Ophthalmology. Glaucoma最新文献

{"title":"Early Outcomes of Combined Phacoemulsification and Ab Interno Tanito Microhook Trabeculotomy in Open-Angle Glaucoma","authors":"Devendra Maheshwari MD ,&nbsp;Davinder S. Grover MD, MPH ,&nbsp;Rengappa Ramakrishnan DO, MS ,&nbsp;Madhavi Ramanatha Pillai DNB ,&nbsp;Drishti Chautani MBBS ,&nbsp;Mohideen Abdul Kader PMT, DNB","doi":"10.1016/j.ogla.2023.10.007","DOIUrl":"10.1016/j.ogla.2023.10.007","url":null,"abstract":"<div><h3>Purpose</h3><p><span><span>To study the early postoperative efficacy and safety of an Ab Interno microhook trabeculotomy (microLOT) combined with </span>cataract surgery </span>in patients with open-angle glaucoma.</p></div><div><h3>Methods</h3><p><span>This prospective, randomized, interventional study was conducted on consecutive patients with visually significant cataract and mild-moderate open-angle glaucoma. One hundred fourteen patients were included for analysis. The patients were randomized to undergo microhook trabeculotomy with phacoemulsification (group 1) or phacoemulsification alone (group 2). All patients were evaluated on postoperative day 1, 15, and 30, as well as 3, 6, and 12 months postoperatively. A </span><em>P</em><span><span> value &lt; 0.05 was considered statistically significant. Baseline and follow-up visits were compared to determine significant differences in the number of antiglaucoma medications (AGMs), intraocular pressure (IOP), and best-corrected </span>visual acuity.</span></p></div><div><h3>Results</h3><p>There were 57 patients in each group. The baseline characteristics were similar between the 2 groups, except the number of AGMs, which was greater in group 2. The mean preoperative IOP for group 1 (phaco-microLOT) was 26.5 mmHg ± 5.2 and group 2 (phaco-alone group) was 25.3 mmHg ± 3.1 which decreased to 12.5 mmHg ±3.6 (<em>P</em> &lt; 0.001) and 20.0 mmHg ± 2.7(<em>P</em> &lt; 0.001) at 12 months, respectively. Logarithm of the minimum angle of resolution visual acuity improved from 0.48 (interquartile range [IQR], 0.30–0.60) preoperatively to 0.00 (0.00–0.18) postoperatively (<em>P</em> &lt; 0001) in group 1 and improved from 0.30 (IQR, 0.30–0.48) to 0.00 (0.00–0.00) in group 2 (<em>P</em><span> &lt; 0.001). In group 1, the mean (standard deviation [SD]) AGM used preoperatively was 0.6 (0.9) which was significantly reduced to 0.2 (0.5) at 12 months postoperatively, whereas in group 2, at 12 months, the mean (SD) AGM used was reduced from 1.4 (0.6) to 1.1 (0.9). In group 1, 90.3% of eyes achieved complete success at the end of 1 year. The most common complication was hyphema<span>, noted in 4 patients with 1 eye requiring an anterior chamber washout.</span></span></p></div><div><h3>Conclusion</h3><p>Ab interno microhook trabeculotomy (microLOT) combined with phacoemulsification in patients with open-angle glaucoma is an efficacious procedure with relatively minimal complications.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 123-130"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241322","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":"Subepithelial Corneal Bullae after Posttrabeculectomy Ocular Digital Massage","authors":"Hansen Dang BS,&nbsp;Nicole Radunzel BFA, CRA,&nbsp;Andrew Pouw MD","doi":"10.1016/j.ogla.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.ogla.2024.01.006","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Page 205"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140163949","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":"Interim Analysis of Clinical Outcomes with Open versus Closed Conjunctival Implantation of the XEN45 Gel Stent","authors":"Elyse J. McGlumphy MD ,&nbsp;Anna Do MD ,&nbsp;Amy Du MD ,&nbsp;Earl Randy Craven MD ,&nbsp;Lawrence S. Geyman MD ,&nbsp;Leo Shen MS ,&nbsp;Joel S. Schuman MD ,&nbsp;Joseph F. Panarelli MD","doi":"10.1016/j.ogla.2023.09.001","DOIUrl":"10.1016/j.ogla.2023.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the longitudinal postoperative outcomes of open versus closed conjunctiva implantation of the XEN45 gel stent.</p></div><div><h3>Design</h3><p>Retrospective multicenter study.</p></div><div><h3>Subjects</h3><p>One hundred ninety-three patients with glaucoma underwent XEN45 implantation via an open or closed conjunctiva approach.</p></div><div><h3>Methods</h3><p>Data on patient demographics; diagnoses; preoperative and postoperative clinical data; outcome measures, including intraocular pressure (IOP); use of glaucoma medications; visual acuity; and complications were collected. Statistical analyses were performed with <em>P</em> &lt; 0.05 as significant.</p></div><div><h3>Main Outcome Measures</h3><p>Failure was defined as &lt; 20% reduction in IOP from the medicated baseline or a IOP of &gt; 21 mmHg at 2 consecutive visits at postoperative month 1 and beyond, the need for subsequent operative intervention or additional glaucoma surgery, or a catastrophic event, such as loss of light perception. Eyes that had not failed by these criteria and were not on glaucoma medications were considered complete successes. Overall success was defined as those who achieved success either with or without topical medications.</p></div><div><h3>Results</h3><p>Patients were followed for an average of 17 months. Complete success was achieved in 42.5% and 24.7% of the open and closed groups, respectively (<em>P</em> = 0.01). Overall success was achieved in 64.2% and 37.0% of the open and closed groups, respectively (<em>P</em> &lt; 0.001) at the last follow-up. Bleb needling was performed in 12.4% of eyes in the open group compared with 40% of eyes in the closed group. An IOP spike of ≥ 10 mmHg was twice as likely to occur in the closed group compared with the open group during the postoperative period (40% vs. 18%; <em>P</em> = 0.001).</p></div><div><h3>Conclusions</h3><p>Implantation of XEN45 with opening of the conjunctiva resulted in a lower IOP with greater success and lower needling rate compared with those achieved with the closed conjunctiva technique. Similar rates of postoperative complications and vision loss were noted in each group. Although both procedures provide substantial IOP reduction, the open technique appears to result in higher success rates and fewer postoperative interventions.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 116-122"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419623001734/pdfft?md5=ed2767a84264117df7947fbe896680d7&pid=1-s2.0-S2589419623001734-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244542","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":"Plate and Tube Rotation of the Glaucoma Drainage Implant: An Unusual Complication","authors":"Arnav Panigrahi MD,&nbsp;Siddhartha Rao BS, MBBS,&nbsp;Viney Gupta MD","doi":"10.1016/j.ogla.2023.12.001","DOIUrl":"10.1016/j.ogla.2023.12.001","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Page 167"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099305","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":"Artifacts in OCT Retinal Nerve Fiber Layer Imaging in Patients with Boston Keratoprosthesis Type 1","authors":"Alexandra G. Castillejos MD ,&nbsp;Julia Devlin BS ,&nbsp;Chhavi Saini MD ,&nbsp;Jessica A. Sun BA ,&nbsp;Mengyu Wang PhD ,&nbsp;Grace Johnson BA ,&nbsp;James Chodosh MD, MPH ,&nbsp;Lucy Q. Shen MD","doi":"10.1016/j.ogla.2023.09.004","DOIUrl":"10.1016/j.ogla.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p><span>To determine the clinical utility of OCT<span> retinal nerve fiber layer (OCT RNFL) imaging for glaucoma evaluation </span></span>in patients<span> with Boston keratoprosthesis type 1 (KPro) by investigating imaging artifacts.</span></p></div><div><h3>Design</h3><p>Case-control study.</p></div><div><h3>Subjects</h3><p>Patients with KPro and without KPro (controls) matched for age, gender, and glaucoma diagnosis.</p></div><div><h3>Methods</h3><p>The most recent Cirrus OCT RNFL scan from 1 eye was categorized as having good signal strength (SS; ≥ 6 out of 10) or poor SS (&lt; 6). Those with good SS were analyzed by 2 independent reviewers for artifacts. Images with good SS and no artifacts affecting the scanning circle were considered useful for glaucoma evaluation.</p></div><div><h3>Main Outcome Measures</h3><p>The incidence of poor SS and artifacts in OCT RNFL images; patient characteristics associated with useful scans.</p></div><div><h3>Results</h3><p>Sixty-five patients with KPro and 75 controls were included; 89.2% of KPro patients and 89.3% of control subjects had glaucoma (<em>P</em> = 0.98). Forty percent of KPro patients and 5.3% of controls had poor SS (<em>P</em> &lt; 0.001). The proportion of images with either poor SS or artifacts was similar in KPro (76.9%) vs. controls (72.0%, <em>P</em> = 0.51). The most common artifacts in both groups were missing data (43.6%, 53.2%, respectively, <em>P</em> = 0.32) and motion artifact (25.6%, 19.7%, respectively, <em>P</em> = 0.47). Images were useful for glaucoma evaluation in 43.1% of KPro patients and in 69.3% of controls (<em>P</em><span> = 0.002). In the KPro group, patients with useful OCT scans, compared with those without, had better visual acuity (0.4 ± 0.3 vs. 0.9 ± 0.7 logarithm of the minimum angle of resolution, </span><em>P</em><span> = 0.004), and did not have congenital corneal pathologies (0.0% vs. 24.3%, </span><em>P</em><span> = 0.008). A multivariate analysis showed that KPro patients with older age had higher odds of useful OCT images (odds ratio, 1.05; </span><em>P</em> = 0.03). Among KPro patients with useful OCT scans, retinal nerve fiber layer thickness correlated with observed cup-to-disc ratio (Pearson correlation: <em>r</em> = −0.42, <em>P</em> = 0.03).</p></div><div><h3>Conclusions</h3><p>The rate of OCT RNFL images with either poor signal strength or artifacts in the KPro and control population was comparable. In patients with KPro, where intraocular pressure measurements are difficult and glaucoma is highly prevalent and often severe, OCT RNFL imaging can be useful for glaucoma evaluation.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 206-215"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162586","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: Castillejos et al.: Artifacts in OCT retinal nerve fiber layer imaging in patients with Boston Keratoprosthesis Type 1 (Ophthalmol Glaucoma. 2024;7:206-215)","authors":"André S. Pollmann MD, FRCSC,&nbsp;Chloé Akl,&nbsp;Mona Harissi-Dagher MD, FRCSC","doi":"10.1016/j.ogla.2023.11.003","DOIUrl":"10.1016/j.ogla.2023.11.003","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Page 216"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813994","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":"Six-Year Incidence and Risk Factors for Primary Open-Angle Glaucoma and Ocular Hypertension","authors":"Sahil Thakur MBBS, MS ,&nbsp;Raghavan Lavanya MRCS ,&nbsp;Marco Yu PhD ,&nbsp;Yih-Chung Tham PhD ,&nbsp;Zhi Da Soh BOptom, MPH ,&nbsp;Zhen Ling Teo MBBS, MRCS ,&nbsp;Victor Koh MBBS, MMed ,&nbsp;Shivani Majithia OD ,&nbsp;Chaoxu Qian MD, PhD ,&nbsp;Tin Aung FRCSEd, PhD ,&nbsp;Monisha E. Nongpiur MD, PhD ,&nbsp;Ching-Yu Cheng MD, PhD","doi":"10.1016/j.ogla.2023.08.003","DOIUrl":"10.1016/j.ogla.2023.08.003","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the incidence and risk factors for primary open-angle glaucoma (POAG) and ocular hypertension (OHT) in a multiethnic Asian population.</p></div><div><h3>Design</h3><p>Population-based cohort study.</p></div><div><h3>Participants</h3><p>The Singapore Epidemiology of Eye Diseases study included 10 033 participants in the baseline examination between 2004 and 2011. Of those, 6762 (response rate = 78.8%) participated in the 6-year follow-up visit between 2011 and 2017.</p></div><div><h3>Methods</h3><p><span><span><span><span>Standardized examination and investigations were performed, including slit lamp biomicroscopy<span>, intraocular pressure (IOP) measurement, </span></span>pachymetry<span>, gonioscopy<span>, optic disc examination and static automated </span></span></span>perimetry. Glaucoma was defined according to a combination of </span>clinical evaluation, </span>ocular imaging<span> (fundus photo, visual field, and OCT) and criteria given by International Society of Geographical and Epidemiological Ophthalmology. OHT was defined on the basis of elevated IOP over the upper limit of normal; i.e., 20.4 mmHg, 21.5 mmHg, and 22.6 mmHg for the Chinese, Indian, and Malay cohort respectively, without glaucomatous optic disc change.</span></p></div><div><h3>Main Outcome Measures</h3><p>Incidence of POAG, OHT, and OHT progression.</p></div><div><h3>Results</h3><p>The overall 6-year age-adjusted incidences of POAG and OHT were 1.31% (95% confidence interval [CI], 1.04–1.62) and 0.47% (95% CI, 0.30–0.70). The rate of progression of baseline OHT to POAG at 6 years was 5.32%. Primary open-angle glaucoma incidence was similar (1.37%) in Chinese and Indians and lower (0.80%) in Malays. Malays had higher incidence (0.79%) of OHT than Indians (0.38%) and Chinese (0.37%). Baseline parameters associated with higher risk of POAG were older age (per decade: odds ratio [OR], 1.90; 95% CI, 1.54–2.35; <em>P</em> &lt; 0.001), higher baseline IOP (per mmHg: OR, 1.20; 95% CI, 1.12–1.29; <em>P</em> &lt; 0.001) and longer axial length (per mm: OR, 1.22; 95% CI, 1.07–1.40, <em>P</em> = 0.004).</p></div><div><h3>Conclusion</h3><p>Six-year incidence of POAG was 1.31% in a multiethnic Asian population. Older age, higher IOP, and longer axial length were associated with higher risk of POAG. These findings can help in future projections and guide public healthcare policy decisions for screening at-risk individuals.</p></div><div><h3>Financial Disclosure(s)</h3><p>The authors have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 157-167"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295269","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":"Anterior Segment OCT for Detection of Narrow Angles","authors":"Sangita Pradhan MD ,&nbsp;Ranjeet K. Sah MD, MS ,&nbsp;Gopal Bhandari M Optom ,&nbsp;Sadhan Bhandari PCLGM ,&nbsp;Raghunandan Byanju MD ,&nbsp;Ram P. Kandel MPH ,&nbsp;Isabel J.B. Thompson MPH ,&nbsp;Valerie M. Stevens MPH ,&nbsp;Krisianne M. Aromin BS ,&nbsp;Julius T. Oatts MD ,&nbsp;Yvonne Ou MD ,&nbsp;Thomas M. Lietman MD ,&nbsp;Kieran S. O’Brien PhD, MPH ,&nbsp;Jeremy D. Keenan MD, MPH","doi":"10.1016/j.ogla.2023.08.005","DOIUrl":"10.1016/j.ogla.2023.08.005","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the diagnostic accuracy of anterior segment OCT (AS-OCT) screening for detecting gonioscopically narrow angles.</p></div><div><h3>Design</h3><p>Population-based cross-sectional study.</p></div><div><h3>Participants</h3><p>A stratified random sample of individuals aged ≥ 60 years, selected from a door-to-door census performed in low-lying Nepal.</p></div><div><h3>Testing</h3><p><span><span>Participants underwent AS-OCT, posterior segment OCT, and intraocular pressure (IOP) testing in the community. Those meeting referral criteria in either eye were invited to have a comprehensive eye examination including </span>gonioscopy. Referral criteria included (i) the lowest 2.5% of AS-OCT measurements, (ii) retinal OCT results suggestive of </span>glaucomatous optic neuropathy<span>, diabetic retinopathy, or age-related macular degeneration, and (iii) elevated IOP.</span></p></div><div><h3>Main Outcome Measures</h3><p>Sensitivity and specificity of 5 semiautomated AS-OCT parameters relative to gonioscopically narrow angles, defined as the absence of visible trabecular meshwork for ≥ 180° on nonindentation gonioscopy.</p></div><div><h3>Results</h3><p>Of 17 656 people aged ≥ 60 years enumerated from 102 communities, 12 633 (71.6%) presented for AS-OCT testing. Referral was recommended for 697 participants based on AS-OCT criteria and 2419 participants based on other criteria, of which 858 had gonioscopy performed by a glaucoma specialist. Each of the 5 AS-OCT parameters offered good diagnostic information for predicting eyes with gonioscopically narrow angles, with areas under the receiver operating characteristic curve ranging from 0.85 to 0.89. The angle opening distance at 750 μm from the scleral spur (AOD750) provided the most diagnostic information, providing an optimal sensitivity of 87% (95% confidence interval [CI], 75%–96%) and specificity of 77% (71%–83%) at a cutpoint of 367 μm, and a sensitivity of 65% (95% CI, 54%–74%) when specificity was constrained to 90% (cutpoint, 283 μm).</p></div><div><h3>Conclusions</h3><p>On AS-OCT, the AOD750 parameter detected approximately two-thirds of cases of gonioscopically narrow angles when test specificity was set to 90%. Although such a sensitivity may not be sufficient when screening solely for narrow angles, AS-OCT requires little additional effort if posterior segment OCT is already being performed and thus could provide incremental benefit when performing OCT-based screening.</p></div><div><h3>Financial Disclosure(s)</h3><p>The authors have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 148-156"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250779","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":"Racial Differences in the Diagnostic Accuracy of OCT Angiography Macular Vessel Density for Glaucoma","authors":"Gopikasree Gunasegaran MD,&nbsp;Sasan Moghimi MD,&nbsp;Takashi Nishida MD, PhD,&nbsp;Evan Walker MS,&nbsp;Alireza Kamalipour MD, MPH,&nbsp;Jo-Hsuan Wu MD,&nbsp;Golnoush Mahmoudinezhad MD, MPH,&nbsp;Linda M. Zangwill PhD,&nbsp;Robert N. Weinreb MD","doi":"10.1016/j.ogla.2023.09.003","DOIUrl":"10.1016/j.ogla.2023.09.003","url":null,"abstract":"<div><h3>Purpose</h3><p><span>To evaluate and compare the diagnostic accuracy of macular vessel density (VD) measured by OCT </span>angiography (OCTA) in individuals of African descent (AD) and European descent (ED) with open-angle glaucoma.</p></div><div><h3>Design</h3><p>Observational, cross sectional study.</p></div><div><h3>Participants</h3><p>A total of 176 eyes of 123 patients with glaucoma and 140 eyes of 88 healthy participants from the Diagnostic Innovations in Glaucoma Study.</p></div><div><h3>Methods</h3><p>Whole-image ganglion cell complex (wiGCC) thickness and macular VD (parafoveal VD and perifoveal VD) were obtained from 6 × 6 macula scans. Area under the receiver operating characteristic (AUROC) curves were used to evaluate the diagnostic accuracy of macular VD and ganglion cell complex (GCC) thickness in AD and ED participants after adjusting for confounders such as age, visual field mean deviation (VF MD), signal strength index, axial length, self-reported hypertension and diabetes.</p></div><div><h3>Main Outcome Measures</h3><p>Macular VD and wiGCC measurements.</p></div><div><h3>Results</h3><p>Parafoveal and perifoveal VD were significantly lower in ED than AD patients with glaucoma. Parafoveal and perifoveal VD performed significantly worse in AD participants compared with ED participants for detection of glaucoma (adjusted AUROC, 0.75 [95% confidence interval (CI), 0.62, 0.87], 0.85 [95% CI, 0.79, 0.90], <em>P</em> = 0.035; and 0.82 [95% CI, 0.70, 0.92], 0.91 [95% CI, 0.87, 0.94], respectively; <em>P</em> = 0.020). In contrast to VD, diagnostic accuracy of GCC thickness was similar in AD and ED individuals (adjusted AUROC, 0.89 [95% CI, 0.79, 0.96], 0.92 [95% CI, 0.86, 0.96], respectively; <em>P</em> = 0.313). The diagnostic accuracies of both macular VD and GCC thickness for differentiating between glaucoma and healthy eyes increased with increasing VF MD in both AD and ED participants.</p></div><div><h3>Conclusions</h3><p>Diagnostic performance of OCTA macular VD, but not GCC thickness, for glaucoma detection varies by race. Moreover, macular VD parameters had lower accuracy for detecting glaucoma in AD individuals than in ED individuals. The diagnostic performance of macular VD is race-dependent, and, therefore, race should be taken into consideration when interpreting macular OCTA results.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 197-205"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154802","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 Glaucoma Diagnosis and Surgical Intervention following Pediatric Cataract Surgery in the IRIS® Registry","authors":"Daniel M. Vu MD ,&nbsp;Tobias Elze PhD ,&nbsp;Joan W. Miller MD ,&nbsp;Alice C. Lorch MD, MPH ,&nbsp;Deborah K. VanderVeen MD ,&nbsp;Isdin Oke MD","doi":"10.1016/j.ogla.2023.08.009","DOIUrl":"10.1016/j.ogla.2023.08.009","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare demographic and clinical factors associated with glaucoma following cataract surgery<span><span> (GFCS) and glaucoma surgery rates between infants, toddlers, and older children using a large, </span>ophthalmic registry.</span></p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Participants</h3><p>Patients in the IRIS® Registry (Intelligent Research in Sight) who underwent cataract surgery at ≤ 17 years old and between January 1, 2013 and December 31, 2020.</p></div><div><h3>Methods</h3><p><span>Glaucoma diagnosis and procedural codes were extracted from the electronic health records of practices participating in the IRIS Registry. Children with glaucoma diagnosis or surgery before cataract removal were excluded. The Kaplan–Meier estimator was used to determine the cumulative probability of GFCS diagnosis and glaucoma surgery after cataract surgery. Multivariable </span>Cox regression was used to identify factors associated with GFCS and glaucoma surgery.</p></div><div><h3>Main Outcome Measures</h3><p>Cumulative probability of glaucoma diagnosis and surgical intervention within 5 years after cataract surgery.</p></div><div><h3>Results</h3><p><span>The study included 6658 children (median age, 10.0 years; 46.2% female). The 5-year cumulative probability of GFCS was 7.1% (95% confidence interval [CI], 6.1%–8.1%) and glaucoma surgery was 2.6% (95% CI, 1.9%–3.2%). The 5-year cumulative probability of GFCS for children aged &lt; 1 year was 22.3% (95% CI, 15.7%–28.4%). Risk factors for GFCS included aphakia (hazard ratio [HR], 2.63; 95% CI, 1.96–3.57), unilateral cataract (HR, 1.48; 95% CI, 1.12–1.96), and Black race (HR, 1.61; 95% CI, 1.12–2.32). The most common surgery was glaucoma drainage device insertion (32.6%), followed by angle surgery (23.3%), cyclophotocoagulation (15.1%), and </span>trabeculectomy (5.8%).</p></div><div><h3>Conclusions</h3><p>Glaucoma following cataract surgery diagnosis in children in the IRIS Registry was associated with young age, aphakia, unilateral cataract, and Black race. Glaucoma drainage device surgery was the preferred surgical treatment, consistent with the World Glaucoma Association 2013 consensus recommendations for GFCS management.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 2","pages":"Pages 131-138"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10243541","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}