Glaucoma Flashcards
What is glaucoma?
Optic neuropathy characterized by progressive degeneration of retinal ganglion cells
An increase in what damages the optic nerve?
Increase intraocular pressure
Glaucoma is the leading cause of blindness for people at what age?
> 60 years
A chronic progressive optic nerve neuropathy in adults where the condition is associated with an open anterior chamber angle by gonioscopy
Primary open angle glaucoma
What are 8 risk factors of POAG?
- High IOP
- Older age
- Family history of glaucoma
- African race
- Latino/Hispanic ethnicity
- Thinner central cornea
- Myopia
- T2D
What are the 4 screenings for glaucoma?
- Goldmann applanation tonometry
- Gonioscopy
- Pachymetry
- Biomicroscope with ancillary lens
What is the normal range for IOP?
11-21 mmHg
What pressure does IOP need to be at for optic nerve damage to occur?
> 21 mmHg
How much should you lower IOP by to slow the progression of IOP?
25%
BIMATOPROST
LUMIGAN
BIMATOPROST IMPLANT
DURYSTA
LATANOPROST
XALATAN; XELPROS
TAFLUPROST
ZIOPTAN
TRAVOPROST
TRAVATAN
TRAVOPROST IMPLANT
iDOSE TR
UNOPROSTONE
RESCULA
LANTANOPROSTENE BUNOD
VYZULTA
What is the MOA of the prostaglandin analogs?
Increase uveoscleral outflow of aqueous humor
How much do the prostaglandin analogs decrease IOP?
By 25-30%
How often are the prostaglandin analogs dosed?
Once a day
What are the 6 prostaglandin analogs?
- Bimatoprost
- Latanoprost
- Travaprost
- Tafluprost
- Unoprostone
- Latanoprost bunod
What are 4 side effects of the prostaglandin analogs?
- Increased brown pigmentation of the iris
- Increased number, thickness, curvature, and pigmentation of eyelashes
- Ocular pruritis/dryness/blurring
- Eyelid erythema
Nitric oxide-donating prostaglandin analog
Latanoprost bunod
What are the 2 moieties that come from the metabolism of latanoprost bunod?
- Latanoprost acid
- Butanediol mononitrate
What prostaglandin analog can be implanted?
Bimatoprost implant
How long does bimatoprost reduce IOP?
15 weeks
What prostaglandin analog is anchored in trabecular meshwork in the sclera wall?
Travoprost implant
When is the TRAVOPROST implant replaced?
Every 4-5 years
What is the MOA of the beta blockers?
Decrease aqueous humor production
How much do the beta blockers decrease IOP by?
20-30%
Which beta blocker is the best at decreasing IOP?
Timolol
When are beta blockers best used in treatment?
As add on therapy for patient on a PG analog