Journal of Glaucoma最新文献

{"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":"10.1097/IJG.0000000000002570","url":null,"abstract":"<p><strong>Prcis: </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, 3 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%], although this heterogeneity resolved when subgrouped 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 with 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 8 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 with 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":"549-554"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","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":"Impact of Physical Activity Levels on Visual Field Progression in Individuals With Glaucoma.","authors":"Je Hyun Seo, Takashi Nishida, Sasan Moghimi, Jo-Hsuan Wu, Massimo A Fazio, Christopher A Girkin, Jeffrey M Liebmann, Linda M Zangwill, Robert N Weinreb","doi":"10.1097/IJG.0000000000002576","DOIUrl":"10.1097/IJG.0000000000002576","url":null,"abstract":"<p><strong>Prcis: </strong>Higher self-reported physical activity level was associated with a slower rate of visual field mean deviation loss in patients with primary open angle glaucoma.</p><p><strong>Purpose: </strong>To determine the impact of physical activity (PA) on visual field (VF) progression rates in patients with primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>In this longitudinal study, POAG patients were included who had ≥5 visits, ≥2 years of follow-up VFs and underwent PA questionnaire at the baseline. PA levels were assessed using the physical activity index (PAI), metabolic equivalents of task (MET)-minutes, and walking pace. Univariable and multivariable linear mixed-effects models were used to determine the impact of PA levels on the rates of VF mean deviation (MD) loss.</p><p><strong>Results: </strong>One hundred thirty-one eyes from 80 POAG patients were included over a median follow-up of 4.9 (IQR: 4.0-6.7) years. The median age of patients was 68.6 (IQR: 59.3-77.8) years and the median baseline VF MD was -3.5 (IQR: -8.3 to -1.3). In the univariable analysis, slower VF MD loss was associated with active PAI category (0.30 [95% CI: 0.01-0.58] dB/year vs. inactive PAI category; P =0.041) and higher PA amount (0.14 [95% CI: 0.01-0.27] dB/year per 1000 MET-minutes; P =0.036). Significant association with the rate of VF MD loss was not found for baseline VF MD ( P =0.263) and walking pace ( Ps >0.05). In the multivariable analysis including glaucoma severity and other covariates, slower VF MD loss was associated with higher PA amounts (0.15 [95% CI: 0.02-0.28] dB/year per 1000 MET-minutes; P =0.024).</p><p><strong>Conclusions: </strong>Higher PA amounts are an independent predictor of a slower rate of VF MD loss. Further research is needed to explore whether increased PA protects against glaucoma progression.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"499-506"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012874","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":"Costs Associated with the Use of Disposable Gonioscopy Lenses and Tonometry Tips.","authors":"Alexis Kassotis, Sean T Berkowitz, Shriji Patel, Emily Schehlein, Jeffrey M Liebmann, George A Cioffi, Alan L Robin, Aakriti Garg Shukla","doi":"10.1097/IJG.0000000000002601","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002601","url":null,"abstract":"<p><strong>Purpose: </strong>The authors performed a cost analysis comparing the use of disposable and reusable tonometry equipment and gonioscopy lenses.</p><p><strong>Methods: </strong>All adult patient (16 years old) visits in a one-year period were included. Scenario analysis was employed to calculate the cost of disposable (Goldmann applanation tonometry (GAT) tips, rebound tonometry tips, gonioscopy lenses) and reusable equipment (GAT tips and gonioscopy lenses) as well as sanitization over 2, 5, and 10 years at a single institution. To account for variability in scenario modeling, a sensitivity analysis was additionally performed. The main outcome measure was cost differences for disposable equipment compared to reusable equipment with sanitization.</p><p><strong>Results: </strong>The total volume included was 80,356 patient visits. Accounting for variable costs, the additional cost associated with disposable tonometry (GAT or rebound tonometry tips) instead of reusable GAT was $118,723 over 2 years and $603,924 over 10 years. Assuming a gonioscopy frequency of 3.2%, the additional cost associated with disposable gonioscopy lenses was $171,100 at 5 years and $361,237 at 10 years. At a gonioscopy frequency of 10%, the additional cost associated with disposable lenses was $1,208,096 without inflation at 10 years. Overall, the total additional cost associated with disposable tonometry tips and gonioscopy lenses over reusable versions of this equipment was $965,161 over 10 years at a single institution.</p><p><strong>Conclusion: </strong>A widespread transition from reusable to disposable tonometry and gonioscopy equipment was associated with an additional cost of $965,161 over a 10- year period at a single institution.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484731","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":"Effectiveness and Safety of Omidenepag Isopropyl 0.002% Ophthalmic Solution in Treatment-Naïve Patients with Primary Open-Angle Glaucoma: A Prospective Multicenter Phase IV Study.","authors":"Hyoung Won Bae, Eun Ji Lee, Jong Jin Jung, Ki Ho Park","doi":"10.1097/IJG.0000000000002605","DOIUrl":"10.1097/IJG.0000000000002605","url":null,"abstract":"<p><strong>Prcis: </strong>Omidenepag isopropyl is a selective E-prostanoid subtype 2 (EP2) receptor agonist that lowers intraocular pressure. Omidenepag isopropyl 0.002% ophthalmic solution is effective and safe to use at first diagnosis of primary open-angle glaucoma.</p><p><strong>Purpose: </strong>To evaluate the effectiveness and safety of omidenepag isopropyl 0.002% ophthalmic solution in treatment-naïve patients at first diagnosis of primary open-angle glaucoma (POAG) in real-world clinical settings in Korea.</p><p><strong>Patients and methods: </strong>In a single-arm, multicenter, open-label, prospective, phase IV clinical trial, patients with newly-diagnosed POAG received omidenepag isopropyl 0.002% (one drop once daily) for 12 weeks. The primary endpoint was change from baseline in intraocular pressure (IOP) at week 12. Secondary endpoints included change from baseline in IOP at week 4; change from baseline in IOP at week 12 in a subgroup with normal tension glaucoma (NTG); occurrences, incidence rates and changes from baseline in safety-related indicators (macular edema, endothelial cell count, central corneal thickness, prostaglandin-associated peri-orbitopathy syndrome). Safety was assessed by the occurrence of adverse events (AEs).</p><p><strong>Results: </strong>The effectiveness analysis set comprised 37 patients and the safety analysis set 50 patients. Mean IOP decreased from 16.19 ± 2.65 mm Hg at baseline to 13.55 ± 2.46 mm Hg at week 12 ( P < 0.0001), representing a 16% reduction. Mean reduction in IOP was 15% at week 4 ( P < 0.0001); and 16% at week 12 ( P < 0.0001) in the NTG subgroup (n=31). Aside from conjunctival injection, no notable changes were observed in safety-related evaluation indicators. The most common AEs were hyperemia (13 cases) and iridocyclitis (5 cases). No systemic AEs were reported.</p><p><strong>Conclusion: </strong>Omidenepag isopropyl 0.002% ophthalmic solution is suitable for first-line use at first diagnosis of POAG, including in patients with NTG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302252","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":"Relationship Between Central Corneal Thickness and Inter-Eye Disease Severity in Primary Angle Closure Glaucoma.","authors":"Shimna C Prasad, Ruthra M Umapathi, Tin Nwe Hlaing, Eray Atalay, Michael J Girard, Tin Aung, Monisha E Nongpiur","doi":"10.1097/IJG.0000000000002553","DOIUrl":"10.1097/IJG.0000000000002553","url":null,"abstract":"<p><strong>Prcis: </strong>Interocular comparison of primary angle closure glaucoma subjects with asymmetrical and symmetrical visual field loss, revealed significantly thinner central corneal thickness and higher presenting intraocular pressure in the worse eye of the asymmetrical group.</p><p><strong>Purpose: </strong>To compare the interocular clinical and biometric parameters of primary angle closure glaucoma (PACG) with asymmetrical and symmetrical visual-field loss at presentation.</p><p><strong>Patient and methods: </strong>A retrospective study in which the following clinical data were extracted: presenting intraocular pressure (IOP), gonioscopy, visual-field mean deviation (MD), central corneal thickness (CCT), anterior chamber depth (ACD), and axial length (AL). Asymmetrical PACG was defined as the inter-eye visual-field MD difference >6 dB, symmetrical PACG <3 dB, and those with inter-eye differences between 3 and 6 dB were excluded. Linear mixed effects model was used to adjust for the interdependence of the right and left eyes.</p><p><strong>Results: </strong>Of 243 PACG subjects, 122 (50.3%) presented with asymmetrical, and 69 (28.4%) with symmetrical disease. The worse eyes in subjects with asymmetrical PACG had significantly higher presenting IOP ( P <0.001), narrower angles ( P <0.001), more myopic refraction ( P <0.001), and thinner CCT (529.2±36.1 vs. 535.8±38.5 μm; P <0.001) compared with the fellow eyes; but no inter-eye differences were observed for AL ( P =0.93) and ACD ( P =0.53). In symmetric PACG, no significant inter-eye differences were observed for CCT (532.3±33.1 vs. 533.1±34.6 μm, P =0.67), AL ( P =0.85) and ACD ( P =0.18), but the relatively worse eye had higher presenting IOP ( P =0.003). In the stepwise multiple linear regression analysis in the asymmetrical group, CCT was the only significant variable ( P =0.006), explaining 12% of the variability of the visual-field MD of the worse eye.</p><p><strong>Conclusions: </strong>In asymmetrical PACG, worse eyes have thinner CCT and higher presenting IOP. Difference in CCT could either be inherent or acquired, and more tests would be needed to tease that out.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"462-467"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408623","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":"Reliability of Self-Monitoring of Intraocular Pressure With iCare Home2 Rebound Tonometry.","authors":"Dario Romano, Giovanni Montesano, Amir A Aminoleslami, Benedetta Colizzi, Luca M Rossetti","doi":"10.1097/IJG.0000000000002560","DOIUrl":"10.1097/IJG.0000000000002560","url":null,"abstract":"<p><strong>Prcis: </strong>Using iCare Home2 (iCare, Finland) rebound tonometry, self-measurement of intraocular pressure has demonstrated good reliability and ease of use.</p><p><strong>Purpose: </strong>To investigate the reliability and repeatability of self-measured intraocular pressure (IOP) with rebound tonometry using iCare Home2.</p><p><strong>Patients and methods: </strong>One hundred four patients out of 110 consecutive patients were recruited for this observational cross-sectional study. One randomly selected eye from each patient underwent 6 consecutive IOP measurements with Goldmann applanation tonometry (GAT), iCare IC200, and iCare Home2. Every eye was tested twice with each device, in random order, by an ophthalmologist for GAT and IC200, and by the patient itself for Home2. In addition, central corneal thickness (CCT) has been collected. The reliability of Home2 has been tested by calculating limits of agreement (LoA) between self-measured and physician-measured IOP, using the Bland-Altman analysis. The repeatability of each device has been tested by calculating the limits of repeatability (LoR) with the same method. Pearson correlation coefficient was used to determine the correlation between differences in IOP measurements and CCT.</p><p><strong>Results: </strong>The mean difference between GAT and iCare Home2 was -0.28±1.57 mmHg ( P =0.070), 95%-LoA: (-3.36 to 2.79 mmHg). The mean difference between IC200 and iCare Home2 was 0.92±1.48 mmHg ( P <0.0001), 95%-LoA (-1.98 to 3.82 mmHg). The mean difference between the first and second measurements with GAT, iCare IC200, and iCare Home2 measurements was 0.21±0.98 mmHg ( P =0.03), -0.02±1.11 mmHg ( P =0.88) and -0.23±1.04 mmHg ( P =0.05).</p><p><strong>Conclusions: </strong>Self-measured IOP with rebound tonometry showed good reliability and repeatability when compared with physician-measured IOP with both standard GAT and rebound tonometry.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"447-454"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573231","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":"One-Year Outcomes of Gonio Scratch as a Minimally Invasive Glaucoma Surgery With Cataract Removal.","authors":"Kana Tokumo, Mitsunobu Yokoyama, Taro Baba, Naoki Okada, Ayaka Edo, Kaori Komatsu, Hideaki Okumichi, Hideki Mochizuki, Teruyuki Miyoshi, Yoshiaki Kiuchi, Kazuyuki Hirooka","doi":"10.1097/IJG.0000000000002563","DOIUrl":"10.1097/IJG.0000000000002563","url":null,"abstract":"<p><strong>Prcis: </strong>This study evaluated the 1-year efficacy and safety of a novel minimally invasive glaucoma surgery, gonio scratch, in reducing intraocular pressure of eyes with open angle glaucoma and cataracts.</p><p><strong>Purpose: </strong>To evaluate the 1-year efficacy and safety of phacoemulsification cataract extraction combined with gonio scratch (GS-Phaco), a novel minimally invasive glaucoma surgery, in patients with open angle glaucoma and cataracts.</p><p><strong>Patients and methods: </strong>This prospective multicenter clinical trial was conducted at Hiroshima University, Yokoyama Retina Clinic, Kusatsu Eye Clinic, and Miyoshi Eye Clinic in Japan. The primary outcome measure was the rate of intraocular pressure (IOP) control. Failure was defined as an IOP of >18 mm Hg or >14 mm Hg, a <20% reduction from baseline IOP on 2 consecutive follow-up visits after 3 months, the need for additional glaucoma surgery, or loss of light perception. Kaplan-Meier analysis was used to assess surgical success rates.</p><p><strong>Results: </strong>Forty-seven eyes of 47 patients who underwent GS-Phaco surgery were included in the analysis. None of the patients had undergone prior ocular surgery. The median baseline IOP was 17 mm Hg. At 12 months postoperatively, there was a significant reduction in IOP to a median of 12 mm Hg ( P <0.01). The number of glaucoma medications also decreased significantly, from a median of 2 to 1 ( P <0.01). The surgical success rate at 12 months was 80.9%. The only complication observed was transient elevation of IOP in 2 (4.3%) eyes. No patients developed anterior chamber hemorrhage or hyphema with niveau formation.</p><p><strong>Conclusion: </strong>GS-Phaco achieved sustained IOP reduction and a decrease in medication use at 12 months postoperatively in patients with open angle glaucoma and cataracts.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"468-475"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605174","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":"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 a 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":"e26-e27"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","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":"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 open angle glaucoma (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 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). In addition, 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 with 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":"484-493"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","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":"Development of a Computerized and Automated Cost-Effectiveness Analysis Application to Aid in Glaucoma Surgical Management.","authors":"Jaideep Prasad, Shefali Sood, Lama A Al-Aswad","doi":"10.1097/IJG.0000000000002557","DOIUrl":"10.1097/IJG.0000000000002557","url":null,"abstract":"<p><strong>Prcis: </strong>In this article, we describe the development of validated software that automates cost-effectiveness analyses of minimally invasive glaucoma surgeries based on modifications to robust mathematical models of glaucoma progression and management discussed in previous literature.</p><p><strong>Purpose: </strong>To develop a validated application to streamline the use of cost-effectiveness (CE) in clinical management and investigations of minimally invasive glaucoma surgeries (MIGS) in the US.</p><p><strong>Design: </strong>Automated cost-utility analysis adapted from Markov models described in prior literature.</p><p><strong>Participants: </strong>Patients of ages 65 years and older with mild to moderate primary open angle glaucoma irrespective of concurrent visually significant cataract.</p><p><strong>Methods: </strong>Markov models simulating glaucoma progression through 37 states and death were constructed based on previous CE models of minimally invasive trabecular meshwork stents. These states represent combinations of various glaucoma severity (mild, moderate, advanced, and severe/blind) with differences in clinical management, including the use of up to 4 medications, selective laser trabeculoplasty, or incisional surgery. These are not mutually exclusive and are based on decisions related to the rate of thinning of the retinal nerve fiber layer. Rather than using fixed sets of transition probabilities for specific surgical interventions, new transition probabilities are dynamically derived based on the expected reduction in intraocular pressure related to visual field mean deviation decline. In addition to the generic MIGS arm, 2 comparison arms (cataract-surgery or medications-only) are included. Medication reduction, whole costs, and utilities are modifiable inputs in the model. Optimal and worst-case results are determined by uncomplicated or complicated (secondary surgical intervention required/medication nonadherence) intervention outcomes. The model was entirely re-implemented in R and validated by comparing results to TreeAge data.</p><p><strong>Main outcome measures: </strong>Total costs, quality-adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>An optimal-case 35-year CE-analysis of the implantation of Hydrus and iStent inject devices provided values of costs and QALY that were similar to prior data (R vs. TreeAge): Hydrus (Cost: $50,446.53 vs. $48,026.13; QALY: 12.18 vs. 12.26), iStent inject (Cost: $52,323.43 vs. $49,599.86; QALY: 12.13 vs. 12.21), cataract (Cost: $54,150.56 vs. $54,409.25; QALY: 12.03 vs. 12.04). Trends of ICER over time were also very similar.</p><p><strong>Conclusions: </strong>Novel software is available to aid in CE analyses of MIGS with modifiable inputs and outcomes of interest. Such a tool makes CE more accessible for use in clinical management decisions and may guide future investigation.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"494-498"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542231","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}