Ophthalmology. Glaucoma最新文献

{"title":"Re: Lee et al.: Associations between statin use and glaucoma in the All of Us Research Program (Ophthalmol Glaucoma. 2024;7:563–571)","authors":"Ayushi S. Shah BS , Pranav Vasu MPH","doi":"10.1016/j.ogla.2025.01.005","DOIUrl":"10.1016/j.ogla.2025.01.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Page e5"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588468","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":"Effect of Blood Pressure on Rates of Progression in Focal Ischemic vs. Generalized Cup Enlargement Glaucoma Phenotypes","authors":"Marcus Guerreiro-Filho MD ,&nbsp;Alessandro A. Jammal MD, PhD ,&nbsp;Rohit Muralidhar BA ,&nbsp;Rafael Scherer MD, PhD ,&nbsp;Luiz F. Beniz MD ,&nbsp;Douglas R. da Costa MD ,&nbsp;Ivan M. Tavares MD, PhD ,&nbsp;Felipe A. Medeiros MD, PhD","doi":"10.1016/j.ogla.2025.01.001","DOIUrl":"10.1016/j.ogla.2025.01.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the impact of blood pressure (BP) on rates of retinal nerve fiber layer (RNFL) thinning in glaucomatous eyes with focal ischemic (FI) vs. generalized cup enlargement (GE) optic disc phenotypes.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>The study included 122 eyes from 101 patients diagnosed with primary open-angle glaucoma. Eyes were classified as FI (n = 31, 25%) or GE (n = 91, 75%) based on masked grading of stereophotographs at baseline.</div></div><div><h3>Methods</h3><div>Subjects underwent comprehensive ophthalmic examinations, including intraocular pressure (IOP) measurement and spectral-domain OCT scans, every 6 months for an overall mean follow-up of 4.2 years ± 1.5 years. Brachial artery BP was measured concurrently, and mean arterial pressure (MAP), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) were calculated. Rates of global RNFL thickness change over time were assessed using linear mixed models, evaluating the impact of BP parameters in each optic disc phenotype, adjusting for IOP and other confounders. Interaction terms were used to test for differences in the effects of BP and IOP between the FI and GE phenotypes.</div></div><div><h3>Main Outcome Measures</h3><div>Effect of MAP, SAP, and DAP on rates of RNFL loss over time in FI and GE optic disc phenotypes.</div></div><div><h3>Results</h3><div>In the adjusted FI group models, each 10 mmHg decrease in MAP, SAP, and DAP was associated with −0.397 μm/year (<em>P</em> = 0.006), −0.211 μm/year (<em>P</em> = 0.029), and −0.471 μm/year (<em>P</em> = 0.005) faster RNFL thinning, respectively. In contrast, BP parameters were not significantly associated with RNFL loss in the GE group. In the multivariable model with interaction terms, the interaction between DAP and phenotype was statistically significant (<em>P</em> = 0.019), indicating the FI phenotype exhibited greater sensitivity to lower diastolic pressure compared to GE eyes. In contrast, interaction terms between IOP and optic disc phenotype were not significant in any of the models, suggesting a similar effect of IOP in both phenotypes.</div></div><div><h3>Conclusions</h3><div>Lower systemic BP levels were associated with faster RNFL thinning in the FI optic disc phenotype but not in the GE phenotype. These findings highlight the importance of considering both IOP and systemic BP when managing patients with the FI optic disc phenotype.</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 3","pages":"Pages 293-301"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973497","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 Factors for Diagnostic Change from Glaucoma Suspect to Primary Open-Angle Glaucoma and Vice Versa Over 2 Years","authors":"Lillian K. To MD, MS ,&nbsp;Nicole V. Carrabba MD ,&nbsp;Chaitanya G. Kalathuru MD ,&nbsp;Alice Z. Chuang PhD ,&nbsp;Logan Smith MD ,&nbsp;Robert M. Feldman MD","doi":"10.1016/j.ogla.2024.12.006","DOIUrl":"10.1016/j.ogla.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the incidence and causes of diagnostic changes from primary open-angle glaucoma suspect (POAGS) to primary open-angle glaucoma (POAG), and vice versa, in clinical practice.</div></div><div><h3>Design</h3><div>This is a retrospective, single-site, case-control study.</div></div><div><h3>Participants</h3><div>It includes patients &gt; 40 years of age diagnosed with either POAG or POAGS between 2013 and 2020. Controls had a minimum of 24 months of follow-up without a diagnostic change, whereas cases underwent a diagnostic change from glaucoma to suspect (POAG to POAGS) or from suspect to glaucoma (POAGS to POAG) within 2 years.</div></div><div><h3>Methods</h3><div>At initial and follow-up visits, diagnosis, treatment, type of ophthalmic provider, and performance of pachymetry, visual fields (VFs), OCT, disc examination, and gonioscopy were recorded.</div></div><div><h3>Main Outcome Measures</h3><div>Data were then analyzed to determine if baseline characteristics, type of provider seen, or ophthalmic testing performed were protective or risk factors in regards to diagnostic change.</div></div><div><h3>Results</h3><div>Nine hundred twenty-two subjects were included, and the incidence of diagnostic changes was 13.8% (127/922), of which 99 (78%) were upstaged from POAGS to POAG and 28 (22%) changed from POAG to POAGS. Pre-existing nonglaucomatous VF defect (<em>P</em> &lt; 0.001) was significantly higher in cases than controls. Cases were significantly less likely to be seen by a glaucoma specialist at the initial visit compared with controls (<em>P</em> &lt; 0.001), and less cases underwent VF testing (<em>P</em> &lt; 0.001), OCT testing (<em>P</em> = 0.017), or gonioscopy (<em>P</em> = 0.013) at the initial visit. On multivariate analysis, performing VFs or OCT at both visits reduced the odds of short-term diagnostic change, whereas changing providers from a nonglaucoma specialist to a glaucoma specialist between visits increased the odds of diagnostic change. In the POAG-to-POAGS cases, 39% (11/28) were treated with either medications or laser trabeculoplasty, whereas 72% (71/99) of the POAGS-to-POAG cases were left untreated between visits.</div></div><div><h3>Conclusions</h3><div>It is important to understand risk factors for diagnostic changes in glaucoma, in order to prevent undertreatment of disease and overtreatment of suspects. Here we find specialist type and adherence to American Academy of Ophthalmology (AAO) recommended testing to be important factors in preventing short term diagnostic changes.</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 257-265"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878691","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":"Cost-Effectiveness Analysis of Hydrus Microstent for Patients with Mild to Moderate Primary Open-Angle Glaucoma in Canada","authors":"Iqbal Ike K. Ahmed MD ,&nbsp;Isra Hussein MD ,&nbsp;Hady Saheb MD ,&nbsp;Matt Schlenker MD ,&nbsp;Steven Schendel MD ,&nbsp;Sergey Muratov PhD ,&nbsp;Cheryl P. Ferrufino BA ,&nbsp;Derek O'Boyle MSc","doi":"10.1016/j.ogla.2025.01.008","DOIUrl":"10.1016/j.ogla.2025.01.008","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the cost-effectiveness of Hydrus Microstent combined with cataract surgery (CS) vs. CS alone for treating patients with mild to moderate primary open-angle glaucoma (POAG).</div></div><div><h3>Design</h3><div>Cost-utility analysis using efficacy and safety results of a pivotal randomized clinical trial.</div></div><div><h3>Subjects</h3><div>Modeled cohort of patients with mild to moderate POAG and visually significant cataract.</div></div><div><h3>Methods</h3><div>A semi-Markov model was developed to model effects and costs over a 15-year time horizon from the Canadian public health care payer perspective for patients with mild or moderate POAG receiving Hydrus Microstent during CS vs. CS alone. The model utilizes the Hydrus Microstent for Lowering IOP in Glaucoma Patients Undergoing Cataract Surgery (HORIZON) trial patient cohort. Progression was guided using the annualized rate of progression derived from a post hoc analysis of 5-year visual field loss data from the HORIZON trial. The amount of visual field lost was mapped on a sequential addition of medications used as a proxy for irreversible progression. Costs were derived from various publicly available sources and publications. Utility values were sourced from a published analysis that conducted a mapping exercise based on Health Utilities Index mark 3 using Canadian tariffs. We conducted deterministic and probabilistic sensitivity analyses to examine the uncertainty around alternative model input values. Scenario analyses explored structural uncertainty.</div></div><div><h3>Main Outcome Measures</h3><div>Total costs per patient, quality-adjusted life years (QALYs), and incremental cost-utility ratio.</div></div><div><h3>Results</h3><div>Compared with CS alone, Hydrus + CS was a dominant strategy (greater benefits and lower costs). Although life years were equivalent between the 2 treatments (11.41 years), the Hydrus + CS arm was associated with higher benefits (9.351 vs. 9.040 in QALYs). This translated into an additional 0.311 QALYs for Hydrus + CS. Total costs were lower with Hydrus + CS (Can$ 26 770 vs. Can$ 27 145) resulting in a saving of Can$ 375. Results of scenario analyses showed robustness of the model. The cost-effectiveness acceptability curve shows a probability of 85.3% of Hydrus + CS being cost-effective compared with CS alone at a willingness-to-pay threshold of 50 000/QALY.</div></div><div><h3>Conclusions</h3><div>Hydrus Microstent combined with CS is a cost-effective long-term treatment for patients with POAG.</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 3","pages":"Pages 302-311"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392497","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: Lee et al.: Associations between statin use and glaucoma in the All of Us Research Program (Ophthalmol Glaucoma. 2024;7:563–571)","authors":"Víctor M. Asensio-Sánchez MD, PhD","doi":"10.1016/j.ogla.2025.01.006","DOIUrl":"10.1016/j.ogla.2025.01.006","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Pages e6-e7"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588473","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":"Validating and Updating the OHTS-EGPS Model Predicting 5-year Glaucoma Risk among Ocular Hypertension Patients Using Electronic Records","authors":"David M. Wright PhD ,&nbsp;Augusto Azuara-Blanco PhD ,&nbsp;Chris Cardwell PhD ,&nbsp;Giovanni Montesano PhD ,&nbsp;David P. Crabb PhD ,&nbsp;Gus Gazzard MD ,&nbsp;Anthony J. King MD ,&nbsp;Rodolfo Hernández PhD ,&nbsp;James E. Morgan DPhil ,&nbsp;Bethany Higgins PhD ,&nbsp;Yemisi Takwoingi PhD","doi":"10.1016/j.ogla.2024.10.009","DOIUrl":"10.1016/j.ogla.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>To validate and update the Ocular Hypertension Treatment Study-European Glaucoma Prevention Study (OHTS-EGPS) model predicting risk of conversion from ocular hypertension (OHT) to glaucoma using electronic medical records (EMR).</div></div><div><h3>Design</h3><div>Evaluation and update of a risk prediction algorithm using EMRs and linked visual field (VF) tests.</div></div><div><h3>Participants</h3><div>Newly diagnosed OHT patients attending hospital glaucoma services in England. Inclusion criteria are as follows: intraocular pressure (IOP) 22 to 32 mmHg (either eye); normal baseline VF test, defined as Glaucoma Hemifield Test (GHT) “within normal range” in a reliable VF test; at least 2 VF tests in total; no significant ocular comorbidities.</div></div><div><h3>Methods</h3><div>Risk factors are as follows: age, ethnicity, sex, IOP, vertical cup-to-disc ratio, central corneal thickness, VF pattern standard deviation, family history of glaucoma, systemic hypertension, diabetes mellitus, and glaucoma treatment. Glaucoma conversion was defined as 2 consecutive and reliable VF tests with GHT “outside normal limits” and/or need for glaucoma surgery. For validation, the OHTS-EGPS model was applied to predict a patient’s risk of developing glaucoma in 5 years. In the updating stage, the OHTS model was refitted by re-estimating the baseline hazard and regression coefficients. The updated model was cross-validated and several variants were explored.</div></div><div><h3>Main Outcome Measures</h3><div>Measures of discriminative ability (c-index) and calibration (calibration slope) were calculated and pooled across hospitals using random effects meta-analysis.</div></div><div><h3>Results</h3><div>From a total of 138 461 patients from 10 hospital glaucoma services in England, 9030 patients with OHT fitted the inclusion criteria. A total of 1530 (16.9%) patients converted to glaucoma during this follow-up period. The OHTS-EGPS model provided a pooled c-index of 0.61 (95% confidence interval: 0.60–0.63), ranging from 0.55 to 0.67 between hospitals. The pooled calibration slope was 0.45 (0.38–0.51), ranging from 0.25 to 0.64 among hospitals. The overall refitted model performed better than the OHTS-EGPS model, with a pooled c-index of 0.67 (0.65–0.69), ranging from 0.65 to 0.75 between hospitals.</div></div><div><h3>Conclusions</h3><div>We performed an external validation of the OHTS-EGPS model in a large English population. Refitting the model achieved modest improvements in performance. Given the poor performance of the OHTS-EGPS model in our population, one should use caution in its application to populations that differ from those in the OHTS and EGPS.</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 2","pages":"Pages 143-151"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592370","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":"Incidence of Uveitis Following Initiation of Prostaglandin Analogs versus Other Glaucoma Medications","authors":"Muhammad Z. Chauhan MD, MS ,&nbsp;Abdelrahman M. Elhusseiny MD, MSc ,&nbsp;Shikha Marwah MS ,&nbsp;Ahmed B. Sallam MD, PhD ,&nbsp;Joshua D. Stein MD, MS ,&nbsp;Krishna S. Kishor MD","doi":"10.1016/j.ogla.2024.10.010","DOIUrl":"10.1016/j.ogla.2024.10.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the risk of incidence rates of uveitis among patients starting topical glaucoma therapy.</div></div><div><h3>Design</h3><div>Retrospective database study utilizing the Sight Outcomes Research Collaborative (SOURCE) Ophthalmology Data Repository.</div></div><div><h3>Participants</h3><div>Adult glaucoma patients who were recently started on topical glaucoma therapy.</div></div><div><h3>Methods</h3><div>Using data from 10 health systems contributing data to the SOURCE data repository, we identified all adult glaucoma patients who had been newly started on a topical glaucoma medication (prostaglandin analogs [PGAs], beta-blockers [BBs], alpha agonists [AAs], and carbonic anhydrase inhibitors [CAIs]). Patients with pre-existing documentation of uveitis were excluded.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of uveitis within 3 months of initiating therapy with different topical glaucoma medications.</div></div><div><h3>Results</h3><div>We included 67 517 patients who were newly prescribed a topical glaucoma medication. The mean age of the patients was 67.3 ± 13.2 years and ∼59% were females. A total of 567 patients (0.87%) developed uveitis within 3 months of initiating the therapy. The incidence of uveitis was 0.32%, 1.95%, 1.63%, and 1.68% for users of PGAs, BBs, AAs, and CAIs, respectively. After adjusting for sociodemographic factors, individuals using topical BBs, AAs, and CAIs had significantly higher odds of developing uveitis versus those using PGAs (<em>P</em> &lt; 0.001 for all comparisons).</div></div><div><h3>Conclusions</h3><div>The use of PGAs was not associated with higher odds of developing uveitis compared with other classes of topical glaucoma medications.</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 2","pages":"Pages 126-132"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633613","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 Association between Glaucoma Severity and Hip Fractures in California Medicare Beneficiaries","authors":"Sayan K. Chatterjee MPH ,&nbsp;Ramin Talebi BS ,&nbsp;Ken Kitayama MD, PhD ,&nbsp;Andrew G. Young MD ,&nbsp;Fei Yu PhD ,&nbsp;Victoria L. Tseng MD, PhD ,&nbsp;Anne L. Coleman MD, PhD","doi":"10.1016/j.ogla.2024.10.002","DOIUrl":"10.1016/j.ogla.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the association between glaucoma severity and hip fractures in older adults.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional study.</div></div><div><h3>Subjects</h3><div>California (CA) Medicare beneficiaries in 2019 with Parts A &amp; B coverage.</div></div><div><h3>Methods</h3><div>Multivariable logistic regression was used to analyze the association between glaucoma severity (mild, moderate, and severe vs. no glaucoma) and hip fracture, after adjusting for age, sex, race and ethnicity, and Charlson Comorbidity Index score. A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma.</div></div><div><h3>Main Outcome Measures</h3><div>The variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma.</div></div><div><h3>Results</h3><div>Of the 2 717 346 beneficiaries in the study population, 220 662 (8.1%) had glaucoma. In multivariable regression analysis, those with mild (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.78–0.88) and moderate glaucoma (OR: 0.88; 95% CI: 0.84–0.92) had reduced odds of hip fracture compared with those with no glaucoma. There was no statistically significant association between severe vs. no glaucoma and hip fracture (OR: 0.96; 95% CI: 0.91–1.02). Among individuals with glaucoma, the odds of hip fracture were higher for those with severe glaucoma (OR: 1.17; 95% CI: 1.08–1.27), compared with those with mild glaucoma.</div></div><div><h3>Conclusions</h3><div>In the CA Medicare population, the presence of glaucoma was associated with decreased likelihood of hip fracture. However, in those with glaucoma, increased glaucoma severity was associated with an increased likelihood of hip fracture. Potential mediating mechanisms requiring further study include fear of falls and physical inactivity in patients with 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 2","pages":"Pages 167-174"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482097","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 Multifaceted Nongenetic Risk Factors for Primary Open-angle Glaucoma","authors":"Jens Rovelt MSc, PhD ,&nbsp;Josefine Freiberg MD, PhD ,&nbsp;Augusto Azuara-Blanco MD, PhD ,&nbsp;Gianni Virgili MD ,&nbsp;Miriam Kolko MD, PhD","doi":"10.1016/j.ogla.2024.10.004","DOIUrl":"10.1016/j.ogla.2024.10.004","url":null,"abstract":"<div><h3>Topic</h3><div>A synthesis of the current knowledge on risk factors for primary open-angle glaucoma (POAG).</div></div><div><h3>Clinical Relevance</h3><div>This review advances understanding, guides future research, and informs strategies for preventing and treating POAG.</div></div><div><h3>Method</h3><div>We conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant systematic reviews (SRs) published in English after 2012. The inclusion criteria focused on SRs investigating risk factors for POAG. We registered the study prospectively in the PROSPERO database (CRD42022351372) and used Covidence and the Risk of Bias in Systematic Reviews tool to manage article selection and assess the risk of bias in the included SRs. Data was extracted independently by 2 authors.</div></div><div><h3>Results</h3><div>After removing duplicate SRs, we assessed 2542 SRs. Of these, 2396 were determined to be irrelevant, leaving 138 for a full-text review. Following this, 78 were excluded with reasons, resulting in 60 SRs. Of these, 30 had a low risk of bias. In our bias assessment, SRs categorized as high risk of bias were characterized by 1) lack of sufficient detail in the bias assessment of the SR and 2) insufficient information or missing calculations of heterogeneity among the included studies. In our study, we identified 22 risk factors associated with POAG. The SRs covered a wide range of risk factors for POAG. Among these, the strongest associations with POAG, based on effect size, were observed in 2 SRs related to obstructive sleep apnea (OSA), with a pooled odds ratio (OR) of 3.66 (95% confidence interval [CI]: 1.70–7.90) and an adjusted OR of 2.46 (95% CI: 1.32–4.59). Similarly, 2 SRs investigating <em>Helicobacter pylori</em> (<em>H. pylori</em>) infections showed significant associations, with pooled ORs of 2.08 (95% CI: 1.48–2.93) and 2.08 (95% CI: 1.42–3.04), respectively.</div></div><div><h3>Conclusion</h3><div>This article summarizes the current knowledge on risk factors for POAG from published SRs. Our findings highlight the complexity of the disease and the nature of the factors that may affect various populations. Among the reported associations with low risk of bias, we found the highest effect estimates for OSA and <em>H. pylori</em> infections in relation to POAG. Our review helps advance understanding, guide future research, and inform strategies for the prevention and treatment of POAG.</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 2","pages":"Pages 188-198"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482098","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":"Lost in the Angle: The Mystery of the Missing XEN","authors":"Miguel Santos MD,&nbsp;Telma Gala,&nbsp;Luís Abegão Pinto MD, PhD","doi":"10.1016/j.ogla.2024.12.005","DOIUrl":"10.1016/j.ogla.2024.12.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 2","pages":"Page e4"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967567","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}