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Glaucoma: HELP
Articles from Singapore Eye Research Institute
Based on 244 articles published since 2008
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These are the 244 published articles about Glaucoma that originated from Singapore Eye Research Institute during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Editorial Minimally invasive glaucoma surgery - coming of age. 2018

Sng, Chelvin C A / Barton, Keith. ·National University Hospital, Singapore, Singapore. · Singapore Eye Research Institute, Singapore, Singapore. · Moorfields Eye Hospital, London, UK. · Moorfields Eye Hospital, London, UK BJO@keithbarton.co.uk. ·Br J Ophthalmol · Pubmed #30249721.

ABSTRACT: -- No abstract --

2 Editorial Mechanisms underlying acute angle closure. 2017

Nongpiur, Monisha E / Aung, Tin. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. · Duke-NUS Medical School, Singapore. · Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. ·Clin Exp Ophthalmol · Pubmed #28618456.

ABSTRACT: -- No abstract --

3 Editorial Flavonoids and glaucoma: revisiting therapies from the past. 2015

Milea, Dan / Aung, Tin. ·Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore. · Neuroscience and Behavioural Disorders Group, Duke-NUS, Singapore, Singapore. · Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore. aung.tin@snec.com.sg. · Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. aung.tin@snec.com.sg. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #26344732.

ABSTRACT: -- No abstract --

4 Editorial Glaucoma and allergies: 'should I get rid of my cat?'. 2015

Sng, Chelvin C A / Barton, Keith. ·Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom Department of Ophthalmology, National University Health System, Singapore Singapore Eye Research Institute, Singapore. · Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom Department of Ophthalmology, National University Health System, Singapore National Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London Department of Epidemiology and Genetics, Institute of Ophthalmology, University College, London. ·Br J Ophthalmol · Pubmed #26130672.

ABSTRACT: -- No abstract --

5 Review Myopic optic disc changes and its role in glaucoma. 2019

Tan, Nicholas Y Q / Sng, Chelvin C A / Ang, Marcus. ·Singapore Eye Research Institute. · Singapore National Eye Centre. · Ophthalmology Department, National University Hospital, Singapore. · Moorfields Eye Hospital, London, UK. · Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore. ·Curr Opin Ophthalmol · Pubmed #30562243.

ABSTRACT: PURPOSE OF REVIEW: Optic nerve head (ONH) changes such as tilt and torsion are associated with the progression of myopia, and may in turn predispose toward glaucoma. At the same time, these ONH deformations also make the structural assessment for glaucoma difficult. Here, we review the mechanisms and changes to the myopic optic disc, and the advances in structural imaging to better evaluate the ONH in myopia. RECENT FINDINGS: The distance, depth, and angle between the optic disc and the deepest point of the elongated eyeball may be related to the degree and direction of optic disc tilt and torsion. It is hypothesized that as the eyeball grows axially, the disc is pulled toward its most protruded point. These ONH deformations in myopia are thought to induce strain on the lamina cribrosa and the axons passing through it. Recent studies have shown unique characteristics of the lamina cribrosa in myopia that may account for susceptibility toward glaucoma. New developments in imaging the ONH in myopia, including the use of optical coherence tomography-angiography may also further our understanding of the relationship between myopia and glaucoma. SUMMARY: Optic disc changes in myopia are secondary to the configuration of the posterior globe. These ONH deformations may predispose toward glaucoma, although the causative relationship between myopia and glaucoma remains to be further clarified.

6 Review Computer-aided diagnosis of glaucoma using fundus images: A review. 2018

Hagiwara, Yuki / Koh, Joel En Wei / Tan, Jen Hong / Bhandary, Sulatha V / Laude, Augustinus / Ciaccio, Edward J / Tong, Louis / Acharya, U Rajendra. ·Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore. · National University of Singapore, Institute of System Science. · Department of Ophthalmology, Kasturba Medical College, Manipal, India. · National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. · Department of Medicine, Columbia University, New York, USA. · Ocular Surface Research Group, Singapore Eye Research Institute, Singapore; Cornea and External Eye Disease Service, Singapore National Eye Center, Singapore; Eye Academic Clinical Program, Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore School of Social Sciences, Singapore; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia. Electronic address: aru@np.edu.sg. ·Comput Methods Programs Biomed · Pubmed #30337064.

ABSTRACT: BACKGROUND AND OBJECTIVES: Glaucoma is an eye condition which leads to permanent blindness when the disease progresses to an advanced stage. It occurs due to inappropriate intraocular pressure within the eye, resulting in damage to the optic nerve. Glaucoma does not exhibit any symptoms in its nascent stage and thus, it is important to diagnose early to prevent blindness. Fundus photography is widely used by ophthalmologists to assist in diagnosis of glaucoma and is cost-effective. METHODS: The morphological features of the disc that is characteristic of glaucoma are clearly seen in the fundus images. However, manual inspection of the acquired fundus images may be prone to inter-observer variation. Therefore, a computer-aided detection (CAD) system is proposed to make an accurate, reliable and fast diagnosis of glaucoma based on the optic nerve features of fundus imaging. In this paper, we reviewed existing techniques to automatically diagnose glaucoma. RESULTS: The use of CAD is very effective in the diagnosis of glaucoma and can assist the clinicians to alleviate their workload significantly. We have also discussed the advantages of employing state-of-art techniques, including deep learning (DL), when developing the automated system. The DL methods are effective in glaucoma diagnosis. CONCLUSIONS: Novel DL algorithms with big data availability are required to develop a reliable CAD system. Such techniques can be employed to diagnose other eye diseases accurately.

7 Review Anterior segment optical coherence tomography. 2018

Ang, Marcus / Baskaran, Mani / Werkmeister, René M / Chua, Jacqueline / Schmidl, Doreen / Aranha Dos Santos, Valentin / Garhöfer, Gerhard / Mehta, Jodhbir S / Schmetterer, Leopold. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Moorfields Eye Hospital, London, United Kingdom. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore. · Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria; Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Austria. · Department of Clinical Pharmacology, Medical University of Vienna, Austria. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria; Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Austria; Department of Clinical Pharmacology, Medical University of Vienna, Austria; Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: leopold.schmetterer@seri.com.sg. ·Prog Retin Eye Res · Pubmed #29635068.

ABSTRACT: Optical coherence tomography (OCT) provides non-contact, rapid in vivo imaging of ocular structures, and has become a key part of evaluating the anterior segment of the eye. Over the years, improvements to technology have increased the speed of capture and resolution of images, leading to the increasing impact of anterior segment OCT imaging on clinical practice. In this review, we summarize the historical development of anterior segment OCT, and provide an update on the research and clinical applications of imaging the ocular surface, cornea, anterior chamber structures, aqueous outflow system, and most recently anterior segment vessels. We also describe advancements in anterior segment OCT technology that have improved understanding with greater detail, such as tear film in dry eye disease evaluation, intra-operative real-time imaging for anterior segment surgery, and aqueous outflow with angle assessment for glaucoma. Improvements to image processing and software have also improved the ease and utility of interpreting anterior segment OCT images in everyday clinical practice. Future developments include refinement of assessing vascular networks for the anterior segment, in vivo ultra-high resolution anterior segment optical coherence tomography with histology-like detail, en-face image with 3-dimensional reconstruction as well as functional extensions of the technique.

8 Review Assessment of flow dynamics in retinal and choroidal microcirculation. 2018

Wei, Xin / Balne, Praveen Kumar / Meissner, Kenith E / Barathi, Veluchamy A / Schmetterer, Leopold / Agrawal, Rupesh. ·National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore. · Singapore Eye Research Institute, Singapore. · Department of Physics, Swansea University, Swansea, UK. · Singapore Eye Research Institute, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria. · National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Singapore Eye Research Institute, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: rupesh_agrawal@ttsh.com.sg. ·Surv Ophthalmol · Pubmed #29577954.

ABSTRACT: Alterations in ocular blood flow have been implicated in mechanisms that lead to vision loss in patients with various ocular disorders such as diabetic retinopathy, glaucoma, and age-related macular degeneration. Assessment of retinal and choroidal blood flow is also a window to evaluate systemic diseases that affect microvasculature. Quantification and qualification of the blood flow in the retina and choroid help us understand pathophysiology, stratify disease risk, and monitor disease progression in these disorders. Multiple methods are used by researchers for assessment of blood flow, but a gold standard is lacking. We review commonly used methods, both invasive and noninvasive, for evaluation of blood flow, including intravital microscopy, laser Doppler velocimetry, laser Doppler flowmetry, laser interferometry, confocal scanning laser Doppler flowmetry, laser speckle flowgraphy, Doppler optical coherence tomography, blue-field entoptic simulation, retinal vessel caliber assessment, optical coherence tomography angiography, retinal function imaging, color Doppler imaging, and scanning laser ophthalmoscope angiogram. As technology evolves, better evaluation of blood flow in various ocular and systemic diseases will likely bring new perspectives into clinical practice and translate to better diagnosis and treatment.

9 Review Imaging of the lamina cribrosa and its role in glaucoma: a review. 2018

Tan, Nicholas Yq / Koh, Victor / Girard, Michaël Ja / Cheng, Ching-Yu. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. · Department of Ophthalmology, National University Hospital, Singapore. · Department of Biomedical Engineering, National University of Singapore, Singapore. · Ophthalmology and Visual Sciences Academic Clinical Program and Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore. · Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. ·Clin Exp Ophthalmol · Pubmed #29214709.

ABSTRACT: The lamina cribrosa of the optic nerve head serves two contrasting roles; it must be porous to allow retinal ganglion cell axons to pass through, and yet at the same time, it must also provide adequate structural support to withstand the stresses and strains across it. Improvements in imaging such as optical coherence tomography image capture and image processing have allowed detailed in vivo studies of lamina cribrosa macro- and micro-architectural characteristics. This has aided our understanding of the optic nerve head as a complex biomechanical structure. In this review, we first aim to frame the biomechanical considerations of lamina cribrosa in a clinical context; in doing so, we also explore the concept of the translaminar pressure difference. Second, we aim to highlight the technological advances in imaging the lamina cribrosa and its accompanying clinical implications, and future directions in this quickly progressing field.

10 Review Descemet membrane endothelial keratoplasty and glaucoma. 2018

Ang, Marcus / Sng, Chelvin C A. ·Singapore National Eye Centre, Singapore Eye Research Institute. · Duke - NUS Graduate Medical School, Singapore. · Moorfields Eye Hospital, London, United Kingdom. · Department of Ophthalmology, National University Health System, Singapore. ·Curr Opin Ophthalmol · Pubmed #29206654.

ABSTRACT: PURPOSE OF REVIEW: The aim of this review is to describe the relationship between Descemet membrane endothelial keratoplasty (DMEK) and glaucoma. RECENT FINDINGS: Glaucoma after DMEK is a serious complication that may cause permanent visual loss, affect donor endothelial cells and graft survival. The mechanisms of raised intraocular pressure (IOP) after DMEK include reverse pupillary block in the early postoperative period, and steroid response in the late phase. The reduced risk of immunogenic graft rejection after DMEK necessitates a shorter duration of steroids, which may in turn reduce the risk of steroid response. On the other hand, eyes with preexisting glaucoma that undergo DMEK may have a poorer prognosis than those without glaucoma. SUMMARY: Early recognition and treatment of raised IOP is important after DMEK. Accurate IOP measurements after DMEK may be difficult to obtain because of the presence of an air bubble, corneal oedema, and corneal irregularities. A prophylactic peripheral iridectomy is recommended to prevent reverse pupillary block. Patients should posture face-up and be evaluated in the early postoperative period, as patients may be asymptomatic despite raised IOP. In order to reduce the risk of steroid response, weaker steroids may be prescribed after 1-3 months without adverse effects on DMEK outcomes.

11 Review Role of anterior segment optical coherence tomography in angle-closure disease: a review. 2018

Porporato, Natalia / Baskaran, Mani / Aung, Tin. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. · Duke-NUS Graduate Medical School, Singapore, Singapore. · Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. ·Clin Exp Ophthalmol · Pubmed #29193702.

ABSTRACT: This article aims to review the published literature pertaining to the use of anterior segment optical coherence tomography (AS-OCT) in the evaluation of angle-closure disease. Searches on the available published literature were last conducted on 15 June 2017. Rated as Level I evidence, we found that AS-OCT has shown good sensitivity and moderate diagnostic accuracy to detect narrow angles when compared with gonioscopy. AS-OCT quantitative and qualitative parameters demonstrated strong association with the presence of gonioscopically closed angles. This technology provides an objective non-contact method of assessing the angle that is well tolerated by the patient and correlates well with the information provided by gonioscopy.

12 Review Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. 2017

Flaxman, Seth R / Bourne, Rupert R A / Resnikoff, Serge / Ackland, Peter / Braithwaite, Tasanee / Cicinelli, Maria V / Das, Aditi / Jonas, Jost B / Keeffe, Jill / Kempen, John H / Leasher, Janet / Limburg, Hans / Naidoo, Kovin / Pesudovs, Konrad / Silvester, Alex / Stevens, Gretchen A / Tahhan, Nina / Wong, Tien Y / Taylor, Hugh R / Anonymous15250923. ·Department of Mathematics and Data Science Institute, Imperial College London, London, UK. · Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK. Electronic address: rb@rupertbourne.co.uk. · Brien Holden Vision Institute, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia. · International Agency for the Prevention of Blindness, London, UK. · Moorfields Eye Hospital NHS Foundation Trust, London, UK. · San Raffaele Scientific Institute, Milan, Italy. · York Hospital, York, UK. · Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. · L V Prasad Eye Institute, Hyderabad, India. · Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; Discovery Eye Center, Addis Ababa, Ethiopia; MyungSung Christian Medical Center, Addis Ababa, Ethiopia. · Nova Southeastern University, Fort Lauderdale, FL, USA. · Health Information Services, Grootebroek, Netherlands. · Brien Holden Vision Institute, Sydney, NSW, Australia; African Vision Research Institute, University of Kwazulu-Natal, Glenwood, Durban, South Africa. · National Health and Medical Research Council Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia. · SpaMedica Research Institute, Bolton, UK. · Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland. · Singapore Eye Research Institute, Duke-National University of Singapore Graduate Medical School, National University of Singapore, Singapore. · Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. ·Lancet Glob Health · Pubmed #29032195.

ABSTRACT: BACKGROUND: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. METHODS: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity of <3/60 in the better eye) by cause, age, region, and year. FINDINGS: We identified 288 studies of 3 983 541 participants contributing data from 98 countries. Among the global population with moderate or severe vision impairment in 2015 (216·6 million [80% uncertainty interval 98·5 million to 359·1 million]), the leading causes were uncorrected refractive error (116·3 million [49·4 million to 202·1 million]), cataract (52·6 million [18·2 million to 109·6 million]), age-related macular degeneration (8·4 million [0·9 million to 29·5 million]), glaucoma (4·0 million [0·6 million to 13·3 million]), and diabetic retinopathy (2·6 million [0·2 million to 9·9 million]). Among the global population who were blind in 2015 (36·0 million [12·9 million to 65·4 million]), the leading causes were cataract (12·6 million [3·4 million to 28·7 million]), uncorrected refractive error (7·4 million [2·4 million to 14·8 million]), and glaucoma (2·9 million [0·4 million to 9·9 million]). By 2020, among the global population with moderate or severe vision impairment (237·1 million [101·5 million to 399·0 million]), the number of people affected by uncorrected refractive error is anticipated to rise to 127·7 million (51·0 million to 225·3 million), by cataract to 57·1 million (17·9 million to 124·1 million), by age-related macular degeneration to 8·8 million (0·8 million to 32·1 million), by glaucoma to 4·5 million (0·5 million to 15·4 million), and by diabetic retinopathy to 3·2 million (0·2 million to 12·9 million). By 2020, among the global population who are blind (38·5 million [13·2 million to 70·9 million]), the number of patients blind because of cataract is anticipated to rise to 13·4 million (3·3 million to 31·6 million), because of uncorrected refractive error to 8·0 million (2·5 million to 16·3 million), and because of glaucoma to 3·2 million (0·4 million to 11·0 million). Cataract and uncorrected refractive error combined contributed to 55% of blindness and 77% of vision impairment in adults aged 50 years and older in 2015. World regions varied markedly in the causes of blindness and vision impairment in this age group, with a low prevalence of cataract (<22% for blindness and 14·1-15·9% for vision impairment) and a high prevalence of age-related macular degeneration (>14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48-3·73]) and cataract (1·21 [1·17-1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57-0·86]) and corneal opacity (0·54 [0·43-0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70-1·14]). INTERPRETATION: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss. FUNDING: Brien Holden Vision Institute.

13 Review Glaucoma. 2017

Jonas, Jost B / Aung, Tin / Bourne, Rupert R / Bron, Alain M / Ritch, Robert / Panda-Jonas, Songhomitra. ·Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. Electronic address: jost.jonas@medma.uni-heidelberg.de. · Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK. · Department of Ophthalmology, University Hospital, Dijon, France; Eye and Nutrition Research Group, Bourgogne Franche-Comté University, Dijon, France. · Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. · Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. ·Lancet · Pubmed #28577860.

ABSTRACT: Glaucoma is a heterogeneous group of diseases characterised by cupping of the optic nerve head and visual-field damage. It is the most frequent cause of irreversible blindness worldwide. Progression usually stops if the intraocular pressure is lowered by 30-50% from baseline. Its worldwide age-standardised prevalence in the population aged 40 years or older is about 3·5%. Chronic forms of glaucoma are painless and symptomatic visual-field defects occur late. Early detection by ophthalmological examination is mandatory. Risk factors for primary open-angle glaucoma-the most common form of glaucoma-include older age, elevated intraocular pressure, sub-Saharan African ethnic origin, positive family history, and high myopia. Older age, hyperopia, and east Asian ethnic origin are the main risk factors for primary angle-closure glaucoma. Glaucoma is diagnosed using ophthalmoscopy, tonometry, and perimetry. Treatment to lower intraocular pressure is based on topical drugs, laser therapy, and surgical intervention if other therapeutic modalities fail to prevent progression.

14 Review Why does acute primary angle closure happen? Potential risk factors for acute primary angle closure. 2017

Zhang, Xiulan / Liu, Yaoming / Wang, Wei / Chen, Shida / Li, Fei / Huang, Wenbin / Aung, Tin / Wang, Ningli. ·Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China. Electronic address: zhangxl2@mail.sysu.edu.cn. · Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China. · Singapore Eye Research Institute and Singapore National Eye Centre, Singapore; Department of Ophthalmology, National University of Singapore, Singapore. · Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China. ·Surv Ophthalmol · Pubmed #28428109.

ABSTRACT: Acute primary angle closure is an ocular emergency and requires immediate management to avoid blindness. Narrow anterior chamber angle, advanced age, female gender, and Asian ethnic background are considered risk factors for acute primary angle closure. The predictive power of these factors is, however, relatively poor, and many questions remain unanswered because acute primary angle closure eventually develops in only a relatively small proportion of anatomically predisposed eyes. We summarize the potential roles of various factors in the pathogenesis of acute primary angle closure.

15 Review Associations between chronic systemic diseases and primary open angle glaucoma: an epidemiological perspective. 2017

Tham, Yih-Chung / Cheng, Ching-Yu. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. · Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. · Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore. ·Clin Exp Ophthalmol · Pubmed #27083150.

ABSTRACT: Glaucoma is a leading cause of global irreversible blindness. Primary open angle glaucoma (POAG) is the most common form of glaucoma and affects 44.1 million individuals worldwide. Elevation of intraocular pressure and impairment of vascular supply to the optic nerve head are two key pathogenic processes in the development of POAG. In this regard, chronic systemic conditions such as hypertension, diabetes and obesity have been postulated to be correlated with these two pathogenic processes. Thus, it is plausible that chronic systemic diseases may act as risk factors for POAG. The aim of this review is to summarize the current evidence on the associations of chronic systemic diseases with POAG. These information will help to further ascertain the risk factors for POAG and improve the early detection of POAG.

16 Review Progress in anterior chamber angle imaging for glaucoma risk prediction - A review on clinical equipment, practice and research. 2016

V K, Shinoj / Hong, Xun Jie Jeesmond / V M, Murukeshan / M, Baskaran / Tin, Aung. ·Center for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore 639798, Singapore. · Center for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore 639798, Singapore. Electronic address: mmurukeshan@ntu.edu.sg. · Singapore Eye Research Institute (SERI) & Singapore National Eye Center (SNEC), Singapore, Singapore 168751, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore 119228, Singapore. ·Med Eng Phys · Pubmed #27789225.

ABSTRACT: The visualization capabilities of various ocular imaging instruments can generally be categorized into photographic (e.g. gonioscopy, Pentacam, RetCam) and optical tomographic (e.g. optical coherence tomography (OCT), photoacoustic (PA) imaging, ultrasound biomicriscopy (UBM)) methods. These imaging instruments allow vision researchers and clinicians to visualize the iridocorneal angle, and are essential in the diagnosis and management of glaucoma. Each of these imaging modalities has particular benefits and associated drawbacks in obtaining repeatable and reliable measurement in the evaluation of the angle. This review article in this context summarized recent progresses in anterior chamber imaging techniques in glaucoma diagnosis and follow-up procedures.

17 Review Glaucoma Genetics: Recent Advances and Future Directions. 2016

Aung, Tin / Khor, Chiea Chuen. ·From the *Singapore Eye Research Institute, Singapore National Eye Centre; †Yong Loo Lin School of Medicine, National University of Singapore; and ‡Genome Institute of Singapore, Singapore. ·Asia Pac J Ophthalmol (Phila) · Pubmed #27488067.

ABSTRACT: Once considered primarily a disease of aging caused by unknown environmental influences, the notion that heritable factors could significantly contribute to the pathogenesis of sporadic glaucoma has rapidly gained traction. In part, this is due to the rapid and definitive identification of genes with strong effects on familial, earlier onset forms of glaucoma. Although the endpoint of glaucoma is irreversible optic nerve damage accompanied by blindness, the initial inciting trigger could differ. To this end, well-powered genome-wide association studies have each been conducted for primary open-angle glaucoma, primary angle-closure glaucoma, along with exfoliation syndrome and glaucoma. Each of these studies has revealed sets of significantly associated genetic loci implicating biological pathways that do not overlap between the forms of glaucoma. Although substantial biological insight has been gained from their identification, much further work remains to definitively link the implicated genetic variants with glaucoma causation. It is also hoped that the genetic findings could point us to potential routes of therapy beyond that of intraocular pressure-lowering medications or surgery.

18 Review Updates on the Surgical Management of Pediatric Glaucoma. 2016

Tan, Yar-Li / Chua, Jocelyn / Ho, Ching-Lin. ·From the Glaucoma Service, Singapore National Eye Centre, Singapore, Singapore; and Singapore Eye Research Institute, Singapore. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26886124.

ABSTRACT: Childhood glaucoma is known to be one of the most challenging conditions to manage. Surgical management is more complicated than in adults because of differences in anatomy from adults along with variations in anatomy caused by congenital and developmental anomalies, wide-ranging pathogenetic mechanisms, a more aggressive healing response, and a less predictable postoperative course. Challenges in postoperative examination and management in less cooperative children and the longer life expectancies preempting the need for future surgeries and reinterventions are also contributing factors. Angle surgery is usually the first-line treatment in the surgical management of primary congenital glaucoma because it has a relatively good success rate with a low complication rate. After failed angle surgery or in cases of secondary pediatric glaucoma, options such as trabeculectomy, glaucoma drainage devices, or cyclodestructive procedures can be considered, depending on several factors such as the type of glaucoma, age of the patient, and the severity and prognosis of the disease. Various combinations of these techniques have also been studied, in particular combined trabeculotomy-trabeculectomy, which has been shown to be successful in patients with moderate-to-advanced disease. Newer nonpenetrating techniques, such as viscocanalostomy and deep sclerectomy, have been reported in some studies with variable results. Further studies are needed to evaluate these newer surgical techniques, including the use of modern minimally invasive glaucoma surgeries, in this special and diverse group of young patients.

19 Review Glaucoma in Asia: regional prevalence variations and future projections. 2016

Chan, Errol Wei'en / Li, Xiang / Tham, Yih-Chung / Liao, Jiemin / Wong, Tien Yin / Aung, Tin / Cheng, Ching-Yu. ·Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore. · Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA Duke-NUS Graduate Medical School, Singapore, Singapore. · Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore. · Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore. ·Br J Ophthalmol · Pubmed #26112871.

ABSTRACT: PURPOSE: To evaluate glaucoma prevalence and disease burden across Asian subregions from 2013 to 2040. METHODS: We conducted a systematic review and meta-analysis of 23 population-based studies of 1318 primary open angle glaucoma (POAG) cases in 66,800 individuals and 691 primary angle closure glaucoma (PACG) cases in 72,767 individuals in Asia. Regions in Asia were defined based on United Nations' (UN) classification of macro-geographic regions. PubMed, Medline and Web of Science databases were searched for population-based glaucoma prevalence studies using standardised criteria published to 31 December 2013. Pooled glaucoma prevalence for individuals aged 40-80 years was calculated using hierarchical Bayesian approaches. Prevalence differences by geographic subregion, subtype and habitation were examined with random effects meta-regression models. Estimates of individuals with glaucoma from 2013 to 2040 were based on the UN World Population Prospects. RESULTS: In 2013, pooled overall glaucoma prevalence was 3.54% (95% credible interval (CrI) 1.83 to 6.28). POAG (2.34%, 95% CrI 0.96 to 4.55) predominated over PACG (0.73%, 95% CrI 0.18 to 1.96). With age and gender adjustment, PACG prevalence was higher in East than South East Asia (OR 5.55, 95% CrI 1.52 to 14.73), and POAG prevalence was higher in urban than rural populations (OR 2.11, 95% CrI 1.57 to 2.38). From 2013 to 2040, South Central Asia will record the steepest increase in number of glaucoma individuals from 17.06 million to 32.90 million compared with other Asian subregions. In 2040, South-Central Asia is also projected to overtake East Asia for highest overall glaucoma and POAG burden, while PACG burden remains highest in East Asia. CONCLUSIONS: Across the Asian subregions, there was greater glaucoma burden in South-Central and East Asia. Sustainable public health strategies to combat glaucoma in Asia are needed.

20 Review Uveitis and glaucoma: new insights in the pathogenesis and treatment. 2015

Sng, Chelvin C A / Ang, Marcus / Barton, Keith. ·Glaucoma Service, Moorfields Eye Hospital, London, UK; Department of Ophthalmology, National University Health System, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore. · Singapore Eye Research Institute, Singapore, Singapore; Singapore National Eye Centre, Singapore, Singapore. · Glaucoma Service, Moorfields Eye Hospital, London, UK; Department of Ophthalmology, National University Health System, Singapore, Singapore; National Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK; Department of Epidemiology and Genetics, Institute of Ophthalmology, University College, London, UK. Electronic address: keith@keithbarton.co.uk. ·Prog Brain Res · Pubmed #26518082.

ABSTRACT: Glaucoma is a potentially blinding complication of uveitis, where intraocular inflammation, secondary corticosteroid response, and varying types and degrees of angle abnormalities contribute to its pathogenesis. Management of uveitic glaucoma remains challenging. Treatment is targeted at reducing the inflammation and lowering the intraocular pressure. Recent studies have highlighted the role of viruses, such as cytomegalovirus, herpes simplex virus, and more recently Ebola virus, in the pathogenesis of uveitic glaucoma. Antiviral therapy may be beneficial in eyes with detectable viral DNA. The success of glaucoma surgery is decreased in eyes with uveitic glaucoma, and surgical interventions are associated with a higher incidence of postoperative complications. Novel glaucoma surgical and laser treatments may improve the predictability of surgery for uveitic glaucoma, but these require further evaluation.

21 Review Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. 2014

Tham, Yih-Chung / Li, Xiang / Wong, Tien Y / Quigley, Harry A / Aung, Tin / Cheng, Ching-Yu. ·Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore. · Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Duke-NUS Graduate Medical School, Singapore. Electronic address: ching-yu_cheng@nuhs.edu.sg. ·Ophthalmology · Pubmed #24974815.

ABSTRACT: PURPOSE: Glaucoma is the leading cause of global irreversible blindness. Present estimates of global glaucoma prevalence are not up-to-date and focused mainly on European ancestry populations. We systematically examined the global prevalence of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and projected the number of affected people in 2020 and 2040. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Data from 50 population-based studies (3770 POAG cases among 140,496 examined individuals and 786 PACG cases among 112 398 examined individuals). METHODS: We searched PubMed, Medline, and Web of Science for population-based studies of glaucoma prevalence published up to March 25, 2013. Hierarchical Bayesian approach was used to estimate the pooled glaucoma prevalence of the population aged 40-80 years along with 95% credible intervals (CrIs). Projections of glaucoma were estimated based on the United Nations World Population Prospects. Bayesian meta-regression models were performed to assess the association between the prevalence of POAG and the relevant factors. MAIN OUTCOME MEASURES: Prevalence and projection numbers of glaucoma cases. RESULTS: The global prevalence of glaucoma for population aged 40-80 years is 3.54% (95% CrI, 2.09-5.82). The prevalence of POAG is highest in Africa (4.20%; 95% CrI, 2.08-7.35), and the prevalence of PACG is highest in Asia (1.09%; 95% CrI, 0.43-2.32). In 2013, the number of people (aged 40-80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040. In the Bayesian meta-regression model, men were more likely to have POAG than women (odds ratio [OR], 1.36; 95% CrI, 1.23-1.52), and after adjusting for age, gender, habitation type, response rate, and year of study, people of African ancestry were more likely to have POAG than people of European ancestry (OR, 2.80; 95% CrI, 1.83-4.06), and people living in urban areas were more likely to have POAG than those in rural areas (OR, 1.58; 95% CrI, 1.19-2.04). CONCLUSIONS: The number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionally affecting people residing in Asia and Africa. These estimates are important in guiding the designs of glaucoma screening, treatment, and related public health strategies.

22 Review Recent advances in OCT imaging of the lamina cribrosa. 2014

Sigal, Ian A / Wang, Bo / Strouthidis, Nicholas G / Akagi, Tadamichi / Girard, Michael J A. ·Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. · NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. · Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore In vivo Biomechanics Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore. ·Br J Ophthalmol · Pubmed #24934221.

ABSTRACT: The lamina cribrosa (LC) is believed to be the site of injury to retinal ganglion cell axons in glaucoma. The ability to visualise this structure has the potential to help increase our understanding of the disease and be useful in the early detection of glaucoma. While for many years the research on the LC was essentially dependent on histology and modelling, a number of recent advances in optical coherence tomography (OCT) have dramatically improved the ability to visualise the LC, such that it is now possible to image the LC in vivo in humans and animals. In this review, we highlight recent advances in OCT imaging of the LC, in the technology, processing and analysis, and discuss the impact that these will have on the ability to diagnose and monitor glaucoma, as well as to expand our understanding of its pathophysiology. With this manuscript, we aspire to share our excitement on the achievements and potential of recent developments as well as advise caution regarding the challenges that remain before imaging of the LC and optic nerve can be used routinely in clinical practice.

23 Review Teleglaucoma: ready to go? 2014

Strouthidis, N G / Chandrasekharan, G / Diamond, J P / Murdoch, I E. ·NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK Singapore Eye Research Institute, Singapore, Singapore. · Institute of Ophthalmology, London, UK. · Bristol Eye Hospital, Bristol, UK. ·Br J Ophthalmol · Pubmed #24723617.

ABSTRACT: Telemedicine technologies and services allow today's ophthalmic clinicians to remotely diagnose, manage and monitor several ophthalmic conditions from a distance. But is this the case for glaucomas? There has been a proliferation of telemedicine friendly devices in recent years that improves the capabilities of the clinician in managing glaucomas. The existing instruments still need to align themselves with accepted industry standards. There are successful programmes running in several areas of the world. The safety and efficacy of these programmes needs further exploration. The inability of a single device or test to diagnose glaucomas satisfactorily has also hampered progress in remotely diagnosing these conditions. There is, however, significant potential for telemedicine-friendly devices to remotely monitor the progress of glaucoma and, thereby, reduce some of the workload on an overstretched health service.

24 Review Angle closure glaucoma: a mechanistic review. 2011

Nongpiur, Monisha E / Ku, Judy Y F / Aung, Tin. ·Singapore National Eye Centre & Singapore Eye Research Institute, Singapore. ·Curr Opin Ophthalmol · Pubmed #21252671.

ABSTRACT: PURPOSE OF REVIEW: With recent advances in imaging techniques such as anterior segment optical coherence tomography and ultrasound biomicroscopy, there is a better understanding of nonpupil block mechanisms and novel risk factors contributing to the pathogenesis of angle closure glaucoma. RECENT FINDINGS: Recent studies suggest that multiple anatomical and physiological factors interplay in the pathogenesis of angle closure glaucoma. The association of greater iris convexity, area and thickness with narrow angles could result in a more anterior bowing and crowding of the peripheral iris. Other novel anatomic parameters such as greater lens vault, smaller anterior chamber width, area and volume, independently increase the risk of having angle closure. Dynamic increase or lesser reduction in iris volume during dilation supports the theory of physiological predisposition to the disease process. Choroidal expansion has been demonstrated in untreated and treated, acute and chronic primary angle closure eyes. It remains unknown whether this finding is a cause or effect in this condition. SUMMARY: With a wider availability of imaging tools and a better understanding of risk factors and mechanisms, clinicians maybe able to more accurately identify those at greater risk of developing angle closure disease and tailor their treatment according to the predominant factor(s) involved.

25 Review Angle imaging: advances and challenges. 2011

Quek, Desmond T L / Nongpiur, Monisha E / Perera, Shamira A / Aung, Tin. ·Singapore National Eye Centre, Singapore Eye Research Institute and Yong Loo Lin School of Medicine, National University of Singapore, Singapore. ·Indian J Ophthalmol · Pubmed #21150037.

ABSTRACT: Primary angle closure glaucoma (PACG) is a major form of glaucoma in large populous countries in East and South Asia. The high visual morbidity from PACG is related to the destructive nature of the asymptomatic form of the disease. Early detection of anatomically narrow angles is important and the subsequent prevention of visual loss from PACG depends on an accurate assessment of the anterior chamber angle (ACA). This review paper discusses the advantages and limitations of newer ACA imaging technologies, namely ultrasound biomicroscopy, Scheimpflug photography, anterior segment optical coherence tomography and EyeCam, highlighting the current clinical evidence comparing these devices with each other and with clinical dynamic indentation gonioscopy, the current reference standard.

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