Browsing by Author "Lang, Matthew"

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    Effects of Sex Hormones on Ocular Blood Flow and Intraocular Pressure in Primary Open Angle Glaucoma: A Review
    (Wolters Kluwer, 2018-10) Patel, Pooja; Harris, Alon; Toris, Carol; Lang, Matthew; Tobe, Leslie; Belamkar, Aditya; Ng, Adrienne; Verticchio Vercellin, Alice C.; Matthew, Sunu; Siesky, Brent; Ophthalmology, School of Medicine
    Primary open-angle glaucoma (POAG) is a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and visual field loss. Some speculate that gender plays a role in the risk of developing POAG and that the physiologic differences between men and women may be attributed to the variable effects of sex hormones on intraocular pressure (IOP), ocular blood flow, and/or neuroprotection. Estrogen, in the form of premenopausal status, pregnancy, and post-menopausal hormone therapy is associated with increase in ocular blood flow, decrease in IOP and neuroprotective properties. The vasodilation caused by estrogen and its effects on aqueous humor outflow may contribute. On the other hand, although testosterone may have known effects in the cardiovascular and cerebrovascular systems, there is no consensus as to its effects in ocular health or POAG. With better understanding of sex hormones in POAG, sex hormone-derived preventative and therapeutic considerations in disease management may provide for improved gender-specific patient care.
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    Noninvasive Monitoring and Neurointerventional Management of Idiopathic Intracranial Hypertension
    (Thieme, 2020-04) Lang, Matthew; Mathew, Sunu; Harris, Alon; Tejada, Juan; Kovoor, Jerry M.; Ophthalmology, School of Medicine
    Idiopathic intracranial hypertension (IIH) is characterized by isolated rise in intracranial pressure (ICP) leading to chronic, debilitating headaches, tinnitus, and vision loss. Conventional diagnostics and monitoring primarily require the use of invasive procedure like lumbar puncture to measure ICP, while traditional management strategies involve weight reduction and medical treatment with acetazolamide. In an effort to reduce the need for invasive procedures, noninvasive methods of ICP monitoring such as optic nerve sheath diameter measurements and two-depth transcranial Doppler ultrasonography have been developed. In cases of refractory and fulminant IIH, surgical management strategies such as optic nerve sheath fenestration (ONSF), ventriculoperitoneal (VP) and lumboperitoneal (LP) shunting, and transverse venous sinus stenting are used to relieve symptoms via ICP reduction. While ONSF and VP/LP shunting exhibit utility primarily for the treatment of vision loss and headache, respectively, venous sinus stenting may prove to be an effective option in the management of all symptoms of IIH. Most importantly, consideration of the patient’s individual symptoms and values should be taken into account when choosing the optimal surgical management strategy for patients with IIH.