The Pathophysiology and Treatment of Glaucoma: A Review
Reads0
Chats0
TLDR
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 and can improve treatment outcomes by reinforcing the importance of medication adherence and persistence.Abstract:
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.read more
Citations
More filters
Journal ArticleDOI
Impact of nitric oxide's bidirectional role on glaucoma: focus on Helicobacter pylori–related nitrosative stress
Apostolis Papaefthymiou,Michael Doulberis,Michael Doulberis,Panagiotis Katsinelos,Christos Liatsos,Stergios A. Polyzos,Georgios Kotronis,Katerina Papanikolaou,Jannis Kountouras +8 more
TL;DR: The role of NO in glaucoma with respect to Hp‐I is elucidated with the aim to stimulate further studies and suggest a potential pathophysiological bridge between these conditions.
Journal ArticleDOI
Increased intraocular pressure alters the cellular distribution of HuR protein in retinal ganglion cells - A possible sign of endogenous neuroprotection failure.
Adrian Smedowski,Adrian Smedowski,Xiaonan Liu,Lucia Podracka,Saeed Akhtar,Anna Trzeciecka,Marita Pietrucha-Dutczak,Joanna Lewin-Kowalik,Arto Urtti,Marika Ruponen,Kai Kaarniranta,Markku Varjosalo,Marialaura Amadio +12 more
TL;DR: It is concluded that the alteration in the HuR content, observed both in rat glaucoma model and human glAUcoma samples, affects post-transcriptionally the expression of genes crucial for maintaining cell homeostasis; therefore, HuR may be involved in the pathogenesis of glau coma.
Journal ArticleDOI
Association between serotonin-norepinephrine reuptake inhibitors and acute angle closure: What is known?
Michał Wiciński,Bartlomiej J. Kaluzny,Sławomir Liberski,Daria Marczak,Małgorzata Seredyka-Burduk,Katarzyna Pawlak-Osińska +5 more
TL;DR: Improved knowledge of the mechanisms linking serotonin-norepinephrine reuptake inhibitors and acute angle closure and of the risk factors predisposing to patients to acute angleclosure will reduce the number of patients affected by this dangerous complication.
Journal ArticleDOI
Early Functional Impairment in Experimental Glaucoma Is Accompanied by Disruption of the GABAergic System and Inceptive Neuroinflammation.
TL;DR: In this article, Adenoviral vectors expressing a pathogenic form of myocilin (Ad5.MYOC) were used to induce intraocular pressure (IOP) elevation in C57BL/6 mice.
Journal ArticleDOI
Is Mental Stress the Primary Cause of Glaucoma
Bernhard A. Sabel,Luisa Lehnigk +1 more
TL;DR: The hypothesis that stress is a possible cause of glaucoma is supported by different observations: (i) acute and chronic stress increases intraocular pressure and (ii) long-term stress can lead to vascular dysregulation of the microcirculation in the eye and brain (Flammer's syndrome) leading to partial hypoxia and hypoglycaemia (hypo-metabolism) as discussed by the authors.
References
More filters
Journal ArticleDOI
The number of people with glaucoma worldwide in 2010 and 2020
Harry A. Quigley,Aimee T. Broman +1 more
TL;DR: Glaucoma is the second leading cause of blindness worldwide, disproportionately affecting women and Asians, and it will be 60.5 million people with OAG and ACG in 2010, increasing to 79.6 million by 2020, and of these, 74% will have OAG.
Journal ArticleDOI
The Ocular Hypertension Treatment Study: A Randomized Trial Determines That Topical Ocular Hypotensive Medication Delays or Prevents the Onset of Primary Open-Angle Glaucoma
Michael A. Kass,Dale K. Heuer,Eve J. Higginbotham,Chris A. Johnson,John L. Keltner,J. Philip Miller,Richard K. Parrish,M. Roy Wilson,Mae O. Gordon +8 more
TL;DR: Topical ocular hypotensive medication was effective in delaying or preventing the onset of POAG in individuals with elevated IOP, and clinicians should consider initiating treatment for individuals with ocular hypertension who are at moderate or high risk for developing POAG.
Journal ArticleDOI
Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.
TL;DR: The first adequately powered randomized trial with an untreated control arm to evaluate the effects of IOP reduction in patients with open-angle glaucoma who have elevated and normal IOP showed considerable beneficial effects of treatment that significantly delayed progression.
Journal ArticleDOI
The advanced glaucoma intervention study (AGIS): 7. the relationship between control of intraocular pressure and visual field deterioration
Fred Ederer,Ma,Douglas E. Gaasterland,E. Kenneth Sullivan,Allen D. Beck,Bruce E. Prum,Marshall N. Cyrlin,Howard S. Weiss +7 more
TL;DR: In both analyses low intraocular pressure is associated with reduced progression of visual field defect, supporting evidence from earlier studies of a protective role for low intracular pressure in visual field deterioration.
Related Papers (5)
The number of people with glaucoma worldwide in 2010 and 2020
Harry A. Quigley,Aimee T. Broman +1 more