Lec.7: Normal Tension Glaucoma and Secondary OAG Flashcards
what can be said about IOP in NTG?
it is constantly variable
aside from IOP, what factors contribute to damage in NTG?
vascular factors
what diseases might patients with NTG have a higher prevalence for?
raynaud phenomena, ischemic vascular disease, autoimmune disorder, coagulopahties
what is the likelihood of NTG progression in patients that are treated vs. non-treated?
treated: 12% non-treated: 35%
what is the likelihood of cataract development in patients that are treated vs. non-treated?
treated: 38% non-treated: 14%
is NTG quick to progress?
no, progression tends to be slow
where does VF defects occur in NTG?
focal, deeper and central
in a patient with NTG, what region of the optic nerve rim tissue tends to be thinner?
inferiorly and inferiotemporally
what type of optic disc appearance do patients with NTG normally present with?
focal and senile sclerotic
what are the 5 types of glaucomatous classification for optic disc?
focal, myopic, senile sclerotic, concentric and advanced
what procedures are performed during a diagnostic evaluation of NTG?
repeated IOP measurements, gonioscopy, stereo optic disc images, medical history
in pigmentary glaucoma, where does the pigment tend to deposit?
corneal endothelium, trabecular meshwork, lens periphery, midperipheral transillumination defects
in PDS, which way does the iris bow? and towards what structure in particular?
concave bowing towards the zonular fibers
what demographic group is most likely to have PDS?
white males (ages 20-50)
what are 3 types of induced open angle lens?
phacolytics, lens particle, phacoanaphylaxis
what type of cataract leads to lens drop and leakage of proteins from the nucleus?
hypermature
(T/F) Phacolytic glaucoma causes flare with keratic precipitates?
False. (causes flare with out KPs)
what types of lens conditions cause moderate anterior chamber reactions and development of synechiae?
lens particle glaucoma and phacoanaphylaxis
what type of glaucoma may occur within weeks or years after cataract extraction?
lens particle glaucoma
what rare condition results in granulomatous inflammation and keratic precipitates?
phacoanaphylaxis
what can lead to unilateral chronic glaucoma?
ocular tumors
what types of tumors lead to secondary angle closure glaucoma?
choroidal melanomas and other retinal and choroidal tumors
what would edema of TM, blockage of TM, steroid induced reduction in aqueous outflow through TM endothelial cell dysfunction of TM lead too?
ocular inflammation and secondary open angle glaucoma.
what happens if episcleral pressure is high?
aqueous humor cannot flow out properly
what is the normal range of episcleral venous pressure?
8-10 mmHg
what can prolonged use of topical corticosteroids lead too?
primary open angle glaucoma
how long does a patient need to be taking steroids in order for IOP to spike?
2 weeks
what mechanism leads to steroids increasing IOP?
due to an increase resistance to aqueous outflow in TM
what other types of drugs may lead to glaucoma?
cycloplegic drugs and routine dilation in patients with open angles
what are the most common causes of neovascular glaucoma?
diabete mellitus and CRVO (central retinal vein occlusion)
what types of ICE (irido-corneal endothelial) syndromes can lead to glaucoma?
chandler syndrome, essential/progressive iris atrophy and iris nevus/ Cogan-Reese syndrome
what characteristic is common in ICE sydnrome?
PAS (peripheral anterior synechiae)
what percentage of ICE cases will go on to develop glaucoma?
50%
what type of glaucomatous disc classification is this?
advanced
what type of glaucomatous disc classification is this?
concentric
what type of glaucomatous disc classification is this?
focal
what type of glaucomatous disc classification is this?
myopic
what type of glaucomatous disc classification is this?
senile sclerotic
what does the picture represent and what layer of the cornea is being effected?
pigment deposits on corneal endothelium
what would be the body’s response to proteins that leak from this lens?
auto-immune
what does this picture represent and what can it lead too overtime?
angle recession in CB band. overtime this can cause scarring and further increase in IOP
which ICE syndrome is being depicted and what layer of the cornea is being affected by these “hammer-silver” findings?
Chandler. the hammer silver appearance represents endothelial changes
