Review
Chemistry, Medicinal
Maria Letizia Salvetat, Francesco Pellegrini, Leopoldo Spadea, Carlo Salati, Marco Zeppieri
Summary: Normal tension glaucoma (NTG) is a subtype of primary open-angle glaucoma (POAG) in which the intraocular pressure (IOP) values are within the normal range without treatment. The exact cause of NTG is not fully understood and multiple factors are believed to contribute to its development. Lowering IOP is the standard treatment for NTG, but it may not be enough in all cases, suggesting the involvement of other factors. Various therapeutic approaches targeting different risk factors have been proposed, but there is no standardized or proven alternative treatment for NTG. This review aims to highlight the strategies reported in the literature and the challenges in finding appropriate and effective treatments for NTG.
Article
Medicine, General & Internal
Akvile Stoskuviene, Lina Siaudvytyte, Ingrida Januleviciene, Antanas Vaitkus, Evelina Simiene, Viktorija Bakstyte, Arminas Ragauskas, Gal Antman, Brent Siesky, Alon Harris
Summary: Growing evidence suggests that intracranial pressure (ICP) is important in the pathophysiology of glaucoma, especially in normal-tension glaucoma (NTG) patients. This study aims to assess the relationship between ICP and visual field (VF) zones in NTG patients. The results showed that higher translaminar pressure difference (TPD) was associated with lower mean deviation (MD) and higher pattern standard deviation (PSD). ICP was significantly associated with the lowest averaged pattern deviation (PD) scores in the nasal VF zone.
Article
Multidisciplinary Sciences
Lei Guo, Jun Tao, Yang Tong, Shichao Chen, Xin Zhao, Rui Hua
Summary: This study investigated the morphological and vascular characteristics of the optic nerve head (ONH) in normal guinea pigs using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The results showed significant differences in refractive error, intraocular pressure (IOP), and circumpapillary retinal nerve fibre layer (cpRNFL) thickness between the 3-week and 4-week groups. There were no significant differences in vascular characteristics between the two groups, but a positive correlation was found between total vessel length and cpRNFL thickness, and a negative correlation was found between total vessel length and IOP.
SCIENTIFIC REPORTS
(2022)
Review
Ophthalmology
Ahmad A. Aref, Paul R. Parker, Michael Y. Y. Chen
Summary: The purpose of this review is to critically summarize and analyze published data from randomized controlled clinical trials (RCTs) investigating the safety and efficacy of microinvasive glaucoma surgeries (MIGS) with and without cataract surgery versus cataract surgery alone. Recent studies have shown that MIGS devices such as iStent (Glaukos), CyPass (Alcon), and Hydrus (Alcon) in combination with cataract surgery are superior to cataract surgery alone. More participants in the combined MIGS procedures achieved significant reduction in intraocular pressure (IOP) without medication compared to cataract surgery alone. Adverse events associated with MIGS were acceptable. Follow-up studies demonstrated sustained efficacy, visual field preservation, cost-effectiveness, and improved quality of life associated with MIGS procedures.
CURRENT OPINION IN OPHTHALMOLOGY
(2023)
Article
Ophthalmology
Gabriel A. Villasana, Chris Bradley, Pradeep Ramulu, Mathias Unberath, Jithin Yohannan
Summary: Failing to achieve target intraocular pressure (IOP) was associated with more rapid visual field (VF) worsening in treated patients, especially in those with moderate glaucoma. The impact of missing target IOP on VF worsening was more pronounced compared to the effect of absolute level of IOP on VF worsening.
Review
Chemistry, Medicinal
Debora Collotta, Simona Colletta, Virginia Carlucci, Claudia Fruttero, Antonio Maria Fea, Massimo Collino
Summary: Glaucoma is a disease that causes optic nerve damage and visual field loss. Lowering intraocular pressure is the only modifiable factor, and medication, laser treatment, or surgery can manage disease progression. Filtering procedures are used when less invasive methods cannot achieve the target pressure. Accurate control of the fibrotic process during these procedures is crucial for surgical success. This review explores available and potential pharmacological treatments that modulate scarring after glaucoma surgery, highlighting the limitations of current strategies and suggesting the need for multi-target approaches to inhibit excessive scarring.
Article
Ophthalmology
Sean Mullany, Lewis Xiao, Ayub Qassim, Henry Marshall, Puya Gharahkhani, Stuart MacGregor, Mark M. Hassall, Owen M. Siggs, Emmanuelle Souzeau, Jamie E. Craig
Summary: This study investigated the association between normal-tension glaucoma (NTG) and cognitive impairment, finding that cognitive impairment was more prevalent in the NTG group compared to the high-tension glaucoma (HTG) group. While a linear trend was observed in lower T-MoCA scores in the NTG group compared to the HTG group, the association was not statistically significant.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2022)
Article
Peripheral Vascular Disease
Jesus D. Melgarejo, Gladys E. Maestre, Luis J. Mena, Joseph H. Lee, Michele Petitto, Carlos A. Chavez, Gustavo Calmon, Egle Silva, Lutgarde Thijs, Lama A. Al-Aswad, Joseph D. Terwilliger, C. Gustavo De Moraes, Fang-Fei Wei, Thomas Vanassche, Peter Verhamme, Jan A. Staessen, Zhen-Yu Zhang
Summary: Hypoperfusion of the optic nerve may contribute to the pathogenesis of normal-tension glaucomatous optic neuropathy. This study found that blood pressure variability, likely operating through hypoperfusion of the optic nerve, is associated with normal-tension glaucomatous optic neuropathy. 24-hour ambulatory blood pressure monitoring may help stratify the risk of normal-tension glaucomatous optic neuropathy.
HYPERTENSION RESEARCH
(2021)
Article
Ophthalmology
Shay Keren, Michael Waisbourd, Nir Gomel, Yael Cohen, Shimon Kurtz
Summary: This study found that there was a small but statistically significant increase in intraocular pressure and a trend towards deterioration of visual field mean deviation following a short mental stress test. Patients with more severe glaucoma showed more pronounced changes. These results suggest that mental stress could affect IOP measurement in the clinic.
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
(2022)
Article
Ophthalmology
Poemen PuiMan Chan, Ruyue Shen, Carol Y. Cheung, Anni Ling, Marco Yu, Chi-Pui Pang, Clement C. Tham
Summary: This study compared the rates of peripapillary vessel density (pVD) loss and retinal nerve fibre layer (RNFL) thinning in normal tension glaucoma (NTG) and primary angle closure glaucoma (PACG). The results showed that NTG eyes had more extensive and faster pVD loss compared to PACG eyes, while the rates of RNFL thinning did not differ significantly between the two groups. Baseline global pVD and mean deviation (MD) were independently associated with the rate of pVD loss in NTG.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2022)
Article
Ophthalmology
Kenji Inoue, Minako Shiokawa, Shiho Kunimatsu-Sanuki, Norie Nozaki, Kosuke Shimizu, Kyoko Ishida, Goji Tomita
Summary: This study retrospectively evaluated the efficacy and safety of single-agent omidenepag isopropyl in patients with normal-tension glaucoma. The results showed that after 1 year of administration, the intraocular pressure decreased and visual fields were maintained, indicating that omidenepag isopropyl can be used as a first-line medication for patients with normal-tension glaucoma.
JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS
(2022)
Article
Ophthalmology
Subathra Gnanavelu, George Varghese Puthuran, Kousalya Pavani Chiranjeevi, Hiruni Kaushalya Wijesinghe, Vishnuvardhan Reddy, Iswarya Mani, Subbaiah Ramasamy Krishnadas, Steven Jon Gedde
Summary: The study found that approximately one-third of NVG eyes treated with AADI failed after 2 years of follow-up, with eyes with open angles having a lower risk of failure.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2023)
Article
Ophthalmology
Bipul Kumer De Sarker, Mohammad Ibn Abdul Malek, Sheikh M. A. Mannaf, Quazi Sazzad Iftekhar, Mallika Mahatma, Mridul Kumar Sarkar, Mostafizur Rahman
Summary: In patients with Sturge-Weber syndrome, both AGV implantation and trabeculectomy appear to be safe and effective in controlling secondary glaucoma. However, potential serious complications such as choroidal detachment should be anticipated, and maintaining stable IOP during and following surgery is recommended to avoid such complications.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2021)
Article
Ophthalmology
Eamon Sharkawi, Daniel Josef Lindegger, Paul H. Artes, Lydia Lehmann-Clarke, Mohamad El Wardani, Marie Misteli, Jerome Pasquier, Adriano Guarnieri
Summary: This study reported on the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG) over a 24-month period. The results showed a high success rate, low complication rate, effective reduction in intraocular pressure, and decrease in the number of medications used for treatment.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2021)
Article
Ophthalmology
Ruth Chen, Anthony J. King
Summary: This study quantifies end of life vision in patients undergoing trabeculectomy, showing that the surgery is successful in maintaining visual function in the majority of eyes for the remainder of life, slowing or preventing further glaucoma progression.
BRITISH JOURNAL OF OPHTHALMOLOGY
(2021)
