Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.05.005
Pranav Vasu MPH , Isabella V. Wagner BS , Paul Connor Lentz MD , Priyanka Gumaste MD , Yazan Abubaker MD , Bryan C.H. Ang MD , Abhimanyu S. Ahuja MD , Emily Dorairaj BS , Ibrahim Qozat MD , Darby D. Miller MD, MPH , Syril Dorairaj MD
Purpose
To evaluate the rate of progression of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA) compared with non-OSA mild-moderate POAG comparators and to assess the utilization of surgical and laser intervention.
Design
A retrospective cohort study of the TriNetX US Collaborative Network was conducted by analyzing international electronic health record data from January 2004 to October 2024.
Participants
Patients in the TriNetX US Collaborative Network with a diagnosis of mild-moderate POAG, stratified with respect to OSA status.
Methods
Patients were assessed for outcomes at 3, 5, and 10 years. Propensity score matching was conducted between cohorts matched for baseline demographics, comorbidities, and medication use. Odds ratios (ORs) and 95% confidence intervals (CIs) were subsequently calculated.
Main Outcome Measures
Risk of development of severe POAG.
Results
After propensity score matching, 5277 patients with, and 5277 patients without OSA were included in final analysis. At 3 (OR, 2.791; 95% CI, 2.289–3.403), 5 (OR, 2.300; 95% CI, 1.947–2.717), and 10 years (OR, 2.198; 95% CI, 1.873–2.578), the OSA cohort demonstrated significantly higher odds of developing severe POAG than the non-OSA comparators. Secondary outcomes of minimally invasive glaucoma surgery and trabeculectomy surgery yielded no significant difference between both cohorts (P > 0.05) at all follow-up times. However, laser therapy and tube shunt surgery demonstrated a significantly greater incidence in the OSA cohort at each time point.
Conclusions
The rate of glaucoma surgery appears similar between patients with POAG with and without OSA, despite those with OSA demonstrating a greater risk of rapid progression and vision loss. Future practice patterns should pay special attention to patients with OSA and consider offering more aggressive or earlier intervention, which may aid in limiting disease progression.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Obstructive Sleep Apnea as a Potentiator of Primary Open-Angle Glaucoma and Necessity for Interventional Therapy","authors":"Pranav Vasu MPH , Isabella V. Wagner BS , Paul Connor Lentz MD , Priyanka Gumaste MD , Yazan Abubaker MD , Bryan C.H. Ang MD , Abhimanyu S. Ahuja MD , Emily Dorairaj BS , Ibrahim Qozat MD , Darby D. Miller MD, MPH , Syril Dorairaj MD","doi":"10.1016/j.ogla.2025.05.005","DOIUrl":"10.1016/j.ogla.2025.05.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the rate of progression of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA) compared with non-OSA mild-moderate POAG comparators and to assess the utilization of surgical and laser intervention.</div></div><div><h3>Design</h3><div>A retrospective cohort study of the TriNetX US Collaborative Network was conducted by analyzing international electronic health record data from January 2004 to October 2024.</div></div><div><h3>Participants</h3><div>Patients in the TriNetX US Collaborative Network with a diagnosis of mild-moderate POAG, stratified with respect to OSA status.</div></div><div><h3>Methods</h3><div>Patients were assessed for outcomes at 3, 5, and 10 years. Propensity score matching was conducted between cohorts matched for baseline demographics, comorbidities, and medication use. Odds ratios (ORs) and 95% confidence intervals (CIs) were subsequently calculated.</div></div><div><h3>Main Outcome Measures</h3><div>Risk of development of severe POAG.</div></div><div><h3>Results</h3><div>After propensity score matching, 5277 patients with, and 5277 patients without OSA were included in final analysis. At 3 (OR, 2.791; 95% CI, 2.289–3.403), 5 (OR, 2.300; 95% CI, 1.947–2.717), and 10 years (OR, 2.198; 95% CI, 1.873–2.578), the OSA cohort demonstrated significantly higher odds of developing severe POAG than the non-OSA comparators. Secondary outcomes of minimally invasive glaucoma surgery and trabeculectomy surgery yielded no significant difference between both cohorts (<em>P</em> > 0.05) at all follow-up times. However, laser therapy and tube shunt surgery demonstrated a significantly greater incidence in the OSA cohort at each time point.</div></div><div><h3>Conclusions</h3><div>The rate of glaucoma surgery appears similar between patients with POAG with and without OSA, despite those with OSA demonstrating a greater risk of rapid progression and vision loss. Future practice patterns should pay special attention to patients with OSA and consider offering more aggressive or earlier intervention, which may aid in limiting disease progression.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 553-559"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.06.006
Debbie S. Kuo MD , Sharon Y.H. Lee OD , Christos N. Theophanous MD, MBA
Purpose
To evaluate the efficacy and safety of the Hydrus Microstent in conjunction with cataract surgery in patients with normal tension glaucoma (NTG) with minimum 12-month follow-up.
Design
Retrospective cohort study.
Subjects
Normal tension glaucoma eyes having Hydrus with cataract surgery and cataract-only controls.
Methods
Glaucoma was staged by the Hodapp–Parrish–Anderson criteria. Generalized estimating equations were used to account for intraocular correlation in regression analyses.
Main Outcome Measures
The primary outcome was medication reduction from baseline at 1 year. Secondary outcomes were medication reduction in subsequent years, mean intraocular pressure (IOP) change from baseline, proportion of eyes meeting IOP targets, and percentage of eyes requiring secondary surgical interventions (SSI) at yearly time points.
Results
Sixty-four eyes of 40 patients undergoing Hydrus Microstent and cataract surgery were included in the analysis, of which 32 eyes were from Asian patients. Thirty-nine eyes of 25 patients were used as cataract-only controls. Glaucoma severity was mild (37.5%), moderate (40.6%) and severe (21.9%) in treated eyes. The median follow-up available was 2.5 years (range: 1–5 years). Baseline IOP was 13.83 ± 2.93 mmHg on 2.11 ± 1.04 medication classes in treated eyes. At year 1, there was a mean reduction of medication classes by 1.25 ± 0.84 (P < 0.0010) and IOP by 0.89 ± 2.61 mmHg (P = 0.02). Medication class reduction remained significant through year 4 and IOP reduction through year 3. Compared to controls, treated eyes had significant differences in mean medication change (−1.25 vs. −0.03 at year 1, P < 0.001) and percentage of eyes with medication reduction (85.9% vs. 5.3% at year 1, P < 0.001), which were sustained through at least year 4. There were no significant differences in medication reduction and IOP observed between treated Asian and non-Asian eyes at any time point. In treated eyes, IOP was 16 mmHg or less on same or fewer medications in more than 90% (range: 90.6%–100%) of eyes at all time points and medication-free in more than 31% (range: 31.3%–54.5%) at all time points. No SSI occurred during the study period.
Conclusions
Hydrus Microstent was safe and effective in all NTG eyes with a significant, sustained reduction in medication use through at least 4 years of follow-up.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Outcomes of Hydrus Microstent with Cataract Surgery in Asian and Non-Asian Eyes with Normal Tension Glaucoma","authors":"Debbie S. Kuo MD , Sharon Y.H. Lee OD , Christos N. Theophanous MD, MBA","doi":"10.1016/j.ogla.2025.06.006","DOIUrl":"10.1016/j.ogla.2025.06.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy and safety of the Hydrus Microstent in conjunction with cataract surgery in patients with normal tension glaucoma (NTG) with minimum 12-month follow-up.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Normal tension glaucoma eyes having Hydrus with cataract surgery and cataract-only controls.</div></div><div><h3>Methods</h3><div>Glaucoma was staged by the Hodapp–Parrish–Anderson criteria. Generalized estimating equations were used to account for intraocular correlation in regression analyses.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was medication reduction from baseline at 1 year. Secondary outcomes were medication reduction in subsequent years, mean intraocular pressure (IOP) change from baseline, proportion of eyes meeting IOP targets, and percentage of eyes requiring secondary surgical interventions (SSI) at yearly time points.</div></div><div><h3>Results</h3><div>Sixty-four eyes of 40 patients undergoing Hydrus Microstent and cataract surgery were included in the analysis, of which 32 eyes were from Asian patients. Thirty-nine eyes of 25 patients were used as cataract-only controls. Glaucoma severity was mild (37.5%), moderate (40.6%) and severe (21.9%) in treated eyes. The median follow-up available was 2.5 years (range: 1–5 years). Baseline IOP was 13.83 ± 2.93 mmHg on 2.11 ± 1.04 medication classes in treated eyes. At year 1, there was a mean reduction of medication classes by 1.25 ± 0.84 (<em>P</em> < 0.0010) and IOP by 0.89 ± 2.61 mmHg (<em>P</em> = 0.02). Medication class reduction remained significant through year 4 and IOP reduction through year 3. Compared to controls, treated eyes had significant differences in mean medication change (−1.25 vs. −0.03 at year 1, <em>P</em> < 0.001) and percentage of eyes with medication reduction (85.9% vs. 5.3% at year 1, <em>P</em> < 0.001), which were sustained through at least year 4. There were no significant differences in medication reduction and IOP observed between treated Asian and non-Asian eyes at any time point. In treated eyes, IOP was 16 mmHg or less on same or fewer medications in more than 90% (range: 90.6%–100%) of eyes at all time points and medication-free in more than 31% (range: 31.3%–54.5%) at all time points. No SSI occurred during the study period.</div></div><div><h3>Conclusions</h3><div>Hydrus Microstent was safe and effective in all NTG eyes with a significant, sustained reduction in medication use through at least 4 years of follow-up.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 589-598"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess patients' understanding of glaucoma surgery and their postoperative satisfaction, to study the factors that may influence them, and to investigate correlations between these 2 determining factors.
Design
A multicenter observational study.
Subjects
Patients scheduled for glaucoma filtration surgery were included.
Methods
Participants responded preoperatively to a questionnaire developed after literature review, evaluating their understanding of the surgery, and to a second questionnaire evaluating their postoperative satisfaction, between 2 and 3 months after surgery.
Main Outcome Measures
The primary outcomes were the mean scores for preoperative understanding and postoperative satisfaction. The influence of demographic, clinical, and surgical factors on comprehension and satisfaction was analyzed using univariate and multivariate models.
Results
In this study, 97 patients responded to the questionnaire evaluating their understanding of the surgery preoperatively. Postoperative satisfaction could be evaluated in 86 of them. The mean understanding score was 13.4 ± 5.4 (out of 25). Level of education (P < 0.01) and reading the French Society of Ophthalmology's information form on glaucoma filtering surgery (P < 0.05) were statistically correlated with a better understanding after multivariate analysis. The mean postoperative satisfaction score was 7.13 ± 3.0 (out of 10). Needling (P < 0.01) and resumption of hypotensive treatment (P < 0.001) were statistically correlated with poorer satisfaction after multivariate analysis. In addition, poorer preoperative understanding was correlated with lower postoperative satisfaction with a Pearson coefficient of 0.42 (95% confidence interval: 0.23–0.57 [P < 0.01]).
Conclusions
Overall, patient understanding was limited, and poor understanding negatively influenced postoperative satisfaction.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
{"title":"Survey of Patient Understanding and Satisfaction in Glaucoma Filtering Surgery","authors":"Farid Akkouche MD , Paul Bastelica MD , Christophe Baudouin MD, PhD , Shaya Sable MD , Antoine Labbe MD, PhD","doi":"10.1016/j.ogla.2025.06.007","DOIUrl":"10.1016/j.ogla.2025.06.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess patients' understanding of glaucoma surgery and their postoperative satisfaction, to study the factors that may influence them, and to investigate correlations between these 2 determining factors.</div></div><div><h3>Design</h3><div>A multicenter observational study.</div></div><div><h3>Subjects</h3><div>Patients scheduled for glaucoma filtration surgery were included.</div></div><div><h3>Methods</h3><div>Participants responded preoperatively to a questionnaire developed after literature review, evaluating their understanding of the surgery, and to a second questionnaire evaluating their postoperative satisfaction, between 2 and 3 months after surgery.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were the mean scores for preoperative understanding and postoperative satisfaction. The influence of demographic, clinical, and surgical factors on comprehension and satisfaction was analyzed using univariate and multivariate models.</div></div><div><h3>Results</h3><div>In this study, 97 patients responded to the questionnaire evaluating their understanding of the surgery preoperatively. Postoperative satisfaction could be evaluated in 86 of them. The mean understanding score was 13.4 ± 5.4 (out of 25). Level of education (<em>P</em> < 0.01) and reading the French Society of Ophthalmology's information form on glaucoma filtering surgery (<em>P</em> < 0.05) were statistically correlated with a better understanding after multivariate analysis. The mean postoperative satisfaction score was 7.13 ± 3.0 (out of 10). Needling (<em>P</em> < 0.01) and resumption of hypotensive treatment (<em>P</em> < 0.001) were statistically correlated with poorer satisfaction after multivariate analysis. In addition, poorer preoperative understanding was correlated with lower postoperative satisfaction with a Pearson coefficient of 0.42 (95% confidence interval: 0.23–0.57 [<em>P</em> < 0.01]).</div></div><div><h3>Conclusions</h3><div>Overall, patient understanding was limited, and poor understanding negatively influenced postoperative satisfaction.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 634-642"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.06.008
Adam Jacobson MD , Brenda L. Bohnsack MD, PhD
Purpose
Determine 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGDs) in children with glaucoma.
Design
Retrospective interventional case series.
Subjects
Children (<18 years of age) with glaucoma requiring surgery for intraocular pressure (IOP) control with at least 2 years of postoperative follow-up.
Methods
Placement of OAGD between 2018 and 2022.
Main Outcome Measures
Change in IOP, number of glaucoma medications and best-corrected visual acuity from preoperative to final follow-up, and success of surgery (complete defined as IOP 5 to 20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications).
Results
Forty eyes of 28 patients underwent OAGD at median age of 2.6 years (interquartile range [IQR], 0.6–7.8). Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients), followed by glaucoma secondary to nonacquired ocular anomaly (11 eyes of 6 patients). Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [interquatile range (IQR), 1–2]). Preoperative IOP was a median of 27 mmHg (IQR, 24–35) on a median of 3 (IQR, 2–3) glaucoma medications. At final follow-up (median 3.6 years [IQR, 2.9–4.3]), IOP (median, 15 mmHg [IQR, 13–17]) and glaucoma medications (median, 0 [IQR, 0–0]) were significantly decrease (P < 0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% (95% confidence interval [CI], 59–86) and 57% (95% CI, 35–74). Qualified success rate was 75% (30 of 40 eyes) with 3- and 5-year survival rates of 87% (95% CI, 71–95) and 67% (95% CI, 42–83), respectively.
Conclusions
Although OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Ologen-Augmentation of Ahmed Valves in Pediatric Glaucomas","authors":"Adam Jacobson MD , Brenda L. Bohnsack MD, PhD","doi":"10.1016/j.ogla.2025.06.008","DOIUrl":"10.1016/j.ogla.2025.06.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Determine 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGDs) in children with glaucoma.</div></div><div><h3>Design</h3><div>Retrospective interventional case series.</div></div><div><h3>Subjects</h3><div>Children (<18 years of age) with glaucoma requiring surgery for intraocular pressure (IOP) control with at least 2 years of postoperative follow-up.</div></div><div><h3>Methods</h3><div>Placement of OAGD between 2018 and 2022.</div></div><div><h3>Main Outcome Measures</h3><div>Change in IOP, number of glaucoma medications and best-corrected visual acuity from preoperative to final follow-up, and success of surgery (complete defined as IOP 5 to 20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications).</div></div><div><h3>Results</h3><div>Forty eyes of 28 patients underwent OAGD at median age of 2.6 years (interquartile range [IQR], 0.6–7.8). Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients), followed by glaucoma secondary to nonacquired ocular anomaly (11 eyes of 6 patients). Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [interquatile range (IQR), 1–2]). Preoperative IOP was a median of 27 mmHg (IQR, 24–35) on a median of 3 (IQR, 2–3) glaucoma medications. At final follow-up (median 3.6 years [IQR, 2.9–4.3]), IOP (median, 15 mmHg [IQR, 13–17]) and glaucoma medications (median, 0 [IQR, 0–0]) were significantly decrease (<em>P</em> < 0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% (95% confidence interval [CI], 59–86) and 57% (95% CI, 35–74). Qualified success rate was 75% (30 of 40 eyes) with 3- and 5-year survival rates of 87% (95% CI, 71–95) and 67% (95% CI, 42–83), respectively.</div></div><div><h3>Conclusions</h3><div>Although OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 609-615"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.09.002
Chun-Hsiang Chang MD, Fu-Chin Huang MD, I-Huang Lin MD
{"title":"Re: Han et al.: Comparison of structural changes after epiretinal membrane peeling between nonglaucomatous eyes and eyes with open-angle glaucoma (Ophthalmology Glaucoma. 2025;8:351-359)","authors":"Chun-Hsiang Chang MD, Fu-Chin Huang MD, I-Huang Lin MD","doi":"10.1016/j.ogla.2025.09.002","DOIUrl":"10.1016/j.ogla.2025.09.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Page e19"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310211","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.06.013
Manju R. Pillai DNB , George Varghese Puthuran MS , David S. Friedman MD, PhD , Vijayakumar Valaguru MSW , Raheem Rahmathullah BA , Santhosha P. Ganesh MSW , Janani Rajendran MS , Iswarya Mani MSc , Ramasamy Krishnadas DNB , Maria Papadopoulos MBBS, FRCOphth
Objective
To understand predictors and barriers of adherence to follow-up and identify strategies to improve follow-up in childhood glaucoma.
Design
Cross-sectional study.
Subjects
Caregivers of children with glaucoma diagnosed between January 2014 and January 2019 residing within 200 km of the base hospital.
Methods
Home visits were conducted with consenting caregivers to collect information on socioeconomic status, education, occupation, activities, and quality of life. Caregivers were subsequently invited to bring their affected children to the base hospital for a comprehensive eye evaluation. Adherence was defined as returning within 6 months of the recommended follow-up visit. Logistic regression was used to identify factors associated with adherence.
Main Outcome Measures
Adherence to follow-up; association of adherence with socioeconomic status, caregiver education, prior glaucoma surgery, and travel-related barriers; perceived facilitators for improving follow-up.
Results
Of 147 caregivers who were interviewed in their homes, 142 reported to the base hospital with the child and were included in the analysis. Of these, 79 (56%) remained adherent to follow-up. Caregivers of adherent children were more likely to be better educated (68.3% vs. 42.9% having at least high school education; P = 0.018); they were more frequently from urban areas (19% vs. 8%; P = 0.084), and more caregivers belonged to upper middle class (17.7% vs. 6.3%; P = 0.027). Multivariable logistic regression adjusting for these factors showed that children who had undergone glaucoma surgery were 3.02 times more likely (95% confidence interval = 1.21–7.54) to be adherent. Travel distance to the hospital was not associated with adherence. Caregivers reported that cost incentives toward travel and medical expenses would encourage follow-up.
Conclusions
Only half the children with childhood glaucoma remained adherent to follow-up. Lack of prior surgery followed by lower socioeconomic status were the key risk factors. Financial assistance may help improve long-term follow-up.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Identifying Barriers and Improving Adherence to Follow-up of Childhood Glaucoma in South India","authors":"Manju R. Pillai DNB , George Varghese Puthuran MS , David S. Friedman MD, PhD , Vijayakumar Valaguru MSW , Raheem Rahmathullah BA , Santhosha P. Ganesh MSW , Janani Rajendran MS , Iswarya Mani MSc , Ramasamy Krishnadas DNB , Maria Papadopoulos MBBS, FRCOphth","doi":"10.1016/j.ogla.2025.06.013","DOIUrl":"10.1016/j.ogla.2025.06.013","url":null,"abstract":"<div><h3>Objective</h3><div>To understand predictors and barriers of adherence to follow-up and identify strategies to improve follow-up in childhood glaucoma.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Subjects</h3><div>Caregivers of children with glaucoma diagnosed between January 2014 and January 2019 residing within 200 km of the base hospital.</div></div><div><h3>Methods</h3><div>Home visits were conducted with consenting caregivers to collect information on socioeconomic status, education, occupation, activities, and quality of life. Caregivers were subsequently invited to bring their affected children to the base hospital for a comprehensive eye evaluation. Adherence was defined as returning within 6 months of the recommended follow-up visit. Logistic regression was used to identify factors associated with adherence.</div></div><div><h3>Main Outcome Measures</h3><div>Adherence to follow-up; association of adherence with socioeconomic status, caregiver education, prior glaucoma surgery, and travel-related barriers; perceived facilitators for improving follow-up.</div></div><div><h3>Results</h3><div>Of 147 caregivers who were interviewed in their homes, 142 reported to the base hospital with the child and were included in the analysis. Of these, 79 (56%) remained adherent to follow-up. Caregivers of adherent children were more likely to be better educated (68.3% vs. 42.9% having at least high school education; <em>P</em> = 0.018); they were more frequently from urban areas (19% vs. 8%; <em>P</em> = 0.084), and more caregivers belonged to upper middle class (17.7% vs. 6.3%; <em>P</em> = 0.027). Multivariable logistic regression adjusting for these factors showed that children who had undergone glaucoma surgery were 3.02 times more likely (95% confidence interval = 1.21–7.54) to be adherent. Travel distance to the hospital was not associated with adherence. Caregivers reported that cost incentives toward travel and medical expenses would encourage follow-up.</div></div><div><h3>Conclusions</h3><div>Only half the children with childhood glaucoma remained adherent to follow-up. Lack of prior surgery followed by lower socioeconomic status were the key risk factors. Financial assistance may help improve long-term follow-up.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 616-626"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585678","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.06.003
Kasem Seresirikachorn MD, PhD , Daniel M. Vu MD , Anila Narayana BA , Kornkamol Annopawong MD , Boonsong Wanichwecharungruang MD , Ta Chen Peter Chang MD
Purpose
To report the visual outcomes of patients diagnosed with juvenile open-angle glaucoma (JOAG) at presentation and final follow-up and to analyze the rate of visual impairment progression and associated risk factors.
Design
A retrospective clinical cohort study.
Participants
This retrospective study included all patients diagnosed with JOAG over 13 years from 2 tertiary hospitals in Bangkok, Thailand, with a minimum follow-up of 1 year.
Methods
We categorized visual impairment and blindness according to the World Health Organization criteria at both the initial presentation and the final follow-up visit. Progression was defined as a shift to a more severe category of visual impairment in each eye; we identified the risk factors associated with visual impairment progression.
Main Outcome Measures
The proportions of visual impairment and blindness at the beginning and end of the study period. The progression rates of visual impairments were calculated at 1, 3, and 5 years.
Results
We included a total of 203 eyes from 106 patients in this study. At the initial assessment, 31.5% of eyes were blind, and this percentage significantly increased to 35.5% (P < 0.001) after an average follow-up of nearly 8 years. Bilateral blindness in patients rose from 15.2% to 19.8% (P < 0.001) over the same period. Among patients without visual impairment at presentation, 96.3%, 93.1%, and 87.7% maintained stable vision at 1, 3, and 5 years, respectively. In comparison, patients with moderate visual impairment had stable outcomes in 84.6%, 67.7%, and 67.7% of cases at the same time points. However, the progression rates of visual outcomes did not significantly differ across varying visual impairment categories (P = 0.08). A higher number of glaucoma surgeries per patient was identified as an associated factor for visual impairment progression (adjusted hazard ratio = 2.25; 95% confidence interval: 1.34–3.78, P = 0.002).
Conclusions
Juvenile open-angle glaucoma is associated with severe visual impairment both at initial presentation and after treatment. Despite slow progression, more than 10% of patients experienced worsening vision over 5 years, with the number of glaucoma surgeries being a significant associated factor for progression. Lifelong follow-up and early detection are crucial in reducing morbidity in this patient group.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Visual Outcomes and Risk Factors for Progression in Juvenile Open-Angle Glaucoma","authors":"Kasem Seresirikachorn MD, PhD , Daniel M. Vu MD , Anila Narayana BA , Kornkamol Annopawong MD , Boonsong Wanichwecharungruang MD , Ta Chen Peter Chang MD","doi":"10.1016/j.ogla.2025.06.003","DOIUrl":"10.1016/j.ogla.2025.06.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the visual outcomes of patients diagnosed with juvenile open-angle glaucoma (JOAG) at presentation and final follow-up and to analyze the rate of visual impairment progression and associated risk factors.</div></div><div><h3>Design</h3><div>A retrospective clinical cohort study.</div></div><div><h3>Participants</h3><div>This retrospective study included all patients diagnosed with JOAG over 13 years from 2 tertiary hospitals in Bangkok, Thailand, with a minimum follow-up of 1 year.</div></div><div><h3>Methods</h3><div>We categorized visual impairment and blindness according to the World Health Organization criteria at both the initial presentation and the final follow-up visit. Progression was defined as a shift to a more severe category of visual impairment in each eye; we identified the risk factors associated with visual impairment progression.</div></div><div><h3>Main Outcome Measures</h3><div>The proportions of visual impairment and blindness at the beginning and end of the study period. The progression rates of visual impairments were calculated at 1, 3, and 5 years.</div></div><div><h3>Results</h3><div>We included a total of 203 eyes from 106 patients in this study. At the initial assessment, 31.5% of eyes were blind, and this percentage significantly increased to 35.5% (<em>P</em> < 0.001) after an average follow-up of nearly 8 years. Bilateral blindness in patients rose from 15.2% to 19.8% (<em>P</em> < 0.001) over the same period. Among patients without visual impairment at presentation, 96.3%, 93.1%, and 87.7% maintained stable vision at 1, 3, and 5 years, respectively. In comparison, patients with moderate visual impairment had stable outcomes in 84.6%, 67.7%, and 67.7% of cases at the same time points. However, the progression rates of visual outcomes did not significantly differ across varying visual impairment categories (<em>P</em> = 0.08). A higher number of glaucoma surgeries per patient was identified as an associated factor for visual impairment progression (adjusted hazard ratio = 2.25; 95% confidence interval: 1.34–3.78, <em>P</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Juvenile open-angle glaucoma is associated with severe visual impairment both at initial presentation and after treatment. Despite slow progression, more than 10% of patients experienced worsening vision over 5 years, with the number of glaucoma surgeries being a significant associated factor for progression. Lifelong follow-up and early detection are crucial in reducing morbidity in this patient group.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 627-633"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.05.004
Sylvia L. Groth MD, MSCI , Craig W. Newcomb MS , Wei Yang PhD , Abhishek Payal MD , Hosne Begum MD , Naira Khachatryan MD, DrPH , R. Oktay Kaçmaz MD, MPH , Kurt A. Dreger BS , James T. Rosenbaum MD , H. Nida Sen MD, MHS , Eric B. Suhler MD, MPH , Jennifer E. Thorne MD, PhD , Nirali P. Bhatt MD , C. Stephen Foster MD , Douglas A. Jabs MD, MBA , Grace A. Levy-Clarke MD , Jeanine M. Buchanich PhD , Gui-Shuang Ying PhD , John H. Kempen MD, PhD , Sapna Gangaputra MD, MPH , Sunir J. Garg MD (Clinic Director)
Purpose
To evaluate the incidence of failure of trabeculectomy versus tube shunt (TS) glaucoma surgery in eyes of patients with uveitis.
Design
Multicenter retrospective cohort study.
Participants
Among 356 eyes of 288 patients with noninfectious inflammatory eye disease undergoing first incisional glaucoma surgery using one of the techniques, 244 eyes had TSs, and 112 eyes had trabeculectomy augmented with mitomycin-C (Trab-MMC).
Methods
A standardized chart review was used to collect clinical data over time retrospectively. Cox regression analyses with adjustment for propensity score and intereye correlations were performed to compare the incidence of failure of glaucoma surgery between TS and Trab-MMC.
Main Outcome Measures
Failure of glaucoma surgery of the first 5 years postoperatively, defined as the following: (1) intraocular pressure (IOP) ≤ 5 or > 21 mmHg at 2 consecutive visits at least 90 days apart beginning 3 months after surgery; or (2) reoperation; or (3) complete blindness (no light perception).
Results
The median age was 40.3 years (interquartile range [IQR], 13.4–57.3 years) in the TS group and 44.2 years (IQR, 29.0–58.9 years) in the Trab-MMC group. The median preglaucoma surgery IOP was 30.0 mmHg (IQR, 21–35.5 mmHg) in the TS group and 30.5 mmHg (IQR, 20–38 mmHg) in the Trab-MMC group. Anterior uveitis was the most common location of primary inflammation in both the TS (52.5%) and Trab-MMC 55.4%) groups. Failure was observed in the TS group in 23.5%, 27.1%, and 30.8% cumulatively through 12, 24, and 36 months, respectively, versus 16.1%, 25.6%, and 30.0%, respectively, in the Trab-MMC group. In the propensity score–adjusted Cox regression analysis, there was no significant difference in failure incidence rate between the TS and Trab-MMC groups (adjusted hazard ratio, 1.08; 95% confidence interval, 0.65–1.78; P = 0.77). Success without the requirement for IOP-lowering medicines was observed more frequently in the Trab-MMC group.
Conclusions
Tube shunt and Trab-MMC fail frequently with similar incidences when done as the first glaucoma surgery among eyes with uveitis over 5 years of follow-up, but there were more complete successes in the Trab-MMC group than in the TS group at 12, 24, and 36 months.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的：比较葡萄膜炎患者行小梁切除术与分流青光眼手术的失败率。设计：多中心回顾性队列研究。参与者：288例非感染性炎症性眼病患者的356只眼接受了首次切口青光眼手术，其中244只眼接受了管分流术（TS）， 112只眼接受了丝裂霉素- c （trb - mmc）强化小梁切除术。方法：采用标准化图表回顾法，回顾性收集临床资料。采用Cox回归分析，校正倾向评分和眼间相关性，比较TS和Trab-MMC青光眼手术失败的发生率。主要结局指标：术后前5年青光眼手术失败，定义为：(1)术后3个月开始连续两次就诊IOP≤5mmhg或>≤21mmhg；或(2)再操作；或者(3)完全失明（没有光感知）。结果：TS组患者中位年龄为40.3岁（IQR为13.4 ~ 57.3），Trab-MMC组患者中位年龄为44.2岁（IQR为29.0 ~ 58.9）。TS组青光眼术前中位IOP为29.0 mm Hg (IQR 21-35.5)， Trab-MMC组为30.0 mm Hg （IQR 20-38）。在TS组（52.5%）和Trab-MMC组（55.4%）中，前葡萄膜炎是最常见的原发性炎症部位。TS组在12、24和36个月的累计失败率分别为23.5%、27.1%和30.8%，而Trab-MMC组的失败率分别为16.1%、25.6%和30.0%。经倾向评分校正的Cox回归分析，TS组和trab-MMC组的失败率无显著差异（校正风险比1.08,95% CI 0.65 ~ 1.78, p=0.77）。在Trab-MMC组中，不需要使用降血压药物的成功率更高。结论：5年随访期间，伴有葡萄膜炎的患者首次行青光眼手术时，TS和Trab-MMC失败率相似，但Trab-MMC组在12个月、24个月和36个月时比TS组更完全成功。
{"title":"The Rate of Failure of Trabeculectomy and Tube Shunt Surgery in Eyes with Uveitic Glaucoma and Ocular Hypertension","authors":"Sylvia L. Groth MD, MSCI , Craig W. Newcomb MS , Wei Yang PhD , Abhishek Payal MD , Hosne Begum MD , Naira Khachatryan MD, DrPH , R. Oktay Kaçmaz MD, MPH , Kurt A. Dreger BS , James T. Rosenbaum MD , H. Nida Sen MD, MHS , Eric B. Suhler MD, MPH , Jennifer E. Thorne MD, PhD , Nirali P. Bhatt MD , C. Stephen Foster MD , Douglas A. Jabs MD, MBA , Grace A. Levy-Clarke MD , Jeanine M. Buchanich PhD , Gui-Shuang Ying PhD , John H. Kempen MD, PhD , Sapna Gangaputra MD, MPH , Sunir J. Garg MD (Clinic Director)","doi":"10.1016/j.ogla.2025.05.004","DOIUrl":"10.1016/j.ogla.2025.05.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the incidence of failure of trabeculectomy versus tube shunt (TS) glaucoma surgery in eyes of patients with uveitis.</div></div><div><h3>Design</h3><div>Multicenter retrospective cohort study.</div></div><div><h3>Participants</h3><div>Among 356 eyes of 288 patients with noninfectious inflammatory eye disease undergoing first incisional glaucoma surgery using one of the techniques, 244 eyes had TSs, and 112 eyes had trabeculectomy augmented with mitomycin-C (Trab-MMC).</div></div><div><h3>Methods</h3><div>A standardized chart review was used to collect clinical data over time retrospectively. Cox regression analyses with adjustment for propensity score and intereye correlations were performed to compare the incidence of failure of glaucoma surgery between TS and Trab-MMC.</div></div><div><h3>Main Outcome Measures</h3><div>Failure of glaucoma surgery of the first 5 years postoperatively, defined as the following: (1) intraocular pressure (IOP) ≤ 5 or > 21 mmHg at 2 consecutive visits at least 90 days apart beginning 3 months after surgery; or (2) reoperation; or (3) complete blindness (no light perception).</div></div><div><h3>Results</h3><div>The median age was 40.3 years (interquartile range [IQR], 13.4–57.3 years) in the TS group and 44.2 years (IQR, 29.0–58.9 years) in the Trab-MMC group. The median preglaucoma surgery IOP was 30.0 mmHg (IQR, 21–35.5 mmHg) in the TS group and 30.5 mmHg (IQR, 20–38 mmHg) in the Trab-MMC group. Anterior uveitis was the most common location of primary inflammation in both the TS (52.5%) and Trab-MMC 55.4%) groups. Failure was observed in the TS group in 23.5%, 27.1%, and 30.8% cumulatively through 12, 24, and 36 months, respectively, versus 16.1%, 25.6%, and 30.0%, respectively, in the Trab-MMC group. In the propensity score–adjusted Cox regression analysis, there was no significant difference in failure incidence rate between the TS and Trab-MMC groups (adjusted hazard ratio, 1.08; 95% confidence interval, 0.65–1.78; <em>P</em> = 0.77). Success without the requirement for IOP-lowering medicines was observed more frequently in the Trab-MMC group.</div></div><div><h3>Conclusions</h3><div>Tube shunt and Trab-MMC fail frequently with similar incidences when done as the first glaucoma surgery among eyes with uveitis over 5 years of follow-up, but there were more complete successes in the Trab-MMC group than in the TS group at 12, 24, and 36 months.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 580-588"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the performance of the 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and Standard with the 10-2 SITA Standard in assessing visual function in patients with glaucoma.
Design
A multicenter prospective cross-sectional study.
Participants
Overall, 71 eyes of 71 patients with primary open-angle or normal-tension glaucoma were included.
Methods
The participants underwent visual field testing using the 24-2C SITA Faster, 24-2C SITA Standard (research prototype), and 10-2 SITA Standard in a randomized order on the same day. The global indices, threshold values, total deviation (TD), pattern deviation (PD), and test durations of the algorithms were compared. Correlations among the 10-2 SITA Standard mean deviation (MD) and number of depressed test point locations in the TD and PD probability plots at P < 5%, P < 2%, and P < 1% significance levels within the central 10° were analyzed.
Main Outcome Measures
Differences in global indices, threshold values, TD, PD, and test duration between algorithms. Correlations of the MD and number of TD and PD points of the 10-2 SITA Standard and those of the central 10° region for the 24-2C algorithms.
Results
No significant differences were found in the global indices between the 24-2C SITA Faster and Standard. The 24-2C SITA Faster had a significantly shorter test duration (55.2% shorter) than the 24-2C SITA Standard. The 24-2C SITA Standard was 45.2% shorter than the combined 24-2 SITA Standard plus 10-2 SITA Standard. The 24-2C SITA Standard showed significantly higher correlation with the 10-2 SITA Standard than the 24-2C SITA Faster.
Conclusions
There were no significant differences in global indices between the 24-2C SITA Standard and 24-2C SITA Faster. However, the 24-2C SITA Standard showed a stronger correlation with the 10-2 SITA Standard. The 24-2C SITA Standard demonstrates potential for more effectively assessing central visual field function in patients with glaucoma.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的：比较24-2C瑞典交互阈值算法（SITA）快速标准与10-2 SITA标准在青光眼患者视功能评估中的表现。设计：多中心前瞻性横断面研究。参与者：总的来说，71例原发性开角型或正常眼压型青光眼患者的71只眼睛被纳入研究。方法：参与者在同一天随机使用24-2C SITA Faster、24-2C SITA Standard（研究原型）和10-2 SITA Standard进行视野测试。比较了算法的全局指标、阈值、总偏差（TD）、模式偏差（PD）和测试持续时间。10-2 SITA标准平均偏差（MD）与pdp和PD概率图中下降的测试点位置数量之间的相关性主要结果测量：全局指数，阈值，TD， PD和算法之间的测试持续时间的差异。24-2C算法的10-2 SITA标准的MD和TD、PD点数与中心10°区域的MD和TD、PD点数的相关性。结果：24-2C SITA Faster与Standard的整体指标无显著差异。24-2C SITA Faster的测试时间明显比24-2C SITA Standard短55.2%。24-2C SITA标准比24-2 SITA标准加10-2 SITA标准短45.2%。24-2C SITA标准与10-2 SITA标准的相关性显著高于24-2C SITA Faster。结论：24-2C SITA Standard与24-2C SITA Faster的Global指标无显著差异。然而，24-2C SITA标准与10-2 SITA标准的相关性更强。24-2C SITA标准显示了更有效地评估青光眼患者中央视野功能的潜力。
{"title":"A Prospective Study of a New 24-2C Algorithm Using the Swedish Interactive Thresholding Algorithm Standard","authors":"Euido Nishijima MD, PhD , Takahiko Noro MD, PhD , Kei Sano MD , Shumpei Ogawa MD, PhD , Shunsuke Sumi MD, PhD , Yuka Igari MD , Tomoyuki Watanabe MD, PhD , Nanami Kishimoto MD , Sachiyo Okude BA, CO , Gary C. Lee PhD , Aiko Iwase MD, PhD , Tadashi Nakano MD, PhD","doi":"10.1016/j.ogla.2025.07.004","DOIUrl":"10.1016/j.ogla.2025.07.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the performance of the 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and Standard with the 10-2 SITA Standard in assessing visual function in patients with glaucoma.</div></div><div><h3>Design</h3><div>A multicenter prospective cross-sectional study.</div></div><div><h3>Participants</h3><div>Overall, 71 eyes of 71 patients with primary open-angle or normal-tension glaucoma were included.</div></div><div><h3>Methods</h3><div>The participants underwent visual field testing using the 24-2C SITA Faster, 24-2C SITA Standard (research prototype), and 10-2 SITA Standard in a randomized order on the same day. The global indices, threshold values, total deviation (TD), pattern deviation (PD), and test durations of the algorithms were compared. Correlations among the 10-2 SITA Standard mean deviation (MD) and number of depressed test point locations in the TD and PD probability plots at <em>P</em> < 5%, <em>P</em> < 2%, and <em>P</em> < 1% significance levels within the central 10° were analyzed.</div></div><div><h3>Main Outcome Measures</h3><div>Differences in global indices, threshold values, TD, PD, and test duration between algorithms. Correlations of the MD and number of TD and PD points of the 10-2 SITA Standard and those of the central 10° region for the 24-2C algorithms.</div></div><div><h3>Results</h3><div>No significant differences were found in the global indices between the 24-2C SITA Faster and Standard. The 24-2C SITA Faster had a significantly shorter test duration (55.2% shorter) than the 24-2C SITA Standard. The 24-2C SITA Standard was 45.2% shorter than the combined 24-2 SITA Standard plus 10-2 SITA Standard. The 24-2C SITA Standard showed significantly higher correlation with the 10-2 SITA Standard than the 24-2C SITA Faster.</div></div><div><h3>Conclusions</h3><div>There were no significant differences in global indices between the 24-2C SITA Standard and 24-2C SITA Faster. However, the 24-2C SITA Standard showed a stronger correlation with the 10-2 SITA Standard. The 24-2C SITA Standard demonstrates potential for more effectively assessing central visual field function in patients with glaucoma.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 569-579"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700461","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ogla.2025.05.001
Andrew M. Williams MD , Hai-Wei Liang PhD , Hsing-Hua Sylvia Lin PhD
Purpose
To assess the association between loss to follow-up (LTFU) and risk of incident blindness among a national registry cohort of patients with primary open-angle glaucoma (POAG).
Design
Retrospective longitudinal cohort study.
Participants
Patients with a POAG diagnosis who had at least 2 visual acuity (VA) measurements documented in the IRIS® Registry (Intelligent Research in Sight) in both 2014 and 2019.
Methods
Loss to follow-up was defined as a calendar year or more without an encounter. Univariable and multivariable robust log-Poisson regression models were used to estimate the risk of incident blindness, with intervals of LTFU as the primary exposure of interest. Effect modification by baseline characteristics on the association between LTFU and incident blindness was also assessed.
Main Outcome Measures
Incident blindness in 1 or both eyes (VA ≤ 20/200) in 2019 among patients who were not blind in 2014.
Results
Among the 149 172 patients, incident monocular blindness occurred in 6338 (4.2%), and incident binocular blindness occurred in 691 (0.5%) over the 6-year period. While most patients maintained follow-up every year (90%), 8.8% were LTFU for 1-2 years, and 1.1% were LTFU for 3-4 years. Patients with LTFU had greater risk of blindness. In an adjusted model that accounted for age, sex, race/ethnicity, insurance, smoking status, glaucoma severity, baseline intraocular pressure, baseline cup-to-disc ratio, and history of glaucoma surgery, risk of incident monocular blindness was greater among patients with a lapse of 1-2 years (adjusted relative risk [aRR] = 1.19, 95% confidence interval [CI]: 1.05–1.35) or a lapse of 3-4 years (aRR = 2.17, 95% CI: 1.66–2.78) compared to patients with no lapse in care. Race/ethnicity demonstrated a significant effect modification in the association between the longest lapse between encounters and the risk of blindness (P = 0.02). The risk of incident blindness after a lapse of 3-4 years (compared to no lapse) was higher among Black patients (aRR = 3.12, 95% CI: 2.06–4.76) than White patients (aRR = 1.93, 95% CI: 1.37–2.73). No effect modifications were identified by other baseline variables.
Conclusions
Loss to follow-up is an independent risk factor for incident blindness among patients with POAG. Lapses in care are particularly consequential for Black patients. Efforts to reduce LTFU may mitigate preventable glaucoma blindness.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Loss to Follow-up and Risk of Incident Blindness among Patients with Glaucoma in the IRIS® Registry","authors":"Andrew M. Williams MD , Hai-Wei Liang PhD , Hsing-Hua Sylvia Lin PhD","doi":"10.1016/j.ogla.2025.05.001","DOIUrl":"10.1016/j.ogla.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the association between loss to follow-up (LTFU) and risk of incident blindness among a national registry cohort of patients with primary open-angle glaucoma (POAG).</div></div><div><h3>Design</h3><div>Retrospective longitudinal cohort study.</div></div><div><h3>Participants</h3><div>Patients with a POAG diagnosis who had at least 2 visual acuity (VA) measurements documented in the IRIS® Registry (Intelligent Research in Sight) in both 2014 and 2019.</div></div><div><h3>Methods</h3><div>Loss to follow-up was defined as a calendar year or more without an encounter. Univariable and multivariable robust log-Poisson regression models were used to estimate the risk of incident blindness, with intervals of LTFU as the primary exposure of interest. Effect modification by baseline characteristics on the association between LTFU and incident blindness was also assessed.</div></div><div><h3>Main Outcome Measures</h3><div>Incident blindness in 1 or both eyes (VA ≤ 20/200) in 2019 among patients who were not blind in 2014.</div></div><div><h3>Results</h3><div>Among the 149 172 patients, incident monocular blindness occurred in 6338 (4.2%), and incident binocular blindness occurred in 691 (0.5%) over the 6-year period. While most patients maintained follow-up every year (90%), 8.8% were LTFU for 1-2 years, and 1.1% were LTFU for 3-4 years. Patients with LTFU had greater risk of blindness. In an adjusted model that accounted for age, sex, race/ethnicity, insurance, smoking status, glaucoma severity, baseline intraocular pressure, baseline cup-to-disc ratio, and history of glaucoma surgery, risk of incident monocular blindness was greater among patients with a lapse of 1-2 years (adjusted relative risk [aRR] = 1.19, 95% confidence interval [CI]: 1.05–1.35) or a lapse of 3-4 years (aRR = 2.17, 95% CI: 1.66–2.78) compared to patients with no lapse in care. Race/ethnicity demonstrated a significant effect modification in the association between the longest lapse between encounters and the risk of blindness (<em>P =</em> 0.02). The risk of incident blindness after a lapse of 3-4 years (compared to no lapse) was higher among Black patients (aRR = 3.12, 95% CI: 2.06–4.76) than White patients (aRR = 1.93, 95% CI: 1.37–2.73). No effect modifications were identified by other baseline variables.</div></div><div><h3>Conclusions</h3><div>Loss to follow-up is an independent risk factor for incident blindness among patients with POAG. Lapses in care are particularly consequential for Black patients. Efforts to reduce LTFU may mitigate preventable glaucoma blindness.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 544-552"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041863","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号