Glaucoma Therapy

Cover......Page 1
GLAUCOMA THERAPY......Page 2
CONTENTS......Page 4
CONTRIBUTORS......Page 6
FOREWORD......Page 9
Clinical changes......Page 10
Peripapillary atrophy......Page 11
Optic disc hemorrhage......Page 12
Alterations of the lamina cribrosa in glaucoma......Page 13
Axonal transport in glaucoma......Page 16
Reactivation of glial cells......Page 17
References......Page 18
The structure of the trabecular meshwork......Page 26
Localization of outflow resistance......Page 27
Structural changes with POAG......Page 29
The role of the TM cytoskeleton and contractility......Page 30
References......Page 31
Introduction......Page 36
Risk factors for GON......Page 37
Pathomechanism of GON......Page 38
The concept of cell stress......Page 39
GON as a consequence of repeated reperfusion damage......Page 40
The role of oxidative damage......Page 41
The role of optic nerve head hemorrhages......Page 42
The present concept......Page 43
References......Page 44
The magnitude of the problem......Page 46
To treat or not to treat......Page 50
Practical approaches......Page 52
Research attitude changes......Page 54
References......Page 56
Introduction......Page 60
Design......Page 61
Aim......Page 62
Results......Page 63
Results......Page 64
IOP control......Page 65
Results......Page 66
References......Page 67
Introduction......Page 70
Clinically investigated prostaglandin analogs......Page 71
Cannabinoids and intraocular pressure......Page 73
References......Page 74
Mechanism of action......Page 78
Pharmacokinetics......Page 79
Compared with dorzolamide......Page 80
Compared with other prostanglandins......Page 85
Adjunct to timolol or other β-blocker therapy......Page 86
Angle-closure and other types of glaucoma......Page 87
Tolerability/safety......Page 91
References......Page 92
Bimatoprost and ocular hypertension......Page 100
Advanced glaucoma......Page 101
Eyes non-responders to prostaglandins......Page 102
References......Page 103
First medical glaucoma treatment......Page 106
Prostaglandin analogues and prostamides......Page 107
Indication for travoprost......Page 109
Travoprost pharmacokinetics and pharmacodynamics......Page 110
Clinical efficacy of travoprost......Page 112
Clinical trials......Page 113
Clinical safety in prostaglandin derivatives......Page 114
Clinical safety in travoprost......Page 115
References......Page 117
Description of ocular hypotensive lipids......Page 122
Administration once daily......Page 124
Systemic side-effects......Page 125
Iris pigmentation changes......Page 126
Is there a best drug for a specific patient?......Page 127
References......Page 128
Clinical efficacy......Page 132
Safety profile......Page 133
Vascular effects in the posterior eye......Page 134
Clinical efficacy......Page 136
Vascular effects in the posterior eye......Page 137
Cosopt......Page 140
Cosopt versus Xalatan......Page 141
References......Page 143
Introduction......Page 152
A selective β1-receptor blocker: betaxolol......Page 154
Non-selective β-receptor blockers: timolol, levobunolol, carteolol and nipradilol......Page 157
Carbonic anhydrase inhibitors: acetazolamide, brinzolamide and dorzolamide......Page 158
Isopropyl unoprostone......Page 159
Latanoprost, travoprost, and bimatoprost......Page 160
α2 -Adrenoreceptor agonists: clonidine, apraclonidine and brimonidine......Page 161
References......Page 163
Non-IOP-lowering effects of primarily IOP-lowering medications......Page 172
Common antiglaucoma medications and ocular blood flow......Page 173
Optimizing the blood pressure......Page 175
Regulating the vascular dysregulation......Page 176
Calcium channel blockers in glaucoma......Page 178
Neuroprotection in glaucoma treatment, a brief overview......Page 180
Endothelin antagonists in glaucoma treatment......Page 181
Alpha1-blockers in glaucoma treatment......Page 182
Chinese herbal medicine in glaucoma......Page 183
Physical exercise in glaucoma......Page 184
A word on gene therapy for glaucoma......Page 185
Comment......Page 186
References......Page 187
Can we obtain IOPs in the low teens more easily with surgery?......Page 210
Can medical therapy be harmful?......Page 211
Quality of life and cost of therapy......Page 212
References......Page 213
Introduction......Page 216
Introduction......Page 217
Preoperative preparation......Page 218
Treatment guidelines......Page 219
Complications......Page 220
Long-term effect of ALT......Page 221
Laser filtration procedures......Page 222
Neodymium: yttrium—aluminum—garnet laser sclerostomy......Page 223
Erbium: YAG laser trabecular ablation......Page 224
Contraindications......Page 225
Lens......Page 226
Nd: YAG laser iridotomy......Page 227
Complications......Page 228
Postoperative management......Page 229
Indication......Page 230
Contraindications......Page 231
Laser cyclodestructive procedures......Page 233
References......Page 234
Introduction......Page 236
Cyclocryocoagulation......Page 237
Ruby laser......Page 238
810 nm diode laser......Page 239
Red 647 nm krypton and 670 nm diode lasers......Page 241
Indications for partial cyclodestruction......Page 242
References......Page 243
Introduction......Page 248
Conjunctival flap......Page 249
Dilation of Schlemm’s canal......Page 250
Phacoemulsification......Page 251
Descemetic window......Page 252
Intraocular pressure......Page 253
Conclusion......Page 254
References......Page 255
Origin in......Page 258
Results......Page 260
References......Page 262
Introduction......Page 266
Surgical technique of non-penetrating glaucoma surgery......Page 267
Nd-YAG goniopuncture after DS (Figure 19.2)......Page 269
Mechanisms of filtration after non-penetrating surgeries for glaucoma (Figure 19.3)......Page 270
Flow through the TDM......Page 271
Subchoroidal space......Page 272
Do non-penetrating glaucoma surgeries lower IOP?......Page 273
Summary and conclusion......Page 274
References......Page 275
Reaching the ‘guesstimated’ target IOP in the individual patient......Page 278
Summary......Page 279
Sparing vision......Page 280
Conclusions......Page 281
References......Page 282
Overview of modern-day drainage implants......Page 284
Indications for glaucoma drainage implant surgery......Page 285
Molteno implant......Page 286
Technique of implantation......Page 287
Modifications of the technique to prevent postoperative hypotony......Page 289
Surgical outcome......Page 290
Complications......Page 291
References......Page 293
Background......Page 300
Inflammation......Page 301
Growth factors......Page 304
Improved techniques of antimetabolite use......Page 307
Fibroblast migration, tissue contraction and extracellular matrix synthesis......Page 311
Cessation of healing......Page 312
References......Page 313
Introduction......Page 320
Concept of the therapeutic goal......Page 321
Current therapy modalities......Page 322
Future development......Page 325
References......Page 329
INDEX......Page 332