Ophthalmology. Glaucoma最新文献

{"title":"A Systematic Review of Sex-Based Reporting in Topical Glaucoma Medication Clinical Trials","authors":"Helen Zhao BA ,&nbsp;Rachel E. Davis MD ,&nbsp;Alexander S. Davis MD, PhD ,&nbsp;Susan L. Meoli RPh, PharmD ,&nbsp;Elizabeth A. Cretara MD","doi":"10.1016/j.ogla.2025.03.010","DOIUrl":"10.1016/j.ogla.2025.03.010","url":null,"abstract":"<div><h3>Topic</h3><div>The National Institutes of Health (NIH) issued guidance in 2016 that sex should be treated as a biological variable in clinical studies; however, previous research has shown that biomedical studies still fail to include sex as a biological variable (SABV) in study design and analysis. We hypothesize that despite evidence for sex-specific glaucoma risk factors, clinical trials for glaucoma topical medications also fail to treat SABV.</div></div><div><h3>Clinical Relevance</h3><div>Prior studies have found sex-specific genetic and hormonal risk factors for glaucoma suggesting that biological sex may influence the disease course.</div></div><div><h3>Methods</h3><div>We performed a systematic review on Pubmed and Google Scholar using terms including generic names of common glaucoma medications, and filters “randomized control trial” and “clinical trial.” Resulting studies were reviewed and included if they met inclusion criteria including randomized controlled trial design, testing of topical glaucoma medications in patients with open-angle glaucoma or ocular hypertension, and published between 2002-2022. Included studies were read and assessed on metrics pertinent to SABV including sex reporting and matching, sex-based analysis of medication efficacy, adverse events (AEs), and mention of SABV in the discussion and conclusion.</div></div><div><h3>Results</h3><div>We identified 543 studies; 122/543 (22.5%) met inclusion criteria representing 31 644 subjects; 16 656/31 644 (52.6%) were women. Sex of subjects was reported in 109/122 (89%) studies. However, only 5/122 (4%) mentioned sex in data analysis, including efficacy (1), AEs (1), and mention of sex in the discussion or conclusion (4). We found that studies published after the NIH guidance on SABV in 2016 and studies funded by the NIH were not more likely to include SABV, however only 3 of 122 (2.5%) studies were NIH-funded. Pregnancy or lactation were exclusion criteria for 31/122 (25%) studies.</div></div><div><h3>Conclusions</h3><div>While the majority of glaucoma topical medication clinical trials reported sex and achieved sex-matching, they failed to include sex-based analysis of medication efficacy or AEs. Opportunities remain to include SABV to improve our understanding of the impact of biological sex on glaucoma treatment, although that may require increases in sample size.</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 400-406"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756235","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":"Retinal Nerve Fiber Layer Rates of Change","authors":"Vahid Mohammadzadeh MD ,&nbsp;Erica Su PhD ,&nbsp;Iris Zhuang MD ,&nbsp;Sajad Besharati MD ,&nbsp;Justin Park MD ,&nbsp;Andrea Yonge MD ,&nbsp;Lynn Shi MD ,&nbsp;Joseph Caprioli MD ,&nbsp;Robert E. Weiss PhD ,&nbsp;Kouros Nouri-Mahdavi MD, MS","doi":"10.1016/j.ogla.2025.02.005","DOIUrl":"10.1016/j.ogla.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare retinal nerve fiber layer (RNFL) thickness rates of change and their variability between 2 commercial OCT devices.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>Ninety-four glaucoma eyes (94 patients) with central damage or moderate to advanced glaucoma with ≥ 2 years of follow-up and ≥ 4 pairs of OCT scans.</div></div><div><h3>Methods</h3><div>A bivariate longitudinal Bayesian model was designed to compare inferences on RNFL rates of change from the 2 devices, both globally and in 12 clock hour sectors. Optic nerve OCT scans were acquired with Spectralis and Cirrus OCT devices in the same session. We inspected longitudinal RNFL profile plots from both OCT devices for all subjects across all sectors and globally.</div></div><div><h3>Main Outcome Measures</h3><div>The rates of change, longitudinal variances, and proportions of significant negative and positive slopes (slope &lt; 0 or &gt; 0 μm/year and 1-sided <em>P</em> &lt; 0.025, respectively) were compared between the devices.</div></div><div><h3>Results</h3><div>The mean (standard deviation) baseline 24-2 visual field mean deviation and median (range) follow-up time were −8.2 (5.5) dB and 4.5 (2.2–6.7) years, respectively. The mean (95% credible interval [CrI]) estimated global baseline RNFL thickness for Spectralis and Cirrus OCTs were 61.5 (58.6–64.1) and 65.3 (63.2–67.4) μm, respectively. The global RNFL rates of change for Spectralis and Cirrus OCTs were −0.70 μm/year (95% CrI = −0.88 to −0.51 μm/year) and −0.45 μm/year (95% confidence interval = −0.63 to −0.27 μm/year) and were significantly faster for Spectralis compared to Cirrus OCT (difference = –0.24 μm/year, 95% CrI −0.45 to −0.04 μm/year, <em>P</em> &lt; 0.001) as were sectoral rates in 5 out of 12 sectors. Higher proportions of significant negative RNFL rates of change were found with Spectralis OCT globally and in clock hour sectors 2 to 6 and 8 to 10 (corresponding to nasal, inferonasal, inferotemporal, and temporal regions). The proportions of significant positive rates of change were small (0%–3%) across sectors and similar between the devices.</div></div><div><h3>Conclusions</h3><div>Spectralis OCT rates of RNFL change were faster compared to those from Cirrus OCT. Spectralis OCT detected a higher proportion of significant negative rates globally and in some sectors. OCT devices are not comparable regarding detection of change in eyes with central damage or moderate to advanced 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 375-383"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574748","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":"Comparative Study of Early Safety and Effectiveness Outcomes of the PreserFlo MicroShunt with and without an Intraluminal Suture Stent","authors":"Jason Chami MD ,&nbsp;Jeremy C.K. Tan MD, FRANZCO ,&nbsp;David Manning FRANZCO ,&nbsp;George Kong FRANZCO, PhD ,&nbsp;Jason Cheng FRANZCO, FRCOphth ,&nbsp;Hamish Dunn FRANZCO, PhD ,&nbsp;Anna Galanopoulos FRANZCO ,&nbsp;Brian Chua FRANZCO, MPH ,&nbsp;Joanne Thai MD ,&nbsp;Mark Hassall FRANZCO, DPhil (Oxon) ,&nbsp;Jamie E. Craig FRANZCO, DPhil ,&nbsp;Mitchell Lawlor FRANZCO, PhD","doi":"10.1016/j.ogla.2025.03.003","DOIUrl":"10.1016/j.ogla.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the early safety and effectiveness outcomes of the PreserFlo MicroShunt with and without an intraluminal suture stent.</div></div><div><h3>Design</h3><div>Multicenter observational retrospective study using data from the Fight Glaucoma Blindness registry.</div></div><div><h3>Participants</h3><div>A total of 183 eyes in 172 patients, with a mean age of 73 ± 14 years, who underwent PreserFlo MicroShunt surgery with/without intraluminal stent suture placement, and with at least 6 months of follow-up. Eyes were divided into 2 groups: stent (68 eyes) and no-stent (115 eyes).</div></div><div><h3>Methods</h3><div>Baseline and postoperative measurements of intraocular pressure (IOP), visual acuity (VA), number of glaucoma medications, and adverse events were recorded at 1, 3, and 6 months. Outcomes were compared between stent and no-stent groups using <em>t</em> tests for continuous variables and Fisher exact tests for categorical variables.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measures were the incidence of numerical hypotony (IOP ≤ 5 mmHg) and symptomatic hypotony (numerical hypotony plus ≥10 letters of VA loss) within 1 month, 1 to 3 months, and 3 to 6 months postoperatively. Secondary outcome measures included surgical success rates (defined as IOP ≤12, ≤15, ≤18, or ≤21 mmHg and ≥20% IOP reduction without hypotony and without additional glaucoma medications) and the need for secondary surgical interventions.</div></div><div><h3>Results</h3><div>In the first postoperative month, the stent group had significantly lower rates of numerical hypotony (24% vs. 44%; <em>P</em> = 0.007) and symptomatic hypotony (13% vs. 28%; <em>P</em> = 0.027) than the no-stent group. The rate of device revision, explant, or replacement with an alternative shunt was also significantly lower in the stent group (3 eyes; 4.4%) than in the no-stent group (17 eyes; 14.8%; <em>P</em> = 0.047). No significant differences in hypotony rates were observed in the later follow-up windows (1–3 and 3–6 months), nor were there significant differences in surgical success rates between the stent and no-stent groups at any time point.</div></div><div><h3>Conclusions</h3><div>The use of an intraluminal suture stent in PreserFlo MicroShunt surgery reduces the incidence of early hypotony without compromising surgical success. These findings suggest that routine use of intraluminal sutures may improve early postoperative safety.</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 367-374"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639876","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":"Rapid Reversal of Optic Nerve Cupping in Steroid-Induced Glaucoma","authors":"Manasi Tripathi MD, FRCS,&nbsp;Vinit Tanwar MD,&nbsp;Varun Gogia MD","doi":"10.1016/j.ogla.2025.03.005","DOIUrl":"10.1016/j.ogla.2025.03.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Page e13"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Zhou et al.: Incidence of acute cystoid macular edema after starting a prostaglandin analog compared with other classes of glaucoma medications (Ophthalmol Glaucoma. 2025;8:4-11)","authors":"James O. Robbins MD, ScM,&nbsp;Sanjay G. Asrani MD","doi":"10.1016/j.ogla.2025.04.008","DOIUrl":"10.1016/j.ogla.2025.04.008","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Page e9"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054088","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":"Risk of Falls, Fear of Falling, and Rates of Visual Field Progression in Glaucoma in the African Descent and Glaucoma Evaluation Study","authors":"Alexander F. Dagi MPhil ,&nbsp;C. Gustavo De Moraes MD, PhD ,&nbsp;Christopher A. Girkin MD, MSPH ,&nbsp;George A. Cioffi MD ,&nbsp;Robert N. Weinreb MD ,&nbsp;Linda M. Zangwill PhD ,&nbsp;Jeffrey M. Liebmann MD","doi":"10.1016/j.ogla.2025.02.002","DOIUrl":"10.1016/j.ogla.2025.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the relationships between rates of glaucomatous visual field (VF) progression, fear of falling (FoF), history of falls, and ancestry.</div></div><div><h3>Design</h3><div>Prospective, multicenter, longitudinal cohort.</div></div><div><h3>Subjects</h3><div>Patients followed in the multisite African Descent and Glaucoma Evaluation Study with primary open-angle glaucoma and who completed a validated fear of falling questionnaire along with a self-reported history of falls in the past year were enrolled.</div></div><div><h3>Methods</h3><div>Baseline VF severity and VF progression rates were assessed using 24-2 VF mean deviation (MD). We used univariable and multivariable models adjusting for confounders (age, sex, ancestry, and baseline MD) using clustered robust logistic regression and linear regression.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measure was the relationship between history of falls (yes vs. no) as a dependent variable and MD slopes (dB/year). The secondary outcome measure was the relationship between FoF scores (continuous) as a dependent variable and MD slopes (dB/year).</div></div><div><h3>Results</h3><div>There were 4453 patient encounters, including at least 5 VF tests per patient with a minimum of 2 years of follow-up in 277 eyes of 183 individuals. Faster MD slopes were significantly associated with a history of falls in both univariable (odds ratio [OR]: 2.68 per dB/year faster rates; 95% confidence interval [CI]: 1.35–5.33; <em>P</em> = 0.005) and multivariable models (OR: 2.55; 95% CI: 1.29–5.04; <em>P</em> = 0.007). Rapid progressors (MD slope less than −0.5 dB/year) were 2.45-fold more likely to have a positive history of falls (95% CI: 1.22–4.91, <em>P</em> = 0.012). Faster MD slopes were significantly associated with worse FoF in both univariable (β: 2.97 per dB/year faster rates; 95% CI: 0.41–5.54; <em>P</em> = 0.023) and multivariable (β: 2.27; 95% CI: 0.17–4.36; <em>P</em> = 0.034) models. Patients of African descent (AD) were as likely to have a history of falls and had similar FoF scores as those of European descent (ED) (all <em>P</em> &gt; 0.40).</div></div><div><h3>Conclusions</h3><div>A faster rate of MD progression is associated with a greater fear of falling and history of falls among AD and ED treated glaucoma patients. Rapid progressors were almost threefold more likely to have a history of falls. The 2 ancestry groups also experienced similar rates of falls and fear of fall scores.</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 360-366"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484977","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":"Milky Aqueous Humor","authors":"Tarannum Mansoori MS ,&nbsp;Mantravadi Lakshmi Karthika MS","doi":"10.1016/j.ogla.2025.04.007","DOIUrl":"10.1016/j.ogla.2025.04.007","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Page e10"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095945","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":"An Outflow of Trials, Tribulations, and Perseverance","authors":"Ronald L. Fellman MD,&nbsp;Davinder S. Grover MD, MPH,&nbsp;Ruikang K. Wang PhD","doi":"10.1016/j.ogla.2025.05.002","DOIUrl":"10.1016/j.ogla.2025.05.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Pages 331-332"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276826","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":"Microspherophakia: Kugel Fountain Presentation","authors":"Devendra Maheshwari MS,&nbsp;Shivam Gupta MBBS, MS,&nbsp;Madhavi Pillai MBBS, MS","doi":"10.1016/j.ogla.2025.03.004","DOIUrl":"10.1016/j.ogla.2025.03.004","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 4","pages":"Page e12"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065233","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 between the Fast Strategies of a Virtual Reality Perimetry and the Humphrey Field Analyzer in Patients with Glaucoma","authors":"Fernanda Nicolela Susanna MD ,&nbsp;Carolina Nicolela Susanna MD ,&nbsp;Pedro Gabriel Salomão Libânio MD ,&nbsp;Fernanda Tiemi Nishikawa MD ,&nbsp;Renato Antunes Schiave Germano MD, PhD ,&nbsp;Remo Susanna Junior MD, PhD","doi":"10.1016/j.ogla.2024.12.004","DOIUrl":"10.1016/j.ogla.2024.12.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the agreement between the Humphrey Field Analyzer (HFA) SITA Fast strategy and a novel virtual reality head-mounted visual perimetry device (VisuALL) in patients with glaucoma.</div></div><div><h3>Design</h3><div>This is prospective observational study.</div></div><div><h3>Participants</h3><div>This study was conducted on 62 eyes of 39 glaucoma subjects.</div></div><div><h3>Methods</h3><div>All participants had visual field (VF) testing with the VisuALL AVAFAST strategy and the HFA (24-2, Swedish Interactive Threshold Algorithm FAST). The mean sensitivity of the whole VF and each quadrant was compared between both machines. Additionally, the pattern deviation plot was analyzed to compare the agreement of both devices to detect localized VF defects.</div></div><div><h3>Main Outcome Measures</h3><div>Correlation and agreement between the mean sensitivity of the fast strategies from VisuALL and HFA.</div></div><div><h3>Results</h3><div>The global mean sensitivity of the VisuALL and the HFA correlated significantly (r = 0.60; <em>P</em> &lt; 0.001) and was in agreement (r = 0.73; <em>P</em> &lt; 0.001). The detection of VF defects in all quadrants was also moderately correlated and in agreement. Participants overwhelmingly preferred the VisuALL over the conventional (80%).</div></div><div><h3>Conclusions</h3><div>Although the mean sensitivity and ability to detect localized VF defects of the VisuALL were correlated and in agreement with the HFA, this was only moderate. This indicates that the VisuALL AVAFast strategy must be used with caution.</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 3","pages":"Pages 227-234"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856859","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}