ABSTRACT
Biometric studies of the ocular dimensions in eyes with narrow anterior chamber angles provide insight into the pathophysiology of pupillary block and may show which eyes are more prone to develop angle-closure glaucoma. We reviewed the records of 56 patients with occludable angles examined between 1980 and 1984. Initial biometric data obtained on the patients included corneal diameter, anterior chamber depth, lens thickness, and ocular axial length. The average length of follow-up was five years. Of 54 patients with complete clinical records, 20 (37%) eventually required peripheral iridectomy after a mean duration of 16 months from the initial examination. Cox's survival analysis showed a strong correlation between shortened duration to peripheral iridectomy and increasing lens thickness/ocular axial length ratio factor (P = .03). No other variables were significantly related to outcome. This suggests that the lens thickness/ocular axial length ratio may be useful as a predictor of clinical outcome in narrow-angle glaucoma.
Subject(s)
Anterior Chamber/pathology , Glaucoma, Angle-Closure/pathology , Biometry , Female , Follow-Up Studies , Humans , Iris/surgery , Lens, Crystalline/pathology , Male , Middle Aged , Random Allocation , Survival AnalysisABSTRACT
Fourteen patients with advanced open-angle glaucoma were evaluated prospectively by electroretinography and the results were compared with normal controls who were matched for age and sex. All glaucoma patients had visual acuity of 20/50 or better, cup-to-disc ratios of 0.7 or greater in at least one eye, and visual field loss consistent with advanced glaucoma. Numerous electroretinographic parameters were significantly abnormal when compared with the control group.
Subject(s)
Glaucoma, Open-Angle/physiopathology , Adult , Aged , Electroretinography , Female , Humans , Intraocular Pressure , Male , Middle Aged , Statistics as TopicABSTRACT
In a prospective, randomized, double-masked study, 2% epinephrine applied topically twice each day for two weeks to the eyes of patients with glaucoma or ocular hypertension caused an 8.1 +/- 1.4-mm Hg (mean +/- S.E.M.) reduction of intraocular pressure in placebo-treated patients, but only a 1.9 +/- 0.6-mm Hg decrease in patients treated with 25 mg of orally administered indomethacin four times each day (P less than .0005). Systemic treatment with indomethacin for one week did not significantly increase intraocular pressure by itself (baseline, 19.7 +/- 0.6 mm Hg, vs 20.1 +/- 1.4 mm Hg after indomethacin treatment). When indomethacin treatment was discontinued in those patients receiving topical epinephrine, there was a further significant (P less than .05) reduction in intraocular pressure compared with the placebo-treated group. Since the ocular hypotensive effect of topically applied epinephrine is inhibited by indomethacin, a cyclo-oxygenase inhibitor, these results suggest that this reduction of intraocular pressure is at least partially mediated by the endogenous production of prostaglandins, or other cyclo-oxygenase products, and that the intraocular pressure of glaucoma patients undergoing epinephrine therapy may increase when systemic cyclo-oxygenase inhibitors such as indomethacin or aspirin are taken.
Subject(s)
Epinephrine/antagonists & inhibitors , Glaucoma/physiopathology , Indomethacin/pharmacology , Intraocular Pressure/drug effects , Administration, Oral , Administration, Topical , Adult , Aged , Clinical Trials as Topic , Double-Blind Method , Epinephrine/administration & dosage , Female , Glaucoma/drug therapy , Humans , Indomethacin/administration & dosage , Male , Middle Aged , Prospective Studies , Random AllocationABSTRACT
We reviewed the records of all inpatients of the UCLA Medical Center from 1955 to 1980 with the discharge diagnosis of "glaucoma." Nine cases of acute angle-closure glaucoma occurring after spinal or general anesthesia were identified among the 913 records reviewed. Of the nine cases, two were bilateral. Seven patients were female and two were male; the mean age was 63 years. Six of the nine surgical procedures were extraperitoneal and abdominal or pelvic. Parenteral atropine sulfate or scopolamine hydrobromide was administered to seven patients and ephedrine sulfate to four; drug-induced mydriasis may have contributed to this complication. Succinylcholine chloride, which causes contraction of the extraocular muscles, was administered to six patients. Additionally, psychological stress in the surgical patient may increase the risk of this disease by causing mydriasis. Our cases are compared with previous reports.
Subject(s)
Anesthesia, General/adverse effects , Anesthesia, Spinal/adverse effects , Glaucoma/etiology , Surgical Procedures, Operative , Acute Disease , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Central corneal thickness of four human subjects was monitored by optical pachometry during wear of selected hydrophilic (polymacon) contact lenses of known parameters. Simple algebraic techniques were used to calculate anterior corneal surface oxygen flux using central corneal thickness change as an indication of tear layer oxygen tension.
