Ophthalmology. Glaucoma最新文献

{"title":"The Impact of Trabecular Meshwork Remnants on Goniotomy Outcomes","authors":"Kevin C. Allan MD, PhD , Kevin Zhang MD , Shirley Z. Wu MD , Madhukar Kumar MD , Andy Kuo MD , Archana Murali BS , Ang Li MD","doi":"10.1016/j.ogla.2024.08.005","DOIUrl":"10.1016/j.ogla.2024.08.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 106-108"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115515","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":"Visualizing the Void: 3-Dimensional Insights into Optic Disc Pit","authors":"Kanishk Singh MS, Sagarika Snehi DNB, FAICO, Rajesh Pattebahadur MS","doi":"10.1016/j.ogla.2024.07.005","DOIUrl":"10.1016/j.ogla.2024.07.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Page e1"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914760","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 Bent Ab-Interno Needle Goniectomy and Goniotomy in Primary Congenital Glaucoma","authors":"Sushmita Kaushik MS, FAICO,&nbsp;Kajree Gupta MS,&nbsp;Shrushti Hunashyal MBBS,&nbsp;Manik Sardana MS,&nbsp;Faisal Thattaruthody MS,&nbsp;Surinder Singh Pandav MS","doi":"10.1016/j.ogla.2024.08.003","DOIUrl":"10.1016/j.ogla.2024.08.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Primary congenital glaucoma (PCG) is a potentially blinding disease, and the search for the best surgical option always remains. This study investigated the efficacy of Bent Ab-Interno Needle Goniectomy (BANG) compared to the established standard of traditional goniotomy.</div></div><div><h3>Design</h3><div>Parallel-group randomized controlled trial.</div></div><div><h3>Participants</h3><div>Infants with PCG aged 1 month to 1 year with similar clinical features in both eyes.</div></div><div><h3>Intervention</h3><div>The 2 eyes of eligible patients were randomized to either goniotomy or BANG using a 25-gauge needle bent as a reverse cystitome, and the surgeries were done on the same day in both eyes. Postoperatively each infant was followed up for a minimum period of 1 year.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes measured were intraocular pressure (IOP) control and the requirement for antiglaucoma medications (AGMs). The secondary outcome measures included corneal clarity enhancement, axial length stability, incidence of surgical complications, or the need for repeat surgery.</div></div><div><h3>Results</h3><div>Eight infants with both eyes eligible, were included. In each infant, 1 eye was randomized to BANG and the other to conventional goniotomy. The mean age was 7.6 ± 3.6 months. There was no significant difference in the mean preoperative IOP (16.8 ± 8.87 mm Hg vs. 17 ± 6.0 mm Hg; <em>P</em> = 0.48) in eyes randomized to goniotomy or BANG. The mean number of AGMs (1.7 ± 1.11 vs. 2 ± 0.81 respectively; <em>P</em> = 0.26) were similar in both groups. Postoperatively, the IOP at 6 months (14.05 ± 4.1 vs. 16.2 ± 4.07; <em>P</em> = 0.22) and 1 year (15.3 ± 3.4 vs. 17.1 ± 3.0; <em>P</em> = 0.15) were similar in eyes that underwent goniotomy or BANG respectively. Both procedures demonstrated significant improvements in corneal clarity and maintained normal axial length growth. However, the BANG group required slightly more AGMs than the goniotomy group. There were no serious complications in either group. Both eyes of 1 patient required repeat surgery for IOP control and underwent a combined trabeculotomy with trabeculectomy at 9 months and 1 year postoperatively, respectively.</div></div><div><h3>Conclusions</h3><div>This study indicates that goniotomy remains an effective surgical treatment for PCG. The absence of discernible superiority in IOP control or overall outcomes implies that the added complexity of excising the trabecular meshwork in BANG may not confer additional benefits over the established approach.</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 1","pages":"Pages 46-52"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057426","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":"Female-Specific Association between the Apolipoprotein E E4 Allele and Age at Diagnosis of Glaucoma in UK Biobank","authors":"Yan Shi MD, PhD ,&nbsp;Junming Hu PhD ,&nbsp;William Liu ,&nbsp;Wei Qiao Qiu MD, PhD ,&nbsp;Xinyue He MD, PhD ,&nbsp;Miao Zhang MD ,&nbsp;Yan Gao MD ,&nbsp;Xiaoling Zhang MD, PhD ,&nbsp;Zhigang Fan MD, PhD","doi":"10.1016/j.ogla.2024.07.009","DOIUrl":"10.1016/j.ogla.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the impact of the apolipoprotein E (<em>APOE</em>) E4 allele in the gender-specific aging process in glaucoma by illustrating the interaction between risk factors, including the <em>APOE</em> E4 allele, gender, and intraocular pressure (IOP), for age at diagnosis (AAD) of glaucoma.</div></div><div><h3>Design</h3><div>A cross-sectional study included UK Biobank participants with complete data (2006–2010) for analysis. Data were analyzed in December 2023.</div></div><div><h3>Participants</h3><div>Two thousand two hundred thirty-six glaucoma patients and 103 232 controls.</div></div><div><h3>Methods</h3><div>We evaluated multivariable-adjusted associations of AAD of glaucoma, <em>APOE</em> E4 allele (0: absence; 1: presence), and IOP using linear mixed model (LMM) analyses across groups stratified by AAD of mean age of menopause (50 years) and gender.</div></div><div><h3>Main Outcomes Measures</h3><div>Age at diagnosis of glaucoma, <em>APOE</em> E4 allele, and IOP.</div></div><div><h3>Results</h3><div>Patients with glaucoma were older and had a higher percentage of males and a higher mean IOP compared to controls (all <em>P</em> &lt; 0.001). Further stratifying the patients with glaucoma by AAD of 50 and gender, lower IOP (model 1 adjusted by age, β_IOP = −0.096 ± 0.041, <em>P</em> = 0.019), and positive <em>APOE</em> E4 allele (model 2 adjusted by age and IOP, β_e4 = 1.093 ± 0.488, <em>P</em> = 0.026) were associated with an older AAD in females with an AAD &lt;50 years under univariate LMM. In multivariate LMM adjusted by age (model 3), the effect size of both factors increased in the multivariate model as the beta-value increased (β_IOP = −0.111 ± 0.040, <em>P</em> = 0.007; β_e4 = 1.235 ± 0.485, <em>P</em> = 0.012) (model 1 vs. model 3: <em>P</em> = 0.011). In females with an AAD ≥50 years, only positive <em>APOE</em> E4 allele (adjusted by age and IOP, β_e4 = −1.121 ± 0.412, <em>P</em> = 0.007) was associated with a younger AAD. In males, only higher IOP was associated with an older AAD in those with an AAD ≥50 years (β_IOP = 0.088 ± 0.032, <em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>Apolipoprotein E E4 allele may initially delay and later accelerate the development of glaucoma in females around the transition period of 50 years, which is the mean age of menopause, and importantly, this is independent of IOP. Understanding the specific transition states and modifiable factors within each age phase is crucial for developing interventions or strategies that promote healthy aging.</div></div><div><h3>Financial Disclosures</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 1","pages":"Pages 53-62"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891172","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":"Iridoschisis: The Shredded Iris","authors":"Harshal Sahare MS, FAICO ,&nbsp;Darshika Nag MS ,&nbsp;Kamala Subramaniam DNB","doi":"10.1016/j.ogla.2024.04.003","DOIUrl":"10.1016/j.ogla.2024.04.003","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Page e10"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900569","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":"Evaluation of Research Productivity among Academic Glaucoma Specialists Using the Relative Citation Ratio","authors":"Matthew N. Henderson MD ,&nbsp;Hartej Singh BS ,&nbsp;Lucy S. Guan MPH ,&nbsp;Ang Li MD ,&nbsp;Jonathan L. Prenner MD","doi":"10.1016/j.ogla.2024.06.004","DOIUrl":"10.1016/j.ogla.2024.06.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To provide relative citation ratio (RCR) benchmark data for the field of glaucoma.</div></div><div><h3>Design</h3><div>Cross-sectional bibliometric analysis.</div></div><div><h3>Subjects</h3><div>Fellowship-trained glaucoma faculty at Accreditation Council for Graduate Medical Education-accredited institutions.</div></div><div><h3>Methods</h3><div>Glaucoma faculty were individually indexed using the National Institutes of Health (NIH) iCite website. Publication count, mean RCR score, and weighted RCR score were collected for each author between May and August 2023 and included PubMed-listed articles from 1980 to 2023. Data were compared by sex, career duration, academic rank, and acquisition of a Doctor of Philosophy (PhD).</div></div><div><h3>Main Outcome Measures</h3><div>Total number of publications, mean RCR value, and weighted RCR value.</div></div><div><h3>Results</h3><div>Five hundred twenty-six academic glaucoma specialists from 113 institutions were indexed. These physicians produced highly impactful research with a median publication count of 13 (interquartile range [IQR] 4–38), median RCR of 1.41 (IQR 0.97–1.98), and median weighted RCR of 16.89 (4.80–63.39). Academic rank, career duration, and having a PhD were associated with increased publication count, mean RCR, and weighted RCR. Publication count and weighted RCR differed significantly by sex; however, no difference was observed with mean RCR.</div></div><div><h3>Conclusions</h3><div>Current academic glaucoma specialists have high mean RCR values relative to the NIH standard RCR value of 1. This benchmark data serve as a more accurate gauge of research impact within the glaucoma community and can be used to inform self, institutional, and departmental evaluations. Additionally, the mean RCR may provide an accurate metric for quantifying research productivity among historically underrepresented groups that are disadvantaged by time-dependent factors such as number of publications.</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 6","pages":"Pages 531-538"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437862","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":"Reprint of: Transactional Care and the Looming Glaucoma Public Health Crisis","authors":"Kuldev Singh MD, MPH","doi":"10.1016/j.ogla.2024.08.002","DOIUrl":"10.1016/j.ogla.2024.08.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Pages 515-517"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693924","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":"Candy-Stripe Hyphema after Laser Peripheral Iridotomy","authors":"Premanand Chandran MS,&nbsp;Rasna Bhanuman DNB,&nbsp;Ganesh V. Raman MS","doi":"10.1016/j.ogla.2024.04.004","DOIUrl":"10.1016/j.ogla.2024.04.004","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Page e11"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913532","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 and Baseline Predictors of Failure in Primary Standalone Xen45 Gel Stent versus Trabeculectomy for Glaucoma","authors":"Jeremy C.K. Tan MD, FRANZCO ,&nbsp;Yohei Hashimoto MD, PhD ,&nbsp;Pierre Henry Gabrielle PhD ,&nbsp;Catherine Creuzot Garcher MD, PhD ,&nbsp;Andrew White PhD, FRANZCO ,&nbsp;Hamish Dunn MBBS, FRANZCO ,&nbsp;Mark Walland FRANZCO, FRACS ,&nbsp;David Wechsler MBBS, FRANZCO ,&nbsp;Louis Arnould MD, PhD ,&nbsp;Mitchell Lawlor PhD, FRANZCO","doi":"10.1016/j.ogla.2024.07.002","DOIUrl":"10.1016/j.ogla.2024.07.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To compare safety, effectiveness, and baseline predictors of failure in standalone primary Xen45 gel stent (Xen) versus trabeculectomy (Trab) in glaucoma.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Retrospective study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Subjects that underwent primary Xen or Trab augmented by mitomycin-C with at least 12 months follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Multinational observational study of eyes in the Fight Glaucoma Blindness international registry&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The primary outcome was success at 12 months defined by intraocular pressure (IOP) reduction ≥ 20% from baseline and ≤ threshold IOPs of 15, 18, and 21 mmHg with (qualified) or without (complete) medications and without secondary glaucoma surgery. Multivariable mixed effects Cox regression models were used to identify risk factors for failure in each cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 701 eyes (Xen, 308; Trab, 393) of 596 subjects were included with baseline IOP being significantly higher (22.4 vs. 19.9 mmHg, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and baseline medications significantly lower in the Xen versus the Trab group (2.9 vs. 3.4, &lt;em&gt;P&lt;/em&gt; &lt; 0.001). Baseline visual field mean deviation was less severe in the Xen group (–9.47 vs. –13.04 dB, &lt;em&gt;P&lt;/em&gt; &lt; 0.001). The proportion of complete surgical success was significantly lower in the Xen versus Trab group across the 3 upper IOP limits at 12 months; 32% versus 52% at 15 mmHg, 37% versus 54% at 18 mmHg, and 39% versus 55% at 21 mmHg (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). The incidence of postoperative numerical and symptomatic hypotony was lower in the Xen versus Trab group. In the Xen cohort, a higher failure rate was associated with Asian ethnicity (hazard ratio [HR], 1.97; 95% confidence interval (CI), 1.03–3.79) and use of oral acetazolamide at baseline (HR, 1.74; 95% CI, 1.13–2.70), whereas a lower failure rate was associated with diagnosis of ocular hypertension/open-angle glaucoma suspect (HR, 0.40; 95% CI, 0.20–0.82) and secondary open-angle glaucoma (HR, 0.46; 95% CI, 0.26–0.82). Exposure to prostaglandin analog was associated with greater failure in the Trab group (HR, 2.66; 95% CI, 1.18–6.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;There was significantly greater complete success at 12 months across all complete success definitions for Trab compared with Xen, whereas the rate of postoperative hypotony was significantly lower in the Xen group. Asian ethnicity and use of oral acetazolamide at baseline were associated with greater failure in Xen, whereas exposure to prostaglandin analog was associated with greater failure in Trab patients. Such baseline predictors of success and failure may help guide patient selection for subconjunctival minimally invasive glaucoma surgery in patients undergoing surgical intervention.&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 F","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Pages 539-550"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617695","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":"Insight on the Optic Nerve and Ahmed Valve Tube through a Type II Keratoprosthesis","authors":"Irene Koc BS ,&nbsp;Demetrios G. Vavvas MD, PhD ,&nbsp;Teresa C. Chen MD","doi":"10.1016/j.ogla.2024.06.006","DOIUrl":"10.1016/j.ogla.2024.06.006","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Page e13"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635974","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}