Journal of Glaucoma最新文献

{"title":"Gap Analysis of Standard Automated Perimetry Concept Representation in Medical Terminologies.","authors":"Shahin Hallaj, William Halfpenny, Niloofar Radgoudarzi, Michael V Boland, Swarup S Swaminathan, Sophia Y Wang, Benjamin Y Xu, Dilru C Amarasekera, Brian Stagg, Aiyin Chen, Michelle Hribar, Kaveri A Thakoor, Kerry E Goetz, Jonathan S Myers, Aaron Y Lee, Mark A Christopher, Linda M Zangwill, Robert N Weinreb, Sally L Baxter","doi":"10.1097/IJG.0000000000002575","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002575","url":null,"abstract":"<p><strong>Precis: </strong>In this multi-institutional effort, we identified gaps in SAP data elements within medical terminologies. We proposed new concepts to LOINC to enhance SAP data standards and big data representation and improve interoperability across healthcare systems.</p><p><strong>Purpose: </strong>To identify gaps in the representation of Standard Automated Perimetry (SAP) data elements in Logical Observation Identifiers Names and Codes (LOINC) and the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) and propose solutions for those gaps.</p><p><strong>Methods: </strong>SAP source data elements and Digital Imaging and Communications in Medicine (DICOM) standard from two commonly used perimeter devices were extracted and compared against existing concepts in standardized terminologies using the OMOP CDM Athena browser and LOINC using the LOINC browser. Gap areas were identified and classified following conventions used by Health Level 7 Fast Healthcare Interoperability Resources and discussed within the OHDSI Eye Care and Vision Research Workgroup in iterative rounds aiming to address gaps. New codes were developed upon reaching a consensus and proposed for inclusion in LOINC.</p><p><strong>Results: </strong>Among 107 data elements extracted from the perimeters, 82%(n=88) of SAP data elements lacked representation. Of the 19 remaining elements, 2.8%(n=3) were wider, 1.9%(n=2) were narrower, and 13%(n=14) had equivalent representation. Additionally, only 2.6%(n=3) of the 116 DICOM attributes related to SAP had representation in standardized terminologies. Several existing relevant codes were defined ambiguously or erroneously (e.g., visual field index, pupil diameter, perimeter format Kowa). New codes closely aligning with DICOM standard for SAP were proposed for addition to LOINC.</p><p><strong>Conclusion: </strong>There is a lack of representation of some SAP data elements in standardized medical terminologies, hampering interoperability and data-sharing. We identified gaps and proposed new concepts for addition to LOINC, aiming to improve SAP data standards and interoperability.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Event-Based Analysis Versus Trend-Based Analysis in the Detection of Glaucoma Progression by Optical Coherence Tomography 3-Dimensional Rim Measurements.","authors":"Tamara D Scott, Maria A Guzman Aparicio, Kitiya Ratanawongphaibul, Hang Lee, Michele Zemplenyi, Edem Tsikata, Milica A Margeta, Courtney L Ondeck, Anne L Coleman, Fei Yu, Johannes F de Boer, Teresa C Chen","doi":"10.1097/IJG.0000000000002573","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002573","url":null,"abstract":"<p><strong>Precis: </strong>Compared to trend-based analysis, event-based analysis detects OCT structural progression in more patients and at an earlier timepoint. Using event-based analysis, MDB rim thickness detects progression more often than RNFL thickness.</p><p><strong>Purpose: </strong>To determine if event-based or trend-based analysis best detects glaucoma progression using spectral domain optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and minimum distance band (MDB) neuroretinal rim measurements.</p><p><strong>Methods: </strong>Over 5 years, 124 open-angle glaucoma patients had yearly dilated eye exams, disc photography, Humphrey visual field (HVF 24-2) testing, 2-dimensional (2D) OCT RNFL thickness measurements, and 3-dimensional (3D) OCT MDB rim measurements, all on the same day. One eye of each patient was analyzed, which was randomly selected if both eyes from a patient were eligible. Using global RNFL thickness and global MDB rim thickness, event-based progression was defined as change greater than normal aging change and expected inter-test variability. Trend-based analysis used linear regression with progression defined as rate of decline greater than age-related decline.</p><p><strong>Results: </strong>Average follow-up for the 124 open-angle glaucoma patients was 66.9±16.4 months. Event-based analysis was better than trend-based analysis, because it detected progression in more patients (15.3% by RNFL event-based analysis versus 8.1% by RNFL trend-based analysis, P=0.025; 52.4% by MDB event-based analysis versus 9.7% by MDB trend-based analysis, P<0.001) and earlier (RNFL: mean 28.8 months vs. 63.2 months; P<0.001; MDB: mean 30.7 months vs. 56.2 months; P<0.003) whether using MDB rim thickness or RNFL thickness. Using event-based analysis, MDB rim thickness detected progression more often than RNFL thickness (52.4% vs. 15.3%; P<0.001).</p><p><strong>Conclusions: </strong>Compared to trend-based analysis, event-based analysis detected OCT structural progression in more glaucoma patients and at an earlier timepoint.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of the PRESERFLO™ MicroShunt in Pediatric Glaucoma.","authors":"Susana Rebocho Duarte, Afonso Lima-Cabrita, Rafael Correia Barão, André Barata, Cristina Brito, Ingeborg Stalmans, Sophie Lemmens, João Barbosa Breda, Luís Abegão Pinto, Filipa Jorge Teixeira","doi":"10.1097/IJG.0000000000002574","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002574","url":null,"abstract":"<p><strong>Prcis: </strong>PRESERFLO™ significantly reduced both intraocular pressure and the number of glaucoma medications in selected cases of pediatric glaucoma, as far as a 2-year period, with a favorable safety profile.</p><p><strong>Purpose: </strong>To assess the efficacy and safety of the PRESERFLO™ device in selected cases of pediatric glaucoma.</p><p><strong>Methods: </strong>Retrospective multi-center observational study. Patients ≤18 years of age who underwent PRESERFLO™ implantation with at least 6 months of follow-up were included. Primary outcome was surgical success, defined as an intraocular pressure between 6 - 21 mmHg with a reduction of ≥20% (criterion A) or ≥30% (criterion B), no need for further surgery and no severe surgery-related complications. Secondary outcomes included postoperative intraocular pressure, number of hypotensive drugs and adverse effects.</p><p><strong>Results: </strong>Twenty eyes from 20 patients (mean age 11.7±1.1 y) were included, most with uveitic glaucoma (n=8 eyes; 40%). Average follow-up was 18.3±7.7 months, with 55% (n=11) completing 24 months. Mean intraocular pressure was significantly reduced from 27.8±1.3 mmHg at baseline to 14.2±8.5 mmHg and 14.6±13.9 mmHg at 12 and 24 months, respectively (P<0.001 for both). Average medication reduced from 2.9±1.1 to 0.9±1.3 (P=0.006) at 24 months. Qualified surgical success (regardless of medication) was 60% and 50% after 12 months, for criteria A and B, and 45% at 24 months (criteria A and B). In both time-points and for both criteria, 35% of cases were complete successes (drop-free). No sight-threatening complications were registered.</p><p><strong>Conclusion: </strong>Real-world data from PRESERFLO™ use suggests this to be a safe and effective surgical option for the treatment of selected cases of pediatric glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Long-Term Effects of Selective Laser Trabeculoplasty in Patients With Primary Open Angle Glaucoma.","authors":"Michele Lanza, Luigi Serra, Rosa Boccia, Teresa Cangiano, Maria Coniglio, Italo Fattore, Francesca Simonelli","doi":"10.1097/IJG.0000000000002547","DOIUrl":"10.1097/IJG.0000000000002547","url":null,"abstract":"<p><strong>Prcis: </strong>Data coming from this study suggest that selective laser trabeculoplasty could be a very important tool in the overall management of glaucoma patients at every stage, aiming to better control the visual field deterioration.</p><p><strong>Purpose: </strong>To evaluate selective laser trabeculoplasty (SLT) effectiveness in lowering intraocular pressure (IOP) and in visual field defect progression in eyes affected by primary open angle glaucoma (POAG) at long-term follow-up.</p><p><strong>Methods: </strong>A retrospective study was conducted with 67 eyes of 67 patients affected by POAG who underwent SLT between 2014 and 2021. Each patient was routinely observed in the Glaucoma Office of Università della Campania Luigi Vanvitelli and underwent a complete eye visit and visual field test with 30-2 SITA standard automated perimetry (SAP) every 6 months. When both eyes in the same patient were treated, only the eye with a lower mean deviation (MD) of SAP was included. Patients were observed at 6, 12, 18, 24, 30, 36, 42, 48, and 54 months.</p><p><strong>Results: </strong>A mean significant ( P <0.01) lower IOP was detected at 6 months (12.92±2.7 mm Hg) and at 54 months (13.08±2.42 mm Hg) compared with baseline (17.91±4 mm Hg). Mean MD values showed significant ( P <0.01) reduction both at the 6-month follow-up (-0.07±0.21dB) and at the 54-month follow-up (-0.3±0.34dB), demonstrating satisfactory clinical deceleration of the progression of the disease.Mean IOP medical lowering therapy was 1.34±0.9 drugs, showing a significant ( P <0.01) decrease 6 months after SLT (0.87±0.85), that remained stable [ P = at 54  mo follow up (0.9±0.76)].</p><p><strong>Conclusions: </strong>The results observed confirm not only the high level of effectiveness of SLT in lowering IOP and reducing the need for topical medications but also its role in decelerating visual field deterioration in eyes affected by POAG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"325-329"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Second Trabeculectomy Versus Glaucoma Drainage Device in Juvenile Open Angle Glaucoma After Primary Trabeculectomy Failure.","authors":"Kasem Seresirikachorn, Kornkamol Annopawong, Nucharee Parivisutt, Boonsong Wanichwecharungruang, David S Friedman, Daniel M Vu","doi":"10.1097/IJG.0000000000002525","DOIUrl":"10.1097/IJG.0000000000002525","url":null,"abstract":"<p><strong>Prcis: </strong>Second trabeculectomy and glaucoma drainage device implantation offer similar success rates for juvenile open angle glaucoma after initial trabeculectomy failure. However, second trabeculectomies required fewer medications. A quarter of patients in both groups required a third operation after 2.5±2.3 years.</p><p><strong>Purpose: </strong>To compare outcomes between second trabeculectomy surgery versus glaucoma drainage device (GDD) insertion in juvenile open angle glaucoma (JOAG) patients after primary trabeculectomy failure.</p><p><strong>Method: </strong>A retrospective review was performed on all JOAG patients who underwent a second glaucoma surgery after primary trabeculectomy failure across 2 tertiary hospitals in Bangkok, Thailand between 2009 and 2020. Demographics, intraoperative reports, and clinical findings were collected. The primary outcomes were complete and qualified success rates at 5 years; secondary outcomes included differences in intraocular pressures and a number of glaucoma medications postoperatively.</p><p><strong>Results: </strong>Fifty-two eyes of 38 patients underwent a second glaucoma surgery after primary trabeculectomy: 30 had a second trabeculectomy, 17 received a GDD (10 valved, 7 non-valved), and 5 underwent cyclophotocoagulation. Before surgery, there were no significant differences except in mean refractive error. The average follow-up length was 66.9±53.7 months. Qualified success rates were 81.5% and 63.2% at 3 and 5 years (complete success: 55.6% and 42.1%) for the second trabeculectomy group and 80.0% and 70.0% (complete success: 53.3% and 50.0%) for the GDD group, respectively. There were no significant differences in group success or IOP postoperatively. The GDD group required more medications at 5 years (1.3±1.9 vs. 2.3±1.5, P =0.03). Two cases of tube exposure in the GDD group resulted in implant removal. About a quarter of patients in both groups required a third operation after 2.5±2.3 years.</p><p><strong>Conclusion: </strong>Both second trabeculectomy and GDD insertion are effective treatments for JOAG after trabeculectomy failure. The second trabeculectomy required fewer medications for intraocular pressure control.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"297-303"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking More Than 10,000 Steps Per Day May Be Associated With Increased Optic Disc Vessel Density in Patients With Primary Open Angle Glaucoma.","authors":"Yuanbo Liang, Yun Yu, Xin Wen, Mei Wang, Yuqing Lan, Xiafei Pan","doi":"10.1097/IJG.0000000000002548","DOIUrl":"10.1097/IJG.0000000000002548","url":null,"abstract":"<p><strong>Prcis: </strong>Patients with primary open angle glaucoma (POAG) with average daily steps (ADS) >10,000 exhibited higher papillary vessel density (VD) compared with those with ADS ≤10,000, implying that increasing daily steps, particularly exceeding 10,000 steps, may potentially enhance ocular blood flow.</p><p><strong>Purpose: </strong>The study aimed to investigate the relationship between ADS and optic disc angioflow VD in patients with POAG.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study. Forty-one patients with POAG (74 eyes) were recruited from the Wenzhou Glaucoma Progression Study (WGPS) and were divided into 2 groups based on international physical activity guidelines: 21 subjects (38 eyes) in the ADS >10,000 group and 20 patients (36 eyes) in the ADS ≤10,000 group. ADS was monitored using a waist-worn accelerometer (ActiGraph wGT3x-BT) for 7 consecutive days, while optic disc VD was assessed by the optical coherence tomography angiography.</p><p><strong>Results: </strong>Papillary VD was significantly denser in the ADS >10,000 group (ADS:12782±2925) compared with that of the ADS ≤10,000 group (ADS:7418±1543) for both whole image-all VD (WIAVD) and whole image-capillary VD (WICVD) ( P =0.026, 0.032, respectively). Univariate analysis indicates that WIAVD was denser in the ADS >10,000 group versus the ADS ≤10,000 group ( P =0.013) and that WICVD was denser in the ADS >10,000 group versus the ADS ≤10,000 group ( P =0.019). Furthermore, every 1 μm thicker in retinal nerve fiber layer (RNFL) thickness was associated with a 0.24 denser in WIAVD ( P <0.0001) and a 0.23 denser in WICVD ( P <0.0001). Each 1-dB improvement in mean deviation (MD) was linked to a 0.75 increase in WIAVD ( P <0.0001) and a 0.83 increase in WICVD ( P <0.0001). In addition, a 1 mm Hg increase in intraocular pressure was associated with a 0.5 decrease in WIAVD ( P <0.009) in univariate analysis and a 0.31 decrease in multivariate analysis ( P <0.012). Multivariate analysis revealed that patients with ADS >10,000 had 1.75 higher WIAVD and 1.64 higher WICVD compared with those with ADS ≤10,000 after adjusting for other risk factors.</p><p><strong>Conclusion: </strong>Patients with POAG with ADS >10,000 exhibited higher papillary VD compared with those with ADS ≤10,000, implying that increasing daily steps, particularly exceeding 10,000 steps, may potentially enhance ocular blood flow.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"249-255"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow-Coagulation Transscleral Cyclophotocoagulation in Pseudoexfoliation Glaucoma.","authors":"Mohamed M Khodeiry, Ramsey Yusuf, Christopher A Dorizas, Abdelrahman M Elhusseiny, Mohamed S Sayed, Merry Ruan, Richard K Lee","doi":"10.1097/IJG.0000000000002534","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002534","url":null,"abstract":"<p><strong>Prcis: </strong>Further prospective investigations are suggested to confirm these findings.</p><p><strong>Purpose: </strong>To evaluate the outcomes of slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) in pseudoexfoliation glaucoma (PXG).</p><p><strong>Methods: </strong>A single-center, retrospective non-comparative study including consecutive patients with medically uncontrolled PXG who underwent SC-TSCPC (1250-milliwatt power and 4-second duration). The primary outcome measure was surgical success [defined as intraocular pressure (IOP) between 6 and 21 mmHg with ≥20% reduction compared with baseline and no need for further glaucoma surgeries or development of vision-threatening complications]. Success was considered qualified when achieved with additional glaucoma medications and complete when achieved without additional glaucoma medications. The secondary outcomes included IOP, glaucoma medication numbers, visual acuity, and postoperative complications at 1 and 2 years after laser treatment.</p><p><strong>Results: </strong>This study included 48 eyes of 48 patients. The median age of study participants was 87.5 years, with a median follow-up duration of 24.0 months. The qualified success for a single SC-TCPC treatment at 1 and 2 years was 58.3% and 47.9%, respectively. Cumulative qualified success (>1 SC-TSCPC) was 64.6% at 1 year and 56.2% at 2 years. Complete surgical success after a single SC-TSCPC was 45.8% at 1 year and 33.3% at 2 years, increased to 50.0% at 1 year and 39.6% at 2 years after >1 SC-TSCPC. After SC-TSCPC treatment, the mean IOP decreased from 29.2±10.3 mmHg on 3.7±1.0 medications pretreatment to 14.3±6.43 mmHg on 2.6±1.3 medications at the final follow-up visit ( P <0.001). Seven eyes (14.6%) had SC-TSCPC retreatment, and 2 eyes (4.2%) required incisional glaucoma surgeries. Reported postoperative complications included: decreased visual acuity in 9 (18.8%) eyes, iridocyclitis in 5 (10.4%) eyes, hyphema in 5 (10.4%) eyes, cystoid macular edema in 2 (4.2%) eyes, and transient hypotony in 2 (4.2%) eyes.</p><p><strong>Conclusions: </strong>SC-TSCPC is an effective, relatively safe, and repeatable surgical treatment option in PXG. Further prospective investigations are suggested to confirm these findings.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"34 4","pages":"304-309"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioequivalence of Preservative-Free and Preserved Omidenepag Isopropyl 0.002% Ophthalmic Solutions in Patients With Primary Open Angle Glaucoma or Ocular Hypertension: Phase 3 DAISY Study.","authors":"Makoto Aihara, Fenghe Lu, Toshihiro Ikeda, Noriko Odani-Kawabata","doi":"10.1097/IJG.0000000000002533","DOIUrl":"10.1097/IJG.0000000000002533","url":null,"abstract":"<p><strong>Prcis: </strong>Preservative-free omidenepag isopropyl (OMDI) 0.002% ophthalmic solution and OMDI 0.002% ophthalmic solution preserved with benzalkonium chloride (BAK) were bioequivalent in lowering intraocular pressure (IOP) after 4 weeks' treatment in patients with primary open angle glaucoma (POAG) or ocular hypertension (OHT).</p><p><strong>Objective: </strong>Preservatives in ophthalmic solutions for lowering IOP are associated with ocular surface disease. The DAISY study evaluated the bioequivalence of preservative-free OMDI 0.002% ophthalmic solution (DE-117B), with OMDI 0.002% preserved with BAK.</p><p><strong>Methods: </strong>DAISY was a phase 3, randomized, evaluator-masked, crossover study conducted in Japan. Patients with POAG or OHT were randomized 1:1 to DE-117B or OMDI 0.002% for 4 weeks (period 1) and then crossed over for 4 weeks (period 2). A 4-week washout preceded both periods. The primary efficacy endpoint was mean diurnal (MD) IOP at week 4 (combined periods 1 and 2). Bioequivalence between DE-117B and OMDI was defined as a 95% CI between -1.5 and 1.5 for least squares mean between-group difference in MD IOP. Adverse events were monitored.</p><p><strong>Results: </strong>Of 74 patients enrolled, 38 were randomized to DE-117B, then OMDI, and 36 were randomized to OMDI then DE-117B. DE-117B and OMDI demonstrated bioequivalence at week 4 [MD IOP ± SD in summary statistics: 17.76 ± 2.05 mm Hg (DE-117B) vs 17.71 ± 2.01 mm Hg (OMDI); least squares mean ± SE between-group difference in linear mixed effect model: -0.02 ± 0.18 mm Hg (95% CI: -0.38 to 0.35)]. DE-117B versus OMDI was associated with numerically lower overall ocular discomfort.</p><p><strong>Conclusions: </strong>Preservative-free DE-117B and BAK-containing OMDI were bioequivalent in lowering IOP after 4 weeks' treatment in Japanese patients with POAG or OHT. DE-117B was well tolerated with a similar safety profile to OMDI.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"310-316"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aqueous Angiography-Guided Bent Ab Interno Needle Goniectomy in High Versus Low Aqueous Humor Outflow Regions in Primary Open Angle Glaucoma: A Pilot Randomized Controlled Trial.","authors":"Tanuj Dada, Ashi Gupta, Nitika Beri, Alex S Huang, Namrata Sharma, Dewang Angmo, Prafulla K Maharana, Amar Pujari","doi":"10.1097/IJG.0000000000002537","DOIUrl":"10.1097/IJG.0000000000002537","url":null,"abstract":"<p><strong>Prcis: </strong>Trabecular cutting minimally invasive glaucoma surgery like bent ab interno needle goniectomy (BANG) when performed in baseline aqueous angiography identified low aqueous humor outflow regions, results in greater success of intraocular pressure reduction.</p><p><strong>Purpose: </strong>To study the efficacy of bent ab interno needle goniectomy (BANG) in high versus low aqueous humor outflow (AHO) regions as determined by aqueous angiography (AA) in patients with primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>A prospective, single-centre, pilot, randomized control trial recruited 30 eyes of 30 patients of POAG and visually significant cataract (45-80 y) and were randomised into 2 groups (\"A\": BANG performed in the high-flow regions and \"B\": BANG performed in the low-flow regions) of 15 each. AA was performed using indocyanine green dye (0.1%) to identify baseline high-flow and low-flow regions of the AHO pathways followed by BANG in these respective regions as per randomisation. Preoperative and postoperative data on IOP, number of antiglaucoma medications (AGMs), and any complications were noted over 6 months. Overall success was defined as achieving an IOP ≤15 and ≥6 mm Hg at 6 months of follow-up with AGMs (qualified success) or without AGMs (complete success).</p><p><strong>Results: </strong>AA revealed high-flow regions of AHO pathways in the nasal quadrant and low-flow regions of AHO pathways in the temporal quadrant in all 30 patients. Both groups had comparable demographic composition [group A age: 65.3±6.48 y and male:female (14:1) and group B age: 64.6±7.08 y and male:female (13:2)]. The mean preoperative IOPs [group A (17.27±3.43 mm Hg); group B (17.60±5.42 mm Hg)] ( P =0.842) and mean postoperative IOP at 6 months [group A (15.6±4.98 mm Hg); group B (13.13±2.29 mm Hg)] ( P =0.09) were similar. However, lower qualified success was seen in group A (40.00%) compared with group B (86.67%; P =0.021). Survival in Kaplan-Meier analysis was higher in group B ( P =0.021). Complications were comparable in both groups.</p><p><strong>Conclusion: </strong>Short-term results of BANG in low-flow AHO regions show enhanced success compared with those in high-flow AHO regions. This study suggests that trabecular cutting minimally invasive glaucoma surgeries (like BANG) may be performed in baseline low-flow AHO regions (temporal quadrant) instead of the high-flow AHO (nasal quadrant) regions.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"317-324"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Real-World Outcomes of Ab-Externo Gel Stent Placement From the EXPAND Study.","authors":"Brian A Francis, Vanessa Vera, Joshua Kim, Mahdi M Basha, Bryant Lum, Douglas Grayson, Steven Vold, Mini Balaram, Susan Simonyi, Husam Ansari, Natasha Nayak Kolomeyer","doi":"10.1097/IJG.0000000000002543","DOIUrl":"10.1097/IJG.0000000000002543","url":null,"abstract":"<p><strong>Prcis: </strong>In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%).</p><p><strong>Purpose: </strong>To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma.</p><p><strong>Methods: </strong>Multicenter, real-world, retrospective study. Consecutive adults with glaucoma and ab-externo GS implantation (with/without phacoemulsification or open/closed conjunctiva) ≥12 months before study entry. Data were extracted between the baseline/preoperative and last follow-up visit or date of secondary surgical intervention (SSI). Primary effectiveness endpoint: proportion of primary eyes (first eye in bilaterally implanted patients) at month 12 (M12) achieving ≥20% intraocular pressure (IOP) reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or SSI. Secondary effectiveness endpoints included complete success (IOP ≤18 mm Hg and ≥20% IOP reduction from medicated baseline without medication, clinical hypotony, or SSI); qualified success (same but without medication increase); and needling rate. Key safety endpoints (all eyes): intraoperative complications, postoperative adverse events (AEs), and SSIs.</p><p><strong>Results: </strong>The safety population included 466 eyes; 80.7% received the GS alone and 85.0% were implanted with closed conjunctiva. At M12, 39.1% of all primary eyes (N=413) and 54.9% of primary eyes with IOP and medication data at baseline and M12 (N=213) achieved the primary endpoint. At M12 among all primary eyes, the complete success, qualified success, and needling rates were 33.5%, 56.5%, and 28.6%. Most eyes (97.9%) had no intraoperative complications. The most frequent postoperative AE was transient/self-resolving hypotony (IOP <6 mm Hg; 28.1%). Sixty-nine (14.8%) eyes required an SSI.</p><p><strong>Conclusions: </strong>Ab-externo GS placement effectively lowered IOP and the medication count without unexpected complications/AEs, expanding implantation options based on patients' needs and surgeons' preferences.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"330-341"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}