Glaucoma In People Research Articles

INTEGRATING DUAL FUNDUS IMAGE DEEP FEATURE POOLING BASED ON CUP AND DISC SEGMENTATION FOR EFFICIENT GLAUCOMA DETECTION FRAMEWORK INDULGING HEURISTIC CONCEPT

The permanent damage occurring to the optical nerve, which transmits the visualized images to the brain leading to permanent vision loss, is called glaucoma. The detection and diagnosis of glaucoma at the beginning stage are essential to prevent permanent damage caused to vision as there are no initial symptoms to detect the onset of the damage, and there is no cure while the damage progresses to its extreme stage. Many models utilizing deep learning technology have been executed to identify the presence of glaucoma using digital Fundus Images (FI). However, these methods need specialized hardware and are computationally complicated as there is not much-labeled data available, leading to generalization issues in these models. Therefore, the development of a deep learning-oriented model for Glaucoma Detection (GD) using the dual feature pooling of cup and disc segmentation features with the aid of the FI is the main motive behind this work. At first, the digital FI is congregated from standardized online data sources. Then the gathered images are considered for the image segmentation procedure. The disc is segmented from the input image with the aid of the Transformer based Adaptive ResUNet++ (TA-ResUNet++) framework. The segmented disc image is now provided to hybrid convolution networks (HCN) for extracting the disc-oriented features. At the same time, the cup is segmented from the gathered input image using the executed TA-ResUnet++. Following this, the cup features are extracted using the same HCN model. The obtained features regarding the disc and the cup are concatenated in order to generate a single pool of glaucoma features. Then these features are inputted into the implemented bidirectional long short-term memory with multi-head attention (Bi-LSTM-MHA) mechanism to detect the presence of glaucoma in people. The segmentation and detection outcomes are made better by optimizing the parameters in the TA-ResUNet++ and Bi-LSTM-MHA models with the aid of hybrid sewing training with the Chameleon swarm optimization algorithm (HST-CSA). The experimental analysis is done to analyze the effective performance of the developed GD model. Jaccard analysis performed for the developed HST-CSOA-TA-ResUNet++-based disc segmentation gained better performance as 18.29% than MobileNet, 14.11% efficient than ResNet, 12.79% superior to Bi-LSTM and 5.43% higher than Bi-LSTM-MHA while considering best as the statistical measure.

Risks of glaucoma among individuals with psoriasis: apopulation-based cohort study.

Psoriasis is a chronic systemic disorder with ocular involvement. To evaluate the risk of glaucoma among patients with psoriasis. Participants in this cohort study were selected based on Chang Gung Research Database from 1 January 2003 to 31 December 2012. Follow-up ended on 31 December 2017. The participants in the control group were matched with the psoriasis group by sex, age and index date with a 4 : 1 ratio. The hazard ratios of glaucoma were estimated using Cox regression analysis. We also evaluated the relationship between the risk of glaucoma and systemic therapies as well as phototherapy and topical corticosteroid in patients with psoriasis. In total, 6682 patients with psoriasis and 26 728 matched controls were enrolled. The study population was composed mainly of males accounting for 64.2% (21 445/33 410) of the study population. The psoriasis group had higher incidence rates than the control group for glaucoma (adjusted hazard ratio 1.405, 95% confidence interval, 1.051-1.879). Patients with psoriasis receiving psoralen-ultraviolet A (PUVA) therapy for > 200 sessions had an increased risk of glaucoma. Patients with psoriasis had an increased risk of glaucoma. Long-term PUVA therapy raised the risk of glaucoma in people with psoriasis.

The association between obesity and glaucoma in older adults: evidence from the China Health and Retirement Longitudinal Study.

This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study. Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk. Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05). This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.

Prevalence and Associated Risk Factors of Primary Open Angle Glaucoma Among Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study From North India.

BackgroundGlaucoma is a category of disorders that cause visual loss due to damage to the optic nerve. It is the primary cause of irreversible blindness around the globe. In diabetic individuals, intraocular pressure (IOP) was found to be higher than in non-diabetics, and this impact was linked to a rise in fasting blood glucose levels. In light of the foregoing findings, the current investigation was carried out with the goal of determining the prevalence and associated factors for primary open-angle glaucoma in people with diabetes in a tertiary care teaching hospital.MethodsThis cross-sectional study was carried out in a tertiary care teaching hospital. For a twelve-month period (2021-2022), adult patients (with type 2 diabetes and an age of 18 years or more) attending the ophthalmology out patient department (OPD) were included. Demographic information, socioeconomic data, and medical, familial, and ocular history were all gathered. All individuals with diabetes had an initial ophthalmological evaluation [including best corrected visual acuity (BCVA), slit-lamp biomicroscopy, assessment of peripheral anterior chamber depth (ACD), fundus examination, stereoscopic optic disc evaluation, and IOP measurement] by a senior ophthalmologist. Pearson's Chi-square test was used to compare variables on a nominal scale, whereas the t-test for independent samples was used to examine variables on a continuous scale.ResultsOur study enrolled a total of 1262 diabetic patients out of which 62.0% of subjects were male. Most of the enrolled subjects belonged to the 61-70 years of age group (35.8%). The eye examination of enrolled subjects showed that out of 1262 diabetic patients, 197 subjects (15.6%) were having primary open-angle glaucoma (POAG). The vision (in the better eye) was analyzed among three groups [no glaucoma or sight-threatening diabetic retinopathy (STDR); only glaucoma; and glaucoma plus STDR] and it was observed that no perception of light (PL) was noticed in 0.2% and 1.2% of subjects in the “no glaucoma or STDR” and “only glaucoma” groups respectively. In our study, the variables significantly associated with the increased prevalence of glaucoma among diabetic subjects included illiteracy, family history of type 2 diabetes mellitus (DM), being hypertensive, non-intake of anti-hypertensive medication, and >10 years duration of DM (p<0.05).ConclusionFrom our study, we came to the conclusion that there is clear-cut evidence of an increased incidence of POAG in diabetic patients, which was 15.6%. The study also showed a significant association between age, education, diet, hypertension, family history of diabetes and duration of diabetes, and; POAG. However, no significant association was found between gender and POAG.

Incidence and prevalence of coexistent retinal diseases and cognitive impairment or dementia: A systematic review

AbstractBackgroundAs chronic and progressive age‐related diseases, there are commonalities between age‐related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR), and cognitive impairment (CI) and dementia. We undertook a systematic review to quantify such associations.MethodMEDLINE, EMBASE, PsycINFO and CINAHL were searched (from inception to June 2020) for observational studies reporting incidence or prevalence of AMD, glaucoma or DR in people with CI or dementia, and CI or dementia among people with AMD, glaucoma or DR. A 9‐item quality assessment tool was used to categorize studies as having low, moderate or high risk of bias. Rates of comorbid disease were extracted and presented in forest plots. Prospero registration [CRD42020189484].ResultOf 6,803 abstracts reviewed, 76 were considered for full‐text analysis, of which 47 were included for syntheses. There were 27 and 20 assessed as having low and moderate risk of bias, respectively.Incidence of dementia in people with age‐related retinal diseases ranged from 9.5 to 20 (AMD), from 1.1 to 11.6 (glaucoma) and was 32.9 (DR) per 1000 person‐years, respectively (Figure 1). There were no reports on the incidence of CI in AMD, glaucoma or DR, nor of retinal diseases in CI or dementia.There were two studies reporting prevalence of AMD or glaucoma in people with CI (Figure 2). Prevalence of DR in those with CI ranged from 11.4% to 70.1%. Prevalence of AMD, glaucoma and DR among people with dementia ranged from 1.4% to 52.6%, from 0.2% to 25.9% and from 11 to 20%, respectively.Prevalence of CI in people with AMD, glaucoma and DR ranged from 8.4% to 52.4%, from 2.8% to 90.2% and from 3.9% to 45.2%, respectively (Figure 3). Prevalence of dementia in people with AMD, glaucoma and DR ranged from 9.9% to 62.6%, 2.5% to 3% and 0.8% to 12.5%, respectively.ConclusionThere are wide ranging estimates of incidence and prevalence of retinal diseases in relation to CI/dementia. Further research is required to better understand the reasons for such variations.

Variants of WDR36 in Cameroonian glaucoma patients

In Primary Open Angle Glaucoma (POAG), the most common form of glaucoma in people of African origin, it is established that retinal ganglion cells are lost due to apoptosis.

Spectrum of Eye Disease in Diabetes (SPEED) in India: A prospective facility-based study. Report # 4. Glaucoma in people with type 2 diabetes mellitus.

Purpose:To estimate the proportion of people with type 2 diabetes mellitus (T2DM) and glaucoma in a facility-based cross-sectional observational study in India.Methods:All people received a comprehensive eye examination. Glaucoma-specific examinations included applanation tonometry, optic disc and cup evaluation, and stereo biomicroscopy in all people; gonioscopy and visual field testing in glaucoma suspects. The International Society of Geographic and Epidemiologic Ophthalmology guidelines were used to diagnose and classify glaucoma.Results:The study recruited 11,182 people (average age: 58.2 ± 10.6; range 39–96 years). Glaucoma was diagnosed in 4.9% (n = 547) people. About 76.8% (n = 420) of those with glaucoma had bilateral disease, and 98.7% (n = 540) were >40 years. Among people with bilateral disease, 94.5% (n = 397) had primary glaucoma – open angle in 59.3% (n = 228) and angle closure in 40.2% (n = 169). Diabetes duration was ≤10 years in 71.5% (n = 300) people. On linear regression, the following were associated with glaucoma: advancing age [compared with <40 years age group; odds ratio [OR] in 50-60 year age group: 1.36 [95% confidence interval (CI): 1.01–1.8], P < 0.035); >60 years age group (OR: 2.05, 95% CI: 1.57–2.67; P < 0.001), and diabetic neuropathy (OR: 2.62, 95% CI: 1.35–5.10, P < 0.003). Glycemic control did not have significant association (P = 0.425).Conclusion:Presence of glaucoma in people with T2DM in this cohort was similar to the general population prevalence studies in India. Glaucoma was invariably bilateral. A comprehensive eye examination in people age 40 years and older with diabetes and/or glaucoma is beneficial.

PMD73 - ECONOMIC IMPACT OF THE TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA ON HIP FRACTURE: A COST-EFFECTIVENESS ANALYSIS

World prevalence of glaucoma in people between 40-80 years is projected at 76 million people in 2020. A metanalysis found that risk of a fall in people whose visual impairment was caused by glaucoma, was greater versus population with general disability. This study estimates the cost-effectiveness of trabecular micro-bypass stent versus medications only for intraocular pressure control for patients with open-angle glaucoma. A Markov model, with stages from 0 (ocular hypertension without glaucoma) to 5 and bilateral blindness was developed inclusive of Colombian people older than 40 years in 2018 from a societal perspective, comparing trabecular micro-bypass stent versus timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost or timolol+brimonidine, in terms of clinical and economic outcomes over a lifetime horizon. Both costs and health outcomes had an annual rate discount of 5%. Health outcomes were evaluated in terms of hip fractures avoided and life years gained (LYG) by deaths avoided, related with hip fractures complications. Trabecular micro-bypass costs include use of latanoprost in 80% of patients. Trabecular micro-bypass stent were estimated to have 10,569 discounted LYG more than timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost, and 11,413 discounted LYG more than timolol+brimonidine. Trabecular micro-bypass stent avoided 27 hip fractures versus timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost, and 29 versus timolol+brimonidine. Cumulative costs at 40 years with trabecular micro-bypass stent were € $3.756.198 lower than timolol+dorzolamide+latanoprost; € $10.539.157 lower than timolol+dorzolamide+brimatoprost; and € $6.830.957 lower than timolol+brimonidine. With a willingness-to-pay of USD $6,380 GDP per capita, trabecular micro-bypass stent has a probability of 81% to be chosen. In one-way sensitive analysis, with the lowest efficacy of trabecular micro-bypass and the highest efficacy of medications only, trabecular micro-bypass stent always was dominant. Trabecular micro-bypass stent were estimated to be a highly cost-saving strategy, because have more LYG by deaths avoided related with hip fractures complications and avoid more hip fractures.

Swimming goggle wear is not associated with an increased prevalence of glaucoma

Background/aimsPrevious studies have demonstrated a small but significant transient increase in intraocular pressure (IOP) in individuals wearing certain types of swimming goggles. These findings suggested that wearing goggles could represent...

Topographical Analysis of Non-Glaucomatous Myopic Optic Discs Using a Confocal Scanning Laser Ophthalmoscope (TopSS)

Objectives: To show normative data of optic discs and the mechanism of glaucoma in people with myopia. Design: Cross-sectional study. Participants: This study investigated 89 Korean adults with myopia but without glaucoma. Methods: Patients were divided into three groups according to the refractive error: low, moderate, and high; and axial length: normal or below normal length, moderately long, and extremely long. Optic disc variables were obtained by confocal scanning laser ophthalmoscope and compared among groups. Results: The optic disc parameters have a correlation between the refractive error and the optic disc parameters such as average depth, volume below, and half-depth volume. Those parameters also decreased as the axial length increased. The thickness of the volume above decreased significantly as the axial length increased, but a similar relationship was not evident with the refractive error change. In addition, the optic disc parameters were analyzed with respect to the 12 clockwise directions. Conclusions: Analyses of optic disc parameters provided by TopSS™ revealed the height of the disc decreased as the myopic refractive error and/or axial length increased. The RNFL bundle became compacted in the thinner disc of the myopic population. This could be an explanation for the fragility of the RNFL in the myopic population. The 12 radial section analyses revealed the shallow cupping at the temporal side in the high-myopic, very-long-axis group. The neuroretinal rim (NRR) height significantly decreased at the superior and inferior sides. These findings suggest that the RNFL bundle should be under high mechanical strain in these sectors.

Prevalence of Glaucoma in an Urban West African Population

Multiple studies have found an increased prevalence, younger age at onset, and more severe course of glaucoma in people of African descent, but these findings are based on studies conducted outside Africa. To determine the prevalence of glaucoma in an urban West African population of adults. A population-based, cross-sectional study of adults 40 years and older conducted from September 1, 2006, through December 31, 2008, from 5 communities in Tema, Ghana. Participants from randomly selected clusters underwent a screening examination that consisted of visual acuity, frequency doubling perimetry, applanation tonometry, and optic disc photography. Participants who failed any of these tests were referred for complete examination, including gonioscopy, standard automated perimetry, and stereoscopic optic disc photography. A total of 6806 eligible participants were identified, and 5603 (82.3%) were enrolled in the study. The field examination referred 1869 participants (33.3%) to the clinic examination, and 1538 (82.2%) came for complete examination. A total of 362 participants were identified as having glaucoma of any type and category. Primary open-angle glaucoma was the underlying diagnosis in 342 participants (94.5%). The prevalence of primary open-angle glaucoma was 6.8% overall, increasing from 3.7% among those 40 to 49 years old to 14.6% among those 80 years and older, and was higher in men than in women in all age groups, with an overall male-female prevalence ratio of 1.5. Of the participants with glaucoma, 9 (2.5%) were blind using World Health Organization criteria, and only 12 (3.3%) were aware that they had glaucoma. The prevalence of glaucoma is higher in this urban West African population than in previous studies of people of East or South African and of non-African descent. Strategies to identify affected persons and effectively manage the burden of glaucoma are needed in West Africa.

The Glaucoma Guidelines of the Swedish Ophthalmological Society

The Glaucoma Guidelines of the Swedish Ophthalmological Society

Incidence of self reported glaucoma in people with diabetes mellitus

AIMTo determine the incidence of self reported glaucoma in a group of people with diabetes mellitus.METHODSIn an 11 county area in southern Wisconsin, a cohort of people with diabetes mellitus...

The Detection of Post-traumatic Angle Recession by Gonioscopy in a Population-based Glaucoma Survey

Blunt trauma is responsible for most eye injuries in urban populations. Anterior chamber angle recession has been reported to be the most common sign of previous blunt trauma to the eye. The cumulative lifetime prevalence of post-traumatic angle recession has not been reported previously, and the relation between angle recession and glaucoma in a population-based setting is unknown. As part of a population-based glaucoma survey, gonioscopy was performed on 987 (82.7%) of 1194 inhabitants of the village of Mamre, near Cape Town, South Africa, who were 40 years of age or older. Some degree of angle recession was identified in one eye of 60 people and in both eyes of 86 people. Men were affected more than three times as often as women in the fifth, sixth, and seventh decades. The cumulative lifetime prevalence of angle recession in this community was 14.6%. The prevalence of glaucoma in people with angle recession was 5.5% (8/146). Of 87 eyes with 360 degrees of angle recession, only 7 (8.0%) had glaucoma. Excessive alcohol consumption was significantly related to the presence of angle recession in women (P < 0.001). The prevalence of monocular blindness due to trauma was 2.5% (25/987). Although the importance of the study may be limited to this community, the findings suggest that future population-based studies of ocular trauma should include gonioscopy on all individuals examined. Secondary glaucomas, especially those related to trauma, should be screened for in developing countries when trying to establish the prevalence of potential visual loss from glaucoma.

Routine tonometry in 5,000 patients for detection of early glaucoma.

Glaucoma, like the poor, is always with us. All ophthalmic out-patient departments have their share of tragic cases of elderly men and women with glaucoma. The incidence of glaucoma in the general population is high. In 1956 Sorsby reported that 13.6% of all blind ness in England is due to glaucoma. Zeller and Christensen (1954) state that in the United States 20,000 persons are blind from glaucoma, and a further 150,000 have lost the sight in one eye. Further, a number of workers have published the results of mass survey and found that the average incidence of glaucoma in people over 40 years of age is 2% (see Table I).

Personality features of patients with primary glaucoma. A medico psychosocial exploration.

Nineteen patients with primary glaucoma were studied from a medical, sociological, and psychiatric viewpoint in an effort to evaluate the personality features of this group. The control group consisted of 16 patients with nonglaucomatous eye disease, matched as to age, sex, race, socioeconomic class, chronicity of eye disease, and degree of visual impairment. These two groups were assessed and compared with respect to the oft-mentioned emotional and personality characteristics alleged to be typical of glaucomatous patients. The study provided data on the comparative incidence of certain psychosomatic diseases, and, on the basis of their data, the authors seriously question the validity of the concept of a “psychosomatic constitution.” The glaucomatous and control groups were remarkably alike from a sociological and psychiatric viewpoint, and no impressive differences were noted. Emotional factors were recognized equally by both groups as being of importance in precipitating exacerbations of eye symptoms. Depression and other neurotic personality traits were common to both groups, and there appeared to be no particular personality configuration specific to glaucoma. Also discussed is the concept of organ vulnerability as a critical factor in the occurrence and type of psychosomatic disease; the importance of psychic factors in disease in general regardless of etiology; the significance of degree of visual handicap rather than prognosis in influencing the patient's outlook; and the occurrence of glaucoma in people of very diverse personality make-ups. In a subsequent paper, the authors plan to report on the use of psychological tests in the investigation of personality features of patients with primary glaucoma.