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1

Georgopoulos, G., D. Andreanos, N. Liokis, D. Papakonstantinou, J. Vergados, and G. Theodossiadis. "Risk Factors in Ocular Hypertension." European Journal of Ophthalmology 7, no. 4 (October 1997): 357–63. http://dx.doi.org/10.1177/112067219700700409.

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The aim of the study was to determine whether certain factors are related to an increased risk of developing open-angle glaucoma. A total of 345 untreated glaucoma suspects with intraocular pressure (IOP) ≥ 21 mmHg, cup to disc ratio 0.4 or less and no visual field defects, were followed up for 6 to 8 years (mean 7.3). During the follow-up 71 patients developed established glaucoma and were compared to the remaining 274 patients. The following factors were analysed: age, family history of glaucoma, IOP, Humphrey 30-2 visual fields, optic disc appearance, myopia, exfoliation, arterial hypertension and diabetes. Analysis yielded statistically significant results regarding a number of these factors in the patients who subsequently developed open-angle glaucoma. A significant association with the subsequent development of field loss in ocular hypertension (OHT) included: heredity (p < 0.001), age ≥ 60 years (p = 0.013), axial myopia (0.001 < p < 0.01) and arterial hypertension (p = 0.05). About 20% of patients with ocular hypertension developed glaucoma over a period of seven years. Risk factors such as heredity, age, myopia and arterial hypertension, among others, must be considered in the follow-up of glaucoma suspects.
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2

Ponte, Francesco, Giuseppe GiuffrÉ, Raimondo Giammanco, and Gabriella Dardanoni. "Risk factors of ocular hypertension and glaucoma." Documenta Ophthalmologica 85, no. 3 (March 1994): 203–10. http://dx.doi.org/10.1007/bf01664928.

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3

Choi, Jaewan, and Michael S. Kook. "Systemic and Ocular Hemodynamic Risk Factors in Glaucoma." BioMed Research International 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/141905.

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Primary open angle glaucoma (POAG) is a multifactorial disease characterized by progressive retinal ganglion cell death and visual field loss. It is known that alterations in intraocular pressure (IOP), blood pressure (BP), and ocular perfusion pressure (OPP) can play a significant role in the pathogenesis of the disease. Impaired autoregulatory capacity of ocular blood vessels may render tissues vulnerable to OPP changes and potentially harmful tissue ischemia-reperfusion damage. Vascular risk factors should be considered more important in a subgroup of patients with POAG, and especially in patients with normal tension glaucoma (NTG) with evidence of unphysiological BP response. For example, reduction of BP during the nighttime has an influence on OPP, and increased circadian OPP fluctuation, which might stand for unstable ocular blood flow, has been found to be the consistent risk factor for NTG development and progression. Central visual field may be affected more severely than peripheral visual field in NTG patients with higher 24-hour fluctuation of OPP. This review will discuss the current understanding of allegedly major systemic and ocular hemodynamic risk factors for glaucoma including systemic hypertension, arterial stiffness, antihypertensive medication, exaggerated nocturnal hypotension, OPP, and autonomic dysregulation.
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Grzybowski, Andrzej, Mariusz Och, Piotr Kanclerz, Christopher Leffler, and Carlos Gustavo De Moraes. "Primary Open Angle Glaucoma and Vascular Risk Factors: A Review of Population Based Studies from 1990 to 2019." Journal of Clinical Medicine 9, no. 3 (March 11, 2020): 761. http://dx.doi.org/10.3390/jcm9030761.

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Glaucoma is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma. The pathogenesis of primary open angle glaucoma (POAG) is unclear and multiple ocular risk factors have been proposed, including intraocular pressure, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and optic disc hemorrhages. The purpose of this review was to analyze the association between systemic vascular risk factors (including hypertension, diabetes, age, and migraine) and POAG, based on major epidemiological studies. Reports presenting the association between POAG and systemic vascular risk factors included a total of over 50,000 patients. Several epidemiological studies confirmed the importance of vascular risk factors, particularly hypertension and blood pressure dipping, in the pathogenesis and progression of glaucomatous optic neuropathy. We found that diabetes mellitus is associated with elevated intraocular pressure, but has no clear association with POAG. No significant correlation between migraine and POAG was found, however, the definition of migraine varied between studies.
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5

Medvedovskaya, Nataliia, and Zoriana Povch. "Risk Factors for Development of Glaucoma in the Practice of Family Doctor." Family Medicine, no. 5 (December 30, 2016): 52–54. http://dx.doi.org/10.30841/2307-5112.5.2016.248660.

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The objective: studying of risk factors of developing of glaucoma for formation of risk groups in daily practice of the family doctor, in particular timely identification of an ocular hypertension, the prevention of establishment for the first time of the diagnosis in her late stage became a research objective. Patients and methods. Outpatient and polyclinic offices of five healthcare institutions of the city of Kiev in which primary help by the principles of the general medical practice – family medicine is given became scientific base of a research. Forms of account № 12 «The report on the diseases registered at patients who live in the area of service of treatment and prevention facility» and questionnaires of a sociological research of risk factors of glaucoma (820 questionnaires) were primary material. Achievement of goals of a research demanded use of a complex of methods of a research, a basis for which was a system approach, namely: bibliosemantic, sociological (questionnaire), medico-statistical methods. Results. Оf a research it is proved that relevance of a problem of the prevention of a blindness and a low vision owing to glaucoma increases in Ukraine over the years. Modern risk factors of development of glaucoma which have the proved influence on formation of an ocular hypertension, and are studied later and glaucomas, knowledge of which will help physicians of primary contact with the patient to form actively risk groups on glaucoma that, in turn, allows to individualize at the same time preventively – improving, medical and diagnostic medical care in each case and to objectify assessment of its results in dynamics. Conclusion. Knowledge the doctor of the general practice the family doctor of modern risk factors of development of glaucoma is necessary for her effective prevention as it is proved that timely diagnosis of a disease (at an early stage) does possible correction of the existing risk factors of emergence and progressing of glaucoma that is very important in daily practice of the doctor of the general practice – the family doctor.
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6

Bourgeois, Hubert. "EPIDEMIOLOGICAL STUDIES ON RISK FACTORS FOR GLAUCOMA AND OCULAR HYPERTENSION." International Ophthalmology Clinics 29, SUPPLEMENT (1989): S3. http://dx.doi.org/10.1097/00004397-198925000-00003.

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7

Markovic, Vujica, Djordje Kontic, Paraskeva Hentova-Sencanic, Marija Bozic, Ivan Marjanovic, Vera Krstic, and Dragana Kovacevic. "Contribution and significance of Heidelberg retinal tomography II in diagnostics of ocular hypertension and its conversion into primary open-angle glaucoma." Vojnosanitetski pregled 66, no. 4 (2009): 283–89. http://dx.doi.org/10.2298/vsp0904283m.

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Background/Aim. A term 'ocular hypertension' is used when IOP is found to be > 21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II) results that show very early, subtle changes in retinal neurofibre layers (RNFL) in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio), but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. Methods. During a 5-year study period (2002-2007), 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT), central corneal thickness (CCT) determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nervi optici (PNO) examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D) ratio, which was followed during the control examination by each segment, as well as PNO in global. Results. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413) comparing to the last one. Conclusion. In diagnosing ocular hypertension and its conversion to glaucoma, HRT II is used for quantitative evaluation of retinal topography and for quantitative monitoring of topographical changes, especially regarding the increase of C/D ratio and loss of rim volume tissue, which enables to see and register subtle structural changes in optic nerve head and RNFL that are so characteristic for glaucoma, which cannot be seen by an ophthalmoscope. With these results, according to risk factors for glaucoma, one can confirm the diagnosis of ocular hypertension and its conversion to primary open-angle glaucoma. In this study HRT II revealed conversion of ocular hypertension into glaucoma in 10% of the patients.
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8

Jiang, Huaiyan, Yang Gao, Wenzhong Fu, and Hongxia Xu. "Risk Factors and Treatments of Suprachoroidal Hemorrhage." BioMed Research International 2022 (July 14, 2022): 1–5. http://dx.doi.org/10.1155/2022/6539917.

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Suprachoroidal hemorrhage (SCH) is a rare but serious sight-threatening complication of inner eye surgery. Despite continuous advances in treatment, visual prognosis remains poor. The disease has a more typical clinical presentation, the etiology and pathogenesis are not well defined, and intraoperative ocular and systemic factors may induce fulminant SCH. To investigate risk factors and treatments of SCH-associated intraocular surgeries, summarize diagnosis, characteristics, management, and prevention of SCH developed during and after intraocular surgeries. A retrospective study of SCH occurred in six cases of intraocular surgeries including cataract, glaucoma, pars plana vitrectomy (PPV), and silicone oil removal surgery. Assess baseline systemic and ocular characteristics of SCH eyes. Analyze the second surgery timing and technique, and visual outcomes were measured. SCH occurred in six patients including five eyes during surgeries and one eye after the surgery. Three eyes that underwent cataract surgery had hard nucleuses (nuclear sclerotic 4+). One eye was due to hypotony during the vitrectomy procedure. One eye developed SCH when silicone oil was extracted from the eyeball. One eye developed delayed SCH after glaucoma surgery. Incision closure and anterior chamber deepening were performed. B-scan ultrasonography was used to diagnose SCH, and determine the timing and location of sclerotomy for the second surgery. Vitrectomy and sclerotomy were performed in five eyes. The median follow-up time was six months. The final best-corrected visual acuity (BCVA) was 0.3 in one eye, one eye had light perception with retinal adherence, and four eyes had no light perception with retinal detachment. The results showed that risk factors including advanced age, hypertension, taking anticoagulants, antiplatelet drugs, and cardiovascular drugs were systemic risk factors, and hard nucleus (nuclear sclerosis 4 +) cataract, long-term uncontrolled ocular hypertension glaucoma, vitrectomy, silicone oil removal, high myopia, aphakia, previous intraocular surgery, intraocular pressure during surgery, and others were ocular risk factors. The most important risk factor is a sudden drop in intraocular pressure during or after surgery. The outcome of visual acuity depends on retinal status. Because of the poor prognosis, the prevention of SCH is of utmost importance during intraocular surgery.
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9

Rossi, Gemma Caterina Maria, Gian Maria Pasinetti, Luigia Scudeller, Marta Raimondi, Sara Lanteri, and Paolo Emilio Bianchi. "Risk Factors to Develop Ocular Surface Disease in Treated Glaucoma or Ocular Hypertension Patients." European Journal of Ophthalmology 23, no. 3 (December 17, 2012): 296–302. http://dx.doi.org/10.5301/ejo.5000220.

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10

Kosior-Jarecka, Ewa, Dominika Wróbel-Dudzińska, Urszula Łukasik, and Tomasz Żarnowski. "Ocular and Systemic Risk Factors of Different Morphologies of Scotoma in Patients with Normal-Tension Glaucoma." Journal of Ophthalmology 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/1480746.

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The Aim. The aim of this study was to assess general and ocular profiles of patients with single-localisation changes in visual field. Material and Methods. The study group consisted of 215 Caucasian patients with normal-tension glaucoma with scotoma on single localisation or with preperimetric glaucoma. During regular follow-up visits, ophthalmic examination was carried out and medical history was recorded. The results of the visual field were allocated as paracentral scotomas, arcuate scotomas, peripheral defects, or hemispheric defects. Statistical analysis was conducted with Statistica 12, and p<0.05 was considered statistically significant. Results. Risk factors such as notch, disc hemorrhage, general hypertension, migraine, and diabetes were strongly associated with specific visual field defects. Paracentral defect was significantly more frequent for women (p=0.05) and patients with disc hemorrhage (p<0.001). Arcuate scotoma occurred frequently in patients without disc hemorrhage (p=0.046) or migraines (p=0.048) but was observed in coexistence with general hypertension (p<0.001). The hemispheric defect corresponded with notch (p=0.0036) and migraine (p=0.081). Initial IOP was highest in patients with arcuate scotoma and lowest in patients with preperimetric glaucoma (p=0.0120). Conclusions. The specific morphology of scotoma in patients with normal-tension glaucoma is connected with definite general and ocular risk factors.
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11

Ruqaya, Tayaba Kazmi, Tehreem Anis, Iqra Salahuddin, Moomal Zeshan, and Wajiha Israr. "Prevalence of risk factors associated with ocular problems in males and females in type 1 & 2 diabetes." BioSight 2, no. 1 (June 30, 2021): 39–44. http://dx.doi.org/10.46568/bios.v2i1.38.

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Background: The aim of current study was exploring the ocular abnormalities in individuals with Type 1 & 2 diabetes. Methods: Patients referred for diabetic ocular abnormalities (retinopathy, cataract, glaucoma and refractive error) on fundoscopy from LRBT eye hospital Korangi, Karachi were randomly included in the study. Retinopathy, cataract and refractive error were evaluated by slit lamp biomicroscope or indirect ophthalmoscope, & categorized into lacking, non-proliferative, proliferative retinopathy, maculopathy, capsular or sub capsular cataract, myopia and hypermetropia. While glaucoma was assessed by tonometry. Prevalence of eye complication has been seen in subjects. Outcome of substantial risk factors on the diverse phases of retinopathy, multivariate regression analysis was performed. Results: 200 diabetic subjects (106 males and 94 females) when the compared; diabetic subjects and subjects with hypertension; 28.0 % retinopathy, 9.75 % cataract, 7.31 % with glaucoma, and about 2.43% refractive error were found out among the diabetic males. 47.61 % retinopathy, 11.9% Cataract, 40.47% refractive error were found in females. In males with diabetes and hypertension were found 60.46 % retinopathy, 27.9 5% cataract, 11.62 % refractive error & in females 46.15% retinopathy, 19.23 % cataract, and 34.61 % with refractive error. Conclusions: This current study emphasizes screening of diabetic subjects regularly so as to distinguish ocular abnormalities and increasing public awareness.
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12

Kelly, Stephen R., Anthony P. Khawaja, Susan R. Bryan, Augusto Azuara-Blanco, John M. Sparrow, and David P. Crabb. "Progression from ocular hypertension to visual field loss in the English hospital eye service." British Journal of Ophthalmology 104, no. 10 (March 25, 2020): 1406–11. http://dx.doi.org/10.1136/bjophthalmol-2019-315052.

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BackgroundThere are more than one million National Health Service visits in England and Wales each year for patients with glaucoma or ocular hypertension (OHT). With the ageing population and an increase in optometric testing, the economic burden of glaucoma-related visits is predicted to increase. We examined the conversion rates of OHT to primary open-angle glaucoma (POAG) in England and assessed factors associated with risk of conversion.MethodsElectronic medical records of 45 309 patients from five regionally different glaucoma clinics in England were retrospectively examined. Conversion to POAG from OHT was defined by deterioration in visual field (two consecutive tests classified as stage 1 or worse as per the glaucoma staging system 2). Cox proportional hazards models were used to examine factors (age, sex, treatment status and baseline intraocular pressure (IOP)) associated with conversion.ResultsThe cumulative risk of conversion to POAG was 17.5% (95% CI 15.4% to 19.6%) at 5 years. Older age (HR 1.35 per decade, 95% CI 1.22 to 1.50, p<0.001) was associated with a higher risk of conversion. IOP-lowering therapy (HR 0.45, 95% CI 0.35 to 0.57, p<0.001) was associated with a lower risk of conversion. Predicted 5-year conversion rates for treated and untreated groups were 14.0% and 26.9%, respectively.ConclusionLess than one-fifth of OHT patients managed in glaucoma clinics in the UK converted to POAG over a 5-year period, suggesting many patients may require less intensive follow-up. Our study provides real-world evidence for the efficacy of current management (including IOP-lowering treatment) at reducing risk of conversion.
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13

Chung, Hye Jin, Hyung Bin Hwang, and Na Young Lee. "The Association between Primary Open-Angle Glaucoma and Blood Pressure: Two Aspects of Hypertension and Hypotension." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/827516.

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Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG) is not fully understood, elevated intraocular pressure (IOP) is considered the most important risk factor. Several vascular factors have also been identified as risk factors and can lead to hypoperfusion of the optic nerve head and thus may play an important role in the pathogenesis and progression of POAG. The results of the present study suggest that both high and low blood pressure (BP) are associated with an increased risk of POAG based on a comprehensive literature review. Elevated BP is associated with elevated IOP, leading to increased risk of glaucoma, but excessive BP lowering in glaucoma patients may cause a drop in ocular perfusion pressure (OPP) and subsequent ischemic injury. The relationship between IOP, OPP, and BP suggests that the relationship between BP and glaucoma progression is U-shaped.
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González-Pérez, L. M., G. E. Ortiz-Arismendi, and C. J. Moreno. "Prevalence and risk factors to develop ocular hypertension and glaucoma after penetrating keratoplasty." Archivos de la Sociedad Española de Oftalmología (English Edition) 96, no. 8 (August 2021): 415–21. http://dx.doi.org/10.1016/j.oftale.2020.09.019.

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15

Trick, Gary L., Michelle Bickler-Bluth, Dorothy G. Cooper, Allan E. Kolker, and Ronit Nesher. "Pattern reversal electroretinogram (PRERG) abnormalities in ocular hypertension: correlation with glaucoma risk factors." Current Eye Research 7, no. 2 (January 1988): 201–6. http://dx.doi.org/10.3109/02713688808995749.

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16

Kolar, Petr. "Risk Factors for Central and Branch Retinal Vein Occlusion: A Meta-Analysis of Published Clinical Data." Journal of Ophthalmology 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/724780.

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Retinal vein occlusion (RVO) is a major cause of vision loss. Of the two main types of RVO, branch retinal vein occlusion (BRVO) is 4 to 6 times more prevalent than central retinal vein occlusion (CRVO). A basic risk factor for RVO is advancing age. Further risk factors include systemic conditions like hypertension, arteriosclerosis, diabetes mellitus, hyperlipidemia, vascular cerebral stroke, blood hyperviscosity, and thrombophilia. A strong risk factor for RVO is the metabolic syndrome (hypertension, diabetes mellitus, and hyperlipidemia). Individuals with end-organ damage caused by diabetes mellitus and hypertension have greatly increased risk for RVO. Socioeconomic status seems to be a risk factor too. American blacks are more often diagnosed with RVO than non-Hispanic whites. Females are, according to some studies, at lower risk than men. The role of thrombophilic risk factors in RVO is still controversial. Congenital thrombophilic diseases like factor V Leiden mutation, hyperhomocysteinemia and anticardiolipin antibodies increase the risk of RVO. Cigarette smoking also increases the risk of RVO as do systemic inflammatory conditions like vasculitis and Behcet disease. Ophthalmic risk factors for RVO are ocular hypertension and glaucoma, higher ocular perfusion pressure, and changes in the retinal arteries.
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17

Buys, Yvonne M., Paul Harasymowycz, Rania Gaspo, Kenneth Kwok, Cindy M. L. Hutnik, Pierre Blondeau, Catherine M. Birt, et al. "Comparison of Newly Diagnosed Ocular Hypertension and Open-Angle Glaucoma: Ocular Variables, Risk Factors, and Disease Severity." Journal of Ophthalmology 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/757106.

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Purpose. To describe the distribution of ocular variables, risk factors, and disease severity in newly diagnosed ocular hypertension (OH) or open-angle glaucoma (OAG).Methods. Eligible subjects underwent a complete history and examination. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) obtained from multiple logistic regression models were used to compare OAG to OH and advanced to early/moderate OAG.Results. 405 subjects were enrolled: 292 (72.1%) with OAG and 113 (27.9%) with OH. 51.7% had early, 27.1% moderate, and 20.9% advanced OAG. The OR for OAG versus OH was 8.19 (P<0.0001) for disc notch, 5.36 (P<0.0001) for abnormal visual field, 1.45 (P=0.001) for worsening mean deviation, 1.91 (P<0.0001) for increased cupping, 1.03 for increased age (P=0.030), and 0.36 (P=0.010) for smoking.Conclusions. Increased age was a risk for OAG, and smoking decreased the risk of OAG compared to OH. Almost half of the OAG subjects had moderate/advanced disease at diagnosis.
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18

Elalfy, Mohamed, Sundas Maqsood, Shady Soliman, Sherif Momtaz Hegazy, Ahmed Abdou Hannoun, Zisis Gatzioufas, Damian Lake, and Samer Hamada. "Incidence and Risk Factors of Ocular Hypertension/Glaucoma After Descemet Stripping Automated Endothelial Keratoplasty." Clinical Ophthalmology Volume 15 (May 2021): 2179–88. http://dx.doi.org/10.2147/opth.s299098.

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19

Doshi, Vatsal, Mei Ying-Lai, Stanley P. Azen, and Rohit Varma. "Sociodemographic, Family History, and Lifestyle Risk Factors for Open-angle Glaucoma and Ocular Hypertension." Ophthalmology 115, no. 4 (April 2008): 639–47. http://dx.doi.org/10.1016/j.ophtha.2007.05.032.

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20

Kozina, E. V., P. M. Balashova, and S. V. Ivliev. "Intraocular pressure, eye pain and hemodialysis." Russian Ophthalmological Journal 15, no. 1 (March 26, 2022): 140–45. http://dx.doi.org/10.21516/2072-0076-2022-15-1-140-145.

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The review presents data on the effect of program hemodialysis on the state of intraocular pressure in patients with terminal chronic renal failure. Treatment with hemodialysis is accompanied by various effects: from intraocular pressure drop to the development of ophthalmic hypertension with pain syndrome. The state of the iris-corneal angle, neovascularization of the structures of the eye drainage system and the presence of glaucoma are significant, but not indisputable, risk factors for pain-related dialysis ophthalmic hypertension. Their combination with the effect on the osmolar balance of dialysis therapy increases the possibility of the formation of ocular hypertension syndrome formation. The need to eliminate dialysis eye pains and the chance of glaucoma progression due to dialysis-affected fluctuations of intraocular pressure remains relevant.
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Friedman, David S., M. Roy Wilson, Jeffrey M. Liebmann, Robert D. Fechtner, and Robert N. Weinreb. "An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma." American Journal of Ophthalmology 138, no. 3 (September 2004): 19–31. http://dx.doi.org/10.1016/j.ajo.2004.04.058.

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22

Langbøl, Mia, Sarkis Saruhanian, Thisayini Baskaran, Daniel Tiedemann, Zaynab A. Mouhammad, Anne Katrine Toft-Kehler, Bokkyoo Jun, Rupali Vohra, Nicolas G. Bazan, and Miriam Kolko. "Increased Antioxidant Capacity and Pro-Homeostatic Lipid Mediators in Ocular Hypertension—A Human Experimental Model." Journal of Clinical Medicine 9, no. 9 (September 15, 2020): 2979. http://dx.doi.org/10.3390/jcm9092979.

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The main risk factor for primary open-angle glaucoma (POAG) is increased intraocular pressure (IOP). It is of interest that about half of the patients have an IOP within the normal range (normal-tension glaucoma, NTG). Additionally, there is a group of patients with a high IOP but no glaucomatous neurodegeneration (ocular hypertension, OHT). Therefore, risk factors other than IOP are involved in the pathogenesis of glaucoma. Since the retina has a very high oxygen-demand, decreased autoregulation and a fluctuating oxygen supply to the retina have been linked to glaucomatous neurodegeneration. To assess the significance of these mechanisms, we have utilized a human experimental model, in which we stress participants with a fluctuating oxygen supply. Levels of oxidative stress molecules, antioxidants, and lipid mediators were measured in the plasma. Patients with NTG, OHT, and control subjects were found to have similar levels of oxidative stress markers. In contrast, patients with OHT had a higher level of total antioxidant capacity (TAC) and pro-homeostatic lipid mediators. Thus, we suggest that OHT patients manage fluctuating oxygen levels more efficiently and, thus, are less susceptible to glaucomatous neurodegenerations, due to enhanced systemic antioxidant protection.
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Purkait, Sanjib Kumar, Avik Dey Sarkar, Anil Kumar Ghanta, and Sanchari Sarkar. "Clinico-Social Profile of Patients Presenting with Primary Open Angle Glaucoma – A Retrospective Study from Paschim Midnapore, West Bengal." Journal of Evidence Based Medicine and Healthcare 8, no. 22 (May 31, 2021): 1792–96. http://dx.doi.org/10.18410/jebmh/2021/338.

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BACKGROUND Glaucoma is the second most leading cause of visual loss in the world. Different socio epidemiological parameters like gender, age, socio-economic status, educational status etc. has been directly linked to occurrence of glaucoma in previous studies. Review of the western literature showed that the risk factors associated with glaucoma were high intra ocular pressure (IOP), low blood pressure, low ocular perfusion pressure, narrow anterior chamber angles, thin corneas, pseudoexfoliation, a low body mass index (BMI), and myopia. We need to evaluate the clinical and epidemiological factors affecting primary open angle glaucoma. METHODS Records of patients with a diagnosis of primary open-angle glaucoma (POAG) were studied. All data, addressing demographics (gender, age and skin colour), socioeconomic status, educational status, emotional status and clinical information concerning risk factors for developing glaucoma (family history of glaucoma, hypertension and diabetes mellitus) and any treatment history (e.g., corticosteroid intake) were noted. Findings from visual acuity examination, refraction, detailed anterior segment examination by slit lamp, fundus examination with 90 D, gonioscopy, applanation tonometry, VF examination by automated perimetry and A-scan USG were also carefully taken into account. RESULTS A total 920 patients were enrolled of which 67.94 % were males and 57.6 % were from urban population. 18.7 % cases had positive family history. Most of the patients came from lower and middle-income group (43.48 % and 48.37 % respectively). Cup-disc ratio of majority of eyes was found to be more than 0.30 (97.29 %). Different grades of disc changes and field changes were noted. Cupdisc ratio asymmetry of more than 0.20 was found in 355 (38.59 %) eyes. Paracentral and / or arcuate scotoma was detected in 585 eyes (31.80 %). CONCLUSIONS Understanding the socio-demography and socio-economy helps in early diagnosis and better assessment of the disease severity in POAG. KEYWORDS Glaucoma, POAG, CDR, Visual Fields
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Pokharel, Suprada, Dakki Sherpa, and Om Krishna Malla. "Hypertension in Primary Open Angle Glaucoma." Journal of Nepal Medical Association 52, no. 194 (June 30, 2014): 771–74. http://dx.doi.org/10.31729/jnma.2728.

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Introduction: The impact of vascular factors in POAG is well known and controversial. Some reports have shown high blood pressure in POAG, some low systolic blood pressure and some described no difference in blood pressure between POAG and controls. However decreased ocular perfusion pressure was found in most of the studies. Our study aims to assess the role of hypertension in POAG . Methods: It was cross-sectional case–control hospital based study carried out from 1st June 2012 to 1st June 2013. There were 40 cases and 100 controls included in the study. The role of hypertension were compared with those hypertensive patients with glaucoma (cases) and hypertensive patients without glaucoma (controls). Results: Age above 50 years (odds ratio: 4.827 with 95% CI 1.862-12.517), male genders (odds ratio: 3.10 with 95% CI 1.356-7.146) and low diastolic perfusion pressure (odds ratio: 3.857 with 95% CI 1.362-11.224) showed strongly positive association with POAG. High systolic blood pressure (odds ratio: 1.476 95% CI 0.627-3.476), high diastolic blood pressure (odds ratio: 1.348 95% CI 0.587-3.096) and low systolic perfusion pressure (odds ratio: 1.8661 with 95% CI 0.649- 5.335) were weakly associated with glaucoma in our study. Conclusions: Age above 50 years, male gender and low diastolic perfusion pressure were strong risk factor for the development of POAG. Keywords: diastolic blood pressure; diastolic perfusion pressure; POAG; systolic blood pressure; systolic perfusion pressure.
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Waly, M., Amr Sharawy, Khaeld Wahba, Ayman Salah, and Islam Ibrahem. "Sensitivity of the Risk Factors for the Progression of Ocular Hypertension to Primary Open Angle Glaucoma." International Journal of Computer Applications 70, no. 22 (May 31, 2013): 34–42. http://dx.doi.org/10.5120/12202-8486.

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Lee, Josephine En Hui, Suresh Subramanian, Adil Hussein, Kursiah Mohd Razali, and Qi Zhe Ngoo. "Changes of Ocular Biometry and Intraocular Pressure in Patients Treated With Intravitreal Injection of Antivascular Endothelial Growth Factors." Malaysian Journal of Medicine and Health Sciences 18, no. 5 (September 15, 2022): 144–50. http://dx.doi.org/10.47836/mjmhs.18.5.20.

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Introduction: Anti-vascular endothelial growth factors (anti-VEGF) intravitreal injection is one of the popular procedures for medical retina diseases. However, the incidence of angle-closure post intravitreal injection was reported. Several similar studies were conducted previously, but the results were inconsistent and mostly focused on bevacizumab. Methods: A prospective cohort study was conducted. After informed consent, patients who were more than 17 years old and received the first intravitreal anti-VEGF injections (ranibizumab or aflibercept) were recruited. Exclusion criteria included patients with underlying glaucoma, ocular hypertension, intumescence cataract, high refractive error or those with history of intraocular operation or ocular trauma. Pre- and post-injection’s intraocular pressure (IOP) and ocular biometry included “central anterior chamber depth” (CACD), “angle opening distance” (AOD500), and “trabeculo-iris angle” (TIA500) at nasal and temporal 500 µm away the scleral spur were acquired and analyzed. Results: 72 eyes from 66 patients were studied. Mean (SD) increment of IOP following injection within 30 minutes and 1 hour were 6.16 (0.68) mmHg (p<0.001) and 1.26 (0.35) mmHg (p=0.002) respectively. Mean (SD) differences of temporal TIA500 between pre with within 30 minutes and 1-hour post-injection were 1.66 (0.66) degrees (p=0.04) and 1.45 (0.57) degrees (p=0.04) respectively. No significant relationship between the changes of IOP and ocular biometry was found. Conclusion: A single dose of anti-VEGF in a normal population is relatively safe. However, concern on the risk of glaucoma progression and acute angle-closure still needs to be addressed. Further studies on at-risk populations and repeated injections are useful.
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Baudouin, Christophe, Jean-Paul Renard, Jean-Philippe Nordmann, Philippe Denis, Yves Lachkar, Eric Sellem, Jean-François Rouland, Viviane Jeanbat, and Stéphane Bouée. "Prevalence and Risk Factors for Ocular Surface Disease among Patients Treated over the Long Term for Glaucoma or Ocular Hypertension." European Journal of Ophthalmology 23, no. 1 (January 2013): 47–54. http://dx.doi.org/10.5301/ejo.5000181.

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28

Nicolai, Michele, Nicola Lassandro, Alessandro Franceschi, Alessandro Rosati, Serena De Turris, Paolo Pelliccioni, Vittorio Pirani, and Cesare Mariotti. "Intraocular Pressure Rise Linked to Silicone Oil in Retinal Surgery: A Review." Vision 4, no. 3 (August 13, 2020): 36. http://dx.doi.org/10.3390/vision4030036.

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Silicone oil represents the main choice for intraocular tamponade in cases of complicated retinal detachment surgery. The intraocular pressure of an eye filled with silicone oil could increase, driven by a variety of different forces, according to several mechanisms. Two main conditions have been highlighted, depending on the onset: early hypertension or late glaucoma. The different types of silicone oils and their physico-chemical properties are varied and may play a role in the determination of intraocular pressure rise. The current body of literature allows for the illustration and categorization of the incidence and risk factors, as well as the pathogenesis and the management of the early postoperative hypertension subtended by an open- and closed-angle, along with the late onset silicone oil-induced glaucoma. Understanding the leading actors on the stage of ocular pressure elevation concurrently with silicone oil application for retinal surgery could help in guiding the timely and appropriate course of treatment.
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Sharif, Najam A. "Neuropathology and Therapeutics Addressing Glaucoma, a Prevalent Retina-Optic Nerve-Brain Disease that Causes Eyesight Impairment and Blindness." OBM Neurobiology 6, no. 1 (January 24, 2022): 1. http://dx.doi.org/10.21926/obm.neurobiol.2201116.

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Glaucomatous optic neuropathy (GON) associated with different forms of glaucoma and chronic ocular hypertension (cOHT) is characterized by progressive loss of retinal ganglion cells and their axons in the optic nerves that project to the brain to transmit visual information. The resultant thinning of the optic nerves cause loss of peripheral vision, which if not halted or slowed, can lead to irreversible blindness. Whilst the precise triggering insult(s) for the primary open angle glaucoma (POAG), the most prevalent of the glaucomas, remains unknown, the most prominent risk factors include elevated intraocular pressure, increasing age, African-American heritage (genetic predisposition), family history, low cerebral spinal/intracranial pressure, and vascular dysfunctions within the retina. However, whilst reduction of IOP by topical ocularly administered medications is the first-line therapeutic approach to address cOHT / POAG, surgical procedures and aqueous humor drainage devices are also useful means to lower IOP. It is hoped that the intense research into mechanisms underlying neurodegeneration has the potential to lead to discovery of potential neuroprotective and neuroregenerative agents s and technologies including novel sustained drug delivery platforms, gene therapy, cell therapy, physical support systems, food-derived nutrient treatments, neurostimulation via optogenetic, electrical and sonogenetic tools, yielding suitable treatments to treat cOHT / POAG and the attendant GON.
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Suzuki, Yukihisa, and Motohiro Kiyosawa. "Cardiac Hypertrophy May Be a Risk Factor for the Development and Severity of Glaucoma." Biomedicines 10, no. 3 (March 15, 2022): 677. http://dx.doi.org/10.3390/biomedicines10030677.

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The purpose of this study was to examine the relationship between glaucoma and cardiac abnormalities. We evaluated 581 patients with open-angle glaucoma (285 men and 296 women) and 595 individuals without glaucoma (273 men and 322 women). All of the participants underwent visual field testing using a Humphrey Visual Field Analyzer (30-2 program), an electrocardiogram (ECG), and blood pressure measurement. We examined the ECG abnormalities and other factors (age, intraocular pressure (IOP) and systemic hypertension) involved in the development and severity of glaucoma. Logistic regression analyses revealed significant correlations of glaucoma with IOP (OR = 1.43; 95% CI: 1.36–1.51; p < 0.00001), atrial fibrillation (OR = 2.02; 95% CI: 1.01–4.04; p = 0.04), left ventricular hypertrophy (LVH) (OR = 2.21; 95% CI: 1.15–4.25; p = 0.02), and bradycardia (OR = 2.19; 95% CI: 1.25–4.70; p = 0.02). Regression analyses revealed significant correlations of the mean deviation of the visual field with age (t = –6.22; 95% CI: −0.15, −0.08; p < 0.00001), IOP (t = −6.47; 95% CI: −0.42, −0.23; p < 0.00001), and LVH (t = −2.15; 95% CI: −3.36, −0.29; p = 0.02). Atrial fibrillation, LVH and bradycardia may decrease the cerebral blood flow, and may also affect the ocular blood flow. Cardiac abnormalities may be associated with the development and severity of glaucoma.
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Shi, Rui, Di Li, Xuan-Yi Che, and Rechard Hom. "Potential risk factors and treatment of IOP elevation after operation in retinal detachment eyes of diabetic patients." International Eye Research 1, no. 4 (December 28, 2020): 234–39. http://dx.doi.org/10.18240/ier.2020.04.06.

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AIM: To observe the intraocular pressure (IOP) fluctuation at the early stage of pars plana vitrectomy (PPV) and silicon oil tamponade in high myopia with rhegmatogenous retinal detachment (RRD) eyes in diabetic patients and analyze the potential risk factors and effective treatment. METHODS: One hundred consecutive diabetic patients of RRD in highly myopic eyes were retrospectively reviewed. Patients were divided into two groups: the experimental group, those who used Tobramycin Dexamethasone Eye Drops (TDED), and control group. Pre- and postoperative IOPs, retinal nerve fiber thickness (RNFL) and optic nerve head parameters were recorded before and after IOP elevation, and in the contralateral eye before the operation. Graphpad 7.01 was used for data analysis. RESULTS: IOP elevation occurred in 42 eyes within 1wk after vitrectomy in all diabetic participants. Ocular hypertension (OHTN) was observed in 31 of 53 eyes in experimental group and 11 eyes of 47 eyes in control group at the early stage after operation. Significant differences were found between groups in 5d-1wk and 1mo after vitrectomy. In addition, IOP of 39 eyes had decreased by proper treatment and 3 eyes received glaucoma filtration surgery. Compared to the optic disc parameters before IOP elevation, the average and inferior RNFL thickness were thinner and rim area decreased as well as cup volume and vertical C/D radio increased after IOP elevation. The RNFL thickness of the opposite eyes in patients with IOP elevation was found thinner than the ones who never suffered ocular hypertension. CONCLUSION: Continual use of glucocorticoid after vitrectomy is a potential risk factor of IOP elevation in high myopia with diabetes, and doubtful open angle glaucoma should be focused on its sensibility to glucocorticoid and IOP elevation.
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Xu, Sarah C., Angela C. Gauthier, and Ji Liu. "The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns." Journal of Ophthalmology 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/4727423.

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Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments.
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Kovalevskaya, Maria, Alexander Myagkov, and Olga Donkareva. "What makes us meet a patient with ametropia cautiously?" Eye 125, no. 2019-1 (2019): 14–24. http://dx.doi.org/10.33791/2222-4408-2019-1-14-24.

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Purpose: To assess the presence of risk factors for ocular hypertension among students in Voronezh and its connection with various types of ametropia. Material and methods. The present study involved 835 students (454 women, 381 men, 1670 eyes) aged 18 to 27, the average age was 21.2±1.3. Among these students, 442 students (52.9%) had emmetropia, 116 students (13.9%) – hyperopia and 277 students (33.2%) – myopia. The presence of risk factors for the development of glaucoma in medical history was studied using a questionnaire. Complex inspection included visometry, direct ophthalmoscopy, induction-based tonometry. Results. Slightly more than half of the students in the age group from 18 to 27 years had emmetropia, and every fourth had myopia. The IOP level of 22 mm Hg and higher was detected using non-contact tonometry in 6.8% of students, 43.9% of them had risk factors for the development of glaucoma. Students with high myopia had 6 times higher risk of glaucoma development compared to those with mild or moderate myopia, hyperopia and emmetropia. No reliable data on the increase of IOP when comparing it to groups with various types of ametropia was obtained. Conclusion. According to the screening results of 835 students, the risk factors for glaucoma and other eye diseases were studied and analyzed, refractive errors were revealed, IOP was evaluated with an Icare tonometer, the relation of IOP with ametropia type, visual acuity and visual acuity with habitual correction was studied.
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Suryaningrum, I. Gusti Ayu Ratna, I. Made Agus Kusumadjaja, and Ni Made Laksmi Utari. "Central Corneal Thickness in Ocular Hypertension Patients in Sanglah General Hospital Bali." Jurnal Kesehatan Prima 15, no. 1 (February 28, 2021): 83. http://dx.doi.org/10.32807/jkp.v15i1.652.

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Ocular hypertension (OH) is a risk factor in glaucoma and modifiable in its early stages. Goldmann applanation tonometer (GAT) is still the gold standard in measuring intraocular pressure (IOP) which is an important parameter in diagnosing and managing glaucoma. Several factors can affect the accuracy of the GAT, one of them is the thickness of the central cornea. This descriptive study was intended to describe the central corneal thickness (CCT) characteristics of the OH patients. The study was conducted at Eye Clinic - Sanglah General Hospital Denpasar which involved 32 patients with 46 eyes diagnosed with HO in 2018. The mean age of subjects was 43.98 (± 17.92), men had a larger proportion (68.1 %). Sixty-six per cent of patients were diagnosed with bilateral OH. In this study, the mean central corneal thickness in HO subjects was 573.81 ± 33.46 μm. The patients' median vertical cup to disc ratio at the time of diagnosis was 0.33, with a mean visual acuity of 0.85. The median value of IOP at the first time of examination was 24.47 mmHg.Central corneal thickness is known to have a positive correlation with IOP, thus affecting the accuracy of IOP measurements. The thicker central corneal thickness will lead to overestimation of the IOP and the thinner one will cause underestimation.
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Stroh, Inna G., Ahmadreza Moradi, Bryn M. Burkholder, Dana M. Hornbeak, Theresa G. Leung, and Jennifer E. Thorne. "Occurrence of and Risk Factors for Ocular Hypertension and Secondary Glaucoma in Juvenile Idiopathic Arthritis-associated Uveitis." Ocular Immunology and Inflammation 25, no. 4 (March 22, 2016): 503–12. http://dx.doi.org/10.3109/09273948.2016.1142573.

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Coleman, Anne L., Mae O. Gordon, Julia A. Beiser, and Michael A. Kass. "Baseline risk factors for the development of primary open-angle glaucoma in the Ocular Hypertension Treatment Study." American Journal of Ophthalmology 138, no. 4 (October 2004): 684–85. http://dx.doi.org/10.1016/j.ajo.2004.05.030.

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37

Brusini, Paolo, Maria Letizia Salvetat, and Marco Zeppieri. "How to Measure Intraocular Pressure: An Updated Review of Various Tonometers." Journal of Clinical Medicine 10, no. 17 (August 27, 2021): 3860. http://dx.doi.org/10.3390/jcm10173860.

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Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.
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Pedrotti, Emilio, Christian Luigi Demasi, Enrico Bruni, Francesca Bosello, Paolo Plinio Di Sarro, Mattia Passilongo, Adriano Fasolo, et al. "Prevalence and risk factors of eye diseases in adult patients with obstructive sleep apnoea: results from the SLE.E.P.Y cohort study." BMJ Open 7, no. 10 (October 2017): e016142. http://dx.doi.org/10.1136/bmjopen-2017-016142.

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ObjectivesTo assess the occurrence of glaucoma, eyelid, corneal and macular disorders in a cohort of patients with obstructive sleep apnoea (OSA) diagnosed by overnight polysomnography and to investigate into the risk factors for the above eye diseases (EDs).DesignCross-sectional cohort study between 2014 and 2015.SettingUnit of Respiratory Medicine and Eye Clinic of the University of Verona.Participants431 consecutive patients were considered eligible. Of these, 87 declined to participate, 35 were untraceable and 13 were deceased.InterventionsA complete ophthalmic evaluation of both eyes for each patient.Primary and secondary outcome measuresBest-corrected distance visual acuity, intraocular pressure, corneal, macular and optic nerve optical coherence tomography, ocular aberrometry, optic nerve laser polarimetry, visual field test, and eyelid examination.Results296 patients aged 64.5±12.8 years, 23% female and 77% male, underwent ophthalmic examination. There was 56% (n=166) prevalence of eyelid disorders, 27% (n=80) of corneal disorders, 13% (n=39) of macular disorders and 11% (n=33) of glaucoma. Advancing age was not associated with the severity of OSA, while significant differences were found for gender, body mass index, Oxygen Desaturation Index, smoking habit, hypertension and diabetes. Severe OSA was significantly associated with glaucoma (OR, 95% CI 1.05 to 5.93, p=0.037).ConclusionsEDs were more prevalent in our patinets with OSA than in the general population. Severe Apnoea/Hypopnoea Index level seemed to play a role as risk factor only for glaucoma.
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Garcia-Villanueva, Carolina, Elena Milla, José M. Bolarin, José J. García-Medina, Javier Cruz-Espinosa, Javier Benítez-del-Castillo, José Salgado-Borges, et al. "Impact of Systemic Comorbidities on Ocular Hypertension and Open-Angle Glaucoma, in a Population from Spain and Portugal." Journal of Clinical Medicine 11, no. 19 (September 25, 2022): 5649. http://dx.doi.org/10.3390/jcm11195649.

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Open-angle glaucoma (OAG), the most prevalent clinical type of glaucoma, is still the main cause of irreversible blindness worldwide. OAG is a neurodegenerative illness for which the most important risk factor is elevated intraocular pressure (IOP). Many questions remain unanswered about OAG, such as whether nutritional or toxic habits, other personal characteristics, and/or systemic diseases influence the course of glaucoma. As such, in this study, we performed a multicenter analytical, observational, case–control study of 412 participants of both sexes, aged 40–80 years, that were classified as having ocular hypertension (OHT) or OAG. Our primary endpoint was to investigate the relationship between specific lifestyle habits; anthropometric and endocrine–metabolic, cardiovascular, and respiratory events; and commonly used psychochemicals, with the presence of OHT or OAG in an ophthalmologic population from Spain and Portugal. Demographic, epidemiological, and ocular/systemic clinical data were recorded from all participants. Data were analyzed using the R Statistics v4.1.2 and RStudio v2021.09.1 programs. The mean age was 62 ± 15 years, with 67–80 years old comprising the largest subgroup sample of participants in both study groups. The central corneal thickness (ultrasound pachymetry)-adjusted IOP (Goldman tonometry) in each eye was 20.46 ± 2.35 and 20.1 ± 2.73 mmHg for the OHT individuals, and 15.8 ± 3.83 and 16.94 ± 3.86 mmHg for the OAG patients, with significant differences between groups (both p = 0.001). The highest prevalence of the surveyed characteristics in both groups was for overweight/obesity and daily coffee consumption, followed by psychochemical drug intake, migraine, and peripheral vasospasm. Our data show that overweight/obesity, migraine, asthma, and smoking are major risk factors for conversion from OHT to OAG in this Spanish and Portuguese population.
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Landers, John, Ivan Goldberg, and Stuart L. Graham. "Analysis of risk factors that may be associated with progression from ocular hypertension to primary open angle glaucoma." Clinical & Experimental Ophthalmology 30, no. 4 (July 23, 2002): 242–47. http://dx.doi.org/10.1046/j.1442-9071.2002.00528.x.

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41

Bangal, Dr Surekha V., Dr Bhushan Patil, and Dr Akshita Sharma. "Clinical Study of Risk Factors for Diabetic Maculopathy." VIMS Health Science Journal 8, no. 1 (March 18, 2021): 9–13. http://dx.doi.org/10.46858/vimshsj.8103.

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Aim: To determine the association between various systemic risk factors with diabetic maculopathy. Methodology: A prospective observational study was conducted on 50 patients having diabetic maculopathy. Patients with maculopathies secondary to Vitreous Haemorrhage, Ocular disorders like Glaucoma, Uveitis, Advanced Diabetic Eye Disease, Vitreo-macular traction, maculopathy along with proliferative diabetic retinopathy, ischemic maculopathy, and history of laser treatment in last six months were excluded from the study. Data was collected using a structured proforma that included name, age, sex, occupation, height, weight, history of other systemic diseases like hypertension, investigations and treatment taken in past, family history, duration of DM, smoking, hyperlipidemia, hyperglycemia and nephropathy. Results: Out of 50 patients, 38 (76%) were males and 12 (24%) were females suggestive of male predominance. Mean age of the patient was 57.36±11.65 years in males and 56.67±10.17 years in females. Among 50 patients, 19 patients had diabetes mellitus for 6-10 years duration, 14 patients had diabetes mellitus for 1-5 years, in 12 patients for 11-15 years, in 2 patients for 16-20 years, in 2 patients for 21-25 years and only 1 patient more than 25 years. Mean duration of DM was 12.2±6.1 years. Majority of patients having maculopathy had duration of DM up to 20 years. Among 50 patients, 27 patients (54%) had systemic hypertension, 37 patients (74%) had uncontrolled blood sugar level, 29 patients (58%) were found to have hyperlipidemia and 20 patients (40%) had nephropathy. Among 50 patients, pseudophakia was noted in 7 patients (14%), obesity was noted in 21patients (42%). Eleven patients (22%) were found to have anemia, 6 patients (12%) had family history of DM and 13 patients (26%) had history of smoking. Conclusion: Hyperglycemia, hypertension, duration of DM, hyperlipidemia are the major risk factors for the development and progression of diabetic maculopathy. While anemia, smoking, and obesity, family history of DM are the less significant risk factors.
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Wu, Jo-Hsuan, Jih-Shuin Jerng, and Chien-Chia Su. "Insidious-onset, non-wheezing carteolol-induced asthma in an atopic patient without asthma history." BMJ Case Reports 12, no. 4 (April 2019): e229343. http://dx.doi.org/10.1136/bcr-2019-229343.

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Carteolol, a non-selective beta-antagonist with a potential risk of severe bronchial constriction in patients with asthma, is one of the most commonly prescribed medication for managing ocular pressure in glaucoma. We present a case of a 24-year-old woman with a history of atopy but no known asthma who presented an insidious onset of clinical manifestations compatible with drug-induced asthma after the initiation of carteolol for ocular hypertension control. The patient developed progressive chest tightness and dyspnoea for 2 months before the pulmonary function test revealed a positive bronchoprovocation response. She reported significant improvement of respiratory symptoms within 2 weeks after the discontinuation of carteolol, and a negative provocation response was later confirmed by repeat pulmonary function test. In conclusion, eye drops with non-selective beta-antagonising effect can induce asthmatic symptoms in patients without a previous diagnosis of asthma and should be administered with caution in patients with associated risk factors.
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Gavrilova, Tatyana V., Aliya R. Kinkulkina, Hasmik S. Avagyan, and Oksana A. Svitich. "Association between polymorphic <i>eNOS</i> gene markers and risk of primary open-angle glaucoma in the Perm Region population." Russian Journal of Immunology 25, no. 1 (August 3, 2022): 83–92. http://dx.doi.org/10.46235/1028-7221-1081-abp.

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Glaucoma is widely known to have a progressive course and occupy a leading place among the causes of vision loss and blindness. Increased intraocular pressure is the key harmful factor among the causes of glaucoma occurrence. In some cases, however, the progressive disease is also observed at normal values of ophthalmic tonus. Early diagnosis of glaucoma will allow for timely therapy, which in turn will reduce the risk of complications and prevent neuroopticopathy progression. According to the literature data, the pathogenesis of primary open-angle glaucoma is associated with nitric oxide (NO), due to imbalance between endothelium-produced vasoconstrictors and vasodilators, especially, endotelin-1 and nitric oxide. Decreased NO level combined with endotelin-1 hyperproduction is associated with development and progression of a number of ocular disorders including glaucomatous atrophy of the optic nerve. Since nitric oxide is produced by endothelial NO-synthase (eNOS), one may assume that eNOS is involved in pathogenesis of neurodegenerative changes in primary open-angle glaucoma. However, despite numerous studies on the pathogenesis of glaucoma, the distinct factors of innate immune response remain poorly studied. The purpose of the present study was a search for association between polymorphic markers (C774T, T786C, Glu298Asp) of the eNOS gene and the risk of primary open-angle glaucoma among the Perm Region residents. Peripheral blood of patients with primary open-angle glaucoma (the main group) and cataract without glaucoma (a comparison group) was used as initial biomaterial. In comparison group, arterial hypertension was most often encountered as concomitant pathology. Genomic DNA was first isolated from the blood samples, followed by rt-PCR using reagent kits for determining C774T, T786C, Glu298Asp polymorphic markers in the eNOS gene. The prevalence of polymorphic variants of the innate immunity genes T786C, C774T and Glu298Asp of the eNOS gene was analyzed in patients with primary open-angle glaucoma. There were no significant differences in the distribution of genotypes and alleles of eNOS gene for the C774T and Glu298Asp polymorphic markers. An increased frequency of homozygous TT genotype was found, along with decreased occurrence of C allele at the polymorphic T786C locus of the eNOS gene, as well as a trend for decreased frequency of the TC and CC genotypes. Arterial hypertension potentiated the negative effect of increased intraocular pressure upon the glaucoma-associated optic neuropathy. Conclusions. The studied changes in genotypes and allelic frequencies of eNOS gene may be regarded as risk factors that increase probability of the primary open-angle glaucoma and predict severity of the disease.
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Myers, J. S. "Sociodemographic, Family History, and Lifestyle Risk Factors for Open-angle Glaucoma and Ocular Hypertension: The Los Angeles Latino Eye Study." Yearbook of Ophthalmology 2009 (January 2009): 51–52. http://dx.doi.org/10.1016/s0084-392x(09)79090-2.

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Středová, Markéta, Libor Hejsek, Jana Nekolová, and Naďa Jirásková. "Suprachoroidal Haemorrhage in Postoperative Period of Antiglaucoma Surgery, Case Report." Czech and Slovak Ophthalmology 75, no. 2 (February 21, 2019): 92–98. http://dx.doi.org/10.31348/2019/2/6.

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Suprachoroidal haemorrhage (SCH) is a serious complication of intraocular procedures. Physiologically there is only a minimal amount of fluid in the suprachoroid space, pathologically the fluid volume increases, which causes ablation of the choroid. SCH could be divided into different cathegories, according to the character of the fluid into serous and haemorrhagic; by the time of occurrence in relation to the surgery into peroperative and postoperative. Diagnosis is based on biomicroscopic and ultrasound examinations. The ocular risk factors for SCH are glaucoma, myopia and aphakia; systemic risk factors include vascular fragility, arterial hypertension and blood coagulation disorders. In the pathogenesis hypotonia of the eye, that causes rupture of the ciliary vessels, plays a very important role. SCH can be treated both conservatively and surgically. As to pharmacotherapy we use gabapentin to suppress neuropathic pain and prednisone, topical mydriatics and anti-inflammatory agents. The type of surgical treatment differs according to time of occurrence, if SCH occurs during the operation, the intervention consists mainly in the wound closure and the repositioning of the weakening tissues; in postoperative forms, we choose drainage procedures, possibly vitreoretinal procedures. Our patient, an 80-year-old myop and chronic glaucomatic treated intensively both topically and systematically underwent trabeculectomy on his left eye due to unsatisfactory intraocular pressure (IOP) and significant glaucoma progression. The surgical intervention went without any complications. In the early post-operative period, there was persisting elevation of IOP, therefore sclera lap was discontinued and 5-fluorouracil was applied under the filter blister. Subsequent hypotonia caused a hemorrhagic SCH with intraocular hypertension, which was resolved by draining the blood with sclerotomias and thus releasing intraocular hypertension. The visual acuity of the left eye gradually improved to almost original values. Intraocular pressure, however, is not well compensated despite many following antiglaucoma surgeries. Therefore, even with the patient‘s maximum therapy, glaucoma continues to progress. In our case, we confirm that it is possible to solve even the relatively most complicated cases of SCH. We stress the necessity to consider the presence of risk factors of the occurrence of SCH before indicating intraocular procedures and also recommend thinking carefully about other less invasive surgical techniques. In glaucoma, it is appropriate taking in account the prediction of life compared to the expected rate of progression of vision loss.
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Wittström, Elisabeth. "Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature." Open Ophthalmology Journal 11, no. 1 (May 22, 2017): 89–102. http://dx.doi.org/10.2174/1874364101711010089.

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Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature. Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors. Results: Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (µm) at the initial examination to 243.8±48.1 (µm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (µm) in the ischemic CRVO group, which decreased to 211.5±20.2 (µm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described. Conclusion: The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.
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47

Jain, Pragti, Anita Minj, and Ramesh Chandra Mahapatra. "Correlation between Central Corneal Thickness Corrected Intraocular Pressure with Systolic Hypertension in Adults Over 40 Years in a Tertiary Eye Care Centre." Journal of Evidence Based Medicine and Healthcare 8, no. 12 (March 22, 2021): 726–31. http://dx.doi.org/10.18410/jebmh/2021/142.

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BACKGROUND Glaucoma is a chronic, progressive optic neuropathy leading to irreversible blindness. Raised intraocular pressure is one of the modifiable risk factors of developing glaucoma. Regulation of intraocular pressure (IOP) is influenced by various factors and, systolic hypertension is one of them. The objectives of the study was to assess the relationship between systolic hypertension and IOP, also to see the effect of controlled and uncontrolled systolic blood pressure (SBP) on IOP in adults above 40 years of age. METHODS This study included a total of 230 known systemic hypertensive patients of age above 40 years. All the patients underwent detailed history taking, careful systemic and ocular examination. IOP was measured by Goldmann applanation tonometer, central corneal thickness (CCT) by anterior segment optical coherence tomography (OCT) and blood pressure (BP) was recorded after 5 minutes of rest. The data was recorded. RESULTS Correlation coefficient for SBP and IOP in right eye (RE) was 0.290 and for left eye (LE) was 0.354 with a probability value of P < 0.0001 which was statistically highly significant. Mean IOP for controlled SBP was 17.76 mmHg in both eyes (BE) which increased to 20.19 mmHg in RE and 20.64 mmHg in LE in uncontrolled SBP. The Z score value between controlled and uncontrolled systolic hypertensive patients in RE and LE was 6.11 and 7.06 respectively (P < 0.0001). There was an increment of IOP for every 10 mmHg in SBP by 0.56 mmHg in right eye and 0.73 mmHg in left eye. CONCLUSIONS Systolic blood pressure is significantly correlated with IOP. The uncontrolled SBP was related to higher mean IOP and mean IOP was found to increase with rise in SBP. Therefore, patients with known hypertension and glaucoma have to be regularly followed-up and should keep their BP in normal range to prevent disease progression. KEYWORDS Intraocular Pressure, Central Corneal Thickness, Systolic Blood Pressure, Adults Above 40 Years
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Shoeb Ahmad, Syed, Shuaibah Abdul Ghani, Daljit Singh, and Lott Pooi Wah. "The Dynamics of Aqueous Humor Outflow—A Major Review." US Ophthalmic Review 07, no. 02 (2014): 137. http://dx.doi.org/10.17925/usor.2014.07.02.137.

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Aqueous humor outflow occurs through the conventional and unconventional pathway. With aging, the latter becomes less active so that the conventional pathway remains the primary mechanism of aqueous humor outflow. An abnormality of this pathway contributes significantly to disordered aqueous humor dynamics and consequent rise in intraocular pressure seen in primary open angle glaucoma and ocular hypertension. Recently, the ocular lymphatics have been implicated in aqueous humor outflow. Additionally, the trabecular meshwork is now understood to be a complex organization of structures, which are controlled by various biomechanical and biochemical mechanisms. Among others, these include the actinomyosin cytoskeletal system, extracellular matrix, intracellular signaling responses mediated by protein kinase C, Rho/Rho kinase, and other biologic factors. This review shall describe the various pathophysiologic mechanisms involved in aqueous humor dynamics.
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Salvetat, M. L., M. Zeppieri, C. Tosoni, and P. Brusini. "Baseline factors predicting the risk of conversion from ocular hypertension to primary open-angle glaucoma during a 10-year follow-up." Eye 30, no. 6 (May 13, 2016): 784–95. http://dx.doi.org/10.1038/eye.2016.86.

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50

Mannava, Sishir, Luis F. Torres, Keith G. DeSousa, Dileep R. Yavagal, Nicolas A. Yannuzzi, Harry W. Flynn, and Amer M. Malik. "Severe Neovascular Glaucoma Exacerbation as a Complication of Carotid Artery Stenting: A Case Report." Neurohospitalist 10, no. 4 (May 22, 2020): 301–4. http://dx.doi.org/10.1177/1941874420923914.

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Introduction: Neovascular glaucoma (NVG) has been rarely reported as an acute complication of carotid endarterectomy, but there is scant literature available regarding this potential condition following carotid artery stenting (CAS). We present a case of severe worsening of NVG occurring after bilateral CAS with progressive deterioration of vision ultimately leading to blindness. Case Description: A 66-year-old male with multiple stroke risk factors, bilateral cataract extraction, proliferative diabetic retinopathy of left eye, and nonproliferative diabetic retinopathy of right eye, and prior left eye pars plana vitrectomy presented with episodes of transient right eye vision loss in context of bilateral high-grade internal carotid artery stenoses. He underwent right CAS with subsequent elevation of bilateral intraocular pressures (IOPs) concerning for acute NVG. Over time, the patient had some interval improvement in IOPs and underwent planned left CAS. After the procedure, he again developed elevated IOPs, concerning for acute NVG which eventually led to right eye pars plana vitrectomy for vitreous hemorrhage and refractory IOP elevation. At 6-month follow-up from initial stenting, the patient was blind in both eyes. Discussion: We present a case of recurrent IOP elevations following CAS eventually resulting in bilateral eye blindness. This case is important not only as an illustration of an underrecognized postprocedural CAS complication but also as a demonstration of likely elevated risk of NVG following CAS for patients with other predisposing risk factors for ocular hypertension such as glaucoma, proliferative diabetic retinopathy, prior cataract extraction, and prior pars plana vitrectomy.
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