Journal of Glaucoma最新文献

{"title":"Choroidal Structural and Vascular Changes in Early Primary Angle Closure Glaucoma.","authors":"Hui Liu, Shuang Liang, Xiaoli Liu, Yuxin Geng, Taoran Ren, Hui Bu, Danyan Liu","doi":"10.1097/IJG.0000000000002692","DOIUrl":"10.1097/IJG.0000000000002692","url":null,"abstract":"<p><strong>Précis: </strong>Thicker CT and higher CVI in the 1-12 mm circumferential annular area were noted in early PACG patients compared with healthy controls. More importantly, CVI may serve as a more sensitive indicator for disease progression.</p><p><strong>Purpose: </strong>To investigate changes of choroidal thickness (CT) and choroidal vascularity index (CVI) in eyes with early primary angle closure glaucoma (PACG) based on swept source optical coherence tomography angiography (SS-OCTA).</p><p><strong>Methods: </strong>A total of 86 early PACG patients (86 eyes) and 79 healthy individuals (79 eyes) were enrolled. All subjects underwent 12×12 mm macular scan and 6×6 mm optic disc scan to analyze and compare CT and CVI. Univariate and multivariate linear regression analyses were used to evaluate the relevance of CT and CVI to related factors.</p><p><strong>Results: </strong>In all macular regions, patients with early PACG exhibited thicker CT and higher CVI as compared with healthy controls (all P <0.05). Multivariate linear regression analysis showed that increased subfoveal CT and CVI were associated with younger age, PACG diagnosis, and/or shorter axial length (all P <0.05). After adjusting for the compound factors of age and/or axial length, subfoveal CT and CVI remained significantly higher in patients with early PACG than in healthy controls (both P <0.01). In the peripapillary regions, the mean CT in early PACG patients in the inferior nasal and inferior temporal regions was thicker than that of the healthy controls (both P <0.05).</p><p><strong>Conclusion: </strong>Early PACG patients are usually associated with thicker CT and higher CVI in 1-12 mm annular regions of the macula. The changes in CT and CVI were independent of age and axial length, indicating that alterations in choroidal characteristics may contribute to the pathogenesis of PACG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"233-239"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052277","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":"Micropulse Cyclophotocoagulation Versus Continuous Wave Cyclophotocoagulation: A Meta-Analysis.","authors":"Johar Abbas, Ghadeer Mohammed Abbas, Muhammad Maaz, Imama Yaseen, Rabia Asim, Sameen Mukhtar, Zainab Rustam, Somaiya Ahmed, Hajira Arooj, Bo Wang","doi":"10.1097/IJG.0000000000002652","DOIUrl":"10.1097/IJG.0000000000002652","url":null,"abstract":"<p><strong>Précis: </strong>In this systematic review, we find that CW-CPC produces more sustained IOP lowering in children compared with MP-CPC.</p><p><strong>Purpose: </strong>Micropulse cyclophotocoagulation (MP-CPC) and continuous cyclophotocoagulation (CW-CPC) are both surgical interventions used to decrease intraocular pressure (IOP) in pediatric glaucoma. Recent publications have shown conflicting results regarding the effectiveness of MP-CPC compared with CW-CPC, which this systematic review and meta-analysis aims to evaluate.</p><p><strong>Methods: </strong>From inception through March 2025, PubMed, Embase, Scopus, Cochrane Library, and ScienceDirect were searched for studies comparing MP-CPC and CW-CPC in treating pediatric glaucoma, with IOP reported at different time intervals. A random effects model was used across all analyses.</p><p><strong>Results: </strong>At 12 months, CW-CPC showed a significantly greater reduction in IOP compared with MP-CPC (MD: -6.88 mm Hg, 95% CI: -9.46 to -4.30; P < 0.00001). No significant differences in IOP lowering were observed at 1, 3, and 6 months. Overall, CW-CPC was superior in reducing IOP (MD: -4.23 mm Hg, 95% CI: -6.51 to -1.95; P = 0.0003; I² = 80%) at the last follow-up.</p><p><strong>Conclusion: </strong>CW-CPC shows a significantly greater reduction in IOP than MP-CPC, particularly at long-term follow-up. These findings highlight the sustained efficacy of CW-CPC compared with MP-CPC in the management of pediatric glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"261-266"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762973","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":"Phacoemulsification Combined With Endoscopic Cyclophotocoagulation Versus Phacoemulsification Alone in Primary Angle Closure Glaucoma-A Randomized Controlled Trial.","authors":"Dewang Angmo, Adithi K Murthy, Tanuj Dada, Namrata Sharma, Prafulla Maharana, Shivam Pandey","doi":"10.1097/IJG.0000000000002693","DOIUrl":"10.1097/IJG.0000000000002693","url":null,"abstract":"<p><strong>Precis: </strong>Phacoemulsification combined with endoscopic cyclophotocoagulation had a statistically significant reduction in both intraocular pressure and the number of medications compared with phacoemulsification alone.</p><p><strong>Purpose: </strong>Comparative evaluation of phacoemulsification combined with endoscopic cyclophotocoagulation (phaco-ECP) versus phacoemulsification (phaco) alone in primary angle closure glaucoma (PACG) with cataract.</p><p><strong>Design: </strong>Prospective, randomized, parallel-group, active-controlled trial.</p><p><strong>Participants: </strong>Patients with PACG and cataract.</p><p><strong>Methods: </strong>A total of 100 consecutive patients with PACG and cataract were screened, of whom 66 patients who met the inclusion criteria were recruited. Patients were randomized into 2 groups and underwent phaco-ECP or phaco alone. The patients were examined at baseline and at 1 week, 1, 3, 6, 12, 18, and 24 months. The anterior chamber angle parameters on swept-source anterior segment OCT (SS-ASOCT) were noted at baseline and at the 3-, 6-, and 12-month follow-up. The primary outcome measures were reduction in intraocular pressure (IOP) and the number of antiglaucoma medications.</p><p><strong>Results: </strong>The mean baseline IOP was 19.9±5.8 and 19.5±7.2 mm Hg in the phaco-ECP and phaco groups, respectively ( P =0.59). The mean IOP decreased to 14.0±2.6 and 15.7±2.2 mm Hg at 24 months in the phaco-ECP and phaco group, respectively ( P =0.02). The reduction in the number of medications was also significantly higher in the phaco-ECP group (1.8±1.10 vs. 1.0±0.8 mm Hg; P =0.02) as compared with the phaco-alone group. Qualified success with IOP ≤12 mm Hg was obtained in 46.6% of patients in the phaco-ECP group and 13.7% of patients in the Phaco group ( P =0.01). No absolute failures (requiring trabeculectomy) were noted in the phaco-ECP, whereas 6.9% of patients in the phaco group failed ( P =0.23). A significant widening of the angle parameters was noted postoperatively at 3, 6, 12, and 18 months as compared with baseline in both groups. The other secondary outcome parameters, like BCVA, visual field changes, endothelial cell count, pupil diameter, and complication rate, were comparable between the groups.</p><p><strong>Conclusions: </strong>The phaco-ECP group demonstrated a significant reduction in IOP and the number of medications, along with a notable widening of the nasal anterior chamber angle parameters compared with the phaco-alone group.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"207-217"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052393","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 Incidence of Clinically Significant Hypotony After Trabeculectomy.","authors":"Daniela Khaliliyeh, Sangwook Jin, Esteban Morales, Alessandro Rabiolo, Agustina de Gainza, Brayden K Leyva, Joseph Caprioli","doi":"10.1097/IJG.0000000000002690","DOIUrl":"10.1097/IJG.0000000000002690","url":null,"abstract":"<p><strong>Prcis: </strong>This is a retrospective observational study investigating the congruity between numerical and clinical hypotony and the risk factors for clinical manifestations of hypotony after trabeculectomy.</p><p><strong>Purpose: </strong>To identify risk factors associated with clinically meaningful hypotony after trabeculectomy.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Patients who underwent trabeculectomy with mitomycin-C (MMC) were included. Clinical hypotony was defined as the presence (≥ 3 wk after surgery) of choroidal detachment, hypotony keratopathy, hypotony maculopathy, or shallow anterior chamber or the need for trabeculectomy revision to resolve the hypotony at any time after surgery. Numerical hypotony was defined as intraocular pressure (IOP) ≤5 mmHg in 2 or more consecutive visits, at least one of them ≥ 3 weeks after surgery. Baseline, intraoperative, and postoperative characteristics were evaluated as potential risk factors. Univariable and multivariable analyses were conducted to assess the association between each characteristic and the presence of clinical hypotony.</p><p><strong>Results: </strong>Nine hundred ninety-two eyes were included. Two hundred eighty-four eyes (28.6%) met the criteria for numerical hypotony, 222 of which (79.9%) did not show any clinical sequelae of hypotony. 99 eyes (10%) met our criteria for clinical hypotony, whereas 42 of them (42.4%) did not have numerical hypotony. The most frequent manifestation of hypotony was serous choroidal effusion (54 eyes, 5.4%) followed by shallow anterior chamber (28 eyes, 2.8%). Thirty-four eyes (3.4%) underwent trabeculectomy revision to treat the hypotony. Asian ethnicity mitigated against the development of clinical hypotony (OR: 0.29, CI: 0.10-0.72, P =0.015) and the requirement for suture lysis postoperatively was associated with a lower risk of clinical hypotony (OR: 0.49, CI: 0.29-0.81, P =0.006).</p><p><strong>Conclusions: </strong>A minority of eyes (20.1%) with numerical hypotony showed clinical manifestations of low IOP. Asian ethnicity and eyes that required suture lysis postoperatively tended to have less incidence of clinical sequelae of hypotony after trabeculectomy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"249-260"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201940","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":"Intraocular Pressure Changes Following Corneal Cross-Linking in Patients With Keratoconus.","authors":"Wufan Zhao, Jamie Karl, Elizabeth Fan, C Ellis Wisely, Sanjay Asrani","doi":"10.1097/IJG.0000000000002689","DOIUrl":"10.1097/IJG.0000000000002689","url":null,"abstract":"<p><strong>Précis: </strong>This retrospective study found significantly elevated IOP measurements in eyes with keratoconus after CXL at postoperative months 1 and 3, but not after 4.5 months, compared with both baseline and untreated fellow eyes.</p><p><strong>Purpose: </strong>To evaluate intraocular pressure changes after corneal collagen cross-linking in patients with keratoconus and compare intraocular pressure measurements across tonometry methods.</p><p><strong>Methods: </strong>A retrospective chart review was performed of 405 patients (405 index eyes and 218 untreated fellow eyes) who underwent cross-linking between January 1, 2012, and January 1, 2024, at Duke Eye Center. Preoperative and postoperative intraocular pressure measurements were collected at ~1 month, 3 months, and ≥4.5 months postoperatively. Generalized estimating equation models included time point, tonometry method (iCare, Tonopen, Goldmann applanation tonometry), corticosteroid use, age, sex, and race. Wilcoxon rank-sum and sign-rank tests were used for tonometry method sub-analyses.</p><p><strong>Results: </strong>In treated eyes, intraocular pressure significantly increased at 1 month (2.2 mmHg increase, P =0.001) and remained elevated at 3 months (1.1 mmHg increase, P <0.001), returning to baseline by ≥4.5 months ( P =0.168). No significant intraocular pressure change was observed in untreated fellow eyes at any postoperative time point. Tonopen measurements were consistently higher than iCare (all P <0.001). iCare measurements showed significant elevation at 1 month postoperatively ( P =0.005), and Tonopen measurements at 1 month and 3 months (both P <0.001). No elevation was observed beyond 3 months with any tonometry method.</p><p><strong>Conclusions: </strong>Corneal collagen cross-linking was associated with transient intraocular pressure elevations postoperatively that normalized by ≥4.5 months. Tonometry method significantly influences intraocular pressure measurements, with iCare having lower measurements compared with Tonopen. Awareness of this pattern is important when managing patients with risk factors for glaucoma after cross-linking.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"226-232"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052453","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":"Direct Selective Laser Trabeculoplasty for Primary Angle Closure Glaucoma.","authors":"Dana Garzozi, Sharon Braudo, Moshe Carmel, Noa Shohat, David Zadok, Mordechai Goldberg","doi":"10.1097/IJG.0000000000002679","DOIUrl":"10.1097/IJG.0000000000002679","url":null,"abstract":"<p><p>This retrospective single-center case series evaluated the outcomes of direct selective laser trabeculoplasty (DSLT) in patients with primary angle closure glaucoma (PACG). Twelve eyes of 8 phakic patients with PACG and patent laser peripheral iridotomy (LPI) underwent DSLT. The primary outcome was the percentage reduction in intraocular pressure (IOP). Secondary outcomes included treatment success, defined as an IOP reduction of ≥20% from baseline or a reduction in glaucoma medications while maintaining baseline IOP and safety parameters. The mean patient age was 71.0±9.3 years. Baseline IOP was 17.0±2.3 mm Hg and decreased significantly to 13.6±3.0 mm Hg at the 2-month follow-up ( P =0.0024), representing an overall mean IOP reduction of 20.3%±11.6%. Treatment success was achieved in 7 eyes (58.3%), with a mean IOP reduction of 27.6%±7.3%. The mean number of glaucoma medications decreased from 3.17±1.47 to 2.75±1.70 ( P =0.0369), and the medications were completely discontinued in 3 eyes. Corrected distance visual acuity remained stable. The most common transient findings were mild anterior chamber reaction and subconjunctival hemorrhage, and no IOP spikes or other complications occurred. These preliminary results suggest that DSLT is a safe, well-tolerated, and potentially effective noncontact laser therapy for phakic patients with PACG and patent LPI. Larger prospective studies with longer follow-up periods are warranted to confirm these findings.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"267-271"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768251","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":"Twelve-Month Safety Profile of PreserFlo® MicroShunt on Corneal Endothelium in Glaucoma Subtypes.","authors":"Yo Okada, Kazuhiko Mori, Kengo Yoshii, Tsutomu Inatomi, Shigeru Kinoshita","doi":"10.1097/IJG.0000000000002719","DOIUrl":"10.1097/IJG.0000000000002719","url":null,"abstract":"<p><strong>Précis: </strong>PreserFlo® MicroShunt implantation alone may be well tolerated for the corneal endothelium across glaucoma subtypes over 12 months, whereas combination with cataract extraction may increase the risk of endothelial compromise, with a tendency toward a more pronounced reduction in pseudoexfoliation glaucoma.</p><p><strong>Purpose: </strong>To evaluate the impact of PreserFlo® MicroShunt (PMS) implantation on corneal endothelial cell density (ECD) over 12 months, stratified by glaucoma subtype and surgical procedure.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 103 eyes with primary open-angle glaucoma, pseudoexfoliation glaucoma (PEXG), and secondary open-angle glaucoma without PEXG, all undergoing PMS implantation (either alone or combined with cataract extraction [PMS-CE]) between August 2022 and December 2023. Changes in ECD, coefficient of variation (CV), and hexagonal cell percentage (HEX) were assessed. Firth logistic regression was employed to evaluate risk factors for >10% ECD loss. Subgroup analyses were performed by surgical procedure.</p><p><strong>Results: </strong>No significant within-group ECD, CV, or HEX changes were observed at 12 months in any glaucoma subtype. Thirteen eyes (12.6%) exhibited >10% ECD loss, predominantly in the PMS-CE group. Multivariate analysis identified PMS-CE as a significant risk factor (odds ratio [OR]: 12.1; 95% confidence interval [CI]: 2.69-75.0; P <0.001). In the PMS-CE subgroup, PEXG was associated with greater risk of ECD loss (OR: 9.39; CI: 1.19-125.0; P=0.033).</p><p><strong>Conclusions: </strong>PMS-alone demonstrated a favorable safety profile for the corneal endothelium across glaucoma subtypes. However, PMS-CE may pose an elevated risk of endothelial compromise, with a tendency toward a more pronounced reduction in PEXG eyes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581401","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":"Treatment Outcomes of Slow Coagulation Transscleral Cyclophotocoagulation for Medically Uncontrolled Glaucoma in Korean Patients.","authors":"Young Hoon Hwang, Sharon Lee, Mijin Kim, Jaewan Choi","doi":"10.1097/IJG.0000000000002718","DOIUrl":"10.1097/IJG.0000000000002718","url":null,"abstract":"<p><strong>Précis: </strong>Slow coagulation transscleral cyclophotocoagulation showed useful intraocular pressure control in Korean patients with medically uncontrolled glaucoma.</p><p><strong>Purpose: </strong>This study aimed to evaluate the treatment outcomes of slow coagulation transscleral cyclophotocoagulation (SC-CPC) in Korean patients with medically uncontrolled glaucoma.</p><p><strong>Methods: </strong>Medical records of 95 eyes from 95 patients who underwent SC-CPC to control intraocular pressure (IOP) were reviewed. Success was defined as an IOP of 6-21 mmHg with a ≥20% reduction from baseline, and no additional incisional surgery for glaucoma. Visual acuity presented as logarithm of the minimum angle of resolution (logMAR), the number of glaucoma medications, corneal endothelial cell count, and complications were analyzed.</p><p><strong>Results: </strong>At 12 months postoperatively, mean IOP decreased from 32.7±13.8 mmHg to 16.2±9.4 mmHg (P<0.001) and the mean number of medications decreased from 2.6±0.9 to 2.0±1.0 (P<0.001). Mean visual acuity declined from 0.69±0.94 to 0.80±0.99 logMAR (P=0.015). No significant changes were found in corneal endothelial cell counts at any postoperative visits (P>0.05). Eighteen eyes (18.9%) underwent repeated SC-CPC treatments. The most common complication was transient hypotony (4.2%), followed by macular edema (3.2%), prolonged hypotony (1.1%), and corneal decompensation (1.1%). The 12-month success rate was 57.1%.</p><p><strong>Conclusion: </strong>SC-CPC is a useful method for IOP control in Korean patients with medically uncontrolled glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521181","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":"Design and Baseline Characteristics of Participants in the Clarifying the Optimal Application of Selective Laser Trabeculoplasty (SLT) Therapy (COAST) Trial 1.","authors":"Tony Realini, G K Balasubramani, Tanya Kenkre, Jenny Wolsk, Michael A Kass, Gus Gazzard, Stephen R Wisniewski","doi":"10.1097/IJG.0000000000002717","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002717","url":null,"abstract":"<p><strong>Precis: </strong>COAST was designed to investigate alternate approaches to SLT to provide more effective long-term disease control without the need for alternate therapies such as medications or surgery. Methodology and baseline participant characteristics are described.</p><p><strong>Purpose: </strong>To describe the hypothesis and methodology for the ongoing Clarifying the Optimal Application of Selective Laser Trabeculoplasty (SLT) Therapy (COAST) trial 1 and participants' baseline characteristics.</p><p><strong>Methods: </strong>COAST Trial 1 is a multicenter randomized trial comparing standard-energy versus low-energy SLT as initial therapy for newly-diagnosed ocular hypertension (OHT) or mild-moderate primary open-angle glaucoma (POAG). The hypothesis is that 12-month survival following low energy SLT will be non-inferior to 12-month survival with standard energy SLT.</p><p><strong>Results: </strong>When enrollment ceased, 418 participants had been randomized to low-energy (n=203) or standard-energy (n=215) SLT. Demographic and clinical characteristics were similar between groups. Most participants were White (66.5% and 67.9%, respectively) or Black/African American (25.1% and 21.4%, respectively). Qualifying diagnoses were mild POAG (59.6% and 62.1%, respectively), ocular hypertension (32.8% and 30.5%) and moderate POAG (7.6% and 7.4%). Mean optical coherence tomography retinal nerve fiber layer thickness was 81.9 and 82.0 µm, respectively; mean visual field mean deviation was -1.6 dB in both groups. Mean baseline IOP was highest among eyes with ocular hypertension (24.5 and 24.4 mmHg, respectively) and lower in eyes with mild (21.8 and 21.4 mmHg) and moderate POAG (22.0 and 21.0 mmHg).</p><p><strong>Conclusions: </strong>COAST is a timely and potentially highly impactful trial that will clarify the optimal utilization of SLT for long-term glaucoma management without the need for alternative therapies such as medications or surgery. The COAST sample closely resembles the population of newly-diagnosed POAG/OHT patients for whom primary SLT would be appropriate, optimizing generalizability of study results when available.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521165","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":"Residual Structural Differences on Anterior Segment OCT After Laser Peripheral Iridotomy in Primary Angle Closure Disease.","authors":"Jie James Sng, Ki Ho Park, Young Kook Kim, Jin Wook Jeoung","doi":"10.1097/IJG.0000000000002714","DOIUrl":"10.1097/IJG.0000000000002714","url":null,"abstract":"<p><strong>Précis: </strong>AS-OCT parameters, especially ACD and nasal angle parameters, demonstrates persistent structural differences across the PACD disease spectrum even after LPI and may serve as a useful adjunctive tool for structural assessment and risk stratification in treated eyes.</p><p><strong>Purpose: </strong>Although laser peripheral iridotomy (LPI) alleviates pupillary block in primary angle closure disease (PACD), structural differences across the disease spectrum may persist after treatment. This study aimed to evaluate anterior segment optical coherence tomography (AS-OCT) parameters in treated primary angle closure disease (PACD) and identify features associated with severity.</p><p><strong>Patients and methods: </strong>Retrospective analysis was performed on 160 eyes from 91 patients. AS-OCT was conducted using Tomey CASIA2 Angle Protocol. Disease severity was established prior to laser peripheral iridotomy (LPI) based on clinical gonioscopy and standard diagnostic criteria. All eyes underwent AS-OCT after LPI. One-way ANOVA with post-hoc Tukey's HSD and ROC curve analysis evaluated intergroup differences and diagnostic cutoffs.</p><p><strong>Results: </strong>Significant differences in AS-OCT parameters were observed for ACD (P=0.020), AOD (P <0.001), TISA (P <0.001), ARA (P <0.001), ITC Index (P=0.001), and ITC Area (P=0.013). Acute angle closure glaucoma (AACG) had the most narrowing and highest ITC values. ROC analysis demonstrated modest discriminative performance for individual AS-OCT parameters. ACD ≤1.82 mm demonstrated high sensitivity (100%) but low specificity (21.4%), while AOD 250/500 nasal cutoffs demonstrated high specificity (100%/96.4%) with low sensitivity.</p><p><strong>Conclusion: </strong>AS-OCT demonstrates persistent structural differences across the PACD spectrum after LPI and may serve as an adjunct for structural assessment and risk stratification in treated eyes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521213","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}