Journal of Glaucoma最新文献

{"title":"Safety and Efficacy of a Preservative-Free Bimatoprost 0.01% Ophthalmic Gel: Results from a Phase III Controlled Trial.","authors":"Eydie Miller-Ellis, James H Peace, Douglas G Day, Sherif M El-Harazi, Sylvie Nissle, David Wirta, Jason Bacharach","doi":"10.1097/IJG.0000000000002628","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002628","url":null,"abstract":"<p><strong>Precis: </strong>Noninferiority on intraocular pressure (IOP)-lowering efficacy was demonstrated for a preservative-free (PF) bimatoprost 0.01% ophthalmic gel compared with a preserved formulation following a 3-month treatment in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).</p><p><strong>Purpose: </strong>To compare the safety and IOP-lowering efficacy of a preservative-free bimatoprost 0.01% ophthalmic gel (PFB 0.01% gel) with a preserved bimatoprost 0.01% ophthalmic solution (PB 0.01%) in patients with OAG or OHT.</p><p><strong>Methods: </strong>This prospective, Phase III, multicenter, randomized, parallel group, investigator-masked, 3-month study, included patients with OAG or OHT, previously treated with monotherapy, who underwent a maximum 7-week washout period. At Day 1, patients were randomized to receive either PFB 0.01% gel (n=232) or PB 0.01% (n=234) dosed once daily from Day 1 to Day 85. The primary efficacy endpoint was the change from baseline in IOP across 9 timepoints (8 am, 10 am, and 4 pm) at weeks 2, 6 and 12. Safety measures included adverse events (AEs) and conjunctival hyperemia.</p><p><strong>Results: </strong>Change in IOP from baseline was consistent across timepoints and was similar between treatment groups. Noninferiority of PFB 0.01% gel to PB 0.01% on IOP-lowering over a 12-week treatment period was demonstrated based on predetermined noninferiority margins (below 1.5 mm Hg at all timepoints [9/9] and below 1 mm Hg at the majority of time points [6/9]). Tolerability and safety were comparable with fewer treatment-related ocular AEs in the PFB 0.01% gel group compared to the PB 0.01% group (28.1% vs. 34.8%, respectively), and conjunctival hyperemia at Week 2 (54.8% vs. 63.2%, respectively).</p><p><strong>Conclusions: </strong>PF bimatoprost 0.01% ophthalmic gel was noninferior to the preserved bimatoprost 0.01% ophthalmic solution, with similar safety and tolerability over 3 months.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064920","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":"Surgical Efficacy After Viscogonioplasty in Primary Angle Closure Disease with Different Mechanisms.","authors":"Jin Wang, Yue Wang, Ye Zhang, Xin Tang, Dabo Wang, Ningli Wang, Dapeng Mou","doi":"10.1097/IJG.0000000000002631","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002631","url":null,"abstract":"<p><strong>Precis: </strong>Non-pupillary block mechanisms are associated with larger postoperative peripheral anterior synechiae (PAS) extent at 1-year follow-up compared to pupillary block mechanisms in primary angle-closure disease (PACD).</p><p><strong>Purpose: </strong>To evaluate the impact of preoperative angle-closure mechanisms on surgical outcomes of phacoemulsification and intraocular lens implantation (PEI) combined with VGP in PACD patients with cataracts.</p><p><strong>Patients and methods: </strong>This prospective cohort study enrolled 56 patients (68 eyes) with PACD and cataracts. Participants were classified into pupillary block (PB) and non-pupillary block (Non-PB) groups based on the anatomical characteristics of angle closure shown in preoperative ultrasound biomicroscopy imaging. Primary outcomes included peripheral anterior synechiae (PAS) extent, intraocular pressure (IOP), and number of IOP-lowering medications over a 12-month follow-up period.</p><p><strong>Results: </strong>Both groups showed significant reductions in PAS extent at the end of surgery compared to the baseline. At 6 and 12 months postoperatively, the Non-PB group exhibited significantly larger PAS extent compared to the PB group (P=0.025 and P=0.017, respectively). Both groups demonstrated significant IOP reduction and decreased use of IOP-lowering medications postoperatively, with no significant differences between groups. The overall complete and qualified success rates at 12 months were 71.6% and 98.5%, respectively, with no significant difference between groups.</p><p><strong>Conclusions: </strong>Non-PB mechanisms are associated with larger postoperative PAS extent at 1-year follow-up compared to PB mechanisms, emphasizing the importance of comprehensive preoperative angle-closure mechanisms assessment in predicting and potentially minimizing PAS progression for enhanced long-term surgical efficacy in PACD treatment.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064888","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":"Intraoperative Injection Versus Sponge-Applied Mitomycin C During Trabeculectomy In Glaucoma: A Systematic Review And Meta-Analysis.","authors":"Natália Gaban, Gustavo Pelison, William Binotti, Luiz Fernando Taranta, Chandrasekharan Krishnan","doi":"10.1097/IJG.0000000000002624","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002624","url":null,"abstract":"<p><strong>Prcis: </strong>This study highlights intraoperative mitomycin C (MMC) injection in trabeculectomy with higher success rate and reduction in glaucoma medications, however, no difference in mean IOP at 1 year or safety profile, compared to MMC sponge.</p><p><strong>Purpose: </strong>To compare the efficacy and safety of intraoperative injection of mitomycin C (MMC) versus conventional MMC-soaked sponges in patients undergoing trabeculectomy.</p><p><strong>Methods: </strong>Pubmed, Cochrane, and Embase were searched for studies published until December 2023 comparing injection and sponge techniques during trabeculectomy. Main outcomes of interest were postoperative mean intraocular pressure (IOP) at 6 months, complete surgical success (mean IOP 5-21 mmHg without medication), postoperative number of antiglaucoma medications ≥12 months, and postoperative complications. This study was registered in PROSPERO, CRD42023494096.</p><p><strong>Results: </strong>A total of 1665 eyes from 17 studies (9 randomized controlled trials [RCT]) were included, of which 723 (43.42%) received intraoperative injection of MMC. The mean IOP at 6 months was significantly lower in the injection group (mean difference [MD]= -0.93; 95% CI -1.85 - -0.01). Also, the incidence of complete surgical success at ≥6 months was higher in the injection group (OR=1.79; 95% CI 1.33-2.40). There were no significant differences between groups for postoperative complications (OR=1.01, 95% CI 0.69-1.49). Conversely, analysis of RCTs only showed a significant reduction in the number of medications for glaucoma control at ≥12 months with injection (MD= -0.37; 95% CI -0.60- -0.14).</p><p><strong>Conclusion: </strong>Intraoperative MMC injection had greater rate of complete surgical success and reduction in the number of medications. However, there was no significant difference in mean IOP at 12 months between groups. MMC injection was as safe as sponge application in trabeculectomy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 30-2 Visual Field Using Melbourne Rapid Fields Online Perimetry and Humphrey Field Analyzer.","authors":"Kae Sugihara, Yu Xiang George Kong, Mitsuto Hosokawa, Toshio Okanouchi","doi":"10.1097/IJG.0000000000002625","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002625","url":null,"abstract":"<p><strong>Prcis: </strong>Protocol 30-2 of Melbourne Rapid Fields, online computer perimetry, provides a portable, reliable, and patient-friendly alternative to Humphrey Field Analyzer 30-2 SITA fast protocol for Japanese all severity stages of glaucoma patients.</p><p><strong>Purpose: </strong>Melbourne Rapid Fields (MRF) online computer perimetry is a web-browser-based software that offers white-on-white threshold perimetry using any computer. This study evaluates the perimetric results of 30-2 protocol from MRF performed using a laptop computer in comparison to Humphrey Field Analyzer (HFA).</p><p><strong>Methods: </strong>A prospective and cross-sectional study of 87 eyes from 87 Japanese glaucoma patients. The MRF software includes features such as computer vision gaze monitoring and thresholding using Bayes logic. MRF's 30-2 VF results were compared to HFA 30-2 SITA-Fast, including Mean Deviation (MD), Pattern Deviation (PD), and reliability indices. Patients underwent 2 assessments on the MRF to establish test-retest reliability.</p><p><strong>Results: </strong>Of the 87 eyes, 43 eyes had mild field defect (MD>-6 dB), 26 had moderate field defect (-12 dB≤MD≤-6 dB), and 18 had advanced field defects (MD<-12 dB). MRF demonstrated a high level of agreement with HFA in evaluating MD (Intraclass Correlation Coefficient ICC = 0.97 {95% CI 0.95 to 0.98}) and PSD (ICC=0.91 {95% CI 0.86 to 0.94}). Bland-Altman analysis revealed a mean bias of -0.76 decibels (dB) (95% Limits of Agreement LoA -5.82 dB, +4.30 dB) for MD and 0.79 dB (LoA -4.24 dB, +5.82 dB) for PSD. Regarding MRF test-retest, Bland-Altman analysis demonstrated a mean bias of 0.25 dB (LoA - 2.48 dB, +2.99 dB) for MD and -0.21 dB (LoA -3.22 dB, +2.79 dB) for PSD. Although false positives and fixation losses were comparable between MRF and HFA, the MRF showed slightly higher false negatives and longer test times than HFA, though these differences did not reach statistical significance. In the mild group, MRF has a sensitivity of detecting field defect of 80% and a specificity of 72%.</p><p><strong>Conclusion: </strong>MRF provides a portable and accessible alternative to HFA for 30-2 visual field testing, with good agreement in moderate to advanced glaucoma. However, its slightly higher false negatives, longer test duration, and systemic difference in output to HFA should be considered when interpreting results. Further improvements may enhance its clinical utility.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023462","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":"Deep Learning Estimation of 24-2 Visual Field Map from Optic Nerve Head Optical Coherence Tomography Angiography.","authors":"Golnoush Mahmoudinezhad, Sasan Moghimi, Liyang Ru, Yu Xuan Yong, Dongchen Yang, Jiacheng Cheng, Siavash Beheshtaein, Evan Walker, Kareem Latif, Kelvin H Du, Gopikasree Gunasegaran, Takashi Nishida, Mark Christopher, Linda Zangwill, Nuno Vasconcelos, Robert N Weinreb","doi":"10.1097/IJG.0000000000002626","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002626","url":null,"abstract":"<p><strong>Precis: </strong>Artificial intelligence applied to OCTA images demonstrated high accuracy in estimating 24-2 visual field maps by leveraging information from pararpapillary area.</p><p><strong>Purpose: </strong>To develop deep learning (DL) models estimating 24-2 visual field (VF) maps from optical coherence tomography angiography (OCTA) optic nerve head (ONH) en face images.</p><p><strong>Methods: </strong>A total of 3148 VF OCTA pairs were collected from 994 participants (1684 eyes). DL models were trained using radial peripapillary capillary (RPC), superficial, and choroidal, as well as combined ONH VD layers, to estimate 24-2 mean deviation (MD), pattern standard deviation (PSD), 52 total deviation (TD), and pattern deviation (PD) values and compared with a linear regression (LR) model. Model accuracy was assessed by calculating mean absolute error (MAE) and R (Pearson correlation coefficients) between estimated and actual VF values.</p><p><strong>Results: </strong>DL models outperformed LR estimates for the estimation of VF values using individual and combined layers (P<0.001). For example, in the estimation of MD using RPC, DL achieved an R of 0.79 and MAEs of 1.77 dB. Average estimated TDs using RPC had R of 0.63 and MAEs of 3.08 dB. DL estimation using combined layers slightly improved choroid in the estimation of MD (P<0.01) and had comparable performance with RPC and superficial layers. It also slightly improved RPC, superficial and choroidal layer in the estimation of TDs (P<0.01).</p><p><strong>Conclusions: </strong>DL models from OCTA images demonstrated high accuracy in estimating 24-2 VF maps by leveraging information from ONH layers. By extending the application of DL to OCTA images using RPC or superficial layers, it may be possible to reduce the frequency of VF testing to individual patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023470","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 Performance of Large Language Model-Based Tools on Patient-Driven Glaucoma Inquiries.","authors":"Dhruva Gupta, Sarah L Wagner, Alexandra G Castillejos Ellenthal, Andrew W Gross, Edward S Lu, Enchi K Chang, Arya S Rao, Marc D Succi","doi":"10.1097/IJG.0000000000002627","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002627","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLMs) can assist patients who seek medical knowledge online to guide their own glaucoma care. Understanding the differences in LLM performance on glaucoma-related questions can inform patients about the best resources to obtain relevant information.</p><p><strong>Methods: </strong>This cross-sectional study evaluated the accuracy, comprehensiveness, quality, and readability of LLM-generated responses to glaucoma inquiries. Seven questions posted by patients on the American Academy of Ophthalmology's Eye Care Forum were randomly selected and prompted into GPT-4o, GPT-4o Mini, Gemini Pro, and Gemini Flash in September 2024. Four physicians practicing ophthalmology assessed responses using a Likert scale based on accuracy, comprehensiveness, and quality. The Flesch-Kincaid Grade level measured readability while Bidirectional Encoder Representations from Transformers (BERT) Scores measured semantic similarity between LLM responses. Statistical analysis involved either the Kruskal-Wallis test with Dunn's post-hoc test or ANOVA analysis with Tukey's Honestly Significant Difference (HSD) test.</p><p><strong>Results: </strong>GPT-4o rated higher in accuracy (P=0.016), comprehensiveness (P=0.007), and quality (P=0.002) compared to Gemini Pro. GPT-4o Mini rated higher in comprehensiveness (P=0.011) and quality (P=0.007). Gemini Flash and Gemini Pro were similar across all criteria. There were no differences in readability, and LLMs mostly produced semantically similar responses.</p><p><strong>Conclusions: </strong>GPT models surpass Gemini Pro in addressing commonly asked questions about glaucoma, providing valuable insights into the application of LLMs for providing health information.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023493","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":"Bent Ab interno Needle Goniotomy versus Gonioscopy-Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma: A Randomized Clinical Trial.","authors":"Gabriel Ayub, Vital Paulino Costa","doi":"10.1097/IJG.0000000000002629","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002629","url":null,"abstract":"<p><strong>Prcis: </strong>Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.</p><p><strong>Purpose: </strong>To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.</p><p><strong>Results: </strong>Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).</p><p><strong>Conclusion: </strong>GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029926","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":"Associations Between IgE-Allergen Sensitization and Glaucoma: An Analysis of Korea National Health and Nutrition Examination Survey.","authors":"Jiyoon Kwak, Young Kook Kim","doi":"10.1097/IJG.0000000000002630","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002630","url":null,"abstract":"<p><strong>Prcis: </strong>Analysis of 1,175 Korean adults in the 2019 KNHANES study found that sensitization to house dust mites and birch pollen significantly increased glaucoma risk, while oak pollen sensitization showed a protective effect.</p><p><strong>Background: </strong>The relationship between allergen sensitization and glaucoma remains poorly understood. This study investigated the association between specific allergen sensitization patterns and glaucoma risk using data from the 2019 Korea National Health and Nutrition Examination Survey.</p><p><strong>Methods: </strong>In this population-based cross-sectional study, we analyzed 1,175 adult participants (≥19 yrs) who completed ophthalmologic examinations and allergen sensitization assessments. Glaucoma diagnosis was based on International Society of Geographical and Epidemiological Ophthalmology criteria. Specific IgE antibodies against seven common allergens were measured using ImmunoCAP assays, with significant sensitization defined as IgE ≥3.5 kU/L. We employed the Synthetic Minority Over-sampling Technique to address class imbalance. Multiple logistic regression models were employed to evaluate associations between allergen sensitization and glaucoma, adjusting for demographic and clinical factors.</p><p><strong>Results: </strong>Among the participants, 50 (4.3%) were diagnosed with glaucoma. Analysis of allergen sensitization patterns revealed house dust mites as the most prevalent allergen (11.7% overall), with comparable rates between the glaucoma (12.0%) and non-glaucoma groups (11.7%). Birch pollen sensitization followed at 4.1% and 4.0% in the glaucoma and non-glaucoma groups, respectively. Multivariate logistic regression analysis, after adjusting for confounders, identified house dust mite sensitization as having the strongest positive association with glaucoma (OR 3.08, 95% CI 1.40-6.77, P=0.005), followed by birch pollen (OR 2.69, 95% CI 1.02-7.12, P=0.046). Interestingly, oak pollen sensitization demonstrated a protective effect (OR 0.24, 95% CI 0.07-0.81, P=0.022).</p><p><strong>Conclusions: </strong>Our findings suggest a complex relationship between allergen sensitization and glaucoma, with different allergens showing varying associations with disease risk.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029940","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":"Open-Angle Glaucoma Treatment Preferences of US Glaucoma Specialists.","authors":"Jocelyn Liu, Iris M Kim, Evan M Chen, Travis C Porco, Stephen D McLeod, Gus Gazzard, Kieran S O'Brien, Catherine Q Sun","doi":"10.1097/IJG.0000000000002623","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002623","url":null,"abstract":"<p><strong>Prcis: </strong>This cross-sectional survey study evaluated the current treatment preferences of US glaucoma specialists for open-angle glaucoma, finding that most preferred selective laser trabeculoplasty over topical medications for treatment-naïve patients with ocular hypertension and open-angle glaucoma.</p><p><strong>Purpose: </strong>To describe US glaucoma specialists' preferences regarding the use of selective laser trabeculoplasty (SLT) versus topical glaucoma medications for the treatment of open-angle glaucoma.</p><p><strong>Methods: </strong>Actively practicing glaucoma specialists from the American Glaucoma Society were invited to participate in a survey assessing treatment preferences and influencing factors. Multivariable logistic regressions were performed to determine predictors of preference for SLT.</p><p><strong>Results: </strong>Of 136 eligible respondents, 65-71% preferred SLT for treatment-naïve patients with ocular hypertension, mild-to-moderate primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma, or pigmentary glaucoma. For mild-to-moderate POAG on one medication, 75% of respondents favored SLT. For advanced POAG on maximum medical therapy, 57% of respondents favored surgery and 38% preferred SLT. Respondents indicated that reducing medication non-adherence (93%), suitable glaucoma type or stage (88%), and experience performing SLT (83%) were key facilitators in recommending SLT to their patients. In contrast, patients' inability to position for the procedure (78%), unsuitable glaucoma type or stage (67%), and comorbidities or contraindications to SLT (55%) were primary reasons to not recommend SLT. Physicians in private practice, those who completed fellowship training more recently, and those who see more treatment-naïve glaucoma patients were significantly more likely to prefer SLT over medication.</p><p><strong>Conclusion: </strong>The majority of US glaucoma specialists report a preference for SLT over medication for open-angle glaucoma treatment, demonstrating that acceptance of SLT has increased over the past several years, especially for treatment-naïve patients. Statistically significant predictors of SLT preference were practice setting, practice duration, and patient volume.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956941","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 Influencing Discrepancies in Intraocular Pressure Measurements Between iCare IC200 and Goldmann Tonometer.","authors":"Haowei Zhang, Jeong Woo Nam, Mi Sun Sung, Sang Woo Park","doi":"10.1097/IJG.0000000000002591","DOIUrl":"10.1097/IJG.0000000000002591","url":null,"abstract":"<p><strong>Prcis: </strong>Intraocular pressure measured by Goldmann applanation tonometry, central corneal thickness, and history of cataract surgery are factors in the discrepancies in intraocular pressure measurements between the iCare IC200 rebound tonometer and the Goldmann applanation tonometer.</p><p><strong>Purpose: </strong>To investigate the factors affecting the discrepancies in intraocular pressure (IOP) measurements between the iCare IC200 rebound tonometer (RBT) and the Goldmann applanation tonometer (GAT).</p><p><strong>Materials and methods: </strong>The IOP was measured sequentially using RBT followed by GAT. Bland-Altman analysis was used to determine the agreement between the RBT and GAT. Eyes were classified into 3 groups based on the difference calculated as RBT minus GAT: group A (-1 to 1 mm Hg), group B (≥3 mm Hg), and group C (≤-3 mm Hg). Logistic regression analysis was performed to identify the factors associated with the measurement discrepancies.</p><p><strong>Results: </strong>A total of 402 right eyes were included in the study. The RBT and GAT measurements were significantly correlated (Spearman r =0.885, P <0.001). The mean IOP differences between the RBT and GAT were 0.114±2.13 mm Hg (range: -7 to 8, 95% limit of agreement: -4.06 to 4.29 mm Hg). Multivariate logistic analyses revealed that greater central corneal thickness (CCT) ( P =0.002) was significantly associated with overestimation of IOP by RBT relative to GAT. We found that underestimated IOP by RBT relative to GAT in patients with higher GAT-measured IOP ( P =0.002) and those with a history of cataract surgery ( P =0.006).</p><p><strong>Conclusions: </strong>RBT tends to overestimate IOP relative to GAT in patients with thicker CCTs, while it underestimates IOP in those with higher GAT-measured IOP or a history of cataract surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"728-733"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028448","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}