Hypotony as a Hazard of Trabeculectomy with Mitomycin C

An eighty two year old Caucasian lady with primary open angle glaucoma attended eye clinic. She was using guttate latanoprost 50 g/ml, Brimonidine 2 mg/ml and combined Dorzolamide 20 g/ml and Timolol 5 mg/ml.

This lady was myopic with right eye manifest refraction spherical equivalent of -2.00 and left eye manifest refraction spherical equivalent of -8.00 dioptres. The left eye was amblyopic as a result of this anisometropia. This lady had had bilateral uncomplicated cataract extractions by phacoemulsification with intraocular lens implantation and subsequently bilateral neodymium yttrium aluminium garnet or Nd: YAG laser posterior capsulotomies.

This patient had a medical history of pulmonary tuberculosis and pulmonary fibrosis. She also had aortic valve regurgitation and osteoarthritis. Her regular medications were Digoxin 125 μg, Bumetanide 1mg and Lisinopril 1mg daily. She utilized supplementary oxygen for 16 hours daily.

Cornelia de Lange Syndrome with Congenital Glaucoma

Cornelia De Lange syndrome (CDLS), also known as Brachmann de Lange syndrome is a rare syndrome. It is characterised by distinctive facial dysmorphism, growth retardation,developmental delay, upper limb reduction defects, gastroesophageal dysfunction, ophthalmologic and genitourinary anomalies, hirsutism, pyloricstenosis, congenital diaphragmatic hernias, cardiac septal defects, and hearing loss. The syndrome was first described by a Dutch paediatrician named Cornelia de Lange, in 1933.

Though the genetic basis of this syndrome is not clear, a majority of cases are due to spontaneous mutations. The defective gene can be inherited from either parent, making it autosomal dominant type of inheritance.

Synophrys, long curled lashes, myopia, and hypertrichosis of the brows. These patients have also been found to have ptosis, epiphora, nasolacrimal duct obstruction, and micro cornea, congenitalglaucoma, corneal opacities, iris heterochromia and optic nerve head pallor/atrophy.

Higher Axial Length and Flatter Cornea in Primary Open Angle Glaucoma than in the Age Related Glaucoma Cases

Glaucoma is a leading cause for the blindness globally and 79.6% millions might be affected by Open Angle Glaucoma (OAG) and Angle Closure Glaucoma (ACG) by the year 2020. 74% of these patients may be diagnosed OAG and 47% of the Asian population are affected by it. A study among the 209 patients revealed higher axial length and flatter Cornea among the patients affected by POAG than the age-matched control group.

Download PDF

Changes in BDNF and MAPK Signalling Pathways in Experimental Glaucoma

Glaucoma is currently recognized to be a multifactorial, progressive, neurodegenerative disorder. It is characterized by the retinal ganglion cells (RGCs) loss of axons as well as optic nerve atrophy, progressive degeneration of RGCs till cell death. In this work, we used DBA/2J mice as a model of spontaneous glaucoma and we investigated the involvement of BDNF and Mitogen-Activated Protein Kinases (MAPK) pathways in correlation with IOP elevation and progression of neurodegenerative processes in the retina of DBA/2J mice. 

In particular, we performed western blot analysis to study retinal levels of the BDNF and its receptor, TrkB, and to better understand possible modulation of p38 MAPK and ERK1/2 activation at different stages of retinal degeneration in DBA/2J mice. We showed that BDNF starts to decrease already at an early stage in correspondence to IOP elevation (7 months of age). MAPKs, in particular p38 MAPK and ERK1/2, appeared maximally affected at more advanced stages of neuro degeneration (10-12 and 18 months of age) characterized by RGC degeneration and death, optic nerve atrophy. Thus, BDNF signaling and MAPKs are differentially activated at different stages of retinal degeneration in DBA/2J mice, a murine model of glaucoma.a