This study compared the agreement between the Humphrey Field Analyzer (HFA) SITA Fast strategy and a novel virtual reality head-mounted visual perimetry device (VisuALL) in patients with glaucoma.
Design
This is prospective observational study.
Participants
This study was conducted on 62 eyes of 39 glaucoma subjects.
Methods
All participants had visual field (VF) testing with the VisuALL AVAFAST strategy and the HFA (24-2, Swedish Interactive Threshold Algorithm FAST). The mean sensitivity of the whole VF and each quadrant was compared between both machines. Additionally, the pattern deviation plot was analyzed to compare the agreement of both devices to detect localized VF defects.
Main Outcome Measures
Correlation and agreement between the mean sensitivity of the fast strategies from VisuALL and HFA.
Results
The global mean sensitivity of the VisuALL and the HFA correlated significantly (r = 0.60; P < 0.001) and was in agreement (r = 0.73; P < 0.001). The detection of VF defects in all quadrants was also moderately correlated and in agreement. Participants overwhelmingly preferred the VisuALL over the conventional (80%).
Conclusions
Although the mean sensitivity and ability to detect localized VF defects of the VisuALL were correlated and in agreement with the HFA, this was only moderate. This indicates that the VisuALL AVAFast strategy must be used with caution.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的：本研究比较了Humphrey Field Analyzer (HFA) SITA Fast策略和一种新型虚拟现实头戴式视距离仪（VisuALL）在青光眼患者中的一致性。设计：本研究为前瞻性观察性研究。参与者：本研究对39例青光眼患者的62只眼进行了研究。方法：所有受试者采用VisuALL AVAFAST策略和HFA （24-2, Swedish Interactive Threshold Algorithm FAST）进行视野测试。比较两种机器的全视野和各象限平均灵敏度。此外，分析了模式偏差（PD）图，以比较两种设备检测局部VF缺陷的一致性。主要结果：VisuALL和HFA快速策略的平均敏感性之间的相关性和一致性。结果：VisuALL与HFA的整体平均灵敏度有显著相关性（r= 0.60, P < 0.001），两者一致（r= 0.73, P < 0.001）。在所有象限的视野缺陷的检测也适度相关和一致。参与者绝大多数更喜欢VisuALL而不是传统的SAP（80%）。结论：虽然VisuALL的平均灵敏度和检测局部视野缺陷的能力与HFA相关，但这只是适度的。这表明VisuALL AVAFast策略必须谨慎使用。
{"title":"Comparison between the Fast Strategies of a Virtual Reality Perimetry and the Humphrey Field Analyzer in Patients with Glaucoma","authors":"Fernanda Nicolela Susanna MD , Carolina Nicolela Susanna MD , Pedro Gabriel Salomão Libânio MD , Fernanda Tiemi Nishikawa MD , Renato Antunes Schiave Germano MD, PhD , Remo Susanna Junior MD, PhD","doi":"10.1016/j.ogla.2024.12.004","DOIUrl":"10.1016/j.ogla.2024.12.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the agreement between the Humphrey Field Analyzer (HFA) SITA Fast strategy and a novel virtual reality head-mounted visual perimetry device (VisuALL) in patients with glaucoma.</div></div><div><h3>Design</h3><div>This is prospective observational study.</div></div><div><h3>Participants</h3><div>This study was conducted on 62 eyes of 39 glaucoma subjects.</div></div><div><h3>Methods</h3><div>All participants had visual field (VF) testing with the VisuALL AVAFAST strategy and the HFA (24-2, Swedish Interactive Threshold Algorithm FAST). The mean sensitivity of the whole VF and each quadrant was compared between both machines. Additionally, the pattern deviation plot was analyzed to compare the agreement of both devices to detect localized VF defects.</div></div><div><h3>Main Outcome Measures</h3><div>Correlation and agreement between the mean sensitivity of the fast strategies from VisuALL and HFA.</div></div><div><h3>Results</h3><div>The global mean sensitivity of the VisuALL and the HFA correlated significantly (r = 0.60; <em>P</em> < 0.001) and was in agreement (r = 0.73; <em>P</em> < 0.001). The detection of VF defects in all quadrants was also moderately correlated and in agreement. Participants overwhelmingly preferred the VisuALL over the conventional (80%).</div></div><div><h3>Conclusions</h3><div>Although the mean sensitivity and ability to detect localized VF defects of the VisuALL were correlated and in agreement with the HFA, this was only moderate. This indicates that the VisuALL AVAFast strategy must be used with caution.</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 3","pages":"Pages 227-234"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856859","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.12.007
Chao Chen BS , Jiao Qi MD , Keke Zhang MD , Jiaqi Meng MD , Yi Lu MD, PhD , Fei Wang MD, PhD , Xiangjia Zhu MD, PhD
Purpose
Liver disease is associated with a range of extrahepatic complications, which have recently been expanded to include ophthalmic conditions. However, evidence is lacking regarding its impact on primary open-angle glaucoma (POAG). This study aimed to investigate whether major liver diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcoholic liver disease (ALD), viral hepatitis, and liver fibrosis and cirrhosis, were associated with POAG.
Design
A prospective study based on the UK Biobank cohort with a 2-sample Mendelian randomization (MR) analysis for inferring causality.
Participants
A total of 332 345 UK Biobank participants free of glaucoma recruited between 2006 and 2010.
Methods
The exposures of interest were severe liver diseases defined as hospital admission, including MASLD, ALD, viral hepatitis, and liver fibrosis and cirrhosis. The Cox proportional hazard models were used with each liver disease treated as a time-varying exposure. The MR analysis was further conducted based on the genome-wide association studies of a histologically characterized cohort for MASLD (n = 19 264) and the International Glaucoma Genetics Consortium cohort for POAG (n = 216 257).
Main Outcome Measures
The risk of POAG estimated by hazard ratio (HR) and 95% confidence interval (CI) in observational analysis and odds ratio (OR) and 95% CI in MR analysis.
Results
Severe MASLD was associated with a 45% increased risk of POAG (HR, 1.45; 95% CI, 1.12–1.87; P = 0.005), whereas no association was identified between ALD, viral hepatitis, or liver fibrosis and cirrhosis and incident POAG. Subgroup analysis showed that the risk of POAG in relation to MASLD was higher in individuals having more physical activity (HR, 1.53; 95% CI, 1.04–2.25 vs. HR, 1.39; 95% CI, 0.99–1.95, P for interaction = 0.033). Mendelian randomization analysis provided evidence that MASLD was causally associated with a greater risk of POAG (inverse-variance weighted model: OR, 1.035; 95% CI, 1.010–1.061; P = 0.005).
Conclusions
Severe MASLD was longitudinally associated with an increased risk of incident POAG, with MR analyses suggesting a potential causal link. These findings suggest that a POAG examination should be considered in the holistic management of MASLD and further underscore the impact of the liver on eye health.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any materials discussed in this article.
目的：肝脏疾病与一系列肝外并发症相关，最近已扩大到包括眼科疾病。然而，其对原发性开角型青光眼（POAG）的影响尚缺乏证据。本研究旨在探讨主要肝脏疾病，包括代谢功能障碍相关脂肪变性肝病（MASLD）、酒精性肝病（ALD）、病毒性肝炎、肝纤维化和肝硬化是否与POAG相关。设计：一项基于英国生物银行队列的前瞻性研究，采用双样本孟德尔随机化（MR）分析来推断因果关系。参与者：在2006年至2010年期间招募了332,345名无青光眼的英国生物银行参与者。方法：研究对象为入院的严重肝病，包括MASLD、ALD、病毒性肝炎、肝纤维化和肝硬化。Cox比例风险模型用于将每种肝病作为时变暴露治疗。mri分析进一步基于MASLD （n = 19,264）和POAG （n = 216,257）的组织学特征队列的全基因组关联研究。主要结局指标：观察分析以风险比（HR）和95%置信区间（CI）估计POAG的风险，MR分析以优势比（OR）和95% CI估计POAG的风险。结果：重度MASLD与POAG风险增加45%相关(HR 1.45；95% ci 1.12-1.87；P = 0.005)，而ALD （P = 0.953）、病毒性肝炎（P = 0.519）或肝纤维化和肝硬化（P = 0.794）与POAG的发生没有关联。亚组分析显示，体力活动较多的个体与MASLD相关的POAG风险较高(HR 1.53；95% CI 1.04-2.25, HR 1.39；95% CI 0.99-1.95，交互作用P = 0.033)。MR分析提供的证据表明，MASLD与POAG的高风险存在因果关系(反方差加权模型：OR 1.035；95% ci 1.010-1.061；P = 0.005)。结论：严重的MASLD与POAG发生风险增加纵向相关，MR分析表明存在潜在的因果关系。这些发现提示在MASLD的整体治疗中应考虑POAG检查，并进一步强调肝脏对眼睛健康的影响。
{"title":"Metabolic Dysfunction-associated Steatotic Liver Disease Increases the Risk of Primary Open-Angle Glaucoma","authors":"Chao Chen BS , Jiao Qi MD , Keke Zhang MD , Jiaqi Meng MD , Yi Lu MD, PhD , Fei Wang MD, PhD , Xiangjia Zhu MD, PhD","doi":"10.1016/j.ogla.2024.12.007","DOIUrl":"10.1016/j.ogla.2024.12.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Liver disease is associated with a range of extrahepatic complications, which have recently been expanded to include ophthalmic conditions. However, evidence is lacking regarding its impact on primary open-angle glaucoma (POAG). This study aimed to investigate whether major liver diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcoholic liver disease (ALD), viral hepatitis, and liver fibrosis and cirrhosis, were associated with POAG.</div></div><div><h3>Design</h3><div>A prospective study based on the UK Biobank cohort with a 2-sample Mendelian randomization (MR) analysis for inferring causality.</div></div><div><h3>Participants</h3><div>A total of 332 345 UK Biobank participants free of glaucoma recruited between 2006 and 2010.</div></div><div><h3>Methods</h3><div>The exposures of interest were severe liver diseases defined as hospital admission, including MASLD, ALD, viral hepatitis, and liver fibrosis and cirrhosis. The Cox proportional hazard models were used with each liver disease treated as a time-varying exposure. The MR analysis was further conducted based on the genome-wide association studies of a histologically characterized cohort for MASLD (n = 19 264) and the International Glaucoma Genetics Consortium cohort for POAG (n = 216 257).</div></div><div><h3>Main Outcome Measures</h3><div>The risk of POAG estimated by hazard ratio (HR) and 95% confidence interval (CI) in observational analysis and odds ratio (OR) and 95% CI in MR analysis.</div></div><div><h3>Results</h3><div>Severe MASLD was associated with a 45% increased risk of POAG (HR, 1.45; 95% CI, 1.12–1.87; <em>P</em> = 0.005), whereas no association was identified between ALD, viral hepatitis, or liver fibrosis and cirrhosis and incident POAG. Subgroup analysis showed that the risk of POAG in relation to MASLD was higher in individuals having more physical activity (HR, 1.53; 95% CI, 1.04–2.25 vs. HR, 1.39; 95% CI, 0.99–1.95, <em>P</em> for interaction = 0.033). Mendelian randomization analysis provided evidence that MASLD was causally associated with a greater risk of POAG (inverse-variance weighted model: OR, 1.035; 95% CI, 1.010–1.061; <em>P</em> = 0.005).</div></div><div><h3>Conclusions</h3><div>Severe MASLD was longitudinally associated with an increased risk of incident POAG, with MR analyses suggesting a potential causal link. These findings suggest that a POAG examination should be considered in the holistic management of MASLD and further underscore the impact of the liver on eye health.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Pages 266-274"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928525","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.12.009
Judy Figueroa BS , Erica Su PhD , Vahid Mohammadzadeh MD , Sajad Besharati MD , Massood Mohammadi MD , Maryam Ashrafkhorasani MD , Simon K. Law MD, PharmD , Anne L. Coleman MD, PhD , Joseph Caprioli MD , Robert E. Weiss PhD , Kouros Nouri-Mahdavi MD, MS
Purpose
To investigate the influence of baseline blood pressure (BP) on retinal nerve fiber layer (RNFL) rates of change (RoCs) in glaucoma patients with central damage or moderate to severe disease.
Design
Prospective cohort study.
Participants
One hundred ten eyes with ≥ 4 RNFL OCT scans and ≥ 2 years of follow-up.
Methods
Global RNFL RoCs were modeled with a Bayesian hierarchical model with subject- and sector-level random effects. Influence of baseline systolic and diastolic BP measures and their interactions with intraocular pressure (IOP) on global RNFL RoCs was investigated in prognostic models adjusting for relevant baseline demographic and clinical measures.
Main Outcome Measures
Magnitude and direction of coefficients for BP, IOP, and their interaction for prediction of global RNFL RoCs. One-sided Bayesian P values denote posterior probability that a regression coefficient is greater than or less than zero, with P < 0.025 or P > 0.975 defining significance.
Results
Average (standard deviation) 24-2 visual field mean deviation (MD) at baseline, follow-up time, and number of OCT scans were −8.8 (6.0) dB, 4.3 (0.5) years, and 8.3 (1.4), respectively. In multivariable analyses, female sex, Hispanic ethnicity (vs. White ethnicity), better baseline 24-2 MD, higher contrast sensitivity at 12 cycles per degree, presence of diabetes, and thicker central cornea predicted faster RNFL thinning. Adjusted for covariates, lower diastolic BP combined with higher IOP predicted faster RNFL RoCs. Parallel multivariable models incorporating systolic BP showed similar effects. Among various BP/IOP combinations, eyes with IOP at the 90th percentile and diastolic (systolic) BP at 10th percentile demonstrated the fastest RNFL thinning rates (−0.554 and −0.539 μm/year).
Conclusions
Low BP and higher IOP at baseline predicted faster (worse) RNFL RoCs in glaucoma patients with central damage or moderate to advanced disease. Although there may be potential benefits to BP management in glaucoma patients, the therapeutic value of BP manipulation in glaucoma patients is yet to be established given the proven benefits of tight BP control in reducing cardiovascular morbidity and mortality.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
{"title":"Association of Blood Pressure and Retinal Nerve Fiber Layer Rates of Thinning in Patients with Moderate to Advanced Glaucoma","authors":"Judy Figueroa BS , Erica Su PhD , Vahid Mohammadzadeh MD , Sajad Besharati MD , Massood Mohammadi MD , Maryam Ashrafkhorasani MD , Simon K. Law MD, PharmD , Anne L. Coleman MD, PhD , Joseph Caprioli MD , Robert E. Weiss PhD , Kouros Nouri-Mahdavi MD, MS","doi":"10.1016/j.ogla.2024.12.009","DOIUrl":"10.1016/j.ogla.2024.12.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the influence of baseline blood pressure (BP) on retinal nerve fiber layer (RNFL) rates of change (RoCs) in glaucoma patients with central damage or moderate to severe disease.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>One hundred ten eyes with ≥ 4 RNFL OCT scans and ≥ 2 years of follow-up.</div></div><div><h3>Methods</h3><div>Global RNFL RoCs were modeled with a Bayesian hierarchical model with subject- and sector-level random effects. Influence of baseline systolic and diastolic BP measures and their interactions with intraocular pressure (IOP) on global RNFL RoCs was investigated in prognostic models adjusting for relevant baseline demographic and clinical measures.</div></div><div><h3>Main Outcome Measures</h3><div>Magnitude and direction of coefficients for BP, IOP, and their interaction for prediction of global RNFL RoCs. One-sided Bayesian <em>P</em> values denote posterior probability that a regression coefficient is greater than or less than zero, with <em>P</em> < 0.025 or <em>P</em> > 0.975 defining significance.</div></div><div><h3>Results</h3><div>Average (standard deviation) 24-2 visual field mean deviation (MD) at baseline, follow-up time, and number of OCT scans were −8.8 (6.0) dB, 4.3 (0.5) years, and 8.3 (1.4), respectively. In multivariable analyses, female sex, Hispanic ethnicity (vs. White ethnicity), better baseline 24-2 MD, higher contrast sensitivity at 12 cycles per degree, presence of diabetes, and thicker central cornea predicted faster RNFL thinning. Adjusted for covariates, lower diastolic BP combined with higher IOP predicted faster RNFL RoCs. Parallel multivariable models incorporating systolic BP showed similar effects. Among various BP/IOP combinations, eyes with IOP at the 90th percentile and diastolic (systolic) BP at 10th percentile demonstrated the fastest RNFL thinning rates (−0.554 and −0.539 μm/year).</div></div><div><h3>Conclusions</h3><div>Low BP and higher IOP at baseline predicted faster (worse) RNFL RoCs in glaucoma patients with central damage or moderate to advanced disease. Although there may be potential benefits to BP management in glaucoma patients, the therapeutic value of BP manipulation in glaucoma patients is yet to be established given the proven benefits of tight BP control in reducing cardiovascular morbidity and mortality.</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 3","pages":"Pages 285-292"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933339","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.11.007
Wisam O. Najdawi BS , Fangfang Jiang MSc , Gideon K.D. Zamba PhD , Chris A. Johnson PhD , Andrew E. Pouw MD
Purpose
Perimetry is a critical tool for the diagnosis and monitoring of glaucomatous visual field defects. The Humphrey Field Analyzer (HFA) is a large, relatively expensive device that does not normally allow for examination outside of the clinic, and it can be ergonomically difficult to tolerate for some patients. The present study compared the novel Smart System Virtual Reality (SSVR) perimetric headset test to that of the HFA in a group of patients with glaucoma.
Design
Prospective comparative study.
Subjects
Seventy-two eyes from 36 patients with glaucoma recruited at the University of Iowa Hospitals and Clinics.
Methods
Patients completed both HFA and SSVR visual field tests on the same day, with the order of tests randomized. After completing both visual field tests, subjects completed a survey regarding their subjective experience using each perimeter. Visual fields were analyzed using a linear mixed model to assess differences between devices accounting for intereye correlation and Bland–Altman analysis.
Main Outcome Measures
Primary outcome measures included mean deviation (MD), pattern standard deviation (PSD), and test duration.
Results
No statistically significant difference in MD was observed between the SSVR (−7.17 ± 6.36 dB) and HFA (−6.88 ± 6.78 dB; P = 0.859). Statistically significant differences in PSD were observed between the SSVR (4.26 ± 2.37 dB) and HFA (6.38 ± 4.51 dB; P < 0.001) and test duration (323.44 ± 72.27 seconds and 372.20 ± 61.44 seconds, respectively; P < 0.001). Subjectively, the SSVR was the preferred perimeter by 88.5% of patients.
Conclusions
The SSVR headset is a novel visual field testing device that produces similar results to the HFA with a shorter testing duration. The SSVR was the preferred perimeter by the majority of patients. Future study is required to determine if the SSVR can identify visual field progression.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
{"title":"Comparison of a Novel Head-mounted Perimeter vs. the Humphrey Field Analyzer","authors":"Wisam O. Najdawi BS , Fangfang Jiang MSc , Gideon K.D. Zamba PhD , Chris A. Johnson PhD , Andrew E. Pouw MD","doi":"10.1016/j.ogla.2024.11.007","DOIUrl":"10.1016/j.ogla.2024.11.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Perimetry is a critical tool for the diagnosis and monitoring of glaucomatous visual field defects. The Humphrey Field Analyzer (HFA) is a large, relatively expensive device that does not normally allow for examination outside of the clinic, and it can be ergonomically difficult to tolerate for some patients. The present study compared the novel Smart System Virtual Reality (SSVR) perimetric headset test to that of the HFA in a group of patients with glaucoma.</div></div><div><h3>Design</h3><div>Prospective comparative study.</div></div><div><h3>Subjects</h3><div>Seventy-two eyes from 36 patients with glaucoma recruited at the University of Iowa Hospitals and Clinics.</div></div><div><h3>Methods</h3><div>Patients completed both HFA and SSVR visual field tests on the same day, with the order of tests randomized. After completing both visual field tests, subjects completed a survey regarding their subjective experience using each perimeter. Visual fields were analyzed using a linear mixed model to assess differences between devices accounting for intereye correlation and Bland–Altman analysis.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcome measures included mean deviation (MD), pattern standard deviation (PSD), and test duration.</div></div><div><h3>Results</h3><div>No statistically significant difference in MD was observed between the SSVR (−7.17 ± 6.36 dB) and HFA (−6.88 ± 6.78 dB; <em>P</em> = 0.859). Statistically significant differences in PSD were observed between the SSVR (4.26 ± 2.37 dB) and HFA (6.38 ± 4.51 dB; <em>P</em> < 0.001) and test duration (323.44 ± 72.27 seconds and 372.20 ± 61.44 seconds, respectively; <em>P</em> < 0.001). Subjectively, the SSVR was the preferred perimeter by 88.5% of patients.</div></div><div><h3>Conclusions</h3><div>The SSVR headset is a novel visual field testing device that produces similar results to the HFA with a shorter testing duration. The SSVR was the preferred perimeter by the majority of patients. Future study is required to determine if the SSVR can identify visual field progression.</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 3","pages":"Pages 213-226"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740485","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.12.001
Milton Louca MD , David Z. Wechsler MBBS (Hons), FRANZCO
{"title":"Protection from Steroid-Induced Glaucoma via iStent Inject in a Patient with Behçet’s Disease","authors":"Milton Louca MD , David Z. Wechsler MBBS (Hons), FRANZCO","doi":"10.1016/j.ogla.2024.12.001","DOIUrl":"10.1016/j.ogla.2024.12.001","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Pages 323-325"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824959","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.11.006
Clemens A. Strohmaier MD, PhD, Martin Kallab MD, PhD, Saige Oechsli BSc, Alex S. Huang MD, PhD, Osamah J. Saeedi MD, MS
{"title":"Minimally Invasive Glaucoma Surgery and the Distal Aqueous Outflow System: The Final Frontier?","authors":"Clemens A. Strohmaier MD, PhD, Martin Kallab MD, PhD, Saige Oechsli BSc, Alex S. Huang MD, PhD, Osamah J. Saeedi MD, MS","doi":"10.1016/j.ogla.2024.11.006","DOIUrl":"10.1016/j.ogla.2024.11.006","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Pages 209-212"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017049","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2024.11.001
Selvaraj Jerrome MSc, MPhil , Sanil Joseph MHA, MSc , Balasubramaniam Niranjana MS , Majumdar Arkaprava MSc , Pooludaiyar Lakshmanan MSc , Sundar Balagiri MSc , Thandavarayan Kumaragurupari PhD , S. Vidya DO , Vijayalakshmi A. Senthilkumar MS , Subbaiah R. Krishnadas DO, DNB
Topic
The systematic review and meta-analysis consolidates the extant body of evidence comparing reliability and agreement between transpalpebral tonometers (TTs) and Goldmann applanation tonometer (GAT).
Clinical Relevance
With a global prevalence of 3.54 percent, glaucoma stands as the second leading cause of preventable blindness. Projections indicate a rise to 111 million cases by 2040. Existing literature presents inconsistent findings while comparing TT and GAT. The derivation of summary estimates assessing their agreement holds significance, given TT’s multifaceted applicability in clinical, community, and home settings.
Methods
Systematic review was conducted using PubMed, Cochrane Library, and Google Scholar from January 2000 to December 2022. Two reviewers independently evaluated, enumerated, and extracted studies and data based on eligibility criteria. The Quality Assessment for Diagnostic Accuracy Studies checklist was used to assess study quality. The summary measures were pooled using the random-effects model as mean difference (MD), and 95% limits of agreement (LoA). We assessed heterogeneity using the I2 statistic. The study protocol was registered with the International Prospective Register of Systematic Reviews (CRD42022321693).
Results
A total of 26 methods comparison studies (3577 eyes) were included in the meta-analysis. The overall random-effects MD (TT – GAT) and standard deviation (SD) for intraocular pressure (IOP) were −0.70 ± 4.32 mmHg (95% LoA: −8.74 to 7.33 mmHg). In the subgroup analysis based on index test devices used, Easyton showed the lowest MD, SD, (−0.29 ± 2.35 mmHg), and 95% LoA (−4.90 to 4.32 mmHg). In the univariate meta-regression model, we found that, on average, studies examining normal eyes reported a statistically significant lower MD of 2.67 mmHg (95% confidence interval: 0.27–5.07 mmHg; P = 0.03) between TT and GAT, compared to studies that assessed eyes with mixed ocular condition.
Conclusion
In the current meta-analysis, we found a small MD in the measured IOP between the 2 tonometers. However, given the high heterogeneity and a wider LoA, it is not advisable to use TT interchangeably with GAT.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
{"title":"Agreement and Reliability of Transpalpebral Tonometers with Goldmann Applanation Tonometer","authors":"Selvaraj Jerrome MSc, MPhil , Sanil Joseph MHA, MSc , Balasubramaniam Niranjana MS , Majumdar Arkaprava MSc , Pooludaiyar Lakshmanan MSc , Sundar Balagiri MSc , Thandavarayan Kumaragurupari PhD , S. Vidya DO , Vijayalakshmi A. Senthilkumar MS , Subbaiah R. Krishnadas DO, DNB","doi":"10.1016/j.ogla.2024.11.001","DOIUrl":"10.1016/j.ogla.2024.11.001","url":null,"abstract":"<div><h3>Topic</h3><div>The systematic review and meta-analysis consolidates the extant body of evidence comparing reliability and agreement between transpalpebral tonometers (TTs) and Goldmann applanation tonometer (GAT).</div></div><div><h3>Clinical Relevance</h3><div>With a global prevalence of 3.54 percent, glaucoma stands as the second leading cause of preventable blindness. Projections indicate a rise to 111 million cases by 2040. Existing literature presents inconsistent findings while comparing TT and GAT. The derivation of summary estimates assessing their agreement holds significance, given TT’s multifaceted applicability in clinical, community, and home settings.</div></div><div><h3>Methods</h3><div>Systematic review was conducted using PubMed, Cochrane Library, and Google Scholar from January 2000 to December 2022. Two reviewers independently evaluated, enumerated, and extracted studies and data based on eligibility criteria. The Quality Assessment for Diagnostic Accuracy Studies checklist was used to assess study quality. The summary measures were pooled using the random-effects model as mean difference (MD), and 95% limits of agreement (LoA). We assessed heterogeneity using the I<sup>2</sup> statistic. The study protocol was registered with the International Prospective Register of Systematic Reviews (CRD42022321693).</div></div><div><h3>Results</h3><div>A total of 26 methods comparison studies (3577 eyes) were included in the meta-analysis. The overall random-effects MD (TT – GAT) and standard deviation (SD) for intraocular pressure (IOP) were −0.70 ± 4.32 mmHg (95% LoA: −8.74 to 7.33 mmHg). In the subgroup analysis based on index test devices used, Easyton showed the lowest MD, SD, (−0.29 ± 2.35 mmHg), and 95% LoA (−4.90 to 4.32 mmHg). In the univariate meta-regression model, we found that, on average, studies examining normal eyes reported a statistically significant lower MD of 2.67 mmHg (95% confidence interval: 0.27–5.07 mmHg; <em>P</em> = 0.03) between TT and GAT, compared to studies that assessed eyes with mixed ocular condition.</div></div><div><h3>Conclusion</h3><div>In the current meta-analysis, we found a small MD in the measured IOP between the 2 tonometers. However, given the high heterogeneity and a wider LoA, it is not advisable to use TT interchangeably with GAT.</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 3","pages":"Pages 242-256"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633590","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}
Pub Date : 2025-05-01DOI: 10.1016/j.ogla.2025.02.001
David A. Ramirez MD , Blair Shaman MA , Jennifer L. Rossen MD , Adam Jacobson MD , Brenda L. Bohnsack MD, PhD
Purpose
Assess the effect of social determinants of health on presentation and outcomes in primary congenital glaucoma (PCG).
Design
Retrospective case series.
Subjects
Patients with PCG presenting between 2011 and 2023 with > 3 months follow-up.
Methods
The percentage of households with 0, 1–2, or > 3 community resilience estimates (CREs) risk factors and median income for the census tract of residence for each patient were collected. Initial details and final outcomes were correlated with race, ethnicity, insurance type, and census tract data.
Main Outcome Measures
Final best-corrected visual acuity (BCVA).
Results
Of 59 patients (105 eyes, 68% male), the presenting average age was 294 ± 365 days. Black patients (n = 16) were younger (P < 0.001) than White (n = 31) or other race patients (n = 12). Although there was no racial or ethnic differences in initial intraocular pressure (IOP), IOP > 30 mmHg was associated with worse final BCVA. Patients with Medicaid (n = 31) required more glaucoma surgeries compared with those with commercial insurances (n = 28, P = 0.0305), respectively. Linear regression analysis demonstrated that census tracts with higher percentage of households with > 3 CRE risk factors correlated with worse visual acuity (ß = 0.02, P = 0.0028, R2 = 0.2). There were no racial, ethnic, insurance type, tract median income, or CRE risk factor differences in IOP, number of glaucoma medications, spherical equivalent, or cup-to-disc ratio at final follow-up.
Conclusions
Type of insurance and census data as markers for social determinants of health demonstrated increased risk factors can be associated with worse visual outcomes in PCG.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any materials discussed in this article.
{"title":"Influence of Social Determinants of Health on Presentation and Outcomes of Primary Congenital Glaucoma","authors":"David A. Ramirez MD , Blair Shaman MA , Jennifer L. Rossen MD , Adam Jacobson MD , Brenda L. Bohnsack MD, PhD","doi":"10.1016/j.ogla.2025.02.001","DOIUrl":"10.1016/j.ogla.2025.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Assess the effect of social determinants of health on presentation and outcomes in primary congenital glaucoma (PCG).</div></div><div><h3>Design</h3><div>Retrospective case series.</div></div><div><h3>Subjects</h3><div>Patients with PCG presenting between 2011 and 2023 with > 3 months follow-up.</div></div><div><h3>Methods</h3><div>The percentage of households with 0, 1–2, or > 3 community resilience estimates (CREs) risk factors and median income for the census tract of residence for each patient were collected. Initial details and final outcomes were correlated with race, ethnicity, insurance type, and census tract data.</div></div><div><h3>Main Outcome Measures</h3><div>Final best-corrected visual acuity (BCVA).</div></div><div><h3>Results</h3><div>Of 59 patients (105 eyes, 68% male), the presenting average age was 294 ± 365 days. Black patients (n = 16) were younger (<em>P</em> < 0.001) than White (n = 31) or other race patients (n = 12). Although there was no racial or ethnic differences in initial intraocular pressure (IOP), IOP > 30 mmHg was associated with worse final BCVA. Patients with Medicaid (n = 31) required more glaucoma surgeries compared with those with commercial insurances (n = 28, <em>P</em> = 0.0305), respectively. Linear regression analysis demonstrated that census tracts with higher percentage of households with > 3 CRE risk factors correlated with worse visual acuity (ß = 0.02, <em>P</em> = 0.0028, <em>R</em><sup><em>2</em></sup> = 0.2). There were no racial, ethnic, insurance type, tract median income, or CRE risk factor differences in IOP, number of glaucoma medications, spherical equivalent, or cup-to-disc ratio at final follow-up.</div></div><div><h3>Conclusions</h3><div>Type of insurance and census data as markers for social determinants of health demonstrated increased risk factors can be associated with worse visual outcomes in PCG.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 3","pages":"Pages 312-322"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460950","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}
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