Ophthalmology. Glaucoma最新文献

{"title":"Causes and Treatments of Malignant Glaucoma in the United States: Analysis of IRIS® Registry.","authors":"Asahi Fujita, William C Kearney, David S Friedman, Prashit Parikh, Elizabeth Ciociola Kelly, Yusrah Shweikh, Connor Ross, Tobias Elze, Alice C Lorch, Joan W Miller, Nazlee Zebardast","doi":"10.1016/j.ogla.2025.08.006","DOIUrl":"10.1016/j.ogla.2025.08.006","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the causes and treatments of malignant glaucoma (MG) in the United States.</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS: Eyes with diagnosis codes for MG between 2014 and 2023 in the IRIS® Registry (Intelligent Research in Sight).</p><p><strong>Methods: </strong>Precipitating procedures and treatment modality were identified using procedure codes and medication data. Using generalized estimating equations, we investigated factors associated with initial treatment with pars plana vitrectomy (PPV), those associated with undergoing laser or incisional surgeries after medication, and those associated with undergoing surgery or cyclophotocoagulation after laser hyaloidotomy.</p><p><strong>Main outcome measures: </strong>The primary outcomes were a breakdown of precipitating procedures and treatment modalities. The secondary outcomes included factors associated with initial treatment with PPV and those associated with undergoing additional procedures after medication or laser hyaloidotomy.</p><p><strong>Results: </strong>A total of 3554 eyes were diagnosed with MG, among which pre-existing glaucoma was identified in 54.5%. Cataract surgery was the most common precipitating surgery (26.6%), and estimated incidence rate was the highest after tube shunt surgery (23.8/10 000). First-recorded treatment was medication in 54.8%, laser hyaloidotomy in 8.9%, and PPV in 31.9%. Higher intraocular pressure (IOP) at onset (odds ratio: 1.08 [95% confidence interval: 1.03-1.12] per 10 mmHg) and worse visual acuity at onset (odds ratio: 1.27 [95% confidence interval: 1.19-1.35] per 1 unit higher logarithm of the minimum angle of resolution) were associated with initial PPV; 34% and 24% of the eyes underwent additional procedures after medication and laser hyaloidotomy, respectively. Factors associated with subsequent procedures among medically treated eyes included aphakia or pseudophakia (odds ratio: 1.33 [95% confidence interval: 1.09-1.63]) and higher IOP at onset (odds ratio: 1.11 [95% confidence interval: 1.05-1.17] per 10 mmHg). Higher IOP at onset (odds ratio: 1.19 [95% confidence interval: 1.03-1.38] per 10 mmHg) was also associated with additional procedures after laser hyaloidotomy.</p><p><strong>Conclusions: </strong>More than half of the eyes with MG had a pre-existing glaucoma diagnosis. Tube shunt surgery had the highest incidence rate of MG. More than half were initially treated with medication, and one-third were initially treated with PPV. Higher IOP at onset was associated with a higher likelihood of being initially treated with PPV as well as a higher likelihood of requiring additional procedures when initially treated with medication or laser hyaloidotomy.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980485","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":"Long-Term Follow-Up on a Juvenile Open-Angle Glaucoma Pedigree with a Novel EFEMP1 Mutation (c.1313, p.Tyr438Cys).","authors":"Brian P Young, Angela W Nyunt, Molly A Clymer, Mallory R Tollefson, Ben R Roos, Michael J Schnieders, Alan L Robin, John H Fingert","doi":"10.1016/j.ogla.2025.08.003","DOIUrl":"10.1016/j.ogla.2025.08.003","url":null,"abstract":"<p><strong>Purpose: </strong>Determine the genetic cause of glaucoma in a juvenile open-angle glaucoma (JOAG) pedigree of European ancestry.</p><p><strong>Design: </strong>Case series or pedigree analysis PARTICIPANTS: A three-generation JOAG pedigree METHODS: We obtained clinical data and tested DNA for mutations in known JOAG-causing genes with Sanger sequencing for MYOC and whole exome sequencing for EFEMP1. We assessed identified mutations for pathogenicity by (1) frequency in control databases; (2) mutation analysis algorithms; (3) homology analyses; and (4) structural modeling of mutational effects on encoded proteins.</p><p><strong>Main outcome measures: </strong>Detection of a mutation that is coinherited with glaucoma in the JOAG pedigree. Secondary measures include descriptions of glaucoma phenotype (age at presentation, maximum intraocular pressure [IOP], progression rate, and response to therapy).</p><p><strong>Results: </strong>Clinical data from an average follow-up of 11.5 ± 7.05 years were available from four family members with JOAG. Members of this pedigree had a mean age of diagnosis of 32.5 ± 8.6 years (range 25-43 years) and a mean maximum treated IOP of 32.3 ± 12.0 (range 16-50) mmHg. Family members had visual field progression ranging from -0.25 to -1.1 dB/year and required an average of 1.8 ± 1.0 incisional glaucoma surgeries per eye for IOP control. No MYOC mutations were detected. A heterozygous missense mutation (c.1313A>G, p.Tyr438Cys) was detected in the EFEMP1 gene in all four family members with JOAG and is absent from control subjects. The p.Tyr438Cys mutation altered a highly conserved amino acid and was predicted to be pathogenic by 6 mutation analysis algorithms. Modeling of the p.Tyr438Cys mutation indicated it causes structural changes to EFEMP1 protein that are likely detrimental to its function.</p><p><strong>Conclusions: </strong>This study identifies a novel mutation, p.Tyr438Cys, as the first known glaucoma-causing EFEMP1 mutation in a JOAG pedigree of European ancestry. Patients with the EFEMP1 mutation p.Tyr438Cys have an early-onset severe glaucoma phenotype with high maximum IOPs that require surgical interventions and may have rapid progression. These data underscore the severity of this type of JOAG and the need for further research into its pathogenic mechanisms and therapeutic management.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980458","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":"On the Feasibility of Accelerating Glaucoma Clinical Trials Using Portable Perimetry.","authors":"Jeremy C K Tan, Giovanni Montesano, Jonathan Crowston, Katharina Bell, David P Crabb, Pete R Jones","doi":"10.1016/j.ogla.2025.08.004","DOIUrl":"10.1016/j.ogla.2025.08.004","url":null,"abstract":"<p><strong>Purpose: </strong>To model whether more frequent (weekly, monthly) visual field (VF) assessments using portable \"home\" perimetry might more quickly detect glaucoma progression in a clinical trial context.</p><p><strong>Design: </strong>Cross-sectional with additional simulations PARTICIPANTS: Forty patients (78 eyes; n = 21 healthy, n = 16 glaucoma suspects, n = 41 manifest glaucoma).</p><p><strong>Methods: </strong>Participants performed an interleaved sequence of 2 portable (Eyecatcher v3.0; EC3) and 2 reference (Humphrey Field Analzyer [HFA] SITA-Fast) VF tests (4 tests total per eye). Linear mixed modeling was then applied to one randomly selected eye per patient to mathematically predict the expected proportion of progressors detected by EC3/HFA over a 3-year period, given different testing regimens (from weekly to every 4 months), levels of variability, and underlying rates of true progression.</p><p><strong>Main outcome measures: </strong>Test-retest variability and proportion of progressors detected.</p><p><strong>Results: </strong>The portable perimeter was significantly less reliable: the Bland-Altman 95% coefficient of repeatability for mean deviation (CoR_MD^95%) was 6.37 dB for EC3 and 4.25 dB for the HFA. Statistical simulations, however, predicted that this lower reliability would be offset by more frequent testing. Thus, modeling indicated one EC3 test per month would detect a higher proportion of slow (-0.5 dB/year), moderate (-1 dB/year), and fast (-2 dB/year) progressors compared to one HFA test every 4 months. Implications for trial sample sizes were also modeled, with the number of participants required to evidence a 20% reduction in baseline progression over 2 years (following a hypothetical intervention) predicted to decrease by 24.3%/36.3% with the addition of monthly/fortnightly home testing. There was no significant difference in mean test duration between the EC3 and HFA (226 vs. 225 seconds, P = 0.78), and participants rated the EC3 as somewhat easier to use (system usability scale; P = 0.004).</p><p><strong>Conclusions: </strong>Home VF assessments, despite poorer reliability than current reference standard (\"in-clinic\") devices, would allow faster or greater detection of glaucoma progression via an increased frequency of testing, and could reduce the sample size requirements of future clinical trials. Implications on duration, access and overall cost are discussed.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980467","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":"Assessing Agreement of Intraocular Pressure from Four Mechanistically Different Tonometers in the Eye Dynamics and Engineering Network Clinical Trial.","authors":"Max Liu, David M Reed, Shan Fan, Arash Kazemi, Vikas Gulati, Arthur J Sit, Sayoko E Moroi, Carol B Toris","doi":"10.1016/j.ogla.2025.07.010","DOIUrl":"10.1016/j.ogla.2025.07.010","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the measurements of intraocular pressure (IOP) by four mechanistically different tonometers in healthy participants from the Eye Dynamics and Engineering Network Aqueous Humor Dynamics clinical trial using the mean difference estimation, equivalence statistics, and adjusting for proparacaine's effects on IOP.</p><p><strong>Design: </strong>Multicenter open-label clinical trial in healthy adults (NCT01677507).</p><p><strong>Participants: </strong>Enrolled were 122 participants (55.2 ± 8.8 years; 92 women and 30 men), 121 of which had measurements with and without proparacaine.</p><p><strong>Methods: </strong>Participants from 3 sites had their IOPs measured with iCare rebound tonometer (RT), ocular response analyzer corneal-compensated (CC), pneumatonometer (PN), and Goldmann applanation tonometer (GAT). Intraocular pressure readings with RT and CC were collected with and without proparacaine.</p><p><strong>Main outcome measures: </strong>Effect sizes and agreement in IOP measurements from the four tonometers was analyzed with Data analysis using Bootstrap-Coupled ESTimation, Bland-Altman Limits of Agreement (LoAs), Lin's concordance correlation coefficient (CCC), and robust equivalence two 1-sided t-tests in tandem with null hypothesis significance testing. Data analysis using bootstrap-Coupled ESTimation was used to analyze differences in IOP readings from RT and CC before and after administering proparacaine.</p><p><strong>Results: </strong>Data analysis using Bootstrap-Coupled ESTimation, LoA, and CCC showed greatest effect size and poorest agreement between PN and the other tonometers. The lowest mean difference was seen when comparing GAT and CC. However, LoA and CCC found the strongest agreement between RT and GAT. Two 1-sided tests revealed tonometers can be considered equivalent to one another at ± 2 mmHg, except for PN. After applying proparacaine, IOP decreased significantly (P < 0.0001) by RT (1.2 ± 1.9 mmHg right eye [OD]; 1.1 ± 1.7 mmHg left eye [OS]), and CC (1.4 ± 1.8 mmHg OD; 1.3 ± 2.3 mmHg OS).</p><p><strong>Conclusions: </strong>When adjusted for proparacaine's effect on IOP, 3 tonometers were equivalent between each other when determined by equivalence statistical testing with equivalence bounds ± 2 mmHg. The PN reads >2 mmHg higher than RT, CC, or GAT. Therefore, when comparing IOP data from different tonometers, one should consider that not all tonometer measurements are interchangeable and the proparacaine effect should be considered.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849926","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":"Intraocular Pressure Fluctuations Recorded by a Telemetric Sensor After Nonpenetrating Glaucoma Surgery in Primary Open-Angle Glaucoma.","authors":"Colya N Englisch, André Trouvain, Philip Wakili, Kaweh Mansouri, H Burkhard Dick, Esther M Hoffmann, Marc J Mackert, Achim Langenbucher, Karl T Boden, Peter Szurman","doi":"10.1016/j.ogla.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.ogla.2025.07.007","url":null,"abstract":"<p><strong>Objective: </strong>To investigate short- and long-term intraocular pressure (IOP) fluctuations in patients with primary open-angle glaucoma (POAG) after successful nonpenetrating glaucoma surgery (NPGS).</p><p><strong>Design: </strong>Prospective, open-label, multicenter interventional study.</p><p><strong>Subjects: </strong>A total of 20 patients with POAG who underwent NPGS combined with permanent implantation of a suprachoroidal telemetric IOP sensor (EyeMate-SC, Implandata Ophthalmic Products GmbH, Hanover, Germany). The mean age of the cohort was 66.9 ± 10.6 years. Half were male, and half were female.</p><p><strong>Methods: </strong>Telemetric IOP measurements were obtained over a 3-year period, excluding the first 180 postoperative days and those during which ocular glaucoma medications were applied. One day was divided into eight time-of-day periods (TODs). The median absolute difference (MAD) in IOP between day χ and day χ + 7, 30, 90, 180, and 360 was calculated for each TOD and each eye, in which sequential IOP measurements were accordingly available.</p><p><strong>Main outcome: </strong>IOP fluctuations.</p><p><strong>Results: </strong>The mean follow-up duration was 952.8 ± 276.6 days. For analysis, a total of 139,512 mean IOP values were paired. Overall, diurnal IOP decreased by 20.7%, from 11.1 ± 5.0 mmHg in the \"early morning\" to 8.8 ± 3.2 mmHg in the \"late evening\", followed by a nocturnal IOP increase of 13.6% to 10.0 ± 3.8 mmHg in the \"late night\". Independently of the TOD, fluctuations were smallest during the 7-day interval and largest during the 360-day interval. The awake period, lasting from early morning to early evening, displayed increasing MADs with growing time interval, resulting in moderate IOP fluctuations in the short term (1.5 mmHg < MAD < 2.0 mmHg) and large fluctuations in the long term (MAD > 2.0 mmHg). The late-night TOD displayed the lowest fluctuation amplitude.</p><p><strong>Conclusions: </strong>Nychthemeral IOP fluctuations persist in eyes with an average IOP of 10 mmHg following successful NPGS. Short-term IOP fluctuations were moderate, whereas long-term fluctuations were large. Irregular IOP measurements are insufficient to assess IOP fluctuation and thus to determine optimal glaucoma management. The implementation of safe and accurate telemetric sensors has the potential to enhance glaucoma management.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719224","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":"Outcomes in Primary Congenital Glaucoma, 2011-2023: L V Prasad Eye Institute, Hyderabad.","authors":"Anil K Mandal, Vijaya K Gothwal, Mohammed Hasnat Ali","doi":"10.1016/j.ogla.2025.07.005","DOIUrl":"10.1016/j.ogla.2025.07.005","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical outcomes in patients with primary congenital glaucoma (PCG) managed over a period of 13 years.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>One thousand one hundred fifty eyes of 704 patients undergoing surgery for PCG between January 2011 and December 2023 with a minimum follow-up of 6 months.</p><p><strong>Methods: </strong>Medical records of children with PCG were reviewed, and demographic and clinical data were collected. Patients who underwent primary combined trabeculotomy-trabeculectomy (CTT) without mitomycin-C (MMC) as an initial procedure were included (n = 1128 eyes). Complete success was defined as intraocular pressure (IOP) ≥ 6 mmHg and ≤ 16 mmHg without glaucoma medications and qualified success when 1 glaucoma medication was required. Failure was defined as uncontrolled IOP with more than 1 glaucoma medication, need for repeat surgery, chronic hypotony (IOP < 6 mmHg on 2 consecutive visits at 1 month interval) or any sight-threatening complications.</p><p><strong>Main outcome measures: </strong>Intraocular pressure control, number of glaucoma medications, visual acuity (VA), and success rate.</p><p><strong>Results: </strong>The mean age of patients at first surgery was 23.1 (standard deviation [SD]: 44.7) months (range, 9 days to 233 months; median, 5 months) and mean follow-up was 60.1 (SD: 49.6) months. Infantile-onset PCG was the most common form (61%) of presentation. Primary CTT without MMC was performed in 1128 eyes (98.1%). Complete success rate was 85.9%, 69.7%, and 37.8%, at the 1st, 5th, and 10th year, respectively. The corresponding complete plus qualified success rate was 98.2%, 93.3%, and 84.1%, respectively. Overall, infantile-onset PCG showed better success rates than other 2 groups. There was a significant reduction in IOP at last follow-up (43.4%; P < 0.0001). Preoperatively, majority of eyes (n = 937; 81.5%) were using glaucoma medications, whereas at last follow-up, 388 eyes (41.4%) required medications (P < 0.0001). Of the 690 eyes (60%) that presented with corneal edema, 622 eyes (90%) had clear cornea at last follow-up (P < 0.0001). At last follow-up, 190 eyes (23.1%) had VA of ≥20/40. Multivariate Cox proportional hazards analysis revealed level of IOP and corneal diameter to be independent risk factors for poor surgical outcome.</p><p><strong>Conclusions: </strong>Our large cohort study treated by CTT without MMC is encouraging and may be considered as the initial surgical procedure in PCG. The outcomes were more favorable in children with infantile-onset PCG.</p><p><strong>Financial disclosure(s): </strong>The authors have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700462","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 Prospective Study of a New 24-2C Algorithm Using the Swedish Interactive Thresholding Algorithm Standard.","authors":"Euido Nishijima, Takahiko Noro, Kei Sano, Shumpei Ogawa, Shunsuke Sumi, Yuka Igari, Tomoyuki Watanabe, Nanami Kishimoto, Sachiyo Okude, Gary C Lee, Aiko Iwase, Tadashi Nakano","doi":"10.1016/j.ogla.2025.07.004","DOIUrl":"10.1016/j.ogla.2025.07.004","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the performance of the 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and Standard with the 10-2 SITA Standard in assessing visual function in patients with glaucoma.</p><p><strong>Design: </strong>A multicenter prospective cross-sectional study.</p><p><strong>Participants: </strong>Overall, 71 eyes of 71 patients with primary open-angle or normal-tension glaucoma were included.</p><p><strong>Methods: </strong>The participants underwent visual field testing using the 24-2C SITA Faster, 24-2C SITA Standard (research prototype), and 10-2 SITA Standard in a randomized order on the same day. The global indices, threshold values, total deviation (TD), pattern deviation (PD), and test durations of the algorithms were compared. Correlations among the 10-2 SITA Standard mean deviation (MD) and number of depressed test point locations in the TD and PD probability plots at P < 5%, P < 2%, and P < 1% significance levels within the central 10° were analyzed.</p><p><strong>Main outcome measures: </strong>Differences in global indices, threshold values, TD, PD, and test duration between algorithms. Correlations of the MD and number of TD and PD points of the 10-2 SITA Standard and those of the central 10° region for the 24-2C algorithms.</p><p><strong>Results: </strong>No significant differences were found in the global indices between the 24-2C SITA Faster and Standard. The 24-2C SITA Faster had a significantly shorter test duration (55.2% shorter) than the 24-2C SITA Standard. The 24-2C SITA Standard was 45.2% shorter than the combined 24-2 SITA Standard plus 10-2 SITA Standard. The 24-2C SITA Standard showed significantly higher correlation with the 10-2 SITA Standard than the 24-2C SITA Faster.</p><p><strong>Conclusions: </strong>There were no significant differences in global indices between the 24-2C SITA Standard and 24-2C SITA Faster. However, the 24-2C SITA Standard showed a stronger correlation with the 10-2 SITA Standard. The 24-2C SITA Standard demonstrates potential for more effectively assessing central visual field function in patients with glaucoma.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700461","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":"Cumulative Incidence of Bleb-Related Infections after Mitomycin C-Augmented Filtration Surgery over 10 Years in Japanese Patients with Glaucoma.","authors":"Mitsuki Kambayashi, Rei Sakata, Asahi Fujita, Makoto Aihara, Yuko Ohno, Shiroaki Shirato","doi":"10.1016/j.ogla.2025.07.001","DOIUrl":"10.1016/j.ogla.2025.07.001","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the incidence rates and risk factors for bleb-related infections (BRIs) following mitomycin C (MMC)-augmented filtration surgeries, including trabeculectomy and Ex-Press implantation, in Japanese patients with glaucoma.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>Two thousand ninety-seven eyes from 1508 patients who underwent MMC-augmented filtration surgery between 2008 and 2022.</p><p><strong>Methods: </strong>We reviewed and extracted the medical records of baseline characteristics, surgical details, and follow-up data. Patients were categorized by surgery type and glaucoma diagnosis. Bleb-related infection cases were categorized by severity and analyzed in terms of demographic and surgical variables. Kaplan-Meier survival analysis was used to estimate the BRI incidence rate, and a Cox proportional hazards model was used to identify influencing factors.</p><p><strong>Main outcome measures: </strong>The cumulative incidence of BRI in all patients who underwent filtration surgery.</p><p><strong>Results: </strong>In total, 50 eyes with BRI (49 patients; mean age: 52.6 years; 21 eyes from females) were identified, yielding an overall incidence rate of 2.38%. Stage I to III infections were observed in 27, 15, and 8 eyes, respectively. The cumulative incidence of BRI increased over time, with estimated rates of 1.5 ± 0.3% (standard error) at 5 years, 3.8 ± 0.7% at 10 years, and 6.4 ± 1.4% at 14 years. Furthermore, 33 eyes out of 1460 eyes with primary open-angle glaucoma limited to primary surgeries developed BRI. Younger age at surgery was identified as a significant risk factor for BRI (hazard ratio: 0.969 per 1 year; P < 0.001).</p><p><strong>Conclusions: </strong>This study is the first to show that the risk of BRI continues to increase 10 years after MMC-augmented filtration surgery. When considering filtration surgery, it is important to take into account the patient's age and inform them of the benefits of the procedure and the long-term risk of infection.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602383","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":"Identifying Barriers and Improving Adherence to Follow-up of Childhood Glaucoma in South India.","authors":"Manju R Pillai, George Varghese Puthuran, David S Friedman, Vijayakumar Valaguru, Raheem Rahmathullah, Santhosha P Ganesh, Janani Rajendran, Iswarya Mani, Ramasamy Krishnadas, Maria Papadopoulos","doi":"10.1016/j.ogla.2025.06.013","DOIUrl":"10.1016/j.ogla.2025.06.013","url":null,"abstract":"<p><strong>Objective: </strong>To understand predictors and barriers of adherence to follow-up and identify strategies to improve follow-up in childhood glaucoma.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>Caregivers of children with glaucoma diagnosed between January 2014 and January 2019 residing within 200 km of the base hospital.</p><p><strong>Methods: </strong>Home visits were conducted with consenting caregivers to collect information on socioeconomic status, education, occupation, activities, and quality of life. Caregivers were subsequently invited to bring their affected children to the base hospital for a comprehensive eye evaluation. Adherence was defined as returning within 6 months of the recommended follow-up visit. Logistic regression was used to identify factors associated with adherence.</p><p><strong>Main outcome measures: </strong>Adherence to follow-up; association of adherence with socioeconomic status, caregiver education, prior glaucoma surgery, and travel-related barriers; perceived facilitators for improving follow-up.</p><p><strong>Results: </strong>Of 147 caregivers who were interviewed in their homes, 142 reported to the base hospital with the child and were included in the analysis. Of these, 79 (56%) remained adherent to follow-up. Caregivers of adherent children were more likely to be better educated (68.3% vs. 42.9% having at least high school education; P = 0.018); they were more frequently from urban areas (19% vs. 8%; P = 0.084), and more caregivers belonged to upper middle class (17.7% vs. 6.3%; P = 0.027). Multivariable logistic regression adjusting for these factors showed that children who had undergone glaucoma surgery were 3.02 times more likely (95% confidence interval = 1.21-7.54) to be adherent. Travel distance to the hospital was not associated with adherence. Caregivers reported that cost incentives toward travel and medical expenses would encourage follow-up.</p><p><strong>Conclusions: </strong>Only half the children with childhood glaucoma remained adherent to follow-up. Lack of prior surgery followed by lower socioeconomic status were the key risk factors. Financial assistance may help improve long-term follow-up.</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":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585678","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":"Accuracy of ICD-10 Glaucoma Codes in a Large Academic Practice.","authors":"Daniel L Liebman, Grace E Johnson, Anthony Marte, David S Friedman, Michael V Boland, Tobias Elze, Luo Song, Mengyu Wang, Lucy Q Shen","doi":"10.1016/j.ogla.2025.06.012","DOIUrl":"10.1016/j.ogla.2025.06.012","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562106","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}