Journal of Glaucoma最新文献

{"title":"Assessment of Missing Data on Glaucoma Severity Among Participants in the NIH All of Us Research Program of the United States.","authors":"Kaela N Acuff, Bharanidharan Radha Saseendrakumar, Robert N Weinreb, Sally L Baxter","doi":"10.1097/IJG.0000000000002480","DOIUrl":"10.1097/IJG.0000000000002480","url":null,"abstract":"<p><strong>Prcis: </strong>There were statistically significant differences across multiple socioeconomic characteristics and self-reported barriers to care among primary glaucoma patients with severity staging data versus those missing this data in the NIH All of Us database.</p><p><strong>Purpose: </strong>To characterize missing data among glaucoma patients within All of Us .</p><p><strong>Materials and methods: </strong>We used diagnosis codes to define cohorts of primary glaucoma patients with and without severity staging specified. Descriptive analyses were conducted by presence of disease severity stage. Analysis of missing data was conducted using a set intersection plot and the Little Test of Missing Completely at Random. T tests were performed to evaluate differences.</p><p><strong>Results: </strong>Of 2982 participants, 1714 (57%) did not have glaucoma severity stage specified, and 11 of 23 analyzed variables had missing data. The Little Test indicated data was not missing completely at random ( P <0.001). Significant differences existed between the 2 cohorts with respect to age, age of first glaucoma diagnosis, gender, ethnicity, education, income, insurance, history of glaucoma surgery and medication use, and answers regarding the ability to afford eyeglasses and having seen an eye care provider in the last 12 months (all P- values ≤0.01).</p><p><strong>Conclusion: </strong>There were significant differences between glaucoma participants with glaucoma severity stage specified versus those with unstaged disease across multiple socioeconomic characteristics and self-reported barriers to care. Glaucoma severity staging data was not missing completely at random. The unstaged cohort included higher rates of multiple underrepresented communities, which may potentially contribute to bias in ophthalmology research as participants from vulnerable populations may be disproportionately excluded from electronic health records or claims data studies where diagnosis codes with severity/staging levels are used to examine risk factors for disease, progression, and treatment efficacy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"39-46"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916920","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 Impact of Femtosecond Laser on Intraocular Pressure With Cataract Surgery in Healthy Eyes.","authors":"Nurit Mathalone, Or Ben-Shaul, Olga Podkovyrin, Chen Lux, Orna Geyer","doi":"10.1097/IJG.0000000000002491","DOIUrl":"10.1097/IJG.0000000000002491","url":null,"abstract":"<p><strong>Prcis: </strong>Femtosecond laser-assisted cataract surgery (FLACS) leads to an increase in intraocular pressure (IOP) during the procedure and subsequent IOP reduction after surgery, with greater magnitude in eyes with higher preoperative IOP.</p><p><strong>Purpose: </strong>To evaluate the effect of FLACS using the LDVZ8 laser on IOP during and after surgery, and to compare the IOP-lowering effect of FLACS and conventional phacoemulsification cataract surgery (CPCS).</p><p><strong>Patients and methods: </strong>This prospective cohort study enrolled 395 healthy eyes (395 patients) scheduled for FLACS (n=245) and CPCS (n=150). FLACS was performed using the LDVZ8 laser. During FLACS, IOP was assessed before and immediately after docking. IOP reduction during a 6-month postoperative period was evaluated following FLACS and CPCS. Multivariate analyses were performed.</p><p><strong>Results: </strong>The mean IOP increase after docking was 2.3±4.1 mm Hg ( P <0.0001); the maximum increase was 17.6 mm Hg, peak of 38 mm Hg. Sixty-one eyes (25.1%) demonstrated an increase of ≥5 mm Hg and 10 (3.7%) showed an increase of ≥10 mm Hg; predocking IOP was associated with an IOP increase of ≥5 mm Hg ( P =0.029). IOP reduction over 6 months postsurgery was similar for FLACS and CPCS ( P >0.05), -1.33±3.12 mm Hg for FLACS ( P <0.001) and -1.4±2.87 mm Hg for CPCS ( P <0.001). Preoperative IOP correlated statistically significantly with IOP reduction in both FLACS (β -0.742, P <0.001) and CPCS (β -0.743, P <0.001).</p><p><strong>Conclusions: </strong>Although the LDVZ8 laser procedure causes an increase in IOP in some healthy eyes, a subsequent decrease in IOP is observed after FLACS. The IOP-lowering effect of FLACS is similar to CPCS and tends to be more pronounced in eyes with higher preoperative IOP. Eyes with higher preoperative IOP are prone to IOP elevation during FLACS, a critical consideration for glaucoma patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"19-24"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073033","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":"Genetic Variants Associated With a History of Glaucoma Surgery in Japanese Patients With Primary Open Angle Glaucoma.","authors":"Fumihiko Mabuchi, Nakako Tanaka-Mabuchi, Yoichi Sakurada, Seigo Yoneyama, Zentaro Yamagata, Kenji Kashiwagi","doi":"10.1097/IJG.0000000000002510","DOIUrl":"10.1097/IJG.0000000000002510","url":null,"abstract":"<p><strong>Prcis: </strong>The genetic risk score (GRS) of genetic variants associated with intraocular pressure (IOP) elevation, but not those associated with optic nerve vulnerability, was associated with a history of glaucoma surgery in Japanese patients with primary open angle glaucoma (POAG).</p><p><strong>Objective: </strong>To investigate genetic variants associated with a history of glaucoma surgery in Japanese patients with POAG.</p><p><strong>Methods: </strong>Japanese patients with POAG (n = 468), including normal tension glaucoma (n = 246) and high tension glaucoma (n = 222), and control subjects (n = 246) were genotyped for 22 genetic variants predisposing to POAG, which can be classified into those associated with IOP elevation (IOP-related genetic variants) and optic nerve vulnerability independent of IOP (optic nerve-related genetic variants). The unweighted and weighted GRSs of 17 IOP-related, 5 optic nerve-related, and all 22 genetic variants were calculated, and the association between the GRS and a history of glaucoma surgery was evaluated.</p><p><strong>Results: </strong>There was a significant association (odds ratio 1.13 per unweighted GRS, 95% CI: 1.03 to 1.24, P = 0.0093) between IOP-related unweighted GRS and a history of glaucoma surgery. A significant association (odds ratio 1.09 per 0.1 weighted GRS, 95% CI: 1.04 to 1.14, P = 0.00022) was also found between IOP-related weighted GRS and a history of glaucoma surgery. The IOP-related GRS was positively correlated with the need for glaucoma surgery. The mean of IOP-related unweighted and weighted GRS in patients with POAG with a history of glaucoma surgery were significantly higher ( P = 0.013 and P = 0.00031, respectively) than those in patients with POAG without a history of glaucoma surgery.</p><p><strong>Conclusions: </strong>IOP-related, but not optic nerve-related, genetic variants were associated with a history of glaucoma surgery in Japanese patients with POAG. These results indicate that IOP elevation induced by IOP-related genetic variants rather than optic nerve vulnerability induced by optic nerve-related genetic variants may play an important role in requiring glaucoma surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"7-12"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522065","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":"Factors Associated with Lamina Cribrosa Microvasculature Determined via Swept-Source Optical Coherence Tomography Angiography.","authors":"Jooyoung Yoon, Kyung Rim Sung, Jin Yeong Lee, Joong Won Shin, Joon Mo Kim","doi":"10.1097/IJG.0000000000002531","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002531","url":null,"abstract":"<p><strong>Prcis: </strong>The lamina cribrosa microvasculature reduction was associated with the posterior deformation of lamina cribrosa, as well as the functional deterioration, in all spectrums of open-angle glaucoma.</p><p><strong>Purpose: </strong>To investigate the factors associated with the lamina cribrosa vessel density (LCVD) determined via swept-source optical coherence tomography angiography (SS-OCTA).</p><p><strong>Materials and methods: </strong>The optic nerve head (ONH) scan was obtained using SS-OCTA (PLEX Elite 9000; Carl Zeiss Meditec, Inc., Dublin, CA, USA). The lamina cribrosa curvature index (LCCI) was assessed using seven horizontal B-scan images across the ONH. The LCVD was calculated from the segmented layer at the level of lamina cribrosa (LC). Primary open angle glaucoma (POAG) eyes were categorized into two groups according to the visual field mean deviation (VF MD) (mild to moderate [≥ -12 dB] and advanced [< -12 dB]). The factors associated with the LCVD were evaluated using linear regression analysis.</p><p><strong>Results: </strong>A total of 127 POAG and 43 healthy eyes were included. POAG eyes showed significantly thinner circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell inner plexiform layer (mGCIPL), lower LCVD, and greater LCCI compared to healthy eyes (all P<0.05). In the mild to moderate group, lower LCVD was associated with worse VF MD, thinner cpRNFL and mGCIPL, and greater LCCI (all P<0.05). In the advanced group, the LCVD was associated with VF MD and LCCI (both P<0.05). A greater LCVD was correlated with a greater LCCI in the healthy group (P =0.045).</p><p><strong>Conclusions: </strong>Reduced LCVD was associated with an increased LCCI in all spectrums of POAG. LC deformation may affect the ONH microvasculature in glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846850","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 Trabeculectomy on Disc Tissue Blood Flow Across Quadrants in Open-Angle Glaucoma.","authors":"Takeru Shimazaki, Eri Nitta, Yuki Nakano, Nobuko Kobayashi, Hirokazu Kojima, Ayaka Hara, Kiyoshi Suzuma","doi":"10.1097/IJG.0000000000002527","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002527","url":null,"abstract":"<p><strong>Prcis: </strong>Trabeculectomy increases tissue blood flow superior and temporal in the optic nerve head. Improvement of tissue blood flow superior and temporal in the optic nerve could be an indicator of the effectiveness of glaucoma treatment.</p><p><strong>Purpose: </strong>To investigate changes in tissue blood flow at the optic nerve head before and after trabeculectomy.</p><p><strong>Methods: </strong>This prospective study included 53 eyes who underwent trabeculectomy. The mean blur rate of the tissue area (MT) was determined using laser speckle flowgraphy (LSFG) preoperatively and 1 and 3 months postoperatively. MT, LSFG waveform parameters (blowout score [BOS] and resistivity index [RI]), intraocular pressure (IOP), and ocular perfusion pressure (OPP) were analyzed preoperatively and at 3 months postoperatively.</p><p><strong>Results: </strong>Postoperatively, IOP decreased (17.9±6.0 to 9.2±3.4 mmHg) and OPP increased (43.3±9.2 to 52.1±6.4 mmHg). As previously described, BOS increased (73.5±8.3 to 76.7±6.5; P<0.001) with an inverse correlation to IOP and in proportion with OPP; RI decreased (0.40±0.1 to 0.35±0.08; P<0.001) with an inverse correlation to OPP and in proportion to IOP. However, we found that MT increased significantly after surgery (7.9±2.2 to 8.8±2.2 AU; P=0.002) without significant association between MT and IOP or OPP. In the four quadrants of the optic nerve head (ONH), BOS significantly increased, while RI significantly decreased after surgery in all quadrants. On the other hand, MT significantly increased in the superior and temporal quadrants only.</p><p><strong>Conclusions: </strong>Blood flow increases in the superior and temporal of optic nerve head.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807325","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":"https://doi.org/10.1097/IJG.0000000000002525","url":null,"abstract":"<p><strong>Precis: </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 two 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 number of glaucoma medications post-operatively.</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. Prior to surgery, there were no significant differences except in mean refractive error. 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 post-operatively. 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. Second trabeculectomy required fewer medications for IOP control.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-11","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":"Glaucoma Progression in Treatment-Naïve Normal-Tension Glaucoma Patients with Myopia - Role of Intraocular Pressure.","authors":"Dong Kyun Han, Eun Ji Lee, Tae-Woo Kim","doi":"10.1097/IJG.0000000000002528","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002528","url":null,"abstract":"<p><strong>Precis: </strong>While myopia has been recognized as a positive prognostic factor for NTG progression in the adult population, some myopic NTG eyes exhibited significant progression within two years when left untreated, even under low IOP.</p><p><strong>Purpose: </strong>To determine the natural history and risk factors associated with progressive retinal nerve fiber layer (RNFL) thinning in previously stable, treatment-naïve, normal-tension glaucoma (NTG) patients with myopia.</p><p><strong>Methods: </strong>This study included 111 myopic NTG eyes without intraocular pressure (IOP)-lowering treatment for at least 1 year and without disease progression during the treatment-free period. The RNFL thickness was measured and a visual field (VF) test was performed every 6 to 12 months for >2 years. Patients with progressive changes were classified as the P(+) group, while those without progression were classified as the P(-) group. Cox proportional-hazards model assessed risk factors of progression, while linear regression determined factors associated with the rate of RNFL thinning.</p><p><strong>Results: </strong>Progressive change was observed in 25 of the 111 participants [P(+) group, 22.5%]. A family history of glaucoma, higher mean IOP, and maximum IOP during the follow-up were significant factors both for being in the P(+) group and for a faster RNFL thinning. None with a mean IOP <11 mmHg were in the P(+) group. Davies' test identified that 14.2 mmHg was a significant breakpoint (P=0.042), above which the rate of RNFL thinning increased significantly with the mean IOP (R2=0.252, P=0.034).</p><p><strong>Conclusions: </strong>Myopic NTG patients untreated for IOP, especially those with a family history of glaucoma or higher IOP, are at increased risk of progression. Early treatment initiation is advised for high-risk myopic NTG patients, even when their condition appears stable.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807352","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 Microangiography and Progressive Retinal Nerve Fiber Layer Loss in Primary Angle-closure Glaucoma.","authors":"Harsha L Rao, Srilakshmi Dasari, Narendra K Puttaiah, Zia S Pradhan, Sasan Moghimi, Kaweh Mansouri, Carroll Ab Webers, Robert N Weinreb","doi":"10.1097/IJG.0000000000002524","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002524","url":null,"abstract":"<p><strong>Precis: </strong>Younger patient age (coefficient: 0.10, P=0.04) and greater peak IOP during follow-up (coefficient: -0.14, P=0.03), but not baseline optical microangiography parameters, were significantly associated with a faster rate of RNFL loss in mild-moderate PACG.</p><p><strong>Purpose: </strong>To evaluate the association between optical microangiography (OMAG) measurements and progressive retinal nerve fiber layer (RNFL) loss in primary angle-closure glaucoma (PACG).</p><p><strong>Methods: </strong>In a prospective study, 45 eyes of 30 PACG patients (86 hemifields) with mild to moderate functional damage were longitudinally studied for at least 2 years and with a minimum of 3 optical coherence tomography (OCT) examinations. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, gender, presence of systemic diseases, central corneal thickness, mean, peak and fluctuation of intraocular pressure during follow-up), baseline hemifield mean deviation (MD) and baseline OMAG (quadrant peripapillary and macular perfusion density [PD]) on the rate of RNFL change was evaluated using linear mixed models.</p><p><strong>Results: </strong>Average (±SD) hemifield MD, RNFL thickness, peripapillary PD and macular PD of the analyzed quadrants at baseline were -6.0±3.4 dB, 89±21 µm, 40.1±3.5% and 29.6±10.3%, respectively. Rate of quadrant RNFL change was -2.5±1.7 µm/year. Multivariate mixed models showed that younger patient age (coefficient: 0.10, P=0.04) and higher peak IOP during follow-up (coefficient: -0.14, P=0.03) were significantly associated with a faster rate of RNFL loss.</p><p><strong>Conclusions: </strong>Younger patient age and greater peak IOP during follow-up were significantly associated with a faster rate of RNFL loss in PACG patients with mild to moderate severity of functional damage. None of the OMAG parameters at baseline were associated with RNFL thinning suggesting a limited role of OCTA imaging in predicting structural progression in mild-moderate PACG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769693","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":"Assessment of Structural Progression in Glaucoma Through Automated Optic Nerve Head Hemoglobin Measurements.","authors":"Janaina Andrade Guimarães Rocha, Thaíssa Cristina Affonso Nazareth Goytacaz, Maria Betânia Calzavara Lemos, Augusto Paranhos, Sérgio Henrique Teixeira, Fábio Nishimura Kanadani, Carolina Pelegrini Barbosa Gracitelli, Tiago Santos Prata","doi":"10.1097/IJG.0000000000002523","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002523","url":null,"abstract":"<p><strong>Prcis: </strong>Automated optic nerve head hemoglobin measurements through change overtime in the Globin Individual Pointer (GIP) index, provided by the Laguna ONhE software, can be useful to evaluate structural progression in glaucoma.</p><p><strong>Purpose: </strong>To assess the performance of automated optic nerve head hemoglobin measurements (ONH Hb) for detection of structural progression in glaucoma patients using event analysis.</p><p><strong>Patients and methods: </strong>Treated glaucoma patients were included in this cross-sectional study. Two experienced examiners classified patients into progressors and non-progressors (controls) based on serial color retinographies (CR). Progressors were then subdivided in structural changes of the neuroretinal rim (NR) or retinal nerve fiber layer (RNFL). Globin individual pointer (GIP) index, derived from ONH Hb measurements, was calculated for each CR using the Laguna ONhE software. Differences in GIP values, ​​between baseline and last visit CRs, were used to assess structural progression. Sensitivity at a fixed specificity (50%; median GIP difference in controls) and areas under receiver operating characteristic curves (AUROC) were calculated.</p><p><strong>Results: </strong>Eight-seven eyes (35 progressors and 52 controls) from 64 patients were enrolled. Mean GIP reduction overtime was greater in progressors (-13.0±18.6) than controls (-2.9±10.4; P=0.001). In progressors, mean GIP reduction was greater in patients with NR changes (-19.6±19.5) than RNFL changes (-3.1±12.1; P=0.008). GIP difference correctly identified 69% of the progressors (AUROC: 0.66), being 76% of these progressions related to NR changes (AUROC: 0.76) and 57% to RNFL changes (AUROC: 0.52).</p><p><strong>Conclusions: </strong>The GIP index, based on automated ONH Hb measurements demonstrated good sensitivity to differentiate progressors from controls, especially in cases in which progression was documented trough structural NR changes. Using only two CRs and event analysis, GIP changes overtime can be a useful screening tool to evaluate structural progression.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769687","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":"Rates of Visual Field Progression Before and After the Onset of Atrial Fibrillation.","authors":"Takashi Nishida, Sasan Moghimi, Wang Jin, Linda M Zangwill, Robert N Weinreb","doi":"10.1097/IJG.0000000000002500","DOIUrl":"10.1097/IJG.0000000000002500","url":null,"abstract":"<p><strong>Prcis: </strong>This case-control study investigated the effect of atrial fibrillation (AF) on the progression of glaucoma. The presence of AF and related microvascular damage was associated with a slightly faster visual field loss in glaucoma patients.</p><p><strong>Purpose: </strong>To investigate the effect of atrial fibrillation (AF) on glaucoma progression.</p><p><strong>Methods: </strong>In this longitudinal case-control study, a total of 144 eyes from 105 patients with primary open angle glaucoma were included. Forty-eight eyes of case developed AF during the follow-up followed for 15.6 years. Ninety-six eyes of control that did not have AF at baseline or during follow-up matched for age, baseline glaucoma severity, and follow-up period were followed for an average of 14.7 years. Mixed-effects linear models were used to calculate the difference in the VF MD slopes before and after the AF. CHADS 2 and CHA 2 DS 2 -VASc scores were used to evaluate the risk of thrombosis event, and related microvascular damage was assessed based on these scores.</p><p><strong>Results: </strong>The rate of VF MD change was -0.20 (-0.42 to 0.02) dB/y before AF and -0.28 (-0.47 to -0.09) dB/y after AF for the patients with AF, and -0.21 (-0.25 to -0.17) dB/y for the control. In the multivariable models, the VF slope difference before and after the onset of AF [-0.10 (-0.14 to -0.05) dB/y, P <0.001], higher CHADS 2 score [-0.07 (-0.13 to 0.00) dB/y per 1 unit, P =0.040], and higher CHA 2 DS 2 -VASc score [-0.05 (-0.10 to 0.00) dB/y per 1 unit, P =0.039] were associated with faster VF MD loss.</p><p><strong>Conclusions: </strong>The presence of atrial fibrillation and related microvascular damage might accelerate visual field loss. This underscores the need for a comprehensive medical history and management of cardiovascular risk factors to mitigate increased VF loss in glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"909-914"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307905","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}