The aim of the present study was to evaluate sleep and mood disorders and related ocular parameters in glaucoma patients. We focused on visual fields and the retinal nerve fibre layer, because decreased circadian photoreception by damaged intrinsically photosensitive retinal ganglion cells is suspected in glaucoma. A cross-sectional study was performed on 140 subjects: 69 with glaucoma and 71 normal controls. Individuals with cataract, dry eye, or retinal pathology were excluded from the study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) and underwent comprehensive ophthalmological examinations for glaucoma. Patients with advanced glaucoma had significantly worse PSQI scores than normal controls (P < 0.05). Stepwise multivariate linear regression analysis revealed PSQI was significantly correlated with the mean deviation in the worse eye, the number and frequency of medications, and anxiety and depression subscores of the HADS after adjustment for age and sex (P < 0.05). We did not find a significant correlation between PSQI scores and the thickness of retinal nerve fibre layer. In conclusion, the subjective sleep quality of glaucoma patients was correlated with visual field loss and mood status.
Among patients with POAG, the severity of visual field defects is associated with fear of falling. (http://www.umin.ac.jp/ctr/index.htm number, UMIN000005574.).
Purpose. To evaluate efficacy and safety of a trabecular micro-bypass stent system when used as the sole procedure in Japanese patients with medically uncontrolled primary open-angle glaucoma (POAG). Design. Prospective nonrandomized interventional pilot study. Methods. Ten eyes of 10 Japanese patients with medically uncontrolled POAG taking three ocular hypotensive medications were treated using only the implantation of two iStent trabecular micro-bypass stents. Each patient continued to take the same ocular hypotensive medications used preoperatively throughout the study. Intraocular pressure (IOP) and endothelial cell density (ECD) were determined at baseline and at 1, 3, and 6 months postoperatively. Best-corrected visual acuity (BCVA) was measured at baseline and 6 months after surgery. Results. Mean IOP was 22.0 ± 3.0 mmHg at baseline and 16.9 ± 3.6 mmHg at 6 months, which represented a mean reduction of 5.1 mmHg or 23.2%. No significant changes were observed in the ECD and BCVA. Complications that occurred during the early postoperative period included hyphema, peripheral anterior synechiae, and occlusion of the stent by the iris. Conclusion. Implantation of two trabecular micro-bypass stents as the sole procedure in Japanese POAG patients effectively reduced IOP and exhibited a favorable safety profile. Clinical Trials Registration number is UMIN000004002.
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