Ophthalmology. Glaucoma最新文献

{"title":"Ologen-Augmentation of Ahmed Valves in Pediatric Glaucomas: 2- to 6-Year Follow-Up.","authors":"Adam Jacobson, Brenda L Bohnsack","doi":"10.1016/j.ogla.2025.06.008","DOIUrl":"10.1016/j.ogla.2025.06.008","url":null,"abstract":"<p><strong>Purpose: </strong>Determine 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGDs) in children with glaucoma.</p><p><strong>Design: </strong>Retrospective interventional case series.</p><p><strong>Subjects: </strong>Children (<18 years of age) with glaucoma requiring surgery for intraocular pressure (IOP) control with at least 2 years of postoperative follow-up.</p><p><strong>Methods: </strong>Placement of OAGD between 2018 and 2022.</p><p><strong>Main outcome measures: </strong>Change in IOP, number of glaucoma medications and best-corrected visual acuity from preoperative to final follow-up, and success of surgery (complete defined as IOP 5 to 20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications).</p><p><strong>Results: </strong>Forty eyes of 28 patients underwent OAGD at median age of 2.6 years (interquartile range [IQR], 0.6-7.8). Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients), followed by glaucoma secondary to nonacquired ocular anomaly (11 eyes of 6 patients). Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [interquatile range (IQR), 1-2]). Preoperative IOP was a median of 27 mmHg (IQR, 24-35) on a median of 3 (IQR, 2-3) glaucoma medications. At final follow-up (median 3.6 years [IQR, 2.9-4.3]), IOP (median, 15 mmHg [IQR, 13-17]) and glaucoma medications (median, 0 [IQR, 0-0]) were significantly decrease (P < 0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% (95% confidence interval [CI], 59-86) and 57% (95% CI, 35-74). Qualified success rate was 75% (30 of 40 eyes) with 3- and 5-year survival rates of 87% (95% CI, 71-95) and 67% (95% CI, 42-83), respectively.</p><p><strong>Conclusions: </strong>Although OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years.</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":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531323","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":"Survey of Patient Understanding and Satisfaction in Glaucoma Filtering Surgery.","authors":"Farid Akkouche, Paul Bastelica, Christophe Baudouin, Shaya Sable, Antoine Labbe","doi":"10.1016/j.ogla.2025.06.007","DOIUrl":"10.1016/j.ogla.2025.06.007","url":null,"abstract":"<p><strong>Objectives: </strong>To assess patients' understanding of glaucoma surgery and their postoperative satisfaction, to study the factors that may influence them, and to investigate correlations between these 2 determining factors.</p><p><strong>Design: </strong>A multicenter observational study.</p><p><strong>Subjects: </strong>Patients scheduled for glaucoma filtration surgery were included.</p><p><strong>Methods: </strong>Participants responded preoperatively to a questionnaire developed after literature review, evaluating their understanding of the surgery, and to a second questionnaire evaluating their postoperative satisfaction, between 2 and 3 months after surgery.</p><p><strong>Main outcome measures: </strong>The primary outcomes were the mean scores for preoperative understanding and postoperative satisfaction. The influence of demographic, clinical, and surgical factors on comprehension and satisfaction was analyzed using univariate and multivariate models.</p><p><strong>Results: </strong>In this study, 97 patients responded to the questionnaire evaluating their understanding of the surgery preoperatively. Postoperative satisfaction could be evaluated in 86 of them. The mean understanding score was 13.4 ± 5.4 (out of 25). Level of education (P < 0.01) and reading the French Society of Ophthalmology's information form on glaucoma filtering surgery (P < 0.05) were statistically correlated with a better understanding after multivariate analysis. The mean postoperative satisfaction score was 7.13 ± 3.0 (out of 10). Needling (P < 0.01) and resumption of hypotensive treatment (P < 0.001) were statistically correlated with poorer satisfaction after multivariate analysis. In addition, poorer preoperative understanding was correlated with lower postoperative satisfaction with a Pearson coefficient of 0.42 (95% confidence interval: 0.23-0.57 [P < 0.01]).</p><p><strong>Conclusions: </strong>Overall, patient understanding was limited, and poor understanding negatively influenced postoperative satisfaction.</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":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487253","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 of Hydrus Microstent with Cataract Surgery in Asian and Non-Asian Eyes with Normal Tension Glaucoma.","authors":"Debbie S Kuo, Sharon Y H Lee, Christos N Theophanous","doi":"10.1016/j.ogla.2025.06.006","DOIUrl":"10.1016/j.ogla.2025.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of the Hydrus Microstent in conjunction with cataract surgery in patients with normal tension glaucoma (NTG) with minimum 12-month follow-up.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>Normal tension glaucoma eyes having Hydrus with cataract surgery and cataract-only controls.</p><p><strong>Methods: </strong>Glaucoma was staged by the Hodapp-Parrish-Anderson criteria. Generalized estimating equations were used to account for intraocular correlation in regression analyses.</p><p><strong>Main outcome measures: </strong>The primary outcome was medication reduction from baseline at 1 year. Secondary outcomes were medication reduction in subsequent years, mean intraocular pressure (IOP) change from baseline, proportion of eyes meeting IOP targets, and percentage of eyes requiring secondary surgical interventions (SSI) at yearly time points.</p><p><strong>Results: </strong>Sixty-four eyes of 40 patients undergoing Hydrus Microstent and cataract surgery were included in the analysis, of which 32 eyes were from Asian patients. Thirty-nine eyes of 25 patients were used as cataract-only controls. Glaucoma severity was mild (37.5%), moderate (40.6%) and severe (21.9%) in treated eyes. The median follow-up available was 2.5 years (range: 1-5 years). Baseline IOP was 13.83 ± 2.93 mmHg on 2.11 ± 1.04 medication classes in treated eyes. At year 1, there was a mean reduction of medication classes by 1.25 ± 0.84 (P < 0.0010) and IOP by 0.89 ± 2.61 mmHg (P = 0.02). Medication class reduction remained significant through year 4 and IOP reduction through year 3. Compared to controls, treated eyes had significant differences in mean medication change (-1.25 vs. -0.03 at year 1, P < 0.001) and percentage of eyes with medication reduction (85.9% vs. 5.3% at year 1, P < 0.001), which were sustained through at least year 4. There were no significant differences in medication reduction and IOP observed between treated Asian and non-Asian eyes at any time point. In treated eyes, IOP was 16 mmHg or less on same or fewer medications in more than 90% (range: 90.6%-100%) of eyes at all time points and medication-free in more than 31% (range: 31.3%-54.5%) at all time points. No SSI occurred during the study period.</p><p><strong>Conclusions: </strong>Hydrus Microstent was safe and effective in all NTG eyes with a significant, sustained reduction in medication use through at least 4 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":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327813","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":"Visual Outcomes and Risk Factors for Progression in Juvenile Open-Angle Glaucoma.","authors":"Kasem Seresirikachorn, Daniel M Vu, Anila Narayana, Kornkamol Annopawong, Boonsong Wanichwecharungruang, Ta Chen Peter Chang","doi":"10.1016/j.ogla.2025.06.003","DOIUrl":"10.1016/j.ogla.2025.06.003","url":null,"abstract":"<p><strong>Purpose: </strong>To report the visual outcomes of patients diagnosed with juvenile open-angle glaucoma (JOAG) at presentation and final follow-up and to analyze the rate of visual impairment progression and associated risk factors.</p><p><strong>Design: </strong>A retrospective clinical cohort study.</p><p><strong>Participants: </strong>This retrospective study included all patients diagnosed with JOAG over 13 years from 2 tertiary hospitals in Bangkok, Thailand, with a minimum follow-up of 1 year.</p><p><strong>Methods: </strong>We categorized visual impairment and blindness according to the World Health Organization criteria at both the initial presentation and the final follow-up visit. Progression was defined as a shift to a more severe category of visual impairment in each eye; we identified the risk factors associated with visual impairment progression.</p><p><strong>Main outcome measures: </strong>The proportions of visual impairment and blindness at the beginning and end of the study period. The progression rates of visual impairments were calculated at 1, 3, and 5 years.</p><p><strong>Results: </strong>We included a total of 203 eyes from 106 patients in this study. At the initial assessment, 31.5% of eyes were blind, and this percentage significantly increased to 35.5% (P < 0.001) after an average follow-up of nearly 8 years. Bilateral blindness in patients rose from 15.2% to 19.8% (P < 0.001) over the same period. Among patients without visual impairment at presentation, 96.3%, 93.1%, and 87.7% maintained stable vision at 1, 3, and 5 years, respectively. In comparison, patients with moderate visual impairment had stable outcomes in 84.6%, 67.7%, and 67.7% of cases at the same time points. However, the progression rates of visual outcomes did not significantly differ across varying visual impairment categories (P = 0.08). A higher number of glaucoma surgeries per patient was identified as an associated factor for visual impairment progression (adjusted hazard ratio = 2.25; 95% confidence interval: 1.34-3.78, P = 0.002).</p><p><strong>Conclusions: </strong>Juvenile open-angle glaucoma is associated with severe visual impairment both at initial presentation and after treatment. Despite slow progression, more than 10% of patients experienced worsening vision over 5 years, with the number of glaucoma surgeries being a significant associated factor for progression. Lifelong follow-up and early detection are crucial in reducing morbidity in this patient group.</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":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287381","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":"Short-Term Rates of Visual Field Change Predict Glaucoma Progression.","authors":"Mohsen Adelpour, Sasan Moghimi, Takashi Nishida, Leo Meller, Kelvin H Du, Alireza Kamalipour, Natchada Tansuebchueasai, Golnoush Mahmoudinezhad, Linda M Zangwill, Robert N Weinreb","doi":"10.1016/j.ogla.2025.05.006","DOIUrl":"10.1016/j.ogla.2025.05.006","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the prognostic significance of short-term rates of visual field (VF) mean deviation (MD) change in predicting progression across various levels of glaucoma severity.</p><p><strong>Design: </strong>Observational cohort.</p><p><strong>Participants: </strong>A total of 349 eyes from 254 patients followed up to 5 years.</p><p><strong>Methods: </strong>Primary open-angle glaucoma eyes were included with ≥ 5 24-2 VFs tests during the initial 2 years over a period of up to 5 years. Two assessment methods, Guided Progression Analysis (GPA) and a United States Food and Drug Administration (FDA)-consistent end point, were utilized to identify progression events. Rates of change in VF MD during the initial 2 years were calculated, and survival models were employed to evaluate the risk of faster initial VF MD loss on the development of GPA and FDA-consistent end points.</p><p><strong>Main outcomes and measures: </strong>Risk of progression based on initial MD change rates.</p><p><strong>Results: </strong>Over a mean follow-up of 4.3 years, progression was observed in 17.2% (GPA end point) and 24.9% (FDA-consistent end point) of eyes. Faster initial rates of VF MD loss significantly increased the progression risk (hazard ratio [HR] per 0.1 dB/year faster for GPA: 1.16, 95% confidence interval [CI]: 1.12-1.20; HR for FDA: 1.16, 95% confidence interval: 1.12-1.21; both P < 0.001) with survival-adjusted R² values of 0.67 for GPA and 0.75 for FDA-consistent end points. Global initial 2-year slopes showed the highest predictive accuracy for FDA progression events, with adjusted R² values of 0.75 overall, 0.71 for early glaucoma, and 0.42 for moderate-to-advanced glaucoma. Superior and inferior sectoral slopes demonstrated lower abilities to explain the variability across all severity groups. The model's predictive accuracy was higher in early glaucoma (R², 0.71) compared to moderate-advanced stages (R², 0.42) for both criteria.</p><p><strong>Conclusions: </strong>The initial 2-year rate of VF MD change predicts subsequent progression events based on FDA-consistent criteria in both early and moderate-to-advanced glaucoma eyes. These findings suggest initial VF MD change rates identify patients at higher risk of future progression, enabling timely management decisions and, also, potentially serving as a progression end point in clinical trials.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236072","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":"Obstructive Sleep Apnea as a Potentiator of Primary Open-Angle Glaucoma and Necessity for Interventional Therapy.","authors":"Pranav Vasu, Isabella V Wagner, Paul Connor Lentz, Priyanka Gumaste, Yazan Abubaker, Bryan C H Ang, Abhimanyu S Ahuja, Emily Dorairaj, Ibrahim Qozat, Darby D Miller, Syril Dorairaj","doi":"10.1016/j.ogla.2025.05.005","DOIUrl":"10.1016/j.ogla.2025.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the rate of progression of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA) compared with non-OSA mild-moderate POAG comparators and to assess the utilization of surgical and laser intervention.</p><p><strong>Design: </strong>A retrospective cohort study of the TriNetX US Collaborative Network was conducted by analyzing international electronic health record data from January 2004 to October 2024.</p><p><strong>Participants: </strong>Patients in the TriNetX US Collaborative Network with a diagnosis of mild-moderate POAG, stratified with respect to OSA status.</p><p><strong>Methods: </strong>Patients were assessed for outcomes at 3, 5, and 10 years. Propensity score matching was conducted between cohorts matched for baseline demographics, comorbidities, and medication use. Odds ratios (ORs) and 95% confidence intervals (CIs) were subsequently calculated.</p><p><strong>Main outcome measures: </strong>Risk of development of severe POAG.</p><p><strong>Results: </strong>After propensity score matching, 5277 patients with, and 5277 patients without OSA were included in final analysis. At 3 (OR, 2.791; 95% CI, 2.289-3.403), 5 (OR, 2.300; 95% CI, 1.947-2.717), and 10 years (OR, 2.198; 95% CI, 1.873-2.578), the OSA cohort demonstrated significantly higher odds of developing severe POAG than the non-OSA comparators. Secondary outcomes of minimally invasive glaucoma surgery and trabeculectomy surgery yielded no significant difference between both cohorts (P > 0.05) at all follow-up times. However, laser therapy and tube shunt surgery demonstrated a significantly greater incidence in the OSA cohort at each time point.</p><p><strong>Conclusions: </strong>The rate of glaucoma surgery appears similar between patients with POAG with and without OSA, despite those with OSA demonstrating a greater risk of rapid progression and vision loss. Future practice patterns should pay special attention to patients with OSA and consider offering more aggressive or earlier intervention, which may aid in limiting disease progression.</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":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144614","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":"The Rate of Failure of Trabeculectomy and Tube Shunt Surgery in Eyes with Uveitic Glaucoma and Ocular Hypertension.","authors":"Sylvia L Groth, Craig W Newcomb, Wei Yang, Abhishek Payal, Hosne Begum, Naira Khachatryan, R Oktay Kaçmaz, Kurt A Dreger, James T Rosenbaum, H Nida Sen, Eric B Suhler, Jennifer E Thorne, Nirali P Bhatt, C Stephen Foster, Douglas A Jabs, Grace A Levy-Clarke, Jeanine M Buchanich, Gui-Shuang Ying, John H Kempen, Sapna Gangaputra","doi":"10.1016/j.ogla.2025.05.004","DOIUrl":"10.1016/j.ogla.2025.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence of failure of trabeculectomy versus tube shunt (TS) glaucoma surgery in eyes of patients with uveitis.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Participants: </strong>Among 356 eyes of 288 patients with noninfectious inflammatory eye disease undergoing first incisional glaucoma surgery using one of the techniques, 244 eyes had TSs, and 112 eyes had trabeculectomy augmented with mitomycin-C (Trab-MMC).</p><p><strong>Methods: </strong>A standardized chart review was used to collect clinical data over time retrospectively. Cox regression analyses with adjustment for propensity score and intereye correlations were performed to compare the incidence of failure of glaucoma surgery between TS and Trab-MMC.</p><p><strong>Main outcome measures: </strong>Failure of glaucoma surgery of the first 5 years postoperatively, defined as the following: (1) intraocular pressure (IOP) ≤ 5 or > 21 mmHg at 2 consecutive visits at least 90 days apart beginning 3 months after surgery; or (2) reoperation; or (3) complete blindness (no light perception).</p><p><strong>Results: </strong>The median age was 40.3 years (interquartile range [IQR], 13.4-57.3 years) in the TS group and 44.2 years (IQR, 29.0-58.9 years) in the Trab-MMC group. The median preglaucoma surgery IOP was 30.0 mmHg (IQR, 21-35.5 mmHg) in the TS group and 30.5 mmHg (IQR, 20-38 mmHg) in the Trab-MMC group. Anterior uveitis was the most common location of primary inflammation in both the TS (52.5%) and Trab-MMC 55.4%) groups. Failure was observed in the TS group in 23.5%, 27.1%, and 30.8% cumulatively through 12, 24, and 36 months, respectively, versus 16.1%, 25.6%, and 30.0%, respectively, in the Trab-MMC group. In the propensity score-adjusted Cox regression analysis, there was no significant difference in failure incidence rate between the TS and Trab-MMC groups (adjusted hazard ratio, 1.08; 95% confidence interval, 0.65-1.78; P = 0.77). Success without the requirement for IOP-lowering medicines was observed more frequently in the Trab-MMC group.</p><p><strong>Conclusions: </strong>Tube shunt and Trab-MMC fail frequently with similar incidences when done as the first glaucoma surgery among eyes with uveitis over 5 years of follow-up, but there were more complete successes in the Trab-MMC group than in the TS group at 12, 24, and 36 months.</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":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144616","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":"Loss to Follow-Up and Risk of Incident Blindness among Patients with Glaucoma in the IRIS® Registry.","authors":"Andrew M Williams, Hai-Wei Liang, Hsing-Hua Sylvia Lin","doi":"10.1016/j.ogla.2025.05.001","DOIUrl":"10.1016/j.ogla.2025.05.001","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between loss to follow-up (LTFU) and risk of incident blindness among a national registry cohort of patients with primary open-angle glaucoma (POAG).</p><p><strong>Design: </strong>Retrospective longitudinal cohort study.</p><p><strong>Participants: </strong>Patients with a POAG diagnosis who had at least 2 visual acuity (VA) measurements documented in the IRIS® Registry (Intelligent Research in Sight) in both 2014 and 2019.</p><p><strong>Methods: </strong>Loss to follow-up was defined as a calendar year or more without an encounter. Univariable and multivariable robust log-Poisson regression models were used to estimate the risk of incident blindness, with intervals of LTFU as the primary exposure of interest. Effect modification by baseline characteristics on the association between LTFU and incident blindness was also assessed.</p><p><strong>Main outcome measures: </strong>Incident blindness in 1 or both eyes (VA ≤ 20/200) in 2019 among patients who were not blind in 2014.</p><p><strong>Results: </strong>Among the 149 172 patients, incident monocular blindness occurred in 6338 (4.2%), and incident binocular blindness occurred in 691 (0.5%) over the 6-year period. While most patients maintained follow-up every year (90%), 8.8% were LTFU for 1-2 years, and 1.1% were LTFU for 3-4 years. Patients with LTFU had greater risk of blindness. In an adjusted model that accounted for age, sex, race/ethnicity, insurance, smoking status, glaucoma severity, baseline intraocular pressure, baseline cup-to-disc ratio, and history of glaucoma surgery, risk of incident monocular blindness was greater among patients with a lapse of 1-2 years (adjusted relative risk [aRR] = 1.19, 95% confidence interval [CI]: 1.05-1.35) or a lapse of 3-4 years (aRR = 2.17, 95% CI: 1.66-2.78) compared to patients with no lapse in care. Race/ethnicity demonstrated a significant effect modification in the association between the longest lapse between encounters and the risk of blindness (P = 0.02). The risk of incident blindness after a lapse of 3-4 years (compared to no lapse) was higher among Black patients (aRR = 3.12, 95% CI: 2.06-4.76) than White patients (aRR = 1.93, 95% CI: 1.37-2.73). No effect modifications were identified by other baseline variables.</p><p><strong>Conclusions: </strong>Loss to follow-up is an independent risk factor for incident blindness among patients with POAG. Lapses in care are particularly consequential for Black patients. Efforts to reduce LTFU may mitigate preventable glaucoma blindness.</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":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041863","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":"Transscleral Cyclophotocoagulation for Glaucoma in the Setting of Uveal Melanoma.","authors":"Aakriti Garg Shukla, Sarangdev Vaidya, Antonio Yaghy, Reza Razeghinejad, Anand V Mantravadi, Jonathan S Myers, Swathi Kaliki, Carol L Shields","doi":"10.1016/j.ogla.2020.09.011","DOIUrl":"10.1016/j.ogla.2020.09.011","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38403462","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":"Spatial and Temporal Relationship between Structural Progression and Disc Hemorrhage in Glaucoma in a 3-Year Prospective Study.","authors":"Tomomi Higashide, Shinji Ohkubo, Sachiko Udagawa, Kazuhisa Sugiyama, Hidenobu Tanihara, Makoto Araie, Goji Tomita, Chota Matsumoto, Takeo Fukuchi, Atsuo Tomidokoro, Masanori Hangai, Hisashi Kawata, Maya Inai, Yuki Tanaka","doi":"10.1016/j.ogla.2020.08.008","DOIUrl":"10.1016/j.ogla.2020.08.008","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the spatial and temporal relationship between disc hemorrhage (DH) and structural progression in patients with primary open-angle glaucoma (POAG) in a 3-year prospective study.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Participants: </strong>Patients with POAG and intraocular pressure of ≤18 mmHg on monotherapy with prostaglandin analogs.</p><p><strong>Methods: </strong>Fundus photographs were taken at baseline and every 3 months for 3 years. Disc hemorrhage and structural progression were detected independently by flicker chronoscopy. If present, clock-hour disc locations in the right eye format and colocalization were determined. Statistical comparisons were based on mixed-effects models accounting for the correlation between different disc sites within the same eye and between fellow eyes in the same patient.</p><p><strong>Main outcome measures: </strong>Relationship between DH and structural progression at the same site.</p><p><strong>Results: </strong>Among 195 eyes of 115 patients, DH appeared in 85 sites in 65 eyes (33.3%) and was most frequently at the 7 o'clock disc location (29.4%, P < 0.0001). Structural progression occurred at 63 sites of 52 eyes (26.7%) comparably in both superior and inferior hemidiscs, which was mostly detected as widening of the retinal nerve fiber layer defects (RNFLDs). Temporal RNFLD widening was common, whereas nasal widening occurred exclusively in the vertical quadrants (P = 0.035). Of 41 progression sites in eyes with DH, 28 sites (68.2%) had both DH and progression. Progression sites with DH were less common in the superior quadrant than in the inferior and temporal quadrants (P = 0.011). Eyes with DH had a significantly higher risk of progression than eyes without DH (hazard ratio, 3.72; P < 0.0001). For 63 progression sites, DH recurrence and more visits with DH at the progression site were significantly associated with shorter time to progression from baseline (P = 0.021, P = 0.017, respectively), whereas colocalization of DH and progression were not.</p><p><strong>Conclusions: </strong>In a 3-year prospective study with a Japanese POAG cohort, the relationship between DH and RNFLD and the pattern of RNFLD progression differed by disc location. The association between more frequent DH at the progression site and shorter time to progression indicates that DH may reflect vulnerability to same-site structural deterioration.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38296058","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}