Ophthalmology. Glaucoma最新文献_第10页

Comparing Outcomes of 45 μm Gelatin Stent Placed ab Externo with Open Conjunctiva to ab Externo with Closed Conjunctiva 将 45 μm 明胶支架置于开放结膜外侧与置于封闭结膜外侧的结果比较

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.07.009

Hani El Helwe MD , Zoë Ingram BS , Henisk Falah BS , Jonathan Trzcinski BS , David A. Solá-Del Valle MD

Purpose

Compare outcomes of a gelatin stent (XEN45 Gel Stent [XGS]) placed either ab externo with open conjunctiva (AEO) or ab externo with closed conjunctiva (AEC) with or without cataract surgery in patients with glaucoma.

Design

Retrospective nonrandomized comparative study.

Participants

A total of 86 eyes from 86 glaucoma patients who received XGS placed either AEO (N = 49) or AEC (N = 37) with or without cataract surgery between May 2019 and April 2022 at Massachusetts Eye and Ear.

Methods

Reviewed and analyzed 809 visits from patient charts from a level 3 triage center.

Main Outcome Measures

Intraocular pressure (IOP), medication burden, Kaplan–Meier (KM) success rates, 5-fluorouracil (5-FU) impact, and complications.

Results

Baseline demographics were similar between both groups, except for baseline IOP and glaucoma type. Both AEO and AEC procedures resulted in significant patterns of IOP and medication reduction from baseline up to 1 year. The AEO procedure had significantly higher KM qualified success (QS) rates than the AEC procedure, but similar complete success (CS) rates. Under QS, the cumulative probability of survival was 73% in the AEO group and 51% in the AEC group at month 6 and 62% in the AEO group and 20% in the AEC group at year 1. Under CS, the cumulative probability of survival was 41% in the AEO group and 37% in the AEC group at month 6 and 29% in the AEO group and 14% in the AEC group at year 1. The AEO procedure had significantly more IOP reduction than the AEC procedure at all postoperative time points beyond week 2, but similar medication burden reduction. At postoperative year 1 (POY1), the mean IOP was reduced to 10.72 ± 5.71 mmHg on 1.16 ± 1.68 medications after AEO and 17.03 ± 2.37 mmHg on 1.59 ± 1.21 medications after AEC. Phacoemulsification (phaco) was not a significant factor while 5-FU usage trended toward significance. Procedure time was longer for standalone XGS AEO.

Conclusions

We demonstrate that both placements reduce medication and IOP from baseline, with AEO placement having more favorable XGS success rates and IOP control at the expense of longer procedure time and greater 5-FU usage.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的比较青光眼患者在接受白内障手术或未接受白内障手术的情况下，采用开放结膜外置（AEO）或封闭结膜外置（AEC）明胶支架（XEN45 Gel Stent [XGS]）的治疗效果。设计回顾性非随机比较研究。参与者2019年5月至2022年4月期间，马萨诸塞州眼科和耳科共86名青光眼患者的86只眼睛接受了XGS置入AEO（49只）或AEC（37只），并接受或不接受白内障手术。主要结果指标眼压（IOP）、用药负担、Kaplan-Meier（KM）成功率、5-氟尿嘧啶（5-FU）影响和并发症。结果除基线眼压和青光眼类型外，两组的基线人口统计学特征相似。AEO和AEC手术都能显著降低眼压，并在1年内减少用药。AEO手术的KM合格成功率（QS）明显高于AEC手术，但完全成功率（CS）相似。在QS条件下，第6个月时，AEO组的累积存活概率为73%，AEC组为51%；第1年时，AEO组的累积存活概率为62%，AEC组为20%。在CS下，第6个月时AEO组的累积存活概率为41%，AEC组为37%；第1年时AEO组为29%，AEC组为14%。在术后第2周以后的所有时间点上，AEO手术的眼压降低幅度都明显高于AEC手术，但药物负担的减少幅度却相似。在术后第1年，AEO术后平均眼压降至10.72 ± 5.71 mmHg（1.16 ± 1.68），AEC术后平均眼压降至17.03 ± 2.37 mmHg（1.59 ± 1.21），AEO术后平均眼压降至10.72 ± 5.71 mmHg（1.16 ± 1.68），AEC术后平均眼压降至17.03 ± 2.37 mmHg（1.59 ± 1.21）。超声乳化（phaco）不是一个重要因素，而5-FU的使用呈重要趋势。结论我们证明，两种置入方式都能从基线降低用药量和眼压，其中AEO置入方式的XGS成功率和眼压控制更佳，但手术时间更长，5-FU用量更大。

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引用次数: 0

Progressive Macular Vessel Density Loss and Visual Field Progression in Open-angle Glaucoma Eyes with Central Visual Field Damage 伴有中心视野损害的开角型青光眼眼进行性黄斑血管密度丧失和视野恶化

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.06.009

Anna Lee MD, Ko Eun Kim MD, PhD, Woo Keun Song MD, Jooyoung Yoon MD, Michael S. Kook MD

Purpose

To investigate the association between the longitudinal changes in both macular vessel density (mVD) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and visual field (VF) progression (including central VF progression) in open-angle glaucoma (OAG) patients with central visual field (CVF) damage at different glaucoma stages.

Design

Retrospective longitudinal study.

Participants

This study enrolled 223 OAG eyes with CVF loss at baseline classified as early-to-moderate (133 eyes) or advanced (90 eyes) stage based on the VF mean deviation (MD) (−10 dB).

Methods

Serial mVDs at parafoveal and perifoveal sectors and mGCIPLT measurements were obtained using OCT angiography and OCT during a mean follow-up of 3.5 years. Visual field progression was determined using both the event- and trend-based analyses during follow-up.

Main Outcome Measures

Linear mixed-effects models were used to compare the rates of change in each parameter between VF progressors and nonprogressors. Logistic regression analyses were performed to determine the risk factors for VF progression.

Results

In early-to-moderate stage, progressors showed significantly faster rates of change in the mGCIPLT (−1.02 vs. −0.47 $μ$ m/year), parafoveal (−1.12 vs. −0.40%/year), and perifoveal mVDs (−0.83 vs. −0.44%/year) than nonprogressors (all P < 0.05). In advanced stage cases, only the rates of change in mVDs (parafoveal: −1.47 vs. −0.44%/year; perifoveal: −1.04 vs. −0.27%/year; all P < 0.05) showed significant differences between the groups. By multivariable logistic regression analyses, the faster rate of mVD loss was a predictor of VF progression regardless of glaucoma stage, while the rate of mGCIPLT loss was significantly associated with VF progression only in early-to-moderate stage cases.

Conclusions

Progressive mVD loss is significantly associated with VF progression (including central VF progression) in the OAG eyes with CVF loss regardless of the glaucoma stage.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

目的探讨不同青光眼分期的中心视野（CVF）受损的开角型青光眼（OAG）患者的黄斑血管密度（mVD）和黄斑神经节细胞-内丛状层厚度（mGCIPLT）的纵向变化与视野（VF）进展（包括中心视野进展）之间的关系。方法在平均 3.5 年的随访期间，使用 OCT 血管造影术和 OCT 测量眼底旁和眼底周围的连续 mVD 和 mGCIPLT。主要结果测量采用线性混合效应模型比较VF进展者和非进展者之间各参数的变化率。结果在早中期，VF进展者的mGCIPLT（-1.02 vs. -0.47 μm/年）、眼窝旁（-1.12 vs. -0.40%/年）和眼窝周围mVDs（-0.83 vs. -0.44%/年）的变化率明显快于非进展者（所有P均为0.05）。在晚期病例中，只有mVDs的变化率（视网膜旁：-1.47 vs. -0.44%/年）高于非晚期病例（所有P均为0.05）：-0.44%/year; perifoveal：-0.27%/年；均为 P <0.05）有显著差异。通过多变量逻辑回归分析，无论青光眼分期如何，mVD丧失速度越快，VF进展越快；而只有在早中期病例中，mGCIPLT丧失速度与VF进展显著相关。结论无论青光眼分期如何，在有CVF损失的OAG眼中，进行性mVD损失与VF进展（包括中心性VF进展）显著相关。

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引用次数: 0

Baerveldt-350 with 3-0 Prolene Ripcord to Minimize Hypotony-Associated Complications after Spontaneous Ligature Dissolution Baerveldt-350与3-0 Prolene Ripcord配合使用，可最大程度地减少自发结扎松解后与下颌粘连相关的并发症

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.07.005

Jessie Wang MD , Lindsay Y. Chun MD , Mary Qiu MD

Purpose

To describe the technique and demonstrate the utility and outcomes of using a thick 3-0 Prolene ripcord in the lumen of a Baerveldt-350 aqueous shunt until after the ligature suture dissolves.

Design

Single-center, noncontrolled, retrospective case series.

Participants

A total of 50 eyes from 50 patients with glaucoma undergoing placement of Baerveldt-350 aqueous shunts with 3-0 Prolene ripcords.

Methods

A retrospective chart review was performed for all eyes of adult patients that had undergone a Baerveldt-350 aqueous shunt placement by a single surgeon at a single academic center between October 1, 2019 and June 30, 2022.

Main Outcome Measures

Data collected included demographic and clinical characteristics of the patients, preoperative and postoperative clinical data including intraocular pressure (IOP) and glaucoma medications, postoperative timepoints of ligature suture dissolution, and timepoints of 3-0 Prolene ripcord removal or whether they were permanently left in place.

Results

In total, 50 eyes from 50 patients were included; mean age was 69.5 years, 54.0% of patients were female, 92% of patients were Black, and 66% of eyes had primary open-angle glaucoma. Twenty-six of 50 (52%) eyes had ripcord removal at the soonest postoperative visit after spontaneous ligature dissolution, 19/50 (38%) eyes had delayed ripcord removal, and 5/50 (10%) eyes had no ripcord removal. There were no cases of hypotony-associated complications (shallow anterior chamber, hypotony maculopathy, choroidal effusion, suprachoroidal hemorrhage) in this subgroup of eyes that underwent no ripcord removal.

Conclusions

Our results demonstrate that routine use of a 3-0 Prolene ripcord to partially occlude the lumen of a Baerveldt-350 is a useful strategy to minimize sudden hypotony-associated complications when the ligature suture dissolves. This strategy allows for a more controlled postoperative course and a safe 2-step decrease in IOP (1: when the ligature dissolves, and 2: when the ripcord is removed).

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

目的描述在Baerveldt-350分流管腔内使用粗的3-0 Prolene撕裂线直到结扎缝线溶解的技术并展示其实用性和效果。方法对 2019 年 10 月 1 日至 2022 年 6 月 30 日期间在一个学术中心由一名外科医生进行 Baerveldt-350 眼科分流术的所有成年患者的眼睛进行回顾性病历审查。主要结果测量收集的数据包括患者的人口统计学和临床特征、术前和术后临床数据，包括眼压（IOP）和青光眼药物、术后结扎缝线溶解的时间点、3-0 Prolene撕裂线移除的时间点或是否将其永久留在原位。50只眼睛中有26只（52%）在自发结扎溶解后的术后最早就诊时切除了裂孔线，19/50（38%）只眼睛延迟切除了裂孔线，5/50（10%）只眼睛没有切除裂孔线。结论我们的研究结果表明，常规使用 3-0 Prolene 撕裂线部分堵塞 Baerveldt-350 的管腔是一种有效的策略，可以在结扎线溶解时最大限度地减少与低眼压相关的并发症。这种策略可使术后过程得到更好的控制，并使眼压分两步安全下降（1：结扎线溶解时；2：拆除撕裂线时）。

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引用次数: 0

A Rare Presentation of Intraocular Lens Opacification as Phacolytic Glaucoma 一例罕见的晶状体混浊表现为溶解性青光眼。

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.10.005

Madhuri Manapakkam MS, DNB, Rishika Lakshminarayanan MS, Deepa Ramamoorthy MS

引用次数: 0

Charles Bonnet Syndrome Adversely Affects Vision-Related Quality of Life in Patients with Glaucoma 查尔斯-博奈综合征对青光眼患者与视力有关的生活质量产生不利影响

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.07.001

Patrik Randeblad MD , Amardeep Singh MD, PhD , Dorothea Peters MD, PhD

Purpose

To investigate the impact of Charles Bonnet syndrome (CBS) on vision-related quality of life (VRQoL) in patients with glaucoma.

Design

Cross-sectional cohort study.

Participants

Twenty-four patients with CBS and 42 matched controls without CBS out of 337 patients with open-angle glaucoma (OAG) with visual field (VF) loss.

Methods

A matching technique was used to identify control patients with similar disease stage, best-corrected visual acuity (BCVA) and age to patients with CBS. Patients’ VRQoL was determined using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25). Rasch-calibrated NEI VFQ-25 scores of the CBS group and the control group were compared. Uni- and multivariable regression analysis was used to evaluate the impact of different factors on VRQoL.

Main Outcome Measures

Vision-related quality of life in patients with glaucoma with CBS and without CBS.

Results

Vision-related quality of life scores were significantly lower in the CBS group than in the control group on both the visual functioning scale with 39 points (95% confidence interval (CI): 30–48) vs. 52 points (95% CI: 46–58) (P = 0.013) and on the socioemotional scale with 45 points (95% CI: 37–53) vs. 58 points (95% CI: 51–65) (P = 0.015). Univariable regression analysis showed that integrated visual field mean deviation (IVF-MD) (r² = 0.334, P < 0.001), BCVA in the better eye (r² = 0.117, P = 0.003), and the presence of CBS (r² = 0.078, P = 0.013) were significantly correlated to VRQoL scores on the visual functioning scale. Integrated visual field mean deviation (r² = 0.281, P < 0.001), age (r² = 0.048, P = 0.042), and the presence of CBS (r² = 0.076, P = 0.015) were significantly correlated to VRQoL scores on the socioemotional scale. Multivariable regression analysis showed that IVF-MD and the presence of CBS accounted for nearly 40% of the VRQoL score on the visual functioning scale (R² = 0.393, P < 0.001) and for 34% of the VRQoL score on the socioemotional scale (R² = 0.339, P < 0.001).

Conclusions

Charles Bonnet syndrome had a significant negative association to VRQoL in patients with glaucoma. Presence of CBS should be considered when evaluating VRQoL in patients with glaucoma. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

目的探讨查尔斯-博奈综合征（CBS）对青光眼患者视力相关生活质量（VRQoL）的影响。方法采用配对技术确定与 CBS 患者疾病分期、最佳矫正视力（BCVA）和年龄相似的对照组患者。采用美国国家眼科研究所视觉功能问卷 25（NEI VFQ-25）测定患者的 VRQoL。比较了 CBS 组和对照组的 Rasch 校正 NEI VFQ-25 分数。采用单变量和多变量回归分析评估不同因素对 VRQoL 的影响。结果CBS组视觉相关生活质量评分明显低于对照组，在视觉功能量表上，CBS组为39分（95%置信区间（CI）：30-48），对照组为52分（95%置信区间（CI）：46-58）（P = 0.013）；在社会情感量表上，CBS组为45分（95%置信区间（CI）：37-53），对照组为58分（95%置信区间（CI）：51-65）（P = 0.015）。单变量回归分析显示，综合视野平均偏差（IVF-MD）（r2 = 0.334，P <0.001）、较好眼睛的BCVA（r2 = 0.117，P = 0.003）和是否存在CBS（r2 = 0.078，P = 0.013）与视觉功能量表中的VRQoL得分显著相关。综合视野平均偏差（r2 = 0.281，P <0.001）、年龄（r2 = 0.048，P = 0.042）和是否存在 CBS（r2 = 0.076，P = 0.015）与社会情感量表中的 VRQoL 评分明显相关。多变量回归分析显示，IVF-MD 和 CBS 的存在占视觉功能量表 VRQoL 得分的近 40%（R2 = 0.393，P <0.001），占社会情感量表 VRQoL 得分的 34%（R2 = 0.339，P <0.001）。在评估青光眼患者的 VRQoL 时，应考虑是否存在 CBS。财务披露：作者对本文讨论的任何材料均无所有权或商业利益。

{"title":"Charles Bonnet Syndrome Adversely Affects Vision-Related Quality of Life in Patients with Glaucoma","authors":"Patrik Randeblad MD , Amardeep Singh MD, PhD , Dorothea Peters MD, PhD","doi":"10.1016/j.ogla.2023.07.001","DOIUrl":"10.1016/j.ogla.2023.07.001","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the impact of Charles Bonnet syndrome (CBS) on vision-related quality of life (VRQoL) in patients with glaucoma.</p></div><div><h3>Design</h3><p>Cross-sectional cohort study.</p></div><div><h3>Participants</h3><p>Twenty-four patients with CBS and 42 matched controls without CBS out of 337 patients with open-angle glaucoma (OAG) with visual field (VF) loss.</p></div><div><h3>Methods</h3><p>A matching technique was used to identify control patients with similar disease stage, best-corrected visual acuity (BCVA) and age to patients with CBS. Patients’ VRQoL was determined using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25). Rasch-calibrated NEI VFQ-25 scores of the CBS group and the control group were compared. Uni- and multivariable regression analysis was used to evaluate the impact of different factors on VRQoL.</p></div><div><h3>Main Outcome Measures</h3><p>Vision-related quality of life in patients with glaucoma with CBS and without CBS.</p></div><div><h3>Results</h3><p>Vision-related quality of life scores were significantly lower in the CBS group than in the control group on both the visual functioning scale with 39 points (95% confidence interval (CI): 30–48) vs. 52 points (95% CI: 46–58) (<em>P</em> = 0.013) and on the socioemotional scale with 45 points (95% CI: 37–53) vs. 58 points (95% CI: 51–65) (<em>P</em> = 0.015). Univariable regression analysis showed that integrated visual field mean deviation (IVF-MD) (r<sup>2</sup> = 0.334, <em>P</em> < 0.001), BCVA in the better eye (r<sup>2</sup> = 0.117, <em>P</em> = 0.003), and the presence of CBS (r<sup>2</sup> = 0.078, <em>P</em> = 0.013) were significantly correlated to VRQoL scores on the visual functioning scale. Integrated visual field mean deviation (r<sup>2</sup> = 0.281, <em>P</em> < 0.001), age (r<sup>2</sup> = 0.048, <em>P</em> = 0.042), and the presence of CBS (r<sup>2</sup> = 0.076, <em>P</em> = 0.015) were significantly correlated to VRQoL scores on the socioemotional scale. Multivariable regression analysis showed that IVF-MD and the presence of CBS accounted for nearly 40% of the VRQoL score on the visual functioning scale (R<sup>2</sup> = 0.393, <em>P</em> < 0.001) and for 34% of the VRQoL score on the socioemotional scale (R<sup>2</sup> = 0.339, <em>P</em> < 0.001).</p></div><div><h3>Conclusions</h3><p>Charles Bonnet syndrome had a significant negative association to VRQoL in patients with glaucoma. Presence of CBS should be considered when evaluating VRQoL in patients with glaucoma. <strong><em>Financial Disclosure(s)</em></strong>: The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 1","pages":"Pages 30-36"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419623001254/pdfft?md5=921906859597d9c09286264bed549c61&pid=1-s2.0-S2589419623001254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10480327","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}

引用次数: 0

Deep Learning Classification of Angle Closure based on Anterior Segment OCT 基于前段 OCT 的闭角深度学习分类

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.06.011

Jing Shan MD, PhD , Zhixi Li MD , Ping Ma MD, PhD , Tin A. Tun MD , Sean Yonamine , Yangyan Wu MS , Mani Baskaran DO, PhD , Monisha E. Nongpiur MD, PhD , Dake Chen PhD , Tin Aung MMed, PhD , Shuning Li MD , Mingguang He MD, PhD , Yangfan Yang MD , Ying Han MD, PhD

Purpose

To assess the performance and generalizability of a convolutional neural network (CNN) model for objective and high-throughput identification of primary angle-closure disease (PACD) as well as PACD stage differentiation on anterior segment swept-source OCT (AS-OCT).

Design

Cross-sectional.

Participants

Patients from 3 different eye centers across China and Singapore were recruited for this study. Eight hundred forty-one eyes from the 2 Chinese centers were divided into 170 control eyes, 488 PACS, and 183 PAC + PACG eyes. An additional 300 eyes were recruited from Singapore National Eye Center as a testing data set, divided into 100 control eyes, 100 PACS, and 100 PAC + PACG eyes.

Methods

Each participant underwent standardized ophthalmic examination and was classified by the presiding physician as either control, primary angle-closure suspect (PACS), primary angle closure (PAC), or primary angle-closure glaucoma (PACG). Deep Learning model was used to train 3 different CNN classifiers: classifier 1 aimed to separate control versus PACS versus PAC + PACG; classifier 2 aimed to separate control versus PACD; and classifier 3 aimed to separate PACS versus PAC + PACG. All classifiers were evaluated on independent validation sets from the same region, China and further tested using data from a different country, Singapore.

Main Outcome Measures

Area under receiver operator characteristic curve (AUC), precision, and recall.

Results

Classifier 1 achieved an AUC of 0.96 on validation set from the same region, but dropped to an AUC of 0.84 on test set from a different country. Classifier 2 achieved the most generalizable performance with an AUC of 0.96 on validation set and AUC of 0.95 on test set. Classifier 3 showed the poorest performance, with an AUC of 0.83 and 0.64 on test and validation data sets, respectively.

Conclusions

Convolutional neural network classifiers can effectively distinguish PACD from controls on AS-OCT with good generalizability across different patient cohorts. However, their performance is moderate when trying to distinguish PACS versus PAC + PACG.

Financial Disclosures

The authors have no proprietary or commercial interest in any materials discussed in this article.

目的评估卷积神经网络（CNN）模型的性能和可推广性，以客观、高通量地识别原发性闭角型角膜病（PACD），并根据前节扫源OCT（AS-OCT）进行PACD分期。来自中国两个眼科中心的 841 只眼睛被分为 170 只对照眼、488 只 PACS 眼和 183 只 PAC + PACG 眼。方法每位参与者都接受了标准化眼科检查，并由主治医生将其分为对照组、原发性疑似闭角（PACS）组、原发性闭角（PAC）组或原发性闭角型青光眼（PACG）组。深度学习模型用于训练 3 种不同的 CNN 分类器：分类器 1 用于区分对照组与 PACS、PAC + PACG；分类器 2 用于区分对照组与 PACD；分类器 3 用于区分 PACS 与 PAC + PACG。所有分类器均在来自同一地区（中国）的独立验证集上进行了评估，并使用来自不同国家（新加坡）的数据进行了进一步测试。结果分类器 1 在来自同一地区的验证集上的 AUC 为 0.96，但在来自不同国家的测试集上的 AUC 降为 0.84。分类器 2 的通用性最强，在验证集上的 AUC 为 0.96，在测试集上的 AUC 为 0.95。结论卷积神经网络分类器能在 AS-OCT 上有效区分 PACD 和对照组，在不同患者群中具有良好的普适性。然而，在试图区分 PACS 与 PAC + PACG 时，它们的表现一般。

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引用次数: 0

Imaging Angle Recession Using Anterior Segment OCT 利用OCT前段成像角度凹陷。

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.10.002

Khaled Ali Elubous MD, Hady Saheb MD, MPH

引用次数: 0

Iris Bombé, Hypotony, and Silicone Oil after Complex Retinal Detachment Surgeries 复杂视网膜脱离手术后虹膜爆破、低眼压和硅油。

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.10.008

Ibrahim Saleh MD , Monica Patel BS , Karanjit Kooner MD, PhD

引用次数: 0

Bull’s Eye Hyperoleon 牛眼Hyperoleon。

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.10.003

Priyanka Prasad MD , Amber Amar Bhayana MD , Shivam Garg MD

引用次数: 0

Techniques and Preferences for Nonvalved Aqueous Shunts 无阀水箱分流器的技术和偏好

IF 2.9 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-01-01 DOI: 10.1016/j.ogla.2023.07.006

Jason Y. Zhang BS , Mary Qiu MD

Purpose

To assess practice patterns and opinions of glaucoma specialists regarding indications, surgical technique, and postoperative management for nonvalved aqueous shunts.

Design

Anonymous online survey study.

Participants

American Glaucoma Society (AGS) members.

Methods

An anonymous online survey was distributed to glaucoma specialists via the AGS forum from June to August 2022.

Main Outcome Measures

Survey questions and responses were assessed in 4 sections: (1) general demographics and practice patterns; (2) nonvalved tubes vs. trabeculectomy; (3) nonvalved tubes vs. valved tubes; and (4) nonvalved tube techniques.

Results

There were 132 respondents; nonvalved tubes were reported to be performed more often than trabeculectomy by 61% of respondents within 5 years of completing training and 23% of respondents with more than 15 years since completing training. The most frequently preferred types of nonvalved tubes were Baerveldt-350 (41%), Baerveldt-250 (27%), and ClearPath-250 (18%). In patients with lower target intraocular pressure (IOP), 92% of respondents preferred trabeculectomy over nonvalved tube; 33% cited a cutoff of < 12 mmHg, and 31% cited a cutoff of < 15 mmHg. In patients with higher preoperative IOP, 50% of respondents preferred valved over nonvalved tubes; 29% cited a cutoff of > 40 mmHg, and 38% cited a cutoff of > 30 mmHg. The most frequently used ligature was 7-0 Vicryl (69%). The most frequently used strategies for early IOP lowering were fenestrations without wicks (70%) and with wicks (22%), with one 10-0 Nylon being the most used wick technique (22%). Overall, 37% of respondents use a ripcord; among ripcord users, 55% use it for hypotony prevention (3-0 Prolene most common for this purpose at 35%), and 40% use it for optional early IOP lowering (4-0 Nylon most common for this purpose at 21%). If IOP is too high at postoperative week 4, 38% of respondents do not open the tube early.

Conclusions

We demonstrate significant heterogeneity regarding specific indications, surgical technique, and postoperative management for nonvalved tubes. Future work is needed to identify and develop standardized guidelines alongside best practices.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

目的评估青光眼专家对无阀水囊分流术的适应症、手术技术和术后管理的实践模式和意见。方法2022 年 6 月至 8 月，通过 AGS 论坛向青光眼专家发布匿名在线调查。结果132名受访者中，61%完成培训后5年内的受访者和23%完成培训后15年以上的受访者表示，非阀管比小梁切除术更常实施。最常选择的无阀眼管类型是 Baerveldt-350（41%）、Berveldt-250（27%）和 ClearPath-250（18%）。在目标眼压（IOP）较低的患者中，92% 的受访者首选小梁切除术而不是无阀导管；33% 的受访者认为目标眼压的临界值为 12 mmHg，31% 的受访者认为目标眼压的临界值为 15 mmHg。在术前眼压较高的患者中，50% 的受访者选择瓣膜管而不是无瓣膜管；29% 的受访者选择的截止值为 40 mmHg，38% 的受访者选择的截止值为 30 mmHg。最常用的结扎方法是 7-0 Vicryl（69%）。最常用的早期降低眼压策略是无灯芯（70%）和有灯芯（22%）的瓣膜缝合，其中 10-0 Nylon 是最常用的灯芯技术（22%）。总体而言，37% 的受访者使用裂隙灯；在使用裂隙灯的受访者中，55% 的人使用裂隙灯来预防眼压过低（3-0 Prolene 最常用，占 35%），40% 的人使用裂隙灯来选择性地降低早期眼压（4-0 尼龙最常用，占 21%）。如果术后第 4 周眼压过高，38% 的受访者不会提前打开导管。结论我们发现，在无阀导管的具体适应症、手术技巧和术后管理方面存在显著的异质性。未来的工作需要确定和制定最佳实践的标准化指南。

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引用次数: 0