Journal of Glaucoma最新文献

{"title":"Factors Associated With Corneal Hysteresis in an Elderly White Population: The Thessaloniki Eye Study.","authors":"Rodanthi C Bartzoulianou, Anne L Coleman, M Roy Wilson, Alon Harris, Konstantinos I Bougioukas, Theofanis Pappas, Dimitrios A Giannoulis, Fei Yu, Anastasia Raptou, Grigoria Tzoanou, Fotis Topouzis","doi":"10.1097/IJG.0000000000002541","DOIUrl":"10.1097/IJG.0000000000002541","url":null,"abstract":"<p><strong>Prcis: </strong>Corneal hysteresis (CH) was positively associated with female sex and central corneal thickness, and negatively with age and axial length. Diabetes showed no significant association with CH in the adjusted models.</p><p><strong>Purpose: </strong>To provide values of corneal hysteresis (CH) in an elderly, healthy Greek population and to investigate its association with demographic, ocular, and systemic factors.</p><p><strong>Methods: </strong>Cross-sectional population-based study. Out of 1092 participants in the incidence cohort of the Thessaloniki Eye Study (TES) who were re-examined between 2013 and 2015, there were 801 eligible subjects in this study according to prespecified criteria. All subjects underwent an interview and a comprehensive clinical examination. Demographic data and medical and ophthalmic, family, and smoking histories were recorded. CH was evaluated with an Ocular Response Analyzer (ORA).</p><p><strong>Results: </strong>The mean age of study subjects was 79.7±3.9 years and 345 out of 801 participants (43.1%) were female. The mean CH among all subjects was 10.1±1.5 mm Hg. After adjusting for age, sex, central corneal thickness (CCT), axial length (AL), and diabetes, CH was positively associated with female sex (β=0.446; P <0.0001) and CCT (β=0.017; P <0.0001), and negatively associated with age (β=-0.024; P =0.038) and AL (β=-0.181; P <0.0001). There was no association between CH and diabetes (β=0.186; P =0.10). In a supplementary multivariable analysis of a smaller sample size, where we included corneal curvature (CC) as an additional covariate, no association was found between CH and CC (β=-0.235; P =0.26) or age (β=-0.023; P =0.09).</p><p><strong>Conclusion: </strong>This study outlined variations in CH among a Greek population. CH decreased with advancing age while women had greater CH compared with men. In addition, eyes with thinner corneas and longer AL had lower CH values. No significant associations were found between CH and CC or the presence of diabetes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"275-281"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006637","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":"10.1097/IJG.0000000000002527","url":null,"abstract":"<p><strong>Prcis: </strong>Trabeculectomy increases tissue blood flow superior and temporal in the optic nerve head (ONH). 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>Objective: </strong>To investigate changes in tissue blood flow at the ONH before and after trabeculectomy.</p><p><strong>Materials and methods: </strong>This prospective study included 53 eyes who underwent trabeculectomy. The mean blur rate of the tissue area mean blur rate of the tissue area (MT) was determined using laser speckle flowgraphy preoperatively and 1 and 3 months postoperatively. MT, laser speckle flowgraphy 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±6.0-9.2±3.4 mm Hg) and OPP increased (43.3±9.2-52.1±6.4 mm Hg). As previously described, BOS increased (73.5±8.3-76.7±6.5; P < 0.001) with an inverse correlation to IOP and in proportion with OPP; RI decreased (0.40±0.1-0.35±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±2.2-8.8±2.2 AU; P = 0.002) without significant association between MT and IOP or OPP. In the 4 quadrants of the ONH, BOS significantly increased, while RI significantly decreased after surgery in all quadrants. In contrast, MT significantly increased in the superior and temporal quadrants only.</p><p><strong>Conclusions: </strong>Blood flow increases in the superior and temporal ONH.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"290-296"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952685/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Density and Retinal Structure Relationships Across Sectors and Regions of the Optic Nerve in Patients With Primary Open Angle Glaucoma.","authors":"Lukas Ritzer, Alon Harris, Julia Arciero, Brent Siesky, Brendan Fry, Ingrida Januleviciene, Francesco Oddone, Carmela Carnevale, George Eckert, Alice Verticchio Vercellin","doi":"10.1097/IJG.0000000000002536","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002536","url":null,"abstract":"<p><strong>Prcis: </strong>The relationship between structural and hemodynamic parameters in patients with primary open angle glaucoma is strongest in the temporal region of the optic nerve.</p><p><strong>Purpose: </strong>To investigate the relationship between radial peripapillary capillary (RPC) vessel density (VD) and retinal nerve fiber layer (RNFL) thickness in quadrants and sectors of the optic nerve head (ONH) in patients with and without primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>In a cross-sectional prospective analysis, 191 subjects (80 early-stage POAG; 111 non-glaucomatous controls) were assessed for RNFL thickness and RPC VD in each quadrant [superior (S), inferior (I), nasal (N) and temporal (T)] and sector [inferior-temporal (IT), temporo-inferior (TI), temporo-superior (TS), superior-temporal (ST), inferior-nasal (IN), naso-inferior (NI), naso-superior (NS), and superior-nasal (SN) sectors] of the ONH through optical coherence tomography angiography (OCTA). Pearson correlations were used to test for associations between measurements, with P<0.05 considered statistically significant.</p><p><strong>Results: </strong>Significantly stronger positive correlations were found between RPC VD and RNFL thickness in the S, I, and T quadrants in POAG patients compared with non-glaucomatous controls (all P<0.05). The temporal quadrant in POAG patients displayed the largest difference in correlation compared with controls. A stronger positive correlation was also found between RPC VD and RNFL thickness in the temporal sectors of the ONH in POAG patients compared with controls, with the largest difference in the TS sector (all P<0.05).</p><p><strong>Conclusion: </strong>Early-stage POAG patients have a stronger relationship between RPC VD and RNFL in the temporal regions of the ONH compared with non-glaucomatous controls, with the TS sector demonstrating the largest difference between groups. Temporal sector VD loss may represent an early-stage biomarker for vascular-linked POAG disease.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"34 4","pages":"267-274"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719824","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":"Assessing Vascular and Structural Hemiretinal Asymmetry at Different Stages of Normal Tension Glaucoma using Optical Coherence Tomography.","authors":"Xiaonan Lu, De-Fu Chen, Chenmin Wang, Jinrui Zhang, Tao Wang, Cong Zhang, Qiangjie Huang, Yuanbo Liang","doi":"10.1097/IJG.0000000000002572","DOIUrl":"10.1097/IJG.0000000000002572","url":null,"abstract":"<p><strong>Prcis: </strong>Hemiretinal asymmetry in different stages of normal tension glaucoma (NTG) may be helpful in diagnosis and staging.</p><p><strong>Purpose: </strong>To investigate hemiretinal asymmetry in peripapillary capillary vessel density (pcVD), macular vessel density (macVD), circumpapillary retinal nerve fibre layer (RNFL) thickness, and macular ganglion cell-inner plexiform layer (GCIPL) across various stages of normal tension glaucoma (NTG) and determine its potential as a staging tool.</p><p><strong>Subjects and methods: </strong>A total of 199 subjects were included, categorized into the preperimetric, early, moderate and advanced stage based on mean deviation (MD). Vessel density was measured using optical coherence tomography angiography, while peripapillary RNFL and macular GCIPL thickness were assessed with spectral-domain optical coherence tomography scans. The asymmetry parameter was defined as the absolute difference between superior and inferior values in the same eye. We analysed the characteristics of these parameters across glaucoma stages and evaluated the distribution of structural damage among the groups.</p><p><strong>Results: </strong>Hemiretinal asymmetry parameters showed significant statistical differences across the four groups, following a trend of moderate > early > late > preperimetric stages. Furthermore, hemiretinal difference in pcVD (hd pcVD) ( P=0.009 ) and hemiretinal difference in RNFL (hd RNFL) ( P=0.003 ) have statistical difference between preperimetric and early stage. Besides 50% to 80% of the participants in each stage exhibited smaller structural parameters in the inferior hemisphere.</p><p><strong>Conclusions: </strong>Hemiretinal Asymmetry Parameter exhibits a clear trend across different stages of NTG, aiding in staging of NTG before reaching the moderate stage. Furthermore, it has advantages in differentiating between the preperimetric and early stages. Additionally, the intraocular inferior hemisphere structure damage is more severe.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700669","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 Measurements Alteration of The Choroid and Lamina Cribrosa in Pseudoexfoliation Syndrome and Glaucoma.","authors":"Sepehr Fekrazad, Mahdi Gouravani, Golnar Hassanzadeh, Asma Mafhoumi, Mina Mirzad, Saeed Sepehry Vafa, Benjamin Xu, J Fernando Arevalo","doi":"10.1097/IJG.0000000000002571","DOIUrl":"https://doi.org/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 to 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 to 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 meta-regression, 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 to healthy individuals. Additionally, average peripapillary CT and average LCT were significantly reduced in PXG eyes compared to 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 to 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":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","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":"Incidence and Association of Angle-Closure Glaucoma in Retinitis Pigmentosa: A Meta-Analysis.","authors":"Brendan K Tao, Madeleine Wong, Maheshver Shunmugam, Mahadev Bhalla, Jennifer Ling, Kulbir Gill, Steven Schendel, Kevin Gregory-Evans, Eduardo V Navajas","doi":"10.1097/IJG.0000000000002570","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002570","url":null,"abstract":"<p><strong>Precis: </strong>Low certainty evidence suggests elevated angle-closure glaucoma incidence (1.30% (95%CI [0.71-2.36]) with retinitis pigmentosa than without (risk ratio: 2.01, 95%CI [1.59-2.53]). RP patients may benefit from enhanced monitoring for glaucomatous complications.</p><p><strong>Purpose: </strong>To determine the literature-pooled rate and association of angle-closure glaucoma (ACG) with retinitis pigmentosa (RP). ACG is a potentially sight-threatening cause of optic neuropathy. To-date, several reports have documented the potential association between ACG and RP.</p><p><strong>Materials and methods: </strong>Cochrane library, Embase, and Medline were searched to August 2024. We included all studies that reported the incidence of ACG among patients with RP, or the comparative risk of ACG among patients with or without RP. Two independent reviewers completed study screening, data extraction and risk of bias assessment using the Cochrane risk of bias (ROB) in nonrandomized studies (exposure) tool. Non-pairwise and pairwise meta-analyses, using random effects and the Mantel-Haenszel method, were conducted to calculate the pooled rate of ACG in RP patients and to determine whether this risk differed significantly from patients without RP. Subgroup analysis excluded \"high\" ROB studies.</p><p><strong>Results: </strong>Eight observational studies (n=31,501 patients; 456 events) were identified, three of which were of comparative design. Of this pooled population, there were 29,363 patients with RP (238 events). Across all studies, the pooled incidence of ACG with RP was 1.30% (95%CI [0.71-2.36], I2: 97%), though this heterogeneity resolved when sub-grouped by studies with low ROB (1.59%, 95%CI [1.31-0.192], I2: 0%). In the comparative analysis, patients with RP had a significantly higher risk of developing ACG (RR: 2.02 (95%CI [1.61-2.55], I2: 0%) compared to patients without RP. For either outcome, there was no significant evidence of publication bias, and the results remained consistent across subgroup and sensitivity analyses. Six of eight studies were rated as having \"high\" ROB due to a lack of adjusted analyses.</p><p><strong>Conclusion: </strong>Low certainty evidence suggests that RP may confer an increased risk of ACG compared to patients without RP. The results of this study seem to support the view that more extensive clinical monitoring for ACG may be of benefit for patients with RP. Further studies controlling for individual patient-level confounding are needed.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663632","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":"Outcome of Goniotomy over 120°, 240°, and 360° in Juvenile Open-Angle Glaucoma: A Multicenter Study.","authors":"Zefeng Yang, Zhixuan Wang, Hanying Fan, Qingshu Ge, Guangfu Dang, Xiao Yang, Lin Xie, Xiaoming Zhu, Yangfan Yang, Yuhong Wang, Jinkun Liu, Hongyang Zhang, Yuhan Feng, Yongjun Qi, Xiangxiang Ye, Mingying Lai, Peijie Lin, Pusheng Wang, Shumei Han, Jiangang Xu, Liming Tao, Heting Liu, Xin Nie, Mengfei Liao, Kai Zou, Yi Jiang, Yunhe Song, Fengbin Lin, Fengqi Zhou, Dilimulati Xiaokaiti, Xiaoyi Liu, Zige Fang, Ling Jin, Yu Chen, Clement C Tham, Ying Han, Xiaojing Pan, Liuzhi Zeng, Robert N Weinreb, Xiulan Zhang","doi":"10.1097/IJG.0000000000002569","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002569","url":null,"abstract":"<p><strong>Prcis: </strong>240° and 360° goniotomy (GT) demonstrated similar efficacy in intraocular pressure reduction, both outperforming 120°GT in juvenile open-angle glaucoma (JOAG) patients at postoperative 6 months follow-up.</p><p><strong>Purpose: </strong>To compare the surgical efficacy and safety of 120-, 240-, and 360-degree goniotomy (GT) for patients with juvenile open-angle glaucoma (JOAG).</p><p><strong>Patients and methods: </strong>This multicenter retrospective study included 102 eyes of 102 JOAG patients, who underwent GT with a follow up of at least 6 months. Patients were categorized into three groups: (1) 120°GT, (2) 240°GT, and (3) 360°GT. Intraocular pressure (IOP), glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.</p><p><strong>Results: </strong>Mean age of the participants was 24.4±7.9 years. After a mean follow-up of 8.1±2.7 months, complete success rates were similar between the 240°GT (45.2%) and the 360°GT (63.2%) (P=0.135), and both were superior to 120°GT (18.2%) (P<0.05). Qualified success rates among patients in the 120°, 240°, and 360° GT groups were 93.9%, 96.8% and 100%, respectively, and showed no statistically significant difference (P=0.292). 360°GT required fewer medications than 240°GT and 120°GT (P<0.05), with no significant difference in medications between 120°GT and 240°GT (P>0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360°GT (68.4%) compared to the 240°GT (41.9%) and 120°GT (33.3%) (P<0.05).</p><p><strong>Conclusions: </strong>240° and 360°GT showed similar efficacy in IOP reduction, and were superior to 120°GT. More extensive GT may provide better outcomes in JOAG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656814","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":"https://doi.org/10.1097/IJG.0000000000002567","url":null,"abstract":"<p><strong>Precis: </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 five reliable Humphrey visual fields (24-2 SITA Standard) before 24th March 2020 and two or more after. Glaucoma Progression Analysis software was used to carry out both trend and event-based analysis. Rates of progression pre and post pandemic were compared. Univariate and Multivariate logistic regression analysis were done to identify factors affecting progression.</p><p><strong>Results: </strong>Rate of visual field progression increased significantly post lockdown, Mean Deviation(MD) pre lockdown -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 to pre pandemic.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","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":"Fractal Dimension Analysis of Peripapillary Microvasculature in Primary Congenital Glaucoma.","authors":"Emily K Tam, Marco H Ji, Alaa E Fayed, Sherin H Sadek, Nagwa Ahmed, Qais Dihan, Ahmed Alzein, Mohsen Adelpour, Yasmine M El Sayed, Abdelrahman M Elhusseiny","doi":"10.1097/IJG.0000000000002566","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002566","url":null,"abstract":"<p><strong>Precis: </strong>In this prospective multicenter study, eyes with primary congenital glaucoma exhibited lower retinal vascular parameters compared to healthy controls, as assessed by optical coherence tomography angiography fractal dimension analysis.</p><p><strong>Purpose: </strong>To study the retino-choroidal peripapillary microvascular pattern in primary congenital glaucoma (PCG) using fractal dimension (FD) analysis and compare it to healthy controls.</p><p><strong>Methods: </strong>This was a prospective multicenter comparative study. We obtained peripapillary optical coherence tomography angiography (OCTA) scans (Optovue Inc, Fremont, CA) and computed FD at the vitreous/retina (large retinal vessels), inner limiting membrane/nerve fiber layer (ILM-NFL) (radial peripapillary capillary plexus, RPC), and the choroid. Other peripapillary OCTA parameters, including the whole image inside the disk and peripapillary superior and inferior vascular density (VD) parameters, were also collected. One eye per patient was included in the analysis.</p><p><strong>Results: </strong>We included a total of 17 PCG eyes and 24 control eyes. The mean age at the time of enrollment was 8.24±0.75 years in the PCG group compared to 8.33±1.09 in controls (P=0.74). Eight patients (47%) in the PCG group and 14 (58.3%) in the control group were male. Among the PCG group, the mean vitreo-retina (large retinal vessels) FD (1.79) and ILM-NFL (RPC) FD (1.75) were significantly reduced compared to controls (vitreo-retina FD (1.85), ILM-NFL FD (1.82), P-value 0.011 and 0.014, respectively). There was no statistically significant difference in the averaged choroidal FD between both groups (1.89 vs. 1.88, P=0.29). All optic nerve VD parameters (whole image, inside disc, superior, and inferior-hemi) were also significantly reduced in the PCG group.</p><p><strong>Conclusion: </strong>PCG was associated with lower vascular parameters in the vitreo-retina (large retinal vessels) and ILM-NFL (RPC) layers as detected by OCTA FD.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605172","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":"Transscleral Cyclophotocoagulation for Refractory Intraocular Pressure Elevation after Penetrating Keratoplasty.","authors":"Cristina Martin Lesan, Elias Flockerzi, Ursula Löw, Berthold Seitz","doi":"10.1097/IJG.0000000000002562","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002562","url":null,"abstract":"<p><strong>Prcis: </strong>Transscleral cyclophotocoagulation significantly reduces intraocular pressure and antiglaucomatous medication use post-penetrating keratoplasty, with low hypotony risk, particularly if delayed. Safe reintervention is feasible for intraocular pressure recurrence.</p><p><strong>Purpose: </strong>Transscleral cyclophotocoagulation (TSCPC) is an established procedure for lowering intraocular pressure (IOP). We aimed to evaluate the therapeutic efficacy and the safety of TSCPC in patients with refractory IOP elevation after penetrating keratoplasty (PK), as well as to identify risk factors associated with postoperative hypotony.</p><p><strong>Patients and methods: </strong>TSCPC was performed in 52 eyes with inadequate pressure regulation despite maximal conservative therapy after PK. All the patients were reviewed at day one, one month, six months and one year after the TSCPC. A diagnosis of hypotony was considered if the IOP was lower than 6 mmHg at any time postoperatively. Multivariate analysis was applied to identify risk factors for hypotony and elevated IOP recurrence.</p><p><strong>Results: </strong>The IOP value decreased significantly from the median baseline of 29.1±0.7 mmHg to 15.1±0.8 mmHg at one year follow-up. The number of antiglaucomatous medications was significantly reduced one year after TSCPC (2.9±0.1 vs. 2.4±0.2; P<0.01). Only six (11.5%) patients developed transitory hypotony. The mean time between PK and TSCPC was significantly lower (P<0.01) in patients who developed hypotony (5.8±2.2 mo vs. 28.9±5.7 mo). 53.8% of cases had a relapse of IOP increase at any time point during the follow-up. Reintervention with TSCPC was performed in 42.4% of patients.</p><p><strong>Conclusion: </strong>TSCPC after PK reduces significantly IOP and the number of antiglaucomatous medications. The rate of postoperative hypotony is low. Patients with shorter time interval between PK and TSCPC are at higher risk of developing hypotony. TSCPC can be safely reperformed in patients after PK.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604881","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}