Authored by three prominent specialists in the field, this text provides comprehensive coverage of diagnostic and treatment modalities for optimal glaucoma management. Revised throughout, this new edition presents the latest guidance in clinical examination, randomized trials, medical treatment, laser therapy, and surgical procedures. Hundreds of illustrations-with many classic black and white figures from the previous editions supplemented with new color images-depict the features of glaucomas and step-by-step procedures for their management, while expanded use of highlighted boxes, lists, and summary tables make the material easy to access. Evidence-based and updated information on all aspects of the glaucomas-including physiology, genetics, interventional trials, and new surgical techniques-offer a well-rounded foundation of knowledge for making the most informed diagnoses and choosing the most effective course of treatment.Combines the cumulative experience of three prominent glaucoma specialists-addressing a full range of clinical needs for practitioners of all levels-for a uniquely written coherent perspective.Includes extensive references to current and historically important sources to provide comprehensive interpretation of the latest medical literature.Synthesizes a classical approach to the glaucomas-based on seven earlier editions spanning over 40 years-with the most up-to-date evidence-based and epidemiologically-derived classifications and outcomes.Coherently correlates with authoritative consensus documents on key areas of glaucoma, drawn up by the world-wide specialists of the World Glaucoma Association, and reprinted in the text.Revamps traditional teachings on the angle closure glaucomas, in concert with the newest international literature and technologies, to keep you up to date on the latest advances.Illustrates detailed surgical interventions applicable to the complete spectrum of clinical settings-from the developing world through contemporary operating rooms.Examines the newest and most promising developments in pharmacology, laser and surgical advances for glaucoma management, to enable you to choose the most effective patient approach.Illustrates invaluable but little-known instruments for clinical and research diagnoses, including optic nerve cupping scales, bleb assessment instruments, and more.
Author(s): Robert L. Stamper MD, Marc F. Lieberman MD, Michael V. Drake MD
Edition: 8
Publisher: Mosby
Year: 2009
Language: English
Pages: 576
Tags: Медицинские дисциплины;Офтальмология;
Copyright Page......Page 2
Foreword......Page 3
Preface......Page 4
List of Contributors......Page 5
Acknowledgments......Page 6
Dedication......Page 7
In Memorium......Page 8
EPIDEMIOLOGIC AND SOCIOECONOMIC ASPECTS OF THE GLAUCOMAS......Page 9
RISK FACTORS......Page 11
CLASSIFICATION OF THE GLAUCOMAS......Page 12
REFERENCES......Page 14
FUNCTION OF AQUEOUS HUMOR......Page 16
ULTRASTRUCTURE OF THE CILIARY PROCESSES......Page 17
VASCULAR SUPPLY......Page 19
ACTIVE TRANSPORT......Page 20
CHEMICAL COMPOSITION OF THE AQUEOUS HUMOR......Page 22
THE BLOOD–AQUEOUS BARRIER......Page 23
Tonography......Page 24
Paraminohippurate......Page 25
BLOOD FLOW TO THE CILIARY BODY......Page 26
HORMONAL EFFECTS......Page 27
PHARMACOLOGIC AGENTS......Page 28
REFERENCES......Page 29
FUNCTIONS OF THE CONVENTIONAL AQUEOUS OUTFLOW SYSTEM......Page 33
TRABECULAR MESHWORK TISSUES......Page 34
Uveal and corneoscleral meshwork ultrastructure......Page 35
Overview......Page 37
Distending cells that form invaginations or pseudovacuoles, ‘giant vacuoles’......Page 38
Schlemm’s canal endothelium pores......Page 39
Septa......Page 40
Herniations or protrusions of Schlemm’s canal inner wall......Page 41
JUXTACANALICULAR SPACE RESISTANCE......Page 42
TISSUE LOADING STUDIES......Page 43
BOUNDARY CONDITIONS......Page 44
THE AQUEOUS OUTFLOW SYSTEM AS A PASSIVE FILTER......Page 45
UVEOSCLERAL FLOW......Page 46
Perfusion......Page 47
FACTORS AFFECTING THE FACILITY OF OUTFLOW......Page 48
EPISCLERAL VENOUS PRESSURE......Page 49
REFERENCES......Page 50
Goldmann tonometer......Page 55
Pneumatic tonometer......Page 58
The Ocuton™ tonometer......Page 60
Schiøtz tonometer......Page 61
Impact–rebound tonometer......Page 63
DYNAMIC CONTOUR TONOMETRY......Page 64
SUMMARY OF TONOMETRY......Page 65
DISTRIBUTION OF INTRAOCULAR PRESSURE IN THE GENERAL POPULATION......Page 66
AGE......Page 67
CARDIOVASCULAR FACTORS......Page 68
PSYCHIATRIC DISORDERS......Page 69
SURGERY......Page 70
REFERENCES......Page 71
ANATOMIC FEATURES OF NORMAL EYES......Page 76
PUPIL AND IRIS......Page 77
SCLERAL SPUR......Page 78
SCHWALBE’S LINE......Page 79
REFERENCES......Page 80
Indirect gonioscopic lenses......Page 81
Indentation (compression) gonioscopy......Page 83
REFERENCES......Page 85
TRABECULAR PIGMENT BAND......Page 86
SPAETH CLASSIFICATION......Page 88
EXAMPLES......Page 89
DIFFICULTIES AND ARTIFACTS IN GONIOSCOPY......Page 90
USE OF DRUGS......Page 91
SUMMARY OF IMPORTANT GONIOSCOPIC TECHNIQUES......Page 92
APPENDIX......Page 93
TERMINOLOGY AND DEFINITIONS......Page 99
THEORY OF VISUAL FIELD TESTING......Page 100
STATIC PERIMETRY......Page 101
SCREENING TESTS......Page 102
THE FUTURE OF VISUAL FIELD TESTING......Page 103
COMBINED STATIC AND KINETIC PERIMETRY......Page 104
REFERENCES......Page 105
RELIABILITY......Page 106
MEDIA CLARITY......Page 107
BACKGROUND ILLUMINATION......Page 108
STIMULUS EXPOSURE TIME......Page 109
GENERAL PRINCIPLES......Page 110
Preparing the patient......Page 111
Technique of manual bowl (Goldmann) perimetry......Page 112
Technique of computerized bowl perimetry......Page 114
REFERENCES......Page 116
Generalized depression......Page 117
Nasal step or depression......Page 118
Isolated paracentral scotomata......Page 119
CHRONIC OPEN-ANGLE GLAUCOMA......Page 120
OTHER CAUSES......Page 123
Short-term fluctuation......Page 124
DETERMINATION OF NORMAL VISUAL FIELD......Page 127
Global indexes......Page 128
Localized variation within the visual field......Page 129
RECOGNITION OF CHANGE......Page 130
QUANTIFYING VISUAL FIELD CHANGE......Page 133
REFERENCES......Page 137
COLOR VISION AND SHORT-WAVELENGTH AUTOMATED PERIMETRY......Page 139
FREQUENCY-DOUBLING PERIMETRY......Page 142
HIGH-PASS RESOLUTION PERIMETRY......Page 144
The pattern electroretinogram (PERG)......Page 145
The multifocal visual-evoked potential (mfVEP)......Page 146
REFERENCES......Page 148
MECHANISMS OF GLAUCOMATOUSOPTIC NEUROPATHY......Page 151
WHERE ARE THE GANGLION CELLS INJURED?......Page 152
WHAT INJURES GANGLION CELLS?......Page 153
Connective tissue structures within the optic nerve head......Page 154
Vascular nutrition of the optic disc......Page 156
REFERENCES......Page 158
CLINICAL TECHNIQUES OF EVALUATION......Page 162
Optic disc size......Page 164
Neuroretinal rim shape......Page 165
Optic cup configuration and depth......Page 166
Position of central retinal vessels and branches......Page 167
Optic disc hemorrhages......Page 168
Nerve fiber layer defects......Page 169
Peripapillary choroidal atrophy......Page 170
HIGH MYOPIA DISC PATTERN......Page 171
FOCAL NORMAL-PRESSURE PATTERN (FOCAL ISCHEMIC)......Page 174
PRIMARY OPEN-ANGLE GLAUCOMA PATTERN (GENERALIZED ENLARGEMENT)......Page 175
REFERENCES......Page 176
HEIDELBERG RETINA TOMOGRAPHY (HRT)......Page 179
Components of the HRT report......Page 181
OPTICAL COHERENCE TOMOGRAPHY (OCT)......Page 183
Macular scan......Page 185
RNFL thickness average analysis......Page 186
Macular analysis......Page 187
QUALITY ASSESSMENT......Page 188
TESTING FROM THE PATIENT’S PERSPECTIVE......Page 189
LONGITUDINAL EVALUATIONS......Page 190
GDX......Page 191
Strengths and limitations......Page 192
CONCLUSIONS......Page 193
REFERENCES......Page 195
CLASSIFICATIONS OF ANGLE-CLOSURE DISEASE......Page 196
CLARIFICATIONS AND COMMENTARY......Page 197
NEW IMAGING TECHNOLOGIES......Page 199
PUPILLARY BLOCK GLAUCOMA......Page 200
Age......Page 201
Iris bowing and lens–iris channel......Page 202
Provocative tests......Page 204
Clinical examination......Page 205
Medical management of acute PACG......Page 207
Slit-lamp maneuvers in management of acute PACG......Page 208
Laser interventions for acute PACG......Page 209
Management of the fellow eye......Page 210
Correlating older and newer terminologies for angle closure......Page 211
Plateau iris configuration......Page 212
Plateau iris syndrome......Page 213
Intumescent and swollen lens......Page 214
REFERENCES......Page 215
NEOVASCULAR GLAUCOMA......Page 220
Pathogenesis......Page 221
Diabetes mellitus......Page 222
Ocular ischemic syndrome......Page 223
Clinical presentation......Page 224
Treatment......Page 225
Clinical presentation......Page 226
Cogan-Reese syndrome......Page 227
Pathophysiology......Page 228
Treatment......Page 229
INFLAMMATION......Page 230
PENETRATING KERATOPLASTY......Page 231
CILIARY BLOCK GLAUCOMA (AQUEOUS MISDIRECTION OR MALIGNANT GLAUCOMA)......Page 232
INTRAOCULAR TUMORS......Page 233
NANOPHTHALMOS......Page 234
Treatment......Page 235
SCLERAL BUCKLING PROCEDURE......Page 236
Secondary pupillary block glaucoma: iris–lens adhesions......Page 237
Microspherophakia......Page 239
REFERENCES......Page 240
PREVALENCE......Page 247
DIMINISHED AQUEOUS HUMOR OUTFLOW FACILITY......Page 251
Altered corticosteroid metabolism......Page 252
OPTIC NERVE CUPPING AND ATROPHY......Page 253
FINDINGS......Page 254
GOALS......Page 255
TYPES OF TREATMENT......Page 256
PROGNOSIS......Page 257
THE GLAUCOMA SUSPECT AND OCULAR HYPERTENSION......Page 258
EPIDEMIOLOGY OF OCULAR HYPERTENSION......Page 259
RISK FACTORS FOR DEVELOPMENT OF OPEN-ANGLE GLAUCOMA......Page 260
TREATMENT......Page 262
PATHOGENESIS......Page 263
DIFFERENTIAL DIAGNOSIS......Page 264
TREATMENT......Page 265
REFERENCES......Page 266
PIGMENTARY GLAUCOMA......Page 274
EXFOLIATION SYNDROME (PSEUDOEXFOLIATION SYNDROME)......Page 277
CORTICOSTEROID GLAUCOMA......Page 278
LENS-INDUCED GLAUCOMA......Page 279
PHACOLYTIC GLAUCOMA......Page 280
GLAUCOMA AFTER CATARACT SURGERY......Page 281
GLAUCOMA FROM VISCOELASTIC SUBSTANCES......Page 282
GLAUCOMA AFTER NEODYMIUM:YTTRIUM-ALUMINUM-GARNET LASER POSTERIOR CAPSULOTOMY......Page 283
CHEMICAL BURNS......Page 284
CONTUSION INJURIES......Page 285
GHOST-CELL GLAUCOMA......Page 286
HYPHEMA......Page 287
RETINAL DETACHMENT AND GLAUCOMA......Page 288
GLAUCOMA WITH UVEITIS......Page 289
GLAUCOMATOCYCLITIC CRISIS......Page 290
INTRAOCULAR TUMORS AND GLAUCOMA......Page 291
ELEVATED EPISCLERAL VENOUS PRESSURE......Page 292
ARTERIOVENOUS FISTULAS......Page 293
IDIOPATHIC ELEVATIONS......Page 294
REFERENCES......Page 295
SYNDROME CLASSIFICATION......Page 302
Isolated trabeculodysgenesis......Page 303
Anterior stromal defects......Page 305
Corneodysgenesis......Page 306
Office examination......Page 307
Intraocular pressure measurement......Page 308
Corneal measurements: diameter and central thickness......Page 309
Axial length measurement......Page 310
Ophthalmoscopy......Page 311
GENETICS AND HEREDITY......Page 312
PATHOPHYSIOLOGY......Page 313
Other causes of corneal enlargement or clouding......Page 314
Other causes of epiphora or photophobia......Page 315
MANAGEMENT......Page 316
Initial surgery......Page 317
Long-term follow-up, management, and prognosis......Page 318
DEVELOPMENTAL GLAUCOMA WITH ANOMALOUS SUPERFICIAL IRIS VESSELS......Page 319
ANIRIDIA......Page 320
STURGE-WEBER SYNDROME (ENCEPHALOFACIAL ANGIOMATOSIS, ENCEPHALOTRIGEMINAL ANGIOMATOSIS)......Page 321
NEUROFIBROMATOSIS (VON RECKLINGHAUSEN’S DISEASE)......Page 322
Rieger’s anomaly and syndrome......Page 324
PETER’S ANOMALY......Page 326
CHROMOSOME ABNORMALITIES......Page 327
PERSISTENT FETAL VASCULATURE (PERSISTENT HYPERPLASITIC PRIMARY VITREOUS)......Page 328
Aphakic pediatric glaucoma......Page 329
Weill-Marchesani and GEMSS syndromes......Page 330
INFLAMMATION......Page 331
REFERENCES......Page 332
NTRODUCTION......Page 338
PRIMARY OPEN-ANGLE, NORMAL-TENSION, AND JUVENILE-ONSET OPEN-ANGLE GLAUCOMA......Page 339
TIGR/MYOCILIN......Page 340
OPTINEURIN......Page 341
EXFOLIATION SYNDROME AND GLAUCOMA......Page 342
AXENFELD-RIEGER ANOMALY......Page 343
REFERENCES......Page 344
SYMPTOMS AND HISTORICAL INFORMATION RELATED TO THE GLACOMAS......Page 347
IDENTIFYING GLAUCOMA SUSPECTS......Page 348
DETERMINING ADEQUACY OF TREATMENT......Page 349
TREATMENT FOLLOW-UP......Page 350
PATIENT EDUCATION......Page 351
REFERENCES......Page 352
TARGET PRESSURE......Page 353
ADVANTAGES......Page 354
BASIC PHARMACOLOGY......Page 355
CORNEAL BARRIERS......Page 356
DRUG FORMULATION......Page 357
COMPLIANCE......Page 358
ADJUST THE TREATMENT PROGRAM TO THE PATIENT AND HIS OR HER LIFESTYLE......Page 359
INITIATE OR CHANGE THERAPY THROUGHA THERAPEUTIC TRIAL IN ONE EYE......Page 360
WHEN THERAPY IS INEFFECTIVE, SUBSTITUTE RATHER THAN ADD DRUGS......Page 361
TEACH PATIENTS THE PROPER TECHNIQUE FOR INSTILLING EYEDROPS......Page 362
RECOMMEND COMPARISON SHOPPING FOR MEDICATIONS......Page 363
REFERENCES......Page 364
MECHANISM OF ACTION......Page 367
LATANOPROST (XALATAN, PHXA41)......Page 369
ISOPROPYL UNOPROSTONE (UF-021,RESCULA™)......Page 371
SIDE EFFECTS......Page 372
SUGGESTIONS FOR USE......Page 376
REFERENCES......Page 379
The adrenergic system and adrenergic agonists......Page 384
EPINEPHRINE......Page 385
Clonidine......Page 386
MONOAMINE OXIDASE AND CATECHOL O-METHYLTRANSFERASE INHIBITORS......Page 388
Epinephrine (Eppy, Epinal, Epifrin, and generics)......Page 389
Suggestions for use......Page 390
Side effects......Page 391
Laser iridotomy......Page 393
Side effects......Page 394
REFERENCES......Page 395
MECHANISM OF ACTION......Page 400
TIMOLOL MALEATE......Page 401
LEVOBUNOLOL......Page 403
NADOLOL......Page 404
SECONDARY GLAUCOMA......Page 405
BLOOD FLOW AND NEUROPROTECTION......Page 406
OCULAR......Page 407
SYSTEMIC......Page 408
Thymoxamine......Page 409
REFERENCES......Page 410
DIRECT EFFECT ON AQUEOUS HUMOR FORMATION......Page 415
TOPICAL CARBONIC ANHYDRASE INHIBITORS......Page 416
Brinzolamide......Page 417
Methazolamide......Page 418
TOPICAL CARBONIC ANHYDRASE INHIBITORS......Page 419
CONTRAINDICATIONS......Page 420
Other severe symptoms......Page 421
SUGGESTIONS FOR USE......Page 422
OTHER USES......Page 423
REFERENCES......Page 424
ANGLE-CLOSURE GLAUCOMA......Page 428
DRUGS IN CLINICAL USE......Page 429
Pilocarpine......Page 430
Methacholine (Mecholyl)......Page 431
Neostigmine (prostigmine)......Page 432
OCULAR......Page 433
EXAMINATION......Page 435
REFERENCES......Page 436
DRUGS IN CLINICAL USE......Page 439
INTRAVENOUS AGENTS......Page 440
SUGGESTIONS FOR CLINICAL USE......Page 441
REFERENCES......Page 442
PHOTODISRUPTION......Page 444
BASIC LASER SAFETY......Page 445
REFERENCES......Page 446
TYPES OF LASER......Page 447
ND:YAG LASER IRIDOTOMY......Page 448
LIGHT BROWN IRIS......Page 449
Pressure elevation......Page 450
Endothelial damage......Page 451
PLATEAU IRIS......Page 452
REFERENCES......Page 453
RESULTS......Page 455
Mechanism......Page 456
Procedure......Page 457
POSTOPERATIVE TREATMENT......Page 458
Intraocular pressure elevation......Page 459
Technique......Page 460
OTHER LASER SCLEROSTOMY TECHNIQUES......Page 461
REFERENCES......Page 462
CYCLOPHOTOCOAGULATION......Page 464
OTHER LASER PROCEDURES......Page 465
REOPENING FAILED FILTRATION SITES......Page 466
LASER SYNECHIALYSIS......Page 467
REFERENCES......Page 468
INSTRUCTIONS TO THE PATIENT......Page 470
THE OPERATING ROOM......Page 471
ACTIVITY......Page 472
REFERENCES......Page 473
EXTERNAL FILTRATION SURGERY......Page 474
LIMBUS-BASED FLAP......Page 475
FORNIX-BASED FLAP......Page 476
TRABECULECTOMY......Page 478
Standard technique......Page 479
Moorfields Safer Surgery System technique......Page 481
Results......Page 483
Postoperative lasering, adjustment, or release of sutures......Page 485
THERMAL SCLEROSTOMY (SCHEIE PROCEDURE)......Page 488
THE MOLTENO IMPLANT......Page 489
Techniques......Page 490
KRUPIN VALVE AND EX-PRESS IMPLANT......Page 491
AHMED VALVE......Page 492
RESULTS AND COMPLICATIONS OF DRAINAGE DEVICES......Page 493
REFERENCES......Page 495
TYPES OF GLAUCOMA AND THEIR INFLUENCE ON CATARACT MANAGEMENT......Page 499
SELECTING THE APPROPRIATE SURGICAL APPROACH......Page 500
SELECTING THE APPROPRIATE PROCEDURE: HISTORICAL CONSIDERATIONS......Page 501
Incision sites......Page 502
Scleral flap......Page 503
Antimetabolite use......Page 504
Postoperative medical management......Page 506
Miotic pupil......Page 507
Incision construction......Page 509
CATARACT SURGERY WITH PRE-EXISTING FILTRATION BLEB......Page 511
REFERENCES......Page 512
FLAT ANTERIOR CHAMBER WITH HYPOTONY......Page 516
CILIARY BLOCK (MALIGNANT GLAUCOMA)......Page 521
SUPRACHOROIDAL HEMORRHAGE (SCH)......Page 522
INTRAOPERATIVE FLAT ANTERIOR CHAMBER......Page 523
INTRAOCULAR INFECTION......Page 524
DIGITAL PRESSURE......Page 525
RETAINED VISCOELASTIC MATERIAL......Page 526
ENCAPSULATED BLEB......Page 527
Slit-lamp or minor surgery setting......Page 528
BLEB COMPLICATIONS AND MANAGEMENT......Page 529
THIN-WALLED BLEBS......Page 530
OVERFUNCTIONING BLEBS......Page 533
LATE HYPOTONY AFTER FILTERING SURGERY......Page 535
HYPOTONY FROM IRITIS OR ISCHEMIA......Page 536
REFERENCES......Page 537
Intraoperative procedures......Page 540
TRABECULOTOMY AB EXTERNO......Page 543
COMBINED TRABECULOTOMY AND TRABECULECTOMY......Page 546
Cyclocryotherapy......Page 547
REFERENCES......Page 548
VISCOCANALOSTOMY......Page 550
BYPASS INTRASCLERAL CHANNELS (NON-PENETRATING DEEP SCLERECTOMY)......Page 552
SHUNTS INTO SCHLEMM’S CANAL......Page 554
SHUNTS INTO THE SUPRACHOROIDAL SPACE......Page 555
REFERENCES......Page 556
PATHOPHYSIOLOGY......Page 558
TREATMENT......Page 559
REFERENCES......Page 560
Structure......Page 561
Argon laser trabeculoplasty......Page 562
Combined cataract/trabeculectomy......Page 563
Comparison of cyclophotocoagulation and glaucoma drainage device implantation......Page 564
Laser and medical treatment of primary angle-closure glaucoma......Page 565
Measurement of intraocular pressure......Page 566
Epidemiology of intraocular pressure......Page 567
Target intraocular pressure in clinical practice......Page 568
A......Page 569
C
......Page 570
G
......Page 571
L
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P
......Page 573
S
......Page 574
V
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Z
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