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Glaucoma: HELP
Articles from UCLA
Based on 261 articles published since 2010
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These are the 261 published articles about Glaucoma that originated from UCLA during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Editorial Iridotomies on eyes with uveitis: indications and technique. 2020

Holland, Gary N / Barton, Keith. ·UCLA Stein Eye Institute, Los Angeles, California, USA uveitis@jsei.ucla.edu. · Moorfields Eye Hospital, London, UK. ·Br J Ophthalmol · Pubmed #31727623.

ABSTRACT: -- No abstract --

2 Review Macular Imaging with Optical Coherence Tomography in Glaucoma. 2020

Mohammadzadeh, Vahid / Fatehi, Nima / Yarmohammadi, Adeleh / Lee, Ji Woong / Sharifipour, Farideh / Daneshvar, Ramin / Caprioli, Joseph / Nouri-Mahdavi, Kouros. ·Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. · Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California; Saint Mary Medical Center - Dignity health, Long Beach, CA. · Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States. · Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea. · Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran. · Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. Electronic address: nouri-mahdavi@jsei.ucla.edu. ·Surv Ophthalmol · Pubmed #32199939.

ABSTRACT: With the advent of spectral-domain optical coherence tomography (SD-OCT), imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head (ONH), circumpapillary retinal nerve fiber layer (cp-RNFL), and macula. There is now ample evidence to support the role of SD-OCT imaging of the macula for detection of early glaucoma. Macular SD-OCT measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular SD-OCT imaging emerging as an essential diagnostic tool in glaucoma.

3 Review Swept-Source OCT for Evaluating the Lamina Cribrosa: A Report by the American Academy of Ophthalmology. 2019

Takusagawa, Hana L / Hoguet, Ambika / Junk, Anna K / Nouri-Mahdavi, Kouros / Radhakrishnan, Sunita / Chen, Teresa C. ·The Eye Center, Eugene, Oregon, and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon. · Ophthalmic Consultants of Boston, Boston, Massachusetts. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida and Miami Veterans Affairs Healthcare System, Miami, Florida. · Stein Eye Institute, Los Angeles, California. · Glaucoma Center of San Francisco, Glaucoma Research and Education Group, San Francisco, California. · Harvard Medical School, Department of Ophthalmology, Massachusetts Eye & Ear, Glaucoma Service, Boston, Massachusetts. ·Ophthalmology · Pubmed #30953743.

ABSTRACT: PURPOSE: To review the published literature on the use of swept-source (SS) OCT for evaluating the lamina cribrosa in glaucoma. METHODS: A PubMed and Cochrane Library literature search initially conducted on March 3, 2017, and updated on June 26, 2018, yielded a total of 64 articles. Articles that were reviews or that were not published in English were excluded, and 29 were found to fit the inclusion criteria. The panel methodologist then assigned a level of evidence rating to each study. Fifteen studies were rated level III, 14 studies were rated level II, and no studies were rated level I. RESULTS: Different aspects of the lamina cribrosa were studied using SS-OCT, including the anterior lamina cribrosa curvature, anterior lamina cribrosa depth, anterior lamina cribrosa insertions, laminar thickness, focal lamina cribrosa defects (FLCDs), and lamina cribrosa microarchitecture. In general, imaging of the anterior lamina can be achieved reliably, although shadowing from blood vessels at the neuroretinal rim remains an issue. Imaging of the posterior lamina can be achieved with varying levels of success. In glaucoma, there is posterior migration of the anterior lamina cribrosa insertions as well as increased thinning and posterior curvature of the lamina cribrosa. Focal lamina cribrosa defects appear more commonly in glaucoma, and this may hint at the pathogenesis of axonal damage. In addition, there may be remodeling of the microarchitecture of the lamina, resulting in more variable laminar pores. There are limited studies comparing SS-OCT with spectral-domain (SD) OCT with regard to imaging of the lamina, but the difference in image quality between enhanced depth imaging (EDI) with SD-OCT and SS-OCT seems minimal. CONCLUSIONS: Imaging of the lamina cribrosa using SS-OCT has demonstrated that the lamina cribrosa is likely biomechanically active and that significant changes occur in glaucoma. The diagnostic utility of SS-OCT for lamina cribrosa imaging is promising, but standardized nomenclature, automated measurements, and longitudinal studies with larger and more diverse sample sizes are needed.

4 Review Influence of new treatment modalities on adherence in glaucoma. 2019

Meier-Gibbons, Frances / Berlin, Michael S / Töteberg-Harms, Marc. ·Eye Center Rapperswil, Merkurstrasse, Rapperswil, Switzerland. · Glaucoma Institute of Beverly Hills, Professor of Clinical Ophthalmology University of California Los Angeles, Stein Eye Institute, Los Angeles, California, USA. · Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. ·Curr Opin Ophthalmol · Pubmed #30562239.

ABSTRACT: PURPOSE OF REVIEW: It is well known that glaucoma patients are not adherent to their therapeutic regimens. The issue of nonadherence is multifactorial and includes inadequate communication between doctors and patients, resulting in significant costs associated with enhanced disease progression. Therapeutic regimens are risk factors which often influences adherence rates. Thus, alternative treatment modalities, especially those risk factors that do not rely on patients' cooperation, may enable improvements in long-term outcomes of glaucoma in patient. RECENT FINDINGS: The studies selected for this review were divided into new medications, especially advancements in pharmaceutical approaches to treat glaucoma and new ways of delivering the medication, new surgical methods, especially minimally invasive surgery methods for glaucoma, and new studies about adherence in glaucoma. SUMMARY: Surprisingly, a very few studies on glaucoma medication or surgery addressed the concept of adherence. However, adherence is discussed in studies which consider psychological aspects of patients or communication issues between doctors and patients. Although these studies were performed in clinical settings, the issue of adherence is not addressed; despite it has significant effect on long-term outpatient care. A combination of both aspects, adherence and miscommunication, should be considered in studies.

5 Review The Effect of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure and Glaucoma: A Report by the American Academy of Ophthalmology. 2019

Hoguet, Ambika / Chen, Philip P / Junk, Anna K / Mruthyunjaya, Prithvi / Nouri-Mahdavi, Kouros / Radhakrishnan, Sunita / Takusagawa, Hana L / Chen, Teresa C. ·Ophthalmic Consultants of Boston, Boston, Massachusetts. · Department of Ophthalmology, University of Washington, Seattle, Washington. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Miami Veterans Affairs Healthcare System, Miami, Florida. · Byers Eye Institute, Stanford University, Palo Alto, California. · Stein Eye Institute, Los Angeles, California. · Glaucoma Center of San Francisco, Glaucoma Research and Education Group, San Francisco, California. · The Eye Center, Eugene, Oregon, and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon. · Harvard Medical School, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Glaucoma Service, Boston, Massachusetts. ·Ophthalmology · Pubmed #30472176.

ABSTRACT: PURPOSE: To assess the effect of intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents on immediate and long-term intraocular pressure (IOP) elevation and glaucoma. METHODS: Literature searches of the PubMed and Cochrane databases, last conducted in April 2018, yielded 253 unique citations. Of these, 41 met the inclusion criteria and were rated according to the strength of evidence. Two articles were rated level I, 17 were rated level II, and 15 were rated level III; an additional 7 were excluded because of poor study design and lack of relevance to the topic under evaluation. RESULTS: The studies that reported on short-term IOP elevation (i.e., between 0 and 60 minutes) showed that an immediate increase in IOP is seen in all patients when measured between 0 and 30 minutes of intravitreal injection and that the IOP elevation decreases over time. The data on long-term IOP elevation were mixed; 7 studies reported that between 4% and 15% of patients developed sustained elevation of IOP at 9 to 24 months after injection, whereas 6 studies found no long-term change in IOP from 1 to 36 months after injection. Pretreatment with glaucoma medications, anterior chamber tap, vitreous reflux, longer intervals between injections, and longer axial lengths were associated with lower IOP elevations after injection. Data were mixed on the relationship between IOP increase and the type of intravitreal injection, number of intravitreal injections, preexisting glaucoma, and globe decompression before injection. There were no data on the onset or progression of glaucoma in the studies reviewed in this assessment. CONCLUSIONS: Intravitreal injection of anti-VEGF agents results in an immediate and transient increase in IOP. A long-term increase in IOP also may be seen, and further studies are needed to determine at-risk populations. Although there is some suggestion in the literature, there is currently insufficient data to determine the impact of intravitreal anti-VEGF injections on glaucoma progression. Although pretreatment with glaucoma medications, performing anterior chamber paracentesis, or increasing the interval between injections may reduce the impact of transient IOP elevation, the clinical significance and associated risks of these interventions are unknown.

6 Review Cyclodestructive Procedures in Glaucoma: A Review of Current and Emerging Options. 2018

Dastiridou, Anna I / Katsanos, Andreas / Denis, Philippe / Francis, Brian A / Mikropoulos, Dimitrios G / Teus, Miguel A / Konstas, Anastasios-Georgios. ·2nd Department of Ophthalmology, Aristotle University, Thessaloniki, Greece. · Department of Ophthalmology, University of Ioannina, Ioannina, Greece. · University Department of Ophthalmology, Lyons, France. · Doheny and Stein Eye Institutes, University of California Los Angeles (UCLA), Los Angeles, CA, USA. · 3rd University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. · Department of Ophthalmology, Hospital Universitario "Principe de Asturias", Universidad de Alcalá, Alcala De Henares, Spain. · 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. konstas@med.auth.gr. ·Adv Ther · Pubmed #30448885.

ABSTRACT: The first surgical modalities to reduce aqueous humor production by damaging the ciliary body date back to the early twentieth century. Until recently, however, cyclodestructive procedures (e.g., cyclocryotherapy and transscleral diode laser photocoagulation) have been reserved as last option procedures in refractory glaucoma patients with poor visual potential. Emerging technologic innovation has led to the development of promising, safer and less destructive techniques, such as micropulse diode cyclophotocoagulation, endoscopic cyclophotocoagulation and ultrasound cyclodestruction. Consequently, an emerging paradigm shift is under way with the selection of these surgical options in eyes with less severe glaucoma and good visual potential. Although existing evidence has not, as yet, adequately defined the role and value of these procedures, their emergence is a welcome expansion of available options for patients with moderate-to-severe glaucoma. This article reviews the pertinent evidence on both established and evolving cyclodestructive techniques and describes their growing role in the management of glaucoma.

7 Review Potential applications of optical coherence tomography angiography in glaucoma. 2018

Dastiridou, Anna / Chopra, Vikas. ·Ophthalmology Department, University of Thessalia, Thessalia, Greece. · Doheny Image Reading Center, Doheny Eye Institute. · Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. ·Curr Opin Ophthalmol · Pubmed #29553952.

ABSTRACT: PURPOSE OF REVIEW: Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging modality that allows assessment of the retinal and choroidal vasculature. The scope of this review is to summarize recent studies using OCTA in glaucoma and highlight potential applications of this new technology in the field of glaucoma. RECENT FINDINGS: OCTA studies have shown that retinal vascular changes may not develop solely as a result of advanced glaucoma damage. OCTA-derived measurements have provided evidence for lower retinal vascular densities at the optic nerve head, peripapillary and macula in preperimetric-glaucoma and early-glaucoma, as well as, in more advanced glaucoma, in comparison to with normal eyes. SUMMARY: OCTA is a novel imaging modality that has already started to expand our knowledge base regarding the role of ocular blood flow in glaucoma. Future studies will better elucidate the role of OCTA-derived measurements in clinical practice, research, and clinical trials in glaucoma.

8 Review Consensus recommendations for trabecular meshwork cell isolation, characterization and culture. 2018

Keller, Kate E / Bhattacharya, Sanjoy K / Borrás, Theresa / Brunner, Thomas M / Chansangpetch, Sunee / Clark, Abbott F / Dismuke, W Michael / Du, Yiqin / Elliott, Michael H / Ethier, C Ross / Faralli, Jennifer A / Freddo, Thomas F / Fuchshofer, Rudolf / Giovingo, Michael / Gong, Haiyan / Gonzalez, Pedro / Huang, Alex / Johnstone, Murray A / Kaufman, Paul L / Kelley, Mary J / Knepper, Paul A / Kopczynski, Casey C / Kuchtey, John G / Kuchtey, Rachel W / Kuehn, Markus H / Lieberman, Raquel L / Lin, Shan C / Liton, Paloma / Liu, Yutao / Lütjen-Drecoll, Elke / Mao, Weiming / Masis-Solano, Marisse / McDonnell, Fiona / McDowell, Colleen M / Overby, Darryl R / Pattabiraman, Padmanabhan P / Raghunathan, Vijay K / Rao, P Vasanth / Rhee, Douglas J / Chowdhury, Uttio Roy / Russell, Paul / Samples, John R / Schwartz, Donald / Stubbs, Evan B / Tamm, Ernst R / Tan, James C / Toris, Carol B / Torrejon, Karen Y / Vranka, Janice A / Wirtz, Mary K / Yorio, Thomas / Zhang, Jie / Zode, Gulab S / Fautsch, Michael P / Peters, Donna M / Acott, Ted S / Stamer, W Daniel. ·Oregon Health and Science University, United States. · University of Miami, United States. · University of North Carolina-Chapel Hill, United States. · Glaucoma Research Foundation, United States. · University of California, San Francisco, United States. · University of North Texas Health Sciences Center, United States. · Aerie Pharmaceuticals, United States. · University of Pittsburgh, United States. · University of Oklahoma, United States. · Georgia Institute of Technology, United States. · University of Wisconsin, United States. · Massachusetts College of Pharmacy and Health Sciences, United States. · University of Regensburg, Germany. · John H. Stroger, Jr. Hospital of Cook County, United States. · Boston University, United States. · Duke University, United States. · University of California, Los Angeles, United States. · University of Washington, United States. · University of Illinois at Chicago, United States. · Vanderbilt University, United States. · University of Iowa, United States. · Augusta University, United States. · University of Erlangen-Nuremberg, Germany. · Imperial College, London, United Kingdom. · Case Western Reserve University, United States. · University of Houston, United States. · Mayo Clinic, United States. · University of California, Davis, United States. · Western Glaucoma Foundation, United States. · EyeSonix, United States. · Loyola University, Chicago, United States. · University of Southern California, United States. · Glauconix, United States. · Department of Ophthalmology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, United States. Electronic address: fautsch.michael@mayo.edu. · Department of Pathology & Laboratory Medicine, University of Wisconsin, 1300 University Ave, Madison, WI 53706, United States. Electronic address: dmpeter2@wisc.edu. · Department of Ophthalmology, Department of Biochemistry & Molecular Biology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, United States. Electronic address: acott@ohsu.edu. · Department of Ophthalmology, Duke University, DUMC 3802, Durham, NC 27705, United States. Electronic address: dan.stamer@duke.edu. ·Exp Eye Res · Pubmed #29526795.

ABSTRACT: Cultured trabecular meshwork (TM) cells are a valuable model system to study the cellular mechanisms involved in the regulation of conventional outflow resistance and thus intraocular pressure; and their dysfunction resulting in ocular hypertension. In this review, we describe the standard procedures used for the isolation of TM cells from several animal species including humans, and the methods used to validate their identity. Having a set of standard practices for TM cells will increase the scientific rigor when used as a model, and enable other researchers to replicate and build upon previous findings.

9 Review Structural and functional imaging of aqueous humour outflow: a review. 2018

Huang, Alex S / Francis, Brian A / Weinreb, Robert N. ·Doheny Eye Institute, Los Angeles, California, USA. · Doheny Eye Centers, Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, California, USA. · Shiley Eye Institute and Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California, USA. ·Clin Exp Ophthalmol · Pubmed #28898516.

ABSTRACT: Maintaining healthy aqueous humour outflow (AHO) is important for intraocular cellular health and stable vision. Impairment of AHO can lead to increased intraocular pressure, optic nerve damage and concomitant glaucoma. An improved understanding of AHO will lead to improved glaucoma surgeries that enhance native AHO as well as facilitate the development of AHO-targeted pharmaceuticals. Recent AHO imaging has evolved to live human assessment and has focused on the structural evaluation of AHO pathways and the functional documentation of fluid flow. Structural AHO evaluation is predominantly driven by optical coherence tomography, and functional evaluation of flow is performed using various methods, including aqueous angiography. Advances in structural and functional evaluation of AHO are reviewed with discussion of strengths, weaknesses and potential future directions.

10 Review OCULAR HYPERTENSION AND GLAUCOMA FOLLOWING VITRECTOMY: A Systematic Review. 2018

Miele, Alba / Govetto, Andrea / Fumagalli, Carlo / Donati, Simone / Biagini, Ilaria / Azzolini, Claudio / Rizzo, Stanislao / Virgili, Gianni. ·Ophthalmology Clinic, Department of Surgery and Translational Medicine, University of Florence and AOU Careggi, Florence, Italy. · Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California. · Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy. · Department of Surgical and Morphological Sciences, University of Insurbia-Circolo Hospital, Varese, Italy. ·Retina · Pubmed #28426628.

ABSTRACT: PURPOSE: Pars plana vitrectomy has been reported to increase the risk of ocular hypertension and open-angle glaucoma. The authors conducted a systematic review of randomized and nonrandomized studies to compare the incidence of open-angle glaucoma and ocular hypertension in vitrectomized versus nonvitrectomized eyes. METHODS: A literature search was performed using MEDLINE and EMBASE until August 2016. Data on ocular hypertension and open-angle glaucoma incidence and mean intraocular pressure after at least 1 year were pooled using random-effects metaanalysis models. Because only nonrandomized studies were retrieved, ROBINS-I tool was used to assess risk of bias in the review. RESULTS: Seven included studies had a paired design to compare the outcomes of vitrectomized versus fellow eyes, with mean follow-up of least 12 months. Four studies (851 patients) provided data on open-angle glaucoma: incidence in vitrectomized versus non-vitrectomized eyes was 7.8% and 4.8%, respectively, yielding a metaanalytic odds ratio of 1.67 (95% CI: 1.08-2.57). Six studies (1,060 patients) reported on the occurrence of ocular hypertension, which was 5.8% in vitrectomized eyes versus 3.1% in fellow eyes (odds ratio: 2.03, 95% CI: 0.97-4.22), without significant differences in the mean postoperative intraocular pressure (mean difference 0.31 mmHg, 95% CI: -0.26 to 0.89). CONCLUSION: Although the review found increased risk of open-angle glaucoma with pars plana vitrectomy, the studies were heterogenous or inconsistent regarding ocular hypertension and intraocular pressure increase. Larger studies should be conducted in homogenous cohorts of patients undergoing macular surgery, excluding complex conditions such as retinal detachment or diabetic retinopathy.

11 Review Glaucoma, Stem Cells, and Gene Therapy: Where Are We Now? 2017

Daliri, Karim / Ljubimov, Alexander V / Hekmatimoghaddam, Seyedhossein. ·Neurogenetic Ward, Comprehensive Child Developmental Center, Shiraz University of Medical Sciences, Shiraz, Iran. · Visiting Scientist at Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany. · Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. · Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. · Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ·Int J Stem Cells · Pubmed #28844129.

ABSTRACT: Glaucoma is the second most common cause of blindness, affecting 70∼80 million people around the world. The death of retinal ganglion cells (RGCs) is the main cause of blindness related to this disease. Current therapies do not provide enough protection and regeneration of RGCs. A novel opportunity for treatment of glaucoma is application of technologies related to stem cell and gene therapy. In this perspective we will thus focus on emerging approaches to glaucoma treatment including stem cells and gene therapy.

12 Review Aqueous shunts for glaucoma. 2017

Tseng, Victoria L / Coleman, Anne L / Chang, Melinda Y / Caprioli, Joseph. ·Stein Eye Institute, UCLA, 100 Stein Plaza, Los Angeles, California, USA, 90025. ·Cochrane Database Syst Rev · Pubmed #28750481.

ABSTRACT: BACKGROUND: Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. OBJECTIVES: To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase.com (1947 to August 2016), PubMed (1948 to August 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to August 2016), ClinicalTrials.gov (www.clinicaltrials.gov); searched 15 August 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 15 August 2016. We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 15 August 2016. We also searched the reference lists of identified trial reports and the Science Citation Index to find additional trials. SELECTION CRITERIA: We included randomized controlled trials that compared various types of aqueous shunts with standard surgery or to each other in eyes with glaucoma. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results for eligibility, assessed the risk of bias, and extracted data from included trials. We contacted trial investigators when data were unclear or not reported. We graded the certainty of the evidence using the GRADE approach. We followed standard methods as recommended by Cochrane. MAIN RESULTS: We included 27 trials with a total of 2099 participants with mixed diagnoses and comparisons of interventions. Seventeen studies reported adequate methods of randomization, and seven reported adequate allocation concealment. Data collection and follow-up times varied.Four trials compared an aqueous shunt (Ahmed or Baerveldt) with trabeculectomy, of which three reported one-year outcomes. At one-year, the difference in IOP between aqueous shunt groups and trabeculectomy groups was uncertain (mean difference (MD) 2.55 mmHg, 95% confidence interval (CI) -0.78 to 5.87; 380 participants; very low-certainty evidence). The difference in logMAR visual acuity was also uncertain (MD 0.12 units, 95% CI -0.07 to 0.31; 380 participants; very low-certainty evidence). In two trials, the difference in visual field score was uncertain (MD -0.25, 95% CI -1.91 to 1.40; 196 participants; very low-certainty evidence). The mean number of antiglaucoma medications was higher in the aqueous shunt group than the trabeculectomy group in one trial (MD 0.80, 95% CI 0.48 to 1.12; 184 participants; low-certainty evidence). The effect on needing additional glaucoma surgery was uncertain between groups in two trials (risk ratio (RR) 0.24, 95% CI 0.04 to 1.36; 329 participants; very low-certainty evidence). In one trial, fewer total adverse events were reported in the aqueous shunt group than the trabeculectomy group (RR 0.59, 95% CI 0.43 to 0.81; 212 participants; very low-certainty evidence). No trial reported quality-of-life outcomes at one-year follow-up.Two trials that compared the Ahmed implant with the Baerveldt implant for glaucoma found higher mean IOP in the Ahmed group at one-year follow-up (MD 2.60 mmHg, 95% CI 1.58 to 3.62; 464 participants; moderate-certainty evidence). The difference in logMAR visual acuity was uncertain between groups (MD -0.07 units, 95% CI -0.27 to 0.13; 501 participants; low-certainty evidence). The MD in number of antiglaucoma medications was within one between groups (MD 0.35, 95% CI 0.11 to 0.59; 464 participants; moderate-certainty evidence). More participants in the Ahmed group required additional glaucoma surgery than the Baerveldt group (RR 2.77, 95% CI 1.02 to 7.54; 514 participants; moderate-certainty evidence). The two trials reported specific adverse events but not overall number of adverse events. Neither trial reported visual field or quality-of-life outcomes at one-year follow-up.One trial compared the Ahmed implant with the Molteno implant for glaucoma over two-year follow-up. Mean IOP was higher in the Ahmed group than the Molteno group (MD 1.64 mmHg, 95% CI 0.85 to 2.43; 57 participants; low-certainty evidence). The differences in logMAR visual acuity (MD 0.08 units, 95% CI -0.24 to 0.40; 57 participants; very low-certainty evidence) and mean deviation in visual field (MD -0.18 dB, 95% CI -3.13 to 2.77; 57 participants; very low-certainty evidence) were uncertain between groups. The mean number of antiglaucoma medications was also uncertain between groups (MD -0.38, 95% CI -1.03 to 0.27; 57 participants; low-certainty evidence). The trial did not report the proportion needing additional glaucoma surgery, total adverse events, or quality-of-life outcomes.Two trials compared the double-plate Molteno implant with the Schocket shunt for glaucoma; one trial reported outcomes only at six-month follow-up, and the other did not specify the follow-up time. At six-months, mean IOP was lower in the Molteno group than the Schocket group (MD -2.50 mmHg, 95% CI -4.60 to -0.40; 115 participants; low-certainty evidence). Neither trial reported the proportion needing additional glaucoma surgery, total adverse events, or visual acuity, visual field, or quality-of-life outcomes.The remaining 18 trials evaluated modifications to aqueous shunts, including 14 trials of Ahmed implants (early aqueous suppression versus standard medication regimen, 2 trials; anti-vascular endothelial growth factor agent versus none, 4 trials; corticosteroids versus none, 2 trials; shunt augmentation versus none, 3 trials; partial tube ligation versus none, 1 trial; pars plana implantation versus conventional implantation, 1 trial; and model M4 versus model S2,1 trial); 1 trial of 500 mm AUTHORS' CONCLUSIONS: Information was insufficient to conclude whether there are differences between aqueous shunts and trabeculectomy for glaucoma treatment. While the Baerveldt implant may lower IOP more than the Ahmed implant, the evidence was of moderate-certainty and it is unclear whether the difference in IOP reduction is clinically significant. Overall, methodology and data quality among existing randomized controlled trials of aqueous shunts was heterogeneous across studies, and there are no well-justified or widely accepted generalizations about the superiority of one surgical procedure or device over another.

13 Review Optical Coherence Tomography Angiography of the Optic Disc; an Overview. 2017

Akil, Handan / Falavarjani, Khalil Ghasemi / Sadda, Srinivas R / Sadun, Alfredo A. ·Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. · Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. ·J Ophthalmic Vis Res · Pubmed #28299012.

ABSTRACT: Different diseases of the optic disc may be caused by or lead to abnormal vasculature at the optic nerve head. Optical coherence tomography angiography (OCTA) is a novel technology that provides high resolution mapping of the retinal and optic disc vessels. Recent studies have shown the ability of OCTA to visualize vascular abnormalities in different optic neuropathies. In addition, quantified OCTA measurements were found promising for differentiating optic neuropathies from healthy eyes.

14 Review Increasing healthcare costs: can we influence the costs of glaucoma care? 2017

Töteberg-Harms, Marc / Berlin, Michael S / Meier-Gibbons, Frances. ·aDepartment of Ophthalmology, University Hospital Zurich, Zurich, Switzerland bGlaucoma Institute of Beverly Hills, West Hollywood cUniversity of California Los Angeles Stein Eye Institute, Los Angeles, California, USA dEye Center Rapperswil, Rapperswil, Switzerland. ·Curr Opin Ophthalmol · Pubmed #27828895.

ABSTRACT: PURPOSE OF REVIEW: Despite a decrease in real average growth rates per capita since 2009, healthcare costs continue to rise worldwide. Numerous patient-related and doctor-related factors have contributed to this rise. Glaucoma is the leading cause of irreversible blindness and requires chronic, usually lifelong treatment. As with other chronic diseases, the adherence to prescribed treatment is often low and maybe influenced by the cost of the therapy. The purpose of this review is to seek potential solutions to best control the escalating costs of glaucoma care. RECENT FINDINGS: The studies we selected for this review can be divided into four different categories: costs of diagnostic tests; costs of direct comparisons between drugs or laser and conventional surgery; patient-related factors (such as adherence); and general aspects regarding costs: theoretical models and calculations. SUMMARY: It is challenging to find reliable studies concerning this subject matter. As patients are under the umbrellas of variously organized healthcare systems which span different cultures, the costs between countries are difficult to compare. However, one common aspect to lower costs in glaucoma care is to improve patient adherence. Theoretical models with actual patient studies could enable cost reductions by comparing multiple diagnostic and therapeutic scenarios. VIDEO ABSTRACT: http://links.lww.com/COOP/A22.

15 Review Toward in vivo two-photon analysis of mouse aqueous outflow structure and function. 2017

Gonzalez, Jose M / Ko, Minhee K / Masedunskas, Andrius / Hong, Young-Kwon / Weigert, Roberto / Tan, James C H. ·Doheny Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. · Intracellular Membrane Trafficking Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA. · Department of Surgery, Department of Biochemistry and Molecular Biology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. · Doheny Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. Electronic address: oranghutan@aol.com. ·Exp Eye Res · Pubmed #27179411.

ABSTRACT: The promise of revolutionary insights into intraocular pressure (IOP) and aqueous humor outflow homeostasis, IOP pathogenesis, and novel therapy offered by engineered mouse models has been hindered by a lack of appropriate tools for studying the aqueous drainage tissues in their original 3-dimensional (3D) environment. Advances in 2-photon excitation fluorescence imaging (TPEF) combined with availability of modalities such as transgenic reporter mice and intravital dyes have placed us on the cusp of unlocking the potential of the mouse model for unearthing insights into aqueous drainage structure and function. Multimodality 2-photon imaging permits high-resolution visualization not only of tissue structural organization but also cells and cellular function. It is possible to dig deeper into understanding the cellular basis of aqueous outflow regulation as the technique integrates analysis of tissue structure, cell biology and physiology in a way that could also lead to fresh insights into human glaucoma. We outline recent novel applications of two-photon imaging to analyze the mouse conventional drainage system in vivo or in whole tissues: (1) collagen second harmonic generation (SHG) identifies the locations of episcleral vessels, intrascleral plexuses, collector channels, and Schlemm's canal in the distal aqueous drainage tract; (2) the prospero homeobox protein 1-green fluorescent protein (GFP) reporter helps locate the inner wall of Schlemm's canal; (3) Calcein AM, siGLO™, the fluorescent reporters m-Tomato and GFP, and coherent anti-Stokes scattering (CARS), are adjuncts to TPEF to identify live cells by their membrane or cytosolic locations; (4) autofluorescence and sulforhodamine-B to identify elastic fibers in the living eye. These tools greatly expand our options for analyzing physiological and pathological processes in the aqueous drainage tissues of live mice as a model of the analogous human system.

16 Review Heat shock proteins in the retina: Focus on HSP70 and alpha crystallins in ganglion cell survival. 2016

Piri, Natik / Kwong, Jacky M K / Gu, Lei / Caprioli, Joseph. ·Stein Eye Institute, University of California, Los Angeles, CA 90095, USA; Brain Research Institute, University of California, Los Angeles, CA 90095, USA. Electronic address: piri@jsei.ucla.edu. · Stein Eye Institute, University of California, Los Angeles, CA 90095, USA. · Stein Eye Institute, University of California, Los Angeles, CA 90095, USA; Brain Research Institute, University of California, Los Angeles, CA 90095, USA. ·Prog Retin Eye Res · Pubmed #27017896.

ABSTRACT: Heat shock proteins (HSPs) belong to a superfamily of stress proteins that are critical constituents of a complex defense mechanism that enhances cell survival under adverse environmental conditions. Cell protective roles of HSPs are related to their chaperone functions, antiapoptotic and antinecrotic effects. HSPs' anti-apoptotic and cytoprotective characteristics, their ability to protect cells from a variety of stressful stimuli, and the possibility of their pharmacological induction in cells under pathological stress make these proteins an attractive therapeutic target for various neurodegenerative diseases; these include Alzheimer's, Parkinson's, Huntington's, prion disease, and others. This review discusses the possible roles of HSPs, particularly HSP70 and small HSPs (alpha A and alpha B crystallins) in enhancing the survival of retinal ganglion cells (RGCs) in optic neuropathies such as glaucoma, which is characterized by progressive loss of vision caused by degeneration of RGCs and their axons in the optic nerve. Studies in animal models of RGC degeneration induced by ocular hypertension, optic nerve crush and axotomy show that upregulation of HSP70 expression by hyperthermia, zinc, geranyl-geranyl acetone, 17-AAG (a HSP90 inhibitor), or through transfection of retinal cells with AAV2-HSP70 effectively supports the survival of injured RGCs. RGCs survival was also stimulated by overexpression of alpha A and alpha B crystallins. These findings provide support for translating the HSP70- and alpha crystallin-based cell survival strategy into therapy to protect and rescue injured RGCs from degeneration associated with glaucomatous and other optic neuropathies.

17 Review Minimally invasive glaucoma surgery: current status and future prospects. 2016

Richter, Grace M / Coleman, Anne L. ·UCLA Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, CA, USA; USC Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. · UCLA Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, CA, USA. ·Clin Ophthalmol · Pubmed #26869753.

ABSTRACT: Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy); suprachoroidal shunts (Cypass micro-stent); reducing aqueous production (endocyclophotocoagulation); and subconjunctival filtration (XEN gel stent). The data on each surgical procedure for each of these approaches are reviewed in this article, patient selection pearls learned to date are discussed, and expectations for the future are examined.

18 Review Promising alternative clinical uses of prostaglandin F2α analogs: beyond the eyelashes. 2015

Choi, Young M / Diehl, Joseph / Levins, Paul C. ·David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. · Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. · Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. Electronic address: PLevins@mednet.ucla.edu. ·J Am Acad Dermatol · Pubmed #25601618.

ABSTRACT: Prostaglandin F2α analogs, commonly prescribed for glaucoma treatment, have been shown to induce side effects such as cutaneous hypertrichosis and hyperpigmentation. Therefore, these medications have theoretic applications in the treatment of alopecia and disorders of hypopigmentation. We reviewed the literature to find original studies assessing the use of prostaglandin F2α analogs in these settings. Studies and reports were analyzed in regards to androgenic alopecia, alopecia areata, chemotherapy-induced alopecia, vitiligo, and hypopigmented scarring. Based on the results of these studies, and consideration of pathophysiologic mechanism, the most promising applications for prostaglandin F2α analogs include androgenic alopecia, chemotherapy-induced alopecia, and alopecia areata concurrently treated with corticosteroids.

19 Review Measuring rates of structural and functional change in glaucoma. 2015

Nouri-Mahdavi, Kouros / Caprioli, Joseph. ·The Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. ·Br J Ophthalmol · Pubmed #25287369.

ABSTRACT: Glaucoma is a progressive optic neuropathy. Hence, most glaucomatous eyes demonstrate signs of deterioration over time despite what may appear to be adequate treatment. The main goal of glaucoma treatment is to slow the rate of disease so that patients can prolong their functional vision. Therefore, it is important for clinicians caring for patients with glaucoma to be able to estimate rates of change with structural and functional outcomes in their patients. Various trend analysis models have been previously used to estimate rates of decay in glaucoma. The authors discuss the relevant issues and the inherent caveats related to estimating structural and functional rates of change in glaucoma. Patterns of deterioration, testing frequency, and combing structural and functional rates of change are also addressed.

20 Review Selecting visual field tests and assessing visual field deterioration in glaucoma. 2014

Nouri-Mahdavi, Kouros. ·Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Calif.. Electronic address: nouri-mahdavi@jsei.ucla.edu. ·Can J Ophthalmol · Pubmed #25433738.

ABSTRACT: Testing the peripheral field of vision is the mainstay for detection of glaucoma deterioration. Various methods and algorithms are currently available for detection of early glaucoma or establishing disease progression. Alternative testing strategies such as frequency doubling technology perimetry or short-wavelength automated perimetry have been extensively explored over the last 2 decades. The former has been found most promising for detection of earliest evidence of functional glaucoma damage when the standard achromatic perimetry results are still within the normal range. However, standard achromatic perimetry remains the standard technique for establishing deterioration of the disease. Both trend and event analyses are used for establishing change within series of visual fields. Trend analyses provide the clinician with rates of progression, putting the speed of glaucoma progression in the context of patient longevity, whereas event analyses demonstrate a "step" change regardless of the length of time it took for this amount of change to occur. The two techniques are complementary and should be used concurrently.

21 Review Pediatric glaucoma surgery: a report by the American Academy Of Ophthalmology. 2014

Chen, Teresa C / Chen, Philip P / Francis, Brian A / Junk, Anna K / Smith, Scott D / Singh, Kuldev / Lin, Shan C. ·Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Glaucoma Service, Boston, Massachusetts. · Department of Ophthalmology, University of Washington, Seattle, Washington. · Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. · Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida. · Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. · Stanford University School of Medicine, Stanford, California. · Department of Ophthalmology, University of California, San Francisco, San Francisco, California. ·Ophthalmology · Pubmed #25066765.

ABSTRACT: OBJECTIVE: To review the current published literature to evaluate the success rates and long-term problems associated with surgery for pediatric glaucoma. METHODS: Literature searches of the PubMed and Cochrane Library databases were last conducted in May 2012. The search yielded 838 potentially relevant citations, of which 273 were in non-English languages. The titles and abstracts of these articles were reviewed by the authors, and 364 were selected for possible further review. Members of the Ophthalmic Technology Assessment Committee Glaucoma Panel reviewed the full text of these articles and used the 36 that met inclusion and exclusion criteria for this Ophthalmic Technology Assessment. There were no studies on the topic that provided level I evidence. The assessment included only level II and level III studies. RESULTS: Surgeons treat pediatric glaucoma most commonly with goniotomy, trabeculotomy, trabeculectomy, combined trabeculotomy and trabeculectomy, tube shunt surgery, cyclodestruction, and deep sclerectomy. Certain surgical options seem better for specific diagnoses, such as primary congenital glaucoma, aphakic glaucoma, and glaucomas associated with other ocular or systemic anomalies. CONCLUSIONS: There are many surgical options for the treatment of the pediatric glaucomas. The relative efficacy of these various procedures for particular diagnoses and clinical situations should be weighed against the specific risks associated with the procedures for individual patients.

22 Review New directions in the treatment of normal tension glaucoma. 2014

Song, Brian J / Caprioli, Joseph. ·Jules Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, USA. ·Indian J Ophthalmol · Pubmed #24881596.

ABSTRACT: Glaucoma is a progressive optic neuropathy that causes characteristic changes of the optic nerve and visual field in relation to intraocular pressure (IOP). It is now known that glaucoma can occur at statistically normal IOPs and prevalence studies have shown that normal tension glaucoma (NTG) is more common than previously thought. While IOP is believed to be the predominant risk factor in primary open angle glaucoma (POAG), IOP-independent risk factors, such as vascular dysregulation, are believed to play an important part in the pathogenesis of NTG. Though certain distinguishing phenotypic features of NTG have been reported, such as an increased frequency of disc hemorrhages, acquired pits of the optic nerve and characteristic patterns of disc cupping and visual field loss, there is much overlap of the clinical findings in NTG with POAG, suggesting that NTG is likely part of a continuum of open angle glaucomas. However, IOP modification is still the mainstay of treatment in NTG. As in traditional POAG, reduction of IOP can be achieved with the use of medications, laser trabeculoplasty or surgery. Studies now show that the choice of medication may also be important in determining the outcomes of these patients. Though it is likely that future treatment of NTG will involve modification of both IOP and IOP-independent risk factors, current efforts to develop IOP-independent neuroprotective treatments have not yet proven to be effective in humans.

23 Review Endoscopic ophthalmic surgery of the anterior segment. 2014

Francis, Brian A / Kwon, Julie / Fellman, Ronald / Noecker, Robert / Samuelson, Thomas / Uram, Martin / Jampel, Henry. ·Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: bfrancis@usc.edu. · University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey. · Glaucoma Associates of Texas, Dallas, Texas. · Ophthalmic Consultants of Connecticut, Fairfield, Connecticut. · Minnesota Eye Consultants, Minneapolis, Minnesota. · Retina Consultants of New Jersey, Attending Surgeon, Manhattan Eye, Ear and Throat Hospital, New York, New York. · Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland. ·Surv Ophthalmol · Pubmed #23931901.

ABSTRACT: We summarize the uses of anterior segment endoscopic techniques and the basic science and technology of endoscopic cyclophotocoagulation (ECP) as compared with transscleral cyclophotocoagulation. This is followed by an analysis of patient selection for ECP, a description of surgical techniques, and clinical results. In addition, the ophthalmic endoscope has other uses in anterior segment surgeries. We discuss the techniques for these endoscope-assisted surgeries.

24 Review Glaucoma: a disease of early cellular senescence. 2013

Caprioli, Joseph. ·Department of Ophthalmology, Jules Stein Eye Institute, University of California-Los Angeles, Los Angeles, California. ·Invest Ophthalmol Vis Sci · Pubmed #24335071.

ABSTRACT: -- No abstract --

25 Review National Eye Institute Visual Function Questionnaire: usefulness in glaucoma. 2013

Nassiri, Nariman / Mehravaran, Shiva / Nouri-Mahdavi, Kouros / Coleman, Anne L. ·Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095, USA. ·Optom Vis Sci · Pubmed #23851305.

ABSTRACT: The National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) is the most commonly used patient-reported outcome measure to assess vision-related quality of life in patients with glaucoma. Glaucoma negatively affects the composite and several NEI-VFQ subscale scores; this effect is correlated with the severity of glaucomatous visual field loss. Contrast sensitivity, glare, and dark adaptation are potential items that could be added to the NEI-VFQ to make it more responsive to changes in vision-related quality of life in patients with glaucoma.

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