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Ingrida Januleviciene - Biophysical Properties in Glaucoma: Diagnostic Technologies

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Ingrida Januleviciene Biophysical Properties in Glaucoma: Diagnostic Technologies

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This book provides an overview on new insights in glaucoma, the latest technological developments, scientific achievements, and novel research leading to new paradigms in glaucoma diagnosis. Readers will discover a broad picture starting from theoretical perspectives in diagnostic criteria followed by practical examination and clinical interpretations while highlighting potential pitfalls and limitations in analysis. Non-invasive, modern technologies allowing visualization and quantification of various parts of the human eye are fast evolving and improving interpretation of modern diagnostic possibilities are essential to fill the gap between sophisticated equipment, complex clinical data, and the need for precision-medicine based interpretation. Issues such as the importance of intraocular, intracranial, and ocular perfusion pressures (IOP, ICP, OPP) in the pathogenesis of glaucoma; and imaging modalities for examination of the optic nerve head, retinal fiber layer, and visual field assessment in glaucoma are explored in these chapters. The problem-based learning approach presented herein offers a succinct go-to-guide to read and discover answers.

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Editors Ingrida Januleviciene and Alon Harris Biophysical Properties in - photo 1
Editors
Ingrida Januleviciene and Alon Harris
Biophysical Properties in Glaucoma Diagnostic Technologies
Editors Ingrida Januleviciene Lithuanian University of Health Sciences - photo 2
Editors
Ingrida Januleviciene
Lithuanian University of Health Sciences, Kaunas, Lithuania
Alon Harris
Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
ISBN 978-3-319-98197-0 e-ISBN 978-3-319-98198-7
https://doi.org/10.1007/978-3-319-98198-7
Library of Congress Control Number: 2018964715
Springer Nature Switzerland AG 2019
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AG

The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Contents
Part IImportance of Intraocular, Intracranial and Ocular Perfusion Pressures (IOP, ICP, OPP) in the Pathogenesis of Glaucoma
Lina Siaudvytyte
Lina Siaudvytyte
Lina Siaudvytyte
Lina Siaudvytyte
Lina Siaudvytyte
Lina Siaudvytyte
Lina Siaudvytyte
Part IICurrent Visualization of Anterior Chamber Angle
Daiva Paulaviciute-Baikstiene and Renata Vaiciuliene
Daiva Paulaviciute-Baikstiene and Renata Vaiciuliene
Part IIIOptic Nerve Head and Retinal Nerve Fiber Layer Visualization in Glaucoma
Akvile Stoskuviene
Akvile Stoskuviene
Akvile Stoskuviene
Akvile Stoskuviene
Part IVVisual Field in Glaucoma
Loreta Kuzmiene
Loreta Kuzmiene
Loreta Kuzmiene
Loreta Kuzmiene
Part VStructure and Function Congruency in Glaucoma
Ruta Maciulaitiene and Ingrida Januleviciene
Ruta Maciulaitiene and Ingrida Januleviciene
Ruta Maciulaitiene and Ingrida Januleviciene
Part VIOcular Surface and Glaucoma
Giedre Pakuliene
Giedre Pakuliene
Giedre Pakuliene
Giedre Pakuliene
Giedre Pakuliene
Part I Importance of Intraocular, Intracranial and Ocular Perfusion Pressures (IOP, ICP, OPP) in the Pathogenesis of Glaucoma
Springer Nature Switzerland AG 2019
Ingrida Januleviciene and Alon Harris (eds.) Biophysical Properties in Glaucoma https://doi.org/10.1007/978-3-319-98198-7_1
1. Intraocular Pressure as a Risk Factor
Lina Siaudvytyte
(1)
Eye Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania
Lina Siaudvytyte
Email:
Keywords
Intraocular pressure Open-angle glaucoma

Intraocular pressure (IOP) is considered the main risk factor for the prevalence, incidence and progression of glaucoma [].

Large population-based studies showed that the level of IOP is a risk factor for glaucoma progression. (Table ].
Table 1.1

Studies investigating relationship between intraocular pressure and glaucoma progression

Study

Results

Treatment vs. no treatment

CNTGS

[]

A 30% reduction in IOP reduces the risk of visual field progression from 80 to 40% in NTG subjects

EMGT

[]

A 25% reduction in baseline IOP reduces the risk of progression by 50% in OAG

1 mmHg reduction in IOP reduces risk of progression by 10%

OHTS

[]

>90% of untreated OHT patients had not converted to glaucoma after 5 years

IOP lowering drops decrease OHT conversion to glaucoma rate from 10 to 5%

EGPS

[]

With IOP lowering drops OHT conversion to glaucoma rate is 7%

In OHT placebo group the conversion rate is 15%

Different treatments

CIGTS

[]

Reducing IOP to 14 mmHg instead of 18 mmHg decreases by a third the proportion with >3 dB loss of visual field mean deviation

AGIS

[]

No progression only in eyes with IOP <18 mmHg

AGIS Advanced Glaucoma Intervention Study, CIGTS Collaborative Initial Glaucoma Treatment Study, CNTGS The Collaborative Normal Tension Glaucoma Study, EGPS European Glaucoma Prevention Study, EMGT Early Manifest Glaucoma Trial, IOP intraocular pressure, NTG normal tension glaucoma, OAG open-angle glaucoma, OHT ocular hypertension, OHTS The Ocular Hypertension Treatment Study

In ocular hypertension (OHT) conversions to glaucoma occurs in only a small number of patients despite elevated IOP. The Ocular Hypertension Treatment Study (OHTS) compared treatment versus no treatment in OHT [].

IOP fluctuations also play an important role in glaucoma progression. The diurnal IOP fluctuation is defined as difference between the highest and lowest IOP in a single day. Short-term fluctuations are defined as periods of days to weeks, while long-term IOP fluctuationsperiods of months to years. Diurnal IOP fluctuations up to 5 mmHg can occur in healthy subjects, while fluctuations 1030 mmHg have been detected in untreated glaucoma patients [].

References
  1. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA, et al. Interim clinical outcomes in the collaborative initial glaucoma treatment study comparing initial treatment randomized to medications or surgery. Ophthalmology. 2001;108(11):194353. Crossref
  2. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol (Chicago, IL: 1960). 2002;120(6):70130. Crossref
  3. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol (Chicago, IL: 1960). 2003;121(1):4856. Crossref
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