Ophthalmology. Glaucoma最新文献

{"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":"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":"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":"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":"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":"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":"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}

{"title":"Metabolic Dysfunction-associated Steatotic Liver Disease Increases the Risk of Primary Open-Angle Glaucoma","authors":"Chao Chen BS ,&nbsp;Jiao Qi MD ,&nbsp;Keke Zhang MD ,&nbsp;Jiaqi Meng MD ,&nbsp;Yi Lu MD, PhD ,&nbsp;Fei Wang MD, PhD ,&nbsp;Xiangjia Zhu MD, PhD","doi":"10.1016/j.ogla.2024.12.007","DOIUrl":"10.1016/j.ogla.2024.12.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Liver disease is associated with a range of extrahepatic complications, which have recently been expanded to include ophthalmic conditions. However, evidence is lacking regarding its impact on primary open-angle glaucoma (POAG). This study aimed to investigate whether major liver diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcoholic liver disease (ALD), viral hepatitis, and liver fibrosis and cirrhosis, were associated with POAG.</div></div><div><h3>Design</h3><div>A prospective study based on the UK Biobank cohort with a 2-sample Mendelian randomization (MR) analysis for inferring causality.</div></div><div><h3>Participants</h3><div>A total of 332 345 UK Biobank participants free of glaucoma recruited between 2006 and 2010.</div></div><div><h3>Methods</h3><div>The exposures of interest were severe liver diseases defined as hospital admission, including MASLD, ALD, viral hepatitis, and liver fibrosis and cirrhosis. The Cox proportional hazard models were used with each liver disease treated as a time-varying exposure. The MR analysis was further conducted based on the genome-wide association studies of a histologically characterized cohort for MASLD (n = 19 264) and the International Glaucoma Genetics Consortium cohort for POAG (n = 216 257).</div></div><div><h3>Main Outcome Measures</h3><div>The risk of POAG estimated by hazard ratio (HR) and 95% confidence interval (CI) in observational analysis and odds ratio (OR) and 95% CI in MR analysis.</div></div><div><h3>Results</h3><div>Severe MASLD was associated with a 45% increased risk of POAG (HR, 1.45; 95% CI, 1.12–1.87; <em>P</em> = 0.005), whereas no association was identified between ALD, viral hepatitis, or liver fibrosis and cirrhosis and incident POAG. Subgroup analysis showed that the risk of POAG in relation to MASLD was higher in individuals having more physical activity (HR, 1.53; 95% CI, 1.04–2.25 vs. HR, 1.39; 95% CI, 0.99–1.95, <em>P</em> for interaction = 0.033). Mendelian randomization analysis provided evidence that MASLD was causally associated with a greater risk of POAG (inverse-variance weighted model: OR, 1.035; 95% CI, 1.010–1.061; <em>P</em> = 0.005).</div></div><div><h3>Conclusions</h3><div>Severe MASLD was longitudinally associated with an increased risk of incident POAG, with MR analyses suggesting a potential causal link. These findings suggest that a POAG examination should be considered in the holistic management of MASLD and further underscore the impact of the liver on eye health.</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":"8 3","pages":"Pages 266-274"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928525","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}