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Læknablaðið - apr. 2020, Síða 23

Læknablaðið - apr. 2020, Síða 23
LÆKNAblaðið 2020/106 191 R A N N S Ó K N með, virðist meðferðin einstaklingsmiðuð og helsta ábending aðgerðar var versnun á sjónsviði þrátt fyrir lyfjameðferð. Meðal- tal sjónsviðsskerðingar reyndist hærra í okkar rannsókn en í er- lendum samanburðarrannsóknum og tæplega 80% augna höfðu miðlungs eða alvarlega sjónsviðsskerðingu í viðkomandi auga. Sjúklingar með alvarlega sjónsviðsskerðingu höfðu að meðaltali lægri augnþrýsting og þynnri hornhimnu samanborið við sjúk- linga með milda og miðlungsalvarlega sjónsviðsskerðingu. Þetta getur bent til þess að mikil áhersla sé lögð á háan augnþrýsting sem ábendingu fyrir aðgerðarþörf en ef til vill of lítil áhersla lögð á sjónsviðsskerðingu, útlit sjóntaugar og þunna hornhimnu. Lágt hlutfall augna með lágþrýstingsgláku kann að benda til hins sama. Þessar niðurstöður benda til þess að sjúklingar með alvarlega sjón- sviðsskerðingu gætu haft hag af því að undirgangast skurðaðgerð fyrr með það að markmiði að hindra alvarlega og óafturkræfa sjón- sviðsskerðingu. Þakkir Höfundar þakka vísindasjóði Landspítala fyrir veittan fjárstyrk til rannsóknarinnar. Húnbogi Þorsteinsson fær þakkir fyrir yfirlestur greinarinnar og góðar ábendingar. Greinin barst til blaðsins 9. janúar 2020, samþykkt til birtingar 18. mars 2020. 1. Björnsson G. Prevalence and causes of blindness in Iceland. With special reference to glaucoma simplex. Am J Ophthalmol 1955; 39: 202-8. 2. Gunnlaugsdottir E, Arnarsson A, Jonasson F. Prevalence and causes of visual impairment and blindness in Icelanders aged 50 years and older: The Reykjavik Eye Study. Acta Ophthalmol 2008; 86: 778-85. 3. Leske MC, Heijl A, Hyman L, Bengtsson B, Dong LM, Yang Z. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology 2007; 114: 1965- 72. 4. Bertrand V, Fieuws S, Stalmans I, Zeyen T. Rates of visual field loss before and after trabeculectomy. Acta Ophthalmol 2014; 92: 116-20. 5. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS investigators. Am J Ophthalmol 2000; 130: 429-40. 6. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, et al. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 2002; 120: 1268-79. 7. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative Normal-Tension Glaucoma Study Group. Am J Ophthalmol 1998. 8. National Institute for Health and Care Excellence. Glaucoma: diagnosis and management | Guidance and guidelines | NICE. NICE NG81. 2017. 9. Boland MV, Ervin AM, Friedman DS, Jampel HD, Hawkins BS, Vollenweider D, et al. Comparative effectiveness of treatments for open-angle glaucoma: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2013; 158: 271-9. 10. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK; CIGTS Study Investigators. Visual field progression in the Collaborative Initial Glaucoma Treatment Study the impact of treatment and other baseline factors. Ophthalmology 2009; 116: 200-7. 11. Foulsham WS, Fu L, Tatham AJ. Prior rates of visual field loss and lifetime risk of blindness in glaucomatous patients undergoing trabeculectomy. Eye (Lond) 2015; 29: 1353-9. 12. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study compar- ing initial treatment randomized to medications or sur- gery. Ophthalmology 2001; 108: 1943-53. 13. European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 3: Treatment princip- les and options Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 3 Treatment principles and options. Br J Ophthalmol 2017; 101: 130-95. 14. Baril C, Vianna JR, Shuba LM, Rafuse PE, Chauhan BC, Nicolela MT. Rates of glaucomatous visual field change after trabeculectomy. Br J Ophthalmol 2017; 101: 874-8. 15. Junoy Montolio FG, Müskens RPHM, Jansonius NM. Influence of glaucoma surgery on visual function: a clinical cohort study and meta-analysis. Acta Ophthalmol 2019; 97: 193-9. 16. Jiang L, Eaves S, Dhillon N, Ranjit P. Postoperative outcomes following trabeculectomy and nonpenetrating surgical procedures: a 5-year longitudinal study. Clin Ophthalmol 2018; 12: 995-1002. 17. Rowe F. Perimetry Comparisons for Octopus G Top and Dynamic Programmes versus Humphrey 24-2 SITA Fast and SITA Standard Programmes. Ophthalmol Res An Int J 2013; 2: 24-42. 18. Chen PP, Budenz DL. The effects of cataract extraction on the visual field of eyes with chronic open-angle glaucoma. Am J Ophthalmol 1998; 125: 325-33. 19. Jonasson F, Damji KF, Arnarsson A, Sverrisson T, Wang L, Sasaki H, et al. Prevalence of open-angle glaucoma in Iceland: Reykjavik Eye Study. Eye (Lond) 2003; 17: 747-53. 20. Jonasson F, Arnarsson A, Eysteinsson T. The Reykjavik Eye Study on Prevalence of Glaucoma in Iceland and IdentifiedRisk Factors. Tombran-Tink J, Barnstable CJ, Shield MB Mech Glaucomas Ophthalmol Res Humana Press. 2008. 21. Ritch R, Schlötzer-Schrehardt U, Konstas AGP. Why is glaucoma associated with exfoliation syndrome? Prog Retin Eye Res 2003; 22: 253-75. 22. Arnarsson A, Damji KF, Sverrisson T, Sasaki H, Jonasson F. Pseudoexfoliation in the Reykjavik Eye Study: prevalence and related ophthalmological variables. Acta Ophthalmol Scand 2007; 85: 822-7. 23. Forsius H. Prevalence of pseudoexfoliation of the lens in Finns, Lapps, Icelanders, Eskimos, and Russians. Trans Ophthalmol Soc U K 1980; 99: 296-8. 24. Heijl A, Bengtsson B, Hyman L, Leske MC, Early Manifest Glaucoma Trial Group. Natural history of open-angle glaucoma. Ophthalmology 2009; 116: 2271-6. 25. Desai MA, Lee RK. The medical and surgical management of pseudoexfoliation glaucoma. Int Ophthalmol Clin 2008; 48: 95-113. 26. Konstas AG, Stewart WC, Stroman GA, Sine CS. Clinical presentation and initial treatment patterns in patients with exfoliation glaucoma versus primary open-angle glaucoma. Ophthalmic Surg Lasers 1997; 28: 111-7. 27. King AJ, Stead RE, Rotchford AP. Treating patients pres- enting with advanced glaucoma - should we reconsider current practice? Br J Ophthalmol 2011; 95: 1185-92. Heimildir

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