Journal of Glaucoma最新文献

{"title":"The Impact of Femtosecond Laser on Intraocular Pressure With Cataract Surgery in Healthy Eyes.","authors":"Nurit Mathalone, Or Ben-Shaul, Olga Podkovyrin, Chen Lux, Orna Geyer","doi":"10.1097/IJG.0000000000002491","DOIUrl":"10.1097/IJG.0000000000002491","url":null,"abstract":"<p><strong>Prcis: </strong>Femtosecond laser-assisted cataract surgery (FLACS) leads to an increase in intraocular pressure (IOP) during the procedure and subsequent IOP reduction after surgery, with greater magnitude in eyes with higher preoperative IOP.</p><p><strong>Purpose: </strong>To evaluate the effect of FLACS using the LDVZ8 laser on IOP during and after surgery, and to compare the IOP-lowering effect of FLACS and conventional phacoemulsification cataract surgery (CPCS).</p><p><strong>Patients and methods: </strong>This prospective cohort study enrolled 395 healthy eyes (395 patients) scheduled for FLACS (n=245) and CPCS (n=150). FLACS was performed using the LDVZ8 laser. During FLACS, IOP was assessed before and immediately after docking. IOP reduction during a 6-month postoperative period was evaluated following FLACS and CPCS. Multivariate analyses were performed.</p><p><strong>Results: </strong>The mean IOP increase after docking was 2.3±4.1 mm Hg ( P <0.0001); the maximum increase was 17.6 mm Hg, peak of 38 mm Hg. Sixty-one eyes (25.1%) demonstrated an increase of ≥5 mm Hg and 10 (3.7%) showed an increase of ≥10 mm Hg; predocking IOP was associated with an IOP increase of ≥5 mm Hg ( P =0.029). IOP reduction over 6 months postsurgery was similar for FLACS and CPCS ( P >0.05), -1.33±3.12 mm Hg for FLACS ( P <0.001) and -1.4±2.87 mm Hg for CPCS ( P <0.001). Preoperative IOP correlated statistically significantly with IOP reduction in both FLACS (β -0.742, P <0.001) and CPCS (β -0.743, P <0.001).</p><p><strong>Conclusions: </strong>Although the LDVZ8 laser procedure causes an increase in IOP in some healthy eyes, a subsequent decrease in IOP is observed after FLACS. The IOP-lowering effect of FLACS is similar to CPCS and tends to be more pronounced in eyes with higher preoperative IOP. Eyes with higher preoperative IOP are prone to IOP elevation during FLACS, a critical consideration for glaucoma patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"19-24"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073033","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":"Genetic Variants Associated With a History of Glaucoma Surgery in Japanese Patients With Primary Open Angle Glaucoma.","authors":"Fumihiko Mabuchi, Nakako Tanaka-Mabuchi, Yoichi Sakurada, Seigo Yoneyama, Zentaro Yamagata, Kenji Kashiwagi","doi":"10.1097/IJG.0000000000002510","DOIUrl":"10.1097/IJG.0000000000002510","url":null,"abstract":"<p><strong>Prcis: </strong>The genetic risk score (GRS) of genetic variants associated with intraocular pressure (IOP) elevation, but not those associated with optic nerve vulnerability, was associated with a history of glaucoma surgery in Japanese patients with primary open angle glaucoma (POAG).</p><p><strong>Objective: </strong>To investigate genetic variants associated with a history of glaucoma surgery in Japanese patients with POAG.</p><p><strong>Methods: </strong>Japanese patients with POAG (n = 468), including normal tension glaucoma (n = 246) and high tension glaucoma (n = 222), and control subjects (n = 246) were genotyped for 22 genetic variants predisposing to POAG, which can be classified into those associated with IOP elevation (IOP-related genetic variants) and optic nerve vulnerability independent of IOP (optic nerve-related genetic variants). The unweighted and weighted GRSs of 17 IOP-related, 5 optic nerve-related, and all 22 genetic variants were calculated, and the association between the GRS and a history of glaucoma surgery was evaluated.</p><p><strong>Results: </strong>There was a significant association (odds ratio 1.13 per unweighted GRS, 95% CI: 1.03 to 1.24, P = 0.0093) between IOP-related unweighted GRS and a history of glaucoma surgery. A significant association (odds ratio 1.09 per 0.1 weighted GRS, 95% CI: 1.04 to 1.14, P = 0.00022) was also found between IOP-related weighted GRS and a history of glaucoma surgery. The IOP-related GRS was positively correlated with the need for glaucoma surgery. The mean of IOP-related unweighted and weighted GRS in patients with POAG with a history of glaucoma surgery were significantly higher ( P = 0.013 and P = 0.00031, respectively) than those in patients with POAG without a history of glaucoma surgery.</p><p><strong>Conclusions: </strong>IOP-related, but not optic nerve-related, genetic variants were associated with a history of glaucoma surgery in Japanese patients with POAG. These results indicate that IOP elevation induced by IOP-related genetic variants rather than optic nerve vulnerability induced by optic nerve-related genetic variants may play an important role in requiring glaucoma surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"7-12"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522065","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":"Optical Microangiography and Progressive Retinal Nerve Fiber Layer Loss in Primary Angle-closure Glaucoma.","authors":"Harsha L Rao, Srilakshmi Dasari, Narendra K Puttaiah, Zia S Pradhan, Sasan Moghimi, Kaweh Mansouri, Carroll Ab Webers, Robert N Weinreb","doi":"10.1097/IJG.0000000000002524","DOIUrl":"10.1097/IJG.0000000000002524","url":null,"abstract":"<p><strong>Precis: </strong>Younger patient age (coefficient: 0.10, P=0.04) and greater peak IOP during follow-up (coefficient: -0.14, P=0.03), but not baseline optical microangiography parameters, were significantly associated with a faster rate of RNFL loss in mild-moderate PACG.</p><p><strong>Purpose: </strong>To evaluate the association between optical microangiography (OMAG) measurements and progressive retinal nerve fiber layer (RNFL) loss in primary angle-closure glaucoma (PACG).</p><p><strong>Methods: </strong>In a prospective study, 45 eyes of 30 PACG patients (86 hemifields) with mild to moderate functional damage were longitudinally studied for at least 2 years and with a minimum of 3 optical coherence tomography (OCT) examinations. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, gender, presence of systemic diseases, central corneal thickness, mean, peak and fluctuation of intraocular pressure during follow-up), baseline hemifield mean deviation (MD) and baseline OMAG (quadrant peripapillary and macular perfusion density [PD]) on the rate of RNFL change was evaluated using linear mixed models.</p><p><strong>Results: </strong>Average (±SD) hemifield MD, RNFL thickness, peripapillary PD and macular PD of the analyzed quadrants at baseline were -6.0±3.4 dB, 89±21 µm, 40.1±3.5% and 29.6±10.3%, respectively. Rate of quadrant RNFL change was -2.5±1.7 µm/year. Multivariate mixed models showed that younger patient age (coefficient: 0.10, P=0.04) and higher peak IOP during follow-up (coefficient: -0.14, P=0.03) were significantly associated with a faster rate of RNFL loss.</p><p><strong>Conclusions: </strong>Younger patient age and greater peak IOP during follow-up were significantly associated with a faster rate of RNFL loss in PACG patients with mild to moderate severity of functional damage. None of the OMAG parameters at baseline were associated with RNFL thinning suggesting a limited role of OCTA imaging in predicting structural progression in mild-moderate PACG.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769693","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":"Rates of Visual Field Progression Before and After the Onset of Atrial Fibrillation.","authors":"Takashi Nishida, Sasan Moghimi, Wang Jin, Linda M Zangwill, Robert N Weinreb","doi":"10.1097/IJG.0000000000002500","DOIUrl":"10.1097/IJG.0000000000002500","url":null,"abstract":"<p><strong>Prcis: </strong>This case-control study investigated the effect of atrial fibrillation (AF) on the progression of glaucoma. The presence of AF and related microvascular damage was associated with a slightly faster visual field loss in glaucoma patients.</p><p><strong>Purpose: </strong>To investigate the effect of atrial fibrillation (AF) on glaucoma progression.</p><p><strong>Methods: </strong>In this longitudinal case-control study, a total of 144 eyes from 105 patients with primary open angle glaucoma were included. Forty-eight eyes of case developed AF during the follow-up followed for 15.6 years. Ninety-six eyes of control that did not have AF at baseline or during follow-up matched for age, baseline glaucoma severity, and follow-up period were followed for an average of 14.7 years. Mixed-effects linear models were used to calculate the difference in the VF MD slopes before and after the AF. CHADS 2 and CHA 2 DS 2 -VASc scores were used to evaluate the risk of thrombosis event, and related microvascular damage was assessed based on these scores.</p><p><strong>Results: </strong>The rate of VF MD change was -0.20 (-0.42 to 0.02) dB/y before AF and -0.28 (-0.47 to -0.09) dB/y after AF for the patients with AF, and -0.21 (-0.25 to -0.17) dB/y for the control. In the multivariable models, the VF slope difference before and after the onset of AF [-0.10 (-0.14 to -0.05) dB/y, P <0.001], higher CHADS 2 score [-0.07 (-0.13 to 0.00) dB/y per 1 unit, P =0.040], and higher CHA 2 DS 2 -VASc score [-0.05 (-0.10 to 0.00) dB/y per 1 unit, P =0.039] were associated with faster VF MD loss.</p><p><strong>Conclusions: </strong>The presence of atrial fibrillation and related microvascular damage might accelerate visual field loss. This underscores the need for a comprehensive medical history and management of cardiovascular risk factors to mitigate increased VF loss in glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"909-914"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307905","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 Power and Reproducibility of Objective Perimetry in Glaucoma.","authors":"Ted Maddess, Corinne F Carle, Maria Kolic, Özge Saraç, Rohan W Essex, Emilie M F Rohan, Faran Sabeti, Josh P van Kleef","doi":"10.1097/IJG.0000000000002485","DOIUrl":"10.1097/IJG.0000000000002485","url":null,"abstract":"<p><strong>Prcis: </strong>An objective perimetry method provides four 30-2 style reports in 8 minutes. These comprise sensitivity and delay reports for both eyes. A combined report format shows comparable diagnostic power to 2 forms of automated perimetry.</p><p><strong>Purpose: </strong>To compare objective perimetry with 2 forms of standard automated perimetry (SAP) in glaucoma.</p><p><strong>Methods: </strong>The study cohort contained 40 persons with glaucoma (PwG) and 94 normal control subjects. The PwG had both perimetric and preperimetric eyes. Multifocal pupillographic objective perimetry was performed with the objectiveField Analyser (OFA), which independently assesses the visual fields of both eyes concurrently. Its OFA30 test assessed the central ±30 degrees, and the OFA15 test assessed the central ±15 degrees, both providing 30-2 style reports. The OFA tests were repeated 2 weeks apart to assess test-retest variability (TRV). OFA was compared with Matrix and HFA-SITA fast 24-2 threshold testing. Diagnostic power was quantified as the area under the receiver operating characteristic curves (AUROC). Test durations, mean defects, and pattern standard deviations of the 4 tests were compared.</p><p><strong>Results: </strong>At a median of 4.09±0.02 minutes/eye the OFA tests were quicker than SAP (all P ≤0.0001), 2 minutes/eye if OFA per-region sensitivities and delays are considered separately. The %AUROCs for OFA, Matrix, and HFA were not significantly different, averaging 93±3% (mean±SD) in perimetric eyes, and 73±6% in preperimetric eyes. For moderate to severe fields, OFA TRV was less than the published results for SAP. OFA30 mean defects were significantly correlated between repeats ( r =0.91) and with OFA15 ( r =0.93, both P <0.0001).</p><p><strong>Conclusions: </strong>OFA provides extra functional measures in the form of per-region delays and between-eye asymmetries. Both the OFA wide-field and macular tests provided comparable diagnostic power to SAP and better TRV in damaged eyes.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"940-950"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017734","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":"Peripapillary Retinoschisis in Glaucoma: A Systematic Review.","authors":"Maria Carolina Almeida, Margarida Ribeiro, João Barbosa-Breda","doi":"10.1097/IJG.0000000000002437","DOIUrl":"10.1097/IJG.0000000000002437","url":null,"abstract":"<p><strong>Prcis: </strong>Peripapillary retinoschisis (PPRS) may bias optical coherence tomography's (OCT) monitoring of glaucoma progression. Its impact on glaucoma still remains uncertain. Only 2 out of the 10 included studies illustrated a correlation between PPRS and glaucoma progression.</p><p><strong>Objectives: </strong>The frequent use of OCT increased the detection of PPRS, which poses challenges in the follow-up of patients with glaucoma. This systematic review aims to summarize the literature regarding PPRS in glaucoma, exploring its prevalence, impact on disease, and clinical management implications.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Scopus with tailored search queries for each platform. All studies had to report PPRS in patients with glaucoma. Exclusion criteria included studies with <10 eyes, studies focusing on schisis outside the disc area, with concomitant retinal or optic nerve lesions, with animals, reviews, studies written in non-English language, and congress abstracts.</p><p><strong>Results: </strong>Ten studies were included, of which 7 were case-control, one was a cohort study, and 2 were case series.Six studies showed that PPRS often overlapped preexisting retinal nerve fiber layer defects. One study reported that the de novo development of PPRS was more frequent in eyes with glaucoma progression than in eyes without progression.Visual field findings were inconsistent, with just one study (out of 6) showing that patients with glaucoma with PPRS experienced faster visual field deterioration than those without it. Overall, solely 2 studies (out of 7) associated PPRS with faster glaucoma progression.</p><p><strong>Conclusions: </strong>PPRS biases OCT analysis in glaucoma. Caution is needed against overestimation of retinal nerve fiber layer thickness when PPRS develops and misinterpretation of its resolution as rapid progression. PPRS' exact impact on glaucoma progression remains unclear.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"997-1009"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075704","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":"Effects of Stress and Strain on the Optic Nerve Head on the Progression of Glaucoma.","authors":"Edward Kang, Ji-Hye Park, Chungkwon Yoo, Yong Yeon Kim","doi":"10.1097/IJG.0000000000002504","DOIUrl":"10.1097/IJG.0000000000002504","url":null,"abstract":"<p><strong>Prcis: </strong>In primary open angle glaucoma, the rate of retinal nerve fiber layer thickness decrease was negatively correlated with lamina cribrosa strain, which was associated with intraocular pressure and optic nerve head geometric factors.</p><p><strong>Purpose: </strong>We hypothesized that the biomechanical deformation of the optic nerve head (ONH) contributes to the progression of primary open angle glaucoma (POAG). This study investigated the biomechanical stress and strain on the ONH in patients with POAG using computer simulations based on finite element analysis and analyzed its association with disease progression.</p><p><strong>Methods: </strong>We conducted a retrospective analysis that included patients diagnosed with early-to-moderate stage POAG. The strains and stresses on the retinal nerve fiber layer (RNFL) surface, prelaminar region, and lamina cribrosa (LC) were calculated using computer simulations based on finite element analysis. The correlations between the rate of RNFL thickness decrease and biomechanical stress and strain were investigated in both the progression and nonprogression groups.</p><p><strong>Results: </strong>The study included 71 and 47 patients in the progression and nonprogression groups, respectively. In the progression group, the factors exhibiting negative correlations with the RNFL thickness decrease rate included the maximum and mean strain on the LC. In multivariate analysis, the mean strain on the LC was associated with optic disc radius, optic cup deepening, axial length, and mean intraocular pressure (IOP), whereas the maximum strain was only associated with mean IOP.</p><p><strong>Conclusions: </strong>In early-to-moderate stage POAG, the rate of RNFL thickness decrease was influenced by both the mean and maximum strain on the LC. Strains on the LC were associated with mean IOP, optic disc radius, axial length, and optic cup deepening. These results suggest that not only IOP but also ONH geometric factors are important in the progression of glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"915-923"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522064","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":"Optical Coherence Tomography Angiography Assessment of Optic Nerve Head and Macula Across the Primary Angle Closure Disease Spectrum.","authors":"Tin A Tun, Eray Atalay, Arthur Liu, Chang Liu, Tin Aung, Monisha E Nongpiur","doi":"10.1097/IJG.0000000000002488","DOIUrl":"10.1097/IJG.0000000000002488","url":null,"abstract":"<p><strong>Prcis: </strong>The microvasculature of the optic disc and macula in eyes with acute primary angle closure and primary angle closure glaucoma was lower across the disease spectrum, but the significant difference was only observed in primary angle closure glaucoma.</p><p><strong>Purpose: </strong>To assess the microvasculature in the optic nerve head (ONH) and macula across the primary angle closure disease (PACD) spectrum using optical coherence tomography angiography (OCTA).</p><p><strong>Materials and methods: </strong>OCTA (AngioVue, Fremont, CA) imaging was performed on 122 PACD subjects. Flow area (FA) and vessel density (VD) in the ONH, radial peripapillary capillary (RPC) network, and superficial and deep capillary plexuses of the macula were calculated and compared across the PACD spectrum using linear regression models with generalized estimating equations adjusted for inter-eye correlation.</p><p><strong>Results: </strong>A total of 234 eyes including 44 primary angle closure suspects (PACS), 93 primary angle closure (PAC), 79 primary angle closure glaucoma (PACG), and 18 PAC with a history of previous acute primary angle closure (APAC) were included in the analysis. Compared with other groups, PACG eyes showed smaller FA in the ONH (1.35±0.02 mm 2 ), RPC (0.78±0.03 mm 2 ), and the superficial retinal layer (1.08±0.03 mm 2 ) (all P <0.05). Lower VD was also observed in the \"whole image,\" \"inside disc,\" and \"peripapillary\" regions of the ONH and RPC, and the \"whole image\" and \"parafoveal\" regions of the retinal layer in the PACG group when compared with other groups (all P <0.05). No significant differences were found for the other groups (all P >0.05). Lower VD in the ONH, RPC, and superficial retinal layer significantly correlated with worse visual field loss in PACG eyes (all P <0.05).</p><p><strong>Conclusions: </strong>Significant reduction in the microvasculature of the optic disc and macula in PACG suggests that glaucoma development may contribute to lower VD in these regions.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"924-930"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017735","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":"Selective Laser Trabeculoplasty Versus Medical Therapy for the Treatment of Open Angle Glaucoma or Ocular Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Matheus Pedrotti Chavez, Guilherme Barroso Guedes, Eric Pasqualotto, Lucca Moreira Lopes, Rafael Oliva Morgado Ferreira, Eduardo Soares Maia Vieira de Souza, Tiago Tomaz de Souza","doi":"10.1097/IJG.0000000000002466","DOIUrl":"10.1097/IJG.0000000000002466","url":null,"abstract":"<p><strong>Prcis: </strong>Selective laser trabeculoplasty (SLT) and medical therapy groups displayed comparable intraocular pressure (IOP) at most follow-ups. SLT was associated with significantly decreased rates of glaucoma surgeries, antiglaucomatous medications, and ocular adverse effects.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of SLT compared with medical therapy in the treatment of open angle glaucoma (OAG) or ocular hypertension (OHT).</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Embase, Cochrane Library and Web of Science databases. Randomized controlled trials (RCTs) comparing SLT with medical therapy were included. We computed mean differences (MDs) or standardized mean differences (STDs) for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Software R, version 4.2.1, was used for statistical analyses. Subgroup analyses were performed on treatment-naive patients and on the class of drugs in the medical therapy group.</p><p><strong>Results: </strong>Fourteen RCTs comprising 1706 patients were included, of whom 936 were submitted to SLT. Medical therapy was associated with a significantly improved IOP at 1 month and a higher proportion of patients achieving ≥20% IOP reduction. There were no significant differences between groups in IOP at 2, 3, 6, and 12 months, IOP fluctuation, rate of eyes at target IOP, visual field, and quality of life. The SLT group exhibited significantly decreased rates of glaucoma surgeries, antiglaucoma medications, and ocular adverse effects.</p><p><strong>Conclusions: </strong>SLT demonstrated comparable efficacy to medical therapy in IOP control at most follow-ups, along with favorable impacts on critical treatment-related factors. Our findings support SLT as a safe and effective treatment for OAG or OHT.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"973-986"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626893","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":"Three-Dimensional Microarchitecture of Lamina Cribrosa Pores in High and Normal Tension Glaucoma Using Optical Coherence Tomography.","authors":"Paul Bastelica, Antoine Labbé, Pascale Hamard, Florence Rossant, Hélène Urien, Jérémie Sublime, Hélène Claudel, Nan Ding, Michel Paques, Christophe Baudouin","doi":"10.1097/IJG.0000000000002494","DOIUrl":"10.1097/IJG.0000000000002494","url":null,"abstract":"<p><strong>Prcis: </strong>The lamina cribrosa (LC) pores of patients with high-tension glaucoma (HTG) appear to take a more tortuous pathway than the LC pores of patients with non-glaucomatous (NG).</p><p><strong>Objective: </strong>To compare the LC pore microarchitecture in patients with HTG, normal tension glaucoma (NTG), and NG, by reconstructions of the LC made from tomographic images.</p><p><strong>Patients and methods: </strong>Spectral domain-optical coherence tomography images of 52 eyes (18 NG, 18 HTG, and 16 NTG) of 29 patients were analyzed. Pores were traced using segmentation software. Pore length, tortuosity, and verticality were the 3 quantitative parameters compared among the 3 groups. Correlation analyses were performed to determine the effects of covariates on the 3 quantitative parameters.</p><p><strong>Results: </strong>Pore tortuosity in HTG (1.419 ± 0.093) was significantly higher ( P = 0.011) than in NG (1.347 ± 0,034) but did not differ from that of NTG eyes ( P = 0.251). In addition, NTG had significantly shorter pores ( P = 0.005) than NG. No difference in pore tortuosity or verticality was found between NG and NTG ( P = 0.587 and P = 0.120, respectively). Pore verticality and length in HTG eyes did not significantly differ from that of NG eyes ( P = 0.049 and P = 0.033, respectively) and NTG eyes ( P = 0.827 and P = 0.968, respectively). All of the quantitative parameters measured were not correlated with age but were associated with glaucoma severity (Visual Field Index, mean deviation, retinal nerve fiber layer, and ganglion cell complex), except for pore verticality, which was not correlated with retinal nerve fiber layer.</p><p><strong>Conclusion: </strong>The LC pores of patients with HTG appear to be more tortuous than the pores of patients with NG, and the pores of patients with NTG are shorter than those of patients with NG. Changes in pore parameters appear to be associated with the severity of glaucomatous optic neuropathy.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"957-963"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289101","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}