[Quality of life evaluation in elderly normal tension glaucoma patients using the Japanese version of VFQ-25].

PURPOSE: To evaluate the quality of life (QOL) related to the visual functioning of elderly normal-tension glaucoma(NTG) patients quantitatively. SUBJECTS & METHODS: 231 NTG patients 65 years or older with visual field loss in Humphrey visual field analysis were studied. The correlation of the subjects' VFQ-25 scores were studied with their patient background information, as well as with their eye test values for intraocular pressure, corrected visual acuity, refraction, mean deviation (MD), and pattern standard deviation (PSD) in the worst seeing eye. RESULTS: No correlation with the VFQ-25 scores (VFQ-S) was found in any of the 12 sub-scales for gender, age, or duration of the disease. However, the number of glaucoma eye-drop solutions showed a negative correlation with 2 sub-scales. Driving was the only sub-scale in which a correlation was found between the VFQ-S and the subjects' intraocular pressure. Corrected visual acuity demonstrated correlations in many of the sub-scales. MD measurements showed a high correlation with the VFQ-S in all items except general health and ocular pain. On the other hand, no correlation with the VFQ-S was observed in any of the sub-scales for the PSD measurements. CONCLUSION: The VFQ-S of elderly NTG patients showed a high degree of reliability. The VFQ-25 scores were useful and suitable tools for evaluating the QOL of glaucoma patients with visual field and acuity impairment.

Addition of or switch to topical bunazosin hydrochloride in elderly patients with normal-tension glaucoma: A one-year follow-up study.

PURPOSE: To evaluate the efficacy and safety of 0.01% bunazosin hydrochloride ophthalmic solution (bunazosin) for elderly patients with normal-tension glaucoma (NTG) as an addition to or instead of their previous therapy. METHODS: Bunazosin was administered to NTG patients aged 65 years or over who had been undergoing topical glaucoma therapy. In accordance with the study protocol, intraocular pressure (IOP) and visual field measurement were performed and the safety of the treatment was evaluated periodically between week 0 and week 52 at the five facilities where the study was carried out. RESULTS: Of the 98 enrolled patients, 84 (85.7%) were followed up for 52 weeks. During the follow-up period, IOP significantly and persistently decreased (week 0, 15.0 +/- 2.5 mmHg; week 52, 13.4 +/- 2.4 mmHg, P < 0.0001), but the decrease in mean deviation (MD) was not significant. Although no systemic adverse reactions were observed, local adverse events were noted in 7 of the 98 patients. CONCLUSIONS: The addition of or the switch to bunazosin in elderly NTG patients resulted in a significant reduction of IOP without apparent exacerbation of visual field defects or systemic or local adverse reactions other than conjunctival hyperemia.

A high dietary intake of sodium glutamate as flavoring (ajinomoto) causes gross changes in retinal morphology and function.

The purpose of this study was to investigate the effects of glutamate accumulation in vitreous on retinal structure and function, due to a diet high in sodium glutamate. Three different diet groups were created, consisting of rats fed on a regular diet (diet A), a moderate excess of sodium glutamate diet (diet B) and a large excess of sodium glutamate diet (diet C). After 1, 3 and 6 months of the administration of these diets, amino acids concentrations in vitreous were analyzed. In addition, retinal morphology and function by electroretinogram (ERG) of three different diet groups were studied. Significant accumulation of glutamate in vitreous was observed in rats following addition of sodium glutamate to the diet as compared to levels with a regular diet. In the retinal morphology, thickness of retinal neuronal layers was remarkably thinner in rats fed on sodium glutamate diets than in those on a regular diet. TdT-dUTP terminal nick-end labelling (TUNEL) staining revealed significant accumulation of the positive staining cells within the retinal ganglion cell layers in retinas from diets B and C as compared with that from diet A. Similar to this, immunohistochemistry demonstrated increased expression of glial fibrillary acidic protein (GFAP) within the retinal inner layers from diets B and C as compared with diet A. Functionally, ERG responses were reduced in rats fed on a sodium glutamate diets as compared with those on a regular diet. The present study suggests that a diet with excess sodium glutamate over a period of several years may increase glutamate concentrations in vitreous and may cause retinal cell destruction.

[Effect of tonometry on a glaucoma population study].

PURPOSE: The purpose of this study was to evaluate the influence of tonometry in detecting the occurrence of glaucoma. METHODS: The subjects, 845 out of 3,488 residents aged 40 years or older, were examined according to standard protocols, including tonometry, slit lamp examination, fundus photography, and automatic perimetry as a recall examination. The intraocular pressure in each subject was measured by both Goldmann applanation tonometer(GAT) and noncontact tonometer CT-70 (NCT). RESULTS: The mean +/- standard deviation intraocular pressure measured by GAT was 15.52 +/- 2.57 mmHg, and 15.03 +/- 2.90 mmHg by NCT. There was a statistically significant correlation(p < 0.0001). The difference between pairs of measurements by GAT and NCT was 0.50 +/- 1.93 mmHg. There was no influence of tonometry in detecting the incidence of glaucoma, which was 4.14%; primary open-angle glaucoma 0.59%, normal tension glaucoma 2.6%, primary angle-closure glaucoma 0.47%, and other types of glaucoma 0.48%. The detection of ocular hypertension was different, and was 2.13% with GAT and 2.72% with NCT. CONCLUSION: In our study, the influence of tonometry in detecting the incidence of glaucoma was very small. A noncontact tonometer is considered to be useful for glaucoma population study.