Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Glaucoma: HELP
Articles from Seoul
Based on 683 articles published since 2008
||||

These are the 683 published articles about Glaucoma that originated from Seoul during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Editorial Glaucoma: Today and Tomorrow. 2016

Lam, Dennis / Lee, Jacky / Jonas, Jost / Leung, Christopher / Park, Ki-Ho / Sit, Arthur / Ritch, Robert. ·From the *Dennis Lam and Partners Eye Center, Hong Kong, China; †C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China; ‡Zhongshan Ophthalmic Center, Guangzhou, China; §Department of Ophthalmology, Mannheim, Germany; ¶Department of Ophthalmology and Visual Sciences, The Chinese University of Hong; Kong, Hong Kong, China; ∥Seoul National University Hospital, Seoul, South Korea; #Mayo Clinic College of Medicine, Rochester, MN; and **New York Eye and Ear Infirmary of Mount Sinai, New York, NY. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26886113.

ABSTRACT: -- No abstract --

2 Review Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma. 2018

Kim, Ko Eun / Park, Ki Ho. ·Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea. · Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ·Br J Ophthalmol · Pubmed #29055905.

ABSTRACT: The macular area is important to the detection of glaucomatous retinal ganglion cell (RGC) damage. Macular thickness complementary to peripapillary retinal nerve fibre layer (RNFL) thickness can well reflect glaucomatous damage, given that the macula contains more than 50% of the RGCs in a multilayered pattern and larger RGC bodies compared with their axons. Thus, macular ganglion cell thickness parameters recently have been considered to be an effective glaucoma-diagnostic tool comparable to RNFL thickness parameters. Furthermore, spectral-domain optical coherence tomography ganglion cell-inner plexiform layer thickness and deviation maps can provide additional information essential for distinguishing glaucomatous changes from other, myopia-associated or macular disease-associated changes. Therefore, our aim with this study was to review the clinical application of macular imaging by optical coherence tomography and to provide essential clinical tips for its use in the diagnosis and management of glaucoma.

3 Review A novel hypothesis for the pathogenesis of glaucomatous disc hemorrhage. 2017

Lee, Eun Jung / Han, Jong Chul / Kee, Changwon. ·Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea. · Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea. Electronic address: ckee@skku.edu. ·Prog Retin Eye Res · Pubmed #28864288.

ABSTRACT: Disc hemorrhage is known to be associated with glaucoma development and progression. Several hypotheses have been proposed to explain the pathogenesis of disc hemorrhage in glaucoma, including mechanical and ischemic theories. However, no theory has yet provided a clear explanation of cellular-level events and related histologic findings. Moreover, research has yet to elucidate why glaucomatous disc hemorrhage occurs around the optic disc and at the margin of the retinal nerve fiber layer defect. Understanding the pathogenic mechanism of disc hemorrhage will facilitate interpretation of its clinical importance, and provide better insight into clinical practice. In this review, we sought to provide a plausible hypothesis for the development of glaucomatous disc hemorrhage that could explain the aforementioned characteristic features. We suggest a new and detailed mechanism for disc hemorrhage. Critical microscopic events are also discussed in relation to reactive gliosis in glaucoma. With proliferative reactive gliosis, fibrous glial scar forms, and we suggest that the traction force induced by glial scar formation might disrupt capillary at the border between the healthy and damaged retinal nerve fiber layer, and develop splinter-shaped peripapillary hemorrhage. In addition to glial scar formation, remodeling and deformation of lamina cribrosa beams would insult the capillary surrounding the pore of the lamina cribrosa, and lead to development of round blotch-shaped cup hemorrhage. Histopathologic confirmation of these findings should be explored in future investigations.

4 Review Clinical Implications of In Vivo Lamina Cribrosa Imaging in Glaucoma. 2017

Kim, Yong Woo / Jeoung, Jin Wook / Kim, Young Kook / Park, Ki Ho. ·*Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, Korea †Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ·J Glaucoma · Pubmed #28787290.

ABSTRACT: The lamina cribrosa (LC) is a multilayered, collagenous, sieve-like structure at the deep optic nerve head, and is presumed to be the primary site of axonal injury. According to biomechanical theory, intraocular pressure-induced posterior deformation of the LC causes blockage of axonal transport and alters the ocular blood flow, so that the axons of the retinal ganglion cells lead to apoptosis, which results in glaucomatous optic disc change. Although most of the research on the LC to date has been limited to experimental animal or histologic studies, the recent advances in optical coherence tomography devices and image processing techniques have made possible the visualization of the LC structure in vivo. LC deformation in glaucoma typically has been evaluated in terms of its position from a structural reference plane (LC depth), entire curvature or shape, thickness, or localized structural change (focal LC defects or LC pore change). In this review, we highlight the methods of assessing LC deformation from in vivo optical coherence tomography scans, and we discuss the clinical implications of the recent investigations of the in vivo structure of LC in glaucoma.

5 Review Optic disc hemorrhage in glaucoma: pathophysiology and prognostic significance. 2017

Kim, Ko Eun / Park, Ki Ho. ·aDepartment of Ophthalmology, Nowon Eulji Medical Center, Eulji University bDepartment of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Republic of Korea. ·Curr Opin Ophthalmol · Pubmed #27820751.

ABSTRACT: PURPOSE OF REVIEW: This article reviews the recent findings with regard to the pathophysiology and clinical significance of optic disc hemorrhage in glaucoma. RECENT FINDINGS: Even though the pathophysiology of disc hemorrhage has been investigated in depth, its underlying mechanism remains unclear. The key disc hemorrhage mechanisms currently under discussion are mechanical vascular disruption and associated vascular susceptibilities. Recent technical advances in spectral-domain optical coherence tomography have yielded more compelling evidence of mechanical vascular disruption behind the pathogenesis of disc hemorrhage in glaucoma. Studies show that disc hemorrhage is associated with structural and functional glaucoma progression. Furthermore, recent findings suggest that disc hemorrhage can have different significances according to its location, recurrence, and associated underlying mechanism. SUMMARY: The underlying mechanism of disc hemorrhage is complex like that of glaucoma. The ongoing controversy respecting the role of disc hemorrhage as a risk factor for glaucoma progression notwithstanding, special attention entailing closer follow-up and/or treatment escalation is recommended for patients with disc hemorrhage. Further studies investigating the unrevealed pathogenesis of disc hemorrhage and its prognostic value in glaucoma are warranted.

6 Review Psychological Aspects of Glaucoma. 2016

Jeong, Ah Reum / Kim, Chan Yun / Kang, Min Hee / Kim, Na Rae. ·*Department of Ophthalmology and Inha Vision Science Laboratory, Inha University School of Medicine, Incheon; †Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul; and ‡Department of Psychiatry, Inha University School of Medicine, Incheon, Korea. ·J Nerv Ment Dis · Pubmed #26919300.

ABSTRACT: Glaucoma is a group of optic neuropathies that is more prevalent among the elderly population and commonly associates with comorbidities, including mental disorders in that population. This article reviews the relationship between glaucoma and mental disorders. In it, we discuss the coexistence of glaucoma and mental illnesses, including Alzheimer's disease, depression, and personality disorder. We also focus on the proper treatment approaches for glaucoma patients with mental comorbidity and poor treatment adherence. We summarize some cautiously recommended psychotherapeutic medications, while also discussing the psychologically adverse effects of antiglaucoma medications.

7 Review Update on the Prevalence, Etiology, Diagnosis, and Monitoring of Normal-Tension Glaucoma. 2016

Kim, Ko Eun / Park, Ki-Ho. ·From the Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26886116.

ABSTRACT: Glaucoma is a leading cause of blindness worldwide. Normal-tension glaucoma (NTG) is a type of open-angle glaucoma with intraocular pressure measurements always 21 mm Hg or less. A controversy surrounding NTG is the question of whether it should be regarded as a disease within the spectrum of primary open-angle glaucoma or as a distinctive disease entity. Nonetheless, NTG does have distinctive features compared with primary open-angle glaucoma: intraocular pressure-independent risk factors for development of NTG, characteristic patterns of structural and functional damage, and a unique disease course. This review provides an overview and update on the current issues surrounding the prevalence, etiology, diagnosis, and monitoring of NTG.

8 Review The Association between Primary Open-Angle Glaucoma and Blood Pressure: Two Aspects of Hypertension and Hypotension. 2015

Chung, Hye Jin / Hwang, Hyung Bin / Lee, Na Young. ·HanGil Eye Hospital, Incheon 21388, Republic of Korea. · Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 403-720, Republic of Korea. ·Biomed Res Int · Pubmed #26557702.

ABSTRACT: Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG) is not fully understood, elevated intraocular pressure (IOP) is considered the most important risk factor. Several vascular factors have also been identified as risk factors and can lead to hypoperfusion of the optic nerve head and thus may play an important role in the pathogenesis and progression of POAG. The results of the present study suggest that both high and low blood pressure (BP) are associated with an increased risk of POAG based on a comprehensive literature review. Elevated BP is associated with elevated IOP, leading to increased risk of glaucoma, but excessive BP lowering in glaucoma patients may cause a drop in ocular perfusion pressure (OPP) and subsequent ischemic injury. The relationship between IOP, OPP, and BP suggests that the relationship between BP and glaucoma progression is U-shaped.

9 Review Systemic and Ocular Hemodynamic Risk Factors in Glaucoma. 2015

Choi, Jaewan / Kook, Michael S. ·Central Seoul Eye Center, 224 Ichon-ro, Yongsan-gu, Seoul 04427, Republic of Korea. · Department of Ophthalmology, University of Ulsan, Asan Medical Center, Seoul 05505, Republic of Korea. ·Biomed Res Int · Pubmed #26557650.

ABSTRACT: Primary open angle glaucoma (POAG) is a multifactorial disease characterized by progressive retinal ganglion cell death and visual field loss. It is known that alterations in intraocular pressure (IOP), blood pressure (BP), and ocular perfusion pressure (OPP) can play a significant role in the pathogenesis of the disease. Impaired autoregulatory capacity of ocular blood vessels may render tissues vulnerable to OPP changes and potentially harmful tissue ischemia-reperfusion damage. Vascular risk factors should be considered more important in a subgroup of patients with POAG, and especially in patients with normal tension glaucoma (NTG) with evidence of unphysiological BP response. For example, reduction of BP during the nighttime has an influence on OPP, and increased circadian OPP fluctuation, which might stand for unstable ocular blood flow, has been found to be the consistent risk factor for NTG development and progression. Central visual field may be affected more severely than peripheral visual field in NTG patients with higher 24-hour fluctuation of OPP. This review will discuss the current understanding of allegedly major systemic and ocular hemodynamic risk factors for glaucoma including systemic hypertension, arterial stiffness, antihypertensive medication, exaggerated nocturnal hypotension, OPP, and autonomic dysregulation.

10 Review Beneficial effects of adjuvant intravitreal bevacizumab injection on outcomes of Ahmed glaucoma valve implantation in patients with neovascular glaucoma: systematic literature review. 2015

Hwang, Hyung Bin / Han, Jae Wook / Yim, Hye Bin / Lee, Na Young. ·Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Korea. ·J Ocul Pharmacol Ther · Pubmed #25714761.

ABSTRACT: PURPOSE: We evaluated the effects of adjuvant intravitreal bevacizumab injection on the outcomes of Ahmed glaucoma valve (AGV) implantation in patients with neovascular glaucoma (NVG) through a systematic literature review. METHODS: An extensive search of PubMed, EMBASE, and the Cochrane Library was performed in November 2014 for selection of relevant studies. The weighted mean difference of the percentage of intraocular pressure reduction (IOPR%) from baseline to endpoint was used as the primary efficacy estimate, and Mantel-Haenszel odds ratios and 95% confidence intervals (CIs) of the success rate were used as the secondary efficacy estimates. The incidence of adverse events was also documented through a review of the studies. RESULTS: Six studies involving 252 patients (256 eyes) were included in this systematic review. The differences in the means and 95% CIs of the IOPR% of 6 studies showed that adjuvant bevacizumab treatment tended to be more effective than AGV implantation alone. Comparison of the outcomes of AGV implantation only with those of AGV implantation+adjuvant bevacizumab showed a success rate in favor of AGV implantation+adjuvant bevacizumab. The incidence of bleeding-associated complications such as hyphema, vitreous hemorrhage, and suprachoroidal hemorrhage was lower in association with combination treatment than with AGV implantation only. Combination treatment seemed to be associated with a lower incidence of other adverse effects such as hypotony, flat chamber, choroidal detachment/effusion, tube-associated complications, and corneal decompensation. CONCLUSION: AGV implantation with adjuvant bevacizumab was more effective and had a higher success rate than surgery alone for lowering IOP in patients with NVG. The combined procedure tended to show a lower incidence of bleeding-associated complications, such as hyphema.

11 Review Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. 2015

Zhao, Di / Cho, Juhee / Kim, Myung Hun / Friedman, David S / Guallar, Eliseo. ·Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. · Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea; Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea. · Saevit Eye Hospital, Goyang, Gyeonggi-do, Korea; Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Korea. Electronic address: philip.mhkim@gmail.com. · Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland. ·Ophthalmology · Pubmed #25283061.

ABSTRACT: TOPIC: We performed a systematic review to summarize the association of diabetes and blood glucose levels with glaucoma, intraocular pressure (IOP), and ocular hypertension in the general population. CLINICAL RELEVANCE: Diabetes has been proposed as a risk factor for glaucoma, but epidemiologic studies have been inconsistent, and the association is still controversial. Furthermore, no systematic reviews evaluated other metabolic abnormalities, such as the metabolic syndrome, with the risk of glaucoma. METHODS: We identified the studies by searching the PubMed and EMBASE databases. We used inverse-variance weighted random-effects models to summarize relative risks across studies. RESULTS: We identified 47 studies including 2 981 342 individuals from 16 countries. The quality of evidence generally was higher in the cohort compared with case-control or cross-sectional studies. The pooled relative risk for glaucoma comparing patients with diabetes with those without diabetes was 1.48 (95% confidence interval [CI], 1.29-1.71), with significant heterogeneity across studies (I(2) = 82.3%; P < 0.001). The risk of glaucoma increased by 5% (95% CI, 1%-9%) for each year since diabetes diagnosis. The pooled average difference in IOP comparing patients with diabetes with those without diabetes was 0.18 mmHg (95% CI, 0.09-0.27; I(2) = 73.2%), whereas the pooled average increase in IOP associated with an increase in 10 mg/dl in fasting glucose was 0.09 mmHg (95% CI, 0.05-0.12; I(2) = 34.8%). CONCLUSIONS: Diabetes, diabetes duration, and fasting glucose levels were associated with a significantly increased risk of glaucoma, and diabetes and fasting glucose levels were associated with slightly higher IOP.

12 Review Efficacy of Additional Glaucoma Drainage Device Insertion in Refractory Glaucoma: Case Series with a Systematic Literature Review and Meta-Analysis. 2015

Lee, Na Young / Hwang, Hyung Bin / Oh, Seung Hoon / Park, Chan Kee. ·a Department of Ophthalmology and Visual Science , Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea . · b Department of Ophthalmology and Visual Science , Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea , and. · c Department of Ophthalmology and Visual Science , Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea. ·Semin Ophthalmol · Pubmed #24646312.

ABSTRACT: PURPOSE: To report the efficacy of additional glaucoma drainage device (GDD) insertion in eyes with refractory glaucoma and which have a failed primary GDD. METHODS: We conducted a non-comparative, retrospective study on eight eyes of eight patients who had a failed primary GDD and received an additional GDD in the same eye. Intraocular pressure (IOP), visual acuity (VA), the number of anti-glaucomatous medications, and complications were analyzed during the most recent office visit. Success was defined as an IOP between 6 and 21 mmHg and a 20% decrease in IOP after additional GDD insertion, with or without anti-glaucomatous medication. RESULTS: The mean decrease in IOP at the final follow-up was 19.3 mmHg (56.1%). The mean number of anti-glaucomatous medications used at the final follow-up (2.38) was significantly less than the preoperative mean (3.50). Seven patients achieved the criteria for success, whereas one patient had an unsuccessful outcome because of corneal graft failure after additional GDD insertion. CONCLUSIONS: We showed that after the failure of a primary GDD, an additional GDD offered favorable IOP control and stable VA. In agreement with a review of previous literature, GDD insertion is the best option for treating refractory glaucoma, even in patients with a failed primary GDD.

13 Review The association of blood pressure and primary open-angle glaucoma: a meta-analysis. 2014

Zhao, Di / Cho, Juhee / Kim, Myung Hun / Guallar, Eliseo. ·Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. · Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. · Saevit Eye Hospital, Goyang, Gyeonggi-do, South Korea; Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, South Korea. Electronic address: philip.mhkim@gmail.com. ·Am J Ophthalmol · Pubmed #24879946.

ABSTRACT: PURPOSE: To conduct a systematic review and meta-analysis of the association between blood pressure levels and hypertension with primary open-angle glaucoma and intraocular pressure endpoints. DESIGN: Systematic review with quantitative meta-analysis. METHODS: Studies were identified by searching the PubMed and EMBASE databases. Inverse-variance weighted random-effects models were used to summarize relative risks. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity across studies. RESULTS: Sixty observational studies were included. The pooled relative risk for primary open-angle glaucoma comparing patients with hypertension to those without hypertension was 1.16 (95% CI = 1.05-1.28), with modest heterogeneity across studies (I(2) 34.5%). Virtually all studies reported a positive association between blood pressure and intraocular pressure (IOP). The pooled average increase in IOP associated with a 10 mm Hg increase in systolic blood pressure was 0.26 mm Hg (95% CI 0.23-0.28, I(2) 30.7%), and the average increase associated with a 5 mm Hg increase in diastolic blood pressure was 0.17 mm Hg (95% CI 0.11-0.23, I(2) 90.5%). CONCLUSIONS: In this meta-analysis, hypertension was associated with increased intraocular pressure. The association between hypertension and primary open-angle glaucoma was stronger in cross-sectional compared with case-control and longitudinal studies. Our findings support a role of increased blood pressure in elevated intraocular pressure and possibly in the development of glaucoma.

14 Review Population-based glaucoma prevalence studies in Asians. 2014

Cho, Hyun-Kyung / Kee, Changwon. ·Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. · Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: ckee@skku.edu. ·Surv Ophthalmol · Pubmed #24837853.

ABSTRACT: Glaucoma-related population-based studies from Japan, Mongolia, India, Singapore, Thailand, China, Bangladesh, Myanmar, Sri Lanka, and South Korea show a higher glaucoma prevalence in Asian patients, including a higher incidence of primary angle-closure glaucoma, than in white patients, although primary open-angle glaucoma (POAG) is still the most commonly reported. Among POAG, normal tension glaucoma predominates over high tension glaucoma, a distinctive finding. Risk factors for glaucoma in population-based studies in both Asian and white patients are similar, except that myopia is a greater risk factor in Asian patients. Diagnostic criteria differ among studies, some using the International Society of Geographic and Epidemiologic Ophthalmology (ISGEO) classification and others not. The devices used to observe the optic disk and test the visual field are also not uniform across studies. Moreover, the ages of patients, and whether rural or urban, were different. To allow reliable comparison of the results of epidemiologic studies, efforts to standardize the diagnostic criteria, devices, and the age range of the study population are required.

15 Review Prospects for lentiviral vector mediated prostaglandin F synthase gene delivery in monkey eyes in vivo. 2014

Lee, Eun Suk / Rasmussen, Carol A / Filla, Mark S / Slauson, Sarah R / Kolb, Aaron W / Peters, Donna M / Kaufman, Paul L / Gabelt, B'Ann T / Brandt, Curtis R. ·Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine , Seoul , Korea . ·Curr Eye Res · Pubmed #24559478.

ABSTRACT: Currently, the most effective outflow drugs approved for clinical use are prostaglandin F2α analogues, but these require daily topical self-dosing and have various intraocular, ocular surface and extraocular side effects. Lentiviral vector-mediated delivery of the prostaglandin F synthase (PGFS) gene, resulting in long-term reduction of intraocular pressure (IOP), may eliminate off-target tissue effects and the need for daily topical PGF2α self-administration. Lentiviral vector-mediated delivery of the PGFS gene to the anterior segment has been achieved in cats and non-human primates. Although these results are encouraging, our studies have identified a number of challenges that need to be overcome for prostaglandin gene therapy to be translated into the clinic. Using examples from our work in non-human primates, where we were able to achieve a significant reduction in IOP (2 mm Hg) for 5 months after delivery of the cDNA for bovine PGF synthase, we identify and discuss these issues and consider several possible solutions.

16 Review Pathogenesis and clinical implications of optic disk hemorrhage in glaucoma. 2014

Suh, Min Hee / Park, Ki Ho. ·Department of Ophthalmology, Haeundae Paik Hospital, Busan, Korea; Department of Ophthalmology, Inje University College of Medicine, Busan, Korea. · Department of Ophthalmology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea. Electronic address: kihopark@snu.ac.kr. ·Surv Ophthalmol · Pubmed #24156914.

ABSTRACT: The association between optic disk hemorrhage and glaucoma has been studied for many years. Recently, randomized clinical trials have confirmed that disk hemorrhage is a risk factor for development and progression of glaucoma. Disk hemorrhage is more commonly detected in open-angle glaucoma with normal tension than in open-angle glaucoma with high tension. Development of disk hemorrhage possibly is associated with the biomechanical properties of the lamina cribrosa and surrounding tissues, including the intraocular pressure (IOP)-cerebrospinal pressure gradient, arterial pressure, and venous pressure. Disk hemorrhage may be a marker of rapid glaucoma progression, in that localized subclinical structural change predisposes to disk hemorrhage, after which subsequent disease progression is accelerated, and recurrent optic disk hemorrhages are related to rapid structural progression of glaucomatous damage. IOP-lowering therapy can be helpful in halting post-hemorrhage glaucoma progression.

17 Review Imaging of the lamina cribrosa in glaucoma: perspectives of pathogenesis and clinical applications. 2013

Kim, Tae-Woo / Kagemann, Larry / Girard, Michaël J A / Strouthidis, Nicholas G / Sung, Kyung Rim / Leung, Christopher K / Schuman, Joel S / Wollstein, Gadi. ·Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. ·Curr Eye Res · Pubmed #23768229.

ABSTRACT: The lamina cribrosa (LC) is a sieve-like structure in the sclera where retinal ganglion cell axons exit from the eye. The LC has been known to play a critical role in the pathogenesis of glaucoma. With the advent of imaging technologies, such as enhanced depth imaging, spectral-domain optical coherence tomography (OCT) enables us to unveil the LC in vivo features. The application of adaptive optics technology and a compensatory image-processing algorithm has further improved the visualization of the beams and pores and neural pathways of the LC and the scleral insertion sites. Monitoring the changes of these structures in relation to acute and chronic elevation of intraocular pressure would be germane to decipher the relationship between the stress and strain response of the LC and optic nerve damage and improve our understanding of glaucoma pathophysiology. While the impact of investigating the integrity of LC is substantive, considerable challenges remain for imaging the LC. Nevertheless, with the rapid development of the OCT technology, it is expected that some of these limitations can be overcome and the potentials of LC imaging will be unraveled.

18 Review Macular assessment using optical coherence tomography for glaucoma diagnosis. 2012

Sung, Kyung Rim / Wollstein, Gadi / Kim, Na Rae / Na, Jung Hwa / Nevins, Jessica E / Kim, Chan Yun / Schuman, Joel S. ·Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 138-736, Korea. sungeye@gmail.com ·Br J Ophthalmol · Pubmed #23018425.

ABSTRACT: Optical coherence tomography (OCT) is an interferometry-based imaging modality that generates high-resolution cross-sectional images of the retina. Circumpapillary retinal nerve fibre layer (cpRNFL) and optic disc assessments are the mainstay of glaucomatous structural measurements. However, because these measurements are not always available or precise, it would be useful to have another reliable indicator. The macula has been suggested as an alternative scanning location for glaucoma diagnosis. Using time-domain (TD) OCT, macular measurements have been shown to provide good glaucoma diagnostic capabilities. Performance of cpRNFL measurement was generally superior to macular assessment. However, macular measurement showed better glaucoma diagnostic performance and progression detection capability in some specific cases, which suggests that these two measurements may be combined to produce a better diagnostic strategy. With the adoption of spectral-domain OCT, which allows a higher image resolution than TD-OCT, segmentation of inner macular layers becomes possible. The role of macular measurements for detection of glaucoma progression is still under investigation. Improvement of image quality would allow better visualisation, development of various scanning modes would optimise macular measurements, and further refining of the analytical algorithm would provide more accurate segmentation. With these achievements, macular measurement can be an important surrogate for glaucomatous structural assessment.

19 Review Imaging of the retinal nerve fibre layer with spectral domain optical coherence tomography for glaucoma diagnosis. 2011

Sung, Kyung Rim / Kim, Jong S / Wollstein, Gadi / Folio, Lindsey / Kook, Michael S / Schuman, Joel S. ·Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea. sungeye@gmail.com ·Br J Ophthalmol · Pubmed #21030413.

ABSTRACT: Optical coherence tomography (OCT) techniques have been applied to develop a new generation of the technology, called spectral domain (SD) or Fourier domain (FD) OCT. The commercially available SD-OCT technology offers benefits over the conventional time domain (TD) OCT such as a scanning speed up to 200 times faster and higher axial resolution (3 to 6 μm). Overall, SD-OCT offers improved performance in terms of reproducibility. SD-OCT has a level of discriminating capability, between healthy and perimetric glaucoma eyes similar to that obtained with TD-OCT. Furthermore, the capabilities and features of SD-OCT are rapidly evolving, mainly due to three-dimensional imaging and image rendering. More sophisticated approaches for macular and optic disc assessment are expected to be employed in clinical practice. Analysis software should be further refined for interpretation of SD-OCT images in order to enhance the sensitivity and specificity of glaucoma diagnostics. Most importantly for SD-OCT is determination of its ability to diagnostic structural glaucomatous progression. Considering the recent launch time of the commercially available SD-OCT and slow progressing characteristic of glaucoma, we must wait for longitudinal SD-OCT data, with a long enough follow-up, to become available.

20 Clinical Trial Macular Ganglion Cell Imaging Study: Covariate Effects on the Spectral Domain Optical Coherence Tomography for Glaucoma Diagnosis. 2016

Jeong, Jae Hoon / Choi, Yun Jeong / Park, Ki Ho / Kim, Dong Myung / Jeoung, Jin Wook. ·Departement of Ophthalmology, Konyang University Hospital, Daejeon, Korea. · Chung-Ang University Graduate School, Seoul, Korea. · Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea. · Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ·PLoS One · Pubmed #27490718.

ABSTRACT: PURPOSE: To evaluate the effect of multiple covariates on the diagnostic performance of the Cirrus high-definition optical coherence tomography (HD-OCT) for glaucoma detection. METHODS: A prospective case-control study was performed and included 173 recently diagnosed glaucoma patients and 63 unaffected individuals from the Macular Ganglion Cell Imaging Study. Regression analysis of receiver operating characteristic were conducted to evaluate the influence of age, spherical equivalent, axial length, optic disc size, and visual field index on the macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) measurements. RESULTS: Disease severity, as measured by visual field index, had a significant effect on the diagnostic performance of all Cirrus HD-OCT parameters. Age, axial length and optic disc size were significantly associated with diagnostic accuracy of average peripapillary RNFL thickness, whereas axial length had a significant effect on the diagnostic accuracy of average GCIPL thickness. CONCLUSIONS: Diagnostic performance of the Cirrus HD-OCT may be more accurate in the advanced stages of glaucoma than at earlier stages. A smaller optic disc size was significantly associated with improved the diagnostic ability of average RNFL thickness measurements; however, GCIPL thickness may be less affected by age and optic disc size.

21 Clinical Trial Clinical Assessment of Lamina Cribrosa Curvature in Eyes with Primary Open-Angle Glaucoma. 2016

Kim, Yong Woo / Jeoung, Jin Wook / Kim, Dai Woo / Girard, Michael J A / Mari, Jean Martial / Park, Ki Ho / Kim, Dong Myung. ·Department of Ophthalmology, Armed Forces Busan Hospital, Busan, Korea. · Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. · Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea. · Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore. · Singapore Eye Research Institute, Singapore, Singapore. · University of French Polynesia, Tahiti, French Polynesia. ·PLoS One · Pubmed #26963816.

ABSTRACT: PURPOSE: Quantitative evaluation of lamina cribrosa (LC) posterior bowing in primary open-angle glaucoma (POAG) eyes using swept-source optical coherence tomography. METHODS: Patients with POAG (n = 123 eyes) and healthy individuals of a similar age (n = 92 eyes) were prospectively recruited. Anterior laminar insertion depth (ALID) was defined as the vertical distance between the anterior laminar insertion and a reference plane connecting the Bruch's membrane openings (BMO). The mean LC depth (mLCD) was approximated by dividing the area enclosed by the anterior LC, the BMO reference plane, and the two vertical lines for ALID measurement by the length between those two vertical lines. The LC curvature index was defined as the difference between the mLCD and the ALID. The factors influencing the LC curvature index were evaluated. RESULTS: The ALID and mLCD were significantly larger in POAG eyes than in healthy controls (P < 0.05). The LC curvature index was significantly larger in POAG eyes than in healthy controls on both the horizontal (85.8 ± 34.1 vs. 68.2 ± 32.3 μm) and vertical meridians (49.8 ± 38.5 vs. 32.2 ± 31.1 μm, all P < 0.001). Multivariate regression showed significant associations of greater disc area (P < 0.001), vertical C/D ratio (P < 0.001) and mLCD (P < 0.001), smaller rim area (P = 0.001), thinner average RNFLT (P < 0.001), and myopic refraction (P = 0.049) with increased LC curvature index. There was no difference in the LC curvature index between mild (MD > -6 dB) and moderate-to-advanced glaucoma (MD < -6 dB, P = 0.95). CONCLUSIONS: LC posterior bowing was increased in POAG eyes, and was significantly associated with structural optic nerve head (ONH) changes but not with functional glaucoma severity. Quantitative evaluation of LC curvature can facilitate assessment of glaucomatous ONH change.

22 Clinical Trial Estimated Trans-Lamina Cribrosa Pressure Differences in Low-Teen and High-Teen Intraocular Pressure Normal Tension Glaucoma: The Korean National Health and Nutrition Examination Survey. 2016

Lee, Si Hyung / Kwak, Seung Woo / Kang, Eun Min / Kim, Gyu Ah / Lee, Sang Yeop / Bae, Hyoung Won / Seong, Gong Je / Kim, Chan Yun. ·Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea. · Department of Statistics, University of Georgia, Athens, Georgia. ·PLoS One · Pubmed #26840184.

ABSTRACT: BACKGROUND: To investigate the association between estimated trans-lamina cribrosa pressure difference (TLCPD) and prevalence of normal tension glaucoma (NTG) with low-teen and high-teen intraocular pressure (IOP) using a population-based study design. METHODS: A total of 12,743 adults (≥ 40 years of age) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2012 were included. Using a previously developed formula, cerebrospinal fluid pressure (CSFP) in mmHg was estimated as 0.55 × body mass index (kg/m2) + 0.16 × diastolic blood pressure (mmHg)-0.18 × age (years)-1.91. TLCPD was calculated as IOP-CSFP. The NTG subjects were divided into two groups according to IOP level: low-teen NTG (IOP ≤ 15 mmHg) and high-teen NTG (15 mmHg < IOP ≤ 21 mmHg) groups. The association between TLCPD and the prevalence of NTG was assessed in the low- and high-teen IOP groups. RESULTS: In the normal population (n = 12,069), the weighted mean estimated CSFP was 11.69 ± 0.04 mmHg and the weighted mean TLCPD 2.31 ± 0.06 mmHg. Significantly higher TLCPD (p < 0.001; 6.48 ± 0.27 mmHg) was found in the high-teen NTG compared with the normal group. On the other hand, there was no significant difference in TLCPD between normal and low-teen NTG subjects (p = 0.395; 2.31 ± 0.06 vs. 2.11 ± 0.24 mmHg). Multivariate logistic regression analysis revealed that TLCPD was significantly associated with the prevalence of NTG in the high-teen IOP group (p = 0.006; OR: 1.09; 95% CI: 1.02, 1.15), but not the low-teen IOP group (p = 0.636). Instead, the presence of hypertension was significantly associated with the prevalence of NTG in the low-teen IOP group (p < 0.001; OR: 1.65; 95% CI: 1.26, 2.16). CONCLUSIONS: TLCPD was significantly associated with the prevalence of NTG in high-teen IOP subjects, but not low-teen IOP subjects, in whom hypertension may be more closely associated. This study suggests that the underlying mechanisms may differ between low-teen and high-teen NTG patients.

23 Clinical Trial Reproducibility of peripapillary retinal nerve fiber layer thickness measured by spectral domain optical coherence tomography in pseudophakic eyes. 2014

Kim, Gyu Ah / Kim, Ji Hyun / Lee, Jun Mo / Park, Kyoung Soo. ·Siloam Eye Hospital, Seoul, Korea. ·Korean J Ophthalmol · Pubmed #24688256.

ABSTRACT: PURPOSE: To assess the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectral domain optical coherence tomography (OCT) in pseudophakic eyes. METHODS: Two-hundred five participants having glaucoma or glaucoma suspected eyes underwent two repeated Cirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). After classifying participants into three different groups according to their lens status (clear media, cataract, and pseudophakic), values of intra-class coefficient (ICC), coefficient of variance, and test-retest variability were compared between groups for average retinal nerve fiber layer (RNFL) thicknesses and that corresponding to four quadrant maps. Linear weighted kappa coefficients were calculated as indicators of agreement of color code classification in each group. RESULTS: ICC values were all excellent (generally defined as 0.75 to 1.00) for the average and quadrant RNFL thicknesses in all three groups. ICC values of the clear media group tended to be higher than those in the cataract and pseudophakic groups for all quadrants and average thickness. Especially in the superior and nasal quadrants, the ICC value of the cataract group was significantly lower than that of the clear media and pseudophakic groups. For average RNFL thickness, classification agreement (kappa) in three groups did not show a statistically significant difference. For quadrant maps, classification agreement (kappa) in the clear media group was higher than those in the other two groups. CONCLUSIONS: Agreement of cpRNFL measurement and its color code classification between two repeated Cirrus OCT scans in pseudophakic eyes was as good as that in eyes with clear crystalline lens. More studies are required to ascertain the effect of lens status on the reproducibility of Cirrus OCT according to different stages of glaucoma patients.

24 Clinical Trial Cirrus high-definition optical coherence tomography versus spectral optical coherence tomography/scanning laser ophthalmoscopy in the diagnosis of glaucoma. 2014

Koh, Kyung Min / Jin, Sunyoung / Hwang, Young Hoon. ·Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute , Seoul , Korea and. ·Curr Eye Res · Pubmed #24074220.

ABSTRACT: PURPOSE: This study was performed to compare the positive predictive value of peripapillary retinal nerve fiber layer (RNFL) thickness measurements obtained using Cirrus high-definition optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA) and spectral OCT/scanning laser ophthalmoscopy (SLO) (OPKO/OTI, Miami, FL) in the diagnosis of glaucoma. METHODS: A total of 50 eyes of 50 healthy subjects and 60 eyes of 60 subjects with glaucoma were included. All participants underwent RNFL thickness measurement using Cirrus HD-OCT and spectral OCT/SLO on the same day. Average, quadrant, clock-hour RNFL thicknesses, area under the receiver operating characteristic curve (AUC), and sensitivities at fixed specificities (80% and 95%) were calculated for comparison. RESULTS: RNFL thickness as measured by spectral OCT/SLO was greater than that measured using Cirrus HD-OCT (p < 0.001). For both the Cirrus HD-OCT and spectral OCT/SLO, the parameter with the largest AUC was average RNFL thickness (0.954 and 0.944, respectively). The AUCs of RNFL thickness for the discrimination of glaucoma did not differ significantly between the devices (p > 0.05), with the exception of RNFL thickness in the nasal area (nasal quadrant, clock-hour sectors 3 and 4); in these areas, spectral OCL/SLO yielded greater AUCs than Cirrus HD-OCT (p < 0.05). Sensitivities varied similarly to AUCs. CONCLUSIONS: RNFL thicknesses measures using Cirrus HD-OCT and spectral OCT/SLO were not interchangeable. The utility of RNFL thickness measurements in the diagnosis of glaucoma was similar for both the devices.

25 Clinical Trial Intraocular pressure-lowering efficacy of dorzolamide/timolol fixed combination in normal-tension glaucoma. 2014

Kim, Tae-Woo / Kim, Martha / Lee, Eun Ji / Jeoung, Jin Wook / Park, Ki Ho. ·*Department of Ophthalmology, Seoul National University College of Medicine, Seoul †Seoul National University Bundang Hospital, Seongnam, Korea. ·J Glaucoma · Pubmed #23377586.

ABSTRACT: PURPOSE: To investigate the intraocular pressure (IOP)-lowering efficacy and safety of dorzolamide/timolol fixed combination (DTFC) in patients with normal-tension glaucoma (NTG). METHODS: An open-label, 12-week, 2-center study was conducted. Thirty-seven patients with treatment-naïve NTG received DTFC for 12 weeks to reduce IOP. Primary outcome measures were changes in IOP from baseline to 12 weeks of treatment at a peak drug effect. Secondary outcome measures were changes in IOP from baseline to 12 weeks of treatment a trough drug effect and 8 hours after drug administration. At each visit, IOP was measured at 9 AM and then DTFC was administered by a hospital personnel. IOP was also measured at 11 AM and 5 PM At week 12, the IOP was measured at 1 and 3 PM as well. RESULTS: The IOP at peak drug effect (11 AM) at 12 weeks was significantly reduced to 11.9±2.6 mm Hg from the baseline of 15.6±2.5 mm Hg (23.7%, P<0.0001). Significant reduction in the IOP was also achieved at trough drug effect (9 AM) and at 8 hours after drug administration (5 PM) at 12 weeks (20.5% and 24.4%, respectively, all P<0.0001). Eye irritation (59.5%) was the most frequently reported adverse event followed by ocular hyperemia (16.2%). The majority of eye irritations were mild in intensity. No patients discontinued the DTFC due to an adverse event and no systemic adverse event was considered related to study medication. CONCLUSIONS: DTFC is a safe and effective IOP-lowering agent in patients with NTG.

Next