Ophthalmology. Glaucoma最新文献

{"title":"Ophthalmologist and Optometrist Comanagement Model for Glaucoma","authors":"Evan M. Chen MD,&nbsp;Samantha Chan OD,&nbsp;Kelly J. Chen BS,&nbsp;Ashika Kuchhangi BS,&nbsp;Matthew D. Huh BA,&nbsp;Jill Liang BA,&nbsp;Patrick M. Takla BA,&nbsp;Eva Pak BS,&nbsp;Jenny H. Lu BA,&nbsp;Aishwarya Vadivel BS,&nbsp;Dake Chen PhD,&nbsp;Julius Oatts MD,&nbsp;Jing Shan MD, PhD,&nbsp;Yinxi Yu MS,&nbsp;Gui-Shuang Ying PhD,&nbsp;Joshua D. Stein MD, MS,&nbsp;Tin Aung MMed, PhD,&nbsp;Taras Litvin OD, PhD,&nbsp;Ying Han MD, PhD","doi":"10.1016/j.ogla.2026.02.002","DOIUrl":"10.1016/j.ogla.2026.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The growing demand for eye care poses significant challenges to the effective management of patients with glaucoma. This study evaluated long-term clinical outcomes of patients with glaucoma comanaged by institutionally trained optometrists and glaucoma specialists at the University of California San Francisco.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients with glaucoma suspect or stable glaucoma diagnoses from 2016 to 2023.</div></div><div><h3>Methods</h3><div>Patients were comanaged by glaucoma specialists and optometrists with postgraduate institutional glaucoma-specific training via either “alternate care” (alternating glaucoma specialist and optometrist visits) or “transfer care” (optometrist visits only) for up to 5 years of follow-up. Generalized linear models were used to assess long-term changes in clinical parameters.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), medications, Humphrey visual field (HVF), and retinal nerve fiber layer (RNFL) thickness.</div></div><div><h3>Results</h3><div>The study included 391 patients (775 eyes), with 136 (34.8%) in alternate care and 255 (65.2%) in transfer care. The most common diagnoses were glaucoma suspect (51.2%) and primary open-angle glaucoma (POAG, 36.0%). No significant changes were observed in BCVA (<em>P</em> = 0.34), IOP (<em>P</em> = 0.18), medications (<em>P</em> = 0.11), or RNFL (<em>P</em> = 0.65) whereas the mean deviation of HVF improved (<em>P</em> = 0.003) over 5 years among both groups. Overall, 132 eyes (17.0%) required treatment escalation: 81 (10.5%) needed increased medications, 34 (4.4%) underwent glaucoma-related laser treatment, and 17 (2.2%) had incisional surgery. Among all eyes, 56 (14.3%) were rereferred to glaucoma specialists, with 43 (11.0%) returning to comanagement after evaluation or treatment. Alternate care patients saw both optometrists and glaucoma specialists at a median rate of once per year. Transfer care patients saw optometrists at a median rate of twice per year and none by glaucoma specialists. In multivariable analysis, escalation was associated with older age (odds ratio [OR], 1.30 per decade; 95% CI, 1.04–1.63; <em>P</em> = 0.02), POAG vs. suspect (OR, 2.99; 95% CI, 1.59–5.65; <em>P</em> &lt; 0.001), and higher baseline IOP (OR, 1.18 per mmHg; 95% CI, 1.07–1.30; <em>P</em> = 0.01). Care pathway assignment was not significantly associated with treatment escalation.</div></div><div><h3>Conclusions</h3><div>A well-defined and closely monitored comanagement model can maintain patient safety and glaucoma stability over 5 years with improved resource allocation and reduced utilization of glaucoma specialists.</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 5","pages":"Pages 527-536"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319109","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":"What Would We Do with All That Data?","authors":"Loren Engrav MD,&nbsp;Hillary A. Golden BA,&nbsp;Angela Lin OD","doi":"10.1016/j.ogla.2026.05.003","DOIUrl":"10.1016/j.ogla.2026.05.003","url":null,"abstract":"<div><div>Home self-tonometry experience demonstrates the value of remote intraocular pressure monitoring to augment the clinical data, for detecting spikes, measuring treatment effects, tracking diurnal patterns, and personalizing lifestyle interventions — advocating for broader adoption of remote monitoring as the future standard of care.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 5","pages":"Pages 604-609"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935832","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":"Revealing the Hidden Tube: A Simple Laser Solution in a Complex Eye","authors":"Dasari Swetha MS,&nbsp;Gowri Pratinya Kolipaka DNB,&nbsp;Sirisha Senthil MS, FRCS","doi":"10.1016/j.ogla.2026.06.003","DOIUrl":"10.1016/j.ogla.2026.06.003","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 5","pages":"Page e20"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388373","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":"Deep Learning–Predicted RNFL Loss and Incident Glaucoma in the Canadian Longitudinal Study on Aging","authors":"Gustavo A. Samico MD,&nbsp;Douglas R. da Costa MD,&nbsp;Rafael Scherer MD, PhD,&nbsp;Ali Azizi MD,&nbsp;Aaron S. Rabinowitz MD,&nbsp;Davina A. Malek MD,&nbsp;Carolina P.B. Gracitelli MD, PhD,&nbsp;Felipe A. Medeiros MD, PhD","doi":"10.1016/j.ogla.2026.03.006","DOIUrl":"10.1016/j.ogla.2026.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the longitudinal retinal nerve fiber layer (RNFL) thinning predicted from fundus photographs by a machine-to-machine (M2M) model in the Canadian Longitudinal Study on Aging and examine its association with incident glaucoma.</div></div><div><h3>Design</h3><div>A prospective, population-based cohort study of 18 247 participants (30 202 eyes) aged 45–86 years from 11 Canadian sites. Baseline data from 2012–2015 were followed up through 2015–2018.</div></div><div><h3>Methods</h3><div>Fundus photographs analyzed with an OCT-trained M2M algorithm at baseline and after a 3-year follow-up to estimate RNFL thickness change. Demographic factors, intraocular pressure (IOP), and corneal hysteresis (CH) were assessed.</div></div><div><h3>Main Outcome Measures</h3><div>Annual rate of predicted RNFL thickness change and risk of incident glaucoma. Linear mixed-effects models identified predictors of RNFL thinning. Incident glaucoma was defined as new self-reported diagnosis at follow-up. Risk factors were evaluated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Predicted RNFL loss was faster in glaucomatous vs. nonglaucomatous eyes (–0.46 ± 2.28 vs. –0.18 ± 2.07 μm/year; <em>P</em> &lt; 0.001). In multivariable analysis, faster thinning was associated with older age (β = –0.223 μm/year per decade; <em>P</em> &lt; 0.001), higher baseline IOP (β = –0.020 μm/year per mmHg; <em>P</em> &lt; 0.001), lower CH (β = –0.026 μm/year per mmHg lower; <em>P</em> &lt; 0.001), and thicker baseline-predicted RNFL (β = –0.665 μm/year per 10 μm; <em>P</em> &lt; 0.001). A significant age × IOP interaction (β = –0.007 μm/year per mmHg per decade; <em>P</em> = 0.036) indicated greater IOP-related thinning in older participants. Among 17 552 participants without baseline disease, 344 (1.9%) converted to glaucoma. Faster-predicted RNFL loss was independently associated with incident glaucoma during follow-up (hazard ratio = 1.125 per 1 μm/year increase; 95% confidence interval, 1.070–1.183; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Deep learning (DL)–derived RNFL estimates from fundus photographs were associated with clinically meaningful structural change and predicted incident glaucoma in a population-based cohort. These findings highlight the potential of fundus-based DL models to enable glaucoma risk stratification in settings, where OCT is impractical or unavailable.</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 5","pages":"Pages 575-583"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492346","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":"Adverse Events and Intraocular Pressure–Lowering Effect of Topical 0.5% Apraclonidine in Childhood Glaucoma","authors":"Abdelrahman M. Elhusseiny MD, MSc,&nbsp;Marie Michele Macaron MD,&nbsp;Amr K. Hassan MD, MSc,&nbsp;Ta C. Chang MD","doi":"10.1016/j.ogla.2026.03.002","DOIUrl":"10.1016/j.ogla.2026.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the adverse events and intraocular pressure (IOP)–lowering effects of topical apraclonidine in childhood glaucoma management.</div></div><div><h3>Design</h3><div>A retrospective case series.</div></div><div><h3>Participants</h3><div>Glaucoma patients aged ≤18 years who had received topical apraclonidine.</div></div><div><h3>Methods</h3><div>We extracted data on demographics, ocular and systemic adverse events, and IOP reduction. We defined and classified childhood glaucoma based on the Childhood Glaucoma Research Network criteria.</div></div><div><h3>Main Outcome Measures</h3><div>Adverse events and IOP-lowering effect of topical 0.5% apraclonidine.</div></div><div><h3>Results</h3><div>We included 108 eyes (90 patients). Glaucoma associated with non-acquired systemic disease or syndrome (36 eyes, 33.3%) was the most common diagnosis, followed by glaucoma following cataract surgery (29 eyes, 26.9%). The median age at glaucoma diagnosis was 32 months (interquartile range [IQR]: 5.3–68.5 months). The median age at the start of apraclonidine was 5 years (IQR = 3–9). The mean number of glaucoma medications on apraclonidine initiation was 2.7 ± 0.8. The median duration for apraclonidine use was 327 days (IQR = 42–665). There were no local adverse events reported, and only 2 cases of systemic adverse events (1 case [1.1%] of night terror and 1 case [1.1%] of somnolence). The mean baseline IOPs was 30 ± 4.6 mmHg (n = 85 eyes), with a mean IOP reduction of 5.3 mmHg at 6 months after use (n = 20 eyes).</div></div><div><h3>Conclusions</h3><div>Topical apraclonidine use demonstrated a low rate of reported adverse events and was associated with clinically meaningful IOP reduction as an adjunctive treatment in childhood glaucoma.</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 5","pages":"Pages 537-542"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445701","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 Risk of Mortality and Systemic Morbidity in Neovascular Glaucoma","authors":"Ryan Margolis BS,&nbsp;Pranav Vasu MPH,&nbsp;Syril K. Dorairaj MD","doi":"10.1016/j.ogla.2026.01.017","DOIUrl":"10.1016/j.ogla.2026.01.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate long-term systemic risks associated with neovascular glaucoma (NVG) using a large observational data set from the TriNetX Research Network.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Adults &gt;40 years old with central retinal vein occlusion (CRVO) or proliferative diabetic retinopathy (PDR) were compared based on whether they did or did not subsequently develop NVG.</div></div><div><h3>Methods</h3><div>Patients were propensity score matched 1:1 based on demographics and comorbidities. Outcomes were assessed at 1, 5, and 10 years using hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup analysis compared outcomes in PDR + NVG versus CRVO + NVG. Neovascular glaucoma patients were also compared with a cataract control cohort.</div></div><div><h3>Main Outcome Measures</h3><div>Risk of all-cause mortality, stroke, myocardial infarction (MI), end-stage renal disease (ESRD), and deep vein thrombosis (DVT).</div></div><div><h3>Results</h3><div>Patients with PDR who developed NVG had a higher long-term risk than PDR alone, including elevated 10-year mortality (HR, 1.34; 95% CI, 1.14–1.57) and ESRD (HR, 1.43; 95% CI, 1.23–1.67). Among patients with CRVO, the development of NVG increased 10-year mortality (HR, 1.61; 95% CI, 1.17–2.20) and stroke (HR, 1.86; 95% CI, 1.19–2.90), whereas MI and ESRD were not significantly different. DVT risk was not significantly different. Subgroup comparison showed that PDR + NVG had a higher 10-year risk of mortality (HR, 1.56; 95% CI, 1.17–2.07), MI (HR, 1.94; 95% CI, 1.13–3.32), and ESRD (HR, 4.04; 95% CI, 2.43–6.73) compared with CRVO + NVG. Compared with cataract control at 10 years, NVG was associated with higher risks of mortality (HR, 2.66; 95% CI, 2.40–2.94), stroke (HR, 2.17; 95% CI, 1.85–2.54), MI (HR, 1.89; 95% CI, 1.60–2.23), and ESRD (HR, 3.34; 95% CI, 2.89–3.88).</div></div><div><h3>Conclusions</h3><div>Neovascular glaucoma itself appears to add systemic risk beyond underlying PDR or CRVO, suggesting that the onset of NVG may represent a critical breakpoint in the spectrum of systemic vascular disease. Our results highlight the importance of coordinated ophthalmic and multispecialty care at the time of diagnosis.</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 5","pages":"Pages 517-526"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137934","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":"Corneal Endothelial Keratoplasty After Glaucoma Treatment","authors":"Sila B. Bal MD, MPH,&nbsp;Alexander Ivanov MS,&nbsp;William Kearney MS,&nbsp;Eric A. Goldberg MS,&nbsp;Connor Ross BS,&nbsp;Nazlee Zebardast MD,&nbsp;Teresa C. Chen MD,&nbsp;David S. Friedman MD, PhD,&nbsp;Roberto Pineda MD,&nbsp;Alice C. Lorch MD, MPH,&nbsp;Joan Miller MD,&nbsp;John H. Kempen MD, PhD","doi":"10.1016/j.ogla.2026.02.001","DOIUrl":"10.1016/j.ogla.2026.02.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To evaluate the impact of various glaucoma treatments on the incidence of corneal endothelial decompensation requiring corneal endothelial transplantation (CET) and to identify predictive factors for CET in patients with glaucoma or glaucoma suspect status.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A retrospective registry-based cohort study using the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Adults diagnosed with glaucoma or glaucoma suspect status with or without intraocular pressure (IOP)-lowering interventions. Individuals with pre-existing corneal pathology or penetrating trauma were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Demographic and clinic data were extracted for each participant-eye from January 1, 2013, to April 14, 2023, using International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification, and Current Procedural Terminology codes. The eligible cohort was followed forward in time for endothelial keratoplasty incidence. Survival analysis and multivariate Cox proportional hazards regression models were employed to estimate CET incidence and assess predictive factors for CET, defined as partial-thickness lamellar transplantation due to endothelial decompensation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Incidence of CET used as an indicator of corneal endothelial decompensation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 7 827 337 eligible participants (42% men), glaucoma surgery was documented in 615 907 individuals. Overall, 8141 patients (0.13%) underwent CET (incidence rate: 0.03% per person-year). Within the subset undergoing glaucoma surgery, 27 513 (0.4%) had trabeculectomy, and 42 835 (0.5%) had tube or shunt surgery as their initial intervention. Compared to untreated eyes, the risk of subsequent CET was significantly increased after tube/shunt surgery (adjusted hazard ratio [aHR]: 6.63; 95% confidence interval [CI]: 5.93–7.41), trabeculectomy (aHR: 3.06; 95% CI: 2.62–3.59), and IOP-lowering drops (aHR: 1.15; 95% CI: 1.06–1.24). Conversely, minimally invasive glaucoma surgery (MIGS) (aHR: 0.80; 95% CI: 0.68–0.95) and laser trabeculoplasty (aHR: 0.70; 95% CI: 0.63–0.78) were associated with significantly decreased CET risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This large study highlights the substantially elevated risk of endothelial keratoplasty after traditional glaucoma surgeries such as tube/shunt implantation and trabeculectomy as well as the modestly increased risk associated with chronic topical glaucoma therapy. Conversely, MIGS and laser trabeculoplasty were associated with no increase in CET, and possibly even a protective effect on corneal endothelial health. These findings underscore the importance of selecting glaucoma treatments that optimize IOP control while preserving corneal endothelial integrity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 5","pages":"Pages 484-493"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313048","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 Association between a Pharmacy-Based Estimate of Medication Adherence and Surgical and Laser Treatments in Patients with Glaucoma","authors":"Kenneth C. Peng BA,&nbsp;Louay Almidani MD, MSc,&nbsp;Chris Bradley PhD,&nbsp;Jithin Yohannan MD, MPH","doi":"10.1016/j.ogla.2026.02.005","DOIUrl":"10.1016/j.ogla.2026.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate medication adherence in glaucoma and glaucoma suspect patients and explore its relationship with nonpharmacological treatments, including traditional surgery, minimally invasive glaucoma surgery (MIGS), and laser treatment.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Subjects</h3><div>A total of 4480 medically treated glaucoma and glaucoma suspect eyes from 3668 patients who presented to the Wilmer Eye Institute between November 2015 and March 2025, with at least 1 visual field (VF), 1 OCT scan, 1 clinic visit, and corresponding pharmacy claims data for topical intraocular pressure-lowering medications.</div></div><div><h3>Methods</h3><div>Patient procedures were categorized by intervention type based on Current Procedural Terminology codes. Time between the first VF, OCT, or clinic visit and the first laser or surgical procedure was determined. Medication adherence was estimated using the proportion of days covered (PDC), calculated using prescription and dispensing data from electronic medical records and pharmacy claims data. Multivariable Cox regressions assessed the association between PDC and the likelihood of traditional surgery, laser treatment, or MIGS. Subgroup analysis of baseline glaucoma severity was also conducted.</div></div><div><h3>Main Outcome Measures</h3><div>Type and timing of initial nonmedical interventions.</div></div><div><h3>Results</h3><div>The average medication adherence measured by PDC was 56.1% (standard deviation: 23.6). Of the 4480 eyes studied, 1724 (38.5%) eyes received medical treatment exclusively, while 2756 (61.5%) underwent at least 1 procedure. Among those that had a procedure, 1396 (31.2%) underwent laser treatment, 507 (11.3%) underwent MIGS, and 853 (19.0%) underwent traditional surgery. A 10% lower PDC was associated with an increased likelihood of laser treatment (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.02–1.07), MIGS (HR: 1.07, 95% CI: 1.03–1.11), and traditional surgery (HR: 1.15, 95% CI: 1.11–1.18). In suspect and mild baseline glaucoma eyes, lower PDC was associated with laser treatment (HR: 1.12, 1.04), MIGS (HR: 1.16, 1.07), and traditional surgery (HR: 1.14, 1.22). In moderate and severe baseline glaucoma eyes, lower PDC was associated with traditional surgery only (HR: 1.12, 1.09).</div></div><div><h3>Conclusions</h3><div>Lower PDC was associated with an increased likelihood of undergoing any nonmedical intervention. In eyes with severe baseline disease, lower PDC correlated with a higher likelihood of traditional glaucoma surgery but not laser or MIGS procedures.</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 5","pages":"Pages 494-504"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357809","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 Validity of the Distress Thermometer in Patients with Primary Open-Angle Glaucoma","authors":"Natalie A. Chou BA,&nbsp;Eun Young Choi MD,&nbsp;Hannah M. Fisher PhD,&nbsp;Davina Malek MD,&nbsp;Alessandro A. Jammal MD, PhD,&nbsp;Tamara J. Somers PhD,&nbsp;Kelly W. Muir MD,&nbsp;Felipe A. Medeiros MD, PhD,&nbsp;Samuel I. Berchuck PhD","doi":"10.1016/j.ogla.2026.02.006","DOIUrl":"10.1016/j.ogla.2026.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>To validate the Distress Thermometer (DT) as a screening tool for psychosocial distress in primary open-angle glaucoma (POAG) patients and determine optimal cutoff score for clinical use.</div></div><div><h3>Design</h3><div>A clinic-based cross-sectional study.</div></div><div><h3>Participants</h3><div>Three hundred POAG patients without recent glaucoma surgery within the past 6 months were recruited from Duke Eye Center clinics between September 2022 and August 2023.</div></div><div><h3>Methods</h3><div>Participants completed the DT, Hospital Anxiety and Depression Scale (HADS), Self-Efficacy for Managing Chronic Disease 6-item scale, Modified Medical Outcomes Study Social Support Survey 8-item scale, and National Eye Institute Visual Functioning Questionnaire 9-item scale prior to clinic visit. Receiver operating characteristic analysis compared DT cutoff scores (4, 5, and 6) against HADS thresholds for overall distress, anxiety (HADS-A), and depression (HADS-D) subscales. Sensitivity, specificity, positive/negative predictive values, and area under the curve were calculated. Associations between distress and demographic/clinical variables were also explored. Comparison of patient characteristics was conducted between groups correctly and incorrectly classified by the DT relative to the HADS.</div></div><div><h3>Main Outcome Measures</h3><div>Validity of DT in detecting clinically significant distress, as determined by HADS, with secondary outcomes of patient acceptability of DT and factors associated with distress.</div></div><div><h3>Results</h3><div>The optimal DT cutoff was 5 for detecting overall distress (HADS ≥15; sensitivity 0.78, specificity 0.76) and depression (HADS-D ≥8; sensitivity 0.84, specificity 0.73), while a cutoff of 4 best identified anxiety (HADS-A ≥7; sensitivity and specificity both 0.75). Area under the curve values were 0.83 to 0.84, indicating strong discriminative ability. Distress Thermometer negatively correlated with age, social support, self-efficacy, vision-related quality of life, intraocular pressure of the better eye, and standard automated perimetry mean deviation of the worse eye. Distress Thermometer was significantly associated with sex, marital status, income, and employment. Discrepancies between DT and HADS classification were linked to sex, distress, and social support. Patients found the DT highly acceptable (92% easy to complete; 88% not bothered by the question).</div></div><div><h3>Conclusions</h3><div>The DT is a valid, reliable, and acceptable screening tool for psychological distress in POAG patients. Its brevity and ease of use supports implementation into routine glaucoma care, enabling early identification and intervention to improve outcomes and quality of life for distressed POAG patients.</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 5","pages":"Pages 505-516"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357835","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":"What Does the US Food and Drug Administration Regulation of Portable Perimeters Mean?","authors":"Charissa H. Tan MD,&nbsp;Elvin Y. Ng BS,&nbsp;Malvina B. Eydelman MD,&nbsp;Barbara M. Wirostko MD,&nbsp;Brian C. Stagg MD, MS","doi":"10.1016/j.ogla.2026.07.001","DOIUrl":"10.1016/j.ogla.2026.07.001","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 5","pages":"Pages 479-483"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714385","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}