Journal of Glaucoma最新文献

{"title":"Clinical Insights Into a Large Cohort of Phakomatosis Pigmentovascularis.","authors":"Gowri Pratinya Kolipaka, Deepthi Molleti, Rashmi Krishnamurthy, Aparna Rao, Anil K Mandal, Sirisha Senthil","doi":"10.1097/IJG.0000000000002552","DOIUrl":"10.1097/IJG.0000000000002552","url":null,"abstract":"<p><strong>Prcis: </strong>Phakomatosis pigmentovascularis, a multisystem disorder, exhibited male predominance, with Phakomatosis cesioflammea as the most prevalent type. Glaucoma affected 88% of eyes, with three-quarters requiring surgery. Systemic issues, notably epilepsy and anemia, were prevalent in over half of all subjects.</p><p><strong>Purpose: </strong>To report the clinical profile and demographic characteristics of a large cohort with Phakomatosis pigmentovascularis (PPV).</p><p><strong>Participants: </strong>Included 119 eyes of 60 patients with PPV between January 1996 and January 2023 (27 y).</p><p><strong>Methods: </strong>This is a retrospective multicentric study involving 4 tertiary network institutes in India. The diagnosis of PPV was established based on the concurrent presence of pigmentary nevi and capillary malformation, with classification conducted according to the Happle classification system. Demographic information, clinical features at the time of diagnosis (both ocular and systemic), the prevalence of glaucoma, details of management strategies used, and the subsequent outcomes were meticulously documented.</p><p><strong>Main outcome measures: </strong>Key outcome measures included the prevalence of glaucoma among patients, the frequency of systemic abnormalities noted, and the various surgical interventions performed along with their respective success rates.</p><p><strong>Results: </strong>The cohort had male preponderance (male: female ratio of 67%:33%), with median age of presentation at 0.48 (range=0.12, 7.77) years. Glaucoma was observed in 105 eyes (88.2%), with bilateral involvement present in 75% of cases. The most prevalent phenotype observed within the cohort was Phakomatosis cesioflammea (Type iib), affecting 65% of patients. Systemic abnormalities were noted in 51.6% of cases, with epilepsy (45%) and anemia (36%) being the most frequently documented conditions. Surgical intervention was required for 64.7% of eyes for intraocular pressure control, with combined trabeculotomy and trabeculectomy being the predominant procedure used. Surgical success was noted in 87% of eyes, and 19.4% eyes had complications.</p><p><strong>Conclusion: </strong>Phakomatosis cesioflammea (Type iib) was the most common subgroup noted. The majority of patients had glaucoma, often bilateral, with two-thirds requiring surgical intervention for IOP control. Systemic abnormalities were common, emphasizing the need for comprehensive multisystem evaluation in these patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"476-483"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Phacoemulsification-iStent Inject W and Phacoemulsification-Micropulse Transscleral Laser Therapy in Asian Eyes With Mild-Moderate Open Angle Glaucoma.","authors":"Michel M Figueras, Naoki Okada, Chai K Tan, Maria C Aquino, Marcus C J Tan, Katherine W Lun, Dawn K A Lim, Seng C Loon, Paul T K Chew, Victor T Chang Koh","doi":"10.1097/IJG.0000000000002564","DOIUrl":"10.1097/IJG.0000000000002564","url":null,"abstract":"<p><strong>Prcis: </strong>In this retrospective cohort study, the 1-year cumulative probability of failure was comparable, achieving 52.20% in the phacoemulsification-iStent inject W (phaco/iStent) group and 47.80% in the phacoemulsification-micropulse transscleral laser therapy (phaco/MPTLT) group ( P =0.994).</p><p><strong>Purpose: </strong>To compare the 1-year efficacy and safety of phacoemulsification combined with iStent Inject W (phaco/iStent) and phacoemulsification combined with micropulse transscleral laser therapy (phaco/MPTLT).</p><p><strong>Methods: </strong>A retrospective cohort study that included patients with mild-moderate open angle glaucoma (OAG) and cataract who underwent either phaco/iStent or phaco/MPTLT in a tertiary hospital in Singapore between August 1, 2016 and December 31, 2022. The primary outcome measures were cumulative probabilities of failure between the 2 groups, with failure defined as disease progression by ocular coherence tomography (OCT-RNFL) or visual field test (VFT), repeat glaucoma surgery, and inability to maintain intraocular pressure (IOP) lower than preoperative baseline or the use of glaucoma medications for 2 consecutive visits after 1 month postoperatively. In addition, postoperative mean IOP, average number of IOP lowering medications, visual acuity, and complications were analyzed.</p><p><strong>Results: </strong>Forty-six patients were included. Twenty-three eyes underwent phaco/iStent and 23 had phaco/MPTLT. The 2 groups had comparable cumulative probabilities of failure (52.20% phaco/iStent, 47.80% phaco/MPTLT; P =0.994) and mean IOP (15.57±2.95 mm Hg phaco /iStent, 14.39±2.25 mm Hg phaco/MPTLT; P =0.136) after 1 year. The change in IOP before surgery to 12 months is -1.04±3.07 mm Hg in the phaco/iStent group ( P =0.593) and -2.43±4.12 mm Hg in the phaco/MPTLT group ( P =0.022). Both achieved significant medication reduction burdens ( P <0.05). Intraoperative and postoperative complication rates were similar.</p><p><strong>Conclusion: </strong>Both groups showed comparable surgical efficacy and safety after 1 year. The phaco/MPTLT group demonstrated sustained IOP reduction 1 year postoperatively.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"428-432"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605170","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":"Efficacy and Safety of the Preserflo MicroShunt in Pediatric Glaucoma.","authors":"Susana R Duarte, Afonso Lima-Cabrita, Rafael C Barão, André Barata, Cristina Brito, Ingeborg Stalmans, Sophie Lemmens, João B Breda, Luís A Pinto, Filipa J Teixeira","doi":"10.1097/IJG.0000000000002574","DOIUrl":"10.1097/IJG.0000000000002574","url":null,"abstract":"<p><strong>Prcis: </strong>Preserflo significantly reduced both intraocular pressure and the number of glaucoma medications in selected cases of pediatric glaucoma, as far as a 2-year period, with a favorable safety profile.</p><p><strong>Purpose: </strong>To assess the efficacy and safety of the Preserflo device in selected cases of pediatric glaucoma.</p><p><strong>Methods: </strong>Retrospective multicenter observational study. Patients aged 18 years or younger who underwent Preserflo implantation with at least 6 months of follow-up were included. The primary outcome was a surgical success, defined as an intraocular pressure between 6 and 21 mm Hg with a reduction of ≥20% (criterion A) or ≥30% (criterion B), no need for further surgery and no severe surgery-related complications. Secondary outcomes included postoperative intraocular pressure, number of hypotensive drugs, and adverse effects.</p><p><strong>Results: </strong>Twenty eyes from 20 patients (mean age: 11.7±1.1 y) were included, most with uveitic glaucoma (n=8 eyes; 40%). Average follow-up was 18.3±7.7 months, with 55% (n=11) completing 24 months. Mean intraocular pressure was significantly reduced from 27.8±1.3 mm Hg at baseline to 14.2±8.5 mm Hg and 14.6±13.9 mm Hg at 12 and 24 months, respectively ( P <0.001 for both). Average medication reduced from 2.9±1.1 to 0.9±1.3 ( P =0.006) at 24 months. Qualified surgical success (regardless of medication) was 60% and 50% after 12 months, for criteria A and B, and 45% at 24 months (criteria A and B). In both time points and for both criteria, 35% of cases were complete successes (drop-free). No sight-threatening complications were registered.</p><p><strong>Conclusion: </strong>Real-world data from Preserflo use suggests this to be a safe and effective surgical option for the treatment of selected cases of pediatric glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"455-461"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772304","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":"Outcome of Goniotomy Over 120, 240 and 360 Degrees in Juvenile Open Angle Glaucoma: A Multicenter Study.","authors":"Zefeng Yang, Zhixuan Wang, Hanying Fan, Qingshu Ge, Guangfu Dang, Xiao Yang, Lin Xie, Xiaoming Zhu, Yangfan Yang, Yuhong Wang, Jinkun Liu, Hongyang Zhang, Yuhan Feng, Yongjun Qi, Xiangxiang Ye, Mingying Lai, Peijie Lin, Pusheng Wang, Shumei Han, Jiangang Xu, Liming Tao, Heting Liu, Xin Nie, Mengfei Liao, Kai Zou, Yi Jiang, Yunhe Song, Fengbin Lin, Fengqi Zhou, Dilimulati Xiaokaiti, Xiaoyi Liu, Zige Fang, Ling Jin, Yu Chen, Clement C Tham, Ying Han, Xiaojing Pan, Liuzhi Zeng, Robert N Weinreb, Xiulan Zhang","doi":"10.1097/IJG.0000000000002569","DOIUrl":"10.1097/IJG.0000000000002569","url":null,"abstract":"<p><strong>Prcis: </strong>240-degree and 360-degree goniotomy (GT) demonstrated similar efficacy in intraocular pressure (IOP) reduction, both outperforming 120-degree GT in patients with juvenile open angle glaucoma (JOAG) at postoperative 6-month follow-up.</p><p><strong>Objective: </strong>To compare the surgical efficacy and safety of 120-degree, 240-degree, and 360-degree GT for patients with JOAG.</p><p><strong>Patients and methods: </strong>This multicenter retrospective study included 102 eyes of 102 patients with JOAG, who underwent GT with a follow-up of at least 6 months. Patients were categorized into 3 groups: (1) 120-degree GT, (2) 240-degree GT, and (3) 360-degree GT. IOP, glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.</p><p><strong>Results: </strong>Mean age of the participants was 24.4 ± 7.9 years. After a mean follow-up of 8.1 ± 2.7 months, complete success rates were similar between the 240-degree GT (45.2%) and the 360-degree GT (63.2%; P = 0.135), and both were superior to 120-degree GT (18.2%; P < 0.05). Qualified success rates among patients in the 120-degree, 240-degree, and 360-degree GT groups were 93.9%, 96.8%, and 100%, respectively, and showed no statistically significant difference ( P = 0.292). 360-degree GT required fewer medications than 240-degree GT and 120-degree GT ( P < 0.05), with no significant difference in medications between 120-degree GT and 240-degree GT ( P > 0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360-degree GT (68.4%) compared with the 240-degree GT (41.9%) and 120-degree GT (33.3%; P < 0.05).</p><p><strong>Conclusions: </strong>240-degree and 360-degree GT showed similar efficacy in IOP reduction and were superior to 120-degree GT. More extensive GT may provide better outcomes in JOAG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"433-439"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656814","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":"Treatment Outcomes of Micropulse Transscleral Laser Therapy as an Adjunctive Therapy in African American Individuals With Prior Procedural Interventions.","authors":"Anna Dickinson, Luke Leidy, Jella An, Mona Kaleem, Aleksandra Mihailovic, Constance Okeke","doi":"10.1097/IJG.0000000000002559","DOIUrl":"10.1097/IJG.0000000000002559","url":null,"abstract":"<p><strong>Prcis: </strong>Micropulse transscleral laser therapy is a clinically beneficial adjunctive treatment option for African American individuals with severe-stage primary open angle glaucoma who have undergone prior glaucoma procedural interventions.</p><p><strong>Purpose: </strong>To assess the safety and efficacy of micropulse transscleral laser therapy as an adjunctive treatment in reducing intraocular pressure and ocular hypotensive medications in African American patients.</p><p><strong>Methods: </strong>We analyzed 44 eyes of 44 African American individuals with severe-stage primary open angle glaucoma who underwent prior procedural interventions and received a subsequent micropulse treatment. Mean intraocular pressure and ocular hypotensive medications were evaluated at all postoperative visits through 12 months. Main outcome measures included within-group reductions in intraocular pressure and ocular hypotensive medications at 12 months compared with baseline. Univariate and multivariable logistic regression models were used to calculate odds ratios to evaluate characteristics associated with the likelihood of success at 12 months. Success was defined as achieving a target intraocular pressure of ≤12 mm Hg without additional medications and no secondary surgical interventions.</p><p><strong>Results: </strong>Mean intraocular pressure was significantly reduced from 22.9±6.2 mm Hg at baseline to 13.8±4.8 at 12 months following micropulse, a 40% reduction ( P <0.001). The majority of patients were on 4-6 ocular hypotensive medications at baseline. By 12 months, the proportion of patients requiring ≥3 ocular hypotensive medications was significantly reduced compared with baseline ( P =0.03). Univariate analysis revealed that a history of trabeculectomy before micropulse treatment increased the likelihood of successful surgery at 12 months by nearly 5-fold (OR: 4.67; P =0.03).</p><p><strong>Conclusion: </strong>Micropulse is an effective adjunctive treatment in African Americans with severe-stage primary open angle glaucoma and a history of prior glaucoma procedures.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"440-446"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542236","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":"Schlemm's Bidirectional Fluid Wave and Luminal Blood Reflux as Novel Intraoperative Signs Confirming Optimal Placement of the iStent.","authors":"Bryan Chin Hou Ang, Bjorn Kaijun Betzler, Sheng Yang Lim","doi":"10.1097/IJG.0000000000002539","DOIUrl":"10.1097/IJG.0000000000002539","url":null,"abstract":"<p><strong>Purpose: </strong>Trabecular micro-bypass devices (TBDs) such as the iStent series (Glaukos Corporation), are effective in reducing intraocular pressure (IOP). However, precise placement of TBDs is crucial in achieving surgical efficacy, as device malpositioning may lead to suboptimal IOP reduction. We demonstrate 2 novel intraoperative signs to aid confirmation of accurate iStent placement, without reliance on imaging technologies.</p><p><strong>Methods: </strong>Surgical technique report with video accompaniment.</p><p><strong>Surgical technique: </strong>Two intraoperative clinical signs that confirm optimal iStent placement are described: (1) Luminal Blood Reflux-achieved by gently decompressing the anterior chamber, with or without flushing of the stent lumen with balanced salt solution (BSS), thereby confirming stent positioning in the Schlemm canal (SC). (2) Schlemm's Bidirectional Fluid Wave (SBFW)-observable when flushing with BSS, suggesting fluid movement in the canal segments adjacent to the iStent device, thereby confirming stent patency and positioning in the SC.</p><p><strong>Conclusion: </strong>The identified signs are useful, feasible, and reproducible indicators of accurate iStent placement. Future studies may evaluate the application of these confirmatory maneuvers in diverse clinical contexts and further establish a correlation with clinical outcomes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e28-e33"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006683","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":"Effect of Anti-Inflammatory Regimen on Selective Laser Trabeculoplasty Outcomes: A Randomized Controlled Trial.","authors":"Juliana F Miranda, Heloísa A Maestrini, Carolinne C P Barbosa, Laura Oltramari, Guilherme B Guedes, Marcelo M Nascimento, Tiago S Prata, Carla N Urata, Ricardo Y Abe","doi":"10.1097/IJG.0000000000002555","DOIUrl":"10.1097/IJG.0000000000002555","url":null,"abstract":"<p><strong>Prcis: </strong>Patients in the prednisolone acetate 1% group post-SLT had higher treatment success rates comparing with other anti-inflammatory drugs.</p><p><strong>Purpose: </strong>To investigate the effect of different anti-inflammatory regimens on selective laser trabeculoplasty (SLT) outcomes.</p><p><strong>Patients and methods: </strong>A prospective randomized controlled trial. We included newly diagnosed primary open angle glaucoma (POAG) patients that underwent a primary SLT session. Patients were randomly divided into 3 groups (prednisolone acetate 1%, prednisolone acetate 0.12%, and ketorolac tromethamine 0.5%). After SLT, intraocular pressure (IOP) data were collected at different time points: days 7 and 30, and at 3, 6, and 12 months post-SLT. The main outcome measure was the comparison of success rates (Kaplan-Meier survival analysis) between groups (log-rank test).</p><p><strong>Results: </strong>We included a total of 134 eyes from 134 newly diagnosed POAG patients (mean age: 62.64±13.86 y) with a mean follow-up of 287±104 days. We observed a significant IOP reduction following SLT treatment in all groups at 12 months (baseline IOP 19.57±3.78 vs. final IOP: 14.39±2.29 mm Hg, P <0.001). Patients in the acetate prednisolone 1% group presented higher survival rates (83.7%) comparing with the other groups (prednisolone acetate 0.12%=63.9%; ketorolac tromethamine 0.5%=67.0%) at 12 months ( P =0.003). Patients in the acetate prednisolone 1% group had higher chances of treatment success [hazard ratio (HR) 0.30; 95% CI: 0.13-0.68, P =0.004], as well as younger patients (HR: 1.03; 95% CI: 1.00-1.05, P =0.005) and those with higher baseline IOP (HR: 0.78; 95% CI: 0.72-0.85 P <0.001). In the multivariable analysis, patients in the acetate prednisolone 1% group remained with higher chances of treatment success (HR: 0.37; 95% CI: 0.15-0.91, P =0.031). No sight-threatening adverse events was reported during follow-up in all groups.</p><p><strong>Conclusions: </strong>In summary, when evaluating the effect of different anti-inflammatory regimens on SLT outcomes in newly diagnosed POAG patients, we found higher success rates in patients treated with prednisolone acetate 1% after SLT. In addition, higher baseline IOP appears to positively influence postoperative outcomes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"421-427"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440918","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":"Analysis of Standard Automated Visual Field Tests in Glaucoma and the Role of Facial Contour.","authors":"Sepideh Jamali D, Armin Garmany, Tyler M Kaplan, Mostafa Sadegh Mousavi, Helia Ashourizadeh, Zin Tarakji, Cheryl L Khanna","doi":"10.1097/IJG.0000000000002599","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002599","url":null,"abstract":"<p><strong>Prcis: </strong>Using a CNN-enhanced platform, 60-4 visual fields identified peripheral glaucomatous defects missed by central testing in mild cases; facial contour correction showed these defects occurred exclusively outside the temporal visual field.</p><p><strong>Purpose: </strong>To develop a methodology to separate facial contour-induced visual field defects from defects related to glaucoma in patients with peripheral field defects.</p><p><strong>Methods: </strong>Ninety-seven eyes from fifty patients previously diagnosed with glaucoma were enrolled in the study. Thirty-one (62%) participants were male, and 86% were white. The study involved patients with glaucoma who underwent visual field testing using standard automated perimetry, including 10-2, 24-2, 30-2, and 60-4 visual fields. A convolutional neural network (CNN)-enhanced platform, previously developed to identify facial contour-dependent defects in healthy subjects, was used to analyze the visual field data.</p><p><strong>Patients: </strong>The study included ninety-seven eyes from fifty patients with glaucoma, with the majority having primary open angle glaucoma.</p><p><strong>Results: </strong>In ninety out of ninety-seven eyes, there were 60-4 visual field defects. However, 20 (22%) of these eyes did not have glaucomatous defects on the 10-2 or 30-2 visual fields. All patients with 60-4 defects in the absence of more central defects had mild glaucoma, and these eyes comprised 38% of the mild glaucoma group. 60-4 visual field increased the sensitivity of identifying glaucoma in mild disease. Without facial contour, the 60-4 visual field mean threshold summation was 1099.6±346.6 dB, and decreased to 1057±331 dB when accounting for facial contour, which affected 8.03±4.02% of test points. Facial contour-dependent visual field defects were exclusively found outside the temporal visual field.</p><p><strong>Conclusion: </strong>The study demonstrated the potential utility of 60-4 visual fields for identifying early functional glaucomatous changes that may not be detected by more central visual field tests (10-2 or 30-2). It may be important to consider peripheral visual field defects, which can be affected by facial contour, in the diagnosis and monitoring of glaucoma, particularly in mild cases.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078465","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":"Trabeculectomy Bleb Characteristics in Relation to Bleb Success using Anterior Segment Optical Coherence Tomography - A Systematic Review and Meta-Analysis.","authors":"Jackie Jia Lin Sim, Bjorn Kaijun Betzler, Syril Dorairaj, Tanuj Dada, Bryan Chin Hou Ang","doi":"10.1097/IJG.0000000000002595","DOIUrl":"10.1097/IJG.0000000000002595","url":null,"abstract":"<p><strong>Prcis: </strong>ASOCT features of greater bleb height, thicker bleb walls and lower reflectivity are associated with trabeculectomy success, supporting the ASOCT's utility in monitoring and predicting outcomes post-surgery through standardized imaging protocols.</p><p><strong>Purpose: </strong>To evaluate and quantify the relationship between bleb characteristics on ASOCT with surgical outcomes.</p><p><strong>Methods: </strong>Literature search was conducted across Medline, Embase, Cochrane, and Scopus for studies from the past 20 years, until 16 September 2024 on \"glaucoma\", \"trabeculectomy\", and \"ASOCT\". Data collected included patient characteristics, each study's definition of bleb success, clinical outcomes, as well as bleb characteristics. A literature review was conducted on studies which could not be used for meta-analysis.</p><p><strong>Results: </strong>11 studies, with a pooled total of 528 eyes in 517 patients, were included in the final meta-analysis. Successful blebs had significantly higher mean bleb height (mean difference [MD] 0.38 mm, 95%-CI: 0.20-0.56 mm, P=0.002), greater maximum bleb wall thickness (MD 0.21 mm, 95%-CI: 0.07-0.35 mm, P=0.009), and decreased reflectivity (MD -48.9%, 95%-CI: -78.3 to -19.4%, P=0.010), compared to failed blebs. No significant differences were found in bleb fluid cavity height and bleb area. Narrative synthesis revealed that wider blebs, increased fluid-filled cavity height, increased number of microcysts, larger filtration opening widths, and multiform bleb walls were also associated with higher rates of bleb success. Early bleb parameters were statistically significant predictors of bleb success up to 12 months post-operatively.</p><p><strong>Conclusions: </strong>Greater bleb height, thicker bleb walls, and lower reflectivity on ASOCT are consistently associated with successful trabeculectomy outcomes. The ASOCT may be useful in predicting bleb success and in supplementing post-operative monitoring, hence guiding timely medical or procedural interventions, to ensure long-term bleb success.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029184","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 Humor Dynamics Changes and Predictors of IOP Response to Latanoprost in Healthy Subjects.","authors":"Arash Kazemi, Jeremy C Reitinger, Carol B Toris, Vikas Gulati, Shan Fan, David M Reed, Sayoko E Moroi, Arthur J Sit","doi":"10.1097/IJG.0000000000002585","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002585","url":null,"abstract":"<p><strong>Prcis: </strong>In our study of the factors predictive of latanoprost response, we found that normotensive subjects with higher intraocular pressure, lower uveoscleral outflow, and higher body mass index had a greater response to 1-week treatment.</p><p><strong>Purpose: </strong>To evaluate relationships between variable intraocular pressure (IOP) responses to latanoprost and participant characteristics, baseline values and changes in aqueous humor dynamics (AHD) parameters.</p><p><strong>Methods: </strong>We assessed 226 eyes from 113 healthy participants. AHD parameters measured at baseline and after 1-week treatment with latanoprost included: IOP by pneumatonometry, episcleral venous pressure (EVP) by venomanometry, aqueous humor flow rate by fluorophotometry, outflow facility by 2-minute pneumatonography, and uveoscleral outflow calculated using the modified Goldmann equation. IOP responses were categorized into 4 groups: non-responders (<10% reduction), all-responders (≥10% reduction), medium-responders (10-20% reduction), and high-responders (≥20% reduction). Generalized estimating equation models were used to analyze treatment effects and compare groups.</p><p><strong>Results: </strong>Baseline IOP was higher in high-responders than medium-responders and non-responders ( P =0.007 and P <0.001, respectively). Body mass index (BMI) was significantly higher in high-responders and all-responders compared to non-responders ( P =0.02 and P =0.03, respectively). Responders had lower baseline uveoscleral outflow ( P =0.03). There were no significant differences in other baseline characteristics including EVP, outflow facility, and aqueous flow rate between the 4 groups. IOP decreased while outflow facility and uveoscleral outflow increased after latanoprost treatment in all responder groups but did not change in non-responders. EVP and aqueous flow rate did not change significantly in any group. The change in uveoscleral outflow was greater in high-responders than in non-responders ( P =0.004).</p><p><strong>Conclusions: </strong>In healthy subjects, higher baseline IOP, lower uveoscleral outflow and higher BMI are predictors of a greater IOP reduction by latanoprost. A greater increase in uveoscleral outflow is responsible for this larger response.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028384","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}