Ophthalmology. Glaucoma最新文献

{"title":"Melbourne Rapid Fields Online Perimeter Home Visual Field Study for Glaucoma","authors":"George Y.X. Kong PhD, FRANZCO ,&nbsp;Mohamed Dirani PhD, MBA ,&nbsp;Joyce Tiang MOrthoptics ,&nbsp;Selwyn M. Prea OD, PhD ,&nbsp;Phillip Bedggood PhD ,&nbsp;Algis J. Vingrys PhD","doi":"10.1016/j.ogla.2025.10.008","DOIUrl":"10.1016/j.ogla.2025.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the reliability and concordance of visual field (VF) assessments conducted unsupervised at home using the web-browser-based Melbourne Rapid Fields (MRF) online perimetry system, in comparison with conventional supervised clinic-based Humphrey Field Analyzer Swedish Interactive Threshold Algorithm (SITA)-Faster (HFA-SFr) testing.</div></div><div><h3>Design</h3><div>Prospective observational comparison study.</div></div><div><h3>Subjects/Participants</h3><div>Fifty-three glaucoma patients.</div></div><div><h3>Methods</h3><div>Fifty-three patients with glaucoma with prior experience using MRF platform were recruited. Participants completed bilateral 24-2 white-on-white automated perimetry tests at home using the MRF online system on their own personal computers. Humphrey Field Analyzer SITA-Faster results from the most recent clinic visits served as the comparator. Data from the first 3 months of home monitoring were analyzed in this study. Test–retest variability and agreement between MRF and HFA-SFr were analyzed using Bland–Altman plots and intraclass correlation coefficients (ICCs). Regional analysis was conducted using Garway-Heath structurally defined zones.</div></div><div><h3>Main Outcome Measures</h3><div>Mean deviation (MD), pattern deviation/pattern standard deviation (PD/PSD), test–retest variability, agreement between home-based MRF and clinic-based HFA-SFr, and regional visual field variability.</div></div><div><h3>Results</h3><div>Participants comprised 19 preperimetric, 23 early, 6 moderate, and 5 advanced glaucoma cases. Visual field testing with MRF performed at home showed strong correlation for mean deviation (MD) values with HFA-SFr (ICC = 0.905) and moderate correlation for pattern deviation (PD)/pattern standard deviation (ICC = 0.685). Test–retest for MRF also showed strong correlation for MD (ICC = 0.983) and PD/pattern standard deviation (ICC = 0.947). Test–retest variability between MRF tests found a bias of –0.18 dB and 95% limits of agreement of (–2.97, 2.62 dB) for MD, and a bias of +0.21 dB and 95% limits of agreement of (–2.29, 2.68 dB) for PD. Zone-specific analysis showed that the temporal zone has a higher degree of test–retest variability compared with other zones.</div></div><div><h3>Conclusions</h3><div>Melbourne Rapid Fields online perimetry is a reliable and clinically valid tool for monitoring VF at home in glaucoma cases. Future study of a larger sample size and a more diverse cohort is required to assess its potential for teleophthalmology management of glaucoma and earlier detection of disease progression.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 185-192"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and 10-2 SITA Standard for Detecting Damage in the Macula in Mild-Stage Glaucoma","authors":"Euido Nishijima MD, PhD ,&nbsp;Ryosuke Ito MD ,&nbsp;Kei Sano MD, PhD ,&nbsp;Yuka Igari MD ,&nbsp;Sachiyo Okude CO ,&nbsp;Takahiko Noro MD, PhD ,&nbsp;Shumpei Ogawa MD, PhD ,&nbsp;Gary C. Lee PhD ,&nbsp;Aiko Iwase MD, PhD ,&nbsp;Tadashi Nakano MD, PhD","doi":"10.1016/j.ogla.2025.09.009","DOIUrl":"10.1016/j.ogla.2025.09.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the diagnostic accuracy of 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and 10-2 SITA Standard in detecting macular damage in mild-stage glaucoma.</div></div><div><h3>Design</h3><div>Multicenter diagnostic accuracy study based on prospectively collected data.</div></div><div><h3>Participants</h3><div>In total, 108 eyes from 108 patients with mild-stage glaucoma (normal-tension glaucoma, 58; high-tension glaucoma, 50) and 52 eyes from 52 healthy controls at the Jikei University School of Medicine and Tajimi Iwase Eye Clinic.</div></div><div><h3>Methods</h3><div>Participants underwent 24-2C SITA Faster and 10-2 SITA Standard visual field testing on the same day, in randomized order. OCT with ganglion cell analysis identified macular damage. McNemar test and noninferiority analysis (10% margin) compared detection accuracy. Test durations were compared using pairwise t-tests.</div></div><div><h3>Main Outcome Measures</h3><div>Sensitivity and specificity of 24-2C SITA Faster and 10-2 SITA Standard for detecting macular damage and test duration.</div></div><div><h3>Results</h3><div>For overall macular damage, 24-2C SITA Faster demonstrated sensitivity or specificity of 0.64/0.93 (total deviation [TD]) and 0.67/0.93 (pattern deviation [PD]), while 10-2 SITA Standard demonstrated 0.69/0.94 (TD) and 0.77/0.93 (PD). McNemar test revealed no significant difference, and 24-2C SITA Faster was noninferior within the 10% margin. Subanalysis with a strict 5% margin, revealed that 10-2 SITA Standard was superior to 24-2C SITA Faster when using PD plot for all parameters. The mean test duration was significantly shorter for 24-2C SITA Faster (158.5 seconds) than for 10-2 SITA Standard (330.0 seconds; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>24-2C SITA Faster is a noninferior and more time-efficient alternative to 10-2 SITA Standard for detecting macular damage in mild-stage glaucoma; however, 10-2 SITA Standard may be considered superior for detecting subtle macular defects using PD.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 166-175"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glaucoma Polygenic Risk Scores Demonstrate Heterogeneous Performance across 2 Large Multiethnic Cohorts","authors":"Niloufar Bineshfar MD,&nbsp;Liyin Chen PhD,&nbsp;Yan Zhao MS,&nbsp;Kanza Aziz MD,&nbsp;Nazlee Zebardast MD, MPH","doi":"10.1016/j.ogla.2025.11.002","DOIUrl":"10.1016/j.ogla.2025.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Glaucoma is a leading cause of irreversible blindness. While polygenic risk scores (PRSs) have shown promise for patient risk stratification, their consistency and reliability across diverse populations remain insufficiently characterized. This study aimed to determine whether published glaucoma PRSs demonstrate consistent population-level performance and individual-level risk assignment in 2 large, multiethnic cohorts.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Participants</h3><div>A total of 243 300 individuals (7190 open-angle glaucoma [OAG] cases; 236 110 controls) from the <em>All of Us</em> (AoU) Research Program and 30 306 individuals (1899 cases; 28 407 controls) from the Mass General Brigham (MGB) biobank were included. Participants were aged ≥35 years with available genotype and electronic health record phenotype data.</div></div><div><h3>Methods</h3><div>We evaluated the performance of 11 published glaucoma PRSs in the Polygenic Score Catalog using logistic regression models. The agreement of PRSs in risk classification was evaluated using Pearson correlation and Jaccard index.</div></div><div><h3>Main Outcome Measures</h3><div>Associations between cataloged PRSs and OAG and agreement of PRSs in risk classification.</div></div><div><h3>Results</h3><div>Higher PRSs were all significantly associated with higher odds of OAG; odds ratios (ORs) (per standard deviation) ranged from 1.17 to 1.41 (AoU) and 1.17 to 1.57 (MGB). In AoU, associations were strongest in individuals of European ancestry (ORs 1.22–1.55) and attenuated in African (1.08–1.21) and admixed American (1.09–1.33) ancestries. Despite consistent population-level performance, individual risk concordance across PRSs was low: median Pearson r = 0.42 (interquartile range, 0.35–0.50) and median Jaccard index = 0.16 (interquartile range, 0.13–0.19) for high-risk classification. This discordance persisted across cases, controls, ancestries, and both cohorts.</div></div><div><h3>Conclusions</h3><div>Our results demonstrate that while PRSs predict glaucoma risk at the cohort level, their instability at the individual level limits stand-alone clinical application. Polygenic risk scores should therefore be considered adjuncts to established glaucoma risk factors. Future work should prioritize developing tools to assess individual PRS reliability and standardizing analytic methods to improve comparability and clinical applicability.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 202-208"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of 24-Hour Blood Pressure on Rates of Central and Peripheral Glaucomatous Visual Field Progression","authors":"Alessandro A. Jammal MD, PhD,&nbsp;Richard Donkor MSc, PhD,&nbsp;David S. Greenfield MD","doi":"10.1016/j.ogla.2025.10.001","DOIUrl":"10.1016/j.ogla.2025.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the effect of 24-hour ambulatory blood pressure (BP) measurements on the rates of change in central and peripheral visual field (VF) loss in eyes with glaucoma and suspected glaucoma.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>One hundred twenty-four eyes of 63 subjects with glaucoma or suspect of glaucoma at baseline.</div></div><div><h3>Methods</h3><div>Participants underwent 24-hour ambulatory BP measurement acquired at the baseline visit and 24-2C standard automated perimetry (SAP) every 4 months for up to 48 months. The rates of change in mean sensitivity (MS) were calculated with linear mixed models and used to investigate the effect of BP on the rates of VF loss in the central (≤10°, 26 points) and peripheral (&gt;10°, 36 points) regions separately. Models were adjusted for age, gender, race, intraocular pressure during follow-up, baseline glaucoma severity, and central corneal thickness.</div></div><div><h3>Main Outcome Measures</h3><div>Effect of 24-hour BP values on the rates of future central and peripheral VF loss.</div></div><div><h3>Results</h3><div>Eyes had an average of 7.7 ± 2.2 SAP tests over 27.4 ± 6.4 months of follow-up. The median rate in global mean deviation change was 0.23 dB/year (range –1.00 to 0.94 dB/year). Each 10 mmHg lower in 24-hour average systolic BP (SBP) and diurnal mean arterial pressure (MAP) were associated with –0.119 dB/year (<em>P</em> = 0.021) and –0.162 dB/year (<em>P</em> = 0.018) faster rates of MS loss in the central region, respectively, after adjusting for confounding factors. Lower diurnal MAP was also significantly associated (<em>P</em> = 0.003) with faster progression in the peripheral VF. Eyes of subjects within the lowest tertile of average 24-hour SBP (range 100–116 mmHg) had significantly faster rates of central VF loss than the highest tertile (range 125–168 mmHg; difference between tertiles 0.06 dB/year faster; <em>P</em> = 0.045), but not faster peripheral loss (<em>P</em> = 0.101).</div></div><div><h3>Conclusions</h3><div>Lower baseline 24-hour ambulatory BP measurements were significantly associated with faster rates of SAP progression in the central and peripheral regions. Subjects with the lowest values of average 24-hour SBP demonstrated significantly faster rates of central VF loss and may be used as a predictor for severe glaucomatous progression.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 149-157"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perimetry Testing in the 10th Decade of Life","authors":"Ari Leshno MD ,&nbsp;Charu Vyas BA ,&nbsp;Emmanouil Tsamis PhD ,&nbsp;Noga Harizman MD ,&nbsp;Carlos G. De Moraes MD, MPH ,&nbsp;Qing Wang MD, PhD ,&nbsp;George A. Cioffi MD ,&nbsp;Jeffrey Liebmann MD ,&nbsp;Aakriti G. Shukla MD, MSc","doi":"10.1016/j.ogla.2025.10.007","DOIUrl":"10.1016/j.ogla.2025.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The prevalence of glaucoma increases with age and as life expectancy rises, the number of glaucoma patients in their 10th decade of life will increase. Here we aimed to assess the usefulness of glaucoma diagnostic testing in the very old and identify ways to improve testing reliability.</div></div><div><h3>Design</h3><div>Cohort study.</div></div><div><h3>Subjects</h3><div>Patients aged 90-99 years who were seen in our university-based glaucoma division between February 1, 2020, and May 10, 2023.</div></div><div><h3>Methods</h3><div>All Swedish Interactive Testing Algorithm-Standard 24-2 visual fields (VFs) performed by subjects were collected. Reliability indices and summary metrics were recorded.</div></div><div><h3>Main Outcome Measures</h3><div>Rate of reliable VF tests among individuals aged 90 years or older at the time of the test. The main criterion for a reliable field was a false-positive (FP) rate &lt;15%. The effect of age, gender, and time of testing on FP, false-negative (FN), fixation losses (FLs), and test duration were also evaluated.</div></div><div><h3>Results</h3><div>A total of 3951 VF tests were collected from 289 patients (530 eyes) who met the inclusion criteria. The mean age at the time of the most recent VF was 92.8 ± 2.3 years. One hundred six (7.5%) of the VFs were unreliable based on the FP&lt;15% criteria. Testing after age 90 increased the rate of FP, FN, and FL (all <em>P</em> &lt; 0.001) compared to tests performed at a younger age. In addition, among VF performed by nonagenarians, tests performed in the afternoon were associated with statistically significant higher rates of FP (<em>P</em> &lt; 0.01). A higher FP was also found among the eyes tested first. Testing in the afternoon was also associated with significantly increased FN rates (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>In the very old, reliable perimetry can be obtained. Reliability deteriorates with age and testing should be performed in the morning to maximize performance.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 221-228"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1016/S2589-4196(25)00263-7","DOIUrl":"10.1016/S2589-4196(25)00263-7","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages A3-A6"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Glaucoma in an Old Population","authors":"Mukharram M. Bikbov MD, PhD ,&nbsp;Gyulli M. Kazakbaeva MD ,&nbsp;Ellina M. Iakupova MD ,&nbsp;Leisan I. Gilemzianova MD ,&nbsp;Songhomitra Panda-Jonas MD ,&nbsp;Anastasiia V. Insapova MD ,&nbsp;Diana A. Timerbulatova MD ,&nbsp;Liliia R. Rakhimova MD ,&nbsp;Jost B. Jonas MD","doi":"10.1016/j.ogla.2025.11.001","DOIUrl":"10.1016/j.ogla.2025.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess glaucoma prevalence and its determinants in an aged population.</div></div><div><h3>Design</h3><div>Population-based cohort study.</div></div><div><h3>Participants</h3><div>The population-based Ural Very Old Study was performed in a rural area and urban region of Bashkortostan/Russia and consisted of 1526 (81.1%) out of 1882 eligible individuals aged 85+ years.</div></div><div><h3>Methods</h3><div>The study participants underwent a structured interview and a detailed ocular and systemic examination. The presence and degree of glaucoma were assessed on conventional color fundus photographs, red-free fundus images, and OCT images.</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence and associations of glaucoma.</div></div><div><h3>Results</h3><div>Among 961 individuals with available fundus images, glaucomatous optic neuropathy was detected in 116 of 840 right eyes (13.8%; 95% confidence interval [CI]: 11.3–16.3) and 122 of 841 left eyes (14.5%; 95% CI: 12.0–17.0), with overall 148 participants (15.4%) having glaucoma. Out of 111 right and 116 left eyes with glaucoma and measurement of best-corrected visual acuity (BCVA), 18 (16%) and 20 (17%) eyes were blind, respectively (BCVA: &lt;3/60), and 61 (55%) and 63 (54%) eyes had moderate-to-severe vision impairment (MSVI), respectively (BCVA: &lt;6/18 and ≥3/60). In 24 of 38 glaucomatous blind eyes (63%) and 50 of the 124 glaucomatous eyes (40.3%) with MSVI, vision loss was caused by glaucoma. The ratio of open-angle glaucoma to angle-closure glaucoma was 71% to 29%. The prevalence of angle-closure glaucoma was markedly higher in phakic glaucomatous eyes (62/113; 54.9%) than in pseudophakic glaucomatous eyes (6/125; 4.8%). Best-corrected visual acuity did not differ (<em>P</em> = 0.56) between open-angle glaucoma and angle-closure glaucoma. Among 148 participants with glaucoma, 54 (36.5%) individuals were under therapy. Intraocular pressure (IOP) was ≤21 mmHg in 83% of glaucomatous eyes without antiglaucomatous therapy. Higher prevalence (and severity) of glaucoma correlated with longer axial length (odds ratio [OR]: 1.43; 95% CI: 1.14–1.78; <em>P</em> = 0.002), higher IOP (OR: 1.14; 95% CI: 1.07–1.22; <em>P</em> &lt; 0.001), higher prevalence of pseudoexfoliation (OR: 1.39; 95% CI: 1.17–1.65; <em>P</em> &lt; 0.001), and older age (OR: 1.15; 95% CI: 1.04–1.27; <em>P</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>In this population-based recruited multiethnic cohort aged 85+ years, the prevalence factors of glaucoma-related blindness and MSVI were relatively high, and the majority of glaucomatous eyes were untreated and had single IOP readings of ≤21 mmHg. As in younger cohorts, higher glaucoma prevalence was associated with longer axial length, in addition to higher IOP and older age.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 229-238"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnoracial and Geographic Representation in United States Glaucoma Clinical Trials (2004–2023)","authors":"Jainam Shah BS ,&nbsp;Sachin Pathuri BS ,&nbsp;Jason Zheng BS ,&nbsp;Behram Khan BS ,&nbsp;Kemi Okome MD ,&nbsp;Jeffrey S. Schultz MD ,&nbsp;Anurag Shrivastava MD","doi":"10.1016/j.ogla.2025.09.011","DOIUrl":"10.1016/j.ogla.2025.09.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Glaucoma disproportionately affects racial and ethnic minority populations and individuals in medically underserved regions. However, clinical trial data may not reflect this epidemiologic burden. We aimed to characterize trends in race/ethnicity and geographic reporting in US-based glaucoma clinical trials over 2 decades and evaluate disparities in participant representation relative to national demographics and disease prevalence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A retrospective cross-sectional study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Patients enrolled in US-based phase II–IV clinical trials for glaucoma conducted between 2004 and 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Trials were identified from ClinicalTrials.gov using all glaucoma-related keywords and filtered for US location, completion status, and ≥50 enrolled participants. Trials were stratified by enrollment period: decade 1 (2004–2013) and decade 2 (2014–2023). Demographic distributions were compared with 2010 and 2020 US census data. Geographic representation was evaluated against regional glaucoma prevalence estimates from the Centers for Disease Control and Prevention Vision and Eye Health Surveillance System. Descriptive statistics, odds ratios (ORs), and multinomial chi-square tests were used to assess trends in reporting and representation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Change in reporting of race/ethnicity and geography over time; participant race/ethnicity and trial location distribution compared with national census and glaucoma prevalence data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 95 trials, the proportion reporting race/ethnicity increased from 27.08% in decade 1 to 72.34% in decade 2 (OR: 0.14; 95% confidence interval [CI]: 0.06–0.35; &lt;em&gt;P&lt;/em&gt; &lt; 0.001). Geographic reporting remained unchanged (58.33% vs. 51.06%; OR: 1.34; 95% CI: 0.60–3.02; &lt;em&gt;P&lt;/em&gt; = 0.539). Across 13 744 participants in 47 trials reporting race/ethnicity, Black patients were overrepresented in both decades (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). Hispanic and Asian participants were persistently underrepresented (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). In 52 trials with 14 997 participants, the Northeast was overrepresented (36.2% of trials vs. 18.1% of disease burden; &lt;em&gt;P&lt;/em&gt; = 0.002), whereas the Midwest had lower enrollment (6.4% vs. 20.4%; &lt;em&gt;P&lt;/em&gt; = 0.027), although this was not statistically significant after Bonferroni correction. The South and West were proportionally represented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Although racial/ethnic reporting has improved, US-based glaucoma trials continue to underrepresent Hispanic, Asian, and, potentially, Midwestern populations. These disparities may limit the generalizability of trial findings and access to emerging therapies for high-risk groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 209-220"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Aktas et al: Outcomes of gonioscopy-assisted transluminal trabeculotomy in children with early-onset glaucoma secondary to Sturge–Weber syndrome (Ophthalmology Glaucoma. 2025;8:407-413)","authors":"Cullen Moran MD,&nbsp;Rachel W. Kuchtey MD, PhD","doi":"10.1016/j.ogla.2025.11.007","DOIUrl":"10.1016/j.ogla.2025.11.007","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages e4-e5"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multitrait Polygenic Risk Score for Open-Angle Glaucoma Stratifies Risk of Pigmentary Glaucoma in Pigment Dispersion Syndrome","authors":"Antonia Kolovos MD, MPH ,&nbsp;Ayub Qassim MD, PhD ,&nbsp;Henry N. Marshall MBBS ,&nbsp;Thi Thi Nguyen MOptom ,&nbsp;Joshua Schmidt PhD ,&nbsp;Mark M. Hassall DPhil ,&nbsp;Victoria Tang MD ,&nbsp;Giorgina Maxwell MGC ,&nbsp;John Landers MBBS, PhD ,&nbsp;Richard Mills MBBS, PhD ,&nbsp;Stewart Lake MBChB(Hons), PhD ,&nbsp;Stuart L. Graham MS, PhD ,&nbsp;Angela Schulz PhD ,&nbsp;Anna Galanopoulos MBBS ,&nbsp;Robert J. Casson MBBS(Hons), PhD ,&nbsp;Ivan Goldberg MBBS ,&nbsp;Michael Coote MBBS ,&nbsp;Stephen Best MBChB ,&nbsp;Jed Lusthaus MBBS, PhD ,&nbsp;Paul R. Healey MBBS, PhD ,&nbsp;Jamie E. Craig MBBS(Hons), DPhil","doi":"10.1016/j.ogla.2025.10.005","DOIUrl":"10.1016/j.ogla.2025.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Pigment dispersion syndrome (PDS) is a known risk factor for glaucoma, with at least 1 in 10 patients with PDS developing glaucoma. There are no standardized clinical tools to stratify the risk of glaucoma onset or progression in the context of PDS. This study investigated whether multitrait polygenic risk scores (PRSs) built from variants collectively associated with open-angle glaucoma, intraocular pressure (IOP), and vertical cup:disc ratio (VCDR) could stratify individuals with PDS for their risk of glaucoma development.</div></div><div><h3>Design</h3><div>Cross-sectional study of 2 independent PDS cohorts: the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG<em>, n</em> = 264), and the Glaucoma Services at the University of Iowa Carver College of Medicine (<em>n</em> = 203).</div></div><div><h3>Participants</h3><div>Participants of European ancestry with PDS were classified as PDS-Glaucoma (n = 288), PDS-Glaucoma Suspect (<em>n</em> = 110), or PDS-No Glaucoma (<em>n</em> = 69).</div></div><div><h3>Methods</h3><div>Previously published and validated PRS for open-angle glaucoma, IOP, and VCDR were expressed as a percentile or quintile of an ancestrally matched normal population. Multivariable logistic and linear regressions and survival analyses were performed.</div></div><div><h3>Main Outcome Measures</h3><div>Odds of pigmentary glaucoma and odds of clinically relevant outcomes.</div></div><div><h3>Results</h3><div>Participants from ANZRAG with PDS in the top quintile of an open-angle glaucoma-PRS had greater odds of glaucoma diagnosis compared with the bottom quintile (adjusted odds ratio [OR], 5.29; 95% confidence interval [CI], 1.57–21.28; <em>P</em> = 0.011). This observation was replicated among participants with PDS from the University of Iowa (adjusted OR, 4.07; 95% CI, 1.24–13.85; <em>P</em> = 0.021). Among those with PDS-Glaucoma across both cohorts combined, participants in the top quintile of glaucoma-PRS compared with the bottom quintile were diagnosed 8 years earlier (95% CI, 5.17–10.41; <em>P</em> &lt; 0.001), recorded a maximum IOP 8 mmHg higher (95% CI, 2.89–11.95; <em>P</em> = 0.001), were at greater risk of escalation to incisional surgery (adjusted OR, 1.37; 95% CI, 1.03–1.87; <em>P</em> = 0.038), and were at greater risk of additional incisional surgeries to the same eye (adjusted OR, 1.27; 95% CI, 1.08–1.52; <em>P</em> = 0.006). A PRS for IOP also differentiated pigmentary glaucoma status; a PRS for VCDR did not.</div></div><div><h3>Conclusions</h3><div>A multitrait PRS for open-angle glaucoma stratifies risk of glaucoma onset and disease severity among individuals with PDS.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Pages 193-201"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}