Journal of Glaucoma最新文献

{"title":"Correlation of Binocular Perimetry Screening Using imo: A Portable Head Mounted Perimeter With 10-2 Standard Automated Perimetry for Early Glaucoma With Central Visual Field Defects.","authors":"Euido Nishijima, Yoshinori Itoh, Takahiko Noro, Shumpei Ogawa, Sachiyo Okude, Tadashi Nakano","doi":"10.1097/IJG.0000000000002492","DOIUrl":"10.1097/IJG.0000000000002492","url":null,"abstract":"<p><strong>Prcis: </strong>The screening program using imo strongly correlates with 10-2 standard automated perimetry in detecting central visual field defects in early glaucoma, highlighting its potential as a valuable tool for efficient screening and severity quantification.</p><p><strong>Purpose: </strong>To investigate the correlation between abnormalities within the central 10 degrees of the screening program using imo, a portable head-mounted perimeter, and 10-2 standard automated perimetry in early-stage glaucoma with central visual field defects.</p><p><strong>Methods: </strong>This retrospective study included early glaucoma with (26 eyes) and without (38 eyes) central visual field defects. The correlation between the numbers of abnormal points within the central 10 degrees of the imo screening program and those in the probability plot of 10-2, and mean total deviation and pattern deviation, were analyzed.</p><p><strong>Results: </strong>The imo screening program demonstrated sensitivity (80%) and specificity (98.7%) in detecting abnormalities, with a 91.6% agreement rate of 10-2. The mean number of anomalies in the 10-2 plot (pattern deviation) with P <1% was 0.85, 7.75, and 9.69 (95% CI: 0.18-1.51, 5.38-10.1, and 6.89-12.5, respectively) for no, 1, and 2 anomalies in the imo screening program, respectively. The number of anomalies with P <1% was significantly higher when the imo screening program detected 1 anomaly versus none ( P <0.01) and 2 versus 1 ( P <0.05). Mean total deviation values were -1.15, -7.5, and -15.2 (95% CI: -2.32 to 0.03, -11.21 to -3.78, and -19.7 to -10.6, respectively), while mean pattern deviation values were -1.57, -9.0, and -16.0 (95% CI: -2.57 to -0.57, -12.5 to -5.49, and -21.4 to -10.7, respectively), for no, 1, and 2 anomalies in the imo screening program, respectively.</p><p><strong>Conclusions: </strong>The imo portable head-mounted perimeter was found to correlate with 10-2 standard automated perimetry in glaucoma patients with central visual field defects and has the potential to shorten visual field testing times.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"89-94"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080533","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":"Evidence of Mitophagy in Lens Capsule Epithelial Cells of Patients With Pseudoexfoliation Syndrome.","authors":"Dilara Aydemir, Sadi Can Sonmez, Zeynep Busra Kisakurek, Merve Gozel, Melisa Zisan Karslioglu, Umit Yasar Guleser, Afsun Sahin, Murat Hasanreisoglu","doi":"10.1097/IJG.0000000000002484","DOIUrl":"10.1097/IJG.0000000000002484","url":null,"abstract":"<p><strong>Prcis: </strong>Alterations in the PTEN-induced kinase 1 (PINK)-mediated mitophagy pathway play an important role in pseudoexfoliation syndrome (PEX) disease.</p><p><strong>Purpose: </strong>PEX is a condition in which aberrant fibrillary protein builds up in various components of the eye and other extraocular tissues. In this study, we aim to investigate the functionality of intracellular auto-degradative machinery-especially mitophagy-and related genes and proteins in PEX.</p><p><strong>Materials and methods: </strong>Anterior lens capsules were obtained from cataract patients with and without PEX to constitute the PEX group and age-matched controls during microincision cataract surgery. PINK1-mediated mitophagy markers were evaluated on the transcriptional and translational level via reverse transcriptionquantitative polymerase chain reaction and immunohistochemistry analysis, respectively.</p><p><strong>Results: </strong>The lens epithelial cells of PEX patients were characterized by significantly higher PINK1 gene expression compared with that of the controls ( P <0.05). In terms of intensity of staining of expressed proteins, PINK1 ( P <0.05), Parkin ( P <0.01), and microtubule-associated protein 1A/1B-light chain 3 B ( P <0.01) were all statistically higher in PEX, compared with the controls.</p><p><strong>Conclusion: </strong>Altered auto-degradative response-specifically mitophagy-is a component of increased oxidative stress in PEX patients. The role of this mechanism in emerging complications warrants further research.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"114-120"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Trabeculectomy and Predictors of Success in Patients of African Ancestry With Primary Open Angle Glaucoma.","authors":"Anusha Mamidipaka, Amy Shi, Victoria Addis, Jocelyn He, Roy Lee, Isabel Di Rosa, Rebecca Salowe, Gui-Shuang Ying, Joan O'Brien","doi":"10.1097/IJG.0000000000002503","DOIUrl":"10.1097/IJG.0000000000002503","url":null,"abstract":"<p><strong>Prcis: </strong>Trabeculectomy in African ancestry individuals with primary open angle glaucoma (POAG) shows a 46% success rate and frequent complications, indicating that younger age and family history are significant predictors of surgical failure in this high-risk population.</p><p><strong>Objective: </strong>To investigate outcomes of trabeculectomy ab externo in African ancestry POAG patients and to analyze the impact of demographic and phenotypic factors on surgical success and complication rates.</p><p><strong>Patients and methods: </strong>A retrospective case-control study enrolled 63 eyes of 55 POAG cases who underwent trabeculectomy ab externo. Data on demographics, family glaucoma history, surgical specifics, and pre/postoperative measures (intraocular pressure, visual acuity, visual field, medication usage, complications within 1 year) were collected. The analysis included linear/logistic regression models adjusting for inter-eye correlation.</p><p><strong>Results: </strong>Trabeculectomy yielded success without additional medication in 46%, qualified success with medication in 22%, and surgical failure necessitating further intervention in 32% within 1 year. Subjects experienced a reduction in intraocular pressure (IOP) (46%), daily glaucoma medication (73%), and eye drop usage (67%) 1-year post-trabeculectomy (all P <0.001). However, there was a postoperative decline of 56% in visual acuity (VA) ( P <0.001) and a significant worsening of visual field parameters, including a 14% decrease in mean deviation ( P =0.02) and a 19% decrease in visual field index ( P =0.004). Fifty-nine percent of patient eyes experienced complications within 1 year of surgery. Univariate analysis of predictive factors for surgical outcomes revealed that younger age at surgery ( P =0.01) and family history of glaucoma ( P =0.046) were predictive of lower rates of surgical success. Multivariable analysis revealed worse preoperative VA (OR: 0.79 per 0.1 LogMAR increases, P =0.02) was associated with a lower likelihood of surgical success.</p><p><strong>Conclusion: </strong>This study underscores the low rates of trabeculectomy success and high rates of complications in an African ancestry population with POAG. While the procedure exhibited positive effects on IOP control and medication reduction, our analysis found that multiple factors, particularly age, family history, and worse preoperative VA play crucial roles in influencing surgical success.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"127-135"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glaucoma Progression in Treatment-Naïve Patients With Normal Tension Glaucoma With Myopia-Role of Intraocular Pressure.","authors":"Dong Kyun Han, Eun Ji Lee, Tae-Woo Kim","doi":"10.1097/IJG.0000000000002528","DOIUrl":"10.1097/IJG.0000000000002528","url":null,"abstract":"<p><strong>Prcis: </strong>While myopia has been recognized as a positive prognostic factor for normal tension glaucoma (NTG) progression in the adult population, some myopic NTG eyes exhibited significant progression within 2 years when left untreated, even under low intraocular pressure (IOP).</p><p><strong>Objective: </strong>To determine the natural history and risk factors associated with progressive retinal nerve fiber layer (RNFL) thinning in previously stable, treatment-naïve, patients with NTG with myopia.</p><p><strong>Methods: </strong>This study included 111 myopic NTG eyes without IOP-lowering treatment for at least 1 year and without disease progression during the treatment-free period. The RNFL thickness was measured, and a visual field test was performed every 6-12 months for >2 years. Patients with progressive changes were classified as the P(+) group, whereas those without progression were classified as the P(-) group. Cox proportional hazards model assessed risk factors of progression, whereas linear regression determined factors associated with the rate of RNFL thinning.</p><p><strong>Results: </strong>Progressive change was observed in 25 of the 111 participants [P(+) group, 22.5%]. A family history of glaucoma, higher mean IOP, and maximum IOP during the follow-up were significant factors both for being in the P(+) group and for a faster RNFL thinning. None with a mean IOP <11 mm Hg were in the P(+) group. Davies test identified that 14.2 mm Hg was a significant breakpoint ( P = 0.042), above which the rate of RNFL thinning increased significantly with the mean IOP ( R2 = 0.252, P = 0.034).</p><p><strong>Conclusions: </strong>Patients with myopic NTG untreated for IOP, especially those with a family history of glaucoma or higher IOP, are at increased risk of progression. Early treatment initiation is advised for high-risk patients with myopic NTG, even when their condition appears stable.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"61-68"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Results of Preserflo MicroShunt for Primary Open Angle Glaucoma in White Patients.","authors":"Karin R Pillunat, Robert Herber, Melanie Jamke, Carolin S Jasper, Maike A Haase, Anna S Manseck, Lutz E Pillunat","doi":"10.1097/IJG.0000000000002509","DOIUrl":"10.1097/IJG.0000000000002509","url":null,"abstract":"<p><strong>Prcis: </strong>The Preserflo MicroShunt effectively lowered intraocular pressure in primary high and normal pressure open angle glaucoma.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of the Preserflo MicroShunt in patients with primary open angle glaucoma (POAG) and the 2 variants high (HPG) and normal pressure glaucoma (NPG) after 1 year.</p><p><strong>Methods: </strong>Single-center prospective interventional case series consecutively including eyes of White/European patients with POAG, who received the Preserflo MicroShunt as a primary and standalone glaucoma intervention. Primary outcome measures: change in mean 24-hour IOP (mdIOP, mean of 6 measurements), peak IOP, IOP fluctuations, antiglaucoma medications, and success rates. Secondary outcome measures include visual acuity, visual fields, complications, surgical interventions, and adverse events.</p><p><strong>Results: </strong>Forty-two eyes of 42 patients with POAG, 29 in the HPG and 13 in the NPG group, were analyzed after 1-year follow-ups. Median [Q25, Q75] medicated mdIOP (mm Hg) dropped by 30% from 16.5 [13.7-27.3] to 12.8 [10.2-14.5] in the HPG and by 40% from 14.3 [13.3-16.0] to 9.5 [8.3-11.1] in the NPG group, with a median postoperative medication use of 0 [0-0] in both groups. At 1 year, 92.5% of eyes were medication-free versus 0% preoperatively. The reduction of mdIOP ( P =1.0), peak IOP ( P =0.932), IOP fluctuations ( P =0.142), and the rate of interventions ( P =0.298) were not statistically significantly different between the HPG and NPG group. None of the patients experienced severe adverse events or loss of vision.</p><p><strong>Conclusions: </strong>Effective and safe intraocular pressure lowering was observed 1 year following MicroShunt implantation for primary HPG and NPG in White patients of European descent.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"103-113"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467436","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":"Identification of Retinal Amyloid-Beta in Ex Vivo Human Glaucoma Eyes Using a Novel Ocular Tracer.","authors":"Julie Pilotte, Sami Khoury, Ali Tafreshi, Zachary T Mandel, Svasti V Sharma, Peter W Vanderklish, Stella T Sarraf, Alfredo A Sadun, Robert N Weinreb, Alex S Huang","doi":"10.1097/IJG.0000000000002496","DOIUrl":"10.1097/IJG.0000000000002496","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the presence of amyloid-beta (Aβ) in human glaucoma retina and to test the identification of retinal Aβ using a novel fluorescent Aβ-binding small molecule (AMDX-2011).</p><p><strong>Methods: </strong>Postmortem human eyes with (n=4) and without (n=4) glaucoma were acquired from an eye bank. Retinas were dissected, flat-mounted, and fixed. Using the flat mounts, immunofluorescence was performed against Aβ, AMDX-2011 staining was conducted, and images were acquired using fluorescence microscopy.</p><p><strong>Results: </strong>Fluorescence microscopy demonstrated the presence of an Aβ signal that colocalized with AMDX-2011 staining in the glaucoma retina. Colabeled puncta appeared in all quadrants of the retina, including the retina temporal to the optic nerve. The puncta were mainly located within the inner layers of the retina. Glaucoma retinas had more colabeled puncta than control retinas in all locations ( P =0.002-0.02). Colabeled puncta were also larger in the superior quadrant of glaucoma compared with control retinas ( P =0.02).</p><p><strong>Conclusions: </strong>Aβ was detected in human glaucomatous retina, and its distribution was mapped. AMDX-2011 identification of Aβ may lead to future diagnostic tests aimed at detecting Aβ in glaucoma patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e4-e8"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289097","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":"Performance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort.","authors":"Rithambara Ramachandran, Ming-Chen Lu, Leslie M Niziol, Maria A Woodward, Angela R Elam, Leroy Johnson, Martha Kershaw, David C Musch, Amanda Bicket, Denise John, Sarah Dougherty Wood, Amy Zhang, Jason Zhang, Joan O'Brien, Paula Anne Newman-Casey","doi":"10.1097/IJG.0000000000002545","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002545","url":null,"abstract":"<p><strong>Precis: </strong>Current optical coherence tomography normative sample data may not represent diverse human optic nerve anatomy to accurately classify all individuals with true glaucomatous optic neuropathy.</p><p><strong>Purpose: </strong>To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a more diverse cohort of healthy individuals.</p><p><strong>Patients and methods: </strong>ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared. Chi-square tests compared MI-SIGHT retinal nerve fiber layer (RNFL) quadrant color-code labels with the expected distribution and multinomial logistic regression identified factors associated with label classifications.</p><p><strong>Results: </strong>1084 MI-SIGHT and 399 Topcon eyes were evaluated. The MI-SIGHT cohort was older (54 v 46 y), with more individuals identifying as Black (61% v 20%), less as Hispanic (4% v 18%), and spherical equivalents closer to plano (-0.6 v -1.2 diopters) compared to the Topcon cohort (all P<0.001). Black/African American MI-SIGHT participants had larger cup-to-disc ratios and cup volumes, while White MI-SIGHT participants had smaller ONH values, except for rim area and rim volume, compared to Topcon participants (all P<0.001). The MI-SIGHT cohort's RNFL color codes did not follow the expected distribution (P<0.05); more MI-SIGHT RNFL quadrant measurements were assigned as white (10.6% and 6.3% MI-SIGHT v 5% Topcon) and red codes (2.2% and 1.8% MI-SIGHT v <1% Topcon) than expected in the superior and inferior quadrants respectively.</p><p><strong>Conclusion: </strong>OCT normative databases should accurately reflect diverse populations to avoid misclassification by RNFL thickness color codes. Larger datasets should be leveraged to encompass the full spectrum of healthy optic nerve anatomy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059290","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":"Polydipsia Induced Acute Angle-Closure Crisis.","authors":"Akash Maheshwari, Noor Laylani, Pamela Davila Siliezar, Andrew G Lee","doi":"10.1097/IJG.0000000000002546","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002546","url":null,"abstract":"<p><p>We present a case of Acute Angle-Closure Crisis (AACC) precipitated by primary transient psychogenic polydipsia; we believe that our case is the first of its kind to be reported. A 74-year-old male presented to the emergency department with altered mental status due to acute-onset hyponatremia. Six days after admission, the patient noticed painful loss of vision in his right eye and an ipsilateral headache lasting 10-15 minutes. Upon follow-up with his primary care physician several days later, a fixed, dilated right pupil was noted. On ophthalmologic evaluation in the ER the next day, the patient was found to have markedly elevated intraocular pressure (IOP) at 47 mm Hg in the right eye. He started topical brimonidine, dorzolamide 2%/timolol 0.5%, and latanoprost, and underwent phacoemulsification with placement of a posterior chamber intraocular lens (PCIOL) in the right eye. Several mechanisms of polydipsia induced AACC are proposed including choroidal expansion, increased sympathetic α-adrenergic tone, or differences in osmotic potential forces.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059222","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":"Diagnostic Capacity and Correlation of Optic Nerve Colorimetry with Structural Parameters in Primary Open-Angle Glaucoma.","authors":"Liseth Salazar-Quiñones, Yadhira Pérez-Quiñones, Haizea Etxabe-Ávila, José Ignacio Fernández-Vigo, Carmen Méndez-Hernández, Julián García-Feijóo","doi":"10.1097/IJG.0000000000002542","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002542","url":null,"abstract":"<p><strong>Prcis: </strong>The discriminant function of glaucoma, obtained by the Laguna ONhE colorimetric program, significantly correlates with the BMO-MRW. Furthermore, the diagnostic capacity was inferior to other structural tests in POAG patients.</p><p><strong>Purpose: </strong>To evaluate the diagnostic capability for glaucoma and the correlation between peripapillary and macular parameters using spectral domain optical coherence tomography (SD-OCT) and optic nerve head hemoglobin (OHN Hb) levels assessed by the Laguna ONhE® software using colorimetric analysis.</p><p><strong>Methods: </strong>This cross-sectional study included 112 eyes from 112 primary open-angle glaucoma (POAG) patients and 112 eyes from 112 healthy controls. The peripapillary analysis included standard peripapillary retinal nerve fiber layer (pRNFL), Bruch's membrane opening-minimum ring width (BMO-MRW), and peripapillary RNFL thickness measured with the Glaucoma Module Premium Edition program (RNFLT). The macular analysis assessed the ganglion cell layer (GCL), inner plexiform layer (IPL), macular RNFL (mRNFL), total retina, ganglion cell complex (GCC), and the GCL-IPL complex. The Laguna ONhE program evaluated ONH Hb levels and the glaucoma discriminant function (GDF). Pearson correlation was used to analyze the relationships between variables, and the area under the curve (AUC) was calculated.</p><p><strong>Results: </strong>Significant differences in AUC were found between GDF (0.80) and RNFLT global (G) (0.91), BMO-MRW G (0.89), and outer-temporal GCL (0.88). BMO-MRW showed the strongest correlation with the Laguna ONhE parameters (r from 0.271 to 0.682). Additionally, a significant correlation was observed between the temporal-inferior sector of ONH Hb and the inferior macular sector (r=0.40-0.56 for GCL-IPL) (P<0.05 for all).</p><p><strong>Conclusions: </strong>GDF demonstrated lower diagnostic capacity compared to other structural tests. BMO-MRW showed the strongest correlation with the Laguna ONhE parameters, and a significant relationship was identified between the temporal-inferior sector ONH Hb and the inferior macular region.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059274","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":"One-Year Real-World Outcomes of Ab-Externo Gel Stent Placement From the EXPAND Study.","authors":"Brian A Francis, Vanessa Vera, Joshua Kim, Mahdi M Basha, Bryant Lum, Douglas Grayson, Steven Vold, Mini Balaram, Susan Simonyi, Husam Ansari, Natasha Nayak Kolomeyer","doi":"10.1097/IJG.0000000000002543","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002543","url":null,"abstract":"<p><strong>Prcis: </strong>In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%).</p><p><strong>Purpose: </strong>To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma.</p><p><strong>Methods: </strong>Multicenter, real-world, retrospective study. Consecutive adults with glaucoma and ab-externo GS implantation (with/without phacoemulsification or open/closed conjunctiva) ≥12 months before study entry. Data were extracted between the baseline/preoperative and last follow-up visit or date of secondary surgical intervention (SSI). Primary effectiveness endpoint: proportion of primary eyes (first eye in bilaterally implanted patients) at Month 12 (M12) achieving ≥20% intraocular pressure (IOP) reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or SSI. Secondary effectiveness endpoints included complete success (IOP ≤18 mmHg and ≥20% IOP reduction from medicated baseline without medication, clinical hypotony, or SSI); qualified success (same but without medication increase); and needling rate. Key safety endpoints (all eyes): intraoperative complications, postoperative adverse events (AEs), and SSIs.</p><p><strong>Results: </strong>The safety population included 466 eyes; 80.7% received the GS alone and 85.0% were implanted with closed conjunctiva. At M12, 39.1% of all primary eyes (N=413) and 54.9% of primary eyes with IOP and medication data at baseline and M12 (N=213) achieved the primary endpoint. At M12 among all primary eyes, the complete success, qualified success, and needling rates were 33.5%, 56.5%, and 28.6%. Most eyes (97.9%) had no intraoperative complications. The most frequent postoperative AE was transient/self-resolving hypotony (IOP<6 mmHg; 28.1%). Sixty-nine (14.8%) eyes required an SSI.</p><p><strong>Conclusions: </strong>Ab-externo GS placement effectively lowered IOP and the medication count without unexpected complications/AEs, expanding implantation options based on patients' needs and surgeons' preferences.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059279","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}