Ophthalmology. Glaucoma最新文献

{"title":"Time to Identify Glaucoma Progression Given Typical Visual Field Testing Frequencies in a US Nationwide Insured Population","authors":"Brian C. Stagg MD, MS ,&nbsp;Ben J. Brintz PhD ,&nbsp;Joshua D. Stein MD, MS ,&nbsp;Rachel Hess MD, MS ,&nbsp;Kensaku Kawamoto MD, PhD ,&nbsp;Alessandro A. Jammal MD, PhD ,&nbsp;Felipe A. Medeiros MD, PhD","doi":"10.1016/j.ogla.2025.11.004","DOIUrl":"10.1016/j.ogla.2025.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>In a study using US nationwide claims data from 2008 to 2017, the median time between visual field tests for patients with glaucoma was once every 1.59 years (interquartile range: 1.14–3.03 years). This is less frequent than the American Academy of Ophthalmology (AAO)-recommended minimum annual screening. We conducted simulation modeling using clinical data to determine how long it would take to identify trend-based glaucoma visual field progression at this testing frequency and compare it to AAO-recommended annual screening.</div></div><div><h3>Design</h3><div>Simulation modeling using retrospective clinical data.</div></div><div><h3>Subjects</h3><div>Patients with glaucoma in the Duke Glaucoma Registry (DGR).</div></div><div><h3>Methods</h3><div>To determine how long it would take to identify glaucoma progression at testing frequencies in this insured US nationwide population, we conducted simulation modeling using clinical visual field data from the DGR. Models were created to evaluate the time it would take to identify progression for patients with testing frequency at the 25th, 50th, and 75th percentiles in the previously published US nationwide claims data and at the AAO-recommended minimum annual screening. The simulations assumed baseline mean deviation (MD) of –5, –10, or –15 decibels (dB) and a true rate of progression of –0.5 or –1.0 dB/year. Progression was defined as having a negative MD slope estimate with a <em>P</em> value &lt;0.05. We simulated 1000 sequences of visual fields for each test group.</div></div><div><h3>Main Outcome Measures</h3><div>Time to detect glaucoma progression</div></div><div><h3>Results</h3><div>Across the testing scenarios, the time to detect progression in 80% of eyes ranged from 15.2 to 24.3 years for patients receiving visual field testing at the 25th percentile (3.03 years between tests), 9.6 to 17.5 years for patients receiving visual field testing at the 50th percentile (1.59 years between tests), 8.0 to 14.9 years for patients receiving visual field testing at the 75th percentile (1.14 years between tests), and 7.1 to 14.1 years for patients receiving annual testing.</div></div><div><h3>Conclusions</h3><div>These results suggest that either visual field testing needs to be done more frequently or other methods of identification of progressive glaucoma vision loss need to be developed. Clinical decision support systems could help tailor the frequency of visual field testing to the needs of individual patients.</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 3","pages":"Pages 250-256"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642942","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":"Effects of Melatonin Supplementation on Sleep Quality in Patients with Advanced Glaucoma","authors":"Priscilla F. Nogueira MD ,&nbsp;Julia R.S. Vallim PhD ,&nbsp;Marcello N.C. Barboza MD, PhD ,&nbsp;Monica L. Andersen PhD ,&nbsp;Sérgio H. Teixeira MD, PhD ,&nbsp;Carolina P.B. Gracitelli MD, PhD ,&nbsp;Augusto Paranhos Jr. MD, PhD","doi":"10.1016/j.ogla.2025.12.003","DOIUrl":"10.1016/j.ogla.2025.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effect of oral melatonin administration in patients with advanced glaucoma on sleep–wake cycle variables recorded by actigraphy on a single night and sleep quality assessed by specific questionnaires.</div></div><div><h3>Design</h3><div>Prospective, randomized, parallel, crossover, double-masked therapeutic-type.</div></div><div><h3>Participants</h3><div>Sixty-four patients aged between 40 and 80 years, diagnosed with advanced primary open-angle glaucoma, were included.</div></div><div><h3>Methods</h3><div>Participants received 5 mg of melatonin or placebo daily for 30 days, 1-week washout period; all assessments were repeated after each treatment phase. Subjective sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Objective sleep parameters total sleep time (TST), wake after sleep onset (WASO), number of awakenings, and sleep efficiency (SE) were measured by actigraphy. Vision-related quality of life was assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Standardized ophthalmologic exams, visual field testing (Swedish Interactive Threshold Algorithm Standard 24-2), and OCT-based retinal nerve fiber layer analysis were also performed.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were PSQI and actigraphy-measured SE. The secondary outcomes included TST, WASO, number of awakenings, ESS, and NEI VFQ-25 scores.</div></div><div><h3>Results</h3><div>All 64 participants completed the study. No significant differences were found between melatonin and placebo for any sleep or quality of life outcomes. However, both groups showed improvements over time: PSQI scores decreased (–1.36 points; <em>P</em> &lt; 0.001) and NEI VFQ-25 scores increased (+3.09 points; <em>P</em> &lt; 0.001), indicating a temporal effect. Poor sleep quality (PSQI &gt; 5) and reduced SE were associated with worse objective sleep parameters and lower vision–related quality of life. No carryover or sequence effects were observed, and melatonin did not significantly impact actigraphy measures such as TST, WASO, or number of awakenings.</div></div><div><h3>Conclusions</h3><div>Melatonin supplementation did not significantly improve sleep quality compared to a placebo in patients with advanced glaucoma, based on both subjective and objective measures. The improvements observed in the sleep questionnaires during the treatment phases suggest that patient perception may play a significant role in sleep-related outcomes, underscoring the importance of considering placebo effects in clinical trials.</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 3","pages":"Pages 276-286"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745908","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 with Secondary Pigment Dispersion: An Unusual Presentation","authors":"Anand Kumar Pathak MD,&nbsp;Suresh Kumar Yadav PhD,&nbsp;Viney Gupta MD","doi":"10.1016/j.ogla.2026.01.008","DOIUrl":"10.1016/j.ogla.2026.01.008","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 3","pages":"Page e8"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114949","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":"Trabeculectomy Remains Essential for Glaucoma Care","authors":"Kuldev Singh MD,&nbsp;Tin Aung FRCS(Ed), PhD,&nbsp;Fotis Topouzis MD, PhD,&nbsp;Remo Susanna Jr. MD, PhD","doi":"10.1016/j.ogla.2026.03.001","DOIUrl":"10.1016/j.ogla.2026.03.001","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 3","pages":"Pages 239-240"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610522","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 Association between Socioeconomic Status and Structural or Functional Baseline Measurements for Patients Receiving a Trabeculectomy","authors":"Jacqueline L. Chen MSc ,&nbsp;Fabio Lavinsky MD ,&nbsp;Ting-Fang Lee PhD ,&nbsp;Ronald Zambrano MS ,&nbsp;Joel S. Schuman MD","doi":"10.1016/j.ogla.2025.12.007","DOIUrl":"10.1016/j.ogla.2025.12.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between socioeconomic status (SES; represented by a patient’s neighborhood area deprivation index) and structural and functional measurements of the eye at initial presentation for those who eventually underwent trabeculectomy.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Participants</h3><div>We identify patients who underwent a trabeculectomy and had at least 1 OCT scan and 1 visual field (VF) test before undergoing surgery. Patients of any age with either progressing glaucoma or uncontrolled intraocular pressure, or both, who underwent a trabeculectomy and were a part of the DOMAIN cohort study were included.</div></div><div><h3>Methods</h3><div>We use a subject’s first recorded OCT scan and VF test to obtain baseline structural and functional measurements. We next use patient addresses to determine their census block, which is then matched to the corresponding proxy for SES. Univariate and multivariate regressions controlling for race, age, and gender were used to analyze the associations between SES and structural and functional measurements at baseline.</div></div><div><h3>Main Outcome Measure</h3><div>The association between SES and structural and functional measures at baseline.</div></div><div><h3>Results</h3><div>Among the 154 eyes in the study, we find that living in an area with greater deprivation is associated with worse structural (larger cup volumes [CVs], thinner retinal nerve fiber layer, and ganglion cell-inner plexiform layer) and functional (lower visual field index [VFI] and mean deviation [MD]) measures at baseline. However, these associations only remained statistically significant in the multivariate analysis for CV, VFI, and MD after controlling for a patient’s race, gender, and age. In addition, when comparing those living in the best and worst neighborhoods, we find that living in the area with the highest decile level of deprivation is associated with a 6.63 dB lower MD at presentation compared to those living in areas with the least deprivation.</div></div><div><h3>Conclusions</h3><div>Lower SES is associated with worse optic nerve damage and VF performance at presentation for eyes that eventually undergo trabeculectomy surgery.</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 3","pages":"Pages 302-308"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859122","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":"Glaucoma Management in Sturge-Weber Syndrome Using the Delphi Process","authors":"Kinza Abbas MD ,&nbsp;Bailey Harrison MD ,&nbsp;Ta Chen Peter Chang MD ,&nbsp;Beth Edmunds MD, PhD ,&nbsp;Benjamin Hammond MD ,&nbsp;Gregg T. Lueder MD ,&nbsp;Ken K. Nischal MD ,&nbsp;Monte D. Mills MD ,&nbsp;David S. Walton MD ,&nbsp;Lauren S. Blieden MD ,&nbsp;Sharon F. Freedman MD ,&nbsp;David A. Plager MD ,&nbsp;Barbara M. Wirostko MD ,&nbsp;Alex V. Levin MD, MHSc","doi":"10.1016/j.ogla.2025.11.003","DOIUrl":"10.1016/j.ogla.2025.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to identify areas of consensus and nonconsensus in the ophthalmic screening, diagnosis, and management of Sturge-Weber syndrome (SWS).</div></div><div><h3>Design</h3><div>Modified Delphi methodology.</div></div><div><h3>Participants</h3><div>North American glaucoma experts with prior experience managing glaucoma in patients with SWS.</div></div><div><h3>Methods</h3><div>A modified Delphi process was used as a systematic and structured communication technique, consisting of 2 rounds of electronic questionnaires to a wider group, followed by an in-person meeting of selected experts. Questions that did not reach agreement were reformulated in each round, with the aim of reaching consensus.</div></div><div><h3>Main Outcome Measures</h3><div>Consensus was defined as agreement among at least 85% of participants for the electronic questionnaires or a minimum of 70% during the in-person meeting.</div></div><div><h3>Results</h3><div>Among other recommendations, the panel concluded that all patients with a facial port wine birthmark should be assessed for glaucoma within a month of birth, with shorter screening intervals thereafter in patients with bilateral eyelid involvement, choroidal hemangioma, and signs of elevated episcleral venous pressure. There was no consensus on timing of follow-up visits. In children aged ≥4 years with signs of glaucoma, medical intervention is the initial consideration. In children aged &lt;4 years, the primary intervention is likely to be surgical, with some form of goniosurgery as the first-choice procedure.</div></div><div><h3>Conclusions</h3><div>Consensus for screening, diagnosis, and management in patients with SWS is designed to hopefully improve clinical practice and patient outcomes. Questions where consensus was not reached may highlight variations in practice, conflicting evidence, or areas that might benefit from further research and investigation.</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 3","pages":"Pages 336-342"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643463","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":"Phacomatosis Pigmentovascularis and Sturge-Weber Syndrome","authors":"Gowri Pratinya Kolipaka DNB ,&nbsp;Deepthi Molleti DNB ,&nbsp;Rashmi Krishnamurthy DNB ,&nbsp;Aparna Rao FRCS, PhD ,&nbsp;Anil K. Mandal MD ,&nbsp;Sirisha Senthil FRCS","doi":"10.1016/j.ogla.2025.12.001","DOIUrl":"10.1016/j.ogla.2025.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the outcomes of primary combined trabeculotomy with trabeculectomy (CTT) in children diagnosed with early-onset glaucoma associated with phacomatosis pigmentovascularis (PPV) and Sturge-Weber syndrome (SWS).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Forty-seven eyes (47 children) with SWS and 48 eyes (31 children) with PPV, who underwent primary CTT with a minimum follow-up of 1 year between 1996 and 2020 were included.</div></div><div><h3>Methods</h3><div>Preoperative and postoperative data were collected. Surgical success rates were estimated using Kaplan–Meier survival analysis, whereas comparisons between the groups were performed using mixed-effects Weibull proportional hazards models accounting for intrapatient correlation in bilateral cases. Risk factors for failure were assessed with multivariable models incorporating the same adjustment.</div></div><div><h3>Main Outcome Measures</h3><div>Intraocular pressure (IOP) control, complete and qualified success, need for additional medications, postoperative complications in 2 groups.</div></div><div><h3>Results</h3><div>Preoperative ocular characteristics were comparable between the groups, except that PPV cases were more often bilateral. Neurological abnormalities, including epilepsy (<em>P</em> &lt; 0.001) and central nervous system anomalies (<em>P</em> = 0.04), were more common in PPV. The median follow-up was 7 years in the PPV group and 6.5 years in the SWS group. At the final follow-up period, the IOP reduced significantly in both groups when compared with the preoperative values (<em>P</em> &lt; 0.001). Complete success was higher in the SWS group (60%) than in PPV (40%), though not statistically significant (<em>P</em> = 0.15). Qualified success was similar in both groups (<em>P</em> = 0.79). However, the PPV group required significantly more glaucoma medications (<em>P</em> = 0.03) to maintain the IOP. Older age at the time of surgery (<em>P</em> &lt; 0.001), and higher grade of corneal haze at baseline (<em>P</em> = 0.03) were associated with failure (according to complete success criteria) in the PPV group. Although the overall rate of postoperative complications was similar (<em>P</em> = 0.98), sight-threatening complications were more frequent in the PPV group.</div></div><div><h3>Conclusions</h3><div>Primary CTT achieved good long-term IOP control in both the PPV and SWS groups. The PPV group exhibited a higher prevalence of neurological and systemic associations and a greater need for postoperative medications, indicating a more complex disease course. Early surgical intervention and close postoperative monitoring are essential to achieving optimal outcomes in these challenging phakomatoses.</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 3","pages":"Pages 343-352"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727503","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: Schulman et al.: Patient-portal messages reengage glaucoma patients after loss to follow-up (Ophthalmol Glaucoma. 2026;9:353-355)","authors":"Henry Bair MD","doi":"10.1016/j.ogla.2026.01.011","DOIUrl":"10.1016/j.ogla.2026.01.011","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 3","pages":"Page e7"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345983","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":"Management and Outcomes of Glaucoma in Children with Stickler Syndrome","authors":"Adam Jacobson MD ,&nbsp;Safa Rahmani MD ,&nbsp;Brenda L. Bohnsack MD, PhD","doi":"10.1016/j.ogla.2025.12.009","DOIUrl":"10.1016/j.ogla.2025.12.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Assess management and outcomes of glaucoma in children with Stickler syndrome.</div></div><div><h3>Design</h3><div>A retrospective observational case series.</div></div><div><h3>Subjects</h3><div>Children (less than 18 years of age) with Stickler syndrome.</div></div><div><h3>Methods</h3><div>Review of 97 patients who presented between 2010 and 2025 with a clinical diagnosis of Stickler syndrome and had at least 2 documented eye exams. Examination findings, genetic information, ocular diagnoses, and surgeries were collected.</div></div><div><h3>Main Outcome Measures</h3><div>Best-corrected visual acuity, type of glaucoma, type of glaucoma surgeries.</div></div><div><h3>Results</h3><div>Fourteen of 97 patients (14%) with Stickler syndrome were diagnosed with glaucoma at a median age of 8.5 interquartile range [0.6, 12.3] years. There was no difference in age at presentation (<em>P</em> = 0.84) or length of follow-up (<em>P</em> = 0.29) between patients with and without glaucoma, but glaucomatous eyes were significantly more myopic at presentation (<em>P</em> = 0.02) and had worse final best-corrected visual acuity (<em>P</em> &lt; 0.0001). Nine eyes of 5 patients (4 type I and 1 type II) had infantile-onset glaucoma, and all eyes required glaucoma drainage device implantation. Eleven eyes of 9 patients (2 type I, 4 type II, and 3 unknown) developed glaucoma following intraocular surgery (10 after retinal detachment and 1 after lensectomy), and 3 eyes required glaucoma drainage device placement. The other 8 eyes with glaucoma were medically managed.</div></div><div><h3>Conclusions</h3><div>Glaucoma is frequently diagnosed in children with Stickler syndrome. In the infantile-onset form, angle surgery does not seem to yield long-term intraocular pressure control, and these children typically require angle bypass surgery. Glaucoma following intraocular surgery may respond to medications, but some do require glaucoma drainage device placement, which can be complicated by prior scleral buckle or silicone oil.</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 3","pages":"Pages 320-335"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859659","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":"A Large-Scale Cohort Analysis of Topical Prostaglandin Analog Use and Pseudophakic Cystoid Macular Edema Following Cataract Surgery","authors":"Jawad Muayad BS ,&nbsp;Ali O. Mukhtar MD ,&nbsp;Darius D. Bordbar MD ,&nbsp;Asad Loya MD ,&nbsp;Amer F. Alsoudi MD ,&nbsp;Christina Y. Weng MD, MBA ,&nbsp;Ticiana De Francesco MD ,&nbsp;Iqbal Ike K. Ahmed MD","doi":"10.1016/j.ogla.2025.12.010","DOIUrl":"10.1016/j.ogla.2025.12.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether perioperative topical prostaglandin analog (PGA) use alters the risk of pseudophakic cystoid macular edema (PCME) following routine cataract surgery.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients undergoing cataract surgery, without pre-existing high-risk factors for PCME (such as prior cystoid macular edema, uveitis, or retinal vascular diseases), categorized into three perioperative PGA exposure groups: (1) PGA prescribed within 3 months prior to surgery (“PGA Before”), (2) PGA prescribed within 1 month after surgery (“PGA After”), and (3) PGA prescribed both before and after surgery (“PGA Before &amp; After”). The control group included patients with no PGA prescriptions any time before and 3 months after surgery.</div></div><div><h3>Methods</h3><div>The data were collected from the TriNetX United States Collaborative Network. Propensity score matching was conducted to balance demographics, cataract type and surgical complexity, glaucoma type and severity, comorbidities, and concomitant topical and long-term systemic anti-inflammatory medication use between groups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to assess the 3-month risk of PCME following cataract surgery.</div></div><div><h3>Main Outcome Measures</h3><div>Three-month incidence of diagnostically significant PCME following cataract surgery.</div></div><div><h3>Results</h3><div>After matching, 9457 patients were included in the “PGA Before” group and its control, 1993 patients in the “PGA After” group and its control, and 2367 patients in the “PGA Before &amp; After” group and its control. No significant difference in the risk of PCME was observed among those prescribed PGA prior to surgery (HR 1.08, 95% CI: 0.89–1.31), after surgery (HR 1.08, 95% CI: 0.68–1.70), or both before and after surgery (HR 0.86, 95% CI: 0.61–1.23), compared to matched controls.</div></div><div><h3>Conclusions</h3><div>Perioperative PGA use before or after cataract surgery was not associated with an increased risk of PCME. These findings provide evidence that PGA use in the perioperative period may not significantly impact the risk of PCME within 3 months postsurgery.</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 3","pages":"Pages 295-301"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901724","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}