GLAUCOMA - BASIC AND CLINICAL ASPECTS Edited by Shimon Rumelt Glaucoma - Basic and Clinical Aspects http://dx.doi.org/10.5772/45915 Edited by Shimon Rumelt Contributors Demetrios G. Vavvas, Sotiria Palioura, Dajit Singh, Marek Rękas, Karolina Krix-Jachym, Michael Walter, Yoko Ito, Abdulrahman Al-Asmari, Misbahul Arfin, Najwa M. Al- Dabbagh, Sulaiman Al-Saleh, Nourah Al-Dohayan, Najwah Al- Dabbagh, Mohammad Tariq, Hezheng Zhou, Barkur Shastry, Ivan Marjanovic, Cynthia Esponda-Lamoglia, Rafael Castañeda-Díez, Oscar Albis-Donado, Ghanshyam Swarup, Vipul Vaibhava, Ananthamurthy Nagabhushana, Artashes Zilfyan, Makoto Ishikawa, Lizette Mowatt, Maynard Mc Intosh, Aristeidis Konstantinidis, Georgios Labiris, Vassilios Kozobolis, Gianfranco Risuleo, Simona Giorgini, Nicola Calandrella, Javier Paz Moreno-Arrones, Adriana Borges- Giampani, Raymond Chuen-Chung Chang, Kin Chiu, Kwok-Fai So, Shimon Rumelt Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2013 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. 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Publishing Process Manager Iva Simcic Technical Editor InTech DTP team Cover InTech Design team First published April, 2013 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Glaucoma - Basic and Clinical Aspects, Edited by Shimon Rumelt p. cm. ISBN 978-953-51-1064-4 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Section 1 Basic Aspects 1 Chapter 1 Anatomy of Ciliary Body, Ciliary Processes, Anterior Chamber Angle and Collector Vessels 3 Adriana Silva Borges- Giampani and Jair Giampani Junior Chapter 2 Experimental Glaucoma After Oxidative Stress and Modulation of the Consequent Apoptotic Events in a Rat Model 15 Nicola Calandrella, Simona Giorgini and Gianfranco Risuleo Chapter 3 NGenetics and Environmental Stress Factor Contributions to Anterior Segment Malformations and Glaucoma 27 Yoko A. Ito and Michael A. Walter Chapter 4 Emerging Concept of Genetic and Epigenetic Contribution to the Manifestation of Glaucoma 57 Barkur S. Shastry Chapter 5 Modern Aspects of Glaucoma Pathogenesis Local Factors for Development of Primary Open-Angle Glaucoma Associated with Impairment of Secretory Functions of the Eye Membranes 75 A.A. Zilfyan Chapter 6 Functional Defects Caused by Glaucoma – Associated Mutations in Optineurin 103 Ghanshyam Swarup, Vipul Vaibhava and Ananthamurthy Nagabhushana Chapter 7 The Role of Apolipoprotein E Gene Polymorphisms in Primary Glaucoma and Pseudoexfoliation Syndrome 129 Najwa Mohammed Al- Dabbagh, Sulaiman Al-Saleh, Nourah Al- Dohayan, Misbahul Arfin, Mohammad Tariq and Abdulrahman Al- Asmari Chapter 8 Progressive Neurodegeneration of Retina in Alzheimer’s Disease — Are β-Amyloid Peptide and Tau New Pathological Factors in Glaucoma? 157 Kin Chiu, Kwok-Fai So and Raymond Chuen-Chung Chang Chapter 9 Neuroprotection in Glaucoma 179 Sotiria Palioura and Demetrios G. Vavvas Chapter 10 Strategies for Neuroprotection in Glaucoma 203 Lizette Mowatt and Maynard Mc Intosh Chapter 11 Cornea and Glaucoma 227 Gema Bolivar, Javier Paz Moreno-Arrones and Miguel A. Teus Chapter 12 Screening for Narrow Angles in the Japanese Population Using Scanning Peripheral Anterior Chamber Depth Analyzer 251 Noriko Sato, Makoto Ishikawa, Yu Sawada, Daisuke Jin, Shun Watanabe, Masaya Iwakawa and Takeshi Yoshitomi Chapter 13 The History of Detecting Glaucomatous Changes in the Optic Disc 267 Ivan Marjanovic Chapter 14 Recognizing a Glaucomatous Optic Disc 295 Vassilis Kozobolis, Aristeidis Konstantinidis and Georgios Labiris Section 2 Clinical Aspects 331 Chapter 15 Neovascular Glaucoma 333 Cynthia Esponda-Lammoglia, Rafael Castaneda-Díez, Gerardo García-Aguirre, Oscar Albis-Donado and Jesús Jiménez-Román Chapter 16 Uveitic Glaucoma 359 Shimon Rumelt ContentsVI Chapter 17 Clinical Research Progress of Glaucomatocyclitic Crisis 379 He-Zheng Zhou, Qian Ye, Jian-Guo Wu, Wen-Shan Jiang, Feng Chang, Yan-Ping Song, Qing Ding and Wen-Qiang Zhang Chapter 18 Malignant Glaucoma 421 Marek Rękas and Karolina Krix-Jachym Chapter 19 Minimally Invasive Glaucoma Surgery – Strategies for Success 439 Daljit Singh Chapter 20 Combined Cataract-Glaucoma Surgery 473 Vassilis Kozobolis, Aristeidis Konstantinidis and Georgios Labiris Contents VII Preface Glaucoma specialty progressed enormously in the last two decades We are evident to better understanding the genetics and pathogenesis of different types of glaucomas that will ena‐ ble us to develop novel approaches for treatment, new imaging techniques such as anterior segment optical coherence tomography, Heidelberg Retinal Tomography and scanning laser polarimetry. In addition, application of new devices such as the ExPress shunt, iStent and Solx Gold shunt and new procedures such as canaloplasty and deep sclerostomy to mini‐ mize postoperative complications of the traditional trabeculectomy without compromising the success of the procedure have been developed. This book arranged discusses first the basic aspects of glaucomas, including the final offend‐ ers, the retinal ganglion cells and many other topics and clinical aspects including evalua‐ tion and management of glaucoma and the different types of glaucomas, their features, evaluation, differential diagnosis and specific approaches for management. The book covers some but not all the topics in the field. It is a product of a balance between expedited pub‐ lishing process and encompassing the entire field. The book is intended for the general ophthalmologists, glaucoma specialists, and research‐ ers in the field, residents and fellows. It covers both basic and clinical concepts of glaucoma and each author incorporated his/ hers on perspectives on each topic adding his/ hers won theories, future trends and research. Therefore, the book should enable researches and clini‐ cians to adopt new ideas for further basic and clinical research and implementation of the approaches for treating glaucomas. The book is a result of multi-national glaucoma specialists from around the globe with a common characteristic of taking care of patients. Some of the authors are engaged for many years with this field, some are just at their beginning. Some authors are researches, other clinicians. Some are world leaders, others will be. I hope that the readers will be of wide verity as our authors. The book is accessed online to allow a free access to as many readers worldwide as possible and is also available on print for those who do not have online access or are interested in having their own hard copy. This will definitely contribute to the distribution of the knowl‐ edge on glaucoma between researchers and clinicians. The book is a welcome addition to the previous books on the subject published by InTech: “The mystery of glaucoma” edited by Tomaš Kubena, “Glaucoma – current clinical and re‐ search aspects” by Pinakin Gunvant and “Gaucoma – basic and clinical concepts” by Shi‐ mon Rumelt. It expands and updates previous topics and adds new ones. I would like to acknowledge each and every one of the contributors for their excellent work on each chapter. Each one of them devoted time and efforts to write a chapter and to con‐ tribute to the success of this book and for the advancement of glaucoma. I thank Ms. Iva Simcic and Ana Pantar, the book Publishing Process Managers for their tremendous efforts to publish an excellent book and her endless support, to Ms. Ana Nikolic, the Head of Editorial Consultants for her useful assistance and for both for choosing me to be the edi‐ tor of the book. Many thanks to the technical editors for their arranging the book in a uni‐ form format and for the publisher InTech, that without its initiative, this book would have never been published. Lastly, to my family, teachers and students from whom I studied throughout the years. I hope that this book will be part of a series of books in all the different specialties within ophthalmology. I wish you, the reader an enjoyable journey throughout glaucoma, one of the most interesting and challenging specialties in medicine in general and, in ophthalmolo‐ gy, in particular. The book is a product of global cooperation for the benefit of physicians and patients all over the world and I hope that it will serve as an example for others to follow. Shimon Rumelt, MD, MPA Department of Ophthalmology, Western Galilee – Nahariya Medical Center, Nahariya, Israel Preface X [...]... astrocyte cells and microglia, activates the production of cytokines, ROS, nitric oxide and tumor necrosis factor α (TNF-α); all these molecules are mediators involved in the tissue damage [2] In a similar way, glial cells located 17 18 Glaucoma - Basic and Clinical Aspects in the retina and in the head of the optic nerve may carry out their normal physiological role as supporters of the cell bodies and their... Darwin - Sapienza University of Rome, Rome, Italy 21 22 Glaucoma - Basic and Clinical Aspects References [1] Capaccioli, S, Nucci, C, Quattrone, A, & Carella, E Apoptosi nel glaucoma In: Apop‐ tosi in oftalmologia, Ed I.N.C (1998) , 4 4-5 7 [2] Calandrella, N, Scarsella, G, Pescosolido, N, & Risuleo, G Degenerative and apoptot‐ ic events at retinal and optic nerve level after experimental induction of... bution of the p pi varie considerably  with  age  a es  and race.  At  birth,  it  has  no  pigment,  and develops  color  with  age  from  ligh h depe ending on the degree of pigm ment dispersi ion in the ante erior chamber angle.  10 Glaucoma - Basic and Clinical Aspects The trabecular meshwork lies between Schwalbe´s line and the scleral spur, and it may be considered as two separate portions: (a)... [46]) 19 20 Glaucoma - Basic and Clinical Aspects 2 A model of experimental glaucoma in rat Several experimental animal models exist to investigate the ocular pathologies In our laboratory we have developed a rat model of hypertension that mimics and reproduces the situation found in human glaucoma This animal model will be briefly reviewed in the following sections [2] 2.1 Induction of the intra-ocular... Ophthalmology 88: 283, (1981) 11 12 Glaucoma - Basic and Clinical Aspects [5] Aiello, A L, & Tran, V T Rao NA: Postnatal development of the ciliary body and pars plana A morphometric study in childhood Arch Ophthalmol 110:802, (1992) [6] Bruce Shields MAqueous humor dynamics: Anatomy and Physiology In Textbook of glaucoma Williams & Wilkins, Fourth edition,(1997) , 5-3 1 [7] Morrison, J C Van Burskirk... (1998) , 273, 1161 9-1 1624 [26] Vendemiale, G, Grattagliano, I, & Altomare, E An update on the role of free radicals and antioxidant defense in human disease Int J Clin Lab Res (1999) , 29, 4 9-5 5 23 24 Glaucoma - Basic and Clinical Aspects [27] Behndig, A, Svensson, B, Marklund, S L, & Karlsson, K Superoxide dismutase isoen‐ zymes in the human eye Invest Ophthalmol Vis Sci (1998) , 39, 47 1-4 75 [28] [28]... the original work is properly cited 4 Glaucoma - Basic and Clinical Aspects On cross-section, the ciliary body has the shape of a right triangle, approximately 6 mm in length, where its apex is contiguous with the choroid and the base close to the iris Externally, it attaches to the scleral spur creating a potential space, the supraciliary space, between it and the sclera The external surface forms... progression of glaucoma, astrocytes are involved in the re-modeling of the lamina cribrosa and they could act as initiators of the pathology With respect to this see the role of PHB and MMP mentioned in preceding section Studies on experimental models of ocular hypertension and human glaucoma evidenced an astrocyte hypertrophy and a loss of organ‐ ization both at retina and optic nerve level The up-regulation... (third cranial nerve-oculomotor), forming a rich parasympathetic plexus There are also sympathetic fibers originating from the superior cervical ganglion which keep pace with arteries and their branches 5 6 Glaucoma - Basic and Clinical Aspects Figure 3 Histology of human ciliary epithelia 2 Ultrastructure of the ciliary processes Each ciliary process is composed of a central stroma and capillaries, covered... ciliary muscle and iris to reach supra‐ ciliary and suprachoroidal spaces [22,23,24] 3.1 Anatomy of anterior chamber angle (conventional outflow system) a Schwalbe`s line This line or zone represents the transition from the trabecular to corneal endothelium, the termination of Descemet`s membrane, and the trabecular insertion into the corneal stroma 7 8 Glaucoma - Basic and Clinical Aspects Schwalbe`s . GLAUCOMA - BASIC AND CLINICAL ASPECTS Edited by Shimon Rumelt Glaucoma - Basic and Clinical Aspects http://dx.doi.org/10.5772/45915 Edited. orders@intechopen.com Glaucoma - Basic and Clinical Aspects, Edited by Shimon Rumelt p. cm. ISBN 97 8-9 5 3-5 1-1 06 4-4 free online editions of InTech Books and Journals