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Primary open-angle glaucoma (POAG) is a multifactorial chronic optic neuropathy with significant genetic heterogeneity. The pathogenesis of POAG involves an imbalance between the production and drainage of aqueous humor (AH). Genetic theories suggest that transgenic mice demonstrating the GLU50LYS mutation in optineurin (OPTN) experience retinal ganglion cell apoptosis, while mutant myocilin (MYOC) proteins induce endoplasmic reticulum (ER) stress, leading to an unfolded protein response (UPR) and subsequent apoptosis of trabecular meshwork cells (TMC). Furthermore, the interaction between MYOC and mitochondria in the trabecular meshwork (TM) and astrocytes may lead to mitochondrial membrane depolarization and calcium channel dysregulation, contributing to POAG. Overexpression of MYOC variants (P370L, Q368X) is also implicated, as are epigenetic modifications and signaling pathways such as histone and DNA modification. POAG has been associated with autosomal dominant inheritance, with mutations in MYOC and OPTN being prominent causative factors, although many cases involve multiple genetic loci. Currently, over 20 genetic loci have been linked to POAG, with 14 chromosomal loci (GLC1A to GLC1N) identified, 5 of which contribute to juvenile-onset open-angle glaucoma (JOAG). Of these loci, MYOC, OPTN, WD repeat domain 36 (WDR36), and neurotrophin-4 (NTF4) are the most studied causative genes. The ongoing study of molecular genetics offers potential pathways for future therapeutic advances in the treatment of POAG.
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The “multifactorial chronic optic neuropathy” known as primary open angle glaucoma (POAG) is typified by a “progressive loss of retinal ganglion cells (RGC), structural damage to the retinal nerve fiber layer (RNFL) and optic nerve head (ONH), as well as abnormalities in the visual field.” High intraocular pressure (IOP), age, genetics, family history, race, etc. are the main risk factors. One of the pathological implications of POAG is “pressure-induced” ONH damage, which results in modifications to the expression of retinal genes. The ensuing fluid backup raises IOP, which damages optic nerve and results in POAG. Numerous susceptibility genes and environmental factors contribute to the “genetic heterogeneity” of POAG, according to genetic studies. “A set of twelve chromosomal loci, referred to as GLC1A through GLC1L, have been mapped for POAG. Three genes—myocilin (MYOC), optic neuropathy-inducing protein (Optineurin, OPTN)), and WD repeat domain 36 (WDR36)—have been identified as the GLC1A, GLC1E, and GLC1G”. A better understanding of the molecular genetic pathways and the pathological mechanisms involving the disease-causing genes, may help clarify the pathophysiology that leads to the disease and a targeted treatment. The role of genetics in POAG highlights the importance of genes in recent research advances, their future directions, applications, and therapy. The advent of modern genetic discoveries and future directions in vector engineering makes the cure for POAG possible. The paradigm shift in glaucoma treatment has moved from direct RGC and ONH therapy to targeting associated brain centers.
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Purpose- Mathod And Material-Ascertaining the incidence of Undiagnosed Glaucoma in TYPE 2 DIABETES. This study was a hospital-based, non-interventional, cross- sectional prospective study. We selected 704 eyes of 352 diabetic patients for this study. Diabetes was diagnosed by the history of diabetes. In selected diabetic patients, glaucoma was diagnosed by slit lamp examination, assessing the optic disc morphology by indirect ophthalmoscopy and Applanation tonometry (intraocular pressure) and Gonioscopy. Data were collected and calculated and analyzed by using SPSS 19 software. Among 352 diabetic patients 205 were male and 147 were female and among them incidence of glaucoma withResult- diabetic seems slightly more in female than male but was not signi?cant. Incidence of glaucoma was seen in 11.0% and most common type was primary open angle glaucoma. There were 60 (8.52%) primary open angle glaucoma (POAG), 12 (1.7%) with primary angle-closure glaucoma and other types of glaucoma seen in 0.78%. Glaucoma is preventable cause of visual impairement. Every person diagnosed with diabeticConclusion- should undergo ophthalmic examination for diabetic retinopathy and glaucoma and aged more than 40 years should be screened for the glaucoma. Screening in diabetic patients can reduce the diabetic associated visual loss.
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AIM: To determine and compare clinico-sociodemographic profiles of primary open angle glaucoma(POAG)with non-glaucoma eye patients in Gwagwalada, Nigeria.METHODS:A cross-sectional comparative study. A total of 235 adult patients including 96 with POAG and 139 non-glaucoma were included. General characteristics such as age, gender, education, vocation, ethnicity, family history of glaucoma, ocular itching, diabetes mellitus, and hypertension were recorded. Ocular examinations included visual acuity, central visual field, cup disc ratio, anterior chamber angle assessment, and intraocular pressure.RESULTS:Mean age was 49.88+13.75 years and 114(48.5%)were males. Patients with POAG comprised 42 ethnics with Igbo(24/96, 25.0%)and Yoruba(20/96, 20.8%)being most common. Most POAG(74/96, 77.1%)were in the age range 40-69. The POAG(73/96, 76.0%)had varied visual impairment. The POAG versus non-glaucoma as follows: positive family history of glaucoma(34/96, 35.4%)vs (25/139, 18.0%; P=0.012); history of diabetes mellitus(8/96, 8.3%)vs(6/139, 4.3%); hypertension(24/96, 25.0%)vs(28/139, 20.1%); combined diabetes mellitus and hypertension(1/96, 1.0%)vs(4/139, 2.9%; P=0.268); antidiabetic drugs(5/96, 5.2%)vs(7/139, 5.0%); antihypertensives drugs(24/96, 25.0%)vs(23/139, 16.5%); combined antidiabetic and antihypertensive drugs(4/96, 4.2%)vs(5/139, 3.6%; P=0.328); ocular itching(18/96, 18.7%)vs(37/139, 26.6%; P=0.328); visual impairment [right eye(RE):51/96, 53.1%; left eye(LE):60/96, 62.5%] vs(RE:40/139, 28.7%; LE:37/139, 26.6%; P=0.000); vertical cup disc ratio>0.4(RE: 96/96, 100.0%; LE:96/96, 100.0%)vs(RE:131/139, 94.2%; LE:124/139, 89.2%)(RE: P=0.307; LE: P=0.006); intraocular pressure >22 mmHg(RE: 17/96, 17.7%; LE: 22/96, 22.9%)vs(RE: 2/139, 1.4%; LE: 2/139, 1.4%; P=0.006). Most POAG(60/96, 62.5%)were on antiglaucoma drugs and(23/96, 24.0%)were yet to commence medication(P=0.000). Many POAG(32/96, 33.3%)were on combination antiglaucoma drugs of beta blockers, prostaglandin inhibitors and carbonic anhydrase inhibitors.CONCLUSION:Glaucoma has distinguishing clinico-sociodemographic features from other eye conditions. Many participants affirmed family history of glaucoma, and most glaucoma participants were on antiglaucoma treatment. The visual impairment including blindness was significantly associated with glaucoma. The study affirmed open angle glaucoma was associated with high cup-disc ratio and high intra ocular pressure.
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AIM: To investigate the potential causal relationship between gut microbiota(GM)and primary open-angle glaucoma(POAG)based on a two-sample Mendelian randomization(MR)analysis.METHODS: The exposure data was derived from the Genome-Wide Association Studies(GWAS)of GM at the University of Bristol, while the outcome data for POAG was sourced from the MRC Integrative Epidemiology Unit(IEU)Open GWAS database. In this study, inverse variance weighted(IVW), MR Egger, weighted median(WM), Simple Mode, and Weighted Mode were analyzed to investigate the potential causal relationships between GM and POAG. IVW was used as the primary method for this study, and sensitivity analysis was conducted to assess the reliability of the MR analysis.RESULTS: The IVW analysis revealed that Butyrivibrio(OR=1.170, 95%CI: 1.057-1.295, P=0.002), Howardella(OR=1.188, 95%CI: 1.043-1.355, P=0.010), and LachnospiraceaeUCG001(OR=1.229, 95%CI: 1.016-1.485, P=0.033)were correlated with the risk of POAG. Conversely, Candidatus Soleaferrea(OR=0.810, 95%CI: 0.670-0.981, P=0.031), Ruminococcustorquesgroup(OR=0.656, 95%CI: 0.453-0.950, P=0.026), and RuminococcaceaeUCG013(OR=0.770, 95%CI: 0.598-0.990, P=0.041)were protective factors for POAG. Sensitivity analysis showed that there were no heterogeneity and pleiotropy among the instrumental variables.CONCLUSION: The MR study indicated a causal relationship between GM and POAG. Given the sight-threatening characteristic of POAG, early identification and intervention in the relative factors was significant for the prognosis of POAG.
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AIM: To evaluate the effect of ab-externo circumferential suture trabeculotomy(CST)on the 24 h pattern of intraocular pressure(IOP)in primary open angle glaucoma(POAG).METHODS: This retrospective study included 18 POAG patients who had poor control of IOP from March 2021 to May 2022. The ab-externo CST was performed, and IOP was tested preoperatively and 1 a postoperatively(9:00 a.m., 12:00 a.m., 3:00 p.m., 6:00 p.m., 9:00 p.m., 12:00 p.m., 3 a.m., and 6:00 a.m.). The mean, peak, trough, and range of IOP, as well as the average diurnal-nocturnal IOP change were calculated and compared.RESULTS: The 24 h IOP curves exhibited a decreasing trend during the diurnal period and an increasing trend during the nocturnal period, reaching a trough in the afternoon and peaking at night; the time of trough and peak IOP occurred several hours earlier compared to preoperative eyes. Postoperatively, the mean, peak, and trough IOP values were significantly lower compared to preoperative levels. The range of fluctuation showed no significant difference, while the average diurnal-nocturnal IOP change increased significantly.CONCLUSION: CST could reduce IOP of patients with POAG, but could not change the range of IOP fluctuation. However, an increase in the average diurnal-nocturnal IOP change was observed, indicating that CST might not necessarily reduce diurnal-nocturnal IOP fluctuations.
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AIM: To understand the publication status, research trends, and cutting-edge and hot topics in this field by conducting a bibliometrics analysis of relevant literatures on the pathogenesis of primary open angle glaucoma(POAG)in the past 30 a.METHODS:A total of 986 relevant literatures on the pathogenesis of POAG published on the core databases of China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)from 1 September 1993 to 1 September 2023 were retrieved. CiteSpace(6.2.R.4)and VOSviewer(1.6.18)software were used to conduct knowledge graph analysis on the retrieved literature, including publication volume, author, research institution, country/region, and keywords.RESULTS:The United States(243 articles)has the highest number of publications, followed by China(121 articles). The foreign institution with the highest number of publications is Harvard University(37 articles), while domestic institutions such as Zhongshan Ophthalmic Center, Sun Yat-sen University, ophthalmology department of Xuanwu Hospital of Capital Medical University, and Peking University First Hospital tied for the highest number of publications. Louis R. Pasquale(21 articles)is the most prolific English author. Wang Ningli is the most active Chinese researcher in this field. Keywords include trabecular meshwork, intraocular pressure, aqueous humor, glucocorticoid, hemorheology, etc.CONCLUSION: The research on the pathogenesis of POAG is in a period of vigorous development. The United States has the largest number of publications in this field, and Harvard University is a leading institution in this field. The research focus in the field of POAG has shifted from the structural aspect to the genetic level, and gene research and traditional Chinese medicine treatment have broad application prospects in this field.
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AIM: To compare the clinical outcomes of trabeculectomy combined with phacoemulsification intraocular lens implantation with suture-guided penetrating Schlemm canaloplasty combined with phacoemulsification intraocular lens implantation for the treatment of primary open angle glaucoma(POAG).METHODS: A retrospective case-control study was conducted on 53 cases(53 eyes)with advanced-stage POAG and cataract that received surgery at our hospital from June 2021 to June 2022, among which 26 eyes underwent trabeculectomy combined with phacoemulsification and intraocular lens implantation(group A), and 27 eyes underwent suture-guided penetrating Schlemm canaloplasty combined with phacoemulsification and intraocular lens implantation(group B). The best-corrected visual acuity(BCVA), intraocular pressure, and the number of intraocular pressure lowering drugs were compared between the two groups. Furthermore, the intraoperative and postoperative complications and success rate of surgery were recorded.RESULTS: The intraocular pressure of two groups of patients at 1 wk, 1, 3 and 6 mo after surgery were lower than that before preoperatively(all P<0.017). There was a notable disparity in the frequency of anterior chamber hemorrhage between the two groups(P<0.05), but there was no significant variance in the occurrence of superficial anterior chamber and choroid detachment(all P>0.05). There was no significant difference in BCVA(LogMAR)between the two groups at 6 mo after surgery(group A: 1.29±1.19, group B: 0.78±1.01, P=0.098), and there was no significant difference in the number of anti-glaucoma drugs [group A: 0(0, 2.75), group B: 0(0, 1), P=0.209]. Additionally, there was no significant difference in the success rate of surgery between the two groups at 6 mo postoperatively(Z=0.448, P=0.654).CONCLUSIONS: Suture-guided penetrating Schlemmcanaloplasty is a safe and effective treatment for advanced-stage POAG, with a success rate comparable to that of trabeculectomy.
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Background: Primary open-angle glaucoma (POAG) is a multifactorial chronic optic neuropathy, characterized by progressive loss of retinal ganglion cells (RGC), leading to structural damage to the optic nerve head (ONH), retinal nerve fibre layer (RNFL), with visual field defects. This study was carried out at the department of optometry GSVM Medical College, Kanpur, UP from December 2015 to September 2017. Objectives were determination of the relationship between intraocular pressure and blood glucose levels in patients with primary open-angle glaucoma. Methods: A total of 74 subjects, 28 males and 46 females were used for the study. The Accu-Chek glucometer was used to measure the random blood glucose level and the intraocular pressure was measured using the Perkins applanation tonometer. Results: The mean intraocular pressure was 16.57±3.97 while the mean random blood glucose level was 168.43±108.48. Analysis of the SPSS version 23 data using the Pearson product-moment correlation coefficient at a significance level of 0.05 and a 95% confidence interval revealed no correlation between IOP and random blood glucose (p and gt; 0.05). People with primary open-angle glaucoma are advised to have their blood sugar levels monitored frequently. Conclusions: This study showed that there was no significant correlation between intraocular pressure and random blood glucose levels in patients with primary open-angle glaucoma. This would suggest that diabetics should be monitored regularly for intraocular pressure to detect an early onset of glaucoma.
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Purpose: To find out the mean rate of progression (MROP) of visual fields (VF) in patients with primary open?angle glaucoma (POAG) and ocular hypertension (OHT) using FORUM® Glaucoma Workplace. Methods: Two hundred and one eyes of 105 patients were included in this prospective cohort study. Patients with POAG and OHT were recruited, and VF analysis with 24?2 and or 10?2 was done using SITA standard strategy in Zeiss Humphrey Visual Field Analyzer (HFA). All the previous VFs were identified from FORUM software, and the baseline indices were recorded from the first reliable VF analysis. The present VF analysis was compared to the previous one using FORUM software, and the rate of progression (ROP) in VF was obtained by Guided Progression Analysis. Results: MROP of VF in the POAG group was ? 0.085 dB/ year, ranging from ?2.8 to 2.8 dB/year with a standard deviation (SD) of 0.69. In the OHT group, the MROP of VF was ?0.003 dB/year, ranging from ? 0.8 to 0.5 dB/year with an SD of 0.27. The MROP of VF in medically treated eyes with POAG was ?0.14 dB/year with an SD of 0.61 and in surgically treated eyes was ?0.02 dB/year with an SD of 0.78. The overall baseline mean VF index (VFI) was 83.19% and the final mean VFI was 79.80%. There was a statistically significant decrease in the mean VFI value from baseline to the final visit (P?value 0.0005). Conclusion: The mean ROP of VF in the POAG group was ?0.085 dB/year and in the OHT group was ? 0.003 dB/year
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Purpose: To evaluate the determinants affecting the quality of life in monocular glaucoma patients using the Indian vision function questionnaire. Methods: In this prospective cross?sectional study, total of 196 patients were divided into two groups: cases and controls. Indian Vision Function Questionnaire (IND?VFQ) was administered and analyzed. One hundred twenty?nine (58.6%) patients who had lost their vision in one eye due to glaucoma were included as cases and 67 (30.4%) patients who had lost their vision due to other causes were taken as controls. Results: Median composite score of subscales was 54.62 (29.7–74.7) in group 1 and 45.38 (23.7–76.7) in group 2. The psychosocial impact scale was the most affected scale, the median scores were 33.02 (0 to 60.0) and 19.07 (0 to 53.0) in groups 1 and 2, respectively. Among all dimensions of IND?VFQ, the highest score was for color vision 100.0 (0–100.0) and 100.0 (0–100.0), and the lowest median score was found in mental health and dependency in both the groups. Multiple linear regression analysis demonstrated that visual acuity was associated with a low score (P < 0.001). Female gender was significantly associated with the overall score in the univariate model (P = 0.006). Conclusion: Monocular glaucoma patients have a poor general and vision?related quality of life. Depression associated with monocularity and the perception of dependency and being a burden on their family members greatly impacted the mental health of the participants
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BACKGROUND This study was conducted to evaluate the serum lipid profile in different grades of POAG patients and describe the demographic profile of POAG patients. METHODS This was a hospital based observational study comprising of 80 eyes of 40 POAG patients who visited OPD in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya District, over a period of 18 months from March 2021 to August 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. RESULTS Of the 40 study participants, males constituted 62.5% (n=25) and females 32.5% (n=13) in the age group of 70 to 80 years 30% of patients had normal vision; the rest had visual impairments ranging from mild to total blindness. High cholesterol levels were present in 27.5% (n=11), high triglyceride in 42.5% (n=17), low HDL levels were present in 40% (n=16), High LDL levels were observed among 30% (n=12) of participants and high VLDL in 57.5% (n=23). The differences in the distribution of different grades of POAG with respect to different levels of total cholesterol and LDL were not significant, with p-values of 0.202 and 0.123 respectively. However, it was statistically significant for low HDL, high triglycerides and high VLDL with p value of 0.004, 0.05 and 0.017 respectively. CONCLUSIONS In conclusion, this observational study discovered that there is a significant relationship between dyslipidaemia to POAG. Low levels of HDL, high triglycerides, and high VLDL have a significant relationship (p<0.05) to the occurrence of POAG. This lends credence to the idea that abnormal lipid levels increase the likelihood of developing glaucoma.
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Introduction: primary open-angle glaucoma (POAG) is a chronic and progressive anterior optic neuropathy characterized by perimetric alterations and pathological excavation of the optic disc in the absence of other ocular pathologies or congenital anomalies. It is usually accompanied by an increase in intraocular pressure. Gonioscopic examination confirms that the iridocorneal angle is open. The term "risk factor" is defined as a condition statistically leading to an increased risk of occurrence of an event. The purpose of our work is to list the main risk factors of POAG.Patients and Methods: This is a retrospective study carried out in our ophthalmology department over a period of 4 years between January 2018 and December 2021, involving one hundred patients with POAG followed in glaucoma consultation.Results: These are 100 cases, with an average age of 64.27, with a male predominance. The most found risk factors in our series are: age, intraocular hypertension (IOH), thin cornea, arterial hypertension, diabetes and family history of glaucoma.Conclusion: The identification of the main risk factors of POAG at the individual level is a major data of the management. Knowing these factors helps to monitor patients at risk more carefully and to adjust the treatment more appropriately in patients likely to develop glaucoma or to aggravate already known glaucoma. More efforts are required for early screening and education on POAG in communities, especially in a POAG high-risk population
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Purpose: The aim of this trail was to study the efficacy of photobiomodulation (PBM) treatment to reduce the intraocular pressure in subjects with primary open angle glaucoma disease.Methods: Twenty eyes suffering from open angle glaucoma with high IOP level were selected, examined and treated with Thera-RED light diode system. The subjects were divided into two groups (n=10); treated and placebo group respectively; this system provide two lights (red at 660n.m continue and Near IR light micro-pulsed at 850 n.m), the patients received two series of treatment (ten per month within three months between every series of sessions) over five months and follow up taking ocular pressure measurements after every diode delivery session.Results: A significant decrease in IOP has been observed from the first month of the treatment compared to the placebo group (from 22.6mmHg before treatment to 15 mmHg after the tenth session) this amelioration has been also remarked during the second session of treatment (fifth month) to attempt 14.2 mmHg. Conclusion: Thera-RED light diode system treatment shows a significant decrease of IOP and remained to be stable under 14.2 mmHg in all the follow up, which confirm that photobiomodulation help in reducing the intraocular pressure in glaucomatous patients .
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Purpose: To determine the association between serum lipid levels and primary open?angle glaucoma (POAG). Methods: In this case?control study, 50 patients with POAG documented by clinical tests using standard ophthalmologic equipment and 50 age?matched controls were investigated. Twelve?hour fasting serum lipid profiles, including total cholesterol, serum triglycerides, low?density lipoproteins (LDLs), and high?density lipoproteins (HDLs), were compared between the cases and controls. Results: The mean age of cases and controls was 62.84 ± 9.68 and 60.12 ± 8.65, respectively (P = 0.65). High total cholesterol levels (>200 mg/dl) were found in 23 cases (46%) and 8 controls (16%); high serum triglyceride levels (>150 mg/dl) were found in 24 cases (48%) and 7 controls (14%); high LDL levels (130 mg/dl) were found in 28 cases (56%) and 9 controls (18%); and low HDL levels (<40 mg/dl) were found in 38 cases (76%) and 30 controls (60%). The mean total cholesterol levels were 205.24 ± 36.90 mg/dl in cases and 177.68 ± 22.56 mg/dl in controls (P < 0.001); the mean serum triglyceride levels were 150.42 ± 49.55 mg/dl and 130.84 ± 23.16 mg/dl, respectively (P = 0.013); and the mean LDL levels were 139.50 ± 31.03 mg/dl and 114.96 ± 17.73 mg/dl, respectively (P < 0.001). The mean cholesterol, triglyceride, and LDL levels were significantly higher in cases than in controls (P < 0.05). Conclusion: The present study shows that higher proportion of POAG patients have dyslipidemia compared to age?matched controls. Though these findings need to be replicated by others. This study opens new vistas for further studies, such as lowering dyslipidemia, lowering the intra?ocular pressure and incidence of POAG, and whether the use of statins to reduce dyslipidemia affects the progression of POAG.
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Introducción: El glaucoma es la principal causa de ceguera irreversible en el mundo. La prevalencia mundial de glaucoma en personas de 40 a 80 años se estima en un 3,5 %. Objetivo: Comparar el efecto reductor de la PIO de Latanoprostene bunod (LBN) al 0,024% con Latanoprost al 0,005 % en sujetos con glaucoma de ángulo abierto (GAA) o hipertensión ocular (HTO). Metodología: Ensayo observacional de estudio de cohorte prospectivo. Resultados: Fue realizado en 28 pacientes (56 ojos) quienes fueron aleatorizados en 2 grupos paralelos (28 ojos por grupo), el grupo Latanoprost y el grupo LBN. En el grupo LBN la media de la PIO antes del tratamiento fue de 25,3 ± 6,6 mmHg y la media de la PIO luego de 1 mes de tratamiento fue de 16,5 ± 4,9 mmHg (p<0,05). En el grupo Latanoprost la media de la PIO antes del tratamiento fue de 23,6 ± 3,6 mmHg y la media de la PIO luego de 1 mes de tratamiento con Latanoprost al 0,005% fue de 15,3 ± 2,4 mmHg (p<0,05). Sin embargo, al comparar las PIOs luego de 1 mes de tratamiento con LBN 0,024% y Latanoprost 0,005% se objetiva que la diferencia en reducción de la presión intraocular entre estos dos fármacos no fue significativa (p= 0,238). Discusión: Las prostaglandinas tópicas, con su potente efecto hipotensor ocular son una importante opción de tratamiento para el glaucoma. La reducción de la PIO es la esperada con ambos medicamentos, sin embargo, no existen diferencias significativas entre ambas luego de 1 mes de uso. Con respecto a los efectos secundarios, en el grupo LBN se encontró más efectos adversos oculares.
Introduction: Glaucoma is the main cause of irreversible blindness worldwide. The global prevalence of glaucoma in people aged 40 to 80 years is estimated at 3.5%. Objective: To compare the intraocular pressure (IOP) lowering effect of 0.024% Latanoprostene bunod (LBN) with 0.005% Latanoprost in subjects with open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods: Observational trial of prospective cohort study. Results: It was performed in 28 patients (56 eyes) who were randomized into 2 parallel groups (28 eyes per group), the Latanoprost group and the Latanoprostene bunod (LBN) group. In the LBN group, the mean intraocular pressure before treatment was 25.3 ± 6.6 mmHg and the mean intraocular pressure after 1 month of treatment was 16.5 ± 4.9 mmHg (p<0,05). In the Latanoprost group, the mean intraocular pressure before treatment was 23.6 ± 3.6 mmHg and the mean intraocular pressure after 1 month of treatment with 0.005% Latanoprost was 15.3 ± 2.4 mmHg (p<0,05). However, when comparing the IOPs to the 1-month treatment with Latanoprostene bunod 0.024% and Latanoprost 0.005%, it is observed, through ANOVA, that the difference in intraocular pressure reduction between these two drugs is not significant (p= 0,238). Discussion: Topical prostaglandins, with their potent ocular hypotensive effect (resulting from increased uveoscleral outflow), are an important treatment option for glaucoma. The IOP reduction is as expected with both drugs, however, there are no significant differences between the two. In the LBN group, more drug-related ocular adverse effects were found after 1 month of use.
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Objetivo: Evaluar la seguridad de facoemulsificación asociada a la trabeculectomía gonioasistida modificada con tijeras. Métodos: Estudio experimental de intervención en 103 ojos (103 pacientes) con glaucoma primario de ángulo abierto. Se realizó facoemulsificación y trabeculectomía gonioasistida modificada con tijeras (51 ojos, casos) y facoemulsificación- trabeculectomía estándar (52 ojos, controles). En los casos se requirió tijera y pinza vítreo-retinal y se resecó trabéculo por abordaje interno. Se evaluó la agudeza visual, el astigmatismo inducido, la pérdida de células endoteliales y la aparición de complicaciones quirúrgicas en ambos grupos a los tres meses de seguimiento posoperatorio. Resultados: La AVSC se incrementó en ambos grupos a los tres meses postoperatorios. Sin embargo, fue mayor para la FACO-TGAM (0,81 ± 0,16vs. 0,71 ± 0,16), con diferencias significativas (p= 0,002). El astigmatismo inducido fue significativamente mayor en el grupo control (0,53 ± 1,14Dvs.1,8 ± 1,20D (p< 0.001). Las complicaciones quirúrgicas posoperatorias fueron más frecuentes en el grupo control (57 por ciento vs. 73 por ciento p= 0,14). La pérdida de células endoteliales no mostró diferencias significativas (p= 0,82). Conclusiones: La recuperación visual y el menor número de complicaciones ubican la facoemulsificación y trabeculectomía gonioasistida modificada con tijeras como técnica de elección para el tratamiento de pacientes con catarata y el glaucoma primario de ángulo abierto(AU)
Objective: To evaluate the safety of phacoemulsification associated with modified gonio-assisted trabeculectomy with scissors. Methods: Experimental intervention study in 103 eyes (103 patients) with primary open-angle glaucoma. Phacoemulsification and modified gonioassisted trabeculectomy with scissors (51 eyes, cases) and standard phacoemulsification-trabeculectomy (52 eyes, controls) were performed. In the cases, scissors and vitreoretinal forceps were required and trabeculum was resected by internal approach. Visual acuity, induced astigmatism, loss of endothelial cells and the appearance of surgical complications were evaluated in both groups at three months postoperative follow-up. Results: The uncorrected visual acuity increased at three postoperative months in both groups, however it was higher for the PHACO-TGAM (0.81 ± 0.16 vs 0.71 ± 0.16); with significant differences (p = 0.002). Induced astigmatism was significantly higher in the control group (0.53 ± 1.14 D vs. 1.8 ± 1.20 D, (p < 0.001). Postoperative surgical complications were more frequent in the control group (57 percent vs 73 pèrcent, p = 0.14), the endothelial cell loss did not show significant differences (p = 0.82). Conclusions: the visual recovery and the lower number of complications place phacoemulsification and modified gonio-assisted trabeculectomy with scissors as the technique of choice for the treatment of patients with cataract and primary open-angle glaucoma(AU)
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Humans , Trabeculectomy/methods , Phacoemulsification/methodsABSTRACT
Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. Vision impairment is a major public health problem and the burden is increasing with increase in aged population. This study wasAims And Objectives: undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College, Meerut. A total of 60 patients were divided in to two equal groups randomly and studied. Majority of the patients in both the groups wereObservation And Result: aged between 61 – 70 years. Females outnumbered males in this study which was statistically significant between the two groups. The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group. Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group. The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma. This study had found that, the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.
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To conduct an integrated bioinformatics analysis of extant aqueous humor (AH) gene expression datasets in order to identify key genes and the regulatory mechanism governing primary open?angle glaucoma (POAG) progression. Methods: Two datasets (GSE101727 and GSE105269) were downloaded from the Gene Expression Omnibus, and the messenger RNAs (mRNAs), microRNAs (miRNAs), and long noncoding RNAs (lncRNAs) were identified between controls and POAG patients. Differentially expressed (DE) mRNAs and DElncRNAs were then subjected to pathway enrichment analyses, after which a protein–protein interaction (PPI) network was generated. This network was then expanded to establish lncRNA–miRNA–mRNA and miRNA–transcription factor (TF)–mRNA networks. Results: The GSE101727 dataset was used to identify 2746 DElncRNAs and 2208 DEmRNAs, while the GSE105269 dataset was used to identify 45 DEmiRNAs. We ultimately constructed a competing endogenous RNA (ceRNA) network incorporating 47 lncRNAs, six miRNAs, and 17 mRNAs. The proteins encoded by these 17 hub mRNAs were found to be significantly enriched for activities that may be linked to POAG pathogenesis. In addition, we generated a miRNA–TF–mRNA regulatory network containing two miRNAs (miR?135a?5p and miR?139?5p), five TFs (TGIF2, TCF3, FOS, and so on), and five mRNAs (SHISA7, ST6GAL2, TXNIP, and so on). Conclusion: The SHISA7, ST6GAL2, TXNIP, FOS, and DCBLD2 genes may be viable therapeutic targets for the prevention or treatment of POAG and are regulated by the TFs (TGIF2, HNF1A, TCF3, and FOS)
ABSTRACT
AIM:To investigate the ferroptosis-related key genes in the progression of primary open angle glaucoma(POAG)through bioinformatics analysis, aiming to gain a deeper understanding of the biological mechanism of ferroptosis in POAG.METHODS: The GSE27276 dataset, derived from the trabecular meshwork, was obtained from the GEO database. It consisted of 19 trabecular meshwork tissue samples and 17 normal trabecular meshwork tissue samples. The ferroptosis-related genes were obtained from the FerrDb database. Then the GSE27276 dataset with the ferroptosis gene set was mapped, differentially expressed ferroptosis-related genes(DE-FRGs)were identified in POAG, and the correlation analysis was performed. Additionally, the gene ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways of DE-FRGs were further analyzed. This study utilized two machine learning algorithms, namely the LASSO regression model and the SVM-RFE model, to identify the ferroptosis-related key genes of POAG. The screening results from both models were intersected to identify the most significant genes. The clinical diagnostic performance of these genes was evaluated using the receiver operating characteristic curve(ROC); the gene set enrichment analysis(GSEA)and gene set variation analysis(GSVA)were conducted on the most significant genes; the expression levels of these genes were validated using the GSE2378 and GSE9944 datasets obtained from the optic nerve head.RESULTS: In comparison to normal trabecular meshwork tissue, a total of 396 ferroptosis genes exhibited differential expression in POAG trabecular meshwork tissue. Among these, 39 genes were up-regulated while 64 genes were down-regulated. Spearman correlation analysis revealed certain correlation between the up-regulated genes and the down-regulated genes. The GO function and KEGG pathway enrichment analysis revealed that the differential genes were primarily enriched in the oxidative stress response and ferroptosis pathways. A total of 18 DE-FRGs were identified as key genes using LASSO and SVM-RFE algorithms, which demonstrated a higher diagnostic value. GSEA and GSVA revealed a significant association between GDF15, MFN2, and OTUB1 genes with the glutathione metabolic pathway. Moreover, it was observed that MFN2 activated the glutathione metabolic pathway in the high expression group, while OTUB1 activated it in the low expression group. The cross-validation of GSE2378 and GSE9944 datasets revealed a significant increase in the expression level of CREB1 in optic nerve specimens compared to normal optic nerve specimens, and it was consistent with the expression observed in trabecular meshwork samples from the GSE27276 dataset.CONCLUSION: Based on bioinformatics analysis, a total of 396 DE-FRGs were identified in POAG. By constructing a machine screening model and cross-validation of external datasets, CREB1 is expected to be the best characteristic gene for potential diagnostic biomarker, and provide targets for further elucidating the molecular mechanism and the diagnosis of ferroptosis in POAG. However, further in vivo and in vitro validation is required to elucidate the biological mechanism of ferroptosis in POAG.