Background Glaucoma is a major cause of blindness worldwide. The affected population was projected to increase from 60.5 million in 2010 to 79.6 million in 2020. Among the various types of glaucoma, primary open angle glaucoma will account for more than 70% of this population. Treatment by lowering the intraocular pressure is the only proven method to reduce progression. This can be achieved via medication, surgery and laser. Selective laser trabeculoplasty is a relatively new type of laser that is reported to be equally efficacious to a first line medication and other established laser trabeculoplasty, namely argon laser trabeculoplasty. The evidence available, however, is limited to single trials, which may not reach adequate power to detect the difference. A systematic review and meta-analysis would add evidence to consider selective laser trabeculoplasty as an alternative treatment option in open angle glaucoma through assessing its efficacy and effectiveness in lowering the intraocular pressure and through testing for its non-inferiority when compared with other conventional treatment modalities. Method Literature search of Pubmed, EMBASE, CENTRAL, dissertation and thesis databases and hand search of relevant journals was performed for the use of selective laser trabeculoplasty in the treatment of open angle glaucoma. English and Chinese articles were included. Meta-analysis of randomized controlled trials comparing treatment efficacy of selective laser trabeculoplasty and other treatment modalities were performed where appropriate. Results 80 articles were identified to be relevant and provided sufficient data for interpretation for efficacy or safety assessment. It was estimated that selective laser trabeculoplasty resulted in a weighted pooled mean intraocular pressure reduction of 21.9 to 23.8% at different follow-up durations. However, sensitivity analysis including only prospective studies with baseline IOP less than 21mmHg did not show significant IOP lowering effect. Review on side effects of selective laser trabeculoplasty showed a good safety profile in general. Rare occurrences of more severe or long-term complications included persistent intraocular pressure spike requiring surgery, persistent macular edema and corneal haze. Meta-analysis of randomized controlled trials showed that selective laser trabeculoplasty is non-inferior to argon laser trabeculoplasty and medication in intraocular pressure reduction and also in achieving treatment success. Number of medication reduction is similar between selective laser trabeculoplasty and argon laser trabeculoplasty. Conclusion This report demonstrated comparable efficacy of selective laser trabeculoplasty with argon laser trabeculoplasty and medication therapy in the treatment of open angle glaucoma. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M App Physics (Research)) -- University of South Australia, 1992

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 237-244). Available also in a digital version from Dissertation Abstracts.

CAPES / Este trabalho apresenta um sistema automatizado que foi desenvolvido com o objetivo de fabricar estruturas fotônicas por meio da técnica de escrita direta com pulsos de laser de femtossegundo. Tal técnica consiste em focalizar finamente o feixe de laser em substratos transparentes e movimentar o substrato em direções paralela e perpendicular em relação à direção de propagação do feixe de laser. Procedimentos de controle automatizado referente ao feixe de laser e à translação, de substrato foram implementados e integrados, resultando num sistema totalmente automatizado para a gravação de estruturas fotônicas. Utilizando o sistema automatizado de gravação, guias de onda funcionais em forma de reta e com curvaturas foram fabricados com sucesso, cujos perfis de campo próximo demonstraram propagação monomodo da luz vermelha de 635 nm que foi injetada e guiada. Além disso, a possibilidade de gravar estruturas fotônicas 2D e 3D é confirmada pelas gravações de uma estrutura em forma de espiral logarítmica (2D) e uma estrutura fan-out (3D). Estes resultados demonstram que o sistema desenvolvido está totalmente pronto para o uso prático de fabricar diversas estruturas fotônicas com aplicações potenciais nas áreas de redes de comunicação moderna e de circuitos fotônicos integrados. / An automated system is reported in this work with the goal of fabricating photonic structures by the direct-write technique with femtosecond laser pulses. This technique uses a finely focused laser beam into transparent substrates and the translation of the substrate along directions parallel and perpendicular to the propagation direction of the incident laser beam. Control procedures related to laser pulses and sample translation were implemented and integrated, giving rise to a fully automated femtosecond writing system. Functional straight-line and curved waveguides have been successfully achieved with the automated writing system, where single mode propagation is observed from their near filed profiles when 635 nm light is injected and guided. In addition, the possibility of writing 2D and 3D photonic structures is confirmed by tracing a logarithmic spiral structure (2D) and a fan-out structure (3D). These results show that the developed system is fully operational in practice for the purpose of fabricating a variety of photonic structures with potential applications in modern communication networks and integrated photonic circuits.

CAPES / Este trabalho apresenta um sistema automatizado que foi desenvolvido com o objetivo de fabricar estruturas fotônicas por meio da técnica de escrita direta com pulsos de laser de femtossegundo. Tal técnica consiste em focalizar finamente o feixe de laser em substratos transparentes e movimentar o substrato em direções paralela e perpendicular em relação à direção de propagação do feixe de laser. Procedimentos de controle automatizado referente ao feixe de laser e à translação, de substrato foram implementados e integrados, resultando num sistema totalmente automatizado para a gravação de estruturas fotônicas. Utilizando o sistema automatizado de gravação, guias de onda funcionais em forma de reta e com curvaturas foram fabricados com sucesso, cujos perfis de campo próximo demonstraram propagação monomodo da luz vermelha de 635 nm que foi injetada e guiada. Além disso, a possibilidade de gravar estruturas fotônicas 2D e 3D é confirmada pelas gravações de uma estrutura em forma de espiral logarítmica (2D) e uma estrutura fan-out (3D). Estes resultados demonstram que o sistema desenvolvido está totalmente pronto para o uso prático de fabricar diversas estruturas fotônicas com aplicações potenciais nas áreas de redes de comunicação moderna e de circuitos fotônicos integrados. / An automated system is reported in this work with the goal of fabricating photonic structures by the direct-write technique with femtosecond laser pulses. This technique uses a finely focused laser beam into transparent substrates and the translation of the substrate along directions parallel and perpendicular to the propagation direction of the incident laser beam. Control procedures related to laser pulses and sample translation were implemented and integrated, giving rise to a fully automated femtosecond writing system. Functional straight-line and curved waveguides have been successfully achieved with the automated writing system, where single mode propagation is observed from their near filed profiles when 635 nm light is injected and guided. In addition, the possibility of writing 2D and 3D photonic structures is confirmed by tracing a logarithmic spiral structure (2D) and a fan-out structure (3D). These results show that the developed system is fully operational in practice for the purpose of fabricating a variety of photonic structures with potential applications in modern communication networks and integrated photonic circuits.