Ophthalmology. Glaucoma最新文献

{"title":"Cyclophotocoagulation Revisited: Insights from Randomized Trials of Slow-Coagulation and Micropulse Transscleral Cyclophotocoagulation.","authors":"Mohamed M Khodeiry, Abdelrahman M Elhusseiny, Richard K Lee","doi":"10.1016/j.ogla.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.002","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217536","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":"Learning How to Implement Glaucoma Coaching in Academic Medical Centers from a Successful Clinical Trial using Implementation Science.","authors":"Noah L Carey, Norma E Del Risco, Leslie M Niziol, Deborah Darnley-Fisch, Nauman Imami, Jamie Mitchell, Phalatha McHaney-Conner, Chamisa MacKenzie, Michele Heisler, Paula A Newman-Casey","doi":"10.1016/j.ogla.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.012","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate implementation of the Support, Educate, Empower (SEE) personalized glaucoma coaching program.</p><p><strong>Design: </strong>Prospective, two-site randomized clinical trial with an implementation evaluation using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Participants: </strong>Adults aged ≥40 years with glaucoma, glaucoma suspect, or ocular hypertension and poor self-reported medication adherence who were prescribed ≥1 glaucoma medication (n=236 enrolled; additional screened individuals declined [n=1,750] or were ineligible [n=1,701]). Stakeholders (n=8) and participants (n=32) contributed qualitative data.</p><p><strong>Methods: </strong>Participants were randomized to a motivational interviewing (MI)-based glaucoma coaching intervention (SEE program) or standard education. Reach was assessed by comparing demographics across recruitment stages. Effectiveness was evaluated by changes in medication adherence, coach autonomy support, and attrition. Implementation fidelity was measured using counselor MI competency scores (passing ≥5). Adoption and maintenance were evaluated through CFIR-guided interviews, post-intervention adherence monitoring, and cost estimates.</p><p><strong>Main outcome measures: </strong>Glaucoma medication adherence, program reach, implementation fidelity (MI competency scores), qualitative, stakeholder-informed measures of adoption and maintenance, including post-intervention adherence and program cost.</p><p><strong>Results: </strong>Of 2057 individuals screened, 356 (17.3%) were eligible, of which 236 (66.3%) enrolled; no demographic differences were observed between enrollees and non-enrollees, however those who declined screening (n=1750) were older and more likely to be White (both p<0.0001) . Adherence was better with personalized coaching than standard education (77.6%±19.7% versus 58.0%±25.2%; p<0.001). MI fidelity was high (mean score 5.7). Facilitators of implementation included participant engagement and workflow compatibility, while barriers included limited awareness, resource constraints, and concerns about financial sustainability. Participants reported improved engagement and motivation. 84% of participants continued monitoring after counseling ended; adherence declined by 10.0%±21.1% at 1 month and an additional 3.6%±11.7% by 2 months and remained below intervention levels thereafter. A coach could manage approximately 431 patients per year, with an estimated net revenue of $19,272 annually after costs.</p><p><strong>Conclusions: </strong>The SEE MI-based program demonstrated high fidelity and improved adherence during the intervention. Post-intervention adherence decline demonstrates the need for continued coaching. Strong uptake, stakeholder support, and projected reimbursement suggest feasibility and organizational sustainability in clinical pra","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185812","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 Outcomes of Stent vs. Non-Stent Trabecular Minimally Invasive Glaucoma Surgeries: A 4-Year Retrospective Propensity-Matched Study.","authors":"Muhammad Abrar Irfan, Juliet Johnson, Hannah Istre-Wilz, Jella An","doi":"10.1016/j.ogla.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.10.001","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 48-month outcomes of stent-based versus non-stent trabecular minimally invasive glaucoma surgery (MIGS) performed with phacoemulsification in open-angle glaucoma.</p><p><strong>Design: </strong>Retrospective propensity score-matched cohort study.</p><p><strong>Participants: </strong>250 eyes of 250 patients with open-angle glaucoma, matched 1:1 into Stent and Non-Stent groups.</p><p><strong>Methods: </strong>All eyes underwent combined phacoemulsification and trabecular MIGS and were followed through 48 months.</p><p><strong>Main outcome measures: </strong>The primary outcome was surgical success through 48 months at IOP thresholds of ≤15 mmHg and ≤18 mmHg, defined as achieving target IOP, on reduced (qualified) or without (complete) glaucoma medications and ≥20% IOP reduction from baseline without secondary incisional glaucoma surgery. Our secondary endpoints included complete success and qualified success, mean IOP and number of glaucoma medication classes, visual field mean deviation, secondary interventions, and adverse events at each postoperative visit through 48 months.</p><p><strong>Results: </strong>Baseline characteristics were well balanced. By 48 months, there were no statistically significant differences between the Non-Stent and Stent groups in surgical success, visual field mean deviation, or medication burden. At the ≤15 mmHg threshold, surgical success was higher in the Stent group at month 12 (64.5% vs 45.3%; p=0.005) and month 24 (61.7% vs 40.7%; p=0.012), driven primarily by higher qualified success. At the ≤18 mmHg threshold, surgical success was similar between groups throughout follow-up, despite different success patterns: Non-Stent eyes achieved higher complete medication-free success at months 12 and 24, whereas Stent eyes achieved higher qualified success at the same visits. Non-Stent eyes had greater IOP reduction at month 24 and fewer medications at months 24 and 36, but these differences were no longer significant by month 48. Rescue SLT was required more often in Non-Stent eyes (6.2% vs 1.9%; p=0.025), while secondary incisional surgeries and adverse events were uncommon with no significant difference between groups.</p><p><strong>Conclusions: </strong>Stent and non-stent trabecular MIGS combined with phacoemulsification achieved comparable 48-month outcomes through different success patterns.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165755","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":"Scleral-Tunneled, Graft-Free Glaucoma Drainage Device Implantation in Children: Outcomes from a US Tertiary Center.","authors":"Musse Hussein, Ziou Jiang, Raymond G Areaux","doi":"10.1016/j.ogla.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.10.003","url":null,"abstract":"<p><strong>Objective: </strong>To report IOP outcomes, medication use, tube exposure rates, and surgical durability following ST-GDD in children.</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: 40 eyes (32 patients) under age 18 undergoing ST-GDD at the University of Minnesota (2018-2025) with at least 6 months of follow-up.</p><p><strong>Methods, intervention, or testing: </strong>Fourteen eyes received an Ahmed FP-7 valve (New World Medical) and 26 a Baerveldt 350 implant (Alcon).</p><p><strong>Main outcomes and measures: </strong>Primary outcome was IOP control at 6 months and final follow-up. Four groups were analyzed: 1) complete success (IOP 6-21 mm Hg off medications), 2) qualified success (6-21 mm Hg on medications), 3) tolerable success (22-25 mm Hg without progression), or 4) failure (IOP above target, systemic acetazolamide, loss of light perception, or major reoperation). Kaplan-Meier analyses were performed using both a traditional clinical definition (failure = group 4) and a more stringent (\"austere\") definition (failure = groups 3 and 4). Tube exposure was the primary safety endpoint.</p><p><strong>Results: </strong>Mean age was 90.81 months; 71.9% were male. Preoperative mean IOP was 34.5 mm Hg (SD, 6.2) on 3.8 medications (SD, 0.9). At 6 months, IOP fell to 15.75 mm Hg (mean difference, -18.75; 95% CI, -20.8 to -16.7; P < .001) and medications to 0.42 (mean difference, -3.38; 95% CI, -3.73 to -3.02; P < .001). At final follow-up (mean, 36.7 months; range, 6-90 months), mean IOP was 17.78 mm Hg on 0.98 medications (both P < .001 vs baseline). At 6 months, 77.5% achieved complete and 17.5% qualified success with no failures; at final follow-up, 50% complete, 30% qualified, 15% tolerable, and 5% failure. Kaplan-Meier estimated clinical success was 93% and austere success 71.1%; most failures occurred within 32 months. No tube exposures or erosions were observed.</p><p><strong>Conclusions: </strong>This is the first US report of ST-GDD outcomes in children. During a mean follow-up of 36.7 months (range, 6-90 months), ST-GDD resulted in sustained IOP reduction, decreased medication burden, and zero tube exposures. Longer-term prospective comparisons with conventional patch-graft techniques are needed.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170178","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 Severity and Progression in Individuals with Asymmetric β-zone Parapapillary Atrophy: An Intra-patient Comparative Study.","authors":"Se Hie Park, Sung Do Cho, Ki Ho Park, Young Kook Kim, Jin Wook Jeoung","doi":"10.1016/j.ogla.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.10.002","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate inter-eye differences in glaucoma severity and progression in patients with asymmetric baseline β-zone parapapillary atrophy (PPA) morphology.</p><p><strong>Design: </strong>Retrospective, intra-patient comparative study.</p><p><strong>Participants: </strong>Sixty-four eyes of 32 patients with bilateral primary open-angle glaucoma and asymmetric β-zone PPA morphology.</p><p><strong>Methods: </strong>Baseline β-zone PPA was quantitatively assessed using optic disc photographs. Each eye was classified according to angular extent as either Crescent type (<180°) or Solar-eclipse type (≥180°), and according to radial extent as either Short-extent type or Long-extent type. Glaucoma progression was evaluated using linear mixed-effects models with random intercepts and random slopes at both the patient and eye-within-patient levels.</p><p><strong>Main outcome measures: </strong>Rates of change in visual field mean deviation (MD), visual field index (VFI), and retinal nerve fiber layer (RNFL) thickness.</p><p><strong>Results: </strong>The mean age was 53.2 ± 15.6 years, and the mean follow-up duration was 11.4 ± 3.2 years. Eyes with the Solar-eclipse type demonstrated significantly faster functional progression, with greater model-estimated rates of VFI loss (-1.37 vs. -0.71 %/year; P = 0.004) and MD decline (-0.49 vs. -0.27 dB/year; P = 0.006), whereas no significant differences were observed in the rates of change in average, superior, inferior, or temporal RNFL thickness (all P ≥ 0.30). Similarly, eyes with the Long-extent type showed faster decline than those with the Short-extent type for both VFI (-1.33 vs. -0.76 %/year; P = 0.014) and MD (-0.47 vs. -0.29 dB/year; P = 0.026). In multivariable mixed-effects models, β-zone PPA angular extent was the only factor independently associated with the rate of functional progression for both MD (standardized β = -0.123; P = 0.008) and VFI (standardized β = -0.312; P = 0.022). A complementary paired inter-eye difference analysis did not reach statistical significance (all P > 0.05).</p><p><strong>Conclusions: </strong>In this intra-individual analysis, eyes with greater angular extent of β-zone PPA showed faster functional progression, whereas structural progression did not differ. Although this association was not confirmed in a paired inter-eye difference analysis, these findings suggest that β-zone PPA angular extent may be a useful marker of future functional worsening in glaucoma.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169085","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":"Same-Eye Multimodal Correlation of Adaptive Optics Imaging of the Trabecular Meshwork.","authors":"Shigeru Mori","doi":"10.1016/j.ogla.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.004","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170940","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":"Postural Intraocular Pressure Changes and the Trans-Lamina Cribrosa Pressure Difference: A Systematic Review and Meta-Analysis.","authors":"Siddharth Gandhi, Michele Zaman, Michael Balas, David Mathew","doi":"10.1016/j.ogla.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.011","url":null,"abstract":"<p><strong>Topic: </strong>This systematic review and meta-analysis (PROSPERO: CRD42024556443) addresses the magnitude of intraocular pressure (IOP) changes when transitioning from sitting to supine and lateral decubitus positions. It investigates the interaction with intracranial pressure (ICP) to estimate the translaminar cribrosa pressure difference (TLPD). Participants included healthy individuals, glaucoma suspects, and patients with ocular hypertension or glaucoma.</p><p><strong>Clinical relevance: </strong>Glaucoma management relies on IOP measurements taken upright during clinic hours. This paradigm overlooks nocturnal stressors occurring during recumbency, which occupies one-third of a patient's life. Postural IOP elevations, particularly when coupled with low ICP, may drive disease progression in patients who appear stable during diurnal visits, especially those with normal-tension glaucoma (NTG).</p><p><strong>Methods: </strong>We searched Ovid MEDLINE and Embase from inception to July 2024 for observational and interventional studies measuring IOP or ICP in at least two body positions. Eligibility criteria required quantitative reporting in mmHg; studies confounding posture with circadian rhythm were excluded. Risk of bias was assessed using Risk of Bias In Non-randomized Studies - of Interventions for observational studies and the Risk of Bias 2.0 tool for the randomized trial.</p><p><strong>Results: </strong>Thirty-two cohorts comprising 2,842 eyes and 2,385 patients (weighted mean age 61.5 years) were included; 27 studies contributed quantitative data, including 22 for the supine-versus-sitting analysis. Supine IOP increases were +2.49 mmHg (95% CI, 1.33-3.65) in healthy eyes, +2.89 mmHg (95% CI, 2.27-3.50) in the glaucoma spectrum, and +3.60 mmHg (95% CI, 3.24-3.96) in ocular hypertension (one study). The dependent lateral decubitus eye increased by +3.92 mmHg (95% CI, 3.08-4.75). Qualitative synthesis suggested lower ICP in several glaucoma cohorts, although most IOP and ICP measurements were asynchronous.</p><p><strong>Conclusion: </strong>Recumbency induces significant IOP elevations, pronounced in the dependent eye during lateral decubitus positioning. Current evidence hypothesizes a potential double hit for patients with NTG who may lack cerebrospinal fluid counter-pressure, though this relies largely on inferred, asynchronous measurements. While limited by heterogeneity and reliance on ICP estimates, these findings highlight the necessity of future longitudinal research into nocturnal postural physiology to determine its role in glaucoma management.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139401","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":"Retinal Vascular Oxygen Saturation in Primary Open-Angle Glaucoma: A Systematic Review and Meta-Analysis.","authors":"Makan Ziafati, Golnoush Mahmoudinezhad, Chiara Giuffrè, Shakiba Rahimi, Amirhossein Valizadeh, Maya Patel, Erik Buchholz, Vikas Gulati, Shane Havens, Jessica Liu, Abdelrahman M Elhusseiny, Elena Bitrian, Sasan Moghimi, Ronald R Krueger, Robert N Weinreb","doi":"10.1016/j.ogla.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.009","url":null,"abstract":"<p><strong>Topic: </strong>Systematic Review and Meta-Analysis of Retinal Vascular Oxygen Saturation in Primary Open-Angle Glaucoma (POAG).</p><p><strong>Clinical relevance: </strong>To evaluate alterations in retinal arterial oxygen saturation (AO₂S), venous oxygen saturation (VO₂S), and the arteriovenous (A-V) difference among patients with POAG.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Scopus, and EMBASE databases up to June 11, 2025 (PROSPERO: CRD42025633571). Eligible studies reported retinal vascular oxygen saturation parameters in POAG and healthy control groups. Extracted outcomes included AO₂S, VO₂S, and A-V oxygen saturation difference. Meta-analysis was performed using random-effects models, with Hedges' g applied to calculate standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs). Subgroup analysis was conducted based on measurement methodology. Risk of bias and certainty of evidence were evaluated using the Newcastle-Ottawa Scale and the GRADE framework, respectively.</p><p><strong>Results: </strong>Nine studies involving 883 participants (488 patients [511 eyes] with POAG and 395 healthy controls [399 eyes]) were included. Pooled analysis demonstrated a significant elevation in AO₂S and VO₂S in POAG eyes compared with controls (SMD = 0.37; 95% CI: 0.06 to 0.68; P = 0.019; SMD = 0.58; 95% CI: 0.29 to 0.88; P < 0.001), respectively. In contrast, A-V difference showed no significant alteration between groups (SMD = -0.26; 95% CI: -0.58 to 0.06; P = 0.116). Subgroup analyses revealed that both AO₂S and VO₂S were elevated when measured with dual-wavelength oximetry, whereas hyperspectral imaging showed increased VO₂S but no significant alteration in AO₂S.</p><p><strong>Conclusions: </strong>POAG demonstrated elevated retinal vascular O2 saturation, which may reflect reduced retinal oxygen consumption due to structural damage and/or altered vascular regulation. Findings are consistent with vascular-metabolic involvement in glaucoma and suggest retinal oximetry is a promising noninvasive biomarker warranting further prospective validation.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119153","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":"Suprachoroidal Glaucoma Surgery: Time for a Fresh Look.","authors":"JoAnn A Giaconi, Kuldev Singh","doi":"10.1016/j.ogla.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.08.004","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066662","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":"Cardiorespiratory fitness, cardiovascular risk, and disease-related outcomes in primary open-angle glaucoma: a cross-sectional study.","authors":"Valentin Schuhmann, Marie Renier, Denis Infanger, Eva Fleischlin, Jan Van Eijgen, Egbert T Ritter, Thomas Jacobs, Kaatje Goetschalckx, Hans-Jürgen Gruber, Julia Kröpfl, Amaryllis H Van Craenenbroeck, Konstantin Gugleta, Ingeborg Stalmans, Véronique Cornelissen, Henner Hanssen","doi":"10.1016/j.ogla.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.09.006","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the associations of objectively measured cardiorespiratory fitness (CRF) with glaucoma-related functional, structural, and patient-reported outcomes and to compare its explanatory contribution with cumulative cardiovascular (CV) risk in patients with primary open-angle glaucoma (POAG).</p><p><strong>Design: </strong>Cross-sectional baseline analysis of the multicenter HIT-GLAUCOMA trial (NCT06058598).</p><p><strong>Subjects: </strong>One hundred ten patients with mild-to-moderate POAG.</p><p><strong>Methods: </strong>CRF was assessed by symptom-limited cardiopulmonary exercise testing and expressed as peak oxygen uptake (VO₂peak). Cumulative CV risk was estimated using the Systematic COronary Risk Evaluation 2 (SCORE2). Missing data were addressed using multiple imputation. Multivariable linear regression models with restricted cubic splines were used to evaluate associations. Relative explanatory contributions of CRF and SCORE2 were explored using adequacy indices derived from model R² values.</p><p><strong>Main outcome measures: </strong>Visual field mean deviation (MD), global retinal nerve fiber layer (RNFL) thickness, Glaucoma Activity Limitation Questionnaire (GAL-9), and National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25).</p><p><strong>Results: </strong>No statistically significant associations were observed between CRF or SCORE2, and glaucoma-related outcomes. Nevertheless, higher CRF showed directionally more favorable estimates for visual field performance, glaucoma activity limitation, and vision-related quality of life. Higher SCORE2 showed a directionally less favorable estimate for global RNFL thickness, whereas apparent non-linear patterns for patient-reported outcomes should be interpreted cautiously. Exploratory adequacy analyses suggested differential explanatory contributions. CRF retained 95% of the explanatory information for visual field MD compared with 60% for SCORE2, whereas SCORE2 retained more explanatory information for RNFL thickness (97% vs. 86%) and NEI-VFQ-25 scores (86% vs. 40%). Given the modest sample size and the absence of statistically significant primary associations, these adequacy findings should be considered exploratory rather than confirmatory.</p><p><strong>Conclusions: </strong>The observed directional patterns and exploratory adequacy analyses suggest that CRF and cumulative CV risk may reflect different dimensions of CV health across glaucoma-related outcomes. However, these findings are hypothesis-generating and require confirmation in larger, adequately powered longitudinal and interventional studies.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026883","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}