Ophthalmology. Glaucoma最新文献

{"title":"Socioeconomic Differences in Glaucoma Medication Spending under Medicare Part D: Evidence on Price vs. Utilization.","authors":"Taemin Kim, Anh Vu, Chien-Hsiang Weng","doi":"10.1016/j.ogla.2026.05.013","DOIUrl":"10.1016/j.ogla.2026.05.013","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether socioeconomic differences in Medicare Part D glaucoma medication spending are more strongly associated with price exposure (spending per claim) than with utilization intensity.</p><p><strong>Design: </strong>An ecologic observational study using state-year-level data.</p><p><strong>Participants: </strong>Medicare Part D beneficiaries receiving glaucoma medications across 50 states and the District of Columbia from 2019 through 2023 (255 state-years).</p><p><strong>Methods: </strong>We analyzed Centers for Medicare & Medicaid Services Medicare Part D Prescribers-by-Geography and Drug public use files. State-level socioeconomic context was measured using Area Deprivation Index (ADI) national rank and median household income (sensitivity analysis). Outcomes included inflation-adjusted spending per beneficiary and per claim, as well as utilization measures (claims and 30-day fills per beneficiary) and brand spending and claims shares. Multivariable linear regression models included year fixed effects and state-clustered standard errors.</p><p><strong>Main outcome measures: </strong>Spending per beneficiary and spending per claim.</p><p><strong>Results: </strong>Median spending per beneficiary was $403.81 (interquartile range [IQR], $359.74-$444.73), and median spending per claim was $104.22 (IQR, $89.49-$118.41). Higher median household income was associated with greater spending per beneficiary ($18.18 per $10,000; 95% confidence interval [CI], $1.30-$35.06) and per claim ($6.99; 95% CI, $1.95-$12.03). Higher ADI was associated with lower spending per claim, although estimates were imprecise (-$3.69 per 10-point increase; 95% CI, -$7.51 to $0.13). Utilization intensity varied minimally across socioeconomic strata (claims per beneficiary, 3.8-4.0), and neither ADI nor income was consistently associated with brand spending or claims share.</p><p><strong>Conclusions: </strong>State-level socioeconomic context was associated with modest differences in glaucoma medication spending per claim, with minimal differences in utilization intensity. These findings suggest that socioeconomic variation in Medicare Part D glaucoma drug spending is more consistent with differences in price exposure than with differences in volume of use.</p><p><strong>Financial disclosure(s): </strong>The authors have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152316","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":"Primary Open Angle Glaucoma Polygenic Risk Score is Associated with Disease Progression.","authors":"Niloufar Bineshfar, Kanza Aziz, Hetince Zhao, Yan Zhao, Uday Pratap Singh Parmar, Ha My Thi Vy, Ghislain Rocheleau, Ron Do, Jae H Kang, Ayellet V Segrè, Louis R Pasquale, Janey L Wiggs, Nazlee Zebardast","doi":"10.1016/j.ogla.2026.05.014","DOIUrl":"10.1016/j.ogla.2026.05.014","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether a polygenic risk score (PRS) for primary open-angle glaucoma (POAG) is associated with open-angle glaucoma (OAG) progression and treatment burden in a multiancestry population.</p><p><strong>Design: </strong>Longitudinal cohort study.</p><p><strong>Subjects: </strong>A total of 950 individuals with OAG and serial Humphrey visual field (VF) testing were included, comprising 713 participants from the Mass General Brigham Biobank and 237 from the Mount Sinai BioMe Biobank.</p><p><strong>Methods: </strong>A POAG PRS was generated using summary statistics from a cross-ancestry genome-wide association study. Association between PRS and VF progression, defined as a mean deviation slope worse than -0.25 dB/year, was tested with logistic regression models adjusted for age, sex, and ancestry. Associations with treatment burden, defined by a weighted score of medications, laser, and surgical interventions, were analyzed using logistic regression. Association between PRS and surgical interventions were assessed using Cox proportional hazards models.</p><p><strong>Main outcome measures: </strong>OAG progression described by mean deviation slope and treatment intensity.</p><p><strong>Results: </strong>Among 950 individuals with OAG, the mean age at baseline was 71.2 ± 10.5 years; 54.7% were female, and 65.5% were of European descent. The median follow-up duration was 6.5 years. Each standard deviation (SD) increase in PRS was associated with a faster rate of VF decline (β = -0.02 dB/year per SD higher PRS; 95% confidence interval [CI], -0.04 to -0.01; P = 0.007) and 22% higher odds of progression (odds ratio = 1.22 per SD higher PRS; 95% CI, 1.04-1.42; P = 0.014). Higher PRS was also associated with greater treatment burden (odds ratio = 1.47 per SD; 95% CI, 1.27-1.71; P < 0.001). In the Mass General Brigham cohort, higher PRS predicted shorter time to glaucoma procedures (hazard ratio = 1.34 per SD; 95% CI, 1.12-1.59; P = 0.001), and this association persisted among eyes with normal or mild baseline disease severity (hazard ratio = 1.33 per SD; 95% CI, 1.10-1.60; P = 0.003).</p><p><strong>Conclusions: </strong>In 2 independent biobank cohorts, higher POAG PRS was associated with faster VF progression and greater treatment burden in OAG. These findings support the potential utility of genetic risk profiling for prognostication of disease trajectory and management intensity in 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":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152290","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":"Definitions of Fast Progression in Glaucoma Literature.","authors":"Andrea Servillo, Camilla Patelli, Alessandro Ghirardi, Giovanni Montesano, Francesco Oddone, Tin Aung, Stefano De Cillà, Alessandro Rabiolo","doi":"10.1016/j.ogla.2026.05.011","DOIUrl":"10.1016/j.ogla.2026.05.011","url":null,"abstract":"<p><strong>Topic: </strong>Fast glaucoma progression is generally defined using numerical cut-offs applied to the rate of progression. However, no consensus guidelines exist for standardized thresholds, and multiple methods are used to estimate progression rates. We systematically review how fast progression is defined in the glaucoma literature and quantify heterogeneity in criteria, analytic methods, and structural or functional parameters used across studies.</p><p><strong>Clinical relevance: </strong>Potential heterogeneity in defining fast glaucoma progression may influence reported prevalence, risk factor associations, and interpretation of outcomes across studies.</p><p><strong>Methods: </strong>A systematic review (PROSPERO: CRD42024502764) was conducted using MEDLINE and Embase to identify studies assessing fast glaucomatous progression based on visual field (VF) examination, optic disc photography, OCT, confocal scanning laser tomography (CSLT), and OCT angiography (OCT-A). Childhood glaucoma was excluded. Two independent reviewers selected eligible studies and extracted complete definitions of fast progression.</p><p><strong>Results: </strong>Of 31 856 records identified, 122 met the eligibility criteria, yielding 88 definitions of fast progression, including 66 unique criteria and 16 analytic methods. The most frequent definition was mean deviation (MD) rate < -1.0 dB/year calculated using ordinary least squares regression (OLSR) (13 studies, 10.7%). Among structural definitions, the most common was global peripapillary retinal nerve fiber layer thickness decay ≥90th percentile of the study sample using OLSR. When analyzed separately, MD rate < -1.0 dB/year was the most commonly used measure (25 studies, 20.5%) and OLSR the most frequent analytic method (79 studies, 64.8%). Visual field testing was used in 103 studies (84.4%), OCT in 25 (20.5%), and CSLT and OCT-A in 1 study each (0.8%). Seven studies (5.7%) combined VF with a structural device (6 with OCT and 1 with CSLT), and 1 study combined OCT and OCT-A. Among VF-based studies, 3 (2.9%) used central testing (10-2), while among OCT-based studies, 4 (16.0%) focused on macular parameters. Mean deviation was the most frequently adopted index (81 studies, 66.3%), followed by peripapillary retinal nerve fiber layer thickness (21 studies, 17.2%).</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><p><strong>Conclusions: </strong>Definitions of fast glaucomatous progression in the literature are predominantly VF-based but vary widely in terms of indices, analytic model, and threshold used. Further research should clarify how different definitions influence fast progressor classification.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038196","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 Effect of Fast Forceful Abdominal Breathing Yoga in Eyes with Glaucoma.","authors":"Mona Khurana, Pooja Shankar, Ashwini Venkata Reddy Chanakya, Ronnie George","doi":"10.1016/j.ogla.2026.05.010","DOIUrl":"10.1016/j.ogla.2026.05.010","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007500","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 Cost-Effectiveness of Xen45 Gel Stent versus Trabeculectomy in the US Medicare System.","authors":"Deus Bigirimana, Nelson Hu, Janice Soo, Myra McGuinness, Elaine Chong, Catherine Green, Keith R Martin, Nazlee Zebardast, Alp Atik","doi":"10.1016/j.ogla.2026.05.009","DOIUrl":"10.1016/j.ogla.2026.05.009","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the cost-effectiveness of Xen45 Gel Stent (XGS) compared with trabeculectomy for the surgical management of open-angle glaucoma (OAG) in the US Medicare system.</p><p><strong>Design: </strong>Cost-utility analysis using safety and efficacy results of a randomized controlled trial (RCT) and other pivotal RCTs.</p><p><strong>Subjects: </strong>Markov model cohort of adult patients with OAG METHODS: Open-angle glaucoma treatment costs and effects were analyzed with a deterministic model over a 1-year horizon using TreeAge software. Health states included the Hodapp-Parrish-Anderson glaucoma stages (mild, moderate, advanced, blind) and death. Treatment effect was measured as mean number of ocular hypotensive medications and reduction in intraocular pressure, which had a direct impact on transition probabilities between health states. Scenario analyses with future projections were also performed at 2, 5, 10, and 20 years. One-way sensitivity and probabilistic sensitivity analyses were conducted to assess the impact of additional variables, including disutility of XGS relative to trabeculectomy and number of follow-up visits. Both treatment arms were subject to complication and reoperation rates, which were factored in the model.</p><p><strong>Main outcome measures: </strong>Incremental cost per quality-adjusted life-year (QALY) gained at a willingness-to-pay threshold of USD 50 000 per QALY.</p><p><strong>Results: </strong>At 1 year, the expected total cost for XGS was USD 10512 compared with USD 8649 for trabeculectomy. Xen45 Gel Stent yielded 0.8602 QALYs at the 1-year horizon, compared with 0.8523 for trabeculectomy, resulting in an incremental cost-effectiveness ratio (ICER) of USD 236629 per QALY. Xen45 Gel Stent became dominated by trabeculectomy at 5 years, meaning it had higher costs and worse outcomes. When XGS was given half the follow-up rate of trabeculectomy at 1-year, trabeculectomy remained the cost-effective option as the ICER of XGS was USD 200634 per QALY. Trabeculectomy remained cost-effective even when there was no perioperative disutility applied to XGS. Probabilistic sensitivity analysis showed that trabeculectomy was cost-effective in 88.4% of iterations and dominant in 45.8%.</p><p><strong>Conclusions: </strong>Xen45 Gel Stent does not appear to be cost-effective compared to trabeculectomy in the surgical management of glaucoma, even accounting for the purported advantages of less follow-up and decreased postoperative disutility.</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":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990327","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":"Remote Tonometry Identifies Significant Variability in the Timing of Intraocular Pressure Response to Topical Medication Change.","authors":"Jasdeep Sabharwal, Margaret Tharp, Natalie Hamilton, Yulia Nam, Maria Catalina Pizarro Penaranda, Louay Almidani, Jacob Kanter, Elyse McGlumphy, Alan L Robin, Harry A Quigley, Pradeep Y Ramulu, Thomas V Johnson","doi":"10.1016/j.ogla.2026.05.007","DOIUrl":"10.1016/j.ogla.2026.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the time to maximum intraocular pressure (IOP) change after stopping and restarting topical prostaglandin analog (PGA) treatment using remote tonometry.</p><p><strong>Design: </strong>A prospective single-site observational study.</p><p><strong>Subjects: </strong>Patients with primary open-angle glaucoma or ocular hypertension treated with ≥4 weeks of PGA monotherapy, in whom the managing ophthalmologist ordered medication washout to assess the necessity of continued topical therapy.</p><p><strong>Methods: </strong>Patients used a rebound home tonometer to obtain ≥4 daily measurements across 3 periods: \"Baseline\" (1 week while continuing PGA), \"Washout\" (4 weeks off therapy), and \"Restart\" (4 weeks while restarting PGA). Exponential decay functions were used to model IOP from \"Baseline\" through \"Washout\" and then from end of \"Washout\" through \"Restart\" to determine the time to 90% of maximum IOP change (plateau, T_90%%). We evaluated the variation in T_90% using multilevel models to account for the inclusion of both eyes from individual subjects.</p><p><strong>Main outcome measures: </strong>T_90% for \"Washout\" and \"Restart.\"</p><p><strong>Results: </strong>Twenty subjects (34 eyes) successfully recorded multiple daily eye measurements for the 9-week study period. Mean (standard deviation) IOPs during the \"Baseline,\" \"Washout,\" and \"Restart\" periods were 15.6 (4.2) mmHg, 17.3 (5.0) mmHg, and 15.9 (4.7) mmHg, respectively. \"Baseline\" and \"Restart\" IOPs were significantly lower than \"Washout\" IOP (P < 0.001). T_90% was significantly longer and more variable among subjects during Washout (median: 18.5 days; interquartile range 6.0-32.1 days) compared to Restart (2.2 days; 1.3-4.1 days, P < 0.001).</p><p><strong>Conclusions: </strong>Using remote tonometry, we identified a significantly longer T_90% after stopping PGA drops than when they were restarted. The ranges of time to reach the IOP plateau were wide, often exceeding the standardized 4-week washout, and are relevant to clinical assessment of routine treatment effects and determination of accurate washout periods for clinical research studies.</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":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984466","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":"Giant Blebs Post-Glaucoma Drainage Device Implantation in Pediatric Patients.","authors":"Rayan Abou Khzam, Marie Michele Macaron, Arjun Sharma, Alana Grajewski, Elena Bitrian","doi":"10.1016/j.ogla.2026.05.006","DOIUrl":"10.1016/j.ogla.2026.05.006","url":null,"abstract":"","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977555","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":"Childhood Angle Closure: Etiology and Treatment Outcomes from a Large Series Spanning over 20 Years.","authors":"Kasem Seresirikachorn, Daniel M Vu, Alejandro M Perez, Warakorn Thiamthat, Ta Chen Peter Chang","doi":"10.1016/j.ogla.2026.05.005","DOIUrl":"10.1016/j.ogla.2026.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the etiologies of childhood angle closure (CAC) and to compare the long-term outcomes of glaucoma drainage devices (GDDs) vs. lens surgery ± goniosynechialysis (GSL) in the management of CAC-associated glaucoma.</p><p><strong>Design: </strong>Retrospective multicenter cohort study.</p><p><strong>Participants: </strong>Patients under 18 years of age diagnosed with CAC between 2003 and 2023.</p><p><strong>Methods: </strong>Childhood angle-closure cases were categorized by acute vs. chronic presentation and by primary vs. secondary causes. Treatment approaches were analyzed, and surgical outcomes of GDD implantation and lens extraction ± GSL were compared in CAC glaucoma, excluding cases of glaucoma following cataract surgery (GFCS).</p><p><strong>Main outcome measures: </strong>The primary outcome was the distribution of CAC etiologies in pediatric patients. The secondary outcomes included the 5-year complete and qualified success rates of GDDs and lens surgery ± GSL in CAC glaucoma, changes in intraocular pressure, and the number of glaucoma medications required postoperatively.</p><p><strong>Results: </strong>A total of 103 patients (159 eyes) were included, with a slight female predominance (51.5%) and a mean age at diagnosis of 10.3 ± 5.6 years. Acute CAC was observed in 5.7% of eyes, all of which were secondary. The remaining 94.3% had chronic CAC, most associated with retinopathy of prematurity (ROP, 26.7%). Among those with glaucoma, ROP was the leading cause (21.9%), followed by GFCS (16.0%) and uveitis (7.6%). Surgical intervention was required in 63.3% of CAC glaucoma cases, with GDD implantation being the most frequent (38.6%), followed by lens surgery (22.7%, 85% of which included GSL), peripheral iridotomy (15.9%), and trabeculectomy (7.9%). Lens surgery ± GSL demonstrated a significantly higher complete success rate at 5 years compared to GDD (35.5% vs. 9.5%; P = 0.006), while no significant differences were found in qualified success (P = 0.2) or serious surgical complications between the 2 groups.</p><p><strong>Conclusions: </strong>Childhood angle closure is primarily chronic and secondary, most often associated with ROP. Surgical intervention is frequently required in CAC-related glaucoma. Our findings suggest that lens surgery ± GSL may achieve superior long-term complete success compared to GDDs, with a comparable safety profile. However, given the multiple etiologies of glaucoma, the choice of surgical approach should be individualized and guided by the underlying etiology and clinical judgment FINANCIAL DISCLOSURE(S): 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":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959437","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":"Increased Risk of Intraocular Pressure-Lowering Treatment in Patients with End-Stage Renal Disease Undergoing Hemodialysis.","authors":"Su-Ho Lim, Ryan Shean, Kyunghee Lee, Soorack Ryu, Elaine Tran, Rakesh Malhotra, Robert N Weinreb, Benjamin Y Xu, Alex S Huang","doi":"10.1016/j.ogla.2026.05.004","DOIUrl":"10.1016/j.ogla.2026.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the risk of receiving intraocular pressure (IOP)-lowering treatment in patients with end-stage renal diseases (ESRD) undergoing hemodialysis (HD).</p><p><strong>Design: </strong>Retrospective cohort study using electronic health record data obtained from the TriNetX US Collaborative Network.</p><p><strong>Participants: </strong>Patients aged ≥ 20 and ≤ 85 years with a diagnosis of ESRD and HD dependence compared to a healthy control cohort.</p><p><strong>Methods: </strong>Incidence and relative risk for needing IOP-lowering medication or surgery were calculated in the ESRD on HD (ESRD-HD) and control cohorts in an unadjusted analysis. Then, propensity score matching (PSM) was performed to match the cohorts for age and sex (Model 1). Model 2 included Model 1 with additional PSM for systemic comorbidities including diabetes, hypertension, and others. Standardized mean difference (SMD) values were used to assess matching quality. Cumulative incidences and hazard ratios (HR) with 95% confidence intervals (CIs) for IOP-lowering treatment were calculated for glaucoma treatment endpoints at 5 years after the index date.</p><p><strong>Main outcome measures: </strong>Risk of new IOP-lowering treatments including medication and surgery.</p><p><strong>Results: </strong>The unadjusted analysis demonstrated that the ESRD-HD cohort had a higher incidence proportion of receiving IOP-lowering medication or surgery (9.57% vs. 4.38%, P < 0.001). After PSM, SMD was <0.1 for all variables, indicating good matching. In Model 1, the ESRD-HD cohort demonstrated statistically significant higher incidence and increased HRs for receiving new IOP-lowering treatment including medication or surgery 5 years after the index date (1.94, 1.81-2.07; HR, 95% CI). In Model 2, the ESRD-HD cohort showed significantly higher HRs for new IOP-lowering treatment including medication or surgery (1.36, 1.26-1.46), medication use (1.38, 1.32-1.44; HR, 95 CI), new medication use (1.36, 1.27-1.46), and new surgeries (1.57, 1.20-2.05), at the 5-year time point. More specifically particularly high HRs in Model 2 were observed for the ESRD-HD cohort needing glaucoma drainage devices (GDDs) (2.09, 1.34-3.25) and cyclodestruction (3.72, 2.10-6.59).</p><p><strong>Conclusions: </strong>The ESRD-HD cohort was at significantly higher risk of receiving IOP-lowering treatment, ranging from medications to surgery. In particular, the ESRD-HD cohort had a higher risk of undergoing GDD implantation or cyclodestructive procedures, surgical interventions sometimes reserved for patients with more advanced glaucoma. Therefore, patients with ESRD-HD require heightened ophthalmic surveillance to achieve timely intervention.</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":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935638","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":"A Comparative Evaluation of 2 Rapid Strategies for Visual Field Testing: SITA Faster and SPARK Quick.","authors":"Xiaoyan Wang, Xiaoqian Bian, Yize Chen, Chengtan Liu, Hao Lin, Yuanbo Liang, Fan Lu, Cong Ye","doi":"10.1016/j.ogla.2026.05.001","DOIUrl":"10.1016/j.ogla.2026.05.001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study compares the diagnostic performance of 2 rapid visual field testing strategies, SITA Faster and SPARK Quick, against the \"gold standard\" SITA Standard. The measurement accuracy, agreement, and repeatability were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A prospective, cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;A total of 118 eyes of 118 participants were enrolled.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants from a glaucoma clinic underwent multiple visual field tests. All subjects were naïve to SITA Faster and SPARK Quick, with SITA Standard 24-2 serving as the initial test. SITA Faster and SPARK Quick were then administered in random order. Among the 74 participants with visual field defects detected by SITA Standard, 49 underwent testing twice with both rapid strategies. Parameters were compared using one-way ANOVA with Bonferroni post hoc tests, and repeatability was assessed using intraclass correlation coefficients (ICCs). A bootstrap method (5000 samples) evaluated the differences in repeatability. Agreement was analyzed using Bland-Altman quantile regression plots, and diagnostic performance was assessed via receiver operating characteristic curves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Measurement accuracy, agreement, and repeatability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant differences in mean deviation (MD) and pattern standard deviation (PSD) were found between SITA Standard and SITA Faster; however, SPARK Quick demonstrated significantly better MD and PSD (P &lt; 0.001). Test duration was reduced by 57.8% for SITA Faster and 73.8% for SPARK Quick compared to SITA Standard (P &lt; 0.001). Bland-Altman analysis revealed that the mean differences in MD between SITA Standard and SITA Faster and between SITA Standard and SPARK Quick were -0.35 and -3.1, respectively. Intraclass correlation coefficient values indicated excellent repeatability for SITA Faster, whereas SPARK Quick exhibited significantly lower ICCs (P &lt; 0.001). Among the 118 participants, 74 (62.7%) had visual field defects identified by SITA Standard, 72 (61.0%) by SITA Faster, and 31 (26.2%) by SPARK Quick. Sensitivity and specificity for SITA Faster were 83.8% and 77.3%, respectively, compared to 40.5% and 97.7% for SPARK Quick. Receiver operating characteristic analysis yielded area under receiver operating characteristic curves for MD of 0.89 for SITA Faster and 0.86 for SPARK Quick (P = 0.306); for PSD, area under receiver operating characteristic curves were 0.91 and 0.77 (P = 0.005). The Conger's Kappa coefficient indicated fair agreement among the strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both SITA Faster and SPARK Quick significantly shorten testing duration. SITA Faster yields results comparable to SITA Standard, while SPARK Quick may underestimate defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Financial disclosure(s): &lt;/strong&gt;The authors have no proprietary or commercial interest in any materials discussed in th","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935791","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}