Clinical Glaucoma Treatment At A University Hospital: Monthly Cost And Financial Impact [tratamento Clínico Do Glaucoma Em Um Hospital Universitário: Custo Mensal E Impacto Na Renda Familiar]

Purpose: To verify the social characteristics and the impact of glaucoma treatment on the familial income of patients followed at a university hospital. Methods: One hundred and forty six glaucomatous patients were interviewed at the Hospital das Clínicas da Universidade de Campinas to evaluate their social economic profile. The questionnaire investigated the occupation, the individual and familial income, as well as the type and frequency of the antiglaucomatous drugs used by each patient. Knowing the monthly cost of antiglaucomatous drugs available in Brazil, we were able to calculate the monthly cost of glaucoma treatment and the percentage of committed familial income. Results: The mean monthly cost of glaucoma treatment was 36.09 ± 31.99 reais, which corresponded to 15.5% of the familial income. Thirty-six (24%) patients had 25 percent or more of the familial income spent on their treatment. Sixty-six (45.2%) patients had difficulty in buying their medications. Factors associated with this difficulty included low familial income (p=0.0001), and high percentage of the income used to buy the drugs (p=0.0002). Conclusion: The cost of glaucoma treatment is high compared to the income of patients treated at a public institution. This population has a low familial income, of which a high percentage is required to acquire antiglaucoma medications. We suggest that these patients may be at risk for low compliance due to economical limitations.653299303Wilenski, J.T., The role of brimonidine in the treatment of open angle glaucoma (1996) Surv Ophthalmol, 41, pp. S3-7Wilson, M.R., Martone, J.F., Epidemiology of chronic open angle glaucoma (1996) The Glaucomas. 3rd Ed., pp. 407-445. , Ritch R, Shields MB, Krupin T: St. Louis: MosbyAinsworth, J.R., Jay, J.L., Costs analysis of early trabeculectomy versus conventional management in primary open angle glaucoma (1991) Eye, 5 (3 PART), pp. 322-328Amaral, J.M.F., Moreira, R.A.R., Silva, L.M.S., Vasconcellos, J.P., Rocha, E.M., Costa, V.P., Kara-José, N., Custo mensal das medicações anti-glaucomatosas no Brasil (1999) Arq Bras Oftalmol, 62, pp. 123-126Costa, V.P., Vasconcellos, J.P., Pelegrino, M., Kara-José, N., O que os pacientes sabem sobre glaucoma? (1995) Arq Bras Oftalmol, 58, pp. 36-41Yasuoka, E.R., Mello, P.A.A., Quem segue corretamente o tratamento clínico do glaucoma? (1996) Arq Bras Oftalmol, 59, pp. 325-328Goldberg, I., Compliance (1996) The Glaucomas, pp. 1375-1384. , Ritch R, Shields MB, Krupin T. St Louis: Mosby-Year BookPedroso, L., Carvalho Júnior, E.S., Paranhos Júnior, A., Prata Júnior, J.A., Mello, P.A.A., Custo real do tratamento do glaucoma para o paciente (1999) Arq Bras Oftalmol, 62, pp. 677-682Costa, V.P., Vasconcellos, J.P., Pelegrino, M., Kara-José, N., Análise da técnica de instilação do colírio em pacientes glaucomatosos (1995) Rev Bras Oftalmol, 54, pp. 523-528Kobelt, G., Jünsson, L., Gerdtham, U., Krieglstein, G.K., Direct costs of glaucoma management following initiation of medical therapy. A simulation model based on an observacional study of glaucoma treatment in Germany (1998) Graefes Arch Clin Exp Ophthalmol, 236, pp. 811-82

Lack Of Association Between Optineurin Gene Variants T34t, E50k, M98k, 691-692insag And R545q And Primary Open Angle Glaucoma In Brazilian Patients

Purpose: To verify the frequencies of T34T, E50K, M98K, 691-692insAG, and R545Q variants in the optineurin (OPTN) gene in Brazilian subjects with primary open-angle glaucoma (POAG) and controls. Patients and Methods: Ninety-nine patients with POAG and 100 normal controls were enrolled in this study. The frequency of alterations in the OPTN gene was analyzed by direct sequencing and enzymatic digestion of PCR products. Results: None of the five alterations evaluated was significantly associated with POAG when compared to controls. However, the T34T silent change was present in greater frequency in POAG patients (37.37% vs. 23.00% in controls), while the R545Q change was more prevalent in controls (23.00% vs. 10.10% in POAG). The M98K and 691-692insAG presented with low frequencies in POAG patients (1.01% and 2.02%, respectively) and controls (2.00% and 2.00%, respectively). The E50K substitution was not observed. Conclusion: Our data show no association between the five evaluated variants and POAG in the Brazilian population. Copyright © Informa Healthcare USA, Inc.3011318Weinreb, R.N., Glaucoma neuroprotection: What is it? Why is it needed? (2007) Can J Ophthalmol, 42, pp. 396-398Raymond, V., Molecular genetics of the glaucomas: Mapping of the first five "GLC" loci (1997) Am J Hum Genet, 60, pp. 272-277Sarfarazi, M., Recent advances in molecular genetics of glaucomas (1997) Hum Mol Genet, 6, pp. 1667-1677Wilson, M.R., Hertzmark, E., Walker, A.M., Childs-Shaw, K., Epstein, D.L., A case-control study of risk factors in open angle glaucoma (1987) Arch Ophthalmol, 105, pp. 1066-1071Drance, S., Chronic open angle glaucoma: Risk factors in addition to intraocular pressure (2001) Acta Ophthalmol Scand, 79, p. 545Monemi, S., Spaeth, G., DaSilva, A., Popinchalk, S., Ilitchev, E., Liebmann, Ritch, R., Sarfarazi, M., Identification of a novel adult-onset primary open glaucoma (POAG) gene on 5q22.1 (2005) Hum Mol Genet, 14, pp. 725-733Rezaie, T., Child, A., Hitchings, R., Brice, G., Miller, L., Coca-Prados, M., Héon, E., Sarfarazi, M., Adult-onset primary open-angle glaucoma caused by mutations in optineurin (2002) Science, 295, pp. 1077-1079Libby, R.T., Douglas, B., Gould, D.B., Anderson, M.G., John, S.M., Complex Genetic of Glaucoma Susceptibility (2005) Annu Rev Genomics Hum Genet, 6, pp. 15-44Funayama, T., Ishikawa, K., Ohtake, Y., Tanino, T., Kurosaka, D., Kimura, I., Suzuki, K., Mashima, Y., Variants in optineurin gene and their association with tumor necrosis factor-alpha polymorphisms in Japanese patients with glaucoma (2004) Invest Ophthalmol Vis Sci, 45, pp. 4359-4367Hodapp, E., Parrish II, R.K., Anderson, D.R., (1993) Clinical decisions in glaucoma, pp. 52-61. , St Louis, The C.V, Mosby CoWilloughby, C.E., Chan, L.L., Herd, S., Billingsley, G., Noordeh, N., Levin, A.V., Buys, Y., Héon, E., Defining the pathogenicity of optineurin in juvenile open-angle glaucoma (2004) Invest Ophthalmol Vis Sci, 45, pp. 3122-3130Fan, B.J., Wang, D.Y., Fan, D.S., Tam, P.O., Lam, D.S., Tham, C.C., Lam, C.Y., Pang, C.P., SNPs and interaction analyses of myocilin, optineurin, and apolipoprotein E in primary open angle glaucoma patients (2005) Mol Vis, 11, pp. 625-631Tang, S., Toda, Y., Kashiwagi, K., Mabuchi, F., Iijima, H., Tsukahara, S., Yamagata, Z., The association between Japanese primary open-angle glaucoma and normal tension glaucoma patients and the optineurin gene (2003) Hum Genet, 113, pp. 276-279Fuse, N., Takahashi, K., Akiyama, H., Nakazawa, T., Seimiya, M., Kuwahara, S., Tamai, M., Molecular genetic analysis of optineurin gene for primary open-angle and normal tension glaucoma in the Japanese population (2004) J Glaucoma, 13, pp. 299-303Jansson, M., Wadelius, C., Rezaie, T., Sarfarazi, M., Analysis of rare variants and common haplotypes in the optineurin gene in Swedish glaucoma cases (2005) Ophthalmic Genet, 26, pp. 85-89Mukhopadhyay, A., Komatireddy, S., Acharya, M., Bhattacharjee, A., Mandal, A.K., Thakur, S.K., Chandrasekhar, G., Ray, K., Evaluation of Optineurin as a candidate gene in Indian patients with primary open angle glaucoma (2005) Mol Vis, 11, pp. 792-797Hauser, M.A., Sena, D.F., Flor, J., Walter, J., Auguste, J., Larocque-Abramson, K., Graham, F., Wiggs, J.L., Distribution of optineurin sequence variations in an ethnically diverse population of low-tension glaucoma patients from the United States (2006) J Glaucoma, 15, pp. 358-363Leung, Y.F., Fan, B.J., Lam, D.S., Lee, W.S., Tam, P.O., Chua, J.K., Tham, C.C., Pang, C.P., Different optineurin mutation pattern in primary open-angle glaucoma (2003) Invest Ophthalmol Vis Sci, 44, pp. 3880-3884Toda, Y., Tang, S., Kashiwagi, K., Mabuchi, F., Iijima, H., Tsukahara, S., Yamagata, Z., Mutations in the optinurin gene in Japanese patients with primary open angle glaucoma and normal tension glaucoma (2004) Am J Med Genet A, 125 A, pp. 1-4Baird PN, Foote SJ, Mackey DA, Craig J, Speed TP, Bureau A. Evidence for a novel glaucoma locus at chromosome 3p21-22. Hum Genet. 2005;117:249-257Alward, W.L., Kwon, Y.H., Kawase, K., Craig, J.E., Hayreh, S.S., Johnson, A.T., Khanna, C.L., Stone, E.M., Evaluation of optineurin sequence variations in 1048 patients with open angle glaucoma (2003) Am J Ophthalmol, 136, pp. 904-910Aung, T., Rezaie, T., Okada, K., Viswanathan, A.C., Child, A.H., Brice, G., Bhattacharya, S.S., Hitchings, R.A., Clinical features and course of patients with glaucoma with the E50K mutation in the optineurin gene (2005) Invest Ophthalmol Vis Sci, 46, pp. 2816-2822Weisschuh, N., Neumann, D., Wolf, C., Wissinger, B., Gramer, E., Prevalence of myocilin and optineurin sequence variants in German normal tension glaucoma patients (2005) Mol Vis, 11, pp. 284-287Melki, R., Belmouden, A., Akhayat, O., Brézin, A., Garchon, H.J., The M98K variant of the OPTINEURIN (OPTN) gene modifies initial intraocular pressure in patients with primary open angle glaucoma (2003) J Med Genet, 40, pp. 842-844Urbano, A.P., Freitas, T.G., Arcieri, E.S., Urbano, A.P., Costa, V.P., Avaliação dos tipos de glaucoma no Serviço de Oftalmologia da Unicamp. (2001) Arq Bras Oftalmol, 64, pp. P052. , Abstrac

Association of Genetic Variants With Primary Open-Angle Glaucoma Among Individuals With African Ancestry

Item does not contain fulltextImportance: Primary open-angle glaucoma presents with increased prevalence and a higher degree of clinical severity in populations of African ancestry compared with European or Asian ancestry. Despite this, individuals of African ancestry remain understudied in genomic research for blinding disorders. Objectives: To perform a genome-wide association study (GWAS) of African ancestry populations and evaluate potential mechanisms of pathogenesis for loci associated with primary open-angle glaucoma. Design, Settings, and Participants: A 2-stage GWAS with a discovery data set of 2320 individuals with primary open-angle glaucoma and 2121 control individuals without primary open-angle glaucoma. The validation stage included an additional 6937 affected individuals and 14917 unaffected individuals using multicenter clinic- and population-based participant recruitment approaches. Study participants were recruited from Ghana, Nigeria, South Africa, the United States, Tanzania, Britain, Cameroon, Saudi Arabia, Brazil, the Democratic Republic of the Congo, Morocco, Peru, and Mali from 2003 to 2018. Individuals with primary open-angle glaucoma had open iridocorneal angles and displayed glaucomatous optic neuropathy with visual field defects. Elevated intraocular pressure was not included in the case definition. Control individuals had no elevated intraocular pressure and no signs of glaucoma. Exposures: Genetic variants associated with primary open-angle glaucoma. Main Outcomes and Measures: Presence of primary open-angle glaucoma. Genome-wide significance was defined as P C) with primary open-angle glaucoma (odds ratio [OR], 1.32 [95% CI, 1.20-1.46]; P = 2 x 10-8). The association was validated in an analysis of an additional 6937 affected individuals and 14917 unaffected individuals (OR, 1.15 [95% CI, 1.09-1.21]; P < .001). Each copy of the rs59892895*C risk allele was associated with increased risk of primary open-angle glaucoma when all data were included in a meta-analysis (OR, 1.19 [95% CI, 1.14-1.25]; P = 4 x 10-13). The rs59892895*C risk allele was present at appreciable frequency only in African ancestry populations. In contrast, the rs59892895*C risk allele had a frequency of less than 0.1% in individuals of European or Asian ancestry. Conclusions and Relevance: In this genome-wide association study, variants at the APBB2 locus demonstrated differential association with primary open-angle glaucoma by ancestry. If validated in additional populations this finding may have implications for risk assessment and therapeutic strategies