Ophthalmology最新文献

{"title":"Six-year rate of visual field progression in the Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial.","authors":"Giovanni Montesano, David P Crabb, David F Garway-Heath, David M Wright, Evgenia Konstantakopoulou, Neil Nathwani, Giovanni Ometto, Gus Gazzard","doi":"10.1016/j.ophtha.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.023","url":null,"abstract":"<p><strong>Purpose: </strong>to compare the 6-year rate of visual field (VF) progression in the two arms of the Laser in Ocular Hypertension and Glaucoma Trial (LiGHT), comparing selective laser trabeculoplasty (SLT) and drops as first treatment in ocular hypertension (OHT) and open angle glaucoma (OAG).</p><p><strong>Design: </strong>post-hoc analysis of data from randomized clinical trial SUBJECTS: patients with newly diagnosed OHT/OAG recruited in the LiGHT trial.</p><p><strong>Methods: </strong>in each patient, we selected the better (baseline Mean Deviation, MD) eligible eye with at least 3 reliable VFs (false positive errors < 15%) over at least 6 months. We estimated the rate of MD progression using a published hierarchical linear mixed effect model (LMM), designed to increase precision by minimizing the effect of perimetric learning and test-retest noise. Secondary analyses were performed to assess: the differences in rate across baseline severity groups (OHT, mild OAG and moderate/severe OAG); the effect of glaucoma surgery and switch to SLT in the drops-first arm, by truncating the VF series; the effect of cataract and cataract surgery, by using the Mean Pattern Deviation (MPD) instead of the MD.</p><p><strong>Main outcome measure: </strong>mean difference in the rate of VF MD progression between patients in the SLT-first and drops-first arm.</p><p><strong>Results: </strong>Data from 710 eyes (482 with OAG, 354 in the SLT-first arm) were analysed. The two arms had similar baseline MD (p=0.7). The average intraocular pressure (IOP) during follow-up was 16.1 [14.2, 18.2] for the drops-first arm and 16.8 [14.6, 18.6] in the SLT-first arm (Median [Interquartile-range], p=0.057). The mean [95%-Credible interval] MD rate was -0.37 [-0.43, -0.31] dB/year in the drops-first arm and -0.26 [-0.31, -0.21] dB/year in the SLT-first arm (p = 0.007). When stratified by severity, this difference was significant only in mild OAG (p = 0.035, the largest sub-group). The secondary analyses largely confirmed the main results. The difference in MPD rate was also significantly slower in the SLT-first arm (p < 0.001).</p><p><strong>Conclusions: </strong>First-line SLT was more effective than drops at preserving VF. SLT should be preferred as the first line of treatment in newly diagnosed OHT and OAG eyes.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acoltremon Ophthalmic Solution 0.003% for Signs and Symptoms of Dry Eye Disease: Results of Phase 3 Pivotal Studies COMET-2 and COMET-3.","authors":"Guruprasad R Pattar, David Wirta, Gary Jerkins, James Paauw, Eugene B McLaurin, Alex Liu, David G Evans, Kenneth Kenyon, Nancy Cline, Preeya K Gupta, Ian Meng, Michelle Senchyna","doi":"10.1016/j.ophtha.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.018","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate safety and efficacy of the novel transient receptor potential melastatin 8 agonist acoltremon on signs and symptoms of dry eye disease (DED).</p><p><strong>Design: </strong>Two identical randomized, multicenter, double-masked, vehicle-controlled, phase 3 studies.</p><p><strong>Subjects: </strong>Adults aged ≥ 30 years with a DED diagnosis within 6 months, at least 1 eye with both total corneal fluorescein staining (tCFS) score ≥ 2 and ≤ 15 (no region > 3) and anesthetized Schirmer test score ≥ 2 and < 10 mm/5 min, and both ocular discomfort (visual analog scale) and Symptom Assessment iN Dry Eye (SANDE) scores ≥ 50.</p><p><strong>Methods: </strong>Subjects were randomized 1:1 to acoltremon 0.003% (ACO; TRYPTYR®) or vehicle (VEH) twice daily for 90 days (ClinicalTrials.gov identifiers: COMET-2, NCT05285644; COMET-3, NCT05360966).</p><p><strong>Main outcome measures: </strong>Primary endpoint was proportion of subjects achieving ≥ 10-mm increase in unanesthetized Schirmer test (UST) score on day 14. Key secondary endpoint was change from baseline (CFB) in global SANDE score on day 28. Additional secondary endpoints included CFB in UST on days 1, 14, and 90. Exploratory endpoints included CFB in tCFS and total conjunctival staining.</p><p><strong>Results: </strong>465 (COMET-2) and 466 (COMET-3) subjects were randomized. Primary endpoint was met in both studies, with higher proportions of subjects achieving ≥ 10-mm increase in UST on day 14 with ACO versus VEH (COMET-2: 42.6% versus 8.2%, respectively; COMET-3: 53.2% versus 14.4%, respectively; both P < 0.0001). Reduction from baseline in global SANDE score on day 28 (key secondary endpoint) was in favor of ACO in both studies, with statistical significance achieved in COMET-2. Evidence of tear production in favor of ACO versus VEH was observed as early as day 1 through day 90 in both studies (P < 0.0001). Numerically greater reductions with ACO were also observed in tCFS on days 28 and 90 and in total conjunctival staining at all time points in both studies. Mild instillation-site burning/stinging was the only ocular adverse event reported with > 2.5% incidence.</p><p><strong>Conclusions: </strong>In both phase 3 studies, ACO compared with VEH led to consistent, clinically meaningful tear production as well as reductions in other DED signs and symptoms.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating retinopathy of prematurity with dexamethasone eye drops: a difference-in-differences study in Sweden using register data.","authors":"Lotta Akc Gränse, Hanna Maria V Öhnell, Gerd Holmström, Johanna C Sundgren, Kristina Teär Fahnehjelm, Agneta Wallin, Eva Larsson, Despoina Tsamadou, Lars J Björklund, Ann Hellström, Jenny Wallander, Karin Sandgren Hochhard, Sten O L Andreasson, Elisabeth R Olhager, Jonas Björk","doi":"10.1016/j.ophtha.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.020","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the effect of dexamethasone eye drops on the risk of progression from type 2 retinopathy of prematurity (ROP) to ROP requiring traditional treatments.</p><p><strong>Design: </strong>Register-based cohort study SUBJECTS AND CONTROLS: Preterm infants born before 30 weeks gestation during 2015-2018 (control years) and 2020-2021 (intervention years), registered in the Swedish quality register for ROP (SWEDROP) at four Swedish sites were included. In one of these sites, the intervention site, topical dexamethasone was introduced during the later period when type 2 ROP was diagnosed.</p><p><strong>Methods: </strong>The frequency of traditional ROP treatments (laser ablation or intravitreal injection of anti-vascular endothelial growth factor) was compared between the two time periods at sites that had, and had not, introduced topical dexamethasone during the later period. Analyses were conducted both on infants with severe ROP and on all included infants. The difference-in-differences statistical method was used.</p><p><strong>Main outcome measures: </strong>The proportion of infants that required traditional ROP treatment in each group and the interaction odds ratio, adjusted for potential confounding factors.</p><p><strong>Results: </strong>At the intervention site, the incidence of traditional ROP treatment fell from 23/32 (72%) to 4/32 (13%, p < 0.001) in infants with severe ROP, and from 23/409 (5.6%) to 4/217 (1.8%, p = 0.03) in all screened infants. For the three control sites, the equivalent numbers were from 82/175 (47%) to 32/57 (56%, p = 0.22), and 82/950 (8.6%) to 32/441 (7.3%, p = 0.38). The difference-in-differences analyses resulted in an adjusted interaction odds ratio of 0.05 (95% CI 0.01-0.22; p < 0.001) for infants with severe ROP, suggesting a markedly larger decline in occurrence of traditional ROP treatments at the intervention site.</p><p><strong>Conclusion: </strong>In this population of infants with severe ROP, the introduction of dexamethasone eye drops was associated with a significant reduction in the proportion of infants requiring traditional ROP treatments. A timely administration of low-dose dexamethasone eye drops may serve as a simple, cost-effective, and noninvasive intervention to reduce one of the leading causes of severe visual impairment worldwide. Further studies are needed to confirm our findings.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of Escalating to Weekly Adalimumab Dosing for the Treatment of Non-infectious Uveitis: A Multi-Center Study.","authors":"Shani Pillar, Akshay Thomas, Lynn Hassman, Howard Chen, Sapna Gangaputra, Laura J Kopplin, Kelly Boyd, Kareem Moussa, Derek C Pham, Edmund Tsui","doi":"10.1016/j.ophtha.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.019","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of adalimumab (ADA) dose escalation in patients with non-infectious uveitis who are inadequately controlled with standard dosing.</p><p><strong>Design: </strong>Multi-center retrospective interventional case series.</p><p><strong>Participants: </strong>Patients with non-infectious uveitis active on standard biweekly ADA dosing who had treatment escalated to weekly ADA dosing at 6 tertiary referral centers.</p><p><strong>Methods: </strong>Demographic data and clinical findings were assessed at the time of ADA dose escalation and 6-months later. Mixed model analysis was performed to analyze clinical outcomes and to assess predictive factors of success.</p><p><strong>Main outcome measures: </strong>Treatment success composite criteria included: (1) disease quiescence (≤0.5+ anterior chamber cell, ≤0.5+ vitreous haze, inactive retinal/choroidal lesions); (2) prednisone ≤7.5 mg/day; and (3) ≤2 drops/day of prednisolone or equivalent (4) no treatment discontinuation.</p><p><strong>Results: </strong>Fifty patients (44.4±21.2 years old, n=35 female) from 6 tertiary referral centers were included. At 6 months following ADA escalation (median 184 days), 52% of patients had achieved treatment success. Specific inflammatory signs significantly reduced after ADA escalation included anterior chamber cell grade (p=0.025) and presence of active retinal/choroidal lesions (p=0.010). Prednisone was decreased from >7.5 mg daily to lower doses in 63% (p=0.015). The odds ratio for treatment success was 6.88 for patients with posterior uveitis (p=0.024) and 0.14 (p=0.005) for patients with panuveitis. The hazard ratio for treatment success was 3.73 (p=0.009) for eyes with active retinal vasculitis at the time of ADA escalation.</p><p><strong>Conclusion: </strong>Escalation from standard biweekly ADA dosing to weekly ADA dosing achieved treatment success in over half of the patients. Posterior uveitis predicts a favorable chance of success, whereas panuveitis conveys a lower success rate.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Industry Financial Relationships of Presenters at the American Academy of Ophthalmology Annual Meeting with an Emphasis on Consultants.","authors":"Roni M Shtein, Kerby Shedden, Alyssa A Horstman, Paul R Lichter","doi":"10.1016/j.ophtha.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.016","url":null,"abstract":"<p><strong>Objective: </strong>To assess industry financial relationships of ophthalmologist presenters at the American Academy of Ophthalmology (AAO) Annual Meeting between 2016 and 2020.</p><p><strong>Design: </strong>Cross-sectional study PARTICIPANTS: Program presenters from AAO Annual Meetings, 2016 - 2020 METHODS: From the AAO Annual Meeting programs, we determined individual meeting participants and the number of papers, posters, courses and symposia they presented. National Provider Identifier (NPI) numbers were obtained for all participants who had them. The CMS Open Payments Database (OPD) was used to obtain information about physician industry payments from 2016-2020. NPI numbers were used to allow for analysis directly comparing AAO participation and industry payment information by calendar year. Summary statistics were tabulated by year. Linear regression models were used to assess the relationship between participation and payments and between participation and year to assess for time-varying relationships between participation and payments.</p><p><strong>Main outcome measure: </strong>The association of industry payments to AAO Annual Meeting presenters, especially industry consultants, for symposia, courses, papers, and posters.</p><p><strong>Results: </strong>There were 811 distinct program participants who had NPI numbers, with 1584 records of participation over the 5 years studied. Presenters could have multiple participations in each annual meeting. Overall, meeting participants without NPI numbers (presumably meeting participants who do not practice medicine in the US) had a higher proportion of poster presentations and a lower proportion of symposia participation. Most presenters (67-74%) at the AAO Annual Meeting received payments from industry in the same year they presented at the AAO Annual Meeting. AAO Annual Meeting presenters who received industry funding characterized as \"consulting\" in the OPD received higher median payment amounts. Although there was no evidence of change in total OPD payments over the years studied, consulting payments to AAO Annual Meeting participants increased 20% per year (p<0.01) from 2016-2019.</p><p><strong>Conclusion: </strong>Most AAO Annual Meeting presenters have financial relationships with industry. Increased financial transparency required by the Affordable Care Act has not reduced physician financial relationships with industry. There is a higher proportion and higher amounts of industry money given to presenters in symposia, compared to poster presenters. Industry financial relationships are correlated with participation in symposia and courses at AAO Annual Meetings.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Jimmy S Chen, Jeffrey D Esko, Philip L S M Gordts, Evan Walker, Sally L Baxter, Christopher B Toomey","doi":"10.1016/j.ophtha.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.08.018","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Chen et al.: High-density lipoproteins associated with age-related macular degeneration in the All of Us research program (Ophthalmology. 2025;132:684-691).","authors":"Anisha Kasi, John Tan, Richard Rosen, Avnish Deobhakta, Mandip Dhamoon, Gareth Lema, Alauddin Bhuiyan, Larry Yannuzzi, Roland Theodore Smith","doi":"10.1016/j.ophtha.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.08.017","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of glaucoma surgery incidence and outcomes in pseudoexfoliation and primary open-angle glaucoma: IRIS® Registry analysis.","authors":"Asahi Fujita, Tobias Elze, Yan Zhao, Alice C Lorch, Joan W Miller, David S Friedman, Nazlee Zebardast","doi":"10.1016/j.ophtha.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.012","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the incidence of glaucoma surgeries and surgical outcomes between pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG).</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS: Patients with diagnosis codes for PXG and POAG in 2015 in the IRIS® Registry (Intelligent Research in Sight).</p><p><strong>Methods: </strong>Baseline characteristics were balanced between patients with diagnoses of PXG and POAG using propensity score matching, and the cumulative incidence of glaucoma surgery, frequency of records of postoperative IOP spikes, and additional glaucoma surgery were compared. Among patients who underwent each type of surgery, propensity score matching was performed, and the postoperative intraocular pressure (IOP) and visual acuity (VA) were compared between groups.</p><p><strong>Main outcome measures: </strong>The primary outcomes were the cumulative incidence rates of glaucoma surgery in each group. Secondary outcomes included postoperative IOP and VA changes and the proportion of patients experiencing postoperative IOP spikes and additional glaucoma surgery.</p><p><strong>Results: </strong>A total of 801,253 eligible patients were identified and used to create a matched cohort of 28,196 patients from each diagnosis group. The cumulative incidence rates of glaucoma surgery at 4 years were 8.6% (95% confidence interval: 8.3-9.0%) in the POAG group and 13.6% (13.1-14.0%) in the PXG group. Filtering surgery (trabeculectomy and tube shunt surgery) accounted for 39.0% and 51.2% of the first-recorded surgery in POAG and PXG, respectively, whereas trabecular stent accounted for 44.5% and 31.3%, respectively. Significantly more patients with PXG experienced IOP spikes postoperatively than those with POAG (7.5% vs. 5.2%, P = 0.002). Additional glaucoma surgery was recorded more frequently in the PXG group than in the POAG group (10.8% vs. 7.9%, P < 0.001). The mean postoperative course of IOP and VA were similar between the two groups when the preoperative characteristics were balanced.</p><p><strong>Conclusions: </strong>Patients with PXG were nearly twice as likely to undergo glaucoma surgery than those with POAG, even when the baseline characteristics were balanced, reflecting the more aggressive nature of PXG. Postoperatively they experienced IOP spikes and additional glaucoma surgery more frequently, underscoring the importance of close monitoring of patients with PXG.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Vascular Malformation at the Optic Disc in a Pediatric Patient.","authors":"Hanan A Alshalan, Moustafa Magliyah","doi":"10.1016/j.ophtha.2025.08.024","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.08.024","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Measurement of Optic Disc Vessel Density to Detect Glaucoma Progression in High Myopia.","authors":"Min Hee Suh, Robert N Weinreb, Evan Walker, Linda M Zangwill","doi":"10.1016/j.ophtha.2025.07.032","DOIUrl":"10.1016/j.ophtha.2025.07.032","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between optic disc vessel density (ODVD) reduction and visual field (VF) progression in highly myopic glaucomatous eyes.</p><p><strong>Design: </strong>Retrospective, observational case series.</p><p><strong>Participants: </strong>One hundred eighteen primary open-angle glaucoma (POAG) eyes with high myopia (axial length [AXL] ≥ 26.5 mm or spherical equivalent [SE] ≤ -6 diopters [D]) and 118 age-matched and VF severity-matched POAG eyes without high myopia (AXL < 26.0 mm and SE > -6 D).</p><p><strong>Methods: </strong>All participants underwent 5 or more consecutive VF tests, OCT, and OCT angiography (OCTA) over 4.1 years. Optic disc vessel density was calculated as the pixel ratio of vessels in the temporal optic disc area on en face OCTA images.</p><p><strong>Main outcome measures: </strong>The association between VF progression and the rate of ODVD change after adjusting for possible influencing factors, including retinal nerve fiber layer (RNFL) thinning rate.</p><p><strong>Results: </strong>In highly myopic eyes, those with VF progression (n = 41) exhibited a significantly faster rate of global ODVD reduction compared with those without progression (n = 77; -3.96 ± 2.15%/year vs. -1.68 ± 2.37%/year; P < 0.001). In highly myopic eyes, younger age (odds ratio [OR], 1.09 per 1 year younger; P = 0.002), a higher prevalence of optic disc hemorrhage (OR, 6.76; P = 0.002), thinner RFNL at baseline (OR, 1.04 per 1 μm thinner; P = 0.024), and a faster rate of global ODVD change (OR, 1.63 per 1%/year faster; P < 0.001) were associated with VF progression in multivariable regression. Conversely, the rate of average RNFL thinning (P > 0.05) showed no significant association with VF progression in highly myopic eyes. For eyes without high myopia, significant associations with VF progression were found for both a faster rate of average RNFL thinning (OR, 2.43 per 1 μm/year faster; P = 0.006) and ODVD change (OR, 1.42 per 1%/year faster; P = 0.004) in the multivariable regression.</p><p><strong>Conclusions: </strong>In highly myopic glaucomatous eyes, progressive ODVD reduction was associated with VF progression, whereas RNFL thinning was not. This indicates that monitoring of optic disc microvasculature may be useful for detecting glaucoma progression in high myopia.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}