Objective quantification of trabecular meshwork pigmentation and correlation to primary open-angle glaucoma disease severity

IF 2.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the National Medical Association Pub Date : 2025-07-21 DOI:10.1016/j.jnma.2025.06.008

Daniel Laroche , Brian Grodecki , Chester NG

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引用次数: 0

Abstract

Purpose

In this study, we further evaluated a unique early biomarker that has been demonstrated to be correlated with primary open-angle glaucoma in a pilot study. This novel biomarker correlated an increased ratio of pigmentation in the inferior trabecular meshwork (TM) compared to the superior TM with a greater degree of visual field loss in a small subset of patients. We evaluated this association in a larger group of patients.

Methods

This is a retrospective single-center analysis of Black and Afro-Latino patients that make up the local New York inner-city community of Advanced Eyecare of New York in Queens Village and Harlem, New York City with a diagnosis of primary open-angle glaucoma. We reviewed 335 consecutive glaucoma and glaucoma suspect patients with imaging of the TM via the GS-1 gonioscope. The degree of pigmentation was then quantified using ImageJ software to measure the ratio of pigmentation in the superior to inferior TM. We then created a ratio based on these superior to inferior TM measurements for each patient and compared this ratio to the patient’s mean deviation of the visual field.

Results

Results from 529 eyes in 335 patients demonstrated a positive correlation between the superior-inferior ratio (SIR) of pigmentation and visual field loss. The greater the degree of pigmentation asymmetry between the superior and inferior angle, the greater the extent of visual field deterioration. There was also a positive correlation between the SIR and age.

Conclusion

In a larger cohort of patients with glaucoma or glaucoma suspects, on TM pigment assessment with Image J, there was a positive correlation between SIR and worsening visual field mean deviation. Further research is required to evaluate a greater number of normal patients, glaucoma suspects, and glaucoma patients. Further research is also necessary to produce automated TM images and to develop automated assessment of TM pigment density with artificial intelligence to compare with other clinical factors such as age, IOP, OCT, and retinal nerve fiber layer thickness. Since the TM is where damage initially occurs to cause glaucoma, this can potentially lead to earlier detection before IOP elevation and retinal ganglion cell loss.

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目的定量分析小梁网色素沉着与原发性开角型青光眼严重程度的关系。

目的：在这项研究中，我们进一步评估了一种独特的早期生物标志物，该标志物在一项初步研究中被证明与原发性开角型青光眼相关。在一小部分患者中，与上小梁网相比，下小梁网（TM）色素沉着比例增加与更大程度的视野丧失相关。我们在更大的患者群体中评估了这种关联。方法：这是一项回顾性的单中心分析，由纽约皇后区村和哈莱姆区纽约高级眼科中心的黑人和非裔拉丁裔患者组成，他们被诊断为原发性开角型青光眼。我们回顾了335例连续的青光眼和疑似青光眼患者通过GS-1型角膜炎镜的TM成像。然后用ImageJ软件量化色素沉着程度，测量上、下TM色素沉着的比例。然后，我们根据每位患者的TM测量结果创建了一个比率，并将该比率与患者的视野平均偏差进行比较。结果：335例患者529只眼的结果显示，色素沉着的优劣比（SIR）与视野丧失呈正相关。上下角色素沉着不对称程度越大，视野恶化程度越大。SIR和年龄之间也有正相关。结论：在较大的青光眼或疑似青光眼患者队列中，使用Image J进行TM色素评估时，SIR与视野平均偏差恶化呈正相关。需要进一步的研究来评估更多的正常患者、青光眼疑似患者和青光眼患者。还需要进一步研究自动生成TM图像，并利用人工智能自动评估TM色素密度，以与年龄、IOP、OCT和视网膜神经纤维层厚度等其他临床因素进行比较。由于TM是最初发生损伤导致青光眼的地方，这可能导致在IOP升高和视网膜神经节细胞丢失之前更早发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the National Medical Association 医学-医学：内科

CiteScore

4.80

自引率

3.00%

发文量

139

审稿时长

98 days

期刊介绍： Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.