Morphological and Clinical Studies on the Exfoliation Syndrome and Open Angle Glaucoma

Exfoliation syndrome may be defined as a condition in which there is a characteristic clinical pattern of deposition of fine white granular material upon and within ocular and orbital tissues. Morphologically, exfoliation material comprises randomly orientated fibrillar aggregates with the staining and ultrastructural characteristics of a protein. The origin and structure of this protein (exfoliation material) are uncertain. Exfoliation syndrome is a common, but poorly understood cause of glaucoma worldwide. Iris tissue samples from 100 patients operated upon for open angle glaucoma and 31 control subjects with closed angle glaucoma have been subjected to light and electron microscopy. This aimed at establishing a definitive diagnosis for the clinical study described below. Ostensibly normal iris vessels were found close to other vessels with intense perivascular aggregation of exfoliation material. Foci of exfoliation material in the iris stroma exhibited a pattern consistent with 'ghost vessels'. A diffuse distribution would have been anticipated if passive deposition of exfoliation material had taken place. Collagen types I-V and laminin were sought in 16 normal and 20 exfoliative specimens of iris and/or trabecular meshwork, by means of ultrastructural immunogold localisation. Collagen types I-V were not present in the exfoliation material. In this study the glycoprotein laminin has been identified, for the first time, as an integral component of the exfoliation material. The vascular matrices of exfoliative iris exhibited increased amounts of collagen types I and IV in less affected vessels. Depletion of collagen types I, IV and laminin was noted in severely affected vessels. In part II of this thesis the results of two prospective studies are presented. The first investigated the prevalence and clinical characteristics of exfoliation glaucoma. Surgical patients with open angle glaucoma were divided by clinical examination into 3 groups: definite exfoliation (22) ; possible exfoliation (18) and no exfoliation (60). Subsequent morphological assessment delineated two definitive groups: exfoliation glaucoma (26) and primary open angle glaucoma (74). Exfoliation glaucoma patients more frequently had higher untreated 10P at diagnosis, shorter duration of medical therapy, higher treated 10P before surgery and were operated upon more often for high 10P. They also exhibited significantly lower 10P postoperatively compared with age- matched primary open angle glaucoma patients. The second study was performed upon 78 patients and studied the effect of varying the position of a surgical fistula upon the incidence of postoperative hyphaema. This study confirmed that by fashioning the fistula entirely in corneal tissue the incidence and severity of postoperative bleeding is reduced resulting in shorter hospital stay. The incidence of postoperative hyphaema was lower in the exfoliation glaucoma group, but not significantly so. Neither the type of dissection, nor the occurence of hyphaema influenced the 10P at 4 months following surgery

Current Perspectives on the Use of Anti-VEGF Drugs as Adjuvant Therapy in Glaucoma

The approval of one of the first anti-vascular endothelial growth factor (VEGF) agents for the treatment of neovascular age-related macular degeneration one decade ago marked the beginning of a new era in the management of several sight-threatening retinal diseases. Since then, emerging evidence has demonstrated the utility of these therapies for the treatment of other ocular conditions characterized by elevated VEGF levels. In this article we review current perspectives on the use of anti-VEGF drugs as adjuvant therapy in the management of neovascular glaucoma (NVG). The use of anti-VEGFs for modifying wound healing in glaucoma filtration surgery (GFS) is also reviewed. Selected studies investigating the use of anti-VEGF agents or antimetabolites in GFS or the management of NVG have demonstrated that these agents can improve surgical outcomes. However, anti-VEGF agents have yet to demonstrate specific advantages over the more established agents commonly used today. Further studies are needed to evaluate the duration of action, dosing intervals, and toxicity profile of these treatments

A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?

<p><strong>Article full text</strong></p> <br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s12325-017-0498-7"><b>here</b>.</a><br> <br> <strong>Provide enhanced digital features for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced digital features for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slide

A Review of the Clinical Usefulness of Selective Laser Trabeculoplasty in Exfoliative Glaucoma

<p></p><p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s12325-018-0695-z">https://link.springer.com/article/10.1007/s12325-018-0695-z</a></p><p></p><p></p><p> </p><p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p><br><p></p

Association of POAG Risk Factors and the Thr377Met MYOC Mutation in an Isolated Greek Population

The authors investigated the role of the Thr377Met MYOC mutation with the occurrence of POAG in an isolated Greek village. The Thr377Met MYOC mutation was found to be associated with the glaucomatous risk factors, intraocular pressure, and vertical cup-to-disc ratio but not with central corneal thickness

Current Perspectives on the Use of Anti-VEGF Drugs as Adjuvant Therapy in Glaucoma

<p><strong>Article full text</strong></p> <br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s12325-016-0461-z"><b>here</b>.</a><br> <br> <strong>Provide enhanced digital features for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced digital features for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slide