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Diagnostics
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Diagnosis and Management of Glaucoma
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Diagnosis and Management of Glaucoma

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 15595

Special Issue Editor

Dr. Antonio Ferreras

E-Mail Website
Guest Editor
Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Interests: eye
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Glaucoma is one of the leading causes of blindness all over the world. Primary open-angle glaucoma is the most common type of the disease, but other forms, such as pseudoexfoliative, pigmentary, inflammatory, traumatic, normotensive glaucoma or angle-closure glaucoma, are also frequently diagnosed in clinical practice.

New imaging technologies and improvements in psychophysical tests allow early glaucoma diagnosis and more accurate monitoring of the changes over time. Additionally, different medical and surgical approaches have been suggested to effectively treat the disease and reduce the risk of visual impairment.

Quality of life is directly related to the preservation of the visual field, particularly of the central area. Consequently, the correct management of glaucomatous patients is key from the first stage of the disease.

The aim of this Special Issue is to update the current knowledge regarding the diagnosis and treatment of all forms of glaucoma, with a special focus on the clinical point of view. We invite investigators to contribute with their original research as well as review articles related to this topic.

Dr. Antonio Ferreras
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (5 papers)

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Research

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9 pages, 2550 KiB  
Communication
Superpixel-Based Optic Nerve Head Segmentation Method of Fundus Images for Glaucoma Assessment
by Francisco J. Ávila, Juan M. Bueno and Laura Remón
Diagnostics 2022, 12(12), 3210; https://doi.org/10.3390/diagnostics12123210 - 17 Dec 2022
Cited by 2 | Viewed by 2624
Abstract
Glaucoma disease is the second leading cause of blindness in the world. This progressive ocular neuropathy is mainly caused by uncontrolled high intraocular pressure. Although there is still no cure, early detection and appropriate treatment can stop the disease progression to low vision [...] Read more.
Glaucoma disease is the second leading cause of blindness in the world. This progressive ocular neuropathy is mainly caused by uncontrolled high intraocular pressure. Although there is still no cure, early detection and appropriate treatment can stop the disease progression to low vision and blindness. In the clinical practice, the gold standard used by ophthalmologists for glaucoma diagnosis is fundus retinal imaging, in particular optic nerve head (ONH) subjective/manual examination. In this work, we propose an unsupervised superpixel-based method for the optic nerve head (ONH) segmentation. An automatic algorithm based on linear iterative clustering is used to compute an ellipse fitting for the automatic detection of the ONH contour. The tool has been tested using a public retinal fundus images dataset with medical expert ground truths of the ONH contour and validated with a classified (control vs. glaucoma eyes) database. Results showed that the automatic segmentation method provides similar results in ellipse fitting of the ONH that those obtained from the ground truth experts within the statistical range of inter-observation variability. Our method is a user-friendly available program that provides fast and reliable results for clinicians working on glaucoma screening using retinal fundus images. Full article
(This article belongs to the Special Issue Diagnosis and Management of Glaucoma)
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8 pages, 254 KiB  
Article
Association of Intraocular Pressure and Optical Coherence Tomography Angiography Parameters in Early Glaucoma Treatment
by Lan-Hsin Chuang, Ju-Hsien Li, Pei-Wei Huang, Henry S. L. Chen, Chun-Fu Liu, Ju-Wen Yang and Chi-Chun Lai
Diagnostics 2022, 12(9), 2174; https://doi.org/10.3390/diagnostics12092174 - 8 Sep 2022
Cited by 1 | Viewed by 1670
Abstract
This prospective study aimed to explore the effect of medical intraocular pressure (IOP) reduction on structural and capillary vessel density (VD) change by optical coherence tomography (OCT) angiography in early glaucoma. Patients with newly diagnosed glaucoma and a follow-up of ≥6 months were [...] Read more.
This prospective study aimed to explore the effect of medical intraocular pressure (IOP) reduction on structural and capillary vessel density (VD) change by optical coherence tomography (OCT) angiography in early glaucoma. Patients with newly diagnosed glaucoma and a follow-up of ≥6 months were enrolled. An ocular examination that included slit-lamp bio-microscopy, pneumatic tonometry, gonioscopy, standard automated perimetry, and OCT angiography was performed. Quantitative OCT angiography parameters were assessed using a linear mixed model that was adjusted for inter-eye correlation. The correlations between IOP changes and OCT angiography parameter changes were analyzed using Spearman’s correlation test. In total, 52 eyes of 36 participants, including 33 glaucoma eyes of 17 participants and 19 healthy eyes of 19 participants served as the case and control groups, respectively. The IOP of the case group decreased from a baseline mean of 20.4 ± 0.8 mmHg to 15.7 ± 0.5 mmHg at 3 months (p < 0.001) and to 16.1 ± 0.5 mmHg at 6 months (p < 0.001). For the subgroup with an IOP reduction of >20%, the deep macula VD was negatively correlated with baseline IOP and significantly decreased at 3 months follow-up. Additionally, change in retinal nerve fiber layer (RNFL) was positively correlated with a change in IOP at 6 months. In conclusion, the deep-layer macula VD was correlated with baseline IOP and influenced by the reduction in IOP in the short term. The changes in VD revealed the vulnerability of the deep vascular complex. The OCTA parameters provide in vivo monitoring information during medical treatment for early glaucoma. Full article
(This article belongs to the Special Issue Diagnosis and Management of Glaucoma)
11 pages, 610 KiB  
Article
Micropulse Transscleral Cyclophotocoagulation for Glaucoma after Penetrating Keratoplasty
by Mihail Zemba, Otilia-Maria Dumitrescu, Alina-Cristina Stamate, Ileana Ramona Barac, Calin Petru Tataru and Daniel Constantin Branisteanu
Diagnostics 2022, 12(5), 1143; https://doi.org/10.3390/diagnostics12051143 - 5 May 2022
Cited by 4 | Viewed by 1758
Abstract
The main objective of the article was to assess the surgical outcome of micropulse transscleral cyclophotocoagulation in patients presenting with glaucoma after penetrating keratoplasty. We conducted a retrospective study that included 26 eyes of 26 patients who presented with glaucoma after penetrating keratoplasty, [...] Read more.
The main objective of the article was to assess the surgical outcome of micropulse transscleral cyclophotocoagulation in patients presenting with glaucoma after penetrating keratoplasty. We conducted a retrospective study that included 26 eyes of 26 patients who presented with glaucoma after penetrating keratoplasty, and who were treated using micropulse transscleral cyclophotocoagulation between January 2017 and December 2020. The surgeries were performed using the Iridex Cyclo G6 MicroPulse P3 Probe. The intraocular pressure, mean number of antiglaucoma medications, visual acuity, corneal status, and postoperative complications were analyzed. The minimum follow-up period was 12 months. The success rate after 12 months was 76.9%. The baseline median intraocular pressure was 29 mm Hg and decreased to 18 mm Hg after 12 months. The median number of antiglaucoma medications was also reduced from three preoperatively to one after one year. In seven cases (29.92%), the visual acuity decreased and, in four cases (15.38%), the corneal graft was not transparent. We concluded that micropulse transscleral cyclophotocoagulation is an effective and safe method for the treatment of glaucoma after penetrating keratoplasty. Full article
(This article belongs to the Special Issue Diagnosis and Management of Glaucoma)
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Review

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11 pages, 269 KiB  
Review
Surgical Treatment in Silicone Oil-Associated Glaucoma
by Catalin Cornacel, Otilia-Maria Dumitrescu, Alexandra Catalina Zaharia, Ruxandra Angela Pirvulescu, Mihnea Munteanu, Calin Petru Tataru and Sinziana Istrate
Diagnostics 2022, 12(4), 1005; https://doi.org/10.3390/diagnostics12041005 - 16 Apr 2022
Cited by 5 | Viewed by 2826
Abstract
Glaucoma is a vision threatening, not uncommon complication of eyes that have undergone pars plana vitrectomy with silicone oil endotamponade. Although most patients respond well to medical antiglaucoma therapy, there are refractory cases where surgery is required to control the intraocular pressure. This [...] Read more.
Glaucoma is a vision threatening, not uncommon complication of eyes that have undergone pars plana vitrectomy with silicone oil endotamponade. Although most patients respond well to medical antiglaucoma therapy, there are refractory cases where surgery is required to control the intraocular pressure. This review, following a comprehensive literature search in the Medline database, aims to present the most important surgical techniques currently in use for glaucoma associated with silicone oil endotamponade and their indication depending on the mechanism of glaucoma. In cases of pupillary block, the presence of a patent iridotomy or iridectomy must be ensured, either by laser or surgically. When silicone oil is in excess and whenever the retinal status permits it, partial or complete removal of the silicone oil should be performed. Trabeculectomy has shown higher failure rates and more complications in these cases compared to other indications, so alternate methods are warranted. For very high intraocular pressures, glaucoma drainage devices and transscleral cyclophotocoagulation are the most used options, with good efficacy and safety profiles, although rarely they may have serious complications. The Ex-PRESS mini shunt has shown excellent results and lower rates of complications. For less important IOP elevations, minimally invasive glaucoma surgery and selective laser trabeculoplasty may be used, either alone or in conjunction with other methods. Full article
(This article belongs to the Special Issue Diagnosis and Management of Glaucoma)
23 pages, 2029 KiB  
Review
A Comprehensive Review of Methods and Equipment for Aiding Automatic Glaucoma Tracking
by José Camara, Alexandre Neto, Ivan Miguel Pires, María Vanessa Villasana, Eftim Zdravevski and António Cunha
Diagnostics 2022, 12(4), 935; https://doi.org/10.3390/diagnostics12040935 - 8 Apr 2022
Cited by 6 | Viewed by 5804
Abstract
Glaucoma is a chronic optic neuropathy characterized by irreversible damage to the retinal nerve fiber layer (RNFL), resulting in changes in the visual field (VC). Glaucoma screening is performed through a complete ophthalmological examination, using images of the optic papilla obtained in vivo [...] Read more.
Glaucoma is a chronic optic neuropathy characterized by irreversible damage to the retinal nerve fiber layer (RNFL), resulting in changes in the visual field (VC). Glaucoma screening is performed through a complete ophthalmological examination, using images of the optic papilla obtained in vivo for the evaluation of glaucomatous characteristics, eye pressure, and visual field. Identifying the glaucomatous papilla is quite important, as optical papillary images are considered the gold standard for tracking. Therefore, this article presents a review of the diagnostic methods used to identify the glaucomatous papilla through technology over the last five years. Based on the analyzed works, the current state-of-the-art methods are identified, the current challenges are analyzed, and the shortcomings of these methods are investigated, especially from the point of view of automation and independence in performing these measurements. Finally, the topics for future work and the challenges that need to be solved are proposed. Full article
(This article belongs to the Special Issue Diagnosis and Management of Glaucoma)
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