Ophthalmology. Glaucoma最新文献

{"title":"Comparison of the Variational Bayes Linear Regression Visual Field Test Algorithms and the Swedish Interactive Threshold Algorithm Standard in the 10-2 Program","authors":"Kazunori Hirasawa PhD ,&nbsp;Yuki Sanada MD ,&nbsp;Ryohei Komori MD ,&nbsp;Yuri Fujino CO ,&nbsp;Shogo Arimura MD, PhD ,&nbsp;Kentaro Iwasaki MD ,&nbsp;Yusuke Orii MD ,&nbsp;Kimiyo Mashimo ,&nbsp;Akari Nagayama-Ito CO ,&nbsp;Takuma Wada CO ,&nbsp;Hiroshi Murata MD ,&nbsp;Nobuyuki Shoji MD, PhD ,&nbsp;Masaru Inatani MD, PhD ,&nbsp;Ryo Asaoka MD, PhD","doi":"10.1016/j.ogla.2025.10.002","DOIUrl":"10.1016/j.ogla.2025.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare 10-2 visual field (VF) test results obtained with the Swedish Interactive Threshold Algorithm (SITA) Standard and those obtained with a family of variational Bayes linear regression (VBLR) VF algorithms—VBLR-VF (standard program), VBLR-VF Fast, and VBLR-VF Fast+—in patients with glaucoma.</div></div><div><h3>Design</h3><div>Multicenter prospective observational cohort study.</div></div><div><h3>Participants</h3><div>One eye from each of 133 patients with glaucoma.</div></div><div><h3>Methods</h3><div>Among the 133 patients, 43 underwent VBLR-VF and the SITA-Standard, 45 underwent VBLR-VF Fast and the SITA-Standard, and 45 underwent VBLR-VF Fast+ and the SITA-Standard, all of which were performed with the 10-2 test program on the same day. Each test pair was repeated within 6 months in reverse order.</div></div><div><h3>Main Outcome Measures</h3><div>The mean deviation (MD), pattern standard deviation (PSD), pointwise VF sensitivity, test–retest repeatability (root mean square error [RMSE]), and test duration were compared between the SITA-Standard and each VBLR-VF algorithm.</div></div><div><h3>Results</h3><div>There was no significant difference in MD between the SITA-Standard and VBLR-VF. In contrast, the MD values obtained with VBLR-VF Fast and Fast+ were significantly greater than those obtained with the SITA-Standard by 0.61 to 0.81 dB (<em>P</em> &lt; 0.01). Pattern standard deviation with the VBLR-VF method was 0.62 dB greater than that with the SITA-Standard in the second test (<em>P</em> &lt; 0.01), whereas there was no significant difference in the first test. No significant differences in PSD were detected between VBLR-VF Fast or Fast+ and the SITA-Standard. The pointwise VF sensitivities with VBLR-VF were 0.8 to 0.9 dB lower than those with the SITA-Standard (<em>P</em> &lt; 0.01), whereas 0.2 dB higher values were observed with VBLR-VF Fast and Fast+ (<em>P</em> &lt; 0.05). The RMSE did not significantly differ between any of the VBLR-VF algorithms and the SITA-Standard. Test durations with VBLR-VF, VBLR-VF Fast, and VBLR-VF Fast+ at the first visit were significantly shorter than those with the SITA-Standard by 12.2%, 37.8%, and 46.3%, respectively, and were further reduced at the second visit by 10.5%, 26.0%, and 26.3%, respectively (all <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>All the VBLR-VF algorithms substantially reduced the test duration while maintaining repeatability. Significant or nonsignificant minor differences in 10–2 VF sensitivity were observed between the SITA-Standard and the VBLR-VF algorithms.</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 2","pages":"Pages 176-184"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304725","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 Detection of Glaucoma Progression Using Widefield Swept-Source OCT","authors":"Marc G. Sarossy MBBS, PhD ,&nbsp;Maxime Jannaud MEng ,&nbsp;Xavier Hadoux MEng, PhD ,&nbsp;Sandy Rezk MOptom ,&nbsp;Dongzhe Li MD ,&nbsp;Michael A. Coote MBBS ,&nbsp;Ghee Soon Ang MBChB ,&nbsp;Joana Galvao PhD ,&nbsp;Peter van Wijngaarden MBBS(Hons), PhD ,&nbsp;Keith R. Martin DM ,&nbsp;Zhichao Wu BAppSc(Optom), PhD","doi":"10.1016/j.ogla.2025.09.007","DOIUrl":"10.1016/j.ogla.2025.09.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the effectiveness of evaluating widefield swept-source OCT scans for detecting glaucoma progression compared with conventional circumpapillary retinal nerve fiber layer thickness (cpRNFLT) measurements.</div></div><div><h3>Design</h3><div>Longitudinal study.</div></div><div><h3>Participants</h3><div>One hundred and fifty-six eyes with glaucoma from 115 participants.</div></div><div><h3>Methods</h3><div>This study included individuals seen over ≥2 visits that were 12 months apart and those who were also scheduled for retest visits within ≤1 month at the baseline and 12-month visits. A circumpapillary circle scan on spectral-domain OCT and a widefield 15×15 mm OCT volume scan were acquired from each eye at each visit. A total of 286 and 284 unique visit pairs were thus available, where OCT scans were obtained 12 months and ≤1 month apart respectively, serving as the case and control groups respectively. Widefield OCT scans from these visit pairs were evaluated by 2 graders, who assessed the ganglion cell complex (GCC) thickness and thickness difference maps for glaucoma progression, masked to the time difference between the 2 scans.</div></div><div><h3>Main Outcome Measures</h3><div>Percentage of eyes deemed as progressing at 95% specificity.</div></div><div><h3>Results</h3><div>Evaluation of widefield OCT scans identified &gt;2 times as many eyes as progressing over a 12-month period (Grader 1 = 36.7%; Grader 2 = 38.1%) than cpRNFLT measurements from spectral-domain OCT (16.8%; <em>P</em> &lt; 0.001 for both) at 95% specificity. For the subset of 96 (62%) eyes with a baseline visual field mean deviation (MD) ≥–6 dB, evaluation of widefield OCT scans identified ≥3 times as many eyes as progressing (Grader 1 = 41.1%; Grader 2 = 46.3%) compared with cpRNFLT measurements (13.7%; <em>P</em> &lt; 0.001 for both). There was substantial between-grader agreement for the eyes identified as progressing on widefield OCT imaging (Gwet first-order agreement coefficient = 0.76). Evaluation of widefield OCT scans in a 2-arm trial seeking to detect a ≥30% treatment effect in 1 study eye, with 80% power, was estimated to reduce sample size requirements by 69% compared with cpRNFLT measurements, or by 80% when only including eyes with an MD ≥–6 dB.</div></div><div><h3>Conclusions</h3><div>Qualitative evaluation of widefield OCT scans showed an enhanced detection rate for structural progression than cpRNFLT measurements in glaucoma eyes.</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 2","pages":"Pages 139-148"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139632","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":"Double Bubble Trouble: Dual Retinal Tamponade Agents in the Anterior Chamber","authors":"Patrick J. Donegan MD,&nbsp;Jody M. Troyer CRA,&nbsp;Erin A. Boese MD","doi":"10.1016/j.ogla.2025.10.006","DOIUrl":"10.1016/j.ogla.2025.10.006","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 2","pages":"Page e6"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515165","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 Effect of Medication Adherence on Intraocular Pressure and Glaucoma Progression","authors":"Louay Almidani MD, MSc ,&nbsp;Annabelle Pan MD ,&nbsp;Chris Bradley PhD ,&nbsp;Alex Pham MD ,&nbsp;Jithin Yohannan MD, MPH","doi":"10.1016/j.ogla.2025.10.003","DOIUrl":"10.1016/j.ogla.2025.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Little is known about how medication adherence is related to longitudinal structural and functional losses. Here, we investigate the associations between medication adherence with mean intraocular pressure (IOP) measurements, explore whether adherence predicts rates of change in mean deviation (MD) and retinal nerve fiber layer thickness (RNFLT), and identify factors associated with worse adherence using a large sample of glaucoma and glaucoma suspect eyes.</div></div><div><h3>Design</h3><div>A retrospective longitudinal cohort study.</div></div><div><h3>Participants</h3><div>Adults with glaucoma or glaucoma suspect status in at least 1 eye, defined by ICD code H40. All eyes had a minimum of five visual field or OCT tests over time.</div></div><div><h3>Methods</h3><div>Proportion of days covered (PDC), defined as the proportion of days a patient has access to their medication over a given period using pharmacy refill data, was used to assess adherence. Multivariable linear mixed-effects models were used to investigate the relationship between PDC with mean IOP and rates of change in both MD and RNFLT. Similar models were employed to examine predictors of PDC.</div></div><div><h3>Main Outcome Measures</h3><div>Mean IOP, rates of change in MD, and RNFLT.</div></div><div><h3>Results</h3><div>A total of 13 670 eyes from 8163 patients were included with a median (interquartile range) PDC of 60 (40.9–77.5). Below the 60% adherence threshold (median), each 10% decrease in PDC was associated with higher mean IOP (β = 0.82 mmHg, <em>P</em> &lt; 0.001), while the association showed a smaller effect size above the median (β = 0.37 mmHg, <em>P</em> &lt; 0.001). Proportion of days covered was associated with –0.03 units/year faster rates of MD and RNFLT loss (<em>P</em> &lt; 0.01). Predictors of worse PDC included female gender (β = –1.22%, <em>P</em> = 0.02; vs. males), Black race (β = –5.04%, <em>P</em> &lt; 0.001; vs. White), worse baseline MD (β = –0.23%, <em>P</em> = 0.01; per 5 decibel decrease), lower baseline RNFLT (β = –0.17%, <em>P</em> = 0.03; per 10 μm thinner), using two eye drops (β = –6.37%, <em>P</em> &lt; 0.001; vs. 1), and unilateral drop use (β = –8.85%, <em>P</em> &lt; 0.001; vs. bilateral).</div></div><div><h3>Conclusions</h3><div>Lower adherence was associated with higher IOP, with a stronger effect seen at PDC values below the median, and accelerated glaucomatous damage, including faster rates of MD deterioration and increased RNFLT loss. Lower adherence was associated with female gender, Black race, greater baseline damage, greater number of drops, and unilateral drop use.</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 2","pages":"Pages 158-165"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314382","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":"On the Feasibility of Accelerating Glaucoma Clinical Trials Using Portable Perimetry","authors":"Jeremy C.K. Tan MD ,&nbsp;Giovanni Montesano MD, PhD ,&nbsp;Jonathan Crowston MBBS, PhD ,&nbsp;Katharina Bell MD, PhD ,&nbsp;David P. Crabb PhD ,&nbsp;Pete R. Jones PhD","doi":"10.1016/j.ogla.2025.08.004","DOIUrl":"10.1016/j.ogla.2025.08.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To model whether more frequent (weekly, monthly) visual field (VF) assessments using portable “home” perimetry might more quickly detect glaucoma progression in a clinical trial context.</div></div><div><h3>Design</h3><div>Cross-sectional with additional simulations</div></div><div><h3>Participants</h3><div>Forty patients (78 eyes; n = 21 healthy, n = 16 glaucoma suspects, n = 41 manifest glaucoma).</div></div><div><h3>Methods</h3><div>Participants performed an interleaved sequence of 2 portable (Eyecatcher v3.0; EC3) and 2 reference (Humphrey Field Analzyer [HFA] SITA-Fast) VF tests (4 tests total per eye). Linear mixed modeling was then applied to one randomly selected eye per patient to mathematically predict the expected proportion of progressors detected by EC3/HFA over a 3-year period, given different testing regimens (from weekly to every 4 months), levels of variability, and underlying rates of true progression.</div></div><div><h3>Main Outcome Measures</h3><div>Test–retest variability and proportion of progressors detected.</div></div><div><h3>Results</h3><div>The portable perimeter was significantly less reliable: the Bland–Altman 95% coefficient of repeatability for mean deviation (<span><math><mrow><msubsup><mtext>CoR</mtext><mtext>MD</mtext><mrow><mn>95</mn><mo>%</mo></mrow></msubsup></mrow></math></span>) was 6.37 dB for EC3 and 4.25 dB for the HFA. Statistical simulations, however, predicted that this lower reliability would be offset by more frequent testing. Thus, modeling indicated one EC3 test per month would detect a higher proportion of slow (–0.5 dB/year), moderate (–1 dB/year), and fast (–2 dB/year) progressors compared to one HFA test every 4 months. Implications for trial sample sizes were also modeled, with the number of participants required to evidence a 20% reduction in baseline progression over 2 years (following a hypothetical intervention) predicted to decrease by 24.3%/36.3% with the addition of monthly/fortnightly home testing. There was no significant difference in mean test duration between the EC3 and HFA (226 vs. 225 seconds, <em>P</em> = 0.78), and participants rated the EC3 as somewhat easier to use (system usability scale; <em>P</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>Home VF assessments, despite poorer reliability than current reference standard (“in-clinic”) devices, would allow faster or greater detection of glaucoma progression via an increased frequency of testing, and could reduce the sample size requirements of future clinical trials. Implications on duration, access and overall cost are discussed.</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 1","pages":"Pages 106-116"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980467","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":"Widefield OCT Angiography and Euclidian Distance Analysis of Microvascular Deficits in Glaucomatous Eyes","authors":"Diogo F. Muller MD,&nbsp;Yingying Shi MD,&nbsp;Maria J. Chaves-Samaniego MD,&nbsp;Khushali Shah MD,&nbsp;Gustavo Rosa Gameiro MD, PhD,&nbsp;Giovanni Gregori MD, PhD,&nbsp;Steven J. Gedde MD,&nbsp;Luis E. Vazquez MD, PhD","doi":"10.1016/j.ogla.2025.08.010","DOIUrl":"10.1016/j.ogla.2025.08.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To evaluate superficial microvascular deficits of glaucomatous eyes with widefield OCT angiography (OCTA) and Euclidian distance (ED) analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Cross-sectional study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Swept-source OCTA (SS-OCTA) images of healthy and glaucomatous eyes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Twelve-by-twelve mm scans of healthy and glaucomatous eyes were acquired with SS-OCTA (PLEX Elite 9000, ZEISS). The en face images of the superficial retina segmentation were exported and analyzed with ImageJ software. A fixed threshold that predicted the size of the foveal avascular zone was used to generate binarized images with vascular (white) or deficient (black) pixels. Four vascular parameters were measured within a macula-centered 9 × 10.8 mm ellipse: vascular density (VD), average ED (ED&lt;sub&gt;&lt;em&gt;avg&lt;/em&gt;&lt;/sub&gt;), maximum ED (ED&lt;sub&gt;&lt;em&gt;max&lt;/em&gt;&lt;/sub&gt;), and nonperfusion density (NPD). Euclidian distance values were visualized with a heatmap color scale. The vascular parameters were compared between healthy and glaucomatous eyes (Student t-test). Person coefficients were calculated to test correlations between the vascular parameters and retinal nerve fiber layer (RNFL) thickness, macular ganglion cell and inner plexiform layer (GCIPL) thickness, and visual field mean deviation in glaucomatous eyes. &lt;em&gt;P&lt;/em&gt; &lt; 0.05 was considered significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Vascular density, ED&lt;sub&gt;&lt;em&gt;avg&lt;/em&gt;&lt;/sub&gt;, ED&lt;sub&gt;&lt;em&gt;max&lt;/em&gt;&lt;/sub&gt;, and NPD&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Forty glaucomatous and twenty-five healthy eyes were included. Vascular density (fraction) was 0.442 ± 0.029 vs 0.320 ± 0.072 (&lt;em&gt;P&lt;/em&gt; &lt; 0.001), ED&lt;sub&gt;&lt;em&gt;avg&lt;/em&gt;&lt;/sub&gt; (μm) was 17.37 ± 0.55 vs 32.62 ± 9.54 (&lt;em&gt;P&lt;/em&gt; &lt; 0.001), ED&lt;sub&gt;&lt;em&gt;max&lt;/em&gt;&lt;/sub&gt; (μm) was 153.7 ± 49.1 vs 248.5 ± 156.6 (&lt;em&gt;P&lt;/em&gt; = 0.005), and NPD (%) was 0.97 ± 0.82 vs 7.09 ± 5.99 (&lt;em&gt;P&lt;/em&gt; &lt; 0.001) in healthy vs glaucomatous eyes. Vascular density, ED, and NPD were better in optic nerve head sectors than in temporal macula and retinal periphery sectors in both groups, but were worse in the glaucoma group across all sectors of the ellipse (&lt;em&gt;P&lt;/em&gt; &lt; 0.01 for all sectors). Microvascular deficits in glaucomatous eyes often exceeded structural and functional glaucomatous damage, and there was modest correlation between the vascular and structural or functional parameters. Pearson ρ of the correlation with average RNFL and GCIPL were highest for VD (ρ = 0.46, &lt;em&gt;P&lt;/em&gt; = 0.002 and ρ = –0.49, &lt;em&gt;P&lt;/em&gt; = 0.001, respectively) and lowest for ED&lt;sub&gt;&lt;em&gt;max&lt;/em&gt;&lt;/sub&gt; (ρ = –0.19, &lt;em&gt;P&lt;/em&gt; = 0.24 and ρ = –0.23, &lt;em&gt;P&lt;/em&gt; = 0.16, respectively).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Vascular density, ED, and NPD were worse in glaucomatous compared to healthy eyes throughout the widefield OCTA image. High ED and NPD values accentuate regions of inadequate perfusion.&lt;/div&gt;&lt;/","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 117-125"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006935","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":"Assessing Agreement of Intraocular Pressure from Four Mechanistically Different Tonometers in the Eye Dynamics and Engineering Network Clinical Trial","authors":"Max Liu BS ,&nbsp;David M. Reed PhD ,&nbsp;Shan Fan MD ,&nbsp;Arash Kazemi MD ,&nbsp;Vikas Gulati MD, PhD ,&nbsp;Arthur J. Sit SM, MD ,&nbsp;Sayoko E. Moroi MD, PhD ,&nbsp;Carol B. Toris PhD","doi":"10.1016/j.ogla.2025.07.010","DOIUrl":"10.1016/j.ogla.2025.07.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the measurements of intraocular pressure (IOP) by four mechanistically different tonometers in healthy participants from the Eye Dynamics and Engineering Network Aqueous Humor Dynamics clinical trial using the mean difference estimation, equivalence statistics, and adjusting for proparacaine’s effects on IOP.</div></div><div><h3>Design</h3><div>Multicenter open-label clinical trial in healthy adults (NCT01677507).</div></div><div><h3>Participants</h3><div>Enrolled were 122 participants (55.2 ± 8.8 years; 92 women and 30 men), 121 of which had measurements with and without proparacaine.</div></div><div><h3>Methods</h3><div>Participants from 3 sites had their IOPs measured with iCare rebound tonometer (RT), ocular response analyzer corneal-compensated (CC), pneumatonometer (PN), and Goldmann applanation tonometer (GAT). Intraocular pressure readings with RT and CC were collected with and without proparacaine.</div></div><div><h3>Main Outcome Measures</h3><div>Effect sizes and agreement in IOP measurements from the four tonometers was analyzed with Data analysis using Bootstrap-Coupled ESTimation, Bland–Altman Limits of Agreement (LoAs), Lin's concordance correlation coefficient (CCC), and robust equivalence two 1-sided t-tests in tandem with null hypothesis significance testing. Data analysis using bootstrap-Coupled ESTimation was used to analyze differences in IOP readings from RT and CC before and after administering proparacaine.</div></div><div><h3>Results</h3><div>Data analysis using Bootstrap-Coupled ESTimation, LoA, and CCC showed greatest effect size and poorest agreement between PN and the other tonometers. The lowest mean difference was seen when comparing GAT and CC. However, LoA and CCC found the strongest agreement between RT and GAT. Two 1-sided tests revealed tonometers can be considered equivalent to one another at ± 2 mmHg, except for PN. After applying proparacaine, IOP decreased significantly (<em>P</em> &lt; 0.0001) by RT (1.2 ± 1.9 mmHg right eye [OD]; 1.1 ± 1.7 mmHg left eye [OS]), and CC (1.4 ± 1.8 mmHg OD; 1.3 ± 2.3 mmHg OS).</div></div><div><h3>Conclusions</h3><div>When adjusted for proparacaine’s effect on IOP, 3 tonometers were equivalent between each other when determined by equivalence statistical testing with equivalence bounds ± 2 mmHg. The PN reads &gt;2 mmHg higher than RT, CC, or GAT. Therefore, when comparing IOP data from different tonometers, one should consider that not all tonometer measurements are interchangeable and the proparacaine effect should be considered.</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 1","pages":"Pages 126-134"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849926","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":"Likelihood of Corneal Transplantation after Tube versus Trabeculectomy","authors":"Anna Marie Dickinson MD ,&nbsp;Luke Leidy ,&nbsp;Md Enamul Haque PhD ,&nbsp;Helene Lam MD ,&nbsp;Kuldev Singh MD ,&nbsp;Ann Caroline Fisher MD ,&nbsp;Bethlehem Mekonnen MD ,&nbsp;Suzann Pershing MD, MS","doi":"10.1016/j.ogla.2025.09.001","DOIUrl":"10.1016/j.ogla.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Utilization of glaucoma drainage devices (tube shunts) has increased. In this analysis we evaluate long-term likelihood and time-to-event for corneal transplantation after trabeculectomy versus tube shunt glaucoma surgeries.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>American Academy of Ophthalmology IRIS® Registry (Intelligent Research In Sight) patients who underwent glaucoma surgery between 2001 and 2021.</div></div><div><h3>Methods</h3><div>Patients with glaucoma who underwent isolated trabeculectomy, isolated tube shunt, or both surgeries in a given eye were identified by procedure codes. Subsequent corneal transplantation procedures performed in the same eye were similarly identified. Multivariable Cox proportional hazard regression models were used to evaluate the likelihood of corneal transplantation and time from first glaucoma surgery to corneal transplantation.</div></div><div><h3>Main Outcome Measures</h3><div>Hazard ratios and 95% confidence intervals (CIs) for corneal transplantation.</div></div><div><h3>Results</h3><div>We identified 246 521 eyes among 197 910 patients with glaucoma surgery meeting study inclusion criteria. Corneal transplantation was most frequently observed among patients who previously underwent both trabeculectomy and tube shunt (5.00%, n = 672), followed by isolated tube shunt (2.97%, n = 3473) and isolated trabeculectomy (0.80%, n = 929). Eyes that only underwent tube shunts had a mean time to corneal transplantation of 2.49 years (standard deviation [SD], 2.4), compared with 3.75 years (SD, 3.3) for isolated trabeculectomy eyes and 3.21 years (SD, 2.6) for eyes that received both trabeculectomy and tube shunt. Adjusted likelihood of corneal transplantation was highest with both trabeculectomy and tube shunt (hazard ratio [HR], 5.88; 95% CI, 5.34–6.48), and isolated tube shunt (HR, 3.97; 95% CI, 3.69–4.26), compared with isolated trabeculectomy.</div></div><div><h3>Conclusions</h3><div>The likelihood of corneal transplantation is over 4 times higher after tube shunts compared with trabeculectomies. This may reflect factors such as chronic, cumulative corneal endothelial mechanical trauma from the tube shunt, changes to aqueous humor fluid circulation, altered aqueous humor composition and associated signaling pathways, differences in use of antimetabolites as adjunctive therapy, tube material, and tube movement or migration over time. Further research is needed to understand causes of corneal compromise, and consideration of corneal health is warranted in glaucoma surgical decision-making.</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 1","pages":"Pages 1-14"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082157","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: Figueroa et al.: Association of blood pressure and retinal nerve fiber layer rates of thinning in patients with moderate to advanced glaucoma (Ophthalmol Glaucoma. 2025;8:285–292)","authors":"Parth Aphale PhD,&nbsp;Himanshu Shekhar BHMS,&nbsp;Shashank Dokania BHMS","doi":"10.1016/j.ogla.2025.09.005","DOIUrl":"10.1016/j.ogla.2025.09.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Page e1"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310204","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":"Quantitative Classification of Visual Field Defects in Early Glaucoma","authors":"Jeremy C.K. Tan MD, FRANZCO ,&nbsp;Jack Phu PhD","doi":"10.1016/j.ogla.2025.09.010","DOIUrl":"10.1016/j.ogla.2025.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>While qualitative visual field (VF) grading systems enable the classification and description of VF defects in glaucoma, they may be prone to subjective interpretation and interobserver disagreement. In this study, we characterize the types and frequencies of VF defects in a large cohort of subjects with early glaucomatous loss, using a quantitative method based on the Ocular Hypertension Treatment Study (OHTS) VF classification system.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Subjects</h3><div>One thousand three hundred thirty eyes of 733 subjects with healthy, suspect or early glaucoma.</div></div><div><h3>Methods</h3><div>We translated the OHTS system into an objective, quantitative method to classify the VF of each eye into nerve fiber bundle (bundle) and nonbundle defects comprising 14 patterns. This was applied to VF tests from subjects who received two 24-2 Swedish Interactive Thresholding Algorithm-Faster VF tests per eye on the same visit.</div></div><div><h3>Main Outcome Measures</h3><div>Distribution of initial and repeatable VF patterns across cohort and the relationship with mean deviation (MD) and test reliability.</div></div><div><h3>Results</h3><div>The mean baseline MD and pattern standard deviation (SD) was –1.08 (SD, 1.83) and 2.26 (SD, 1.26), respectively. The most common repeatable pattern was the inferior nasal step (22.6%), followed by the inferior enlarged blind spot (19.1%), superior nasal step (12.6%), and superior enlarged blind spot (11.6%). The frequency of occurrence of initial defects was significantly higher than repeatable defects for the majority of patterns. The frequency of nasal step defects decreased as MD worsened, with a corresponding increase in the frequency of arcuate defects. There was a consistently higher frequency of bundle and nonbundle defects in unreliable versus reliable tests based on a false-positive rate above 15%, including an inferior enlarged blind spot (30.0% vs. 20.8%, <em>P</em> &lt; 0.001), superior central defect (13.7% vs. 5.5%, <em>P</em> &lt; 0.001), and partial superonasal quadrant (14.4% vs. 7.2%, <em>P</em> &lt; 0.001) defects.</div></div><div><h3>Conclusions</h3><div>In a large cohort of suspect and early glaucoma, the most common VF defects were nasal step, enlarged blind spot and arcuate defects, with a significant difference in distribution between initial versus repeatable defects and reliable versus unreliable tests. Application of quantitative criteria may improve the accuracy and consistency of classifying VF defects.</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 1","pages":"Pages 96-105"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182450","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}