Ophthalmology. Glaucoma最新文献_第3页

Advanced Imaging in Traumatic Glaucoma: Detection of Intralenticular Foreign Body 创伤性青光眼的高级成像：检测眼球内异物。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.02.007

引用次数: 0

Unusual Posterior Capsular Pigmentation in Axenfeld–Rieger Anomaly 阿森费尔德-里格畸形的异常后囊色素沉着。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.03.004

引用次数: 0

Blind Spots in Therapy 治疗中的盲点：通过全国性分析揭开药物性闭角型青光眼的神秘面纱。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.006

Objective

To identify and quantify medications causing angle-closure glaucoma through the FDA Adverse Event Reporting System (FAERS).

Design

National retrospective database analysis.

Subjects

There were 11 737 133 total adverse event reports from the FDA Federal Adverse Event Reporting System (FAERS) database 2004 to third quarter of 2023 (2023Q3), which included 1629 reports of angle-closure glaucoma.

Methods

Drugs associated with reports of angle-closure glaucoma were identified in FAERS through disproportionality analysis

Main Outcome Measures

To ascertain if these reports yielded statistically significant signals, we used the proportional reporting ratio (PRR), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC). We considered a signal to be detected when all 4 disproportionality analysis metrics were positive.

Results

We identified a total of 1629 adverse event reports linked to 611 suspected drugs over the course of 20 years (2004–2023Q3). Frequently reported drugs included topiramate (520 reports) and citalopram (69 reports), amongst many others. Eighteen medications yielded a positive signal, including lesser-known medications like olanzapine, phentermine, and ranibizumab. Tropicamide exhibited the most robust statistical significance (n = 18; PRR: 164.263; ROR [95% confidence interval {CI}]: 167.95 [104.994–268.655]; EBGM [EBGM05]: 162.421 [109.5]; IC [IC05]: 7.344 [4.591]), while acetazolamide was the second strongest (n = 51; PRR: 113.088; ROR 95% CI: 114.782 [86.665–152.021]; EBGM [EBGM05]: 109.506 [86.501]; IC [IC05]: 6.775 [5.115]).

Conclusions

Drug-induced glaucoma included both well-known medications such as topiramate as well as lesser-known medications such as olanzapine, phentermine, and ranibizumab. Clinician awareness of these findings is important.

Financial Disclosure(s)

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

目的通过美国食品和药物管理局联邦不良事件报告系统（FAERS）识别并量化导致闭角型青光眼的药物：对象、参与者和/或对照组：2004-2022年第三季度FDA联邦不良事件报告系统（FAERS）数据库中的不良事件报告总数为11,737,133份，其中包括1,629份闭角型青光眼报告：在 FAERS 中确定了与闭角型青光眼报告相关的药物。为了确定这些报告是否产生了具有统计学意义的信号，我们使用了比例报告率 (PRR)、报告几率比例 (ROR)、经验贝叶斯几何平均数 (EBGM) 和信息成分 (IC) 作为比例失调分析的一部分。当四项比例失调分析指标均为正值时，我们认为检测到了信号：在 20 年间（2004-2023Q3），我们共发现了 1,629 份与 611 种可疑药物相关的不良事件报告。经常报告的药物包括托吡酯（520 份报告）和西酞普兰（69 份报告）等。有 18 种药物出现了阳性信号，其中包括奥氮平、芬特明和雷尼珠单抗等鲜为人知的药物。托吡卡胺具有最显著的统计学意义（n=18；PRR：164.263；ROR (95%CI)：167.95 (104.994-268.655)；EBGM (EBGM05)：162.421 (109.994-268.655)）：162.421 (109.5)；IC (IC05)：7.344（4.591）），而乙酰唑胺是第二强的（n=51；PRR：113.088；ROR 95% CI：114.782（86.665-152.021）；EBGM（EBGM05）：109.506 (86.501)；IC (IC05)：6.775（5.115））：药物诱发的青光眼既包括托吡酯等知名药物，也包括奥氮平、芬特明和雷尼珠单抗等鲜为人知的药物。临床医生对这些发现的认识非常重要。

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引用次数: 0

Quality of Reporting Electronic Health Record Data in Glaucoma 青光眼电子健康记录数据的报告质量：系统性文献综述。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.002

Topic

Assessing reporting standards in glaucoma studies utilizing electronic health records (EHR).

Clinical Relevance

Glaucoma's significance, underscored by its status as a leading cause of irreversible blindness worldwide, necessitates reliable research findings. This study evaluates adherence to the CODE-EHR best-practice framework in glaucoma studies using EHR, aiming to improve clinical care and patient outcomes.

Methods

A systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42023430025), identified relevant studies (January 2022–May 2023) in MEDLINE, EMBASE, CINAHL, and Web of Science. Eligible studies, using EHR data from clinical institutions for glaucoma research, were assessed for study design, participant characteristics, EHR data, and sources. Quality appraisal used the CODE-EHR best-practice framework, focusing on data construction, linkage, fitness for purpose, disease and outcome definitions, analysis, and ethics and governance.

Results

Of 31 identified studies, predominant EHR sources were hospitals and clinical warehouses. Commonly reported elements included age, gender, glaucoma diagnosis, and intraocular pressure. Only 16% fully adhered to CODE-EHR best-practice framework's minimum standards, with none meeting preferred standards. While statistical analysis and ethical considerations were relatively well-addressed, areas such as EHR data management and study design showed room for improvement. Patient and public involvement, and acknowledgment of data linkage processes, data security, and storage reporting were often missed.

Conclusion

Adherence to CODE-EHR best-practice framework's standards in EHR-based studies of glaucoma can be improved upon. Standardized reporting of EHR data are essential to ensure the reliability of research, facilitating its translation into clinical practice and improving healthcare decision-making for better patient outcomes.

Financial Disclosure(s)

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

主题评估利用电子健康记录（EHR）进行的青光眼研究的报告标准.临床相关性青光眼是导致全球不可逆转性失明的主要原因，其重要性不言而喻，因此需要可靠的研究结果。本研究评估了在使用电子病历的青光眼研究中遵守 CODE-EHR 最佳实践框架的情况，旨在改善临床护理和患者预后。方法根据系统性综述和元分析首选报告项目（PRISMA）指南（PROSPERO CRD42023430025），在 MEDLINE、EMBASE、CINAHL 和 Web of Science 中确定了相关研究（2022 年 1 月至 2023 年 5 月）。符合条件的研究使用了青光眼研究临床机构的电子病历数据，并对研究设计、参与者特征、电子病历数据和来源进行了评估。质量评估采用 CODE-EHR 最佳实践框架，重点关注数据构建、链接、目的适宜性、疾病和结果定义、分析以及伦理和管理。常见的报告要素包括年龄、性别、青光眼诊断和眼压。只有 16% 的研究完全符合 CODE-EHR 最佳实践框架的最低标准，没有一项研究符合首选标准。虽然统计分析和伦理方面的考虑相对较好，但电子病历数据管理和研究设计等方面仍有改进的余地。结论在基于电子病历的青光眼研究中遵守 CODE-EHR 最佳实践框架的标准还有待改进。电子病历数据的标准化报告对于确保研究的可靠性、促进研究成果转化为临床实践以及改善医疗决策以提高患者疗效至关重要。

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引用次数: 0

The Association of Urinary Sodium Excretion with Glaucoma and Related Traits in a Large United Kingdom Population 英国大量人口尿钠排泄量与青光眼及相关特征的关系。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.010

Purpose

Excessive dietary sodium intake has known adverse effects on intravascular fluid volume and systemic blood pressure, which may influence intraocular pressure (IOP) and glaucoma risk. This study aimed to assess the association of urinary sodium excretion, a biomarker of dietary intake, with glaucoma and related traits, and determine whether this relationship is modified by genetic susceptibility to disease.

Design

Cross-sectional observational and gene-environment interaction analyses in the population-based UK Biobank study.

Participants

Up to 103 634 individuals (mean age: 57 years; 51% women) with complete urinary, ocular, and covariable data.

Methods

Urine sodium:creatinine ratio (UNa:Cr; mmol:mmol) was calculated from a midstream urine sample. Ocular parameters were measured as part of a comprehensive eye examination, and glaucoma case ascertainment was through a combination of self-report and linked national hospital records. Genetic susceptibility to glaucoma was calculated based on a glaucoma polygenic risk score comprising 2673 common genetic variants. Multivariable linear and logistic regression, adjusted for key sociodemographic, medical, anthropometric, and lifestyle factors, were used to model associations and gene-environment interactions.

Main Outcome Measures

Corneal-compensated IOP, OCT derived macular retinal nerve fiber layer and ganglion cell-inner plexiform layer (GCIPL) thickness, and prevalent glaucoma.

Results

In maximally adjusted regression models, a 1 standard deviation increase in UNa:Cr was associated with higher IOP (0.14 mmHg; 95% confidence interval [CI], 0.12–0.17; P < 0.001) and greater prevalence of glaucoma (odds ratio, 1.11; 95% CI, 1.07–1.14; P < 0.001) but not macular retinal nerve fiber layer or ganglion cell-inner plexiform layer thickness. Compared with those with UNa:Cr in the lowest quintile, those in the highest quintile had significantly higher IOP (0.45 mmHg; 95% CI, 0.36–0.53, P < 0.001) and prevalence of glaucoma (odds ratio, 1.30; 95% CI, 1.17–1.45; P < 0.001). Stronger associations with glaucoma (P interaction = 0.001) were noted in participants with a higher glaucoma polygenic risk score.

Conclusions

Urinary sodium excretion, a biomarker of dietary intake, may represent an important modifiable risk factor for glaucoma, especially in individuals at high underlying genetic risk. These findings warrant further investigation because they may have important clinical and public health implications.

Financial Disclosure(s)

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

目的：膳食中摄入过多的钠已知会对血管内液容量和全身血压产生不利影响，这可能会影响眼内压（IOP）和青光眼风险。本研究旨在评估作为膳食摄入量生物标志物的尿钠排泄量与青光眼及相关特征的关系，并确定这种关系是否会因遗传易感性而改变：设计：在以人口为基础的英国生物库研究中进行横断面观察和基因与环境相互作用分析：多达 103 634 人（平均年龄 57 岁，51% 为女性）具有完整的尿液、眼部和协变量数据：方法：根据中段尿样计算尿钠肌酐比（UNa:Cr；mmol:mmol）。眼部参数的测量是全面眼部检查的一部分，青光眼病例的确定则是通过自我报告和相关联的国家医院记录相结合的方式进行的。青光眼遗传易感性是根据由 2 673 个常见遗传变异组成的青光眼多基因风险评分（PRS）计算得出的。在对主要的社会人口、医疗、人体测量和生活方式因素进行调整后，采用多变量线性回归和逻辑回归来模拟相关性以及基因与环境之间的相互作用：角膜补偿眼压、光学相干断层扫描得出的黄斑视网膜神经纤维层（mRNFL）和神经节细胞内丛状层（GCIPL）厚度以及青光眼发病率：在最大调整回归模型中，UNa:Cr 每增加一个标准差，眼压就会升高（0.14mmHg；95% CI，0.12 至 0.17；PC 结论：尿钠排泄量是膳食摄入量的生物标志物，它可能是青光眼的一个重要可调节风险因素，尤其是在潜在遗传风险较高的人群中。这些发现值得进一步研究，因为它们可能具有重要的临床和公共卫生意义。

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引用次数: 0

Looking through the Glass: Microspherophakia with LTBP2 Mutation in Siblings 透过玻璃看世界兄弟姐妹中出现 LTBP2 基因突变的小球盲症

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.03.002

引用次数: 0

Comparing Outcomes of Tube Versus Trabeculectomy Among Patients with Angle-closure Glaucoma 比较闭角型青光眼患者接受导管切除术和小梁切除术的疗效。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.005

Purpose

Compare outcomes of tube shunt surgery (Tube) and trabeculectomy with mitomycin C (Trab-MMC) in patients with angle-closure glaucoma (ACG).

Design

Retrospective nonrandomized comparative study.

Participants

A total of 80 eyes from 80 patients with ACG who underwent either Tube (N = 50) or Trab-MMC (N = 30) between January 2015 and January 2022 at Massachusetts Eye and Ear.

Methods

Reviewed and analyzed 390 visits from patient charts.

Main Outcome Measures

Kaplan-Meier (KM) success rates, intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), adjusted hazard ratios (HRs), and complications.

Results

Baseline demographics were similar between both groups, except for a higher proportion of patients with pseudophakia and prior incisional ocular surgery in the Tube group. The Trab-MMC procedure had significantly higher KM complete success (CS) rates than the Tube procedure, but similar qualified success (QS) rates. Under QS, the cumulative probability of survival was 87% in the Tube group and 83% in the Trab-MMC group at year 1 (P = 0.77), and 75% in the Tube group and 58% in the Trab-MMC group at year 2 (P = 0.14). Under CS, the cumulative probability of survival was 13% in the Tube group and 59% in the Trab-MMC group at year 1 (P < 0.001), and 11% in the Tube group and 41% in the Trab-MMC group at year 2 (P < 0.001). Both Tube and Trab-MMC procedures resulted in significant patterns of IOP and medication reduction from baseline up to 2 years with mean IOP reduced to 12.6 ± 5.9 mmHg on 2.8 ± 1.4 medications after Tube and 12.1 ± 6.6 mmHg on 2.4 ± 1.7 medications after Trab-MMC. Patients who underwent Trab-MMC required less IOP-lowering medications at every follow-up visit up to year 1, but a similar number at year 2. No significant differences were found in IOP reduction, BCVA, or complication rates between groups.

Conclusions

We demonstrate that Trab-MMC confers similar IOP reduction and QS rates to Tube placement in patients with ACG. Trab-MMC, however, demonstrated greater medication burden reduction up to 1 year, and more favorable CS rates up to 2 years, while still maintaining similar complication rates to Tube.

Financial Disclosure(s)

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

目的比较闭角型青光眼（ACG）患者接受导管分流手术（Tube）和小梁切除术加丝裂霉素 C（Trab-MMC）的疗效.设计回顾性非随机比较研究.参与者2015 年 1 月至 2022 年 1 月期间在马萨诸塞州眼耳科接受导管分流手术（Tube）（50 例）或小梁切除术加丝裂霉素 C（Trab-MMC）（30 例）治疗的 80 名 ACG 患者的 80 只眼睛.主要结果指标卡普兰-迈尔（KM）成功率、眼压（IOP）、用药负担、最佳矫正视力（BCVA）、调整后危险比（HRs）和并发症。结果两组患者的基线人口统计学特征相似，只是Tube组患者中患有假性角膜和曾接受过眼部切口手术的比例较高。Trab-MMC手术的KM完全成功率（CS）明显高于Tube手术，但合格成功率（QS）相似。在 QS 条件下，第 1 年，Tube 组的累积存活概率为 87%，Trab-MMC 组为 83%（P = 0.77）；第 2 年，Tube 组为 75%，Trab-MMC 组为 58%（P = 0.14）。在 CS 条件下，第 1 年时 Tube 组的累积存活概率为 13%，Trab-MMC 组为 59%（P < 0.001）；第 2 年时 Tube 组的累积存活概率为 11%，Trab-MMC 组为 41%（P < 0.001）。从基线到2年，插管和Trab-MMC手术都能显著降低眼压和减少用药，插管术后平均眼压降至12.6 ± 5.9 mmHg，用药2.8 ± 1.4次；Trab-MMC术后平均眼压降至12.1 ± 6.6 mmHg，用药2.4 ± 1.7次。接受Trab-MMC治疗的患者在第一年前的每次随访中需要的降眼压药物都较少，但在第二年需要的药物数量相似。结论我们证明，在 ACG 患者中，Trab-MMC 的眼压降低率和 QS 率与 Tube 置管术相似。然而，Trab-MMC 在 1 年内减少了更多的用药负担，在 2 年内提高了 CS 率，同时仍保持了与 Tube 相似的并发症发生率。

{"title":"Comparing Outcomes of Tube Versus Trabeculectomy Among Patients with Angle-closure Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.005","DOIUrl":"10.1016/j.ogla.2024.04.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Compare outcomes of tube shunt surgery (Tube) and trabeculectomy with mitomycin C (Trab-MMC) in patients with angle-closure glaucoma (ACG).</div></div><div><h3>Design</h3><div>Retrospective nonrandomized comparative study.</div></div><div><h3>Participants</h3><div>A total of 80 eyes from 80 patients with ACG who underwent either Tube (N = 50) or Trab-MMC (N = 30) between January 2015 and January 2022 at Massachusetts Eye and Ear.</div></div><div><h3>Methods</h3><div>Reviewed and analyzed 390 visits from patient charts.</div></div><div><h3>Main Outcome Measures</h3><div>Kaplan-Meier (KM) success rates, intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), adjusted hazard ratios (HRs), and complications.</div></div><div><h3>Results</h3><div>Baseline demographics were similar between both groups, except for a higher proportion of patients with pseudophakia and prior incisional ocular surgery in the Tube group. The Trab-MMC procedure had significantly higher KM complete success (CS) rates than the Tube procedure, but similar qualified success (QS) rates. Under QS, the cumulative probability of survival was 87% in the Tube group and 83% in the Trab-MMC group at year 1 (<em>P</em> = 0.77), and 75% in the Tube group and 58% in the Trab-MMC group at year 2 (<em>P</em> = 0.14). Under CS, the cumulative probability of survival was 13% in the Tube group and 59% in the Trab-MMC group at year 1 (<em>P</em> < 0.001), and 11% in the Tube group and 41% in the Trab-MMC group at year 2 (<em>P</em> < 0.001). Both Tube and Trab-MMC procedures resulted in significant patterns of IOP and medication reduction from baseline up to 2 years with mean IOP reduced to 12.6 ± 5.9 mmHg on 2.8 ± 1.4 medications after Tube and 12.1 ± 6.6 mmHg on 2.4 ± 1.7 medications after Trab-MMC. Patients who underwent Trab-MMC required less IOP-lowering medications at every follow-up visit up to year 1, but a similar number at year 2. No significant differences were found in IOP reduction, BCVA, or complication rates between groups.</div></div><div><h3>Conclusions</h3><div>We demonstrate that Trab-MMC confers similar IOP reduction and QS rates to Tube placement in patients with ACG. Trab-MMC, however, demonstrated greater medication burden reduction up to 1 year, and more favorable CS rates up to 2 years, while still maintaining similar complication rates to Tube.</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":"7 5","pages":"Pages 476-484"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000681/pdfft?md5=ddab569973d879e52669a4a2fb9b409e&pid=1-s2.0-S2589419624000681-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779765","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

A Retrospective Comparison of Phaco-tube vs. Phaco-trabeculectomy in Glaucoma Patients 青光眼患者的 Phaco-Tube 与 Phaco-Trabeculectomy 的回顾性比较。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.008

Purpose

To compare surgical outcomes of phacoemulsification combined with Baerveldt implantation (phaco-tube) or trabeculectomy with mitomycin-C (MMC) (phaco-trab) in patients without prior incisional ocular surgery.

Design

Single-center, retrospective, comparative case series.

Participants

A total of 90 patients underwent surgical treatment, including 45 patients in the phaco-tube group and 45 patients in the phaco-trab group.

Methods

Eligible patients were identified using current procedural terminology (CPT) codes, and their medical records were retrospectively reviewed.

Main Outcome Measures

The primary outcome measure was the rate of surgical failure (IOP ≤5 mmHg or >21 mmHg or reduced <20% from baseline on 2 consecutive study visits after 3 months, reoperations for glaucoma, or experienced loss of light perception vision). Patients who had successful surgical outcomes without use of glaucoma medications were classified as complete successes, while those who used glaucoma medications were classified as qualified successes. Secondary outcome measures were visual acuity (VA), visual field mean deviation (VFMD), intraocular pressure (IOP), glaucoma medication use, and complications.

Results

The cumulative probability of failure was 6.7% in the phaco-tube group and 32.8% in the phaco-trab group after 3 years (P = 0.005; Restricted Mean Survival Time = 5.9 months, 95% CI = 1.4–10.4 months). The IOP was 13.1 ± 3.4 mmHg in the phaco-tube group and 13.3 ± 6.2 mmHg in the phaco-trab group at 3 years (P = 0.90), and the number of glaucoma medications was 2.6 ± 1.5 in the phaco-tube group and 1.7 ± 1.3 in the phaco-trab group (P = 0.015). The logarithm of the minimum angle of resolution VA was 0.39 ± 0.58 in the phaco-tube group and 0.43 ± 0.73 in the phaco-trab group at 3 years (P = 0.82), and VFMD was −18.3 ± 9.0 dB in the phaco-tube group and −14.1 ± 7.0 dB in the phaco-trab group (P = 0.16). Postoperative complications developed in 21 patients (47%) in the phaco-tube group and 15 patients (33%) in the phaco-trab group (P = 0.28).

Conclusions

Phaco-tubes had a significantly lower rate of surgical failure compared to phaco-trabs after 3 years of follow-up. However, phaco-trabs used significantly fewer glaucoma medications at multiple postoperative timepoints and had a higher proportion of complete success.

Financial Disclosure(s)

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

目的：比较既往未接受过眼部切口手术的患者接受超声乳化联合贝维尔特植入术（phaco-tube）或小梁切除术联合丝裂霉素-C（MMC）（phaco-trab）的手术效果：设计：单中心、回顾性、比较性病例系列：共有 90 名患者接受了手术治疗，其中 phaco-tube 组 45 人，phaco-trab 组 45 人：方法：使用当前程序术语（CPT）代码确定符合条件的患者，并回顾性审查其病历：主要结果指标：手术失败率（眼压≤5 mmHg或>21 mmHg或降低）为主要结果指标：3年后，phaco-tube组的累计失败概率为6.7%，phaco-trab组为32.8%（P= 0.005；限制性平均生存时间=5.9个月，95% CI=1.4至10.4个月）。3年后，phaco-tube组的眼压为13.1 ± 3.4 mmHg，phaco-trab组的眼压为13.3 ± 6.2 mmHg（P= 0.90），phaco-tube组的青光眼用药次数为2.6 ± 1.5，phaco-trab组的青光眼用药次数为1.7 ± 1.3（P= 0.015）。3 年后，phaco-tube 组的 LogMAR VA 为 0.39 ± 0.58，phaco-trab 组为 0.43 ± 0.73（P= 0.82）；phaco-tube 组的 VFMD 为 -18.3 ± 9.0 dB，phaco-trab 组为 -14.1 ± 7.0 dB（P= 0.16）。phaco-tube组有21名患者（47%）出现术后并发症，phaco-trab组有15名患者（33%）出现术后并发症（P= 0.28）：结论：3年随访后，Phaco-tub与phaco-trab相比，手术失败率明显较低。然而，phaco-trabs 在术后多个时间点使用的青光眼药物明显更少，完全成功的比例更高。

{"title":"A Retrospective Comparison of Phaco-tube vs. Phaco-trabeculectomy in Glaucoma Patients","authors":"","doi":"10.1016/j.ogla.2024.04.008","DOIUrl":"10.1016/j.ogla.2024.04.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare surgical outcomes of phacoemulsification<span> combined with Baerveldt implantation (phaco-tube) or trabeculectomy with mitomycin-C (MMC) (phaco-trab) in patients without prior incisional ocular surgery.</span></div></div><div><h3>Design</h3><div>Single-center, retrospective, comparative case series.</div></div><div><h3>Participants</h3><div>A total of 90 patients underwent surgical treatment, including 45 patients in the phaco-tube group and 45 patients in the phaco-trab group.</div></div><div><h3>Methods</h3><div><span>Eligible patients were identified using current procedural terminology (CPT) codes, and their </span>medical records were retrospectively reviewed.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measure was the rate of surgical failure (IOP ≤5 mmHg or >21 mmHg or reduced <20% from baseline on 2 consecutive study visits after 3 months, reoperations<span> for glaucoma, or experienced loss of light perception vision). Patients who had successful surgical outcomes without use of glaucoma medications<span> were classified as complete successes, while those who used glaucoma medications were classified as qualified successes. Secondary outcome measures were visual acuity (VA), visual field mean deviation (VFMD), intraocular pressure (IOP), glaucoma medication use, and complications.</span></span></div></div><div><h3>Results</h3><div>The cumulative probability of failure was 6.7% in the phaco-tube group and 32.8% in the phaco-trab group after 3 years (<em>P</em><span> = 0.005; Restricted Mean Survival Time = 5.9 months, 95% CI = 1.4–10.4 months). The IOP was 13.1 ± 3.4 mmHg in the phaco-tube group and 13.3 ± 6.2 mmHg in the phaco-trab group at 3 years (</span><em>P</em> = 0.90), and the number of glaucoma medications was 2.6 ± 1.5 in the phaco-tube group and 1.7 ± 1.3 in the phaco-trab group (<em>P</em> = 0.015). The logarithm of the minimum angle of resolution VA was 0.39 ± 0.58 in the phaco-tube group and 0.43 ± 0.73 in the phaco-trab group at 3 years (<em>P</em> = 0.82), and VFMD was −18.3 ± 9.0 dB in the phaco-tube group and −14.1 ± 7.0 dB in the phaco-trab group (<em>P</em><span> = 0.16). Postoperative complications developed in 21 patients (47%) in the phaco-tube group and 15 patients (33%) in the phaco-trab group (</span><em>P</em> = 0.28).</div></div><div><h3>Conclusions</h3><div>Phaco-tubes had a significantly lower rate of surgical failure compared to phaco-trabs after 3 years of follow-up. However, phaco-trabs used significantly fewer glaucoma medications at multiple postoperative timepoints and had a higher proportion of complete success.</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":"7 5","pages":"Pages 466-475"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874027","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}

引用次数: 0

Long-Term Systemic Use of Calcium Channel Blockers and Incidence of Primary Open-Angle Glaucoma 长期系统使用钙通道阻滞剂与原发性开角型青光眼的发病率。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.06.003

Purpose

To evaluate the association between the systemic use of calcium channel blockers (CCBs) and primary open-angle glaucoma (POAG) using a diverse nationwide dataset.

Design

Retrospective cohort study.

Subjects

213 424 individuals aged 40 years and older in the National Institutes of Health All of Us dataset, notable for its demographic, geographic, and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of antihypertensive medication were excluded.

Methods

Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. Calcium channel blocker use was further divided into exposure to dihydropyridine CCBs and nondihydropyridine CCBs, and subgroup analyses were performed using chi-square and Fisher tests.

Main Outcome Measures

Diagnosis of POAG.

Results

Within our cohort, 2772 participants (1.3%) acquired a diagnosis of POAG, while 210 652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among patients with POAG, 32.6% used 1 or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a nondihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.27–1.31, P < 0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33–1.74, P < 0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14–1.50, P < 0.001) was associated with increased POAG risk.

Conclusions

Use of dihydropyridine CCBs was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions.

Financial Disclosure(s)

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

目的：利用一个多样化的全国性数据集，评估全身使用钙通道阻滞剂（CCBs）与原发性开角型青光眼（POAG）之间的关联：对象：美国国立卫生研究院（NIH）"我们所有人 "数据集中的 213,424 名 40 岁及以上的患者。在使用任何类型的抗高血压药物之前诊断出 POAG 的患者不包括在内：进行二元和多元回归分析，以评估CCB的使用与POAG之间的关联。将CCB的使用进一步分为接触二氢吡啶类CCB和非二氢吡啶类CCB，并使用Chi-square和Fisher检验进行亚组分析：结果：在我们的队列中，2772 名参与者（1.3%）被诊断为 POAG，210652 名参与者（98.7%）未被诊断为 POAG。在确诊为 POAG 的患者中，平均年龄为 73.3 岁，52.5% 为女性，48.2% 为白人。在 POAG 患者中，32.6% 使用了一种或多种 CCB，28.2% 使用了二氢吡啶类 CCB，2.2% 使用了非二氢吡啶类 CCB。在双变量分析中，使用任何一种CCB都与POAG风险增加有关（OR：1.29，95% CI：1.27-1.31，p结论：使用二氢吡啶类钙通道阻滞剂与罹患 POAG 的风险显著升高有关，无论是在调整人口统计学因素和合并症之前还是之后。

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引用次数: 0

Agreement of Serial iCare HOME2 and Goldmann Applanation Tonometry 系列 iCare HOME2 和戈德曼眼压计的一致性。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.04.007

Purpose

To assess agreement of iCare HOME2 and Goldmann applanation tonometry over a wide range of intraocular pressure (IOP).

Design

A prospective, observational cohort study.

Subjects

Twenty-six adult patients undergoing intravitreal injection, which temporarily raises IOP, were recruited from the Palo Alto Medical Foundation Retina Clinic between October 2022 and February 2023.

Methods

Subjects had serial iCare HOME2 (IOP_I) and Goldmann applanation (IOP_G) IOP measurements before and at 0 and 5 to 10 minutes after injection. Baseline IOPs and pachymetry were taken in both eyes.

Main Outcome Measures

Correlation between IOP_I and IOP_G was tested by within-subjects intraclass correlation coefficient (ICC) for repeated measures. Agreement between IOP_I and IOP_G was evaluated by a Bland–Altman plot with correction for multiple measurements. The difference between IOP_I and IOP_G was evaluated between eyes at baseline (Pearson’s r) and within the injected eye over different timepoints (ICC for absolute agreement). Linear regression was used to evaluate the effects of age, sex, glaucoma, and corneal thickness.

Results

The mean IOP_I and IOP_G were 25.3 (range: 9–55) and 23.5 (range: 8–56) mmHg, respectively. The correlation between IOP_I and IOP_G was 0.99 (P < 0.001). The mean difference (IOP_G − IOP_I) was 2.2 mmHg (95% limits of agreement: −3.4 to 7.8 mmHg). The bias in measurements was correlated between eyes (r, 0.68; P < 0.001) and in the injected eye across all timepoints (ICC, 0.86; 95% CI, 0.75–0.93), but did not show a relationship with age, sex, glaucoma, or corneal thickness.

Conclusions

IOP_I and IOP_G showed excellent correlation; however, there was a stable bias toward IOP_G being higher than IOP_I over a large range of IOP.

Financial Disclosure(s)

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

目的：评估 iCare HOME2 和戈德曼眼压计在不同眼压范围内的一致性：前瞻性、观察性队列研究：在 2022 年 10 月至 2023 年 2 月期间，从帕洛阿尔托医疗基金会视网膜诊所招募了 26 名接受玻璃体内注射的成年患者，注射后眼压会暂时升高：受试者在注射前、注射后 0 分钟和 5-10 分钟接受连续的 iCare HOME2 (IOPI) 和戈德曼角膜塑形镜 (IOPG) 眼压测量。对双眼进行基线眼压和眼底测量：IOPI 和 IOPG 之间的相关性通过重复测量的受试者内类相关系数 (ICC) 进行检验。IOPI 和 IOPG 之间的一致性通过校正多次测量的 Bland-Altman 图进行评估。眼压指数和眼压计之间的差异在基线（Pearson's r）和注射眼内不同时间点（绝对一致的 ICC）之间进行评估。线性回归用于评估年龄、性别、青光眼和角膜厚度的影响：平均 IOPI 和 IOPG 分别为 25.3（范围：9 - 55）mmHg 和 23.5（范围：8 - 56）mmHg。IOPI 和 IOPG 之间的相关性为 0.99（pG - IOPI），为 2.2 mmHg（95% 的一致性范围：-3.4 至 7.8 mmHg）。两眼间的测量偏差具有相关性（r：0.68, p结论：IOPI 和 IOPG 显示出很好的相关性，但在很大的眼压范围内，IOPG 比 IOPI 高的偏差是稳定的。

{"title":"Agreement of Serial iCare HOME2 and Goldmann Applanation Tonometry","authors":"","doi":"10.1016/j.ogla.2024.04.007","DOIUrl":"10.1016/j.ogla.2024.04.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess agreement of iCare HOME2 and Goldmann applanation tonometry over a wide range of intraocular pressure (IOP).</div></div><div><h3>Design</h3><div>A prospective, observational cohort study.</div></div><div><h3>Subjects</h3><div>Twenty-six adult patients undergoing intravitreal injection, which temporarily raises IOP, were recruited from the Palo Alto Medical Foundation Retina Clinic between October 2022 and February 2023.</div></div><div><h3>Methods</h3><div>Subjects had serial iCare HOME2 (IOP<sub>I</sub>) and Goldmann applanation (IOP<sub>G</sub>) IOP measurements before and at 0 and 5 to 10 minutes after injection. Baseline IOPs and pachymetry were taken in both eyes.</div></div><div><h3>Main Outcome Measures</h3><div>Correlation between IOP<sub>I</sub> and IOP<sub>G</sub> was tested by within-subjects intraclass correlation coefficient (ICC) for repeated measures. Agreement between IOP<sub>I</sub> and IOP<sub>G</sub> was evaluated by a Bland–Altman plot with correction for multiple measurements. The difference between IOP<sub>I</sub> and IOP<sub>G</sub> was evaluated between eyes at baseline (Pearson’s <em>r</em>) and within the injected eye over different timepoints (ICC for absolute agreement). Linear regression was used to evaluate the effects of age, sex, glaucoma, and corneal thickness.</div></div><div><h3>Results</h3><div>The mean IOP<sub>I</sub> and IOP<sub>G</sub> were 25.3 (range: 9–55) and 23.5 (range: 8–56) mmHg, respectively. The correlation between IOP<sub>I</sub> and IOP<sub>G</sub> was 0.99 (<em>P</em> < 0.001). The mean difference (IOP<sub>G</sub> − IOP<sub>I</sub>) was 2.2 mmHg (95% limits of agreement: −3.4 to 7.8 mmHg). The bias in measurements was correlated between eyes (<em>r</em>, 0.68; <em>P</em> < 0.001) and in the injected eye across all timepoints (ICC, 0.86; 95% CI, 0.75–0.93), but did not show a relationship with age, sex, glaucoma, or corneal thickness.</div></div><div><h3>Conclusions</h3><div>IOP<sub>I</sub> and IOP<sub>G</sub> showed excellent correlation; however, there was a stable bias toward IOP<sub>G</sub> being higher than IOP<sub>I</sub> over a large range of IOP.</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":"7 5","pages":"Pages 440-444"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000711/pdfft?md5=fc3c2c08e518d4425589fd4f26b26a1f&pid=1-s2.0-S2589419624000711-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861663","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}

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