Journal of Glaucoma最新文献

{"title":"Longitudinal Trends in Resource Utilization Associated with Newly Diagnosed Primary Angle Closure Glaucoma in the United States.","authors":"Daniel Guth, Galo Apolo, Seth A Seabury, Khristina Lung, Brian Toy, Benjamin Y Xu","doi":"10.1097/IJG.0000000000002612","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002612","url":null,"abstract":"<p><strong>Prcis: </strong>Average cumulative two-year cost following first primary angle closure glaucoma diagnosis was $2,960. Elderly and Black patients were at higher risk of being among the costliest 5% (>$9,813) of cases, accounting for 21.3% of costs.</p><p><strong>Purpose: </strong>To assess longitudinal eye care costs associated with newly diagnosed primary angle closure glaucoma (PACG) in the United States.</p><p><strong>Methods: </strong>Patients with a diagnosis of PACG between 2009 to 2017 were identified in Optum's de-identified Clinformatics® Data Mart Database based on International Classification of Diseases (ICD) codes. Newly diagnosed PACG was defined as: 1) diagnosis by an ophthalmologist or optometrist; 2) observable for at least 12 months before and 24 months after index diagnosis; 3) no prior history of glaucoma treatment; 4) PACG-related treatment initiated after index diagnosis. Logistic regression modeling was performed to identify risk factors for being in the top 5% of cumulative two-year costs.</p><p><strong>Results: </strong>Among 12,673 eligible patients, the average cumulative two-year cost following first PACG diagnosis was $2,960. Patient costs were highest in the six months immediately following diagnosis, accounting for 52.3% of all two-year costs. 56.7% of all two-year costs were related to treatment procedures. The costliest 5% (>$9,813) of patients accounted for 21.3% of all two-year PACG-related costs. Risk factors for being in costliest 5% (P<0.05) included older age, Black race, PPO or other Medicare insurance product, living in the Midwest or the South, and recent diagnosis of anatomical narrow angles (ANA).</p><p><strong>Conclusion: </strong>Costs associated with newly diagnosed PACG were found to be disproportionately driven by a small subset of cases. Elderly and Black patients were more likely to be within the top 5% of cumulative two-year costs. Identifying and preventing the costliest PACG cases could reduce PACG-related eye care expenditures.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649662","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 of Filtration Surgery and Risk Factors for Central Visual Field Deterioration in Highly Myopic Eyes with Open-Angle Glaucoma.","authors":"Takeshi Yoshida, Nan Zhou, Sota Yoshimoto, Keigo Sugisawa, Motohisa Ohno, Shintaro Yasuda, Yuto Shiotani, Ryu Teramatsu, Kyoko Ohno-Matsui","doi":"10.1097/IJG.0000000000002611","DOIUrl":"10.1097/IJG.0000000000002611","url":null,"abstract":"<p><strong>Prcis: </strong>This study demonstrates the effectiveness of filtration surgery in preserving the central visual field in eyes showing open-angle glaucoma with high myopia, highlighting the necessity of intraocular pressure reduction ≥30% for optimal outcomes.</p><p><strong>Purpose: </strong>To evaluate the efficacy of filtration surgery in preserving the central visual field (VF) in eyes with open-angle glaucoma (OAG) and high myopia (HM) and identify postoperative intraocular pressure (IOP) targets and factors associated with targeted IOP reduction.</p><p><strong>Methods: </strong>This retrospective cohort study included 55 eyes (48 patients) with OAG and HM who underwent filtration surgery and were followed up for minimum 3 years. Pre- and postoperative IOP values, mean deviation (MD) values, and MD slopes from Humphrey 10-2 VF tests were assessed. Participants were categorized according to the postoperative MD slope (>-0.5 dB/year or ≤-0.5 dB/year) to evaluate surgical success, defined as IOP reduction of ≥20%, ≥30%, or ≥40% from baseline. Predictors of targeted IOP reduction were identified.</p><p><strong>Results: </strong>Significant postoperative IOP reductions were observed at all time points ( P <0.001). The mean MD slope improved from -1.53±0.91 to -1.00±1.40 dB/year ( P =0.001). Eyes with MD slope ≤-0.5 dB/year had a longer axial length (AL; P =0.048), more needling procedures ( P =0.003), and higher postoperative IOP at 1 and 2 years ( P <0.001, P =0.021, respectively). Surgical success rates (IOP reduction ≥30% and ≥40%) were higher for eyes with MD slope >-0.5 dB/year ( P =0.006, P =0.003), with no significant difference for IOP reduction ≥20% ( P =0.087). To achieve postoperative MD slope >-0.5 dB/year, minimum 30% IOP reduction was required. If AL was >28.01 mm, 40% IOP reduction was required. AL and needling procedure frequency were significantly associated with IOP reduction ≥30% (odds ratio=1.79 and 2.26; P =0.018 and 0.039, respectively).</p><p><strong>Conclusions: </strong>Substantial IOP reduction is essential for preserving the central visual field in eyes with OAG and HM, particularly those with AL ≥28.01 mm. Longer AL and frequent needling procedures increase the surgical failure risk.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626528","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":"Quality of Life and Associated Factors in Chinese Glaucoma Patients.","authors":"Yunsheng Qiao, Chen Tan, Junyi Lai, Jiangnan He, Jianfeng Zhu, Haidong Zou, Xinghuai Sun, Junyi Chen","doi":"10.1097/IJG.0000000000002609","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002609","url":null,"abstract":"<p><strong>Precis: </strong>Quality of life scores in Chinese glaucoma patients were mainly associated with disease severity, measured by patients' visual acuity, stages of visual field defects and intraocular pressure.</p><p><strong>Purpose: </strong>To examine the effect of demographic, clinical, and socioeconomic factors on glaucoma patient-reported quality of life (QoL) scores.</p><p><strong>Patients and methods: </strong>In this cross-sectional study, 1,057 consecutive glaucoma patients aged 18 and above were recruited from 34 hospitals across China between November 1, 2022 and December 18, 2022. A smart-phone based survey collected demographic/socioeconomic data and incorporated the Chinese version of the Glaucoma Quality of Life-17 (Glau-QoL-17) questionnaire for patient-reported QoL evaluation. Visual functions (best-corrected visual acuity [BCVA], the higher intraocular pressure [IOP] of both eyes, the stages of visual field impairment) were assessed by ophthalmic professionals. Multiple linear regression models were constructed to identify predictors for both overall and subscale QoL scores. Least Absolute Shrinkage and Selection Operator (LASSO) analysis was used to screen the most influential factors for the overall QoL score.</p><p><strong>Results: </strong>The median (interquartile range) QoL score was 57 (49 - 65). BCVA and the stage of visual field defects of the better eye, the higher IOP reading between both eyes, the employment status and the city tier of residence were independent predictors for QoL after adjusting for age, sex, education level, and comorbidities. LASSO analysis additionally identified primary open-angle glaucoma and combined surgical and pharmacological treatment as one of the most influential factors affecting QoL. Clinical factors explained the largest variation in the multiple linear regression model.</p><p><strong>Conclusions: </strong>QoL of glaucoma patients are primarily determined by clinical indices. Unemployment is also an important correlate of low QoL among glaucoma patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600690","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":"The Effect of Endoscopic Cyclophotocoagulation on the Outcomes of Excisional Goniotomy with and without Phacoemulsification.","authors":"Maxwell Mayeda, Anthony T Scott, Cara Capitena Young, Jeffrey R SooHoo, Mina B Pantcheva, Jennifer L Patnaik, Malik Y Kahook, Leonard K Seibold","doi":"10.1097/IJG.0000000000002610","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002610","url":null,"abstract":"<p><strong>Precis: </strong>Combination MIGS procedures are a potentially more efficacious method to decrease mean IOP and glaucoma medication burden; however, our findings question whether the addition of ECP to excisional goniotomy provides significant additional benefit.</p><p><strong>Purpose: </strong>Combined microinvasive glaucoma surgery (MIGS) procedures are gaining popularity. While the individual efficacy of excisional goniotomy and endoscopic cyclophotocoagulation (ECP) is well established, data supporting their use in combination is lacking. Our study aims to evaluate the additive benefit of ECP to excisional goniotomy with the Kahook Dual Blade (KDB) in the largest patient cohort evaluated to date.</p><p><strong>Materials: </strong>and Methods: A retrospective chart review was performed of adults seen at a tertiary eye center between May 2015 and August 2019. Patients who received goniotomy alone were compared to those who received standalone goniotomy and ECP (KDB/ECP), while those who received goniotomy and phacoemulsification (KDB/phaco) were compared to those undergoing phacoemulsification, goniotomy and ECP (PEcK).</p><p><strong>Results: </strong>A total of 723 eyes were included. All four study groups had a decrease in mean IOP at 6, 12, and 24 months (all P<0.05) and a significant decrease in glaucoma medications at 12 months (all P<0.05). When comparing the KDB group to the KDB/ECP group, there were no statistical differences in mean IOP or number of glaucoma medications at any timepoint (P>0.05 for all). When comparing the KDB/phaco group to the PEcK group there were no statistical differences in mean IOP (P>0.05 for all) or glaucoma medications at 12 and 24 months.</p><p><strong>Conclusion: </strong>Both standalone KDB goniotomy with ECP and the PEcK procedure are efficacious at lowering IOP and glaucoma medication burden. While success rates were not improved, the addition of ECP to KDB goniotomy appears to achieve a more sustained reduction in medication burden compared to goniotomy alone.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600691","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":"Two-year Results of Gonioscopy-Assisted Transluminal Trabeculotomy versus Ab-Externo Visco Circumferential Suture Trabeculotomy in Primary Congenital Glaucoma.","authors":"Ahmed Samy Elwehidy, AbdElhamid Shaker Elhofi, Amr Mohammed Elsayed Abdelkader, Nada Medhat GabAllah","doi":"10.1097/IJG.0000000000002608","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002608","url":null,"abstract":"<p><strong>Precis: </strong>Both Gonioscopy-assisted transluminal trabeculotomy and Ab-Externo Visco Circumferential Suture Trabeculotomy reduced the intraocular pressure in primary congenital glaucoma by more than 50% from baseline at two years. There were no serious adverse events.</p><p><strong>Purpose: </strong>Primary congenital glaucoma (PCG) is a severe form of glaucoma that presents in infancy and requires surgical intervention to prevent irreversible vision loss. Angle-based surgery is the primary treatment for PCG, with recent reports suggesting promising outcomes for gonioscopy-assisted transluminal trabeculotomy (GATT) in children with PCG. Ab-Externo Visco Circumferential Suture Trabeculotomy (AVCST) offers the advantages of combining the efficacy of 360-degree circumferential trabeculotomy via low-cost Prolene sutures with the facilitation of the Schlemm's canal (SC) cannulation using viscoelastic.</p><p><strong>Methods: </strong>This retrospective interventional study compared the one-year outcomes of GATT and AVCST in managing PCG. The records of 65 eyes of 39 children who underwent surgery for their PCG were reviewed.</p><p><strong>Results: </strong>The key outcome measures included reduction of intraocular pressure (IOP), the success rate, and surgical complications. At two years, both surgical techniques demonstrated significant IOP reduction from baseline (GATT: mean reduction of 15.33±2.56 mm Hg; AVCST: mean reduction of 15.96±2.95 mm Hg) but there was no statistical difference between both groups at 2 years (P=0.371). The complete success rate, defined as an IOP ≤16 mm Hg with > 30% reduction from the baseline without antiglaucoma medications (AGMs) or further surgical interventions, was 87.1% for the GATT and 85.3% for the AVCST, which was not statistically significant between the two groups (P=0.710). The complication rates were comparable between the two groups, with transient hyphaema being the most common adverse event.</p><p><strong>Conclusions: </strong>Our findings indicate that GATT and AVCST are both effective and safe surgical options for PCG, with similar efficacy and complication profiles after two years. Further long-term studies are warranted to assess the durability of these outcomes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600692","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":"Visual Field Progression in Glaucoma During COVID-19.","authors":"Bhavini Johri, Lingam Vijaya, Trupti Sudhir Patil, Ronnie George","doi":"10.1097/IJG.0000000000002567","DOIUrl":"10.1097/IJG.0000000000002567","url":null,"abstract":"<p><strong>Prcis: </strong>Visual fields in glaucoma significantly progressed during the COVID-19 pandemic, likely due to reduced compliance and lack of availability of medication.</p><p><strong>Purpose: </strong>To study the impact of the COVID-19 pandemic on the rate of visual field progression in glaucoma and to validate the factors affecting progression.</p><p><strong>Methods: </strong>This hospital-based prospective cohort study included patients diagnosed with primary open angle glaucoma, primary angle closure glaucoma, and ocular hypertension who fulfilled the eligibility criteria. We included 234 eyes with at least 5 reliable Humphrey visual fields (24-2 SITA Standard) before March 24, 2020 and 2 or more after. Glaucoma Progression Analysis software was used to carry out both trend and event-based analysis. Rates of progression prepandemic and postpandemic were compared. Univariate and multivariate logistic regression analyses were done to identify factors affecting progression.</p><p><strong>Results: </strong>The rate of visual field progression increased significantly post lockdown, mean deviation (MD) prelockdown -0.1(SD:0.8) (95% CI: -0.196, 0.001) dB/year versus -0.3 (SD:0.6) (95% CI: -0.362, -0.208) dB/year post lockdown ( P <0.001) and Visual Field Index(VFI) pre lockdown -0.001(SD:0.007) (95% CI: -0.002, 0) %/year versus -0.6 (SD:2.2) (95% CI: -0.903, -0.342) %/year post lockdown ( P <0.001). According to either trend or event analysis, of 234 eyes, 45.3% progressed and 37.6% progressed on any progression post-COVID. The MD of the last field pre-COVID was significantly affecting progression post-COVID based on both trend and event analysis or any progression ( P <0.001).</p><p><strong>Conclusion: </strong>In patients with glaucoma on follow-up, higher rates and proportions of visual field progression were found post the COVID-19 pandemic compared with prepandemic.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"555-560"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604833","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":"SMOTE-Enhanced Explainable Artificial Intelligence Model for Predicting Visual Field Progression in Myopic Normal Tension Glaucoma.","authors":"So Yeon Kim, Jung Jong Jin, Ahnul Ha, Chae Hyun Song, Se Hie Park, Kyoung Hae Kang, Jaekyoung Lee, Min Gu Huh, Jin Wook Jeoung, Ki Ho Park, Young Kook Kim","doi":"10.1097/IJG.0000000000002579","DOIUrl":"10.1097/IJG.0000000000002579","url":null,"abstract":"<p><strong>Prcis: </strong>The AI model, enhanced by SMOTE to balance data classes, accurately predicted visual field deterioration in patients with myopic normal tension glaucoma. Using SHAP analysis, the key variables driving disease progression were identified.</p><p><strong>Purpose: </strong>To develop and validate a Synthetic Minority Over-sampling Technique (SMOTE)-enhanced artificial intelligence (AI) model for predicting visual field progression in myopic normal tension glaucoma (NTG) patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 100 eyes from myopic NTG patients with a mean follow-up of 10.3±3.2 years. Baseline parameters included intraocular pressure (IOP), central corneal thickness, axial length, and visual field metrics. A SMOTE-enhanced AI model was created to address class imbalance in progression events. Model performance was evaluated using receiver operating characteristic (ROC) analysis, cross-validation, and calibration plots. Predictive factor importance was evaluated through SHapley Additive exPlanations (SHAP) analysis.</p><p><strong>Results: </strong>Visual field progression was observed in 28% of patients, with a median progression time of 3.2 years. The AI model achieved an area under the ROC curve (AUC) of 0.83 (95% CI, 0.75-0.91), with promising sensitivity (0.81) and specificity (0.77). SHAP analysis identified baseline mean deviation (MD), age, axial length, baseline IOP, and visual field index (VFI) as key predictors. When patients were stratified based on model-predicted risk scores, those with scores above 0.8 had significantly higher observed progression rates (82.6%) compared with those with lower risk scores. Subgroup analysis revealed strong correlations between progression risks and older age, greater axial length, and worse baseline MD.</p><p><strong>Conclusions: </strong>The SMOTE-enhanced AI model shows reasonable predictive performance and potential clinical utility for identifying visual field progression in myopic NTG patients, though further validation in larger cohorts is needed. By addressing class imbalance and myopia-specific challenges, this approach enables personalized risk stratification and early intervention.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"520-527"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011316","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":"Optical Coherence Tomography Alteration of the Choroid and Lamina Cribrosa in Pseudoexfoliation Syndrome and Glaucoma.","authors":"Sepehr Fekrazad, Mahdi Gouravani, Golnar Hassanzadeh, Asma Mafhoumi, Mina Mirzad, Saeed S Vafa, Benjamin Xu, J Fernando Arevalo","doi":"10.1097/IJG.0000000000002571","DOIUrl":"10.1097/IJG.0000000000002571","url":null,"abstract":"<p><strong>Prcis: </strong>This meta-analysis demonstrates significant thinning of the choroid and lamina cribrosa in eyes with pseudoexfoliation syndrome and pseudoexfoliative glaucoma compared with healthy controls, emphasizing OCT's potential utility for early glaucoma detection in these patients.</p><p><strong>Background: </strong>Pseudoexfoliation syndrome (PXS) is a significant risk factor for pseudoexfoliative glaucoma (PXG), impacting posterior segment tissues such as the choroid and lamina cribrosa (LC). This research aims to investigate the effects of PXS on these layers compared with healthy controls using optical coherence tomography (OCT).</p><p><strong>Methods: </strong>Following the PRISMA checklist, this systematic review, registered at PROSPERO (CRD42023415302), examined OCT measurements in PXS and PXG patients. Searches were conducted in PubMed, Scopus, and EMBASE until April 2023. Selection criteria included human observational studies assessing choroid and lamina cribrosa layers with OCT in PXS and PXG patients. Statistical analyses, including meta-analysis, bias detection, subgroup analysis, and metaregression, were performed.</p><p><strong>Results: </strong>A total of 22 studies, comprising 2293 participants (717 PXG patients, 708 PXS patients, and 868 healthy controls), underwent meta-analysis. In PXG cases, subfoveal choroidal thickness (CT), as well as CT at 1500 µm and 3000 µm temporal and nasal to the fovea, were significantly decreased compared with healthy individuals. In addition, average peripapillary CT and average LCT were significantly reduced in PXG eyes compared with healthy controls. Similarly, eyes with PXS exhibited significantly lower values for subfoveal CT, CT at 1500 µm temporal and 3000 µm nasal to the fovea, average peripapillary CT, and average LC thickness compared with healthy controls.</p><p><strong>Conclusion: </strong>This meta-analysis confirms previously reported decreases in CT and LC thickness in patients with PXG and PXS. Continuous monitoring of choroid and LC using OCT may facilitate the early detection of glaucoma in patients with PXS, addressing a key concern in their management.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"507-519"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700673","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":"Gonioscopy-Assisted Transluminal Trabeculotomy in Patients With Angle Recession Glaucoma.","authors":"Enver Mirza, Gunsu D Mirza","doi":"10.1097/IJG.0000000000002568","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002568","url":null,"abstract":"<p><strong>Prcis: </strong>Gonioscopy-assisted transluminal trabeculotomy (GATT) is a successful minimally invasive glaucoma surgery (MIGS) technique for treating patients with angle recession glaucoma (ARG).</p><p><strong>Purpose: </strong>To share 1-year follow-up outcomes of GATT in patients with ARG.</p><p><strong>Patients and methods: </strong>Six eyes of 6 patients with ARG were reviewed in this retrospective study. All of the patients had uncontrolled intraocular pressure (IOP) with antiglaucoma medications (AGM) and a history of blunt ocular trauma (BOT). Preoperative IOP; the number of preoperative AGM; postoperative IOP at first month, third, sixth, and 12th months; postoperative IOP spikes, the need for postoperative AGM, and the need for further surgical interventions were recorded.</p><p><strong>Results: </strong>Five patients underwent GATT and 1 patient underwent GATT combined with phacoemulsification. IOP decreased from 30.30 [7.20] mm Hg preoperatively to 11.95 [3.45] mm Hg postoperatively at the 12th month (P=0.028), with a median difference of -19.50 mm Hg (95% CI: -25.10 to -14.55). After GATT, all patients had varying degrees of hyphema that did not require surgical intervention. IOP peaks were observed in the postoperative first month in 3 patients and IOP was controlled with AGM in these patients. The median (IQR) preoperative number of AGM decreased significantly compared with the median (IQR) postoperative number of AGM at the 12th month [P=0.038, 4.00 (0.25) vs. 2.00 (1.25), median difference: -1.50, 95% CI: -2.00 to -0.50]. During the 1-year follow-up, no patients with ARG required additional surgical intervention.</p><p><strong>Conclusion: </strong>Due to its low complication rates and successful IOP-lowering effect, we recommended that GATT is an effective, safe, and considerable MIGS procedure for patients with ARG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"34 7","pages":"535-540"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497229","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":"The Role of Vitreous Zonule Attachments to the Posterior Lens Equator in Primary Angle Closure Glaucoma.","authors":"Jie Huang, Mubin Li, Chukai Huang","doi":"10.1097/IJG.0000000000002577","DOIUrl":"10.1097/IJG.0000000000002577","url":null,"abstract":"<p><strong>Prcis: </strong>Shorter axial length was associated with the absence of the attachments between the posterior insertion zone of the vitreous zonules and the posterior lens equator. Primary angle closure disease eyes without vitreous zonules had a more anteriorly rotated ciliary body.</p><p><strong>Purpose: </strong>To assess the clinical significance of the attachments between the posterior insertion zone of the vitreous zonules and the posterior lens equator (PVZ INS-LE strands) and vitreous zonules (VZ) in primary angle closure disease (PACD).</p><p><strong>Methods: </strong>This cross-sectional study consisted of 90 PACD and 30 cataract eyes from an eye clinic. PVZ INS-LE strands, VZ, and anterior segment parameters were assessed by ultrasound biomicroscopy (UBM). The presence of PVZ INS-LE strands and VZ was compared between groups. Baseline ocular characteristics and UBM parameters were compared among PACD eyes. Factors associated with the absence of PVZ INS-LE strands and VZ were identified.</p><p><strong>Results: </strong>Forty percent of control eyes and 71.1% of PACD showed PVZ INS-LE strands absent. PACD 22.2% and no control eyes showed VZ absent. PVZ INS-LE strands absent group had shorter axial length ( P =0.018), larger ciliary-ciliary angle ( P =0.010), and smaller trabecular-ciliary process distance at 750 μm ( P =0.022). Shorter axial length was independently associated with absence of PVZ INS-LE strands (OR=2.230; 95% CI: 1.027-4.838; P =0.043). VZ absent group had larger ciliary-ciliary angle ( P <0.001), smaller trabecular-ciliary angle ( P =0.040), shorter iris-ciliary process distance at 750 μm ( P =0.092), and shorter trabecular-ciliary process distance at 750 μm ( P =0.026).</p><p><strong>Conclusions: </strong>PVZ INS-LE strands were less likely to be seen in APACD and their fellow eyes. All types of PACD eyes had less presence of VZ. PACD eyes without VZ appeared to have more anterior rotation of the ciliary body. Shorter AL was independently associated with the absence of PVZ INS-LE strands.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"528-534"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988415","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}