AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients ...AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients with well-controlled Goldmann applanation tonometer(GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled.GAT and ORA parameters including corneal compensated intraocular pressure(lOPcc),Goldmann estimated intraocular pressure(lOPg),corneal hysteresis(CH),corneal resistance factor(CRF) were recorded.VF was tested by Swedish interactive threshold algorithm(SITA)-standard 30-2 fields.All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up.Patients were divided into four groups according to VF change over 3y,and ORA findings were compared between the upper 25th percentile group(slow progression group) and the lower 25th percentile group(rapid progression group).RESULTS:Eighty-two eyes of 56 patients were studied.There were 21 eyes(21 patients) each in rapid and slow progression groups respectively.GAT,lOPcc,lOPg,CH,CRF were 12.1+1.4 mm Hg,15.8±1.8 mm Hg,12.8±2.0 mm Hg,8.4±1.1 mm Hg,7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg,13.5±2.1 mm Hg,11.2±1.6 mm Hg,9.3±1.1 mm Hg,8.2±0.9 mm Hg respectively in slow progression group(P=0.214,〈0.001,0.007,0.017,0.413,respectively).In bivariate correlation analysis,lOPcc,lOPcc-GAT and CH were significant correlated with m△MD(r =-0.292,-0.312,0.228 respectively,P =0.008,0.004,0.039 respectively).CONCLUSION:Relatively rapid VF progression occurred in NTG patients whose lOPcc are rather high,CH are rather low and the difference between lOPcc and GAT are relatively large.Higher lOPcc and lower CH are associated with VF progression in NTG patients.This study suggests that GAT measures might underestimate the IOP in such patients.展开更多
Purpose: We compared the thickness of circumpapillary retinal nerve fiver layer (cpRNFL) and macular ganglion cell layer with inner plexiform layer (GCL + IPL) using Cirrus HD-OCT (Ver.6.0: Carl Zeiss). Materials and ...Purpose: We compared the thickness of circumpapillary retinal nerve fiver layer (cpRNFL) and macular ganglion cell layer with inner plexiform layer (GCL + IPL) using Cirrus HD-OCT (Ver.6.0: Carl Zeiss). Materials and Methods: This study included 12 eyes of normal controls, 10 eyes of preperimetric glaucoma (PPG) with loss of RNFL either in superior or in inferior hemisphere without visual field defects, and 22 eyes of glaucoma eyes with visual field defects restricted to upper hemifield (UHFD: early 10 eyes, severe 12 eyes). The cpRNFL thickness analyzed from disk center by dividing into 12 sectors. The GCL + IPL thickness analyzed from central fovea by dividing into six sectors. Both compared between normal eye group and other 3 groups using the average value of each sectors. Result: The cpRNFL and the GCL + IPL thickness were obviously thin as compared with normal eyes. Conclusion: Even if it is in the state where abnormalities are not detected using the Humphrey field Analyzer, it is suggested that the early structural change of glaucoma has already arisen.展开更多
Purpose: Fixed-combination medication to treat glaucoma can reduce intraocular pressure (IOP) without negative effects of concomitant medication. Tafluprost/timolol fixed-combination ophthalmic solution (TTFC) has bee...Purpose: Fixed-combination medication to treat glaucoma can reduce intraocular pressure (IOP) without negative effects of concomitant medication. Tafluprost/timolol fixed-combination ophthalmic solution (TTFC) has been reported to show similar effectiveness in lowering IOP, compared with concomitant use of its component drugs, tafluprost and timolol. However, the difference in IOP-lowering effects between TTFC and concomitant use of tafluprost and gel-forming timolol is unknown. Hence, we conducted this switching study from tafluprost and gel-forming timolol to TTFC in glaucoma patients undergoing multi-drug therapy. Design: Multi-center, open-label, interventional clinical study. Methods: Twenty-eight patients (28 eyes;safety analysis set) with primary open-angle glaucoma and ocular hypertension, who had completed the 4-week-concomitant phase of tafluprost and gel-forming timolol, were treated for 8 weeks with TTFC. IOP, adherence, ocular surface safety, and the usability of ophthalmic solution were compared before and after switching. This study was approved by the ethics committees of Kitasato University Hospital and all other study sites. All patients provided written informed consent to participate. Results: IOP at 8 weeks after switching was significantly lower than before switching (P = 0.0001) in the efficacy analysis set (n = 24). The self-reported adherence rate remained high after switching;moreover, there was no meaningful change in ocular surface safety. Patient questionnaires regarding usability of medication revealed that 85.7% of patients preferred their instillation prescription after switching, including TTFC. Among the safety analysis set (n = 28), no adverse events were reported in relation to the study drug. Conclusion: TTFC showed greater IOP reduction than concomitant therapy. Thus, TTFC may be a better option in glaucoma patients than concomitant therapy.展开更多
文摘AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients with well-controlled Goldmann applanation tonometer(GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled.GAT and ORA parameters including corneal compensated intraocular pressure(lOPcc),Goldmann estimated intraocular pressure(lOPg),corneal hysteresis(CH),corneal resistance factor(CRF) were recorded.VF was tested by Swedish interactive threshold algorithm(SITA)-standard 30-2 fields.All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up.Patients were divided into four groups according to VF change over 3y,and ORA findings were compared between the upper 25th percentile group(slow progression group) and the lower 25th percentile group(rapid progression group).RESULTS:Eighty-two eyes of 56 patients were studied.There were 21 eyes(21 patients) each in rapid and slow progression groups respectively.GAT,lOPcc,lOPg,CH,CRF were 12.1+1.4 mm Hg,15.8±1.8 mm Hg,12.8±2.0 mm Hg,8.4±1.1 mm Hg,7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg,13.5±2.1 mm Hg,11.2±1.6 mm Hg,9.3±1.1 mm Hg,8.2±0.9 mm Hg respectively in slow progression group(P=0.214,〈0.001,0.007,0.017,0.413,respectively).In bivariate correlation analysis,lOPcc,lOPcc-GAT and CH were significant correlated with m△MD(r =-0.292,-0.312,0.228 respectively,P =0.008,0.004,0.039 respectively).CONCLUSION:Relatively rapid VF progression occurred in NTG patients whose lOPcc are rather high,CH are rather low and the difference between lOPcc and GAT are relatively large.Higher lOPcc and lower CH are associated with VF progression in NTG patients.This study suggests that GAT measures might underestimate the IOP in such patients.
文摘Purpose: We compared the thickness of circumpapillary retinal nerve fiver layer (cpRNFL) and macular ganglion cell layer with inner plexiform layer (GCL + IPL) using Cirrus HD-OCT (Ver.6.0: Carl Zeiss). Materials and Methods: This study included 12 eyes of normal controls, 10 eyes of preperimetric glaucoma (PPG) with loss of RNFL either in superior or in inferior hemisphere without visual field defects, and 22 eyes of glaucoma eyes with visual field defects restricted to upper hemifield (UHFD: early 10 eyes, severe 12 eyes). The cpRNFL thickness analyzed from disk center by dividing into 12 sectors. The GCL + IPL thickness analyzed from central fovea by dividing into six sectors. Both compared between normal eye group and other 3 groups using the average value of each sectors. Result: The cpRNFL and the GCL + IPL thickness were obviously thin as compared with normal eyes. Conclusion: Even if it is in the state where abnormalities are not detected using the Humphrey field Analyzer, it is suggested that the early structural change of glaucoma has already arisen.
文摘Purpose: Fixed-combination medication to treat glaucoma can reduce intraocular pressure (IOP) without negative effects of concomitant medication. Tafluprost/timolol fixed-combination ophthalmic solution (TTFC) has been reported to show similar effectiveness in lowering IOP, compared with concomitant use of its component drugs, tafluprost and timolol. However, the difference in IOP-lowering effects between TTFC and concomitant use of tafluprost and gel-forming timolol is unknown. Hence, we conducted this switching study from tafluprost and gel-forming timolol to TTFC in glaucoma patients undergoing multi-drug therapy. Design: Multi-center, open-label, interventional clinical study. Methods: Twenty-eight patients (28 eyes;safety analysis set) with primary open-angle glaucoma and ocular hypertension, who had completed the 4-week-concomitant phase of tafluprost and gel-forming timolol, were treated for 8 weeks with TTFC. IOP, adherence, ocular surface safety, and the usability of ophthalmic solution were compared before and after switching. This study was approved by the ethics committees of Kitasato University Hospital and all other study sites. All patients provided written informed consent to participate. Results: IOP at 8 weeks after switching was significantly lower than before switching (P = 0.0001) in the efficacy analysis set (n = 24). The self-reported adherence rate remained high after switching;moreover, there was no meaningful change in ocular surface safety. Patient questionnaires regarding usability of medication revealed that 85.7% of patients preferred their instillation prescription after switching, including TTFC. Among the safety analysis set (n = 28), no adverse events were reported in relation to the study drug. Conclusion: TTFC showed greater IOP reduction than concomitant therapy. Thus, TTFC may be a better option in glaucoma patients than concomitant therapy.