Comparison of Measurement of Anterior Segment Parameters Between Scheimpflug Camera and Ultrasound Biomicroscopy

PURPOSE: To evaluate the clinical reliability of Pentacam(R) by comparing anterior chamber parameters measured by Oculus Pentacam system (Oculus Inc., Germany) and Hi-scan ultrasound biomicroscopy (OPTIKON 2000, Rome, Italy) in primary angle closure (PAC) and normal patients. METHODS: A prospective study was performed from June 2006 to January 2007. Fifty-one eyes in 26 primary angle-closure patients and 39 eyes in 20 normal control patients, for a total of 90 eyes of 46 patients were recruited from glaucoma out-patient clinics. The correlation and agreement of both measurements of anterior chamber depth and anterior chamber angle measured by UBM and Pentacam(R) were calculated. Sensitivity and specificity of each tool were also compared and the diagnostic value of angle closure was examined. RESULTS: Anterior chamber depth measured by UBM and Pentacam(R) showed strong correlation in the normal control group (r=0.821) and PAC group (r=0.957). Anterior chamber angle showed moderate correlation in the normal control group (r=0.523) and PAC group (r=0.456) while good agreement was also observed. In diagnosing angle closure, anterior chamber measurements appear similar in UBM and Pentacam(R) using the ROC curve (AUC of UBM, 0.942; AUC of Pentacam(R), 0.931). CONCLUSIONS: Pentacam(R) shows high to moderate correlation of anterior chamber measurements and good agreement compared with UBM. Pentacam(R) shows similar ability in diagnosing angle closure compared with UBM and thus is expected to be a good tool in diagnosing angle closure.

Differences in the Histopathology and Matrix Metalloproteinase Expression in Tenon's Tissue of Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma

PURPOSE: To investigate the differences in the histopathology and matrix metalloproteinase (MMP) expression in the Tenon's tissue of primary open-angle glaucoma (POAG) patients, primary angle-closure glaucoma (PACG) patients, and non-glaucomatous patients. METHODS: POAG and PACG patients, who underwent a trabeculectomy and had no history of ocular disease except glaucoma, were enrolled. The number and instillation period of topical eye drops were reviewed. For the controls, which were patients without glaucoma or a history of ocular surgery, the Tenon's tissue was obtained in the course of retinal detachment surgery. For glaucoma patients, the Tenon's tissue was obtained during the trabeculectomy. H&E and Masson's trichrome staining and immunohistochemistry for MMP-1, MMP-2, and MMP-9 were performed. A total of six eyes of POAG, six eyes of PACG, and four control eyes were evaluated. RESULTS: The duration of topical anti-glaucoma medication and the mean number of anti-glaucoma medications were similar in the POAG and PACG groups. The levels of MMP-1 and 2 were elevated in the POAG and PACG groups compared to the control group (p=0.03, 0.01, respectively). Compared with the control group, the MMP-2 level was higher in the POAG patients (p=0.01), whereas the MMP-1 was higher in the PACG patients (p=0.04). The levels of MMP-9 in the POAG and PACG patients were not significantly different from that of the control patients (p=0.48, 0.26). The levels of MMP-2 were significantly lower in the PACG patients than in the POAG patients (p=0.02). CONCLUSIONS: The MMP expression was altered in the Tenon's tissue of glaucoma patients compared to the control group. The levels of MMP-2 were lower in the PACG patients than in the POAG patients. These results suggest that there may be histopathological differences in the Tenon's tissue of POAG and PACG patients.

Differences in the Histopathology and Matrix Metalloproteinase Expression in Tenon's Tissue of Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma

PURPOSE: To investigate the differences in the histopathology and matrix metalloproteinase (MMP) expression in the Tenon's tissue of primary open-angle glaucoma (POAG) patients, primary angle-closure glaucoma (PACG) patients, and non-glaucomatous patients. METHODS: POAG and PACG patients, who underwent a trabeculectomy and had no history of ocular disease except glaucoma, were enrolled. The number and instillation period of topical eye drops were reviewed. For the controls, which were patients without glaucoma or a history of ocular surgery, the Tenon's tissue was obtained in the course of retinal detachment surgery. For glaucoma patients, the Tenon's tissue was obtained during the trabeculectomy. H&E and Masson's trichrome staining and immunohistochemistry for MMP-1, MMP-2, and MMP-9 were performed. A total of six eyes of POAG, six eyes of PACG, and four control eyes were evaluated. RESULTS: The duration of topical anti-glaucoma medication and the mean number of anti-glaucoma medications were similar in the POAG and PACG groups. The levels of MMP-1 and 2 were elevated in the POAG and PACG groups compared to the control group (p=0.03, 0.01, respectively). Compared with the control group, the MMP-2 level was higher in the POAG patients (p=0.01), whereas the MMP-1 was higher in the PACG patients (p=0.04). The levels of MMP-9 in the POAG and PACG patients were not significantly different from that of the control patients (p=0.48, 0.26). The levels of MMP-2 were significantly lower in the PACG patients than in the POAG patients (p=0.02). CONCLUSIONS: The MMP expression was altered in the Tenon's tissue of glaucoma patients compared to the control group. The levels of MMP-2 were lower in the PACG patients than in the POAG patients. These results suggest that there may be histopathological differences in the Tenon's tissue of POAG and PACG patients.

A Clinical Study on Glaucoma

We retrospectively analyzed on the data of 189 eyes of 362 patients with glaucoma from January 1986 to December 1990 in the Department of ophthalmolgy of Chonnam National University Hospital. The following results were obtained. 1. The prevalence of glaucoma in all patients was about 1.92%. 2. The glaucoma patients consisted of 35.6% of secondary glaucoma, 30.5% of primary open angle glaucoma (POAG) and 26.2% of primary angle closure glaucoma (PACG). Neovascular glaucoma (44.1 %) has the highest prevalence rate in secondary glaucoma. 3. The mean age of the patients with POAG was 52.5 year and PACG was 60.4 year. 4. In POAG, men were larger than women in number, but in PACG, women were larger than men. 5. The age group over 40 years old of POAG and PACG occupied 85.9% and that of secondary glaucoma did 82.2%. The incidence of glaucoma rises with advancing age. 6. There was no significant difference in laterality between left and right eyes. 7. At first visit, arcuate scotoma and paracentral scotoma were common glaucomatous visual field changes. According to above results, most patients with the glaucoma visited our hospital at advanced state, we should make an effort for early detection and education on the glaucoma.

Clinical Study on Glaucomatous Patients

We analysed clinically 354 glaucomatous patients from 1983 to 1987 who visited the clinic of the Department of Ophthalmology of National Medical Center. The results were as follows: 1) The prevalence of glaucoma was 1.56% among the out-patients. 2) The primary open-angle glaucoma(POAG) was the most frequent type. 3) The mean age of the patients with POAG was 47.8 +/- 14.2 years and 60.8 +/- 8.9 years was that of the patients with primary angle-closure glaucoma(PACG). 4) There was no sexual preference in various types of glacoma, except PACG and secondary glaucoma. 5) There was no significant difference in laterality between right and left eyes.

Clinical study of Korean glaucomatous patients

In order to determine the distribution of each type of glaucoma in Korea, a retrospective clinical study was carried out on 206 glaucomatoils patients (295 eyes) who were followed from July 1982 to December 1985 in theClaucoma Clinic of the Department of Ophthalmology of Hanyang University Hospital. The distribution of glaucomatous patients was as follows; 34.0% primary open-angle glaucoma (POAG),32.5% secondary glaucoma,20.9% primary angle-closure glaucoma (PACG),7.3% ocular hypertension,3.9% congenital glaucoma, and 1.5% low tension glaucoma. In serondary glaucoma, glaucoma associated with uveitis occurred most frequently, and aphakic glaucoma, neovascular glaucoma, steroid-induced glaucoma, pigmentary glaucoma and exfoliative glauroma followed. The acute stage of PACG presented the highest initial IOP, 55.2+/-8.4mmHg, where as the initial IOP of POAG patients was 33.4+/-15.5 mmHg. Sixty-two per percent of POAG and 98% of PACG patients were over 40 years of age, and the mean age of the POAG and PACG patients was 43.1+/-16.3 and 61.6+/-9.5 years, respectively. There was no remarkable sex-difference associated with glaucoma, in PACG which showed an incidence of 79.1% in females. There was no significant difference in laterality between the right and left eyes with either glaucoma or ocular hypertension. Bilateral involvement of POAG and PACG during the follow-up period was 7l.4% and 32.6%, respectively.