Ophthalmology. Glaucoma最新文献_第5页

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。

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引用次数: 0

Mitomycin C 0.2 mg/ml versus Mitomycin C 0.4 mg/ml during the Implantation of an Ab Externo Polystyrene-isobutylene-styrene Microshunt 在植入体外 SIBS 微分流术时，0.2 毫克/毫升的丝裂霉素与 0.4 毫克/毫升的丝裂霉素：一项大型分析。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.06.001

Purpose

To compare the effectiveness and adverse event profile of standalone polystyrene-isobutylene-styrene (SIBS) microshunt implantation with adjunct mitomycin C (MMC) 0.2 mg/ml and MMC 0.4 mg/ml.

Design

Mega-analysis using individual patient data from international prospective and retrospective clinical studies.

Participants

Patients with glaucoma who underwent implantation of a SIBS microshunt with MMC as a standalone procedure.

Methods

A comparison of eyes that received MMC 0.2 mg/ml or 0.4 mg/ml.

Main Outcomes Measures

Primary outcome was complete success defined as the proportion of eyes at 1 year with all of the following: (1) no 2 consecutive intraocular pressures (IOPs) > 17 mmHg; (2) no clinical hypotony; (3) ≥ 20% IOP reduction from baseline; and (4) no use of glaucoma medications. Secondary outcomes included IOP thresholds of 12 mmHg, 14 mm Hg, and 21 mmHg, median IOP, number of medications, risk factors for failure, interventions, adverse events, and reoperations.

Results

At 1 year, the complete success rate was significantly higher (71.3% vs. 50.46%; P < 0.001) and the median IOP was significantly lower (13.0 vs 14.2 mmHg; P < 0.05) in the MMC 0.4 mg/ml group. Mitomycin C 0.2 mg/ml was found to be a significant risk factor for failure (hazard ratio 1.75; 95% confidence interval 1.14–2.67). Needling and surgical revision occurred at a lower rate in the MMC 0.4 mg/ml group (7% vs 18.8%; P = 0.002 and 4.3% vs 13.7% P = 0.0087, respectively). Adverse events occurred at a similar frequency in both groups (26.6% MMC 0.2 mg/ml vs 29.6% MMC 0.4 mg/ml; P = 0.46), most of which were early and transient.

Conclusion

Polystyrene-isobutylene-styrene microshunt implantation with MMC 0.4 mg/ml resulted in a higher success rate with greater IOP reduction compared with MMC 0.2 mg/ml. Higher MMC concentration was not associated with increased serious adverse events.

Financial Disclosure(s)

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

目的：比较独立SIBS微分流植入术与辅助MMC 0.2 mg/ml和MMC 0.4 mg/ml的有效性和不良事件概况：设计：利用国际前瞻性和回顾性临床研究中的单个患者数据进行大规模分析：研究对象：接受SIBS微分流术并将MMC作为独立手术植入的青光眼患者：主要结果测量：主要结果是完全成功，定义为一年后具备以下所有条件的眼睛比例：(1)无连续两次眼压>17 mmHg；(2)无临床低眼压症状；(3)眼压较基线下降≥20%；(4)未使用青光眼药物。次要结果包括 12 毫米汞柱、14 毫米汞柱和 21 毫米汞柱的眼压阈值、中位眼压、用药次数、失败的风险因素、干预措施、不良事件和再次手术：结果：1 年后的完全成功率明显更高（71.3% 对 50.46%，P=0.05）：与 MMC 0.2 mg/ml 相比，使用 MMC 0.4 mg/ml 植入 SIBS 微分流术的成功率更高，眼压降低幅度更大。较高浓度的 MMC 与严重不良事件的增加无关。

{"title":"Mitomycin C 0.2 mg/ml versus Mitomycin C 0.4 mg/ml during the Implantation of an Ab Externo Polystyrene-isobutylene-styrene Microshunt","authors":"","doi":"10.1016/j.ogla.2024.06.001","DOIUrl":"10.1016/j.ogla.2024.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the effectiveness and adverse event profile of standalone polystyrene-isobutylene-styrene (SIBS) microshunt implantation with adjunct mitomycin C (MMC) 0.2 mg/ml and MMC 0.4 mg/ml.</div></div><div><h3>Design</h3><div>Mega-analysis using individual patient data from international prospective and retrospective clinical studies.</div></div><div><h3>Participants</h3><div>Patients with glaucoma who underwent implantation of a SIBS microshunt with MMC as a standalone procedure.</div></div><div><h3>Methods</h3><div>A comparison of eyes that received MMC 0.2 mg/ml or 0.4 mg/ml.</div></div><div><h3>Main Outcomes Measures</h3><div>Primary outcome was complete success defined as the proportion of eyes at 1 year with all of the following: (1) no 2 consecutive intraocular pressures (IOPs) > 17 mmHg; (2) no clinical hypotony; (3) ≥ 20% IOP reduction from baseline; and (4) no use of glaucoma medications. Secondary outcomes included IOP thresholds of 12 mmHg, 14 mm Hg, and 21 mmHg, median IOP, number of medications, risk factors for failure, interventions, adverse events, and reoperations.</div></div><div><h3>Results</h3><div>At 1 year, the complete success rate was significantly higher (71.3% vs. 50.46%; P < 0.001) and the median IOP was significantly lower (13.0 vs 14.2 mmHg; <em>P</em> < 0.05) in the MMC 0.4 mg/ml group. Mitomycin C 0.2 mg/ml was found to be a significant risk factor for failure (hazard ratio 1.75; 95% confidence interval 1.14–2.67). Needling and surgical revision occurred at a lower rate in the MMC 0.4 mg/ml group (7% vs 18.8%; <em>P</em> = 0.002 and 4.3% vs 13.7% <em>P</em> = 0.0087, respectively). Adverse events occurred at a similar frequency in both groups (26.6% MMC 0.2 mg/ml vs 29.6% MMC 0.4 mg/ml; <em>P</em> = 0.46), most of which were early and transient.</div></div><div><h3>Conclusion</h3><div>Polystyrene-isobutylene-styrene microshunt implantation with MMC 0.4 mg/ml resulted in a higher success rate with greater IOP reduction compared with MMC 0.2 mg/ml. Higher MMC concentration was not associated with increased serious adverse events.</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 454-465"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589419624000851/pdfft?md5=b85e8a7f2b431b99a937e28f01a84bd7&pid=1-s2.0-S2589419624000851-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294000","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

Comparison of a Novel Head-Mounted Objective Auto-perimetry (Gaze Analyzing Perimeter) and Humphrey Field Analyzer 新型头戴式客观自动测距仪（注视分析周长）与汉弗莱视场分析仪的比较。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.05.003

Purpose

To evaluate the agreement between 24-2 visual field (VF) test results obtained using the gaze analyzing perimeter (GAP; Findex) and the Humphrey field analyzer (HFA; Carl Zeiss Meditec).

Design

Cross-sectional study.

Participants

Patients underwent HFA 24-2 for suspected or confirmed VF loss and were treated at the Kyoto University Hospital between December 2022 and July 2023.

Methods

Patients underwent consecutive VF tests on the same eye using HFA and GAP 24-2 tests. Bland–Altman analysis was used to compare GAP and HFA results. Examination points where the sensitivity measured using GAP was ≥ 10 dB higher than that measured using HFA were re-evaluated by referring back to the original gaze data; 2 ophthalmologists assessed whether the gaze moved linearly toward the new test target.

Main Outcome Measures

Mean deviation (MD) and elapsed time on an individual basis and sensitivity on an examination point basis.

Results

Forty-seven eyes of 47 patients were analyzed. The correlation coefficient of the MD using HFA and GAP was 0.811 (95% confidence interval [CI]: 0.683–0.891). Bland–Altman analysis showed good agreement between HFA and GAP tests. The mean difference (95% limits of agreement) in MD between HFA and GAP results was −0.63 dB (−5.81 to 4.54 dB). Although no statistically significant differences were observed in the elapsed time (P = 0.99), measurements completed within 200 seconds were observed only in the GAP group (11 cases, 23.4%), who had significantly better HFA MD value than others (P = 0.001). On an examination point basis for sensitivity, the correlation coefficient between HFA and GAP was 0.691 (95% limits of agreement, 0.670–0.711). Original gaze data assessment revealed that the gaze moved linearly toward the new test target for 70.2% of the examination points with a sensitivity discrepancy.

Conclusions

The results indicate that the GAP provides VF assessment outcomes comparable to those of the HFA. The GAP exhibited advantages in terms of testing time, particularly in patients with minimal VF impairment. Furthermore, the GAP records all eye movements, enabling the objective determination of VF abnormalities based on gaze patterns and facilitating easy posthoc verification.

Financial Disclosure(s)

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

目的：评估使用凝视分析仪（GAP；FINDEX，日本东京）和汉弗莱视野分析仪（HFA；卡尔蔡司医疗技术公司，美国加利福尼亚州都柏林）获得的 24-2 视野（VF）测试结果之间的一致性：设计：横断面研究参与者：2022 年 12 月至 2023 年 7 月期间在京都大学医院接受治疗的疑似或确诊 VF 缺失的 HFA 24-2 患者：患者使用 HFA 和 GAP 24-2 测试对同一只眼睛进行连续 VF 测试。使用 Bland-Altman 分析比较 GAP 和 HFA 的结果。对使用 GAP 测得的灵敏度比使用 HFA 测得的灵敏度高≥10 dB 的检查点，通过回溯原始注视数据进行重新评估；由两名眼科医生评估注视是否向新的测试目标线性移动：主要结果测量指标：以个体为单位的平均偏差（MD）和耗时，以及以检查点为单位的灵敏度：对 47 名患者的 47 只眼睛进行了分析。使用 HFA 和 GAP 的 MD 相关系数为 0.811（95% 置信区间 [CI]：0.683-0.891）。Bland-Altman分析表明，HFA和GAP测试之间具有良好的一致性。HFA 和 GAP 结果的 MD 平均差异（95% 置信区间 [LOA]）为 -0.63 dB（-5.81 至 4.54 dB）。虽然在所用时间上没有观察到明显的统计学差异（P = 0.99），但只有 GAP 组（11 例，23.4%）的测量在 200 秒内完成，他们的 HFA MD 值明显优于其他组（P=0.001）。根据检查点的敏感性，HFA 和 GAP 之间的相关系数为 0.691（95% LOA，0.670-0.711）。原始凝视数据评估显示，70.2%的检查点的凝视呈线性向新的测试目标移动，存在灵敏度差异：结果表明，GAP 可提供与 HFA 相当的 VF 评估结果。GAP 在测试时间方面表现出优势，尤其是对视力损害极小的患者。此外，GAP 还能记录所有眼球运动，从而能根据注视模式客观判断 VF 异常，便于事后验证。

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引用次数: 0

Glucagon-Like Peptide 1 Receptor Agonists: A Role in Glaucoma? 胰高血糖素样肽 1 受体激动剂：在青光眼中的作用？

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.03.005

引用次数: 0

Publication Rate of Abstracts Presented at American Glaucoma Society Annual Meetings 在美国青光眼协会年会上提交的摘要的发表率。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.05.001

引用次数: 0

Hidden Depths of Glaucomatous Disc 青光眼椎间盘的隐藏深度

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.03.001

引用次数: 0

Starstruck Lens: Iatrogenic Rosette Cataract and Its Spontaneous Resolution 追星透镜：先天性玫瑰型白内障及其自然消退。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-09-01 DOI: 10.1016/j.ogla.2024.02.006

引用次数: 0

Comparison of Peripapillary Choroidal Thickness Between Primary Open-angle Glaucoma, Normal Tension Glaucoma, and Normal Eyes 原发性开角型青光眼、正常张力性青光眼和正常眼毛细血管周围厚度的比较：系统回顾和元分析。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma

Pub Date : 2024-07-01 DOI: 10.1016/j.ogla.2024.02.008

Topic

To investigate differences in peripapillary choroidal thickness (PPCT) between primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and healthy eyes, additionally comparing differences between POAG and NTG eyes.

Clinical Relevance

Peripapillary choroidal thickness is a well-established OCT parameter in eyes with glaucoma and other ocular pathologies. The relationship between PPCT and glaucoma, if better understood, may facilitate the development of PPCT as a potential diagnostic and monitoring metric for glaucoma. In particular, there has yet to be a synthesis that directly compares PPCT between POAG eyes and NTG eyes.

Methods

A comprehensive literature search was performed on PubMed, EMBASE, and Cochrane Library, identifying studies from inception to December 2022. We included studies that measured PPCT using OCT in POAG, NTG, and healthy eyes. Mean difference (MD) among groups was calculated. Statistical analysis was performed using R version 4.2.0. Risk of bias of included studies was assessed using the Newcastle Ottawa Scale (NOS).

Results

Eighteen studies were included in this meta-analysis, with a pooled total of 935 healthy control eyes, 446 NTG eyes, and 934 POAG eyes. There was a significant reduction of PPCT in POAG eyes compared with healthy eyes [MD = −16.32; 95% confidence interval (CI) (−27.55 to −5.09)]. Reduction in PPCT was also significant in NTG eyes compared with healthy eyes [MD = −34.96; 95% CI (−49.97 to −19.95)]. NTG eyes had significantly reduced PPCT compared with POAG eyes [MD = −26.64; 95% CI (−49.00 to −4.28)].

Conclusions

Glaucomatous eyes appear to have significantly reduced PPCT compared with normal healthy eyes. In addition, PPCT in NTG eyes appear significantly thinner compared with that in POAG eyes.

Financial Disclosure(s)

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

主题研究原发性开角型青光眼（POAG）、正常张力青光眼（NTG）和健康眼之间毛细血管周围脉络膜厚度（PPCT）的差异，并比较POAG和NTG眼之间的差异：毛细血管周围脉络膜厚度（PPCT）是青光眼和其他眼部病变中一个成熟的光学相干断层扫描（OCT）参数。如果能更好地了解 PPCT 与青光眼之间的关系，将有助于将 PPCT 发展成为一种潜在的青光眼诊断和监测指标。特别是，目前还没有直接比较POAG眼和NTG眼的PPCT的综述：在 PubMed、EMBASE 和 Cochrane Library 上进行了全面的文献检索，确定了从开始到 2022 年 12 月的研究。我们纳入了使用光学相干断层扫描（OCT）测量 POAG、NTG 和健康眼 PPCT 的研究。计算各组间的平均差（MD）。统计分析使用 R 4.2.0 版本进行。采用纽卡斯尔-渥太华量表（NOS）对纳入研究的偏倚风险进行评估：本次荟萃分析共纳入了 18 项研究，汇总了 935 只健康对照眼、446 只 NTG 眼和 934 只 POAG 眼。与健康眼相比，POAG 眼的 PPCT 明显下降[MD = -16.32，95% CI (-27.55, -5.09)]。与健康眼睛相比，NTG 眼睛的 PPCT 也有显著降低[MD = -34.96，95% CI (-49.97, -19.95)]。与POAG眼相比，NTG眼的PPCT明显降低[MD = -26.64，95% CI (-49.00, -4.28)]：结论：与正常健康眼相比，青光眼眼的 PPCT 明显降低。结论：与正常健康眼睛相比，青光眼患者眼睛的 PPCT 明显减少。此外，与 POAG 眼睛相比，NTG 眼睛的 PPCT 明显变薄。

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引用次数: 0