Study of optic nerve head (ONH) and intra-ocular pressure (IOP) in pseudoexfoliation syndrome (PXS) patients Thesis prepared to get master’s degree in ophthalmology

Aim: to study the prevalence of glaucomatous injury in pseudoexfoliation patients, and the relation of these injuries with IOP values. Methods: 75 PXS eyes were compared with 75 age matched control eyes, and so 21 unilateral PXS patients were studied by comparing their two eyes. The study contained ONH study with Heidelberg Retina Tomograph (HRT), and mean and range of IOP values. Results: ONH parameters which were compared between patients and controls included: disk area, rim area, cup area, mean RNFL thickness, vertical cup\disk ratio, MRA result, and GPS result. The difference was significant in all these parameters between patients and controls, also it was significant in mean IOP and its fluctuation. For unilateral PXS patients, no statistically significant difference was found in ONH parameters between the two eyes, but there was in IOP mean and range. Conclusion: PXS eyes are at high risk for developing glaucomatous optic nerve injuries, which were more probable with raised IOP mean and range; the risk also involved the other normal eye in unilateral PXS, certaining the systemating nature of pseudo exfoliation disease.

Intraocular Pressure Reduction after Selective Laser Trabeculoplasty in Primary Open Angle Glaucoma

The aim of this clinical study was to investigate the intraocular pressure (IOP) reduction after selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG). The research has been done in Alassad Hospital, Tishreen university, Lattakia, from Feb 2009 to Feb 2011. Fifty eyes with uncontrolled POAG were treated with a frequency doubled, Q-switched Nd:YAG laser (532 nm).The pattern of treatment was applying approximately 50 burns to 180 degrees of the trabecular meshwork at energy levels ranging from 0.40– 0.92 mJ per pulse. After SLT eyes were maintained with the identical hypotensive medical therapy as that before treatment. IOP was measured before treatment, 1 and 7 days after treatment and 1, 3, 6 and 12 months after treatment. The mean pretreatment IOP was 22.48 (SD 1.84) mmHg. At the end of 1 month follow-up period the mean reduction of IOP was 4.86 mmHg (21.6%); after 3 months the mean reduction was 5.66 mmHg (25.2%); after 6 months the mean reduction of IOP was 5.06 mmHg (22.5%); at the end of 12 months follow-up period the mean reduction was 4.92 mmHg (21.9%). It can be concluded that SLT presents a new and effective method of IOP reduction in the treatment of POAG.