Glaucoma Clinical Trial
Official title:
Psychopathology of Normal-tension Glaucoma in Hong Kong Chinese Out-patient
It is suggested the pathogenesis of normal-tension glaucoma (NTG) involves vascular
dysregulation. In the past studies, it is well documented that many physical problems
related to vascular dysregulation, such as angina pectoris (Friedman M et al 1974; Russek HI
et al 1976), migraine (Diener HC et al 1994), primary Raynaud's disease (Wagner HH et al
1993) and stroke (Gainotti G, et al, 2001; Hayee Ma et al 2001), are associated with a high
risk of depressive illness. So, NTG, being a disease involving vascular dysregulation, is
postulated to be associated with psychopathology.
Glaucoma increases after 40 year-old and the number of people over this age in Hong Kong is
rapidly growing. However, we have no knowledge about the link between psychopathology and
NTG in Hong Kong. The present study is sought to overcome the limitation in previous
research and the goals of present study are:
- To identify the prevalence of psychopathology of normal-tension glaucoma Hong Kong
Chinese Out-patients attending a university-affiliated glaucoma clinic.
- To determine whether there are any differences among NTG patients, patients with
glaucoma other than NTG and control in terms of psychopathology and quality of life.
Designs:
Case-control study to compare among patients with normal-tension glaucoma (NTG), patients
with glaucoma other than normal-tension glaucoma (OTNTG) and control in terms of
psychopathology and quality of life
Patients with chronic medical illness have been shown to have higher rates of depression and
other psychopathology (Kimmel PL et al, 1998; Amato L et al, 1996). Glaucoma is a chronic,
progressive ophthalmologic disease. Treatment may involve the use of multiple medications
and surgery. Despite therapy, many patients continue to worsen, and some may even lose
vision. Because of this threat of potential loss of vision and the known depression-related
side effects of some of topical glaucoma medication, particular beta-blocker (Cove-Smith JR
et al, 1985), it can be necessary hypothesized that glaucoma patient may have an increased
prevalence of depression and other psychopathology. It is also reasonable to apply similar
hypothesis on the patients with normal-tension glaucoma.
Normal-tension glaucoma (NTG) is a type of open-angle glaucoma defined as an optic
neuropathy with visual-field defects together normal distribution of intraocular pressure
(<21 mmHg) over a period of twenty-four hour as well as normal chamber-angle anatomy (Levene
RZ, 1980). NTG is associated with different vasospastic syndrome including higher incidence
of migraine (Phelps CD et al, 1985), angina pectoris (Goldberg I et al, 1981), silent
myocardial ischemia (Kaiser HJ et al, 1993) and ocular vasopasm (Flammer J et al, 1991;
Flammer J et al 1987; Orgul S et al 1995). Such associated clinical characteristics suggest
that the pathogenesis of NTG involves vascular dysregulation. In the past studies, it is
well documented that many physical problems related to vascular dysregulation, such as
angina pectoris (Friedman M et al 1974; Russek HI et al 1976), migraine (Diener HC et al
1994), primary Raynaud's disease (Wagner HH et al 1993) and stroke (Gainotti G, et al, 2001;
Hayee Ma et al 2001), are associated with a high risk of depressive illness. So, NTG, being
a disease involving vascular dysregulation, is postulated to be associated with
psychopathology.
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