terminology and guidelines for glaucoma ii - Kwaliteitskoepel

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1.5 - BLOOD FLOW 1.5.1 - VASCULAR FACTORS AND GLAUCOMA Factors involved in the aetiology and progression of glaucomatous optic neuropathy are not only pressure dependent and are also related to the vascular supply of the optic nerve head. Many observations indicate the need to study the relationship between blood flow and glaucoma: - existence of normal tension glaucoma (NTG) 1-4 - presence of disc haemorrhages in glaucoma patients - higher prevalence of retinal vein occlusion in glaucoma patients - association of NTG and migraine, Raynaud’s phenomenon, vasospasm 5,6,7 - association of NTG and systemic hypotension and excessive number of nocturnal “dips” in diastolic blood pressure 8,9 - association of glaucoma and abnormal blood coagulability profile 10,11 - association of NTG and silent myocadial ischaemia 9 - association of glaucoma (NTG) and cerebral infarcts 12,16 - association of NTG and an history of hypotensive shock or episode of severe blood loss. 5 1.5.2 - MEASUREMENTS METHODS OF OCULAR BLOOD FLOW Many methods have been used to calculate ocular blood flow: fluorescein angiography 14,15 , scanning laser ophthalmoscope 16 , videoangiography 17,18 , laser Doppler velocimetry 19,20 , laser speckle phenomenon, blue field entoptic phenomenon 21 , pulsatile ocular blood flow 22 , colour Doppler imaging 23,24 , oculodynamography 25-27 . For technical reasons, wide interindividual variations can occur with problems related to posture, as well as technician experience, patient cooperation. Multiple measurements are therefore required. More importantly in glaucoma, it is relevant to measure the blood supply to the retrolaminar portion of the optic nerve head, i.e. small vessels which are difficult to visualise and have wide anatomic variability. The number of methods used illustrate the difficulty of measurements of ocular blood flow relative to the blood supply of the optic nerve head, size of of vessels, individual variations, reproducibility of measurements techniques. At the present time the clinical role of blood flow measurements in glaucoma management (and the relevance of changes noted with drug treatments) are unclear and these techniques remain research tools. However clinical vascular risk factors should be taken into account in glaucoma management especially when the IOP is low (over 24 hours and with normal CCT) and visual fields show severe and progressive alteration 28 . 1.6 - AXIAL LENGTH MEASUREMENTS For follow-up of congenital glaucoma axial length measurement is a useful tool, especially to correlate with IOP findings, refraction and corneal diameter 29,30 . Ch. 1 - 33 EGS
References 1) Pillunat LE, Stodtmeister R, Marquardt R, Mattern A. Ocular perfusion pressures in different types of glaucoma. Int Ophthalmol 1989;13:37-42. 2) Nicolela MT, Walman BE, Buckley AR, Drance SM. Ocular hypertension and primary open-angle glaucoma: a comparative study of their retrobulbar blood flow velocity. J Glaucoma 1996;5:308-310. 3) Nicolela MT, Hnik P, Drance SM. Scanning laser Doppler flowmeter study of retinal and optic disk blood flow in glaucomatous patients. Am J Ophthalmol 1996;122:775-783. 4) O’Brien C, Saxton V, Crick RP, Meire H. Doppler carotid artery studies in asymmetric glaucoma. Eye 1992;6:273-276. 5) Drance SM. Some factors in the production of low tension glaucoma. Br J Ophthalmol 1972 56(3):229-242. 6) Fechtner R, Weinreb R. Mechanisms of optic nerve damage in primary open-angle glaucoma. Surv Ophthalmol 1994;39:23-42. 7) Phelps CD, CorbettJJ. Migraine and low tension glaucoma. A case control sudy. Invest Ophthalmol Vis Sci. 1985;26:1105-1108. 8) Hayreh SS, Zimmerman, Podhajsky P, Alward WLM. Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol 1994,117:603-624. 9) Kaiser HJ, Flammer J, Graf T, Stumpfig D. Systemic blood pressure in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 1993;231:677-680. 10) Hamard P, Hamard H, Dufaux J et al. Optic nerve head blood flow using a laser doppler velocimeter and haemorheology in primary open-angle glaucoma and normal pressure glaucoma. Br J Ophthalmol 1994;78:449-453. 11) Mary A, Serre I, Brun J-F, et al. Erythrocyte deformability measurements in patients with glaucoma. J Glaucoma 1993;2:155-157. 12) Ong K, Farinelli A, Bilson F et al. Comparative study of brain magnetic resonance imaging findings in patients with low tension glaucoma and control subjects. Ophthalmology 1995;102:1632-1638. 13) Stroman, G Golnik, K., Hund, P. Magnetic Resonance Imaging in patients with Unexplained Optic Neuropathy. Arch Ophthalmol 1995;113:1041-1044. 14) Cantor LB, Harris A, Wolf S, Sponsel W, Arend O. Measurement of superficial optic nerve head capillary blood velocities by scanning laser fluorescein angiography. J Glaucoma 1994;3:S61-S64. 15) Koyama T, Matsuo N, Shimizu K, Mihara M, Tsuchida Y et al. Retinal circulation times in quantitative fluorescein angiography. Graefes Arch Clin Exp Ophthalmol 1990;228(5):442-446. 16) Ulrich WD, Ulrich C, Walter G. Ocular perfusion pressure and ocullo-oscillo-dynamography. In: Ocular Blood Flow in Glaucoma. Lambrou GN, Greve EL, Kugler ang Ghedini, ed 1989;101-115. 17) Tanaka Y. Color-fluorescein relationship in glaucomatous optic damage. Jpn JOphthalmol 1995;39:180-186. 18) Laatikainen L. Fluorescein angiographic studies of the peripapillary and perilimbal regions in simple, capsular and low-tension glaucoma. Acta Ophthalmol Suppl 1971;111:3-83. 19) Iester M, Altieri M, Michelson G, Vittone P, Calabria G, Traverso CE. Intraobserver riproducibility of a two dimensional mapping of the optic nerve head perfusion. J Glaucoma 2002;11:488-492. 20) Michelson G, Schmauss B. Two dimensional mapping of the perfusion of the retina and optic nerve head. Br J Ophthalmol 1995;79:1126-1132. 21) Riva CE, Petrig B. Blue field entoptic phenomenon and blood velocity in the retinal capillaries. J Op Soc Am 1980;70:1234-1238. 22) Butt Z, O’Brien C. Reproducibility of pulsatile ocular blood flow measurements. J Glaucoma 1995;4:214-218. 23) Williamson TH, Harris A. Color Doppler ultrasound imaging of the eye and orbit. Surv Ophthalmol 1996;40:255-267. 24) Lachkar Y, Migdal C Danjil S. Effect of Brimonidine tartrate on ocular hemodynamic measurements. Arch Ophthalmol 1998;116:1591-1594. 25) Jonas JB. Ophthalmodynamometry in eyes with dilated episcleral veins. JGlaucoma 2003;12:282-287. 26) Jonas JB, Niessen A. Ophthalmodynamometric diagnosis of unilateral ischemic ophthalmopathy. Am J Ophthalmol 2002;134:911-912. 27) Jonas JB. Reproducibility of ophthalmodynamometric measurements of central retinal artery and vein collapse pressure. Br J Opthalmol 2003;87:577-579. Ch. 1 - 34 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
Page 18 and 19: No stratification for stage of dise
Page 20 and 21: II. 6. 3 - from CNTG 1. Therapy tha
Page 22 and 23: References 1) The Ocular Hypertensi
Page 24 and 25: I - QUESTIONS TO ASK TO YOUR GLAUCO
Page 26 and 27: III - ABNORMAL THRESHOLD VISUAL FIE
Page 28 and 29: V - GONIOSCOPIC OPEN ANGLES SOME DI
Page 30 and 31: VII - TREATMENT STEPLADDER JUVENILE
Page 32 and 33: IX - MONOTHERAPY (in alphabetic ord
Page 34 and 35: XI - MANAGEMENT ACUTE ANGLE CLOSURE
Page 36 and 37: XIII - ANTIMETABOLITES FOR WOUND MO
Page 38 and 39: CHAPTER 1 PATIENT EXAMINATION
Page 40 and 41: Other methods 22-25 : Air-puff tono
Page 42 and 43: References 1) Martin XD. Normal int
Page 44 and 45: 1.2 - GONIOSCOPY Gonioscopy is a fu
Page 46 and 47: 1 2 3 4 Fig. 1 Dynamic indentation
Page 48 and 49: The Spaeth classification Insertion
Page 50 and 51: References 1) Palmberg P. Gonioscop
Page 52 and 53: small - size mid - size large - siz
Page 54 and 55: Fig. 5 A) Cirumlinear vessel, B) Ba
Page 56 and 57: 1.3.4.3 - OCT The Optical Coherence
Page 58 and 59: 31) Carpineto P, Ciancaglini M, Zup
Page 60 and 61: central 24 or 30 central degrees re
Page 62 and 63: A retinal sensitivity value worse t
Page 64 and 65: HODAPP CLASSIFICATION 31 EARLY GLAU
Page 66 and 67: References 1) Bengtsson B, Heijl A,
Page 70 and 71: 28) Flammer J, Orgul S, Costa VP, O
Page 72 and 73: All forms of glaucoma should be cla
Page 74 and 75: 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
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3.5.2 - LASER TRABECULOPLASTY 77-89
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3.5.4 - CYCLOPHOTOCOAGULATION Indic
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Although medical therapy is still t
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3.6.4 - COMPLEX CASES Complicated g
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Post-operative use Concentration: 0
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25) Janz NK, Wren PA, Lichter PR, M
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(Rescula TM ) in patients with glau
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in white patients with open-angle g
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CHAPTER 4 TREATMENT GUIDELINES
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4.2 - PRIMARY OPEN-ANGLE GLAUCOMAS
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4.2.7 - OCULAR HYPERTENSION (OH) Al
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4.3.1.7 - Glaucoma associated with
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• Withdrawal of aqueous from vitr
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4.5 - SECONDARY ANGLE-CLOSURE GLAUC
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4.5.3 - SECONDARY ANGLE-CLOSURE GLA
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NOTES
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NOTES
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NOTES
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