Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Lee, Jacky; Chan, Poemen P.; Zhang, Xiu Juan; Chen, Li Jia; Jonas, Jost B.

doi:10.1097/01.apo.0000605096.48529.9c

Cited by 50 publications

(30 citation statements)

References 109 publications

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“…The incidence of glaucoma was 3.5% among the population from 40 to 80 years old in a global study performed in 2013 18 . Age-standardized incidence of primary glaucoma was estimated to be 2.6% in the general population in China 19 . According to these data, our study suggested that the incidence of ocular hypertension was increased in patients with CD comparing to the general population.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Ocular Hypertension in Patients with Cushing’s Disease: An Underestimated Comorbidity

Chen

et al. 2020

Preprint

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BackgroundThe association between ocular hypertension and endogenous hypercortisolemia, as well as the ophthalmological outcomes after endocrine remission due to a surgical resection were still unknown. MethodsIntraocular pressure (IOP), visual field and peripapillary retinal nerve fiber layer thickness were documented in all patients with Cushing’s disease (CD) admitted to a tertiary pituitary center for surgery from Jan to Jul 2019. Patients with acromegaly and patients with nonfunctioning pituitary adenoma (NFPA) during the same study period were served as controls. We calculated the odds ratio and identified risk factors of developing ocular hypertension, and presented postoperative trends of IOP.Results52 patients (38.4±12.4 years old) with CD were included. IOP was higher in patients with CD (left 19.4 ± 5.4 mmHg and right 20.0 ± 7.1 mmHg) than patients with acromegaly (left 17.5 ± 2.3 mmHg and right 18.6 ± 7.0 mmHg, p = 0.033) and patients with NFPA (left 17.8 ± 2.6 mmHg and right 17.4 ± 2.4 mmHg, p = 0.005). 21 eyes (20.2%) in patients with CD were diagnosed with ocular hypertension comparing to 4 eyes (4.7%) in the acromegaly group and 4 eyes (4.5%) in the NFPA group. The odds ratio of developing ocular hypertension in patients with CD was 5.1 (95% CI, 1.3 – 25.1, p = 0.029) and 6.6 (95% CI, 1.8 – 30.3, p = 0.007), comparing with the two control groups, respectively. Among patients with CD, those with higher urine free cortisol were more likely to develop ocular hypertension (OR 19.4, 95% CI 1.7 – 72.6). IOP decreased at one-month follow-up in patients with CD and the change sustained at three-month follow-up. ConclusionsIn conclusion, patients with CD had increased risk of developing ocular hypertension comparing to other types of pituitary adenomas, which warrant the discretion of both ophthalmologists and neuroendocrinologists.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Ocular Hypertension in Patients with Cushing’s Disease: An Underestimated Comorbidity

Chen

et al. 2020

Preprint

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“…When the variables were of the score type, the appropriate method of graphical analysis was the scatter plot. For the analysis of the nominal variables, the Chi-Square Test was used to evaluate the existence of a significant difference between two or more samples [ 24 , 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Aspects of Tertiary Prevention in Patients with Primary Open Angle Glaucoma

Munteanu

Roiu

et al. 2021

JPM

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The purpose of the study is to assess the health of patients in the activity of tertiary prevention dedicated to preventing blindness caused by POAG (primary glaucoma with open angle and high tension) and NTG (primary glaucoma with open-angle and statistically normal tension—particular form of glaucoma with open angle) and preservation of the remaining visual function. The design of the study is epidemiological, observational, descriptive and retrospective, and uses only the data recorded in the existing records in the archives of the Ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea (IOCECHO) during the years 1999–2019 (anamnestic data; objective examination and paraclinical examination: intraocular pressure—IOP and visual field—VF). The methods of the study included the standardized protocol: anamnesis, physical ophthalmological examination, IOP determination, and computerized perimetry with the “Fast Threshold” strategy performed with the “Opto AP-300” perimeter. The obtained results were statistically processed with a specialized software (S.P.S.S.—I.B.M. Statistics version 22). The study examined the available data of 522 patients of which 140 were men (26.8%) and 382 were women (73.2%). The gender ratio was 0.37. In the period 1999–2019, 150,844 people with ophthalmic pathology were consulted in the Ophthalmology office of IOCECHO out of which 522 patients (0.35%) were diagnosed with primitive open-angle glaucoma, 184 people (35.2%) presented high IOP (POAG), and 338 people (64.8%) had statistically normal IOP (NTG). The annual proportion of cases diagnosed with glaucoma in the total number of patients examined was between 0.1% (2005; 2008; 2010) and 2.4% in 2012, when 101 people were detected. In the studied records, no cases of uni- and/or bilateral blindness were mentioned. The mean age of glaucoma patients at the first consultation was 60.81 ± 12.14 years with high frequencies in the 55–69 age groups and at the last consultation it was 66.10 ± 12.47 years with high frequencies in the age groups between 60–74 years. Monitoring and treatment of glaucoma patients was beneficial; IOP decreased statistically significantly: in patients with POAG by 46.16%, from 30.50 ± 7.98 mmHg to 16.42 ± 3.01 mmHg (p = 0.000) and in those with NTG by 17.44%, at 16.39 ± 3.66 mmHg at 13.53 ± 1.92 mmHG (p = 0.000). The duration of treatment and monitoring was on average 5.1 ± 3.4 years, for 184 patients (35.2%) with POAG and 5.1 ± 3.8 years for 338 patients (64.8%) with NTG. Tertiary prevention of glaucoma, by providing specialized care, ensures effective control of IOP and implicitly of the long-term evolution of the disease. IOP is the only modifiable risk factor in patients with POAG and NTG and its decrease prevents the progression of the disease and emphasizes the importance of early diagnosis and treatment. The management of the glaucoma patient consisted of: complete ophthalmological examination (subjective and objective), paraclinical examination with IOP, and VF measurement (valuable ophthalmological diagnostic tool) for disease detection and effective assessment of disease progression in order to improve the process of therapeutic decision making.

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“…Glaucoma is the most common causative disease of blindness in Japan [ 1 ]. One of the critical risk factors for glaucoma is the intraocular pressure (IOP) [ 2 – 5 ]. IOP-lowering eye drops and surgeries, such as selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS), have been developed and used for treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of adherence between fixed and unfixed topical combination glaucoma therapies using Japanese healthcare/pharmacy claims database: a retrospective non-interventional cohort study

2021

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Background Adherence to chronic therapies is crucial to prevent the progression of disease, such as glaucoma. However, only a limited number of studies have investigated them using real-world data in Japan. This study aimed to evaluate Japanese patients’ adherence to fixed- and unfixed-combination eye drops as a second-line therapy for glaucoma in real-world practice. Methods This retrospective, non-interventional cohort study utilized a commercially available Japanese healthcare database (MinaCare database). Medical/pharmacy claims data were collected from 2011 to 2016. The primary endpoint was adherence to medications, assessed by proportion of days covered (PDC) with medication during a 12-month post-index period. Meanwhile, the secondary endpoints included the persistence rate. Results A total of 738 patients were included in this study: 309 and 329 in the fixed- and unfixed-combination cohorts, respectively. Prostaglandin analog (PG)/β-blocker (BB) was most commonly claimed in 241/309 (78.0%) patients in the fixed-combination cohort. In the unfixed-combination cohort, PG and BB were claimed in 130/329 (39.5%) patients, whereas PG and α2-agonist were claimed in 87/329 (26.4%) patients. Patients were more adherent to the fixed-combination than the unfixed-combinations (mean PDCs [SD], 79.1% [32.1] vs. 62.2% [38.0]; P < 0.0001). The proportion of patients with good adherence (PDC ≥ 80%) was also higher in the fixed-combination cohort (69.6%) than in the unfixed-combination cohort (48.6%) (P < 0.0001). During the 12-month post-index period, the persistence rate was higher in the fixed-combination cohort than in the unfixed-combination cohort (47.6% [95% confidence intervals (CI): 41.9–53.0] vs. 24.9% [95% CI: 20.4–29.7], P < 0.0001). Conclusions Japanese patients with glaucoma preferred the fixed-combination therapies over the unfixed-combination therapies. Hence, fixed-combination therapies would contribute to the improvement of adherence.

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Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Cited by 50 publications

References 109 publications

Increased Risk of Ocular Hypertension in Patients with Cushing’s Disease: An Underestimated Comorbidity

Increased Risk of Ocular Hypertension in Patients with Cushing’s Disease: An Underestimated Comorbidity

Aspects of Tertiary Prevention in Patients with Primary Open Angle Glaucoma

Comparison of adherence between fixed and unfixed topical combination glaucoma therapies using Japanese healthcare/pharmacy claims database: a retrospective non-interventional cohort study

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