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Glaucoma: HELP
Articles from San Diego
Based on 300 articles published since 2008
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These are the 300 published articles about Glaucoma that originated from San Diego during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12
1 Editorial Structure versus Function in Glaucoma: The Debate That Doesn't Need to Be. 2016

Medeiros, Felipe A / Tatham, Andrew J. ·San Diego, California. Electronic address: fmedeiros@ucsd.edu. · Edinburgh, United Kingdom. ·Ophthalmology · Pubmed #27210598.

ABSTRACT: -- No abstract --

2 Editorial Drugs, Inflammation, and the Eye. 2016

Cunningham, Emmett T / London, Nikolas J S / Moorthy, Ramana / Garg, Sunir J / Zierhut, Manfred. ·a California Pacific Medical Center , San Francisco , California , USA . · b The Department of Ophthalmology , Stanford University School of Medicine , Stanford , California , USA . · c The Francis I. Proctor Foundation, UCSF School of Medicine , San Francisco , California , USA . · d West Coast Retina Medical Group , San Francisco , California , USA . · e Retina Consultants San Diego , La Jolla , California , USA . · f Associated Vitreoretinal and Uveitis Consultants, Indiana University School of Medicine , Indianapolis , Indiana , USA . · g MidAtlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , Pennsylvania , USA , and. · h Centre for Ophthalmology, University Tuebingen , Tuebingen , Germany. ·Ocul Immunol Inflamm · Pubmed #27074544.

ABSTRACT: -- No abstract --

3 Review The Role of Axon Transport in Neuroprotection and Regeneration. 2018

Shah, Sahil H / Goldberg, Jeffrey L. ·Byers Eye Institute, Stanford University, Palo Alto, California. · Neurosciences Graduate Program, University of California, San Diego, California. · Medical Scientist Training Program, University of California, San Diego, California. ·Dev Neurobiol · Pubmed #30027690.

ABSTRACT: Retinal ganglion cells and other central nervous system neurons fail to regenerate after injury. Understanding the obstacles to survival and regeneration, and overcoming them, is key to preserving and restoring function. While comparisons in the cellular changes seen in these non-regenerative cells with those that do have intrinsic regenerative ability has yielded many candidate genes for regenerative therapies, complete visual recovery has not yet been achieved. Insights gained from neurodegenerative diseases, like glaucoma, underscore the importance of axonal transport of organelles, mRNA, and effector proteins in injury and disease. Targeting molecular motor networks, and their cargoes, may be necessary for realizing complete axonal regeneration and vision restoration.

4 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.

5 Review Will Perimetry Be Performed to Monitor Glaucoma in 2025? 2017

Camp, Andrew S / Weinreb, Robert N. ·Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California-San Diego, La Jolla, California. · Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California-San Diego, La Jolla, California. Electronic address: rweinreb@ucsd.edu. ·Ophthalmology · Pubmed #28865878.

ABSTRACT: Visual field testing has played an essential role in the diagnosis and management of glaucoma for more than a century. Methods to examine the visual field have been refined from early kinetic perimetry to current standard automated perimetry (SAP). Clinicians now use SAP for the diagnosis and management of glaucoma throughout the world. Various testing paradigms and analytic methods have been developed to simplify the diagnosis of glaucoma and the interpretation of progression. Moreover, strategies have been implemented to improve patient experience with visual field testing and to increase reliability. Objective functional tests, such as electroretinography, provide an alternative to subjective visual field testing but are not yet ready for widespread adoption. Standard automated perimetry is being adapted and improved constantly. New devices may allow patients to complete visual field tests at home, which could relieve patients and clinicians from in-office testing and allow for more frequent examinations. Glaucoma detection and progression analysis also are incorporating progressively more information and will be improved as deep learning strategies are applied. Finally, perimetric and structural testing likely will become more closely intertwined as testing platforms and progression analysis incorporate both of these measures. Visual field testing will continue to have an important role in the diagnosis and management of glaucoma.

6 Review Biomarkers and Surrogate Endpoints: Lessons Learned From Glaucoma. 2017

Medeiros, Felipe A. ·Hamilton Glaucoma Center, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States. ·Invest Ophthalmol Vis Sci · Pubmed #28475699.

ABSTRACT: With the recent progress in imaging technologies for assessment of structural damage in glaucoma, a debate has emerged on whether these measurements can be used as valid surrogate endpoints in clinical trials evaluating new therapies for the disease. A discussion of surrogates should be grounded on knowledge acquired from their use in other areas of medicine as well as regulatory requirements. This article reviews the conditions for valid surrogacy in the context of glaucoma clinical trials and critically evaluates the role of biomarkers such as IOP and imaging measurements as potential surrogates for clinically relevant outcomes. Valid surrogate endpoints must be able to predict a clinically relevant endpoint, such as loss of vision or decrease in quality of life. In addition, the effect of a proposed treatment on the surrogate must capture the effect of the treatment on the clinically relevant endpoint. Despite its widespread use in clinical trials, no proper validation of IOP as a surrogate endpoint has yet been conducted for any class of IOP-lowering treatments. Although strong evidence has accumulated about imaging measurements as predictors of relevant functional outcomes in glaucoma, there is still insufficient evidence to support their use as valid surrogate endpoints. However, imaging biomarkers could potentially be used as part of composite endpoints in glaucoma trials, overcoming weaknesses of the use of structural or functional endpoints in isolation. Efforts should be taken to properly design and conduct studies that can provide proper validation of potential biomarkers in glaucoma clinical trials.

7 Review Steroid-induced glaucoma in the pediatric population. 2017

Nuyen, Brenda / Weinreb, Robert N / Robbins, Shira L. ·Ratner Children's Eye Center at the Shiley Eye Institute, University of California San Diego, La Jolla, California. · Shiley Eye Institute, University of California San Diego, La Jolla, California. · Ratner Children's Eye Center at the Shiley Eye Institute, University of California San Diego, La Jolla, California. Electronic address: srobbins@ucsd.edu. ·J AAPOS · Pubmed #28087345.

ABSTRACT: Steroid medications may cause elevation of intraocular pressure, sometimes with permanent damage to the optic nerve. These therapies, via various routes of administration, are commonly prescribed for children, but the potential sequelae of elevated intraocular pressure and glaucomatous optic nerve damage can be even more severe and devastating in children than in adults. This review discusses the pathophysiology and potential risk factors, including the impact of intraocular pressure elevation via the different common routes of administration of steroids, clinical evaluation, and management of steroid response and steroid-induced glaucoma in children.

8 Review Role of cyclic AMP in the eye with glaucoma. 2017

Shim, Myoung Sup / Kim, Keun-Young / Ju, Won-Kyu. ·Hamilton Glaucoma Center and Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92037, USA. · Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San Diego, La Jolla 92093, CA 92093, USA. ·BMB Rep · Pubmed #27916026.

ABSTRACT: Glaucoma is characterized by a slow and progressive degeneration of the optic nerve, including retinal ganglion cell (RGC) axons in the optic nerve head (ONH), leading to visual impairment. Despite its high prevalence, the biological basis of glaucoma pathogenesis still is not yet fully understood, and the factors contributing to its progression are currently not well characterized. Intraocular pressure (IOP) is the only modifiable risk factor, and reduction of IOP is the standard treatment for glaucoma. However, lowering IOP itself is not always effective for preserving visual function in patients with primary open-angle glaucoma. The second messenger cyclic adenosine 3',5'-monophosphate (cAMP) regulates numerous biological processes in the central nervous system including the retina and the optic nerve. Although recent studies revealed that cAMP generated by adenylyl cyclases (ACs) is important in regulating aqueous humor dynamics in ocular tissues, such as the ciliary body and trabecular meshwork, as well as cell death and growth in the retina and optic nerve, the functional role and significance of cAMP in glaucoma remain to be elucidated. In this review, we will discuss the functional role of cAMP in aqueous humor dynamics and IOP regulation, and review the current medications, which are related to the cAMP signaling pathway, for glaucoma treatment. Also, we will further focus on cAMP signaling in RGC growth and regeneration by soluble AC as well as ONH astrocytes by transmembrane ACs to understand its potential role in the pathogenesis of glaucoma neurodegeneration. [BMB Reports 2017; 50(2): 60-70].

9 Review 24-h monitoring devices and nyctohemeral rhythms of intraocular pressure. 2016

Aptel, Florent / Weinreb, Robert N / Chiquet, Christophe / Mansouri, Kaweh. ·Inserm U1042, Hypoxia and Physiopathology Laboratory, University Grenoble Alpes, Grenoble, France; Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble, France. · Hamilton Glaucoma Center, Shiley Eye Center and Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA. · Glaucoma Center, Montchoisi Clinic, Swiss Vision Network, Lausanne, Switzerland; Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA. Electronic address: kawehm@yahoo.com. ·Prog Retin Eye Res · Pubmed #27477112.

ABSTRACT: Intraocular pressure (IOP) is not a fixed value and varies over both the short term and periods lasting several months or years. In particular, IOP is known to vary throughout the 24-h period of a day, defined as a nyctohemeral rhythm in humans. In clinical practice, it is crucial to evaluate the changes in IOP over 24 h in several situations, including the diagnosis of ocular hypertension and glaucoma (IOP is often higher at night) and to optimize the therapeutic management of glaucoma. Until recently, all evaluations of 24-h IOP rhythm were performed using repeated IOP measurements, requiring individuals to be awakened for nocturnal measurements. This method may be imperfect, because it is not physiologic and disturbs the sleep architecture, and also because it provides a limited number of time point measurements not sufficient to finely asses IOP changes. These limitations may have biased previous descriptions of physiological IOP rhythm. Recently, extraocular and intraocular devices integrating a pressure sensor for continuous IOP monitoring have been developed and are available for use in humans. The objective of this article is to present the contributions of these new 24-h monitoring devices for the study of the nyctohemeral rhythms. In healthy subjects and untreated glaucoma subjects, a nyctohemeral rhythm is consistently found and frequently characterized by a mean diurnal IOP lower than the mean nocturnal IOP, with a diurnal bathyphase - usually in the middle or at the end of the afternoon - and a nocturnal acrophase, usually in the middle or at the end of the night.

10 Review Management of advanced glaucoma: Characterization and monitoring. 2016

de Moraes, C Gustavo / Liebmann, Jeffrey M / Medeiros, Felipe A / Weinreb, Robert N. ·Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA. Electronic address: gustavo.demoraes@columbia.edu. · Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA. · Shiley Eye Institute, Hamilton Glaucoma Center and Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. ·Surv Ophthalmol · Pubmed #27018149.

ABSTRACT: Recent advances in glaucoma diagnosis focus on diagnosing the disease in early stages. Despite the importance of such efforts, a meaningful proportion of patients present in advanced stages. The cost for treatment and monitoring of advanced glaucoma often exceeds that with earlier disease, not to mention the significant effect of visual impairment on quality of life. Moreover, structural and functional tests used to monitor changes encounter technical limitations in advanced cases that can delay detection of true progression. New technologies and methods to analyze longitudinal data may prove helpful for monitoring patients with advanced glaucoma and reduce the burdens of the disease.

11 Review Strategies to improve early diagnosis in glaucoma. 2015

Tatham, Andrew J / Medeiros, Felipe A / Zangwill, Linda M / Weinreb, Robert N. ·Princess Alexandra Eye Pavilion, Edinburgh, Scotland, UK; Department of Ophthalmology, University of Edinburgh, Edinburgh, Scotland, UK. Electronic address: andrewjtatham@gmail.com. · Hamilton Glaucoma Center, Shiley Eye Center, San Diego, CA, USA; Department of Ophthalmology, University of California, San Diego, CA, USA. ·Prog Brain Res · Pubmed #26518075.

ABSTRACT: Early diagnosis and treatment of glaucoma is important to reduce the risk of progressive and irreversible visual loss. The key to diagnosis is recognition of morphological changes to the optic nerve head and retinal nerve fiber layer, but in some patients, functional abnormalities are detected first. This review describes recent innovations with the potential to improve the early detection of glaucoma. Developments in imaging include novel optic nerve head metrics such as Bruch's membrane opening-minimum rim width, enhanced ability to quantify inner layers of the glaucomatous macula, and ability to image deep optic nerve head structures, including the lamina cribrosa. Developments in detection of early glaucomatous functional loss include novel perimetric tests using frequency-doubling technology and flicker-defined form stimuli. Methods to combine results of structural and functional assessments are also presented that may improve early detection of glaucoma.

12 Review Fundamentals and Advances in Tonometry. 2015

Nuyen, Brenda / Mansouri, Kaweh. ·From the *Hamilton Glaucoma Center and the Department of Ophthalmology, University of California, San Diego, La Jolla, CA; †Glaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland; and ‡Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26065347.

ABSTRACT: According to the World Health Organization, glaucoma is the leading cause of irreversible blindness worldwide. Although intraocular pressure (IOP) is not considered any more to be a defining feature of the disease, its lowering remains the only treatment option for glaucoma. Therefore, accurate and precise measurement of IOP is the cornerstone of glaucoma. Intraocular pressure is a highly dynamic physiological parameter with individual circadian rhythms. The main limitation of current tonometry methods remains the static and mostly office-based nature of their measurements. This review provides a brief historical overview on tonometry and discusses current tonometry instruments. In recent years, approaches to 24-hour IOP monitoring have been introduced, and there is hope that they may become part of routine clinical management in the future.

13 Review Ambulatory 24-h intraocular pressure monitoring in the management of glaucoma. 2015

Mansouri, Kaweh / Weinreb, Robert N. ·aGlaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland bDepartment of Ophthalmology, University of Colorado School of Medicine, Denver, Colorado cHamilton Glaucoma Center and Shiley Eye Institute, University of California San Diego, California, USA. ·Curr Opin Ophthalmol · Pubmed #25784109.

ABSTRACT: PURPOSE OF REVIEW: To review current status and future of ambulatory 24-h intraocular pressure monitoring. Despite important advances in the diagnosis and management of glaucoma during the last decade, the fundamental understanding of intraocular pressure, its only modifiable risk factor, remains elusive. The current practice of single intraocular pressure measurements during a clinic visit does not adequately reflect the variability of intraocular pressure throughout the 24-h day. RECENT FINDINGS: There has been considerable progress recently with the prototype and commercial introduction of continuous 24-h intraocular pressure monitoring devices. Implantable intraocular pressure sensors have the advantage to directly measure intraocular pressure over many months and years, whereas temporary (contact lens based) approaches provide a noninvasive alternative for repeated 24-h periods. This review provides an overview of implantable devices as well as a critical assessment of a 24-h contact lens sensor. SUMMARY: Recent advances in microelectromechanical systems and nanoelectromechanical systems have enabled the development of 24-h intraocular pressure monitoring devices. Once these technologies have shown their safety and efficacy, larger questions as to the data interpretation and handling will arise. It is likely that the use of 24-h intraocular pressure monitoring will herald fundamental changes in our understanding and management of glaucoma.

14 Review A model-based dose-response meta-analysis of ocular hypotensive agents as a drug development tool to evaluate new therapies in glaucoma. 2015

Raber, Susan / Mandema, Jaap W / Li, Hanbin / Nickens, Dana J. ·1 Pfizer Inc. , San Diego, California. ·J Ocul Pharmacol Ther · Pubmed #25714918.

ABSTRACT: PURPOSE: To characterize dose and response for intraocular pressure (IOP) reduction and incidence of hyperemia using a model-based meta-analysis of IOP-lowering monotherapy studies to evaluate new ocular antihypertensive therapies for glaucoma. METHODS: Published randomized controlled trials, regulatory documents, and sponsor reports of IOP-lowering monotherapies were used to develop dose-response models to characterize efficacy (IOP change from baseline) and safety (incidence of hyperemia) profiles. RESULTS: The meta-analysis for efficacy included 31 trials with 6,516 patients receiving bimatoprost, latanoprost, travoprost, timolol, or placebo. Estimated IOP reduction with placebo was -2.01 mmHg. Maximal IOP reduction was similar among the prostaglandin analogs (estimate, -6.27 mmHg; baseline, 25 mmHg). Estimated median effective IOP-lowering dose (ED50) was 0.002%, 0.00098%, and 0.00063% daily with bimatoprost, latanoprost, and travoprost, respectively. The hyperemia (safety) analysis included 25 trials with 6,244 patients. Typical maximal estimated difference between drug and placebo was 43%, and estimated ED50 of 0.011%, 0.014%, and 0.0015% daily for bimatoprost, latanoprost, and travoprost, respectively. Latanoprost treatment was predicted to incur the lowest rate of hyperemia of the prostaglandins, for equivalent IOP reduction. CONCLUSIONS: Model-based meta-analyses for IOP reduction and incidence of hyperemia among prostaglandin analogs are well described by maximal efficacy models and can provide a useful methodology for evaluating glaucoma therapies.

15 Review The pathophysiology and treatment of glaucoma: a review. 2014

Weinreb, Robert N / Aung, Tin / Medeiros, Felipe A. ·Hamilton Glaucoma Center, Shiley Eye Center and Department of Ophthalmology, University of California, San Diego, La Jolla. · Singapore National Eye Center, Singapore, Singapore3Yong Loo Lin School of Medicine, National University of Singapore, Singapore. ·JAMA · Pubmed #24825645.

ABSTRACT: IMPORTANCE: Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. OBJECTIVE: To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. EVIDENCE REVIEW: A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. FINDINGS: The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. CONCLUSIONS AND RELEVANCE: Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries.

16 Review Improved visualization of deep ocular structures in glaucoma using high penetration optical coherence tomography. 2013

Mansouri, Kaweh / Nuyen, Brenda / N Weinreb, Robert. ·Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA. ·Expert Rev Med Devices · Pubmed #23972075.

ABSTRACT: The introduction of optical coherence tomography (OCT) has revolutionized ophthalmology through the ability to non-invasively image the retina in vivo. Glaucoma is the leading cause of irreversible blindness worldwide. Despite major advances in imaging techniques, the pathogenesis of glaucoma remains poorly understood at present. The lamina cribrosa (LC) is the presumed site of axonal injury in glaucoma. Its thinning and deformation have been suggested to contribute to glaucoma development and progression by impeding axoplasmic flow within the optic nerve fibers, leading to apoptosis of retinal ganglion cells. To visualize the deep ocular structures such as the choroid and the LC, OCT imaging has been used, particularly the enhanced depth imaging (EDI)-OCT modality of spectral domain (SD)-OCT. However, the posterior laminar surface especially is not seen clearly using this method. A new generation of OCTs, swept-source (SS)-OCT, is able to image the LC and the choroid in vivo. SS-OCT employs a longer wavelength compared with the conventional OCT, generally set at 1050 nm (instead of 840 nm). We review current knowledge of the LC, findings from trials that use SD-OCT and EDI-OCT, and our experience with a prototype SS-OCT to quantify choroid changes and visualize the LC in its entirety.

17 Review Is 24-hour intraocular pressure monitoring necessary in glaucoma? 2013

Mansouri, Kaweh / Weinreb, Robert N / Medeiros, Felipe A. ·Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093-0946, USA. ·Semin Ophthalmol · Pubmed #23697618.

ABSTRACT: Although intraocular pressure (IOP) is the only treatable risk factor for glaucoma, its 24-hour behavior is poorly understood. Conflicting information is available in the literature with regard to the importance and predictive value of IOP peaks and fluctuations on the risk of glaucoma development and progression. This may be secondary to lack of prospective studies designed to address this issue. This article critically reviews the current evidence for the importance of 24-h IOP measurements in glaucoma and discusses shortcomings of current methods to assess 24-h IOP data, drawing attention to new developments in this field.

18 Review Combining structure and function to evaluate glaucomatous progression: implications for the design of clinical trials. 2013

Lisboa, Renato / Weinreb, Robert N / Medeiros, Felipe A. ·Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, USA; Federal University of São Paulo, Department of Ophthalmology, Brazil. ·Curr Opin Pharmacol · Pubmed #23219155.

ABSTRACT: The selection of a suitable method for assessment of glaucomatous progression and estimation of rates of change is an essential component of the design of clinical trials investigating neuroprotective therapies for the disease. Due to the limitations of currently available tests, approaches combining structural and functional tests are essential in order to provide reliable detection of endpoints. This could also potentially enable shorter clinical trials with relatively smaller sample size requirements. A recent approach for estimating rates of retinal ganglion cell loss using a combination of structural and functional tests has been shown to perform better than isolated parameters from conventional tests for diagnosing, staging and detecting glaucoma progression and may prove useful as an outcome measure in clinical trials of the disease.

19 Review Meeting an unmet need in glaucoma: continuous 24-h monitoring of intraocular pressure. 2012

Mansouri, Kaweh / Weinreb, Robert N. ·Department of Ophthalmology, Hamilton Glaucoma Center, University of California, La Jolla, San Diego, CA, USA. kawehm@yahoo.com ·Expert Rev Med Devices · Pubmed #22702252.

ABSTRACT: Intraocular pressure (IOP) is a major risk factor for glaucoma and lowering IOP remains the mainstay of glaucoma treatment. Current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that the majority of glaucoma patients have their highest IOP levels outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients have progressive disease despite treatment. The search for devices to facilitate continuous 24-h IOP monitoring started over 50 years ago, but only recently have technological advances provided clinicians with a device for continuous IOP monitoring. We discuss the shortcomings of Goldmann Applanation Tonometry, the current gold standard for tonometry, and our experience with the SENSIMED Triggerfish®, a telemetric contact lens sensor for 24-h IOP monitoring. It may be possible to integrate 24-h continuous IOP monitoring into clinical practice, and this has the potential to contribute to the reduction of glaucoma-related vision loss.

20 Review Advances in treatment and management: immunologic and cell-based regenerative therapies. 2012

Friedlander, Martin. ·Department of Cell Biology, The Scripps Research Institute, La Jolla, California 92037, USA. friedlan@scripps.edu ·Invest Ophthalmol Vis Sci · Pubmed #22562853.

ABSTRACT: -- No abstract --

21 Review Continuous 24-hour intraocular pressure monitoring for glaucoma--time for a paradigm change. 2012

Mansouri, K / Weinreb, R. ·Hamilton Glaucoma Center, Department of Ophthalmology, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA. kawehm@yahoo.com ·Swiss Med Wkly · Pubmed #22457163.

ABSTRACT: Glaucoma is the main cause of irreversible blindness and intraocular pressure (IOP) is its only modifiable risk factor. The importance of robust lowering of IOP for prevention of glaucoma onset and progression is well established. Although IOP is a dynamic parameter with individual circadian rhythms, current management usually relies on single IOP measurements during regular clinic hours performed a few times a year. Recent technological advances have provided clinicians with tools for continuous IOP monitoring during a 24 hour period in an ambulatory setting. There are two approaches being investigated. The first is permanent IOP monitoring through an implantable sensor and the other is temporary monitoring through a contact lens sensor. In this article, we discuss the shortcomings of the current gold standard for tonometry (Goldmann Applanation Tonometry) and the current experience with the first commercially available continuous 24 hour IOP monitoring technology (SENSIMED Triggerfish®); a telemetric contact lens sensor produced by a Swiss start-up company (Sensimed AG, Lausanne, Switzerland). Recent studies suggest that 24 hour continuous monitoring of IOP can be integrated into clinical practice and have the potential to contribute to the reduction of glaucoma-related vision loss.

22 Review Assessment of rates of structural change in glaucoma using imaging technologies. 2011

Mansouri, K / Leite, M T / Medeiros, F A / Leung, C K / Weinreb, R N. ·Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, CA, USA. ·Eye (Lond) · Pubmed #21212798.

ABSTRACT: PURPOSE: To review the ability of current imaging technologies to provide estimates of rates of structural change in glaucoma patients. PATIENTS AND METHODS: Review of literature. RESULTS: Imaging technologies, such as confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP), and optical coherence tomography (OCT), provide quantifiable and reproducible measurements of the optic disc and parapapillary retinal nerve fibre layer (RNFL). Rates of change as quantified by the rim area (RA) (for CSLO) and RNFL thickness (for SLP and OCT) are related to glaucoma progression as detected by conventional methods (eg, visual fields and optic disc photography). Evidence shows that rates of RNFL and RA loss are significantly faster in progressing compared with non-progressing glaucoma patients. CONCLUSION: Measurements of rates of optic disc and RNFL change are becoming increasingly precise and individualized. Currently available imaging technologies have the ability to detect and quantify progression in glaucoma, and their measurements may be suitable end points in glaucoma clinical trials.

23 Review Rho-kinase inhibitors as therapeutics: from pan inhibition to isoform selectivity. 2010

Hahmann, C / Schroeter, T. ·Discovery Biology, Translational Research Institute, The Scripps Research Institute, Scripps Florida, 130 Scripps Way, Jupiter, FL 33458, USA. ·Cell Mol Life Sci · Pubmed #19907920.

ABSTRACT: The emerging critical implications of Rho/Rho-kinase (ROCK) signaling in neurodegenerative diseases, glaucoma, renoprotection, diabetes and cancer have sparked growing interest in the pharmacological potential of ROCK inhibitors beyond their current application in cardiovascular disease. This article discusses the therapeutic benefits of novel ROCK inhibitors in development, and highlights the recent advances in the current understanding of disease-dependent and isoform-specific functions of ROCK and their potential impact on future therapeutic strategies.

24 Review Cataract surgery and glaucoma. 2010

Vizzeri, Gianmarco / Weinreb, Robert N. ·Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California 92093-0946, USA. mvizzeri@glaucoma.ucsd.edu ·Curr Opin Ophthalmol · Pubmed #19829115.

ABSTRACT: PURPOSE OF REVIEW: To summarize the recent advances in the management of patients with coexisting cataract and glaucoma. RECENT FINDINGS: Although some evidence suggests that cataract surgery may be useful in the clinical management of eyes with angle closure glaucoma, recent studies show that the decrease in intraocular pressure (IOP) following cataract surgery alone in eyes with open angle glaucoma may be limited and transient. Combining cataract surgery with a trabeculectomy remains the preferred option. However, when IOP lowering is indicated, newer surgical techniques to lower IOP to be performed along with cataract extraction offer a promising alternative in patients with uncontrolled glaucoma and a visually significant cataract. SUMMARY: Cataract surgery alone or combined with trabeculectomy should be considered in the treatment of angle closure glaucoma. However, in eyes with open angle glaucoma, cataract surgery alone may be of limited clinical benefit in lowering IOP. Surgical alternatives to be combined with cataract extraction may be utilized to achieve a more significant IOP reduction. The appropriate treatment should be tailored based on patient's characteristics and the target IOP to be achieved.

25 Review Anterior-segment retinoblastoma mimicking pseudoinflammatory angle-closure glaucoma: review of the literature and the important role of imaging. 2009

Saket, R R / Mafee, M F. ·Department of Radiology, University of California-San Diego, 1130 Grand Avenue, San Diego, CA 92109, USA. rrsaket@yahoo.com ·AJNR Am J Neuroradiol · Pubmed #19369612.

ABSTRACT: A 7-year-old boy presented with angle-closure glaucoma, initially presumed to be idiopathic. A ciliary body mass was later detected on MR imaging, suggestive of medulloepithelioma but pathologically proved to be diffuse infiltrating retinoblastoma. We discuss the patient management and review the literature, with emphasis on the role of CT and MR imaging in evaluating pediatric angle-closure glaucoma and in influencing the management of patients with retinoblastoma and medulloepithelioma.

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