Ophthalmology. Glaucoma最新文献

{"title":"Optic Disc Size and Circumpapillary Retinal Nerve Fiber Layer Thinning in Glaucoma","authors":"Takashi Nishida MD, PhD ,&nbsp;Vincent Q. Pham BS ,&nbsp;Sasan Moghimi MD ,&nbsp;Christopher A. Girkin MD, MSPH ,&nbsp;Massimo A. Fazio PhD ,&nbsp;Jeffrey M. Liebmann MD ,&nbsp;Linda M. Zangwill PhD ,&nbsp;Robert N. Weinreb MD","doi":"10.1016/j.ogla.2025.02.003","DOIUrl":"10.1016/j.ogla.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the association between optic disc size and circumpapillary retinal nerve fiber layer (cpRNFL) thinning in eyes with preperimetric glaucoma and glaucoma.</div></div><div><h3>Design</h3><div>Observational cohort.</div></div><div><h3>Participants</h3><div>A total of 841 eyes (554 primary open angle glaucoma and 287 preperimetric glaucoma) from 553 patients who had at least 4 visits and 2 years of follow-up using OCT.</div></div><div><h3>Methods</h3><div>Multivariable linear mixed-effects modeling was used to estimate the effect of optic disc size on cpRNFL thinning while controlling for covariates. To eliminate the floor effect, eyes with baseline visual field mean deviation less than −14 dB were excluded.</div></div><div><h3>Main Outcome Measures</h3><div>The effect of optic disc size on cpRNFL thinning.</div></div><div><h3>Results</h3><div>Of the participants, 189 (34.2%) were Black, 338 (61.1%) were White, 20 (3.6%) were Asian, and 6 (1.1%) were another race or ethnicity. Mean follow-up period was 5.3 (95% confidence interval [CI], 5.2–5.5) years, and the mean rate of cpRNFL change was −0.54 (95% CI, −0.61 to 0.47) μm/year. After adjusting for covariates with the Littmann’s formula correction, larger optic disc size was associated with faster cpRNFL thinning (−0.03; 95% CI, −0.05 to 0.00) μm/year faster per 0.1 mm² larger; <em>P</em> = 0.034), while no significant differences were found for race and its interaction with optic disc size.</div></div><div><h3>Conclusions</h3><div>Larger optic disc size is associated with faster cpRNFL thinning in glaucoma, independent of race. Although previous studies have indicated that Black individuals may be at higher risk for glaucoma development, the present study suggests that race may not be a significant predictor of faster cpRNFL thinning when controlling for optic disc size and other clinical and demographic factors in 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":"8 4","pages":"Pages 343-350"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484974","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":"Patient Challenges with Glaucoma Eye Drops: A Need to Identify Nonadherence and Facilitate Appropriate Support and Disease Management","authors":"Paula Anne Newman-Casey MD,&nbsp;Douglas J. Rhee MD,&nbsp;Alan L. Robin MD,&nbsp;Steven L. Mansberger MD, MPH","doi":"10.1016/j.ogla.2024.12.002","DOIUrl":"10.1016/j.ogla.2024.12.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Pages 327-330"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017050","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":"Enhanced Aqueous Humor Outflow Following Trabeculotomy in Primary Congenital Glaucoma Eyes","authors":"Shikha Gupta MD ,&nbsp;Xiaowei Zhang MD ,&nbsp;Arnav Panigrahi MD ,&nbsp;Robert N. Weinreb MD ,&nbsp;Viney Gupta MD ,&nbsp;Alex S. Huang MD, PhD","doi":"10.1016/j.ogla.2025.04.002","DOIUrl":"10.1016/j.ogla.2025.04.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Pages 424-426"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063392","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":"Silicone Oil and Glaucoma-Related Adverse Events in Pediatric Vitreoretinal Surgery","authors":"Meghan Sharma MD, MPH ,&nbsp;Laura Huertas MPH ,&nbsp;David J. Taylor Gonzalez MD ,&nbsp;Roya Garakani DO, OD ,&nbsp;Audina M. Berrocal MD ,&nbsp;Ta C. Chang MD","doi":"10.1016/j.ogla.2025.03.006","DOIUrl":"10.1016/j.ogla.2025.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to assess the risk of glaucoma-related adverse events (GRAEs) in pediatric patients following silicone oil use in vitreoretinal (VR) surgery, positing that silicone oil exposure increases GRAE risk.</div></div><div><h3>Design</h3><div>A single-center retrospective cohort study at a tertiary care facility.</div></div><div><h3>Participants</h3><div>Pediatric patients aged 0 to 18 years who underwent VR surgery between April 2019 and April 2021 were included. Patients with previously diagnosed glaucoma or who had undergone glaucoma surgery were excluded.</div></div><div><h3>Methods</h3><div>Review of medical records for intraoperative use of silicone oil and postoperative occurrence of GRAE, defined as elevated intraocular pressure (&gt;21 mmHg), initiation of pressure-lowering medications, performance of pressure-lowering surgery, or a diagnosis of childhood glaucoma based on the Childhood Glaucoma Research Network criteria.</div></div><div><h3>Main Outcome Measures</h3><div>Survival analysis of GRAE between patients exposed vs. not exposed to silicone oil during VR surgery.</div></div><div><h3>Results</h3><div>Of the 186 pediatric patients analyzed, 64 (34.4%) were exposed to silicone oil, and 102 developed GRAE (54.8%). Median survival time to GRAE was 2.0 months (95% confidence interval [CI]: 0.3, 7.7) for silicone oil exposure in patients vs. 25.3 months (95% CI: 3.6, N/A) for patients not exposed to silicone oil (<em>P</em> = 0.0045). Patients exposed to silicone oil had a 52% increased risk of GRAE compared to those not exposed to silicone oil when adjusted for age at VR surgery (hazard ratio: 1.52 [95% CI: 1.01, 2.28], <em>P</em> = 0.0425).</div></div><div><h3>Conclusions</h3><div>In this exploratory study, GRAE was commonly observed following pediatric VR surgery, particularly in patients exposed to silicone oil. These findings underscore the importance of careful glaucoma surveillance following VR surgery in children.</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":"8 4","pages":"Pages 393-399"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694417","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":"Visual Field of Eyes with Peripapillary Intrachoroidal Cavitation and Its Association with Deep Optic Nerve Head Structural Changes","authors":"Kaho Akiyama MD ,&nbsp;Shuichiro Aoki MD ,&nbsp;Shiroaki Shirato MD, PhD ,&nbsp;Rei Sakata MD, PhD ,&nbsp;Megumi Honjo MD, PhD ,&nbsp;Makoto Aihara MD, PhD ,&nbsp;Hitomi Saito MD, PhD","doi":"10.1016/j.ogla.2025.03.007","DOIUrl":"10.1016/j.ogla.2025.03.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the location-specific association of deep optic nerve head (ONH) structures and background characteristics with visual field (VF) sensitivity in eyes with peripapillary intrachoroidal cavitation (PICC).</div></div><div><h3>Design</h3><div>A prospective cross-sectional study.</div></div><div><h3>Subjects</h3><div>One hundred twenty-nine eyes of 93 consecutive cases with PICC determined on fundus photographs and confirmed on OCT.</div></div><div><h3>Methods</h3><div>Peripapillary intrachoroidal cavitation location was determined on ONH-centered OCT radial slices according to Garway-Heath sectors. Visual field defect (VFD) corresponding to the location of the PICC sector was considered absent when the pattern deviation probability plot showed no point with a probability &lt; 1% within the corresponding 24-2 Humphrey VF sector. Sectoral mean total deviation (TD) was calculated for structure–function analysis. The presence of full-thickness retinal defect was determined, and PICC depth and deep ONH parameters were calculated with OCT slices.</div></div><div><h3>Main Outcome Measures</h3><div>A best-fit multivariable linear mixed model was applied to identify factors associated with sectoral mean TD corresponding to PICC location. Explanatory variables included age, sex, axial length, intraocular pressure, presence of full-thickness retinal defect, circumpapillary retinal nerve fiber layer thickness (cpRNFLT), PICC depth, Bruch membrane opening (BMO) area, scleral flange opening (SFO) area, and SFO/BMO offset magnitude.</div></div><div><h3>Results</h3><div>Among 254 sectors with PICC, 136 sectors (54%) did not present corresponding VFD. Suspected VFD was most frequent in the temporal (34/50, 68%) and inferior temporal (67/104, 64%) sectors. In the best-fit multivariable analysis, worse sectoral TD in the PICC sectors was associated with the presence of full-thickness retinal defect (<em>P</em> = 0.036) and thinner cpRNFLT (<em>P</em> &lt; 0.001) but was not associated with PICC depth or other deep ONH parameters.</div></div><div><h3>Conclusions</h3><div>Although PICC alone did not necessarily cause corresponding VFD, PICC in the temporal sectors should be carefully examined for VFD. Full-thickness retinal defect, a myopia-induced tissue disruption, and cpRNFLT thinning at the PICC location were significantly associated with worse VF, whereas PICC size and other myopia-related deep ONH structural changes were not. Identification of these factors provides a foundation for understanding VF sensitivity reduction in eyes with characteristically highly myopic ONH changes.</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":"8 4","pages":"Pages 414-423"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733313","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":"Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy in Children with Early-Onset Glaucoma Secondary to Sturge–Weber Syndrome","authors":"Zeynep Aktas MD, FGS ,&nbsp;Yasmine El Sayed MD, MRCSEd ,&nbsp;Ahmet Yucel Ucgul MD, FRCS ,&nbsp;Ghada Gawdat MD ,&nbsp;Hala Elhilali MD ,&nbsp;Fayrouz Aboalazayem MD","doi":"10.1016/j.ogla.2025.03.009","DOIUrl":"10.1016/j.ogla.2025.03.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in managing early-onset glaucoma secondary to Sturge–Weber syndrome (SWS).</div></div><div><h3>Design</h3><div>A retrospective interventional case series.</div></div><div><h3>Participants</h3><div>Medical records of 16 patients (22 eyes) diagnosed with early-onset glaucoma secondary to SWS who underwent GATT surgery were reviewed.</div></div><div><h3>Methods</h3><div>All patients underwent GATT surgery using a 5-0 or 6-0 prolene suture under general anesthesia.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were intraocular pressure (IOP) reduction, complete surgical success (IOP ≤ 18 mmHg without medications), qualified surgical success (IOP ≤ 18 mmHg with medications), and postoperative complications.</div></div><div><h3>Results</h3><div>The mean IOP decreased significantly from 25.4 ± 4.8 mmHg at baseline to 15.7 ± 4.2 mmHg at the final follow-up (<em>P</em> &lt; 0.001), representing a 38.19% reduction. The mean age at the time of GATT surgery was 33.6 ± 33.9 months. The mean follow-up duration was 16.3 ± 6.4 months. Complete surgical success was achieved in 45.4% of eyes (10 out of 22), while qualified success was reached in 81.8% of eyes (18 out of 22). Despite the overall success, 18.1% of eyes (4 eyes) required additional surgical interventions during the follow-up period. These included Ahmed glaucoma valve implantation in 1 eye, trabeculectomy in 2 eyes, and transscleral diode laser cyclophotocoagulation in 1 eye. Transient hyphema was the only reported complication, resolving spontaneously within 1 week without further intervention.</div></div><div><h3>Conclusions</h3><div>Gonioscopy-assisted transluminal trabeculotomy appears to be a promising surgical option for managing early-onset glaucoma in patients with SWS, offering significant IOP reduction and a favorable safety profile within the limitations of our study. However, further studies with longer follow-up periods and comparative groups are necessary to confirm these findings.</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":"8 4","pages":"Pages 407-413"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744518","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":"Sepetaprost 0.002% Noninferiority vs. Timolol 0.5% in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension","authors":"David L. Wirta MD ,&nbsp;Sherif M. El-Harazi MD ,&nbsp;Michael E. Tepedino MD ,&nbsp;Jason Bacharach MD","doi":"10.1016/j.ogla.2025.02.004","DOIUrl":"10.1016/j.ogla.2025.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Sepetaprost is a novel investigative prodrug, the active form of which is a dual agonist targeting both prostaglandin F receptors and prostaglandin E receptor 3. This study (NCT04742283) aimed to demonstrate the noninferiority of sepetaprost ophthalmic solution 0.002% to timolol maleate ophthalmic solution 0.5% in participants with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).</div></div><div><h3>Design</h3><div>A phase IIb, randomized, double-masked, active-controlled, multicenter study conducted in the United States.</div></div><div><h3>Participants</h3><div>In total, 323 adult (≥18 years) participants (POAG, 68.4%; OHT, 31.6%) were randomized 1:1 to receive either once-daily sepetaprost (n = 162) or twice-daily timolol (n = 161) in 1 eye for 3 months.</div></div><div><h3>Methods</h3><div>Intraocular pressure (IOP) was measured at 3 timepoints (8:00 <span>am</span>, 10:00 <span>am</span>, and 4:00 <span>pm</span>) at 3 visits (weeks 2 and 6 and month 3).</div></div><div><h3>Main Outcome Measures</h3><div>The primary efficacy endpoint was noninferiority of sepetaprost to timolol. Noninferiority was established if the upper limit of the 2-sided 95% confidence interval (CI) for the difference in mean IOP (sepetaprost minus timolol) was ≤1.5 mmHg at all 9 specified timepoints and ≤1.0 mmHg at 5 or more of the 9 timepoints. Superiority was tested if noninferiority was achieved. Safety, including adverse events (AEs) and suspected adverse reactions, was evaluated throughout.</div></div><div><h3>Results</h3><div>The primary endpoint, the noninferiority of sepetaprost to timolol in mean IOP reductions, was met. The upper limit of the 2-sided 95% CI for the between-group difference in mean IOP score was &lt;1.0 mmHg at all 9 timepoints. Superiority of sepetaprost to timolol was observed at 4:00 <span>pm</span> in week 2, week 6, and month 3; IOP mean difference (standard error): −0.76 (0.302), –0.73 (0.328), and −0.95 (0.319), respectively (all <em>P</em> &lt; 0.05). Overall, 23.6% of participants receiving sepetaprost and 21.3% receiving timolol experienced AEs. The most commonly reported ocular AE in both groups was conjunctival hyperemia (sepetaprost, 9.9%; timolol, 2.5%).</div></div><div><h3>Conclusions</h3><div>Once-daily sepetaprost 0.002% was statistically noninferior to twice-daily timolol 0.5% for lowering IOP in participants with POAG or OHT. There were no unexpected safety concerns observed, and all AEs were mild or moderate in severity.</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":"8 4","pages":"Pages 384-392"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568883","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":"Comparison of Structural Changes after Epiretinal Membrane Peeling between Nonglaucomatous Eyes and Eyes with Open-Angle Glaucoma","authors":"Dong Kyun Han MD,&nbsp;Eun Ji Lee MD, PhD,&nbsp;Tae-Woo Kim MD, PhD","doi":"10.1016/j.ogla.2025.03.001","DOIUrl":"10.1016/j.ogla.2025.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the structural changes in the peripapillary and macular regions following pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling between nonglaucomatous eyes and eyes with primary open-angle glaucoma (POAG).</div></div><div><h3>Design</h3><div>A retrospective, longitudinal, observational study.</div></div><div><h3>Participants</h3><div>Sixty-eight eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 68 eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery. The circumpapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), and interdigitation zone (IZ) defects were assessed using spectral-domain OCT before and 6 months after surgery and compared between nonglaucomatous and POAG eyes.</div></div><div><h3>Main Outcome Measures</h3><div>Comparison of structural changes between POAG eyes and nonglaucomatous eyes after PPV with ERM peeling surgery.</div></div><div><h3>Results</h3><div>Both nonglaucomatous and POAG eyes showed significant reductions in CMT and temporal RNFL thicknesses postoperatively, but significant increases were observed in nasal RNFL thicknesses. However, the changes were less prominent in POAG eyes, with significantly smaller decreases in CMT (<em>P</em> = 0.044) and temporal RNFL thickness (<em>P</em> = 0.020), and smaller increases in the nasal (<em>P</em> = 0.022) and inferonasal (<em>P</em> = 0.005) RNFL thicknesses. In nonglaucomatous eyes, the length of the IZ defect decreased significantly postoperatively (<em>P</em> = 0.009), while no significant change was observed in POAG eyes (<em>P</em> = 0.115).</div></div><div><h3>Conclusions</h3><div>Structural changes in the macula and peripapillary areas following PPV with ERM peeling were less pronounced in POAG eyes than in nonglaucomatous eyes, probably due to preexisting optic nerve damage. These different structural outcomes should be considered in the diagnosis and monitoring of patients with glaucoma accompanied by ERM.</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":"8 4","pages":"Pages 351-359"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588463","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":"Association of Systemic Calcium Channel Blocker Use with Visual Field Progression in a Large Real-World Cohort from Glaucoma Clinics","authors":"Giovanni Montesano MD, PhD ,&nbsp;Alessandro Rabiolo MD ,&nbsp;David F. Garway-Heath MD ,&nbsp;Dun Jack Fu MD, PhD ,&nbsp;Gus Gazzard MD ,&nbsp;Giovanni Ometto PhD ,&nbsp;David P. Crabb PhD ,&nbsp;Anthony P. Khawaja PhD, FRCOphth","doi":"10.1016/j.ogla.2025.03.002","DOIUrl":"10.1016/j.ogla.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To test the association between use of calcium channel blocker (CCB) medications and the rate of visual field (VF) progression in a large cohort of patients from 5 glaucoma clinics.</div></div><div><h3>Design</h3><div>Retrospective longitudinal case-control study.</div></div><div><h3>Subjects</h3><div>Patients attending 5 glaucoma clinics in the United Kingdom using the same electronic medical record (EMR) system.</div></div><div><h3>Methods</h3><div>For the main analysis, we selected 1 eye from patients with at least 5 reliable (false positive errors &lt; 15%) VFs over a period of at least 4 years. The use of systemic medications was derived from the EMR system. Calcium channel blocker users were identified as cases. Propensity score matching (PSM) and multivariable analyses (MVAs) were used to adjust for confounders. A directed acyclic graph of the relevant variables guided the selection of covariates. Linear mixed-effect models (LMMs) were used to test the effect on the rate of VF mean deviation (MD) associated with CCB use and other covariates (for the MV analysis). Sensitivity analyses were conducted with different inclusion criteria and cutoffs on the estimated duration of CCB use.</div></div><div><h3>Main Outcome Measures</h3><div>The mean difference in the rate of VF MD progression between CCB users and controls.</div></div><div><h3>Results</h3><div>The main analysis included 14 475 eyes (1942 from CCB users) that met the selection criteria (1 eye per patient). The median (interquartile range) VF series length was 8 (6, 11) tests, with a follow-up of 8.6 (6, 11.5) and 8.2 (5.9, 11.2) years in CCB users and controls, respectively. One-to-one PSM pairing with controls was achieved for all CCB users. The estimated rate of MD progression was −0.31 (−0.33 to −0.28) dB/year (mean [95% confidence intervals]) in the CCB users and −0.35 (−0.37 to −0.33) dB/year in the matched controls (<em>P</em> = 0.016). This significant difference was confirmed with the MV analysis including all controls (<em>P</em> = 0.020). All sensitivity analyses confirmed the main results.</div></div><div><h3>Conclusions</h3><div>Calcium channel blocker use was statistically significantly associated with a slower rate of VF deterioration after multivariable adjustment. The estimated difference was small and likely not clinically significant but may be influenced by the limited information on the duration of CCB exposure in this cohort.</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":"8 4","pages":"Pages 333-342"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635001","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":"Reverse Pupillary Block in Yamane Technique Scleral-Fixated Intraocular Lens","authors":"Pietro Paolo Saba MD ,&nbsp;Edoardo Panico MD ,&nbsp;Mario R. Romano MD, PhD","doi":"10.1016/j.ogla.2025.03.008","DOIUrl":"10.1016/j.ogla.2025.03.008","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Page e11"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031324","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}