Analysis of long-term outcomes for combined pars plana vitrectomy (PPV) and glaucoma tube shunt surgery in eyes with advanced glaucoma.

PURPOSE: To analyze 12- and 24-month visual acuity, intraocular pressure, and complications associated with combined pars plana vitrectomy (PPV) and glaucoma tube shunt placement in eyes with glaucoma. PATIENTS AND METHODS: A retrospective chart review was performed of patients with advanced glaucoma who underwent combined PPV and tube shunt surgery from 2006 to 2010. A minimum of 12 months of follow-up was required for their inclusion in the study. Visual acuity, intraocular pressure, complications, and number of glaucoma medications at 1 and 2 years postoperatively were analyzed. RESULTS: Twenty-eight eyes met the inclusion and exclusion criteria. Baseline visual acuity was 20/200 or worse in 14/28 eyes (50.0%) and 20/40 or better in 2/28 eyes (7.1%). Visual acuity remained 20/200 or worse in 50.0% (P=0.921) and 44.4% (P=0.973) of eyes after 1 and 2 years postoperatively, respectively. At baseline, the mean intraocular pressure was 30.4 mm Hg. There was significant improvement in mean IOP at 1 year (14.7 mm Hg, P=0.001) and at 2 years (15.2 mm Hg, P=0.001) postoperatively. Baseline number of glaucoma medications averaged 3.0±1.09 (SD), and improved to 1.8±1.28 (SD) at 1 year (P=0.0002) and to 1.4±1.33 at 2 years (P<0.0001) postoperatively. CONCLUSION: In this retrospective interventional case series, surgical management of advanced glaucoma with a combination of PPV and glaucoma tube shunt resulted in significantly reduced IOP and glaucoma medications at 1 and 2 years postoperatively.

Association between lower optic nerve laser Doppler blood volume measurements and glaucomatous visual field progression.

AIM: To perform a preliminary assessment of the relation between optic nerve circulatory parameters and glaucomatous visual field progression. METHODS: This study included 29 eyes of 23 patients with open angle glaucoma that had typical glaucomatous nerve fibre bundle visual field defects and increased cup to disc ratios. Laser Doppler flowmetry (Oculix) was used to measure relative optic nerve blood volume (Vol), velocity (Vel) and flow in the superior temporal (ST) and inferior temporal (IT) neuroretinal rim of the optic nerve. After blood flow measurements patients were followed for 6-62 months (mean 33 (SD 17) months) and 2-11 Humphrey visual fields (4.7 (2.6) fields) were obtained. Progression of glaucoma was assessed by the slope of the corrected pattern standard deviation (CPSD) values versus time, which was calculated manually for each eye using regression analysis. RESULTS: A significant negative correlation was observed between Vol in the IT rim and the CPSD slope (r=-0.56, p=0.002); patients with lower Vol tended to show faster progression of glaucomatous field damage than those with higher Vol. When the eyes were arbitrarily divided into two groups according to lower Vol (0.32 (0.06) arbitrary units, AU, n=15) or higher Vol (0.49 (0.06) AU, n=14), those with lower Vol had significantly worse mean CPSD slopes (0.50 (0.48) dB/year) than those with higher Vol (-0.67 (1.38) dB/year; Student's t test, p=0.009). CONCLUSIONS: In the IT rim, the area most prone to develop glaucomatous field damage, lower Vol is associated with subsequently faster CPSD progression. These measurements suggest that circulatory abnormalities may have a role in the development of glaucoma.

Determination of water content in bovine lenses using near-infrared spectroscopy.

Near-infrared spectral data of bovine nuclear lens tissue was collected in the 3,500- to 6,500-cm(-1) frequency range. The intensity ratios of the water peak at 5,194 cm(-1) to characteristic protein peaks at 4,862, 4,599, and 4,368 cm(-1) were determined for the nucleus of bovine lens samples. The water and protein mass percentages were determined by using a calibration curve established by spectra obtained from aqueous solutions with various concentrations of bovine serum albumin. The bovine fetal nucleus was found to contain 61.2 +/- 1.6, 61.2 +/- 1.9, and 58.4 +/- 1.9 water using the ratio of the water peak intensity to each of the three characteristic protein peaks within each spectrum. These results are consistent with other analytical techniques, thus showing the accuracy of this technique for obtaining chemical information on lens tissue.

The effects of cytomegalovirus infection on polar lipids and neutral lipids in cultured human cells.

The effects of infection by the human cytomegaloviruses Ad-169 on the incorporation of [14C]acetate into the polar and neutral lipids of human embryonic lung cells and human saphenous vein smooth muscle cells were compared to [14C]acetate incorporation in mock-infected control cells. Cytomegalovirus infection caused a shift in the relative amounts of polar and neutral lipids, with infected cells having lower amounts of polar lipids and higher amounts of neutral lipids than mock-infected controls. When neutral lipids were separated into diglyceride (DG), cholesterol (C), fatty acid, triglyceride (TG) and cholesterol ester (CE) components, Ad-169-infected cells had lower levels of incorporation of label into CE, TG, and DG fractions, and higher levels of label incorporation into C than mock-infected cells.