Browsing by Author "Baumane, Kristine"

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    The effect of glaucoma filtration surgery on structural and functional eye parameters in a short-term study
    (2017-04) Baumane, Kristine; Ranka, Renate; Laganovska, Guna; Rīga Stradiņš University
    Glaucoma filtration surgery (trabeculectomy) is an effective glaucoma treatment method that provides significant intraocular pressure (IOP) reduction. Indications for this method are in cases where other forms of therapy, like medicines or lasers, have failed, other forms of therapy are not suitable (compliance or side-effects are a problem), in cases where a target pressure is required to prevent clinically significant disease progression that cannot be reached with topical medications and/or laser and in cases that have such advanced glaucoma and high IOP at presentation that other forms of treatment are unlikely to be successful. The aim of this study was to evaluate the effect of glaucoma surgery on the structural and functional eye parameters at different stages of glaucoma. A total of 96 eyes of 96 patients (only one eye from each patient) with different stages of glaucoma (stages 2 to 4) who were undergoing trabeculectomy were recruited. Quadrant retinal nerve fibre layer RNFL) thickness (33 patients), cup/disc vertical and horizontal ratio (36 patients) and MD of visual fields (27 patients) were analysed up to one week before and 1 month after the successful surgery. The results show that the MD value was slightly improved in 50%, 85.7%, and 71.4% of patients with glaucoma stages 2, 3, and 4, respectively. The mean RNFL of all four optic nerve head quadrants increased slightly after the surgery for patients with glaucoma stage 2; in contrast, a decrease in the mean RNFL values for all four quadrants was observed for patients with glaucoma stage 4. Statistically significant changes in the mean values for the optic nerve horizontal c/d ratio after glaucoma surgery were observed (p = 0.033) in contrast to the vertical c/d values (p = 0.77). In total, improvement of the horizontal and vertical c/d ratio was detected in 61.1% and 55.6% of the glaucoma patients, respectively. Although the observed changes were statistically insignificant, the positive influence of glaucoma surgery on the structural and functional eye parameters was more pronounced in moderate stages than in advanced or severe stages of glaucoma.
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    The epidemiological and clinical findings from the Latvian registry of primary congenital glaucoma and evaluation of prognostic factors
    (2021-01-07) Elksne, Eva; Baumane, Kristine; Ozolins, Arturs; Valeina, Sandra; Department of Ophthalmology; Department of Surgery; Faculty of Medicine
    Background and objectives: primary congenital glaucoma (PCG) is a rare, potentially blinding disease that affects children worldwide. The aim of the study was to describe the epidemiological and clinical characteristics, outcomes for newly diagnosed patients with PCG, as well as evaluate the prognostic factors that are related to the outcomes. Materials and Methods: a retrospective cohort study was conducted at a tertiary referral centre among patients diagnosed with PCG. Evaluation of the clinical data was performed preoperatively at three, six, and 12 months after the surgery and at the last follow-up. Results: during the 15 years of follow-ups, 24 eyes of 18 patients were diagnosed with PCG. Unilateral and bilateral PCG constituted 50% of cases each. A slight male predominance was observed (55.6% vs. 44.4%), with a relative risk of 1.3. The incidence of PCG was 1:19,033 live births. The mean age of the patients at the time of diagnosis was 10.1 ± 10.0 months, with a diagnostic delay of 2.0 ± 1.9 months. Furthermore, 75% of patients indicated an enlargement of an eyeball, followed by excessive tearing (58.3%) and corneal opacity (41.7%). After 85.9 ± 51.2 months, the mean intraocular pressure (IOP) value was 14.6 ± 4.9 mmHg. Surgical treatment provided sufficient IOP control in 75% of PCG cases at the last follow-up visit. The only prognostic factor that was related to the outcome of IOP control that was statistically significant was axial length at the time of diagnosis. Conclusions: the incidence of PCG in Latvia was 5.3 patients per 100,000 live births. PCG was more common among males than females with a relative risk of 1.3. The enlargement of an eyeball was the leading clinical sign.
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    Switching to Preservative-Free Tafluprost/Timolol Fixed-Dose Combination in the Treatment of Open-Angle Glaucoma or Ocular Hypertension : Subanalysis of Data from the VISIONARY Study According to Baseline Monotherapy Treatment
    (2022-08) Oddone, Francesco; Kirwan, James; Lopez-Lopez, Fernando; The VISIONARY Study Group; Laganovska, Guna; Baumane, Kristine
    Introduction: The VISIONARY study demonstrated statistically significant intraocular pressure (IOP) reductions with the preservative-free fixed-dose combination of tafluprost 0.0015% and timolol 0.5% (PF tafluprost/timolol FC) in open-angle glaucoma (OAG) or ocular hypertension (OHT) patients, sub-optimally controlled with topical prostaglandin analogue (PGA) or beta-blocker monotherapy. Current subanalyses have examined these data according to the baseline monotherapy. Methods: A European, prospective, observational study included adults (aged ≥ 18 years) with OAG or OHT, who were switched to the PF tafluprost/timolol FC from PGA or beta-blocker monotherapy. Treatment outcomes were reported according to prior monotherapy subgroup: beta-blocker, preserved latanoprost, PF-latanoprost, bimatoprost, tafluprost, and travoprost. Endpoints included the mean change from baseline regarding IOP, conjunctival hyperemia, and corneal fluorescein staining (CFS) at Week 4 and Week 12, and at Month 6. Results: The subanalysis included 577 patients. All prior monotherapy subgroups demonstrated statistically significant IOP reductions from baseline at Week 4, that were maintained through Month 6 (p < 0.001). Mean (SD) IOP change at Month 6 was 6.6 (4.16), 6.3 (4.39), 5.6 (3.67), 4.9 (2.97), 4.6 (4.39), and 4.7 (3.64) mmHg for prior beta-blocker, preserved latanoprost, PF-latanoprost, tafluprost, bimatoprost, and travoprost subgroups, respectively. The largest IOP change was observed in the preserved latanoprost subgroup for each of the ≥ 20%, ≥ 25%, ≥ 30%, and ≥ 35% IOP reduction categories at Month 6, demonstrating respective reductions of 8.06, 9.20, 10.64, and 11.55 mmHg. CFS was significantly reduced at Month 6 in the prior bimatoprost subgroup (p = 0.0013). Conjunctival hyperemia severity was significantly reduced at each study visit for prior preserved latanoprost users (p < 0.001). Conclusion: PF tafluprost/timolol FC therapy provided statistically and clinically significant IOP reductions from Week 4 over the total 6-month period, in patients with OAG/OHT, regardless of the type of prior PGA or beta-blocker monotherapy used. Conjunctival hyperemia severity and CFS decreased significantly in prior bimatoprost and preserved latanoprost users, respectively. Clinical Study Number: European Union electronic Register of Post-Authorization Studies (EU PAS) register number: EUPAS22204.