The effect of medical therapy on IOP control in Ghana

Gyasi, Michael E; Andrew, F; Adjuik, Martin; Kesse, E; Kodjo, R A; Herndon, Leon W.

doi:10.4314/gmj.v48i3.5

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…This result is consistent with another previous study [ 40 ] which stated that the therapy given to glaucoma patients after cataract surgery is inadequate and needs further intervention compared to patients treated without cataract surgery. On the other hand, it is not uncommon for glaucoma patients who already have a compromised trabecular meshwork to experience pressure spikes after cataract surgery [ 41 ]. Removing the cataract lens also reduces the production of PEX material [ 17 , 33 , 34 ] that may produce obstruction of the collector openings.…”

Section: Discussionmentioning

confidence: 99%

Predictors for elevation of Intraocular Pressure (IOP) on glaucoma patients; a retrospective cohort study design

Birhanu

Tegegne

2022

BMC Ophthalmol

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Objective Because of the increase in the number of cases, currently, glaucoma is a significant public health issue that it leads to optic nerve damage and vision loss. High Intraocular Pressure reading indicates that the treatment given to a glaucoma patient is not sufficient/ adequate. Hence, the elevation of intraocular pressure is one of the indicators that, the therapy given to glaucoma patients under treatment is inadequate. Therefore, the main objective of the current study was to investigate predictors for the variation of elevation of IOP readings on glaucoma patients. Materials and methods A retrospective cohort study design was conducted on 1254 glaucoma patients, whose followed-ups were from September 2015 to August 2016 at Felege Hiwot Teaching and Specialized Hospital, North West Ethiopia. Data analysis was conducted using Statistical Analysis of Systems (SAS) software version 9.2 and AMOS software. The parameter estimation was conducted using the maximum likelihood estimation technique. Results Main effects like age (β = 0.01, t-value = 0.15, p-value = 0.018), patients with normal blood pressure (β = -3.35, t-value = -2.28, p-value = 0.0263), patients without diabetics (β = -3.79, t-value = -2.47, p-value = 0.014), visiting times (β = -6.00, t-value = -5.02, p-value = 0.0001), farmer glaucoma patients (β = -6.04, t-value = 3.87, p-value = 0.0001) had significant and indirect effect for the variation of elevation of IOP on glaucoma patients. Interaction effects like visiting time with existence of diabetes, visiting time with cataract surgery significantly effected on the variable of interest. Hence, both main and interaction effects had significant effects on the variable of interest. This study had identified socio-demographic characteristics, personal/individual behaviors, and clinical factors for the variation of elevation of IOP. The findings, in the current investigation, help health staff to conduct health-related education for awareness creation. Health-related education, about the progression of glaucoma, should be conducted on patients.

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Section: Discussionmentioning

confidence: 99%

Predictors for elevation of Intraocular Pressure (IOP) on glaucoma patients; a retrospective cohort study design

Birhanu

Tegegne

2022

BMC Ophthalmol

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“…The IOP-lowering effects of antiglaucoma medications on POAG patients ranged from 12.8% with the use of beta-blockers 17 to 63.7% with the use of Timolol–Latanoprost combination 40 ( Table 2 ). This evidence is, however, weak because all the three studies 17 , 36 , 40 that reported the IOP-lowering effects of medical treatment of glaucoma were retrospective patient record studies which are prone to selection and misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, using the findings of AGIS 44 as a benchmark for successful IOP control, the best reported IOP control in this review (mean IOP consistently ≤18 mm Hg) for patients on topical glaucoma medications at 6 months was achieved in 25% of patients. 36 Based on these findings, a practical GSR is best computed from 75% of the population of POAG patients. This would be a GSR targeted at POAG patients with clearly progressive disease who are very likely to go blind without trabeculectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies 33 , 34 were able to achieve 80% adherence which is the minimum regarded as good adherence to medications, 35 so this proportion of medication adherence was assumed in the best-case scenario model ( Flowchart 2 ). Only 25% of patients are expected to have adequate control of IOP (mean IOP ≤ 18 mm Hg) on drops at 6 months, 36 and for our model, we, therefore, assigned 75% of diagnosed glaucoma cases as requiring trabeculectomy. The 75% cut-off also ensured that an achievable target is developed, 37 in addition to the fact that in practice not all POAG patients will be fit for surgery.…”

Section: R Esultsmentioning

confidence: 99%

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What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic Review

Eni¹,

Nolan²,

Eval³

2021

Journal of Current Glaucoma Practice

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A bstract Aim and objective This study aimed to use the available evidence to model a glaucoma surgical rate (GSR), which could serve as a target for West Africa. Materials and methods A comprehensive literature search was performed in Medline, Embase, Global Health, and CINAHL, and studies published between January 1, 2000, and June 19, 2020, were retrieved. Study selection, quality appraisal, and data extraction were performed and the results of individual studies aggregated and presented using a narrative synthesis. Using these data, we aimed to construct a target GSR per million population per year that is sufficient to offer trabeculectomy to most patients with glaucoma who are diagnosed, and for whom other treatment options are either ineffective or inappropriate. The findings were then used to develop a trabeculectomy target for West Africa. Results Initial searches returned 633 references, of which 33 unique studies were eligible for inclusion. The glaucoma prevalence population-based surveys identified, reported a wide range of prevalence of primary open-angle glaucoma (POAG) ranging from 1.0 to 8.4%. The studies on glaucoma medications reported intraocular pressure (IOP)-lowering effects ranging from 12.8% (beta-blockers) to 63.7% (Timolol–Latanoprost combinations). The adherence rate to antiglaucoma medications spanned from 10.3 to 82.3%. Regarding selective laser trabeculoplasty (SLT), only two studies were found. All the studies on trabeculectomy showed a significant reduction in IOPs at different follow-up periods with many reporting the absence of vision-threatening complications. From these available data, a GSR of 50 trabeculectomies was suggested for countries in West Africa. Conclusion This trabeculectomy target metric is expected to minimize POAG blindness in the West African subregion. Clinical significance The proposed GSR will enable eye care workers involved in glaucoma care in West Africa to assess their efforts compared with the proposed target. The gap will signal the potential for improvement. How to cite this article Eni EN, Nolan W, Eval B, et al. What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic Review. J Curr Glaucoma Pract 2021;15(1):19–27.

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“…Gyasi et al in Ghana also found the high pre-treatment IOP mean in POAG patients, with significantly decreased IOP from 31.9 ± 8.9 mmHg to 21.3 ± 6.6 mmHg at the sixth month of treatment. 24 The increased IOP is preceded by increased resistance of the aqueous humor outflow in the trabecular meshwork. This trabecular meshwork has abnormal changes in collagen structure, intertrabecular space, juxtacanalicular connective tissue, and endothelial function.…”

Section: Research Articlementioning

confidence: 99%

Clinical Characteristics and Managements of Primary Open-Angle Glaucoma Patients at National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia

Salsabila

Gandasubrata²,

Rifada³

2023

J. Med. Health

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Glaucoma is the largest cause of permanent blindness globally. Primary open-angle glaucoma (POAG) is one of chronic glaucoma and is asymptomatic in the early stage. This study was performed to identify the clinical characteristics and management of POAG patients at the Cicendo Eye Hospital, Bandung, Indonesia. This retrospective, descriptive study was conducted on medical records of POAG patients in Cicendo Eye Hospital in January-December 2020 using whole sampling method. Sociodemographic, clinical characteristics, and management data were collected. From 147 subjects obtained, the largest age group of POAG patients was 60-69 years old (30.6%), with most of the patients being male (68.0%). Most of the patients experienced blindness (37.6%) and had cup-to-disc ratio (CDR) 0.9-1.0 (36.8%). The mean of pre-treatment IOP was 29.1±13.1 mmHg, and the mean of post-treatment was 19.3±7.7 mmHg. The mean of anti-glaucoma medication in the first and the last control were 1.93±0.59 and 1.48±0.70, respectively. The most common treatments were medication only (69.8%), with combined surgery as the most performed surgery. In conclusion, most POAG patients were 60 years old or older and male, with most eyes being blind. The POAG treatments were mostly anti-glaucoma medication only to lower IOP as the goals of the treatment.

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The effect of medical therapy on IOP control in Ghana

Cited by 4 publications

References 18 publications

Predictors for elevation of Intraocular Pressure (IOP) on glaucoma patients; a retrospective cohort study design

Predictors for elevation of Intraocular Pressure (IOP) on glaucoma patients; a retrospective cohort study design

What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic Review

Clinical Characteristics and Managements of Primary Open-Angle Glaucoma Patients at National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia

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