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9 Cards in this Set

  • Front
  • Back
what is glaucoma?
group of ocular disorders involving optic neuropathy seen by changes in optic disk and loss of visual sensitivity and field, involve increase in introculat pressure (no longer diagnostic though)
What is IOP?
Intraocular pressure, factor associated with development and progression of glaucomatous damage, average IOP= 15.5+/-2.5mmHg and increases with age, role is clear in CAG (not in OAG), factors determining level of IOP are rate of aqueous humor production (inflow) and resistance in outflow channels (outflow)
Describe aqueous humor dynamics?
produced in ciliary epithelium through ultrafiltration and secretion (aqueous inflow), reduced by alpha 2 adrenergic agens, alpha adrenergic, beta adrenergic, dopamine receptor blocking agents, CAI
How does aqueous humor flow out of eye and what affects the outflow?
outflow of aqueous humor occurs by 2 routes, 80% through trabecular meshwork and 20% through uveoscleral outflow(aqueous outflow), increased by cholinergic agents prostaglandin F2alpha and beta and alpha2 adrenergic agonists which affect uveosceral outflow
what is the clinical presentation of OAG?
visial field loss occurs with loss of visual acuity later in the disease, isolated scotomas, reduced contrast sensitivity, altered color vision, normal tension glaucoma paitents have IOP<21mmHg, IOP >21mmHg (ocular HTN) w/o disk changes or visual field loss is observed in glaucome suspects, prognosis is good when discovered early and treated
what is the pharmacotherapeutic approach to tx of OAG and ocular HTN?
tx all pts with elevate IOP and disk changes and/or visual filed defects, patients with OHT but no signs are usually monitored and note tx unless risk factors exist, target IOP reduction by 30% is desired and normal tension glaucoma patiens have target IOP of <10-12mmHg, therapy is started in stepwise manner with single agent in one eye
what are the first line tx options for OAG and Ocular HTN?
initiated with beta blocker if no CI exist
suitable 1st line or alternate intial therapy are brimodnidine, PG analogs and topicl CAIs
what are some third line therapies for OAG and ocular HTN?
pilocarpine, epinepherine(dipivefrin) and apraclonidine are mroe commonly used at 3rd line therapies
what are last line therapies for treating OAG and ocular HTN?
carbachol, topical cholinesterase inhibitors, oral CAIs and combo therapies are considered last line agencies