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Lin S, Shang X, Wang X, Chu X, Hu C, Si Y, Chen DF, Zhou W, Kong YXG, Liang Y. Decreased macular deep capillary plexus is associated with functional progression of normal tension glaucoma patients with unilateral visual field loss. Br J Ophthalmol 2024; 108:188-194. [PMID: 36575622 DOI: 10.1136/bjo-2022-322362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate whether quantitative optical coherence tomography angiography (OCTA) metrics of the superficial/deep macular retina are associated with the development of visual field (VF) loss in the fellow eyes of normal tension glaucoma (NTG) patients with unilateral VF loss. METHODS A longitudinal study was conducted in which 61 eyes with normal VF (mean VF mean deviation -0.7±1.6 dB) from 61 NTG patients were included. All subjects underwent OCTA imaging, spectral-domain-OCT imaging and VF testing. OCTA metrics of superficial capillary plexus and deep capillary plexus (DCP) in the macular region were measured. Relationships between baseline OCTA metrics, demographics and ocular characteristics and the risk of VF glaucoma progression were analysed with a Cox proportional hazards model. RESULTS During a mean follow-up of 38 months, 11 fellow eyes (18.0%) with normal VF at baseline were determined to have VF progression, while 21.3% of affected eyes had VF progression. After adjustment for potential confounding factors, decreased baseline DCP in the fellow eyes was significantly associated with future VF progression (HR 1.33, 95% CI 1.03 to 1.73, p=0.031). CONCLUSION Decreased DCP was associated with a higher risk of developing VF damage in NTG patients with unilateral VF loss. Assessments of DCP may help improve the evaluation of the risk of functional deterioration in fellow eyes with an initially normal VF.
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Affiliation(s)
- Sigeng Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xiao Shang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xiaoyan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xizhong Chu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Chengju Hu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yuqing Si
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - De-Fu Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Weihe Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yu Xiang George Kong
- Department of Ophthalmology, The University of Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
- Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia
| | - Yuanbo Liang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Lee JY, Shin JW, Lee A, Baek MS, Kook MS. Association of baseline optical coherence tomography angiography with the development of glaucomatous visual field defects in preperimetric glaucoma eyes. Br J Ophthalmol 2023; 107:1621-1629. [PMID: 37863500 DOI: 10.1136/bjo-2021-321025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/22/2022] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate whether baseline vessel density (VD) parameters derived from optical coherence tomography angiography (OCT-A) is associated with the development of glaucomatous visual field (VF) defects in preperimetric glaucoma (PPG) patients. METHODS One eye from each of 200 consecutive PPG patients with a normal standard automated perimetry and OCT-A at baseline was retrospectively analysed. OCT-A was used to measure the circumpapillary VD (cpVD) and the parafoveal and perifoveal VD. The retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer thicknesses were measured as reference standards. Two patient groups were stratified based on the development of repeatable glaucomatous VF loss. A Cox proportional hazards model was constructed to determine the predictive ability of OCT-A parameters for VF defects. The correlation between these baseline OCT-A parameters and the rate of global VF sensitivity loss (dB/year) was calculated using linear regression analysis. RESULTS During a 3.1-year average follow-up period, 18 eyes (9.0%) developed glaucomatous VF defects. At baseline, the lower inferior temporal cpVD (HR (95% CI)=0.934 (0.883 to 0.988); p=0.017) and thinner inferior RNFL (HR (95% CI)=0.895 (0.839 to 0.956); p=0.001) were predictive of glaucomatous VF loss. A lower inferior temporal cpVD and thinner RNFL at baseline were associated with faster rate of global VF sensitivity loss (β=0.015; p=0.001). CONCLUSION In PPG eyes, a lower baseline inferior temporal cpVD is significantly associated with glaucomatous VF defect development and a faster rate of global VF loss.
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Affiliation(s)
- Jin Yeong Lee
- Department of Ophthalmology, Asan Medical Center, Seoul, Korea (the Republic of)
| | - Joong Won Shin
- Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea (the Republic of)
| | - Anna Lee
- Department of Ophthalmology, Asan Medical Center, Seoul, Korea (the Republic of)
| | - Min Su Baek
- Department of Ophthalmology, Asan Medical Center, Seoul, Korea (the Republic of)
| | - Michael S Kook
- Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea (the Republic of)
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Lee JY, Sung KR, Kim JM, Shin JW, Kim KE. Association Between Optic Disc Perfusion Determined by Swept-Source Optical Coherence Tomography Angiography and Visual Field Progression in Glaucoma. J Glaucoma 2023; 32:833-840. [PMID: 37523643 DOI: 10.1097/ijg.0000000000002275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
PRCIS Reduced optic disc vessel density determined by swept-source optical coherence tomography angiography (SS-OCTA) was associated with visual field (VF) deterioration in glaucomatous eyes, which suggested that this parameter can be a potential biomarker that correlates well with functional deterioration. PURPOSE The purpose of this study was to identify the association between optic disc perfusion evaluated by SS-OCTA and VF progression in primary open angle glaucoma (POAG) eyes. METHODS A total of 266 POAG eyes of 266 patients (5.4 y of mean follow-up) were included. Optic nerve head SS-OCTA was performed to evaluate the optic disc vessel density (dVD), parapapillary choroidal vessel density (pcVD), choroidal microvascular dropout (cMvD), and optic disc microvascular dropout (dMvD). VF progression was defined using Early Manifest Glaucoma Trial criteria. Factors associated with VF worsening were assessed by Cox proportional hazard analysis. RESULTS Eighty (30.1%) out of the 266 POAG eyes showed VF progression. The progression group showed a significantly higher proportion of disc hemorrhage, cMvD, and dMvD but lower dVD and pcVD than the stable group (all P <0.05). Considering the strong association between the parameters [dMvD vs. dVD ( r = -0.757, P =0.010], cMvD vs. pcVD ( r = -0.745, P =0.012), dMvD vs. cMvD ( r = 0.802, P <0.001], dVD vs. pcVD ( r = 0.862, P <0.001), CMvD vs. dVD ( r = -0.698, P =0.031), and dMvD vs. pcVD ( r = -0.688, P =0.034)], 6 models with different combinations of covariates compensating for multicollinearity were developed. Younger age, presence of disc hemorrhage, and lower dVD were consistently associated with progression in all models that included these parameters. CONCLUSIONS Optic disc perfusion, represented as dVD, may be a useful biomarker that correlates well with functional deterioration in POAG eyes.
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Affiliation(s)
- Jin Yeong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joong Won Shin
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ko Eun Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kiuchi Y, Inoue T, Shoji N, Nakamura M, Tanito M. The Japan Glaucoma Society guidelines for glaucoma 5th edition. Jpn J Ophthalmol 2023; 67:189-254. [PMID: 36780040 DOI: 10.1007/s10384-022-00970-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 02/14/2023]
Abstract
We are pleased to bring you the 5th edition of the Glaucoma Clinical Practice Guidelines. Clinical practice guidelines are based on evidence (scientific grounds). It is a document that presents the treatment that is the most appropriate for the patient. "Glaucoma Clinical Guidelines" was first published in 2003. This was the first guideline for glaucoma treatment in Japan. The principle of glaucoma treatment is to lower intraocular pressure. Means for lowering intraocular pressure includes drugs, lasers, and surgery; Glaucoma is a disease that should be considered as a complex syndrome rather than a single condition. Therefore, the actual medical treatment is not as simple as one word. This time we set the Clinical Questionnaire with a focus on glaucoma treatment. We hope that you will take advantage of the 5th edition.
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Affiliation(s)
- Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-31 Kasumi, Minami-ku, Hiroshima, Japan.
| | - Toshihiro Inoue
- Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Kumamoto, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Makoto Nakamura
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan
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Chan PP, Zhang Y, Pang CP. Myopic tilted disc: Mechanism, clinical significance, and public health implication. Front Med (Lausanne) 2023; 10:1094937. [PMID: 36844216 PMCID: PMC9947511 DOI: 10.3389/fmed.2023.1094937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Myopic tilted disc is a common structural change of myopic eyes. With advancing ocular imaging technology, the associated structural changes of the eye, particularly the optic nerve head, have been extensively studied. These structural changes may increase patients' susceptibility to axonal damage and the risk of developing serious optic neuropathies including glaucoma. They also lead to diagnostic difficulties of disease suspects and treatment dilemmas of patients, which implicate clinical practice and subsequently the health care system. In the context of the mounting prevalence of myopia worldwide and its implications to irreversible visual impairment and blindness, it is essential to gain a thorough understanding of the structural changes of myopia. Myopic tilted disc has been extensively investigated by different study groups. However, generalizing the knowledge could be difficult because of the variable definitions of myopic tilted disc utilized in these studies and the complexities of the changes. The current review aimed to clarify the concepts and discuss various aspects of myopic tilted disc, including the definitions, association with other myopia-related changes, mechanism of tilted disc development, structural and functional changes, and clinical implications.
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Affiliation(s)
- Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Hong Kong Eye Hospital, Hong Kong, Hong Kong SAR, China,Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China,*Correspondence: Poemen P. Chan,
| | - Yuqiao Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Joint Shantou International Eye Centre of Shantou University, The Chinese University of Hong Kong, Shantou, Hong Kong SAR, China,Chi Pui Pang,
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Jaumandreu L, Antón A, Pazos M, Rodriguez-Uña I, Rodriguez Agirretxe I, Martinez de la Casa JM, Ayala ME, Parrilla-Vallejo M, Dyrda A, Díez-Álvarez L, Rebolleda G, Muñoz-Negrete FJ. Glaucoma progression. Clinical practice guide. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:40-57. [PMID: 36089479 DOI: 10.1016/j.oftale.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To provide general recommendations that serve as a guide for the evaluation and management of glaucomatous progression in daily clinical practice based on the existing quality of clinical evidence. METHODS After defining the objectives and scope of the guide, the working group was formed and structured clinical questions were formulated following the PICO (Patient, Intervention, Comparison, Outcomes) format. Once all the existing clinical evidence had been independently evaluated with the AMSTAR 2 (Assessment of Multiple Systematic Reviews) and Cochrane "Risk of bias" tools by at least two reviewers, recommendations were formulated following the Scottish Intercollegiate Guideline network (SIGN) methodology. RESULTS Recommendations with their corresponding levels of evidence that may be useful in the interpretation and decision-making related to the different methods for the detection of glaucomatous progression are presented. CONCLUSIONS Despite the fact that for many of the questions the level of scientific evidence available is not very high, this clinical practice guideline offers an updated review of the different existing aspects related to the evaluation and management of glaucomatous progression.
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Affiliation(s)
- L Jaumandreu
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - A Antón
- Institut Català de la Retina (ICR), Barcelona, Spain; Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M Pazos
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - I Rodriguez-Uña
- Instituto Oftalmológico Fernández-Vega, Universidad de Oviedo, Oviedo, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - I Rodriguez Agirretxe
- Servicio de Oftalmología, Hospital Universitario Donostia, San Sebastián, Gipuzkoa, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - J M Martinez de la Casa
- Servicio de Oftalmología, Hospital Clinico San Carlos, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), IIORC, Universidad Complutense de Madrid, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M E Ayala
- Institut Català de la Retina (ICR), Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M Parrilla-Vallejo
- Servicio de Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A Dyrda
- Institut Català de la Retina (ICR), Barcelona, Spain
| | - L Díez-Álvarez
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - G Rebolleda
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Lauwers A, Barbosa Breda J, Stalmans I. The natural history of untreated ocular hypertension and glaucoma. Surv Ophthalmol 2022; 68:388-424. [PMID: 36563707 DOI: 10.1016/j.survophthal.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022]
Abstract
Glaucoma is a chronic, progressive disease leading to irreversible blindness if left untreated; however, since reducing intraocular pressure has proven to be successful in slowing disease progression, little is known about the natural history of untreated glaucoma. This knowledge can be valuable in guiding management decisions in the era of personalized medicine. A systematic search was performed in Medline (PubMed), Embase, and Web of Science in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRIMSA) guidelines. The rate of structural and/or functional progression and conversion to glaucoma or to a more advanced stage of glaucoma are discussed for ocular hypertension and different types of open-angle glaucoma. Forty-three studies were included. Different rates of progression were found both among and within the different diagnostic groups that belong to the open-angle glaucoma spectrum. The highest rate was found in pseudoexfoliation glaucoma, followed by high tension glaucoma, normal tension glaucoma, and ocular hypertension, in decreasing order. The lowest rate was observed in glaucoma suspects. The known rates of progression provide valuable prognostic information for ophthalmologists and patients. Nonetheless, due to high variability among patients, individual progression cannot be accurately predicted and repeated follow-up examinations are required to estimate individual progression.
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Affiliation(s)
- Amelien Lauwers
- Department of Ophthalmology, Faculty of Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - João Barbosa Breda
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium; Department of Ophthalmology, Centro Hospitalar e Universitário São João, 4200-319 Porto, Portugal; Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal.
| | - Ingeborg Stalmans
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium; Department of Ophthalmology, University Hospitals Leuven, 3000 Leuven, Belgium
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Patterns of Optical Coherence Tomography Imaging in Preperimetric Open Angle Glaucoma: A Comparative Study With Young-Age-Onset and Old-Age-Onset Eyes. J Glaucoma 2022; 31:860-867. [PMID: 35980848 DOI: 10.1097/ijg.0000000000002104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
PRCIS Optic coherence tomography imaging in preperimetric open angle glaucoma (OAG) differed between young-age-onset and old-age-onset eyes. Inferior and superior quadrants were thinner in young and old-age-onset eyes, respectively. Understanding the specific patterns of early glaucomatous damage based on age-at-onset may improve glaucoma diagnosis and monitoring. PURPOSE To investigate the patterns of retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thinning in preperimetric OAG by optical coherence tomography based on age at onset ("young-age onset (<40 y)" vs. "old-age onset (≥40 y)". MATERIALS AND METHODS The RNFL and GCIPL deviation images were acquired by Cirrus HD-optical coherence tomography, and overlaid, thus converted to a "deviation frequency map", respectively. The topographic thinning patterns and parameters of RNFL and GCIPL thickness measurements were compared. RESULTS A total of 194 eyes of 194 patients with preperimetric OAG and 97 eyes of 97 age-matched normal subjects were analyzed. Young-age-onset eyes of preperimetric OAG mainly had RNFL defects inferotemporally (264-296 degrees) with GCIPL defects in the inferior region (213-357 degrees). Old-age-onset preperimetric OAG eyes had RNFL defects inferotemporally (266-294°) and superotemporally (33-67 degrees), with GCIPL defects in the inferior and superior regions (206-360 degrees, 0-22 degrees). The inferior quadrant of RNFL and GCIPL thicknesses were significantly thinner in young-age-onset eyes compared with old-age-onset eyes ( P =0.012, 0.016), while the superior quadrant of those were significantly thinner in the old-age-onset eyes ( P =0.003, 0.005). CONCLUSION Young-age-onset and old-age-onset eyes of preperimetric OAG present different specific patterns of RNFL and GCIPL thinning.
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Impact of Systemic Comorbidities on Ocular Hypertension and Open-Angle Glaucoma, in a Population from Spain and Portugal. J Clin Med 2022; 11:jcm11195649. [PMID: 36233515 PMCID: PMC9570920 DOI: 10.3390/jcm11195649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Open-angle glaucoma (OAG), the most prevalent clinical type of glaucoma, is still the main cause of irreversible blindness worldwide. OAG is a neurodegenerative illness for which the most important risk factor is elevated intraocular pressure (IOP). Many questions remain unanswered about OAG, such as whether nutritional or toxic habits, other personal characteristics, and/or systemic diseases influence the course of glaucoma. As such, in this study, we performed a multicenter analytical, observational, case–control study of 412 participants of both sexes, aged 40–80 years, that were classified as having ocular hypertension (OHT) or OAG. Our primary endpoint was to investigate the relationship between specific lifestyle habits; anthropometric and endocrine–metabolic, cardiovascular, and respiratory events; and commonly used psychochemicals, with the presence of OHT or OAG in an ophthalmologic population from Spain and Portugal. Demographic, epidemiological, and ocular/systemic clinical data were recorded from all participants. Data were analyzed using the R Statistics v4.1.2 and RStudio v2021.09.1 programs. The mean age was 62 ± 15 years, with 67–80 years old comprising the largest subgroup sample of participants in both study groups. The central corneal thickness (ultrasound pachymetry)-adjusted IOP (Goldman tonometry) in each eye was 20.46 ± 2.35 and 20.1 ± 2.73 mmHg for the OHT individuals, and 15.8 ± 3.83 and 16.94 ± 3.86 mmHg for the OAG patients, with significant differences between groups (both p = 0.001). The highest prevalence of the surveyed characteristics in both groups was for overweight/obesity and daily coffee consumption, followed by psychochemical drug intake, migraine, and peripheral vasospasm. Our data show that overweight/obesity, migraine, asthma, and smoking are major risk factors for conversion from OHT to OAG in this Spanish and Portuguese population.
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Affiliation(s)
- Jeffrey K Aronson
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
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11
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Yan Z, Liao H, Deng C, Zhong Y, Mayeesa TZ, Zhuo Y. DNA damage and repair in the visual center in the rhesus monkey model of glaucoma. Exp Eye Res 2022; 219:109031. [DOI: 10.1016/j.exer.2022.109031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 11/04/2022]
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12
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Selvan H, Gupta S, Wiggs JL, Gupta V. Juvenile-onset open-angle glaucoma - A clinical and genetic update. Surv Ophthalmol 2022; 67:1099-1117. [PMID: 34536459 PMCID: PMC9192165 DOI: 10.1016/j.survophthal.2021.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 01/03/2023]
Abstract
Juvenile-onset open-angle glaucoma (JOAG) is a subset of primary open-angle glaucoma that is diagnosed before 40 years of age. The disease may be familial or non-familial, with proportions varying among different populations. Myocilin mutations are the most commonly associated. JOAG is characterized by high intraocular pressures (IOP), with many patients needing surgery. The mean age at diagnosis is in the 3rd decade, with a male preponderance. Myopia is a common association. The pathophysiology underlying the disease is immaturity of the conventional outflow pathways, which may or may not be observed on gonioscopy and anterior segment optical coherence tomography. The unique optic nerve head features include large discs with deep, steep cupping associated with high IOP-induced damage. Progression rates among JOAG patients are comparable to adult primary glaucomas, but as the disease affects younger patients, the projected disability from this disease is higher. Early diagnosis, prompt management, and life-long monitoring play an important role in preventing disease progression. Gene-based therapies currently under investigation offer future hope.
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Affiliation(s)
- Harathy Selvan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shikha Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Janey L. Wiggs
- Ocular Genomics Institute, Massachusetts Eye and Ear, Boston, MA, USA,Department of Ophthalmology, Harvard Medical School, MA, USA
| | - Viney Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India,Corresponding author: Viney Gupta, MD, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029 India. (V. Gupta)
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García-Medina JJ, Pinazo-Durán MD. Updates in Clinical and Translational Glaucoma Research. J Clin Med 2021; 11:jcm11010221. [PMID: 35011961 PMCID: PMC8745984 DOI: 10.3390/jcm11010221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/28/2021] [Indexed: 12/22/2022] Open
Abstract
Glaucoma is a sight-threatening disease and the primum mobile of irreversible blindness worldwide [...].
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Affiliation(s)
- José Javier García-Medina
- Department of Ophthalmology, General University Hospital Morales Meseguer, 30007 Murcia, Spain
- Department of Ophthalmology and Optometry, University of Murcia, 30120 Murcia, Spain
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Correspondence: (J.J.G.-M.); (M.D.P.-D.)
| | - Maria Dolores Pinazo-Durán
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Ophthalmic Research Unit “Santiago Grisolia”/FISABIO, 46017 Valencia, Spain
- Cellular and Molecular Ophthalmobiology Group, University of Valencia, 46010 Valencia, Spain
- Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Correspondence: (J.J.G.-M.); (M.D.P.-D.)
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The Diagnostic Value of Pulsar Perimetry, Optical Coherence Tomography, and Optical Coherence Tomography Angiography in Pre-Perimetric and Perimetric Glaucoma. J Clin Med 2021; 10:jcm10245825. [PMID: 34945121 PMCID: PMC8706528 DOI: 10.3390/jcm10245825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/28/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this article is to investigate the diagnostic value of Pulsar perimetry (PP), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in pre-perimetric glaucoma (PPG) and perimetric glaucoma (PG). This retrospective cross-sectional study included 202 eyes (145 eyes in the control group, 40 eyes in the PPG group, and 17 eyes in the PG group) from 105 subjects. The results were analyzed by paired t-tests and Wilcoxon signed-rank test. The area under the curve (AUC), sensitivity, and specificity were used to evaluate the diagnostic accuracy. Pearson correlation was used to investigate the relationships of each parameter. The most sensitive parameters for differentiating the control group from the PPG group by using Pulsar, OCT, and OCTA were square loss variance of PP (AUC = 0.673, p < 0.001), superior ganglion cell complex thickness (AUC = 0.860, p < 0.001), and superior-hemi retina thickness (AUC = 0.817, p < 0.001). In the PG group, the most sensitive parameters were mean defect of PP (AUC = 0.885, p < 0.001), whole image of ganglion cell complex thickness (AUC = 0.847, p < 0.001), and perifoveal retina thickness (AUC = 0.833, p < 0.001). The mean defect of PP was significantly correlated with vascular parameters (radial peripapillary capillary (RPC), p = 0.008; vessel density of macular superficial vascular complex (VDms), p = 0.001; vessel density of macular deep vascular complex (VDmd), p = 0.002). In conclusion, structural measurements using OCT were more sensitive than vascular measurements of OCTA and functional measurements of PP for PPG, while PP was more sensitive than the structural and vascular measurements for PG. The mean defect of PP was also shown to be highly correlated with the reduction of vessel density.
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Ha A, Chung W, Shim SR, Kim CY, Chang IB, Kim YK, Park KH. Association of Optic Disc Tilt and Torsion with Open-Angle Glaucoma Progression Risk: Meta-Analysis and Meta-Regression Analysis. Am J Ophthalmol 2021; 232:30-39. [PMID: 34107309 DOI: 10.1016/j.ajo.2021.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/15/2021] [Accepted: 06/01/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE To evaluate the association of optic disc deformation with open-angle glaucoma (OAG) progression risk. DESIGN Meta-analysis and meta-regression analysis. METHODS Reports on the association of optic disc tilt and/or torsion with OAG progression published to June 2020 were identified in the PubMed, EMBASE, and Cochrane databases. Tilt ratio was measured as the longest-to-shortest diameter ratio of the optic disc. The angle (in degrees) between the vertical meridian and the disc's long axis was defined as the torsional angle. We used random-effects models to combine the pooled effects. Random-effects meta-regression was used to quantify the study characteristics' potential moderating influences. The protocol was registered in the PROSPERO International Database (CRD42020201151). RESULTS Eleven longitudinal studies (1100 participants) were included. For 10 of them evaluated for tilt ratio and glaucoma progression, the pooled hazard ratio (HR) was 0.988 (95% confidence interval [CI] 0.921-1.059; I2 = 59%) per 0.1-unit increase. In the meta-regression-based subgroup analysis, risk tended to decrease as the patients' mean age increased (P = .08). For 7 of the studies (605 patients) reporting data on torsion and glaucoma progression, the pooled HR was 0.936 (95% CI 0.860-1.018; I2 = 32%) per 10-degree increase. The meta-regression analyses showed that the glaucoma progression assessment methods had a modulating influence (P = .01). In studies assessing just functional glaucomatous progression, the pooled HR was 0.890 (95% CI 0.831-0.952; I2 = 0%). CONCLUSION Evidence for the effects of optic nerve deformation on glaucoma progression is still lacking. Future research using stratified analysis according to age and tailored diagnostic criteria will allow for more rigorous analyses for this topic.
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Affiliation(s)
- Ahnul Ha
- From the Department of Ophthalmology (A.H., Y.K.K., K.H.P.), Seoul National University College of Medicine, Seoul; Department of Ophthalmology (A.H.), Jeju National University Hospital, Jeju-si
| | - Woosuk Chung
- Preliminary Medicine Courses (W.C.), Seoul National University College of Medicine, Seoul
| | - Sung Ryul Shim
- Department of Preventive Medicine (S.R.S.), Korea University College of Medicine, Seoul
| | | | | | - Young Kook Kim
- From the Department of Ophthalmology (A.H., Y.K.K., K.H.P.), Seoul National University College of Medicine, Seoul; Department of Ophthalmology (Y.K.K., K.H.P.), Seoul National University Hospital, Seoul.
| | - Ki Ho Park
- From the Department of Ophthalmology (A.H., Y.K.K., K.H.P.), Seoul National University College of Medicine, Seoul; Department of Ophthalmology (Y.K.K., K.H.P.), Seoul National University Hospital, Seoul
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