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New treatments for glaucoma

Kateki Vinod, Steven J Gedde
PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and complication profiles of novel glaucoma procedures promoting aqueous outflow. RECENT FINDINGS: Literature from the 2015 to 2016 review period includes abundant data regarding new and emerging glaucoma procedures. Notable findings from recent randomized clinical trials include titratability of intraocular pressure with multiple trabecular microbypass stents (iStent; Glaukos, Laguna Hills, California, USA) and greater reduction in intraocular pressure and medication usage following intracanalicular scaffolding (Hydrus Microstent; Ivantis Inc...
October 19, 2016: Current Opinion in Ophthalmology
Chelvin C A Sng, Marcus Ang, Keith Barton
PURPOSE OF REVIEW: The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient. RECENT FINDINGS: The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist...
October 19, 2016: Current Opinion in Ophthalmology
Beatriz I Gallego, Pablo de Gracia
Glaucoma is a multifactorial optic neuropathy characterized by the damage and death of the retinal ganglion cells. This disease results in vision loss and blindness. Any vision loss resulting from the disease cannot be restored and nowadays there is no available cure for glaucoma; however an early detection and treatment, could offer neuronal protection and avoid later serious damages to the visual function. A full understanding of the etiology of the disease will still require the contribution of many scientific efforts...
August 2016: Neural Regeneration Research
Yvonne Ou, Rebecca E Jo, Erik M Ullian, Rachel O L Wong, Luca Della Santina
UNLABELLED: Key issues concerning ganglion cell type-specific loss and synaptic changes in animal models of experimental glaucoma remain highly debated. Importantly, changes in the structure and function of various RGC types that occur early, within 14 d after acute, transient intraocular pressure elevation, have not been previously assessed. Using biolistic transfection of individual RGCs and multielectrode array recordings to measure light responses in mice, we examined the effects of laser-induced ocular hypertension on the structure and function of a subset of RGCs...
August 31, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Kenneth A Jacobson, Mortimer M Civan
Agonists and antagonists of various subtypes of G protein coupled adenosine receptors (ARs), P2Y receptors (P2YRs), and ATP-gated P2X receptor ion channels (P2XRs) are under consideration as agents for the treatment of ocular diseases, including glaucoma and dry eye. Numerous nucleoside and nonnucleoside modulators of the receptors are available as research tools and potential therapeutic molecules. Three of the 4 subtypes of ARs have been exploited with clinical candidate molecules for treatment of the eye: A1, A2A, and A3...
October 2016: Journal of Ocular Pharmacology and Therapeutics
Gábor Holló
BACKGROUND/PURPOSE: Optical coherence tomography (OCT) angiography is a new noninvasive method to measure peripapillary microcirculation in various retinal layers, separately. In this case series, we investigate whether large medical intraocular pressure (IOP) reduction (>50% of the untreated baseline value) to IOP≤18 mm Hg influences peripapillary angioflow density (PAFD, percentage of the analyzed retinal area) in the retinal nerve fiber layer in high pressure (IOP≥35 mm Hg) ocular hypertensive and glaucoma eyes...
August 26, 2016: Journal of Glaucoma
Chaobin Lin, Xiaomin Wu
PURPOSE: Glaucoma is closely linked with oxidative stress and inflammation, and difficult to treat. Its occurrence frequently is contributed by the failure of the trabecular meshwork (TM). Curcumin is known as an antioxidative and anti-inflammatory substance, possessing the potential to treat glaucoma. METHODS: Using TM cells as the in vitro model system, we investigated the effects of curcumin on oxidative stress-induced markers for TM impairments, including cell death, production of intracellular reactive oxygen species (iROS), induction of proinflammatory proteins, activation of senescence marker, accumulation of carbonylated proteins, and apoptotic cell numbers...
August 1, 2016: Investigative Ophthalmology & Visual Science
Jed Asher Lusthaus, Ivan Goldberg
INTRODUCTION: Intraocular pressure (IOP) is the most significant modifiable risk factor to prevent onset or progression of glaucoma. Glaucoma prevalence continues to increase, emphasizing the need for improved ocular hypotensive treatment options. To try to improve on both tolerance and IOP control of currently available therapies, different receptors or mechanisms are being explored to reduce IOP more effectively and to improve tolerance. AREAS COVERED: We review synthetic topical and oral drugs in early development for the management of ocular hypertension and glaucoma...
October 2016: Expert Opinion on Investigational Drugs
Panos G Christakis, Jeffrey W Kalenak, James C Tsai, David Zurakowski, Jeffrey A Kammer, Paul J Harasymowycz, Juan J Mura, Louis B Cantor, Iqbal I K Ahmed
PURPOSE: To compare 2 frequently used aqueous shunts for the treatment of glaucoma. DESIGN: International, multicenter, randomized trial. PARTICIPANTS: Patients aged 18 years or older with uncontrolled glaucoma despite maximum tolerated medical therapy, many of whom had failed or were at high risk of failing trabeculectomy. METHODS: Eligible patients were randomized to receive an Ahmed-FP7 valve implant (New World Medical, Inc, Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc, Santa Ana, CA) using a standardized surgical technique...
October 2016: Ophthalmology
Erhan Başar, Ekrem Tunca, Metin Bülbül, Muharrem Kaya
Novel sulfonamide derivatives 6a-i, as new carbonic anhydrase inhibitors which candidate for glaucoma treatment, were synthesized from the reactions of 4-amino-N-(4-sulfamoylphenyl) benzamide 4 and sulfonyl chloride derivatives 5a-i with high yield (71-90%). The structures of these compounds were confirmed by using spectral analysis (FT-IR, (1)H NMR, (13)C NMR, LC/MS and HRMS). The inhibition effects of 6a-i on the hydratase and esterase activities of human carbonic anhydrase isoenzymes, hCA I and II, which were purified from human erythrocytes with Sepharose®4B-l-tyrosine-p-aminobenzene sulfonamide affinity chromatography, were studied as in vitro, and IC50 and Ki values were determined...
December 2016: Journal of Enzyme Inhibition and Medicinal Chemistry
Padmaja K Rani, Isha Gulati, Harsha Laxmana Rao, Sirisha Senthil
PURPOSE: To describe a new surgical technique in the management of malignant glaucoma in phakic eyes. METHODS: We performed 25-gauge pars plana vitrectomy with anterior irido-zonulo-hyaloido-vitrectomy in 2 young phakic patients with malignant glaucoma after trabeculectomy. This technique allowed posteroanterior aqueous communication, relieved aqueous misdirection, helped restoring anterior chamber depth, normalized the intraocular pressure and most importantly helped to preserve the crystalline lens...
August 8, 2016: Retinal Cases & Brief Reports
B A Sabel
Visual field defects are considered irreversible because the retina and optic nerve do not regenerate. Nevertheless, there is some potential for recovery of the visual fields. This can be accomplished by the brain, which analyses and interprets visual information and is able to amplify residual signals through neuroplasticity. Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy. This is actually the neurobiological basis of normal learning...
August 9, 2016: Klinische Monatsblätter Für Augenheilkunde
Milan Sonka, Michael D Abràmoff
Clinical acceptance of 3-D OCT retinal imaging brought rapid development of quantitative 3-D analysis of retinal layers, vasculature, retinal lesions as well as facilitated new research in retinal diseases. One of the cornerstones of many such analyses is segmentation and thickness quantification of retinal layers and the choroid, with an inherently 3-D simultaneous multi-layer LOGISMOS (Layered Optimal Graph Image Segmentation for Multiple Objects and Surfaces) segmentation approach being extremely well suited for the task...
October 2016: Medical Image Analysis
G M Stolyarov, N V Tikhomirova, I V Tikhomirov
UNLABELLED: The leading role in glaucoma treatment is now played by prostaglandin analogues (PGAs), whose point of application is the uveoscleral outflow of aqueous humor. Quantitative evaluation of the latter is, however, a problem yet unsolved. AIM: To assess the clinical applicability of a new method for quantitative evaluation of the uveoscleral outflow in human eyes, which is meant to help with optimization of glaucoma therapy. MATERIAL AND METHODS: Patients with early (n=33) and advanced (n=30) primary open-angle glaucoma (POAG) were enrolled...
May 2016: Vestnik Oftalmologii
Anja Tuulonen, Marko Kataja, Ulla Syvänen, Sirpa Miettunen, Hannu Uusitalo
PURPOSE: The report describes the concepts behind procedures implemented in Tays Eye Centre to enable improved access to care and improved productivity. METHODS: The strategy was developed in 2009 after hospital district decided to construct a new eye hospital which was opened in 2012. The following principles were implemented: (i) identification of high-volume patient groups: the 'big four' eye diseases accounting for 70% of patient visits and costs: age-related macular degeneration (AMD), glaucoma, retinal diseases and cataract; (ii) stratification and prioritization of patient care based on risk of permanent visual disability; (iii) standardization of services for low-risk patients; (iv) maximization of productivity; and (v) shared care...
July 16, 2016: Acta Ophthalmologica
Mark A Babizhayev
Senile cataract is a clouding of the lens in the aging eye leading to a decrease in vision. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide. Cataracts result from the deposition of aggregated proteins in the eye lens and lens fiber cells plasma membrane damage which causes clouding of the lens, light scattering, and obstruction of vision...
December 2016: BBA Clinical
Michael S Broder, Khaled Sarsour, Eunice Chang, Neil Collinson, Katie Tuckwell, Pavel Napalkov, Micki Klearman
OBJECTIVE: Corticosteroids (CS) are standard treatment for giant cell arteritis (GCA), but concerns persist over toxicities associated with long-term use. In this retrospective study of medical claims data, we estimated risks for adverse events (AEs) in CS-treated GCA patients. METHODS: Cox regression analyses with CS use as a time-dependent variable were conducted on data from the 2003 to 2012 Truven Health Analytics MarketScan Database. Patients 50 years of age and older who had ≥2 claims of newly diagnosed GCA, ≥1 filled oral CS prescription, and no AEs before GCA diagnosis were included...
October 2016: Seminars in Arthritis and Rheumatism
W M Mao, Y Liu, Y H Wordinger, Abbot F Clark, Iok-Hou Pang
Glaucoma is a major cause of blindness in China and the world. Currently, all therapeutic means in treating open-angle glaucoma are limited to control the progression of optic neuropathy by lowering intraocular pressure (IOP). Clinically available medicines lower IOP by either enhancing the uveoscleral pathway or inhibiting aqueous humor production. Since the primary cause of IOP elevation in POAG is elevated outflow resistance in the trabecular outflow pathway, current medicines are not able to correct the underlying pathogenesis and pathophysiology of the disease...
June 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Riccardo Petrelli, Mario Grifantin, Loredana Cappellacci
In this review, we first highlighted on C-methyl-branched nucleosides and nucleotides approved as anti-hepatitis C infection (HCV) drugs, their mechanism of action and recent progress in the development of new clinical candidates. Then, we report on our attempt to develop several C-methyl nucleosides/tides potentially useful for treatment of various diseases such cancer, pain, epilepsy and glaucoma. Design, synthesis and pharmacological screening of 1'-C-, 2'-C-, 3'-C-methyladenosine or other purine/pyrimidine nucleosides allowed us to discover some promising new molecules...
June 26, 2016: Current Medicinal Chemistry
Richard Sheer, Suvapun Bunniran, Claudia Uribe, Richard G Fiscella, Vaishali D Patel, Hitesh S Chandwani
BACKGROUND: Reported adherence rates with ocular hypotensive medications typically range from 51% to 56% over the first year of therapy. As intraocular pressure (IOP) reduction slows the progression of vision loss from glaucoma, early identification of nonadherent members is crucial to effective disease management. OBJECTIVES: To (a) identify member characteristics and other factors related to nonadherence with topical IOP-lowering medications available in administrative claims data and (b) create a predictive model incorporating these variables...
July 2016: Journal of Managed Care & Specialty Pharmacy
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