Ophthalmology. Glaucoma最新文献

{"title":"Identifying Barriers and Improving Adherence to Follow-up of Childhood Glaucoma in South India","authors":"Manju R. Pillai DNB ,&nbsp;George Varghese Puthuran MS ,&nbsp;David S. Friedman MD, PhD ,&nbsp;Vijayakumar Valaguru MSW ,&nbsp;Raheem Rahmathullah BA ,&nbsp;Santhosha P. Ganesh MSW ,&nbsp;Janani Rajendran MS ,&nbsp;Iswarya Mani MSc ,&nbsp;Ramasamy Krishnadas DNB ,&nbsp;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}

{"title":"Visual Outcomes and Risk Factors for Progression in Juvenile Open-Angle Glaucoma","authors":"Kasem Seresirikachorn MD, PhD ,&nbsp;Daniel M. Vu MD ,&nbsp;Anila Narayana BA ,&nbsp;Kornkamol Annopawong MD ,&nbsp;Boonsong Wanichwecharungruang MD ,&nbsp;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> &lt; 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> &lt; 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}

{"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 ,&nbsp;Craig W. Newcomb MS ,&nbsp;Wei Yang PhD ,&nbsp;Abhishek Payal MD ,&nbsp;Hosne Begum MD ,&nbsp;Naira Khachatryan MD, DrPH ,&nbsp;R. Oktay Kaçmaz MD, MPH ,&nbsp;Kurt A. Dreger BS ,&nbsp;James T. Rosenbaum MD ,&nbsp;H. Nida Sen MD, MHS ,&nbsp;Eric B. Suhler MD, MPH ,&nbsp;Jennifer E. Thorne MD, PhD ,&nbsp;Nirali P. Bhatt MD ,&nbsp;C. Stephen Foster MD ,&nbsp;Douglas A. Jabs MD, MBA ,&nbsp;Grace A. Levy-Clarke MD ,&nbsp;Jeanine M. Buchanich PhD ,&nbsp;Gui-Shuang Ying PhD ,&nbsp;John H. Kempen MD, PhD ,&nbsp;Sapna Gangaputra MD, MPH ,&nbsp;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 &gt; 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}

{"title":"A Prospective Study of a New 24-2C Algorithm Using the Swedish Interactive Thresholding Algorithm Standard","authors":"Euido Nishijima MD, PhD ,&nbsp;Takahiko Noro MD, PhD ,&nbsp;Kei Sano MD ,&nbsp;Shumpei Ogawa MD, PhD ,&nbsp;Shunsuke Sumi MD, PhD ,&nbsp;Yuka Igari MD ,&nbsp;Tomoyuki Watanabe MD, PhD ,&nbsp;Nanami Kishimoto MD ,&nbsp;Sachiyo Okude BA, CO ,&nbsp;Gary C. Lee PhD ,&nbsp;Aiko Iwase MD, PhD ,&nbsp;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> &lt; 5%, <em>P</em> &lt; 2%, and <em>P</em> &lt; 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}

{"title":"Loss to Follow-up and Risk of Incident Blindness among Patients with Glaucoma in the IRIS® Registry","authors":"Andrew M. Williams MD ,&nbsp;Hai-Wei Liang PhD ,&nbsp;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}

{"title":"Accuracy of ICD-10 Glaucoma Codes in a Large Academic Practice","authors":"Daniel L. Liebman MD, MBA ,&nbsp;Grace E. Johnson BA ,&nbsp;Anthony Marte MD ,&nbsp;David S. Friedman MD, PhD ,&nbsp;Michael V. Boland MD, PhD ,&nbsp;Tobias Elze PhD ,&nbsp;Luo Song PhD ,&nbsp;Mengyu Wang PhD ,&nbsp;Lucy Q. Shen MD","doi":"10.1016/j.ogla.2025.06.012","DOIUrl":"10.1016/j.ogla.2025.06.012","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 643-645"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Incidence of Bleb-Related Infections after Mitomycin C–Augmented Filtration Surgery over 10 Years in Japanese Patients with Glaucoma","authors":"Mitsuki Kambayashi MD ,&nbsp;Rei Sakata MD ,&nbsp;Asahi Fujita MD ,&nbsp;Makoto Aihara MD ,&nbsp;Yuko Ohno PhD ,&nbsp;Shiroaki Shirato MD","doi":"10.1016/j.ogla.2025.07.001","DOIUrl":"10.1016/j.ogla.2025.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the incidence rates and risk factors for bleb-related infections (BRIs) following mitomycin C (MMC)–augmented filtration surgeries, including trabeculectomy and Ex-Press implantation, in Japanese patients with glaucoma.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Two thousand ninety-seven eyes from 1508 patients who underwent MMC-augmented filtration surgery between 2008 and 2022.</div></div><div><h3>Methods</h3><div>We reviewed and extracted the medical records of baseline characteristics, surgical details, and follow-up data. Patients were categorized by surgery type and glaucoma diagnosis. Bleb-related infection cases were categorized by severity and analyzed in terms of demographic and surgical variables. Kaplan–Meier survival analysis was used to estimate the BRI incidence rate, and a Cox proportional hazards model was used to identify influencing factors.</div></div><div><h3>Main Outcome Measures</h3><div>The cumulative incidence of BRI in all patients who underwent filtration surgery.</div></div><div><h3>Results</h3><div>In total, 50 eyes with BRI (49 patients; mean age: 52.6 years; 21 eyes from females) were identified, yielding an overall incidence rate of 2.38%. Stage I to III infections were observed in 27, 15, and 8 eyes, respectively. The cumulative incidence of BRI increased over time, with estimated rates of 1.5 ± 0.3% (standard error) at 5 years, 3.8 ± 0.7% at 10 years, and 6.4 ± 1.4% at 14 years. Furthermore, 33 eyes out of 1460 eyes with primary open-angle glaucoma limited to primary surgeries developed BRI. Younger age at surgery was identified as a significant risk factor for BRI (hazard ratio: 0.969 per 1 year; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study is the first to show that the risk of BRI continues to increase 10 years after MMC-augmented filtration surgery. When considering filtration surgery, it is important to take into account the patient's age and inform them of the benefits of the procedure and the long-term risk of infection.</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 599-608"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLAUrious but Not Entirely Noninferior: A Critical Review of Clinical Trial Design","authors":"Aakriti Garg Shukla MD, MSc,&nbsp;Vishwanath H. Prathikanti MS,&nbsp;Henry D. Jampel MD, MHS","doi":"10.1016/j.ogla.2025.08.005","DOIUrl":"10.1016/j.ogla.2025.08.005","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 541-543"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Rates of Visual Field Change Predict Glaucoma Progression","authors":"Mohsen Adelpour MD ,&nbsp;Sasan Moghimi MD ,&nbsp;Takashi Nishida MD, PhD ,&nbsp;Leo Meller BS ,&nbsp;Kelvin H. Du BS ,&nbsp;Alireza Kamalipour MD, MPH ,&nbsp;Natchada Tansuebchueasai MD ,&nbsp;Golnoush Mahmoudinezhad MD, MPH ,&nbsp;Linda M. Zangwill PhD ,&nbsp;Robert N. Weinreb MD","doi":"10.1016/j.ogla.2025.05.006","DOIUrl":"10.1016/j.ogla.2025.05.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the prognostic significance of short-term rates of visual field (VF) mean deviation (MD) change in predicting progression across various levels of glaucoma severity.</div></div><div><h3>Design</h3><div>Observational cohort.</div></div><div><h3>Participants</h3><div>A total of 349 eyes from 254 patients followed up to 5 years.</div></div><div><h3>Methods</h3><div>Primary open-angle glaucoma eyes were included with ≥ 5 24-2 VFs tests during the initial 2 years over a period of up to 5 years. Two assessment methods, Guided Progression Analysis (GPA) and a United States Food and Drug Administration (FDA)–consistent end point, were utilized to identify progression events. Rates of change in VF MD during the initial 2 years were calculated, and survival models were employed to evaluate the risk of faster initial VF MD loss on the development of GPA and FDA-consistent end points.</div></div><div><h3>Main Outcome Measures</h3><div>Risk of progression based on initial MD change rates.</div></div><div><h3>Results</h3><div>Over a mean follow-up of 4.3 years, progression was observed in 17.2% (GPA end point) and 24.9% (FDA-consistent end point) of eyes. Faster initial rates of VF MD loss significantly increased the progression risk (hazard ratio [HR] per 0.1 dB/year faster for GPA: 1.16, 95% confidence interval [CI]: 1.12–1.20; HR for FDA: 1.16, 95% confidence interval: 1.12–1.21; both <em>P</em> &lt; 0.001) with survival-adjusted R² values of 0.67 for GPA and 0.75 for FDA-consistent end points. Global initial 2-year slopes showed the highest predictive accuracy for FDA progression events, with adjusted R² values of 0.75 overall, 0.71 for early glaucoma, and 0.42 for moderate-to-advanced glaucoma. Superior and inferior sectoral slopes demonstrated lower abilities to explain the variability across all severity groups. The model's predictive accuracy was higher in early glaucoma (R², 0.71) compared to moderate-advanced stages (R², 0.42) for both criteria.</div></div><div><h3>Conclusions</h3><div>The initial 2-year rate of VF MD change predicts subsequent progression events based on FDA-consistent criteria in both early and moderate-to-advanced glaucoma eyes. These findings suggest initial VF MD change rates identify patients at higher risk of future progression, enabling timely management decisions and, also, potentially serving as a progression end point in clinical trials.</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 560-568"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Myocilin Mutations in a Cohort of Patients with Juvenile Open-Angle Glaucoma from sub-Saharan Africa","authors":"Olusola Olawoye MBBS, PhD ,&nbsp;Brian P. Young BS ,&nbsp;Angela W. Nyunt BS ,&nbsp;Oluwatoyin F. Fafowora MD, PhD ,&nbsp;Magdalene Ajani MBBS, FWACS ,&nbsp;Tarela Sarimiye MBBS, FWACS ,&nbsp;Brendan A. Creemer BS ,&nbsp;Ben R. Roos BS ,&nbsp;Anne L. Coleman MD, PhD ,&nbsp;Michael B. Gorin MD, PhD ,&nbsp;Michael A. Hauser PhD ,&nbsp;Todd E. Scheetz PhD ,&nbsp;Adeyinka Ashaye MBBS, FWACS ,&nbsp;John H. Fingert MD, PhD","doi":"10.1016/j.ogla.2025.04.010","DOIUrl":"10.1016/j.ogla.2025.04.010","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Determine the prevalence and the role of myocilin (</span><em>MYOC</em><span>) gene mutations in a sub-Saharan population of patients with juvenile open-angle glaucoma (JOAG).</span></div></div><div><h3>Design</h3><div>Prospective case-control.</div></div><div><h3>Participants</h3><div>Forty-five patients with JOAG and 41 normal control subjects from the ophthalmology clinics of the University College Hospital Ibadan, Nigeria.</div></div><div><h3>Methods</h3><div>DNA was tested for <em>MYOC</em><span><span> coding sequence mutations using Sanger sequencing. Identified mutations were evaluated for </span>pathogenicity using ClinGen scoring; assessing prevalence in large public databases of patients with African ancestry (gnomAD and 1000 Genomes); and mutation analysis algorithms: PolyPhen, Sorting Intolerant from Tolerant (SIFT), BLOSUM62, MutationTaster, Combined Annotation Dependent Depletion (CADD), and AlphaMissense. The prevalence of variants was compared between patients with JOAG and normal controls from Ibadan using a mutation burden analysis using Sequence Kernel Association Test (SKAT-O).</span></div></div><div><h3>Main Outcome Measures</h3><div><span>Sanger DNA sequencing data indicating the presence or absence of glaucoma-causing mutations in the </span><em>MYOC</em> gene.</div></div><div><h3>Results</h3><div>A total of 10 instances of 4 <em>MYOC</em><span> variants were detected. A p.Pro370Leu variant, which has been previously categorized by the ClinGen as pathogenic, was detected in 3 (6.7%) of 45 JOAG probands. A p.Arg470Cys </span><em>MYOC</em><span><span> variant, previously categorized a variant of unknown significance, was identified in 1 (2.2%) of 45 JOAG probands. A p.Glu352Lys variant, previously categorized as benign, was detected in 2 (4.4%) of JOAG probands. Both the p.Pro370Leu and p.Arg470Cys variants were absent from control subjects and large public databases, whereas p.Glu352Lys was present at a frequency &gt; 1%, which is inconsistent with pathogenicity. Finally, synonymous </span>missense variant, p.Glu396Glu, was also detected. A total of 5 of 6 mutation analysis algorithms supported the pathogenicity of the p.Pro370Leu and p.Arg470Cys variants, whereas slightly fewer (4 of 6) suggested that p.Glu352Lys is pathogenic.</span></div></div><div><h3>Conclusions</h3><div>Myocilin mutations are the most common known cause of JOAG in populations of European ancestry. Our case-control study estimated the prevalence of pathogenic <em>MYOC</em> mutations to be 8.9% in an African population from Nigeria. Myocilin mutations are the most common known cause of JOAG in sub-Saharan Africa; however, they account for a minority of cases.</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 5","pages":"Pages 450-456"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065319","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}