Research

12 pages, 411 KiB

Open AccessArticle

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

by Qëndresë Daka, Maja Sustar Habjan, Andrej Meglič, Darko Perovšek, Makedonka Atanasovska Velkovska and Barbara Cvenkel

J. Clin. Med. 2024, 13(5), 1226; https://doi.org/10.3390/jcm13051226 - 21 Feb 2024

Viewed by 505

Abstract

(1) Background: Given the global prevalence of glaucoma and the crucial role of intraocular pressure (IOP) reduction in the management of the disease, understanding the immediate effects on retinal structure and function is essential. (2) Methods: This study aimed to assess the [...] Read more.

(1) Background: Given the global prevalence of glaucoma and the crucial role of intraocular pressure (IOP) reduction in the management of the disease, understanding the immediate effects on retinal structure and function is essential. (2) Methods: This study aimed to assess the effects of preservative-free latanoprost on morphological and functional parameters in treatment-naïve patients with ocular hypertension and open-angle glaucoma. (3) Results: This study showed a significant reduction in IOP by an average of 30.6% after treatment with preservative-free latanoprost. Despite the significant reduction in IOP, no statistically significant changes were observed in the electroretinogram (ERG) nor the optical coherence tomography/angiography (OCT/OCTA) parameters compared to baseline. An exploration of the correlation between IOP changes and various parameters revealed a significant association solely with the macular IPL/INL plexus vessel density (VD) measured with OCTA. (4) Conclusions: This finding suggests a possible association between IOP reduction and changes in the macular microcirculation and provides valuable insights into the differential effects of latanoprost. Acknowledging the study limitations, this study emphasizes the need for larger, longer-term investigations to comprehensively assess the sustained effects of preservative-free latanoprost on both IOP and retinal parameters. In addition, exploring systemic factors and conducting subgroup analyses could improve personalized approaches to glaucoma treatment. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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13 pages, 977 KiB

Open AccessArticle

Safety and Efficacy of the Rho-Kinase Inhibitor (Ripasudil) in Bleb Needling after Trabeculectomy: A Prospective Multicenter Study

by Yu Mizuno, Kaori Komatsu, Kana Tokumo, Naoki Okada, Hiromitsu Onoe, Hideaki Okumichi, Kazuyuki Hirooka, Gaku Aoki, Yukiko Miura and Yoshiaki Kiuchi

J. Clin. Med. 2024, 13(1), 75; https://doi.org/10.3390/jcm13010075 - 22 Dec 2023

Viewed by 623

Abstract

Ripasudil, a rho-associated protein kinase inhibitor ophthalmic solution, shows a protective effect in preventing excessive scarring in vitro. This study aims to evaluate the safety and efficacy of ripasudil for glaucoma patients submitted to the needling procedure. In this prospective, multicenter, single-arm study, [...] Read more.

Ripasudil, a rho-associated protein kinase inhibitor ophthalmic solution, shows a protective effect in preventing excessive scarring in vitro. This study aims to evaluate the safety and efficacy of ripasudil for glaucoma patients submitted to the needling procedure. In this prospective, multicenter, single-arm study, we included 20 eyes of 20 patients with glaucoma who underwent the needling procedure without antimetabolites. All patients administered ripasudil after needling for three months. The primary endpoint of this study was the safety of ripasudil in patients, and the secondary endpoint was the change in IOP at 12 weeks after the needling procedure. No serious complications were found in the patients. One eye experienced pruritus and conjunctival follicle, while another eye had conjunctival follicle. These complications were transient and resolved quickly after discontinuation of ripasudil. The mean preoperative IOP was 14.6 ± 4.6 mmHg, which decreased to 11.0 ± 4.7 mmHg (p = 0.0062) at 1 week postoperatively. The IOP reduction effect continued to 12 weeks (11.8 ± 3.1 mmHg; p = 0.0448). The administration of the ROCK inhibitor, ripasudil, after the needling procedure is safe and effective in maintaining IOP for 12 weeks. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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12 pages, 2021 KiB

Open AccessArticle

Ocular Distribution of Brimonidine and Brinzolamide after Topical Instillation of a 0.1% Brimonidine Tartrate and 1% Brinzolamide Fixed-Combination Ophthalmic Suspension: An Interventional Study

by Yusuke Orii, Eriko Kunikane, Yutaka Yamada, Masakazu Morioka, Kentaro Iwasaki, Shogo Arimura, Akemi Mizuno and Masaru Inatani

J. Clin. Med. 2023, 12(13), 4175; https://doi.org/10.3390/jcm12134175 - 21 Jun 2023

Cited by 3 | Viewed by 1082

Abstract

Purpose: To evaluate the concentrations of brimonidine and brinzolamide in the vitreous and aqueous humor after instillation of a 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Methods: The present investigation involved patients with macular holes or idiopathic epiretinal membranes who were [...] Read more.

Purpose: To evaluate the concentrations of brimonidine and brinzolamide in the vitreous and aqueous humor after instillation of a 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Methods: The present investigation involved patients with macular holes or idiopathic epiretinal membranes who were planning to undergo vitrectomy. One week prior to surgery, the patients received twice-daily topical treatment with 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Before vitrectomy, vitreous and aqueous humor samples were collected, and the mean concentrations of brimonidine and brinzolamide were determined through liquid chromatography-tandem spectrometry. Results: Ten eyes (nine phakic and one pseudophakic eyes; 10 patients) were examined. The concentration of brimonidine in vitreous and aqueous humor samples was 5.02 ± 2.24 and 559 ± 670 nM, respectively. The concentration of brimonidine in the vitreous humor, which is needed to activate α2 receptors, was >2 nM in all patients. The concentration of brinzolamide was 8.96 ± 4.65 and 1100 ± 813 nM, respectively. However, there was no significant correlation between the concentrations of brimonidine in the vitreous and aqueous humor samples. Conclusions: Sufficient concentrations of brimonidine were detected in all vitreous samples. The dissociated correlation of the drug concentrations between aqueous and vitreous humors implies the possibility of another pathway to vitreous humor, different from the pathway to aqueous humor. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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10 pages, 421 KiB

Open AccessArticle

Factors Associated with Visual Acuity in Advanced Glaucoma

by Hyun Jee Kim, Mi Sun Sung and Sang Woo Park

J. Clin. Med. 2023, 12(9), 3076; https://doi.org/10.3390/jcm12093076 - 24 Apr 2023

Viewed by 1135

Abstract

This study aimed to comprehensively analyze various parameters in advanced glaucoma patients to identify the factors that can affect best-corrected visual acuity (BCVA) in advanced glaucoma. This cross-sectional retrospective study included 113 patients (mean age, 61.66 ± 13.26 years; males, 67) who had [...] Read more.

This study aimed to comprehensively analyze various parameters in advanced glaucoma patients to identify the factors that can affect best-corrected visual acuity (BCVA) in advanced glaucoma. This cross-sectional retrospective study included 113 patients (mean age, 61.66 ± 13.26 years; males, 67) who had advanced glaucomatous damage (113 eyes; mean BCVA, 0.18 ± 0.38 logMAR; mean deviation of 30-2 visual field [VF], −19.08 ± 6.23 dB). Peripapillary retinal nerve fiber layer (RNFL) and total and segmented macular thickness (RNFL, ganglion cell layer (GCL), and inner plexiform layer (GCL)) were measured using Spectralis optical coherence tomography (OCT). Correlations between BCVA and OCT parameters or 30-2 VF parameters were assessed using Pearson correlation analysis. Multivariate regression analysis was performed to determine the factors associated with BCVA in advanced glaucoma patients. Peripapillary RNFL thickness, subfoveal choroidal thickness, and global macular RNFL, GCL, IPL, and total thickness were found to be significantly correlated with BCVA and central visual function. Multivariate analysis showed a significant correlation between subfoveal choroidal thickness and BCVA. In addition, central VF mean sensitivity, especially inferior hemifield, showed a significant relationship with BCVA. In conclusion, subfoveal choroidal thickness and central VF sensitivity, especially the inferior hemifield area, are factors that affect BCVA in advanced glaucoma. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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6 pages, 212 KiB

Open AccessArticle

Comparison between Intraocular Pressure Profiles over 24 and 48 h in the Management of Glaucoma

by Philip Keye, Daniel Böhringer, Alexandra Anton, Thomas Reinhard and Jan Lübke

J. Clin. Med. 2023, 12(6), 2247; https://doi.org/10.3390/jcm12062247 - 14 Mar 2023

Cited by 1 | Viewed by 956

Abstract

(1) Background: Due to significant variation, sporadic IOP measurements often fail to correctly assess the IOP situation in glaucoma patients. Thus, diurnal-nocturnal IOP profiles can be used as a diagnostic tool. The purpose of this study is to determine the additional diagnostic value [...] Read more.

(1) Background: Due to significant variation, sporadic IOP measurements often fail to correctly assess the IOP situation in glaucoma patients. Thus, diurnal-nocturnal IOP profiles can be used as a diagnostic tool. The purpose of this study is to determine the additional diagnostic value of prolonged IOP profiles. (2) Methods: All diagnostic 48 h IOP profiles from a large university hospital, between 2017 and 2019, were reviewed. Elevated IOP > 21 mmHg, IOP variation > 6 mmHg and nocturnal IOP peaks were defined as IOP events of interest and counted. The analysis was repeated for the first 24 h of every IOP profile only. The Chi² test was used for statistical analysis. (3) Results: 661 IOP profiles were included. Specifically, 59% of the 48 h IOP profiles revealed IOP values above 21 mmHg, and 87% showed IOP fluctuation greater than 6 mmHg. Nocturnal peaks in the supine position could be observed in 51% of the patients. In the profiles censored for the first 24 h, the fractions were 50%, 71% and 48%, (p < 0.01, p < 0.01 and p = 0.12) respectively. (4) Conclusions: the 48 h IOP profiles identified more patients with IOP events of interest than the 24 h IOP profiles. The additional diagnostic value must be weighed against the higher costs. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

9 pages, 774 KiB

Open AccessArticle

Goniotomy for Non-Infectious Uveitic Glaucoma in Children

by Charlotte L. L. I. van Meerwijk, Astrid B. Edema, Laurentius J. van Rijn, Leonoor I. Los and Nomdo M. Jansonius

J. Clin. Med. 2023, 12(6), 2200; https://doi.org/10.3390/jcm12062200 - 12 Mar 2023

Cited by 2 | Viewed by 1186

Abstract

Secondary glaucoma is still a blinding complication in childhood uveitis, for which most commonly used surgical interventions (trabeculectomy or glaucoma drainage implant) involve multiple re-interventions and/or complications postoperatively. The goniotomy procedure has never been investigated in the current era, in which patients with [...] Read more.

Secondary glaucoma is still a blinding complication in childhood uveitis, for which most commonly used surgical interventions (trabeculectomy or glaucoma drainage implant) involve multiple re-interventions and/or complications postoperatively. The goniotomy procedure has never been investigated in the current era, in which patients with pediatric uveitis receive biologics as immunosuppressive therapy for a prolonged period, with potential implications for the outcome. The purpose of the study is to evaluate the efficacy and safety of a goniotomy procedure in pediatric non-infectious uveitis in a retrospective, multicenter case series. The primary outcomes were the postoperative intraocular pressure (IOP), number of IOP-lowering medications, and success rate. Postoperative success was defined as 6 ≤ IOP ≤ 21 mmHg, without major complications or re-interventions. Fifteen eyes of ten children were included. Median age of the included patients at goniotomy was 7 years; median follow-up was 59 months. Median (interquartile range) IOP before surgery was 30 (26–34) mmHg with 4 (3–4) IOP-lowering medications. At 1, 2, and 5 years after goniotomy, median IOP was 15, 14, and 15 mmHg with 2 (0–2), 1 (0–2), and 0 (0–2) medications, respectively (p < 0.001 postoperatively versus preoperatively for all timepoints). Success rate was 100%, 93%, and 80% after 1, 2, and 5 years, respectively. There were no significant changes in visual acuity and uveitis activity or its treatment, and there were no major complications. Our results show that the goniotomy is an effective and safe surgery for children with uveitic glaucoma. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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10 pages, 1273 KiB

Open AccessArticle

Association between Optic Nerve Sheath Diameter and Lamina Cribrosa Morphology in Normal-Tension Glaucoma

by Seung Hyen Lee, Tae-Woo Kim, Eun Ji Lee and Hyunkyung Kil

J. Clin. Med. 2023, 12(1), 360; https://doi.org/10.3390/jcm12010360 - 02 Jan 2023

Cited by 5 | Viewed by 1415

Abstract

(1) Background: To compare optic nerve sheath diameter (ONSD) in normal-tension glaucoma (NTG) and healthy eyes and to investigate the association between ONSD and lamina cribrosa (LC) morphology. (2) Methods: This cross-sectional study included 69 NTG eyes and 69 healthy eyes matched for [...] Read more.

(1) Background: To compare optic nerve sheath diameter (ONSD) in normal-tension glaucoma (NTG) and healthy eyes and to investigate the association between ONSD and lamina cribrosa (LC) morphology. (2) Methods: This cross-sectional study included 69 NTG eyes and 69 healthy eyes matched for age, axial length, and intraocular pressure. The LC curvature index (LCCI) was measured from horizontal Cirrus HD-OCT B-scan images from five uniformly divided positions vertically of the optic nerve. The average LCCI was defined as the mean of the measurements at these five locations. ONSD was measured as the width of the optic nerve sheath at the site perpendicular 3 mm behind the posterior globe. LCCI and ONSD were compared in eyes with NTG and healthy eyes. The clinical factors that could affect LCCI were analyzed. (3) Results: NTG eyes had significantly smaller mean ONSD (4.55 ± 0.69 mm vs. 4.97 ± 0.58 mm, p < 0.001) and larger average LCCI (11.61 ± 1.43 vs. 7.58 ± 0.90, p < 0.001) than matched healthy control eyes. LCCI was significantly correlated with smaller ONSD, higher intraocular pressure, thinner global retinal nerve fiber thickness, and worse visual field loss in all subjects (all Ps ≤ 0.022). (4) Conclusions: NTG eyes had smaller ONSD and greater LCCI than healthy control eyes. In addition, a negative correlation was observed between ONSD and LCCI. These findings suggest that cerebrospinal fluid pressure, which ONSD indirectly predicts, may affect LC configuration. Changes in the retrolaminar compartment may play a role in glaucoma pathogenesis. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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12 pages, 1434 KiB

Open AccessArticle

Anterior Segment Parameter Changes after Cataract Surgery in Open-Angle and Angle-Closure Eyes: A Prospective Study

by Kangyi Yang, Zhiqiao Liang, Kun Lv, Yao Ma, Xianru Hou and Huijuan Wu

J. Clin. Med. 2023, 12(1), 327; https://doi.org/10.3390/jcm12010327 - 31 Dec 2022

Cited by 3 | Viewed by 1528

Abstract

Background: To investigate the anterior segment parameters before and after cataract surgery in open-angle eyes and different subtypes of primary angle-closure glaucoma (PACG) eyes and to further explore the potential relationship between the anterior rotation of the ciliary process and crystalline lens. Methods: [...] Read more.

Background: To investigate the anterior segment parameters before and after cataract surgery in open-angle eyes and different subtypes of primary angle-closure glaucoma (PACG) eyes and to further explore the potential relationship between the anterior rotation of the ciliary process and crystalline lens. Methods: An observational, prospective study was performed on 66 patients who had cataract surgery including 22 chronic PACG patients, 22 acute PACG patients, and 22 open-angle cataract patients. Anterior segment parameters including the trabecular-ciliary process distance, ciliary process area, trabecular-ciliary angle (TCA), maximum ciliary body thickness (CBTmax), and so on, were measured using ultrasound biomicroscopy preoperatively and 3 months postoperatively. Results: After the surgery, there were significant increases in TCA (p < 0.001) and CBTmax (p < 0.05) in all three groups, while there was no significant change in the trabecular-ciliary process distance (p > 0.05) in all three groups. No significant difference in the changes of ciliary process area, TCA, and CBTmax (p > 0.05) pre- and postoperatively among the three groups were identified. Conclusions: Extractions of crystalline lenses played similar roles in terms of decreasing the anterior rotation of ciliary processes in open-angle eyes and angle-closure eyes. A natural anatomical abnormality may be a more important factor in the anterior rotation of ciliary processes in PACG patients. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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Review

Jump to: Research, Other

20 pages, 1733 KiB

Open AccessReview

Update on Diagnosis and Treatment of Uveitic Glaucoma

by Ioannis Halkiadakis, Kalliroi Konstantopoulou, Vasilios Tzimis, Nikolaos Papadopoulos, Klio Chatzistefanou and Nikolaos N. Markomichelakis

J. Clin. Med. 2024, 13(5), 1185; https://doi.org/10.3390/jcm13051185 - 20 Feb 2024

Viewed by 725

Abstract

Glaucoma is a common and potentially blinding complication of uveitis. Many mechanisms are involved alone or in combination in the pathogenesis of uveitic glaucoma (UG). In terms of diagnostic evaluation, the effects of inflammatory activity in the retinal nerve fiber layer may be [...] Read more.

Glaucoma is a common and potentially blinding complication of uveitis. Many mechanisms are involved alone or in combination in the pathogenesis of uveitic glaucoma (UG). In terms of diagnostic evaluation, the effects of inflammatory activity in the retinal nerve fiber layer may be a source of bias in the interpretation of optical coherence tomography measurements. For the successful treatment of UG, the control of intraocular inflammation specific to the cause or anti-inflammatory treatment, combined with IOP management, is mandatory. The early institution of specific treatment improves the prognosis of UG associated with CMV. The young age of UG patients along with increased failure rates of glaucoma surgery in this group of patients warrants a stepwise approach. Conservative and conjunctival sparing surgical approaches should be adopted. Minimally invasive surgical approaches were proved to be effective and are increasingly being used in the management of UG along with the traditionally used techniques of trabeculectomy or tubes. This review aims to summarize the progress that recently occurred in the diagnosis and treatment of UG. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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31 pages, 22717 KiB

Open AccessReview

Trabecular Meshwork Movement Controls Distal Valves and Chambers: New Glaucoma Medical and Surgical Targets

by Murray Johnstone, Chen Xin, Elizabeth Martin and Ruikang Wang

J. Clin. Med. 2023, 12(20), 6599; https://doi.org/10.3390/jcm12206599 - 18 Oct 2023

Viewed by 1334

Abstract

Herein, we provide evidence that human regulation of aqueous outflow is by a pump-conduit system similar to that of the lymphatics. Direct observation documents pulsatile aqueous flow into Schlemm’s canal and from the canal into collector channels, intrascleral channels, aqueous veins, and episcleral [...] Read more.

Herein, we provide evidence that human regulation of aqueous outflow is by a pump-conduit system similar to that of the lymphatics. Direct observation documents pulsatile aqueous flow into Schlemm’s canal and from the canal into collector channels, intrascleral channels, aqueous veins, and episcleral veins. Pulsatile flow in vessels requires a driving force, a chamber with mobile walls and valves. We demonstrate that the trabecular meshwork acts as a deformable, mobile wall of a chamber: Schlemm’s canal. A tight linkage between the driving force of intraocular pressure and meshwork deformation causes tissue responses in milliseconds. The link provides a sensory-motor baroreceptor-like function, providing maintenance of a homeostatic setpoint. The ocular pulse causes meshwork motion oscillations around the setpoint. We document valves entering and exiting the canal using real-time direct observation with a microscope and multiple additional modalities. Our laboratory-based high-resolution SD-OCT platform quantifies valve lumen opening and closing within milliseconds synchronously with meshwork motion; meshwork tissue stiffens, and movement slows in glaucoma tissue. Our novel PhS-OCT system measures nanometer-level motion synchronous with the ocular pulse in human subjects. Movement decreases in glaucoma patients. Our model is robust because it anchors laboratory studies to direct observation of physical reality in humans with glaucoma. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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10 pages, 294 KiB

Open AccessReview

Exploring the Relationship between Anti-VEGF Therapy and Glaucoma: Implications for Management Strategies

by Qëndresë Daka, Nina Špegel, Makedonka Atanasovska Velkovska, Tjaša Steblovnik, Miriam Kolko, Burim Neziri and Barbara Cvenkel

J. Clin. Med. 2023, 12(14), 4674; https://doi.org/10.3390/jcm12144674 - 14 Jul 2023

Cited by 5 | Viewed by 1407

Abstract

A short-term increase in intraocular pressure (IOP) is a common side effect after intravitreal anti-VEGF therapy, but a sustained increase in IOP with the development of secondary glaucoma has also been reported in some studies after repeated intravitreal anti-VEGF injections. The aim of [...] Read more.

A short-term increase in intraocular pressure (IOP) is a common side effect after intravitreal anti-VEGF therapy, but a sustained increase in IOP with the development of secondary glaucoma has also been reported in some studies after repeated intravitreal anti-VEGF injections. The aim of this review is to present and discuss the possible pathophysiological mechanisms and factors contributing to a sustained rise in IOP, as well as treatment strategies for patients at risk. Close monitoring and adjustable IOP-lowering treatment are recommended for high-risk patients, including those with glaucoma, angle-closure anomalies, ocular hypertension or family history of glaucoma; patients receiving a high number of injections or at shorter intervals; and patients with capsulotomy. Strategies are needed to identify patients at risk in a timely manner and to prevent sustained elevation of IOP. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

Other

Jump to: Research, Review

13 pages, 2655 KiB

Open AccessSystematic Review

Efficacy and Safety of Rho Kinase Inhibitors vs. Beta-Blockers in Primary Open-Angle Glaucoma: A Systematic Review with Meta-Analysis

by Brenda Nana Wandji, Noélie Bacq and Adèle Ehongo

J. Clin. Med. 2024, 13(6), 1747; https://doi.org/10.3390/jcm13061747 - 18 Mar 2024

Viewed by 479

Abstract

Background: In order to support the positioning of Rho kinase inhibitors (Rhokis) in the European market for the treatment of glaucoma, scientific evidence comparing the efficacy and safety of Rhokis and beta-blockers (β-βs) in the treatment of open-angle glaucoma after 3 months was [...] Read more.

Background: In order to support the positioning of Rho kinase inhibitors (Rhokis) in the European market for the treatment of glaucoma, scientific evidence comparing the efficacy and safety of Rhokis and beta-blockers (β-βs) in the treatment of open-angle glaucoma after 3 months was assembled through a systematic review and meta-analysis (meta-A) of randomized controlled trials (RCTs). Methods: Relevant articles were searched for on PubMed, EMBASE, and the Cochrane Library. Of the 251 articles found, three met all eligibility criteria. These three articles were assessed for risk of bias. Data were extracted and a random effects meta-A was performed. The studies’ methods were homogeneous but there was great heterogeneity within the data (I² = 92–93%; p < 0.001). Results: All studies had low risk of bias. The meta-A showed statistically better efficacy of β-βs, resulting in an intraocular pressure (IOP) reduction mean difference of 1.73 (1.19–2.27) at 8 a.m., 0.66 (0.19–1.15) at 10 a.m. and 0.49 mmHg (0.001–0.98) at 4 p.m., compared to Rhokis. This difference is not clinically significant as intra-operator variability of IOP measurements varies from ±2 to ±3 mmHg The adverse effects of Rhokis were essentially topical, whereas β-βs mainly caused systemic side effects. Conclusions: This Meta-A showed that Rhokis are clinically non-inferior to beta-blockers in reducing IOP. Rhokis have a better safety profile. Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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2 pages, 190 KiB

Open AccessReply

Reply to Wostyn, P. Could Young Cerebrospinal Fluid Combat Glaucoma? Comment on “Lee et al. Association between Optic Nerve Sheath Diameter and Lamina Cribrosa Morphology in Normal-Tension Glaucoma. J. Clin. Med. 2023, 12, 360”

by Seung Hyen Lee, Tae-Woo Kim, Eun Ji Lee and Hyunkyung Kil

J. Clin. Med. 2023, 12(11), 3784; https://doi.org/10.3390/jcm12113784 - 31 May 2023

Viewed by 466

Abstract

We are pleased to see that Peter Wostyn has contributed a Comment: “Could Young Cerebrospinal Fluid Combat Glaucoma?" [...] Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

3 pages, 187 KiB

Open AccessComment

Could Young Cerebrospinal Fluid Combat Glaucoma? Comment on Lee et al. Association between Optic Nerve Sheath Diameter and Lamina Cribrosa Morphology in Normal-Tension Glaucoma. J. Clin. Med. 2023, 12, 360

by Peter Wostyn

J. Clin. Med. 2023, 12(9), 3285; https://doi.org/10.3390/jcm12093285 - 05 May 2023

Cited by 1 | Viewed by 650

Abstract

I enjoyed reading the article by Lee et al. [...] Full article

(This article belongs to the Special Issue Advances in Glaucoma Management and Intraocular Pressure Physiology)

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