Acta Ophthalmologica最新文献

{"title":"One tube for all: 1-year outcomes after transition to Paul glaucoma implant at a tertiary centre.","authors":"Anne Studsgaard, Stine Elkjær Nielsen, Niklas Telinius","doi":"10.1111/aos.17443","DOIUrl":"https://doi.org/10.1111/aos.17443","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the intraocular pressure (IOP) lowering effect and success rate of Paul glaucoma implant (PGI) in refractory glaucoma after changing practice pattern from Ahmed and Baerveldt tubes to PGI.</p><p><strong>Methods: </strong>A prospective observational study of the first 50 consecutive PGI surgeries at a single Danish tertiary centre from January 2022 to October 2023. Primary endpoints were IOP and success rates after 12 months. Secondary endpoints were the use of IOP-lowering medications and complications. All cases had a risk of failure for traditional glaucoma surgery (neovascular glaucoma, oil-filled eye or uveitis).</p><p><strong>Results: </strong>Preoperative IOP was 29.9 ± 8.6 mmHg and the mean number of topical IOP-lowering medications used was 3.4 ± 0.76 with 14 cases of systemic acetazolamide. Twelve months after surgery IOP was reduced to 11.4 ± 3.1 mmHg and complete success rate with (a) IOP≤21 mmHg was achieved in 43%, (b) IOP≤18 mmHg in 43%, (c) IOP≤15 mmHg in 41% and (d) IOP≤12 mmHg in 33%. Qualified success rate (on topical glaucoma medications) was achieved in (a) 96%, (b) 94%, (c) 86% and (d) 71% of the cases. The number of topical IOP-lowering medications was 0.9 ± 0.9 after surgery and 47% were medication free. Early (<3 months) and late (>3 months) complications were observed in 22% and 16% of patients respectively.</p><p><strong>Conclusion: </strong>This study indicates that PGI provides a good IOP-lowering effect after 12 months in a population with risk factors for failure for traditional glaucoma surgery.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered retinal vasculature in childhood cancer survivors: Data from the German CVSS-study.","authors":"Alexander K Schuster, Anna Maria Voigt, Tamara Jäger, Stefan Nickels, Andreas Schulz, Jörg Faber, Arthur Wingerter, Hiltrud Merzenich, Irene Schmidtmann, Manfred E Beutel, Thomas Münzel, Karl J Lackner, Norbert Pfeiffer, Philipp S Wild","doi":"10.1111/aos.17438","DOIUrl":"https://doi.org/10.1111/aos.17438","url":null,"abstract":"<p><strong>Aims: </strong>Childhood cancer is a risk factor for cardiovascular diseases in later life. Retinal examination allows to non-invasively observe the vasculature of an end-organ. We observe alterations in long-term childhood cancer survivors (CCS).</p><p><strong>Methods: </strong>In the Cardiac and Vascular Late Sequelae in Long-Term Survivors of Childhood Cancer-Study, 1002 CCS (23-48 years) having neoplasia prior to 15 years of age were prospectively enrolled in a general and ophthalmologic examination including fundus photography. Central retinal vessel equivalents (arterial: CRAE; venous CRVE) were measured and linear regression analysis was computed to compare CCS to controls from the population-based Gutenberg Health Study (GHS) with adjustment for potential cardiovascular and ophthalmological confounders. Differences in cancer types and treatments were explored.</p><p><strong>Results: </strong>For 837 CCS (45.3% female), CRAE and CRVE were conducted. Both were smaller in CCS previously having leukaemia, central nervous system tumour, neuroblastoma, renal tumour, malignant bone tumour, soft tissue sarcoma and germ cell tumour than in GHS controls. No difference was found for CCS with prior lymphoma. Previous radiotherapy of head or neck was associated with a smaller CRVE. Higher mean arterial blood pressure and intake of antihypertensive medication were associated with smaller CRAE.</p><p><strong>Conclusions: </strong>Retinal vasculature is altered in CCS leading to smaller retinal arteries and veins. Our finding indicates that childhood cancer and its treatment leads to systemic alterations of the microcirculation on both branches of the vasculature system. While the retinal venous vasculature is altered by radiotherapy, the lower vessel width of the arterial branch is associated with arterial hypertension.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior segment optical coherence tomography (AS-OCT) assisted analysis of characteristics of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty.","authors":"Pratima Vishwakarma, Mert Mestanoglu, Veronika Welge-Lüßen, Simona Schlereth, Claus Cursiefen, Björn Bachmann","doi":"10.1111/aos.17445","DOIUrl":"https://doi.org/10.1111/aos.17445","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse anterior segment optical coherence tomography (AS-OCT) parameters of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for graft failure post penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>Retrospective evaluation of AS-OCT images of 142 dehiscences post-DMEK in 75 eyes. Dehiscences' size, depth, location, correlation with graft-host interface (GHI) override and step at GHI were assessed.</p><p><strong>Results: </strong>The majority of patients were male (58.7%) and mean age was 67 ± 13.6 years. Multiple dehiscences were observed in 49.3% eyes. Rebubbling was required once in 72% and multiple times in 24% eyes. Among 142 dehiscences, crossing over GHI was noted in 53.5%. The median distance of peripheral edge of dehiscences from GHI was 0.21 mm. Steps at GHI were noted in 41.5% where 22.5% dehiscences with step crossed the GHI. For dehiscences crossing versus not crossing GHI, no significant difference was noted in median depth (p = 0.268) and size (p = 0.206). For dehiscences crossing over GHI with presence versus absence of step, median depth (p = 0.23) and size (p = 0.196) showed no significant difference. No significant difference was noted in dehiscences' median depth (p = 0.16) and size (p = 0.926) among different step sizes. Incidence of dehiscence with or without steps (p = 0.8853) and graded as per size of steps, showed no significant difference.</p><p><strong>Conclusion: </strong>Size and depth of dehiscence were not influenced by their crossing over GHI or the presence and size of steps. Dehiscences typically occurred in close vicinity to GHI, suggesting that DMEK graft should be placed 0.25 mm centrally from the prior PK interface, independent of GHI irregularities.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brolucizumab for treating neovascular age-related macular degeneration: An alternative for treatment-refractory patients.","authors":"Martin Biilmann Groen, Anders Højslet Vestergaard, Lasse Jørgensen Cehofski","doi":"10.1111/aos.17446","DOIUrl":"https://doi.org/10.1111/aos.17446","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neovascular age-related macular degeneration on three nationwide survey and register data in Finland during 2000-2017.","authors":"Petri Purola, Seppo Koskinen, Kai Kaarniranta, Hannu Uusitalo","doi":"10.1111/aos.17444","DOIUrl":"https://doi.org/10.1111/aos.17444","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate time trends in the incidence and prevalence of neovascular age-related macular degeneration (nAMD) and its treatments, associated factors, and effects on vision in Finland during 2000-2017.</p><p><strong>Methods: </strong>We used three nationwide health examination surveys representing the Finnish population aged 30 years or older. All three surveys were linked to the national care register covering nAMD diagnoses and intravitreal injections between 2000 and 2017. All three surveys included a health examination in which distance and near visual acuity (VA) were measured, as well as self-reported and register-based information on socio-demographic status and lifestyle, health care use, co-morbidities, and quality of life. The data included two cross-sectional time points in 2011 and 2017 and two 11 year longitudinal follow-ups during 2000-2011 and 2006-2017.</p><p><strong>Results: </strong>The incidence and prevalence of nAMD were two times higher in women than in men. The annual prevalence of nAMD increased from 0.51% to 0.70% and from 0.22% to 0.46% in treated nAMD between 2011 and 2017. Treated nAMD patients had an average of 4 intravitreal injections per treatment year. nAMD patients showed significantly poorer distance and near VA than persons without any AMD in 2011 and 2017 (p < 0.001). However, near VA was significantly better in 2017 than in 2011 among nAMD patients (p = 0.036). The duration of nAMD showed weak negative correlation with distance and near VA. After adjusting for age and sex, nAMD patients showed significantly higher univariable odds ratios for lower distance VA, low consumption of vegetables, living in central Finland, a higher number of hospitalisations per year, and older age compared with persons without any AMD.</p><p><strong>Conclusion: </strong>Since nAMD is an increasing burden for public health with gender discrepancy and a detrimental impact on vision, we should better find patients who have a high risk of developing nAMD and try to optimise their preventive intervention. Once nAMD is developed, we should understand treatment and follow-up demands at the personalised level. The nationwide register data help us in those challenges.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Societal costs of decreased visual acuity: A Finnish cohort study with 15 years of registry data follow-up.","authors":"Joonas Taipale, Petri K M Purola, Saku Väätäinen, Janika E Nättinen, Seppo V P Koskinen, Hannu M T Uusitalo","doi":"10.1111/aos.17439","DOIUrl":"https://doi.org/10.1111/aos.17439","url":null,"abstract":"<p><strong>Purpose: </strong>To examine what direct and indirect societal costs are associated with decreased visual acuity (VA).</p><p><strong>Methods: </strong>Nationally representative sample of 8028 Finnish adults aged 30 years or older with survey data and clinical examination including VA assessment was evaluated. These data were linked with multiple national registers to capture health care services utilization during 1999-2013. All direct and indirect costs were calculated using prevalence-based bottom-up approach and adjusted for age, sex, and comorbidities with generalized linear models. The results in 2019 cost level are presented according to VA groups at baseline per person, and with population estimates.</p><p><strong>Results: </strong>Total direct health care costs ranged from 1996 €/year/person for those with VA ≥1.0 to 3277 €/year/person for those with weak (0.32-0.5) VA. The increase in direct costs was notable even before the onset of visual impairment. Indirect costs showed monotonously increasing trend with decreasing VA. At the population level, the additional annual direct costs associated with decreased VA were estimated at 1.9 billion €. Only 2% or less of the additional costs are due to increased direct eye-related secondary health care usage. Estimated additional annual national indirect costs were 1.2 billion €.</p><p><strong>Conclusions: </strong>In addition to those with visual impairment or blindness, health care need, and societal costs are elevated even among those with adequate VA. We conclude, that focusing on prevention of VA decrease would not only help sustain the patients' quality of life but could also reduce the future societal costs.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of the benefits of new types of optical corrections for myopia prevention?","authors":"Olavi Pärssinen","doi":"10.1111/aos.16890","DOIUrl":"https://doi.org/10.1111/aos.16890","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Over the past few decades, the prevalence of myopia has significantly increased, especially in East and Southeast Asian countries, where the prevalence of myopia in school leavers is now around 80%. The risk of myopia related complications such as myopic macular degeneration, retinal detachment, cataract, glaucoma, visual impairment and blindness, all increase with increased severity of myopia without any safe threshold of myopia for any of its known ocular complications.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Various specially designed contact lenses and spectacle lenses has been developed to prevent myopic progression. The Orto-K treatment contact lenses are worn during the night to decrease the corneal refractive power so that during the day you can see far without optical correction. Peripheral hyperopic refraction is assumed to increase the progression of myopia. To correct the relative peripheral hyperopic refraction various contact lenses and glasses have been developed so that the central myopic refractive error is fully corrected and the peripheral refraction corrected to the direction of hyperopia in relation to the central correction.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The main aims this presentation is to highlight the chalenges, related to conducting and reporting these studies, and with a few examples show differences between statistically significant and in practice significant treatment benefits.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;There is a large individual variation in the progression of myopia. Progression of myopia in two same aged myopics with the same myopia can significantly differ from each other. Myopia progresses generally more in the early stages. The most significant factors causing variation in myopia progression are parental myopia, time and intensity spent on near work, time spent outdoors, age of myopia onset, and change in refraction prior to the myopia examination point. Especially the wide range range in baseline refraction and age at the beginning of the research intervention makes reliable randomization challenging. Comparability would be improved if the randomisation to the treatment and control group could be carried out for example half or one year before beginning the treatment intervention. In this way, the potential effects of the natural progression of myopia in study groups could be taken into account.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The the difference between treatment and control groups are often reported as percentage benefit, which actually does mean much. For example 50% benefit of treatment can be received from refraction canges 0.1 D vs 0.2 D, which is practicaly nothing or 1.0 D vs. 2.0. It is also important to report in what period of time the benefit of treatment occurs and when the treatment is no longer beneficial, instead of reporting about sustained benefit, when the changes between the groups do not change.&lt;/p&gt;\u0000 \u0000 &lt;p","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of post-refractive surgery corneal ectasia","authors":"Yengwoo Son,&nbsp;Hyun Sun Jeon","doi":"10.1111/aos.17196","DOIUrl":"https://doi.org/10.1111/aos.17196","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> The aim of this study was to explore the clinical characteristics, visual acuity (VA), and topographic patterns in patients who developed corneal ectasia (CE) following myopic laser vision correction (LVC).</p>\u0000 \u0000 <p><b>Methods:</b> We conducted a retrospective review of medical records for patients diagnosed with CE after laser vision correction between 2009 and 2023 at a tertiary hospital in Korea. We collected various data, including patient demographics, medical history, the type of refractive surgery and postoperative periods., VA at their initial and final visits, refractive errors, and topographic biometric data.</p>\u0000 \u0000 <p><b>Results:</b> In total, 36 eyes of 28 patients (13 females and 15 males) were included, and 8 (28.5%) cases were bilaterally involved. The most common type of surgery was LASIK (24 patients, 85.7%), while the remaining patients underwent LASEK (3 patients, 10.7%) or PRK (1 patient, 3.6%). In unilaterally involved eyes (20 eyes), VA, spherical equivalent (SE), and astigmatism of CE-affected eyes were significantly different from those of eyes with uninvolved eyes (all <i>p</i> &lt; 0.001). In eyes with over 12 months of follow-up observation (12 eyes of 9 patients), no significant progression was noted in VA (<i>p</i> = 0.392), SE (<i>p</i> = 0.675), astigmatism (<i>p</i> = 0.737), and topographic parameters.</p>\u0000 \u0000 <p><b>Conclusions:</b> CE can develop even after comprehensive preoperative screening following LVC. This condition can significantly impact patients' quality of life by substantially reducing VA. Moreover, considering the spectrum of diseases that keratoconus represents, there is a possibility that CE may cease to progress after a certain age. Further investigations are required to understand the progression of CE concerning age in affected patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of postoperative subconjunctival corticosteroid injections in a multimodal approach for the treatment of severe symblepharon","authors":"Dmitri Artemiev","doi":"10.1111/aos.17197","DOIUrl":"https://doi.org/10.1111/aos.17197","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> To report on the impact of additional subconjunctival corticosteroid injections in a subsequent multimodal treatment of a challenging case of symblepharon following a Roper Hall Grade III chemical burn.</p>\u0000 \u0000 <p><b>History and signs:</b> A 42-year-old male patient was referred due to multiple failed treatment attempts for his corneal disease and severe symblepharon formation. The initial cause of the accident was a chemical burn on the right eye (OD) caused by potassium hydroxide. At the time of referral, extensive ocular surface damage was present with corneal vascularization, fibrovascular pannus, persistent central corneal ulcer, distichiasis, upper eyelid nasal entropion, and limbal stem cell deficiency (LSCD), with visual acuity reduced to finger counting.</p>\u0000 \u0000 <p><b>Results:</b> To treat this patient's condition, we adopted a multimodal three-step approach. The first step was to reconstruct the fornix, with additional preoperatively intensive topical therapy with autologous serum drops and antibiotic eye drops to reepithelialize the corneal ulcer. In the crucial postoperative period, we administered a subconjunctival injection of 0.5ml betamethasone and a week later 1ml triamcinolone to prevent recurrence of symblepharon. The healing process went well and there were no further signs of symblepharon recurrence three months later. To improve tissue modulation, we administered a subconjunctival injection of triamcinolone again to achieve a more lasting effect and planned step two, which included a limbal stem cell transplant and lastly a penetrating keratoplasty as the final step.</p>\u0000 \u0000 <p><b>Conclusions:</b> There are numerous therapeutic approaches to treat symblepharon, which are primarily based on surgical procedures and these remain an important cornerstone for the chances of recovery. In addition to surgical treatment, postoperative adjustment is also crucial for success. With our new approach we took action in the fibrosis formation process by administering early postoperative subconjunctival injections, this to achieve better bioavailability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of age, baseline severity and follow-up time on visual field progression in primary open angle glaucoma","authors":"Achilleas Ghinis,&nbsp;Jan Van Eijgen,&nbsp;Celine Vens,&nbsp;Geert Molenberghs,&nbsp;Ingeborg Stalmans","doi":"10.1111/aos.17083","DOIUrl":"https://doi.org/10.1111/aos.17083","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Challenges in modeling rates of visual field (VF) progression relate to flooring effects and sensitivity to inclusion criteria like follow-up (FU) duration. We explored the relationship between VF progression and age, disease severity, and FU duration in primary open angle glaucoma (POAG).</p>\u0000 \u0000 <p><b>Methods:</b> Mean Deviation (MD) of 655 POAG eyes of 424 patients from the UZ Leuven Glaucoma Clinic with at least 5 VFs and 2 years of follow-up were used. Baseline severity was defined as Above 0 (≥0dB), mild ( &lt; 0 and ≥-6dB), moderate ( &lt; -6 and ≥-12dB), advanced ( &lt; -12 and ≥-15dB), and severe ( &lt; -15dB) disease. Linear mixed models and changepoint detection were used. Sensitivity analysis of modeled progression rates within each severity group was done by varying maximally included duration of FU.</p>\u0000 \u0000 <p><b>Results:</b> MD progression rates per year were -0.34dB (<i>p</i> &lt; 0.001) for Above 0, -0.49dB (<i>p</i> &lt; 0.001) for mild, -0.49dB (<i>p</i> &lt; 0.001) for moderate, -0.26dB (<i>p</i> = 0.009) for advanced, and +0.1dB (<i>p</i> = 0.317) for severe POAG. Random effects correlation between baseline MD and progression rates was 0.36. The fixed effects for age and test related learning effect were non-significant (<i>p</i> = 0.65) and -0.21 (<i>p</i> = 0.004) respectively. The correlation between the implied slope and baseline age was -0.26. Changepoint analysis showed that group level progression estimates stabilized when minimum FU times were at least 2.17, 1.99, 2.18, and 4.56 years for mild, moderate, advanced and severe POAG respectively.</p>\u0000 \u0000 <p><b>Conclusions:</b> Older patients progress faster across severity levels and a significant learning effect is present when excluding patients with severe POAG. Excluding patients with a baseline MD above 0dB, the modeled average MD change is similar between mild and moderate POAG. Less progression is observed in advanced and no progression in severe POAG, consistent with the flooring effect. In mild and moderate POAG patients progression estimates converged after a minimum FU of at least 2 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}