Glaucomatous Eyes Research Articles

Assessment of Schlemm’s canal with swept-source optical coherence tomography in Graves’ ophthalmopathy

PurposeTo evaluate the Schlemm’s canal (SC) parameters obtained by swept-source optical coherence tomography (OCT) different in Graves’ ophthalmopathy (GO) eyes compared to healthy eyes.MethodsThis cross-sectional observational study evaluated 64 eyes of 32 GO cases and 56 eyes of 28 healthy controls. The study was conducted between October 2020 and June 2021. SC images were obtained from the temporal limbus of individuals using swept-source OCT. SC length (SCL) and SC area (SCA) were measured. The relationship between SC parameters in the patient group and intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, Graves’ disease (GD) duration, and clinical activity score (CAS) was evaluated.ResultsIn the GO group, 64 eyes of 32 patients were evaluated, and in the age and gender-matched healthy control group, 56 eyes of 28 individuals were assessed. SC images from 4 eyes of 4 patients in the patient group and 1 eye of 1 patient in the control group were not clear, preventing SCL and SCA measurements for these eyes. SCL and SCA measurements were found to be lower, and IOP and Hertel values were higher in the GO group compared to the healthy controls. However, no significant correlation was observed between SCL and SCA with IOP, RNFL thickness, GD duration, GO duration, or CAS in the GO group. In the GO group, the mean value of SCA was found to be higher in eyes with glaucoma or OHT compared to those without.ConclusionThese findings indicate that SC in GO-affected eyes is shorter and has a smaller area than in healthy individuals. Additionally, higher IOP and Hertel values were observed in the GO group compared to healthy controls. This study suggests that assessing SC using anterior segment OCT could provide valuable insights into the regulation of IOP and the development of glaucoma in GO-affected eyes.

From the past to the present, optical coherence tomography in glaucoma: a practical guide to a common disease.

Glaucoma comprises a group of disorders of the optic nerve that cause degenerative optic neuropathy, characterised by failure of neuroretinal rim tissue in the optic nerve head, retinal nerve fibre layer, and retinal ganglion cells. Glaucoma imposes a serious epidemiological threat, with an steady increase in the global number of cases. In the current ophthalmological practice, glaucoma is diagnosed via a series of examinations, including routine funduscopic examination, ocular tonometry, gonioscopy, measurement of the visual field, and assessment using the optical coherence tomography (OCT) technique. Nowadays, the OCT technique helps in systematising the diagnostic pathway and is a basic diagnostic tool for detection of early glaucomatous eye changes. It is also vital in assessing progression and monitoring treatment results of patients. The aim of this review was to present the OCT technique as a main tool in diagnosing and monitoring glaucoma.

Visual field progression patterns in the ocular hypertension treatment study correspond to vulnerability regions of the disc.

To determine the locations on the 24-2 visual field (VF) testing grid that are most likely to progress in patients with ocular hypertension (OHTN). Based on a structural model of superior and inferior areas of relative vulnerability at the optic disc, we hypothesized that the nasal and paracentral regions are more prone to show a reduction in sensitivity. Posthoc analysis of data collected in phases 1 and 2 of the Ocular Hypertension Treatment Study (OHTS). A pointwise analysis was applied to determine the progression patterns in the early and delayed treatment groups. Each group's progression rate and frequency were calculated for each of the 52 locations corresponding to the 24-2 VF strategy, using trend- and event-based analyses, respectively. For the event-based analysis, the events were most commonly found in the nasal and paracentral regions. The same regions, with some modest variation, were found to have the fastest rates of progression (ROP) measured with trend analysis. A similar pattern of progression was observed in both the early and delayed treatment groups. The difference in event rates and ROP between the early and delayed treatment groups was also greatest in the nasal and paracentral regions. Development of VF loss in ocular hypertensive eyes appears to be consistent with the vulnerability zones previously described in glaucomatous eyes with established VF loss. Ocular hypotensive treatment likely helps to slow the rate of progression in these regions. This suggests that careful monitoring of these locations may be useful.

Management of Secondary Angle Closure Glaucoma in Nanophthalmic Eye : A Challenging Case

Introduction : Nanophthalmos is a condition characterized by short eyeball length (AXL <20.0mm), short and dense anterior segment, high eye volume or lens ratio, hypermetropia (+8.00 to +20.00) and scleral thickening (>1.7mm)
 Case Illustration : A 63-year-old man came to the Glaucoma outpatient clinic at Cicendo Hospital with complaints of blurry eyes since 3 years ago. The visual acuity in the right eye was light perception, and in the left eye was hand movement. The anterior chamber was shallow, with seclusio pupil in both eyes (Figure1). Biometry showed axial length 17.06 mm in the right eye and 16.82 mm in the left eye. The patient underwent phacoemulsification surgery + IOL + iris retractor + pupiloplasty + synechiolysis + sclerectomy for the right eye with satisfactory result (Figure3).
 Discussion : This surgical procedure for nanophthalmos has its own challenges for the operator due to the shallow anterior segment and small corneal diameter. In this case, surgery was performed first in the right eye, with consideration of a greater anterior chamber depth than the left eye. The sclerectomy procedure performed on this patient was 4 mm from the limbus and was performed full thickness only in one quadrant (Figure2).
 Conclusion : Multiple anatomic abnormalities in nanophthalmic eyes make surgery extremely challenging and are associated with a high incidence of significant intraoperative and postoperative complications. Phocoemulsification with sclerectomy can be alternative option to manage secondary glaucoma in nanophthalmic eye.

Spontaneous Globe Rupture due to Neglected Glaucoma: How can it be?


 
 
 Introduction: Globe rupture is usually associated with spontaneous traumatic processes with the worst prognosis. The occurrence without prior trauma is only reported in small numbers of cases. This paper will describe a globe rupture in glaucomatous eye and share our experience with its management.
 Case Illustration: A 66-year-old male presented to the emergency department (ED) with reddish and progressive pain in the right eye (RE) followed by severe headaches for the last three days. On history taking, the patient complained of a progressive blurry vision to total blindness of his RE for 1 year. The patient admitted to having a history of glaucoma on previous primer examination but did not routinely control it. On initial examination, the patient was hypertensive , and suddenly began bleeding within 10 minutes upon arrival at ED. The diagnosis of globe rupture was made and he underwent emergency evisceration.
 Discussiona: Spontaneous globe rupture is very rare, with an incidence of 3 per 100.000 in the United States, while no definite number is found in Indonesia due to the rarity. In glaucoma patients, spontaneous globe rupture is postulated to occur due to suprachoroidal hemorrhage. Our patients had multiple risk factors such as advanced age, systemic hypertension, and chronic untreated glaucoma. Evisceration went down to reduce pain, stop bleeding and prevent the spread of infection. Performing surgery within 10 days of the initial injury suggests a lower risk of post-operative endophthalmitis or sympathetic ophthalmia.
 Conclusion: Spontaneous globe rupture in neglected chronic glaucoma has a very poor outcome but preventable.
 
 

Spontaneous Globe Rupture due to Neglected Glaucoma: How can it be?

IntroductionGlobe rupture is usually associated with spontaneous traumatic processes with the worst prognosis.The occurrence without prior trauma is only reported in small numbers of cases. This paper willdescribe a globe rupture in glaucomatous eye and share our experience with its management.
 Case IllustrationA 66-year-old male presented to the emergency department (ED) with reddish and progressive painin the right eye (RE) followed by severe headaches for the last three days. On history taking, thepatient complained of a progressive blurry vision to total blindness of his RE for 1 year. The patientadmitted to having a history of glaucoma on previous primer examination but did not routinelycontrol it. On initial examination, the patient was hypertensive , and suddenly began bleeding within10 minutes upon arrival at ED. The diagnosis of globe rupture was made and he underwentemergency evisceration.
 DiscussionSpontaneous globe rupture is very rare, with an incidence of 3 per 100.000 in the United States,while no definite number is found in Indonesia due to the rarity. In glaucoma patients, spontaneousglobe rupture is postulated to occur due to suprachoroidal hemorrhage. Our patients had multiplerisk factors such as advanced age, systemic hypertension, and chronic untreated glaucoma.Evisceration went down to reduce pain, stop bleeding and prevent the spread of infection.Performing surgery within 10 days of the initial injury suggests a lower risk of post-operativeendophthalmitis or sympathetic ophthalmia.
 ConclusionSpontaneous globe rupture in neglected chronic glaucoma has a very poor outcome but preventable.

Immediate Bilateral Sequential Cataract Surgery (IBSCS): Special Procedure for Specific Patients

Abstract
 Introduction & Objectives : Immediate Bilateral Sequential Cataract Surgery (IBSCS) are still controversial topic in Ophthalmology. This paper aims to report the outcome and the efficacy of Immediate Bilateral Sequential Cataract Surgery in writer’s experience.
 Methods : This paper collects datas from 150 patients that underwent IBSCS. The procedure was done if patient have one or more from these criteria: live far away from hospital, difficult to mobilize to hospital, extreme urgency to return to work as fast as possible (daily paid worker), and if general anesthesia was used. The exclusion criterias were if there was intraoperative complication during the 1st eye, any posterior segment abnormality, and in complicated cataract cases (bad cornea, glaucoma eyes, small pupil eye, zonular loss / weakness, post uveitic eye). During intraoperative, after the 1st eye was finished all instruments and consumable was changed before proceed to the second eye.
 Results : From 150 patients, there were 0 (zero) case of endophthalmitis. At 7th days post op results all patients achieve normal range pressures, quiet anterior chamber, and good visual acuity improvement.
 Conclusion : Immediate Bilateral Sequential Cataract Surgery is not less safe than traditional delayed sequential cataract surgery. IBSCS definitely should be considered when encountered with specific patients and specific needs.

Virna Glaucoma Implant (VGI) as the Management of Secondary Glaucoma following TASS : A Case Report

Introduction : Secondary glaucoma may occur in severe TASS. The inflammatory cell and debris can clog trabecular meshwork causing IOP to rise. In this case, we describe the successful management of secondary glaucoma due to TASS using Virna Glaucoma Implant (VGI).
 Case Illustration : A 66-year-old woman presented with decreased vision in the left eye one week after anterior vitrectomy and anterior segment lavage due to TASS. She had a history of phacoemulsification and intraocular lens placement with complication of PCR. On ocular examination, the visual acuity was 1/60 in the left eye with intraocular pressure (IOP) 55 mmHg. After maximum glaucoma medication using timolol, latanoprost, brinzolamide eye-drops and oral acetazolamide IOP was 22mmHg. Glaucoma Drainage Device (GDD) surgery using VGI was performed. After 2.5 weeks, IOP in the left eye was reduced to 19 mmHg without anti-glaucoma medication and visual acuity has improved to 6/60, showing a favourable outcome.
 Discussion : TASS may cause significant damage to the trabecular meshwork, which leads to secondary glaucoma. Although medical therapy is often used to control elevated IOP, surgical therapy may be required to treat refractor IOP elevation. GDD surgery has been reported to have effective outcomein secondary glaucoma and pseudophakic eyes.
 Conclusion : Secondary glaucoma is considered as one of the characteristics in the late stages of TASS, and required prompt treatment. VGI implantation is a promising choice of treatment in managing secondary glaucoma following TASS when medication is not effective.

PUPIL CYCLE TIME AND PERIPAPILLARY PERFUSION IN ANGLE CLOSURE GLAUCOMA

Introduction and Objective: One of important roles in the pathogenesis of glaucoma is vascular condition. To enhance glaucoma management, the clinical assessment of ocular perfusion is required. The pupillary light reflex's afferent or efferent pathways may become impaired as a result of pupil cycle time (PCT) elongation. PCT is a simple objective method to measure the function of optic nerve, including glaucoma. The purpose of this study is to evaluate the connection between pupil PCT and peripapillary perfusion. Methods: A cross-sectional study from Kariadi Hospital included 26 eyes with angle closure glaucoma and 26 eyes of healthy patients. Complete ophthalmologic examinations, PCT measurements, and OCT peripapillary angiography were performed on each patient. Patients with history of drugs use that can affect pupillary reflexes such as barbiturates, methyldopa, anaesthetics, and antidepressant, and patients with history of glaucoma attack are excluded. The comparisons between the two groups were examined, with a p<0.05 indicating statistical significance. Results: The mean PCT of normal subjects was 943,4ms (882,4ms – 993,4ms) and angle closure glaucoma subject was 1789,5ms (1060ms – 4600ms). There were statistically significant difference of PCT value in angle closure glaucoma compared to normal subjects (P<0,05). Peripapillary flow index and peripapillary vessel density in closed angle glaucomatous eyes were lower than normal eyes (P<0.05). There is a significant relationship between PCT with peripapillary flow index and peripapillary vessel density. (P<0,05). Conclusion: In angle closure glaucoma, prolonged PCT associated with decreased peripapillary perfusion as shown by decreases in peripapillary flow index and peripapillary vascular density.

PUPIL CYCLE TIME AND PERIPAPILLARY PERFUSION IN ANGLE CLOSURE GLAUCOMA

Introduction & ObjectivesOne of important roles in the pathogenesis of glaucoma is vascular condition. To enhance glaucomamanagement, the clinical assessment of ocular perfusion is required. The pupillary light reflex'safferent or efferent pathways may become impaired as a result of pupil cycle time (PCT) elongation.PCT is a simple objective method to measure the function of optic nerve, including glaucoma. Thepurpose of this study is to evaluate the connection between pupil PCT and peripapillary perfusion.
 MethodsA cross-sectional study from Kariadi Hospital included 26 eyes with angle closure glaucoma and 26eyes of healthy patients. Complete ophthalmologic examinations, PCT measurements, and OCTperipapillary angiography were performed on each patient. Patients with history of drugs use thatcan affect pupillary reflexes such as barbiturates, methyldopa, anaesthetics, and antidepressant, andpatients with history of glaucoma attack are excluded. The comparisons between the two groupswere examined, with a p<0.05 indicating statistical significance.
 ResultsThe mean PCT of normal subjects was 943,4ms (882,4ms – 993,4ms) and angle closure glaucomasubject was 1789,5ms (1060ms – 4600ms). There were statistically significant difference of PCTvalue in angle closure glaucoma compared to normal subjects (P<0,05). Peripapillary flow index andperipapillary vessel density in closed angle glaucomatous eyes were lower than normal eyes(P<0.05). There is a significant relationship between PCT with peripapillary flow index andperipapillary vessel density. (P<0,05).
 ConclusionIn angle closure glaucoma, prolonged PCT associated with decreased peripapillary perfusion asshown by decreases in peripapillary flow index and peripapillary vascular density.

The comparison of corneal densitometry in cases with glaucoma following childhood cataract surgery and juvenile glaucoma

PurposeTo compare the corneal densitometry (CD) in pediatric cases with glaucoma following childhood cataract surgery and juvenile open-angle glaucoma (JOAG).MethodsThis prospective comparative study involved 13 eyes with JOAG, 12 eyes with pseudophakic glaucoma, 13 eyes with aphakic glaucoma, and 15 control subjects. Pentacam HR Scheimpflug corneal topography was employed to evaluate corneal thickness (CCT) and CD values.ResultsThe mean intraocular pressure (IOP) and CCT were significantly higher in aphakic glaucoma cases than the other groups (p = 0.001). In aphakic eyes, the mean CD values were higher in most of the anterior, center, and posterior layers of 0–2 mm, 2–6 mm, 6–10 mm, and total zones (p < 0.001 for all). In pseudophakic eyes, the mean CD values were statistically similar with that of aphakic eyes and higher than that of JOAG and control eyes in all layers of 0–2 mm zone and in anterior layer of 10–12 mm and anterior and total layers of 2–6 mm zones (p < 0.05 for all). The CD values demonstrated significant correlations with CCT values in both aphakic and pseudophakic eyes. However, a significant correlation of CD values with IOP was only demonstrated in aphakic eyes (p = 0.01 for all).ConclusionThe probable effects of childhood cataract surgery especially aphakia might cause corneal backscatter of light and increased CD in all layers in all zones of the cornea. Increased CD values and its correlation with CCT and IOP in aphakic glaucoma eyes may be of importance in clinical management.

Real-time in vivo monitoring of intraocular pressure distribution in the anterior chamber and vitreous chamber for diagnosis of glaucoma.

Glaucoma causes irreversible vision loss due to optic nerve damage and retinal cell degeneration. Since high intraocular pressure (IOP) is a major risk factor for glaucoma development, accurate IOP measurement is crucial, especially intravitreal IOP affecting the optical nerve and cells. However, conventional methods have limits in selectively and directly detecting local retina pressure. Here, we present continuous measurements of local IOP values in the anterior chamber and vitreous chamber of living animals using minimally invasive probes with pressure-sensitive transistors. After inducing glaucoma in animal models, we compared the local IOP distribution between normal and glaucomatous eyes. We also compared IOP values detected in the cornea using tonometry measurements. Our findings revealed that glaucoma induced higher IOP in the vitreous chamber than in the anterior chamber, indicating that measuring IOP in the vitreous chamber is key to the glaucoma model. This progress offers future directions for diagnosis and treatment of glaucoma.

Evaluation of the Diagnostic Capability of Spectralis SD-OCT 8 × 8 Posterior Pole Software with the Grid Tilted at 7 Degrees and Horizontalized in Glaucoma.

Background: The goal was to evaluate the diagnostic capability of different parameters obtained with the posterior pole (PP) software in Spectralis SD-OCT with the 8 × 8 grid tilted at 7° and horizontalized in glaucomatous eyes. Methods: A total of 299 eyes were included, comprising 136 healthy eyes and 163 with primary open-angle glaucoma (POAG). The following segmentations were evaluated: complete retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), GCL and inner plexiform layer (GCLIPL), ganglion cell complex (GCC), outer plexiform layer and outer nuclear layer (OPLONL), inner retinal layer (IRL), and outer retinal layer (ORL). Different patterns of macular damage were represented using heatmaps for each studied layer, where the areas under the curve (AUROC) values and a retinal thickness cutoff point were defined to discriminate POAG patients. Results: There was not any difference in the diagnostic capability for detecting glaucoma between the grid tilted at 7° and horizontalized. The macular segmentations that offer the highest diagnostic ability in glaucoma discrimination were, in the following order, RNFL (AUROC = 0.796), GCC (AUROC = 0.785), GCL (AUROC = 0.784), GCLIPL (AUROC = 0.770), IRL (AUROC = 0.755), and the complete retina (AUROC = 0.752). In contrast, ORL and OPLONL do not appear to be helpful for discriminating POAG. Conclusions: Some results of PP software may be useful for discriminating POAG.

Knowledge about age-related eye diseases in the general population in Germany

BackgroundWith a rising prevalence of age-related eye diseases, prevention and early diagnosis of these conditions are key goals of public eye health. Disease-related knowledge in the general public supports these goals but there is little data available. Thus, we have assessed knowledge of cataract, glaucoma, age-related macular degeneration (AMD) and diabetic eye disease in the German adult general population in a cross-sectional study and identified target groups for health education interventions.MethodsKnowledge assessment content was identified based on a literature review, expert input, and a list of items was generated after a qualitative selection process. The resulting 16-item instrument (4 items per condition) was administered to 1,008 participants from a survey panel, demographically representative of the adult German population. Test properties were evaluated based on a Rasch model and multiple correspondence analysis (MCA). Binary-logistic regression analysis was performed to investigate associations with age, sex, education level, employment status, marital status, income, reported health status, visual difficulties, and recent general practitioner (GP) and ophthalmologist consultations.ResultsReplies were correct for a median of 9 out of 16 (range 2 – 16) items, which differed between conditions (p < 0.0001). Most responses were correct for cataract items (median: 3 / 4) and least were correct for AMD items (median: 2 / 4). 27%, 9%, 1% and 19% of respondents replied correctly to all cataract, glaucoma, AMD and diabetic eye disease-related items, respectively. Rasch analysis suggested an adequate targeting of items and in MCA, no evidence of multidimensionality was present. Older age, being retired, decreased general health and recent GP or ophthalmology consultations were significantly associated with more knowledge about common eye conditions (p ≤ 0.005). GP or ophthalmology consultations remained significant in a multivariable model (p ≤ 0.011).ConclusionsKnowledge gaps regarding eye health are considerable in the German general population and should therefore be addressed in educational interventions targeting the public. Special attention when designing such campaigns needs to be paid to infrequent users of the healthcare system. Knowledge of AMD seems to be poorer compared to other eye conditions.

Mikroperymetria w diagnostyce jaskry

Glaucoma is a degenerative optic neuropathy leading to characteristic optic nerve head features, alternations in retinal nerve fiber layer thicknesses and visual field defects. Decrease of retinal sensitivity in the macular area is considered an important sign of glaucomatous damage. Accurate assessment of the function of the retina in macular region is possible thanks to microperimetry. Simultaneously, it is possible to evaluate the fixation behavior using the eye-tracking feature independent of eye movement and to correct gaze movements. To date, small number of studies have reported alternations in fixation stability in glaucoma eyes. The microperimetry test is reliable and reproducible. Microperimetry allowing for the assessment of changes in the central part of the field of view, both in qualitative and quantitative terms. Comparative studies on microperimetry and standard automated perimetry have shown that the reis a good quantitative correlation between the two devices in glaucoma. The usefulness of microperimetry in the management of glaucoma is currently the subject of research. The aim of this article is to review of clinical utility of microperimetry in patients of glaucoma.

Advancements in Glaucoma Diagnosis: A Comprehensive Literature Survey on CNN-based Deep Learning Approaches

This literature survey review explores advancements in glaucoma diagnosis using convolutional neural networks (CNNs) within the realm of deep learning (DL). Glaucoma, a chronic and irreversible eye disease leading to vision deterioration, poses a significant global health challenge. Traditional diagnosis through colour fundus images is time-consuming, requiring skilled clinicians. The paper examines the development of a six-layered CNN architecture, integrating dropout and data augmentation techniques to enhance diagnostic accuracy. Focused on identifying intricate features like microaneurysms, exudate, and hemorrhages on the retina, this CNN-based approach offers a streamlined and efficient alternative to manual diagnosis. With glaucoma being a leading cause of blindness worldwide, the proposed methodology, trained on high-performance GPUs, presents a promising avenue for improving diagnostic efficiency and accuracy, thereby contributing to the evolution of glaucoma diagnosis

Predicting the Extent of Damage in the Humphrey Field Analyzer 24-2 Visual Fields Using 10-2 Test Results in Patients With Advanced Glaucoma.

To predict Humphrey Field Analyzer 24-2 test (HFA 24-2) results using 10-2 results. A total of 175 advanced glaucoma eyes (175 patients) with HFA 24-2 mean deviation (MD24-2) of < -20dB were prospectively followed up for five years using HFA 10-2 and 24-2 (twice and once in a year, respectively). Using all the HFA 24-2 and 10-2 test result pairs measured within three months (350 pairs from 85 eyes, training dataset), a formula to predict HFA 24-2 result using HFA 10-2 results was constructed using least absolute shrinkage and selection operator regression (LASSO). Using 90 different eyes (testing dataset), the absolute differences between the actual and LASSO-predicted MD24-2 and that between the slopes calculated using five actual and LASSO-predicted MD24-2 values, were adopted as the prediction error. Similar analyses were performed for the mean total deviation values (mTD) of the superior (or inferior) hemifield [hemi-mTDsup.24-2(-hemi-mTDinf.24-2)]. The prediction error for the LASSO-predicted MD24-2 and its slope were 2.98 (standard deviation [SD] = 1.90)dB and 0.32 (0.33)dB/yr, respectively. The LASSO-predicted hemi-mTDsup.24-2 (hemi-mTDinf.24-2), and its slope were 3.02 (2.89) and 3.76 (2.72)dB, and 0.37 (0.41) and 0.44 (0.38)dB/year, respectively. These prediction errors were within two times SD of repeatability of the simulated stable HFA 24-2 VF parameter series. HFA 24-2 results could be predicted using the paired HFA 10-2 results with reasonable accuracy using LASSO in patients with advanced glaucoma. It is useful to predict HFA24-2 test from HFA10-2 test, when the former is not available, in advanced glaucoma.

Individual vs simultaneous macular and optic disc measurements with spectral domain optical coherence tomography in glaucoma and healthy eyes

We assessed the repeatability and agreement of ganglion cell complex (GCC) in the macular area and the peripapillary retinal nerve fiber layer (ppRNFL) with individual and combined macula and disc scans. The macular GCC and ppRNFL thicknesses from 34 control eyes and 43 eyes with glaucoma were measured with the Canon Optical Coherence Tomography (OCT) HS-100. Two repeated measurements were performed with both scan modes. The repeatability limit (Rlim) and agreement analysis were performed. The individual scan showed better repeatability than the combined scan in both groups. However, the differences in the Rlim for the GCC in most sectors were lower than 3 μm (axial resolution of the OCT), and this was larger than 3 μm for most of the ppRNFL sectors. The mean differences in the thickness between both scan modes for the GCC and ppRNFL measurements were less than 3 and 6 μm, respectively. The interval of the limits of agreement was about 10 μm in some sectors for the GCC, and about 40 and 60 μm in some sectors in controls and glaucoma eyes, respectively. Both scan modes showed good repeatability in both groups. The agreement results suggest that the scan modes cannot be used interchangeably.

Comparison of Ocular Blood Flow in Glaucomatous Eyes and Nonglaucomatous Eyes at a Tertiary Hospital in South India: A Prospective Case-control Study.

To compare the ocular blood flow in glaucomatous eyes and normal healthy eyes. This study compares open-angle glaucoma patients to healthy adults by measuring various parameters in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary artery (SPCA). A total of 50 glaucomatous eyes and 50 normal eyes were included in a prospective case-control study over 1 year. The color Doppler imaging (CDI) was conducted using a noninvasive linear multifrequency probe with a frequency range of 5-9 MHz. OA, CRA, and SPCA were measured for peak systolic velocity (PSV), end-diastolic volume (EDV), pulsatility index (PI), and resistivity index (RI). When compared with controls, PSV was decreased in all three vessels, with the results being remarkable only in CRA. The EDV also showed a remarkable decrease in all three vessels. Additionally, all three vessels showed significant increases in PI and RI except OA, p-value < 0.05. Blood velocity is decreased, and resistive indices are increased in glaucomatous eyes compared with normal eyes. Variations in ocular blood flow could be a cause or consequence of glaucomatous optic neuropathy and are an important predictor of disease progression. Murugesan MAD, Venkat P, Basetti B. Comparison of Ocular Blood Flow in Glaucomatous Eyes and Nonglaucomatous Eyes at a Tertiary Hospital in South India: A Prospective Case-control Study. J Curr Glaucoma Pract 2024;18(2):45-50.

Discovery of water-soluble semicarbazide-containing sulfonamide derivatives possessing favorable anti-glaucoma effect in vivo and drug-like properties

In order to obtain topical and non-irritating anti-glaucoma drugs, novel semicarbazide-containing sulfonamide derivatives were designed and synthetized by sugar tail method in this study. The hydrophilic monosaccharides were expected to form interaction with the hydrophilic site of hCA II meanwhile the linker semicarbazides are used to further enhance water solubility, and more importantly, regulate the pH values of the target compounds in aqueous solution. First, all target compounds were synthesized and evaluated for their CA inhibitory activities. The results showed our target compounds demonstrated comparable activity to the positive control drug acetazolamide. The best derivative 11d exhibits an IC50 value of 14 nM for hCA II and 2086-fold selectivity over CA I. Subsequently, physicochemical properties study showed that the target compounds displayed very good water solubility (up to 3 %) and neutral pH value in solutions. Meanwhile, the artificial membrane permeability assay was performed to verify that the target compound could also pass through the membrane structure despite their strong water solubility. In the glaucomatous rabbit eye model, the applied topically representative compounds showed strongly lowered intraocular pressure (IOP), as 1 % or 2 % water solutions. Subsequent drug-like evaluation showed our target compounds possessed low hemolysis effect and low cytotoxicity toward human corneal epithelial cell line. Also, it was not found that these target compounds had significant inhibition of hERG and CYP. In addition, these novel analogs also displayed good liver microsomal metabolic stability and plasma stability. Finally, docking studies provided the rational binding modes of representative compounds in complex with hCA II. Taken together, these results suggested that compound 11d may be a promising hCA II inhibitor deserving further development.