Clinical Profile of Myopic Patients as a Risk Factor for Primary Open Angle Glaucoma - A Prospective Observational Study in Gorakhpur, Uttar Pradesh

2021 ◽  
Vol 8 (33) ◽  
pp. 3084-3089
Author(s):  
Ram Kumar Jaiswal ◽  
Ramyash Singh Yadav ◽  
Mridula Ranjan ◽  
Dipti Wahi ◽  
Chiranji Rai
Keyword(s):  
Risk Factor ◽  
Intraocular Pressure ◽  
Observational Study ◽  
High Myopia ◽  
Central Corneal Thickness ◽  
Prospective Observational Study ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Open Angle

BACKGROUND Myopia is a complex trait including both genetic and environmental factors as well as gene-environment interactions. It has been recognized as a risk factor for development of glaucoma. Both Myopia and raised IOP are known to increase mechanical stress at optic nerve head leading to glaucomatous nerve damage. This study intends to evaluate the clinical profile of myopic subjects and its correlation with Primary open angle glaucoma (POAG). METHODS A prospective observational study done from November 2019 to December 2020 after taking proper informed consent and ethical clearance. 164 eyes of 96 patients studied were divided into three groups, Group 1: low myopia (< -3.00D), Group 2: moderate myopia (-3.00 D to -5.75 D), Group 3: high myopia (≥ -6.00 D). A complete ocular examination was performed. Intraocular pressure was measured using Goldmann applanation tonometer. Visual field analysis using Humphrey automated perimetry was done in patients with suspected primary open angle glaucoma (POAG). Angle parameters and central corneal thickness (CCT) were measured using anterior segment optical coherence tomography (AS-OCT). RESULTS 164 eyes of 96 Myopic subjects were studied with no dropout during study period. Mean age was 46.05 yr. (range: 25-75 yr.). The refraction ranged from -0.50 DS to -17.00 DS. There was no statistically significant difference between Intraocular pressure (IOP), Central corneal thickness (CCT), corrected IOP and Nasal and Temporal Trabecular-iris Angle (TIA) between male and female of same age group. Mean IOP and mean CCT were found to vary significantly with age and with higher degree of myopia. Corrected IOP, Nasal and Temporal TIA increase significantly with higher degree of myopia. Cup-disc ratio (CDR) was found to be significantly higher in patients with moderate to high degree of Myopia. CONCLUSIONS Myopia is an important risk factor for development of primary open angle glaucoma, with its incidence increasing in patients with moderate to high myopia. KEYWORDS Myopia, Primary Open Angle Glaucoma, Intraocular Pressure, Central Corneal Thickness, Trabecular Iris Angle

scholarly journals Adjusting Intraocular Pressure for Central Corneal Thickness Does Not Improve Prediction Models for Primary Open-Angle Glaucoma

Ophthalmology ◽  
2012 ◽  
Vol 119 (3) ◽  
pp. 437-442 ◽  
Author(s):  
James D. Brandt ◽  
Mae O. Gordon ◽  
Feng Gao ◽  
Julia A. Beiser ◽  
J. Phillip Miller ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Central Corneal Thickness ◽  
Prediction Models ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Open Angle

scholarly journals Does the Central Corneal Thickness (CCT) retain its predictive value as a risk factor in Primary Open Angle Glaucoma patients with Diabetes Mellitus?

2019 ◽  
Vol 3 (2) ◽  
pp. 32-41
Author(s):  
Anadi Khatri ◽  
Bal Kumar Khatri ◽  
Madhu Thapa ◽  
Muna Kharel ◽  
Ashma K.C. ◽  
...  
Keyword(s):  
Risk Factor ◽  
Predictive Value ◽  
Central Corneal Thickness ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Diabetic Patients ◽  
Open Angle ◽  
Cross Sectional ◽  
Patients With Diabetes

Background: Central Corneal thickness (CCT) is thicker in diabetic patients. This may cause the CCT to lose predictive power as a risk factor for primary open angle glaucoma (POAG) in patients with diabetes. Objective: To evaluate if CCT of POAG patients with diabetes retains its predictive value as a risk factor. Methods: A cross sectional analysis of sequential group of patients with POAG with and without diabetes were evaluated HbA1C in diabetic patients and CCT in both groups was measured and the severity of POAG was evaluated using visual field changes and optic disc changes. The correlation was evaluated using confidence interval and liner regression estimator analysis. Results: Five hundred and eighty-seven patients with POAG were evaluated. The mean CCT for the group combined was 540±34.9 μm. Three hundred and thirty-seven patients had no history of diabetes and had mean CCT of 531.1±19.6 μm. Two hundred and fifty of them had diabetes with mean corneal thickness of 549±20.2 μm. CCT retained its predictive value as a risk factor for severity in POAG patient without diabetes (p<0.05). CCT however was a less sensitive for evaluating risk/severity in POAG patients with diabetes (p>0.05). Conclusions: CCT values may not retain its predictive value of severity of POAG in patients with diabetes. Hence, CCT alone may not be a reliable marker and mislead treating physicians.

scholarly journals Genomic Locus Modulating Corneal Thickness in the Mouse Identifies POU6F2 as a Potential Risk of Developing Glaucoma

2017 ◽  
Author(s):  
Rebecca King ◽  
Felix L. Struebing ◽  
Ying Li ◽  
Jiaxing Wang ◽  
Allison Ashley Koch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinal Ganglion Cells ◽  
Central Corneal Thickness ◽  
Primary Open Angle Glaucoma ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Retinal Ganglion ◽  
Open Angle

AbstractPurpose: Central corneal thickness (CCT) is one of the most heritable ocular traits and it is also a phenotypic risk factor for primary open angle glaucoma (POAG). The present study uses the BXD Recombinant Inbred (RI) strains to identify novel quantitative trait loci (QTLs) modulating CCT in the mouse with the potential of identifying a molecular link between CCT and risk of developing POAG.Methods: The BXD RI strain set was used to define mammalian genomic loci modulating CCT, with a total of 818 corneas measured from 61 BXD RI strains (between 60-100 days of age). The mice were anesthetized and the eyes were positioned in front of the lens of the Phoenix Micron IV Image-Guided OCT system or the Bioptigen OCT system. CCT data for each strain was averaged and used to identify quantitative trait loci (QTLs) modulating this phenotype using the bioinformatics tools on GeneNetwork (www.genenetwork.org). The candidate genes and genomic loci identified in the mouse were then directly compared with the summary data from a human primary open-angle glaucoma (POGA) genome wide association study (NEIGHBORHOOD) to determine if any genomic elements modulating mouse CCT are also risk factors for POAG.Results: This analysis revealed one significant QTL on Chr 13 and a suggestive QTL on Chr 7. The significant locus on Chr 13 (13 to 19 Mb) was examined further to define candidate genes modulating this eye phenotype. For the Chr 13 QTL in the mouse, only one gene in the region (Pou6f2) contained nonsynonymous SNPs. Of these five nonsynonymous SNPs in Pou6f2, two resulted in changes in the amino acid proline which could result in altered secondary structure affecting protein function. The 7 Mb region under the mouse Chr 13 peak distributes over 2 chromosomes in the human: Chr 1 and Chr 7. These genomic loci were examined in the NEIGHBORHOOD database to determine if they are potential risk factors for human glaucoma identified using meta-data from human GWAS. The top 50 hits all resided within one gene (POU6F2), with the highest significance level of p = 10−6 for SNP rs76319873. POU6F2 is found in retinal ganglion cells and in corneal limbal stem cells. To test the effect of POU6F2 on CCT we examined the corneas of a Pou6f2-null mice and the corneas were thinner than those of wild-type littermates. In addition, these POU6F2 RGCs die early in the DBA/2J model of glaucoma than most RGCs.Conclusions: Using a mouse genetic reference panel, we identified a transcription factor, Pou6f2, that modulates CCT in the mouse. POU6F2 is also found in a subset of retinal ganglion cells and these RGCs are sensitive to injury.Authors SummaryGlaucoma is a complex group of diseases with several known causal mutations and many known risk factors. One well-known risk factor for developing primary open angle glaucoma is the thickness of the central cornea. The present study leverages a unique blend of systems biology methods using BXD recombinant inbred mice and genome-wide association studies from humans to define a putative molecular link between a phenotypic risk factor (central corneal thickness) and glaucoma. We identified a transcription factor, POU6F2, that is found in the developing retinal ganglion cells and cornea. POU6F2 is also present in a subpopulation of retinal ganglion cells and in stem cells of the cornea. Functional studies reveal that POU6F2 is associated the central corneal thickness and with susceptibility of retinal ganglion cells to injury.

scholarly journals Multicenter study of intraocular pressure level in patients with moderate and advanced primary open-angle glaucoma on treatment

2015 ◽  
Vol 8 (1) ◽  
pp. 43-60 ◽  
Author(s):  
L. D. Abysheva ◽  
R. V. Avdeev ◽  
A. S. Alexandrov ◽  
A. S. Basinsky ◽  
E. A. Blyum ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Healthy Subjects ◽  
Central Corneal Thickness ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Disease Stage ◽  
Open Angle ◽  
Significant Difference ◽  
Advanced Glaucoma

Introduction. For the past several decades, there has been a discussion as to whether elevated intraocular pressure is just ocular hypertension in a healthy eye, or a sign of glaucoma. Objective. To study the IOP values in patients with primary open-angle glaucoma at the beginning of the study and to correlated them with the disease progression and to determine optimal IOP levels. Material and methods. The final protocol included data from 812 right eyes of 637 glaucoma patients and 175 healthy subjects; the latter formed the control group. The mean age of examined patients was 71.8 ± 0.28 years; 72.00 (66.00; 77.00). Mean disease duration in glaucoma patients was 5.41 ± 0.17 years. The following parameters were assessed: visual acuity, clinical refraction, IOP level by Maklakov tonometry, central corneal thickness and IOP-lowering medication use. Results. In the age group - between 60 and 69 y.o., the IOP level in patients with advanced glaucoma was significantly higher than in patients with moderate glaucoma and healthy subjects. There was no significant difference in central corneal thickness either between glaucoma patients and healthy subjects (both male and female) or between glaucoma patients with different glaucoma changes. The IOP level was higher in patients treated with non-fixed combination of beta-blockers (BB) and prostaglandins (PG) regardless of the disease stage. According to the common standards the IOP level was found to be controlled in 69.93 % of patients with moderate glaucoma and 14.42 % of patients with advanced glaucoma. Conclusion. The results of the study could be used as clinical guidelines for determination of the optimal IOP range, choosing the optimal IOP-lowering medication(s) for starting therapy and during the follow-up in patients with moderate and advanced glaucoma stages.

scholarly journals Central corneal thickness and intraocular pressure in patients of primary open angle glaucoma and normal population in Nepalese population: A hospital based study

2019 ◽  
Vol 11 (1) ◽  
pp. 46-54
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Badri Prasad Badhu ◽  
Poonam Lavaju
Keyword(s):  
Intraocular Pressure ◽  
Central Corneal Thickness ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Normal Population ◽  
Corneal Thickness ◽  
Open Angle ◽  
Glaucomatous Damage ◽  
Significant Difference ◽  
Primary Glaucoma

Introduction: Central corneal thickness (CCT) is a powerful predictor of primary open angle glaucoma. Individualized risk assessment is critical for early diagnosis and management of glaucoma. Objectives: To compare CCT and intraocular pressure in patients of primary openangle glaucoma (POAG) with those of normal population. Materials and methods: A Comparative Cross-Sectional Study was performed in Ophthalmology department of B. P. Koirala Institute of Health Sciences, Nepal. Newly diagnosed cases of primary glaucoma (open angle, normal tension) of 18 years and above, without known systemic diseases were included. Results: Out of a total of 291 subjects (582 eyes), 105 subjects (210 eyes) were with primary glaucoma and 186 (382 eyes) were normal subjects. There was no significant difference in CCT between glaucomatous (533.57 μm) and normal (530.06 μm) eyes (p=0.1). Cornea was thinner (518.±18.03 μm) in eyes with severe glaucomatous damage (cup:disc ratio > 0.8) than in moderate glaucomatous damage (cup:disc ratio=0.5-0.8)(p=0.003). There was a statistically significant difference of 22.05 μm in CCT between POAG and NTG (p<0.001). A positive correlation was found between IOP & CCT in both cases and control group (p=0.000; r = 0.355, 0.254; r2 =0.126, 0.064 respectively). Conclusion: Majority of studied Nepalese population have CCT less than 550 μm, thus increasing the risk of POAG. CCT decreases with age, and females with glaucoma have significantly thicker cornea than men. There is a significant positive correlation between CCT and IOP, and IOP will have to be adjusted for CCT for proper diagnosis and monitoring of glaucomatous damage in Nepalese population too.  

scholarly journals Genetic African Ancestry Is Associated With Central Corneal Thickness and Intraocular Pressure in Primary Open-Angle Glaucoma

2017 ◽  
Vol 58 (7) ◽  
pp. 3172 ◽  
Author(s):  
Pieter W. M. Bonnemaijer ◽  
Colin Cook ◽  
Abhishek Nag ◽  
Christopher J. Hammond ◽  
Cornelia M. van Duijn ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Central Corneal Thickness ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
African Ancestry ◽  
Corneal Thickness ◽  
Open Angle
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