Journal of Glaucoma最新文献

{"title":"Slow-Coagulation Transscleral Cyclophotocoagulation in Pseudoexfoliation Glaucoma.","authors":"Mohamed M Khodeiry, Ramsey Yusuf, Christopher A Dorizas, Abdelrahman M Elhusseiny, Mohamed S Sayed, Merry Ruan, Richard K Lee","doi":"10.1097/IJG.0000000000002534","DOIUrl":"10.1097/IJG.0000000000002534","url":null,"abstract":"<p><strong>Prcis: </strong>Further prospective investigations are suggested to confirm these findings.</p><p><strong>Purpose: </strong>To evaluate the outcomes of slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) in pseudoexfoliation glaucoma (PXG).</p><p><strong>Methods: </strong>A single-center, retrospective non-comparative study including consecutive patients with medically uncontrolled PXG who underwent SC-TSCPC (1250-milliwatt power and 4-second duration). The primary outcome measure was surgical success [defined as intraocular pressure (IOP) between 6 and 21 mmHg with ≥20% reduction compared with baseline and no need for further glaucoma surgeries or development of vision-threatening complications]. Success was considered qualified when achieved with additional glaucoma medications and complete when achieved without additional glaucoma medications. The secondary outcomes included IOP, glaucoma medication numbers, visual acuity, and postoperative complications at 1 and 2 years after laser treatment.</p><p><strong>Results: </strong>This study included 48 eyes of 48 patients. The median age of study participants was 87.5 years, with a median follow-up duration of 24.0 months. The qualified success for a single SC-TCPC treatment at 1 and 2 years was 58.3% and 47.9%, respectively. Cumulative qualified success (>1 SC-TSCPC) was 64.6% at 1 year and 56.2% at 2 years. Complete surgical success after a single SC-TSCPC was 45.8% at 1 year and 33.3% at 2 years, increased to 50.0% at 1 year and 39.6% at 2 years after >1 SC-TSCPC. After SC-TSCPC treatment, the mean IOP decreased from 29.2±10.3 mmHg on 3.7±1.0 medications pretreatment to 14.3±6.43 mmHg on 2.6±1.3 medications at the final follow-up visit ( P <0.001). Seven eyes (14.6%) had SC-TSCPC retreatment, and 2 eyes (4.2%) required incisional glaucoma surgeries. Reported postoperative complications included: decreased visual acuity in 9 (18.8%) eyes, iridocyclitis in 5 (10.4%) eyes, hyphema in 5 (10.4%) eyes, cystoid macular edema in 2 (4.2%) eyes, and transient hypotony in 2 (4.2%) eyes.</p><p><strong>Conclusions: </strong>SC-TSCPC is an effective, relatively safe, and repeatable surgical treatment option in PXG. Further prospective investigations are suggested to confirm these findings.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"34 4","pages":"304-309"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730304","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":"Aqueous Angiography-Guided Bent Ab Interno Needle Goniectomy in High Versus Low Aqueous Humor Outflow Regions in Primary Open Angle Glaucoma: A Pilot Randomized Controlled Trial.","authors":"Tanuj Dada, Ashi Gupta, Nitika Beri, Alex S Huang, Namrata Sharma, Dewang Angmo, Prafulla K Maharana, Amar Pujari","doi":"10.1097/IJG.0000000000002537","DOIUrl":"10.1097/IJG.0000000000002537","url":null,"abstract":"<p><strong>Prcis: </strong>Trabecular cutting minimally invasive glaucoma surgery like bent ab interno needle goniectomy (BANG) when performed in baseline aqueous angiography identified low aqueous humor outflow regions, results in greater success of intraocular pressure reduction.</p><p><strong>Purpose: </strong>To study the efficacy of bent ab interno needle goniectomy (BANG) in high versus low aqueous humor outflow (AHO) regions as determined by aqueous angiography (AA) in patients with primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>A prospective, single-centre, pilot, randomized control trial recruited 30 eyes of 30 patients of POAG and visually significant cataract (45-80 y) and were randomised into 2 groups (\"A\": BANG performed in the high-flow regions and \"B\": BANG performed in the low-flow regions) of 15 each. AA was performed using indocyanine green dye (0.1%) to identify baseline high-flow and low-flow regions of the AHO pathways followed by BANG in these respective regions as per randomisation. Preoperative and postoperative data on IOP, number of antiglaucoma medications (AGMs), and any complications were noted over 6 months. Overall success was defined as achieving an IOP ≤15 and ≥6 mm Hg at 6 months of follow-up with AGMs (qualified success) or without AGMs (complete success).</p><p><strong>Results: </strong>AA revealed high-flow regions of AHO pathways in the nasal quadrant and low-flow regions of AHO pathways in the temporal quadrant in all 30 patients. Both groups had comparable demographic composition [group A age: 65.3±6.48 y and male:female (14:1) and group B age: 64.6±7.08 y and male:female (13:2)]. The mean preoperative IOPs [group A (17.27±3.43 mm Hg); group B (17.60±5.42 mm Hg)] ( P =0.842) and mean postoperative IOP at 6 months [group A (15.6±4.98 mm Hg); group B (13.13±2.29 mm Hg)] ( P =0.09) were similar. However, lower qualified success was seen in group A (40.00%) compared with group B (86.67%; P =0.021). Survival in Kaplan-Meier analysis was higher in group B ( P =0.021). Complications were comparable in both groups.</p><p><strong>Conclusion: </strong>Short-term results of BANG in low-flow AHO regions show enhanced success compared with those in high-flow AHO regions. This study suggests that trabecular cutting minimally invasive glaucoma surgeries (like BANG) may be performed in baseline low-flow AHO regions (temporal quadrant) instead of the high-flow AHO (nasal quadrant) regions.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"317-324"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006556","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":"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 mm Hg 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 mm Hg; 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":"330-341"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952689/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Lamina Cribrosa Microvasculature Determined Through Swept-Source Optical Coherence Tomography Angiography.","authors":"Jooyoung Yoon, Kyung Rim Sung, Jin Yeong Lee, Joong Won Shin, Joon Mo Kim","doi":"10.1097/IJG.0000000000002531","DOIUrl":"10.1097/IJG.0000000000002531","url":null,"abstract":"<p><strong>Prcis: </strong>The lamina cribrosa (LC) microvasculature reduction was associated with the posterior deformation of LC, as well as the functional deterioration, in all spectrums of open angle glaucoma.</p><p><strong>Objective: </strong>To investigate the factors associated with the lamina cribrosa vessel density (LCVD) determined through swept-source optical coherence tomography angiography.</p><p><strong>Materials and methods: </strong>The optic nerve head (ONH) scan was obtained using swept-source optical coherence tomography angiography (PLEX Elite 9000; Carl Zeiss Meditec, Inc.). The lamina cribrosa curvature index (LCCI) was assessed using seven horizontal B-scan images across the ONH. The LCVD was calculated from the segmented layer at the level of LC. Primary open angle glaucoma (POAG) eyes were categorized into 2 groups according to the visual field mean deviation (VF MD; mild to moderate [≥ -12 dB] and advanced [< -12 dB]). The factors associated with the LCVD were evaluated using linear regression analysis.</p><p><strong>Results: </strong>A total of 127 POAG and 43 healthy eyes were included. POAG eyes showed a significantly thinner circumpapillary retinal nerve fiber layer and macular ganglion cell inner plexiform layer, lower LCVD, and greater LCCI compared with healthy eyes (all P < 0.05). In the mild to moderate group, lower LCVD was associated with worse VF MD, thinner circumpapillary retinal nerve fiber layer and macular ganglion cell inner plexiform layer, and greater LCCI (all P < 0.05). In the advanced group, the LCVD was associated with VF MD and LCCI (both P < 0.05). A greater LCVD was correlated with a greater LCCI in the healthy group ( P = 0.045).</p><p><strong>Conclusions: </strong>Reduced LCVD was associated with an increased LCCI in all spectrums of POAG. LC deformation may affect the ONH microvasculature in glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"256-266"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846850","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":"Delayed Onset Spontaneous Hyphema After an OMNI Surgical Procedure.","authors":"Natasha Gautam, Arthur J Sit","doi":"10.1097/IJG.0000000000002511","DOIUrl":"10.1097/IJG.0000000000002511","url":null,"abstract":"<p><p>Minimally invasive glaucoma surgery (MIGS) offers options for glaucoma treatment that have generally improved safety profiles compared with filtering surgery. MIGS vary in design and procedure, but all angle-based MIGS function by bypassing or removing aqueous humor outflow resistance at the level of the trabecular meshwork. This can lower intraocular pressure but also remove the blood-aqueous barrier. Most studies of MIGS report on relatively short-term safety, but awareness of potential long-term complications is critical for optimal patient management. This case report describes a patient with recurrent and refractory delayed onset spontaneous hyphema after an OMNI procedure. To the best of our knowledge, this is the first case report describing this complication of the OMNI surgical system.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e13-e16"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522063","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":"Cognitive Impairment in Primary Open Angle Glaucoma: A Case-Control Study.","authors":"Muskan Garg, Neha Midha, Rohit Verma, Vivek Gupta, Dewang Angmo, Thirumurthy Velpandian, Prafulla Kumar Maharana, Sujata Satapathy, Namrata Sharma, Tanuj Dada","doi":"10.1097/IJG.0000000000002544","DOIUrl":"10.1097/IJG.0000000000002544","url":null,"abstract":"<p><strong>Prcis: </strong>Cognitive impairment in multiple domains was observed in primary open angle glaucoma patients as compared with age and gender-matched healthy controls.</p><p><strong>Objective: </strong>Evaluation of cognitive impairment in individuals with primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>In this case-control study, individuals with POAG (cases, n=70) were compared with age-matched and sex-matched healthy individuals (controls, n=70) using detailed ophthalmological evaluation, cognitive assessment, and serum cortisol level. A multitude of tests were employed to comprehensively assess various domains of cognitive function: Addenbrooke Cognitive Examination (ACE-III; attention/orientation, memory, language, verbal fluency, and visuospatial skills), Postgraduate Institute Memory Scale (PGIMS; verbal and nonverbal memory), Wisconsin Card Sorting Test (WCST; nonverbal executive functions), Go No-Go task (GNG; inhibitory control), and Trail Making Test (TMT; attention and working memory).</p><p><strong>Results: </strong>Intraocular pressure and cup disc ratio were significantly higher ( P <0.001), while retinal nerve fiber layer (RNFL) thickness and mean deviation were significantly lower in cases as compared with controls. Cases had significantly lower scores on ACE-III and PGIMS ( P <0.001) and longer test completion time in TMT-A ( P =0.001). The performance of cases was also significantly worse on most parameters of the WCST and GNG tasks. Serum cortisol level was significantly higher in cases (11.75±7.41 mcg/dL) compared with controls (7.93±2.39 mcg/dL; P =0.02). A significant correlation was observed between serum cortisol level and WCST correct response ( P =0.04), WCST error response ( P =0.002), and total time taken in TMT-A ( P =0.03). Visual field mean deviation also exhibited a significant correlation with serum cortisol level ( P <0.001) and total time taken on WCST ( P =0.03) and TMT-A ( P =0.03).</p><p><strong>Conclusions: </strong>Individuals with POAG exhibited higher cognitive impairment and raised serum cortisol levels than age-matched healthy controls. Early recognition and management of cognitive impairment are pivotal for enhancing the quality of life and implementing comprehensive glaucoma care.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"282-289"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059269","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 Associated With Corneal Hysteresis in an Elderly White Population: The Thessaloniki Eye Study.","authors":"Rodanthi C Bartzoulianou, Anne L Coleman, M Roy Wilson, Alon Harris, Konstantinos I Bougioukas, Theofanis Pappas, Dimitrios A Giannoulis, Fei Yu, Anastasia Raptou, Grigoria Tzoanou, Fotis Topouzis","doi":"10.1097/IJG.0000000000002541","DOIUrl":"10.1097/IJG.0000000000002541","url":null,"abstract":"<p><strong>Prcis: </strong>Corneal hysteresis (CH) was positively associated with female sex and central corneal thickness, and negatively with age and axial length. Diabetes showed no significant association with CH in the adjusted models.</p><p><strong>Purpose: </strong>To provide values of corneal hysteresis (CH) in an elderly, healthy Greek population and to investigate its association with demographic, ocular, and systemic factors.</p><p><strong>Methods: </strong>Cross-sectional population-based study. Out of 1092 participants in the incidence cohort of the Thessaloniki Eye Study (TES) who were re-examined between 2013 and 2015, there were 801 eligible subjects in this study according to prespecified criteria. All subjects underwent an interview and a comprehensive clinical examination. Demographic data and medical and ophthalmic, family, and smoking histories were recorded. CH was evaluated with an Ocular Response Analyzer (ORA).</p><p><strong>Results: </strong>The mean age of study subjects was 79.7±3.9 years and 345 out of 801 participants (43.1%) were female. The mean CH among all subjects was 10.1±1.5 mm Hg. After adjusting for age, sex, central corneal thickness (CCT), axial length (AL), and diabetes, CH was positively associated with female sex (β=0.446; P <0.0001) and CCT (β=0.017; P <0.0001), and negatively associated with age (β=-0.024; P =0.038) and AL (β=-0.181; P <0.0001). There was no association between CH and diabetes (β=0.186; P =0.10). In a supplementary multivariable analysis of a smaller sample size, where we included corneal curvature (CC) as an additional covariate, no association was found between CH and CC (β=-0.235; P =0.26) or age (β=-0.023; P =0.09).</p><p><strong>Conclusion: </strong>This study outlined variations in CH among a Greek population. CH decreased with advancing age while women had greater CH compared with men. In addition, eyes with thinner corneas and longer AL had lower CH values. No significant associations were found between CH and CC or the presence of diabetes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"275-281"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Density and Retinal Structure Relationships Across Sectors and Regions of the Optic Nerve in Patients With Primary Open Angle Glaucoma.","authors":"Lukas Ritzer, Alon Harris, Julia Arciero, Brent Siesky, Brendan Fry, Ingrida Januleviciene, Francesco Oddone, Carmela Carnevale, George Eckert, Alice Verticchio Vercellin","doi":"10.1097/IJG.0000000000002536","DOIUrl":"10.1097/IJG.0000000000002536","url":null,"abstract":"<p><strong>Prcis: </strong>The relationship between structural and hemodynamic parameters in patients with primary open angle glaucoma is strongest in the temporal region of the optic nerve.</p><p><strong>Purpose: </strong>To investigate the relationship between radial peripapillary capillary (RPC) vessel density (VD) and retinal nerve fiber layer (RNFL) thickness in quadrants and sectors of the optic nerve head (ONH) in patients with and without primary open angle glaucoma (POAG).</p><p><strong>Methods: </strong>In a cross-sectional prospective analysis, 191 subjects (80 early-stage POAG; 111 non-glaucomatous controls) were assessed for RNFL thickness and RPC VD in each quadrant [superior (S), inferior (I), nasal (N) and temporal (T)] and sector [inferior-temporal (IT), temporo-inferior (TI), temporo-superior (TS), superior-temporal (ST), inferior-nasal (IN), naso-inferior (NI), naso-superior (NS), and superior-nasal (SN) sectors] of the ONH through optical coherence tomography angiography (OCTA). Pearson correlations were used to test for associations between measurements, with P<0.05 considered statistically significant.</p><p><strong>Results: </strong>Significantly stronger positive correlations were found between RPC VD and RNFL thickness in the S, I, and T quadrants in POAG patients compared with non-glaucomatous controls (all P<0.05). The temporal quadrant in POAG patients displayed the largest difference in correlation compared with controls. A stronger positive correlation was also found between RPC VD and RNFL thickness in the temporal sectors of the ONH in POAG patients compared with controls, with the largest difference in the TS sector (all P<0.05).</p><p><strong>Conclusion: </strong>Early-stage POAG patients have a stronger relationship between RPC VD and RNFL in the temporal regions of the ONH compared with non-glaucomatous controls, with the TS sector demonstrating the largest difference between groups. Temporal sector VD loss may represent an early-stage biomarker for vascular-linked POAG disease.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"34 4","pages":"267-274"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Trabeculectomy on Disc Tissue Blood Flow Across Quadrants in Open Angle Glaucoma.","authors":"Takeru Shimazaki, Eri Nitta, Yuki Nakano, Nobuko Kobayashi, Hirokazu Kojima, Ayaka Hara, Kiyoshi Suzuma","doi":"10.1097/IJG.0000000000002527","DOIUrl":"10.1097/IJG.0000000000002527","url":null,"abstract":"<p><strong>Prcis: </strong>Trabeculectomy increases tissue blood flow superior and temporal in the optic nerve head (ONH). Improvement of tissue blood flow superior and temporal in the optic nerve could be an indicator of the effectiveness of glaucoma treatment.</p><p><strong>Objective: </strong>To investigate changes in tissue blood flow at the ONH before and after trabeculectomy.</p><p><strong>Materials and methods: </strong>This prospective study included 53 eyes who underwent trabeculectomy. The mean blur rate of the tissue area mean blur rate of the tissue area (MT) was determined using laser speckle flowgraphy preoperatively and 1 and 3 months postoperatively. MT, laser speckle flowgraphy waveform parameters [blowout score (BOS) and Resistivity Index (RI)], intraocular pressure (IOP), and ocular perfusion pressure (OPP) were analyzed preoperatively and at 3 months postoperatively.</p><p><strong>Results: </strong>Postoperatively, IOP decreased (17.9±6.0-9.2±3.4 mm Hg) and OPP increased (43.3±9.2-52.1±6.4 mm Hg). As previously described, BOS increased (73.5±8.3-76.7±6.5; P < 0.001) with an inverse correlation to IOP and in proportion with OPP; RI decreased (0.40±0.1-0.35±0.08; P < 0.001) with an inverse correlation to OPP and in proportion to IOP. However, we found that MT increased significantly after surgery (7.9±2.2-8.8±2.2 AU; P = 0.002) without significant association between MT and IOP or OPP. In the 4 quadrants of the ONH, BOS significantly increased, while RI significantly decreased after surgery in all quadrants. In contrast, MT significantly increased in the superior and temporal quadrants only.</p><p><strong>Conclusions: </strong>Blood flow increases in the superior and temporal ONH.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"290-296"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractal Dimension Analysis of Peripapillary Microvasculature in Primary Congenital Glaucoma.","authors":"Emily K Tam, Marco H Ji, Alaa E Fayed, Sherin H Sadek, Nagwa Ahmed, Qais Dihan, Ahmed Alzein, Mohsen Adelpour, Yasmine M El Sayed, Abdelrahman M Elhusseiny","doi":"10.1097/IJG.0000000000002566","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002566","url":null,"abstract":"<p><strong>Precis: </strong>In this prospective multicenter study, eyes with primary congenital glaucoma exhibited lower retinal vascular parameters compared to healthy controls, as assessed by optical coherence tomography angiography fractal dimension analysis.</p><p><strong>Purpose: </strong>To study the retino-choroidal peripapillary microvascular pattern in primary congenital glaucoma (PCG) using fractal dimension (FD) analysis and compare it to healthy controls.</p><p><strong>Methods: </strong>This was a prospective multicenter comparative study. We obtained peripapillary optical coherence tomography angiography (OCTA) scans (Optovue Inc, Fremont, CA) and computed FD at the vitreous/retina (large retinal vessels), inner limiting membrane/nerve fiber layer (ILM-NFL) (radial peripapillary capillary plexus, RPC), and the choroid. Other peripapillary OCTA parameters, including the whole image inside the disk and peripapillary superior and inferior vascular density (VD) parameters, were also collected. One eye per patient was included in the analysis.</p><p><strong>Results: </strong>We included a total of 17 PCG eyes and 24 control eyes. The mean age at the time of enrollment was 8.24±0.75 years in the PCG group compared to 8.33±1.09 in controls (P=0.74). Eight patients (47%) in the PCG group and 14 (58.3%) in the control group were male. Among the PCG group, the mean vitreo-retina (large retinal vessels) FD (1.79) and ILM-NFL (RPC) FD (1.75) were significantly reduced compared to controls (vitreo-retina FD (1.85), ILM-NFL FD (1.82), P-value 0.011 and 0.014, respectively). There was no statistically significant difference in the averaged choroidal FD between both groups (1.89 vs. 1.88, P=0.29). All optic nerve VD parameters (whole image, inside disc, superior, and inferior-hemi) were also significantly reduced in the PCG group.</p><p><strong>Conclusion: </strong>PCG was associated with lower vascular parameters in the vitreo-retina (large retinal vessels) and ILM-NFL (RPC) layers as detected by OCTA FD.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}