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https://www.readbyqxmd.com/read/29194069/changing-patterns-in-treatment-of-angle-closure-glaucoma
#1
Maria L Napier, Augusto Azuara-Blanco
PURPOSE OF REVIEW: Angle closure glaucoma is a leading cause of blindness globally and trends of how best to treat this disease are evolving. The advent of anterior segment imaging aids our understanding of pathogenesis and allows more robust and objective measurement of treatment modalities. We will also review recent literature regarding the role of laser and surgical interventions for the treatment of primary angle closure disease. RECENT FINDINGS: Recent studies evaluating the efficacy of laser peripheral iridotomy (LPI) in primary angle closure suspects (PACs) show that while it is a safe intervention and initially anterior chamber angle widens following the laser treatment, the effect is lost with time...
November 30, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29189543/acute-angle-closure-glaucoma-associated-with-aripiprazole-in-the-setting-of-plateau-iris-configuration
#2
Elizabeth Shen, Sarah Farukhi, Mason Schmutz, Sameh Mosaed
PURPOSE OF THE STUDY: To report a novel case of drug-induced angle-closure from aripiprazole (Abilify), an atypical antipsychotic, and propose a mechanism for this association. METHODS/RESULTS: We report a case of a 45 year-old Caucasian woman who presented in subacute angle closure two months after initiating aripiprazole 5 mg daily for depression. This patient reported no prior ocular history and had been on longstanding duloxetine (Cymbalta) 60 mg daily for over ten years prior to starting aripiprazole...
November 17, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/29151687/medium-term-anatomical-results-of-laser-peripheral-iridoplasty-an-anterior-segment-optical-coherence-tomography-study
#3
Joobin Hooshmand, James Cy Leong, Jeremy O'Connor, Ghee S Ang, Anthony P Wells
Aim: To evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty. Materials and methods: This is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI)...
September 2017: Journal of Current Glaucoma Practice
https://www.readbyqxmd.com/read/29118500/iridoplasty-of-fixed-dilated-pupil-urrets-zavalia-syndrome-after-deep-anterior-lamellar-keratoplasty
#4
Efthalia Ntora, Nikolaos Ziakas
A 38-year-old woman with advanced keratoconus initially developed Urrets-Zavalia Syndrome (UZS) in the left eye after deep anterior lamellar keratoplasty. During the uneventful surgery, a 7-mm-wide pupil unresponsive to light was noticed. On the first postoperative day, intraocular pressure (IOP) was elevated up to 45 mmHg with shallow anterior chamber (AC). A peripheral iridotomy in 2 o'clock position was conducted and a fixed combination of brinzolamide 1% and timolol 0.5% was administered topically. In the subsequent postoperative period, IOP was successfully reduced, but the patient reported severe photophobia, glare, and decreased vision...
September 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28978593/asymmetric-glaucoma-in-pseudoplateau-iris-syndrome
#5
John S Swogger, Shelly G Jain, Andrea K Sawchyn, Gloria P Fleming
A 39-year-old Caucasian man with bilateral narrow angles, a plateau-like iris configuration on gonioscopy and elevated intraocular pressure (IOP) presented with significant asymmetric glaucoma, left eye affected more than right. Initial management with topical medical therapy, laser iridoplasty and peripheral iridotomy in the left eye was ineffective in lowering the IOP or opening the anterior chamber angle. Ultrasound biomicroscopy demonstrated bilateral ciliary body cysts. The patient ultimately required surgical management, consisting of cataract extraction and endoscopic cyclophotocoagulation of ciliary body cysts in the left eye and trabeculectomy in the right eye, for persistent IOP control to prevent further optic nerve damage and subsequent visual field loss...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28767461/long-term-outcome-of-argon-laser-peripheral-iridoplasty-in-the-management-of-plateau-iris-syndrome-eyes
#6
Jeffrey R Peterson, John W Anderson, Lauren S Blieden, Alice Z Chuang, Robert M Feldman, Nicholas P Bell
PURPOSE: To report long-term (>5 y) outcomes of plateau iris syndrome patients treated with argon laser peripheral iridoplasty (ALPI). PATIENTS AND METHODS: A retrospective chart review was performed on all patients with plateau iris syndrome treated with ALPI from 1996 to 2007. The study included 22 eyes from 22 patients with plateau iris after peripheral iridotomy that were followed for at least 1 year after ALPI. The primary outcome was incidence of needing any intraocular pressure (IOP)-lowering medications or surgery (either a filtering procedure or phacoemulsification)...
September 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28556512/comparison-of-circumferential-peripheral-angle-closure-using-iridotrabecular-contact-index-after-laser-iridotomy-versus-combined-laser-iridotomy-and-iridoplasty
#7
Hyun-Kyung Cho, Changwon Kee, Heon Yang, Hyoun Do Huh, Su Jin Kim, Young Min Park, Jong Moon Park
PURPOSE: To compare the quantitative changes of peripheral angle after laser iridotomy (LI) alone (group A) or combined LI and Iridoplasty (group B) using iridotrabecular contact (ITC) index by swept-source anterior segment optical coherence tomography (AS-OCT). METHODS: In this prospective comparative observational study, OCT images were obtained before and after the procedure. In each image frame, scleral spur (SS) and the ITC end point (EP) were marked and ITC index was calculated as a percentage of the angle closure from 360°...
May 27, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28302178/laser-peripheral-iridotomy-versus-laser-peripheral-iridotomy-plus-laser-peripheral-iridoplasty-in-the-treatment-of-multi-mechanism-angle-closure-study-protocol-for-a-randomized-controlled-trial
#8
Shida Chen, Jianhua Lv, Sujie Fan, Hong Zhang, Lin Xie, Ling Xu, Bing Jiang, Huipin Yuan, Yuanbo Liang, Shuning Li, Pingyan Chen, Xiulan Zhang, Ningli Wang
BACKGROUND: China has the largest burden of primary angle-closure glaucoma (PACG) worldwide. The mechanism of the angle closure is complex and includes pupillary block and non-pupillary block. Currently, opinion is that laser peripheral iridotomy (LPI) alone is not sufficient to prevent disease progression. Laser peripheral iridoplasty (LPIP) is an alternative and effective way of widening the angle recess in eyes that are affected by primary angle closure (PAC). However, it is not known if greater benefit would be achieved using LPI plus LPIP for PAC with multiple mechanisms (MAC)...
March 17, 2017: Trials
https://www.readbyqxmd.com/read/28039061/primary-angle-closure-glaucoma-what-we-know-and-what-we-don-t-know
#9
REVIEW
Xinghuai Sun, Yi Dai, Yuhong Chen, Dao-Yi Yu, Stephen J Cringle, Junyi Chen, Xiangmei Kong, Xiaolei Wang, Chunhui Jiang
Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG...
March 2017: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/28002189/to-study-the-efficacy-of-laser-peripheral-iridoplasty-in-the-treatment-of-eyes-with-primary-angle-closure-and-plateau-iris-syndrome-unresponsive-to-laser-peripheral-iridotomy-using-anterior-segment-oct-as-a-tool-comment
#10
https://www.readbyqxmd.com/read/27927679/temporal-ocular-coherence-tomography-measured-changes-in-anterior-chamber-angle-and-diurnal-intraocular-pressure-after-laser-iridoplasty-impact-study
#11
RANDOMIZED CONTROLLED TRIAL
Rupert R A Bourne, Ivailo Zhekov, Shahina Pardhan
AIMS: To evaluate temporal change in anterior chamber angle anatomy following argon laser peripheral iridoplasty (ALPI) in eyes with occludable angles postlaser peripheral iridotomy (LPI) compared with control eyes. Additionally, the effect on diurnal intraocular pressure (DIOP) fluctuation (maximum-minimum IOP) was investigated. METHODS: Twenty-two patients with bilateral primary angle closure/suspects with gonioscopically occludable anterior chamber angles following LPI were randomised to receive ALPI (n=11) or no further treatment (n=11)...
July 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27686782/an-overview-of-treatment-methods-for-primary-angle-closure
#12
REVIEW
Farihah Anwar, Angela Turalba
BACKGROUND: Glaucoma is the second leading cause of blindness in the world. Angle closure glaucoma accounts for 25% of all glaucoma, with Asia having the highest rate. Angle closure is an anatomical variation, making the Inuit, Chinese, and other Asians more susceptible. Current treatments include medical, laser, and surgical modalities. PURPOSE: To identify the current treatment protocols for primary angle closure. DISCUSSION: The current general protocol to treat angle closure is to lower the intraocular pressure with medications and perform laser iridotomy...
2017: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/27475976/management-of-plateau-iris-syndrome-with-cataract-extraction-and-endoscopic-cyclophotocoagulation
#13
REVIEW
David A Hollander, Mark E Pennesi, Jorge A Alvarado
Plateau iris configuration describes an anatomic abnormality in which large or anteriorly positioned pars plicata push the iris root forward, thereby narrowing the anterior chamber angle. Plateau iris syndrome (PIS) is diagnosed if the angle remains occludable, either spontaneously or pharmacologically, after iridotomy. PIS has traditionally been treated with chronic pilocarpine or laser peripheral iridoplasty. A series of 9 eyes of 6 patients with PIS, diagnosed by dark room provocative testing and ultrasound biomicroscopy (UBM) following iridotomy, underwent cataract extraction and endoscopic cyclophotocoagulation (ECP)...
May 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/27230214/recurrent-acute-angle-closure-attack-due-to-plateau-iris-syndrome-after-cataract-extraction-with-or-without-argon-laser-peripheral-iridoplasty-a-case-report
#14
Bonnie Nga Kwan Choy, Jonathan Cheuk Hung Chan, Carol Pui Yang Chien, Jimmy Shiu Ming Lai
BACKGROUND: We describe two cases of recurrent acute angle-closure attack in patients with plateau iris syndrome after cataract extraction. Argon laser peripheral iridoplasty and cataract extraction have been used to reduce the occurrence of acute angle-closure attack in plateau iris syndrome although the risk cannot be completely eliminated. There is no consensus on the long term management of plateau iris syndrome. This is, as far as we know, the first case report of recurrent acute angle-closure attack in plateau iris syndrome after cataract extraction...
May 26, 2016: BMC Ophthalmology
https://www.readbyqxmd.com/read/26886121/management-of-primary-angle-closure-glaucoma
#15
REVIEW
Jimmy Lai, Bonnie N K Choy, Jennifer W H Shum
Primary angle-closure glaucoma (PACG) is a progressive optic nerve degeneration and is defined as a glaucomatous optic neuropathy with associated characteristic enlargement of optic disc cupping and visual field loss that is secondary to ocular hypertension caused by closure of the drainage angle. Angle closure is caused by appositional approximation or adhesion between the iris and the trabecular meshwork. The main treatment strategy for PACG lies in the reduction of intraocular pressure, reopening of the closed angle, and possible prevention of further angle closure...
January 2016: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/26831495/nd-yag-laser-goniopuncture-for-deep-sclerectomy-efficacy-and-outcomes
#16
Federico Di Matteo, Paolo Bettin, Marina Fiori, Carlo Ciampi, Alessandro Rabiolo, Francesco Bandello
PURPOSE: To report on the safety and efficacy of Nd: YAG laser goniopuncture (LGP) for postsurgical intraocular pressure increase after deep sclerectomy (DS) in a consecutive cohort of open-angle glaucoma patients. METHODS: This case series included 56 eyes from 49 consecutive patients who underwent LGP between November 2008 and March 2015. Prior to LGP, patients had undergone DS augmented with mitomycin C and injectable cross-linked hyaluronic acid implant between October 2008 and May 2014...
March 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/26707418/argon-laser-peripheral-iridoplasty-for-primary-angle-closure-glaucoma-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Arun Narayanaswamy, Mani Baskaran, Shamira A Perera, Monisha E Nongpiur, Hla M Htoon, Tin A Tun, Tina T Wong, David Goh, Daniel H Su, Paul T K Chew, Ching-Lin Ho, Tin Aung
PURPOSE: To determine the effectiveness of argon laser peripheral iridoplasty (ALPI) in primary angle closure (PAC) and primary angle-closure glaucoma (PACG). DESIGN: Randomized controlled trial. PARTICIPANTS: Eighty PAC or PACG subjects who underwent laser iridotomy (LI) and had at least 180° of persistent appositional angle closure and intraocular pressure (IOP) of more than 21 mmHg were enrolled. METHODS: Subjects were randomized to receive either 360° ALPI (Visulas 532s; Carl Zeiss Meditec, Jena, Germany) or medical therapy (Travoprost 0...
March 2016: Ophthalmology
https://www.readbyqxmd.com/read/26372154/to-study-the-efficacy-of-laser-peripheral-iridoplasty-in-the-treatment-of-eyes-with-primary-angle-closure-and-plateau-iris-syndrome-unresponsive-to-laser-peripheral-iridotomy-using-anterior-segment-oct-as-a-tool
#18
Rengappa Ramakrishnan, Arijit Mitra, Mohideen Abdul Kader, Sasmita Das
PURPOSE: To use anterior-segment optical coherence tomography (AS-OCT) as a tool to monitor the outcome of iridoplasty in patients with primary angle closure (PAC) and plateau iris syndrome (PIS), who were unresponsive to a previous laser peripheral iridotomy. MATERIALS AND METHODS: This was a prospective, observational case control study. Patients diagnosed with PAC and PIS who had undergone laser peripheral iridotomy earlier, but were unresponsive to the procedure, were subjected to an iridoplasty...
May 2016: Journal of Glaucoma
https://www.readbyqxmd.com/read/26294102/anterior-segment-morphology-after-acute-primary-angle-closure-treatment-a-randomised-study-comparing-iridoplasty-and-medical-therapy
#19
RANDOMIZED CONTROLLED TRIAL
Chelvin C A Sng, Maria Cecilia D Aquino, Jiemin Liao, Ce Zheng, Marcus Ang, Paul T K Chew
PURPOSE: To compare the effect of argon laser peripheral iridoplasty (ALPI) and conventional medical therapy in the immediate treatment of acute primary angle closure (APAC) using anterior segment optical coherence tomography (ASOCT). METHODS: In this single tertiary centre, prospective comparative study, we randomised 30 consecutive patients with unilateral APAC into two groups: ALPI and medical treatment (n=15 each). Immediately before and 1 h after either intervention, ASOCT imaging was performed...
April 2016: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/26119516/primary-angle-closure-glaucoma-an-update
#20
REVIEW
Carrie Wright, Mohammed A Tawfik, Michael Waisbourd, Leslie J Katz
Primary angle-closure glaucoma is potentially a devastating disease, responsible for half of glaucoma-related blindness worldwide. Angle closure is characterized by appositional approximation or contact between the iris and trabecular meshwork. It tends to develop in eyes with shallow anterior chambers, anteriorly positioned or pushed lenses, and angle crowding. Risk of primary angle-closure glaucoma is high among women, the elderly and the hyperopic, and it is most prevalent in Asia. Investigation into genetic mechanisms of glaucoma inheritance is underway...
May 2016: Acta Ophthalmologica
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