Ophthalmology. Glaucoma最新文献

{"title":"Rapid Retinal Nerve Fiber Layer Thinning in the Unaffected Contralateral Eyes of Patients with Unilateral Normal-Tension Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.009","DOIUrl":"10.1016/j.ogla.2024.04.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To observe the rate of progressive retinal nerve fiber layer (RNFL) thinning in the unaffected eyes of patients with unilateral normal-tension glaucoma (NTG), in comparison with that of healthy subjects, and to identify the factors associated with progressive RNFL thinning.</div></div><div><h3>Design</h3><div>Retrospective, longitudinal, observational study.</div></div><div><h3>Participants</h3><div>Ninety-five patients with unilateral NTG and 61 healthy controls.</div></div><div><h3>Methods</h3><div>This study included unilateral NTG and healthy control subjects who were followed up for longer than 4 years and in whom at least 5 reliable retinal nerve fiber layer thickness (RNFLT) measurements were performed using OCT. Factors associated with the rate of thinning of the unaffected eyes of unilateral patients with NTG were identified using regression analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The rate of progressive RNFL thinning and the associated factors.</div></div><div><h3>Results</h3><div>Retinal nerve fiber layer thickness decreased significantly in both the unaffected eyes of unilateral patients with NTG and the healthy eyes (both <em>P</em> &lt; 0.001). The RNFL thinning was significantly faster in the unaffected eyes of unilateral patients with NTG than in the healthy eyes (<em>P</em> &lt; 0.001), specifically in the temporal-inferior (TI) sector (<em>P</em> = 0.003). Factors associated with faster RNFL thinning in the unaffected eyes of unilateral patients with NTG were thicker baseline RNFL of the unaffected eyes (<em>P</em> = 0.002) and a worse visual field (VF) mean deviation (MD) in the NTG eyes (<em>P</em><span> = 0.040). In the healthy controls, the rate of RNFL thinning in the contralateral eyes was the only factor associated with faster thinning (</span><em>P</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>The unaffected eyes of unilateral patients with NTG showed faster RNFL thinning than healthy control eyes, more obviously in the TI sector, and were likely to progress faster when they had a thicker baseline RNFL, and when the NTG eyes had a worse VF MD. In unilateral patients with NTG, initiation of prophylactic treatment could be considered for the unaffected eyes when they are accompanied by a risk of developing glaucoma.</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":"7 5","pages":"Pages 431-439"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856835","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":"Advanced Imaging in Traumatic Glaucoma: Detection of Intralenticular Foreign Body","authors":"","doi":"10.1016/j.ogla.2024.02.007","DOIUrl":"10.1016/j.ogla.2024.02.007","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Page e2"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141256","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":"Unusual Posterior Capsular Pigmentation in Axenfeld–Rieger Anomaly","authors":"","doi":"10.1016/j.ogla.2024.03.004","DOIUrl":"10.1016/j.ogla.2024.03.004","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Page e5"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764790","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":"Blind Spots in Therapy","authors":"","doi":"10.1016/j.ogla.2024.04.006","DOIUrl":"10.1016/j.ogla.2024.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and quantify medications causing angle-closure glaucoma through the FDA Adverse Event Reporting System (FAERS).</div></div><div><h3>Design</h3><div>National retrospective database analysis.</div></div><div><h3>Subjects</h3><div>There were 11 737 133 total adverse event reports from the FDA Federal Adverse Event Reporting System (FAERS) database 2004 to third quarter of 2023 (2023Q3), which included 1629 reports of angle-closure glaucoma.</div></div><div><h3>Methods</h3><div>Drugs associated with reports of angle-closure glaucoma were identified in FAERS through disproportionality analysis</div></div><div><h3>Main Outcome Measures</h3><div>To ascertain if these reports yielded statistically significant signals, we used the proportional reporting ratio (PRR), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC). We considered a signal to be detected when all 4 disproportionality analysis metrics were positive.</div></div><div><h3>Results</h3><div>We identified a total of 1629 adverse event reports linked to 611 suspected drugs over the course of 20 years (2004–2023Q3). Frequently reported drugs included topiramate (520 reports) and citalopram (69 reports), amongst many others. Eighteen medications yielded a positive signal, including lesser-known medications like olanzapine, phentermine, and ranibizumab. Tropicamide exhibited the most robust statistical significance (n = 18; PRR: 164.263; ROR [95% confidence interval {CI}]: 167.95 [104.994–268.655]; EBGM [EBGM05]: 162.421 [109.5]; IC [IC05]: 7.344 [4.591]), while acetazolamide was the second strongest (n = 51; PRR: 113.088; ROR 95% CI: 114.782 [86.665–152.021]; EBGM [EBGM05]: 109.506 [86.501]; IC [IC05]: 6.775 [5.115]).</div></div><div><h3>Conclusions</h3><div>Drug-induced glaucoma included both well-known medications such as topiramate as well as lesser-known medications such as olanzapine, phentermine, and ranibizumab. Clinician awareness of these findings is important.</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":"7 5","pages":"Pages 485-490"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258941962400070X/pdfft?md5=d3cea46460ded90fa28e8c0f41e3e3b4&pid=1-s2.0-S258941962400070X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Reporting Electronic Health Record Data in Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.002","DOIUrl":"10.1016/j.ogla.2024.04.002","url":null,"abstract":"<div><h3>Topic</h3><div>Assessing reporting standards in glaucoma studies utilizing electronic health records (EHR).</div></div><div><h3>Clinical Relevance</h3><div>Glaucoma's significance, underscored by its status as a leading cause of irreversible blindness worldwide, necessitates reliable research findings. This study evaluates adherence to the CODE-EHR best-practice framework in glaucoma studies using EHR, aiming to improve clinical care and patient outcomes.</div></div><div><h3>Methods</h3><div>A systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42023430025), identified relevant studies (January 2022–May 2023) in MEDLINE, EMBASE, CINAHL, and Web of Science. Eligible studies, using EHR data from clinical institutions for glaucoma research, were assessed for study design, participant characteristics, EHR data, and sources. Quality appraisal used the CODE-EHR best-practice framework, focusing on data construction, linkage, fitness for purpose, disease and outcome definitions, analysis, and ethics and governance.</div></div><div><h3>Results</h3><div>Of 31 identified studies, predominant EHR sources were hospitals and clinical warehouses. Commonly reported elements included age, gender, glaucoma diagnosis, and intraocular pressure. Only 16% fully adhered to CODE-EHR best-practice framework's minimum standards, with none meeting preferred standards. While statistical analysis and ethical considerations were relatively well-addressed, areas such as EHR data management and study design showed room for improvement. Patient and public involvement, and acknowledgment of data linkage processes, data security, and storage reporting were often missed.</div></div><div><h3>Conclusion</h3><div>Adherence to CODE-EHR best-practice framework's standards in EHR-based studies of glaucoma can be improved upon. Standardized reporting of EHR data are essential to ensure the reliability of research, facilitating its translation into clinical practice and improving healthcare decision-making for better patient outcomes.</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":"7 5","pages":"Pages 422-430"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000644/pdfft?md5=01bb52e638af196f1ad6623b8bf24ae5&pid=1-s2.0-S2589419624000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Urinary Sodium Excretion with Glaucoma and Related Traits in a Large United Kingdom Population","authors":"","doi":"10.1016/j.ogla.2024.04.010","DOIUrl":"10.1016/j.ogla.2024.04.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Excessive dietary sodium intake has known adverse effects on intravascular fluid volume and systemic blood pressure, which may influence intraocular pressure (IOP) and glaucoma risk. This study aimed to assess the association of urinary sodium excretion, a biomarker of dietary intake, with glaucoma and related traits, and determine whether this relationship is modified by genetic susceptibility to disease.</div></div><div><h3>Design</h3><div>Cross-sectional observational and gene-environment interaction analyses in the population-based UK Biobank study.</div></div><div><h3>Participants</h3><div>Up to 103 634 individuals (mean age: 57 years; 51% women) with complete urinary, ocular, and covariable data.</div></div><div><h3>Methods</h3><div>Urine sodium:creatinine ratio (UNa:Cr; mmol:mmol) was calculated from a midstream urine sample. Ocular parameters were measured as part of a comprehensive eye examination, and glaucoma case ascertainment was through a combination of self-report and linked national hospital records. Genetic susceptibility to glaucoma was calculated based on a glaucoma polygenic risk score comprising 2673 common genetic variants. Multivariable linear and logistic regression, adjusted for key sociodemographic, medical, anthropometric, and lifestyle factors, were used to model associations and gene-environment interactions.</div></div><div><h3>Main Outcome Measures</h3><div>Corneal-compensated IOP, OCT derived macular retinal nerve fiber layer and ganglion cell-inner plexiform layer (GCIPL) thickness, and prevalent glaucoma.</div></div><div><h3>Results</h3><div>In maximally adjusted regression models, a 1 standard deviation increase in UNa:Cr was associated with higher IOP (0.14 mmHg; 95% confidence interval [CI], 0.12–0.17; <em>P</em> &lt; 0.001) and greater prevalence of glaucoma (odds ratio, 1.11; 95% CI, 1.07–1.14; <em>P</em> &lt; 0.001) but not macular retinal nerve fiber layer or ganglion cell-inner plexiform layer thickness. Compared with those with UNa:Cr in the lowest quintile, those in the highest quintile had significantly higher IOP (0.45 mmHg; 95% CI, 0.36–0.53, <em>P</em> &lt; 0.001) and prevalence of glaucoma (odds ratio, 1.30; 95% CI, 1.17–1.45; <em>P</em> &lt; 0.001). Stronger associations with glaucoma (<em>P</em> interaction = 0.001) were noted in participants with a higher glaucoma polygenic risk score.</div></div><div><h3>Conclusions</h3><div>Urinary sodium excretion, a biomarker of dietary intake, may represent an important modifiable risk factor for glaucoma, especially in individuals at high underlying genetic risk. These findings warrant further investigation because they may have important clinical and public health implications.</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":"7 5","pages":"Pages 499-511"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000747/pdfft?md5=48a5fcdfa0a405a825317de129686e72&pid=1-s2.0-S2589419624000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking through the Glass: Microspherophakia with LTBP2 Mutation in Siblings","authors":"","doi":"10.1016/j.ogla.2024.03.002","DOIUrl":"10.1016/j.ogla.2024.03.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Page e4"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775017","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":"Comparing Outcomes of Tube Versus Trabeculectomy Among Patients with Angle-closure Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.005","DOIUrl":"10.1016/j.ogla.2024.04.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Compare outcomes of tube shunt surgery (Tube) and trabeculectomy with mitomycin C (Trab-MMC) in patients with angle-closure glaucoma (ACG).</div></div><div><h3>Design</h3><div>Retrospective nonrandomized comparative study.</div></div><div><h3>Participants</h3><div>A total of 80 eyes from 80 patients with ACG who underwent either Tube (N = 50) or Trab-MMC (N = 30) between January 2015 and January 2022 at Massachusetts Eye and Ear.</div></div><div><h3>Methods</h3><div>Reviewed and analyzed 390 visits from patient charts.</div></div><div><h3>Main Outcome Measures</h3><div>Kaplan-Meier (KM) success rates, intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), adjusted hazard ratios (HRs), and complications.</div></div><div><h3>Results</h3><div>Baseline demographics were similar between both groups, except for a higher proportion of patients with pseudophakia and prior incisional ocular surgery in the Tube group. The Trab-MMC procedure had significantly higher KM complete success (CS) rates than the Tube procedure, but similar qualified success (QS) rates. Under QS, the cumulative probability of survival was 87% in the Tube group and 83% in the Trab-MMC group at year 1 (<em>P</em> = 0.77), and 75% in the Tube group and 58% in the Trab-MMC group at year 2 (<em>P</em> = 0.14). Under CS, the cumulative probability of survival was 13% in the Tube group and 59% in the Trab-MMC group at year 1 (<em>P</em> &lt; 0.001), and 11% in the Tube group and 41% in the Trab-MMC group at year 2 (<em>P</em> &lt; 0.001). Both Tube and Trab-MMC procedures resulted in significant patterns of IOP and medication reduction from baseline up to 2 years with mean IOP reduced to 12.6 ± 5.9 mmHg on 2.8 ± 1.4 medications after Tube and 12.1 ± 6.6 mmHg on 2.4 ± 1.7 medications after Trab-MMC. Patients who underwent Trab-MMC required less IOP-lowering medications at every follow-up visit up to year 1, but a similar number at year 2. No significant differences were found in IOP reduction, BCVA, or complication rates between groups.</div></div><div><h3>Conclusions</h3><div>We demonstrate that Trab-MMC confers similar IOP reduction and QS rates to Tube placement in patients with ACG. Trab-MMC, however, demonstrated greater medication burden reduction up to 1 year, and more favorable CS rates up to 2 years, while still maintaining similar complication rates to Tube.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Pages 476-484"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000681/pdfft?md5=ddab569973d879e52669a4a2fb9b409e&pid=1-s2.0-S2589419624000681-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Comparison of Phaco-tube vs. Phaco-trabeculectomy in Glaucoma Patients","authors":"","doi":"10.1016/j.ogla.2024.04.008","DOIUrl":"10.1016/j.ogla.2024.04.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare surgical outcomes of phacoemulsification<span> combined with Baerveldt implantation (phaco-tube) or trabeculectomy with mitomycin-C (MMC) (phaco-trab) in patients without prior incisional ocular surgery.</span></div></div><div><h3>Design</h3><div>Single-center, retrospective, comparative case series.</div></div><div><h3>Participants</h3><div>A total of 90 patients underwent surgical treatment, including 45 patients in the phaco-tube group and 45 patients in the phaco-trab group.</div></div><div><h3>Methods</h3><div><span>Eligible patients were identified using current procedural terminology (CPT) codes, and their </span>medical records were retrospectively reviewed.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measure was the rate of surgical failure (IOP ≤5 mmHg or &gt;21 mmHg or reduced &lt;20% from baseline on 2 consecutive study visits after 3 months, reoperations<span> for glaucoma, or experienced loss of light perception vision). Patients who had successful surgical outcomes without use of glaucoma medications<span> were classified as complete successes, while those who used glaucoma medications were classified as qualified successes. Secondary outcome measures were visual acuity (VA), visual field mean deviation (VFMD), intraocular pressure (IOP), glaucoma medication use, and complications.</span></span></div></div><div><h3>Results</h3><div>The cumulative probability of failure was 6.7% in the phaco-tube group and 32.8% in the phaco-trab group after 3 years (<em>P</em><span> = 0.005; Restricted Mean Survival Time = 5.9 months, 95% CI = 1.4–10.4 months). The IOP was 13.1 ± 3.4 mmHg in the phaco-tube group and 13.3 ± 6.2 mmHg in the phaco-trab group at 3 years (</span><em>P</em> = 0.90), and the number of glaucoma medications was 2.6 ± 1.5 in the phaco-tube group and 1.7 ± 1.3 in the phaco-trab group (<em>P</em> = 0.015). The logarithm of the minimum angle of resolution VA was 0.39 ± 0.58 in the phaco-tube group and 0.43 ± 0.73 in the phaco-trab group at 3 years (<em>P</em> = 0.82), and VFMD was −18.3 ± 9.0 dB in the phaco-tube group and −14.1 ± 7.0 dB in the phaco-trab group (<em>P</em><span> = 0.16). Postoperative complications developed in 21 patients (47%) in the phaco-tube group and 15 patients (33%) in the phaco-trab group (</span><em>P</em> = 0.28).</div></div><div><h3>Conclusions</h3><div>Phaco-tubes had a significantly lower rate of surgical failure compared to phaco-trabs after 3 years of follow-up. However, phaco-trabs used significantly fewer glaucoma medications at multiple postoperative timepoints and had a higher proportion of complete success.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Pages 466-475"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874027","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":"Long-Term Systemic Use of Calcium Channel Blockers and Incidence of Primary Open-Angle Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.06.003","DOIUrl":"10.1016/j.ogla.2024.06.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between the systemic use of calcium channel blockers (CCBs) and primary open-angle glaucoma (POAG) using a diverse nationwide dataset.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>213 424 individuals aged 40 years and older in the National Institutes of Health <em>All of Us</em> dataset, notable for its demographic, geographic, and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of antihypertensive medication were excluded.</div></div><div><h3>Methods</h3><div>Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. Calcium channel blocker use was further divided into exposure to dihydropyridine CCBs and nondihydropyridine CCBs, and subgroup analyses were performed using chi-square and Fisher tests.</div></div><div><h3>Main Outcome Measures</h3><div>Diagnosis of POAG.</div></div><div><h3>Results</h3><div>Within our cohort, 2772 participants (1.3%) acquired a diagnosis of POAG, while 210 652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among patients with POAG, 32.6% used 1 or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a nondihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.27–1.31, <em>P</em> &lt; 0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33–1.74, <em>P</em> &lt; 0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14–1.50, <em>P</em> &lt; 0.001) was associated with increased POAG risk.</div></div><div><h3>Conclusions</h3><div>Use of dihydropyridine CCBs was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions.</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":"7 5","pages":"Pages 491-498"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433556","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}