terminology and guidelines for glaucoma ii - Kwaliteitskoepel

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$Refractiechirurgie - Nederlands Oogheelkundig Gezelschap$

Post-operative use Concentration: 0.2 mg/ml 0.02 mg injections. Small calibre needle (e.g. 30 G needle on insulin syringe) Adjacent to but not into bleb Multiple injections possible - some evidence that less than a total of 3 injections has a minimal impact GENERAL PRINCIPLES The use of cytotoxics increases the requirement for accurate surgery. If aqueous flow is not well controlled persistent hypotony will occur. Strategies to increase control of flow include smaller sclerostomies, larger scleral flaps and releaseable or adjustable sutures. Recent research has suggested that a large surface area of cytotoxic treatment together with large scleral flaps and fornix based conjunctival flaps leads to diffuse, posteriorly extended non-cystic blebs with a considerable reduction in bleb related complications such as blebitis and endophthalmitis 160-161 . Start with weaker agents (e.g. 5-FU rather than MMC) and lower concentrations (of MMC) until familiar with these agents CAUTION Do not allow cytotoxic agents to enter the eye. 5-FU has a pH of 9.0. One drop (0.05ml) of MMC would cause irreversible endothelial damage. Observe precautions for cytotoxic use and disposal Complications: Corneal epitheliopathy (5FU) Wound Leak Bleb leak Hypotony Blebitis Endophthalmitis IMPORTANT: assess each individual case for risk factors, and/or for the need of low target IOP and titrate the substance and dosage used accordingly based on local experience 5-FU and MMC are not officially approved for direct ocular applications. Their use in selected cases as adjunctives in filtration surgery, however, has become standard clinical practice. Ch. 3 - 38 EGS
References 1) Sommer A, Tielsch JM, Katz J, Quigley HA, Gottsch JD, Javitt J, Singh K. Relationship between intraocular pressure and primary open-angle glaucoma among white and black Americans. The Baltimore Eye Survey. Arch Ophthalmol 1991;109:1090-1095. 2) Tielsch JM, Katz J, Singh K, Quigley HA, Gottsch JD, Javitt J, Sommer A. A population-based evaluation of glaucoma screening. Am J Epidemiol 1991;134:1102-1110. 3) Leske MC, Wu SY, Nemesure B, Hennis A. Incident open-angle glaucoma and blood pressure. Arch Ophthalmol 2002;120:954-959. 4) Butt Z, McKillop G, O’Brien C, Allan P. Measurement of ocular blood flow velocity using colour Doppler imaging in low tension glaucoma. Eye 1995;9:29-33. 5) Bojic L, Skare-Librenjak L. Circulating platelet aggregates in glaucoma. In Ophthalmol 1999;22:151-155. 6) Costa VP, Sergott RC, Smith M, Spaeth GL, Wilson RP, Moster MR, et al. Color Doppler imaging in glaucoma patients with asymmetric optic cups. JGlaucoma 1994;3 Suppl 1:S91-97. 7) Drance SM, Douglas GR, Wijsman K, Schulzer M, Britton RJ. Response of blood flow to warm and cold in normal and low-tension glaucoma patients. Am J Ophthalmol 1988;105:35-39. 8) Flammer J, Guthauser U, Mahler F. Do ocular vasospasms help cause lowtension glaucoma Doc Ophthalmol Proc Seri 1987;49:397-399. 9) Galassi F, Nuzzaci G, Sodi A, CasiP, Vielmo A. Color Doppler imaging in evaluation of optic nerve blood supply in normal and glaucomatous subjects. Int Ohthalmol 1992;16:273-276. 10) Graham SL, Drance SM, Wijsman K, Mikelberg FS, Douglas GR. Nocturnal hypotension in glaucoma patients. Invest Ophthalmol Vis Sci 1993;34:1286. 11) Graham SL, Drance SM. Nocturnal Hypotension. Role in glaucoma progression. Surv Ophthalmol 1999;43 suppl 1:S10-16. 12) Guthauser U, Flammer J, Mahler F. The relationship between digital and ocular vasospasm. Graefes Arch Clin Exp Ophthalmol 1988;226:224-226. 13) Flammer J, Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP, Sefansson E. The impact of ocular blood flow in glaucoma. Progress in retinal and eye research. 2002;21(4):359-393. 14) The AGIS Investigators. The advanced glaucoma intervention study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol 2000;130:429-440. 15) Kass MA, Heuer DK, Higginbotham EJ et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary openangle glaucoma. Arch Ophthalmol 2002;120:701-713. 16) Heijl A, Leske MC, Bengtsson B, et al. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 2002; 120: 1268-1279. 17) Leske CM, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E for the Early Manifest Glaucoma Trial Group. Factors for glaucoma progression and the effect of treatmen. The Early Manifest Glaucoma Trial. Arch Ophthalmol 2003;1210:48-569. 18) Wilensky JT, Gieser DK, Dietsche ML, Mori MT, Zeimer R. Individual variability in the diurnal intraocular pressure curve. Ophthalmol 1993;100:940-944. 19) Zeimer RC, Wilensky JT, Gieser DK, Viana MA. Association between intraocular pressure peaks and progression of visual field loss. Ophthalmol 1991;98:64-69. 20) Niesel P, Flammer J. Correlations between intraocular pressure, visual field and visual acuity, based on 11 years of observations of treated chronic glaucomas. Int Ophthal 1980;3:31-35. 21) Flammer J, Eppler E, Niesel P. Quantitative perimetry in glaucoma patient without local visual field defects. Graefe’s Arch Clin Exp Ophthalmol 1982;219:92-94. 22) Asrani A et al. Large diurnal fluctuations in intraocular pressure as an independent risk factor in patients with glaucoma. Journal of Glaucoma 2000;9:134-142. 23) Goldberg I. Compliance. In: Ritch R, Shields M B, Krupin T (eds.). The glaucomas. Mosby, St. Louis 1996;1375-1384. 24) Janz NK, Wren PA, Lichter PR, Musch DC, Gillespie BW, Guire KE, The CIGTS Group. Quality of life in diagnosed glaucoma patients. The Collaborative Initial Glaucoma Treatment Study. Ophthalmology 2001;108:887-898. Ch. 3 - 39 EGS
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ISBN: 88-87434-13-1 Editrice DOGMA
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ACKNOWLEDGEMENT This work was made
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2.2.5 - Primary Open-Angle Glaucoma
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Foreword These Definitions and Guid
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INTRODUCTION The aim of the book is
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Since resources are limited worldwi
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II - RANDOMIZED CONTROLLED TRIALS F
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II.3 - COLLABORATIVE NORMAL TENSION
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No stratification for stage of dise
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II. 6. 3 - from CNTG 1. Therapy tha
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References 1) The Ocular Hypertensi
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I - QUESTIONS TO ASK TO YOUR GLAUCO
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III - ABNORMAL THRESHOLD VISUAL FIE
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V - GONIOSCOPIC OPEN ANGLES SOME DI
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VII - TREATMENT STEPLADDER JUVENILE
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IX - MONOTHERAPY (in alphabetic ord
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XI - MANAGEMENT ACUTE ANGLE CLOSURE
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XIII - ANTIMETABOLITES FOR WOUND MO
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CHAPTER 1 PATIENT EXAMINATION
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Other methods 22-25 : Air-puff tono
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References 1) Martin XD. Normal int
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1.2 - GONIOSCOPY Gonioscopy is a fu
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1 2 3 4 Fig. 1 Dynamic indentation
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The Spaeth classification Insertion
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References 1) Palmberg P. Gonioscop
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small - size mid - size large - siz
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Fig. 5 A) Cirumlinear vessel, B) Ba
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1.3.4.3 - OCT The Optical Coherence
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31) Carpineto P, Ciancaglini M, Zup
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central 24 or 30 central degrees re
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A retinal sensitivity value worse t
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HODAPP CLASSIFICATION 31 EARLY GLAU
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References 1) Bengtsson B, Heijl A,
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1.5 - BLOOD FLOW 1.5.1 - VASCULAR F
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28) Flammer J, Orgul S, Costa VP, O
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All forms of glaucoma should be cla
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2.2 - PRIMARY OPEN-ANGLE GLAUCOMAS
Page 76 and 77: 2.2.4 - PRIMARY OPEN-ANGLE GLAUCOMA
Page 78 and 79: 2.3 - SECONDARY OPEN-ANGLE GLAUCOMA
Page 80 and 81: 2.3.1.6 - Glaucoma due to intraocul
Page 82 and 83: 2.4 - PRIMARY ANGLE-CLOSURE Primary
Page 84 and 85: Systemic Risk factors for primary a
Page 86 and 87: OCCLUDABLE ANGLE: “Occludable”
Page 88 and 89: 2.5.3 - SECONDARY ANGLE-CLOSURE GLA
Page 90 and 91: CHAPTER 3 TREATMENT PRINCIPLES and
Page 92 and 93: Furthermore, blindness may occur de
Page 94 and 95: T A R G E T I O P Target IOP range
Page 96 and 97: Practical points for topical medica
Page 98 and 99: 3.3.1.1 - Category: ADRENERGIC AGON
Page 100 and 101: 3.3.1.2 - Category: ADRENERGIC ANTA
Page 102 and 103: 3.3.1.3 - Category: CARBONIC ANHYDR
Page 104 and 105: 3.3.1.4 - Category: PARASYMPATHOMIM
Page 106 and 107: 3.3.1.5 - Category: PROSTAGLANDIN D
Page 108 and 109: Drug interactions Precipitation occ
Page 110 and 111: COMBINATION THERAPY Starting* Addit
Page 112 and 113: 3.3.2.2 - Category: ADRENERGIC ANTA
Page 114 and 115: Pregnancy and nursing mothers Only
Page 116 and 117: 3.5 - LASER SURGERY 3.5.1 - LASER I
Page 118 and 119: 3.5.2 - LASER TRABECULOPLASTY 77-89
Page 120 and 121: 3.5.4 - CYCLOPHOTOCOAGULATION Indic
Page 122 and 123: Although medical therapy is still t
Page 124 and 125: 3.6.4 - COMPLEX CASES Complicated g
Page 128 and 129: 25) Janz NK, Wren PA, Lichter PR, M
Page 130 and 131: (Rescula TM ) in patients with glau
Page 132 and 133: in white patients with open-angle g
Page 134 and 135: CHAPTER 4 TREATMENT GUIDELINES
Page 136 and 137: 4.2 - PRIMARY OPEN-ANGLE GLAUCOMAS
Page 138 and 139: 4.2.7 - OCULAR HYPERTENSION (OH) Al
Page 140 and 141: 4.3.1.7 - Glaucoma associated with
Page 142 and 143: • Withdrawal of aqueous from vitr
Page 144 and 145: 4.5 - SECONDARY ANGLE-CLOSURE GLAUC
Page 146 and 147: 4.5.3 - SECONDARY ANGLE-CLOSURE GLA
Page 148 and 149: NOTES
Page 150 and 151: NOTES
Page 152: NOTES
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