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Glaucoma Drainage Devices. Radheeka Gandhi Rashmi Kamath Sandra Nakasone Sneha Thomas BME 525: Biomaterials Duke University Fall 2012. [1]. Click Here to Begin Navigation Tutorial. Click Here to Begin Module.
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Glaucoma Drainage Devices Radheeka Gandhi RashmiKamath Sandra Nakasone Sneha Thomas BME 525: Biomaterials Duke University Fall 2012 [1] Click Here to Begin Navigation Tutorial Click Here to Begin Module
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Executive Summary • ? What is glaucoma? • Eye condition marked by obstructed flow of aqueous humor resulting in increased intraocular pressure (IOP) leading to progressive vision loss What is a glaucoma drainage device (GDD)? • A device designed to provide an alternative pathway forflow and drainage of aqueous humor from the anterior chamber in order to reduce IOP. GDDs are the last option for patients with previously failed therapies. What is the outcome? • GDDs successfully decrease IOP to normal levels in 60 – 95% of cases, depending on device and glaucoma type. As IOP reaches normal levels, progressive vision deterioration is halted, preventing further blindness. NAVIGATION TUTORIAL MAIN MENU
Home 2. Glaucoma Drainage Device Design 1. Disease State [3] [2] Click on a topic! 3. Material Selection & Device Manufacturing 4. Implantation and Clinical Performance [4] [5]
Disease State Bleb Formation & Eye Wound Healing Glaucoma Normal Eye Anatomy Bleb [62] [6] [2] Click on a topic!
Disease State Normal Eye Anatomy Click on a topic! Visual Perception Overview Labeled Anatomy Aqueous Humor Flow [7] [8] [9]
Disease State Normal Eye Visual Perception Process- 1 3 2 4 [7] Hover over a step number for more information
Disease State Normal Eye Visual Perception Process- Initial Image Detection– Light reflects off object 1 3 2 4 [7] Hover over a step number for more information
Disease State Normal Eye Visual Perception Process- 1 3 2 4 Light enters the lens, which changes shape to focus light reflecting from near or distant objects onto the back of the eye [7] Hover over a step number for more information
Disease State Normal Eye Visual Perception Process- The focused light is projected onto the retina, which is rich with photoreceptors 1 3 2 4 [7] Hover over a step number for more information
Disease State Normal Eye Visual Perception Process- [7] 1 3 2 4 The optic nerve sends the signals from the photoreceptors to the visual center in the back of the brain. Hover over a step number for more information
Disease State Normal Eye Eye Anatomy All parts of the eye work in a synergistic manner to accomplish the goal of providing sight to the individual Click on a labeled feature for more information [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Anterior Chamber: The part of the aqueous-containing space of the eyeball between the cornea and the iris. Click Here for Aqueous Humor Description [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Posterior Chamber: The ring-like space filled with aqueous humor between the iris, the crystalline lens, and the ciliary body. Click Here for Aqueous Humor Description [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Suspensory Ligaments: Delicate ligaments suspending the lens from the ciliary body of the eye. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Ciliary body & muscle: The thickened part of the vascular tunic of the eye, connecting the choroid and iris. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Cornea: Clearstructure at the front of the eye located in front of the iris. The cornea lets light into the eye and partially focuses it. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Pupil: The black circular opening in the center of the iris that manages light entering the eye with the help of the muscles of the iris [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Iris: The pigmented, round, contractile membrane of the eye, suspended between the cornea and lens and perforated by the pupil. It regulates the amount of light entering the eye. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Sclera: The white part of the eye that gives the eye protection and strength [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Lateral rectus muscle: The ocular muscle whose contraction turns the eyeball outward [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Choroid: The middle, vascular coat of the eye, between the sclera and the retina. The choroid underlies and nourishes the retina and absorbs scattered light. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Retina: The light-sensitive membrane that lines the inside of the back of the eyeball and connects to the brain by the optic nerve. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Macula lutea: A minute yellowish area containing the fovea centralis located near the center of the retina of the eye, at which visual perception is most acute. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Fovea centralis: Asmall depression in the center of the retina that contains only cone cells and is therefore the area of sharpest vision [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Optic nerve & retinal blood vessels : Serves as the conductor, transmitting electrical impulses from the retina back to the brain. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Medial rectus muscle: The ocular muscle whose contraction turns the eyeball medially [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Eye lid: Either of two folds of skin and muscle that can be closed over the exposed portion of the eyeball. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Lacrimal caruncle: Small, pink, globe-like nodule at the inner corner (the medial angle) of the eye. Made of skin covering oil and sweat glands. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Tear Duct: Any of several small ducts that carry tears from the lacrimal glands. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Lens: A transparent structure behind the iris of the eye that focuses light entering the eye on the retina. [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Vitreous body: Body containing transparent gelatinous substance, permeated by fine fibrils, that fills the interior of the eyeball between the lens and the retina [8]
Disease State Normal Eye Eye Anatomy Click on a labeled feature for more information Optic disc: a small oval-shaped area on the retina marking the site of entrance into the eyeball of the optic nerve. Also known as the “blind spot.” [8]
Disease State Normal Eye Aqueous Humor Click Here to Return to Previously Viewed Slide • The clear, watery fluid circulating in the anterior and posterior chambers of the eye. • Composition: Amino Acids (similar to plasma) • Other Ions Involved: Na+, Cl-, K+, HCO3- • Maintains the intraocular pressure and inflates the globe of the eye. • Produced by the Ciliary body • Rate of production: about 2.5 μL/min • Reabsorbed into the venous system primarily at the iridocorneal angle by means of the Trabecular Meshwork and Schlemm’s canal (large arrow). • Alternate drainage route also occurs via uvealscleral pathway (small arrow). [9] Ciliary Body
Disease State Glaucoma Types of Glaucoma What is Glaucoma? [10] [6] Diagnosis Methods of Treatment [12] [11] [13]
Disease State Glaucoma What is Glaucoma? Click on a labeled feature for more information Eye condition due to increase in intraocular pressure (IOP) due to obstructed flow of aqueous humor Dangers And Symptoms Aqueous Humor Flow in the Normal Eye Pathology of Glaucomatous Eye Aqueous Humor Production [16] [14] [17] [15] Ciliary Bodies
What is Glaucoma? Disease State Glaucoma Aqueous Humor Flow in Normal Eye Hover mouse over image, and click ARROW to PLAY video. [18] http://www.youtube.com/watch?v=Y9UfvjJh3VM&feature=plcp
What is Glaucoma? Disease State Glaucoma Aqueous Humor Production Hover mouse over image, and click ARROW to PLAY video. [18] http://www.youtube.com/watch?v=ENv0nm_0iA8&feature=plcp
What is Glaucoma? Disease State Glaucoma Pathology of Glaucomatous Eye • Increase in IOP • Damage to Optic Nerve • Subsequent blindness if left untreated • Collapse of Schlemm’s Canal • Herniation of Trabecular Meshwork • Obstructed Trabecular Meshwork [19]
What is Glaucoma? Disease State Glaucoma Pathology of Glaucomatous Eye Glaucomatous Eye Pressure Normal Eye Pressure 12 – 22 mm Hg Above 20 mm Hg [20] [20] Strained Optic Nerve Intact Optic Nerve
What is Glaucoma? Disease State Glaucoma Cell Death in Glaucoma • Damaged optic nerve axons • Death of retinal ganglion cells (RGCs) • Primary damaged region is the optic nerve head (ONH) • Loss of RGCs results in loss of vision [108]
What is Glaucoma? Disease State Glaucoma Cell Death in Glaucoma • Damaged optic nerve axons • Death of retinal ganglion cells (RGCs) • Primary damaged region is the optic nerve head (ONH) • Loss of RGCs results in loss of vision Nerve cells of the retina with central processes (axons) that form the optic nerve. Collectively transmit image-forming and non-image forming visual information from the retina to several regions in the thalamus, hypothalamus, and menencephalon or midbrain. Neurotrophin deprivation resulting from optic nerve injury is thought to cause RGCs to die by apoptosis by inhibition of cell survival pathways
What is Glaucoma? Disease State Glaucoma Dangers and Symptoms Tunnel Vision Halos around light [22] [21] Hazy Vision Redness in the eye [23] [23]
What is Glaucoma? Disease State Glaucoma Vision Deterioration Click on the tabs to proceed [24]
What is Glaucoma? Disease State Glaucoma Vision Deterioration Click on the tabs to proceed [24]
What is Glaucoma? Disease State Glaucoma Vision Deterioration Click on the tabs to proceed [24]
What is Glaucoma? Disease State Glaucoma Vision Deterioration Click on the tabs to proceed [24]
What is Glaucoma? Disease State Glaucoma Vision Deterioration Subsequently leads to blindness [24]
Disease State Glaucoma Types of Glaucoma Click on images for further information on Glaucoma Types 2 main types: Open Angle Glaucoma Closed-Angle Glaucoma Other Rare Types of Glaucoma [26] [25] [25]
Types of Glaucoma Disease State Glaucoma Open Angle Glaucoma 1/10 Most common form of glaucoma Can lead to loss of vision or blindness [18] Click on the bluearrows for a visual explanation of Open Angle Glaucoma