Ophthalmology. Glaucoma最新文献

{"title":"Ophthalmological Examination and Imaging Features that Better Predict Risk of Angle Closure in Siblings","authors":"Shwetha Mudalegundi BS ,&nbsp;Aleksandra Mihailovic ScM ,&nbsp;Louay Almidani MD, MSc ,&nbsp;Elizabeth C. Ciociola MD ,&nbsp;Nazlee Zebardast MD, MS ,&nbsp;Sharmila Rajendrababu MD ,&nbsp;Mohideen Abdul Kader MD ,&nbsp;Ganesh V. Raman MD ,&nbsp;Venkatesh Rengaraj MD ,&nbsp;Kavitha Srinivasan MD ,&nbsp;Pradeep Y. Ramulu MD, PhD","doi":"10.1016/j.ogla.2024.09.003","DOIUrl":"10.1016/j.ogla.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Characteristics of individuals with angle closure may be useful in targeted screening of family members. Here, we assess if findings gathered during examination and imaging of patients with a known angle-closure diagnosis (probands) could better determine the risk of angle closure in the patients’ siblings.</div></div><div><h3>Design</h3><div>Cross-sectional study of patients with known angle closure and their siblings.</div></div><div><h3>Participants</h3><div>South Indian patients (probands) 30 years and older with open angles, primary angle-closure suspect (PACS), or primary angle closure/primary angle-closure glaucoma (PAC/PACG) and a biological sibling age 30 years or older (<em>n</em> = 292 proband/sibling pairs).</div></div><div><h3>Methods</h3><div>Demographic data, relevant ocular history, and a comprehensive ophthalmic examination with anterior segment OCT (AS-OCT) were obtained. Three clinically relevant models were created to analyze the contribution of specific proband factors in predicting sibling angle-closure diagnosis, using demographic (age, sex), ocular examination (gonioscopy, optic nerve examination, visual acuity, intraocular pressure), and AS-OCT features to improve prediction beyond proband diagnosis alone evaluated by log likelihood ratio testing and statistical comparison of receiver operating characteristics (ROCs).</div></div><div><h3>Main Outcome Measures</h3><div>Sibling angle-closure diagnostic accuracy.</div></div><div><h3>Results</h3><div>Demographic and ocular examination metrics did not improve the prediction of sibling angle closure for all 3 outcomes (sibling diagnosis: (1) PACS/PAC/PACG vs. OA, (2) PAC/PACG vs. PACS/OA, and (3) PAC/PACG vs. PACS), adding no model improvement when compared to diagnosis alone. Models adding AS-OCT metrics to the prior model including proband diagnosis, demographics, and ocular examination measures led to significantly improved prediction of 2 of the 3 angle-closure outcomes. Specifically, improvement was noted via likelihood ratio testing for prediction of PAC/PACG vs. PACS/OA (<em>P</em> = 0.01) or PAC/PACG vs. PACS (<em>P</em> = 0.001). For all 3 angle-closure outcomes, ROC comparisons demonstrated significant improvement in area under the curve (AUC) between the 3 models predicting sibling outcomes, demonstrating an increase in AUC with each successive nested model across all 3 sibling angle-closure outcomes.</div></div><div><h3>Conclusions</h3><div>Structural features of eyes with angle closure may assist in stratifying the risk of angle closure in patients’ siblings. Further studies should consider evaluating this approach to achieve more targeted screenings.</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 1","pages":"Pages 12-21"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333474","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":"Incidence of Acute Cystoid Macular Edema after Starting a Prostaglandin Analog Compared with Other Classes of Glaucoma Medications","authors":"Yujia Zhou MD, MS ,&nbsp;Amanda K. Bicket MD, MS ,&nbsp;Shikha Marwah MS ,&nbsp;Joshua D. Stein MD, MS ,&nbsp;Krishna S. Kishor MD","doi":"10.1016/j.ogla.2024.07.010","DOIUrl":"10.1016/j.ogla.2024.07.010","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a longstanding belief that prostaglandin analogs (PGAs) may predispose patients with glaucoma to develop acute cystoid macular edema (CME). However, there is little solid evidence supporting this notion. The purpose of this study is to compare CME incidence rates among patients initiating treatment with different glaucoma medication classes.</div></div><div><h3>Design</h3><div>Database study.</div></div><div><h3>Participants</h3><div>A total of 39 948 patients who were newly prescribed glaucoma medications</div></div><div><h3>Methods</h3><div>Using data from 10 health systems contributing data to the Sight Outcomes Research Collaborative Ophthalmology Data Repository, we identified all adults with glaucoma who had been newly started on a topical glaucoma medication. Patients with pre-existing documentation of macular edema were excluded. We assessed the incidence of CME among patients with glaucoma who were newly started on PGAs, topical beta blockers (BBs), alpha agonists (AAs), and carbonic anhydrase inhibitors (CAIs). Using multivariable logistic regression, and adjusting for sociodemographic factors, we assessed the odds of developing CME among patients prescribed each of the 4 glaucoma medication classes. We also performed a subset regression analysis including lens status as a covariate.</div></div><div><h3>Main outcome measures</h3><div>Incidence of CME within 3 months of initiating therapy with different topical glaucoma medications.</div></div><div><h3>Results</h3><div>Among the 39 948 patients who were newly treated with a topical glaucoma medication, 139 (0.35%) developed CME. The incidence of CME was 0.13%, 0.65%, 0.55%, and 1.76% for users of PGAs, BBs, AAs, and CAIs, respectively. After adjusting for sociodemographic factors, users of topical BBs, AAs, and CAIs had substantially higher odds of developing CME compared with PGA users (<em>P</em> &lt; 0.001 for all comparisons). The subset analysis also showed higher odds ratio of the non-PGA medication classes in association with CME.</div></div><div><h3>Conclusions</h3><div>Clinicians should reconsider the notion that PGAs carry a higher risk of CME versus other glaucoma medication classes. If additional studies support the findings of these analyses, clinicians may feel more comfortable prescribing PGAs to patients with glaucoma without fear they will predispose patients to CME.</div></div><div><h3>Financial Disclosures</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 4-11"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914759","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":"Characterizing Longitudinal Changes in Fear of Falling and Quality of Life in Patients with Varying Levels of Visual Field Damage","authors":"Louay Almidani MD, MSc ,&nbsp;Aleksandra Mihailovic ScM ,&nbsp;Zhuochen Yuan BS ,&nbsp;Chhavi Saini MD, MPH ,&nbsp;Pradeep Y. Ramulu MD, PhD","doi":"10.1016/j.ogla.2024.08.008","DOIUrl":"10.1016/j.ogla.2024.08.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the relationship between baseline visual field (VF) severity and rates of visual field loss with changes in quality of life (QoL) and fear of falling (FoF) in adults with glaucoma.</div></div><div><h3>Methods</h3><div>Prospective cohort study, including participants from the Falls In Glaucoma Study. Quality of life and FoF were assessed annually using the Glaucoma Quality of Life-15 Questionnaire, and the University of Illinois at Chicago FoF Questionnaire, respectively, with higher Rasch-analyzed scores (in logits) indicating better QoL and greater FoF. Mean deviation (MD) values of each eye were collected, with better-eye MD taken as the primary exposure. Change rates in better-eye MD, QoL, and FoF were computed using linear regression. Separate regression models were employed to explore the relationship between baseline better-eye MD and its rate of change with rates of change in QoL and FoF.</div></div><div><h3>Results</h3><div>The mean (standard deviation) rate of change in better-eye MD was −0.08 dB/year (0.5), rate of QoL change was −0.08 logits/year (0.4), and rate of FoF change was 0.16 logits/year (0.7). At baseline, better-eye MD (per dB worse) was significantly associated with worse baseline QoL (β = −0.10 logits [95% confidence interval [CI]: −0.13, −0.08]) and greater FoF (β = 0.06 logits [95% CI: 0.01, 0.10]). Baseline better-eye MD was associated with no significant change in QoL ( −0.004 logits/year, 95% CI: −0.02, 0.01) or FoF (–0.0001 logits/year, 95% CI: −0.02, 0.02) over time. Change rates in better-eye MD showed significant associations with faster increases in FoF over time (β = 0.26 logits/year [95% CI: 0.06, 0.45]; per dB loss/year), but not with changes in QoL (<em>P</em> = 0.79).</div></div><div><h3>Conclusions</h3><div>Patients with glaucoma generally showed worsening of QoL and FoF over time, though the degree of change was modest and not related to the degree of damage at baseline. Faster rates of better-eye MD change alone were associated with faster increases in FoF. Further studies are needed to evaluate the reasons (visual and nonvisual) for changes in QoL and functionality over time and find ways in which QoL and mobility can be improved for those with VF damage.</div></div><div><h3>Financial Disclosures</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 63-72"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147022","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":"Relationships between Frailty and the Risk of Glaucoma in Middle-aged and Older Adults","authors":"Jianqi Chen MD ,&nbsp;Xu Cao MD, PhD ,&nbsp;Xiaohua Zhuo OD ,&nbsp;Xuhao Chen MD, PhD ,&nbsp;Yuyao Ling MD ,&nbsp;Yuwen Wen MD ,&nbsp;Guitong Ye MD ,&nbsp;Yuan Zhang MD ,&nbsp;Jinan Zhan MD ,&nbsp;Hongmei Tan MD, PhD ,&nbsp;Yingting Zhu MD, PhD ,&nbsp;Yehong Zhuo MD, PhD","doi":"10.1016/j.ogla.2024.09.006","DOIUrl":"10.1016/j.ogla.2024.09.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Increased frailty in older individuals increases health risks, but its relationship with glaucoma, the leading cause of irreversible blindness in middle-aged and older adults, is unclear. We investigated the association between frailty and glaucoma in a large-scale representative sample and explored possible causal relationships.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Combined cross-sectional and Mendelian randomization (MR) study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;In the cross-sectional analysis, we included 5744 participants of the US National Health and Nutrition Examination Surveys 2005 to 2008 ≥ 40 years of age. For the MR analysis, frailty genome-wide association study (GWAS) data were sourced from a UK Biobank and TwinGen meta-analysis, and GWAS data on glaucoma subtypes were derived from FinnGen.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;According to the 49-item frailty index, we classified participants into nonfrail (≤ 0.10), prefrail (0.10−0.21), and frail (&gt; 0.21) groups. Using survey-weighted logistic regression models adjusted for multiple covariates, we explored the association between frailty and glaucoma. We further assessed causation using MR.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The associations between different levels of frailty (nonfrail, prefrail, and frail) and glaucoma, as well as causal relationships between genetically predicted frailty and various subtypes of glaucoma (primary open-angle glaucoma [POAG], primary angle-closure glaucoma [PACG], normotensive glaucoma [NTG], exfoliation glaucoma, and suspected glaucoma).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;After adjusting for covariates, higher frailty levels were significantly associated with glaucoma in frail individuals (odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.05–3.19, &lt;em&gt;P&lt;/em&gt; = 0.036) but not prefrail (OR = 1.90, 95% CI = 0.99–3.64, &lt;em&gt;P&lt;/em&gt; = 0.052). The association was significantly stronger among male participants (&lt;em&gt;P&lt;/em&gt; interaction = 0.042). The variation in the association between frailty and glaucoma did not reach statistical significance across age groups (&lt;em&gt;P&lt;/em&gt; interaction = 0.575) or race groups (&lt;em&gt;P&lt;/em&gt; interaction = 0.092). Mendelian randomization revealed that genetically predicted frailty was linked to greater risks for POAG (OR = 1.67, 95% CI = 1.24–2.25, &lt;em&gt;P&lt;/em&gt; = 0.001), PACG (OR = 2.78, 95% CI = 1.48–5.20, &lt;em&gt;P&lt;/em&gt; = 0.001), exfoliation glaucoma (OR = 1.70, 95% CI = 1.18–2.43, &lt;em&gt;P&lt;/em&gt; = 0.004), and suspected glaucoma (OR = 1.74, 95% CI = 1.30–2.34, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) but not for NTG (OR = 1.01, 95% CI = 0.61–1.68, &lt;em&gt;P&lt;/em&gt; = 0.956).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our study revealed an association between frailty and increased glaucoma risk and emphasized the significance of glaucoma screening in frail individuals. Targeted health-care strategies can help prevent or delay irreversible blindness among middle-aged and older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Fin","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 73-82"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382582","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":"Tibial Bone Keratoprosthesis: Seeing into the Third Decade","authors":"Dinukie-Chantal Perera BS ,&nbsp;James Chodosh MD, MPH ,&nbsp;Teresa C. Chen MD","doi":"10.1016/j.ogla.2024.10.003","DOIUrl":"10.1016/j.ogla.2024.10.003","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Page e2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649567","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":"Manometric Intraocular Pressure Reduction with Negative Pressure Using Ocular Pressure Adjusting Pump Goggles","authors":"Katherine S. Peters MD ,&nbsp;Enrico Brambilla ME ,&nbsp;Tanner Ferguson MD ,&nbsp;Brent Kramer MD ,&nbsp;Daniel Terveen MD ,&nbsp;John Berdahl MD","doi":"10.1016/j.ogla.2024.09.005","DOIUrl":"10.1016/j.ogla.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>The ocular pressure adjusting pump is a novel noninvasive and nonpharmacological intraocular pressure (IOP)-lowering device consisting of goggles attached to a negative pressure (NP) pump. This study aimed to determine the effect of NP in ocular pressure adjusting pump goggles on IOP using continuous direct manometry.</div></div><div><h3>Design</h3><div>Prospective, single-arm, single center, basic physiological research trial.</div></div><div><h3>Subjects</h3><div>Adult patients undergoing cataract surgery.</div></div><div><h3>Methods</h3><div>Direct manometry was performed via an anterior chamber cannula attached to an IOP sensor. This was placed just prior to each subject’s previously scheduled cataract surgery. Intraocular pressure was continuously monitored every 0.5 seconds through the following sequence of 30 seconds each: baseline IOP measurement, NP –10 mmHg, NP off, NP –20 mmHg, and NP off.</div></div><div><h3>Main Outcome Measures</h3><div>Intraocular pressure response to application of NP.</div></div><div><h3>Results</h3><div>All 17 subjects had a dose-dependent reduction in IOP, with a mean IOP decrease from 16.9 to 11.3 (33%) with –10 mmHg of NP and from 15.7 to 7.7 (51%) mmHg with –20 mmHg of NP. Intraocular pressure returned to baseline for each cycle when NP was discontinued. There were no patients with increased IOP.</div></div><div><h3>Conclusions</h3><div>Negative pressure with the ocular pressure adjusting pump results in a consistent dose-dependent reduction in IOP, with return to baseline IOP when NP is discontinued.</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 1","pages":"Pages 22-27"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333473","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":"Federated Learning in Glaucoma","authors":"Shahin Hallaj MD ,&nbsp;Benton G. Chuter MS ,&nbsp;Alexander C. Lieu BS ,&nbsp;Praveer Singh PhD ,&nbsp;Jayashree Kalpathy-Cramer PhD ,&nbsp;Benjamin Y. Xu MD, PhD ,&nbsp;Mark Christopher PhD ,&nbsp;Linda M. Zangwill PhD ,&nbsp;Robert N. Weinreb MD ,&nbsp;Sally L. Baxter MD, MSc","doi":"10.1016/j.ogla.2024.08.004","DOIUrl":"10.1016/j.ogla.2024.08.004","url":null,"abstract":"<div><h3>Clinical Relevance</h3><div>Glaucoma is a complex eye condition with varied morphological and clinical presentations, making diagnosis and management challenging. The lack of a consensus definition for glaucoma or glaucomatous optic neuropathy further complicates the development of universal diagnostic tools. Developing robust artificial intelligence (AI) models for glaucoma screening is essential for early detection and treatment but faces significant obstacles. Effective deep learning algorithms require large, well-curated datasets from diverse patient populations and imaging protocols. However, creating centralized data repositories is hindered by concerns over data sharing, patient privacy, regulatory compliance, and intellectual property. Federated Learning (FL) offers a potential solution by enabling data to remain locally hosted while facilitating distributed model training across multiple sites.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted on the application of Federated Learning in training AI models for glaucoma screening. Publications from 1950 to 2024 were searched using databases such as PubMed and IEEE Xplore with keywords including “glaucoma,” “federated learning,” “artificial intelligence,” “deep learning,” “machine learning,” “distributed learning,” “privacy-preserving,” “data sharing,” “medical imaging,” and “ophthalmology.” Articles were included if they discussed the use of FL in glaucoma-related AI tasks or addressed data sharing and privacy challenges in ophthalmic AI development.</div></div><div><h3>Results</h3><div>FL enables collaborative model development without centralizing sensitive patient data, addressing privacy and regulatory concerns. Studies show that FL can improve model performance and generalizability by leveraging diverse datasets while maintaining data security. FL models have achieved comparable or superior accuracy to those trained on centralized data, demonstrating effectiveness in real-world clinical settings.</div></div><div><h3>Conclusions</h3><div>Federated Learning presents a promising strategy to overcome current obstacles in developing AI models for glaucoma screening. By balancing the need for extensive, diverse training data with the imperative to protect patient privacy and comply with regulations, FL facilitates collaborative model training without compromising data security. This approach offers a pathway toward more accurate and generalizable AI solutions for glaucoma detection and management.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 92-105"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115514","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":"Visualizing the Void: 3-Dimensional Insights into Optic Disc Pit","authors":"Kanishk Singh MS,&nbsp;Sagarika Snehi DNB, FAICO,&nbsp;Rajesh Pattebahadur MS","doi":"10.1016/j.ogla.2024.07.005","DOIUrl":"10.1016/j.ogla.2024.07.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Page e1"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Trabecular Meshwork Remnants on Goniotomy Outcomes","authors":"Kevin C. Allan MD, PhD ,&nbsp;Kevin Zhang MD ,&nbsp;Shirley Z. Wu MD ,&nbsp;Madhukar Kumar MD ,&nbsp;Andy Kuo MD ,&nbsp;Archana Murali BS ,&nbsp;Ang Li MD","doi":"10.1016/j.ogla.2024.08.005","DOIUrl":"10.1016/j.ogla.2024.08.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 106-108"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Bent Ab-Interno Needle Goniectomy and Goniotomy in Primary Congenital Glaucoma","authors":"Sushmita Kaushik MS, FAICO,&nbsp;Kajree Gupta MS,&nbsp;Shrushti Hunashyal MBBS,&nbsp;Manik Sardana MS,&nbsp;Faisal Thattaruthody MS,&nbsp;Surinder Singh Pandav MS","doi":"10.1016/j.ogla.2024.08.003","DOIUrl":"10.1016/j.ogla.2024.08.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Primary congenital glaucoma (PCG) is a potentially blinding disease, and the search for the best surgical option always remains. This study investigated the efficacy of Bent Ab-Interno Needle Goniectomy (BANG) compared to the established standard of traditional goniotomy.</div></div><div><h3>Design</h3><div>Parallel-group randomized controlled trial.</div></div><div><h3>Participants</h3><div>Infants with PCG aged 1 month to 1 year with similar clinical features in both eyes.</div></div><div><h3>Intervention</h3><div>The 2 eyes of eligible patients were randomized to either goniotomy or BANG using a 25-gauge needle bent as a reverse cystitome, and the surgeries were done on the same day in both eyes. Postoperatively each infant was followed up for a minimum period of 1 year.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes measured were intraocular pressure (IOP) control and the requirement for antiglaucoma medications (AGMs). The secondary outcome measures included corneal clarity enhancement, axial length stability, incidence of surgical complications, or the need for repeat surgery.</div></div><div><h3>Results</h3><div>Eight infants with both eyes eligible, were included. In each infant, 1 eye was randomized to BANG and the other to conventional goniotomy. The mean age was 7.6 ± 3.6 months. There was no significant difference in the mean preoperative IOP (16.8 ± 8.87 mm Hg vs. 17 ± 6.0 mm Hg; <em>P</em> = 0.48) in eyes randomized to goniotomy or BANG. The mean number of AGMs (1.7 ± 1.11 vs. 2 ± 0.81 respectively; <em>P</em> = 0.26) were similar in both groups. Postoperatively, the IOP at 6 months (14.05 ± 4.1 vs. 16.2 ± 4.07; <em>P</em> = 0.22) and 1 year (15.3 ± 3.4 vs. 17.1 ± 3.0; <em>P</em> = 0.15) were similar in eyes that underwent goniotomy or BANG respectively. Both procedures demonstrated significant improvements in corneal clarity and maintained normal axial length growth. However, the BANG group required slightly more AGMs than the goniotomy group. There were no serious complications in either group. Both eyes of 1 patient required repeat surgery for IOP control and underwent a combined trabeculotomy with trabeculectomy at 9 months and 1 year postoperatively, respectively.</div></div><div><h3>Conclusions</h3><div>This study indicates that goniotomy remains an effective surgical treatment for PCG. The absence of discernible superiority in IOP control or overall outcomes implies that the added complexity of excising the trabecular meshwork in BANG may not confer additional benefits over the established approach.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 1","pages":"Pages 46-52"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}