ABSTRACT
@#Wound healing is a complex process that includes haemostasis and inflammation, followed by a proliferation period and repair and finally remodelling. Ocular surgeries, particularly in glaucoma cases, aim at minimal fibrosis to preserve the function of trabeculectomy as an alternative pathway for aqueous drainage. Hence, it is important to find an agent to modulate the wound healing process. This review presents compilation of wound modulation agents that have been tested in vitro, in vivo, or clinically on patients undergoing ocular surgeries, particularly for glaucoma. We identified agents into four groups, mostly for glaucoma filtration operations: anti-metabolites, anti-growth factors, mechanical barriers and rho kinases. The effect of these agents is highlighted in this review. In conclusion, despite recognized drawbacks of antimetabolites, they are still regarded as the gold standard and the most efficient treatment as anti-scarring agents use in ocular surgeries. More studies are needed to inquire agents that efficient yet has minimal adverse effects both in short and long term.
ABSTRACT
Background and objective The majority of glaucoma patients are asymptomatic and are usually diagnosed at an advanced stage of the disease. This study aimed to assess the outcomes of glaucoma screening among known first-degree relatives of primary glaucoma patients. Materials and methods This study involved primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) patients who attended the glaucoma clinic at the Hospital Universiti Sains Malaysia between January 2014 and December 2015. First-degree relatives of the patients underwent a preliminary eye-screening evaluation, including visual acuity (Snellen chart), intraocular pressure (IOP) measurement (air-puff tonometry), and non-mydriatic fundus photography. Patients with visual acuity worse than 6/12, IOP measuring more than 21 mmHg or a difference of more than 3 mmHg between the eyes, and a vertical cup-disc ratio (VCDR) of 0.7 or higher were given a comprehensive eye examination. Results Seventy indexed glaucoma patients were recognized, and 368 first-degree relatives were identified. Forty-five relatives underwent the preliminary screening. Of these, 29 showed normal findings (62%), one had corneal pathology (2%), and 16 (36%) underwent a complete eye examination after failing the initial screening. Among the indexed JOAG group, five relatives (11%) were diagnosed as having JOAG; two were treated medically, while the remaining three required surgical intervention. Conclusion Opportunistic glaucoma screening of high-risk groups, especially JOAG is a feasible and cost-effective way to detect early glaucoma and prevent irreversible blindness. However, improvement in our healthcare system, including the involvement of multicentre clinics in other states in screening initiatives, is required to promote and facilitate the response to screening opportunities.
