The current research status of normal tension glaucoma

Mi, Xue; Yuan, Ti‐Fei; So, Kwok‐Fai

doi:10.2147/cia.s67263

Cited by 33 publications

(25 citation statements)

References 99 publications

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“…Surgical procedures cut small holes in the eye to drain the aqueous humor or lasers are used to produce holes in the trabecular meshwork to increase outflow of aqueous humor (Cairns, 1968). Eye drop or surgery treatment is also used in normotensive glaucoma patients, even when IOP measurements never exceed 22 mmHg (Mi et al, 2014; Jeong et al 2014). However, these treatments alone are insufficient to halt the progression of blindness associated with glaucoma (Lickter et al, 2001; Heijl et al, 2002; Kass et al, 2002; Beidoe and Mousa, 2012; Jeong et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Retinal ganglion cell neuroprotection induced by activation of alpha7 nicotinic acetylcholine receptors

Mata

Linn²,

Linn

2015

Neuropharmacology

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The α7nAChR agonist, PNU-282987, has previously been shown to have a neuroprotective effect against loss of retinal ganglion cells (RGCs) in an in vivo glaucoma model when the agent was injected into the vitreous chamber of adult Long Evans rat eyes. Here, we characterized the neuroprotective effect of PNU-282987 at the nerve fiber and retinal ganglion cell layer, determined that neuroprotection occurred when the agonist was applied as eye drops and verified detection of the agonist in the retina, using LC/MS/MS. To induce glaucoma-like conditions in adult Long Evans rats, hypertonic saline was injected into the episcleral veins to induce scar tissue and increase intraocular pressure. Within one month, this procedure produced significant loss of RGCs compared to untreated conditions. RGCs were quantified after immunostaining with an antibody against Thy 1.1 and imaged using a confocal microscope. In dose-response studies, concentrations of PNU-282987 were applied to the animal’s right eye two times each day, while the left eye acted as an internal control. Eye drops of PNU-282987 resulted in neuroprotection against RGC loss in a dose-dependent manner using concentrations between 100 µM and 2 mM PNU-282987. LC/MS/MS results demonstrated that PNU-282987 was detected in the retina when applied as eye drops, relatively small amounts of PNU-282987 were measured in blood plasma and no PNU-282987 was detected in cardiac tissue. These results support the hypothesis that eye drop application of PNU-282987 can prevent loss of RGCs associated with glaucoma, which can lead to neuroprotective treatments for diseases that involve α7nAChRs.

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Section: Introductionmentioning

confidence: 99%

Retinal ganglion cell neuroprotection induced by activation of alpha7 nicotinic acetylcholine receptors

Mata

Linn²,

Linn

2015

Neuropharmacology

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“…Patients with POAG who suffer glaucomatous ON damage at normal IOP levels have been considered by some to have normal tension glaucoma (NTG). 9 While others dispute the value of NTG as a diagnostic entity, 9 it is generally accepted that a subgroup of patients with POAG suffer significant ON damage without evidence of IOP elevated above the statistical range of normal IOPs recorded in population-based surveys, 10 and the term is now so widespread in the published literature that there were over 2000 citations of it in PubMed by mid-2017. Notwithstanding that IOP reduction may slow the glaucomatous process in some of these patients, 11 – 13 there clearly must exist an IOP-independent mechanism of progressive optic neuropathy unresponsive to IOP reduction to any level.…”

mentioning

confidence: 99%

Magnetic Resonance Imaging of Optic Nerve Traction During Adduction in Primary Open-Angle Glaucoma With Normal Intraocular Pressure

Demer

Clark

Suh

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeWe used magnetic resonance imaging (MRI) to ascertain effects of optic nerve (ON) traction in adduction, a phenomenon proposed as neuropathic in primary open-angle glaucoma (POAG).MethodsSeventeen patients with POAG and maximal IOP ≤ 20 mm Hg, and 31 controls underwent MRI in central gaze and 20° to 30° abduction and adduction. Optic nerve and sheath area centroids permitted computation of midorbital lengths versus minimum paths.ResultsAverage mean deviation (±SEM) was −8.2 ± 1.2 dB in the 15 patients with POAG having interpretable perimetry. In central gaze, ON path length in POAG was significantly more redundant (104.5 ± 0.4% of geometric minimum) than in controls (102.9 ± 0.4%, P = 2.96 × 10−4). In both groups the ON became significantly straighter in adduction (28.6 ± 0.8° in POAG, 26.8 ± 1.1° in controls) than central gaze and abduction. In adduction, the ON in POAG straightened to 102.0% ± 0.2% of minimum path length versus 104.5% ± 0.4% in central gaze (P = 5.7 × 10−7), compared with controls who straightened to 101.6% ± 0.1% from 102.9% ± 0.3% in central gaze (P = 8.7 × 10−6); and globes retracted 0.73 ± 0.09 mm in POAG, but only 0.07 ± 0.08 mm in controls (P = 8.8 × 10−7). Both effects were confirmed in age-matched controls, and remained significant after correction for significant effects of age and axial globe length (P = 0.005).ConclusionsAlthough tethering and elongation of ON and sheath are normal in adduction, adduction is associated with abnormally great globe retraction in POAG without elevated IOP. Traction in adduction may cause mechanical overloading of the ON head and peripapillary sclera, thus contributing to or resulting from the optic neuropathy of glaucoma independent of IOP.

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“…Sonuç olarak, güncel araştırmalar NTG ve PAAG arasında hem benzerlik hem de fark olduğunu ortaya koymuştur. [36] DSH değerinin dikkate alınmamış olması bu çalışmanın bir limitasyonudur. 2016 yılında yapılan bir çalışmada [30] hipertansif glokomlu hastalar ile normal tansiyonlu glokomlu hastalar arasındaki tek istatistiksel olarak anlamlı farkın PSA DSH düzeyinde olduğu ve NTG olanlarda DSH'nin azaldığı rapor edilmiştir.…”

Section: Discussionunclassified

Doppler Ultrasonography in Primary Open-Angle and Normal Tension Glaucoma Patients

Çiçek¹

2019

bogazicitip

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Objectives:This study was designed to evaluate hemodynamic alterations in the retrobulbar blood flow in primary open-angle and normal-tension glaucoma patients using Doppler ultrasonography (US) and to emphasize the importance of diagnostic imaging and vascular factors in the etiology.Methods: A total of 98 eyes of 50 patients were examined for the study. The control group consisted of 14 normal cases. The patient groups were comprised of 25 patients with primary open-angle and 11 patients with normaltension glaucoma. All of the examinations were performed using a multifrequency (5-7.5-10 MHz) linear transducer and a Toshiba PowerVision 7000 SSA-380A color Doppler US device (Toshiba Corp., Tokyo, Japan). The peak systolic velocity and resistive index values of the ophthalmic artery, central retinal artery, and temporal posterior ciliary arteries were examined. Results:There was no significant difference between the groups in terms of age and gender distribution, and no ÖZET Amaç: Çalışmanın amacı, primer açık açılı glokom ve normal tansiyonlu glokom olgularında, retrobulber bölgenin akım özelliklerinde ortaya çıkabilecek hemodinamik değişiklikleri Doppler ultrasonografi ile değerlendirerek, etiyolojide vasküler faktörlerin önemini ve tanıda görüntülemenin rolünü araştırmaktır.Yöntem: Çalışma için toplam 50 olgunun 98 adet gözü incelendi. Kontrol grubu 14 normal olgudan oluşmakta idi. 25 adet primer açık açılı ve 11 adet normal tansiyonlu glokom olgusu hasta gruplarını oluşturdu. Tüm incelemeler Toshiba PowerVision 7000 SSA-380A renkli Doppler US cihazı ile multifrekans (5-7.5-10 MHz) lineer transdüser ile gerçekleştirildi. Oftalmik arter, santral retinal arter ve temporal posterior silier arterlerin piksistolik hız ve rezistif indeks değerleri incelendi. Bulgular:Olguların yaş ve cinsiyetlerinin dağılımı ile her iki gözün karşılaştırılmasında piksistolik hız ve rezistif indeks değerlerinde anlamlı fark saptanmadı. Her iki glokom grubunda da oftalmik arterin piksistolik hız, rezistif indeks ve santral retinal arterin piksistolik hız değerlerinde, normal olgulardan oluşan kontrol grubu ile anlamlı istatistiksel fark saptanmadı. Glokom olgularında santral retinal arterin rezistif indeks değeri kontrol grubuna göre yüksek bulundu. Posterior silier arterlerde ise piksistolik hız değeri glokomlu olgularda kontrol grubuna göre düşük, rezistif indeks değeri ise yüksek bulundu. İki glokom grubu arasında yapılan karşılaştırmada ise incelenen değerlerde anlamlı istatistiksel fark saptanmadı.Sonuç: Çalışmamızda santral retinal arter ve özellikle posterior silier arterde tespit ettiğimiz bulgular vasküler hemodinamideki değişikliklerin glokom etiyolojisinde rol oynayabileceği kuramını desteklemektedir. Retrobulber kan akımının değerlendirilmesinde renkli Doppler US inceleme noninvaziv, kontrast madde gerektirmeyen, radyasyon içermeyen, tekrar edilebilir güvenilir bir yöntemdir.Anahtar sözcükler: Doppler ultrasonografi; glokom; oftalmik arter; posterior silier arter; santral retinal arter. difference in peak systolic velocity ...

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The current research status of normal tension glaucoma

Cited by 33 publications

References 99 publications

Retinal ganglion cell neuroprotection induced by activation of alpha7 nicotinic acetylcholine receptors

Retinal ganglion cell neuroprotection induced by activation of alpha7 nicotinic acetylcholine receptors

Magnetic Resonance Imaging of Optic Nerve Traction During Adduction in Primary Open-Angle Glaucoma With Normal Intraocular Pressure

Doppler Ultrasonography in Primary Open-Angle and Normal Tension Glaucoma Patients

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