Yuan Xie, Yunxiao Sun, Yaqi Shao, Jiaxing Tian, Yingdi Fu, Diya Yang, Yiquan Yang, Kai Cao, Ye Zhang, Huaizhou Wang, Guozhong Wang, Ningli Wang
{"title":"Impact of Acute Short-term Hypobaric Hypoxia on Anterior Chamber Geometry.","authors":"Yuan Xie, Yunxiao Sun, Yaqi Shao, Jiaxing Tian, Yingdi Fu, Diya Yang, Yiquan Yang, Kai Cao, Ye Zhang, Huaizhou Wang, Guozhong Wang, Ningli Wang","doi":"10.1097/IJG.0000000000002498","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002498","url":null,"abstract":"<p><strong>Prcis: </strong>Hypobaric hypoxia, the major environmental factor at high altitudes, has been observed to induce pupil miosis and widening of the anterior chamber angle. This environment may be safe for individuals with narrow angle and deserves further study.</p><p><strong>Purpose: </strong>This study aimed to quantify anterior chamber biometric parameters before and after acute short-term, effortless exposure to hypobaric hypoxia (HH) in healthy lowlanders using swept-source anterior segment optical coherence tomography (SS AS-OCT).</p><p><strong>Methods: </strong>This prospective study included 25 healthy young lowlanders (50 eyes) who underwent SS AS-OCT measurements and intraocular pressure (IOP) assessments under baseline sea-level conditions (T1).They were then passively exposed to simulated 4000 m above sea level for 3 hours and underwent Acute mountain sickness (AMS) symptoms evaluation and IOP measurement after 2-hours exposure to HH (T2).Repeat SS AS-OCT measurements and IOP assessments were taken within 15 minutes after leaving the hypobaric chamber (T3). Anterior segment parameters including anterior chamber depth (ACD),lens vault (LV),angle opening distance (AOD500), trabecular-iris space area (TISA500), angle recess area (ARA500) at 500 μm from the scleral spur, iris curvature (IC), iris volume (IV), pupil diameter (PD), and central corneal thickness (CCT) were obtained through SS AS-OCT. These repeated measurements were compared using linear mixed model analysis.</p><p><strong>Results: </strong>In comparison to sea level, both IOP (16.4±3.4 vs. 14.9±2.4 mm Hg, P=0.029) and PD (5.36±0.77 vs. 4.78±0.89 mm, P=0.001) significantly decreased after exposure to HH. Significant post-HH changes (Mean difference (95% CI)) were observed in AOD500 (0.129 (0.006, 0.252), P=0.04), TISA500 (0.059 (0.008, 0.11), P=0.025), ARA500 (0.074 (0.008, 0.141), P=0.029), IV (1.623 (0.092, 3.154), P=0.038), and IC (-0.073 (-0.146, 0.001), P=0.047), while CCT, ACD, and LV remained stable. After adjusting for age, post-HH variations in AOD500 (Beta=0.553, 95% CI: 0.001, 1.105, P=0.048) and TISA500 (Beta=0.256, 95% CI: 0.02, 0.492, P=0.034) were associated with decreased IC but were not related to lowered arterial oxygen pressure or IV increase per millimeter of pupil miosis (IV/PD). These differences in anterior segment parameters were neither correlated with differences in IOP nor AMS.</p><p><strong>Conclusion: </strong>After short-term, effortless exposure to hypobaric hypoxia, pupil miosis occurred with widening of the anterior chamber angle and decreased IC. These changes in anterior chamber angle parameters were associated with decreased IC but did not correlate with the post-hypobaric variations in IV/PD, IOP, or AMS.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289098","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}
Huishan Lin, Xinbo Gao, Zixing Xu, Yuxuan Zhang, Yunru Liao, Jiawei Ren, Xi Qin, Yao Liu, Wei Huang, Chengguo Zuo, Mingkai Lin
{"title":"The Burden and Clinical Features of Neovascular Glaucoma in A Major Tertiary Care Center in China.","authors":"Huishan Lin, Xinbo Gao, Zixing Xu, Yuxuan Zhang, Yunru Liao, Jiawei Ren, Xi Qin, Yao Liu, Wei Huang, Chengguo Zuo, Mingkai Lin","doi":"10.1097/IJG.0000000000002497","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002497","url":null,"abstract":"<p><strong>Prcis: </strong>This research presents the burden and clinical characteristics of NVG in Zhongshan Ophthalmic Center, employing the most extensive sample size and the longest uninterrupted temporal duration so far, which may provide a theoretical reference for the effective prevention and diagnosis of NVG.</p><p><strong>Purpose: </strong>To summarize the burden and clinical characteristics of neovascular glaucoma (NVG) in a major tertiary care center in China.</p><p><strong>Methods: </strong>The clinical data of NVG patients in Zhongshan Ophthalmic Center (ZOC) between 2012 and 2021 were collected retrospectively, including their age, sex, affected eye, best-corrected visual acuity (BCVA), intraocular pressure (IOP), clinical stage and aetiology.</p><p><strong>Results: </strong>In this study, we included 1877 eyes of 1749 patients who developed NVG, with 2.01:1 ratio of male to female. Their mean age was 53.14±16.69 years and those aged 41-70 years (65.2%) were most affected. Monocular patients were more predominant in most of them (92.7%), while 7.3% were binocular and 1667 eyes (88.8%) were at the angle‑closure stage. The BCVA and IOP were 2.42±0.70 logMAR and 38.6±12.2 mmHg, respectively. Over the decade, the number of NVG patients and the proportion of NVG patients among glaucoma patients showed an increasing trend, with annual percentage changes (APCs) of 9.1% (95% CI: 5.0-13.3%, P=0.001) and 4.8% (95% CI: 2.2-7.4%, P=0.003), respectively. The top three primary conditions were diabetic retinopathy (DR), retinal vein occlusion (RVO), and retinal detachment (RD). Moreover, the APCs for the constituent ratio of DR and RVO were 4.4% (95% CI: 0.5-8.4%, P=0.031) and ﹣4.6% (95% CI: ﹣8.4% to ﹣0.7%, P=0.028), respectively. However, the first and second causes of NVG in minors (<18 years old) were Coat's disease and ocular tumours, followed by RD and RVO in third place. The top cause of NVG in patients aged 65 years and older was RVO.</p><p><strong>Conclusions: </strong>The burden of NVG is increasing, emphasizing the need to improve preventive strategies focusing on primary diseases such as DR, RVO, and RD, particularly the increasing proportion of DR cases and the previously underemphasized RD patients, while also highlighting the differences in primary diseases across different age groups.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289100","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}
Julie Pilotte, Sami Khoury, Ali Tafreshi, Zachary T Mandel, Svasti V Sharma, Peter Vanderklish, Stella T Sarraf, Alfredo A Sadun, Robert N Weinreb, Alex S Huang
{"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 Vanderklish, Stella T Sarraf, Alfredo A Sadun, Robert N Weinreb, Alex S Huang","doi":"10.1097/IJG.0000000000002496","DOIUrl":"https://doi.org/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 identification of retinal Aβ using a novel fluorescent Aβ-binding small molecule (AMDX-2011).</p><p><strong>Methods: </strong>Post-mortem 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 presence of Aβ signal that co-localized with AMDX-2011 staining in glaucoma retina. Co-labeled puncta appeared in all quadrants of the retina, including retina temporal to the optic nerve. The puncta were mainly located within the inner layers of the retina. Glaucoma retinas had more co-labeled puncta than control retinas in all locations (P = 0.002-0.02). Co-labeled puncta were also larger in the superior quadrant of glaucoma compared to 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":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-17","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":"Association of Quality of Life and Visual Function in Glaucoma with Tests of Structure and Function.","authors":"Fatma Merve Bektaş, Oya Tekeli","doi":"10.1097/IJG.0000000000002495","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002495","url":null,"abstract":"<p><strong>Prcis: </strong>In addition to standard automated perimetry tests, contrast sensitivity testing and macular analyses may predict changes in the quality of life in patients at different stages of glaucoma.</p><p><strong>Purpose: </strong>To examine the relationship between functional and structural tests of visual function and the 25-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ-25) and the 36-item Short Form Health Survey (SF-36) in patients with different stages of glaucoma.</p><p><strong>Materials and methods: </strong>Standard automated perimetry tests, optical coherence tomography scans, and contrast sensitivity (CS) testing were prospectively performed in 160 patients with glaucoma. The Hoddap-Parrish-Anderson staging system was used for glaucoma staging. Health-related quality of life questionnaires (NEI-VFQ-25, SF-36) were also administered to all patients.</p><p><strong>Results: </strong>The study group comprised 29 patients with suspected glaucoma, 104 with mild glaucoma, 15 with moderate glaucoma, and 12 with severe glaucoma. The mean total score of the NEI-VFQ-25 was 88.8±8.2. The SF-36 did not show a significant correlation with the data on functional and structural tests of visual function, whereas the NEI-VFQ-25 showed a low to moderate correlation (r=0.212--0.492). Vision parameters can explain up to 18.6% of the total score of the NEI-VFQ-25. CS was the only function significantly correlated with glaucoma suspects, while in the early stages, VA was the strongest correlated function with the NEI-VFQ-25 total score (P=0.003 and r=0.551; P=0.001 and r=0.343, respectively). The impact of the visual field on vision-related quality of life increased in the advanced stages (P=0.013, r=0.688). The macular retinal ganglion cell plus inner plexiform layer thickness remained associated with NEI-VFQ-25 at all stages of glaucoma (r=0.335-0.802). The NEI-VFQ-25 total score and most of the subscales were correlated with the physical and mental component summary scores of the SF-36 (r=0.159-0.587).</p><p><strong>Conclusion: </strong>VA correlated the most with quality of life in glaucoma patients, as measured with the NEI-VFQ-25 to assess quality of life in glaucoma. The impact of visual functions on quality of life varies at different stages of glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289196","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-05-10DOI: 10.1097/IJG.0000000000002423
Parth Palan, Sirisha Senthil
{"title":"False Passage of 5-0 Polypropylene Suture into Episcleral Vein during Gonioscopy-Assisted Transluminal Trabeculotomy.","authors":"Parth Palan, Sirisha Senthil","doi":"10.1097/IJG.0000000000002423","DOIUrl":"10.1097/IJG.0000000000002423","url":null,"abstract":"<p><p>Gonioscopy-assisted transluminal trabeculotomy (GATT) is a promising cost-effective minimally invasive glaucoma surgery (MIGS). The main advantage is safety with regards to low risk for hypotony and its related complications. However, the Schlemm's canal (SC) based procedures have a different set of complications, the most common being hyphema and transient intraocular pressure spike. The other rare complications being, the false passage of the suture by traversing the external wall of the SC into the suprachoroidal space or posterior chamber or breaching the internal wall of the SC into the anterior chamber. Although these complications are rare, knowledge about them is important not only for early identification but for prevention and management if they occur. Through this case report, we describe a rare complication where the suture had traversed through a dilated episcleral vein during GATT. To our knowledge, there has been no prior report of such a complication.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e78-e80"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917673","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-05-24DOI: 10.1097/IJG.0000000000002443
Xinbo Gao, Fengbin Lin, Ping Lu, Lin Xie, Li Tang, Xiaomin Zhu, Yao Zhang, Aiguo Lv, Guangxian Tang, Hengli Zhang, Xiaowei Yan, Yunhe Song, Jiangang Xu, Jingjing Huang, Yingzhe Zhang, Kun Hu, Yuying Peng, Zhenyu Wang, Xiaoyan Li, Weirong Chen, Ningli Wang, Keith Barton, Ki Ho Park, Tin Aung, Robert N Weinreb, Dennis S C Lam, Sujie Fan, Clement C Tham, Xiulan Zhang
{"title":"Efficacy and Safety of Surgical Peripheral Iridectomy, Goniosynechialysis, and Goniotomy for Advanced Primary Angle Closure Glaucoma Without Cataract: 1-Year Results of a Multicenter Study.","authors":"Xinbo Gao, Fengbin Lin, Ping Lu, Lin Xie, Li Tang, Xiaomin Zhu, Yao Zhang, Aiguo Lv, Guangxian Tang, Hengli Zhang, Xiaowei Yan, Yunhe Song, Jiangang Xu, Jingjing Huang, Yingzhe Zhang, Kun Hu, Yuying Peng, Zhenyu Wang, Xiaoyan Li, Weirong Chen, Ningli Wang, Keith Barton, Ki Ho Park, Tin Aung, Robert N Weinreb, Dennis S C Lam, Sujie Fan, Clement C Tham, Xiulan Zhang","doi":"10.1097/IJG.0000000000002443","DOIUrl":"10.1097/IJG.0000000000002443","url":null,"abstract":"<p><strong>Prcis: </strong>The combination of surgical peripheral iridectomy, goniosynechialysis, and goniotomy is a safe and effective surgical approach for advanced primary angle closure glaucoma without cataract.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) in advanced primary angle closure glaucoma (PACG) eyes without cataract.</p><p><strong>Patients and methods: </strong>A prospective multicenter observational study was performed for patients who underwent combined SPI, GSL, and GT for advanced PACG without cataract. Patients were assessed before and after the operation. Complete success was defined as achieving intraocular pressure (IOP) between 6 and 18 mm Hg with at least a 20% reduction compared with baseline, without the use of ocular hypotensive medications or reoperation. Qualified success adopted the same criteria but allowed medication use. Factors associated with surgical success were analyzed using logistic regression.</p><p><strong>Results: </strong>A total of 61 eyes of 50 advanced PACGs were included. All participants completed 12 months of follow-up. Thirty-six eyes (59.0%) achieved complete success, and 56 eyes (91.8%) achieved qualified success. Preoperative and postsurgical at 12 months mean IOPs were 29.7±7.7 and 16.1±4.8 mm Hg, respectively. The average number of ocular hypotensive medications decreased from 1.9 to 0.9 over 12 months. The primary complications included IOP spike (n=9), hyphema (n=7), and shallow anterior chamber (n=3). Regression analysis indicated that older age (odds ratio [OR]=1.09; P =0.043) was positively associated with complete success, while a mixed angle closure mechanism (OR=0.17; P =0.036) reduced success rate.</p><p><strong>Conclusions: </strong>The combination of SPI, GSL, and GT is a safe and effective surgical approach for advanced PACG without cataract. It has great potential as a first-line treatment option for these patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"632-639"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081772","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-05-16DOI: 10.1097/IJG.0000000000002421
Francesco Giorgio Merlo Pich, Leandro Oliverio, Kevin Gillmann, André Mermoud
{"title":"Outcomes of Nonpenetrating Versus Penetrating Deep Sclerectomy in Open Angle Glaucoma.","authors":"Francesco Giorgio Merlo Pich, Leandro Oliverio, Kevin Gillmann, André Mermoud","doi":"10.1097/IJG.0000000000002421","DOIUrl":"10.1097/IJG.0000000000002421","url":null,"abstract":"<p><strong>Prcis: </strong>In this retrospective study, nonpenetrating deep sclerectomy (NPDS) and penetrating deep sclerectomy (PDS) interventions showed similar >90% complete success rates at 1-year postsurgery. However, NPDS achieved a superior safety profile in terms of best-corrected visual acuity (BCVA) recovery and rates of post-surgical complications.</p><p><strong>Objective: </strong>Comparing the surgical outcomes of 2 surgical techniques: NPDS and PDS.</p><p><strong>Patients and methods: </strong>This was a retrospective, longitudinal, comparative study including 66 eyes from 57 patients aged 69 ± 9 years who underwent either NPDS or PDS for medically uncontrolled open angle glaucoma. Outcome measurements included intraocular pressure (IOP), BCVA, rates of complications, postoperative corrective interventions, and glaucoma medications at baseline and at all postoperative appointments up to 1 year. An exploratory mixed-effect model was used to assess the intergroup differences between IOP and BCVA.</p><p><strong>Results: </strong>One-year postsurgery, a similar significant IOP reduction from baseline was observed in NPDS (from 19.9 ± 1.3 to 11.5 ± 0.9 mm Hg, P < 0.001) and PDS (from 19.5 ± 1.1 to 10.7 ± 0.6 mm Hg, P < 0.001). A conservative complete success rate (defined as medicated IOP ≤16 mm Hg and ≥20% reduction in IOP) was 87% for NPDS and 97% for PDS. No BCVA changes were observed between baseline and 1-year postsurgery in both groups, and glaucoma medications showed a similar 10-fold reduction in both groups ( P < 0.001 vs baseline). However, a significant difference in the speed of postoperative BVCA recovery was observed between NPDS and PDS ( P < 0.01), with NPDS showing a faster recovery. Moreover, lower numbers of postsurgical complications and postoperative interventions were observed after NPDS compared with PDS [NPDS, n = 30 and 34 vs PDS, n = 80 and 48 ( P < 0.05), respectively].</p><p><strong>Conclusions: </strong>The present study confirmed that both NPDS and PDS are highly effective surgical interventions for the management of primary open angle glaucoma. However, NPDS had a superior safety profile in terms of BCVA recovery, complication rates, and postoperative interventions.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"640-644"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922351","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-06-28DOI: 10.1097/IJG.0000000000002458
Gloria M Elongo, Nicole N Buvy, Nelly N Kabedi, Jean-Claude Mwanza
{"title":"Glaucoma Severity Stage at First Visit at a University Eye Clinic in Congo.","authors":"Gloria M Elongo, Nicole N Buvy, Nelly N Kabedi, Jean-Claude Mwanza","doi":"10.1097/IJG.0000000000002458","DOIUrl":"10.1097/IJG.0000000000002458","url":null,"abstract":"<p><strong>Prcis: </strong>Initial presentation of glaucoma at a major eye clinic mostly features advanced disease with a high proportion of blindness. This is likely a microcosm of a nationwide issue requiring concerted strategies to detect glaucoma early.</p><p><strong>Purpose: </strong>To characterize the severity stage of new glaucoma patients in Congolese attending a university eye clinic.</p><p><strong>Methods: </strong>New glaucoma patients (n=118) were labeled as early or late presenters based on visual field sensitivity in the worse eye.</p><p><strong>Results: </strong>Mean age was 58.9±15.7 years, 51.7% were males. Overall, the worse eye had advanced, whereas the better eye had moderate glaucoma, with an asymmetry of -7.4 dB ( P <0.001). Blindness was present in 30.5% of worse and 5.1% of better eyes. Seventy-two patients (61.0%) were late presenters. Visual acuity was lower ( P <0.001), intraocular pressure (IOP) higher ( P =0.02), cup-to-disc ratio larger ( P =0.011), and retinal nerve fiber layer thinner ( P =0.001) in late presenters' worse than better eye. The worse and better eyes of late presenters had advanced glaucoma, with a -9.6 dB interocular asymmetry ( P <0.001); 40.3% and 8.3% were blind, respectively. In early presenters, the worse and better eyes had moderate and early disease, respectively; the asymmetry was -3.2 dB ( P <0.001), and 15.2% were blind. Overall, 58.5% and 65.3% presented with advanced disease in the worse eye based on visual field and cup-to-disc ratio criteria of the Canadian Ophthalmological Society staging scale, respectively.</p><p><strong>Conclusions: </strong>Most new glaucoma patients had bilateral advanced but asymmetric disease. These findings call for the establishment of community-based measures for early detection of glaucoma and a referral network system connecting community healthcare to tertiary eye clinics.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"679-685"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457368","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-05-29DOI: 10.1097/IJG.0000000000002444
Omar Salamanca
{"title":"Letter to the Editor: The Use of Cost-Effectiveness Analyses in Open Angle Glaucoma Management: A Systematic Review of the Current Literature.","authors":"Omar Salamanca","doi":"10.1097/IJG.0000000000002444","DOIUrl":"10.1097/IJG.0000000000002444","url":null,"abstract":"","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e81"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161892","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}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-05-16DOI: 10.1097/IJG.0000000000002428
Marco A C Olyntho, Carlos A C Jorge, Everton B Castanha, Andreia N Gonçalves, Barbara L Silva, Bernardo V Nogueira, Geovana M Lima, Carolina P B Gracitelli, Andrew J Tatham
{"title":"Artificial Intelligence in Anterior Chamber Evaluation: A Systematic Review and Meta-Analysis.","authors":"Marco A C Olyntho, Carlos A C Jorge, Everton B Castanha, Andreia N Gonçalves, Barbara L Silva, Bernardo V Nogueira, Geovana M Lima, Carolina P B Gracitelli, Andrew J Tatham","doi":"10.1097/IJG.0000000000002428","DOIUrl":"10.1097/IJG.0000000000002428","url":null,"abstract":"<p><strong>Prcis: </strong>In this meta-analysis of 6 studies and 5269 patients, deep learning algorithms applied to AS-OCT demonstrated excellent diagnostic performance for closed angle compared with gonioscopy, with a pooled sensitivity and specificity of 94% and 93.6%, respectively.</p><p><strong>Purpose: </strong>This study aimed to review the literature and compare the accuracy of deep learning algorithms (DLA) applied to anterior segment optical coherence tomography images (AS-OCT) against gonioscopy in detecting angle closure in patients with glaucoma.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis evaluating DLA in AS-OCT images for the diagnosis of angle closure compared with gonioscopic evaluation. PubMed, Scopus, Embase, Lilacs, Scielo, and Cochrane Central Register of Controlled Trials were searched. The bivariate model was used to calculate pooled sensitivity and specificity.</p><p><strong>Results: </strong>The initial search identified 214 studies, of which 6 were included for final analysis. The total study population included 5269 patients. The combined sensitivity of the DLA compared with gonioscopy was 94.0% (95% CI: 83.8%-97.9%), whereas the pooled specificity was 93.6% (95% CI: 85.7%-97.3%). Sensitivity analyses removing each individual study showed a pooled sensitivity in the range of 90.1%-95.1%. Similarly, specificity results ranged from 90.3% to 94.5% with the removal of each individual study and recalculation of pooled specificity.</p><p><strong>Conclusion: </strong>DLA applied to AS-OCT has excellent sensitivity and specificity in the identification of angle closure. This technology may be a valuable resource in the screening of populations without access to experienced ophthalmologists who perform gonioscopy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"658-664"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922321","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}