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1.  Use of the structure-function relationship in detecting glaucoma progression in early glaucoma 
BMC Ophthalmology  2014;14(1):118.
To evaluate the use of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and visual field (VF) measurements in detecting disease progression in patients with early glaucoma.
Over a 3-year period, this study examined 60 eyes of 39 glaucoma patients whose total deviation in the superior or inferior hemifield was more than -6 dB. All eyes underwent at least four serial RNFL measurements performed by Cirrus OCT, with the first and last measurements separated by at least three years. On the same day as the RNFL imaging, VF testing was also performed by using the Swedish Interactive Threshold Algorithm Standard 30–2 program of the Humphrey Field Analyzer. Serial RNFL thicknesses and VF progression were assessed using the Guided Progression Analysis (GPA) software program. RNFL thickness progression and VF progression were evaluated by the event analysis.
The mean observation period was 57.6 ± 10.0 months, and during this time, a total of 366 OCT and 366 VF measurements were performed. Using only OCT, progression was found in 2 eyes, while progression was found in 1 eye when only using VF GPA. When combined measurement findings were used, the analysis found progression in 8 eyes.
When mild VF defect is present, OCT RNFL thickness measurements can be helpful in discerning glaucoma progression.
PMCID: PMC4192289  PMID: 25281998
Optical coherence tomography; Visual field; Retinal nerve fiber layer; Glaucoma progression
2.  Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy 
Journal of Ophthalmology  2014;2014:801967.
Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy.
PMCID: PMC4127218  PMID: 25136454
3.  Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma 
BMC Ophthalmology  2012;12:29.
To compare peripapillary choroidal thickness measurements between normal and normal-tension glaucoma eyes.
Cross-sectional comparative study. 50 normal and 52 normal-tension glaucoma subjects were enrolled in the study. Peripapillary choroidal thickness was measured with spectral-domain optical coherence tomography and enhanced depth imaging. After obtaining circular B-scans around the disc, choroidal thicknesses were calculated based on the exported segmentation values. Visual fields were measured using automated perimetry. Difference in peripapillary choroidal thickness between the normal subjects and the patients with normal-tension glaucoma was analyzed.
There were no significant differences in age, axial length, or refraction between the two groups. Peripapillary choroidal thickness was inversely correlated with age in both the normal (r = −0.287, P = 0.04) and normal and normal-tension glaucoma (r = −0.322, P = 0.02) groups. Peripapillary choroidal thickness of inferonasal (125 vs 148 μm, P < 0.05), inferior (101 vs 122 μm, P < 0.05), or inferotemporal (100 vs 127 μm, P < 0.05) regions were significantly thinner in the normal-tension glaucoma group as compared to normal subjects. Superior visual hemifield defect was significantly worse than inferior visual hemifield defect in normal and normal-tension glaucoma patients.
As compared to normal subjects, peripapillary choroidal thickness was significantly thinner in the normal and normal-tension glaucoma patients, at least in some locations.
PMCID: PMC3479055  PMID: 22839368
Peripapillary choroidal thickness; Enhanced depth imaging optical coherence tomography; Normal-tension glaucoma
4.  Potential role for angiotensin-converting enzyme inhibitors in the treatment of glaucoma 
Therapeutic methods directed at alleviating the basic pathological processes of normal-tension glaucoma (NTG) are yet to be established. Although there seems to be little doubt that intraocular pressure (IOP) represents a risk factor in most patients, reduction of IOP does not prevent progression in every patient with NTG, indicating that factors other than elevated IOP are involved in glaucoma progression. New avenues of treatment under investigation include agents that could improve blood flow to the eye and neuroprotective drugs. The major components of the renin-angiotensin system have been identified in ocular tissue. Angiotensin-converting enzyme (ACE) inhibitors are widely used to treat systemic hypertension. ACE inhibitors are inhibitors of kininase II and thus prevent breakdown of bradykinin. Bradykinin displays protective actions against glutamate neurotoxicity through bradykinin-B2 receptors in cultured retinal neurons. ACE inhibitors blocked the liberation of angiotensin II from angiotensin I. Lower angiotensin II levels may have beneficial effects on outcomes by lowering vascular superoxide anion production. The effects of ACE inhibitor as a potential antiglaucoma therapy deserve intense scrutiny.
PMCID: PMC2701139  PMID: 19668475
glaucoma; angiotensin-converting enzyme inhibitor; bradykinin; neuroprotection; ACE inhibitor

Results 1-4 (4)