Ophthalmology. Glaucoma最新文献

{"title":"Gonioscopy-Assisted Transluminal Trabeculotomy for Myocilin-Associated Juvenile Open-Angle Glaucoma: A Case Series of 8 Eyes Over 2.2 to 4.1 Years.","authors":"Erin A Boese, Wallace L M Alward, John H Fingert","doi":"10.1016/j.ogla.2025.03.011","DOIUrl":"10.1016/j.ogla.2025.03.011","url":null,"abstract":"<p><strong>Objective: </strong>Mutations within the myocilin (MYOC) gene are the first known single-gene cause of both primary open-angle glaucoma and juvenile open-angle glaucoma (JOAG). Subsequent studies have shown these mutations cause trabecular meshwork dysfunction, resulting in markedly elevated intraocular pressures (IOPs) at young ages. Angle-based procedures, like gonioscopy-assisted transluminal trabeculotomy (GATT), bypass the trabecular meshwork, and as such, are hypothesized to be particularly effective in this angle-based disease. The purpose of this case series is to evaluate the efficacy of GATT for MYOC-associated JOAG.</p><p><strong>Design: </strong>A retrospective chart review was performed evaluating patients under the age of 18 years with known MYOC-associated JOAG who underwent GATT. A total of 8 eyes of 4 children are included.</p><p><strong>Participants: </strong>All participants had a strong family history of MYOC glaucoma.</p><p><strong>Methods: </strong>All patients underwent a thorough clinical evaluation, including visual acuity, slit lamp examination, optic nerve fundoscopy, and IOP measurements by Goldmann applanation. Most patients also underwent 24-2 Swedish Interactive Thresholding algorithm (SITA) standard Humphrey visual fields and fundus photography, and all patients had retinal nerve fiber layer OCT.</p><p><strong>Main outcome measures: </strong>Main outcome measures include IOP and number of medications. Additional measures include visual acuity, optic nerve photos, visual field testing, and OCT.</p><p><strong>Results: </strong>Following 360° GATT, all 8 eyes of 4 children had a mean drop in IOP of 26 mmHg (68%), and all were able to stop glaucoma medications entirely. Our patients were followed up between 2.2 and 4.1 years with no evidence of decreasing efficacy or glaucomatous progression. All patients maintain 20/20 visual acuity or better in both eyes, and glaucoma has stabilized on all available ancillary testing (OCT, Humphrey visual field, and optic nerve photos). One patient (patient 4) had a notable reversal of cupping.</p><p><strong>Conclusions: </strong>In MYOC-associated JOAG, the pathology is concentrated at the trabecular meshwork (TM), lending itself well to angle-based surgeries, especially GATT. Gonioscopy-assisted transluminal trabeculotomy is particularly effective in children with MYOC JOAG, allowing them to avoid, or at least delay, the need for more invasive surgeries like trabeculectomy and tube shunt surgeries with over 4 years of follow-up. To date, this is the first genetically directed glaucoma surgery available.</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":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797239","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 Systematic Review of Sex-Based Reporting in Topical Glaucoma Medication Clinical Trials.","authors":"Helen Zhao, Rachel E Davis, Alexander S Davis, Susan L Meoli, Elizabeth A Cretara","doi":"10.1016/j.ogla.2025.03.010","DOIUrl":"10.1016/j.ogla.2025.03.010","url":null,"abstract":"<p><strong>Topic: </strong>The National Institutes of Health (NIH) issued guidance in 2016 that sex should be treated as a biological variable in clinical studies; however, previous research has shown that biomedical studies still fail to include sex as a biological variable (SABV) in study design and analysis. We hypothesize that despite evidence for sex-specific glaucoma risk factors, clinical trials for glaucoma topical medications also fail to treat SABV.</p><p><strong>Clinical relevance: </strong>Prior studies have found sex-specific genetic and hormonal risk factors for glaucoma suggesting that biological sex may influence the disease course.</p><p><strong>Methods: </strong>We performed a systematic review on Pubmed and Google Scholar using terms including generic names of common glaucoma medications, and filters \"randomized control trial\" and \"clinical trial.\" Resulting studies were reviewed and included if they met inclusion criteria including randomized controlled trial design, testing of topical glaucoma medications in patients with open-angle glaucoma or ocular hypertension, and published between 2002-2022. Included studies were read and assessed on metrics pertinent to SABV including sex reporting and matching, sex-based analysis of medication efficacy, adverse events (AEs), and mention of SABV in the discussion and conclusion.</p><p><strong>Results: </strong>We identified 543 studies; 122/543 (22.5%) met inclusion criteria representing 31 644 subjects; 16 656/31 644 (52.6%) were women. Sex of subjects was reported in 109/122 (89%) studies. However, only 5/122 (4%) mentioned sex in data analysis, including efficacy (1), AEs (1), and mention of sex in the discussion or conclusion (4). We found that studies published after the NIH guidance on SABV in 2016 and studies funded by the NIH were not more likely to include SABV, however only 3 of 122 (2.5%) studies were NIH-funded. Pregnancy or lactation were exclusion criteria for 31/122 (25%) studies.</p><p><strong>Conclusions: </strong>While the majority of glaucoma topical medication clinical trials reported sex and achieved sex-matching, they failed to include sex-based analysis of medication efficacy or AEs. Opportunities remain to include SABV to improve our understanding of the impact of biological sex on glaucoma treatment, although that may require increases in sample size.</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":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756235","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 Gonioscopy-Assisted Transluminal Trabeculotomy in Children with Early-Onset Glaucoma Secondary to Sturge-Weber Syndrome.","authors":"Zeynep Aktas, Yasmine El Sayed, Ahmet Yucel Ucgul, Ghada Gawdat, Hala Elhilali, Fayrouz Aboalazayem","doi":"10.1016/j.ogla.2025.03.009","DOIUrl":"10.1016/j.ogla.2025.03.009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in managing early-onset glaucoma secondary to Sturge-Weber syndrome (SWS).</p><p><strong>Design: </strong>A retrospective interventional case series.</p><p><strong>Participants: </strong>Medical records of 16 patients (22 eyes) diagnosed with early-onset glaucoma secondary to SWS who underwent GATT surgery were reviewed.</p><p><strong>Methods: </strong>All patients underwent GATT surgery using a 5-0 or 6-0 prolene suture under general anesthesia.</p><p><strong>Main outcome measures: </strong>The primary outcomes were intraocular pressure (IOP) reduction, complete surgical success (IOP ≤ 18 mmHg without medications), qualified surgical success (IOP ≤ 18 mmHg with medications), and postoperative complications.</p><p><strong>Results: </strong>The mean IOP decreased significantly from 25.4 ± 4.8 mmHg at baseline to 15.7 ± 4.2 mmHg at the final follow-up (P < 0.001), representing a 38.19% reduction. The mean age at the time of GATT surgery was 33.6 ± 33.9 months. The mean follow-up duration was 16.3 ± 6.4 months. Complete surgical success was achieved in 45.4% of eyes (10 out of 22), while qualified success was reached in 81.8% of eyes (18 out of 22). Despite the overall success, 18.1% of eyes (4 eyes) required additional surgical interventions during the follow-up period. These included Ahmed glaucoma valve implantation in 1 eye, trabeculectomy in 2 eyes, and transscleral diode laser cyclophotocoagulation in 1 eye. Transient hyphema was the only reported complication, resolving spontaneously within 1 week without further intervention.</p><p><strong>Conclusions: </strong>Gonioscopy-assisted transluminal trabeculotomy appears to be a promising surgical option for managing early-onset glaucoma in patients with SWS, offering significant IOP reduction and a favorable safety profile within the limitations of our study. However, further studies with longer follow-up periods and comparative groups are necessary to confirm these findings.</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":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744518","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 Field of Eyes with Peripapillary Intrachoroidal Cavitation and Its Association with Deep Optic Nerve Head Structural Changes.","authors":"Kaho Akiyama, Shuichiro Aoki, Shiroaki Shirato, Rei Sakata, Megumi Honjo, Makoto Aihara, Hitomi Saito","doi":"10.1016/j.ogla.2025.03.007","DOIUrl":"10.1016/j.ogla.2025.03.007","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the location-specific association of deep optic nerve head (ONH) structures and background characteristics with visual field (VF) sensitivity in eyes with peripapillary intrachoroidal cavitation (PICC).</p><p><strong>Design: </strong>A prospective cross-sectional study.</p><p><strong>Subjects: </strong>One hundred twenty-nine eyes of 93 consecutive cases with PICC determined on fundus photographs and confirmed on OCT.</p><p><strong>Methods: </strong>Peripapillary intrachoroidal cavitation location was determined on ONH-centered OCT radial slices according to Garway-Heath sectors. Visual field defect (VFD) corresponding to the location of the PICC sector was considered absent when the pattern deviation probability plot showed no point with a probability < 1% within the corresponding 24-2 Humphrey VF sector. Sectoral mean total deviation (TD) was calculated for structure-function analysis. The presence of full-thickness retinal defect was determined, and PICC depth and deep ONH parameters were calculated with OCT slices.</p><p><strong>Main outcome measures: </strong>A best-fit multivariable linear mixed model was applied to identify factors associated with sectoral mean TD corresponding to PICC location. Explanatory variables included age, sex, axial length, intraocular pressure, presence of full-thickness retinal defect, circumpapillary retinal nerve fiber layer thickness (cpRNFLT), PICC depth, Bruch membrane opening (BMO) area, scleral flange opening (SFO) area, and SFO/BMO offset magnitude.</p><p><strong>Results: </strong>Among 254 sectors with PICC, 136 sectors (54%) did not present corresponding VFD. Suspected VFD was most frequent in the temporal (34/50, 68%) and inferior temporal (67/104, 64%) sectors. In the best-fit multivariable analysis, worse sectoral TD in the PICC sectors was associated with the presence of full-thickness retinal defect (P = 0.036) and thinner cpRNFLT (P < 0.001) but was not associated with PICC depth or other deep ONH parameters.</p><p><strong>Conclusions: </strong>Although PICC alone did not necessarily cause corresponding VFD, PICC in the temporal sectors should be carefully examined for VFD. Full-thickness retinal defect, a myopia-induced tissue disruption, and cpRNFLT thinning at the PICC location were significantly associated with worse VF, whereas PICC size and other myopia-related deep ONH structural changes were not. Identification of these factors provides a foundation for understanding VF sensitivity reduction in eyes with characteristically highly myopic ONH 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":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733313","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":"Silicone Oil and Glaucoma-Related Adverse Events in Pediatric Vitreoretinal Surgery.","authors":"Meghan Sharma, Laura Huertas, David J Taylor Gonzalez, Roya Garakani, Audina M Berrocal, Ta C Chang","doi":"10.1016/j.ogla.2025.03.006","DOIUrl":"10.1016/j.ogla.2025.03.006","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the risk of glaucoma-related adverse events (GRAEs) in pediatric patients following silicone oil use in vitreoretinal (VR) surgery, positing that silicone oil exposure increases GRAE risk.</p><p><strong>Design: </strong>A single-center retrospective cohort study at a tertiary care facility.</p><p><strong>Participants: </strong>Pediatric patients aged 0 to 18 years who underwent VR surgery between April 2019 and April 2021 were included. Patients with previously diagnosed glaucoma or who had undergone glaucoma surgery were excluded.</p><p><strong>Methods: </strong>Review of medical records for intraoperative use of silicone oil and postoperative occurrence of GRAE, defined as elevated intraocular pressure (>21 mmHg), initiation of pressure-lowering medications, performance of pressure-lowering surgery, or a diagnosis of childhood glaucoma based on the Childhood Glaucoma Research Network criteria.</p><p><strong>Main outcome measures: </strong>Survival analysis of GRAE between patients exposed vs. not exposed to silicone oil during VR surgery.</p><p><strong>Results: </strong>Of the 186 pediatric patients analyzed, 64 (34.4%) were exposed to silicone oil, and 102 developed GRAE (54.8%). Median survival time to GRAE was 2.0 months (95% confidence interval [CI]: 0.3, 7.7) for silicone oil exposure in patients vs. 25.3 months (95% CI: 3.6, N/A) for patients not exposed to silicone oil (P = 0.0045). Patients exposed to silicone oil had a 52% increased risk of GRAE compared to those not exposed to silicone oil when adjusted for age at VR surgery (hazard ratio: 1.52 [95% CI: 1.01, 2.28], P = 0.0425).</p><p><strong>Conclusions: </strong>In this exploratory study, GRAE was commonly observed following pediatric VR surgery, particularly in patients exposed to silicone oil. These findings underscore the importance of careful glaucoma surveillance following VR surgery in children.</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":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Early Safety and Effectiveness Outcomes of the PreserFlo MicroShunt with and without an Intraluminal Suture Stent.","authors":"Jason Chami, Jeremy C K Tan, David Manning, George Kong, Jason Cheng, Hamish Dunn, Anna Galanopoulos, Brian Chua, Joanne Thai, Mark Hassall, Jamie E Craig, Mitchell Lawlor","doi":"10.1016/j.ogla.2025.03.003","DOIUrl":"10.1016/j.ogla.2025.03.003","url":null,"abstract":"<p><strong>Objective: </strong>To assess the early safety and effectiveness outcomes of the PreserFlo MicroShunt with and without an intraluminal suture stent.</p><p><strong>Design: </strong>Multicenter observational retrospective study using data from the Fight Glaucoma Blindness registry.</p><p><strong>Participants: </strong>A total of 183 eyes in 172 patients, with a mean age of 73 ± 14 years, who underwent PreserFlo MicroShunt surgery with/without intraluminal stent suture placement, and with at least 6 months of follow-up. Eyes were divided into 2 groups: stent (68 eyes) and no-stent (115 eyes).</p><p><strong>Methods: </strong>Baseline and postoperative measurements of intraocular pressure (IOP), visual acuity (VA), number of glaucoma medications, and adverse events were recorded at 1, 3, and 6 months. Outcomes were compared between stent and no-stent groups using t tests for continuous variables and Fisher exact tests for categorical variables.</p><p><strong>Main outcome measures: </strong>The primary outcome measures were the incidence of numerical hypotony (IOP ≤ 5 mmHg) and symptomatic hypotony (numerical hypotony plus ≥10 letters of VA loss) within 1 month, 1 to 3 months, and 3 to 6 months postoperatively. Secondary outcome measures included surgical success rates (defined as IOP ≤12, ≤15, ≤18, or ≤21 mmHg and ≥20% IOP reduction without hypotony and without additional glaucoma medications) and the need for secondary surgical interventions.</p><p><strong>Results: </strong>In the first postoperative month, the stent group had significantly lower rates of numerical hypotony (24% vs. 44%; P = 0.007) and symptomatic hypotony (13% vs. 28%; P = 0.027) than the no-stent group. The rate of device revision, explant, or replacement with an alternative shunt was also significantly lower in the stent group (3 eyes; 4.4%) than in the no-stent group (17 eyes; 14.8%; P = 0.047). No significant differences in hypotony rates were observed in the later follow-up windows (1-3 and 3-6 months), nor were there significant differences in surgical success rates between the stent and no-stent groups at any time point.</p><p><strong>Conclusions: </strong>The use of an intraluminal suture stent in PreserFlo MicroShunt surgery reduces the incidence of early hypotony without compromising surgical success. These findings suggest that routine use of intraluminal sutures may improve early postoperative safety.</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":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639876","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":"Association of Systemic Calcium Channel Blocker Use with Visual Field Progression in a Large Real-World Cohort from Glaucoma Clinics.","authors":"Giovanni Montesano, Alessandro Rabiolo, David F Garway-Heath, Dun Jack Fu, Gus Gazzard, Giovanni Ometto, David P Crabb, Anthony P Khawaja","doi":"10.1016/j.ogla.2025.03.002","DOIUrl":"10.1016/j.ogla.2025.03.002","url":null,"abstract":"<p><strong>Purpose: </strong>To test the association between use of calcium channel blocker (CCB) medications and the rate of visual field (VF) progression in a large cohort of patients from 5 glaucoma clinics.</p><p><strong>Design: </strong>Retrospective longitudinal case-control study.</p><p><strong>Subjects: </strong>Patients attending 5 glaucoma clinics in the United Kingdom using the same electronic medical record (EMR) system.</p><p><strong>Methods: </strong>For the main analysis, we selected 1 eye from patients with at least 5 reliable (false positive errors < 15%) VFs over a period of at least 4 years. The use of systemic medications was derived from the EMR system. Calcium channel blocker users were identified as cases. Propensity score matching (PSM) and multivariable analyses (MVAs) were used to adjust for confounders. A directed acyclic graph of the relevant variables guided the selection of covariates. Linear mixed-effect models (LMMs) were used to test the effect on the rate of VF mean deviation (MD) associated with CCB use and other covariates (for the MV analysis). Sensitivity analyses were conducted with different inclusion criteria and cutoffs on the estimated duration of CCB use.</p><p><strong>Main outcome measures: </strong>The mean difference in the rate of VF MD progression between CCB users and controls.</p><p><strong>Results: </strong>The main analysis included 14 475 eyes (1942 from CCB users) that met the selection criteria (1 eye per patient). The median (interquartile range) VF series length was 8 (6, 11) tests, with a follow-up of 8.6 (6, 11.5) and 8.2 (5.9, 11.2) years in CCB users and controls, respectively. One-to-one PSM pairing with controls was achieved for all CCB users. The estimated rate of MD progression was -0.31 (-0.33 to -0.28) dB/year (mean [95% confidence intervals]) in the CCB users and -0.35 (-0.37 to -0.33) dB/year in the matched controls (P = 0.016). This significant difference was confirmed with the MV analysis including all controls (P = 0.020). All sensitivity analyses confirmed the main results.</p><p><strong>Conclusions: </strong>Calcium channel blocker use was statistically significantly associated with a slower rate of VF deterioration after multivariable adjustment. The estimated difference was small and likely not clinically significant but may be influenced by the limited information on the duration of CCB exposure in this cohort.</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":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635001","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":"Comparison of Structural Changes after Epiretinal Membrane Peeling between Nonglaucomatous Eyes and Eyes with Open-Angle Glaucoma.","authors":"Dong Kyun Han, Eun Ji Lee, Tae-Woo Kim","doi":"10.1016/j.ogla.2025.03.001","DOIUrl":"10.1016/j.ogla.2025.03.001","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the structural changes in the peripapillary and macular regions following pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling between nonglaucomatous eyes and eyes with primary open-angle glaucoma (POAG).</p><p><strong>Design: </strong>A retrospective, longitudinal, observational study.</p><p><strong>Participants: </strong>Sixty-eight eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery.</p><p><strong>Methods: </strong>This retrospective study analyzed 68 eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery. The circumpapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), and interdigitation zone (IZ) defects were assessed using spectral-domain OCT before and 6 months after surgery and compared between nonglaucomatous and POAG eyes.</p><p><strong>Main outcome measures: </strong>Comparison of structural changes between POAG eyes and nonglaucomatous eyes after PPV with ERM peeling surgery.</p><p><strong>Results: </strong>Both nonglaucomatous and POAG eyes showed significant reductions in CMT and temporal RNFL thicknesses postoperatively, but significant increases were observed in nasal RNFL thicknesses. However, the changes were less prominent in POAG eyes, with significantly smaller decreases in CMT (P = 0.044) and temporal RNFL thickness (P = 0.020), and smaller increases in the nasal (P = 0.022) and inferonasal (P = 0.005) RNFL thicknesses. In nonglaucomatous eyes, the length of the IZ defect decreased significantly postoperatively (P = 0.009), while no significant change was observed in POAG eyes (P = 0.115).</p><p><strong>Conclusions: </strong>Structural changes in the macula and peripapillary areas following PPV with ERM peeling were less pronounced in POAG eyes than in nonglaucomatous eyes, probably due to preexisting optic nerve damage. These different structural outcomes should be considered in the diagnosis and monitoring of patients with glaucoma accompanied by ERM.</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":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588463","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":"Sepetaprost 0.002% Noninferiority vs. Timolol 0.5% in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: ANGEL-2.","authors":"David L Wirta, Sherif M El-Harazi, Michael E Tepedino, Jason Bacharach","doi":"10.1016/j.ogla.2025.02.004","DOIUrl":"10.1016/j.ogla.2025.02.004","url":null,"abstract":"<p><strong>Purpose: </strong>Sepetaprost is a novel investigative prodrug, the active form of which is a dual agonist targeting both prostaglandin F receptors and prostaglandin E receptor 3. This study (NCT04742283) aimed to demonstrate the noninferiority of sepetaprost ophthalmic solution 0.002% to timolol maleate ophthalmic solution 0.5% in participants with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).</p><p><strong>Design: </strong>A phase IIb, randomized, double-masked, active-controlled, multicenter study conducted in the United States.</p><p><strong>Participants: </strong>In total, 323 adult (≥18 years) participants (POAG, 68.4%; OHT, 31.6%) were randomized 1:1 to receive either once-daily sepetaprost (n = 162) or twice-daily timolol (n = 161) in 1 eye for 3 months.</p><p><strong>Methods: </strong>Intraocular pressure (IOP) was measured at 3 timepoints (8:00 am, 10:00 am, and 4:00 pm) at 3 visits (weeks 2 and 6 and month 3).</p><p><strong>Main outcome measures: </strong>The primary efficacy endpoint was noninferiority of sepetaprost to timolol. Noninferiority was established if the upper limit of the 2-sided 95% confidence interval (CI) for the difference in mean IOP (sepetaprost minus timolol) was ≤1.5 mmHg at all 9 specified timepoints and ≤1.0 mmHg at 5 or more of the 9 timepoints. Superiority was tested if noninferiority was achieved. Safety, including adverse events (AEs) and suspected adverse reactions, was evaluated throughout.</p><p><strong>Results: </strong>The primary endpoint, the noninferiority of sepetaprost to timolol in mean IOP reductions, was met. The upper limit of the 2-sided 95% CI for the between-group difference in mean IOP score was <1.0 mmHg at all 9 timepoints. Superiority of sepetaprost to timolol was observed at 4:00 pm in week 2, week 6, and month 3; IOP mean difference (standard error): -0.76 (0.302), -0.73 (0.328), and -0.95 (0.319), respectively (all P < 0.05). Overall, 23.6% of participants receiving sepetaprost and 21.3% receiving timolol experienced AEs. The most commonly reported ocular AE in both groups was conjunctival hyperemia (sepetaprost, 9.9%; timolol, 2.5%).</p><p><strong>Conclusions: </strong>Once-daily sepetaprost 0.002% was statistically noninferior to twice-daily timolol 0.5% for lowering IOP in participants with POAG or OHT. There were no unexpected safety concerns observed, and all AEs were mild or moderate in severity.</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":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Nerve Fiber Layer Rates of Change: Comparison of 2 OCT Devices.","authors":"Vahid Mohammadzadeh, Erica Su, Iris Zhuang, Sajad Besharati, Justin Park, Andrea Yonge, Lynn Shi, Joseph Caprioli, Robert E Weiss, Kouros Nouri-Mahdavi","doi":"10.1016/j.ogla.2025.02.005","DOIUrl":"10.1016/j.ogla.2025.02.005","url":null,"abstract":"<p><strong>Purpose: </strong>To compare retinal nerve fiber layer (RNFL) thickness rates of change and their variability between 2 commercial OCT devices.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Participants: </strong>Ninety-four glaucoma eyes (94 patients) with central damage or moderate to advanced glaucoma with ≥ 2 years of follow-up and ≥ 4 pairs of OCT scans.</p><p><strong>Methods: </strong>A bivariate longitudinal Bayesian model was designed to compare inferences on RNFL rates of change from the 2 devices, both globally and in 12 clock hour sectors. Optic nerve OCT scans were acquired with Spectralis and Cirrus OCT devices in the same session. We inspected longitudinal RNFL profile plots from both OCT devices for all subjects across all sectors and globally.</p><p><strong>Main outcome measures: </strong>The rates of change, longitudinal variances, and proportions of significant negative and positive slopes (slope < 0 or > 0 μm/year and 1-sided P < 0.025, respectively) were compared between the devices.</p><p><strong>Results: </strong>The mean (standard deviation) baseline 24-2 visual field mean deviation and median (range) follow-up time were -8.2 (5.5) dB and 4.5 (2.2-6.7) years, respectively. The mean (95% credible interval [CrI]) estimated global baseline RNFL thickness for Spectralis and Cirrus OCTs were 61.5 (58.6-64.1) and 65.3 (63.2-67.4) μm, respectively. The global RNFL rates of change for Spectralis and Cirrus OCTs were -0.70 μm/year (95% CrI = -0.88 to -0.51 μm/year) and -0.45 μm/year (95% confidence interval = -0.63 to -0.27 μm/year) and were significantly faster for Spectralis compared to Cirrus OCT (difference = -0.24 μm/year, 95% CrI -0.45 to -0.04 μm/year, P < 0.001) as were sectoral rates in 5 out of 12 sectors. Higher proportions of significant negative RNFL rates of change were found with Spectralis OCT globally and in clock hour sectors 2 to 6 and 8 to 10 (corresponding to nasal, inferonasal, inferotemporal, and temporal regions). The proportions of significant positive rates of change were small (0%-3%) across sectors and similar between the devices.</p><p><strong>Conclusions: </strong>Spectralis OCT rates of RNFL change were faster compared to those from Cirrus OCT. Spectralis OCT detected a higher proportion of significant negative rates globally and in some sectors. OCT devices are not comparable regarding detection of change in eyes with central damage or moderate to advanced 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":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574748","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}