Ophthalmology. Glaucoma最新文献

{"title":"Three-Year Treatment Outcomes of Ahmed Glaucoma Valve Implantation with Adjunctive Intraoperative and Postoperative Mitomycin C.","authors":"Binh Cao, Brad Kline, Brandon Kao, Yinxi Yu, Gui-Shuang Ying, Julius T Oatts, Steven J Gedde, Iqbal Ike K Ahmed, Ying Han","doi":"10.1016/j.ogla.2026.08.001","DOIUrl":"10.1016/j.ogla.2026.08.001","url":null,"abstract":"<p><strong>Purpose: </strong>To describe 3-year outcomes of Ahmed glaucoma valve (AGV) implantation with adjunctive use of intraoperative and postoperative mitomycin C (MMC).</p><p><strong>Design: </strong>Retrospective observational consecutive case series.</p><p><strong>Participants: </strong>One hundred and twenty-one eyes of 95 patients with medically uncontrolled glaucoma who underwent AGV implantation combined with intraoperative and postoperative subconjunctival MMC injections between 2011 and 2017 at University of California, San Francisco Medical Center.</p><p><strong>Methods: </strong>Clinical data were extracted from patients' medical records, including intraocular pressure (IOP), number of glaucoma medications, best-corrected visual acuity (BCVA), and surgical complications.</p><p><strong>Main outcome measures: </strong>Intraocular pressure, treatment failure (defined as IOP > 21 mmHg or reduced <20% from baseline, IOP ≤ 5 mmHg, reoperation for glaucoma, and loss of light perception vision), number of glaucoma medications, BCVA, and surgical complications.</p><p><strong>Results: </strong>Intraocular pressure (mean ± SD) decreased from 23.7 ± 9.5 mmHg preoperatively to 12.7 ± 3.9 mmHg at 3 years (P < 0.001), and the number of glaucoma medications (mean ± SD) decreased from 2.9 ± 1.0 to 1.3 ± 0.9 (P < 0.001). The cumulative probability of failure at 3-year was 26% (95% confidence interval, 19%-34%). Best-corrected visual acuity (logarithm of the minimum angle of resolution [logMAR] mean ± SD) remained stable from preoperative vision (logMAR 0.45 ± 0.68 preoperatively, 0.56 ± 0.77 at 3 years, P = 0.16). The complication rate was 17% and the most common early postoperative complications were diplopia and hypotony maculopathy.</p><p><strong>Conclusions: </strong>Ahmed glaucoma valve implantation combined with intraoperative and postoperative MMC resulted in a significant reduction in IOP and number of glaucoma medications with a low rate of surgical complications and stable BCVA during 3 years of 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":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801831","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 of New Glaucoma Diagnosis and Surgery for Patients with Intravitreal Injections in the TriNetX Database.","authors":"Shon B Shmushkevich, Sandi Bajrami, Zachary A Grand, Jonathan D Tijerina, Basil K Williams, Adam L Rothman","doi":"10.1016/j.ogla.2026.08.002","DOIUrl":"10.1016/j.ogla.2026.08.002","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the long-term risk of incident glaucoma and of undergoing glaucoma surgery associated with intravitreal injection therapy using a large electronic health record network.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>Patients with no prior glaucoma diagnosis in the TriNetX US Collaboration Network seen between 03/14/2006 and 03/14/2026 with either exudative age-related macular degeneration (AMD) or intravitreal injection or nonexudative AMD with no history of injection.</p><p><strong>Methods: </strong>Patients with exudative AMD who received intravitreal injections (Current Procedural Terminology 67028) were compared with patients with nonexudative AMD. Patients with retinal vascular occlusions, proliferative diabetic retinopathy, retinal ischemia, pseudoexfoliation syndrome, or pigment dispersion syndrome were excluded. Cohorts were propensity score matched 1:1 for age, sex, race, ethnicity, and systemic comorbidities. Time-to-event analyses were performed, and effect estimates included risk ratios (RRs), odds ratios (ORs), and hazard ratios (HRs).</p><p><strong>Main outcome measures: </strong>New glaucoma diagnosis (International Classification of Diseases-10 H40) and glaucoma surgical interventions.</p><p><strong>Results: </strong>After exclusions and matching, each cohort contained 27 967 patients. Incident glaucoma occurred in 15.1% (4218/27 967) of injection patients versus 12.9% (3621/27 967) of controls (RR 1.17; OR 1.19; HR 1.08, P < 0.001). Any glaucoma surgery occurred in 1.6% (435/27 967) of injection patients compared with 0.8% (236/27 967) of controls (RR 1.84; OR 1.86; HR 1.66, P < 0.001). Patients with intravitreal injection were more likely to undergo glaucoma tube implantation (P < 0.001), laser trabeculoplasty (P < 0.001), cyclodestructive procedures (P = 0.001), and trabeculectomy (P = 0.03). Incisional angle surgery trended toward significance (P = 0.054).</p><p><strong>Conclusions: </strong>In a large cohort, intravitreal injection therapy for exudative AMD was associated with higher risks of incident glaucoma and glaucoma surgery compared with matched nonexudative AMD controls, corresponding to a number needed to harm of approximately 47 for incident 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":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801619","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":"Posterior Lens Dislocation to Pupillary Block in Isolated Microspherophakia.","authors":"Madhuri Manapakkam, Neethu Mohan, Nasreen Pullipurayil","doi":"10.1016/j.ogla.2026.07.006","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.07.006","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762245","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":"Standardizing Glaucoma Fellowship Evaluation: Analysis of Goals, Objectives, and Fellowship Evaluation Criteria Across United States Programs.","authors":"Anna Haeyoon Kim, Pradeep Ramulu, Mary Qiu","doi":"10.1016/j.ogla.2026.07.004","DOIUrl":"10.1016/j.ogla.2026.07.004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the variability and alignment of learning objectives and evaluation practices across US glaucoma fellowship programs, including an assessment of goal and evaluation quality using SMART (Specific, Measurable, Achievable, Relevant, Time-bound) criteria to inform the development of a standardized evaluation rubric.</p><p><strong>Design: </strong>Cross-sectional qualitative study.</p><p><strong>Participants: </strong>Twenty-three of 70 US glaucoma fellowship programs (32.9%) responding to a survey distributed to fellowship directors.</p><p><strong>Methods: </strong>Fellowship directors submitted program goals and objectives and fellow evaluation forms. Documents underwent qualitative content analysis to characterize themes, granularity and alignment between objectives and evaluations. Goals and evaluation items were graded using SMART criteria on a 0-25 scale. Alignment was assessed by determining the proportion of stated objectives that were evaluated.</p><p><strong>Main outcome measures: </strong>(1) Thematic categories of learning objectives, (2) degree of detail in goals and evaluation rubrics, (3) SMART scores, and (4) alignment between goals and evaluation tools.</p><p><strong>Results: </strong>In total, 30.4% of responding programs lacked formal goals/objectives or evaluation forms. Goals varied widely in length (55-3382 words) and detail. Common themes in goals included diagnostic acumen, medical and surgical management, and professional development. Evaluation criteria commonly aligned with Accreditation Council for Graduate Medical Education criteria. Mean SMART scores were 9.1/25 (range: 6.9-10.6) for goals documents, and 7.7/25 (range: 4.6-12.3) for evaluations, with lowest performance in the measurable and time-bound domains. Among six programs providing both goals and evaluations, a median of 83.4% of objectives were evaluated; however, evaluations frequently relied on broad nonstandardized domains (e.g. \"patient care,\" \"medical knowledge\") rather than milestone- or competency-based categories with behavioral anchors. Many specific competencies, such as office-based laser procedure proficiency or leadership and teaching responsibilities, were not explicitly assessed.</p><p><strong>Conclusions: </strong>United States glaucoma fellowship programs demonstrate substantial variability in goals and evaluation tools. Qualitative analysis revealed poor alignment between training objectives and assessment practices, with SMART criteria grading highlighting limited measurability and lack of time-bound expectations in both goals and evaluations. These findings underscore the need for a standardized, competency-based rubric with clear behavioral anchors to support consistent fellow training and evaluation across programs.</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":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671326","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":"Clinical Course and Predictors of Glaucoma Conversion in Pediatric Ocular Hypertension without Ocular or Systemic Risk Factors.","authors":"Meron Haile, Nur Cardakli, Catherine S Yao, Evan Lau, Mitali Barik, Britney Sun, Courtney L Kraus","doi":"10.1016/j.ogla.2026.07.010","DOIUrl":"10.1016/j.ogla.2026.07.010","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the long-term clinical course of pediatric ocular hypertension in patients without associated ocular or systemic risk factors and identify predictors of glaucoma conversion.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Pediatric patients evaluated as glaucoma suspects for ocular hypertension at the Johns Hopkins Wilmer Eye Institute between January 1, 2005, and June 1, 2024.</p><p><strong>Methods: </strong>Medical records of pediatric glaucoma suspects were reviewed. Eligible eyes were from patients aged <18 years with intraocular pressure (IOP) > 21 mmHg on at least 2 encounters, ≥180 days of follow up, and no ocular or systemic glaucoma-associated risk factors. Multivariable logistic regression identified predictors of conversion.</p><p><strong>Main outcome measures: </strong>Primary outcome was conversion to glaucoma based on Childhood Glaucoma Research Network criteria or glaucoma-related surgical intervention. Secondary outcomes included IOP-lowering treatment use and final IOP status.</p><p><strong>Results: </strong>Among 1390 eyes screened, 449 eyes from 247 patients met inclusion criteria. Mean follow up was 7.1 ± 4.9 years. During follow up, 39 eyes (8.7%) converted to glaucoma. Compared with nonconverters, converter eyes had higher baseline IOP (28.53 ± 12.25 vs. 24.32 ± 4.76 mmHg, P < 0.001), larger cup-to-disc ratio (CDR) (0.59 ± 0.22 vs. 0.43 ± 0.23, P < 0.001), and were more frequently male (61.5% vs. 41.1%, P = 0.014). In multivariable analysis, male sex (adjusted odds ratio [aOR]: 3.19; P = 0.006), higher baseline IOP (aOR: 1.12 per mmHg, P = 0.001), larger baseline CDR (aOR: 1.32 per 0.1 increase, P = 0.001), Goldmann applanation (aOR: 3.17, P = 0.010), and Tono-Pen tonometry (aOR: 5.48, P = 0.013) were associated with conversion. Among converters, treatment initiation was more common (92.3% vs. 23.2%, P < 0.001), while treatment discontinuation was less common (8.3% vs. 30.4%, P = 0.009). At final follow up, all converted eyes achieved normalized IOP, although 92.3% required ongoing treatment. Among nonconverters, 50.7% achieved normalized IOP at the final follow up (76.9% without treatment and 23.1% with treatment).</p><p><strong>Conclusions: </strong>Isolated pediatric ocular hypertension is not uniformly benign and carries a measurable long-term risk of glaucoma conversion. Higher baseline IOP, larger CDR, and male sex were associated with progression and may assist in early risk stratification. These findings support individualized surveillance and treatment strategies, with closer monitoring and earlier therapeutic consideration for children with higher-risk baseline features.</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":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610676","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 Elevation after Suprachoroidal Triamcinolone Acetonide in Noninfectious Uveitis: An IRIS® Registry Study.","authors":"Amin Nabavi, Swarup S Swaminathan, Janet L Davis, Felipe A Medeiros, Siamak Yousefi","doi":"10.1016/j.ogla.2026.07.009","DOIUrl":"10.1016/j.ogla.2026.07.009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence of intraocular pressure (IOP) elevation and glaucoma-related complications after suprachoroidal triamcinolone acetonide (SCS-TA) injection in patients with noninfectious uveitis (NIU) using clinical setting data from the IRIS® Registry (Intelligent Research in Sight).</p><p><strong>Design: </strong>Retrospective propensity score matched (PSM) cohort study.</p><p><strong>Participants: </strong>Adults with NIU recorded in the American Academy of Ophthalmology IRIS Registry who received SCS-TA, a dexamethasone intravitreal implant (DEX), or systemic immunosuppressive therapy without local corticosteroid (CS) treatment.</p><p><strong>Methods: </strong>Eyes treated with SCS-TA were matched 1:1:1 with eyes receiving DEX or systemic therapy controls using PSM based on baseline demographics and clinical characteristics. One eye per patient was included. Time-to-event analyses of IOP elevation and glaucoma surgery over the 12-month follow-up period were performed using Cox proportional hazards models.</p><p><strong>Main outcome measures: </strong>Occurrence of IOP ≥24 mmHg, IOP ≥30 mmHg, or an increase in IOP ≥10 mmHg from baseline within 12 months, as well as IOP-lowering medication use and glaucoma surgery.</p><p><strong>Results: </strong>A total of 790 eyes treated with SCS-TA were matched to 790 DEX-treated eyes and 790 control eyes. The SCS-TA group received a mean of 0.6 additional SCS-TA injections and 1.0 total CS injections, compared with 1.0 DEX injections and 1.2 total CS injections in the DEX group. Within 12 months, IOP ≥24 mmHg occurred in 25.7% of SCS-TA eyes and 24.7% of DEX eyes compared with 12.0% of controls (SCS-TA: hazard ratio [HR] 2.21, 95% confidence interval [CI] 1.73-2.82; DEX: HR 2.11, 95% CI 1.65-2.69; both P < 0.001). Intraocular pressure-lowering medication use increased in both CS groups during follow-up. Glaucoma surgery occurred at crude 12-month rates of 2.0% for SCS-TA, 1.1% for DEX, and 1.4% for controls, with no significant differences between groups (SCS-TA: HR 1.33, 95% CI 0.62-2.86, P = 0.469; DEX: HR 0.74, 95% CI 0.31-1.78, P = 0.50).</p><p><strong>Conclusions: </strong>In this large clinical setting cohort of patients with NIU, both SCS-TA and DEX were associated with higher risks of clinically significant IOP elevation than systemic therapy controls, with broadly similar incidence between the 2 CS delivery approaches. Although IOP-lowering medications were more frequently required, the overall incidence of glaucoma surgery remained low.</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":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610653","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":"Intermediate Outcomes of Styrene-Block-Isobutylene-Block-Styrene Microshunt, Gelatin Microstent, and Trabeculectomy: A Comparative Retrospective Cohort Study.","authors":"Moncef Berkache, Rayan Tolba, Kenan Bachour, Wissam Nassrallah, Georges M Durr","doi":"10.1016/j.ogla.2026.07.011","DOIUrl":"10.1016/j.ogla.2026.07.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare the 2-year surgical success rates, the complications, and risk factors for failure of the styrene-block-isobutylene-block-styrene (SIBS) microshunt, the gelatin microstent, and trabeculectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Single-center, single-surgeon retrospective cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects: &lt;/strong&gt;142 eyes from 124 adult patients diagnosed with glaucoma (43 SIBS microshunt, 63 gelatin microstent, and 36 trabeculectomy).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive eyes that underwent SIBS microshunt implantation, gelatin microstent implantation, and trabeculectomy were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was the proportion of eyes achieving surgical success at 2 years, defined as (1) intraocular pressure (IOP) between 6 and 17 mmHg (inclusive) without the number of glaucoma medication classes (meds) (complete success) or with meds (qualified success); (2) no IOP readings &gt;17 mmHg or &lt;6 mmHg with clinical hypotony, on 2 consecutive visits; and (3) no surgical revision, reoperation, or loss of light perception. Secondary outcomes included success rates for IOP range of 6 to 14 and 6 to 21 mmHg, postoperative IOP, meds, complications, additional interventions, and risk factors for failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;SIBS microshunt group included a significantly higher proportion of eyes with prior failed glaucoma filtering surgery (41.9% vs. 0% for gelatin microstent and 2.8% for trabeculectomy, respectively; P &lt; 0.001). At 24 months, complete success rates in the 6 to 17 mmHg range were 72.1% for SIBS microshunt, compared with 50.0% for trabeculectomy (P = 0.034) and 38.1% for gelatin microstent (P &lt; 0.0001). Qualified success was achieved in 83.7%, 66.7%, and 55.6%, respectively, with SIBS demonstrating superior outcomes to gelatin microstent (P = 0.003). In the multivariable analysis, the gelatin microstent (hazard ratio [HR]: 3.43; 95% confidence interval [CI]: 1.61-7.31) and combined cataract surgery (HR: 2.06; 95% CI: 1.27-3.35) were associated with increased hazard of failure, while age ≥70 years was associated with lower risk of failure (HR: 0.54; 95% CI: 0.30‑0.98). All procedures significantly reduced IOP and meds (P &lt; 0.001). Complication rates were similar across groups, most resolving before 3 months. Needling was performed in 2.3% (SIBS microshunt), 30.2% (gelatin microstent), and 30.6% (trabeculectomy) of eyes, and 5-fluorouracil injections in 48.8%, 25.4%, and 50.0%, respectively. Revision rates were 4.7%, 7.9%, and 0%, respectively (P = 0.283), while reoperations were higher with gelatin microstent (15.9% vs. 2.3% and 2.8%; P = 0.022).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite higher-risk baseline profile, the SIBS microshunt achieved higher 2-year success rates than trabeculectomy and gelatin microstent across multiple IOP ranges, with comparable complications and fewer reoperations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Financial disclosure(s): &lt;/strong","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610645","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":"Multi-Ancestry Genome-Wide Association with Fine-Mapping Identifies Novel Loci for Pigment Dispersion Syndrome and Pigmentary Glaucoma.","authors":"Mark Dibbs, Christina Jayaraj, James F Martone, Christine Y Bakhoum, Mathieu F Bakhoum","doi":"10.1016/j.ogla.2026.07.008","DOIUrl":"10.1016/j.ogla.2026.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>Pigment dispersion syndrome and pigmentary glaucoma are important causes of ocular hypertension and glaucomatous optic neuropathy, yet their genetic determinants remain incompletely defined, particularly across diverse ancestries. This study aimed to use a large multi-ancestry cohort from the All of Us Research Program to investigate the genetic basis of pigment dispersion syndrome and pigmentary glaucoma.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Participants: </strong>In total, 572 cases and 37 808 controls with array genotyping and 537 cases and 35 493 controls with whole-genome sequencing.</p><p><strong>Methods: </strong>Using electronic health record phenotyping in the All of Us Research Program, we performed multi-ancestry genome-wide association analyses using both array-based data and whole-genome sequencing-based data, comparing patients with pigment dispersion syndrome or pigmentary glaucoma to those without either condition. We also performed Firth penalized regression and Fisher analyses, and we performed principal component analyses to assess effect sizes across genetic ancestries. We applied statistical fine-mapping, examined for cross-trait overlap, and assessed expression quantitative trait locus associations for lead variants.</p><p><strong>Main outcome measures: </strong>P values and odds ratios of lead loci from genome-wide association analyses; size of credible sets determined from fine-mapping; allele frequency of lead variants in cases, controls, and the general population; expression quantitative trait loci effect size and P values linking lead variants to gene expression.</p><p><strong>Results: </strong>We identified 4 loci reaching genome-wide significance across analyses, including signals near EPHA7 (which mediates cell-cell signaling), within TYR (involved in melanin synthesis and replicated from prior studies), within LINC01138, and near OTX2. Statistical fine-mapping refined 3 of these loci to single-variant 95% credible sets and narrowed the TYR locus to small credible sets, prioritizing possible causal variants. Effect estimates were broadly consistent across genetic ancestry clusters. Lead variants showed regulatory evidence in expression quantitative trait locus, including reduced EPHA7 expression.</p><p><strong>Conclusions: </strong>These findings implicate both melanogenesis and cell-cell adhesion and signaling pathways in pigment dispersion syndrome and pigmentary 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":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610673","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":"Rare Complications of Selective Laser Trabeculoplasty: Corneal Edema and Thinning in the United States Using Insurance Claims Data.","authors":"Bryce P Hwang, Anna M Dickinson, Natacha C Villegas, Sophia Y Wang, Ann Shue","doi":"10.1016/j.ogla.2026.07.007","DOIUrl":"10.1016/j.ogla.2026.07.007","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence of corneal edema and thinning following selective laser trabeculoplasty (SLT) and identify associated risk factors.</p><p><strong>Design: </strong>Population-based retrospective cohort study.</p><p><strong>Participants: </strong>Patients who underwent SLT at 18 years of age or older were identified in Optum's deidentified Clinformatics Data Mart Database between 2003 and 2021.</p><p><strong>Methods: </strong>Patients who underwent SLT were identified by current procedural terminology. The primary outcome was the incidence of corneal edema within 30 days or other corneal pathology within 120 days after SLT. The secondary outcome was time to first corneal complication after SLT. The demographic and clinical risk factors investigated included age, sex, race, baseline myopia, and glaucoma type.</p><p><strong>Main outcome measures: </strong>Kaplan-Meier estimated cumulative incidence of corneal edema 30 days after or thinning 120 days after SLT. Hazard ratios (HRs) with 95% confidence intervals (CIs) from multivariable Cox proportional hazards regression models.</p><p><strong>Results: </strong>Corneal edema within 30 days or other corneal pathology within 120 days was observed in 61/82 317 (0.07%) patients who underwent SLT. The cumulative incidence of post-SLT corneal pathology was 0.07% (95% CI, 0.06%-0.09%). Post-SLT corneal pathology was more common in males (61% vs. 45%, P = 0.02); in multivariable analysis, male sex (HR, 1.85; 95% CI 1.11-3.12, P = 0.02) and myopia (HR, 1.91; 95% CI 1.02-3.61, P = 0.04) were independently associated with increased risk. Age at SLT, patient race, glaucoma type, and the use of glaucoma drops before SLT were not significantly associated with post-SLT corneal pathology after adjusting for all other covariates.</p><p><strong>Conclusions: </strong>Our results suggest that approximately 1 in 1350 adults will develop corneal edema or thinning after SLT. Male and myopic patients undergoing SLT may be at greatest risk for developing post-SLT corneal changes.</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":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586123","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":"In Vivo Evidence of the Histopathologic Reappraisal of Posterior Embryotoxon.","authors":"Archeesha Vyas, Shubham Manchanda, Sushmita Kaushik","doi":"10.1016/j.ogla.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.ogla.2026.06.011","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594451","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}