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Glaucoma is one of the leading causes of blindness worldwide that is a chronic public health problem. Unfortunately, glaucoma can be diagnosed when the disease reaches a certain level in today's conditions. The aim of this study was to investigate the diagnostic methods that can diagnose glaucoma before it reaches the advanced level and to identify pathophysiological processes. In this study, choroidal thickness was investigated in primary open-angle glaucoma cases and its correlations with OCT and multifocal ERG parameters were evaluated.
In this study, patients with primary open-angle glaucoma who have recently received a new diagnosis with healthy volunteers with age-matched groups were enrolled. All data from 49 glaucoma patients and 47 healthy volunteers were recorded and the study was completed. The study was carried out at the Afyon Kocatepe University Ophthalmology Department between January 2014 and April 2015. Routine ophthalmologic examinations of all participants were performed. Medical treatment was initiated on patients diagnosed with primary open-angle glaucoma. Intraocular pressures and visual acuities of all participants were recorded at baseline, at 1-month, at 3-month, and at 6-month. All participants underwent tests of multifocal electroretinography and the measurements of optic nerve head optical coherence tomography parameters and the choroidal thickness, at the same follow-ups. Visual acuities were measured by using the Snellen chart as the best corrected visual acuity. Intraocular pressures were measured by using applanation tonometry. Choroid thicknesses were also measured and recorded using EDI-OCT mode of optical coherence tomography device (Cirrus HD 4000, Carl Zeiss Meditec AG, Germany). Choroidal thicknesses were measured in three regions: fovea, 3mm nasal and temporal distances of the fovea. The mean of these three measurements was recorded as macular choroidal thickness. The same technician performed all multifocal electroretinography tests of the participants (Metrovision Monpack 3, Metrovision, France). Multifocal electroretinography tests were carried out from a distance of 33 cm using ERG-jet electrode, ground electrode, and a reference electrode. Electrical potential responses from 103 retina regions were recorded. Results were compared statistically and correlations were analyzed (SPSS 20.0, SPSS Inc. IL, USA).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary open-angle glaucoma | Experimental | Participants over 40 years of age and diagnosed with primary open-angle glaucoma. Medical treatment was initiated for the diagnosed participants. |
|
| Healthy | No Intervention | Healthy volunteers who do not have systemic disease that may affect the choroidal thickness and have no ocular features that may affect test measurements. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Brimonidine Tartrate | Drug | Brimonidine tartrate 0.15% 1 eye drop, every day for 6-months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Macular choroidal thickness measure | Measuring macular choroidal thickness at baseline, at 1-month, at 3-month and at 6-month by using optical coherence tomography | Baseline, 1-month, 3-month, 6-month |
| Changes in multifocal electroretinography parameters (Amplitudes [nv/deg2] and impulse times [ms] of N1, N2 and P1 waves in Ring-1, Ring-2, Ring-3 and Ring-4) | Comparison of the mean multifocal electroretinography parameters (Amplitudes [nv/deg2] and impulse times [ms] of N1, N2 and P1 waves in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in amplitudes of N1 wave in Ring-1, Ring-2, Ring-3 and Ring-4 [nv/deg2] | Comparison of the mean amplitudes of N1 wave [nv/deg2] in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in amplitudes of N2 wave in Ring-1, Ring-2, Ring-3 and Ring-4 [nv/deg2] | Comparison of the mean amplitudes of N2 wave [nv/deg2] in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in amplitudes of P1 wave in Ring-1, Ring-2, Ring-3 and Ring-4 [nv/deg2] | Comparison of the mean amplitudes of P1 wave [nv/deg2] in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in impulse times of N1 wave in Ring-1, Ring-2, Ring-3 and Ring-4 [ms] |
| Measure | Description | Time Frame |
|---|---|---|
| Best-corrected visual acuity measure | Comparison of the mean best-corrected visual acuities at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Intraocular pressure measure |
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Inclusion Criteria for the glaucoma group:
Exclusion Criteria for the glaucoma group:
Inclusion Criteria for the healthy group:
Exclusion Criteria for the healthy group:
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Aug 11, 2020 | |
| Reset | Aug 26, 2020 |
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prospective controlled clinical trial
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| Dorzolamide (as Dorzolamide Hydrochloride) 20 Mg/mL and Timolol (as Timolol Maleate) 5 Mg/mL Eye Drops | Drug | Dorzolamide and timolol fixed combination 2 eye drops, every day for 6 months |
|
|
| Brinzolamide/Timolol 10 MG/1 ML-5 MG/1 ML Ophthalmic Suspension | Drug | Brinzolamide and timolol fixed combination 2 eye drops, every day for 6 months |
|
|
| Travoprost and Timolol | Drug | Travoprost and Timolol fixed combination 1 eye drop, every day for 6 months |
|
|
| Bimatoprost and Timolol | Drug | Bimatoprost and Timolol fixed combination 1 eye drop, every day for 6 months |
|
|
| Latanoprost | Drug | Latanoprost 0.005% 1 eye drop, every day for 6 months |
|
|
Comparison of the mean impulse times of N1 wave [ms] in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month
| Baseline, 1-month, 3-month, 6-month |
| Changes in impulse times of P1 wave in Ring-1, Ring-2, Ring-3 and Ring-4 [ms] | Comparison of the mean impulse times of P1 wave [ms] in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in P1/N1 ratio of N2 wave in Ring-1, Ring-2, Ring-3 and Ring-4 | Comparison of the mean P1/N1 ratios of N2 wave in Ring-1, Ring-2, Ring-3 and Ring-4) at baseline, at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean optic nerve head optical coherence tomography parameters (Retinal nerve fiber layer thickness [micrometers], disc area [mm2], cup-to-disc ratios, cup volume [mm3], neuroretinal rim area [mm2]) | Measuring optic nerve head optical coherence tomography parameters (Retinal nerve fiber layer thickness [micrometers], disc area [mm2], cup-to-disc ratios, cup volume [mm3], neuroretinal rim area [mm2]) at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean neuroretinal rim area [mm2]) | Measuring neuroretinal rim area [mm2] at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean cup volume [mm3] | Measuring cup volume [mm3] at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean cup-to-disc ratios | Measuring cup-to-disc ratios at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean disc area [mm2] | Measuring disc area [mm2] at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
| Changes in the mean retinal nerve fiber layer thickness [micrometers] | Measuring retinal nerve fiber layer thicknesses [micrometers] at 1-month, at 3-month and at 6-month | Baseline, 1-month, 3-month, 6-month |
Measuring intraocular pressure at 1-month, at 3-month and at 6-month
| Baseline, 1-month, 3-month, 6-month |
| Correlations between choroidal thickness and other parameters | Analyze correlations between changes of choroidal thicknesses and changes of other parameters during the study. | Baseline, 6-month |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Aug 11, 2020 | Aug 26, 2020 |
| ID | Term |
|---|---|
| D005902 | Glaucoma, Open-Angle |
| ID | Term |
|---|---|
| D005901 | Glaucoma |
| D009798 | Ocular Hypertension |
| D005128 | Eye Diseases |
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| ID | Term |
|---|---|
| D000068438 | Brimonidine Tartrate |
| C062765 | dorzolamide |
| D013999 | Timolol |
| D009883 | Ophthalmic Solutions |
| C111827 | brinzolamide |
| C571754 | Duotrav |
| D000069557 | Travoprost |
| C571755 | Ganfort |
| D000069580 | Bimatoprost |
| D000077338 | Latanoprost |
| ID | Term |
|---|---|
| D011810 | Quinoxalines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D011412 | Propanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D020005 | Propanols |
| D000588 | Amines |
| D013830 | Thiadiazoles |
| D013844 | Thiazoles |
| D013457 | Sulfur Compounds |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D009025 | Morpholines |
| D010078 | Oxazines |
| D019999 | Pharmaceutical Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
| D045506 | Therapeutic Uses |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D020313 | Specialty Uses of Chemicals |
| D003008 | Cloprostenol |
| D011461 | Prostaglandins F, Synthetic |
| D011465 | Prostaglandins, Synthetic |
| D011453 | Prostaglandins |
| D015777 | Eicosanoids |
| D005231 | Fatty Acids, Unsaturated |
| D005227 | Fatty Acids |
| D008055 | Lipids |
| D012898 | Autacoids |
| D018836 | Inflammation Mediators |
| D001685 | Biological Factors |
| D000577 | Amides |
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