.; Henderer, Jeffery D.; Hark, Lisa A.; Katz, L. Jay

    2016-01-01

    Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT

  14. Congenital glaucoma in cutis marmorata teleangiectatica congenita.

    PubMed

    Mayatepek, E; Krastel, H; Völcker, H E; Pfau, B; Almasan, K

    1991-01-01

    A case of congenital glaucoma in cutis marmorata teleangiectatica congenita (CMTC, van Lohuizen syndrome) is described. The cutaneous anomaly and heterochromia iridium were noticed at birth. Brown discoloration of one iris was due to iris anterior layer dysplasia, resulting in unilateral glaucoma. Two trabeculotomies were performed until persistent normalization of intraocular pressure could be achieved. The possibility of a genetic basis and hereditary condition of CMTC and its association with congenital glaucoma is discussed. Patients with CMTC should regularly undergo ophthalmological follow-up to rule out development of glaucoma.

  15. Design parameters for rotating cylindrical filtration

    NASA Technical Reports Server (NTRS)

    Schwille, John A.; Mitra, Deepanjan; Lueptow, Richard M.

    2002-01-01

    Rotating cylindrical filtration displays significantly reduced plugging of filter pores and build-up of a cake layer, but the number and range of parameters that can be adjusted complicates the design of these devices. Twelve individual parameters were investigated experimentally by measuring the build-up of particles on the rotating cylindrical filter after a fixed time of operation. The build-up of particles on the filter depends on the rotational speed, the radial filtrate flow, the particle size and the gap width. Other parameters, such as suspension concentration and total flow rate are less important. Of the four mechanisms present in rotating filters to reduce pore plugging and cake build-up, axial shear, rotational shear, centrifugal sedimentation and vortical motion, the evidence suggests rotational shear is the dominant mechanism, although the other mechanisms still play minor roles. The ratio of the shear force acting parallel to the filter surface on a particle to the Stokes drag acting normal to the filter surface on the particle due to the difference between particle motion and filtrate flow can be used as a non-dimensional parameter that predicts the degree of particle build-up on the filter surface for a wide variety of filtration conditions. c2002 Elsevier Science B.V. All rights reserved.

  16. Design parameters for rotating cylindrical filtration

    NASA Technical Reports Server (NTRS)

    Schwille, John A.; Mitra, Deepanjan; Lueptow, Richard M.

    2002-01-01

    Rotating cylindrical filtration displays significantly reduced plugging of filter pores and build-up of a cake layer, but the number and range of parameters that can be adjusted complicates the design of these devices. Twelve individual parameters were investigated experimentally by measuring the build-up of particles on the rotating cylindrical filter after a fixed time of operation. The build-up of particles on the filter depends on the rotational speed, the radial filtrate flow, the particle size and the gap width. Other parameters, such as suspension concentration and total flow rate are less important. Of the four mechanisms present in rotating filters to reduce pore plugging and cake build-up, axial shear, rotational shear, centrifugal sedimentation and vortical motion, the evidence suggests rotational shear is the dominant mechanism, although the other mechanisms still play minor roles. The ratio of the shear force acting parallel to the filter surface on a particle to the Stokes drag acting normal to the filter surface on the particle due to the difference between particle motion and filtrate flow can be used as a non-dimensional parameter that predicts the degree of particle build-up on the filter surface for a wide variety of filtration conditions. c2002 Elsevier Science B.V. All rights reserved.

  17. An adaptive threshold based image processing technique for improved glaucoma detection and classification.

    PubMed

    Issac, Ashish; Partha Sarathi, M; Dutta, Malay Kishore

    2015-11-01

    Glaucoma is an optic neuropathy which is one of the main causes of permanent blindness worldwide. This paper presents an automatic image processing based method for detection of glaucoma from the digital fundus images. In this proposed work, the discriminatory parameters of glaucoma infection, such as cup to disc ratio (CDR), neuro retinal rim (NRR) area and blood vessels in different regions of the optic disc has been used as features and fed as inputs to learning algorithms for glaucoma diagnosis. These features which have discriminatory changes with the occurrence of glaucoma are strategically used for training the classifiers to improve the accuracy of identification. The segmentation of optic disc and cup based on adaptive threshold of the pixel intensities lying in the optic nerve head region. Unlike existing methods the proposed algorithm is based on an adaptive threshold that uses local features from the fundus image for segmentation of optic cup and optic disc making it invariant to the quality of the image and noise content which may find wider acceptability. The experimental results indicate that such features are more significant in comparison to the statistical or textural features as considered in existing works. The proposed work achieves an accuracy of 94.11% with a sensitivity of 100%. A comparison of the proposed work with the existing methods indicates that the proposed approach has improved accuracy of classification glaucoma from a digital fundus which may be considered clinically significant.

  18. Glaucoma detection using novel optic disc localization, hybrid feature set and classification techniques.

    PubMed

    Akram, M Usman; Tariq, Anam; Khalid, Shehzad; Javed, M Younus; Abbas, Sarmad; Yasin, Ubaid Ullah

    2015-12-01

    Glaucoma is a chronic and irreversible neuro-degenerative disease in which the neuro-retinal nerve that connects the eye to the brain (optic nerve) is progressively damaged and patients suffer from vision loss and blindness. The timely detection and treatment of glaucoma is very crucial to save patient's vision. Computer aided diagnostic systems are used for automated detection of glaucoma that calculate cup to disc ratio from colored retinal images. In this article, we present a novel method for early and accurate detection of glaucoma. The proposed system consists of preprocessing, optic disc segmentation, extraction of features from optic disc region of interest and classification for detection of glaucoma. The main novelty of the proposed method lies in the formation of a feature vector which consists of spatial and spectral features along with cup to disc ratio, rim to disc ratio and modeling of a novel mediods based classier for accurate detection of glaucoma. The performance of the proposed system is tested using publicly available fundus image databases along with one locally gathered database. Experimental results using a variety of publicly available and local databases demonstrate the superiority of the proposed approach as compared to the competitors.

  19. CENTRIFUGAL MEMBRANE FILTRATION

    SciTech Connect

    William A. Greene; Patricia A. Kirk; Richard Hayes; Joshua Riley

    2005-10-28

    SpinTek Membrane Systems, Inc., the developer of a centrifugal membrane filtration technology, has engineered and developed a system for use within the U.S. Department of Energy (DOE) Environmental Management (EM) Program. The technology uses supported microporous membranes rotating at high rpm, under pressure, to separate suspended and colloidal solids from liquid streams, yielding a solids-free permeate stream and a highly concentrated solids stream. This is a crosscutting technology that falls under the Efficient Separations and Processing Crosscutting Program, with potential application to tank wastes, contaminated groundwater, landfill leachate, and secondary liquid waste streams from other remediation processes, including decontamination and decommissioning systems. SpinTek II High Shear Rotary Membrane Filtration System is a unique compact crossflow membrane system that has large, demonstrable advantages in performance and cost compared to currently available systems: (1) High fluid shear prevents membrane fouling even with very high solids content; hazardous and radioactive components can be concentrated to the consistency of a pasty slurry without fouling. (2) Induced turbulence and shear across the membrane increases membrane flux by a factor of ten over existing systems and allows operation on fluids not otherwise treatable. (3) Innovative ceramic membrane and mechanical sealing technology eliminates compatibility problems with aggressive DOE waste streams. (4) System design allows rapid, simple disassembly for inspection or complete decontamination. (5) Produces colloidal- and suspended-solids-free filtrate without the addition of chemicals. The first phase of this project (PRDA maturity stage 5) completed the physical scale-up of the SpinTek unit and verified successful scale-up with surrogate materials. Given successful scale-up and DOE concurrence, the second phase of this project (PRDA maturity stage 6) will provide for the installation and

  20. [21st century management of glaucoma].

    PubMed

    Tsukahara, Shigeo

    2003-12-01

    According to a recent epidemiological study done in Japan, 2 or 3 million Japanese people are thought to be suffering from glaucoma, and 70-80% of them have not been examined or diagnosed by ophthalmologists. Therefore, the problem is how to find these untreated and undiagnosed people. At present, treatment of glaucoma continues to be directed at lowering intraocular pressure to prevent progression of glaucomatous optic neuropathy. However, theoretically, there are three stages in the prevention of progression of glaucoma. In the first stage, diagnosis of glaucoma can be done by genetic examination, before occurrence of glaucoma. The MYOCILIN/trabecular meshwork-inducible glucocorticoid response gene and the optineurin gene were identified as the genes that cause open angle glaucoma. Although some Japanese patients have sequence changes in the myocilin gene, there are no apparent specific mutations in Japanese glaucoma patients, in the MYOCILIN/TIGR and optineurin genes. Secondary glaucoma such as steroid glaucoma, induced by allergic diseases, and neovascular glaucoma, induced by retinal circulatory insufficiency, are preventable by improving the causal diseases, diabetes and hypertension. The education of doctors and laymen is important to reduce the occurrence of diabetes, and hypertension to prevent diabetic retinopathy, and retinal vessel occlusion. The second stage in preventing progression of glaucoma is to find the disease as early as possible. In Japan, a physical examination system is in place for everybody over 40 years old, in companies and local districts. Therefore, ocular examination, specially non-mydriatic fundus photographs should be taken in these examinations, and the film should be evaluated by an ophthalmologist, to search for retinal and optic disc abnormalities. Primary open angle glaucoma can be detected through this system in early stages. In primary angle closure glaucoma, instruments for estimating anterior chamber rapidly and accurately

  1. Detecting Glaucoma Using Automated Pupillography

    PubMed Central

    Tatham, Andrew J.; Meira-Freitas, Daniel; Weinreb, Robert N.; Zangwill, Linda M.; Medeiros, Felipe A.

    2014-01-01

    Objective To evaluate the ability of a binocular automated pupillograph to discriminate healthy subjects from those with glaucoma. Design Cross-sectional observational study. Participants Both eyes of 116 subjects, including 66 patients with glaucoma in at least 1 eye and 50 healthy subjects from the Diagnostic Innovations in Glaucoma Study. Eyes were classified as glaucomatous by repeatable abnormal standard automated perimetry (SAP) or progressive glaucomatous changes on stereophotographs. Methods All subjects underwent automated pupillography using the RAPDx pupillograph (Konan Medical USA, Inc., Irvine, CA). Main Outcome Measures Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic ability of pupil response parameters to white, red, green, yellow, and blue full-field and regional stimuli. A ROC regression model was used to investigate the influence of disease severity and asymmetry on diagnostic ability. Results The largest area under the ROC curve (AUC) for any single parameter was 0.75. Disease asymmetry (P < 0.001), but not disease severity (P = 0.058), had a significant effect on diagnostic ability. At the sample mean age (60.9 years), AUCs for arbitrary values of intereye difference in SAP mean deviation (MD) of 0, 5, 10, and 15 dB were 0.58, 0.71, 0.82, and 0.90, respectively. The mean intereye difference in MD was 2.2±3.1 dB. The best combination of parameters had an AUC of 0.85; however, the cross-validated bias-corrected AUC for these parameters was only 0.74. Conclusions Although the pupillograph had a good ability to detect glaucoma in the presence of asymmetric disease, it performed poorly in those with symmetric disease. PMID:24485921

  2. Modus of filtration.

    PubMed

    Meltzer, Theodore H

    2006-01-01

    Experience teaches that particles larger than the pores of a filter cannot negotiate its passage. Other retention mechanisms are less obvious than sieve retention or size exclusion. They are electrical in nature, and find expression in the bonding alliances that mutually attract (or repel) filters and particles. The influence of hydrogen bonds, of van der Waals forces, of hydrophobic adsorptions, and of transient polarities on particle retentions are set forth in terms of the double electrical layer concept that also governs colloidal destabilizations. The origins of differences in membrane porosities is explained, as also the importance of the filtration conditions. The singularity of the particle-fluid-filter relationship on organism and/or pore size alteration is stressed.

  3. Post-penetrating keratoplasty glaucoma

    PubMed Central

    Aggarwal, Anand; Minudath, KB; Vanathi, M; Choudhary, Sunil; Gupta, Viney; Sihota, Ramanjit; Panda, Anita

    2008-01-01

    Post-penetrating keratoplasty (post-PK) glaucoma is an important cause of irreversible visual loss and graft failure. The etiology for this disorder is multifactorial, and with the use of new diagnostic equipment, it is now possible to elucidate the exact pathophysiology of this condition. A clear understanding of the various mechanisms that operate during different time frames following PK is essential to chalk out the appropriate management algorithms. The various issues with regard to its management, including the putative risk factors, intraocular pressure (IOP) assessment post-PK, difficulties in monitoring with regard to the visual fields and optic nerve evaluation, are discussed. A step-wise approach to management starting from the medical management to surgery with and without metabolites and the various cycloablative procedures in cases of failed filtering procedures and excessive perilimbal scarring is presented. Finally, the important issue of minimizing the incidence of glaucoma following PK, especially through the use of oversized grafts and iris tightening procedures in the form of concomitant iridoplasty are emphasized. It is important to weigh the risk-benefit ratio of any modality used in the treatment of this condition as procedures aimed at IOP reduction, namely trabeculectomy with antimetabolites, and glaucoma drainage devices can trigger graft rejection, whereas cyclodestructive procedures can not only cause graft failure but also precipitate phthisis bulbi. Watchful expectancy and optimal time of intervention can salvage both graft and vision in this challenging condition. PMID:18579984

  4. Update on Normal Tension Glaucoma

    PubMed Central

    Mallick, Jyotiranjan; Devi, Lily; Malik, Pradeep K.; Mallick, Jogamaya

    2016-01-01

    Normal tension glaucoma (NTG) is labelled when typical glaucomatous disc changes, visual field defects and open anterior chamber angles are associated with intraocular pressure (IOP) constantly below 21 mmHg. Chronic low vascular perfusion, Raynaud's phenomenon, migraine, nocturnal systemic hypotension and over-treated systemic hypertension are the main causes of normal tension glaucoma. Goldmann applanation tonometry, gonioscopy, slit lamp biomicroscopy, optical coherence tomography and visual field analysis are the main tools of investigation for the diagnosis of NTG. Management follows the same principles of treatment for other chronic glaucomas: To reduce IOP by a substantial amount, sufficient to prevent disabling visual loss. Treatment is generally aimed to lower IOP by 30% from pre-existing levels to 12-14 mmHg. Betaxolol, brimonidine, prostaglandin analogues, trabeculectomy (in refractory cases), systemic calcium channel blockers (such as nifedipine) and 24-hour monitoring of blood pressure are considered in the management of NTG. The present review summarises risk factors, causes, pathogenesis, diagnosis and management of NTG. PMID:27413503

  5. Cost analysis of glaucoma medications.

    PubMed

    Vold, S D; Wiggins, D A; Jackimiec, J

    2000-04-01

    To evaluate the yearly cost in 1998 of glaucoma medications to patients and to the Health Plan at a university-affiliated teaching hospital with its own health maintenance organization. Data concerning Health Plan glaucoma-medication prescriptions for 1998 were retrieved from the hospital pharmacy database. The most costly medication per patient per year was latanoprost (Xalatan; Pharmacia & Upjohn, Kalamazoo, MI [$337]), followed by betaxolol hydrochloride (Betoptic-S; Alcon, Fort Worth, TX [$336]), dorzolamide (Trusopt; Merck & Co., West Point, PA [$288]), brimonidine tartrate (Alphagan; Allergan Pharmaceuticals, Irvine, CA [$260]), timolol maleate 0.5% in a gel-forming solution (Timoptic-XE 0.5%; Merck & Co., West Point, PA [$199]), levobunolol hydrochloride (Betagan; Allergan Pharmaceuticals, Irvine, CA [$195]), and generic timolol maleate 0.5% ($132). Cost per unit was greatest for Betoptic-S ($51), exceeding that of Trusopt ($43) and Xalatan ($43), Alphagan ($42), Betagan ($38), Timoptic-XE 0.5% ($32), and timolol maleate 0.5% ($27). Variability in the cost of medications may influence the long-term medical management of glaucoma patients.

  6. Filtration: Principles and practices. 2. edition

    SciTech Connect

    Matteson, M.J.; Orr, C.

    1998-12-31

    This new book is the most authoritative and comprehensive guide to essential, state-of-the-art data. It provides the very latest theoretical and practical data on filtration for gas and liquids. The 2nd edition has been revised and updated to include several new chapters which detail filtration in the mineral industry, high-efficiency air filtration, cartridge filters, and ultrafiltration. The contents include: Gas filtration theory; Liquid-filtration theory; Filter media; Industrial gas filtration; Filtration pretreatment; Filtration in the chemical process industry; Ultrafiltration; Filtration in the mineral industry; Filtration in heating, ventilating, and air conditioning; Cartridge filtration; High-efficiency air filtration; Analytical applications of filtration; and Filter evaluation and testing.

  7. A PERSPECTIVE OF RIVERBANK FILTRATION

    EPA Science Inventory

    Riverbank filtration is a process in which pumping of wells located along riverbanks induce a portion of the river water to flow toward the pumping wells. The process has many similarities to the slow sand filtration process. River water contaminants are attenuated due to a combi...

  8. A PERSPECTIVE OF RIVERBANK FILTRATION

    EPA Science Inventory

    Riverbank filtration is a process in which pumping of wells located along riverbanks induce a portion of the river water to flow toward the pumping wells. The process has many similarities to the slow sand filtration process. River water contaminants are attenuated due to a combi...

  9. 40 CFR 141.173 - Filtration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving 10,000 or More People § 141.173 Filtration. A public water system subject to the requirements of this subpart that does... treatment, direct filtration, slow sand filtration, or diatomaceous earth filtration. A public water...

  10. 40 CFR 141.173 - Filtration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving 10,000 or More People § 141.173 Filtration. A public water system subject to the requirements of this subpart that does... treatment, direct filtration, slow sand filtration, or diatomaceous earth filtration. A public water...

  11. 40 CFR 141.173 - Filtration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving 10,000 or More People § 141.173 Filtration. A public water system subject to the requirements of this subpart that does... treatment, direct filtration, slow sand filtration, or diatomaceous earth filtration. A public water...

  12. 40 CFR 141.173 - Filtration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving 10,000 or More People § 141.173 Filtration. A public water system subject to the requirements of this subpart that does... treatment, direct filtration, slow sand filtration, or diatomaceous earth filtration. A public water...

  13. 40 CFR 141.173 - Filtration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving 10,000 or More People § 141.173 Filtration. A public water system subject to the requirements of this subpart that does... treatment, direct filtration, slow sand filtration, or diatomaceous earth filtration. A public water...

  14. Glaucoma Genetics: Recent Advances and Future Directions.

    PubMed

    Aung, Tin; Khor, Chiea Chuen

    2016-01-01

    Once considered primarily a disease of aging caused by unknown environmental influences, the notion that heritable factors could significantly contribute to the pathogenesis of sporadic glaucoma has rapidly gained traction. In part, this is due to the rapid and definitive identification of genes with strong effects on familial, earlier onset forms of glaucoma. Although the endpoint of glaucoma is irreversible optic nerve damage accompanied by blindness, the initial inciting trigger could differ. To this end, well-powered genome-wide association studies have each been conducted for primary open-angle glaucoma, primary angle-closure glaucoma, along with exfoliation syndrome and glaucoma. Each of these studies has revealed sets of significantly associated genetic loci implicating biological pathways that do not overlap between the forms of glaucoma. Although substantial biological insight has been gained from their identification, much further work remains to definitively link the implicated genetic variants with glaucoma causation. It is also hoped that the genetic findings could point us to potential routes of therapy beyond that of intraocular pressure-lowering medications or surgery.

  15. Bilateral angle closure glaucoma following general anaesthesia.

    PubMed

    Raj, K Mohan; Reddy, P Arun Subhash; Kumar, Vikram Chella

    2015-04-01

    Angle closure glaucoma is one of the ophthalmic emergencies and treatment has to be given at the earliest. It is a rare complication of general anesthesia. A female patient underwent Hysterectomy under general anesthesia. Following this, patient developed bilateral angle closure glaucoma. This patient was treated with antiglaucoma medications followed by YAG laser iridotomy and patient regained vision.

  16. [Treatment of glaucoma with beta receptor blockers].

    PubMed

    Demmler, N

    1980-06-19

    We report the possibility of treatment with beta-adrenergic blocking agents in glaucoma-therapy. In open-angle glaucoma the therapy with beta-adrenergic blocking agents is often the best one. The combination of beta-adrenergic blocking agents with miotics is the therapy of choice in the treatment of closure-angle glaucoma. In special forms of glaucoma it is necessary to decide if the best therapy is the treatment with beta-adrenergaic blocking agents alone or a combined treatment of beta-adrenergic blocking agents with miotics. The beta-adrenergic blocking agent timolol (Chibro-Timoptol) and bupranolol (Ophtorenin) lower in the intraocular pressure to a greater extent than other beta-adrenergic blocking agents. Timolol eye drops and bupranolol eye drops are therefore the best beta-adrenergic blocking agents in therpay of glaucoma.

  17. Animal models of glucocorticoid-induced glaucoma.

    PubMed

    Overby, Darryl R; Clark, Abbot F

    2015-12-01

    Glucocorticoid (GC) therapy is widely used to treat a variety of inflammatory diseases and conditions. While unmatched in their anti-inflammatory and immunosuppressive activities, GC therapy is often associated with the significant ocular side effect of GC-induced ocular hypertension (OHT) and iatrogenic open-angle glaucoma. Investigators have generated GC-induced OHT and glaucoma in at least 8 different species besides man. These models mimic many features of this condition in man and provide morphologic and molecular insights into the pathogenesis of GC-OHT. In addition, there are many clinical, morphological, and molecular similarities between GC-induced glaucoma and primary open-angle glaucoma (POAG), making animals models of GC-induced OHT and glaucoma attractive models in which to study specific aspects of POAG.

  18. Animal Models of Glucocorticoid-Induced Glaucoma

    PubMed Central

    Overby, Darryl R.; Clark, Abbot F.

    2015-01-01

    Glucocorticoid (GC) therapy is widely used to treat a variety of inflammatory diseases and conditions. While unmatched in their anti-inflammatory and immunosuppressive activities, GC therapy is often associated with the significant ocular side effect of GC-induced ocular hypertension (OHT) and iatrogenic open-angle glaucoma. Investigators have generated GC-induced OHT and glaucoma in at least 8 different species besides man. These models mimic many features of this condition in man and provide morphologic and molecular insights into the pathogenesis of GC-OHT. In addition, there are many clinical, morphological, and molecular similarities between GC-induced glaucoma and primary open-angle glaucoma (POAG), making animals models of GC-induced OHT and glaucoma attractive models in which to study specific aspects of POAG. PMID:26051991

  19. The contribution of the sclera and lamina cribrosa to the pathogenesis of glaucoma: Diagnostic and treatment implications.

    PubMed

    Quigley, Harry A

    2015-01-01

    Glaucoma, the second most common cause of world blindness, results from loss of retinal ganglion cells (RGC). RGC die as a consequence of injury to their axons, as they pass through the transition between the environment within the eye and that of the retrobulbar optic nerve, as they course to central visual centers. At the optic nerve head (ONH), axonal transport becomes abnormal, at least in part due to the effect of strain induced by intraocular pressure (IOP) on the sclera and ONH. Animal glaucoma models provide the ability to study how alterations in ocular connective tissues affect this pathological process. New therapeutic interventions are being investigated to mitigate glaucoma blindness by modifying the remodeling of ocular tissues in glaucoma. Some genetically altered mice are resistant to glaucoma damage, while treatment of the sclera with cross-linking agents makes experimental mouse glaucoma damage worse. Inhibition of transforming growth factor β activity is strikingly protective. Treatments that alter the response of ocular connective tissues to IOP may be effective in protecting those with glaucoma from vision loss.

  20. Medical therapy cost considerations for glaucoma.

    PubMed

    Fiscella, Richard G; Green, Amy; Patuszynski, Daniel H; Wilensky, Jacob

    2003-07-01

    To determine the calculated daily patient cost (cost minimization) of medical glaucoma therapy and review cost trends. Experimental, controlled, prospective study. The actual volume of various glaucoma medications or glaucoma medications with redesigned bottles was determined for most commercially available sizes of the tested products. The drops per milliliter based on the actual volume and the daily costs of the dosage schedules recommended by the manufacturers were compared. The cost of each bottle of medication was determined from the average wholesale price (AWP) in the United States. A comparison to 1999 prices where applicable will be analyzed to review costing trends. The generic timolol products (range, US dollars 0.38-US dollars 0.46 per day) were similar on a cost per day basis vs Betimol (Santen, Napa Valley, California, USA), Optipranolol (Bausch and Lomb Pharmaceuticals, Tampa, Florida, USA) and Timoptic (Merck, West Point, Pennsylvania, USA). Their percentage cost increase ranged from 5% to 22% since 1999, except for generic timolol XE gel-forming solution (48%). Betagan (Allergan, Irvine, California, USA), Betoptic S (Alcon Laboratories, Fort Worth, Texas, USA), and Ocupress (Novartis, Duluth, Georgia, USA) ranged from US dollars 0.88 to US dollars 1.11 per day, and their percentage cost increase ranged from 33% to 53%. Some brand-only products have raised their AWPs a greater percentage, including Betoptic S (37%), Iopidine (Alcon, Fort Worth, Texas, USA) (50%), Ocupress (Novartis Ophthalmics, Duluth, Georgia, USA) (53%), and Pilopine gel (Alcon, Fort Worth, Texas, USA) (32%). The mean cost per day for the topical carbonic anhydrase inhibitors Azopt (Alcon Laboratories; US dollars 1.33 per day) and Trusopt (Merck; US dollars 1.05 per day) differed from 1999 when prices were almost identical. Cosopt (Merck; timolol 0.5% plus dorzolamide 2%, US dollars 1.04 per day) was less than the cost of separate bottles of a topical carbonic anhydrase inhibitor

  1. Nonlinear filtration of the spoken language signals

    NASA Astrophysics Data System (ADS)

    Kolchenko, Lilia V.; Sinitsyn, Rustem B.

    2009-06-01

    Work is devoted to important topic of acoustic signals processing in a pilot's cabin of aircraft in which the high noise level is observed. We have investigated heuristic approach of acoustic signal nonlinear filtration. First of all the kernel estimate of the cumulative distribution function was done. The signal was transformed using the estimate of the cumulative distribution function as a functional transform. Then measurements of acoustic signals' parameters and an estimation of their spectral density were done. The estimation was measured by means of fast Fourier transform procedure with use of window functions. At the second stage the new procedure of the adaptive filtration based on the Wiener frequency approach has been offered. The estimations of spectra received at the first stage have been thus used. Results are confirmed by experimental processing of spoken language signals.

  2. Recent advances in pharmacotherapy of glaucoma

    PubMed Central

    Gupta, S. K.; Niranjan D., Galpalli; Agrawal, S. S.; Srivastava, Sushma; Saxena, Rohit

    2008-01-01

    Glaucoma is a slow progressive degeneration of the retinal ganglion cells (RGCs) and the optic nerve axons, leading to irreversible blindness if left undiagnosed and untreated. Although increased intraocular pressure is a major risk factor of glaucoma, other factors include increased glutamate levels, alterations in nitric oxide (NO) metabolism, vascular alterations and oxidative damage caused by reactive oxygen species. Glaucoma is the second leading cause of blindness globally, accounting for 12.3% of the total blindness. Glaucoma has been broadly classified as primary or secondary open-angle or angle-closure glaucoma. The primary goal in management of glaucoma is to prevent the risk factor, especially elevated intraocular pressure (IOP), using medications, laser therapy or conventional surgery. The first-line treatment of glaucoma usually begins with the use of a topical selective or nonselective blocker or a prostaglandin analog. Second-line drugs of choice include alpha-agonists and topical carbonic anhydrase inhibitors. Cholinergic agonists are considered third-line treatment options. When a single therapy is not sufficient to lower the IOP, a combination therapy is indicated. To enhance the patient compliance, drug delivery systems like electronic devices, ocular inserts, tansdermal and mechanical drug delivery systems have been developed. Use of viscoelastic agents in ophthalmic formulations, emulsions and soluble ophthalmic drug inserts (SODI) enhance patience compliance and ocular drug delivery in patients in long-term glaucoma therapy. For patients who do not respond to antiglaucoma medications, laser trabeculoplasty and incisional surgery are recommended. Several nutrients and botanicals hold promise for the treatment of glaucoma, but most studies are preliminary, and larger, controlled studies are required. Future directions for the development of a novel therapy glaucoma may target glutamate inhibition, NMDA receptor blockade, exogenously applied

  3. [Protein glaucoma, a formerly unknown form of glaucoma].

    PubMed

    Zirm, M; Egger-Büssing, C

    1981-06-11

    As a possible reason for a secondary glaucoma generally an unphysiological aggregation of proteins or blood in the aqueous humor is discussed. A positive Tyndall-phenomenon shows an increase of proteins in aqueous humor. We were able to demonstrate earlier that a negative Tyndall-phenomenon does not exclude this as well. In this contribution examples are given that disruption of vessel-membranes in retina and uvea lead to an increase of low molecular proteins in aqueous humor. Contrary to current knowledge we found that an overtaxing of active flow mechanisms by these additional proteins can cause a so-called protein-glucoma.

  4. Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients.

    PubMed

    Waldock, A; Snape, J; Graham, C M

    2000-07-01

    To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients. 141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the chi(2) test. Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 mm Hg and 4.1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management. Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical beta blocker therapy to control their glaucoma.

  5. Quadrant Field Pupillometry Detects Melanopsin Dysfunction in Glaucoma Suspects and Early Glaucoma

    PubMed Central

    Adhikari, Prakash; Zele, Andrew J.; Thomas, Ravi; Feigl, Beatrix

    2016-01-01

    It is difficult to detect visual function deficits in patients at risk for glaucoma (glaucoma suspects) and at early disease stages with conventional ophthalmic tests such as perimetry. To this end, we introduce a novel quadrant field measure of the melanopsin retinal ganglion cell mediated pupil light response corresponding with typical glaucomatous arcuate visual field defects. The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 46 patients with different stages of glaucoma including glaucoma suspects and compared to a healthy group of 21 participants with no disease. We demonstrate that the superonasal quadrant PIPR differentiated glaucoma suspects and early glaucoma patients from controls with fair (AUC = 0.74) and excellent (AUC = 0.94) diagnostic accuracy, respectively. The superonasal PIPR provides a linear functional correlate of structural retinal nerve fibre thinning in glaucoma suspects and early glaucoma patients. This first report that quadrant PIPR stimulation detects melanopsin dysfunction in patients with early glaucoma and at pre-perimetric stages may have future implications in treatment decisions of glaucoma suspects. PMID:27622679

  6. Prevalence of glaucoma in Eastern India: The Hooghly River Glaucoma Study

    PubMed Central

    Paul, Chandrima; Sengupta, Subhrangshu; Choudhury, Sumit; Banerjee, Souvik; Sleath, Betsy L

    2016-01-01

    Context: Glaucoma is the leading cause of global irreversible blindness. No recent study with adequate sample size has been carried out to estimate glaucoma prevalence in Eastern India. Aims: The aim of this study was to assess and compare the prevalence and types of glaucoma in a rural and urban East Indian population. Settings and Design: The Hooghly River Glaucoma Study (HRGS) is a population-based cross-sectional study from West Bengal. A tertiary hospital in Kolkata was our urban study center. Our rural study area included 28 contiguous villages from the district of Hooghly surrounding the rural base hospital located at Dhobapara in village Bakulia. Individuals aged 40 years and above were included in this study. Subjects and Methods: All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. Glaucoma was defined using modified International Society of Geographical and Epidemiological Ophthalmology criteria. Statistical Analysis Used: Analysis was performed using Chi-square test and multiple logistic regression using SPSS. Results: Totally, 14,092 individuals participated; 2.7% were detected to have glaucoma in rural arm and 3.23% in urban arm (P < 0.001). In urban population, 2.10% had primary open angle glaucoma (POAG), 0.97% had primary angle closure glaucoma (PACG), and 0.15% had secondary glaucoma. In rural population, 1.45% had POAG, 1.15% had ACG, and 0.10% had secondary glaucoma. Conclusions: HRGS is the largest population-based glaucoma study in India to date with glaucoma prevalence comparable to other landmark Indian studies. POAG was the most common form of glaucoma in our study population as well. PACG was more common in this region than previously thought. PMID:27688279

  7. Sympathectomy for glaucoma: Its rise and fall (1898-1910).

    PubMed

    Feibel, Robert M

    2015-01-01

    The influence of the sympathetic nervous system upon intraocular pressure (IOP) has been a subject of great interest since 1727, when the first experimental ocular sympathetic paralysis was produced in dogs. By the middle of the 19th century, it was known that excision of the superior cervical sympathetic ganglion lowered, and that electrical stimulation of the sympathetic nerve trunk raised IOP in various animals. From these observations, it was thought that excision of this ganglion could replace or supplement the available operations for glaucoma of which iridectomy was the most popular. Iridectomy was acknowledged to be of great value in acute and subacute glaucoma, but less useful in chronic glaucoma. Iridectomy, however, was associated with major surgical complications and long-term failure, so that there was considerable appeal of an extraocular operation that avoided the risks of intraocular surgery. Beginning in 1898, cervical sympathectomy became a widely performed operation around the world, with most surgeons enthusiastic about its results, at least initially, and many publications from 1898 to 1905 claimed excellent results for various types of glaucoma. Opponents of the procedure emphasized that the effect on IOP was transient, and that the published reports of successful results were poorly documented. The popularity of sympathectomy gradually diminished and by 1910 it was abandoned. I discuss the reasons why cervical sympathectomy received such initial enthusiasm but was then questioned and discarded. These included bias from the surgeons promoting this surgery; the placebo effect; short follow-up; inaccurate, subjective, and variable measures of the surgical results; and the development of more effective procedures such as filtering surgery and cyclodialysis.

  8. Structural basis for misfolding in myocilin-associated glaucoma

    PubMed Central

    Donegan, Rebecca K.; Hill, Shannon E.; Freeman, Dana M.; Nguyen, Elaine; Orwig, Susan D.; Turnage, Katherine C.; Lieberman, Raquel L.

    2015-01-01

    Olfactomedin (OLF) domain-containing proteins play roles in fundamental cellular processes and have been implicated in disorders ranging from glaucoma, cancers and inflammatory bowel disorder, to attention deficit disorder and childhood obesity. We solved crystal structures of the OLF domain of myocilin (myoc-OLF), the best studied such domain to date. Mutations in myoc-OLF are causative in the autosomal dominant inherited form of the prevalent ocular disorder glaucoma. The structures reveal a new addition to the small family of five-bladed β-propellers. Propellers are most well known for their ability to act as hubs for protein–protein interactions, a function that seems most likely for myoc-OLF, but they can also act as enzymes. A calcium ion, sodium ion and glycerol molecule were identified within a central hydrophilic cavity that is accessible via movements of surface loop residues. By mapping familial glaucoma-associated lesions onto the myoc-OLF structure, three regions sensitive to aggregation have been identified, with direct applicability to differentiating between neutral and disease-causing non-synonymous mutations documented in the human population worldwide. Evolutionary analysis mapped onto the myoc-OLF structure reveals conserved and divergent regions for possible overlapping and distinctive functional protein–protein or protein–ligand interactions across the broader OLF domain family. While deciphering the specific normal biological functions, ligands and binding partners for OLF domains will likely continue to be a challenging long-term experimental pursuit, atomic detail structural knowledge of myoc-OLF is a valuable guide for understanding the implications of glaucoma-associated mutations and will help focus future studies of this biomedically important domain family. PMID:25524706

  9. [The denominations cataract and glaucoma].

    PubMed

    Tornquist, R

    1997-01-01

    Since ancient times a grey or white pupil in an nearly blind eye was thought to be caused by a mucous substance in front of the lens. It was called "hypochysis" or "hypochyma" in Greece and "suffusio" in Rome. Later the term "cataract" (=waterfall) was the most popular denomination. A surgical method was tried very early with usually good effect, when with a thin needle, introduced into the eye, the opaque material was removed from the pupillary area. In the middle of the 17th century more careful investigations showed that there was no membrane in front of the lens, but the lens itself was opaque. The final proof was delivered when an extraction of the lens was performed with good effect. In ancient times incurable blindness, which was called glaucoma, was thought to be located to the lens, which probably had a very important role in the seeing process. The name (of Greek orgin) is translated "green" or "blue-green", which was sometimes notified to be the color of the lens, seen through the pupil, in these cases. A period of great confusion followed when the removal of this very important part of the eye did not lead to blindness but rather an improved vision. As there were significant difficulties in identifying the specific color of the pupil the name glaucoma seemed to be very inadequate. In the beginning of the 19th century a disease entity (which is to-day called acute closed-angle glaucoma) seemed to eventually fullfill the demand of a greenlooking pupil. The most characteristic symptoms are pain and a high intraocular pressure causing a corneal edema and a change of the blackness of the pupil to hazy grey (and maybe a little green?).

  10. Diffusion tensor magnetic resonance imaging reveals visual pathway damage that correlates with clinical severity in glaucoma.

    PubMed

    Chen, Zhiqi; Lin, Fuchun; Wang, Junming; Li, Zheng; Dai, Hui; Mu, Ketao; Ge, Jian; Zhang, Hong

    2013-01-01

    To investigate nerve fibre damage of the visual pathway in patients with primary open-angle glaucoma using tract-based spatial statistical analysis of diffusion tensor imaging and correlate these measures with the clinical severity of glaucoma. Cross-sectional study. Twenty-five individuals with primary open-angle glaucoma and 24 healthy controls were recruited. All subjects underwent detailed ophthalmological examinations, including the cup-to-disc ratio, retinal nerve fibre layer thickness and visual fields test. Diffusion tensor imaging of the visual pathway was performed using a 3.0-T magnetic resonance scanner. Diffusivity changes of the nerve fibres in the visual pathway were calculated through tract-based spatial statistical analysis. The mean diffusivity and fractional anisotropy were assessed and compared with ophthalmological measurements. Compared with controls, bilateral optic tracts and optic radiations in primary open-angle glaucoma patients showed significantly decreased fractional anisotropy and increased mean diffusivity (P < 0.05). In the glaucoma group, the fractional anisotropy of the optic tracts and optic radiations varied consistently with the cup-to-disc ratio, retinal nerve fibre layer thickness and visual function analysis, respectively (P < 0.05). The mean diffusivity of the optic tracts correlated with these ophthalmological measurements (P < 0.05). However, no significant correlation was observed between the mean diffusivity of the optic radiations and the ophthalmological measurements (P > 0.05). The optic tracts and optic radiations of primary open-angle glaucoma patients demonstrated radiological evidence of neurodegeneration. This varied with damage to the optic disc and with the loss of visual function. Tract-based spatial statistical analysis of diffusion tensor imaging is an objective and effective tool for detecting the loss of cortical nerve fibres in primary open-angle glaucoma. © 2012 The Authors. Clinical and Experimental

  11. Neuroinflammation in glaucoma: A new opportunity.

    PubMed

    Williams, Pete A; Marsh-Armstrong, Nick; Howell, Gareth R

    2017-02-24

    Mounting evidence suggests neuroinflammation is a key process in glaucoma, yet the precise roles are not known. Understanding these complex processes, which may also be a key in other common neurodegenerations such as Alzheimer's disease, will lead to targeted therapeutics for a disease that affects as many as 80 million people worldwide. Here, we define neuroinflammation as any immune-relevant response by a variety of cell types including astrocytes, microglia, and peripherally derived cells occurring in the optic nerve head and/or retina. In this review article, we first discuss clinical evidence for neuroinflammation in glaucoma and define neuroinflammation in glaucoma. We then review the inflammatory pathways that have been associated with glaucoma. Finally, we set out key research directions that we believe will greatly advance our understanding of the role of neuroinflammation in glaucoma. This review arose from a discussion of neuroinflammation in glaucoma at the 2015 meeting of the The Lasker/IRRF Initiative for Innovation in Vision Science. This manuscript sets out to summarize one of these sessions; "Inflammation and Glaucomatous Neurodegeneration", as well as to review the current state of the literature surrounding neuroinflammation in glaucoma.

  12. Glaucoma as a Metabolic Optic Neuropathy: Making the Case for Nicotinamide Treatment in Glaucoma.

    PubMed

    Williams, Pete A; Harder, Jeffrey M; John, Simon W M

    2017-08-28

    Mitochondrial dysfunction may be an important, if not essential, component of human glaucoma. Using transcriptomics followed by molecular and neurobiological techniques, we have recently demonstrated that mitochondrial dysfunction within retinal ganglion cells is an early feature in the DBA/2J mouse model of inherited glaucoma. Guided by these findings, we discovered that the retinal level of nicotinamide adenine dinucleotide (NAD, a key molecule for mitochondrial health) declines in an age-dependent manner. We hypothesized that this decline in NAD renders retinal ganglion cells susceptible to damage during periods of elevated intraocular pressure. To replete NAD levels in this glaucoma, we administered nicotinamide (the amide of vitamin B3). At the lowest dose tested, nicotinamide robustly protected from glaucoma (~70% of eyes had no detectable glaucomatous neurodegeneration). At this dose, nicotinamide had no influence on intraocular pressure and so its affect was neuroprotective. At the highest dose tested, 93% of eyes had no detectable glaucoma. This represents a ~10-fold decrease in the risk of developing glaucoma. At this dose, intraocular pressure still became elevated but there was a reduction in the degree of elevation showing an additional benefit. Thus, nicotinamide is unexpectedly potent at preventing this glaucoma and is an attractive option for glaucoma therapeutics. Our findings demonstrate the promise for both preventing and treating glaucoma via interventions that bolster metabolism during increasing age and during periods of elevated intraocular pressure. Nicotinamide prevents age-related declines in NAD (a decline that occurs in different genetic contexts and species). NAD precursors are reported to protect from a variety of neurodegenerative conditions. Thus, nicotinamide may provide a much needed neuroprotective treatment against human glaucoma. This manuscript summarizes human data implicating mitochondria in glaucoma, and argues for studies

  13. Oral Microbiome Link to Neurodegeneration in Glaucoma

    PubMed Central

    Astafurov, Konstantin; Elhawy, Eman; Ren, Lizhen; Dong, Cecilia Q.; Igboin, Christina; Hyman, Leslie; Griffen, Ann; Mittag, Thomas; Danias, John

    2014-01-01

    Background Glaucoma is a progressive optic nerve degenerative disease that often leads to blindness. Local inflammatory responses are implicated in the pathology of glaucoma. Although inflammatory episodes outside the CNS, such as those due to acute systemic infections, have been linked to central neurodegeneration, they do not appear to be relevant to glaucoma. Based on clinical observations, we hypothesized that chronic subclinical peripheral inflammation contributes to neurodegeneration in glaucoma. Methods Mouthwash specimens from patients with glaucoma and control subjects were analyzed for the amount of bacteria. To determine a possible pathogenic mechanism, low-dose subcutaneous lipopolysaccharide (LPS) was administered in two separate animal models of glaucoma. Glaucomatous neurodegeneration was assessed in the retina and optic nerve two months later. Changes in gene expression of toll-like receptor 4 (TLR4) signaling pathway and complement as well as changes in microglial numbers and morphology were analyzed in the retina and optic nerve. The effect of pharmacologic blockade of TLR4 with naloxone was determined. Findings Patients with glaucoma had higher bacterial oral counts compared to control subjects (p<0.017). Low-dose LPS administration in glaucoma animal models resulted in enhancement of axonal degeneration and neuronal loss. Microglial activation in the optic nerve and retina as well as upregulation of TLR4 signaling and complement system were observed. Pharmacologic blockade of TLR4 partially ameliorated the enhanced damage. Conclusions The above findings suggest that the oral microbiome contributes to glaucoma pathophysiology. A plausible mechanism by which increased bacterial loads can lead to neurodegeneration is provided by experiments in animal models of the disease and involves activation of microglia in the retina and optic nerve, mediated through TLR4 signaling and complement upregulation. The finding that commensal bacteria may play a

  14. Health Benefits of Particle Filtration

    SciTech Connect

    Fisk, William J.

    2013-10-01

    The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also, reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percent age improvement in health outcomes is typically modest, for example, 7percent to 25percent. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.

  15. Health benefits of particle filtration.

    PubMed

    Fisk, W J

    2013-10-01

    The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also, reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percentage improvement in health outcomes is typically modest, for example, 7% to 25%. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.

  16. Health Benefits of Particle Filtration

    SciTech Connect

    Fisk, William J.

    2013-10-01

    The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percentage improvement in health outcomes is typically modest, e.g., 7percent to 25percent. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.

  17. [Steroid induced ocular hypertension and glaucoma].

    PubMed

    Călugăru, D; Călugăru, M

    2009-01-01

    Steroid induced ocular hypertension and glaucoma represent iatrogenic changes of pharmacogenic nature. They are mainly due to exogenous steroids following ocular periocular, intravitreal and systemic administration. Elevated ocular pressure is brought about by structural trabecular changes as well as obstruction of the outflow ways of the aqueous humor localized within the trabecular juxtacanalicular area. Although mostly raised ocular pressure spontaneously descends to basal values after ceasing the steroid therapy, progressive optic nerve damages and glaucomatous visual field defects may occur. Therapy of steroid induced ocular hypertension and glaucoma is similar to that of ocular hypertension and primary open-angle glaucoma.

  18. Normotensive pseudoexfoliation glaucoma: a new phenotype?

    PubMed

    Rao, Aparna

    2012-01-01

    We herein report the clinical profile of five eyes of three patients with normotensive pseudoexfoliation glaucoma. Three patients who presented with clinical evidence of pseudoexfoliation with evident glaucomatous damage and normal intraocular pressure underwent comprehensive ophthalmic evaluation, central corneal thickness, diurnal IOP recording (in two patients), and visual field examination. Five eyes of the three patients were found to have advanced glaucomatous damage, thin cornea, and an IOP recording of <23 mm Hg at all occasions. Case 1 had macular branch retinal vein occlusion while case 3 had disc collaterals. Normotensive pseudoexfoliation glaucoma may represent a new phenotype highlighting the possible role of pressure-independent mechanisms of glaucoma in pseudoexfoliation.

  19. Management of complications in glaucoma surgery

    PubMed Central

    Vijaya, Lingam; Manish, Panday; Ronnie, George; Shantha, B

    2011-01-01

    Surgical option for glaucoma is considered when other modalities are not working out to keep the intraocular pressure under control. Since the surgical procedures for glaucoma disrupt the integrity of the globe, they are known to produce various complications. Some of those complications can be vision-threatening. To minimize the morbidity, it is very important that one should know how to prevent them, recognize them and treat them. The objective of this article is to provide insight into some of those complications that will help the ophthalmologists in treating glaucoma patients in their clinical practice. PMID:21150025

  20. Management of advanced glaucoma: Characterization and monitoring.

    PubMed

    de Moraes, C Gustavo; Liebmann, Jeffrey M; Medeiros, Felipe A; Weinreb, Robert N

    2016-01-01

    Recent advances in glaucoma diagnosis focus on diagnosing the disease in early stages. Despite the importance of such efforts, a meaningful proportion of patients present in advanced stages. The cost for treatment and monitoring of advanced glaucoma often exceeds that with earlier disease, not to mention the significant effect of visual impairment on quality of life. Moreover, structural and functional tests used to monitor changes encounter technical limitations in advanced cases that can delay detection of true progression. New technologies and methods to analyze longitudinal data may prove helpful for monitoring patients with advanced glaucoma and reduce the burdens of the disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Myocilin and glaucoma: facts and ideas.

    PubMed

    Tamm, Ernst R

    2002-07-01

    Mutations in the MYOC gene that encodes for myocilin are causative for some forms of juvenile and adult-onset primary open-angle glaucoma (POAG). Myocilin is a secreted 55-57kDa glycoprotein that forms dimers and multimers. Characteristic structural motifs include a myosin-like domain, a leucine zipper region and an olfactomedin domain. Most of the mutations that have been identified in patients with POAG are localized in the olfactomedin domain, which is highly conserved among species. In the eye, myocilin is expressed in high amounts in the trabecular meshwork (TM), sclera, ciliary body and iris, and at considerable lower amounts in retina and optic nerve head. Secreted myocilin is present in the aqueous humor. In the TM, myocilin is found within the cytoplasm of TM cells and in the juxtacanalicular region in association with fibrillar extracellular matrix components. Since patients with mutations in myocilin may have high intraocular pressures, the role of myocilin for aqueous humor outflow has been investigated and conflicting results have been obtained. Recombinant myocilin increases outflow resistance in perfused anterior segment organ cultures, while overexpression of myocilin after viral gene transfer appears to reduce outflow resistance. In TM cells, the expression of myocilin is induced upon treatment with dexamethasone at a time course similar to that observed in steroid-induced glaucoma. Other factors that induce myocilin expression are transforming growth factor-beta and mechanical stretch. Promoter elements that are important for the glucocorticoid induction have not been identified, but it has been shown that upstream stimulatory factor is critical for the basal promoter activity of MYOC. Mice with a targeted disruption of the myocilin gene do not express a phenotype, indicating that the glaucomatous phenotype in humans is not because of a loss-of-function effect. Experimental studies show that mutated myocilin is not secreted, but appears to

  2. Autophagy in glaucoma: Crosstalk with apoptosis and its implications.

    PubMed

    Wang, Yao; Huang, Changquan; Zhang, Hongbing; Wu, Renyi

    2015-08-01

    Glaucoma is characterized by elevated intraocular pressure that causes progressive loss of retinal ganglion cells (RGCs). Autophagy is a lysosomal degradative process that updates the cellular components and plays an important role in cellular homeostasis. Recent studies have shown that autophagy is involved in the pathophysiological process of glaucoma. The role played by autophagy in glaucoma is complex, and conflicting evidence shows that autophagy promotes both RGC survival and death. The understanding of the major pattern of RGC loss and the crosstalk between autophagy and apoptosis remains limited in glaucoma. This review focuses on the relationship between autophagy and glaucoma, particularly on the influence of autophagy on apoptosis in glaucoma. Further research on autophagy in glaucoma may provide a novel understanding of the glaucoma pathology and novel treatment targets for glaucoma in the future.

  3. Nanofiber filter media for air filtration

    NASA Astrophysics Data System (ADS)

    Raghavan, Bharath Kumar

    Nanofibers have higher capture efficiencies in comparison to microfibers in the submicron particle size range of 100-500 nm because of small fiber diameter and increased surface area of the fibers. Pressure drop across the filter increases tremendously with decrease in fiber diameter in the continuum flow regime. Nanofibers with fiber diameter less than 300 nm are in the slip flow regime as a consequence of which steep increase in pressure drop is considerably reduced due to slip effect. The outlet or inlet gases have broad range of particle size distribution varying from few micrometers to nanometers. The economic benefits include capture of a wide range of particle sizes in the gas streams using compact filters composed of nanofibers and microfibers. Electrospinning technique was used to successfully fabricate polymeric and ceramic nanofibers. The nanofibers were long, continuous, and flexible with diameters in the range of 200--300 nm. Nanofibers were added to the filter medium either by mixing microfibers and nanofibers or by directly electrospinning nanofibers as thin layer on the surface of the microfiber filter medium. Experimental results showed that either by mixing Nylon 6 nanofibers with B glass fibers or by electrospinning Nylon 6 nanofibers as a thin layer on the surface of the microfiber medium in the surface area ratio of 1 which is 0.06 g of nanofibers for 2 g of microfibers performed better than microfiber filter media in air filtration tests. This improved performance is consistent with numerical modeling. The particle loading on a microfibrous filter were studied for air filtration tests. The experimental and modeling results showed that both pressure drop and capture efficiency increased with loading time. Nanofiber filter media has potential applications in many filtration applications and one of them being hot gas filtration. Ceramic nanofibers made of alumina and titania nanofibers can withstand in the range of 1000°C. Ceramic nanofibers

  4. Design, Fabrication, and In Vitro Testing of an Anti-biofouling Glaucoma Micro-shunt.

    PubMed

    Harake, Ryan S; Ding, Yuzhe; Brown, J David; Pan, Tingrui

    2015-10-01

    Glaucoma, one of the leading causes of irreversible blindness, is a progressive neurodegenerative disease. Chronic elevated intraocular pressure (IOP), a prime risk factor for glaucoma, can be treated by aqueous shunts, implantable devices, which reduce IOP in glaucoma patients by providing alternative aqueous outflow pathways. Although initially effective at delaying glaucoma progression, contemporary aqueous shunts often lead to numerous complications and only 50% of implanted devices remain functional after 5 years. In this work, we introduce a novel micro-device which provides an innovative platform for IOP reduction in glaucoma patients. The device design features an array of parallel micro-channels to provide precision aqueous outflow resistance control. Additionally, the device's microfluidic channels are composed of a unique combination of polyethylene glycol materials in order to provide enhanced biocompatibility and resistance to problematic channel clogging from biofouling of aqueous proteins. The microfabrication process employed to produce the devices results in additional advantages such as enhanced device uniformity and increased manufacturing throughput. Surface characterization experimental results show the device's surfaces exhibit significantly less non-specific protein adsorption compared to traditional implant materials. Results of in vitro flow experiments verify the device's ability to provide aqueous resistance control, continuous long-term stability through 10-day protein flow testing, and safety from risk of infection due to bacterial ingression.

  5. Glaucoma classification using Regional Wavelet Features of the ONH and its surroundings.

    PubMed

    Haleem, Muhammad Salman; Han, Liangxiu; van Hemert, Jano; Fleming, Alan

    2015-08-01

    Glaucoma is one of the leading cause of blindness but the detection at its earliest stage and subsequent treatment can aid patients to preserve blindness. The existing work has been focusing on global features such as texture, grayscale and wavelet energy of the Optic Nerve Head (ONH) and its surrounding to differentiate between normal and glaucoma images. In contrast to previous approaches which focus on global information only, this work proposes a new approach to automatically classify between the normal and glaucoma images based on Regional Wavelet Features of the ONH and different regions around it. These regions are usually used for diagnosis of glaucoma by clinicians through visual observation only. Our method automatically determines different clinically observed regions around the ONH and performs classification on the basis of wavelet energy at different frequency subbands. We have conducted experiments based on different global features and regional features respectively and applied it to RIMONE (An Open Retinal Image Database for Optic Nerve Evaluation) database with 158 images. The experimental evaluation demonstrated that the classification accuracy of normal and glaucoma images using Regional Wavelet Features of different regions with 93% outperforms all other feature sets.

  6. Acquired color vision loss and a possible mechanism of ganglion cell death in glaucoma.

    PubMed Central

    Nork, T M

    2000-01-01

    PURPOSE: First, to study the cellular mechanisms of acquired color vision loss in retinal detachment and diabetic retinopathy. Second, to learn why, in glaucoma, the type of color vision deficit that is observed is more characteristic of a retinal injury than it is of an optic neuropathy. Third, to test a hypothesis of photoreceptor-induced, ganglion cell death in glaucoma. METHODS: Various histologic techniques were employed to distinguish the L/M-cones (long/medium wavelength-sensitive cones, or red/green sensitive cones) from the S-cones (short wavelength-sensitive cones, or blue sensitive cones) in humans and monkeys with retinal detachment, humans with diabetic retinopathy, and both humans and monkeys with glaucoma. To test if the photoreceptors were contributing to ganglion cell death, laser photocoagulation was used in a experimental model of glaucoma to focally eliminate the photoreceptors. As a control, optic nerve transection was done following retinal laser photocoagulation in one animal. RESULTS: Selective and widespread loss of the S-cones was found in retinal detachment as well as diabetic retinopathy. By contrast, in human as well as experimental glaucoma, marked swelling of the L/M-cones was the predominant histopathologic feature. Retinal laser photocoagulation followed by experimental glaucoma resulted in selective protection of ganglion cells overlying the laser spots. This was not seen with retinal laser photocoagulation by optic nerve transection. CONCLUSIONS: In retinal detachment and diabetic retinopathy, acquired tritan-like color vision loss could be caused, or contributed to, by selective loss of the S-cones. Both L- and M-cones are affected in glaucoma, which is also consistent with a tritan-like deficit. Although not a therapeutic option, protection of ganglion cells by retinal laser in experimental glaucoma is consistent with an hypothesis of anterograde, photoreceptor-induced, ganglion cell death. Images FIGURE 1 FIGURE 2 FIGURE 3

  7. 40 CFR 141.73 - Filtration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.73 Filtration. A public water system... filtration, the turbidity level of representative samples of a system's filtered water must be less than or....74 (a)(1) and (c)(1). (d) Other filtration technologies. A public water system may use a...

  8. 40 CFR 141.73 - Filtration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.73 Filtration. A public water system... filtration, the turbidity level of representative samples of a system's filtered water must be less than or....74 (a)(1) and (c)(1). (d) Other filtration technologies. A public water system may use a...

  9. 40 CFR 141.73 - Filtration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.73 Filtration. A public water system... filtration, the turbidity level of representative samples of a system's filtered water must be less than or....74 (a)(1) and (c)(1). (d) Other filtration technologies. A public water system may use a...

  10. 40 CFR 141.73 - Filtration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.73 Filtration. A public water system... filtration, the turbidity level of representative samples of a system's filtered water must be less than or....74 (a)(1) and (c)(1). (d) Other filtration technologies. A public water system may use a...

  11. 40 CFR 141.73 - Filtration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.73 Filtration. A public water system... filtration, the turbidity level of representative samples of a system's filtered water must be less than or....74 (a)(1) and (c)(1). (d) Other filtration technologies. A public water system may use a...

  12. Microscope-integrated optical coherence tomography for image-aided positioning of glaucoma surgery

    NASA Astrophysics Data System (ADS)

    Li, Xiqi; Wei, Ling; Dong, Xuechuan; Huang, Ping; Zhang, Chun; He, Yi; Shi, Guohua; Zhang, Yudong

    2015-07-01

    Most glaucoma surgeries involve creating new aqueous outflow pathways with the use of a small surgical instrument. This article reported a microscope-integrated, real-time, high-speed, swept-source optical coherence tomography system (SS-OCT) with a 1310-nm light source for glaucoma surgery. A special mechanism was designed to produce an adjustable system suitable for use in surgery. A two-graphic processing unit architecture was used to speed up the data processing and real-time volumetric rendering. The position of the surgical instrument can be monitored and measured using the microscope and a grid-inserted image of the SS-OCT. Finally, experiments were simulated to assess the effectiveness of this integrated system. Experimental results show that this system is a suitable positioning tool for glaucoma surgery.

  13. Linkage analysis excludes the glaucoma locus on 1q from involvement in autosomal dominant glaucoma with iris hypoplasia

    SciTech Connect

    Heon, E.; Sheth, B.P.; Kalenak, J.W.

    1994-09-01

    Genetic factors have been implicated in a variety of types of glaucoma including primary open-angle glaucoma, infantile glaucoma, pigmentary glaucoma, and juvenile open-angle glaucoma. We previously mapped the disease-causing gene for one type of juvenile open angle glaucoma to chromosome 1q21-31. Weatherill and Hart (1969) and Pearce (1983) each noted the association of iris hypoplasia and early-onset autosomal dominant glaucoma. We recently had the opportunity to study a large family (12 affected members) with this phenotype. Affected individuals developed glaucoma at an average age of 30 years. These patients also have a strikingly underdeveloped iris stroma which causes a peculiar eye color. Linkage analysis was able to completely exclude the 1q glaucoma locus from involvement in the disorder that affects this family. A complete clinical description of the family and linkage results at additional candidate loci will be presented.

  14. Particle Dynamics in Tangential Flow Filtration

    NASA Astrophysics Data System (ADS)

    Garcia, Mike; Pennathur, Sumita

    2015-11-01

    Tangential Flow Filtration (TFF) is a rapid and efficient method for filtration and separation of solutions containing particles such as viruses, bacteria or cellular material. Enhancing the efficiency of TFF not only requires a detailed understanding of the individual mechanisms behind particle transport, but the interaction between these transport mechanisms and a porous wall. In this work, we numerically and experimentally explore how inertial migration is affected by the presence of a permeate flow through the porous walls of a microchannel in order to develop a platform for further studies of particle transport in a TFF device. Numerically, we use COMSOL multiphysics to model the large parameter space of permeate versus inertial forces. Experimentally, we develop a MEMS fabricated TFF device to confirm the results of the numerical model, where the permeate flow is controlled using multiple pumps and pressure transducers regulated by a feedback loop. Experimental and numerical results reveal interesting dynamics, including the competition between permeate and inertial forces and the consequences of this competition on particle trajectories and equilibrium location.

  15. Glaucoma Disparities in the Hispanic Population.

    PubMed

    Nathan, Niraj; Joos, Karen M

    2016-01-01

    The Hispanic population is the United States' largest minority and one of the fastest growing as well. In the next 30 to 40 years, the proportion of open-angle glaucoma patients represented by Hispanics is expected to dramatically rise. Here we examine the unique considerations and challenges of glaucoma care in this population, from demographics to risk factors to treatments and outcomes. Currently, access to care and the under-diagnosis of glaucoma in this population are significant issues that look only to grow in significance as the glaucoma burden continues to grow. Additionally, utilization of medical and surgical therapy remains lower in Hispanics than in many other ethnic groups. Understanding and proactively addressing the unique challenges in the screening and treatment of Hispanics will be of utmost importance to providing effective care to this population.

  16. Dry Eyes and Glaucoma: Double Trouble

    MedlinePlus

    ... News About Us Donate In This Section Dry Eyes and Glaucoma: Double Trouble email Send this article ... disease bothers the patient more. What Causes Dry Eye Syndrome? Dry eye can be caused by many ...

  17. Management of exfoliative glaucoma: challenges and solutions

    PubMed Central

    Holló, Gábor; Katsanos, Andreas; Konstas, Anastasios GP

    2015-01-01

    Exfoliative glaucoma is the most common type of secondary open-angle glaucoma worldwide. It is characterized by high intraocular pressure (IOP) and worse 24-hour IOP characteristics. In order to minimize progression, treatment of exfoliative glaucoma has to provide a low long-term mean IOP and good 24-hour IOP control. To achieve these goals, fixed-dose combination eye drops, argon and selective laser trabeculoplasty, and various forms of surgery (trabeculectomy, deep sclerectomy, viscocanalostomy, ab interno trabeculotomy, trabecular aspiration, and cataract surgery) all need to be considered during the long-term management of the disease. Since exfoliative glaucoma is a disease of the elderly, and is frequently associated with systemic vascular disease, interdisciplinary consultations are of great clinical importance. These management aspects and the current medical, laser, and surgical results are covered in this review, with a special focus on the needs of the general ophthalmologist. PMID:26045655

  18. Management of exfoliative glaucoma: challenges and solutions.

    PubMed

    Holló, Gábor; Katsanos, Andreas; Konstas, Anastasios Gp

    2015-01-01

    Exfoliative glaucoma is the most common type of secondary open-angle glaucoma worldwide. It is characterized by high intraocular pressure (IOP) and worse 24-hour IOP characteristics. In order to minimize progression, treatment of exfoliative glaucoma has to provide a low long-term mean IOP and good 24-hour IOP control. To achieve these goals, fixed-dose combination eye drops, argon and selective laser trabeculoplasty, and various forms of surgery (trabeculectomy, deep sclerectomy, viscocanalostomy, ab interno trabeculotomy, trabecular aspiration, and cataract surgery) all need to be considered during the long-term management of the disease. Since exfoliative glaucoma is a disease of the elderly, and is frequently associated with systemic vascular disease, interdisciplinary consultations are of great clinical importance. These management aspects and the current medical, laser, and surgical results are covered in this review, with a special focus on the needs of the general ophthalmologist.

  19. [Early Manifest Glaucoma Trial update 2004].

    PubMed

    Erb, C

    2005-03-01

    Elevated intraocular pressure (IOP) represents one of the most important risk factors for developing glaucomatous optic neuropathy. The "Early Manifest Glaucoma Trial" (EMGT) was initiated to answer the question of how immediate IOD-lowering therapy affects the progression of early manifest glaucoma and which clinically relevant factors are important. The study compares 129 patients undergoing treatment with 126 patients receiving no IOP-lowering therapy. IOP remained virtually constant in the untreated group, while a reduction of 25% was achieved in the treatment group. The results of the EMGT indicate that glaucoma progression is influenced by higher initial IOP, pseudoexfoliation or bilateral glaucoma, poorer MD value, higher age, and marginal papillary hemorrhage. No clear conclusions can be drawn regarding the significance of cardiovascular risk factors.

  20. Genetics Home Reference: early-onset glaucoma

    MedlinePlus

    ... a group of eye disorders in which the optic nerves connecting the eyes and the brain are ... most people with glaucoma, the damage to the optic nerves is caused by increased pressure within the ...

  1. Current perspective of neuroprotection and glaucoma

    PubMed Central

    Tian, Kailin; Shibata-Germanos, Shannon; Pahlitzsch, Milena; Cordeiro, M Francesca

    2015-01-01

    Glaucoma is the second leading cause of blindness worldwide and is most notably characterized by progressive optic nerve atrophy and advancing loss of retinal ganglion cells (RGCs). The main concomitant factor is the elevated intraocular pressure (IOP). Existing treatments are focused generally on lowering IOP. However, both RGC loss and optic nerve atrophy can independently occur with IOP at normal levels. In recent years, there has been substantial progress in the development of neuroprotective therapies for glaucoma in order to restore vital visual function. The present review intends to offer a brief insight into conventional glaucoma treatments and discuss exciting current developments of mostly preclinical data in novel neuroprotective strategies for glaucoma that include recent advances in noninvasive diagnostics going beyond IOP maintenance for an enhanced global view. Such strategies now target RGC loss and optic nerve damage, opening a critical therapeutic window for preventative monitoring and treatment. PMID:26635467

  2. Medical management of glaucoma: Principles and practice

    PubMed Central

    Singh, Kuldev; Shrivastava, Anurag

    2011-01-01

    Glaucoma care is more an art than science. The introduction of several new classes of glaucoma medications and the completion of many large randomized clinical trials have not changed this fact. While we now have better choices when initiating glaucoma therapy relative to our predecessors, the principles of glaucoma therapy have not changed much during this period. Debates continue regarding the utility of concepts such as “the monocular therapeutic trial,” “target intraocular pressure (IOP),” and “maximal medical therapy.” Our tools for detecting and following glaucomatous disease have improved but are not precise enough for us to prospectively predict which patients will do better or worse than others. Much attention has been given to disease stage, rate of progression, and compliance with medications but regular patient follow-up, an area that has received little attention, may be among the most important predictors of patient outcomes. PMID:21150040

  3. Methylphenidate (Ritalin)-associated cataract and glaucoma.

    PubMed

    Lu, Chao-Kung; Kuang, Tung-Mei; Chou, Joe Ching-Kuang

    2006-12-01

    Methylphenidate hydrochloride (Ritalin) is the drug of choice for attention deficit hyperactivity disorder (ADHD). However, an association of Ritalin with glaucoma has been reported. We report a case of Ritalin-associated cataract and glaucoma. A 10-year-old boy was diagnosed with ADHD and had received methylphenidate hydrochloride, 60 mg/day for 2 years. He presented with blurred vision. Best-corrected visual acuity was 6/60 in both eyes. Ocular examinations revealed intraocular pressure (IOP) of 30 mmHg under medication, dense posterior subcapsular opacity of lens, pale disc with advanced cupping, and marked constriction of visual field. Despite maximal anti-glaucomatous medication, IOP still could not be controlled. The patient then received combined cataract and glaucoma surgery. Visual acuity improved and IOP was within normal limits in both eyes postoperatively. Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate.

  4. A pilot project of glaucoma in Barbados.

    PubMed Central

    Leske, M C; Connell, A M; Kehoe, R

    1989-01-01

    The prevalence of open-angle glaucoma is believed to be very high among West Indian blacks. To begin investigating the prevalence and risk factors for glaucoma and other eye diseases in Barbados, WI, a pilot study was conducted. The pilot project identified a stratified, random national sample of 300 persons over 35 years of age who were invited to participate in an ophthalmic examination and an interview. Of those contacted 89% were eligible and 95% of these agreed to participate. The overall glaucoma prevalence in the participants was 6%; it was 13% among black and mixed persons over 54 years. Age related cataract, hypertension, and diabetes were frequent findings. Although the sample size of the pilot project is small, the results suggest a high prevalence of glaucoma in Barbados, a finding that merits further study. PMID:2730859

  5. Glaucoma and the Origins of Its Name.

    PubMed

    Laios, Konstantinos; Moschos, Marilita M; Androutsos, George

    2016-05-01

    To identify the origins of the name of the disease Glaucoma. Ancient Greek medical literature, Homeric poems, and ancient Greek religion and art were examined. The roots of the name Glaucoma could be traced back to Homeric times. Ancient Greek physicians following the Hippocratic tradition preferred the use of the terms Hypochysis or Hypochyma for the same disease. This fact indicates that the older term Glaucoma did not fulfill strict medical criteria, but had a long history connected to superstition, which the rational ancient Greek physician tried to overcome using terms derived from their fundamental principal of humoral pathology. In ancient Greek medical literature, Glaucoma had a significant place among ocular diseases. The origin of its name could be traced back to Homeric times and could be connected to the ancient belief of a primitive folk about the apotropaic role of animals against diseases, which in this case is represented by the superstitious role of the owl.

  6. Diagnosis and management of pigmentary glaucoma.

    PubMed

    Lehto, I; Vesti, E

    1998-04-01

    Pigment dispersion syndrome and pigmentary glaucoma affect typically young, myopic persons. Iridozonular contact causes pigment dispersion and obstruction of the trabecular meshwork. Accumulation of pigment may result in transient elevation of intraocular pressure or irreparable damage to the meshwork accompanied by uncontrolled glaucoma. In the reviewed publications the transition from pigment dispersion syndrome to pigmentary glaucoma was found to be 20%. The main risk factors for the transition were ocular hypertension and myopia. Dapiprazole, an alpha-adrenergic blocking agent, was found to be effective in treating pigmentary glaucoma and in preventing pressure spikes after exercise. Dapiprazole causes miosis without affecting accommodation. Yttrium aluminum garnet laser iridotomy reduced the incidence of ocular hypertension in pigment dispersion syndrome, although the effect was less pronounced in persons older than 40 years of age. Lattice degeneration was found in 33.3% of the eyes with pigment dispersion syndrome.

  7. Quantitative Mapping of Collagen Fiber Orientation in Non-glaucoma and Glaucoma Posterior Human Sclerae

    PubMed Central

    Pijanka, Jacek K.; Coudrillier, Baptiste; Ziegler, Kimberly; Sorensen, Thomas; Meek, Keith M.; Nguyen, Thao D.; Quigley, Harry A.; Boote, Craig

    2012-01-01

    Purpose. The posterior sclera has a major biomechanical influence on the optic nerve head, and may therefore be important in glaucoma. Scleral material properties are influenced significantly by collagen fiber architecture. Here we quantitatively map fiber orientation in non-glaucoma and glaucoma posterior human sclerae. Methods. Wide-angle x-ray scattering quantified fiber orientation at 0.5-mm intervals across seven non-glaucoma post-mortem human sclerae, and five sclerae with glaucoma history and confirmed axon loss. Multiphoton microscopy provided semiquantitative depth-profiling in the peripapillary sclera. Results. Midposterior fiber orientation was either uniaxial (one preferred direction) or biaxial (two directions). The peripapillary sclera was characterized by a ring of fibers located mainly in the mid-/outer stromal depth and encompassing ∼50% of the total tissue thickness. Fiber anisotropy was 37% higher in the peripapillary sclera compared with midposterior, varied up to 4-fold with position around the scleral canal, and was consistently lowest in the superior-nasal quadrant. Mean fiber anisotropy was significantly lower in the superior-temporal (P < 0.01) and inferior-nasal (P < 0.05) peripapillary scleral quadrants in glaucoma compared with non-glaucoma eyes. Conclusions. The collagen fiber architecture of the posterior human sclera is highly anisotropic and inhomogeneous. Regional differences in peripapillary fiber anisotropy between non-glaucoma and glaucoma eyes may represent adaptive changes in response to elevated IOP and/or glaucoma, or baseline structural properties that associate with predisposition to glaucomatous axon damage. Quantitative fiber orientation data will benefit numerical eye models aimed at predicting the sclera's influence on nerve head biomechanics, and thereby its possible role in glaucoma. PMID:22786908

  8. Driving patterns in older adults with glaucoma

    PubMed Central

    2013-01-01

    Background The ability to drive is important for ensuring quality of life for many older adults. Glaucoma is prevalent in this age group and may affect driving. The purpose of this study is to determine if glaucoma and glaucomatous visual field (VF) loss are associated with driving cessation, limitations, and deference to another driver in older adults. Methods Cross-sectional study. Eighty-one glaucoma subjects and 58 glaucoma suspect controls between age 60 and 80 reported if they had ceased driving, limited their driving in various ways, or preferred another to drive. Results Twenty-three percent of glaucoma subjects and 6.9% of suspects had ceased driving (p = 0.01). Glaucoma subjects also had more driving limitations than suspects (2.0 vs. 1.1, p = 0.007). In multivariable models, driving cessation was more likely for glaucoma subjects as compared to suspects (OR = 4.0; 95% CI = 1.1-14.7; p = 0.03). The odds of driving cessation doubled with each 5 decibel (dB) decrement in the better-eye VF mean deviation (MD) (OR = 2.0; 95% CI = 1.4-2.9; p < 0.001). Glaucoma subjects were also more likely than suspects to report a greater number of driving limitations (OR = 4.7; 95% CI = 1.3-16.8; p = 0.02). The likelihood of reporting more limitations increased with the VF loss severity (OR = 1.6 per 5 dB decrement in the better-eye VF MD; 95% CI = 1.1-2.4; p = 0.02). Neither glaucoma nor VF MD was associated with other driver preference (p > 0.1 for both). Conclusions Glaucoma and glaucomatous VF loss are associated with greater likelihood of driving cessation and greater limitation of driving in the elderly. Further prospective study is merited to assess when and why people with glaucoma change their driving habits, and to determine if their observed self-regulation of driving is adequate to ensure safety. PMID:23432845

  9. Glaucoma Associated with Boston Type 1 Keratoprosthesis

    PubMed Central

    Kamyar, Roheena; Weizer, Jennifer S.; de Paula, Fernando Heitor; Stein, Joshua D.; Moroi, Sayoko E.; John, Denise; Musch, David C.; Mian, Shahzad I.

    2012-01-01

    Purpose To evaluate outcomes of the Boston Type 1 keratoprosthesis (KPro) and associated incidence of glaucoma. Design Retrospective cohort study. Participants All patients who underwent KPro surgery at one institution from 2003-2009 with at least 3 months follow-up. Methods Preoperative visual acuity, diagnosis, history of glaucoma, intraoperative and postoperative parameters were recorded. Statistical analysis was performed to identify factors that may influence increase in intraocular pressure (IOP) and glaucoma development or progression after surgery. Main Outcome Measures Best corrected visual acuity (BCVA), IOP, postoperative medical and surgical treatments for glaucoma, and KPro retention and complications. Results Thirty-six KPro procedures were performed in 30 eyes of 29 patients with mean (± SD) follow-up of 17±19 months (range 3-67 months). The main indication for KPro implantation was corneal graft failure (77%). Primary KPros were performed in 23% of eyes for limbal stem cell deficiency secondary to chemical burns and aniridia, and for herpetic disease. Median preoperative BCVA was hand motions with an overall improvement to 20/330 (range 20/20 to hand motions) at nine months postoperatively; mean BCVA was 20/600 (range 20/40 to NLP) at last follow-up. Twenty eyes (67%) had a preoperative history of glaucoma with eight of those eyes (40%) having undergone prior glaucoma surgery. Twenty-one eyes (70%) underwent concomitant glaucoma surgery. Postoperative increased IOP (22 mmHg or higher) was noted in 15 eyes (50%) while definite glaucoma development or progression was noted in 7 of those 15 eyes (23% of total eyes). Mean BCVA at last follow-up in eyes with glaucoma development or progression was 3/200 compared to 20/563 in the remaining 23 eyes. Six patients (20%) required repeat KPro implantation, and retroprosthetic membranes developed in 23 eyes (77%). No patient developed vitritis or infectious endophthalmitis. Conclusions The Boston Type 1 KPro

  10. Incidence of secondary glaucoma in behcet disease.

    PubMed

    Elgin, Ufuk; Berker, Nilufer; Batman, Aygen

    2004-12-01

    To determine the incidence of secondary glaucoma in Behcet disease. A total of 230 eyes of 129 patients with Behcet disease, were examined in uveitis and glaucoma clinics of Ankara Social Security Eye Hospital between January 1997 and September 2002. The data from all patients were investigated both retrospectively and prospectively. The mean age of 129 patients was 34.2 +/- 7.4 years (range, 18 to 55 years). In 22 patients (17%), the disease was diagnosed on the basis of the ocular findings, while in the remaining 107 patients (83%), the period between the diagnosis of Behcet disease and the onset of the ocular symptoms was 23.3 +/- 17 months (range, 1 month to 5.3 years); 122 eyes (53%) had the episodes of acute recurrent iridocyclitis, while 108 eyes (47%) developed chronic posterior uveitis, including vitreitis, retinitis, vasculitis, or optic nerve involvement. Secondary glaucoma was diagnosed in 25 eyes (10.9%); 11 eyes (44%) with steroid or inflammation induced open angle glaucoma, 6 eyes (24%) with partial angle-closure glaucoma and peripheral anterior synechiae, 5 eyes (20%) with angle closure glaucoma, peripheral anterior synechiae, and pupil block and 3 eyes (12%) with neovascular glaucoma. The treatments included YAG-laser iridotomy in 5 eyes, diode-laser cyclodestruction in 3 eyes, primary trabeculectomies with mitomycin-c in 4 eyes, secondary trabeculectomies with mitomycin-c in 2 eyes, Ahmed valve implantations in 2 eyes, and cyclocryotherapy in 3 eyes. We suggest that secondary glaucoma is a common and serious complication of Behcet disease. It develops as a result of multiple factors, generally triggered by recurrent intraocular inflammation. Early recognition and treatment of these factors have vital importance to avoid the visual morbidity.

  11. The Pathophysiology and Treatment of Glaucoma

    PubMed Central

    Weinreb, Robert N.; Aung, Tin; Medeiros, Felipe A.

    2015-01-01

    IMPORTANCE Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. OBJECTIVE To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. EVIDENCE REVIEW A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. FINDINGS The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. CONCLUSIONS AND RELEVANCE Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries. PMID:24825645

  12. The Economic Burden of Childhood Glaucoma.

    PubMed

    Liu, Dan; Huang, Linda; Mukkamala, Lekha; Khouri, Albert S

    2016-10-01

    To date, there are limited data on the economic burden of childhood glaucoma, a relatively rare but visually debilitating disease. The purpose of this study is to evaluate the immediate costs of illness associated with childhood glaucoma during the first 4 years after presentation. Data on age, sex, surgical interventions, visits, examinations under anesthesia, and medications were collected yearly following presentation in patients with childhood glaucoma. Inclusion criteria included diagnosis of primary or secondary childhood glaucoma, age less than 21 years, and follow-up of 4 years. A total of 23 patients (39 eyes) were included. Cost analysis used 2013 hospital-specific charges and US average hourly wage to calculate outcomes of total, direct, and indirect costs (significance level P<0.05). The annual cost of care of childhood glaucoma averaged $21,441.61 per patient, representing 1100% of annual costs in adult glaucoma and an increase of 800% in annual costs of health care per pediatric patient. The average total 4-year cost of care was $85,074.96 per patient. Surgical interventions and examinations under anesthesia were the greatest contributors to costs, representing 69.0% and 23.2% of total 4-year costs, respectively. The annual costs of care for childhood glaucoma were highest in the first year compared with subsequent years, averaging $46,293.62 per patient (P<0.05). Childhood glaucoma carries a substantial economic burden with the highest costs occurring in the first year after presentation. The greatest contributors to cost of illness are surgical interventions and examinations and anesthesia.

  13. Evaluating glaucoma damage: emerging imaging technologies

    PubMed Central

    Kostanyan, Tigran; Wollstein, Gadi; Schuman, Joel S

    2015-01-01

    The use of ocular imaging tools to estimate structural and functional damage in glaucoma has become a common clinical practice and a substantial focus of vision research. The evolution of the imaging technologies through increased scanning speed, penetration depth, image registration and development of multimodal devices has the potential to detect the pathology more reliably and in earlier stages. This review is focused on new ocular imaging modalities used for glaucoma diagnosis. PMID:27087829

  14. Features of saturates mixture filtration in porous medium

    NASA Astrophysics Data System (ADS)

    Kachalov, V. V.; Maikov, I. L.; Molchanov, D. A.; Torchinsky, V. M.; Zaichenko, V. M.

    2015-11-01

    Consideration is given to the filtration process of the two-phase multicomponent mixture in the porous. It is shown that “mixture-porous medium” system becomes self- oscillating one during filtration process under special conditions when there is a region of retrograde condensation on the phase diagram of the mixture. A mathematical model of the hydrocarbon mixtures filtration process of the methane series has been developed and a computer program for calculating hydrodynamic and thermodynamic characteristics of this process under isothermal conditions with phase transitions has been created. Consideration is given to the basic mechanisms influencing the filtration dynamics. Limits of the model applicability are discussed. Condition range for occurring self-oscillatory properties in “mixture-porous medium” system is determined by medium permeability, viscosity of the mixture, initial and boundary filtration conditions. Experimental filtration research of mixtures “methane-n-butane”, “methane-propane-butane”, “methane-pentane” under the thermodynamic conditions corresponding retrograde condensation region on the phase diagram have shown validity of this model. It is argued that any multicomponent mixture having a retrograde condensation region on the phase diagram appears as self-oscillating system under right conditions.

  15. Characterization and modification of particulate properties to enhance filtration performance

    SciTech Connect

    Snyder, T.R.; Vann Bush, P.; Robinson, M.S.

    1990-06-01

    The specific objectives of this project are to characterize the particulate properties that determine the filtration performance of fabric filters, and to investigate methods for modifying these particulate properties to enhance filtration performance. Inherent in these objectives is the development of an experimental approach that will lead to full-scale implementation of beneficial conditioning processes identified during the project. The general approach has included a large number of laboratory evaluations to be followed by optional field tests of a new successful conditioning processes performed on a sidestream device. This project was divided into five tasks. The schedule followed for these tasks is shown in Figure 4. Tasks 2 and 3 each focus on one of the two complementary parts of the project. Task 2 Parametric Tests of Ashes and Fabrics, evaluates the degree to which ash properties and fabric design determine filtration performance. Task 3 Survey of Methods to Modify the Particle Filtration Properties, provides a literature review and laboratory study of techniques to modify ash properties. The results of these two tasks were used in Task 4 Proof-of-Concept Tests of Methods to Modify Particle Filtration Properties to demonstrate the effects on filtration performance of modifying ash properties. The findings of all the tasks are summarized in this Final Report. 13 refs.

  16. 3D Air Filtration Modeling for Nanofiber Based Filters in the Ultrafine Particle Size Range

    NASA Astrophysics Data System (ADS)

    Sambaer, Wannes; Zatloukal, Martin; Kimmer, Dusan

    2011-07-01

    In this work, novel 3D filtration model for nanofiber based filters has been proposed and tested. For the model validation purposes, filtration efficiency characteristics of two different polyurethane nanofiber based structures (prepared by the electrospinning process) were determined experimentally in the ultrafine particle size range (20-400 nm). It has been found that the proposed model is able to reasonably predict the measured filtration efficiency curves for both tested samples.

  17. Characterization of Filtration Scale-Up Performance

    SciTech Connect

    Daniel, Richard C.; Billing, Justin M.; Luna, Maria L.; Cantrell, Kirk J.; Peterson, Reid A.; Bonebrake, Michael L.; Shimskey, Rick W.; Jagoda, Lynette K.

    2009-03-09

    The scale-up performance of sintered stainless steel crossflow filter elements planned for use at the Pretreatment Engineering Platform (PEP) and at the Waste Treatment and Immobilization Plant (WTP) were characterized in partial fulfillment (see Table S.1) of the requirements of Test Plan TP RPP WTP 509. This test report details the results of experimental activities related only to filter scale-up characterization. These tests were performed under the Simulant Testing Program supporting Phase 1 of the demonstration of the pretreatment leaching processes at PEP. Pacific Northwest National Laboratory (PNNL) conducted the tests discussed herein for Bechtel National, Inc. (BNI) to address the data needs of Test Specification 24590-WTP-TSP-RT-07-004. Scale-up characterization tests employ high-level waste (HLW) simulants developed under the Test Plan TP-RPP-WTP-469. The experimental activities outlined in TP-RPP-WTP-509 examined specific processes from two broad areas of simulant behavior: 1) leaching performance of the boehmite simulant as a function of suspending phase chemistry and 2) filtration performance of the blended simulant with respect to filter scale-up and fouling. With regard to leaching behavior, the effect of anions on the kinetics of boehmite leaching was examined. Two experiments were conducted: 1) one examined the effect of the aluminate anion on the rate of boehmite dissolution and 2) another determined the effect of secondary anions typical of Hanford tank wastes on the rate of boehmite dissolution. Both experiments provide insight into how compositional variations in the suspending phase impact the effectiveness of the leaching processes. In addition, the aluminate anion studies provide information on the consequences of gibbsite in waste. The latter derives from the expected fast dissolution of gibbsite relative to boehmite. This test report concerns only results of the filtration performance with respect to scale-up. Test results for boehmite

  18. Cyclodialysis ab interno as a surgical approach to intractable glaucoma.

    PubMed

    Jordan, Jens F; Dietlein, Thomas S; Dinslage, Sven; Lüke, Christoph; Konen, Walter; Krieglstein, Günter K

    2007-08-01

    In glaucoma filtration surgery, the problem of subconjunctival scarring has still not been satisfactorily solved. Suprachoroidal drainage of aqueous humour offers a promising, alternative option for intractable glaucoma. We here present a clinical study on the surgical approach of gonioscopic cyclodialysis ab interno. Twenty-eight eyes of 20 patients with intractable glaucoma were included in this prospective, consecutive, case-control study. The eyes had had a mean of 4.4 +/- 2.4 previous antiglaucomatous interventions. Baseline intraocular pressure (IOP) was 34.3 +/- 10.5 mmHg despite maximum therapy. Under gonioscopic control, cyclodialysis ab interno was performed over two clock times to gain access to the suprachoroidal space. No additional trabecular meshwork surgery was performed. Success was defined as a lowering of IOP to below 21 mmHg without the need for further medication or intervention. Mean postoperative IOP was 14.6 +/- 12.4 mmHg. Mean follow-up (FU) for all eyes was 121.8 days. After a mean of 60 days, 21 eyes (75%) needed further surgical intervention. Qualified success was seen in four eyes (14.3%), with a mean FU of 383.6 days. Three eyes (10.7%) showed absolute success after a mean FU period of 202.7 days. In our series, we obtained the best results for phakic eyes, followed by pseudophakic and aphakic eyes. The results of this study do not provide convincing evidence of the functional efficacy of cyclodialysis ab interno. Nevertheless, the technique is easy to perform and offers safe and atraumatic access to the resorptive capability of the choroid. Conjunctival manipulation is avoided. Contrary to reports in the current literature, in our series, the best results were obtained for phakic eyes, though the small number of eyes included does not allow reliable statistics. Further studies will need to focus on the use of different space-retaining substances or a widening of the cyclodialysis cleft to improve surgical outcome.

  19. The role of matricellular proteins in glaucoma.

    PubMed

    Wallace, Deborah M; Murphy-Ullrich, Joanne E; Downs, J Crawford; O'Brien, Colm J

    2014-07-01

    Glaucoma is an optic neuropathy affecting approximately 60million people worldwide and is the second most common cause of irreversible blindness. Elevated intraocular pressure (IOP) is the main risk factor for developing glaucoma and is caused by impaired aqueous humor drainage through the trabecular meshwork (TM) and Schlemm's canal (SC). In primary open angle glaucoma (POAG), this elevation in IOP in turn leads to deformation at the optic nerve head (ONH) specifically at the lamina cribrosa (LC) region where there is also a deposition of extracellular matrix (ECM) molecules such as collagen and fibronectin. Matricellular proteins are non-structural secreted glycoproteins that help cells communicate with their surrounding ECM. This family of proteins includes connective tissue growth factor (CTGF), also known as CCN2, thrombospondins (TSPs), secreted protein acidic and rich in cysteine (SPARC), periostin, osteonectin, and Tenascin-C and -X and other ECM proteins. All members appear to play a role in fibrosis and increased ECM deposition. Most are widely expressed in tissues particularly in the TM and ONH and deficiency of TSP1 and SPARC have been shown to lower IOP in mouse models of glaucoma through enhanced outflow facility. The role of these proteins in glaucoma is emerging as some have an association with the pathophysiology of the TM and LC regions and might therefore be potential targets for therapeutic intervention in glaucoma. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Genetic and Biochemical Biomarkers in Canine Glaucoma.

    PubMed

    Graham, K L; McCowan, C; White, A

    2017-03-01

    In many health-related fields, there is great interest in the identification of biomarkers that distinguish diseased from healthy individuals. In addition to identifying the diseased state, biomarkers have potential use in predicting disease risk, monitoring disease progression, evaluating treatment efficacy, and informing pathogenesis. This review details the genetic and biochemical markers associated with canine primary glaucoma. While there are numerous molecular markers (biochemical and genetic) associated with glaucoma in dogs, there is no ideal biomarker that allows early diagnosis and/or identification of disease progression. Genetic mutations associated with canine glaucoma include those affecting ADAMTS10, ADAMTS17, Myocilin, Nebulin, COL1A2, RAB22A, and SRBD1. With the exception of Myocilin, there is very limited crossover in genetic biomarkers identified between human and canine glaucomas. Mutations associated with canine glaucoma vary between and within canine breeds, and gene discoveries therefore have limited overall effects as a screening tool in the general canine population. Biochemical markers of glaucoma include indicators of inflammation, oxidative stress, serum autoantibodies, matrix metalloproteinases, tumor necrosis factor-α, and transforming growth factor-β. These markers include those that indicate an adaptive or protective response, as well as those that reflect the damage arising from oxidative stress.

  1. Current status of epibulbar anti-glaucoma drainage devices in glaucoma surgery.

    PubMed

    Thieme, Hagen

    2012-10-01

    The term "glaucoma" covers a heterogeneous group of progressive optic neuropathies that are accompanied by characteristic visual-field defects. Primary open-angle glaucoma, the most common type, progresses insidiously and causes blindness if untreated. All current forms of treatment aim at lowering the intraocular pressure (IOP) in patients whose IOP is elevated. The implantation of anti-glaucoma drainage systems is one of the available options for surgical treatment. This review is based on pertinent literature retrieved by a selective search, including glaucoma treatment guidelines from Germany and abroad. A paradigm shift is currently underway regarding the indications for the implantation of anti-glaucoma drainage systems. Trabeculectomy (a "fistulating" operation in which the aqueous humor is led out of the eye under the conjunctiva) is still considered the surgical gold standard, but drainage systems have been implanted with increasing frequency in recent years. Studies have shown that these systems are more likely to be beneficial the earlier they are implanted in the course of the patient's disease. Five-year follow-up data from the randomized, multicenter Tube Versus Trabeculectomy (TVT) study have now revealed that anti-glaucoma drainage systems are equivalent to trabeculectomy with respect to long-term IOP reduction, complication rates, and absolute and relative clinical success rates. Glaucoma is a major clinical and socio-economic problem whose surgical treatment increasingly involves the implantation of anti-glaucoma drainage systems.

  2. What Do Patients With Glaucoma See? Visual Symptoms Reported by Patients With Glaucoma

    PubMed Central

    Hu, Cindy X.; Zangalli, Camila; Hsieh, Michael; Gupta, Lalita; Williams, Alice L.; Richman, Jesse

    2014-01-01

    Abstract: Background: Vision loss from glaucoma has traditionally been described as loss of “peripheral vision.” In this prospective study, we aimed to improve our clinical understanding of the visual symptoms caused by glaucoma by asking patients specific detailed questions about how they see. Methods: Patients who were clinically diagnosed with various types and stages of glaucoma were included. All had a comprehensive ocular examination, including Octopus visual field testing. Patients were excluded if they had other ocular conditions that affected their vision, including cornea, lens or retina pathologies. Patients responded to an oral questionnaire about their visual symptoms. We investigated the visual symptoms described by patients with glaucoma and correlated the severity of visual field loss with visual symptoms reported. Results: Ninety-nine patients completed the questionnaire. Most patients (76%) were diagnosed with primary open-angle glaucoma. The most common symptoms reported by all patients, including patients with early or moderate glaucoma, were needing more light and blurry vision. Patients with a greater amount of field loss (Octopus mean defect >+9.4 dB) were more likely to report difficulty seeing objects to one or both sides, as if looking through dirty glasses and trouble differentiating boundaries and colors. Conclusions: Vision loss in patients with glaucoma is not as simple as the traditional view of loss of peripheral vision. Needing more light and blurry vision were the most common symptoms reported by patients with glaucoma. PMID:24992392

  3. A framework to explore the visual brain in glaucoma with lessons from models and man.

    PubMed

    Yucel, Yeni H; Gupta, Neeru

    2015-12-01

    Vision loss in glaucoma is associated with death of retinal ganglion cells. High intraocular pressure is a major risk factor for vision loss from glaucoma, and lowering eye pressure is the goal of all available medical and surgical treatments. Taking a bold step forward, the restoration of vision after severe glaucoma damage is a new Audacious Goal established by National Eye Institute (Sieving, 2012). This means that retinal ganglion cell repair, and replacement, must be considered in the context of visual function restoration. To restore visual function, retinal ganglion cells, after long-distance axonal growth and guidance, should connect to specific target neurons in subcortical visual structures. At the time of the establishment of these connections, the fate of target cells is critical along with the health of retinal ganglion cells. In fact, several lines of evidence demonstrate glaucomatous neural degeneration occurs throughout the central visual system where most information processing takes place. Evidence from multiple studies in experimental glaucoma models, human autopsy cases and neuroimaging studies point to the degeneration of neurons in the lateral geniculate nucleus, a subcortical hub of functional connectivity between the eye and the visual cortex. Maintaining and re-establishing connections of retinal ganglion cells to target neurons in major visual structures is a key endpoint for regenerative medicine strategies. This paper critically reviews studies of visual brain changes in man and experimental animal models, and discusses key factors in the experimental design that are relevant to restoring vision loss in human disease.

  4. Regional Image Features Model for Automatic Classification between Normal and Glaucoma in Fundus and Scanning Laser Ophthalmoscopy (SLO) Images.

    PubMed

    Haleem, Muhammad Salman; Han, Liangxiu; Hemert, Jano van; Fleming, Alan; Pasquale, Louis R; Silva, Paolo S; Song, Brian J; Aiello, Lloyd Paul

    2016-06-01

    Glaucoma is one of the leading causes of blindness worldwide. There is no cure for glaucoma but detection at its earliest stage and subsequent treatment can aid patients to prevent blindness. Currently, optic disc and retinal imaging facilitates glaucoma detection but this method requires manual post-imaging modifications that are time-consuming and subjective to image assessment by human observers. Therefore, it is necessary to automate this process. In this work, we have first proposed a novel computer aided approach for automatic glaucoma detection based on Regional Image Features Model (RIFM) which can automatically perform classification between normal and glaucoma images on the basis of regional information. Different from all the existing methods, our approach can extract both geometric (e.g. morphometric properties) and non-geometric based properties (e.g. pixel appearance/intensity values, texture) from images and significantly increase the classification performance. Our proposed approach consists of three new major contributions including automatic localisation of optic disc, automatic segmentation of disc, and classification between normal and glaucoma based on geometric and non-geometric properties of different regions of an image. We have compared our method with existing approaches and tested it on both fundus and Scanning laser ophthalmoscopy (SLO) images. The experimental results show that our proposed approach outperforms the state-of-the-art approaches using either geometric or non-geometric properties. The overall glaucoma classification accuracy for fundus images is 94.4% and accuracy of detection of suspicion of glaucoma in SLO images is 93.9 %.

  5. Filtrates and Residues: Gel Filtration--An Innovative Separation Technique.

    ERIC Educational Resources Information Center

    Blumenfeld, Fred; Gardner, James

    1985-01-01

    Gel filtration is a form of liquid chromatography that separates molecules primarily on the basis of their size. Advantages of using this technique, theoretical aspects, and experiments (including procedures used) are discussed. Several questions for students to answer (with answers) are also provided. (JN)

  6. Integrated pore blockage-cake filtration model for crossflow filtration

    SciTech Connect

    Daniel, Richard C.; Billing, Justin M.; Russell, Renee L.; Shimskey, Rick W.; Smith, Harry D.; Peterson, Reid A.

    2011-07-01

    Crossflow filtration is to be a key process in the treatment and disposal of approximately 60,000 metric tons of high-level radioactive waste stored at the Hanford Site in Richland, Washington. Pacific Northwest National Laboratory is assessing filter performance with waste simulant materials that mimic the chemical and physical properties of Hanford tank waste. Prior simulant studies indicated that waste filtration performance may be limited by pore and cake fouling. To limit the shutdown of waste treatment operations, the pre-treatment facility plans to recover filter flux losses from cake formation and filter fouling by frequently backpulsing the filter elements. The objective of the current paper is to develop a simple model of flux decline resulting from cake and pore fouling and potential flux recovery through backpulsing of the filters for Hanford waste filtration operations. To this end, a model capable of characterizing the decline in waste-simulant filter flux as a function of both irreversible pore blockage and reversible cake formation is proposed. This model is used to characterize the filtration behavior of Hanford waste simulants in both continuous and backpulsed operations. The model is then used to infer the optimal backpulse frequency under specific operating conditions.

  7. Evaluation of an Injectable Thermosensitive Hydrogel As Drug Delivery Implant for Ocular Glaucoma Surgery

    PubMed Central

    Zhao, Feng; Zheng, Qiongjuan; Li, Xiaoning; Luo, Jing; Liu, Ji; Quan, Daping; Ge, Jian

    2014-01-01

    In this study, a biodegradable thermo-sensitive hydrogel from poly(trimethylene carbonate)15-F127-poly(trimethylene carbonate)15 (PTMC15-F127-PTMC15) was designed and evaluated as an injectable implant during ocular glaucoma filtration surgery in vivo and in vitro. Mitomycin C (MMC) was loaded into this hydrogel for controlled released to prolong the efficacy and to reduce the long-term toxicity. The properties of the hydrogel were confirmed using 1H NMR and gel permeation chromatography (GPC). Compared to the Pluronic F127 hydrogel, the PTMC15-F127-PTMC15 hydrogel showed a good solution-gel transition temperature at 37°C, a lower work concentration of 5% w/v and a longer mass loss time of more than 2 weeks. The in vitro study showed that the drug could be released from PTMC15-F127-PTMC15 (5% w/v) hydrogel for up to 16 days with only 57% of drug released in the first day. Moreover, the cell toxicity, which was tested via LDH and ANNEXIN V/PI, decreased within 72 h in human tenon's fibroblast cells (HTFs). The in vivo behavior in a rabbit glaucoma filtration surgery model indicated that this hydrogel loaded with 0.1 mg/ml MMC led to a better functional bleb with a prolonged mean bleb survival time (25.5±2.9 days). The scar tissue formation, new collagen deposition and myofibroblast generation appeared to be reduced upon histological and immunohistochemistry examinations, with no obvious side effects and inflammatory reactions. The in vitro and in vivo results demonstrated that this novel hydrogel is a safe and effective drug delivery candidate in ocular glaucoma surgery. PMID:24950176

  8. Maladaptive coping strategies and glaucoma progression.

    PubMed

    Freeman, Ellen E; Lesk, Mark R; Harasymowycz, Paul; Desjardins, Daniel; Flores, Veronica; Kamga, Hortence; Li, Gisèle

    2016-08-01

    The identification of modifiable risk factors for glaucoma progression is needed. Our objective was to determine whether maladaptive coping styles are associated with recent glaucoma progression or worse visual field mean deviation.A hospital-based case-control study was conducted in the Glaucoma Service of Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients with primary open angle glaucoma or normal tension glaucoma with ≥4 years of follow-up and ≥5 Humphrey visual fields were included. Cases had recent visual field progression as defined according to the Early Manifest Glaucoma Trial pattern change probability maps. Controls had stable visual fields. The Brief Cope questionnaire, a 28-item questionnaire about 14 different ways of coping with the stress of a chronic disease, was asked. Questions were also asked about demographic and medical factors, and the medical chart was examined. Outcomes included glaucoma progression (yes, no) and visual field mean deviation. Logistic and linear regressions were used.A total of 180 patients were included (82 progressors and 98 nonprogressors). Although none of the 14 coping scales were associated with glaucoma progression (P > 0.05), higher denial was correlated with worse visual field mean deviation (r = -0.173, P = 0.024). In a linear regression model including age, sex, education, depression, intraocular pressure, and family history of glaucoma, greater levels of denial (β = -1.37, 95% confidence interval [CI] -2.32, -0.41), Haitian ethnicity (β = -7.78, 95% CI -12.52, -3.04), and the number of glaucoma medications (β = -1.20, 95% CI -2.00, -0.38) were statistically significantly associated with visual field mean deviation.The maladaptive coping mechanism of denial was a risk factor for worse visual field mean deviation. Further prospective research will be required to verify the pathways by which denial may exert an effect on glaucomatous visual field loss.

  9. Is Estrogen a Therapeutic Target for Glaucoma?

    PubMed

    Dewundara, Samantha S; Wiggs, Janey L; Sullivan, David A; Pasquale, Louis R

    2016-01-01

    This article's objective is to provide an overview of the association between estrogen and glaucoma. A literature synthesis was conducted of articles published in peer-reviewed journals screened through May 5, 2015, using the PubMed database. Keywords used were "estrogen and glaucoma," "reproductive factors and glaucoma," and "estrogen, nitric oxide and eye." Forty-three journal articles were included. Results indicated that markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open-angle glaucoma (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses' Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 years had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk), while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma-related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of postmenopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in

  10. Implantation of a second glaucoma drainage device.

    PubMed

    Francis, Brian A; Fernandes, Rodrigo A B; Akil, Handan; Chopra, Vikas; Diniz, Bruno; Tan, James; Huang, Alex

    2017-05-01

    To evaluate success rates in controlling intraocular pressure (IOP) after implantation of a second glaucoma drainage device (GDD) with a Baerveldt glaucoma implant in patients with refractory glaucoma, with a secondary aim of reducing the need for postoperative glaucoma medications. This retrospective, noncomparative, interventional study included patients undergoing a second GDD for uncontrolled glaucoma from a tertiary care glaucoma service. Data were obtained from the medical records for the preoperative period and after the 1st, 15th, and 30th day, 3, 6, and 12 months, and then yearly until the last postoperative visit. Visual acuity, IOP, and number of glaucoma medications (NGM) from the follow-up visits were compared to baseline. Success and failure criteria were analyzed based on IOP level or need of glaucoma medications. Forty-nine patients were studied, with a mean follow-up time of 25 ± 21 months. The mean preoperative IOP was 23.7 ± 8.2 mmHg, and decreased to 14.8 ± 4.0 mmHg after 1 year, 14.4 ± 3.9 mmHg after 2 years, and 16.6 ± 8.5 mmHg after 3 years. The mean preoperative NGM was 3.4 ± 1.3, and decreased to 2.0 ± 1.8 after 1 year, 2.5 ± 1.6 after 2 years, and 2.8 ± 2.0 after 3 years. Absolute success was 9% after 1 year for a postoperative IOP between 5 and 18 mmHg, and 76% for a postoperative IOP between 5 and 21 mmHg. The qualified success was 88% at the first and second years and 83% at the third year. With up to 3 years of follow-up, a second glaucoma drainage device was successful in reducing IOP to below 21 mmHg, but not as successful below 18 mmHg. The success rate is improved with the use of glaucoma medications with up to 3 years of follow-up.

  11. Glaucoma

    MedlinePlus

    ... geteyesmart.org. Accessed April 24, 2015. Drug monograph: Marijuana, medical. Gold Standard. https://www.clinicalkey.com. Accessed July 23, 2015. Volkow ND, et al. Adverse health effects of marijuana use. New England Journal of Medicine. 2014;370: ...

  12. Glaucoma

    MedlinePlus

    ... visual function, preservation of sight, and the special health problems and requirements of the blind.” News & Events Events Calendar NEI Press Releases News from NEI Grantees Spokesperson bios Statistics and ... Frequently asked questions Clinical Studies Publications Catalog ...

  13. Glaucoma

    MedlinePlus Videos and Cool Tools

    ... part of the federal government’s National Institutes of Health (NIH), the National Eye Institute’s mission is to “conduct and support research, training, health information dissemination, and other programs with respect to ...

  14. Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients

    PubMed Central

    Waldock, A; Snape, J; Graham, C

    2000-01-01

    AIMS—To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients.
METHODS—141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the χ2 test.
RESULTS—Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 mm Hg and 4.1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management.
CONCLUSIONS—Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical β blocker therapy to control their glaucoma.

 PMID:10873979

  15. Study Finds a Connection between Glaucoma and Sleep Apnea

    MedlinePlus

    ... News Study Finds a Connection Between Glaucoma and Sleep Apnea Sep. 06, 2013 Over the years, several studies have demonstrated an increased rate of glaucoma among those with sleep apnea, but these studies only proved that the ...

  16. Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study

    ClinicalTrials.gov

    2017-05-02

    Glaucoma; Glaucoma Suspect; Diabetic Retinopathy; Ocular Hypertension; Cataract; Branch Retinal Vein Occlusion; Branch Retinal Arterial Occlusion; Central Retinal Vein Occlusion; Central Retinal Artery Occlusion; Epi-retinal Membrane; Macular Degeneration; Drusen; Loss of Vision

  17. The School's Role in Preventing Blindness from Glaucoma.

    ERIC Educational Resources Information Center

    Penland, Lynn R.; Penland, William R.

    1980-01-01

    While glaucoma generally strikes those over 35 years of age, awareness of glaucoma should be promoted in junior and senior high school and college by incorporating information into a unit on eye health or chronic diseases. (MJB)

  18. U.S. Glaucoma Cases Expected to Surge by 2030

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_162924.html U.S. Glaucoma Cases Expected to Surge by 2030 Routine eye ... 6, 2017 FRIDAY, Jan. 6, 2017 (HealthDay News) -- Glaucoma affects more than 3 million Americans, but that ...

  19. The School's Role in Preventing Blindness from Glaucoma.

    ERIC Educational Resources Information Center

    Penland, Lynn R.; Penland, William R.

    1980-01-01

    While glaucoma generally strikes those over 35 years of age, awareness of glaucoma should be promoted in junior and senior high school and college by incorporating information into a unit on eye health or chronic diseases. (MJB)

  20. Efficacy and Safety of Trabectome Surgery in Chinese Open-Angle Glaucoma

    PubMed Central

    Lee, Jacky W.Y.; Yick, Doris W.F.; Tsang, Susanna; Yuen, Can Y.F.; Lai, Jimmy S.M.

    2016-01-01

    Abstract To investigate the clinical outcome of the Trabectome in Chinese open-angle glaucoma (OAG). This prospective case series recruited pseudophakic glaucoma subjects with open-angle configuration. Trabeculectomy ab interno was performed using the Trabectome to 120° of the trabecular meshwork. Intraocular pressure (IOP) and medications were recorded preoperatively and every 3 months postoperatively. Visual acuity was measured preoperatively and at 1 and 6 months postoperatively. One-way ANOVA with Tukey Multiple Comparison Test were used to measure the pre and postoperative parameters. In 19 eyes of 19 Chinese subjects, 26.3% were uveitic, 68.4% were primary open-angle glaucoma, and 5.3% had a history of chronic angle-closure glaucoma with open-angles after cataract extraction. The subjects’ mean age was 67.5 ± 14.4 years, with 4 females and 15 males. Two patients required secondary filtration procedure. At 6 months, the IOP reduced by 34.8% (24.4 ± 4.4 mm Hg to 15.9 ± 5.1 mm Hg, P < 0.0001). The number of types of antiglaucoma medications was reduced by 28.2% (3.9 ± 0.8–2.8 ± 1.6, P < 0.0001). The visual acuity was static at 1 and 6 months postoperatively (P = 0.4). There were no intraoperative complications. 26.3% of subjects had a transient IOP spike > 21 mm Hg, 1 had hyphema requiring washout, and 1 had reactivation of herpetic keratitis. The success rate at 6 months was 89.5%. Trabectome achieved a modest reduction in IOP and medications in the majority of pseudophakic Chinese OAG eyes. PMID:27082559

  1. Demographic features of subjects with congenital glaucoma

    PubMed Central

    Tamçelik, Nevbahar; Atalay, Eray; Bolukbasi, Selim; Çapar, Olgu; Ozkok, Ahmet

    2014-01-01

    Context: Congenital glaucoma is a potentially blinding ocular disease of the childhood. Identification of the possible associated risk factors and may be helpful for prevention or early detection of this public health problem. Aims: To demonstrate the demographic features of congenital glaucoma subjects. Setting and Design: The charts of congenital glaucoma patients referred to Tamcelik Glaucoma Center were retrospectively reviewed through the dates of 2000 and 2013. Materials and Methods: Analyzed data included diagnosis, age at first presentation, symptoms at first presentation, laterality of the disease, sex, presence of consanguinity, family history of congenital glaucoma, maturity of the fetus at delivery, and maternal age at conception. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) version 19.0 by IBM (SPSS Inc, Chicago, Illinois, USA) was used to compare the mean of continuous variables with Student's t-test and analysis of variance (ANOVA) and χ2 test was used to test differences in proportions of categorical variables. Results: The data of 600 eyes of 311 patients were analyzed. The distribution of primary and secondary congenital glaucoma among the patients were 63.3% (n = 197) and 36.7% (n = 114), respectively. Of the 311 patients, 57.2% (n = 178) were male and 42.8% (n = 133) were female. The overall frequency of bilateral disease was 92.3% (n = 287). Overall rate of consanguinity and positive family history was 45.3% (n = 141) and 21.2% (n = 66), respectively. Conclusions: Bilateral disease in this study was more common than previously reported studies. Positive family history was more frequent in primary congenital glaucoma although not statistically significant. PMID:24881602

  2. Oral fluoroquinolones and risk of glaucoma.

    PubMed

    Yang, Louis; Etminan, Mahyar; Mikelberg, Frederick S

    2014-09-01

    To evaluate the risk of developing glaucoma in patients taking systemic fluoroquinolones. A case-control study was carried out among a cohort of subjects who had visited an ophthalmologist in the Province of British Columbia, Canada from 2000 to 2007. Cases were identified as those newly diagnosed with glaucoma (ICD-9 360). For each case, 5 controls were selected and matched to the cases by age and calendar time. Crude and adjusted rate ratios (RRs) for current, recent, past, and distant use of fluoroquinolones were calculated. From the cohort of 989,591 subjects, 178,264 subjects were diagnosed with glaucoma and 891,320 were corresponding controls. The 2 groups had same average age of 65 and comparable systemic comorbidities including hypertension, coronary artery disease, and diabetes. There was no statistically significant association between the use of systemic fluoroquinolones and the development of glaucoma for current use [RR=1.01 (95% confidence interval (CI), 0.95-1.07)], recent use [RR=1.00 (95% CI, 0.92-1.08)], or past use [RR=0.94 (95% CI, 0.90-1.00)]. Distant use of systemic fluoroquinolones had a small statistically significant increased risk of developing glaucoma [RR=1.12 (95% CI, 1.09-1.14)]. There was no detected increased association of the development of glaucoma with current, recent, or past use of systemic fluoroquinolone but a minimal statistically significant increased risk was associated with distant use. Future studies should further examine a potential delayed response with fluoroquinolones and glaucoma.

  3. Placement of a collagen glaucoma drainage device to control intraocular pressure and chronic iritis secondary to juvenile rheumatoid arthritis.

    PubMed

    Price, Francis W; Ziemba, Steven L

    2002-01-01

    A patient with juvenile rheumatoid arthritis and chronic iritis is reported with intraocular pressure near 30 mm Hg and previous episodes of intraocular pressure as high as 50 mm Hg despite maximally tolerated medical therapy. Because of the potential risk involved with a full-thickness filtration procedure, it was decided that a nonpenetrating deep sclerectomy would be appropriate, followed by placement of a collagen glaucoma drainage device to maintain aqueous outflow. Immediately postoperatively, intraocular pressure was stabilized. At 24 months postoperatively, intraocular pressure was well controlled at 15 mm Hg with patient receiving only Lotemax. No significant complications were noted at any point in the postoperative course. Because of the patient's predisposition for serious complications frequently associated with trabeculectomy, nonpenetrating deep sclerectomy with the collagen glaucoma drainage device was an effective alternative for this patient.

  4. Health benefits of particle filtration

    EPA Science Inventory

    This product was developed under an interagency agreement between the U.S. EPA and the U.S. Department of Energy - Lawrence Berkeley National Laboratory (LBNL). The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews o...

  5. Filtration combustion: Smoldering and SHS

    NASA Technical Reports Server (NTRS)

    Matkowsky, Bernard J.

    1995-01-01

    Smolder waves and SHS (self-propagating high-temperature synthesis) waves are both examples of combustion waves propagating in porous media. When delivery of reactants through the pores to the reaction site is an important aspect of the process, it is referred to as filtration combustion. The two types of filtration combustion have a similar mathematical formulation, describing the ignition, propagation and extinction of combustion waves in porous media. The goal in each case, however, is different. In smoldering the desired goal is to prevent propagation, whereas in SHS the goal is to insure propagation of the combustion wave, leading to the synthesis of desired products. In addition, the scales in the two areas of application may well differ. For example, smoldering generally occurs at a relatively low temperature and with a smaller propagation velocity than SHS filtration combustion waves. Nevertheless, the two areas of application have much in common, so that mechanisms learned about in one application can be used to advantage in the other. In this paper we discuss recent results in the areas of filtration combustion.

  6. Health benefits of particle filtration

    EPA Science Inventory

    This product was developed under an interagency agreement between the U.S. EPA and the U.S. Department of Energy - Lawrence Berkeley National Laboratory (LBNL). The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews o...

  7. Improving IAQ Via Air Filtration.

    ERIC Educational Resources Information Center

    Monk, Brian

    1999-01-01

    Provides tips on using air filtration to control indoor air quality in educational facilities, including dedicated spaces with unique air quality conditions such as in libraries, museums and archival storage areas, kitchens and dining areas, and laboratories. The control of particulate contaminants, gaseous contaminants, and moisture buildup are…

  8. MICROBIOLOGICAL REMOVAL BY FILTRATION PROCESSES

    EPA Science Inventory

    Filtration ws originally used to remove contaminants that affect the appearance, odor, and taste of drinking water. Later it was demonstrated that bacteria in drinking water were causative agents of disease. Water treatment technology improved with the addition of disinfection, c...

  9. Improving IAQ Via Air Filtration.

    ERIC Educational Resources Information Center

    Monk, Brian

    1999-01-01

    Provides tips on using air filtration to control indoor air quality in educational facilities, including dedicated spaces with unique air quality conditions such as in libraries, museums and archival storage areas, kitchens and dining areas, and laboratories. The control of particulate contaminants, gaseous contaminants, and moisture buildup are…

  10. Filtration combustion: Smoldering and SHS

    NASA Technical Reports Server (NTRS)

    Matkowsky, Bernard J.

    1995-01-01

    Smolder waves and SHS (self-propagating high-temperature synthesis) waves are both examples of combustion waves propagating in porous media. When delivery of reactants through the pores to the reaction site is an important aspect of the process, it is referred to as filtration combustion. The two types of filtration combustion have a similar mathematical formulation, describing the ignition, propagation and extinction of combustion waves in porous media. The goal in each case, however, is different. In smoldering the desired goal is to prevent propagation, whereas in SHS the goal is to insure propagation of the combustion wave, leading to the synthesis of desired products. In addition, the scales in the two areas of application may well differ. For example, smoldering generally occurs at a relatively low temperature and with a smaller propagation velocity than SHS filtration combustion waves. Nevertheless, the two areas of application have much in common, so that mechanisms learned about in one application can be used to advantage in the other. In this paper we discuss recent results in the areas of filtration combustion.

  11. Dynamics and filtration of microgel suspensions

    NASA Astrophysics Data System (ADS)

    Naegele, Gerhard; Roa, Rafael; Riest, Jonas

    Microgel suspensions exhibit interesting transport properties determined by direct and hydrodynamic interactions. Using an annulus model to account for solvent permeability, we calculate the diffusion function and sedimentation coefficient of PNiPAM microgel suspensions, in excellent agreement with experimental results. Moreover, an extension of our precise analytic methods to long-time properties including viscosity and self-diffusion coefficient is presented, with results compared to simulation and experimental data. The predicted transport properties are an important ingredient to the modeling of convective-diffusive transport in membrane ultrafiltration of permeable particles. The efficiency of the separation process depends on hydrodynamic boundary conditions, membrane properties and particle interactions. We calculate the concentration polarization layer and permeate flux at different operating conditions for cross-flow ultrafiltration of non-ionic and ionic microgels. Small microgel permeability already affects the filtration significantly.

  12. Glaucoma Structural and Functional Progression in American and Korean Cohorts

    PubMed Central

    Kostanyan, Tigran; Sung, Kyung Rim; Schuman, Joel S.; Ling, Yun; Lucy, Katie A.; Bilonick, Richard A.; Ishikawa, Hiroshi; Kagemann, Larry; Lee, Jin Y.; Wollstein, Gadi

    2016-01-01

    Objective To compare the rate of glaucoma structural and functional progression in American and Korean cohorts. Design Retrospective longitudinal study. Participants 313 eyes from 189 glaucoma and glaucoma suspects, followed for an average of 38 months. Methods All subjects were examined semiannually with visual field (VF) testing and spectral-domain optical coherence tomography. All subjects had ≥5 reliable visits. Main Outcome Measurements The rates of change of retinal nerve fiber layer (RNFL) thickness, cup-to-disc (C/D) ratios, and VF mean deviation (MD) were compared between the cohorts. Variables affecting the rate of change for each parameter were determined, including ethnicity, refraction, baseline age and severity, disease subtype (high vs. normal tension glaucoma), clinical diagnosis (glaucoma vs. glaucoma suspect), and the interactions between variables. Results The Korean cohort was predominantly normal tension glaucoma, while the American cohort was high tension glaucoma. Cohorts had similar VF parameters at baseline, but the Korean eyes had significantly thinner mean RNFL and larger cups. Korean glaucoma eyes showed a faster thinning of mean RNFL (mean: −0.71 vs. −0.24μm/year, p<0.01). There was no detectable difference in the rate of change between the glaucoma cohorts for C/D ratios and VF MD and for all parameters in glaucoma suspect eyes. Different combinations of the tested variables significantly impacted the rate of change. Conclusion Ethnicity, baseline severity, disease subtype, and clinical diagnosis should be considered when comparing glaucoma progression studies. PMID:26778345

  13. Is Estrogen a Therapeutic Target for Glaucoma?

    PubMed Central

    Dewundara, Samantha; Wiggs, Janey; Sullivan, David A.; Pasquale, Louis R.

    2016-01-01

    Objective To provide an overview of the association between estrogen and glaucoma. Methods A literature synthesis of articles published in peer review journals screened through May 05, 2015 using the PubMed database. Key words used were “estrogen and glaucoma,” “reproductive factors and glaucoma,” “estrogen, nitric oxide and eye.” Forty three journal articles were included. Results Markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open angle (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses’ Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk) while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of post-menopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in endothelial nitric oxide synthase, a gene receptive to

  14. Influence of Diastolic Blood Pressure on Glaucoma Progression in Glaucoma Patients with Systemic Hypertension.

    PubMed

    Suić, Smiljka Popović; Skegro, Ivan; Jandroković, Sonja; Kordić, Rajko; Kutija, Maria Barisić

    2015-09-01

    The aim of this study is to determine relationship between glaucoma progression and diastolic blood pressure. It was conducted on 64 glaucoma patients at the Department of Ophthalmology of Clinical Hospital Centre Zagreb in three years period. The patients were on anti glaucoma therapy and had mean intraocular pressure values under 20 mmHg. At the same time they were on antihypertensive drug therapy. Patients were classified according Glaucoma Staging System based on the perimetric indices mean deviation (MD) and Pattern Standard Deviation into stage 2-4 (moderate glaucoma) at baseline. Rate of visual field progression was calculated in db/year for MD in the last three visits. Patients were divided in 3 groups according to progression--stabile, moderate and progressive. There was no statistically significant difference between 3 groups in terms of intraocular pressure values at baseline and in follow up period. After reviewing their blood pressure, the progressive group showed a significantly lower diastolic blood pressure compared to both stable group and the group with moderate progression. There was no statistical difference between the group with moderate progression and the stable group in terms of diastolic blood pressure. Results suggest that greater risk of glaucoma progression is connected with lower diastolic blood pressure. Diastolic pressure values could be important as one of the risk factors for progression in glaucoma patients with controlled intraocular pressure values.

  15. 24-h Efficacy of Glaucoma Treatment Options.

    PubMed

    Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

    2016-04-01

    Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

  16. Topical glaucoma therapy cost in Mexico.

    PubMed

    Lazcano-Gomez, Gabriel; Hernandez-Oteyza, Alejandra; Iriarte-Barbosa, María José; Hernandez-Garciadiego, Carlos

    2014-04-01

    Glaucoma is an important cause of irreversible blindness that represents a significant economic burden; most direct costs of glaucoma are drug-related. We calculated the annual cost of some of the most commonly prescribed glaucoma medications in Mexico, according to their average wholesale price (AWP) and dose regimen. Annual costs ranged from USD4.97 for Imot 15 ml (timolol 0.5 %; Laboratorios Sophia) to USD675.39 for Alphagan 5 ml (brimonidine 0.2 %; Allergan, Inc.). β-Blockers were the least expensive glaucoma medications (range USD20.44-55.44). Alphagan 5 ml was 250 % more expensive than other selective α(2)-agonists. Of the carbonic anhydrase inhibitors, dorzolamide 2 % was less expensive than brinzolamide 1 % (USD326.91 vs. USD418.96). The annual cost for prostaglandin analogs ranged from USD235.58 for bimatoprost 0.03 % to USD337.78 for latanoprost 0.005 %. Some fixed combinations were less expensive than separate combinations. The average annual cost for all treatments increased by 27.87 ± 10.09 % between 2009 and 2012. Annual glaucoma therapy cost seems to be lower in Mexico than in other countries, due to a lower AWP, especially for some medications made by Mexican laboratories.

  17. Filtration Understanding: FY10 Testing Results and Filtration Model Update

    SciTech Connect

    Daniel, Richard C.; Billing, Justin M.; Burns, Carolyn A.; Peterson, Reid A.; Russell, Renee L.; Schonewill, Philip P.; Shimskey, Rick W.

    2011-04-04

    This document completes the requirements of Milestone 2-4, Final Report of FY10 Testing, discussed in the scope of work outlined in the EM31 task plan WP-2.3.6-2010-1. The focus of task WP 2.3.6 is to improve the U.S. Department of Energy’s (DOE’s) understanding of filtration operations for high-level waste (HLW) to improve filtration and cleaning efficiencies, thereby increasing process throughput and reducing the Na demand (through acid neutralization). Developing the cleaning/backpulsing requirements will produce much more efficient operations for both the Hanford Tank Waste Treatment and Immobilization Plant (WTP) and the Savannah River Site (SRS), thereby significantly increasing throughput by limiting cleaning cycles. The scope of this work is to develop the understanding of filter fouling to allow developing this cleaning/backpulsing strategy.

  18. Activity Limitation in Glaucoma: Objective Assessment by the Cambridge Glaucoma Visual Function Test.

    PubMed

    Skalicky, Simon E; McAlinden, Colm; Khatib, Tasneem; Anthony, Louise May; Sim, Sing Yue; Martin, Keith R; Goldberg, Ivan; McCluskey, Peter

    2016-11-01

    We design and evaluate a computer-based objective simulation of activity limitation related to glaucoma. A cross-sectional study was performed involving 70 glaucoma patients and 14 controls. Mean age was 69.0 ± 10.2 years; 49 (58.3%) were male. The Cambridge Glaucoma Visual Function Test (CGVFT) was administered to all participants. Rasch analysis and criterion, convergent, and divergent validity tests assessed the psychometric properties of the CGVFT. Regression modeling was used to determine factors predictive of CGVFT person measures. Sociodemographic information, better and worse eye visual field parameters, visual acuity, contrast sensitivity, and the Rasch-analyzed Glaucoma Activity Limitation-9 (GAL-9) and Visual Function Questionnaire Utility Index (VFQUI) questionnaire responses were recorded. From 139 pilot CGVFT items, 59 had acceptable fit to the Rasch model, with acceptable precision (person separation index, 2.13) and targeting. Cambridge Glaucoma Visual Function Test person measure (logit) scores increased between controls (-0.20 ± 0.08) and patients with mild (-0.15 ± 0.08), moderate (-0.13 ± 0.10), and severe (-0.05 ± 0.10) glaucoma (P < 0.001, ANOVA) indicating good criterion validity. Correlation coefficients of 0.455 (P < 0.001) between CGVFT and GAL-9 person measures and 0.399 (P = 0.005) between CGVFT and VFQUI person measures demonstrated convergent validity. Divergent validity was suboptimal. On multivariable analysis, lower better eye mean deviation and greater age were associated with worsening CGVFT person measures (P ≤ 0.001). The CGVFT is a computerized visual challenge test administered to a cohort of glaucoma patients. It may benefit glaucoma patients, careers, health care providers, and policy makers, providing increased awareness of activity limitation due to glaucoma.

  19. Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

    PubMed Central

    Yarmohammadi, Adeleh; Zangwill, Linda M.; Diniz-Filho, Alberto; Suh, Min Hee; Manalastas, Patricia Isabel; Fatehee, Naeem; Yousefi, Siamak; Belghith, Akram; Saunders, Luke J.; Medeiros, Felipe A.; Huang, David; Weinreb, Robert N.

    2016-01-01

    Purpose The purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients. Methods Two hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy. Results Age-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P < 0.001; and wiVD: 46.2 ± 6%, 51.3 ± 5%, and 56.6 ± 3%, respectively; P < 0.001). For differentiating between glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65). Conclusions Optical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG. PMID:27409505

  20. Impaired ocular blood flow regulation in patients with open-angle glaucoma and diabetes.

    PubMed

    Shoshani, Yochai; Harris, Alon; Shoja, Mohammadali M; Arieli, Yoel; Ehrlich, Rita; Primus, Sally; Ciulla, Thomas; Cantor, Adam; Wirostko, Barbara; Siesky, Brent A

    2012-01-01

    contribute to glaucoma progression. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  1. Lymphatic and Blood Vessel Density in Human Conjunctiva After Glaucoma Filtration Surgery.

    PubMed

    Bouhenni, Rachida A; Al Jadaan, Ibrahim; Rassavong, Heidi; Al Shahwan, Sami; Al Katan, Hind; Dunmire, Jeffrey; Krasniqi, Mirela; Edward, Deepak P

    2016-01-01

    To investigate the lymphatic vascular microvessel density (LVD) and the blood vascular microvessel density (MVD) and their distribution in excised leaking blebs after mitomycin C trabeculectomy and normal conjunctiva specimens. LVD and MVD in normal human conjunctiva (n=8) and excised blebs in the hypocellular stroma and peribleb tissue (conjunctiva adjacent to hypocellular bleb tissue) (n=8) were evaluated by immunohistochemistry using antibodies raised against Lymphatic Vessel Endothelial Receptor 1 (D2-40, lymphatic endothelium) and CD34 (vascular endothelium). LVD and MVD counts were performed by light microscopy in 5 fields at ×20 magnification by 3 observers. Differences were determined using Mann-Whitney U test (P<0.05 was considered significant). The leaking blebs showed typical epithelial-stromal domes with areas of acellular stroma covered by attenuated epithelium and surrounded by normal conjunctival epithelium and a dense scar-like matrix replacing the substantia propria. The LVD and MVD were significantly reduced to nil in the hypocellular conjunctival stroma of the excised blebs compared with normal conjunctiva (21.42 vs. 1.16, P<0.002 and 24.28 vs. 1, P<0.008, respectively). The LVD and MVD was also reduced (2- to 2.5-fold) in the peribleb stroma when compared with normal conjunctiva specimens. In this study we show reduced LCD and MVD in the hypocellular and peribleb stroma. These results may suggest a role of these vessels in an altered immune response in leaking blebs leading to an increased risk for blebitis.

  2. Approximate theory for radial filtration/consolidation

    SciTech Connect

    Tiller, F.M.; Kirby, J.M.; Nguyen, H.L.

    1996-10-01

    Approximate solutions are developed for filtration and subsequent consolidation of compactible cakes on a cylindrical filter element. Darcy`s flow equation is coupled with equations for equilibrium stress under the conditions of plane strain and axial symmetry for radial flow inwards. The solutions are based on power function forms involving the relationships of the solidosity {epsilon}{sub s} (volume fraction of solids) and the permeability K to the solids effective stress p{sub s}. The solutions allow determination of the various parameters in the power functions and the ratio k{sub 0} of the lateral to radial effective stress (earth stress ratio). Measurements were made of liquid and effective pressures, flow rates, and cake thickness versus time. Experimental data are presented for a series of tests in a radial filtration cell with a central filter element. Slurries prepared from two materials (Microwate, which is mainly SrSO{sub 4}, and kaolin) were used in the experiments. Transient deposition of filter cakes was followed by static (i.e., no flow) conditions in the cake. The no-flow condition was accomplished by introducing bentonite which produced a nearly impermeable layer with negligible flow. Measurement of the pressure at the cake surface and the transmitted pressure on the central element permitted calculation of k{sub 0}.

  3. Structural and Functional Evaluations for the Early Detection of Glaucoma.

    PubMed

    Lucy, Katie A; Wollstein, Gadi

    2016-01-01

    The early detection of glaucoma is imperative in order to preserve functional vision. Structural and functional methods are utilized to detect and monitor glaucomatous damage and the vision loss it causes. The relationship between these detection measures is complex and differs between individuals, especially in early glaucoma. Using both measures together is advised in order to ensure the highest probability of glaucoma detection, and new testing methods are continuously developed with the goals of earlier disease detection and improvement of disease monitoring. The purpose of this review is to explore the relationship between structural and functional glaucoma detection and discuss important technological advances for early glaucoma detection.

  4. Structural and Functional Evaluations for the Early Detection of Glaucoma

    PubMed Central

    Lucy, Katie A.; Wollstein, Gadi

    2016-01-01

    The early detection of glaucoma is imperative in order to preserve functional vision. Structural and functional methods are utilized to detect and monitor glaucomatous damage and the vision loss it causes. The relationship between these detection measures is complex and differs between individuals, especially in early glaucoma. Using both measures together is advised in order to ensure the highest probability of glaucoma detection, and new testing methods are continuously developed with the goals of earlier disease detection and improvement of disease monitoring. The purpose of this review is to explore the relationship between structural and functional glaucoma detection and discuss important technological advances for early glaucoma detection. PMID:28603546

  5. Spontaneous water filtration of bio-inspired membrane

    NASA Astrophysics Data System (ADS)

    Kim, Kiwoong; Kim, Hyejeong; Lee, Sang Joon

    2016-11-01

    Water is one of the most important elements for plants, because it is essential for various metabolic activities. Thus, water management systems of vascular plants, such as water collection and water filtration have been optimized through a long history. In this view point, bio-inspired technologies can be developed by mimicking the nature's strategies for the survival of the fittest. However, most of the underlying biophysical features of the optimized water management systems remain unsolved In this study, the biophysical characteristics of water filtration phenomena in the roots of mangrove are experimentally investigated. To understand water-filtration features of the mangrove, the morphological structures of its roots are analyzed. The electrokinetic properties of the root surface are also examined. Based on the quantitatively analyzed information, filtration of sodium ions in the roots are visualized. Motivated by this mechanism, spontaneous desalination mechanism in the root of mangrove is proposed by combining the electrokinetics and hydrodynamic transportation of ions. This study would be helpful for understanding the water-filtration mechanism of the roots of mangrove and developing a new bio-inspired desalination technology. This research was financially supported by the National Research Foundation (NRF) of Korea (Contract Grant Number: 2008-0061991).

  6. Clinical Characteristics and Current Treatment of Glaucoma

    PubMed Central

    Cohen, Laura P.; Pasquale, Louis R.

    2014-01-01

    Glaucoma is a neurodegenerative disorder in which degenerating retinal ganglion cells (RGC) produce significant visual disability. Clinically, glaucoma refers to an array of conditions associated with variably elevated intraocular pressure (IOP) that contributes to RGC loss via mechanical stress, vascular abnormalities, and other mechanisms, such as immune phenomena. The clinical diagnosis of glaucoma requires assessment of the ocular anterior segment with slit lamp biomicroscopy, which allows the clinician to recognize signs of conditions that can produce elevated IOP. After measurement of IOP, a specialized prismatic lens called a gonioscope is used to determine whether the angle is physically open or closed. The structural manifestation of RGC loss is optic nerve head atrophy and excavation of the neuroretinal rim tissue. Treatment is guided by addressing secondary causes for elevated IOP (such as inflammation, infection, and ischemia) whenever possible. Subsequently, a variety of medical, laser, and surgical options are used to achieve a target IOP. PMID:24890835

  7. Linkage studies in primary open angle glaucoma

    SciTech Connect

    Avramopoulos, D.; Grigoriadu, M.; Kitsos, G.

    1994-09-01

    Glaucoma is a leading cause of blindness worldwide. The majority of glaucoma is associated with an open, normal appearing anterior chamber angle and is termed primary open angle glaucoma (POAG, MIM 137760). It is characterized by elevated intraocular pressure and onset in middle age or later. A subset of POAG with juvenile onset has recently been linked to chromosome 1q in two families with autosomal dominant inheritance. Eleven pedigrees with autosomal dominant POG (non-juvenile-onset) have been identified in Epirus, Greece. In the present study DNA samples have been collected from 50 individuals from one large pedigree, including 12 affected individuals. Preliminary results of linkage analysis with chromosome 1 microsatellites using the computer program package LINKAGE Version 5.1 showed no linkage with the markers previously linked to juvenile-onset POAG. Further linkage analysis is being pursued, and the results will be presented.

  8. Novel therapies for open-angle glaucoma

    PubMed Central

    Wentz, Scott M.; Kim, Nathaniel J.; Wang, Jenny; Amireskandari, Annahita; Siesky, Brent

    2014-01-01

    Open-angle glaucoma is a multifactorial optic neuropathy characterized by progressive loss of retinal ganglion cells and their axons. It is an irreversible disease with no established cure. The only currently approved treatment is aimed at lowering intraocular pressure, the most significant risk factor known to date. However, it is now clear that there are other risk factors involved in glaucoma's pathophysiology. To achieve future improvements in glaucoma management, new approaches to therapies and novel targets must be developed. Such therapies may include new tissue targets for lowering intraocular pressure, molecules influencing ocular hemodynamics, and treatments providing neuroprotection of retinal ganglion cells. Furthermore, novel drug delivery systems are in development that may improve patient compliance, increase bioavailability, and decrease adverse side effects. PMID:25580256

  9. [Experience in laser treatment of primary glaucoma].

    PubMed

    Mel'nikov, V Ia; Osykhovskiĭ, A L; Dogadova, D P

    1995-01-01

    An Interdistrict Laser Center has been functioning in Vladivostok for 10 years. Laser exposure was used in the treatment of 749 patients with primary glaucoma. Yatagan-1, Orion-3001, YAG Pegaus-3002 lasers (Germany) were employed. In 55% cases primary glaucoma was concomitant with essential hypertension, in 12% with diabetes mellitus. Laser iridectomy, laser goniopuncture, laser trabeculoplasty were used. Hypotensive effect lasting for at least 6 months was attained in 69.1% cases. Complications presenting as hemorrhages in the anterior chamber, which spontaneously resolved on day 2 after exposure, were observed in only 4% cases. Laser therapy in patients aged 50 to 70 is the only means of reducing ophthalmic tone and preserving the visual function because of somatic diseases present at this age. Laser treatment of primary glaucoma brings about an appreciable economic effect and creates favorable conditions for subsequent microsurgery.

  10. Lamina Cribrosa in Glaucoma: Diagnosis and Monitoring

    PubMed Central

    Abe, Ricardo Y.; Gracitelli, Carolina P. B.; Diniz-Filho, Alberto; Tatham, Andrew J.

    2015-01-01

    The lamina cribrosa is the putative site of retinal ganglion cell axonal injury in glaucoma. Although histological studies have provided evidence of structural changes to the lamina cribrosa, even in early stages of glaucoma, until recently, the ability to evaluate the lamina cribrosa in vivo has been limited. Recent advances in optical coherence tomography, including enhanced depth and swept-source imaging, have changed this, providing a means to image the lamina cribrosa. Imaging has identified general and localized configurational changes in the lamina of glaucomatous eyes, including posterior laminar displacement, altered laminar thickness, and focal laminar defects with spatial association with conventional structural and functional losses. In addition, although the temporal relationship between changes to the lamina cribrosa and glaucomatous retinal ganglion cell loss is yet to be elucidated, quantitative measurements of laminar microarchitecture have good reproducibility and offer the potential to serve as biomarkers for glaucoma diagnosis and progression. PMID:26052477

  11. Diagnostic tools for glaucoma detection and management.

    PubMed

    Sharma, Pooja; Sample, Pamela A; Zangwill, Linda M; Schuman, Joel S

    2008-11-01

    Early diagnosis of glaucoma is critical to prevent permanent structural damage and irreversible vision loss. Detection of glaucoma typically relies on examination of structural damage to the optic nerve combined with measurements of visual function. To aid the clinician in evaluation of visual function and structure, computer-based devices such as confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography provide quantitative assessments of structural damage, and visual function testing includes standard automated perimetry as well as selective techniques, including short-wavelength automated perimetry and frequency-doubling technology perimetry are available. This article will review current literature on diagnostic modalities available for glaucoma with emphasis on the best evidence available in the literature to support their use in clinical practice.

  12. [Influence of Luxury Foodstuffs on Glaucoma].

    PubMed

    Huber-van der Velden, K K

    2017-02-01

    The term "luxury foodstuffs" refers to foods which are not consumed because of their nutritional value. Classic modern luxury foodstuffs are alcohol, caffeine-containing drinks, cocoa, sugar and tobacco. The following review article examines some of these modern luxury foodstuffs in detail, as well as their influence on glaucoma. Thus, small quantities of alcohol lower high intraocular pressure and have a positive influence on the blood circulation of the optic nerve. In addition, red wine polyphenols exert vasoprotective effects. In general, however, alcohol consumption appears to have no significant effect on the prevalence of glaucoma. The most important source of caffeine intake is coffee consumption. In some studies, coffee consumption caused no changes in intraocular pressure, while others reported a rise. A large study showed a connection between heavy coffee consumption and the risk of pseudoexfoliation glaucoma. Green and black teas are rich sources of flavonoids with antioxidant activity. In addition, a slight trend for lowering the intraocular pressure has been measured. As regards chocolate, flavonoid-rich dark chocolate should be favoured, due to its antioxidant activity. It lowers blood pressure and improves endothelium-dependent vascular relaxation. Excessive sugar consumption over many years can lead to increased body mass index (BMI) and type 2 diabetes. Many studies show a positive relationship between BMI and intraocular pressure. Some studies have identified significant correlations between type 2 diabetes and the risk of glaucoma. Smoking is a very widespread stimulant; it narrows the blood vessels and thus reduces the blood circulation of the optic nerve. Otherwise, studies on the role of smoking as a risk factor for glaucoma have been very inconsistent. Luxury foodstuffs may effect glaucoma and should be included in the medical history.

  13. [Glaucoma in the over-eighties].

    PubMed

    Detry-Morel, M

    2007-11-01

    Due to the recent rapid increase in the aging population, glaucoma in the over-eighties population will become a significant problem of ocular health in the coming decades. It is important to determine the natural effects of aging on the optic nerve head and aqueous humor dynamics in these patients for early diagnosis and monitoring of glaucoma. Its characteristics, context, management, and treatment are very perceptibly different from those of the younger glaucomatous patient. For many reasons, such as its frequent association with macular age-related degeneration, diagnosis of glaucoma in the over-eighties may be difficult. Management of the over-eighties glaucoma is frequently difficult and time-consuming. Less aggressive than in a younger patient and based on topical medications in most cases, it must be discussed case by case and will be based on the general context, the quality of compliance, and especially on the potential consequences of the glaucomatous visual-field defects on the patient's quality of life. In any case, overtreatment as well as treatments that are too complex must be avoided. Given the reduced metabolism in the very elderly, the safest medications must also be selected. It is important to always consider glaucoma medications as part of the patient's medicine regimen. Associated risk factors, especially concomitant systemic hypotension, will be simultaneously treated. Laser trabeculoplasties probably have broader indications than in younger patients. Except for phacoextraction, which is very frequently helpful in controlling IOP, incisional filtering procedures or laser diode cyclophotocoagulations remain infrequently indicated in over-eighties glaucoma patients.

  14. Visual object categorisation in people with glaucoma.

    PubMed

    Lenoble, Quentin; Lek, Jia Jia; McKendrick, Allison M

    2016-11-01

    There is evidence that people with glaucoma exhibit difficulties with some complex visual tasks such as face recognition, motion perception and scene exploration. The purpose of this study was to determine whether glaucoma affects the ability to categorise briefly presented visual objects in central vision. Visual categorisation performance of 14 people with glaucoma (primary open angle glaucoma and preperimetric) and 15 age-matched controls was measured, assessing both accuracy and response times. Grey level photographs of objects (size) were presented for 28 ms foveally. Perimetric thresholds were normal for all participants within the central 3°. Two levels of contrasts were included: one medium level at 50% and one with high contrast at 100%. On average, accuracy was significantly decreased by 7% (p=0.046) for the medium contrast stimuli in patients with glaucoma (87% of correct response, SD: 5%) compared with controls (94% of correct response, SD: 4.7%). Group average response times were significantly slower for the patients relative to the control group (712 ms, SD: 53 ms compared with 643 ms, SD: 34 ms for the control group; p<0.01). Performance was equivalent in the two groups when the picture contrast was 100%. The impairment observed in the categorisation task supports previous work that demonstrates that people with glaucoma can have greater difficulties with complex visual tasks than is predicted by their visual field loss. The performance was equivalent to age-matched controls when contrast was maximised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. High Temperature Particle Filtration Technology

    SciTech Connect

    Besmann, T.M.

    2001-11-13

    High temperature filtration can serve to improve the economic, environmental, and energy performance of chemical processes. This project was designed to evaluate the stability of filtration materials in the environments of the production of dimethyldichlorosilane (DDS). In cooperation with Dow Corning, chemical environments for the fluidized bed reactor where silicon is converted to DDS and the incinerator where vents are cornbusted were characterized. At Oak Ridge National Laboratory (ORNL) an exposure system was developed that could simulate these two environments. Filter samples obtained from third parties were exposed to the environments for periods up to 1000 hours. Mechanical properties before and after exposure were determined by burst-testing rings of filter material. The results indicated that several types of filter materials would likely perform well in the fluid bed environment, and two materials would be good candidates for the incinerator environment.

  16. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

    PubMed Central

    Cham, Abdourahman; Bansal, Mayank; Banda, Himanshu K; Kwon, Young; Tlucek, Paul S; Bassuk, Alexander G; Tsang, Stephen H; Sobol, Warren M; Folk, James C; Yeh, Steven; Mahajan, Vinit B

    2016-01-01

    Objective The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), a hereditary autoimmune uveitis due to mutations in CAPN5. Patients and methods A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP), visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT) were also analyzed. Results Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA) implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5) required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser peripheral iridotomy. Patient 4 had both hypotony and elevated IOP that required periodic antiglaucoma medication in the FA-implanted eye. Patient 3 did not develop steroid-response glaucoma in either eye. Optic disk examinations were obscured by fibrosis and better assessed with OCT. Conclusion ADNIV patients show combined mechanism secondary glaucoma best assessed by OCT of the optic disk. The FA implants have reduced uveitic and neovascular glaucoma. Nevertheless, IOP management remains complex due to steroid-response glaucoma, angle closure glaucoma, and hypotony. PMID:27390515

  17. Risk Factors for Secondary Glaucoma in Herpetic Anterior Uveitis.

    PubMed

    Hoeksema, Lisette; Jansonius, Nomdo M; Los, Leonoor I

    2017-09-01

    To determine the incidence of elevated intraocular pressure (IOP) and secondary glaucoma in herpetic anterior uveitis (AU), owing to either herpes simplex or varicella zoster virus, by using the Standardization of Uveitis Nomenclature (SUN) criteria, and to identify risk factors for the development of glaucoma. Retrospective observational cohort study. Patients with herpetic AU presenting themselves between 2001 and 2013 at the ophthalmology department of the University Medical Center Groningen were included. Main outcome measures were the incidence of elevated IOP and glaucoma and risk factors for the development of glaucoma. Seventy-three herpetic AU patients were included. Ocular complications most commonly seen during follow-up for uveitis were elevated IOP (75%), keratitis (59%), dry eyes (34%), posterior synechiae (34%), cataract (32%), and glaucoma (15%). Glaucoma patients, in comparison to non-glaucoma patients, had a higher number of IOP peaks during their follow-up for uveitis (P < .001). The majority of patients with elevated IOP (91%) had this already at the start of the uveitis. Nineteen percent of the patients needed glaucoma surgery. Using the SUN criteria, our study confirmed that elevated IOP and secondary glaucoma are major complications in herpetic AU. If an elevated IOP occurred, it was usually already present at the start of a uveitis episode. A risk factor for the development of glaucoma was the number of endured IOP peaks. Future studies are needed to evaluate whether early and prolonged use of antiviral and IOP-lowering medication may prevent glaucoma. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Rare Diseases Leading to Childhood Glaucoma: Epidemiology, Pathophysiogenesis, and Management

    PubMed Central

    Abdolrahimzadeh, Solmaz; Fameli, Valeria; Mollo, Roberto; Contestabile, Maria Teresa; Perdicchi, Andrea; Recupero, Santi Maria

    2015-01-01

    Noteworthy heterogeneity exists in the rare diseases associated with childhood glaucoma. Primary congenital glaucoma is mostly sporadic; however, 10% to 40% of cases are familial. CYP1B1 gene mutations seem to account for 87% of familial cases and 27% of sporadic cases. Childhood glaucoma is classified in primary and secondary congenital glaucoma, further divided as glaucoma arising in dysgenesis associated with neural crest anomalies, phakomatoses, metabolic disorders, mitotic diseases, congenital disorders, and acquired conditions. Neural crest alterations lead to the wide spectrum of iridocorneal trabeculodysgenesis. Systemic diseases associated with childhood glaucoma include the heterogenous group of phakomatoses where glaucoma is frequently encountered in the Sturge-Weber syndrome and its variants, in phakomatosis pigmentovascularis associated with oculodermal melanocytosis, and more rarely in neurofibromatosis type 1. Childhood glaucoma is also described in systemic disorders of mitotic and metabolic activity. Acquired secondary glaucoma has been associated with uveitis, trauma, drugs, and neoplastic diseases. A database research revealed reports of childhood glaucoma in rare diseases, which do not include glaucoma in their manifestation. These are otopalatodigital syndrome, complete androgen insensitivity, pseudotrisomy 13, Brachmann-de Lange syndrome, acrofrontofacionasal dysostosis, caudal regression syndrome, and Wolf-Hirschhorn syndrome. PMID:26451378

  19. Centrifugal membrane filtration -- Task 9

    SciTech Connect

    1996-08-01

    The Energy and Environmental Research Center (EERC) has teamed with SpinTek Membrane Systems, Inc., the developer of a centrifugal membrane filtration technology, to demonstrate applications for the SpinTek technology within the US Department of Energy (DOE) Environmental management (EM) Program. The technology uses supported microporous membranes rotating at high rpm, under pressure, to separate suspended and colloidal solids from liquid streams, yielding a solids-free permeate stream and a highly concentrated solids stream. This is a crosscutting technology that falls under the Efficient Separations and Processing Crosscutting Program, with potential application to tank wastes, contaminated groundwater, landfill leachate, and secondary liquid waste streams from other remediation processes, including decontamination and decommissioning systems. Membrane-screening tests were performed with the SpinTek STC-X4 static test cell filtration unit, using five ceramic membranes with different pore size and composition. Based on permeate flux, a 0.25-{micro}m TiO{sub 2}/Al{sub 2}O{sub 3} membrane was selected for detailed performance evaluation using the SpinTek ST-IIL centrifugal membrane filtration unit with a surrogate tank waste solution. An extended test run of 100 hr performed on a surrogate tank waste solution showed some deterioration in filtration performance, based on flux, apparently due to the buildup of solids near the inner portion of the membrane where relative membrane velocities were low. Continued testing of the system will focus on modifications to the shear pattern across the entire membrane surface to affect improved long-term performance.

  20. Uveitis and glaucoma: new insights in the pathogenesis and treatment.

    PubMed

    Sng, Chelvin C A; Ang, Marcus; Barton, Keith

    2015-01-01

    Glaucoma is a potentially blinding complication of uveitis, where intraocular inflammation, secondary corticosteroid response, and varying types and degrees of angle abnormalities contribute to its pathogenesis. Management of uveitic glaucoma remains challenging. Treatment is targeted at reducing the inflammation and lowering the intraocular pressure. Recent studies have highlighted the role of viruses, such as cytomegalovirus, herpes simplex virus, and more recently Ebola virus, in the pathogenesis of uveitic glaucoma. Antiviral therapy may be beneficial in eyes with detectable viral DNA. The success of glaucoma surgery is decreased in eyes with uveitic glaucoma, and surgical interventions are associated with a higher incidence of postoperative complications. Novel glaucoma surgical and laser treatments may improve the predictability of surgery for uveitic glaucoma, but these require further evaluation.

  1. Current Approach in the Diagnosis and Management of Uveitic Glaucoma

    PubMed Central

    Muñoz-Negrete, Francisco J.; Hernández-Martínez, Paula; Rebolleda, Gema

    2015-01-01

    Uveitic glaucoma (UG) typically is associated with very high intraocular pressure (IOP) and more intense optic nerve damage than other glaucoma types. This secondary glaucoma requires an early diagnosis and adequate management of both uveitis and glaucoma. It is mandatory to identify the mechanisms of IOP elevation that in many eyes have multiple combined mechanisms. Management of these patients commonly requires an interdisciplinary approach that includes a glaucoma specialist and rheumatologist to control the inflammation and IOP. Glaucoma surgery is required early in these patients due to the high IOP usually present and is less successful than in primary open-angle glaucoma. Recurrent uveitic episodes, multiple mechanism, and the complications associated with uveitis make surgical management of UG challenging. In this review, the management and treatment of UG are updated to clarify the pathogenesis and prevent optic nerve damage. PMID:26558280

  2. New trends in glaucoma risk, diagnosis & management

    PubMed Central

    Kersey, Thomas; Clement, Colin I.; Bloom, Phillip; Cordeiro, M. Francesca

    2013-01-01

    Recent advances have seen a surge of new ideas and technologies to aid in the detection, treatment and further understanding of glaucoma. These technologies and advances are discussed to provide information on risk-factors, diagnosis and treatment. Glaucoma has never before seen such an advance in research and therapies coming forward in to the clinical workplace. It is an exciting time for physicians and researchers alike and over the next decade will certainly see advances in early detection, efficacious treatments and neuroprotection. PMID:23703333

  3. Definition, Classification, and Pathophysiology of Canine Glaucoma.

    PubMed

    Pizzirani, Stefano

    2015-11-01

    Glaucoma is a common ocular condition in humans and dogs leading to optic nerve degeneration and irreversible blindness. Primary glaucoma is a group of spontaneous heterogeneous diseases. Multiple factors are involved in its pathogenesis and these factors vary across human ethnic groups and canine breeds, so the clinical phenotypes are numerous and their classification can be challenging and remain superficial. Aging and oxidative stress are major triggers for the manifestation of disease. Multiple, intertwined inflammatory and biochemical cascades eventually alter cellular and extracellular physiology in the optic nerve and trabecular meshwork and lead to vision loss.

  4. Management of coexisting cataract and glaucoma.

    PubMed

    Crichton, Andrew

    2010-03-01

    The optimal management of cataract in the glaucoma patient must be constantly updated as advances in both subspecialties impact the surgical decision. The primary considerations at this time include combining the procedures as opposed to sequential operations and optimizing the effectiveness of the operations while reducing complications. Recent findings would certainly suggest an individualized approach based not only on the glaucoma and cataract condition of the patient but also on the experience of the surgeon with varied techniques. Further time and research are required to determine whether certain approaches or techniques will become more universally adopted. At present, there certainly is support for a variety of approaches.

  5. [Differential diagnosis of juvenile normal pressure glaucoma].

    PubMed

    Geidel, K; Wiedemann, P; Unterlauft, J D

    2016-12-05

    The case of a 50-year-old female patient with autosomal dominant optic atrophy is described, which was initially misinterpreted and treated as normal pressure glaucoma. Bilateral partial optic atrophy can be diagnosed by chance with mild manifestation of symptoms and can initially be misinterpreted as glaucoma. Taking a detailed medical history and performing a thorough optic nerve head examination can raise the suspicion of hereditary optic atrophy. The reliable detection of autosomal dominant optic atrophy by genetic investigations should be strived for in such cases.

  6. [Initial clinical experience with deep sclerectomy in ambulatory surgery in glaucoma].

    PubMed

    Pitrová, S; Pesková, H; Lesták, J

    1999-01-01

    Deep sclerectomy is a non-perforating filtering operation used in surgical treatment of open angle glaucomas. The advantage of the operation is the creation of gradual filtration due to the thin trabecular Descement membrane which reduces markedly the risk of development of postoperative complications typical for perforating antiglaucomatous operations. The authors operated at the out-patient department 10 eyes of 8 patients (age 46-81 years). Indications for deep sclerectomy was seven times primary open angle glaucoma (POAG), once capsular glaucoma and twice normotensive glaucoma (NTG). In all eyes deep sclerectomy was indicated because of decompensation of the intraocular pressure with maximum tolerated therapy before surgery. None of the eyes were operated previously. The mean value of intraocular pressure before surgery was 25.1 +/- 6.5 mm Hg. From the results ensues that in nine operated eyes the intraocular pressure at the end of the 6-month follow-up period was compensated without supplementary therapy, only in one eye beta-blockers were prescribed one month after surgery. The cause of failure of filtration was the development of superficial adherence at the site of microperforatiion of the trabecular Descemet membrane which developed during operation. The mean intraocular pressure values at the end of the investigation period were 14.3 +/- 2.8 mm Hg. In two eyes haemorrhage into the anterior chamber was observed on the first day after surgery, the blood was absorbed within 24 hours. Hypotonia in two eyes was only transient and was not associated with a change in the depth of the anterior chamber or other complications. In none of the patients a decline of visual acuity was observed. In three operated eyes a change of refraction was necessary due to discontinuation of miotics after surgery. Deep sclerectomy is a delicate microsurgical technique which calls for experience and skill of the surgeon. The most complicated task is to prevent perforation of the

  7. Anterior Chamber Angle Shape Analysis and Classification of Glaucoma in SS-OCT Images

    PubMed Central

    Ni Ni, Soe; Tian, J.; Marziliano, Pina; Wong, Hong-Tym

    2014-01-01

    Optical coherence tomography is a high resolution, rapid, and noninvasive diagnostic tool for angle closure glaucoma. In this paper, we present a new strategy for the classification of the angle closure glaucoma using morphological shape analysis of the iridocorneal angle. The angle structure configuration is quantified by the following six features: (1) mean of the continuous measurement of the angle opening distance; (2) area of the trapezoidal profile of the iridocorneal angle centered at Schwalbe's line; (3) mean of the iris curvature from the extracted iris image; (4) complex shape descriptor, fractal dimension, to quantify the complexity, or changes of iridocorneal angle; (5) ellipticity moment shape descriptor; and (6) triangularity moment shape descriptor. Then, the fuzzy k nearest neighbor (fkNN) classifier is utilized for classification of angle closure glaucoma. Two hundred and sixty-four swept source optical coherence tomography (SS-OCT) images from 148 patients were analyzed in this study. From the experimental results, the fkNN reveals the best classification accuracy (99.11 ± 0.76%) and AUC (0.98 ± 0.012) with the combination of fractal dimension and biometric parameters. It showed that the proposed approach has promising potential to become a computer aided diagnostic tool for angle closure glaucoma (ACG) disease. PMID:25197561

  8. Visual Field Defects and Retinal Ganglion Cell Losses in Human Glaucoma Patients

    PubMed Central

    Harwerth, Ronald S.; Quigley, Harry A.

    2007-01-01

    Objective The depth of visual field defects are correlated with retinal ganglion cell densities in experimental glaucoma. This study was to determine whether a similar structure-function relationship holds for human glaucoma. Methods The study was based on retinal ganglion cell densities and visual thresholds of patients with documented glaucoma (Kerrigan-Baumrind, et al.) The data were analyzed by a model that predicted ganglion cell densities from standard clinical perimetry, which were then compared to histologic cell counts. Results The model, without free parameters, produced accurate and relatively precise quantification of ganglion cell densities associated with visual field defects. For 437 sets of data, the unity correlation for predicted vs. measured cell densities had a coefficient of determination of 0.39. The mean absolute deviation of the predicted vs. measured values was 2.59 dB, the mean and SD of the distribution of residual errors of prediction was -0.26 ± 3.22 dB. Conclusions Visual field defects by standard clinical perimetry are proportional to neural losses caused by glaucoma. Clinical Relevance The evidence for quantitative structure-function relationships provides a scientific basis of interpreting glaucomatous neuropathy from visual thresholds and supports the application of standard perimetry to establish the stage of the disease. PMID:16769839

  9. Predegenerated Schwann cells–a novel prospect for cell therapy for glaucoma: neuroprotection, neuroregeneration and neuroplasticity

    PubMed Central

    Smedowski, Adrian; Liu, Xiaonan; Pietrucha-Dutczak, Marita; Matuszek, Iwona; Varjosalo, Markku; Lewin-Kowalik, Joanna

    2016-01-01

    Glaucoma is an optic neuropathy that leads to irreversible blindness. Because the current therapies are not sufficient to protect against glaucoma-induced visual impairment, new treatment approaches are necessary to prevent disease progression. Cell transplantation techniques are currently considered to be among the most promising opportunities for nervous system damage treatment. The beneficial effects of undifferentiated cells have been investigated in experimental models of glaucoma, however experiments were accompanied by various barriers, which would make putative treatment difficult or even impossible to apply in a clinical setting. The novel therapy proposed in our study creates conditions to eliminate some of the identified barriers described for precursor cells transplantation and allows us to observe direct neuroprotective and pro-regenerative effects in ongoing optic neuropathy without additional modifications to the transplanted cells. We demonstrated that the proposed novel Schwann cell therapy might be promising, effective and easy to apply, and is safer than the alternative cell therapies for the treatment of glaucoma. PMID:27034151

  10. Corneal hysteresis in patients with glaucoma-like optic discs, ocular hypertension and glaucoma.

    PubMed

    Murphy, Melissa L; Pokrovskaya, Olya; Galligan, Marie; O'Brien, Colm

    2017-01-10

    To compare corneal hysteresis (CH) measurements between patients with glaucoma, ocular hypertension (OHT) and glaucoma-like optic discs (GLD)- defined as a cup to disc ratio greater than or equal to 0.6 with normal intraocular pressure (IOP) and visual fields. The secondary aim was to investigate whether corneal resistance factor (CRF) and central corneal thickness (CCT) differ between patient groups. In this cross sectional study a total of 123 patients (one eye each) were recruited from a glaucoma outpatient department to undergo ocular response analyser (ORA) testing and ultrasound pachymetry as well as clinical examination. A One-way Analysis of Covariance (ANCOVA) was conducted to evaluate the mean difference in CH between the three diagnostic groups (glaucoma, OHT and GLD) correcting for potential confounding factors, IOP and age. Analysis was repeated for CRF and CCT. There was a significant difference in mean CH across the three diagnosis groups; F(2, 115) = 96.95; p < 0.001. Mean CH significantly higher for GLD compared to glaucoma (mean difference 1.83, p < 0.001), and significantly higher for OHT compared to glaucoma (mean difference 2.35, p < 0.001). Mean CH was slightly lower in patients with GLD than those with OHT but this difference was not statistically significant. A similar pattern was seen when the analysis was repeated for CRF and CCT. Higher CH in GLD and OHT compared to glaucoma suggests increased viscoelasticity of ocular tissues may have a protective role against glaucoma.

  11. Relation Between Filtration and Soil Consolidation Theories

    NASA Astrophysics Data System (ADS)

    Strzelecki, Tomasz; Strzelecki, Michał

    2015-03-01

    This paper presents a different, than commonly used, form of equations describing the filtration of a viscous compressible fluid through a porous medium in isothermal conditions. This mathematical model is compared with the liquid flow equations used in the theory of consolidation. It is shown that the current commonly used filtration model representation significantly differs from the filtration process representation in Biot's and Terzaghi's soil consolidation models, which has a bearing on the use of the methods of determining the filtration coefficient on the basis of oedometer test results. The present analysis of the filtration theory equations should help interpret effective parameters of the non-steady filtration model. Moreover, equations for the flow of a gas through a porous medium and an interpretation of the filtration model effective parameters in this case are presented.

  12. [The place of SLT in managing glaucoma].

    PubMed

    Nordmann, J-P

    2008-07-01

    Selective laser trabeculoplasty (SLT) is effective in reducing intraocular pressure (IOP) in glaucomatous patients and patients with ocular hypertension. Equivalent to argon laser trabeculoplasty in terms of IOP reduction, SLT has the advantage of preserving surrounding structures. Easy and rapid to perform, SLT may be an interesting therapeutic approach in the management of glaucoma.

  13. Management of Primary Angle-Closure Glaucoma.

    PubMed

    Lai, Jimmy; Choy, Bonnie N K; Shum, Jennifer W H

    2016-01-01

    Primary angle-closure glaucoma (PACG) is a progressive optic nerve degeneration and is defined as a glaucomatous optic neuropathy with associated characteristic enlargement of optic disc cupping and visual field loss that is secondary to ocular hypertension caused by closure of the drainage angle. Angle closure is caused by appositional approximation or adhesion between the iris and the trabecular meshwork. The main treatment strategy for PACG lies in the reduction of intraocular pressure, reopening of the closed angle, and possible prevention of further angle closure. There is no universally agreed best surgical treatment for PACG. Trabeculectomy, goniosynechialysis (GSL), glaucoma implant, and cyclodestructive procedures are effective surgical options. Each of them plays an important role in the management of PACG with its own pros and cons. Accumulating evidence is available to show the effectiveness of visually significant and visually nonsignificant cataract extraction in the treatment of PACG. Trabeculectomy and GSL are often combined with cataract extraction, which may offer additional pressure control benefits to patients with PACG. This review article will discuss laser peripheral iridotomy, argon laser peripheral iridoplasty, and surgeries such as GSL, phacoemulsification, and phaco plus glaucoma surgeries that lower intraocular pressure and also alter the anterior segment and/or drainage angle anatomy. Currently, glaucoma implants and cyclodestruction are mainly reserved for PACG patients who have failed previous filtering operations. Their role as initial surgical treatment for PACG will not be discussed.

  14. Structural basis for reduced glomerular filtration capacity in nephrotic humans.

    PubMed Central

    Drumond, M C; Kristal, B; Myers, B D; Deen, W M

    1994-01-01

    Previous studies have established that in a variety of human glomerulopathies the reduced glomerular filtration rate (GFR) is due to a marked lowering of the ultrafiltration coefficient (Kf). To identify the factors which lower Kf, we measured the filtering surface area per glomerulus, filtration slit frequency, basement membrane thickness, and GFR and its determinants in patients with minimal change and membraneous nephropathies and in age-matched healthy controls. Overall values of Kf for the two kidneys were calculated from GFR, renal plasma flow rate, systemic colloid osmotic pressure, and three assumed values for the transcapillary pressure difference. "Experimental" values of the glomerular hydraulic permeability (kexp) were then calculated from Kf, glomerular filtering surface area, and estimates of the total number of nephrons of the two kidneys. Independent estimates of the glomerular hydraulic permeability (kmodel) were obtained using a recent mathematical model that is based on analyses of viscous flow through the various structural components of the glomerular capillary wall. Individual values of basement membrane thickness and filtration slit frequency were used as inputs in this model. The results indicate that the reductions of Kf in both nephropathies can be attributed entirely to reduced glomerular hydraulic permeability. The mean values of kexp and kmodel were very similar in both disorders and much smaller in the nephrotic groups than in healthy controls. There was good agreement between kexp and kmodel for any given group of subjects. It was shown that, in both groups of nephrotics, filtration slit frequency was a more important determinant of the water flow resistance than was basement membrane thickness. The decrease in filtration slit frequency observed in both disorders caused the average path length for the filtrate to increase, thereby explaining the decreased hydraulic permeability. Images PMID:8083359

  15. Clinical impact of 8 prospective, randomized, multicenter glaucoma trials.

    PubMed

    Panarelli, Joseph F; Banitt, Michael R; Sidoti, Paul A; Budenz, Donald L; Singh, Kuldev

    2015-01-01

    To determine the impact of 8 multicenter randomized clinical trials (RCTs) on glaucoma practice. An electronic survey was distributed to the members of the American Glaucoma Society (AGS). Each participant was asked 2 study-specific questions and 1 standard question common to all 8 RCTs assessing the study's impact on clinical practice. RCTs included in the survey were the Advanced Glaucoma Intervention Study (AGIS), Collaborative Initial Glaucoma Treatment Study (CIGTS), Collaborative Normal Tension Glaucoma (CNTG) Study, European Glaucoma Prevention Study (EGPS), Early Manifest Glaucoma Trial (EMGT), Glaucoma Laser Trial (GLT), Ocular Hypertension Treatment Study (OHTS), and Tube Versus Trabeculectomy (TVT) Study. A 5-point Likert scale was used for rating all responses. The practice setting and duration of glaucoma practice was determined for all AGS members who responded. A total of 206 (23.0%) of 894 AGS members participated in the survey. Among those who responded, 46.4% were self classified as academic practitioners and 53.6% worked in a private practice setting. Mean Likert scores for the standard question evaluating the overall impact of the RCT were OHTS 4.47, CNTG Study 4.13, AGIS 3.78, TVT Study 3.53, EMGT 3.48, CIGTS 3.44, GLT 3.39, and 2.69 EGPS. Substantial differences were observed in the clinical impact of several RCTs in glaucoma. The reported impact of each study likely reflects several factors including study timing, design, conduct, and interpretation of results.

  16. Childhood glaucoma surgery in the 21st Century

    PubMed Central

    Papadopoulos, M; Edmunds, B; Fenerty, C; Khaw, P T

    2014-01-01

    Most children with glaucoma will require surgery in their lifetime, often in their childhood years. The surgical management of childhood glaucoma is however challenging, largely because of its greater potential for failure and complications as compared with surgery in adults. The available surgical repertoire for childhood glaucoma has remained relatively unchanged for many years with most progress owing to modifications to existing surgery. Although the surgical approach to childhood glaucoma varies around the world, angle surgery remains the preferred initial surgery for primary congenital glaucoma and a major advance has been the concept of incising the whole of the angle (circumferential trabeculotomy). Simple modifications to the trabeculectomy technique have been shown to considerably minimise complications. Glaucoma drainage devices maintain a vital role for certain types of glaucoma including those refractory to other surgery. Cyclodestruction continues to have a role mainly for patients following failed drainage/filtering surgery. Although the prognosis for childhood glaucoma has improved significantly since the introduction of angle surgery, there is still considerable progress to be made to ensure a sighted lifetime for children with glaucoma all over the world. Collaborative approaches to researching and delivering this care are required, and this paper highlights the need for more high-quality prospective surgical trials in the management of the childhood glaucoma. PMID:24924446

  17. Image processing based automatic diagnosis of glaucoma using wavelet features of segmented optic disc from fundus image.

    PubMed

    Singh, Anushikha; Dutta, Malay Kishore; ParthaSarathi, M; Uher, Vaclav; Burget, Radim

    2016-02-01

    Glaucoma is a disease of the retina which is one of the most common causes of permanent blindness worldwide. This paper presents an automatic image processing based method for glaucoma diagnosis from the digital fundus image. In this paper wavelet feature extraction has been followed by optimized genetic feature selection combined with several learning algorithms and various parameter settings. Unlike the existing research works where the features are considered from the complete fundus or a sub image of the fundus, this work is based on feature extraction from the segmented and blood vessel removed optic disc to improve the accuracy of identification. The experimental results presented in this paper indicate that the wavelet features of the segmented optic disc image are clinically more significant in comparison to features of the whole or sub fundus image in the detection of glaucoma from fundus image. Accuracy of glaucoma identification achieved in this work is 94.7% and a comparison with existing methods of glaucoma detection from fundus image indicates that the proposed approach has improved accuracy of classification. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Diffuse loss of sensitivity in early glaucoma.

    PubMed

    Henson, D B; Artes, P H; Chauhan, B C

    1999-12-01

    To establish whether there is significant diffuse loss of sensitivity in a population of patients with early glaucoma. The differential light sensitivities at the 10 most sensitive locations from within the central 24 degrees of program 30-2 of the Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA) were compared in 38 pairs of age-matched subjects, one of each pair with early primary open-angle glaucoma (POAG) and the other with normal eyes. All subjects had had experience with automated perimetry and had clear media, visual acuity of 20/25 or better, and one or fewer false-positive or false-negative responses to catch trials. The mean difference in age between the subjects with glaucoma and normal subjects was 29 days (P = 0.44, maximum 1.42 years). The mean paired difference in pupil size was 0.16 mm (P = 0.26), and visual acuity was higher in the glaucoma-affected subjects (P = 0.044). The 10 highest sensitivity measurements in the POAG-affected subjects were found to be lower by a median of between 1.0 and 2.0 dB than those in the normal pair members (0.0001glaucoma is rare. These observations could not be explained by factors of pupil size and media opacity.

  19. [Compliance of treatment in glaucoma patients].

    PubMed

    Banc, Ana; Stan, Cristina

    2013-01-01

    To evaluate the treatment compliance level of glaucoma patients and the correlation between the compliance level and a series of patient's demographic characteristics. We conducted an observational study in which we studied 100 glaucoma patients who answered the questions we included into a questionnaire. We defined and calculated a broad compliance score and a narrow score, and we investigated the connection between the first score and age, gender, demographic location (urban versus rural), education level, current occupation and duration of disease respectively. The mean of the broad compliance score was 9.64 +/- 1.72, which represents 80% of the maximum value of the score, and the mean of the narrow compliance score was 4.73 +/- 1.12, (78% of the maximum value). The correlation coefficient between score and age was z = -0.09 (p value = 0.19), the Z value for the evaluation of the connection between score and gender was -1.16 (p value = 0.24), and for the connection between compliance score and demographic location Z value = -2.42 (p value = 0.01). Chi-square value for the evaluation of the relation between the score and education level was 14.66 (p value = 0.001), and for the current occupation Chi-square value = 3.47 (p value = 0.06). The correlation coefficient between score and disease duration was tau = 0.09 (p value = 0.23). According to the answers the patients gave, we identified the parameters that require more attention in the ophthalmologist - glaucoma patient communication: genetic transmission of glaucoma, treatment's side effects, number of visits to the ophthalmologist, awareness of the life-long gradului period of treatment. In this study, the compliance level of glaucoma patients is relatively high and we observe a correlation between the compliance level and demographic location, and between the compliance level and patient's education level respectively.,

  20. Sioux City Riverbank Filtration Study

    NASA Astrophysics Data System (ADS)

    Mach, R.; Condon, J.; Johnson, J.

    2003-04-01

    The City of Sioux City (City) obtains a large percentage of their drinking water supply from both a horizontal collector well system and vertical wells located adjacent to the Missouri River. These wells are set in either the Missouri Alluvium or the Dakota Sandstone aquifer. Several of the collector well laterals extend out beneath the Missouri River, with the laterals being over twenty feet below the river channel bottom. Due to concerns regarding ground water under direct surface water influence, the Iowa Department of Natural Resources (IDNR) required the City to expand their water treatment process to deal with potential surface water contaminant issues. With the extensive cost of these plant upgrades, the City and Olsson Associates (OA) approached the IDNR requesting approval for assessing the degree of natural riverbank filtration for water treatment. If this natural process could be ascertained, the level of treatment from the plant could be reduced. The objective of this study was to quantify the degree of surface water (i.e. Missouri River) filtration due to the underlying Missouri River sediments. Several series of microscopic particulate analysis where conducted, along with tracking of turbidity, temperature, bacteria and a full scale particle count study. Six particle sizes from six sampling points were assessed over a nine-month period that spanned summer, fall and spring weather periods. The project was set up in two phases and utilized industry accepted statistical analyses to identify particle data trends. The first phase consisted of twice daily sample collection from the Missouri River and the collector well system for a one-month period. Statistical analysis of the data indicated reducing the sampling frequency and sampling locations would yield justifiable data while significantly reducing sampling and analysis costs. The IDNR approved this modification, and phase II included sampling and analysis under this reduced plant for an eight

  1. Water Filtration Using Plant Xylem

    PubMed Central

    Chambers, Valerie; Venkatesh, Varsha; Karnik, Rohit

    2014-01-01

    Effective point-of-use devices for providing safe drinking water are urgently needed to reduce the global burden of waterborne disease. Here we show that plant xylem from the sapwood of coniferous trees – a readily available, inexpensive, biodegradable, and disposable material – can remove bacteria from water by simple pressure-driven filtration. Approximately 3 cm3 of sapwood can filter water at the rate of several liters per day, sufficient to meet the clean drinking water needs of one person. The results demonstrate the potential of plant xylem to address the need for pathogen-free drinking water in developing countries and resource-limited settings. PMID:24587134

  2. Water filtration using plant xylem.

    PubMed

    Boutilier, Michael S H; Lee, Jongho; Chambers, Valerie; Venkatesh, Varsha; Karnik, Rohit

    2014-01-01

    Effective point-of-use devices for providing safe drinking water are urgently needed to reduce the global burden of waterborne disease. Here we show that plant xylem from the sapwood of coniferous trees--a readily available, inexpensive, biodegradable, and disposable material--can remove bacteria from water by simple pressure-driven filtration. Approximately 3 cm(3) of sapwood can filter water at the rate of several liters per day, sufficient to meet the clean drinking water needs of one person. The results demonstrate the potential of plant xylem to address the need for pathogen-free drinking water in developing countries and resource-limited settings.

  3. Critical analysis of uncertainties during particle filtration

    NASA Astrophysics Data System (ADS)

    Badalyan, Alexander; Carageorgos, Themis; Bedrikovetsky, Pavel; You, Zhenjiang; Zeinijahromi, Abbas; Aji, Keyiseer

    2012-09-01

    Using the law of propagation of uncertainties we show how equipment- and measurement-related uncertainties contribute to the overall combined standard uncertainties (CSU) in filter permeability and in modelling the results for polystyrene latex microspheres filtration through a borosilicate glass filter at various injection velocities. Standard uncertainties in dynamic viscosity and volumetric flowrate of microspheres suspension have the greatest influence on the overall CSU in filter permeability which excellently agrees with results obtained from Monte Carlo simulations. Two model parameters "maximum critical retention concentration" and "minimum injection velocity" and their uncertainties were calculated by fitting two quadratic mathematical models to the experimental data using a weighted least squares approximation. Uncertainty in the internal cake porosity has the highest impact on modelling uncertainties in critical retention concentration. The model with the internal cake porosity reproduces experimental "critical retention concentration vs velocity"-data better than the second model which contains the total electrostatic force whose value and uncertainty have not been reliably calculated due to the lack of experimental dielectric data.

  4. Membrane filtration of food suspensions.

    PubMed Central

    Sharpe, A N; Peterkin, P I; Dudas, I

    1979-01-01

    Factors affecting the membrane filtration of food suspensions were studied for 58 foods and 13 membrane filters. Lot number within a brand, pore size (0.45 or 0.8 micrometer), and time elapsed before filtration had little effect on filterability. Brand of membrane filter, flow direction, pressure differential, age (microbiological quality) of the food, duration of the blending process, temperature, and concentration of food in the suspension had significant and often predictable effects. Preparation of suspensions by Stomacher (relative to rotary blender) addition of surfactant (particularly at elevated temperature) and prior incubation with proteases sometimes had dramatic effects of filterability. In contrast to popular opinion, foods can be membrane filtered in quantities pertinent to the maximums used in conventional plating procedures. Removal of growth inhibitors and food debris is possible by using membrane filters. Lowering of the limits of detection of microorganisms by concentration on membrane filters can be considered feasible for many foods. The data are particularly relevant to the use of hydrophobic grid-membrane filters (which are capable of enumerating up to 9 X 10(4) organisms per filter) in instrumented methods of food microbiological analysis. Images PMID:760637

  5. Trabeculectomy with mitomycin C in the treatment of post-traumatic angle recession glaucoma

    PubMed Central

    Manners, T; Salmon, J; Barron, A; Willies, C; Murray, A

    2001-01-01

    AIM—The presence of traumatic angle recession is a risk factor for failure of glaucoma filtration surgery and a previous study has suggested that antimetabolite treatment should be used in these patients. This study was undertaken to determine for the first time the mid term results of trabeculectomy with intraoperative application of mitomycin C in patients with post-traumatic angle recession glaucoma.
METHODS—A retrospective analysis was made of 43 consecutive trabeculectomy procedures in 41 young black/mixed race patients followed for a mean period of 25 months (range 2-66 months). Mitomycin C 0.02% was applied between the sclera and conjunctiva for 1-5 minutes at the time of surgery. The intraocular pressure and visual acuity were measured postoperatively. The success of this technique was analysed by using a Kaplan-Meier cumulative survival curve.
RESULTS—The intraocular pressure was successfully controlled at last follow up without topical treatment in 77% (33/43 eyes) and the visual acuity was the same or better in 81% (35/43 eyes). Cumulative probability of success was 85% at 1 year follow up, 81% at 2 years, and 66% at 3 years and thereafter. Hypotonous maculopathy occurred in one patient and no cases of late bleb infection were found.
CONCLUSIONS—In medically uncontrolled post-traumatic angle recession glaucoma trabeculectomy with mitomycin C is an effective surgical procedure with an acceptable complication rate. Good intraocular pressure control and preservation of vision can be expected in most patients.

 PMID:11159478

  6. The Endocannabinoid System as a Therapeutic Target in Glaucoma

    PubMed Central

    Cairns, Elizabeth A.; Baldridge, William H.; Kelly, Melanie E. M.

    2016-01-01

    Glaucoma is an irreversible blinding eye disease which produces progressive retinal ganglion cell (RGC) loss. Intraocular pressure (IOP) is currently the only modifiable risk factor, and lowering IOP results in reduced risk of progression of the disorder. The endocannabinoid system (ECS) has attracted considerable attention as a potential target for the treatment of glaucoma, largely due to the observed IOP lowering effects seen after administration of exogenous cannabinoids. However, recent evidence has suggested that modulation of the ECS may also be neuroprotective. This paper will review the use of cannabinoids in glaucoma, presenting pertinent information regarding the pathophysiology of glaucoma and how alterations in cannabinoid signalling may contribute to glaucoma pathology. Additionally, the mechanisms and potential for the use of cannabinoids and other novel agents that target the endocannabinoid system in the treatment of glaucoma will be discussed. PMID:26881140

  7. Alternative therapy in glaucoma management: is there any role?

    PubMed

    Parikh, Rajul S; Parikh, Shefali R

    2011-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Various randomized controlled clinical trials have shown that lowering intraocular pressure (IOP) does reduce progression of primary open-angle glaucoma. However, there is lots of interest in nonpharmacological options that includes lifestyle adjustment and alternative and complementary therapy (ACT). At least 5% glaucoma population uses ACT. Various lifestyle activities like exercise and alcohol can reduce IOP by 1 to 2 mm Hg but would have small effect on glaucoma. The psychological stress can increase IOP. Hypothetically and few studies do show neuroprotective effect (or effect on ocular blood flow) of alcohol, Gingko biloba, bilberry, but the current evidence is weak for its routine use. We must also remember the side effects of 'medications' (e.g., marijuana, alcohol) before promoting as remedy for glaucoma. In current armamentarium of glaucoma management, ACT cannot substitute the conventional treatment available to lower IOP.

  8. The photopic negative response of the blue-on-yellow flash-electroretinogram in glaucomas and normal subjects.

    PubMed

    Wakili, Nina; Horn, Folkert K; Jünemann, Anselm G; Nguyen, Nhung X; Mardin, Christian Y; Korth, Matthias; Kremers, Jan

    2008-09-01

    The photopic negative response of the flash-electroretinogram driven by the middle- and long-wavelength cones has been shown to be reduced in non-human primates with experimental glaucoma and in human patients with glaucoma. The photopic negative response for the blue-sensitive response has been studied using a blue-green silent-substitution-technique on a red background. The aim of this study was to re-evaluate the value of the photopic negative response of the blue-sensitive pathway in glaucoma using a conventional flash-electroretinogram. In 37 eyes of 37 controls (age: 53 +/- 13.6 years) and 37 eyes of 37 patients with open-angle glaucoma of different perimetric visual field defects (age: 58.3 +/- 10 years; MD: 11.7 +/- 6.7 dB) of the Erlangen glaucoma registry Ganzfeld flash-electroretinograms (LKC, UTAS 3000) were recorded using blue Xenon-flashes of increasing photopic luminance (0.013, 0.018, 0.030, and 0.052 cd s/m(2); 440 nm) on a bright yellow background (238 cd/m(2); 550 nm) after 2 min of light adaptation. Amplitudes and implicit times of the photopic negative response and of L&M-cone- and S-cone-driven b-waves were compared between glaucomas and controls for all flash energies (unpaired t-test). The amplitudes of the photopic negative response were significantly reduced in glaucoma patients for all flash energies (P < 0.001). The implicit times of L&M-cone-driven b-wave (0.013, 0.018, 0.030, and 0.052 cd s/m(2)) and S-cone-driven b-wave (0.030 and 0.052 cd s/m(2)) were significantly prolonged in glaucoma patients (P < 0.05). The changes in these implicit times, however, are very small (1.5 ms or less). The other measures did not differ significantly. The amplitude of the photopic negative response and the implicit times of the L&M-cone and S-cone b-wave in the same responses of the blue-on-yellow flash-electroretinogram are potentially useful in the evaluation of inner-retinal function in glaucoma.

  9. Loading and filtration characteristics of filtering facepieces.

    PubMed

    Chen, C C; Lehtimäki, M; Willeke, K

    1993-02-01

    Most filtering facepieces used today are made of electret material (material with significant electrical charges on the filter fibers). Because of the addition of this electrical removal force, the filtration efficiency can be significantly increased without increasing the air pressure drop inside the respirator; pressure drop is closely related to physiological load. However, the removal by electrical forces is reduced in time, as aerosols deposit on the filter fibers. We have studied the contribution of this electrical removal and its change in time as a function of aerosol loading. To prove the change in aerosol penetration is due to the reduction of electrical force, the electrical charges were removed from new facepieces by the application of appropriate chemicals. The dust-mist filtering facepieces tested have similar fiber diameters and packing densities, as determined by scanning electron microscopy and pressure drop data. At a face velocity of 10 cm/s (corresponding to 100 L/min through a complete filtering facepiece) and an aerosol size of 0.16 microns, electrical force removal accounts for 69% of the total filtration for the respirator found to have the best filter quality but only 25% for the respirator (from a different manufacturer) found to have the worst filter quality. Our experimental data show that the removal efficiency of these facepieces is reduced in time by as much as this amount. However, under normal wear conditions, the total aerosol particle load is not as high as shown and the filtering facepieces are likely to be discarded before the fiber charges (i.e., the electrostatic attractions) are significantly diminished.

  10. Microwave cyclodestruction for glaucoma in a rabbit model

    SciTech Connect

    Finger, P.T.; Moshfeghi, D.M.; Smith, P.D.; Perry, H.D. )

    1991-07-01

    Microwave thermotherapy was used to treat experimentally induced glaucoma. Microwave-induced cyclodestruction was successful in reducing intraocular pressure in all treated glaucomatous eyes for 4 weeks. Two additional glaucomatous eyes were left untreated to serve as controls, and were noted to have persistently elevated intraocular pressures. Six additional eyes were then subjected to an equivalent treatment (50 degrees C in five 1-minute applications), which resulted in approximately 180 degrees of heat treatment just posterior to the corneoscleral limbus. These specimens were evaluated with light microscopy at baseline, 24 hours, and 7 days after treatment. The authors clinical and histopathologic evaluations suggested that microwave thermotherapy (delivered under thermometry control) allowed for chorioretinal/ciliary body destruction that resulted in reductions of intraocular pressure in glaucomatous eyes.

  11. Side Stream Filtration for Cooling Towers

    SciTech Connect

    2012-10-20

    This technology evaluation assesses side stream filtration options for cooling towers, with an objective to assess key attributes that optimize energy and water savings along with providing information on specific technology and implementation options. This information can be used to assist Federal sites to determine which options may be most appropriate for their applications. This evaluation provides an overview of the characterization of side stream filtration technology, describes typical applications, and details specific types of filtration technology.

  12. Filtration Behaviour and Fouling Mechanisms of Polysaccharides

    PubMed Central

    Jamal, Sondus; Chang, Sheng; Zhou, Hongde

    2014-01-01

    This study investigated filtration behaviors of polysaccharides solutions, both alone and in mixture with proteins, in the short-time constant flux filtration with the focus on factors affecting the transmembrane pressure (TMP) increase rate, the irreversible filtration resistance, and the membrane rejection behavior. The results showed that the TMP increase rates in the short-time constant flux filtration of alginate solutions were significantly affected by the calcium addition, alginate concentration, and flux. Although the addition of calcium resulted in a decrease in the TMP increase rate, it was found that the irreversible fouling developed during the filtration increased with the calcium addition, implying that the double-sided effect of calcium on membrane filtration and that the TMP increase rate observed in the filtration does not always reflect the irreversible membrane fouling development. It was also found that for the filtration of solutions containing mixed alginate and BSA, alginate exerted a dominant effect on the TMP increase rate and the membrane exhibited a reduced rejection to both alginate and BSA molecules compared to that in the filtration of the pure alginate or BSA. PMID:25007243

  13. Persistent homology in graph power filtrations

    PubMed Central

    Marchette, David J.

    2016-01-01

    The persistence of homological features in simplicial complex representations of big datasets in Rn resulting from Vietoris–Rips or Čech filtrations is commonly used to probe the topological structure of such datasets. In this paper, the notion of homological persistence in simplicial complexes obtained from power filtrations of graphs is introduced. Specifically, the rth complex, r ≥ 1, in such a power filtration is the clique complex of the rth power Gr of a simple graph G. Because the graph distance in G is the relevant proximity parameter, unlike a Euclidean filtration of a dataset where regional scale differences can be an issue, persistence in power filtrations provides a scale-free insight into the topology of G. It is shown that for a power filtration of G, the girth of G defines an r range over which the homology of the complexes in the filtration are guaranteed to persist in all dimensions. The role of chordal graphs as trivial homology delimiters in power filtrations is also discussed and the related notions of ‘persistent triviality’, ‘transient noise’ and ‘persistent periodicity’ in power filtrations are introduced. PMID:27853540

  14. Altered mechanobiology of Schlemm’s canal endothelial cells in glaucoma

    PubMed Central

    Overby, Darryl R.; Zhou, Enhua H.; Vargas-Pinto, Rocio; Pedrigi, Ryan M.; Fuchshofer, Rudolf; Braakman, Sietse T.; Gupta, Ritika; Perkumas, Kristin M.; Sherwood, Joseph M.; Vahabikashi, Amir; Dang, Quynh; Kim, Jae Hun; Ethier, C. Ross; Stamer, W. Daniel; Fredberg, Jeffrey J.; Johnson, Mark

    2014-01-01

    Increased flow resistance is responsible for the elevated intraocular pressure characteristic of glaucoma, but the cause of this resistance increase is not known. We tested the hypothesis that altered biomechanical behavior of Schlemm’s canal (SC) cells contributes to this dysfunction. We used atomic force microscopy, optical magnetic twisting cytometry, and a unique cell perfusion apparatus to examine cultured endothelial cells isolated from the inner wall of SC of healthy and glaucomatous human eyes. Here we establish the existence of a reduced tendency for pore formation in the glaucomatous SC cell—likely accounting for increased outflow resistance—that positively correlates with elevated subcortical cell stiffness, along with an enhanced sensitivity to the mechanical microenvironment including altered expression of several key genes, particularly connective tissue growth factor. Rather than being seen as a simple mechanical barrier to filtration, the endothelium of SC is seen instead as a dynamic material whose response to mechanical strain leads to pore formation and thereby modulates the resistance to aqueous humor outflow. In the glaucomatous eye, this process becomes impaired. Together, these observations support the idea of SC cell stiffness—and its biomechanical effects on pore formation—as a therapeutic target in glaucoma. PMID:25201985

  15. Histological biocompatibility of a stainless steel miniature glaucoma drainage device in humans: a case report.

    PubMed

    De Feo, Fabio; Jacobson, Stewart; Nyska, Abraham; Pagani, Paola; Traverso, Carlo Enrico

    2009-06-01

    The purpose of this study was to evaluate the histological biocompatibility of a stainless steel miniature glaucoma drainage device. Twenty-four months before death due to heart failure, this seventy-three-year-old female patient underwent filtration surgery for primary open-angle glaucoma uncontrolled in the right eye. The device was implanted at the limbus under a scleral flap. For histopathological evaluation, two corneoscleral specimens were embedded in methacrylate blocks sectioned to a thickness of 50 microns, polished and stained with periodic acid schiff. Some sections included a longitudinal cross-section of the implant. At the interface between the spur and the flange of the device and the cornea, there was a small shoulder of fibrous tissue. A thin, fibrous capsule covered the remainder of the body of the device up to the distal tip. No inflammatory cells occurred within the fibrous capsule. No material or blockage was noted within the lumen. Our results support the biological inertness of the device.

  16. Glaucoma: genes, phenotypes, and new directions for therapy.

    PubMed

    Fan, Bao Jian; Wiggs, Janey L

    2010-09-01

    Glaucoma, a leading cause of blindness worldwide, is characterized by progressive optic nerve damage, usually associated with intraocular pressure. Although the clinical progression of the disease is well defined, the molecular events responsible for glaucoma are currently poorly understood and current therapeutic strategies are not curative. This review summarizes the human genetics and genomic approaches that have shed light on the complex inheritance of glaucoma genes and the potential for gene-based and cellular therapies that this research makes possible.

  17. Glaucoma, Stem Cells, and Gene Therapy: Where Are We Now?

    PubMed

    Daliri, Karim; Ljubimov, Alexander V; Hekmatimoghaddam, Seyedhossein

    2017-08-31

    Glaucoma is the second most common cause of blindness, affecting 70~80 million people around the world. The death of retinal ganglion cells (RGCs) is the main cause of blindness related to this disease. Current therapies do not provide enough protection and regeneration of RGCs. A novel opportunity for treatment of glaucoma is application of technologies related to stem cell and gene therapy. In this perspective we will thus focus on emerging approaches to glaucoma treatment including stem cells and gene therapy.

  18. Ocular blood flow in glaucoma - the Leuven Eye Study.

    PubMed

    Abegão Pinto, Luís; Willekens, Koen; Van Keer, Karel; Shibesh, Abraham; Molenberghs, Geert; Vandewalle, Evelien; Stalmans, Ingeborg

    2016-09-01

    Elevated intra-ocular pressure (IOP) has been identified as a major risk factor for glaucoma. Additionally, extensive literature depicts a vascular dysfunction to exist in these patients. However, a large ocular blood flow-oriented trial to integrate these findings in the clinical setting is lacking. This study would likely help to identify which of these vascular data can be used as a clinical tool for screening and disease stratification. Prospective, cross-sectional, case-control hospital-based study. Patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), ocular hypertension (OHT), glaucoma suspects and healthy volunteers were recruited. In addition to a comprehensive ophthalmological examination, a vascular-oriented questionnaire was completed and ocular blood flow assessment (colour Doppler imaging of retrobulbar vessels, retinal oximetry, dynamic contour tonometry, optical coherent tomography enhanced-depth imaging of the choroid) were performed. Statistical analysis was based on multiple imputation to account for missingness. A total of 614 subjects (291 males) were recruited between March and December 2013 (POAG: 214, NTG: 192; OHT: 27; glaucoma suspect: 41; healthy controls: 140). Glaucoma groups (NTG and POAG) were age and gender matched with the control group (p > 0.05). Glaucoma groups were paired in terms of functional and structural parameters (p > 0.08). Mean ocular perfusion pressure was higher in the glaucoma groups than in controls (p < 0.001). Glaucoma groups had lower retrobulbar velocities, higher retinal venous saturation and choroidal thickness asymmetries when compared to the healthy group, in line with the current literature. The Leuven Eye Study stands as one of the largest clinical trials on ocular blood flow in glaucoma. The creation of this vast database may help integrate the vascular aspects of glaucoma into the clinical practice of glaucoma. © 2016 Acta Ophthalmologica Scandinavica Foundation

  19. Effect of leukocyte filtration on the P-selectin expression of apheresis platelets.

    PubMed

    Xie, Z T; Chen, C; Zhang, S H; Yang, H M; Tao, Z H

    2015-06-01

    The aim of this study was to investigate the effect of leukocyte filtration on the P-selectin (CD62P) surface expression of apheresis platelets during the retention period. Ten bags of apheresis platelets stored for 1 day (0-24 h) and 10 bags of apheresis platelets stored for 2 days (24-48 h) were used for leukocyte filtration (experimental group). Ten bags of apheresis platelets with the corresponding retention periods but without filtration were used as a negative control (control group). Thereafter, 100 μL of platelet suspensions from apheresis platelets with or without leukocyte filtration were sampled before and after leukocyte filtration for the detection of CD62P surface expression by flow cytometry. No statistical difference in the CD62P surface expression of apheresis platelets was observed before and after leukocyte filtration (P > 0.05), neither did the CD62P surface expression exhibit any change among the different retention periods. Leukocyte filtration does not affect the CD62P surface expression of apheresis platelets stored for up to 2 days, which indicates that leukocyte filtration does not damage the activation of apheresis platelets within the retention period.

  20. Robust scale-up of dead end filtration: impact of filter fouling mechanisms and flow distribution.

    PubMed

    Laska, Michael E; Brooks, Ralph P; Gayton, Marshall; Pujar, Narahari S

    2005-11-05

    Robust design of a dead end filtration step and the resulting performance at manufacturing scale relies on laboratory data collected with small filter units. During process development it is important to characterize and understand the filter fouling mechanisms of the process streams so that an accurate assessment can be made of the filter area required at manufacturing scale. Successful scale-up also requires integration of the lab-scale filtration data with an understanding of flow characteristics in the full-scale filtration equipment. A case study is presented on the development and scale-up of a depth filtration step used in a 2nd generation polysaccharide vaccine manufacturing process. The effect of operating parameters on filter performance was experimentally characterized for a diverse set of process streams. Filter capacity was significantly reduced when operating at low fluxes, caused by both low filtration pressure and high stream viscosity. The effect of flux on filter capacity could be explained for a variety of diverse streams by a single mechanistic model of filter fouling. To complement the laboratory filtration data, the fluid flow and distribution characteristics in manufacturing-scale filtration equipment were carefully evaluated. This analysis identified the need for additional scale-up factors to account for non-uniform filter area usage in large-scale filter housings. This understanding proved critical to the final equipment design and depth filtration step definition, resulting in robust process performance at manufacturing scale. Copyright (c) 2005 Wiley Periodicals, Inc.

  1. Novel filtration mode for fouling limitation in membrane bioreactors.

    PubMed

    Wu, Jinling; Le-Clech, Pierre; Stuetz, Richard M; Fane, Anthony G; Chen, Vicki

    2008-08-01

    A novel filtration mode is presented to reduce fouling propensity in membrane bioreactors (MBR). During this mode, an elevated high instantaneous flux (60Lm(-2)h(-1)) is initially applied for a short time (120s), followed by a longer filtration (290s) at lower flux (10.3Lm(-2)h(-1)) and a backwash in each filtration cycle. The mixed mode is expected to limit irreversible fouling as the reversible fouling created during the initial stage appears to protect the membrane. Hydraulic performance and the components of foulants were analyzed and compared with conventional continuous and backwash modes. It was found that the mixed mode featured lower trans-membrane pressure (TMP) after 24h of filtration when compared to other modes. The mixed mode was effective in preventing soluble microbial products (SMP) attaching directly onto the membrane surface, keeping the cake layer weakly compressed, and reducing the mixed liquor suspended solids (MLSS) accumulation on the membrane. This strategy reduced the resistances of both the cake layer and the gel layer. A factorial experimental design was carried out for eight runs with different conditions to identify the major operational parameters affecting the hydraulic performances. The results showed that the value of the flux in the initial high-flux period had the most effect on the performance of the mixed mode: high initial flux (60Lm(-2)h(-1)) led to improved performance.

  2. Little evidence for association of the glaucoma gene MYOC with open-angle glaucoma

    PubMed Central

    Sohn, Seongsoo; Hur, Wonhee; Choi, Young Ran; Chung, Yun Shin; Ki, Chang-Seok

    2010-01-01

    Background/aim To determine if overexpression of the glaucoma gene MYOC is involved in the development of open-angle glaucoma (OAG) and if its promoter variants are associated with glaucoma in the Korean population. Methods Human trabecular meshwork cells were cultured in the presence of ophthalmic steroids such as fluorometholone, fluorometholone acetate, dexamethasone, prednisolone acetate and rimexolone. The cells were cultured at a hydrostatic pressure of 32 mm Hg above atmospheric pressure and induction of MYOC was evaluated by northern blot analysis. Genomic DNA was extracted from blood samples obtained from 74 normal controls and 168 unrelated Korean patients with OAG, including primary OAG, normal tension glaucoma and steroid-induced glaucoma. A 461 base pair (bp) DNA fragment of the MYOC promoter region was amplified using PCR and its genotype was analysed by directly sequencing the product. Results The potencies of steroid eye drops in MYOC induction in vitro was the same regardless of their potential for elevating intraocular pressure in vivo. Hydrostatic pressure had no effect on MYOC induction. A dinucleotide repeat polymorphism and three single nucleotide polymorphisms were identified, but no obvious differences in the genotype distribution and allele frequency of the variants between the control group and any type of OAG were observed. Conclusion Our data suggest that MYOC overexpression is not a cause or an effect of intraocular pressure elevation and that MYOC itself is not associated with OAG. PMID:20447966

  3. Differentiating Leber Hereditary Optic Neuropathy from Normal-Tension Glaucoma.

    PubMed

    Souto, Fernanda Maria Silveira; de Vasconcellos, José Paulo Cabral; de Melo, Mônica Barbosa; Sartorato, Edi Lúcia; Moura, Frederico Castelo

    2017-04-01

    Glaucoma is a neurodegenerative disorder characterized by thinning of neuroretinal rim, enlarged cup-to-disc ratio (CDR) and visual field damage. Although raised intraocular pressure is main risk factor for development of glaucoma, it can occur with consistently normal measurements in the intraocular pressure as normal tension glaucoma (NTG). Enlargement of CDR is a classical sign of glaucoma, but it can also result from non-glaucomatous optic neuropathies such as Leber hereditary optic neuropathy (LHON). We describe a case of LHON with increased CDR, discuss its differential diagnosis with NTG and highlight the reasons for misdiagnoses between these two entities.

  4. Optic Disk Pit and Iridociliary Cyst Precipitating Angle Closure Glaucoma.

    PubMed

    Kaushik, Sushmita; Ichhpujani, Parul; Kaur, Savleen; Singh Pandav, Surinder

    2014-01-01

    Primary angle closure glaucoma is usually a bilateral disease, though it may be asymmetrical. However, it is unusual to see advanced glaucoma in one eye and no disk damage in the other. We present a case of unilateral angle closure glaucoma complicated by an optic disk pit and iridociliary cysts. How to cite this article: Kaushik S, Ichhpujani P, Kaur S, Pandav SS. Optic Disk Pit and Iridociliary Cyst Precipitating Angle Closure Glaucoma. J Current Glau Prac 2014;8(1): 33-35.

  5. Pigment dispersion syndrome and pigmentary glaucoma--a major review.

    PubMed

    Niyadurupola, Nuwan; Broadway, David C

    2008-12-01

    Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.

  6. Glaucoma Surgery in Pregnancy: A Case Series and Literature Review

    PubMed Central

    Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S.; Moster, Marlene R.

    2016-01-01

    Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon’s lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594

  7. Inter-eye comparison of retinal oximetry and vessel caliber between eyes with asymmetrical glaucoma severity in different glaucoma subtypes.

    PubMed

    Cheng, Clarissa Shu Ming; Lee, Yi Fang; Ong, Charles; Yap, Zhu Li; Tsai, Andrew; Mohla, Aditi; Nongpiur, Monisha E; Aung, Tin; Perera, Shamira A

    2016-01-01

    To compare retinal vessel oxygenation and vessel caliber in primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and normal controls, as well as between eyes of asymmetrical glaucoma severity. This was a prospective, cross-sectional study. The 159 subjects (PACG, n=39; POAG, n=41; NTG, n=41; normal controls, n=38) underwent retinal oxygen saturation measurements using the Oxymap T1 Retinal Oximeter, optical coherence tomography, and Humphrey visual field testing. Retinal oxygen saturation and vessel diameter were compared between the glaucoma groups and normal controls, as well as between eyes of asymmetrical glaucoma severity. Kruskal-Wallis test was performed for comparison among different subtypes of glaucoma. Wilcoxon signed-rank test was used to compare the inter-eye differences. Compared to normal controls, arteriolar oxygen saturation was increased in PACG eyes (P=0.048) but not in POAG or NTG eyes. There were no significant differences in oxygen saturation in venules or arteriovenous (AV) difference in all three glaucoma groups. Venular diameter was significantly reduced in all glaucoma groups compared to normal controls (P<0.001), but no such change was observed in arteriolar diameter (P=0.10). When comparing between eyes of asymmetrical glaucoma severity, arteriolar oxygen saturation (P=0.03) and AV difference (P=0.04) were significantly higher, while arteriolar diameter was significantly lower (P=0.001) in the worse eye in PACG group. There were no significant differences in oximetric parameters or vessel calibers between the worse and the better eyes in POAG and NTG groups. Eyes with PACG showed increased arteriolar oxygen saturation and increased AV difference. This was not observed in POAG and NTG eyes. Arteriolar diameter in PACG and venular diameter in all three glaucoma groups were reduced. The difference observed in PACG eyes may be due to an increased metabolic demand in the disease process

  8. Tangential flow filtration of hemoglobin.

    PubMed

    Palmer, Andre F; Sun, Guoyong; Harris, David R

    2009-01-01

    Bovine and human hemoglobin (bHb and hHb, respectively) was purified from bovine and human red blood cells via tangential flow filtration (TFF) in four successive stages. TFF is a fast and simple method to purify Hb from RBCs using filtration through hollow fiber (HF) membranes. Most of the Hb was retained in stage III (100 kDa HF membrane) and displayed methemoglobin levels less than 1%, yielding final concentrations of 318 and 300 mg/mL for bHb and hHb, respectively. Purified Hb exhibited much lower endotoxin levels than their respective RBCs. The purity of Hb was initially assessed via SDS-PAGE, and showed tiny impurity bands for the stage III retentate. The oxygen affinity (P(50)) and cooperativity coefficient (n) were regressed from the measured oxygen-RBC/Hb equilibrium curves of RBCs and purified Hb. These results suggest that TFF yielded oxygen affinities of bHb and hHb that are comparable to values in the literature. LC-MS was used to measure the molecular weight of the alpha (alpha) and beta (beta) globin chains of purified Hb. No impurity peaks were present in the HPLC chromatograms of purified Hb. The mass of the molecular ions corresponding to the alpha and beta globin chains agreed well with the calculated theoretical mass of the alpha- and beta- globin chains. Taken together, our results demonstrate that HPLC-grade Hb can be generated via TFF. In general, this method can be more broadly applied to purify Hb from any source of RBCs. This work is significant, since it outlines a simple method for generating Hb for synthesis and/or formulation of Hb-based oxygen carriers.

  9. Tangential Flow Filtration of Hemoglobin

    PubMed Central

    Sun, Guoyong; Harris, David R.

    2009-01-01

    Bovine and human hemoglobin (bHb and hHb, respectively) was purified from bovine and human red blood cells (bRBCs and hRBCs, respectively) via tangential flow filtration (TFF) in four successive stages. TFF is a fast and simple method to purify Hb from RBCs using filtration through hollow fiber (HF) membranes. Most of the Hb was retained in stage III (100 kDa HF membrane) and displayed methemoglobin levels less than 1%, yielding final concentrations of 318 and 300 mg/mL for bHb and hHb, respectively. Purified Hb exhibited much lower endotoxin levels than their respective RBCs. The purity of Hb was initially assessed via SDS-PAGE, and showed tiny impurity bands for the stage III retentate. The oxygen affinity (P50), and cooperativity coefficient (n) were regressed from the measured oxygen-RBC/Hb equilibrium curves of RBCs and purified Hb. These results suggest that TFF yielded oxygen affinities of bHb and hHb that are comparable to values in the literature. LC-MS was used to measure the molecular weight of the alpha (α) and beta (β) globin chains of purified Hb. No impurity peaks were present in the HPLC chromatograms of purified Hb. The mass of the molecular ions corresponding to the α and β globin chains agreed well with the calculated theoretical mass of the α-and β-globin chains. Taken together, our results demonstrate that HPLC grade Hb can be generated via TFF. In general, this method can be more broadly applied to purify Hb from any source of RBCs. This work is significant, since it outlines a simple method for generating Hb for synthesis and/or formulation of Hb-based oxygen carriers (HBOCs). PMID:19224583

  10. Lasers in the treatment of glaucoma

    NASA Astrophysics Data System (ADS)

    Kecik, Tadeusz

    1995-03-01

    The task of the laser methods of glaucoma treatment used up to the present day is to reduce the intraocular pressure. They are the modification of the surgical procedures. The radiation of the laser is the tool that enables us to perform the procedure in a more precise and safe manner. Most of the procedures are ambulatory, thus, making the expenses for the treatment lower. The results of the treatment are satisfactory, and in many cases, enable the patient to avoid surgical procedures. In practice, for the anti-glaucoma procedures the argon laser, YAG Nd+3, of free generation, and Q-switch, Holm laser, are being used. The perspectives to use other lasers also exist.

  11. Ocular Drug Delivery for Glaucoma Management

    PubMed Central

    Gooch, Nathan; Molokhia, Sarah A.; Condie, Russell; Burr, Randon Michael; Archer, Bonnie; Ambati, Balamurali K.; Wirostko, Barbara

    2012-01-01

    Current glaucoma management modalities are hindered by low patient compliance and adherence. This can be due to highly complex treatment strategies or poor patient understanding. Treatments focus on the management or reduction of intraocular pressure. This is most commonly done through the use of daily topical eye drops. Unfortunately, despite effective therapies, glaucoma continues to progress, possibly due to patients not adhering to their treatments. In order to mitigate these patient compliance issues, many sustained release treatments are being researched and are entering the clinic. Conjunctival, subconjunctival, and intravitreal inserts, punctal plugs, and drug depots are currently in clinical development. Each delivery system has hurdles, yet shows promise and could potentially mitigate the current problems associated with poor patient compliance. PMID:24300188

  12. [Tearing in a patient with glaucoma].

    PubMed

    De Popa, D P; Andreescu, G; Albu, C

    1998-01-01

    Lacrimal secretion analysis in glaucoma patients shows several changes depending on the kind of local treatment. The study shows: a. timolol induces: decreasing of the lacrimal secretion (Schirmer's test), decreasing of the basic lacrimal secretion (between 10-25%), the change of the stability and composition of the tears (tear film break-up time is reduced); b. pilocarpine induces: lacrimal puncta occlusion, increased lacrimal secretion, orbicular spasms and palpebral myoclonias. All this changes justify the careful follow-up of the glaucoma patients, specially of the patients of full age, in which normally appear a decrease of lacrimal secretions and of the patients using beta blockers, neuroleptics and other drugs with a known effect of decreasing lacrimal secretion.

  13. Compliance and adherence in glaucoma management

    PubMed Central

    Robin, Alan; Grover, Davinder S

    2011-01-01

    Glaucoma is a preventable cause of blindness if timely effective and successful treatment is provided. Patient adherence to the medication is a constant challenge that is now recognized as an essential component to treatment. Several studies have demonstrated that patients are more likely to be adherent to their medication if they understand the disease and the rationale for treatment and if their treatment regimen is simplified. Additionally, using eye drops has its own set of challenges that must be recognized and addressed at the clinical level. Although numerous socioeconomic factors are associated with poor adherence, these factors must be addressed at the societal level. Maximizing patient adherence to medication has the potential to reduce the number of surgical interventions required to treat glaucoma, prevent unnecessary vision loss, and save the overall healthcare system money in the long run. PMID:21150041

  14. Melanomalytic glaucoma secondary to iris melanoma.

    PubMed

    Ajamil Rodanés, S; García-Álvarez, C; Saornil Alvarez, M A; López-Lara, F; Frutos Baraja, J M; Quiñones, M

    2017-08-01

    A 35-year-old male with unilateral ocular hypertension in the right eye (RE). Anterior segment examination of the RE showed a melanotic lesion. Intraocular pressure (IOP) was 40mmHg in RE. Gonioscopy revealed extension into the anterior chamber angle. Excisional biopsy was performed and consistent with iris melanoma and secondary melanomalytic glaucoma. Brachytherapy was performed as adjuvant therapy. In patients presenting with unilateral glaucoma and increased pigmentation in the trabecular meshwork, it is crucial to perform imaging studies. Resection by iridectomy with adjuvant episcleral brachytherapy is effective in controlling the disease. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Factors for progression and glaucoma treatment: the Early Manifest Glaucoma Trial.

    PubMed

    Leske, M Cristina; Heijl, Anders; Hyman, Leslie; Bengtsson, Bo; Komaroff, Eugene

    2004-04-01

    This review summarizes factors for progression in the Early Manifest Glaucoma Trial (EMGT), including the effect of treatment. EMGT randomized patients with early glaucoma either to argon laser trabeculoplasty plus betaxolol (n = 129) or to no immediate treatment (n = 126) and followed them every 3 months. Treated patients had delayed progression, as compared with controls. In Cox regression, EMGT treatment halved the risk of progression (hazard ratio = 0.50; 95% confidence interval: 0.35, 0.71). Risk decreased about 10% with each millimeter mercury of intraocular pressure (IOP) reduction from baseline; the higher (or lower) the IOP at follow-up, the higher (or lower) the risk. Baseline factors increasing progression were higher IOP, exfoliation, bilateral disease, worse perimetric mean deviation and older age; frequent disc hemorrhages at follow-up also increased risk. EMGT treatment reduced progression risk in half, demonstrating the value of IOP lowering in early glaucoma. Age and indicators of disease severity also predicted progression.

  16. Effect of betaxolol on primary open-angle glaucoma and normal-tension glaucoma patients.

    PubMed

    Saccà, S C; Macrì, A; Rolando, M; Ciurlo, G

    1998-06-01

    This study is aimed at establishing the efficacy of the therapeutic agent, betaxolol, in diurnal control of IOP (intraocular pressure). Therapy was performed on 32 eyes affected by POAG (primary open-angle glaucoma) and 16 eyes affected by NTG (normal-tension glaucoma). Two preparations of betaxolol were utilized: betaxolol hydrochloride 0.50% (Betoptic) was administered to 15 POAG and 7 NTG eyes; betaxolol hydrochloride 0.25% ophthalmic suspension (Betoptic S) was administered to 17 POAG and 9 NTG eyes. IOP measurements were taken every two hours from 8 a.m. to 8 p.m. IOP was measured before therapy and at 12 hours, 30 days, and 3 months of therapy. Betaxolol hydrochloride 0.50% was more effective at lowering IOP during the day. Diurnal pressure peaks, which are a risk factor concerning the maintenance of visual field in glaucoma patients, were also reduced using 0.50% betaxolol hydrochloride.

  17. Recurrent vitreous occlusion of glaucoma drainage device tube in a patient with glaucoma in aphakia: a case report

    PubMed Central

    2010-01-01

    Patients with spontaneous lens dislocation and glaucoma can be challenging to manage. We present a forty-six year old Caucasian lady who was referred with bilateral high intraocular pressure, and was subsequently diagnosed with glaucoma in association with lens dislocation and Marfan syndrome. Baerveldt glaucoma drainage device tubes were inserted in both eyes due to poor response to medical therapy. However, this was complicated by recurrent vitreous occlusion of both glaucoma drainage tubes requiring further multiple surgical interventions. There have not been any further recurrences of vitreous incarceration or posterior segment complications since, but the patient remains under close follow-up. PMID:20181147

  18. Hypothyroidism and Glaucoma in The United States

    PubMed Central

    Kakigi, Caitlin; Kasuga, Toshimitsu; Wang, Sophia Y.; Singh, Kuldev; Hiratsuka, Yoshimune; Murakami, Akira; Lin, Shan C.

    2015-01-01

    Purpose To investigate the association between hypothyroidism and glaucomatous disease. Methods This cross-sectional study included all subjects above the age of 40 years from two nationwide surveys: the 2008 National Health Interview Survey (NHIS) as well as the 2007 and 2008 National Health and Nutrition Examination Survey (NHANES). The presence or absence of glaucoma, thyroid disease and other demographic and health-related information including comorbidities was ascertained via interview. Blood samples were collected from NHANES subjects and analyzed for thyrotropin (TSH). Results A total of 13,599 and 3,839 NHIS and NHANES participants respectively were analyzed to assess for a possible relationship between self-reported glaucoma, and self-reported hypothyroidism as well as self-reported thyroid disease. The unadjusted odds ratio (OR) for NHIS showed a significant association between self-reported glaucoma and self-reported hypothyroidism (OR 1.46, 95% confidence interval [CI] 1.07-1.99). Multivariate logistic regression analysis adjusted for age, gender, race, comorbidities, and health-related behavior, however, showed no association between self-reported glaucoma and hypothyroidism or thyroid disease in both surveys (OR 1.60, 95%CI 0.87-2.95 for NHIS; OR 1.05, 95%CI 0.59-1.88 for NHANES). Conclusion A previously reported association between hypothyroidism and glaucomatous disease was not confirmed in two large U.S. health survey populations. While such an association was noted in the univariate analysis for the NHIS survey, such a relationship was not found in the multivariate analysis after adjustment for potential confounding variables. PMID:26230664

  19. Latanoprost in the treatment of glaucoma.

    PubMed

    Alm, Albert

    2014-01-01

    Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1-2 hours after topical dosing (15-30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy-tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free latanoprost.

  20. Drug-induced Angle-Closure Glaucoma

    PubMed Central

    Khurana, Aruj K; Khurana, Bhawna

    2012-01-01

    Drug-induced angle-closure glaucoma is an important entity for the ophthalmologist as well as the general physician as it represents a preventable cause of potential blindness. This brief review highlights the fact that a high index of suspicion, in a susceptible individual followed by confirmation on appropriate imaging modality (UBM, ultrasound or anterior segment OCT) can alleviate the threat to sight and also help to institute appropriate therapy. PMID:27990064

  1. Latanoprost in the treatment of glaucoma

    PubMed Central

    Alm, Albert

    2014-01-01

    Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1–2 hours after topical dosing (15–30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy–tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free latanoprost. PMID:25328381

  2. Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma

    PubMed Central

    Jimenez-Roman, Jesus; Lazcano-Gomez, Gabriel; Martínez-Baez, Karina; Turati, Mauricio; Gulías-Cañizo, Rosario; Hernández-Zimbrón, Luis F.; Ochoa-De la Paz, Lenin; Zamora, Rubén; Gonzalez-Salinas, Roberto

    2017-01-01

    AIM To compare the effect of phacoemulsification on intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG). METHODS A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico. The study enrolled consecutive patients having phacoemulsification with intraocular lens (IOL) implantation and a diagnosis of POAG or PXG. Data about IOP values and number of glaucoma medications used was collected at baseline, 1, 3, 6 and 12mo postoperatively. RESULTS The study enrolled 88 patients (88 eyes). After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients (P<0.001). In the POAG group, a 20% decrease in IOP values was evidenced, and a 56.5% reduction in the number of medications used at the one-year follow-up. The PXG group showed a 20.39%, and a 34.46% decrease in IOP and number of medications used, respectively. A significant difference in the mean ΔIOP (postoperative changes in IOP) was evidenced between groups (P=0.005). The reduction of the postsurgical IOP mean values in both groups, the POAG group showed a greater reduction in IOP values compared to the PXG group. CONCLUSION In both types of glaucoma, phacoemulsification cataract surgery can result in a significant IOP reduction (20%) over a 12mo follow-up period. The number of medications used is also significantly reduced up to 12mo after surgery, especially in the PXG group. PMID:28944195

  3. Novel drug delivery systems for glaucoma

    PubMed Central

    Lavik, E; Kuehn, M H; Kwon, Y H

    2011-01-01

    Reduction of intraocular pressure (IOP) by pharmaceutical or surgical means has long been the standard treatment for glaucoma. A number of excellent drugs are available that are effective in reducing IOP. These drugs are typically applied as eye drops. However, patient adherence can be poor, thus reducing the clinical efficacy of the drugs. Several novel delivery systems designed to address the issue of adherence and to ensure consistent reduction of IOP are currently under development. These delivery systems include contact lenses-releasing glaucoma medications, injectables such as biodegradable micro- and nanoparticles, and surgically implanted systems. These new technologies are aimed at increasing clinical efficacy by offering multiple delivery options and are capable of managing IOP for several months. There is also a desire to have complementary neuroprotective approaches for those who continue to show progression, despite IOP reduction. Many potential neuroprotective agents are not suitable for traditional oral or drop formulations. Their potential is dependent on developing suitable delivery systems that can provide the drugs in a sustained, local manner to the retina and optic nerve. Drug delivery systems have the potential to improve patient adherence, reduce side effects, increase efficacy, and ultimately, preserve sight for glaucoma patients. In this review, we discuss benefits and limitations of the current systems of delivery and application, as well as those on the horizon. PMID:21475311

  4. Analysis of visual field progression in glaucoma.

    PubMed Central

    Fitzke, F W; Hitchings, R A; Poinoosawmy, D; McNaught, A I; Crabb, D P

    1996-01-01

    BACKGROUND: Despite the widespread use of computerised perimetry the diagnosis of visual field deterioration in following glaucoma patients over time remains particularly difficult. A new method of analysis using a novel graphical display of longitudinal field data is presented. METHODS: A linear regression model of the luminance sensitivity at each stimulus location against time of follow up transforms the quantitative data from a series of fields into a colour coded form which illustrates the spatial configuration of change to aid the interpretation of field loss. The method of analysis and the developed computer software (PROGRESSOR) is described. Comparison with STATPAC-2 glaucoma change probability analysis is given including levels of agreement between the techniques using series of fields of 10 eyes from patients with normal tension glaucoma. RESULTS: Examples of this new method compare well with STATPAC-2 analysis. The level of agreement between the techniques to separate progressing from stable retinal locations is good (kappa = 0.62; SE = 0.04). CONCLUSIONS: This new technique, which combines the change in perimetric sensitivity over time with colour coding of significant change into one image may provide an efficient method to detect true progression in glaucomatous field loss. Images PMID:8664231

  5. Fellow Eye in Unilateral Primary Congenital Glaucoma

    PubMed Central

    2017-01-01

    ABSTRACT Aim This is a report of the incidence of bilateral cases in a cohort of primary congenital glaucoma (PCG) cases and a study of the biometric characteristics of the fellow normal eyes in unilateral cases. Materials and methods The charts of 134 PCG children were reviewed, of which 78 cases (58.2%) were found to have bilateral disease. The remaining 56 patients (41.8%) with unilateral disease had their fellow normal eyes compared with an age-matched cohort of ophthalmologically free children. Results There were no differences between the normal fellow eyes of PCG cases and the control eyes in the corneal diameter and central corneal thickness (CCT), whereas the normal fellow eyes of PCG cases had higher intraocular pressure (IOP) and cup/disc (C/D) ratios. Conclusion The fellow eyes of apparently unilateral PCG cases are not typically normal anatomically like other children unaffected by PCG. Clinical significance A very high index of suspicion has to be kept for PCG cases that present apparently unilaterally, and meticulous prolonged follow-up is mandatory. How to cite this article Bayoumi NHL. Fellow Eye in Unilateral Primary Congenital Glaucoma. J Curr Glaucoma Pract 2017;11(1):28-30. PMID:28138215

  6. [Basic biochemical processes in glaucoma progression].

    PubMed

    von Thun und Hohenstein-Blaul, N; Kunst, S; Pfeiffer, N; Grus, F H

    2015-05-01

    The term glaucoma summarizes a group of eye diseases that are accompanied by impairments of the optic nerve and related visual field deficits. An early diagnosis of glaucoma is currently not possible due to a lack of diagnostic tests; therefore, in most cases the disease is diagnosed many years after onset, which prevents an early therapy. The known risk factors for the development and progression of glaucomatous optic neuropathy comprise elevated intraocular pressure and a broad range of pressure fluctuations as well as lipometabolic disorders, genetic factor and diabetes. The consequences include the induction of anti-inflammatory proteins, elevated levels of oxidative stress and the destruction of retinal ganglion cells. Changes in the autoantibody repertoire have also been observed in the course of the disease. Basic ophthalmological research therefore focuses on the investigation of basic biochemical processes in the course of the disease. A better understanding of physiological and biochemical events is sought in order to develop new and more sensitive diagnostic options and to allow more targeted therapeutic measures. The understanding of biochemical processes allows a better insight into glaucoma progression to be gained, which will lead to improvements in diagnosis and therapy.

  7. Surgical Management of Iatrogenic Pigment Dispersion Glaucoma

    PubMed Central

    Mierlo, Camille Van; Pinto, Luis Abegão

    2015-01-01

    ABSTRACT Introduction: Iatrogenic pigment dispersion syndrome generally originates from a repetitive, mechanical trauma to the pigmented posterior epithelium of the iris. This trauma can arise after intraocular surgery, most commonly due to an abnormal contact between the intraocular lens (IOL) and the iris. Whether surgical removal of this primary insult can lead to a successful intraocular pressure (IOP) control remains unclear. Methods: Case-series. Patients with IOP elevation and clinical signs of pigment dispersion were screened for a diagnosis of iatrogenic IOL-related pigment dispersion. Results: Three patients in which the IOL or the IOL-bag complex caused a pigment dispersion through a repetitive iris chafing were selected. In two cases, replacement of a sulcus-based single-piece IOL (patient 1) or a sub-luxated in-the-bag IOL (patient 2) by an anterior-chamber (AC) iris-fixed IOL led to a sustained decrease in IOP. In the third case, extensive iris atrophy and poor anatomical AC parameters for IOL implantation precluded further surgical intervention. Conclusion: IOL-exchange appears to be a useful tool in the management of iatrogenic pigment dispersion glaucoma due to inappropriate IOL implantation. This cause-oriented approach seems to be effective in controlling IOP, but should be offered only if safety criteria are met. How to cite this article: Van Mierlo C, Abegao Pinto L, Stalmans I. Surgical Management of Iatrogenic Pigment Dispersion Glaucoma. J Curr Glaucoma Pract 2015;9(1):28-32. PMID:26997830

  8. African Descent and Glaucoma Evaluation Study (ADAGES)

    PubMed Central

    Racette, Lyne; Liebmann, Jeffrey M.; Girkin, Christopher A.; Zangwill, Linda M.; Jain, Sonia; Becerra, Lida M.; Medeiros, Felipe A.; Bowd, Christopher; Weinreb, Robert N.; Boden, Catherine; Sample, Pamela A.

    2010-01-01

    Objective To investigate differences in visual function between the healthy eyes of people of African (AD) and European descent (ED). Methods Visual function was assessed in 393 AD and 367 ED participants selected from the African Descent and Glaucoma Evaluation Study and the Diagnostic Innovations in Glaucoma Study. Participants had normal appearance of the optic disc and intraocular pressure of less than 22 mm Hg. Each participant had 2 reliable 24-2 standard automated perimetry tests, and most had short-wavelength automated perimetry and frequency-doubling technology tests. The generalized estimating equation was used to adjust for intereye correlations. Results were adjusted for age, vertical cup-disc ratio, disc size, central corneal thickness, and presence of high blood pressure. Results The AD participants were younger (mean [SD] age, 46.2 [13.2] years) than the ED participants (age, 49.5 [16.6] years) (P=.003). The AD participants had worse mean deviation and pattern standard deviation and more points triggered as abnormal on the total and pattern deviation plots compared with ED participants on all tests (P<.05). A larger percentage of AD participants had confirmed abnormal glaucoma hemifield test results on standard automated perimetry only. Conclusions People of AD have significantly worse performance than people of ED on all tests of visual function. Additional research using longitudinal data is needed to determine the cause of these small but significant ancestry differences in visual function. Trial Registration clinicaltrials.gov Identifier: NCT00221923 PMID:20457975

  9. Effect of health education on patients' beliefs about glaucoma and compliance.

    PubMed

    Rendell, J

    2000-01-01

    A pretest-posttest control group experimental design (n = 100) was used to determine the effectiveness of an interactive patient education program compared with a didactic approach for persons with primary open angle glaucoma at a major specialist eye hospital in England. This study used a questionnaire with a knowledge test to explore patients' glaucoma knowledge, a series of vignettes to explore understanding of compliance and health motivation, and health locus of control scales to assess the effect of these variables. The improved posttest results (P = .000) suggest that patients benefit from education programs and that the ophthalmic nurse is an effective patient teacher. The interactive program has no statistically significant difference from the didactic presentation. Other types of interactive programs may prove to be more beneficial.

  10. Genes, pathways, and animal models in primary open-angle glaucoma

    PubMed Central

    Iglesias, A I; Springelkamp, H; Ramdas, W D; Klaver, C C W; Willemsen, R; van Duijn, C M

    2015-01-01

    Glaucoma is an optic neuropathy characterized by loss of retinal ganglion cells (RGCs) and consequently visual field loss. It is a complex and heterogeneous disease in which both environmental and genetic factors play a role. With the advent of genome-wide association studies (GWASs), the number of loci associated with primary open-angle glaucoma (POAG) have increased greatly. There has also been major progress in understanding the genes determining the vertical cup–disc ratio (VCDR), disc area (DA), cup area (CA), intraocular pressure (IOP), and central corneal thickness (CCT). In this review, we will update and summarize the genetic loci associated so far with POAG, VCDR, DA, CA, IOP, and CCT. We will describe the pathways revealed and supported by genetic association studies, integrating current knowledge from human and experimental data. Finally, we will discuss approaches for functional genomics and clinical translation. PMID:26315706

  11. Glaucoma and globe enlargement associated with neurofibromatosis type 1.

    PubMed

    Morales, Jose; Chaudhry, Imtiaz A; Bosley, Thomas M

    2009-09-01

    To describe the features of glaucoma and globe enlargement sometimes associated with neurofibromatosis type 1 (NF1). Single institution, retrospective, and cross-sectional study. Eighty medical records of patients treated at King Khaled Eye Specialist Hospital in Saudi Arabia with NF1 were reviewed, and 46 patients were examined. We reviewed the charts of patients with NF1 and examined available individuals, including gonioscopy, axial length, and ultrasound biomicroscopy in appropriate patients. Presence and type of glaucoma, anterior chamber angle abnormalities, globe axial length, ultrasound biomicroscopy, and visual outcome. Two patient groups were identified: Group 1 had 56 patients with orbito-facial NF1, and group 2 had 24 patients with NF1 but without orbito-facial involvement. Group 1 included 13 patients with glaucoma (23%), which occurred only ipsilateral to the orbito-facial involvement and generally presented before age 3 years. Glaucoma surgery was required in all of these patients, and visual prognosis was poor. In group 1, mean axial length on the side affected by NF1 was 29.8+/-4.1 mm in patients with glaucoma and 25.6+/-2.0 mm in patients without glaucoma. Patients with glaucoma (P<0.001) and without glaucoma (P<0.0001) in group 1 had significantly larger globes on the affected side. Group 2 patients had a mean axial length of 23.6+/-1.6 mm for both eyes without significant globe asymmetry. In this Arab population, glaucoma associated with orbito-facial NF1 occurred less often than the 50% rate that is typically cited. Glaucoma presented early in life and only in patients with ipsilateral orbito-facial involvement. Glaucoma in this setting was always associated with globe enlargement. Glaucoma required surgery, and visual prognosis was poor because of glaucoma and concurrent pathology. Globe enlargement was most severe when associated with glaucoma but also present on the side with orbito-facial involvement in patients without glaucoma. The

  12. [Bibliometric analysis of current glaucoma research based on Pubmed database].

    PubMed

    Huang, Wen-bin; Wang, Wei; Zhou, Min-wen; Chen, Shi-da; Zhang, Xiu-lan

    2013-11-01

    To survey the distribution pattern and subject domain knowledge of worldwide glaucoma research based on literatures in Pubmed database. Literatures on glaucoma published in 2007 to 2011 were identified in Pubmed database. The analytic items of an article include published year, country, language author, and journal. After core mesh terms had been characterized by BICOMS, the co-occurrence matrix was built. Cluster analysis was finished by SPSS 20.0. Then visualized network was drawn using ucinet 6.0. Totally 6427 literatures were included, the number of annual articles changed slightly between 2007 and 2011. The United States, England, Germany, Australia, and France together accounted for 77.63% of articles. There were 52 high-frequency subjects and hot topics were clustered into the following 10 categories: (1) Pathology of optic disc and nerve fibers and OCT application, (2) METHODS: of visual field (VF) and visual function examination, (3) Glaucoma drug medications, (4) Pathology and physiology of primary open angle glaucoma (POAG) including VF and intraocular pressure (IOP), (5) Glaucoma surgery, (6) Gene research related to POAG, (7) Glaucoma disease pathology and animal models, (8) Ocular hypertension (OHT) induced complications and corneal changes, (9) Etiology of congenital glaucoma and complications, (10) Etiology and epidemiology of glaucoma. The visualized domain knowledge mapping was successfully built. The pathology of optic disc and nerve fibers, medications, and surgery were well developed. Study on IOP and visual field was in the core domain, which have an important link to etiology, diagnosis, and therapy. The researches on glaucomatous gene, disease pathology model, congenital glaucoma, etiology and epidemiology were not developed well, which are of great promotion space. The distribution pattern and subject domain knowledge of worldwide glaucoma research in the recent five years were shown by using bibliometric analysis.Western developed

  13. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.

    PubMed

    Heijl, Anders; Leske, M Cristina; Bengtsson, Bo; Hyman, Leslie; Bengtsson, Boel; Hussein, Mohamed

    2002-10-01

    To provide the results of the Early Manifest Glaucoma Trial, which compared the effect of immediately lowering the intraocular pressure (IOP), vs no treatment or later treatment, on the progression of newly detected open-angle glaucoma. Randomized clinical trial. Two hundred fifty-five patients aged 50 to 80 years (median, 68 years) with early glaucoma, visual field defects (median mean deviation, -4 dB), and a median IOP of 20 mm Hg, mainly identified through a population screening. Patients with an IOP greater than 30 mm Hg or advanced visual field loss were ineligible. Patients were randomized to either laser trabeculoplasty plus topical betaxolol hydrochloride (n = 129) or no initial treatment (n = 126). Study visits included Humphrey Full Threshold 30-2 visual field tests and tonometry every 3 months, and optic disc photography every 6 months. Decisions regarding treatment were made jointly with the patient when progression occurred and thereafter. Glaucoma progression was defined by specific visual field and optic disc outcomes. Criteria for perimetric progression were computer based and defined as the same 3 or more test point locations showing significant deterioration from baseline in glaucoma change probability maps from 3 consecutive tests. Optic disc progression was determined by masked graders using flicker chronoscopy plus side-by-side photogradings. After a median follow-up period of 6 years (range, 51-102 months), retention was excellent, with only 6 patients lost to follow-up for reasons other than death. On average, treatment reduced the IOP by 5.1 mm Hg or 25%, a reduction maintained throughout follow-up. Progression was less frequent in the treatment group (58/129; 45%) than in controls (78/126; 62%) (P =.007) and occurred significantly later in treated patients. Treatment effects were also evident when stratifying patients by median IOP, mean deviation, and age as well as exfoliation status. Although patients reported few systemic or ocular

  14. Single clear corneal incision for glaucoma drainage device shortening in pediatric glaucoma.

    PubMed

    Radke, Phillip M; Bitrian, Elena; Grajewski, Alana L

    2016-06-01

    Glaucoma drainage devices are commonly used for management of glaucoma in adults and children. With time, the position of the tube can change and cause damage such as corneal scarring, iris or lens contact, and uveitis. Most of these problems can be improved with tube shortening and/or excision of adherent iris or fibrous tissue. We describe a surgical technique that uses a single clear corneal incision to externalize and trim the shunt in pediatric patients. The technique has a short surgical. We review the indications and outcomes for this procedure in 13 eyes of 12 children who required shunt revision.

  15. Mechanism of reduced glomerular filtration rate in chronic malnutrition.

    PubMed

    Ichikawa, I; Purkerson, M L; Klahr, S; Troy, J L; Martinez-Maldonado, M; Brenner, B M

    1980-05-01

    rats, we studied a third group of seven rats (group 3) allowed an ad lib. intake of the same high protein diet as given to group 2 rats. Average values for single nephron glomerular filtration rate and its determinants were found to be indistinguishable between groups 2 and 3. These results suggest that low protein intake, rather than calorie deficiency per se, is primarily responsible for the reduction in filtration rate seen in this experimental model of chronic malnutrition.

  16. Factors in the Membrane Filtration of Enteroviruses

    PubMed Central

    Cliver, D. O.

    1965-01-01

    The filtration of two species of enteroviruses through membranes of porosity ranging from 50 to 220 mμ was studied. It was shown that extensive or total losses of virus may attend filtration at these porosities, apparently owing to adsorption of the virus to the membrane matrix. This could be minimized by the incorporation of serum into the virus suspension at the time of filtration, or by pretreating the membrane with serum or with a gelatin solution. It was also found that the first few drops of filtrate, even under optimal conditions, were likely to be virus-free, so that the filtration of too small a volume of virus suspension would result in a relatively great loss of titer. The degree to which these factors were critical was found to decrease with increasing pore diameter. PMID:14325282

  17. Influence of external cake formation on optimization of crossflow filtration

    NASA Astrophysics Data System (ADS)

    Kuberkar, Vinod Trimbakrao

    The external foulant cake is an extremely important aspect of membrane filtration processes, influencing permeation rates of all species. This thesis work provides understanding of the mechanisms of formation and removal of the external cake, and of its influence on permeation rates. The prevention of formation of non-adhesive cakes using backpulsing was studied by solving the convection-diffusion equation for concentration polarization and depolarization during cyclic operation of forward filtration and reverse filtration. The theory predicted an optimum duration of the forward filtration which maximizes the net flux. Theoretical predictions showed very good agreement with experimental results for backpulsing of washed yeast suspensions. The removal of an adhesive cake was studied using filtration of bacterial suspensions with and without backpulsing. Due to the strong adhesive nature of the bacterial cake, the removal of the external cake is incomplete. A phenomenological model based on nonuniform cleaning of the membrane was proposed. The model contains an adjustable parameter termed the cleaning efficiency which provides measure of the removal of the adhesive cake. Though the model does not have fully predictive abilities, as the cleaning efficiency depends on the operating conditions, it provides important understanding of the underlying physical phenomena. During the filtration of a multicomponent mixture, the large particles form an external cake on the membrane, which then acts as a secondary membrane for other species in the mixture, affecting their permeation rates. This phenomenon was studied for a mixture of yeast and bovine serum albumin (BSA). In the absence of yeast, BSA aggregates block the membrane pores and eventually form an external fouling layer on the membrane surface, which prevents BSA monomers from access to the membrane pores. BSA transmission then drops to 25--40%. For filtration of a yeast-BSA mixture, yeast cells form the external cake

  18. [Research for the test method of polypropylene fiber liquid filtration membrane particles shedding].

    PubMed

    Song, Jinzi; Jia, Yufei; Chai, Yulian; Sun, Bingcheng; Li, Haixin

    2011-11-01

    Through five experiments, such as "Circle", "square", "side that does not shake", "burning edge", "filter", this paper discussed the effect of different experimental methods of polypropylene fiber liquid filtration membrane particles shedding. The results show that: the particles falling off the edge of the polypropylene fiber Double-sided liquid filtration membrane are very important and must be considered off the evaluation of particle pollution.

  19. Daily cost of glaucoma medications in China.

    PubMed

    Gao, Ying; Wu, Lingling; Li, Aijun

    2007-01-01

    To determine and compare the daily cost of various glaucoma medications in China. The majority of glaucoma medications commercially available in China were included in this research. The total number of drops in 1 bottle of each medication was counted drop by drop. The mean volume per bottle of each medication was calculated. The cost per drop, number of days for both eyes usage per bottle, and daily cost was calculated. (1) The volume per drop ranged from 0.03 mL (brinzolamide 1%, travoprost 0.004%, bimatoprost 0.03%, and latanoprost 0.005%) to 0.05 mL (timolol 0.5%-Chengrui and pilocarpine 0.5% and 2%-Zhenrui). (2) The cost per bottle ranged from $0.69 (US dollar) (timolol 0.5%-Malaisuan Saimaluo'er) to $40.78 (latanoprost 0.005%). (3) The number of days for both eyes usage per bottle ranged from 52 days (bimatoprost 0.03%) to 11 days (pilocarpine nitrate 0.5%-Zhenrui). (4) The daily cost for both eyes usage from expensive to cheap were latanoprost 0.005%-$0.91, travoprost 0.004%-$0.77, brimonidine 0.2%-$0.61, bimatoprost 0.03%-$0.46, D-timolol 1%-$0.36, brinzolamide 1%-$0.34, pilocarpine 2%-Zhenrui-$0.28, levobunolol 0.5%-$0.25, betaxolol 0.25%-$0.24, pilocarpine 0.5%-Zhenrui-$0.18, pilocarpine 2%-Huming-$0.16, carteolol 1%-Mikelan-$0.15, carteolol 2%-Mikelan-$0.15, pilocarpine 1%-Huming-$0.10, timolol 0.5%-Chengrui-$0.08, timolol 0.5%-Malaisuan Saimaluo'er-$0.03. The daily cost of glaucoma medications in China ranged much more wildly than developed countries. These data may be useful in selecting medications for glaucoma therapy. The ophthalmic solution of prostaglandins is powerful in reducing intraocular pressure. However, its high price should be considered when selecting glaucoma medications in China.

  20. Pharmacological therapy for glaucoma: a review.

    PubMed

    Hoyng, P F; van Beek, L M

    2000-03-01

    For some time the medical treatment of glaucoma has consisted of topical beta-blockers, adrenergic agents, miotics and oral carbonic anhydrase inhibitors (CAIs). However, the therapeutic arsenal available for the medical treatment of glaucoma has recently extended with new classes of ocular hypotensive agents i.e. prostaglandins, local CAIs and alpha2-adrenergic agents. Beta-blockers are still the mainstay in glaucoma treatment and are first line drugs. However, even if they are applied once daily, as with timolol in gel forming solution and levobunolol, the possible cardiopulmonary adverse effects of beta-blockers remain a cause for concern. When monotherapy with beta-blockers is ineffective in reducing intraocular pressure (IOP) or is hampered by adverse effects, a change of monotherapy to prostaglandins, local CAIs, alpha2-adrenergic agonists (brimonidine) or to dipivalyl epinephrine is advised. Prostaglandins, local CAIs and alpha2-adrenergic agonists, such as brimonidine, may in time become first line drugs because they reduce IOP effectively and until now systemic adverse effects have rarely been reported with these agents. The development of a pro-drug of either a local CAI or an alpha2-adrenergic agonist with a sustained and continuous effect on IOP level, which could be applied once a day is suggested. Because of these new developments, miotics, i.e. pilocarpine and carbachol, are recommended as second or third line drugs. The cholinesterase inhibitors are considered third line drugs as better agents with fewer local and systemic adverse effects have become available. Oral CAIs may be used temporarily in patients with elevated IOPs e.g. postsurgery or post-laser, or continuously in patients with glaucoma resistant to other treatment. Combining ocular hypotensive drugs is indicated when the target pressure for an individual patient cannot be reached with monotherapy. Combination therapy of beta-blockers is additive with prostaglandins, topical CAIs and