Journal of Glaucoma最新文献

{"title":"Accuracy of the Heijl-Krakau Method During Blind-Spot Stimulation With the Head Mounted Imo Perimeter in Patients With Glaucoma and Glaucoma Suspects.","authors":"Mariko Eura, Hiroki Nomoto, Chota Matsumoto, Takuya Ishibashi, Fumi Tanabe, Keiji Yoshikawa, Mami Nanno, Shunji Kusaka","doi":"10.1097/IJG.0000000000002549","DOIUrl":"10.1097/IJG.0000000000002549","url":null,"abstract":"<p><strong>Prcis: </strong>13.9% of fixation loss responses by the Heijl-Krakau method were observed even in stable fixation eyes. The Heijl-Krakau method would overestimate the fixation loss responses.</p><p><strong>Purpose: </strong>This study aimed to evaluate the accuracy of the Heijl-Krakau method by measuring eye positions during blind-spot stimulation.</p><p><strong>Methods: </strong>Two thousand one hundred fifty-three eyes of 1155 glaucoma and glaucoma-suspect patients. All patients underwent a head-mounted perimeter imo test. The imo has an eye tracking system that records eye position during tests and assists the device with stimulating corrected points corresponding to eye movement. All stimulus presentations were classified into 3 groups: (1) fixation loss (FL) stimulus: responded to Heijl-Krakau stimuli; (2) non-FL stimulus: did not respond to Heijl-Krakau stimuli; and (3) total stimuli: all other stimuli except for Heijl-Krakau stimuli. We compared the amount of fixation displacement between the FL, non-FL, and total stimuli by the Mann-Whitney U test. Relationships between the FL and mean deviation (MD), the FL and age were analyzed.</p><p><strong>Results: </strong>The median fixation displacements with the FL, non-FL, and total stimuli were 3.2, 1.4, and 1.5 degrees, respectively. The fixation displacement in the FL stimulus group was greater than that in the non-FL and total stimuli groups ( P <0.001). When we defined fixation displacement in the range of <1 degree as \"stable eye fixation,\" 13.9% of the stimulus points corresponded to \"stable eye fixation\" with the FL stimulus. No significant relationships were found in the FL and MD, as well as in the FL and age.</p><p><strong>Conclusion: </strong>In glaucoma and glaucoma suspected patients, after allowance for eye movement by imo patients still responded to the Heijl-Krakau blind spot monitor on 13.9% of occasions. Our results suggest that the Heijl-Krakau method overestimates the FL response in glaucoma and glaucoma suspected patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"400-403"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189490","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":"Telemedicine in Glaucoma Management: Patient Perspectives.","authors":"Angela J Oh, Ella Bouris, Brayden K Leyva, Mashal Malik, Joseph Caprioli","doi":"10.1097/IJG.0000000000002558","DOIUrl":"10.1097/IJG.0000000000002558","url":null,"abstract":"<p><strong>Prcis: </strong>Patient satisfaction and perspectives on telemedicine for glaucoma are crucial for validating the efficacy of remote health care. This study underscores its acceptance by patients in a single academic practice.</p><p><strong>Purpose: </strong>To evaluate patient satisfaction and preferences with telemedicine visits integrated into a glaucoma practice.</p><p><strong>Methods: </strong>A prospective observational study of patients of a single glaucoma specialist's telemedicine practice was performed using an online questionnaire.</p><p><strong>Results: </strong>Of the 219 patients contacted, 153 (69%, mean age 67.0 y, 58% women) completed the survey. 68% had glaucoma (43% mild, 44% moderate, and 13% severe) and 32% were glaucoma suspects. Patients had been under the care of the specialist for 10±6.2 years, with 41% having undergone surgery with the specialist. The mean number of prior office visits with the specialist was 9.7±6.3 (range 1-24 y) with an average of 0.8 (range 0-3) prior telemedicine visits at the time of the survey. Ninety-seven percent reported satisfaction with integrated telehealth visits, and 78% would recommend telemedicine visits. Ninety-three percent planned to continue with telemedicine; 5 patients (3%) requested switching to in-person only visits with another provider. Compared with their in-person visits, patients found integrated telemedicine visits less time-consuming and more convenient.</p><p><strong>Conclusions: </strong>This study demonstrates high satisfaction and support for integrated telemedicine visits among glaucoma patients within a specialized practice setting.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"365-370"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542235","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":"Intraocular Pressure Measurements With the Tono-Vera: A New Handheld Rebound Tonometer.","authors":"Luiz A F Beniz, Alessandro A Jammal, Davina A Malek, Henry Tseng, Felipe A Medeiros","doi":"10.1097/IJG.0000000000002556","DOIUrl":"10.1097/IJG.0000000000002556","url":null,"abstract":"<p><strong>Prcis: </strong>In a cross-sectional study comparing the novel Tono-Vera handheld rebound tonometer with the Ocular Response Analyzer, a strong agreement was found between the intraocular pressure measurements of the 2 devices.</p><p><strong>Purpose: </strong>To compare intraocular pressure (IOP) measurements obtained by the new Tono-Vera (Reichert Technologies), a novel handheld rebound tonometer with a proprietary camera-based positioning system, with those from the Ocular Response Analyzer (ORA, Reichert Technologies) non-contact tonometer.</p><p><strong>Patients: </strong>Fifty-four eyes of normal individuals and open angle glaucoma subjects.</p><p><strong>Methods: </strong>All subjects had at least 6 reliable measurements with the Tono-Vera and 3 with the ORA, acquired by the same technician in the same visit. The sample was randomly split into calibration and validation samples. An ordinary least squares linear regression model generated a calibration formula for Tono-Vera readings using ORA's Goldmann-correlated IOP (IOPg) as a target. Bland-Altman plots evaluated the agreement between Tono-Vera calibrated IOP (IOPtv) and ORA IOPg in the validation sample.</p><p><strong>Main outcome measures: </strong>Agreement between IOPtv and IOPg measurements.</p><p><strong>Results: </strong>Fifty glaucoma and 4 normal eyes were included, mean age 68.3 ± 9.4 years, mean central corneal thickness 535.0 ± 39.6 μm. In the validation sample, mean IOPtv was 14.6 ± 5.2 mmHg (range, 7.4-28.5 mmHg) versus 15.0 ± 5.3 mmHg (range, 6.6-28.6 mmHg) for ORA IOPg ( R ² = 0.782). Bland-Altman plots showed a mean difference of -0.4 ± 2.5 mmHg (95% limits of agreement: -5.4 to 4.5 mmHg). 58.6%, 79.3%, and 96.5% of IOPtv measurements fell within ± 2, ± 3, and ± 5 mmHg of ORA measurements. No fixed or proportional biases were observed ( P = 0.620).</p><p><strong>Conclusion: </strong>There was a strong correlation and agreement in IOP measurements between calibrated Tono-Vera IOP and ORA IOPg.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"343-348"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542233","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":"Persistent Serous Choroidal and Retinal Detachment After Ab Interno Trabeculotomy for Glaucoma.","authors":"Suguru Nakagawa, Kiyoshi Ishii","doi":"10.1097/IJG.0000000000002508","DOIUrl":"10.1097/IJG.0000000000002508","url":null,"abstract":"<p><p>We describe a case of serous retinal detachment (SRD) with ciliochoroidal detachment (CCD) that persisted for 2 years and 7 months after minimally invasive glaucoma surgery (MIGS). A 71-year-old woman with primary open angle glaucoma and cataracts had a central corneal thickness of 489 μm/492 μm and an ocular axis length of 24.05 mm/24.30 mm. She underwent phacoemulsification and intraocular lens implantation in the right eye (OD), along with goniosynechialysis and microhook ab interno trabeculotomy. Postoperative intraocular pressure was 4-6 mm Hg in the OD. Five months later, SRD was observed temporally and inferiorly to the macula, with increased choroidal thickness. Best-corrected visual acuity at 5 months was (1.2)/(1.2) (right eye [OD]/left eye [OS]), and intraocular pressure was 6 mm Hg/13 mm Hg. CCD in the OD was accompanied by choroidal vessel dilation and choroidal vascular hyperpermeability. Two years and 7 months postsurgery, intraocular pressure spiked to 50-54 mm Hg but settled at 12 mm Hg 1 week later. CCD resolved, and choroidal folds and SRD disappeared, with decreased choroid thickness. Two years and 10 months postoperatively, there was no SRD recurrence at 10 mm Hg on 2 antiglaucoma eye drops, and best-corrected visual acuity remained stable at (1.0)/(1.0). This case suggests that SRD may result from increased choroidal vessel permeability and retinal pigment epithelium dysfunction secondary to prolonged CCD/low IOP after MIGS. The prolonged disease course may be attributed to the balance between aqueous humor excretion and absorption, influenced by the limited size of the cyclodialysis cleft caused by MIGS.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e17-e22"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522066","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":"Performance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort.","authors":"Rithambara Ramachandran, Ming-Chen Lu, Leslie M Niziol, Maria A Woodward, Angela R Elam, Leroy Johnson, Martha Kershaw, David C Musch, Amanda Bicket, Denise John, Sarah Dougherty Wood, Amy Zhang, Jason Zhang, Joan O'Brien, Paula Anne Newman-Casey","doi":"10.1097/IJG.0000000000002545","DOIUrl":"10.1097/IJG.0000000000002545","url":null,"abstract":"<p><strong>Prcis: </strong>Current optical coherence tomography normative sample data may not represent the diversity of human optic nerve anatomy needed to accurately classify all individuals with true glaucomatous optic neuropathy.</p><p><strong>Purpose: </strong>To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a larger, more diverse cohort of healthy individuals.</p><p><strong>Patients and methods: </strong>ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared. χ 2 tests compared MI-SIGHT retinal nerve fiber layer (RNFL) quadrant color-code labels with the expected distribution and multinomial logistic regression identified factors associated with label classifications.</p><p><strong>Results: </strong>In all, 1084 MI-SIGHT and 399 Topcon eyes were evaluated. The MI-SIGHT cohort was older (54 vs. 46 y), with more individuals identifying as black (61% vs. 20%), fewer as Hispanic (4% vs. 18%), and spherical equivalents closer to plano (-0.6 vs. -1.2 diopters) compared to the Topcon cohort (all P <0.001). Black/African American MI-SIGHT participants had larger cup-to-disc ratios and cup volumes, while white MI-SIGHT participants had smaller ONH values, except for rim area and rim volume, compared to Topcon participants (all P <0.001). The MI-SIGHT cohort's RNFL color codes did not follow the expected distribution ( P <0.05); more MI-SIGHT RNFL quadrant measurements were assigned as white (10.6% and 6.3% MI-SIGHT vs. 5% Topcon) and red codes (2.2% and 1.8% MI-SIGHT vs. <1% Topcon) than expected in the superior and inferior quadrants, respectively.</p><p><strong>Conclusions: </strong>OCT normative databases should accurately reflect diverse populations to avoid misclassification by RNFL thickness color codes. Larger data sets should be leveraged to encompass the full spectrum of healthy optic nerve anatomy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"404-414"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059290","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":"Peripapillary Vascular Density Differentiates Glaucomatous Cupping From Physiological Cupping Using Optical Coherence Tomography Angiography.","authors":"Doaa Maamoun Ashour, Nesrin Said Madkour, Weam Mohamed Ebeid, Rabab A Mahmoud","doi":"10.1097/IJG.0000000000002530","DOIUrl":"10.1097/IJG.0000000000002530","url":null,"abstract":"<p><strong>Prcis: </strong>In glaucoma, peripapillary vascular density was reduced compared with normal eyes, with or without physiological cupping.</p><p><strong>Purpose: </strong>To assess the ability of radial peripapillary capillaries vessel density (RPC VD) to distinguish between physiological and glaucomatous cupping using optical coherence tomography angiography (OCTA).</p><p><strong>Patients and methods: </strong>An observational study was conducted at Ain Shams University, involving 98 eyes from 98 patients, divided into 3 groups. Group 1 included 30 eyes with primary open angle glaucoma, group 2 included 28 normal eyes with physiological cupping [vertical cup/disc ratio 0.6 or more based on structural optical coherence tomography (OCT) and no evidence of glaucoma], and group 3 included 40 age-matched normal eyes (vertical cup/disc ratio ≤0.5). Participants were subjected to ophthalmological examination, structural OCT, and OCTA of the optic disc.</p><p><strong>Results: </strong>Group 1 exhibited significantly lower RPC VD than the other groups ( P <0.001), while no significant differences were noted between groups 2 and 3 ( P =0.559). Moderate negative correlations were observed between C/D vertical ( r =-0.556, P =0.002), and horizontal ratios ( r =-0.430, P =020), and RPC VD in glaucomatous eyes across the whole image and its 4 quadrants. No significant correlations were found between these parameters in the other groups.</p><p><strong>Conclusion: </strong>Using OCTA, glaucomatous eyes showed reduced RPC VD compared with normal eyes, even in the presence of physiological cupping. This finding may help to differentiate between physiological and glaucomatous cupping.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"415-420"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818425","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":"Effectiveness and Safety of Resident-Performed Same-Day Bilateral 360-Degree Selective Laser Trabeculoplasty in Patients With Open Angle Glaucoma.","authors":"Jason Xiao, Zhuangjun Si, Mary Qiu","doi":"10.1097/IJG.0000000000002526","DOIUrl":"10.1097/IJG.0000000000002526","url":null,"abstract":"<p><strong>Prcis: </strong>Resident-performed same-day bilateral selective laser trabeculoplasty are safe and effective for patients with primary open angle glaucoma or ocular hypertension.</p><p><strong>Purpose: </strong>To assess the efficacy and safety of resident-performed same-day bilateral 360-degree selective laser trabeculoplasty (SLT).</p><p><strong>Patients and methods: </strong>A retrospective chart review was performed for patients who received bilateral, resident-performed SLT at the University of Chicago from January 1, 2020 to December 31, 2022 under the supervision of 1 glaucoma surgeon (M.Q.). Patients were included in this analysis if they underwent same-day bilateral 360-degree SLT and had at least 6 months of follow-up available. Data were collected on visual acuity, intraocular pressure (IOP), number of IOP-lowering medications, and complications for up to 2 years after the procedure.</p><p><strong>Results: </strong>There were 48 patients included in this analysis, and the diagnosis was either primary open angle glaucoma (85.4%) or ocular hypertension (14.6%). For patients whose SLT goal was to lower IOP (n=38), the mean baseline IOP in right eyes (OD) was 19.2 mm Hg on 2.1 medications, and in left eyes (OS) was 19.5 mm Hg on 2.1 medications. At the final follow-up (mean 519 d), the mean IOP in the right eyes was 15.8 mm Hg on 2.0 medications, and in the left eyes was 15.8 mm Hg OS on 2.2 medications, resulting in an IOP reduction of 17.6% OD and of 18.8% OS. For patients whose SLT goal was to lower medication number (n=10), the mean baseline IOP in right eyes was 16.7 mm Hg on 2.3 medications, and in left eyes was 16.4 mm Hg OS on 2.3 medications. At the final follow-up (mean 528 d), the mean IOP in the right eye was 17.6 mm Hg on 1.1 medications, and in the left eye was 16.3 mm Hg OS on 1.1 medications, resulting in a medication reduction of 1.1 fewer medications OD and 1.1 fewer medications OS. One patient experienced a 6 mm Hg IOP rise above baseline 4 weeks after SLT, and another developed 2 small, focal areas of peripheral anterior synechiae. Six (12.5%) patients underwent additional IOP-lowering surgery during the chart review period.</p><p><strong>Conclusions: </strong>Resident-performed same-day bilateral 360-degree SLT was effective and associated with minimal complications, with rates comparable to those of attending-performed SLT in the literature. SLT can be individualized to patients' goals of IOP-lowering or medication reduction. Teaching institutions can consider incorporating this method of education for appropriate patients with primary open angle glaucoma or ocular hypertension.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"388-393"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818422","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":"Impact of Glaucoma Surgery on Corneal Graft Survival After Keratoplasty: A Systematic Review and Meta-Analysis.","authors":"Abdelrahman M Tawfik, Rawan A Kasem, Zeyad M Wesh, Sara M Abo Daif, Abdulla Aly Elmansoury, Raouf Korish, Mohammad Bazzazeh, Kai-Yang Chen, Alaa Ramadan, Almoatazbellah A Attalla, Nada M GabAllah","doi":"10.1097/IJG.0000000000002540","DOIUrl":"10.1097/IJG.0000000000002540","url":null,"abstract":"<p><strong>Prcis: </strong>Glaucoma surgery impacts corneal graft survival differently by procedure type, with GDDs being most effective at reducing intraocular pressure. However, graft survival rates are comparable across trabeculectomy, CPC, and GDDs. Trabeculectomy improves visual acuity best but often requires additional interventions.</p><p><strong>Purpose: </strong>To investigate the impact of different glaucoma procedures on corneal graft survival and corneal endothelium health.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, Scopus, and Web of Science, to identify eligible studies. Studies were included based on predetermined criteria. The primary outcome was corneal graft survival, and secondary outcomes included intraocular pressure (IOP) control, visual acuity, antiglaucoma medications, additional glaucoma surgery, and postoperative complications. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed using the ( I2 ) test.</p><p><strong>Results: </strong>Our results included 27 studies involving 905 patients were analyzed. However, there were no randomized comparative studies. The overall proportion of corneal graft survival at the last follow-up was 66.4%, with the 3 subgroups of trabeculectomy, cyclophotocoagulation (CPC), and Glaucoma drainage devices (GDD) showing similar survival rates of 66.6%, 64.8%, and 65.6%, respectively. Short-term graft survival (6 mo) was similar across groups; however, 2-year survival favored trabeculectomy. GDDs were the most effective in reducing IOP with an average reduction of 21.4 mmHg compared with 18.9 mmHg for trabeculectomy and 14.8 mmHg for CPC. CPC yielded the best improvement in visual acuity reported as BCVA. GDD required the fewest postoperative antiglaucoma medications. Trabeculectomy had the highest proportion of patients needing additional surgery for glaucoma. The most common complications were hypotony, uveitis, and tube obstruction.</p><p><strong>Conclusion: </strong>There were no significant differences in corneal graft survival rates among various glaucoma surgical techniques, but these findings must be interpreted with caution due to the limitations of primary research. GDDs effectively reduced IOP and minimized the need for antiglaucoma medications. Trabeculectomy may be associated with the greatest visual acuity improvement but may carry a higher likelihood of requiring further glaucoma surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"376-387"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006680","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":"Characteristics of Eyes With Asymptomatic Primary Angle Closure Glaucoma With Varying Severity of Visual Field Loss at Presentation.","authors":"Ruthra M Umapathi, Tin Nwe Hliang, Audrey Su-Min Koh, Charmaine Sim, Shamira A Perera, Rahat Husain, Ching Lin Ho, Tina T Wong, Tin Aung, Monisha E Nongpiur","doi":"10.1097/IJG.0000000000002554","DOIUrl":"10.1097/IJG.0000000000002554","url":null,"abstract":"<p><strong>Prcis: </strong>Approximately 38% of 467 asymptomatic primary angle closure glaucoma subjects had severe visual field loss (<-20 dB) at first presentation. Sex-based differences in prevalence and biometry suggest the need for an integrated approach for assessing risk.</p><p><strong>Purpose: </strong>To compare the clinical characteristics of patients with asymptomatic primary angle closure glaucoma (PACG) across varying disease severity at presentation.</p><p><strong>Methods: </strong>Of 681 PACG patients recruited, 196 were excluded due to acute primary angle closure and 18 due to pretreatment. Clinical data from 467 patients were analysed, including age at presentation, presenting intraocular pressure (IOP), pre-intervention gonioscopy, vertical cup-to-disc ratio, biometry, pre-surgery refractive data, and visual field (VF) mean deviation (MD) at presentation (excluding the first VF). Disease severity was classified based on the VF MD as early-to-moderate (≥-12 dB), advanced (-12.01 to -20 dB), and severe (<-20 dB).</p><p><strong>Results: </strong>Of the 467 patients, 304 had reliable VFs within 1.5 years of presentation and were categorized as early-to-moderate (n=129; 42.4%), advanced (n=57; 18.8%), and severe PACG (n=118; 38.8%). The mean age at presentation was 64.7±8.6 years and 52.6% were male. Patients with severe PACG were more likely to be male (61.9%), with the highest presenting IOP ( P <0.001), and narrowest anterior chamber angle ( P <0.001). Significantly smaller anterior chamber depth and shorter axial length across worsening disease severity were only observed in female but not in male subjects. There was no significant difference in mean age at presentation across groups ( P =0.12). Presenting IOP of ≤21 mm Hg was observed in 49.1% (n=28) advanced and 29.7% (n=35) severe PACG.</p><p><strong>Conclusions: </strong>Similar age at presentation of severe PACG and those with less severe disease suggests that the severe group either developed PACG at an earlier age or underwent rapid disease progression. Sex-based differences of prevalence and biometry may also impact disease risk.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"358-364"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414382","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 Outcomes of Deep Sclerectomy, Canaloplasty, and Viscocanaloplasty: A Multicenter Study.","authors":"Karl Mercieca, Matthew Azzopardi, Neeru A Vallabh, Cristina Cristian, Verena Prokosch, Vincent Dubois, Christopher Hemmerdinger, Stefano De Cillà, Divya Mathews, Andre Mermoud, Matthias C Grieshaber, Gordana Sunaric Mégevand, Nitin Anand, Alessandro Rabiolo","doi":"10.1097/IJG.0000000000002535","DOIUrl":"10.1097/IJG.0000000000002535","url":null,"abstract":"<p><strong>Prcis: </strong>Deep sclerectomy (DS) and canaloplasty provide better intraocular pressure (IOP) control than viscocanalostomy. DS required less glaucoma medications but more interventions to reach the target IOP.</p><p><strong>Purpose: </strong>To compare real-world outcomes of 3 non-penetrating glaucoma surgery (NPGS) techniques.</p><p><strong>Methods: </strong>Retrospective, cohort study of consecutive patients undergoing canaloplasty (CP), deep sclerectomy (DS), and viscocanalostomy (VC), across 9 European glaucoma units. Four intraocular pressure (IOP) criteria were used to define success at 2-year follow-up: (A) IOP≤21 mmHg and ≥20% reduction; (B) IOP≤18 mmHg and ≥20% reduction; (C) IOP≤15 mmHg and ≥25% reduction; (D) IOP≤12 mmHg and ≥30% reduction. Secondary outcomes included IOP control, BCVA, number of medications over time, risk factors for failure, complications, and post-operative interventions. Success was distinguished as qualified or complete, if reached with or without antiglaucoma medications, respectively.</p><p><strong>Results: </strong>Six hundred eyes (545 patients) undergoing standalone CP (201 eyes), DS (200 eyes), and VC (199 eyes) were included. Qualified success rates of CP, DS, and VP at 24 months were, respectively: (criterion A) 85.1%, 67.6%, and 64.6%; (criterion B) 85.1%, 66.1%, and 58.6%; (criterion C) 76.6%, 55.5%, and 39.0%; (criterion D) 27.7%, 28.5%, and 22.1%. Success rates were significantly different across the 3 techniques ( P =0.04 or below), except for complete success according to criterion A ( P =0.07). Mean IOP(±SD) reduced from 25.2 (±6.9), 20.5 (±6.7), and 22.7 (±7.2)mmHg preoperatively to 13.1 (±3.1), 12.9 (±4.5), and 14.7 (±4.6)mmHg at postoperative year 2 in the CP, DS, and VC groups, respectively ( P <0.001 between preoperative and postoperative time points for all groups).</p><p><strong>Conclusions: </strong>All 3 NPGS provide sustained IOP reduction, but DS and CP provide better success rates and IOP control. Success rates were low for the most stringent cutoffs, suggesting that other techniques such as trabeculectomy may be indicated when a very low target IOP is demanded.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"349-357"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006565","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}