Editorial

3 pages, 172 KiB

Open AccessEditorial

by Barbara Cvenkel and Miriam Kolko

J. Clin. Med. 2023, 12(17), 5494; https://doi.org/10.3390/jcm12175494 - 24 Aug 2023

Viewed by 551

Glaucoma is the second leading cause of blindness in people over 50 years of age worldwide, and with the ageing population, this number will continue to rise, resulting in a reduced quality of life for these people and an increased social and economic [...] Read more.

Glaucoma is the second leading cause of blindness in people over 50 years of age worldwide, and with the ageing population, this number will continue to rise, resulting in a reduced quality of life for these people and an increased social and economic burden on society [...] Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

Research

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12 pages, 10685 KiB

Open AccessArticle

An Evaluation of the Physicochemical Properties of Preservative-Free 0.005% (w/v) Latanoprost Ophthalmic Solutions, and the Impact on In Vitro Human Conjunctival Goblet Cell Survival

by Josefine C. Freiberg, Anne Hedengran, Steffen Heegaard, Goran Petrovski, Jette Jacobsen, Barbara Cvenkel and Miriam Kolko

J. Clin. Med. 2022, 11(11), 3137; https://doi.org/10.3390/jcm11113137 - 31 May 2022

Cited by 6 | Viewed by 3636

Abstract

Purpose: To examine the physicochemical properties of five preservative-free (PF) 0.005% latanoprost ophthalmic products; Monoprost^®, Latanest^®, Gaap Ofteno^®, Xalmono^®, and Xaloptic^® Free. Furthermore, the study investigated the mucin production and cell survival of primary [...] Read more.

Purpose: To examine the physicochemical properties of five preservative-free (PF) 0.005% latanoprost ophthalmic products; Monoprost^®, Latanest^®, Gaap Ofteno^®, Xalmono^®, and Xaloptic^® Free. Furthermore, the study investigated the mucin production and cell survival of primary cultured human conjunctival goblet cells when treated with PF eye drops. Method: The pH value, osmolality, and surface tension were examined. Cell survival was analyzed using lactate dehydrogenase and tetrazolium dye colorimetric assays. Mucin production was analyzed with immunohistochemical staining. Results: Monoprost^® (pH value 6.84 ± 0.032) had a pH value closest to the pH value of tear fluid (pH value 7.4–7.6), whereas Gaap Ofteno^® (pH value 6.34 ± 0.004) and Latanest^® (pH value 6.33 ± 0.003) had the lowest pH values. Gaap Ofteno^® (325.9 ± 2.9 mosmol/kg) showed iso-osmolar probabilities, whereas the other products were hypo-osmolar. Gaap Ofteno^® (60.31 ± 0.35 mN/m) had a higher surface tension compared to the tear fluid (40 to 46 mN/m), as described in the literature. No significant differences in goblet cell survival or mucin release were observed between the treatments and control. Conclusion: Significant differences in pH value, osmolality, and surface tension were observed. However, this did not affect the viability of the goblet cells or the release of mucin. Clinical studies are required to evaluate the long-term effects of use on efficacy and safety. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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13 pages, 2942 KiB

Open AccessArticle

Rapid Campimetry—A Novel Screening Method for Glaucoma Diagnosis

by Fabian Müller, Khaldoon O. Al-Nosairy, Francie H. Kramer, Christian Meltendorf, Nidele Djouoma, Hagen Thieme, Michael B. Hoffmann and Friedrich Hoffmann

J. Clin. Med. 2022, 11(8), 2156; https://doi.org/10.3390/jcm11082156 - 12 Apr 2022

Cited by 1 | Viewed by 3767

Abstract

One of the most important functions of the retina—the enabling of perception of fast movements—is largely suppressed in standard automated perimetry (SAP) and kinetic perimetry (Goldmann) due to slow motion and low contrast between test points and environment. Rapid campimetry integrates fast motion [...] Read more.

One of the most important functions of the retina—the enabling of perception of fast movements—is largely suppressed in standard automated perimetry (SAP) and kinetic perimetry (Goldmann) due to slow motion and low contrast between test points and environment. Rapid campimetry integrates fast motion (=10°/4.7 s at 40 cm patient–monitor distance) and high contrast into the visual field (VF) examination in order to facilitate the detection of absolute scotomas. A bright test point moves on a dark background through the central 10° VF. Depending on the distance to the fixation point, the test point automatically changes diameter (≈0.16° to ≈0.39°). This method was compared to SAP (10-2 program) for six subjects with glaucoma. Rapid campimetry proved to be comparable and possibly better than 10-2 SAP in identifying macular arcuate scotomas. In four subjects, rapid campimetry detected a narrow arcuate absolute scotoma corresponding to the nerve fiber course, which was not identified as such with SAP. Rapid campimetry promises a fast screening method for the detection of absolute scotomas in the central 10° visual field, with a potential for cloud technologies and telemedical applications. Our proof-of-concept study motivates systematic testing of this novel method in a larger cohort. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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12 pages, 697 KiB

Open AccessArticle

Macular Pigment and Open-Angle Glaucoma in the Elderly: The Montrachet Population-Based Study

by Louis Arnould, Alassane Seydou, Christine Binquet, Pierre-Henry Gabrielle, Chloé Chamard, Lionel Bretillon, Alain M. Bron, Niyazi Acar and Catherine Creuzot-Garcher

J. Clin. Med. 2022, 11(7), 1830; https://doi.org/10.3390/jcm11071830 - 25 Mar 2022

Cited by 1 | Viewed by 1615

Abstract

(1) Background: To compare macular pigment optical density (MPOD) and its spatial distribution between eyes with primary open-angle glaucoma (POAG) and control eyes in an elderly population. (2) Methods: The Montrachet study (Maculopathy Optic Nerve and nutrition neurovAsCular and HEarT) is a population-based [...] Read more.

(1) Background: To compare macular pigment optical density (MPOD) and its spatial distribution between eyes with primary open-angle glaucoma (POAG) and control eyes in an elderly population. (2) Methods: The Montrachet study (Maculopathy Optic Nerve and nutrition neurovAsCular and HEarT) is a population-based study including participants aged 75 years and over. All participants had a slit lamp examination, fundus photographs, and a questionnaire about their medical past history and smoking status. Optic disc spectral domain optical coherence tomography was also performed. All glaucoma-suspected patients were convocated to have a new full examination. We only retained one eye with POAG for analysis in the glaucoma group and one eye without optic neuropathy in the control participants group. MPOD measurements were performed with the two-wavelength autofluorescence method (488 and 514 nm). (3) Results: Overall, 601 eyes had MPOD measurements among 1153 participants. Among the 601 eyes, 48 had POAG. The mean age for the glaucoma and control participants was 84.01 ± 4.22 years and 81.94 ± 3.61 years, respectively (p < 0.001). In the multivariable analysis, we could not find any association between POAG and MPOD at 0.5° (p = 0.336). We found no significant difference regarding MP spatial distribution between the two groups (p = 0.408). (4) Conclusion: In this elderly population-based study, eyes with POAG and control eyes without optic neuropathy did not differ in terms of MPOD and MP spatial distribution. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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10 pages, 1379 KiB

Open AccessArticle

Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy

by Yu Mizuno, Kazuyuki Hirooka and Yoshiaki Kiuchi

J. Clin. Med. 2022, 11(1), 177; https://doi.org/10.3390/jcm11010177 - 29 Dec 2021

Cited by 1 | Viewed by 2314

Abstract

Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 [...] Read more.

Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 patients with overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C (overhanging bleb group) and 65 eyes from 54 glaucoma patients with no history of glaucoma surgery (control group). Corneal higher-order aberrations (total higher-order aberrations, coma aberrations, coma-like aberrations, spherical aberrations, and spherical-like aberrations) on a 4 mm pupil diameter were measured using the TOPCON KR-1W wavefront analyzer. Corneal coma aberrations were higher in the overhanging bleb group than in the control group (0.16 ± 0.13 μm and 0.10 ± 0.05 μm, respectively; p = 0.042). Corneal coma-like aberrations were also higher in the overhanging bleb group than in the control group (0.31 ± 0.32 μm and 0.16 ± 0.09 μm, respectively; p = 0.022). With an increasing ratio of cornea covered by the bleb to the entire cornea, all corneal higher-order aberrations increased except for corneal coma-like aberrations. Overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C and its size influenced corneal higher-order aberrations. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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9 pages, 387 KiB

Open AccessArticle

Impact of Short-Term Topical Steroid Therapy on Selective Laser Trabeculoplasty Efficacy

by Tomaž Gračner

J. Clin. Med. 2021, 10(18), 4249; https://doi.org/10.3390/jcm10184249 - 19 Sep 2021

Cited by 4 | Viewed by 1351

Abstract

Background: To evaluate whether short-term use of topical steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT) for primary open-glaucoma (POAG). Methods: 25 eyes of 25 patients, who used a drop of dexamethasone 0.1% 4 times a day for 7 days as [...] Read more.

Background: To evaluate whether short-term use of topical steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT) for primary open-glaucoma (POAG). Methods: 25 eyes of 25 patients, who used a drop of dexamethasone 0.1% 4 times a day for 7 days as post-laser therapy, formed the Steroid SLT group and 24 eyes of 24 patients, where no topical steroids or nonsteroidal anti-inflammatory agents as post-laser therapy were used, formed the No-steroid SLT group. Success was defined as an intraocular pressure (IOP) lowering exceeding 20% of pretreatment IOP. Results: The mean follow-up time was 21.24 months for the Steroid SLT group and 20.25 months for the No-steroid SLT group (p = 0.990). No significant difference was found between the two groups for mean pretreatment IOP (22.20 mmHg vs. 22.33 mmHg), and for mean IOP reductions during whole follow-up period. At all follow-up visits, the mean IOP reductions were smaller in the Steroid SLT group than in the No-steroid SLT group. At all follow-up visits, the mean percent IOP reduction was smaller in the Steroid SLT group than in the No-steroid SLT group, and such a difference was significant at 12 months (25.4% vs. 29.6%, p = 0.047) and 24 months (25.3% vs. 29.7%, p = 0.024). According to the Kaplan–Meier survival analysis, the 24-month success rate was 84% in the Steroid SLT group and 79.2% in the No-steroid SLT group, with no differences between the groups (p = 0.675). Conclusion: Short-term use of topical steroid therapy had no impact on the efficacy of SLT for POAG. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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14 pages, 11791 KiB

Open AccessArticle

Comparison of Glaucoma-Relevant Transcriptomic Datasets Identifies Novel Drug Targets for Retinal Ganglion Cell Neuroprotection

by Tim J. Enz, James R. Tribble and Pete A. Williams

J. Clin. Med. 2021, 10(17), 3938; https://doi.org/10.3390/jcm10173938 - 31 Aug 2021

Cited by 7 | Viewed by 2462

Abstract

Glaucoma is a leading cause of blindness and is characterized by the progressive dysfunction and irreversible death of retinal ganglion cells. We aimed to identify shared differentially expressed genes (DE genes) between different glaucoma relevant models of retinal ganglion cell injury using existing [...] Read more.

Glaucoma is a leading cause of blindness and is characterized by the progressive dysfunction and irreversible death of retinal ganglion cells. We aimed to identify shared differentially expressed genes (DE genes) between different glaucoma relevant models of retinal ganglion cell injury using existing RNA-sequencing data, thereby discovering targets for neuroprotective therapies. A comparison of DE genes from publicly available transcriptomic datasets identified 12 shared DE genes. The Comparative Toxicogenomics Database (CTD) was screened for compounds targeting a significant proportion of the identified DE genes. Forty compounds were identified in the CTD that interact with >50% of these shared DE genes. We next validated this approach by testing select compounds for an effect on retinal ganglion cell survival using a mouse retinal explant model. Folic acid, genistein, SB-431542, valproic acid, and WY-14643 (pirinixic acid) were tested. Folic acid, valproic acid, and WY-14643 demonstrated significant protection against retinal ganglion cell death in this model. The increasing prevalence of open access-omics data presents a resource to discover targets for future therapeutic investigation. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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Review

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20 pages, 369 KiB

Open AccessReview

Devices and Treatments to Address Low Adherence in Glaucoma Patients: A Narrative Review

by Barbara Cvenkel and Miriam Kolko

J. Clin. Med. 2023, 12(1), 151; https://doi.org/10.3390/jcm12010151 - 24 Dec 2022

Cited by 9 | Viewed by 2452

Abstract

Poor adherence to topical glaucoma medications has been linked to worse visual field outcomes in glaucoma patients. Therefore, identifying and overcoming the adherence barriers are expected to slow down the progression of disease. The most common barriers to adherence, in addition to the [...] Read more.

Poor adherence to topical glaucoma medications has been linked to worse visual field outcomes in glaucoma patients. Therefore, identifying and overcoming the adherence barriers are expected to slow down the progression of disease. The most common barriers to adherence, in addition to the lack of knowledge, include forgetfulness, side effects of medications, difficulties with drop instillation and low self-efficacy. Symptoms and signs of ocular surface disease, which importantly reduce patients’ quality of life, are decreased by using preservative-free topical medications. Sustained drug delivery systems using different vehicles seem promising for relieving the burden of drop administration. Currently, only the bimatoprost sustained-release intracameral implant is available for clinical use and single administration. In the era of digitalization, smart drug delivery-connected devices may aid adherence and, by sharing data with care providers, improve monitoring and adjusting treatment. Selective laser trabeculoplasty as first-line treatment delays the need for drops, whereas minimally invasive glaucoma procedures with and without devices combined with cataract surgery increase the likelihood of patients with early-to-moderate glaucoma to remain drop free or reduce the number of drops needed to control intraocular pressure. The aim of this narrative review is to present and discuss devices and treatments that may improve adherence by reducing the need for drops and side effects of medications and aiding in glaucoma monitoring. For the future, there is a need for studies focusing on clinically important outcomes, quality of life and the cost of intervention with longer post-interventional follow up. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

24 pages, 1094 KiB

Open AccessReview

Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

by Anne-Sophie Simons, Julie Vercauteren, João Barbosa-Breda and Ingeborg Stalmans

J. Clin. Med. 2021, 10(20), 4785; https://doi.org/10.3390/jcm10204785 - 19 Oct 2021

Cited by 5 | Viewed by 2050

Abstract

Glaucoma patients require lifelong management, and the prevalence of glaucoma is expected to increase, resulting in capacity problems in many hospital eye departments. New models of care delivery are needed to offer requisite capacity. This review evaluates two alternative schemes for glaucoma care [...] Read more.

Glaucoma patients require lifelong management, and the prevalence of glaucoma is expected to increase, resulting in capacity problems in many hospital eye departments. New models of care delivery are needed to offer requisite capacity. This review evaluates two alternative schemes for glaucoma care within a hospital, i.e., shared care (SC) and virtual clinics (VCs), whereby non-medical staff are entrusted with more responsibilities, and compares these schemes with the “traditional” ophthalmologist-led outpatient service (standard care). A literature search was conducted in three large bibliographic databases (PubMed, Embase, and Trip), and the abstracts from the prior five annual meetings of the Association for Research in Vision and Ophthalmology were consulted. Twenty-nine were included in the review (14 on SC and 15 on VCs). Patients with low risk of vision loss were considered suitable for these approaches. Among the non-medical staff, optometrists were the most frequently involved. The quality of both schemes was good and improved with the non-medical staff being trained in glaucoma care. No evidence was found on patients feeling disadvantaged by the lack of a doctor visit. Both schemes increased the hospital’s efficiency. Both SC and VCs are promising approaches to tackle the upcoming capacity problems of hospital-based glaucoma care. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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20 pages, 632 KiB

Open AccessReview

Telehealth and Screening Strategies in the Diagnosis and Management of Glaucoma

by Sze H. Wong and James C. Tsai

J. Clin. Med. 2021, 10(16), 3452; https://doi.org/10.3390/jcm10163452 - 04 Aug 2021

Cited by 8 | Viewed by 3019

Abstract

Telehealth has become a viable option for glaucoma screening and glaucoma monitoring due to advances in technology. The ability to measure intraocular pressure without an anesthetic and to take optic nerve photographs without pharmacologic pupillary dilation using portable equipment have allowed glaucoma screening [...] Read more.

Telehealth has become a viable option for glaucoma screening and glaucoma monitoring due to advances in technology. The ability to measure intraocular pressure without an anesthetic and to take optic nerve photographs without pharmacologic pupillary dilation using portable equipment have allowed glaucoma screening programs to generate enough data for assessment. At home, patients can perform visual acuity testing, web-based visual field testing, rebound tonometry, and video visits with the physician to monitor for glaucomatous progression. Artificial intelligence will enhance the accuracy of data interpretation and inspire confidence in popularizing telehealth for glaucoma. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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18 pages, 675 KiB

Open AccessReview

Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

by Adela Magdalena Ciobanu, Vlad Dionisie, Cristina Neagu, Otilia Maria Bolog, Sorin Riga and Ovidiu Popa-Velea

J. Clin. Med. 2021, 10(13), 2947; https://doi.org/10.3390/jcm10132947 - 30 Jun 2021

Cited by 10 | Viewed by 14389

Abstract

Through the years, the available psychopharmacological treatments have expanded with numerous new drugs. Besides weight gain, gastro-intestinal problems or Parkinson-like symptoms, ocular adverse effects of psychiatric drugs have been reported. These adverse effects are not common, but can be dangerous for the patient. [...] Read more.

Through the years, the available psychopharmacological treatments have expanded with numerous new drugs. Besides weight gain, gastro-intestinal problems or Parkinson-like symptoms, ocular adverse effects of psychiatric drugs have been reported. These adverse effects are not common, but can be dangerous for the patient. This review summarises the current knowledge on the risk of raised intraocular pressure and glaucoma entailed by psychopharmacological treatment. Also, it provides updated data for clinicians involved in the treatment of patients with glaucoma or glaucoma risk factors. For this purpose, we performed an extensive literature search in the PubMed database using specific terms. Selective serotonin and noradrenaline reuptake inhibitors are the best evidenced as having no association with glaucoma. Antipsychotics, and especially first generation, seem to have no correlation with an increased intraocular pressure and therefore possibly with a risk of glaucoma, although a special attention should be paid when using ziprasidone. Tricyclic antidepressants, benzodiazepines and topiramate should be avoided in patients diagnosed with glaucoma or at risk. Clinicians should be aware of the possible psychotropic drug induced glaucoma and monitor at risk patients closely in order to prevent this condition. Irrespective of the psychopharmacological regimen taken into consideration, the glaucoma patient should be under the strict supervision of the ophthalmologist. Full article

(This article belongs to the Special Issue Going for Gaps in Glaucoma)

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