Journal of Glaucoma最新文献

{"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":"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 2 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 through 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 1-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 2 years, both surgical techniques demonstrated significant IOP reduction from baseline (GATT: mean reduction of 15.33±2.56 mmHg; AVCST: mean reduction of 15.96±2.95 mmHg) but there was no statistical difference between both groups at 2 years ( P =0.371). The complete success rate, defined as an IOP ≤16 mmHg 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 2 groups ( P =0.710). The complication rates were comparable between the 2 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 2 years. Further long-term studies are warranted to assess the durability of these outcomes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"811-818"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","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":"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. Preoperative 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/y or ≤-0.5 dB/y) 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, 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, 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":"762-770"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","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":"A Model to Estimate the Unmedicated Intraocular Pressure of Patients on Glaucoma Medications.","authors":"Olivier Benoit, Clotilde Jumelle, Esmeralda Meunier, Philippe Sourdille, Christophe Baudouin, Antoine Labbe","doi":"10.1097/IJG.0000000000002638","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002638","url":null,"abstract":"<p><strong>Prcis: </strong>This report presents a model which can be used to determine the IOP-lowering effect of a glaucoma procedure or treatment when a medication washout is not ethical or not possible to be performed.</p><p><strong>Background: </strong>The effect of individual (or certain predefined combinations of) glaucoma medications on intraocular pressure (IOP) has been well documented in various clinical trials. Conversely, the cumulative effect of several glaucoma medications, let alone their discontinuation (i.e. washout), on IOP is still relatively unknown. This is why it is generally recommended to perform a medications' washout to analyze the effect of glaucoma procedure without confounding factors. However, a washout is not always possible or ethical for some patients and can also increase the costs and complexity of clinical trials.</p><p><strong>Aims: </strong>To build and validate a mathematical model of the IOP change after glaucoma medications washout.</p><p><strong>Method: </strong>A literature search was conducted to identify studies reporting IOP values before and after washout, as well as the number of glaucoma medications used. Based on this, a quadratic equation was fitted to estimate the IOP change after washout, using the mean medicated IOP and the mean number of medications as input parameters.</p><p><strong>Findings: </strong>A total of 31 groups (each group having a precise mean medicated IOP, mean number of medications, and mean post washout IOP) from 15 studies were selected to build and validate the model. Overall, over 90% of the variability of IOP change reported in the studies was explained by the model (R2=0.9007). The mean difference between the IOP changes estimated by the model and the IOP changes reported in the studies was less than 1 mmHg.</p><p><strong>Conclusion: </strong>Estimating the IOP change using this model may represent an useful tool to determine the IOP-lowering effect of a glaucoma procedure or treatment when the washout is not ethical or not possible to be performed on patients. More studies need to be conducted to validate the practical robustness of this formula.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124915","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 Different Intraocular Pressure and Medication Endpoint Criteria on Success Rates in Subconjunctival Minimally Invasive Glaucoma Surgery.","authors":"Jeremy C K Tan, George Kong, Louis Arnould, Vincent Lee, Colin Clement, Jason Cheng, Gus Gazzard, Mitchell Lawlor","doi":"10.1097/IJG.0000000000002639","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002639","url":null,"abstract":"<p><strong>Precis: </strong>Applying different combinations of intraocular pressure and medication endpoint criteria recommended by the World Glaucoma Association can have a significant influence on the risk of failure following glaucoma surgery, which hinders the comparison of outcomes.</p><p><strong>Purpose: </strong>The definition of success in glaucoma surgical trials lacks standardization, leading to difficulty comparing outcomes across studies. This study evaluates how different intraocular pressure (IOP) and medication criteria affect success in a representative subconjunctival Minimally invasive glaucoma surgery (MIGS) dataset.</p><p><strong>Methods: </strong>A literature review identified the range of criteria used to define surgical success in studies of Xen gel stent, which were summarized into four definitions: (A) final IOP within upper and lower thresholds only, (B) criteria A plus ≥20% decrease in IOP vs baseline, (C) ≥20% IOP decrease plus no increase in medications vs baseline, (D) all three criteria combined. These definitions were then applied to a cohort of 308 eyes that underwent Xen surgery to compare the apparent risks of failure.</p><p><strong>Results: </strong>Success rates at 12 months across studies reviewed ranged from 18.5% to 33.4% for complete and 22.4% to 64.6% for qualified success. In our cohort, the hazard ratios of failure ranged from 0.27 to 5.87 (95% confidence intervals 0.21 to 7.63, P<0.001) across the four definitions. The greatest degree of difference in apparent failure rates was observed at the upper IOP threshold of 21 mmHg , and when evaluating qualified success.</p><p><strong>Conclusion: </strong>Using different IOP and medication criteria to define success can have a significant influence on the apparent risk of failure, particularly at the 21 mmHg threshold and when incorporating a minimum 20% IOP reduction from baseline. Reporting success using guidelines-recommended criteria and at multiple upper IOP thresholds may enable better comparison of outcomes between studies.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124902","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":"Predictors of Long Term Visual Acuity and Intraocular Pressure Outcomes in Childhood Glaucoma: A Multicenter Study by the Childhood Glaucoma Research Network (CGRN).","authors":"Huda Sheheitli, James Brandt, Alana Grajewski, Caitlynn Cooper, Beth Edmunds, Sushmita Kaushik, Rachida Bouhenni, Christiane Al-Haddad, Hounsh Munshi, Ziou Jiang, Nicholas Marka, Bibiana Jin Reiser, Ta Chen Chang","doi":"10.1097/IJG.0000000000002637","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002637","url":null,"abstract":"<p><strong>Precis: </strong>This study identifies visual acuity and intraocular pressure at 3- and 5-year follow-ups, along with other variables such as media opacity and nystagmus, as key predictors of long-term outcomes in childhood glaucoma, aiding better management and prognostication.</p><p><strong>Purpose: </strong>This study aims to identify key predictive variables of visual acuity (VA) and intraocular pressure (IOP) outcomes in childhood glaucoma. By understanding these factors, the study seeks to improve prognostication and management strategies for pediatric patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on pediatric glaucoma patients across multiple centers within the Childhood Glaucoma Research Network (CGRN). The study included patients with at least 5 years of follow-up. Variables such as sex, race, ethnicity, age of onset, laterality, and clinical measures including VA and IOP at various stages (initial visit, 3-year, 5-year, and final visits) were evaluated. Additional factors considered were anisometropia, media opacities, nystagmus, anterior segment dysgenesis (ASD), strabismus, and angle closure.</p><p><strong>Results: </strong>The study included 396 eyes from 243 patients, with a mean age at presentation of 1.5 months. Several variables showed statistically and clinically significant correlations with final outcomes including IOP and VA at both 3-year and 5-year visits, as well as the presence of media opacities, unilateral glaucoma, nystagmus, and ASD. Based on multivariable prediction model analysis the two statistically significant predictors for visual acuity (n=31) were VA at 5-year visit and presence of angle closure. As for IOP outcomes (n=31), significant predictors included were IOP at 5-year visit and presence of nystagmus.</p><p><strong>Conclusions: </strong>This multicenter study highlights that VA and IOP measurements at 3 and 5 years post-diagnosis, along with the presence of specific ocular conditions such as media opacity and nystagmus, are crucial in predicting long-term outcomes in childhood glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113467","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 Glaucomatous Visual Field Defects on Driving - A Systematic Review.","authors":"Zhi Hong Toh, Serene Yi Ning Koh, Wei Yun Lily Yang, Yasmin Lynda Munro, Bryan Chin Hou Ang","doi":"10.1097/IJG.0000000000002633","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002633","url":null,"abstract":"<p><strong>Prcis: </strong>Glaucoma patients with significant visual field defects show poorer driving performance, higher collision risks, and a greater likelihood of driving cessation. They face difficulties with lane maintenance, slower hazard responses, and self-regulation while driving.</p><p><strong>Purpose: </strong>Glaucoma is a chronic, progressive optic neuropathy associated with visual field (VF) defects, which in advanced disease has been shown to affect patients' activities of daily living. This systematic review qualitatively analyzes existing literature that explores the impact of glaucomatous VF loss on the driving performance of glaucoma patients, the extent of driving limitation and cessation, as well as the risk of motor vehicle collisions (MVCs).</p><p><strong>Methods: </strong>A literature search of MEDLINE and Embase (via Ovid), PubMed, Cochrane Library and Web of Science databases was performed for studies published from 2003 to 2023, with the terms \"glaucoma\", \"visual field defect/disorder\" and \"driving\", followed by selective vetting based on inclusion criteria. Within studies, data pertaining to study design, subject demographics, VF defect characteristics, driving performance and related outcomes were extracted.</p><p><strong>Results: </strong>Initial search yielded 835 studies, with 20 studies selected. 3 more studies were included through hand-searching, with a total of 23 studies included for final review. Moderate to severe VF defects resulted in poorer driving performance, with slower response times to road hazards, decreased ability for lane maintenance, and increased difficulty driving at night. Patients with more severe VF defects and with bilateral glaucoma were more likely to limit or cease driving compared to those with milder and unilateral glaucoma. A greater severity of VF loss was associated with a higher risk of MVCs.</p><p><strong>Conclusion: </strong>More severe glaucomatous VF and bilateral glaucoma is associated with worse driving performances and a higher risk of MVCs, in both simulator and real-world settings.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075405","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":"Online Circular Contrast Perimetry: Validity and Repeatability of Home Performance.","authors":"Yang X Chen, James Corbett, Jesse Gale, Joshua Meyerov, Angela Gong, Jason Cheng, Simon E Skalicky","doi":"10.1097/IJG.0000000000002635","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002635","url":null,"abstract":"<p><strong>Precis: </strong>Online Circular Contrast Perimetry (OCCP) offers clinically validated threshold perimetry to patients via a web-application from their own devices. This study evaluates the feasibility, repeatability and reliability of OCCP when performed in unsupervised home environments.</p><p><strong>Purpose: </strong>To evaluate the feasibility, repeatability and reliability of online circular contrast perimetry (OCCP) when performed in unsupervised home environments on personal devices.</p><p><strong>Patients and methods: </strong>55 participants (20 control and 35 open-angle glaucoma patients) were recruited. Participants underwent baseline visual field testing using OCCP in a clinical setting, followed by weekly unsupervised home tests over six weeks on their personal computers. An online survey was completed afterwards. Global perimetric indices and reliability indices were compared between clinic-based and home-based tests and analyzed to assess the repeatability and reliability of OCCP at home. Rasch analysis assessed the psychometric properties of the survey and intergroup variability.</p><p><strong>Results: </strong>No statistically significant differences were found in mean deviation (MD), pattern standard deviation (PSD), or visual index values between home and clinic tests (P>0.05), and these values did not significantly alter over the 6 weekly at-home tests. OCCP false positive and fixation loss responses were statistically higher at home compared to baseline (P=0.002 & P=0.001). Test-retest intraclass correlation coefficients for OCCP home use compared to in-clinic for MD ranged from 0.90 to 0.93, and for PSD ranged from 0.81 to 0.85. Bland-Altman analysis for MD revealed zero test-retest bias with limits of agreement ranging from ±5.28 to ±5.83 dB across the six weeks. The survey indicated high user satisfaction, however Rasch analysis revealed suboptimal precision and targeting.</p><p><strong>Conclusions: </strong>OCCP retains a similar diagnostic accuracy and repeatability in home environments on personal devices compared to clinic-based environments and has the potential to be utilized as a remote tool for glaucoma screening and surveillance.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075428","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":"Relationships of Paracentral Scotoma With Structural and Vascular Parameters in Highly Myopic Eyes With Early Open-angle Glaucoma.","authors":"Jing Huang, Litong Ye, Nan Luo, Lu Cheng, Yuzhou Xiang, Ying Han, Jingjing Huang","doi":"10.1097/IJG.0000000000002636","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002636","url":null,"abstract":"<p><strong>Prcis: </strong>This study revealed the prevalence of paracentral scotoma in highly myopic eyes with early open-angle glaucoma, and highlighted structural and vascular parameters associated with paracentral scotoma, which may facilitate the assessment of central visual function.</p><p><strong>Purpose: </strong>To investigate the prevalence and associated factors of paracentral scotoma in patients with high myopia and early open-angle glaucoma (OAG).</p><p><strong>Methods: </strong>In this cross-sectional study, myopic eyes with early OAG (mean deviation of visual field> -6 dB) were categorized into the high myopia group and the low-to-moderate myopia group. Paracentral scotoma was defined as a visual field defect in one hemifield within 10 degrees of fixation. The prevalence of paracentral scotoma was compared between the two groups. Association between structural and vascular factors and paracentral scotoma were investigated by logistic regression analysis.</p><p><strong>Results: </strong>A total of 220 myopic eyes with early OAG were enrolled, including 136 highly myopic eyes, and 84 low-to-moderate myopic eyes. Paracentral scotoma was more prevalent in the high myopia group (39.7% vs. 22.6%, P = 0.012). Multivariate logistic regression analysis showed that thinner circumpapillary retinal nerve fiber layer (cpRNFL) thickness in inferior-temporal and temporal-upper sectors, thinner inferior ganglion cell complex (GCC) thickness, lower radial peripapillary capillary (RPC) vessel density in inferior-temporal and temporal-lower sectors, lower inferior perifoveal vessel density were significantly associated with paracentral scotoma in highly myopic eyes with early OAG (all P < 0.05).</p><p><strong>Conclusions: </strong>Compared with low-to-moderate myopia, highly myopic eyes with early OAG were more likely to develop paracentral scotoma. The measurement of cpRNFL thickness and RPC vessel density in the temporal and inferior-temporal sectors, GCC thickness and perifoveal vessel density in the inferior sector may help assessment of central visual function in highly myopic eyes with early OAG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075422","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":"Augmentation of Aqueous Outflow After Trabecular MIGS in Primary Angle Closure Glaucoma Demonstrated by Aqueous Angiography.","authors":"Tanuj Dada, Nitika Beri, Anuja Patil, Ekta Shaw, Dewang Angmo","doi":"10.1097/IJG.0000000000002632","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002632","url":null,"abstract":"<p><p>Minimally invasive glaucoma surgeries (MIGS) targeting the trabecular meshwork are emerging as a new modality in the management of primary angle closure glaucoma (PACG). Aqueous angiography (AA) allows in vivo, real-time assessment of conventional aqueous humor outflow (AHO) using tracer dyes. Herein, we discuss a novel case of AA demonstrating changes seen in AHO post-trabecular MIGS in a PACG patient. This case provides evidence that supports the hypothesis of using trabecular MIGS in treating PACG patients and encourages further research to innovate and study the efficacy of trabecular MIGS in the management of primary angle closure disease.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075467","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":"Comparing Online Circular Contrast Perimetry and the Esterman Visual Field Test in Glaucoma for Driving-Relevant Vision.","authors":"Alexandra Klejn, Angela Gong, Simon E Skalicky","doi":"10.1097/IJG.0000000000002634","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002634","url":null,"abstract":"<p><strong>Precis: </strong>Online binocular perimetry showed moderate to strong agreement with Esterman visual field testing in glaucoma patients and controls, with high correlation coefficients and predictive capability. This tool may offer a viable, accessible alternative perimetry for driving licence assessment.</p><p><strong>Purpose: </strong>To assess the feasibility of an online computer-based binocular driving perimetry assessment (OBDP) based on online circular contrast perimetry, and agreement with binocular static Esterman visual field testing (EVFT).</p><p><strong>Methods: </strong>A prospective comparative cohort study was conducted on patients with or without open-angle glaucoma, recruited from a single site glaucoma subspecialty practice. Eligible subjects underwent two visual field tests using OBDP and this was compared to the results of a single EVFT.</p><p><strong>Results: </strong>80 patients were enrolled in the study, with a mean age of 69 years (+/- 13.4 SD). Of these, 49% were female, 18 were healthy controls, while 20, 18 and 24 had mild, moderate and severe glaucoma respectively. Pearson and intraclass correlation between the two perimetry methods for percentage of points not seen (PNS) was 0.85 and 0.86 (95% confidence interval (CI) 0.78-0.9) respectively for the overall binocular visual field. When the binocular field was subdivided into 8 sectors, intra-class coefficients (ICCs) ranged from 0.76 to 0.93 for each sector. Bland-Altman analysis revealed a difference of 1.24% (95%CI -16.93 to 19.30%) between the two methods for the overall field, ranging from 0.04% to 4.17% for each sector. Based on the Austroads fitness to drive guidelines, OBDP demonstrated a sensitivity of 96.97% and specificity of 78.57% when compared to the EVFT. ICCs evaluating the repeatability of OBDP testing for percentage of PNS were excellent overall (0.97) and ranged from moderate to excellent for each of the 8 sectors (0.67 - 0.98).</p><p><strong>Conclusion: </strong>OBDP showed strong agreement with EVFT. As an online application that easily runs on any computer, it could expand the scope of binocular perimetry screening for licence assessment. With modifications, integration into modern clinical licencing procedures could be considered.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075452","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}