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Lee, Yan-yee Jacinta. "Ultrastructural basis of steroid-induced ocular hypertension." Click to view the E-thesis via HKUTO, 2010. http://sunzi.lib.hku.hk/hkuto/record/B43957869.
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Lee, Yan-yee Jacinta, and 李茵怡. "Ultrastructural basis of steroid-induced ocular hypertension." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B43957869.
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Kerr, Jan M. "Ocular blood flow in untreated ocular hypertension and primary open angle glaucoma." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/24770.
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PURPOSE: To compare ocular and systemic circulation and haematological factors affecting perfusion in groups of untreated ocular hypertensives (OHT) and primary open angle glaucoma patients (POAG) matched for IOP. METHODS: This was a prospective observational study. Twenty seven high risk OGT (IOP>25mmHg), 24 low risk OHT (IOP<26mmHg), 24 POAG patients and 234 normal subjects were recruited. Subjects were admitted for a morning during which the following measurements were made; intraocular pressure, visual fields, sitting standing and supine pulsatile ocular blood flow, scanning laser Doppler retinal blood flow and finger tip laser doppler blood flow. Venous blood was taken for the following; full blood count, manual fibrinogen, D-dimer, prothrombin fragments F1 and 2, von Willebrand antigen and beta-thromboglobin. RESULTS: Pulsatile ocular blood flow: High risk ocular hypertensives (HROHT) were similar to POAG subjects in terms of their pulsatile ocular blood flow and both groups had reduced POBF compared to normal. POAG had a smaller fall in POBF on lying down that the other 3 groups. Scanning laser doppler flow: POAG had reduced blood flow at the optic cup and increased blood flow in the temporal retina compared to HROHT matched for IOP. Finger tip laser doppler flow: No difference in fingertip blood flow was found between HROHT and POAG. Haematology: A small but significant increase in platelets and fibrinogen was seen in POAG compared to normals. There was no differences between HROHT and POAG. CONCLUSIONS: Ocular hypertensives with IOP above 25mmHg have levels of POBF similar to POAG. Differences in the response of POBF to changing posture and the distribution of blood flow in the retina in POAG compared to OHT point to a failure of control of ocular blood flow as a possible factor in the aetiology of glaucoma.
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Garbe, Edeltraut. "Glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29696.pdf.
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Garbe, Edeltraut. "Glucocorticoids and the risks of ocular hypertension of open-angle glaucoma." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27321.
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This thesis presents results of a case-control study investigating the excess risk of ocular hypertension or open-angle glaucoma associated with the use of oral, inhaled and nasal glucocorticoids. Data on 9,793 cases and 38,325 control subjects were obtained from the computerized administrative health databases of the province of Quebec, Canada.For oral glucocorticoids, a 40% increase in the risk of ocular hypertension or open-angle glaucoma was observed. The risk increased with higher daily doses and increasing duration of treatment.
Exposure to inhaled glucocorticoids was not associated with an elevated risk, except when they were administered in high doses over extended periods of time. No elevated risk was observed for exposure to nasal glucocorticoids.
The study results are discussed in view of pharmacological data for different forms of glucocorticoids and compared to findings for ophthalmic glucocorticoids. The database is used to illustrate empirical explorations of concerns about bias.
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Rowe, Fiona J. "Idiopathic intracranial hypertension : assessment of visual function and prognosis for visual outcome." Thesis, Anglia Ruskin University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299989.
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Landers, John Arthur William. "Epidemiological study of risk factors associated with progression from ocular hypertension to primary open angle glaucoma." Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/798.
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Background: As a multifactorial disease glaucoma may be associated with pressure-dependent and -independent factors. Ocular hypertension (OHT) may develop into primary open angle glaucoma (POAG) for many patients. We compared groups with OHT and POAG for pressure-dependent and -independent risk factors. A high prevalence of any factor(s) could indicate a contribution to progression from OHT to POAG. Method: A sample of patients with POAG (n 438) and with OHT (n 301) were selected from those attending a tertiary referral private glaucoma practice, and data were collected regarding age and intraocular pressure at the time of diagnosis, gender, family history of glaucoma, systemic hypertension, diabetes, Raynaud's phenomenon, migraine and myopia. Results: After multivariate analysis, older age at time of diagnosis (P<0.001), myopia (odds ratio (O.R) 1.5, 95percent confidence interval (C.I)1.0-2.2; P 0.05), a family history of glaucoma (O.R 1.6, 95 percent C.I 1.1-2.3; P 0.01) and a high intraocular pressure (P 0.002) were associated with POAG. No other significant differences were found between the two groups. Conclusion: Patients who have OHT may be at higher risk of developing POAG if they also have myopia, a family history of glaucoma or are of older age.
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Landers, John Arthur William. "Epidemiological study of risk factors associated with progression from ocular hypertension to primary open angle glaucoma." University of Sydney. Population Health and Health Sciences Research, 2001. http://hdl.handle.net/2123/798.
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Background: As a multifactorial disease glaucoma may be associated with pressure-dependent and -independent factors. Ocular hypertension (OHT) may develop into primary open angle glaucoma (POAG) for many patients. We compared groups with OHT and POAG for pressure-dependent and -independent risk factors. A high prevalence of any factor(s) could indicate a contribution to progression from OHT to POAG. Method: A sample of patients with POAG (n 438) and with OHT (n 301) were selected from those attending a tertiary referral private glaucoma practice, and data were collected regarding age and intraocular pressure at the time of diagnosis, gender, family history of glaucoma, systemic hypertension, diabetes, Raynaud's phenomenon, migraine and myopia. Results: After multivariate analysis, older age at time of diagnosis (P<0.001), myopia (odds ratio (O.R) 1.5, 95percent confidence interval (C.I)1.0-2.2; P 0.05), a family history of glaucoma (O.R 1.6, 95 percent C.I 1.1-2.3; P 0.01) and a high intraocular pressure (P 0.002) were associated with POAG. No other significant differences were found between the two groups. Conclusion: Patients who have OHT may be at higher risk of developing POAG if they also have myopia, a family history of glaucoma or are of older age.
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Gunvant, Pinakin. "The influence of corneal dimensions on measurement related to glaucoma and ocular hypertension." Thesis, Anglia Ruskin University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398245.
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Kreuz, André Carvalho. "Eletrorretinograma de padrão reverso macular e multifocal e tomografia de coerência óptica em olhos suspeitos de glaucoma e glaucomatosos com perda de hemicampo." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5149/tde-06022017-110458/.
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Objetivos: Avaliar a capacidade do eletrorretinograma de padrão reverso (PERG) macular e multifocal (mf) de diferenciar pacientes com suspeita de glaucoma (SG) e glaucoma com defeito de campo hemianópico (GH) de controles, comparar a capacidade de discriminação do PERG e tomografia de coerência óptica (TCO) fourrier domain, e avaliar a relação entre as medidas do PERG e TCO. Métodos: Medidas do campo visual (CV) computadorizado, respostas do PERG transiente e modo estacionário e PERGmf foram obtidos dos SG (n=14, 24 olhos), GH (n=5, 7 olhos) e controles (n=19, 22 olhos). Os seguintes parâmetros de TCO foram investigados: camada de fibras nervosas da retina peripapilar (CFNRpp), espessura total da mácula e espessuras das camadas segmentadas da mácula. As medidas foram analizadas utilizando-se modelos lineares de efeito misto. Também foi avaliada a relação entre as medidas e a performance diagnóstica de cada tecnologia. Resultados: Comparado aos controles, a média do tempo de pico de P50 da resposta do PERG transiente estava reduzida nos SG e GH, enquanto que a fase, a amplitude do modo estacionário e respostas do PERGmf estavam anormais apenas no GH. A média das medidas da TCO de espessura macular e da CFNRpp nos SG e GH diferiram significativamente dos controles. Uma significativa relação foi observada entre o PERG e a maior parte dos dos parâmetros do CV central e TCO. A análise por regressão e componentes principais revelou que a TCO de nervo óptico e mácula, assim como o PERG transiente e PERGmf tiveram estatisticamente capacidade similar em discriminar os SG dos controles. Conclusões: Os parâmetros do PERG e da TCO podem estar anormais, com significativa relação entre as medidas, em uma porcentagem alta de olhos com SG com CV normal. Nossos achados sugerem que as duas tecnologias podem ser úteis e complementares na detecção precoce de glaucomaPurpose: To evaluate the ability of macular and multifocal (mf) pattern electroretinogram (PERG) to differentiate glaucoma suspects (GS) and glaucoma with hemifield loss (GHL) from controls, to compare the discrimination ability of PERG and fourier-domain optical coherence tomography (fdOCT), and to assess the relationship between PERG and fdOCT measurements. Methods: Standard automated perimetry (SAP), steady-state and transient PERG responses and mfPERG measurements were obtained from GS (n=14, 24 eyes), GHL (n=5, 7 eyes) and controls (n=19, 22 eyes). The following fdOCT parameters were investigated: circumpapillary retinal nerve fiber layer (cpRNFL), full-thickness macula, and segmented macular layer thicknesses. Measurements were compared using mixed effects linear models. The relationships between measurements and the diagnostic performance of each technology were also assessed. Results: Compared to controls, average P50 peak time transient PERG responses were reduced in GS and GHL, whereas average phase and amplitude steady-state and mfPERG responses were abnormal only in GHL. The average fdOCT-measured cpRNFL and macular thickness measurements in GS and GHL differed significantly from controls. A significant relationship was found between PERG and most fdOCT or central SAP sensitivity parameters. Principal component regression analysis revealed that optic disc and macular OCT parameters, along with mfPERG and transient PERG parameters had statistically similar ability to discriminate GS from controls. Conclusions: PERG and OCT parameters may be abnormal, with significant correlations between measurements, in a high percentage of GS eyes with normal SAP. Our findings suggest that both technologies may be helpful and complementary in early glaucoma detection
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Peeters, Andrea. "Primary open-angle glaucoma and ocular hypertension cost-effectiveness of early detection and treatment /." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?did=12706.
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Martins, Tessie Beck. "PATOLOGIA OCULAR EM ANIMAIS DOMÉSTICOS." Universidade Federal de Santa Maria, 2015. http://repositorio.ufsm.br/handle/1/4107.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorThis doctoral thesis involved the study of ocular and periocular diseases affecting domestic animals, and included one manuscript about lesions of surgical pathology and one manuscript about hyphema in dogs and cats submitted to necropsy. In the first part, 33,075 reports of hystopathological exams performed in a veterinary pathology diagnostic laboratory in the Central Region of the State of Rio Grande do Sul, Brazil, over 50 years. From the total amount, 540 (1.6%) concerned ocular and periocular lesions. For various reasons ninety specimens were excluded from the study, 450 remaining. More than half of all cases consisted of samples from dogs (53.5%), followed by cattle (28.2%), cats (11.1%), horses (5.1%) sheep (1.3%), rabbits (0.4%), and pig (0.2%). The eyelids were the most prevalent (248/450) site of lesions in each of the species studied, followed by third eyelid (73/450), and conjunctiva (27/450). In dogs lesions in sebaceous glands were the most common findings (75/241), followed by melanocytic tumors and nonspecific conjunctivitis. In cattle, anatomical sites affected by ocular and periocular lesions, in decreasing order of frequency, were eyelid, cornea and third eyelid. Squamous cell carcinoma (SCC) alone accounted for 80.3% of all lesions diagnosed in cattle. Neoplasia accounted for most of the lesions diagnosed in cats (39/50 cases); all of these were malignant, and SCC, hemangiosarcoma and fibrosarcoma were the most common types diagnosed. In horses, 19 out of 23 submissions were neoplasms and most were sarcoid (8/23) and SCC (8/23). In sheep, all samples represented SCC of the eyelids (5) and third eyelid (1). For the second manuscript, cases of hyphema in dogs and cats submitted to necropsy were examined. Twenty cases, 14 dogs and six cats of several ages and breeds and of both sexes were included in the study. Hyphema presented as a unilateral (14 cases out of 20) or bilateral (6/20) disorder in dogs and cats and extension of hemorrhage varied from minimal to diffuse. Hyphema was secondary to systemic disease (15/20) or occurred as a primary ocular lesion (5/20) in four dogs and one cat. Primary hyphema was always unilateral. In four of these cases, the cause of hyphema was trauma and remaining case was caused by phacoclastic uveitis in a dog with bilateral hypermature cataract. Various causes of bleeding disorders were found related to secondary hyphema: in decreasing order of frequency, they included vasculitis (8/15), systemic hypertension (5/15), and acquired coagulopathies (2/15).
Esta tese envolveu o estudo de doenças oculares e perioculares de animais domésticos, e incluiu um artigo sobre lesões de patologia cirúrgica e um artigo sobre hifema em cães e gatos submetidos à necropsia. Para o primeiro trabalho, foram examinados 33.075 laudos de exames histopatológicos realizados num laboratório de diagnóstico de patologia veterinária na Região Central do Rio Grande do Sul durante 50 anos. Destes, 540 (1,6%) eram de lesões oculares e perioculares. Por várias razões, 90 espécimes foram excluídos do estudo, restando 450. Mais da metade dos casos correspondiam a espécimes de cães (53,5%), seguidos por bovinos (28,2%), gatos (11,1%), cavalos (5,1%), ovelhas (1,3%), coelhos (0,4%), e porco (0,2%). As pálpebras foram o local mais prevalente (248/450) de ocorrência das lesões em cada uma das espécies, seguidas da terceira pálpebra (73/450) e conjuntiva (27/450). Em cães, as lesões nas glândulas sebáceas consistiram nos achados mais comuns, seguidos dos tumores melanocíticos e de conjuntivites inespecíficas. Em bovinos, os locais anatômicos afetados por lesões perioculares e oculares, em ordem decrescente de frequência, foram pálpebra, córnea e terceira pálpebra. Somente o carcinoma de células escamosas (CCE) perfez 80,3% de todas as lesões diagnosticadas em bovinos. Em gatos, a maioria (39/50 casos) das lesões diagnosticadas era de neoplasia maligna, e CCE hemangiossarcoma e fibrosarcoma foram os diagnósticos mais frequentes. Em equinos 19 de 23 submissões eram neoplasmas e os mais comuns foram sarcoide (8/23) e CCE (8/23). Em ovinos, todas as amostras correspondiam a casos de CCE de pálpebra (5/6) ou terceira pálpebra (1/6). Para o segundo trabalho, casos de hifema em cães e gatos submetidos à necropsia foram examinados. Vintes casos, 14 cães e seis gatos de várias idades e raças e de ambos os sexos foram incluídos no estudo. O hifema teve uma apresentação unilateral (14 casos dos 20) ou bilateral (6/20), e a extensão da hemorragia variou de mínima a difusa. O hifema era secundário à doença sistêmica (15/20) ou ocorreu como lesão ocular primária em cinco dos 20 casos (quatro cães e um gato). O hifema primário foi sempre unilateral; a causa foi traumatismo em quatro desses casos, e o caso restante foi causado por uveíte facoclástica em um cão com catarata hipermadura bilateral. Várias causas de distúrbios hemorrágicos foram encontradas em relação ao hifema secundário: em ordem decrescente de frequência foram: vasculite (8/15), hipertensão sistêmica (5/15) e coagulopatias adquiridas (2/15).
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Addad, Mariluci Tosi [UNESP]. "Pico e flutuação da pressão intra-ocular: comparação entre curva tensional diária e teste de sobrecarga hídrica e comparação entre 2 testes de sobrecarga hídrica em horários diferentes." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/86314.
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addad_mt_me_botfm.pdf: 674800 bytes, checksum: 101691ff84e6e0c57b104e36c6ab28a2 (MD5)Comparar pico e flutuação de pressão intra-ocular (PIO) entre curva tensional diária e teste de sobrecarga hídrica, detectar os horários de pico de PIO, comparar os valores da PIO nos horários das 6 horas da manhã deitado e sentado. 30 olhos direitos de 30 pacientes portadores de glaucoma primário de ângulo aberto (GPAA) ou hipertensão ocular (HO), foram submetidos à curva tensional diária de 24 horas (CTD) e teste de sobrecarga hídrica (TSH). Foram avaliados: pico (maior valor da PIO durante a CTD e TSH ) e flutuação (maior valor da PIO menos o menor valor da PIO durante o CTD e TSH). A PIO foi avaliada, com tonômetro de aplanação de Goldmann às 9, 12, 15, 18, 21, 24 e 6h, com paciente sentado. As medidas das 3 e 6 horas da manhã foram realizadas no leito com tonômetro de Perkins com o paciente em posição supina (deitado). Imediatamente após a medida no leito deitado, foi realizada outra medida das 6 horas com o paciente sentado. Para realização do TSH, os pacientes ingeriam 1 litro de água, em até 5 minutos. A PIO foi avaliada imediatamente antes e durante uma hora após a ingestão de água, com intervalos de 15 minutos entre as medidas. O TSH foi realizado logo após a avaliação da PIO às 6h da manhã. Foram calculados valores de média (M) e desvio padrão (s) para pico e flutuação e mediana (Md) e quartís (Q2) para flutuação em porcentagem (%). Para comparação de médias foi realizado o teste t de Student para amostras dependentes. Foi utilizado teste de Wilcoxon para comparação de medianas entre amostras dependentes. Para todas as análises foi considerado nível de significância p <0,05. A média dos valores de pico de PIO foi significativamente maior na CTD (20,39 ±1,03 mmHg) do que no TSH (17,37 ± 0,78 mmHg), p < 0,001. A média dos valores de flutuação também foi maior na CTD (10,17 ± 0,90) do que no TSH (5,0 ± 0,45), p < 0,001...
Comparing peak and fluctuation of intraocular pressure (IOP) between diurnal tension curve and water drinking test, detect the peak of IOP, compare the IOP at 6AM in supine and sitting position. 30 right eyes of 30 glaucoma patients with open angle glaucoma (OAG) or ocular hypertension (HO) were submitted to water drinking test (WDT) and diurnal tension curve (DTC). Were evaluated: peak (higher value of IOP observed during WDT and DTC), fluctuation (difference between highest and lowest value of IOP WDT and DTC). IOP was measured with applanation Goldmann tonometry at 9AM, 12AM, 3PM, 6PM, 9PM, 12PM and 6 AM, with the patient sitting. Measurements of 3AM and 6AM were made in bed with Perkins tonometer with the patient in the supine position. Immediately after the measure in supine position, another measure was done at 6AM, with the patient seated. The WDT involved ingestion of 1 liter of tap water in 5 minutes. IOP was measured immediately before and one hour after ingestion of water at intervals of 15 minutes between measurements. The WDT was performed immediately after the measure IOP at 6 AM. For comparison of means was performed Student's t test for dependent samples. Wilcoxon test was used to compare medians between dependent samples. The level of significance was considered p <0.05. The mean peak IOP was significantly higher in the DTC (20.39 ± 1.03 mmHg) than in TSH (17.37 ± 0.78 mmHg), p <0.001. The mean fluctuation was also higher in the DTC (10.17 ± 0.90) than in WDT (5.0 ± 0.45), p <0.001. The value of the fluctuation in the DTC percentile was 90.46% (70.00, 129.90) while the WDT was 35.42% (27.92, 56.95), p <0.001. The IOP of 6 AM showed a statistically significant when performed with the patient in supine position (17,47 mmHg) and sitting (14,30 mmHg) and was significantly higher with the patient in supine position. (p < 0,001). The WDT peak and underestimates of ... (Complete abstract click electronic access below)
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Addad, Mariluci Tosi. "Pico e flutuação da pressão intra-ocular : comparação entre curva tensional diária e teste de sobrecarga hídrica e comparação entre 2 testes de sobrecarga hídrica em horários diferentes /." Botucatu : [s.n.], 2010. http://hdl.handle.net/11449/86314.
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Resumo: Comparar pico e flutuação de pressão intra-ocular (PIO) entre curva tensional diária e teste de sobrecarga hídrica, detectar os horários de pico de PIO, comparar os valores da PIO nos horários das 6 horas da manhã deitado e sentado. 30 olhos direitos de 30 pacientes portadores de glaucoma primário de ângulo aberto (GPAA) ou hipertensão ocular (HO), foram submetidos à curva tensional diária de 24 horas (CTD) e teste de sobrecarga hídrica (TSH). Foram avaliados: pico (maior valor da PIO durante a CTD e TSH ) e flutuação (maior valor da PIO menos o menor valor da PIO durante o CTD e TSH). A PIO foi avaliada, com tonômetro de aplanação de Goldmann às 9, 12, 15, 18, 21, 24 e 6h, com paciente sentado. As medidas das 3 e 6 horas da manhã foram realizadas no leito com tonômetro de Perkins com o paciente em posição supina (deitado). Imediatamente após a medida no leito deitado, foi realizada outra medida das 6 horas com o paciente sentado. Para realização do TSH, os pacientes ingeriam 1 litro de água, em até 5 minutos. A PIO foi avaliada imediatamente antes e durante uma hora após a ingestão de água, com intervalos de 15 minutos entre as medidas. O TSH foi realizado logo após a avaliação da PIO às 6h da manhã. Foram calculados valores de média (M) e desvio padrão (s) para pico e flutuação e mediana (Md) e quartís (Q2) para flutuação em porcentagem (%). Para comparação de médias foi realizado o teste t de Student para amostras dependentes. Foi utilizado teste de Wilcoxon para comparação de medianas entre amostras dependentes. Para todas as análises foi considerado nível de significância p <0,05. A média dos valores de pico de PIO foi significativamente maior na CTD (20,39 ±1,03 mmHg) do que no TSH (17,37 ± 0,78 mmHg), p < 0,001. A média dos valores de flutuação também foi maior na CTD (10,17 ± 0,90) do que no TSH (5,0 ± 0,45), p < 0,001... (Resumo completo, clicar acesso eletrônico abaixo)Abstract: Comparing peak and fluctuation of intraocular pressure (IOP) between diurnal tension curve and water drinking test, detect the peak of IOP, compare the IOP at 6AM in supine and sitting position. 30 right eyes of 30 glaucoma patients with open angle glaucoma (OAG) or ocular hypertension (HO) were submitted to water drinking test (WDT) and diurnal tension curve (DTC). Were evaluated: peak (higher value of IOP observed during WDT and DTC), fluctuation (difference between highest and lowest value of IOP WDT and DTC). IOP was measured with applanation Goldmann tonometry at 9AM, 12AM, 3PM, 6PM, 9PM, 12PM and 6 AM, with the patient sitting. Measurements of 3AM and 6AM were made in bed with Perkins tonometer with the patient in the supine position. Immediately after the measure in supine position, another measure was done at 6AM, with the patient seated. The WDT involved ingestion of 1 liter of tap water in 5 minutes. IOP was measured immediately before and one hour after ingestion of water at intervals of 15 minutes between measurements. The WDT was performed immediately after the measure IOP at 6 AM. For comparison of means was performed Student's t test for dependent samples. Wilcoxon test was used to compare medians between dependent samples. The level of significance was considered p <0.05. The mean peak IOP was significantly higher in the DTC (20.39 ± 1.03 mmHg) than in TSH (17.37 ± 0.78 mmHg), p <0.001. The mean fluctuation was also higher in the DTC (10.17 ± 0.90) than in WDT (5.0 ± 0.45), p <0.001. The value of the fluctuation in the DTC percentile was 90.46% (70.00, 129.90) while the WDT was 35.42% (27.92, 56.95), p <0.001. The IOP of 6 AM showed a statistically significant when performed with the patient in supine position (17,47 mmHg) and sitting (14,30 mmHg) and was significantly higher with the patient in supine position. (p < 0,001). The WDT peak and underestimates of ... (Complete abstract click electronic access below)
Orientador: César Tadeu Spadella
Coorientador: Maria Rosa Bet de Moraes Silva
Banca: Maria de Lourdes Veronese Rodrigues
Banca: Roberto Murad Vessani
Mestre
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Hernandez, Rodolfo. "Broadening the valuation space in health technology assessment : the case of monitoring individuals with ocular hypertension." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=230150.
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The economic evaluation (EE) component of health technology assessments (HTA) often defines value in terms of health related quality of life, with many HTA agencies requiring the use of EQ-5D based Quality Adjusted Life Years (QALYs). These approaches do not capture value derived from patient experience factors and the process of care. This thesis widens the valuation space beyond this limited perspective, taking account of such factors, using monetary values generated from a discrete choice experiment (DCE), incorporating these into a discrete event simulation (DES) and conducting a cost-benefit analysis (CBA). The case study is monitoring individuals with ocular hypertension. Five strategies were compared using a DES: 'Treat All' at ocular hypertension diagnosis with minimal followup; Biennial monitoring (either in primary or secondary care) with treatment according to predicted glaucoma risk; and monitoring and treatment according to the UK National glaucoma guidance (either conservative or intensive). DCE based Willingness to pay (WTP) estimates for relevant health outcomes (e.g. risk of developing or progressing glaucoma and treatment side effects), patient experience factors (e.g. communication and understanding with the health care professional) and process of care (e.g. monitoring setting) were obtained. Conditional logit, mixed logit preference space and mixed logit WTP-space (rarely used within health economics) econometric specifications were used. These WTP valuations were aggregated in the DES, as fixed mean values or allowing variation between simulated individuals. While the standard cost-utility analysis (CUA) using EQ-5D implied 'Treat All' was most likely cost-effective, CBA with broadened valuation space identified, consistently across different econometric specifications, 'Biennial hospital' as the best choice. This thesis proposes an approach to broaden the valuation space that can be promptly used for EE-HTA. Researchers should be attentive of the valuation space considered in their EE and choose wisely the EE approach to be used (e.g. CUA and/or CBA).
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Sapienza, Anaïs. "Etude des mécanismes neuro-inflammatoires dans les voies visuelles sur un modèle murin d’hypertonie oculaire." Thesis, Paris 6, 2015. http://www.theses.fr/2015PA066589/document.
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La neuropathie optique glaucomateuse est une pathologie du système visuel entrainant une cécité irréversible qui affectera 80 millions de personnes en 2020. Le principal facteur de risque du glaucome est l'élévation de la pression intraoculaire qui mène à la mort progressive des cellules ganglionnaires de la rétine (CGR) du nerf optique jusqu'aux voies visuelles dans le cerveau. Il a été montré que le glaucome partageait des mécanismes neuro-inflammatoires communs avec les pathologies neurodégénératives. Nous avons émis l'hypothèse que ces mécanismes contribueraient à la progression du glaucome. L'objectif de ma thèse a été d'analyser les processus neuro-inflammatoires observés de la rétine jusqu'aux colliculus supérieurs sur un modèle expérimental d'hypertension oculaire unilatérale chez le rat obtenu après la cautérisation des veines épisclérales. Par des approches de biologie cellulaire et moléculaire, nous avons montré que ce modèle animal se caractérise par 1) une atteinte neuronale des CGR de l'oeil cautérisé; 2) l'augmentation de marqueurs pro-inflammatoires dans la rétine de l'oeil cautérisé, dans la rétine de l'oeil controlatéral, dans le nerf optique et dans les colliculus supérieurs et 3) la transmission de la neuro-inflammation à l'oeil controlatéral se fait majoritairement par les fibres des CGR qui projettent dans les deux colliculus supérieurs. Toutes ces données mettent en évidence le rôle complexe joué par le colliculus supérieur chez le rat dans la propagation de la neuro-inflammation induite par l'hypertension oculaire unilatéraleGlaucoma is a visual system disorder leading to irreversible blindness and affecting 80 millions people worldwide by 2020. The major risk factor is elevated intraocular pressure leading to progressive retinal ganglion cell (RGC) death from the optic nerve (ON) to visual pathways in the brain. Glaucoma has been reported to share neuroinflammatory mechanisms with neurodegenerative disorders. We therefore hypothesize that mechanisms in central visual pathways may contribute to the spread of glaucoma disease. The aim of the present study was to analyze the neuroinflammation processes that occur from the pathological retina to the superior colliculi (SCs) in a rat model of unilateral ocular hypertension induced by episcleral vein cauterization. By molecular and cell biology methods, we have shown that this animal model is characterized by 1) neuronal damage of CGR from the cauterized eye; 2) the increase in proinflammatory markers in the retina of the cauterized eye, in the retina of the contralateral eye, in the optic nerve and in the superior colliculus and 3) transmission of neuroinflammation in contralateral eye is done mainly by CGR fibers that project into the two superior colliculus. All these data evidence the complex role played by the SCs, in rat, in the propagation of neuroinflammatory events induced by unilateral ocular hypertension
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Matusow, Rachel Brodman. "Perioperative Administration of Topical Dorzolamide Hydrochloride/Timolol Maleate Reduces Postoperative Ocular Hypertension in Dogs Undergoing Cataract Surgery." Thesis, Virginia Tech, 2015. http://hdl.handle.net/10919/73382.
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Development of cataracts is a relatively frequent ocular disease of the dog and cataract extraction via phacoemulsification (PE) is commonly performed by veterinary ophthalmologists. Postoperative ocular hypertension (POH) describes the elevation of pressures within the eye during the acute postoperative period and can result in vision loss and poor surgical outcome. Relatively little is known about risk factors or efficacy of prophylactic treatment for POH, and current clinical practice with regard to pressure monitoring and medication administration are highly variable. The literature on POH prophylaxis in humans indicates that improved efficacy may be achieved with a multi-dose approach and that dorzolamide hydrochloride/timolol maleate (DHTM) may be more efficacious than other pressure lowering medications. The canine literature on POH prophylaxis is limited and DHTM has not yet been evaluated despite common use in the clinical setting. Our objectives, therefore, were to investigate risk factors for POH and to test the hypothesis that perioperative topical ophthalmic dorzolamide hydrochloride 2%/timolol maleate 0.5% (DHTM) reduces the prevalence and/or severity of postoperative ocular hypertension (POH) in dogs undergoing cataract extraction by phacoemulsification (PE). We employed a randomized double-masked placebo-controlled study and enrolled 103 dogs (180 eyes) presenting for unilateral or bilateral PE. Select historical, signalment, ophthalmic examination, and surgical data was collected. Dogs were treated with DHTM or Blink Contacts (BC) placebo at 14- and 2-h preoperatively and at conclusion of surgical closure. Intraocular pressures were assessed by rebound tonometry at 2, 4, 6, and 8 hours after surgery and at 8 am the following morning. POH was defined as IOP>25 mmHg and intervention consisted of latanoprost 0.005% if IOP rose to 26 mmHg - 45 mmHg or surgeon treatment of choice if >45 mmHg. Our investigation of risk factors yielded a statistically significant association only with surgeon and surgical time, which were also associated with one another. DHTM significantly reduced the prevalence of POH in comparison with BC (26% versus 49% of eyes, OR=0.36; 34% versus 62% of dogs, OR=0.32). There was also a trend toward reduction of POH severity in DHTM-treated eyes (POH value 37.17±10.47 mmHg with BC, 32.67±6.39 mmHg with DHTM). DHTM-treated eyes that developed POH were significantly more likely to respond favorably (1 hour post-treatment IOP <25 mmHg) to treatment with latanoprost than those in the BC group (76% versus 51%, OR=3.87). We conclude that multi-dose perioperative administration of DHTM may be recommended in dogs undergoing PE to reduce the risk of POH and improve responsiveness of POH to treatment with latanoprost.Master of Science
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Swaminathan, Swarup Sai. "The Role of SPARC in Aqueous Humor Outflow and TGFß2-mediated Ocular Hypertension in a Murine Model." Thesis, Harvard University, 2014. http://etds.lib.harvard.edu/hms/admin/view/56.
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Glaucoma is the leading cause of irreversible blindness worldwide, and is a major cause of blindness in the United States. It affects approximately 5% of Caucasians and 10% of African- Americans over the age of 60 years. Elevated intraocular pressure (IOP) is currently the only modifiable risk factor for glaucoma. Impaired outflow of aqueous humor from the eye is thought to be the cause of pathologically elevated IOP. However, the etiology of outflow impairment is unknown. Anatomically, the aqueous humor drains into the iridocorneal angle of the eye, where the iris inserts at the transition between the cornea and sclera. In humans, approximately 80-90% of the aqueous traverses through the trabecular meshwork (TM), juxtacanalicular connective tissue (JCT), Schlemm’s canal, collector channels and empties into episcleral veins. Abnormalities at these sites are thought to cause impaired outflow. Abnormal accumulation of extracellular matrix (ECM) in the TM or JCT, abnormal endothelial function in Schlemm’s canal, or a combination of these components have been strongly implicated. Our laboratory has focused on the role of Secreted Protein Acidic and Rich in Cysteine (SPARC) in regulating outflow. SPARC is the prototypical matricellular protein that mediates ECM organization and turnover in numerous human tissues. Our lab was first to demonstrate that SPARC is highly expressed in the TM and JCT regions of the eye, and that the SPARC knockout (KO) mouse has a significant decrease in IOP of 15-20%. SPARC may affect the degree of segmental flow, a theory that states that variable aqueous outflow occurs around the circumference of the eye; only certain portions of the TM are thought to display active outflow at any particular moment. The cytokine transforming growth factor-ß2 (TGFß2) has been shown to modulate multiple ECM proteins, including SPARC. TGFß2 is significantly upregulated by 2 to 3-fold in the aqueous humor of glaucoma patients compared to controls. In addition, when TGFß2 is overexpressed in rodent eyes, increased ECM deposition is observed within the trabecular meshwork leading to IOP elevation. SPARC is one of the most highly upregulated proteins by TGFß2, and is downstream of TGFß2. We hypothesized that wild-type (WT) mice would demonstrate segmental flow, while SPARC KO mice would display a more continuous pattern of outflow around the eye. We also believed that IOP would be inversely correlated with outflow area. We also hypothesized that SPARC is essential to the process of TGFß2-mediated ocular hypertension, and that the lack of SPARC would impair IOP elevation.
We conducted a tracer study utilizing fluorescent microbeads to determine the location of outflow circumferentially around the mouse TM. Microbeads were injected intracamerally into the eyes of WT and KO mice. After a 45-minute incubation period, the mice were euthanized and eyes were processed for confocal, light, and electron microscopy. During the second group of experiments, empty or TGFß2-containing adenovirus was injected intravitreally into WT and SPARC KO mice and IOP was measured for 2 weeks. Immunohistochemistry was completed on all tissues to assess for changes in major ECM proteins.
Percentage effective filtration length (PEFL), or area of the TM labeled by tracer, was significantly increased in SPARC KO mice (70.61% ± 11.36%, p<0.005; N=11) compared to WT mice (54.68% ± 9.95%; N=11). In addition, the pressures between the two sets of eyes were significantly different with mean pressures of 16.3 mm Hg in WT mice and 12.6 mm Hg in KO mice (p<0.005, N=11 pairs). In addition, PEFL and IOP were inversely correlated with R2 = 0.72 (N=10 pairs); in eyes with higher IOP, PEFL was reduced. Electron microscopy demonstrated that high-tracer TM areas had a greater separation between trabecular beams. Collagen fibril diameter was found to be smaller in the KO (28.272 nm) compared to WT (34.961 nm; p<0.0005, N=3 pairs). These data provided structural correlations to the functional data regarding segmental flow.
In the second set of experiments, IOP was found to be significantly elevated in TGFß2- injected WT mice compared to empty vector-injected WT mice during days 4-11 (p<0.05, N=8). However, IOP was not significantly elevated in TGFß2-injected KO mice compared to controls. Immunohistochemistry demonstrated that TGFß2 increased expression of collagen IV, fibronectin, plasminogen activator inhibitor-1 (PAI-1), connective tissue growth factor (CTGF), and SPARC within the TM of WT mice, but only PAI-1 and CTGF in KO mice (p<0.05, N=3 pairs).
These data support our hypotheses, indicating that SPARC plays an integral role in the modulation of aqueous humor outflow. In addition, it appears as though SPARC is essential to the regulation of TGFß2-mediated ocular hypertension. Aside from providing further evidence of the importance of ECM in IOP regulation, our work presents the novel discovery of segmental flow in the mouse. Given the potential role of SPARC in TGFß2-mediated ocular hypertension, SPARC may not only play an integral role in ECM homeostasis within the trabecular meshwork, but may be a valuable target for pharmacologic therapy in treating primary open-angle glaucoma.
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Landers, John. "An epidemiological study of risk factors associated with progression from ocular hypertension to primary open angle glaucoma." Connect to full text, 2001. http://hdl.handle.net/2123/798.
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Thesis (M.P.H.)--University of Sydney, 2001.Includes tables. Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Master of Public Health to the Dept. of Public Health and Community Medicine, Faculty of Medicine. Includes bibliography. Also available in print form.
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Gradvohl, Hissa Tavares de Lima. "Amplitude de pulso ocular em pacientes com hipertensão arterial sistêmica." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/17/17150/tde-21072016-105946/.
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Objetivo: Avaliar a amplitude de pulso ocular (APO) em pacientes com hipertensão arterial sistêmica, comparando com o grupo controle, e eventuais influências da espessura central da córnea e do comprimento axial (COMPRaxial) do olho na APO. Método: Foram examinados 152 olhos de 76 pacientes com hipertensão arterial sistêmica e 136 olhos de 68 indivíduos que compuseram o grupo controle. Todas as medidas foram tomadas pelo mesmo examinador, no período das 7 às 10h da manhã, na seguinte ordem: pressão arterial sistêmica, tonometria de contorno dinâmico, COMPRaxial e paquimetria (PAQ). A análise estatística foi realizada utilizando-se o teste t para médias de dados pareados e, para as correlações, os coeficientes de Pearson ou o de Spearman. Considerou-se o nível de significância de 5%. Resultados: A APO média dos olhos direitos dos pacientes com hipertensão arterial sistêmica foi 2,10 (+/- 0.9 mmHg) e a dos olhos esquerdos foi 2,03 (+/-0,828 mmHg). A PAQ média dos olhos direitos foi 532.2 mµ (+/- 39 mµ), e a dos olhos esquerdos 532.1 mµ (+/- 36.5 mµ), não influenciando a APO. A variável COMPRaxial para o olho direito (OD) apresentou média de 23,44 mm (+/- 1.477 mm) e para o olho esquerdo (OE) foi de 23.343 em média (+/- 1,32 mm). Houve significância estatística quando estudada a influência do COMPRaxial sobre a APO, demonstrando correlação inversamente proporcional. A média da APO dos controles foi de 2,10 (+/- 0.9 mmHg) e para o OD e OE média de 2,03 (+/-0,828 mmHg). Quando comparados os valores médios da APO dos casos e controles, a diferença foi estatisticamente significante, sendo os valores dos controles maiores do que os encontrados nos pacientes com hipertensão arterial sistêmica (p <0 ,001). Constatou-se que existe diferença entre caso e controle, tanto para o OD quanto para o OE. Conclusões: O valor médio de APO foi menor nos pacientes com hipertensão arterial sistêmica do que nos controles; a APO não foi influenciada pela espessura central da córnea; e olhos com maior COMPRaxial apresentaram APO menorObjective: The objectives of this study were to assess the ocular pulse amplitude (OPA) in patients with hypertension, compared with control group and to evaluate possible influences of central corneal thickness and axial length of eye in OPA. Method: We evaluated 152 eyes of 76 patients with hypertension and 136 eyes of 68 individuals who comprised the control group. All measurements were made by the same examiner in the period of 7 am and 10 am, in following order: blood pressure, dynamic contour tonometry, axial length and pachymetry. Statistical analysis was performed using the t test for paired data and averages for correlations, the Pearson correlation coefficients of Spearman. Considered the significance level of 5%. Results: The average OPA in right eyes of patients with hypertension was 2.10 (standard deviation (SD) 0.9 mmHg) and in left eyes was 2.03 (SD =0.828 mmHg). The average pachymetry of right eyes was 532.2 mµ (+/- 39 mµ); and for left eyes was 53.1 mµ ( +/-36.5 mµ). The variable diameter axial in right eye showed an average of 23.44 mm (+/- 1.477 mm); for the left eye 23,343 mm (+/- 1.32). There was statistical significance when studied the influence of the axial diameter of OPA, with inverse correlation. The average of controls OPA was presented mean 2.10 (+/- 0.9 mmHg) for the right eye and the left mean 2.03 (+/- 0.828 mmHg). When comparing the mean values of OPA in cases and controls the difference was statistically significant, the values of the controls are larger those found in patients with hypertension (p<0,001), so it was found difference between cases and controls, both for the right and left eye. Conclusions: The mean OPA was lower in patients with hypertension than in controls, the OPA was not influenced by central corneal thickness, and eyes with greater axial length showed lower OPA
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Dong, Jin. "Slope analysis of the optic disc in eyes with ocular hypertension and early normal-tension glaucoma by confocal scanning laser ophthalmoscope." Kyoto University, 2000. http://hdl.handle.net/2433/151429.
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Garbe, Edeltraut. "Pharmakoepidemiologische Analyse zu okulärer Hypertension, Offenwinkelglaukom und Katarakt als unerwünschte Wirkungen von Glukokortikoiden." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2000. http://dx.doi.org/10.18452/13703.
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Die vorliegende Arbeit diskutiert methodische Aspekte und Ergebnisse eigener pharmakoepdemiologischer Untersuchungen zum Risiko von okulärer Hypertension, Glaukom und Katarakt unter verschiedenen Darreichungsformen von Glukokortikoiden. Prospektive Studien der frühen 60er Jahre haben gezeigt, daß die Verabreichung topischer Glukokortikoide am Auge bei ca. einem Drittel der Bevölkerung zu einem Augeninnendruckanstieg führt. Bei langdauernder Therapie kann sich ein Kortikosteroidglaukom entwickeln, das in seiner Symptomatik und den klinischen Befunden einem primären Offenwinkelglaukom entspricht. Für orale Glukokortikoide untersuchten wir das Risiko von okulärer Hypertension und Offenwinkelglaukom in einer großen Fall-Kontroll-Studie, die 9.793 augenärztliche Patienten mit neu diagnostizierter okulärer Hypertension und Offenwinkelglaukom einschloß und 38.325 augenärztliche Kontrollpatienten ohne diese Erkrankungen. Die Einnahme oraler Glukokortikoide war mit einem Risikoanstieg von über 40% verbunden. Es zeigte sich ein deutlicher Anstieg des Risikos mit zunehmender Glukokortikoid-Tagesdosis: Für Patienten, die mehr als 80 mg Hydrokortisonäquivalent pro Tag erhalten hatten, war das Risiko über 80% erhöht. Unsere Berechnungen zeigten, daß unter solch hohen Dosen 93 zusätzliche Fälle von okulärer Hypertension oder Offenwinkelglaukom pro 10.000 Patienten und Jahr auftreten können. In derselben Fall-Kontroll-Studie analysierten wir auch das Risiko für inhalative und nasale Glukokortikoide. Zwar ist für diese Glukokortikoidformen das Risiko systemischer Glukokortikoidnebenwirkungen durch die topische Applikation deutlich reduziert, doch legen verschiedene klinisch-pharmakologische Untersuchungen nahe, daß inhalative Glukokortikoide in hoher Dosierung systemische Effekte ausüben können. Verschiedene Einzelfallberichte ließen ein erhöhtes Risiko von okulärer Hypertension und Glaukom für inhalative und nasale Glukokortikoide möglich erscheinen. Unsere Fall-Kontroll-Studie zeigte, daß inhalative Glukokortikoide, wenn sie in hohen Tagesdosen kontinuierlich über 3 Monate verabreicht werden, das Risiko von okulärer Hypertension und Offenwinkelglaukom um über 40% erhöhen. Wir beobachteten kein erhöhtes Risiko für nasale Glukokortikoide. In einer weiteren Fall-Kontroll-Studie untersuchten wir das Kataraktrisiko für inhalative Glukokortikoide. Orale Glukokortikoide sind ein etablierter Risikofaktor für eine Katarakt. Für inhalative Glukokortikoide lagen widersprüchliche Studienergebnisse vor. Während mehrere kleine Studien an Kindern kein erhöhtes Risiko gezeigt hatten, war in einer großen populationsbasierten australischen Studie ein erhöhtes Kataraktrisiko unter inhalativen Glukokortikoiden beobachtet worden. Wir konnten das Ergebnis der australischen Studie in unserer Fall-Kontroll-Studie bestätigen, die 3.677 Fallpatienten und 21.868 Kontrollpatienten einschloß. Eine Verabreichung inhalativer Glukokortikoide über mehr als 3 Jahre führte zu einer Verdreifachung des Risikos einer Kataraktextraktion. Das Risiko war nur für hohe Dosen inhalativer Glukokortikoide statistisch signifikant erhöht, nicht jedoch für niedrige bis mittlere Tagesdosen. Zusammengefaßt zeigen die Ergebnisse unserer Studien, daß inhalative Glukokortikoide in hoher Dosierung trotz topischer Applikation zu systemischen Glukokortikoidkomplikationen am Auge führen können. Dies läßt es geboten erscheinen, bei Patienten, die inhalative Glukokortikoide in hoher Dosierung erhalten, augenärztliche Kontrolluntersuchungen durchführen zu lassenThis work presents methodological aspects and results of own pharmacoepidemiologic studies investigating the risk of ocular hypertension, glaucoma and cataract for different forms of glucocorticoids.. Prospective studies of the early 60ies have shown that administration of topical glucorticoids at the eye will lead to ocular hypertension in about one third of the population. If ophthalmic glucocorticoid treatment is prolonged, a corticosteroid glaucoma may develop which closely resembles primary open-angle glaucoma.. We investigated the risk of ocular hypertension or open-angle glaucoma for oral glucocorticoids in a large case-control-study which included 9,793 ophthalmology patients with newly diagnosed ocular hypertension or open-angle glaucoma and 38,325 ophthalmology patients without these diseases (controls). Intake of oral glucocorticoids led to an increase in risk by over 40%. The risk increased markedly with the daily dose of glucocorticoid. For patients who had received more than 80 mg hydrocortisone-equivalent per day, the risk was more than 80% elevated. Our calculations showed that for such high doses, 93 additional cases of ocular hypertension or glaucoma per 10,000 patients and year may be expected. In the same case-control study, we analysed the risk of ocular hypertension and open-angle glaucoma for inhaled and nasal glucocorticoids. These forms of glucocorticoids have been developed to reduce the risk of systemic glucocorticoid complications by topical administration. Some clinical pharmacology studies have shown that high doses of inhaled glucocorticoids may cause systemic effects. Some published case reports suggested an increased risk of ocular hypertension and glaucoma for inhaled and nasal glucocorticoids. Our case-control study showed that high dose, continuous administration of inhaled glucocorticoids for more than 3 months increases the risk of ocular hypertension or open angle glaucoma by more than 40%. We did not observe an increased risk for nasal glucocorticoids. In another case-control study, we investigated the risk of cataract for inhaled glucocorticoids. Oral glucocorticoids are an established risk factor for cataract. For inhaled glucocorticoids, there have been contradictory results from several studies. Whereas some small studies in children did not show an increased risk, a population-based larger study from Australia demonstrated an elevated risk. We confirmed this increase in risk in our case-control study which included 3,677 elderly cases and 21,868 elderly controls. We observed a more than 3-fold risk of cataract extraction in patients who had been treated with inhaled glucocorticoids for more than three years. The risk was significantly increased only for high daily doses of glucocorticoids, but not for low-to-medium doses. In summary, the results of our studies show that high doses of inhaled glucocorticoids despite their topical administration may lead to systemic complications of glucocorticoids at the eye. Therefore it is recommended to have patients who are prescribed high daily doses of inhaled glucocorticoids examined by an ophthalmologist.
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Souza, Maria Alice Fusco de. "Meloxicam e prednisona: efeito do tratamento oral de curto prazo nos n?veis de press?o intra-ocular de c?es (Canis familiaris)." Universidade Federal Rural do Rio de Janeiro, 2006. https://tede.ufrrj.br/jspui/handle/tede/907.
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It is recognized the role of prostaglandins in lowering de intraocular pressure, and more recently, the observation of constitutive expression of COX-2 in the healthy eyes and the absence of this isoenzyme in glaucomatous eyes. These discoveries bring the hypothesis that the use of anti-inflammatory drugs may cause, as unwanted effects, ocular hypertension through the inhibition of COX expression and the reduction of prostaglandins production. The increase of intraocular pressure, even in a transient way, is a risk factor for the development of the glaucoma. In order to observe a possible ocular hypertension associated with the use of anti-inflammatory drugs, 28 beagle dogs were selected from the kennel of the Laboratory of Development of Parasiticide Products, Department of Animal Parasitology, Veterinary Institute, Universidade Federal Rural do Rio de Janeiro. On day 0 (zero) the totality of animals had their intraocular pressure measured using applanation tonometry at 8 a.m. and 4 p.m., for evaluation of intraocular pressure before treatment; on the following day 10 animals received meloxican, associated with wet feeding, on dosage of 0.2 mg Kg-1 and 0.1 mg weight on the remainder of the four days, nine dogs received prednisone, associated with wet feeding, on dosage of 1,0 mg Kg-1 during five days and nine dogs received only wet feeding. On the fifth day of treatment the totality of dogs had their intraocular pressure measured again using applanation tonometry at 8 a.m. and 4 p.m. For all groups, including control-group, the highest average values of intraocular pressure were observed on day 5 (five). The difference between intra-ocular pressure mensurations of the 08 hours and of the 16 hours was significant, independent of treatment and of the considered day. The use of both steroidal or non-steroidal anti-inflammatory were not capable of causing ocular hypertension and some factors can be incriminated, such as route of administration, dosage and duration of therapy chosen, besides genetic inheritance and absence of glaucomatous disorder between the selected dogs.
? reconhecido o papel hipotensor ocular das prostaglandinas e mais recentemente, a observa??o da express?o de COX-2 constitutiva em olhos saud?veis e aus?ncia desta isoenzima em olhos glaucomatosos. Estas descobertas geram a hip?tese de que o uso de antiinflamat?rios apresente como efeito colateral, a hipertens?o ocular pela inibi??o da express?o da COX e diminui??o da produ??o de prostaglandinas. O aumento de press?o intra-ocular, mesmo que transit?rio, ? um fator de risco para o desenvolvimento do glaucoma. Para poss?vel observa??o da hipertens?o ocular com o uso de antiinflamat?rios, foram selecionados 28 c?es da ra?a beagle pertencentes ao Canil do Laborat?rio de Desenvolvimento de Produtos Parasiticidas do Departamento de Parasitologia Animal do Instituto de Veterin?ria da Universidade Federal Rural do Rio de Janeiro. No dia 0 (zero) todos os animais tiveram a press?o intra-ocular mensurada com o uso do ton?metro de aplana??o ?s 08 horas e ?s 16 horas, para avalia??o da press?o intra-ocular antes do tratamento; no dia seguinte dez c?es receberam meloxicam, junto ? por??o de ra??o ?mida, na dosagem de 0,2 mg/Kg e 0,1mg/Kg nos restantes quatro dias, nove c?es receberam prednisona, junto ? por??o de ra??o ?mida, na dosagem de 1,0 mg/Kg durante cinco dias e nove c?es receberam somente a por??o de ra??o ?mida. No quinto dia do tratamento todos os animais tiveram novamente a press?o intra-ocular mensurada com o uso do ton?metro de aplana??o ?s 08 horas e ?s 16 horas. Em todos os grupos, incluindo o grupo-controle, as maiores m?dias de press?o intra-ocular foram observadas no dia 5 (cinco). A diferen?a dos valores de press?o intra-ocular observada entre as medi??es das 08 horas e das 16 horas foi significativa, independente do tratamento e do dia considerado. O uso dos antiinflamat?rios esteroidal e n?o-esteroidal n?o foi capaz de causar hipertens?o ocular e alguns fatores podem ser incriminados, como via de administra??o, dosagem e dura??o do tratamento utiliz ados, al?m da heran?a gen?tica e aus?ncia de doen?a glaucomatosa nos c?es selecionados.
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Leger-Charnay, Elise. "Régulation du métabolisme du cholestérol dans la rétine en conditions expérimentales associées au glaucome." Thesis, Bourgogne Franche-Comté, 2019. http://www.theses.fr/2019UBFCK090.
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Le cholestérol est un lipide présent dans toutes les cellules animales et indispensable à leur survie. Parmi les rôles multiples qu’il joue dans l’organisme, celui de composant des membranes cellulaires est essentiel pour le maintien de leur structure, de leur fluidité et donc clé dans la modulation de nombreuses voies de signalisation. A ce titre, les neurones sont particulièrement dépendants de l’apport en cholestérol car l’intégrité de la composition de leur membrane est requise pour l’exocytose vésiculaire des neurotransmetteurs et la transduction du signal post-synaptique. Ainsi, il a été montré qu’un excès ou un défaut de ce composé est neurotoxique. De nombreuses maladies neurodégénératives, comme la maladie d’Alzheimer, ont d’ailleurs été associées à des perturbations de l’homéostasie du cholestérol, soulignant la nécessité d’une régulation fine de son métabolisme dans les tissus nerveux. Dans ce cadre, l’existence de mécanismes de coordination entre les actions des neurones et de la glie, dont les fonctions sont complémentaires, semble indispensable. Dans le cerveau, les astrocytes, cellules macrogliales majoritaires, seraient le principal lieu de synthèse et d’export du cholestérol. Les neurones, plutôt consommateurs, seraient spécifiquement en charge de son élimination, via sa conversion en 24(S)-hydroxycholestérol (24S-OHC) par l’enzyme CYP46A1. Ce métabolite ne serait pas seulement un produit d’excrétion du cholestérol, mais jouerait également le rôle de molécule signal dans les cellules gliales. Il permettrait d’adapter le métabolisme de la glie aux besoins en cholestérol, afin d’éviter toute surcharge dans les tissus cérébraux. Dans la rétine, le métabolisme du cholestérol et sa régulation, en condition physiologique et pathologique, sont encore peu décrits. Les cellules de Müller, macroglie majoritaire de la rétine, pourraient participer à la synthèse de cholestérol dans ce tissu, mais les arguments dans ce sens méritent d’être étoffés. Concernant le 24S-OHC, sa synthèse est essentiellement restreinte aux cellules ganglionnaires, neurones chargés de transmettre l’influx nerveux de la rétine au cerveau. Les résultats de quelques études menées au laboratoire suggèrent d’ailleurs que l’enzyme CYP46A1 et son métabolite seraient impliqués dans la physiopathologie du glaucome, maladie liée à la dégénérescence des cellules ganglionnaires.Le but de ce projet de thèse est de contribuer à une meilleure compréhension du métabolisme du cholestérol dans les cellules de Müller et son éventuelle régulation par le 24S-OHC. L’objectif était également de mettre en évidence de potentielles altérations du métabolisme du cholestérol au cours du glaucome en caractérisant, à différents points de temps, les acteurs moléculaires impliqués dans sa synthèse, son transport et son élimination.Nos expériences menées sur des cultures primaires de cellules de Müller indiquent que ces cellules possèdent la machinerie moléculaire pour synthétiser et exporter le cholestérol, et pourraient donc participer activement à son métabolisme dans la rétine. Nous avons également décrit un effet hypocholestérolémiant du 24S-OHC dans les cellules de Müller, ce qui renforce l’hypothèse selon laquelle ce composé pourrait intervenir dans la régulation du métabolisme du cholestérol dans la rétine. Dans un modèle de glaucome expérimental, par hyperpression oculaire chez le rat, nous avons observé des modifications majeures du métabolisme du cholestérol. De manière très précoce, il s’agit d’une surexpression des gènes impliqués dans la synthèse et la captation de cholestérol dans la rétine, puis d’une élévation transitoire des taux de ses précurseurs. Un élément important de notre travail a été de montrer que ces perturbations initiales sont suivies de l’activation de mécanismes de contre-régulation coordonnés, permettant de maintenir l’homéostasie du cholestérol dans la rétine et participant donc sans doute positivement à la survie des cellules ganglionnairesCholesterol is a lipid found in every animal cell and is necessary for its survival. Among its multiple roles in the body, it is a component of cell membranes that is crucial for the maintenance of their structure and fluidity and is thus implicated in the modulation of many signalling pathways. Neurons are especially dependant on cholesterol input since the proper composition of their plasma membrane is required for vesicular exocytosis of neurotransmitters and transduction of the post-synaptic signal. It has been shown that both an excess and a lack of cholesterol is neurotoxic. Moreover, many neurodegenerative diseases, such as Alzheimer’s or Huntington’s disease, have been associated with dysregulation of cholesterol homeostasis, highlighting the need for a fine regulation of its metabolism in nervous tissues. Coordinated actions of neurons and glia, that exhibit complementary functions, are mandatory in that respect. In the brain, astrocytes, the main macroglial cells, may be the major source of cholesterol biosynthesis and export. Neurons, acting as consumers, may be specifically in charge of cholesterol elimination via conversion into 24S-OHC by the CYP46A1 enzyme. This metabolite is likely not only an elimination product of cholesterol but also a signalling molecule in glial cells. It might enable glial cholesterol metabolism to adjust as needed and avoid an overload in brain tissues. In the retina, cholesterol metabolism and its regulation under physiological and pathological conditions remain largely unknown. Müller cells, the major macroglial cells of the retina, could participate in cholesterol synthesis in this tissue even though evidence is still needed. Regarding 24S-OHC, its synthesis is mainly restricted to retinal ganglion cells, neurons responsible for nervous signal transmission from the retina to the brain. Studies performed in our laboratory suggest that CYP46A1 and its product could be implicated in the physiopathology of glaucoma, a disease characterized by ganglion cell degeneration.The present project aims to provide a better understanding of cholesterol metabolism in Müller cells and its potential regulation by 24S-OHC. The goal is also to unveil changes in cholesterol metabolism during the progression of glaucoma by characterizing, at different time points, the molecular players implicated in its biosynthesis, transport and elimination. Our experiments performed on primary Müller cell cultures indicate that these cells possess the molecular machinery to synthesize and export cholesterol and could therefore actively participate in its metabolism in the retina. We also reported a strong hypocholesterolemic effect of 24S-OHC in Müller cells, reinforcing the hypothesis that this compound could be a regulator of cholesterol metabolism in the retina. In an experimental glaucoma model, induced by an elevation in intraocular pressure in rats, we observed major changes in cholesterol metabolism. At the earliest time points, genes implicated in cholesterol biosynthesis and uptake in the retina were upregulated, and cholesterol precursor levels were consecutively and transiently elevated. An important component of our work was to demonstrate that counter-regulatory mechanisms were activated in response to these initial dysregulations, that enabled the maintenance of cholesterol homeostasis in the retina and likely participated in ganglion cell survival
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Ficarrotta, Kayla R. "Aqueous Humor Dynamics and the Constant-Pressure Perfusion Model of Experimental Glaucoma in Brown-Norway Rats." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7503.
Full textAbstract:
Glaucoma affects tens of millions of people and is the leading cause of irreversible blindness worldwide. Virtually all current glaucoma therapies target elevated intraocular pressure (IOP); however, the contribution of intracranial pressure (ICP) to glaucoma has recently garnered interest. Strain at the optic nerve head is now known to depend on the translaminar pressure difference (TLPD), which is the difference between IOP and ICP, rather than IOP alone. A better understanding of how IOP and ICP relate to glaucoma development and progression is essential for developing improved therapies and diagnostic tests. Glaucoma is commonly modeled in rats, yet aqueous humor dynamics are not well-documented in healthy nor diseased rat eyes. Moreover, because rats do not develop glaucoma spontaneously, it is essential to develop low-cost, reliable, and relevant models of glaucomatous pathology in the animal.
The purpose of this dissertation work is to achieve the following goals: i) quantitatively assess aqueous humor dynamics in healthy, living rat eyes, ii) develop an ideal model of experimental glaucoma in rats, iii) quantitatively characterize aqueous humor dynamics throughout experimental glaucoma in living rats, and iv) investigate the effects of ICP manipulations on aqueous humor dynamics in living rats. Chapter 2 reports physiological parameters of aqueous humor dynamics for the first time in the eyes of living, healthy Brown-Norway rats, and presents a novel perfusion technique for efficiently and accurately estimating these parameters. Chapter 3 introduces the constant-pressure perfusion model of experimental glaucoma: a powerful new model which overcomes several limitations of existing techniques. The constant-pressure perfusion model induces IOP elevations which are prescribable and easily manipulated, does not directly target the trabecular meshwork or its vasculature, and offers continuous records of IOP rather than requiring regular animal handling and tonometry. Chapter 3 characterizes IOP-induced optic neuropathies in rats and demonstrates their resemblance to human glaucoma. Chapter 4 evaluates whether the constant-pressure perfusion model affects ocular physiology, specifically showing that resting IOP and conventional outflow facility are not permanently nor significantly altered in the model. Chapter 5 examines the effect of ICP manipulations on aqueous outflow physiology in living rats, and reports for the first time a graded effect of intracranial hypertension on conventional outflow facility. Evidence for a neural feedback mechanism that may serve to regulate the TLPD is also presented. Chapter 6 summarizes the results of this dissertation, provides recommendations for future work, and gives closing remarks.
These collective projects provide insight into IOP regulation in both healthy and diseased rat eyes, advancing our understanding of glaucomatous development and damage in rats. A novel model of experimental glaucoma and several perfusion systems have been developed which are distinctly tailored for use in future glaucoma studies and will allow future investigators to study the disease with enhanced efficiency and exactitude. The results of this dissertation work suggest that detecting and correcting impairments of either IOP or ICP homeostatic capabilities may be of utmost importance for improving clinical outcomes in human glaucoma.
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Salinas, Navarro Manuel Ángel. "Efecto de la hipertensión ocular en la población de células ganglionares de la retina de rata y ratón." Doctoral thesis, Universidad de Murcia, 2011. http://hdl.handle.net/10803/37386.
Full textAbstract:
En esta tesis estudiamos la población total de las células ganglionares de la retina (CGR) en rata y ratón, y desarrollamos un modelo experimental de hipertensión ocular mediante fotocoagulación láser. La población de CGR proyecta masivamente a los colículos superiores. Se observa una estría visual en la retina dorsal donde se encuentra las densidades más altas de CGR. La pequeña población de CGR ipsilateral se distribuye mayoritariamente en la periferia de la retina temporal.
El aumento de la presión intraocular induce una compresión de los axones en la cabeza del nervio óptico que provoca una alteración del transporte axonal retrógrado, que induce una degeneración sectorial localizada y difusa de las CGR, preferentemente en la retina dorsal, así como de sus axones. La pérdida selectiva de las CGR en la capa de CGR, sugiere que la causa de la muerte de las CGR no se debe a una isquemia retiniana.In this thesis we have studied the total population of retinal ganglion cells (RGCs) in rat and mouse, and developed an experimental model of ocular hypertension by laser photocoagulation. The RGC population projects massively to the superior colliculi. There is a visual streak in the dorsal retina where the highest densities of RGCs are found. The small population of ipsilateral RGCs is distributed mainly in the periphery of the temporal retina. The increase of intraocular pressure induces a compression of the axons at the optic nerve head that causes a disturbed retrograde axonal transport, inducing a localized, diffuse and sectorial degeneration of RGCs and their axons, preferably in the dorsal retina. The selective loss of RGCs in the RGC layer, suggests that the cause of the RGC loss is not due to retinal ischemia.
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Gerzenstein, Sabrina Melisa. "Pharmacogenomics of the Intraocular Pressure Response to Glucocorticoids." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_theses/285.
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Glucocorticoids (GCs) have been widely used as a therapeutic agent for diverse inflammatory ocular diseases. However, a high percentage of patients undergoing this treatment develop high intraocular pressure (IOP), which if left unsupervised may lead to glaucoma. It is believed that the IOP elevation in response to GC treatment has a genetic determinant. In order to test this hypothesis, we analyzed in 52 patients the presence of single nucleotide polymorphisms (SNPs) in the glucocorticoid receptor gene (GR), the principal mediator of GCs uptake by the cells. We studied six GR SNPs previously reported to be associated with sensitivity and resistance to GCs: GluArg22/23GluLys (codon 22-23), Asn363Ser (codon 363), IVS2+646C>G (intron 2/BclI), IVS3-46G>C (intron 3), IVS4-16G>T (intron 4), Asn766Asn (Codon 766). Nevertheless, the results of this preliminary study did not show any specific correlation between SNPs in the GR gene and IOP elevation. Therefore, we proceeded to perform a whole genome SNP screen with the DNA samples of these patients to search for possible target genes responsible for the elevated IOP after GC treatment. As a result, we identified forty-eight SNPs in thirty-three genes that correlate with the high IOP response. The gene showing the strongest association is a poorly known G-protein coupled receptor. In addition, four SNPs hit a single transporter gene. Other candidate genes identified are a translation elongation factor, an F-box protein, an oxysterol binding protein, and a solute carrier family gene. These results support our hypothesis that IOP elevation following GC treatment is a genetically determined response. GCs are a common treatment for innumerable medical conditions; we believe that a genetic association between GC treatment and its physiological response may be important for improving treatment management and drug development for retinal diseases as well as for other medical ailments. However, further studies need to be performed to analyze in depth the association between the candidate genes identified in this study and the steroid response.
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Hatanaka, Marcelo. "Reprodutibilidade da curva tensional diária modificada e do teste de sobrecarga hídrica." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5149/tde-11082014-113511/.
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OBJETIVO: avaliar a reprodutibilidade da curva tensional modificada e do teste de sobrecarga hídrica em portadores de glaucoma de ângulo aberto ou hipertensos oculares, sem uso de hipotensor ocular, em dois dias consecutivos. MÉTODOS: análise prospectiva de pacientes portadores de glaucoma de ângulo aberto ou hipertensos oculares, submetidos à curva tensional modificada (medida da pressão intraocular às 8h, 11h, 14h e 16h), seguida do teste de sobrecarga hídrica (três medidas com intervalo de 15 minutos, iniciando-se 15 minutos após a ingestão, em cinco minutos, de um litro de água em temperatura ambiente), realizados pelo mesmo examinador, em dois dias consecutivos. Foram avaliadas: a reprodutibilidade da pressão intraocular em cada horário de medida durante a curva tensional modificada; a reprodutibilidade da pressão intraocular média, flutuação e pico de pressão durante a curva tensional modificada; a reprodutibilidade da flutuação e do pico de pressão durante o teste de sobrecarga hídrica. Calculou-se o coeficiente de correlação intraclasse para cada parâmetro. RESULTADOS: oitenta e oito olhos de 88 pacientes foram estudados. Destes, 64 eram portadores de glaucoma de ângulo aberto. A média das idades dos participantes foi 68,7+10,8 (51-79) anos. 65% dos pacientes eram do sexo feminino. A curva tensional modificada apresentou coeficiente de correlação intraclasse igual a 0,80, 0,82, 0,83 e 0,86 para as medidas realizadas às 8h, 11h, 14h e 16h, respectivamente (p < 0,001). A flutuação da pressão durante a curva tensional modificada, calculada pela diferença entre as pressões máxima e mínima e pelo desvio-padrão da média das medidas diurnas de pressão, a pressão média e o pico pressórico apresentaram coeficientes 0,60, 0,62, 0,91 e 0,85, respectivamente (p < 0,001). Durante o teste de sobrecarga hídrica, a flutuação apresentou coeficiente de 0,37 e o pico pressórico, 0,79. (p < 0,001). CONCLUSÕES: neste estudo, as medidas de pressão intraocular realizadas durante a curva tensional modificada, a média e o pico apresentaram excelentes níveis de reprodutibilidade. O pico pressórico durante o teste de sobrecarga hídrica apresentou também excelente reprodutibilidade. A flutuação, tanto na curva tensional modificada, quanto no teste de sobrecarga hídrica, apresentou os menores índices de reprodutibilidadeOBJECTIVE: to evaluate the reproducibility of the modified daily tension curve and the water drinking test in patients with open-angle glaucoma or ocular hypertension, not under topical treatment, during two consecutive days. METHODS: prospective analysis of open-angle glaucoma or ocular hypertensive patients, submitted to a modified daily tension curve (intraocular pressure measurements at 8AM, 11AM, 2PM and 4PM), followed by the water drinking test (three intraocular pressure measurements with 15 minutes intervals, 15 minutes after ingestion of one liter of tap water), performed by the same examiner, within two consecutive days. The following parameters were evaluated for reproducibility: intraocular pressure obtained at each time-point during the modified daily tension curve; mean, peak and pressure fluctuation during the curve and peak and fluctuation during the water drinking test. Reproducibility was assessed using the intraclass correlation coefficient. RESULTS: eighty-eight eyes from 88 patients were studied. From these, 64 presented open-angle glaucoma. Mean age was 68.7+10.8 (51-79) years. 65% patients were female. Intraclass correlation coefficients were 0.80, 0.82, 0.83 and 0.86 for intraocular pressure measurements at 8AM, 11AM, 2PM and 4PM, respectively (p<0.001) Fluctuation calculated as the difference between maximum and minimum intraocular pressures, fluctuation calculated as the standard deviation of the four daily measurements, mean and peak pressures presented coefficients of 0.60, 0.62, 0.91 and 0.85, respectively (p<0.001). During the water drinking test, coefficient values for fluctuation and peak pressure were 0.37 and 0.79 (p<0.001). CONCLUSIONS: in this study, intraocular pressure measurements during a modified daily tension curve, mean intraocular pressure and pressure peaks presented excellent reproducibility levels; pressure peaks during the water drinking test also presented excellent reproducibility level, whereas fluctuation, both during the modified daily tension curve and during the water drinking test, was the least reproducible parameter
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Castro, Emerson Fernandes de Sousa e. "Avaliação dos efeitos da variabilidade da pressão arterial sistêmica sobre a pressão de perfusão ocular e suas repercussões sobre o estresse oxidativo em retinas de ratos normotensos e hipertensos." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-01122014-144509/.
Full textAbstract:
Introdução: A hipertensão arterial sistêmica (HAS) é uma doença que pode determinar lesões em diversos órgãos inclusive nos olhos. As doenças vasculares oculares constituem a grande maioria das causas de cegueira na atualidade e a HAS tem contribuição importante nesta estatística. A variabilidade da pressão arterial tem sido implicada na gênese de uma série de lesões de órgãos-alvo. Na tentativa de compreender melhor a patogênese das doenças vasculares oculares testamos a hipótese de que não apenas os efeitos da HAS, mas também a variabilidade da pressão arterial (PA) poderia determinar lesão de órgão-alvo (ocular). Materiais e Métodos: A desnervação sino-aórtica (DSA), um modelo experimental de aumento da variabilidade da pressão arterial foi utilizado nos experimentos. Foram obtidas medidas da pressão intraocular e a partir destas medidas, a pressão de perfusão ocular. Foram analisados marcadores de estresse oxidativo (8-OHdG e nitrotirosina),VEGF e receptores AT1 na retina de animais normotensos e hipertensos com e sem DSA aguda (12 e 24 horas) e crônica (10 semanas). Resultados: Os animais desnervados apresentaram aumento da variabilidade da PA sem modificar a PA basal e redução da sensibilidade do barorreflexo. Houve aumento da modulação simpática vascular e da pressão de perfusão ocular (PPO), nos animais hipertensos, com aumento adicional da PPO nos hipertensos e desnervados crônicos.Observou-seestresse oxidativo retiniano nos animais desnervados agudos e noshipertensos desnervados crônicos, além do aumento da expressão de receptores AT1 da Angiotensina II nos animais hipertensos. Os níveis de VEGF retinianos dos animais desnervados crônicos, apresentaram comportamento inverso aos níveis de Caspase-3. Conclusão: Tais resultados indicam que só a HAS, mas também a variabilidade da PA podem determinar variações na pressão de perfusão ocular, assim como também podem induzir dano oxidativo às células retinianas. Além disso, pode-se sugerir efeito neuroprotetor retiniano do VEGFIntroduction: High blood pressure (HBP) is a disease that can determine lesions in many organs including the eyes. The ocular vascular diseases constitute the vast majority of causes of blindness and hypertension has important contribution in this statistic. Blood pressure variability has been implicated in the genesis of a series of end-organ damage. In an attempt to better understand the pathogenesis of ocular vascular diseases, we hypothesized that not only the effects of hypertension, but also the variability of blood pressure (BPV) could determine target end-organ damage (ocular). Materials and Methods: Sino-aortic denervation (SAD), an experimental model of increased blood pressure variability was used in the experiments. The intraocular pressure measurements were performed and from these measurements the ocular perfusion pressure was estimated. Oxidative stress markers (8-OHdG and nitrotyrosine), VEGF and AT1 receptor in rat retinas were analyzed inacute and chronic hypertensive and normotensiveSAD rats and in controls. Results: Denervated animals showed increased BP variability without altering the basal BP, while presenting reduced baroreflex sensitivity.There was an increase in sympatheticvascular modulation and in OPP,in hypertensive animals, that was additionally in chronic denervated hypertensive animals.Acute denervated and chronic hypertensive denervated animals showed retinal oxidative stress as well as hypertensive animals presented increased expression of AT1 receptors of angiotensin II. The levels of retinal VEGF of chronically denervated animals showed inverse behavior of levels of Caspase-3 Conclusion: These results suggest that, apart from the arterial hypertension, BP variability not only determines changes in ocular perfusion pressure, but also induces oxidative damage to retinal cells. Furthermore, one can suggest retinal neuroprotective effect of VEGF
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Hedman, Katarina. "Pooling Data from Similar Randomized Clinical Trials Comparing Latanoprost with Timolol; Medical Results and Statistical Aspects." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3392.
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Fu, Qingling. "Characterization of novel neuroprotectants for rescuing retinal ganglion cell loss in an ocular hypertensive model of glaucoma." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/HKUTO/record/B39557510.
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Fu, Qingling, and 付清玲. "Characterization of novel neuroprotectants for rescuing retinal ganglion cell loss in an ocular hypertensive model of glaucoma." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39557510.
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Barthou, Vincent. "Le tartrate de brimonidine : nouvelle approche thérapeutique dans le traitement du glaucome." Bordeaux 2, 2000. http://www.theses.fr/2000BOR2P029.
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"Chemical prevention of corticosteroid-induced ocular hypertension in vitro and in vivo." Thesis, 2011. http://library.cuhk.edu.hk/record=b6075405.
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Xu Li.Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 204-242).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.
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"Noninvasive determination of arterial pulse waveforms by applanation tonometry." 1998. http://library.cuhk.edu.hk/record=b5889794.
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Leong Hok Chong.Thesis (M.Phil.)--Chinese University of Hong Kong, 1998.
Includes bibliographical references (leaves 87-103).
Abstract also in Chinese.
Chapter 1. --- Abstract --- p.5
Chapter 2. --- Introduction --- p.8
Chapter 3. --- Noninvasive Methodology in Pulse Wave Assessment --- p.20
Chapter 3.1 --- Applanation Tonometry --- p.20
Chapter 3.2 --- The Instrument: Sphygmocardiograph --- p.20
Chapter 3.3.0 --- Reproducibility of Sphygmocardiograph --- p.27
Chapter 3.3.1 --- Background --- p.27
Chapter 3.3.2 --- Study Aims --- p.28
Chapter 3.3.3 --- Subjects and Methods --- p.28
Chapter 3.3.4 --- Statistical Analysis --- p.29
Chapter 3.3.5 --- Results --- p.31
Chapter 3.3.6 --- Discussion --- p.35
Chapter 4. --- Radial Artery-Derived Aortic Augmentation Indexin Normotensive Subjects --- p.36
Chapter 4.1 --- Background --- p.36
Chapter 4.2 --- Study Aims --- p.36
Chapter 4.3 --- Subjects and Methods --- p.38
Chapter 4.4 --- Statistical Analysis --- p.38
Chapter 4.5 --- Results --- p.39
Chapter 4.6 --- Discussion --- p.52
Chapter 5. --- Changes of Arterial Pulses in Normotensive Subjects with Family History of Hypertension --- p.56
Chapter 5.1 --- Background --- p.56
Chapter 5.2 --- Study Aims --- p.58
Chapter 5.3 --- Subjects and Methods --- p.58
Chapter 5.4 --- Statistical Analysis --- p.59
Chapter 5.5 --- Results --- p.59
Chapter 5.6 --- Discussion --- p.65
Chapter 6. --- Radial Artery-Derived Aortic Augmentation Indexin Hypertensive Subjects --- p.67
Chapter 6.1 --- Background --- p.57
Chapter 6.2 --- Study Aims --- p.68
Chapter 6.3 --- Subjects and Methods --- p.68
Chapter 6.4 --- Statistical Analysis --- p.69
Chapter 6.5 --- Results --- p.69
Chapter 6.6 --- Discussion --- p.70
Chapter 7. --- Changes of Arterial Pulses in Antihypertensive Therapies: Comparison between Diuretic and Long-Acting Calcium Antagonist --- p.72
Chapter 7.1 --- Background --- p.72
Chapter 7.2 --- Study Aims --- p.73
Chapter 7.3 --- Subjects and Methods --- p.73
Chapter 7.4 --- Statistical Analysis --- p.74
Chapter 7.5 --- Results --- p.74
Chapter 7.6 --- Discussion --- p.76
Chapter 8. --- General Remarks and Conclusion --- p.80
Chapter 9. --- Acknowledgments --- p.86
Chapter 10. --- References --- p.87
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Chen, Ming-Hui, and 陳明輝. "CMFE (Chrysanthemum Morifolium Flower Extract) prevents retinal ischemic damages in an AOH (Acute Ocular Hypertension) glaucoma mouse model." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/17897268897629382921.
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碩士中山醫學大學
生化暨生物科技研究所
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Glaucoma is ranked as the second most prevalent factor in causing blindness. Acute high intraocular pressure leads to gigantic damages to the eyes and such injuries are irreversible. Chrysanthemum morifolium flower extract (CMFE) by water is known as an anti-inflammatory agent for ages and is used as an antioxidant. Previous studies have shown that dietary CMFE intake can protect against photokeratitis induced by UVB exposure. This study aims to analyze the efficacy of CMFE on retinal damages by using a mouse glaucoma model. Male ICR mice aged 6- 8 weeks were randomly allocated into 3 groups: (1) control group: normal diet without CMFE and without high intraocular pressure induced, (2) damaged group: induced high intraocular pressure, but without CMFE given, (3) preventive group: induced high intraocular pressure, and with CMFE given at 100 ppm, 500 ppm, or 1000 ppm. The mice were sacrificed and eyes extracted for histological and immunohistochemical analyses. Total retinal thickness, outer nuclear layer thickness, retinal pigment epithelium cell number, and retinal ganglion cell number were quantified. The results showed that CMFE can prevent glaucomatous damages caused by high intraocular pressure, as evidenced by maintenance of retinal thickness, retinal pigment epithelium and retinal ganglion cell numbers.
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Hafez, Ali S. "Vascular and morphological changes of the optic nerve head following therapeutic intraocular pressure reduction in open angle glaucoma and ocular hypertension." Thèse, 2007. http://hdl.handle.net/1866/6504.
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Phillips, Kevin Clyde. "Patient's knowledge of diabetes, its ocular complications and management in a private practice population in the Western Cape, South Africa." Thesis, 2011. http://hdl.handle.net/10413/6293.
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The aim of this study was to determine management regimens and level of knowledge of diabetes and its‟ ocular complications among private patients in a sample of the population of the Western Cape region of South Africa. A population-based cross-sectional study design, using purposive accidental random sampling, was used. Questionnaires completed by diabetic patients who fund their condition privately outside of the South African Public Health sector were used. One hundred and twenty-two subjects participated in the research, 66 (54%) males and 56 (46%) females. There were 73 rural and 49 urban participants. The overall sample mean BMI was 30.7, average fasting plasma glucose (FPG) 8.1 mmol/l and the majority of respondents did not perform a daily FPG test or know the significance of the HbA1c test. The majority of participants were unaware of the serious ocular consequences of prolonged hyperglycaemia. Sixty-seven percent of respondents considered that they knew enough about diabetes to manage their own condition. From the data it is apparent that private patients‟ knowledge of the systemic and ocular complications of diabetes is sub-optimal. Whilst the majority considered annual eye examinations as important, less than one-third of respondents actually undertook them. Optometrists should be offered programmes to enhance their skills and co-manage and educate diabetic patients with other health care practitioners on a formal basis. Health insurance institutions should take cognisance of the value of patient education and preventative diabetic management and incentivize patients and health care providers in this regard.Thesis (M.Optom.)-University of KwaZulu-Natal, Westville, 2011.
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Wild, J. M., L. S. Kim, Ian E. Pacey, and I. A. Cunliffe. "Evidence for a learning effect in short-wavelength automated perimetry." 2006. http://hdl.handle.net/10454/3530.
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NoPurpose To document the magnitude of any learning effect for short-wavelength automated perimetry (SWAP) in patients with either ocular hypertension (OHT) or open-angle glaucoma (OAG) who are experienced in standard automated perimetry (SAP). Participants Thirty-five patients (22 with OHT and 13 with OAG) who had previously undergone at least 3 threshold SAP visual field examinations with the Humphrey Field Analyzer (HFA; Carl Zeiss Meditech Inc., Dublin, CA), and 9 patients with OHT who had not previously undertaken any form of perimetry. Methods Each patient attended for SWAP on 5 occasions, each separated by 1 week. At each visit, both eyes were examined using Program 24-2 of the HFA; the right eye was always examined before the left eye. Main Outcome Measures (1) Change over the 5 examinations, in each eye, of the visual field indices Mean Deviation (MD), Short-term Fluctuation (SF), Pattern Standard Deviation (PSD), and Corrected Pattern Standard Deviation. (2) Change in each eye between Visits 1 and 5 in proportionate Mean Sensitivity (pMS) for the central annulus of stimulus locations compared with that for the peripheral annulus thereby determining the influence of stimulus eccentricity on any alteration in sensitivity. (3) Change between Visits 1 and 5 in the number and magnitude of the Pattern Deviation (PD) probability levels associated with any alteration in sensitivity. Results The MD, SF, and PSD each improved over the 5 examinations (each at P<0.001). The improvement in pMS between Visits 1 and 5 was greater for the peripheral annulus than for the central annulus by approximately twofold for the patients with OAG. Considerable variation was present between patients, within and between groups, in the number of locations exhibiting an improving sensitivity between Visits 1 and 5 by 1 or more PD probability levels. Conclusions Care should be taken to ensure that, during the initial examinations, apparent field loss with SWAP in patients exhibiting a normal field by SAP is not the result of inexperience in SWAP. Apparently deeper or wider field loss in the initial examinations with SWAP compared with that exhibited by SAP in OAG also may arise from inexperience in SWAP.