Ophthalmology. Glaucoma最新文献

{"title":"Secondary Glaucoma after Cataract Surgery Performed in Infancy in Congenital Rubella Syndrome","authors":"Gayathri J. Panicker MS ,&nbsp;Sumita Agarkar MS, DNB ,&nbsp;Mona Khurana MS ,&nbsp;Visakh Thomas DNB","doi":"10.1016/j.ogla.2024.07.001","DOIUrl":"10.1016/j.ogla.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the incidence of secondary glaucoma after cataract surgery performed in infancy in children with congenital rubella syndrome (CRS) and children with nonrubella cataracts and to identify associated risk factors.</div></div><div><h3>Design</h3><div>Retrospective case control study.</div></div><div><h3>Participants</h3><div>Children with CRS who had undergone cataract surgery in infancy and age-matched infants who had undergone cataract surgery for infantile cataracts were included.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of glaucoma and probability of survival was compared among the 2 groups.</div></div><div><h3>Methods</h3><div>Risk factors for the development of glaucoma were assessed. The minimum follow-up was 1 year after cataract surgery.</div></div><div><h3>Results</h3><div>The study included 211 eyes of 115 children. The CRS group (cases) had 101 eyes (58 children) and the nonrubella cataract group (controls) included 110 eyes (57 children). There was no significant difference in the mean age at surgery among the 2 groups (<em>P</em> = 0.96). Cumulative incidence of secondary childhood glaucoma for the entire study period of 14 years was 32.7% in the CRS group and 24.5% in the control group (<em>P</em> = 0.19). Mean follow-up was 5.8 ± 3.7 years for CRS group and 6.4 ± 3.4 years for the nonrubella group. A significant difference in the cumulative probability of glaucoma free survival at 10 years after cataract surgery (cases 0.53 vs controls 0.8; log rank <em>P</em> = 0.034) was present. Both groups had no significant difference in the time of onset of secondary glaucoma, average number of intraocular pressure lowering medications and number of eyes with surgical intervention for glaucoma (<em>P</em> &gt; 0.05). Microcornea was associated with the development of glaucoma (hazard ratio 2.83; 95% confidence interval, 1.44–5.57; <em>P</em> = 0.002) in CRS eyes.</div></div><div><h3>Conclusion</h3><div>There was no significant difference in the incidence of secondary glaucoma after cataract surgery performed in infants with CRS compared with infants who had undergone surgery for infantile cataracts. Because the 10-year probability of glaucoma free survival was significantly less in children with CRS, a closer and longer follow-up is recommended especially in eyes with at-risk features.</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 6","pages":"Pages 602-607"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617697","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":"Double-Arc Slow-Coagulation Transscleral Cyclophotocoagulation Laser Protocol","authors":"Izabela N.F. Almeida MD, PhD ,&nbsp;Isabella C.T.P. Resende MD ,&nbsp;Lucas M. Magalhães MD ,&nbsp;Hemengella K.A. Oliveira BM ,&nbsp;Fábio N. Kanadani MD, PhD ,&nbsp;Tiago S. Prata MD, PhD","doi":"10.1016/j.ogla.2024.06.008","DOIUrl":"10.1016/j.ogla.2024.06.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the short-term effectiveness and safety results of a new continuous laser protocol, double-arc slow-coagulation transscleral cyclophotocoagulation (DA-TSCPC).</div></div><div><h3>Design</h3><div>Multicenter retrospective study.</div></div><div><h3>Participants</h3><div>We reviewed the clinical records of refractory glaucoma patients that had undergone DA-TSCPC between April 2019 and July 2022, with at least 12 months of postoperative follow-up.</div></div><div><h3>Methods</h3><div>The technique was standardized (energy: 1400 mW; duration: 4 seconds; 28 applications). The applications were divided into 2 rows (upper and lower arcs). For each arc, 7 spots were applied over the ciliary body shadow and 7 spots 1.5 mm behind, sparing the 3 and 9 o’clock meridians.</div></div><div><h3>Main Outcome Measures</h3><div>Success was defined as postoperative intraocular pressure (IOP) between 6 and 18 mmHg and an IOP reduction of 30% (without oral acetazolamide). For eyes with no light perception (NLP), in which treatment goal was pain relief, success was defined as a 30% IOP reduction and no pain (without oral acetazolamide). Patients were divided according to visual acuity: ≥ 20/400 (group 1) and &lt; 20/400 (group 2).</div></div><div><h3>Results</h3><div>Ninety eyes of 90 patients (mean age: 61 ± 15 years) were included. Glaucoma diagnosis frequency was: neovascular glaucoma (38%), open-angle glaucoma (28%), silicone oil secondary glaucoma (17%), and others (18%). Overall, the mean IOP was significantly reduced from 35 ± 12 to 22 ± 14 mmHg (<em>P</em> &lt; 0.01) at the last follow-up visit. The number of hypotensive eye drops (2.6 ± 1–2.3 ± 1; <em>P</em> = 0.02) and the use of oral acetazolamide (61%–11%; <em>P</em> &lt; 0.01) were also reduced. Kaplan–Meier survival analysis revealed a global success rate of 65.6% after 12 months. A higher success rate was found for group 1 (78.6%) compared to group 2 (59.6%; <em>P</em> = 0.047; logrank test). The main complications observed were corneal ulcer (4.4%), macular edema (1.1%), and hyphema (1.1%). Among the 26 eyes with NLP, 65% achieved success criteria at 12 months and 2 (7.7%) developed phthisis.</div></div><div><h3>Conclusions</h3><div>Based on these initial retrospective data, the DA-TSCPC protocol seems to be an alternative for refractory glaucoma management, presenting significant IOP reduction and a good safety profile after 1 year. Better outcomes were observed in eyes with less severe functional damage.</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 6","pages":"Pages 580-586"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545581","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":"Refractive Outcomes Following Combined Cataract and Microinvasive Glaucoma Surgery","authors":"Abdulla Shaheen MD ,&nbsp;Gabriele Gallo Afflitto MD ,&nbsp;Swarup S. Swaminathan MD","doi":"10.1016/j.ogla.2024.07.003","DOIUrl":"10.1016/j.ogla.2024.07.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare refractive outcomes in eyes undergoing cataract extraction (CE) alone, CE with goniotomy (CE/goniotomy), and CE with Schlemm’s canal stent (CE/SCS) insertion.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Eyes from the Bascom Palmer Glaucoma Repository undergoing CE/goniotomy, CE/SCS insertion, or uncomplicated CE alone between July 2014 and February 2022 were identified.</div></div><div><h3>Methods</h3><div>Refraction data were analyzed at postoperative month (POM) 1 and 6 with Kruskal–Wallis and Dunn’s tests. Anisometropia was defined as a spherical equivalent (SE) difference of ≥2D.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was mean refraction at POM1 and POM6 across the 3 surgical groups. Secondary outcomes were comparisons of refraction and visual acuity (VA) among different goniotomy and Schlemm’s canal stent (SCS) devices, as well as incidence of anisometropia.</div></div><div><h3>Results</h3><div>A total of 8360 eyes (150 CE/goniotomy, 395 CE/SCS, and 7815 CE alone) from 6059 patients were analyzed. At POM1, mean SE in the CE/goniotomy, CE/SCS, and CE alone groups was −0.36 ± 0.91D, −0.31 ± 0.85D, and −0.39 ± 0.88D respectively (<em>P</em> = 0.019). Mean logarithm of the minimum angle of resolution VA was 0.10 ± 0.20, 0.08 ± 0.19, and 0.14 ± 0.26 respectively (<em>P</em> = 0.002, CE/SCS vs. CE alone). No statistically significant differences were noted at POM6. Anisometropia occurred at POM1 in 2 patients (13.3%) in the CE/goniotomy-CE group, 1 patient (3.2%) in the CE/SCS-CE group, and 184 patients (4.9%) in the CE-CE group (<em>P</em> = 0.217). At POM6, mean SEs were −0.38 ± 0.97D (CE/goniotomy), −0.35 ± 0.81D (CE/SCS), and −0.40 ± 0.91D (CE alone; <em>P</em> = 0.473). No significant differences in overall refractive outcomes were observed with different SCS or goniotomy devices. Among primary open-angle glaucoma/normal-tension glaucoma eyes, mean SE at POM1 was −0.36 ± 0.73D (CE/goniotomy), −0.24 ± 0.84D (CE/SCS), and −0.45 ± 0.81D (CE alone; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Concurrent SCS insertion or goniotomy with CE was associated with some statistically significant differences in postoperative refraction and VA, although these small magnitude differences were unlikely to be clinically meaningful.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 6","pages":"Pages 608-614"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617696","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":"Psychological Stress and Intraocular Pressure in Glaucoma","authors":"Nathalie Sena Ferreira MD ,&nbsp;Vital Paulino Costa MD, PhD ,&nbsp;Juliana Frange Miranda MD ,&nbsp;Lucas Oliveira Cintra MD ,&nbsp;Lucas Santos Barbosa MD ,&nbsp;Maira Gomes Barbosa da Silva MD ,&nbsp;Nayara Alves Abreu MD ,&nbsp;Ricardo Yuji Abe MD, PhD","doi":"10.1016/j.ogla.2024.07.004","DOIUrl":"10.1016/j.ogla.2024.07.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the intraocular pressure (IOP) behavior after applying a standardized protocol to induce psychological stress in patients with primary open-angle glaucoma (POAG).</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Participants</h3><div>A total of 39 patients with POAG were included: 18 in the stress group and 21 in the control group.</div></div><div><h3>Methods</h3><div>Patients were randomized to undergo the Trier Social Stress Test (TSST) or to be included in the control group. All participants were submitted to a modified diurnal tension curve (DTC) 1–4 weeks before randomization, with 3 IOP measurements performed between 8:00 <span>am</span> and 2:00 <span>pm</span><span>.</span> We evaluated the response to the TSST by measuring the levels of salivary cortisol, salivary amylase, IOP, mean arterial pressure, and heart rate before, immediately after, and 40 minutes after the TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in IOP (mmHg), salivary cortisol and amylase, heart rate, mean arterial pressure, and STAI scores.</div></div><div><h3>Results</h3><div>At baseline, there were no significant differences between the groups regarding age (<em>P</em> = 0.661), sex (<em>P</em> = 0.669), salivary cortisol (<em>P</em> = 0.104), and mean DTC IOP for the right (<em>P</em> = 0.439) and left (<em>P</em> = 0.576) eyes. We observed a significant mean IOP increase of 3.8 mmHg (right eye; <em>P</em> &lt; 0.001) and 4.1 mmHg (left eye; <em>P</em> &lt; 0.001) when we compared IOP measurements obtained during the DTC and immediately after TSST. Salivary cortisol (5.9 nmol/L; <em>P</em> = 0.004), salivary amylase (323 388 UL; <em>P</em> = 0.004), mean arterial pressure (10.1 mmHg; <em>P</em> &lt; 0.001), and heart rate (12.9 bpm; <em>P</em> &lt; 0.001) also increased significantly after the TSST. In addition, 61.1% (11 of 18) of the patients in the TSST group showed an IOP increase &gt; 4 mmHg following the test. The STAI-state score significantly increased after the TSST compared to baseline (<em>P</em> &lt; 0.001) and decreased from poststress to the recovery period (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Patients with POAG present significant elevations of IOP, salivary cortisol and amylase, mean arterial pressure, heart rate, and STAI scores after psychological stress induced by the TSST.</div></div><div><h3>Financial Disclosures</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 6","pages":"Pages 518-530"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636008","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":"Rapid Retinal Nerve Fiber Layer Thinning in the Unaffected Contralateral Eyes of Patients with Unilateral Normal-Tension Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.009","DOIUrl":"10.1016/j.ogla.2024.04.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To observe the rate of progressive retinal nerve fiber layer (RNFL) thinning in the unaffected eyes of patients with unilateral normal-tension glaucoma (NTG), in comparison with that of healthy subjects, and to identify the factors associated with progressive RNFL thinning.</div></div><div><h3>Design</h3><div>Retrospective, longitudinal, observational study.</div></div><div><h3>Participants</h3><div>Ninety-five patients with unilateral NTG and 61 healthy controls.</div></div><div><h3>Methods</h3><div>This study included unilateral NTG and healthy control subjects who were followed up for longer than 4 years and in whom at least 5 reliable retinal nerve fiber layer thickness (RNFLT) measurements were performed using OCT. Factors associated with the rate of thinning of the unaffected eyes of unilateral patients with NTG were identified using regression analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The rate of progressive RNFL thinning and the associated factors.</div></div><div><h3>Results</h3><div>Retinal nerve fiber layer thickness decreased significantly in both the unaffected eyes of unilateral patients with NTG and the healthy eyes (both <em>P</em> &lt; 0.001). The RNFL thinning was significantly faster in the unaffected eyes of unilateral patients with NTG than in the healthy eyes (<em>P</em> &lt; 0.001), specifically in the temporal-inferior (TI) sector (<em>P</em> = 0.003). Factors associated with faster RNFL thinning in the unaffected eyes of unilateral patients with NTG were thicker baseline RNFL of the unaffected eyes (<em>P</em> = 0.002) and a worse visual field (VF) mean deviation (MD) in the NTG eyes (<em>P</em><span> = 0.040). In the healthy controls, the rate of RNFL thinning in the contralateral eyes was the only factor associated with faster thinning (</span><em>P</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>The unaffected eyes of unilateral patients with NTG showed faster RNFL thinning than healthy control eyes, more obviously in the TI sector, and were likely to progress faster when they had a thicker baseline RNFL, and when the NTG eyes had a worse VF MD. In unilateral patients with NTG, initiation of prophylactic treatment could be considered for the unaffected eyes when they are accompanied by a risk of developing 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":"7 5","pages":"Pages 431-439"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856835","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":"Advanced Imaging in Traumatic Glaucoma: Detection of Intralenticular Foreign Body","authors":"","doi":"10.1016/j.ogla.2024.02.007","DOIUrl":"10.1016/j.ogla.2024.02.007","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Page e2"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141256","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":"Unusual Posterior Capsular Pigmentation in Axenfeld–Rieger Anomaly","authors":"","doi":"10.1016/j.ogla.2024.03.004","DOIUrl":"10.1016/j.ogla.2024.03.004","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"7 5","pages":"Page e5"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764790","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":"Blind Spots in Therapy","authors":"","doi":"10.1016/j.ogla.2024.04.006","DOIUrl":"10.1016/j.ogla.2024.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and quantify medications causing angle-closure glaucoma through the FDA Adverse Event Reporting System (FAERS).</div></div><div><h3>Design</h3><div>National retrospective database analysis.</div></div><div><h3>Subjects</h3><div>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.</div></div><div><h3>Methods</h3><div>Drugs associated with reports of angle-closure glaucoma were identified in FAERS through disproportionality analysis</div></div><div><h3>Main Outcome Measures</h3><div>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.</div></div><div><h3>Results</h3><div>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]).</div></div><div><h3>Conclusions</h3><div>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.</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 485-490"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258941962400070X/pdfft?md5=d3cea46460ded90fa28e8c0f41e3e3b4&pid=1-s2.0-S258941962400070X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874028","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}

{"title":"Quality of Reporting Electronic Health Record Data in Glaucoma","authors":"","doi":"10.1016/j.ogla.2024.04.002","DOIUrl":"10.1016/j.ogla.2024.04.002","url":null,"abstract":"<div><h3>Topic</h3><div>Assessing reporting standards in glaucoma studies utilizing electronic health records (EHR).</div></div><div><h3>Clinical Relevance</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</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 422-430"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000644/pdfft?md5=01bb52e638af196f1ad6623b8bf24ae5&pid=1-s2.0-S2589419624000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771251","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}

{"title":"The Association of Urinary Sodium Excretion with Glaucoma and Related Traits in a Large United Kingdom Population","authors":"","doi":"10.1016/j.ogla.2024.04.010","DOIUrl":"10.1016/j.ogla.2024.04.010","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Design</h3><div>Cross-sectional observational and gene-environment interaction analyses in the population-based UK Biobank study.</div></div><div><h3>Participants</h3><div>Up to 103 634 individuals (mean age: 57 years; 51% women) with complete urinary, ocular, and covariable data.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Main Outcome Measures</h3><div>Corneal-compensated IOP, OCT derived macular retinal nerve fiber layer and ganglion cell-inner plexiform layer (GCIPL) thickness, and prevalent glaucoma.</div></div><div><h3>Results</h3><div>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; <em>P</em> &lt; 0.001) and greater prevalence of glaucoma (odds ratio, 1.11; 95% CI, 1.07–1.14; <em>P</em> &lt; 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, <em>P</em> &lt; 0.001) and prevalence of glaucoma (odds ratio, 1.30; 95% CI, 1.17–1.45; <em>P</em> &lt; 0.001). Stronger associations with glaucoma (<em>P</em> interaction = 0.001) were noted in participants with a higher glaucoma polygenic risk score.</div></div><div><h3>Conclusions</h3><div>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.</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 499-511"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000747/pdfft?md5=48a5fcdfa0a405a825317de129686e72&pid=1-s2.0-S2589419624000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900573","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}