Absence Of Glaucoma Research Articles

A cross-sectional study on the proper administration of eye medications and its determinants among outpatients attending Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea

ObjectiveThis study aimed to assess the administration technique of eye medications, its determinants and disposal practices among ophthalmic outpatients.DesignAn analytical cross-sectional study was conducted.SettingBrhan Aini Ophthalmic National Referral Hospital in...

Extracting decision-making features from the unstructured eye movements of clinicians on glaucoma OCT reports and developing AI models to classify expertise.

This study aimed to investigate the eye movement patterns of ophthalmologists with varying expertise levels during the assessment of optical coherence tomography (OCT) reports for glaucoma detection. Objectives included evaluating eye gaze metrics and patterns as a function of ophthalmic education, deriving novel features from eye-tracking, and developing binary classification models for disease detection and expertise differentiation. Thirteen ophthalmology residents, fellows, and clinicians specializing in glaucoma participated in the study. Junior residents had less than 1 year of experience, while senior residents had 2-3 years of experience. The expert group consisted of fellows and faculty with over 3 to 30+ years of experience. Each participant was presented with a set of 20 Topcon OCT reports (10 healthy and 10 glaucomatous) and was asked to determine the presence or absence of glaucoma and rate their confidence of diagnosis. The eye movements of each participant were recorded as they diagnosed the reports using a Pupil Labs Core eye tracker. Expert ophthalmologists exhibited more refined and focused eye fixations, particularly on specific regions of the OCT reports, such as the retinal nerve fiber layer (RNFL) probability map and circumpapillary RNFL b-scan. The binary classification models developed using the derived features demonstrated high accuracy up to 94.0% in differentiating between expert and novice clinicians. The derived features and trained binary classification models hold promise for improving the accuracy of glaucoma detection and distinguishing between expert and novice ophthalmologists. These findings have implications for enhancing ophthalmic education and for the development of effective diagnostic tools.

Comparison of age-related vascular changes in the optic disc of patients with diabetes, with glaucomatous and non-glaucomatous features

ObjectiveTo identify age-related vascular changes in the optic discs of patients with diabetes with and without signs of glaucoma.Methods and analysisA total of 2153 eyes of 1797 patients with diabetes...

Evaluation of Lamina Cribrosa by Using Enhanced Depth Imaging Optical Coherence Tomography in Ocular Sarcoidosis during Quiescent Phase.

Enhanced depth imaging optical coherence tomography is a useful method to allow for the evaluation of deep ocular structures, such as choroid and lamina cribrosa (LC), which are affected by ocular diseases. We hypothesized that choroidal and optic nerve inflammation in patients with ocular sarcoidosis (OS) might affect the LC structure. This study aimed to evaluate changes in the LC and anterior LC depth (ALCD) in patients with OS. Forty-eight eyes of 26 patients with OS who received the treatment of panuveitis and were in the quiescent phase for at least 6 months were included in the study. Thirty healthy subjects' randomly selected eyes were selected as a control group. Eyes with OS were divided into two subgroups according to the presence (OS eyes with glaucoma [OSWG], n = 23) or absence of glaucoma (OS eyes without glaucoma [OSWOG], n = 25). The LC thickness, ALCD, and peripapillary choroidal thickness were measured using enhanced depth imaging optical coherence tomography in eyes with OS and in controls. The mean LC thickness was found significantly thinner in both OSWG and OSWOG eyes compared with the healthy controls (P < .001 and P = .001, respectively). The mean ALCD was found significantly higher in OSWG eyes (462 ± 65 μm) compared with OSWOG eyes (417 ± 58 μm) and the healthy control eyes (397 ± 59 μm; P = .03 and P = .001, respectively). The average peripapillary choroidal thickness was found to be significantly thinner in OSWG eyes compared with the control eyes (P = .05). The present study revealed that OS is associated with a thinned LC independent of the presence of glaucoma. The degenerative changes in the LC, which is the transition point of the retinal nerve fibers, may cause long-term visual dysfunction in OS. These degenerative changes should be prevented by controlling inflammation with early diagnosis and treatment in patients with OS.

ASSOCIATION BETWEEN GLAUCOMA PREVALENCE AND SUPPLEMENTATION WITH CALCIUM, IRON AND CAFFEINE

PURPOSE. To investigate the relationship between supplementary consumption of the oxidants calcium and iron and caffeine and the prevalence of glaucoma. METHODS. This cross-sectional study included 3833 participants 40 years of age, who reported a presence or absence of glaucoma. Participants were interviewed regarding the use of dietary supplements and antacids during the preceding 30-day period. Data pertaining to the supplementary intake of calcium, iron and caffeine was aggregated and divided into quintiles. Information regarding the presence or absence of glaucoma and demographics, comorbidities, and health-related behavior was obtained via interview. RESULTS. Participants who consumed 800 mg/d of supplementary calcium or 18 mg/d of supplementary iron had significantly higher odds of having been diagnosed with glaucoma than did those who had not consumed supplementary calcium or iron, after adjustment for potential confounders. Concurrent consumption of both calcium and iron above these levels was associated with still greater odds of having been diagnosed with glaucoma. Compared with participants whose cumulatively updated total caffeine consumption was &lt;125 mg/day, participants who consumed ≥500 mg/day had a trend toward increased risk of glaucoma. CONCLUSIONS. These results suggest that there may be a threshold intake of iron, calcium and caffeine above which there is an increased risk of development of glaucoma. Prospective longitudinal studies are needed, to assess whether oxidant intake is a risk factor for development and progression of glaucoma.

Роль полиморфизма rs2075575 гена аквапорина 4 в развитии первичной открытоугольной глаукомы

Актуальность. Несмотря на всестороннее изучение патогенеза первичной открытоугольной глаукомы (ПОУГ), механизмы возникновения заболевания до конца не изучены. В настоящее время определена роль аквапоринов в регуляции внутриглазного давления. Были обнаружены мутации, усиливающие и снижающие функции аквапорина 4, описано влияние различных генетических вариантов аквапоринов на величину внутриглазного давления. Цель исследования. Исследовать частоту встречаемости вариантов полиморфизма rs2075575 (C/Т) гена аквапорина 4 у больных ПОУГ. Материалы и методы. В исследовании приняли участие 101 пациент с ПОУГ и 80 здоровых людей (контрольная группа). Возраст исследуемых колебался от 45 до 87 лет. Средний возраст составил 66 лет. Критерием включения в основную группу служил диагноз ПОУГ развитой, далеко зашедшей и терминальной стадий. Критериями включения в контрольную группу служили возраст старше 60 лет, отсутствие глаукомы и выраженной соматической патологии. ДНК выделяли из буккального эпителия. Полиморфизм гена аквапорина 4 rs2075575 определяли методом полимеразной цепной реакции. Результаты. Установлено, что распределение генотипов у пациентов с ПОУГ отличается от группы здоровых лиц. Обнаружено, что генотип СС среди больных глаукомой встречается в 1,8 раза чаще, чем в контрольной группе. Наоборот, генотип СТ выявляется в 1,5 раза чаще в контрольной группе. Отношение шансов (OR) для генотипа СС равно 2,48 (95% CI 1,30-4,74). У генотипа СТ выявляется протекторная роль, OR =0,52 (95% CI 0,28-0,97). Частота встречаемости генотипа ТТ в исследуемых группах не различается. Выводы. Полиморфный вариант rs2075575 (C/Т) гена аквапорина 4 вносит вклад в риск развития ПОУГ в исследованной выборке. Background. Despite a comprehensive study of the pathogenesis of the disease, the mechanisms of primary open-angle glaucoma are not completely clear. Currently, the role of aquaporins in the regulation of intraocular pressure has been determined. Mutations were discovered that enhance and decrease the functions of aquaporin 4. The effect of various genetic variants of aquaporins on the value of intraocular pressure is described. The aim of research. To investigate the variability of the polymorphism of aquaporin 4 rs2075575 (C / T) in patients with glaucoma. Materials and methods. 101 persons with primary open-angle glaucoma and 80 persons without glaucoma (the control group) were examined. The age of the subjects ranged from 45 to 87 years. The average age was 66 years. The criterion for inclusion in the main group was the diagnosis of primary open-angle glaucoma of a developed, distant and terminal stage. The criteria for inclusion in the control group were age over 60 years, the absence of glaucoma, the absence of pronounced somatic pathology. DNAs were extracted from buccal epithelium. The polymerase chain reaction (PCR) method was used to determine the polymorphism of the aquaporin gene 4 rs2075575. Results. There was a significant difference in the distribution of genotypes in the study and control groups. СС genotype among patients with glaucoma occurs 1.8 times more often than in the control group. CT genotype, on the contrary, is 1.5 times more often in the control group. The odds ratio (OR) for this genotype is 2.48 (95% CI 1.30 - 4.74). The CT genotype reveals a protective role, OR = 0.52 (95% CI 0.28 - 0.97). The genotype of TT in the studied groups is slightly different in frequency of occurrence. Conclusion. The frequencies of gene polymorphisms of aquaporin 4 rs2075575 (C/Т) in patients with primary open-angle glaucoma and healthy were diverse. The likelihood of developing primary open-angle glaucoma is increased in carriers of the СС genotype. Genotype CT play a protective role for primary open-angle glaucoma.

Automatic Detection of Glaucoma based on Refined Complete Local Binary Pattern and Random Forest Classification Method

Glaucoma is considered to be one of the main root causes of blindness. As it shows no symptoms, if not properly identified at the correct time would result in the loss of vision. This paper proposes a method for the Automatic Detection of Glaucoma based on Refined Complete Local Binary Pattern and Random Forest Classification Method(RCLBP-RFC), which identifies the presence or the absence of glaucoma in a patient at an early stage. The first step is use to convert a color image into gray scale image and the second step we use Neighborhood Fuzzy K Means Clustering to segment Optic Disc(OD) and Optic Cup(OC). In the third step Statistical Optimized and Restoration model is use to extract the enhanced images using the restoration technique. In the Fourth step we exploit Refined Complete Local Binary Patterns Extraction to extract the most relevant features and finally, Random Forest Classification methods are involved to classify the features as normal, abnormal or early detected glaucoma. The experiments show that our RCLBP-RFC method achieves state-of-the-art OD and OC segmentation result on DRIONS dataset. Experimental results indicates that the proposed method identifies the presence or absence of glaucoma more precisely than other existing methods in terms of computational time and complexity, and accuracy

Recognition of Glaucoma by means of Gray Wolf Optimized Neural Network

Glaucoma is the secondary most considerable causes of blindness after Cataracts. As it shows no symptoms, it is entitled to “snake thief of sight”. Glaucoma is the condition in which optic nerve fibers are damaged that causes loss of vision and may even blindness if not diagnosed on time. If this chronic disease is not identified in the initial stage it negatively rooted for permanent blindness. Many manual scanning methods are available however they are costly, time-consuming and require experts of these fields to use them. To circumvent such adversarial effects, it is necessary to spot the disease earlier. This paper proposes a technique for the recognition of Glaucoma called Gray Wolf Optimized Neural Network (GWO-NN), which recognizes the presence or the absence of Glaucoma in a patient. Initially, as a preprocessing phase, the inputted image is transformed to greyscale, noise is eliminated using Adaptive Median Filter (AMF) and image normalization is done. Now, feature extraction is executed in features of GLCM (Gray Level C0-occurrence Matrix features), SURF (Speeded Up Robust Feature), HOG (Histogram of Oriented Gradients features) along with the Global features which are taken from the previously processed image. Now, classification follows utilizing NN of GWO (grey wolf optimization) technique. Experimental outcome indicates that the proposed optimized classifier identifies the existence or nonexistence of Glaucoma more precisely than other existing methods.

Prevalence of depression and anxiety among participants with glaucoma in a population-based cohort study: The Gutenberg Health Study

BackgroundTo investigate the prevalence of depression and anxiety among subjects with self-reported glaucoma and the association between self-reported glaucoma and depression respectively anxiety in a European cohort.MethodsA study sample of 14,657 participants aged 35 to 74 years was investigated in a population-based cohort study. All participants reported presence or absence of glaucoma. Ophthalmological examinations were carried out in all participants and demographic and disease related information were obtained by interview. Depression was assessed with the Patient Health Questionnaire (PHQ-9), and generalized anxiety with the two screening items (GAD-2) of the short form of the GAD-7 (Generalized Anxiety Disorder-7 Scale). Prevalence of depression and generalized anxiety were investigated for subjects with and without self-reported glaucoma. Logistic regression analyses with depression, respectively anxiety as dependent variable and self-reported glaucoma as independent variable were conducted and adjusted for socio-demographic factors, systemic comorbidities (arterial hypertension, myocardial infarction, stroke, diabetes mellitus, chronic obstructive pulmonary disease, cancer), ocular diseases (cataract, macular degeneration, corneal diseases, diabetic retinopathy), visual acuity, intraocular pressure, antiglaucoma eye drops (sympathomimetics, parasympathomimetics, carbonic anhydrase inhibitors, beta-blockers, prostaglandins) and general health status.Results293 participants (49.5% female) reported having glaucoma. Prevalence of depression among participants with and without self-reported glaucoma was 6.6% (95%-CI 4.1–10.3) respectively 7.7% (95%-CI 7.3–8.2), and for anxiety 5.3% (95%-CI 3.1–8.7) respectively 6.6% (95%-CI 6.2–7.1). Glaucoma was not associated with depression (Odds ratio 1.10, 95%-CI 0.50–2.38, p = 0.80) or anxiety (1.48, 95%-CI 0.63–3.30, p = 0.35) after adjustment for socio-demographic factors, ocular/systemic diseases, ocular parameters, antiglaucoma drugs and general health status. A restriction to self-reported glaucoma cases either taking topical antiglaucoma medications or having a history of glaucoma surgery did not alter the result.ConclusionsThis is the first study analyzing both depression and anxiety among glaucoma patients in a European cohort. Subjects with and without self-reported glaucoma had a similar prevalence of depression and anxiety in our population-based sample. Self-reported glaucoma was not associated with depression or anxiety. A lack of a burden of depressive symptoms may result from recruitment from a population-based sample as compared to previous study groups predominantly recruited from tertiary care hospitals.

Risk of obstructive sleep apnea in open-angle glaucoma versus controls using the STOP-Bang questionnaire

ObjectiveTo compare the percentage of patients at risk for obstructive sleep apnea (OSA) in open-angle glaucoma (OAG) versus controls using the STOP-Bang questionnaire. MethodsThis study used a cross-sectional survey. Patients with OAG and controls completed the STOP-Bang questionnaire—a validated tool to identify patients at high risk for OSA. Patients were considered at risk if they scored 3 or more points or at high risk for moderate/severe OSA if they scored 5 or more out of the maximum 8 points. Demographic information, medical history, and previous diagnosis of OSA were recorded. Details regarding the patients’ glaucoma were obtained from their medical records. ResultsA total of 437 patients with OAG and 441 controls were included. The mean STOP-Bang score was 3.01 ± 1.3 for the glaucoma group and 3.03 ± 1.4 for the control group (p = 0.92). There was no significant difference between the percentage of subjects considered at risk for OSA (62.7% OAG vs 59.4% controls, p = 0.37) or at high risk for moderate/severe OSA (12.6% OAG vs 16.5% controls, p = 0.1). Significantly more patients in the control group had a previous diagnosis of OSA (p = 0.01). More patients with OAG reported feeling tired compared with controls (p = 0.003). A risk/high risk for OSA was not associated with glaucoma severity, progression, intraocular pressure control, or glaucoma type. ConclusionsOur results indicate that a risk or high risk for moderate/severe OSA as measured by the STOP-Bang questionnaire is not correlated with the presence or absence of glaucoma (regardless of the type), glaucoma severity, glaucoma progression, or IOP control.

Choroidal Vessel Diameters in Pseudoexfoliation and Pseudoexfoliation Glaucoma Analyzed Using Spectral-Domain Optical Coherence Tomography.

The purpose of the study was to analyze choroidal vessel diameters in pseudoexfoliation (PXF) and pseudoexfoliation glaucoma (PXFG) using spectral-domain optical coherence tomography (SD-OCT). Fifty patients (100 eyes) with PXF and PXFG who underwent high-definition 1-line raster SD-OCT imaging at New England Eye Center, Boston, were retrospectively identified and divided into unilateral PXFG (26 patients, 52 eyes), unilateral PXF (4 patients, 8 eyes), bilateral PXFG (4 patients, 8 eyes), and bilateral PXF (16 patients, 32 eyes). Eyes with concomitant chorioretinal pathology, history of shunting/filtering for glaucoma, and significant anisometropia were excluded. SD-OCT scans were divided into subfoveal, central, and peripheral zones and choroidal vessel diameters were measured. In patients with unilateral PXFG, mean choroidal vessel diameter was 12.9 μm smaller in the affected eyes when compared with their contralateral eyes (45.7 vs. 58.6 μm; P<0.0001) with the greatest reduction (16.6 μm) in the subfoveal zone (49.0 vs. 65.6 μm; P<0.0001). In patients with unilateral PXF, the mean choroidal vascular diameter was 13.3 μm smaller in the affected eyes when compared with their contralateral eyes (42.8 vs. 56.1 μm; P=0.02). As expected, no significant difference was observed between the 2 eyes of patients with bilateral PXFG (45.5 vs. 45.7 μm; P=0.95) and bilateral PXF (51.4 vs. 50.2 μm; P=0.52). Choroidal vessel diameters are smaller in the affected eyes of patients with unilateral PXF and PXFG when compared with their contralateral unaffected eyes. These changes appear to be independent of the presence or absence of glaucoma. Future studies may identify the choroidal vascular changes and their relationship with the pathogenesis of these conditions.

СORNEAL ENDOTHELIUM IN EYES WITH PSEUDOEXFOLIATION SYNDROME (DATA OF ENDOTHELIAL MICROSCOPY)

Objective: To compare corneal endothelial indexes in eyes with pseudoexfoliation syndrome (PEX) and without it, and identify the dependence of corneal endothelial cell density (CD) on the age and stage of glaucoma. Patients and Methods: The study included 55 people (96 eyes). There were 53 eyes with PEX and 43 eyes without it. Patients were divided into 2 age groups: 40–60 years (41 eyes) and 61–80 years (55 eyes). The groups were homogeneous with respect to the level of IOP, Central corneal thickness, anteposterior axis of the eye and the stages of glaucoma. Endothelial microscopy was performed on a SP-3000P (Topcon). Statistical processing was made with SPSS 16.0 for Windows(methods of variation statistics, discriminant analysis). Results: There were significant difference in eyes with PEX and without PEX in CD in ages of 40–60 years (2309,57±87,77 cells/mm 2 and 2642,39±64,81 cells/mm 2 , p=0.005) and 61–80 years (2247,02±59,5 (cells/mm2 and 2590,18±93,39 cells/mm2, p=0.004), as well as in the average surface area of endothelial cell (434,08±17,43 µm 2 and 385,17±9,57 µm 2 , p=0,024; 461,14±15,23 µm 2 and of 395.00±13,21 µm 2 , p=0.002, respectively).There was age difference of CD reduction: the highest CD was at 40–50 years (2722.75±63.05 cells/mm 2 ), and at 81–90 years if fells to 1872.67±417.29 cells/mm 2 (at a given age are found only patients with PEX). Revealed that the CD is dependent on the stage of glaucoma: the density was highest in the absence of glaucoma (2603.00±162.61 cells/mm 2 ) and at an initial stage of glaucoma (2480.65±48.88 cells/mm 2 ), while the density was lowest at stage 3 of glaucoma (2118.73±150.51 cells/mm 2 ). Here reducing of the CD was due to patients with PEX, while in patients without PEX the differences were not statistically significant in different stages of glaucoma. Conclusion: Our study showed that the eyes with PEX are characterized by a more pronounced damage to the corneal endothelium, than eyes without it. The condition of endothelium cells worsens in eyes with PEX, depending on the age and stage of glaucoma. Thus, the performing of endothelial microscopy can be seen as a necessary tool in the monitoring of patients with PEG for the solution of a question on tactics of treatment and timely phacoemulsification.

Подозрение и начальная стадия глаукомы: дифференциально-диагностические критерии

Purpose: to set out morphofunctional differences in the ophthalmic status between suspected glaucoma (SG) and the initial stage of primary open angle glaucoma (POAG), determine the values of interocular asymmetry of the analyzed parameters of fellow eyes and create a model able to distinguish, with high accuracy, between healthy subjects, SG patients and POAG patients relying on a few independent parameters. Material and methods. A multicenter study performed between July and November, 2016, by 34 research and clinical facilities of four countries (Russia, Belarus, Uzbekistan, and Moldova) involved 501 patients (824 eyes), of which 362 (72 %) were female and 139 (28 %) male. The main analyzed group consisted of 128 eyes with SG, 228 eyes with early stage POAG and 145 eyes of healthy subjects (the control group with comparable sex and age distribution and no history of glaucoma). The fellow-eye symmetry analysis group involved 190 eyes with SG, 336 eyes with early stage POAG and 220 eyes of 110 subjects with no glaucoma. Results. Differences were found in the structural and functional ophthalmologic parameters in early-stage POAG, SG, and the absence of glaucoma. The precision of SG and early POAG may be increased by cumulative consideration of several clinical parameters. Conclusions. The sensitivity and specificity of the integral index of condition prognostication increases when several parameters are analyzed simultaneously, as compared to the separate analysis of constituents. For citations: Avdeev R.V., Alexandrov A.S., Arapiev M.U., et al. Suspected glaucoma and early stage glaucoma: differential diagnostic criteria. Russian ophthalmological journal. 2017; 10 (4): 5-15. doi: 10.21516/2072-0076-2017-10-4-5-15 (In Russian).

Взаимосвязь особенностей аутоиммунного статуса у пациентов с катарактой на фоне псевдоэксфолиативного синдрома с развитием у них нарушений гидродинамики глаза

Pseudoexfoliation syndrome (PEX) is the established trigger of glaucoma. The systemic character of PEX and the multifactor character of glaucoma can point to possible changes of the autoimmune profile of human body in the presence of this pathology and its possible link with hydrodynamic disturbances. Purpose. To study the peculiarities of the autoimmune serum profile in patients with cataract and PEX in the presence and absence of glaucoma. Material and methods. In the study there were examined 45 female patients aged 70-84 years with cataract and severe PEX. The patients were divided into 3 groups depending on the intensity of systemic cardio-vascular pathology and the presence or absence of glaucoma. Enzyme-linked immunosorbent assay was used to define the serum autoantibody level. Results. In examined groups it was detected the exceeding of the average statistical norm of the following serum autoantibodies: to the cytoplasm of neutrophilic granulocytes (ANCA), β1-adrenoreceptors and membrane antigen of trombocyte, which was the most pronounced one in the presence of systemic cardiovascular pathology and glaucoma process. Conclusions . The detected peculiarities of the autoimmune activity in patients with PEX can point to the significant role of the endothelial dysfunction in the development of glaucoma in such group of patients.

Prevalence of Glaucoma in the United States: The 2005-2008 National Health and Nutrition Examination Survey.

PurposeTo estimate the prevalence of glaucoma in the US population based on optic nerve head photography, to estimate the prevalence of glaucoma awareness, and to identify demographic and ocular risk factors for being unaware of having glaucoma.MethodsThe study included 5746 men and women 40 years of age and older participating in the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Each participant had 45° photographs of the macula and optic disc of both eyes. Fundus photographs were first graded by a reading center, and those with a cup-to-disc ratio (CDR) ≥ 0.6 were regraded by three glaucoma specialists to determine the presence or absence of glaucoma. Analyses were performed using NHANES weights to account for the complex multistage probability sampling design.ResultsThe estimated overall prevalence of glaucoma in the US civilian, noninstitutionalized population 40 years of age and older was 2.1% (95% confidence interval [CI], 1.7%–2.6%). Glaucoma affected 2.9 million individuals, including 1.4 million women; 1.5 million men; 2.3 million people 60 years of age and older; and 0.9 million blacks, Mexican Americans, and people of other races. The prevalence of glaucoma was highest in non-Hispanic blacks, followed by non-Hispanic whites, Mexican Americans, and others. Over half of participants with glaucoma were unaware that they had the disease.ConclusionsThe prevalence of glaucoma based on optic nerve fundus photography assessment in the general US population 40 years of age and older was 2.1%. Approximately half of glaucoma cases were previously undiagnosed. Studies to determine whether and how to identify undiagnosed glaucoma are an important next step.

Oral Contraceptive Use and Prevalence of Self-Reported Glaucoma or Ocular Hypertension in the United States

To investigate the association between oral contraceptive (OC) use and glaucoma prevalence in the United States. Cross-sectional study. A total of 3406 female participants, aged 40 years or older, from the 2005 to 2008 National Health and Nutrition Examination Survey, who reported a presence or absence of glaucoma or ocular hypertension completed both the vision and the reproductive health questionnaires and underwent eye examinations. Multivariate regression analysis was used to assess the correlation between OC use and self-reported glaucoma or ocular hypertension (n = 231 cases), controlling for potential confounders, including age, ethnicity, systemic comorbidities such as hypertension and stroke, ocular diseases such as cataract and diabetic retinopathy, and reproductive health factors, including age at menopause, age at menarche, history of hormone replacement therapy, and gynecological surgical history. The outcome variable was self-reported glaucoma or ocular hypertension. After adjusting for confounders, those with ≥3 years of OC use had greater odds (odds ratio, 1.94; 95% confidence interval, 1.22-3.07) of self-reported glaucoma or ocular hypertension. Other factors associated with higher glaucoma or ocular hypertension prevalence included older age, African American race, and later age at menarche. Oral contraceptive use may be associated with increased risk of self-reported glaucoma or ocular hypertension.

Lamellar keratoplasty in a referral center in northeastern Brazil

Objective : To clinically characterize some cases of lamellar keratoplasty performed in a referral center of Rio Grande do Norte state. Methods : This is a cross-sectional, retrospective study, which is the review of the medical records of 18 patients who underwent keratoplasty of lamellar type in a referral service in Natal/RN. Results : it was found that of 18 patients who underwent keratoplasty, 55.56% were male, being all patients with deep anterior lamellar. Regarding the age group, 66.67% were thirty years old or less. The corneal vascularization of tissue was a factor receptor absent in 77.78% of cases. The main indication for lamellar keratoplasty were keratoconus (66.66%). Of the cases in which transplantation was done with urgency, ocular diagnoses were not infectious ulcerative keratitis (50%), corneal degeneration (25%) and leukoma (25%). Conclusion : it is cocluded that the main indicator condition for lamellar keratoplasty was keratoconus. Patients who underwent the procedure were 30 years old or less, with minimum level of corneal vascularization and absence of glaucoma. Furthermore, the surgical technique predominantly used for lamellar transplantation was the deep lamellar keratoplasty due to its advantages over penetrating keratoplasty.

Hypothyroidism and Glaucoma in The United States.

PurposeTo investigate the association between hypothyroidism and glaucomatous disease.MethodsThis cross-sectional study included all subjects above the age of 40 years from two nationwide surveys: the 2008 National Health Interview Survey (NHIS) as well as the 2007 and 2008 National Health and Nutrition Examination Survey (NHANES). The presence or absence of glaucoma, thyroid disease and other demographic and health-related information including comorbidities was ascertained via interview. Blood samples were collected from NHANES subjects and analyzed for thyrotropin (TSH).ResultsA total of 13,599 and 3,839 NHIS and NHANES participants respectively were analyzed to assess for a possible relationship between self-reported glaucoma, and self-reported hypothyroidism as well as self-reported thyroid disease. The unadjusted odds ratio (OR) for NHIS showed a significant association between self-reported glaucoma and self-reported hypothyroidism (OR 1.46, 95% confidence interval [CI] 1.07-1.99). Multivariate logistic regression analysis adjusted for age, gender, race, comorbidities, and health-related behavior, however, showed no association between self-reported glaucoma and hypothyroidism or thyroid disease in both surveys (OR 1.60, 95%CI 0.87-2.95 for NHIS; OR 1.05, 95%CI 0.59-1.88 for NHANES).ConclusionA previously reported association between hypothyroidism and glaucomatous disease was not confirmed in two large U.S. health survey populations. While such an association was noted in the univariate analysis for the NHIS survey, such a relationship was not found in the multivariate analysis after adjustment for potential confounding variables.

Association between serum ferritin and glaucoma in the South Korean population.

Evidence suggests that altered iron metabolism may be associated with oxidative damage to several organ systems, including the eye. Supplementary iron consumption is also associated with greater odds of self-reported glaucoma. To investigate the association between serum ferritin level and the likelihood of a glaucoma diagnosis in a cross-sectional, population-based study. Data were collected from 17,476 participants in the first and second years of the Fifth Korea National Health and Nutrition Examination Survey, a cross-sectional study of the South Korean population conducted from January 1, 2010, through December 31, 2011. Data pertaining to the serum ferritin level were aggregated and divided into quartiles. Demographic, comorbidity, and health-related behavior information was obtained via interview. The presence or absence of glaucoma. The definition of glaucoma was based on criteria established by the International Society of Geographical and Epidemiological Ophthalmology. Participants whose serum ferritin level was greater than 61 ng/mL (to convert to picomoles per liter, multiply by 2.247) had significantly higher odds of a glaucoma diagnosis when compared with those with a level less than 31 ng/mL, after adjustment for potential confounders (ferritin levels of 31-61 ng/mL: odds ratio [OR], 1.17; 95% CI, 0.84-1.62; ferritin levels of 62-112 ng/mL: OR, 1.60; 95% CI, 1.16-2.20; and ferritin levels of 113-3018 ng/mL: OR, 1.89; 95% CI, 1.32-2.72). Our study reveals that a higher serum ferritin level was associated with greater odds of glaucoma in a representative sample of the South Korean population, even at levels normally observed in the general population. This novel finding may help elucidate the pathogenesis and lead to novel therapeutic approaches for glaucomatous disease.

Visual Acuity and Subfoveal Choroidal Thickness: The Beijing Eye Study

To examine the association between best corrected visual acuity (BCVA) and subfoveal choroidal thickness. Population-based study. The Beijing Eye Study 2011 included 3468 subjects with ages of 50+ years. The participants underwent an ophthalmologic examination including spectral-domain optical coherence tomography with enhanced depth imaging for measurement of choroidal thickness. BCVA was measured as logarithm of the minimal angle of resolution. Of the 3468 participants, choroidal measurements were available for 3233 (93.2%) subjects. In multivariate analysis, better BCVA was significantly associated with thicker subfoveal choroid (P < 0.001) in general and a subfoveal choroid thicker than 30 μm (P < 0.001) in particular, after adjusting for younger age (P < 0.001), higher level of education (P < 0.001), taller body stature (P < 0.001), higher body mass index (P = 0.005), absence of glaucoma (P = 0.001), absence of diabetic retinopathy (P < 0.001), absence of late-stage age-related macular degeneration (P < 0.001), and axial length shorter than 26.0 mm (P < 0.001) (correlation coefficient r:0.56). If eyes with glaucoma, diabetic retinopathy, late-stage age-related macular degeneration or myopic retinopathy were excluded, better BCVA was still significantly associated with thicker subfoveal choroid (P < 0.001) and subfoveal choroid thicker than 30 μm (P < 0.001) in multivariate analysis. In a reverse manner, thicker subfoveal choroid was associated with better BCVA (P < 0.001) after adjusting for younger age (P < 0.001), male gender (P < 0.001), longer axial length (P < 0.001), and higher corneal curvature radius (P < 0.001). Better visual acuity is strongly associated with thicker subfoveal choroid independent of additional factors, such as age, axial length, education level, and major ocular diseases.