Neuro-Ophthalmologic Disorders That Mimic Glaucoma: A Review

Background: To summarize the neuro-ophthalmologic disorders that mimic glaucoma. Material and Methods: All studies from PubMed, Scopus, and Google Scholar were found using these keywords: optic atrophy, neuro-ophthalmologic disorders, glaucoma mimicker, glaucoma masquerader, and mimic glaucoma. Results: The main neuro-ophthalmologic disorders that mimic glaucoma are large physiologic cupping, optic disc cup asymmetry, hereditary optic neuropathy, tilted disc syndrome, morning glory anomaly, superior segmental optic nerve hypoplasia, optic disc coloboma, optic disc pits, optic disc drusen, high myopia, inflammatory conditions (optic neuritis), toxic-nutritional optic neuropathy, nutritional deficiency, toxins, traumatic optic neuropathy, compressive optic neuropathy, periventricular leukomalacia, hydrocephalus, perinatal asphyxia, ischemic optic neuropathy, and radiation optic neuropathy. Conclusion: Repeated evaluations of visual functions such as visual acuity, visual field, and color vision are necessary for diagnosing glaucoma mimickers. Furthermore, a precise examination of the optic disc and retina is crucial. Notably, it is necessary to consider normal-tension glaucoma as an exclusionary diagnosis. &nbsp

Glaucoma in Iridocorneal Endothelial Syndrome: A Brief Review

The iridocorneal endothelial (ICE) syndrome is a sporadic corneal endothelial disease that causes corneal endothelial cell abnormality as epithelialization, resulting in intractable glaucoma and corneal decompensation, often needing glaucoma surgery and corneal transplantation without a good prognosis. The most effective way to diagnose early is in-vivo confocal microscopy. Early treatment, especially for resultant glaucoma, improves diagnosis

Optical Coherence Tomography Interpretation for Glaucoma

Structural glaucomatous changes occur more frequently in the earlier stages of glaucoma than functional defects so we should give special care on oct (optical coherence tomography) importance as the best current method. RNFL change detection are more useful in early glaucoma, GCC in moderate to advanced glaucoma while visual field test is more useful in advanced stages but overall using a combination of RNFL, ONH and macular measurement modalities is recommended for glaucoma evaluation because each of these parameters may be affected earlier than the others so, taking into account the findings from the RNFL, ONH and macula enhances early diagnosis of glaucoma

Error in Measurement of Visual Field Caused by False Eyelashes: A Case Report

Many cosmetic enhancements to the natural appearance of the eyes are readily available today.A relatively popular form of eye beauty enhancement is false (fake) cosmetic eyelashes and veyelash extensions. Due to the increasing popularity of these cosmetic products, it is essential for ophthalmologists to be aware of their potential risks and complications. Here we report a case of error in measurement of visual field caused by false eyelashes.Keywords: Eyelashes; Cosmetics; Visual Fields

The Long Term Outcome of Ahmed Glaucoma Valve Insertion in Neovascular Glaucoma

Purpose: To evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation for neovascular glaucoma (NVG), in short, intermediate, and long term follow ups. Patients and Methods: The present study was a retrospective review of 23 eyes of 23 patients with NGV who underwent AGV implantation at Imam Hussein Medical Center, Tehran, Iran, between January 2008 and March 2017. Pre and post operative intraocular pressure (IOP), visual acuity, surgical success rate, number of medications, and complications were recorded. The primary outcome was surgical success  defined  in  terms  of  5 ≤ IOP ≤ 21 mmHg and at least 20 %  reduction  in  IOP without glaucoma medication (complete success), or with medications (qualified success). The sum of complete success and qualified success was reported as cumulative success. Results: The mean follow up period was 4.69 years (range, 2-10 years). The mean IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years (P < 0.001). The cumulative surgical success rate at 1 year, 2 years and 3 years were 91.3 %, 82.6 %, 78.3 % respectively. The mean number of drugs needed to control IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years. &nbsp

Avascular Blebs and Late Bleb Leakage; A Review of Causes and Management

Trabeculectomy with mitomycin-C remains the gold standard for surgical glaucoma management; however, this technique includes some sight-threatening complications like avascular thin bleb, subsequent leakage and ultimately endophthalmitis.  To date, various non surgical methods have been reported for the management of bleb leakage, but surgical management frequently becomes necessary especially in frank leakages. The most common surgical approach includes excision of the avascular and necrotic leaking bleb combined with the advancement of adjacent healthy conjunctiva. The aim of the present review is to discuss avascular bleb and late bleb leakage after trabeculectomy including their histopathology, risk factors, prevention and management.Keywords: Trabeculectomy; Mitomycin, Leakage, Avascular

Ophthalmic Manifestations of Acute Leukemia: A Review

Acute leukemias are the most prevalent neoplastic disorder among children. In these patients the leukemic cells or blasts have replaced normal hematopoietic cells in bone marrow and have spread to different extramedullary sites. Increased survival among leukemic patients in recent decades has led to diagnosing some previously less recognized complications among these patients. One of these morbidities is ophthalmic involvement. The presence of ophthalmic involvement among leukemia patients is associated with poor prognosis. Ophthalmic involvement is more common in patients with AML and in adult patients. Leukemia may involve any ocular tissue such as conjunctiva, sclera, cornea, anterior chamber, iris, lens, vitreous, retina, choroid and optic nerve. In this review, the ocular manifestations of leukemia have been discussed

Corneal Endothelial Cell Loss in Glaucoma Treatment Procedures: A Brief Review

AbstractGlaucoma surgeons should be careful about damage to the corneal endothelial cells during glaucoma surgeries particularly during glaucoma drainage device implantation. The patients should be monitored for possible corneal decompensation. Also shunt procedures should be performed with a wider tube corneal angle to avoid possible endothelial cell damage. Here we briefly review corneal endothelial cell loss in different glaucoma treatment methods.Keywords: Cornea; Endothelial Cell Loss; Glaucoma; Review

The Use of Subconjunctival Erythropoietin Injection to Treat Avascular Bleb after Trabeculectomy: A Case Report

Purpose: To report a patient with avascular bleb after trabeculectomy who showed promising results after subconjunctival erythropoietin injection. Case Report: A 45-year-old woman with the diagnosis of primary open-angle glaucoma and history of trabeculectomy three years prior was admitted to our center. The corrected distance visual acuity (CDVA) was 20/20 in both eyes. Her ocular examination revealed an avascular and cystic bleb in the right eye. Seidel test was negative while bleb sweating was observed after fluorescein staining of the bleb area. Intraocular pressure (IOP) was 5 mmHg in the right eye. Erythropoietin (2000 unit in 0.1 ml) was injected subconjuctivally around the bleb area in the temporal quadrant. Six weeks after the injection, the bleb area just superior to the conjunctiva showed an increased fibrosis formation while the IOP remained the same as before injection. &nbsp

Elevated Intraocular Pressure after Pars Plana Vitrectomy: A Review

Intraocular pressure (IOP) elevation is a well-known complication after pars plana vitrectomy with or without tamponade. The mechanism of increase in IOP can be open angle, closed angle or both. Oxidative stress is hypothesized to have a significant role in the pathogenesis of post vitrectomy elevated IOP and the presence of the lens probably has a protective role. The use of silicone oil and intraocular gases as tamponade is related to higher risk of post-operative elevated IOP and causes longer-term IOP elevation. Anti-inflammatory agents, mydriatics, anti-glaucoma medications especially aqueous suppressants, glaucoma surgery and laser procedures might be used for controlling post vitrectomy elevated IOP. Glaucoma shunt implantation and cyclodestructive procedures are the most important surgeries performed for treatment of uncontrolled intraocular pressure after vitrectomy