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Sun CQ, McSoley MJ, Lum F, Chang TC, Gedde SJ, Vanner EA. Tube Versus Trabeculectomy IRIS Registry Study: 1-Year Secondary Treatment Outcomes. Am J Ophthalmol 2023; 256:97-107. [PMID: 37625509 PMCID: PMC11085044 DOI: 10.1016/j.ajo.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE To describe 1-year secondary outcomes in the Tube Versus Trabeculectomy IRIS® (Intelligent Registry In Sight) Registry Study (TVTIRIS), and to compare to the TVT randomized controlled trial (TVTRCT). DESIGN TVTIRIS was a retrospective cohort study. METHODS The 2013-2017 IRIS Registry was used to identify eyes that received a tube shunt (tube) or trabeculectomy after a previous trabeculectomy and/or cataract surgery and had 1 year of follow-up. The TVTRCT compared a Baerveldt 350-mm2 glaucoma implant to trabeculectomy in similar eyes. RESULTS In the TVTIRIS cohort, the tube (n = 236, 56.3%) and trabeculectomy (n = 183, 43.7%) groups had similar and significant reductions in intraocular pressure (IOP) from baseline to 1 year. In the tube group, IOP (mean ± SD) decreased from 26.6 ± 6.5 mm Hg at baseline to 14.3 ± 4.8 mm Hg at 1 year. In the trabeculectomy group, IOP decreased from 25.3 ± 6.4 mm Hg at baseline to 13.5 ± 5.2 mm Hg at 1 year. The trabeculectomy groups from both studies had similar 1-year IOP reduction (P = .18), although the TVTRCT cohort used fewer medications at all time points (P < .01). There were more pronounced differences in the mean IOP and medications between the tube groups in the 2 studies, presumably due to the inclusion of valved tubes in TVTIRIS. More reoperations occurred in TVTIRIS. CONCLUSIONS The TVTIRIS tube and trabeculectomy groups had comparable 1-year IOP reduction, although trabeculectomy eyes used fewer glaucoma medications. The trabeculectomy group in TVTIRIS and TVTRCT had similar IOP and medication reduction at 1 year. Randomized controlled trials and electronic health record data both provide invaluable insight into surgical outcomes.
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Affiliation(s)
- Catherine Q Sun
- From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA; Department of Ophthalmology (C.Q.S.), University of California, San Francisco, California, USA; F.I. Proctor Foundation (C.Q.S.), University of California, San Francisco, California, USA.
| | - Matthew J McSoley
- From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA; University of Miami Miller School of Medicine (M.J.M.), Miami, Florida, USA
| | - Flora Lum
- American Academy of Ophthalmology (F.L.), San Francisco, California, USA
| | - Ta C Chang
- From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA
| | - Steven J Gedde
- From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA
| | - Elizabeth A Vanner
- From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA
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Liu Y, Yao B, Chen X, Yang X, Liu Y, Xie Z, Chen X, Yuan Z, Wang X, Hu D, Ma X, Gao W, Wang R, Yang Y, Chen S, Zhang J, Song Z, Wang J, Wang J, Pei J, Wang W, Wang M, Gao J, Zhang H, Tan L, Du W, Pan X, Liu G, Du X, Hou X, Gao X, Zhang Z, Shen Z, Wu C, Yan X, Bo S, Sun X, Tang NJ, Zhang C, Yan H. Glaucoma in rural China (the Rural Epidemiology for Glaucoma in China (REG-China)): a national cross-sectional study. Br J Ophthalmol 2023; 107:1458-1466. [PMID: 35840290 DOI: 10.1136/bjo-2021-320754] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China. DESIGN A population-based cross-sectional study. METHODS All participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. RESULTS From June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye. CONCLUSIONS Rural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.
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Affiliation(s)
- Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Yong Liu
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Zhenggao Xie
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiaofeng Chen
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Zhigang Yuan
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xingrong Wang
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Dan Hu
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xiang Ma
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Weiqi Gao
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ruifeng Wang
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Yuzhong Yang
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Song Chen
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingkai Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zuoqing Song
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Junsu Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Wang
- Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinyun Pei
- Department of Ophthalmology, Santan Hospital, Tianjin, China
| | - Weijuan Wang
- Department of Ophthalmology, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Meiyan Wang
- Department of Ophthalmology, Tianjin Haibin People's Hospital, Tianjin, China
| | - Jun Gao
- Department of Ophthalmology, Tianjin Third Central Hospital, Tianjin, China
| | - Hongwen Zhang
- Department of Ophthalmology, Tianjin Jizhou District People's Hospital, Tianjin, China
| | - Lian Tan
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Wei Du
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xuehui Pan
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Gang Liu
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xiujuan Du
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Xu Hou
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xin Gao
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Zhen Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhansheng Shen
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Changfu Wu
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Xiaochang Yan
- National School of Development, Peking University, Beijing, China
| | - Shaoye Bo
- Department of Supervisory Board, China Foundation for Disabled Persons, Beijing, China
| | - Xinghuai Sun
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Eye Center, Third Hospital of Peking University, Beijing, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
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Sen S, Mishra A, Das M, Iyer V, Sethi M. Assessment of quality of life in glaucoma patients in a tertiary care center in Eastern India. Indian J Ophthalmol 2023; 71:2767-2772. [PMID: 37417118 PMCID: PMC10491073 DOI: 10.4103/ijo.ijo_3050_22] [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: 11/19/2022] [Revised: 04/11/2023] [Accepted: 05/26/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose The aim of this study is to assess the quality of life (QOL) in glaucoma patients and find out the sociodemographic factors predicting QOL. Methods A cross-sectional study was conducted in a tertiary care center from August 2021 to February 2022. Subjects diagnosed with glaucoma for at least 6 months were enrolled. After taking informed consent, demographic details and detailed history were collected for all patients. Comprehensive eye examination (visual acuity, intraocular pressure, gonioscopy, fundoscopy, visual field assessment, ocular coherence tomogram assessment) was done for all and they were asked to fill the WHOQOL-BREF questionnaire. Data were collected and analyzed using SPSS 21. Results One hundred and ninety-nine patients were recruited. Mean age of participants was 57.99 ± 10.76 years. Based on various domains and subgroups, QOL values were significant with respect to income (P = 0.016). Gender-wise QOL in females was lower than that of males with respect to all the domains (P = 0.001). While marital status affected both environmental and social domain, literacy affected only the social domain. A variation in intraocular pressure affected the QOL in the psychological domain. QOL was not significantly associated with the severity of the disease. Gender was the most predominant predictor out of all sociodemographic factors. Conclusion Chronic diseases affect the QOL of individuals in many ways. Glaucoma being a chronic disease hampers patients' vision irreversibly and by extension the various physical, social, and psychological aspects of the patient's life as well. Hence, knowledge of the change in QOL it brings about can help plan the treatment, counseling, and management of these patients.
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Affiliation(s)
- Saswati Sen
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Alpana Mishra
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Matuli Das
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Vanaja Iyer
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mehak Sethi
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Cho HK, Han JC, Choi JA, Chae JE, Kim RB. Association between atrial fibrillation and the risk of glaucoma development: a 12-year Nationwide cohort study. Eye (Lond) 2023; 37:2033-2041. [PMID: 36371604 PMCID: PMC10333229 DOI: 10.1038/s41433-022-02274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 09/02/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the risk of glaucoma development in patients with atrial fibrillation (A-fib) using Korean National Health Insurance Service data. METHODS The present study used a National Sample Cohort consisting of approximately one million random subjects who were tracked from 2002 to 2013 (12 years). Newly diagnosed glaucoma and A-fib were included based on the Korean Classification of Disease codes. The A-fib group consisted of patients who received an initial A-fib diagnosis between January 2003 and December 2007 as an index period (n = 8765). The control group (n = 43,352) was selected using a 1:5 propensity-score matching for social and demographic factors. Each subject was followed up until 2013. Multivariate Cox proportional hazard regression analysis was performed to compare the risk of glaucoma development between the A-fib group and the control group. RESULTS The rate of glaucoma development was 3.54% in the A-fib group and 2.96% in the control group (P < 0.0001). A-fib increased the risk of glaucoma development [hazard ratio = 1.31; 95% confidence interval (CI): 1.15 to 1.48] after adjusting for age, sex, comorbidities, residence, household income, and year of enrollment. In multivariable Cox regression analysis, patients with comorbidity of diabetes mellitus and chronic renal failure and those aged ≥50 years showed significantly higher risk of glaucoma development (all P < 0.001). CONCLUSIONS A-fib was significantly associated with the development of glaucoma after adjusting for potential confounding factors. Physicians may need to monitor patients with A-fib carefully for possible glaucoma development.
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Affiliation(s)
- Hyun-Kyung Cho
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Gyeongsang National University, School of Medicine, Changwon, Republic of Korea.
- lnstitute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea.
| | - Jong Chul Han
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin A Choi
- Department of Ophthalmology, St Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Republic of Korea
| | - Jae Eun Chae
- STAT Department, LSK Global Pharma Services, Seoul, Republic of Korea
| | - Rock Bum Kim
- Regional Cardiocerebrovascular Disease Center, Gyeongsang National University, Jinju, Republic of Korea
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Sun Y, Chen A, Zou M, Liu Z, Young CA, Zheng D, Jin G. Disease Burden of Glaucoma in China: Findings from the Global Burden of Disease 2019 Study. Clin Epidemiol 2022; 14:827-834. [PMID: 35815296 PMCID: PMC9266675 DOI: 10.2147/clep.s357188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/22/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To provide evidence for future strategies in preventing glaucomatous blindness by investigating the disease burden in terms of age, year, and gender from 1990 to 2019 in China. Methods The prevalence and disability-adjusted life years (DALYs) of blindness and vision loss due to glaucoma in China were extracted from the Global Burden of Disease (GBD) 2019 study. Age-standardized data is presented in comparison to China’s neighboring countries. Results From 1990 to 2019, the prevalent cases and DALYs number with glaucomatous blindness and vision loss increased by 129.53% and 67.29%, respectively. Overall, higher age-standardized prevalence and DALYs rate were detected in males than in females between 1990 and 2019, and people aged 60 to 89 years suffered from a higher DALY number than other age groups in 2019. Among the neighboring countries, China ranked from fourth in 1990 (88.52, 95% uncertainty interval [UI]: 74.62 to 103.24, per 100,000 population) to third in 2019 (71.14, 95% UI: 59.34 to 84.42, per 100,000 population) in age-standardized prevalence while from fourth in 1990 (10.13, 95% UI: 6.68 to 14.46, per 100,000 population) to sixth in 2019 (5.98, 95% UI: 4.14 to 8.42, per 100,000 population) in age-standardized DALYs. Compared with other GBD regions, the largest decrease in age-standardized DALY rate due to glaucoma was found in China (−40.87%, 95% UI: −43.97% to −37.82%). A higher percentage decrease in age-standardized prevalence was also found in China (−19.66%, 95% UI: −22.44% to −17.09%). Conclusion Substantial increases in the prevalence of visual impairment and DALYs number of glaucoma were observed from 1990 to 2019. Efforts targeting glaucoma prevention and treatment in China are urgently required, especially for the elderly population and men.
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Affiliation(s)
- Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Aiming Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People’s Republic of China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Charlotte Aimee Young
- Department of Ophthalmology, Third Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
- Correspondence: Guangming Jin; Danying Zheng, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, #54 Xianlie South Road, Yuexiu District, Guangzhou, 510060, People’s Republic of China, Email ;
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Fine Particulate Matter Exposure Levels in Patients with Normal-Tension Glaucoma and Primary Open-Angle Glaucoma: A Population-Based Study from Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074224. [PMID: 35409910 PMCID: PMC8998620 DOI: 10.3390/ijerph19074224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/20/2022]
Abstract
Patients with NTG or POAG with more than one outpatient or discharge diagnosis from the ophthalmology department were included in the study. These data were merged with the PM2.5 data from the Air Quality Monitoring Network for analysis. This was a case−control study, with 1006 participants in the NTG group and 2533 in the POAG group. To investigate fine particulate matter (PM2.5) exposure levels in patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG), patient data were obtained from Taiwan’s Longitudinal Health Insurance Database 2000 for the 2008 to 2013 period. We used a multivariate logic regression model to assess the risk for each participant. The PM2.5 exposure levels were divided into four groups: <25th percentile (Q1), <617 μg/mm3; 25th to 50th percentile (Q2), 617 to 1297 μg/mm3; 50th to 75th percentile (Q3), 1297 to 2113 μg/mm3; and >75th percentile (Q4), >2113 μg/mm3. The results are expressed in terms of odds ratio (OR) and 95% CI. A multiple logistic regression was used to compare the results of the NTG group with those of the POAG group. Compared with the PM2.5 Q1 level, the OR of the PM2.5 Q2 level was 1.009 (95% CI 0.812−1.254), the PM2.5 Q3 level was 1.241 (95% CI 1.241−1.537, p < 0.05), and the PM2.5 Q4 level was 1.246 (95% CI 1.008−1.539, p < 0.05). Our research reveals that compared with POAG, the risk of developing NTG is more closely related with PM2.5 exposure, and PM2.5 has a concentration−dose effect. It is hoped that in the future, in the clinical judgment of NTG and POAG, the level of PM2.5 in the environment can be taken as a risk factor.
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Sun Y, Chen A, Zou M, Zhang Y, Jin L, Li Y, Zheng D, Jin G, Congdon N. Time trends, associations and prevalence of blindness and vision loss due to glaucoma: an analysis of observational data from the Global Burden of Disease Study 2017. BMJ Open 2022; 12:e053805. [PMID: 34992115 PMCID: PMC8739070 DOI: 10.1136/bmjopen-2021-053805] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To estimate global prevalence of blindness and vision loss caused by glaucoma, and to evaluate the impact of socioeconomic factors on it. DESIGN A population-based observational study. SETTING The prevalence of blindness and vision loss due to glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), inequality-adjusted HDI and other socioeconomic data were acquired from international open databases. MAIN OUTCOME MEASURES The prevalence of blindness and vision loss due to glaucoma by age, gender, subregion and Socio-Demographic Index (SDI) levels. Multiple linear regression analysis was performed to explore the associations between the prevalence and socioeconomic indicators. RESULTS The overall age-standardised prevalence of blindness and vision loss due to glaucoma worldwide was 81.5 per 100 000 in 1990 and 75.6 per 100 000 in 2017. In 2017, men had a higher age-standardised prevalence than women (6.07% vs 5.42%), and the worldwide prevalence increased with age, from 0.5 per 100 000 in the 45-49 year age group to 112.9 per 100 000 among those 70+. Eastern Mediterranean and African regions had the highest prevalence during the whole period, while the Americas region had the lowest prevalence. The prevalence was highest in low-SDI and low-income regions while lowest in high-SDI and high-income regions over the past 27 years. Multiple linear regression showed cataract surgery rate (β=-0.01, p=0.009), refractive error prevalence (β=-0.03, p=0.024) and expected years of schooling (β= -8.33, p=0.035) were associated with lower prevalence, while gross national income per capita (β=0.002, p<0.001) was associated with higher prevalence. CONCLUSIONS Lower socioeconomic levels and worse access to eyecare services are associated with higher prevalence of glaucoma-related blindness and vision loss. These findings provide evidence for policy-makers that investments in these areas may reduce the burden of the leading cause of irreversible blindness.
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Affiliation(s)
- Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Aiming Chen
- Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yichi Zhang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yi Li
- Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, Hongkong, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Orbis International, New York, New York, USA
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Shakya R, Ahlawat R, Ahluwalia NS, Kuyyadiyil S, Jain B, Shah C. Reasons for Delayed Presentation for Cataract Surgery in Patients of Lens Induced Glaucoma - A Questionnaire-based Study at a Tertiary Eye Care Centre of Central Rural India. Ophthalmic Epidemiol 2021; 29:656-661. [PMID: 34781811 DOI: 10.1080/09286586.2021.2002914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the socioeconomic profile, awareness level and reasons for the delay in accessing timely eye care for cataract surgery in patients of lens-induced glaucoma (LIG). METHODS This cross-sectional observational study included all patients with LIG who presented to a tertiary eye care centre in central rural India between March 2019 to February 2020. Data were collected through a questionnaire. RESULTS Out of the 731 patients included in the study, the majority were females (69.36%). The mean age of the patients at presentation was 62.66 ± 10.37 years. Only a few participants, 193 (26.40%) were aware of LIG. Lower socioeconomic profile, older age, female gender and illiteracy were found to be strongly associated with awareness about LIG (p < .001). Patients waiting for the winter season (58.27%) to get operated was the major reason for delayed presentation to the hospital. Other reasons for the delayed presentation were - need not felt (feeling that intervention was not necessary) due to good vision in other eye (14.36%), financial issues (11.63%), long travelling distance (7.11%), no caretaker (6.89%), medical illness (1.78%) and fear of surgery (0.55%). CONCLUSION Delayed reporting for eye healthcare in patients of LIG is found to be multifactorial. Most patients preferred waiting for the winter season to get their eyes operated, which throws light on the mindset and ignorance of the patients in this part of central rural India. We further emphasize on strengthening the education and counseling efforts in the community to enable patients to access services in a timely fashion.
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Affiliation(s)
- Rakesh Shakya
- Department of Glaucoma, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
| | - Reena Ahlawat
- Department of Glaucoma, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
| | - Navjot Singh Ahluwalia
- Department of Glaucoma, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
| | - Subeesh Kuyyadiyil
- Centre for Community Ophthalmology, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
| | - Bk Jain
- Quality Assurance, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
| | - Chintan Shah
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, India
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Jang JH, Lee KW, Baek SU. Path to Diagnosis and Clinical Characteristics of Advanced Glaucoma at Initial Diagnosis: a Tertiary Single Center Experience. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.11.1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: As routine health examinations become more common, many patients first diagnosed with glaucoma have advanced glaucoma. We analyzed the routes to diagnosis and the characteristics of patients initially diagnosed with advanced glaucoma.Methods: We retrospectively retrieved the medical records of patients first diagnosed with advanced glaucoma in our tertiary care center. The inclusion criteria were a mean deviation (MD) less than -12 dB on the visual field test, accompanied by structural damage. All patients were classified in terms of unilateral/bilateral disease, the intraocular pressure before medication, and lens status. We divided patients into those with monocular or binocular advanced glaucoma, high- or normal-pressure glaucoma, and those who were pseudophakic or phakic.Results: We included 73 patients of mean age 69.3 years. The visual field test MD was -19.6 dB. In those with binocular advanced glaucoma, incidental ophthalmic examination was the most common means of diagnosis (52.2%). Central-island visual field defects were the most common defects (54.2%). In those with monocular advanced glaucoma, glaucoma-associated symptoms most commonly triggered diagnosis (46.9%). Both superior and inferiorvisual field defects were the most common defects (42.8%). Glaucoma-associated symptoms were present in 68.2 and 22.8% of patients with high- and normal-pressure glaucoma, respectively. Central-island visual field defects were present in 43.6 and 29.4% of those with high- and normal-pressure glaucoma, respectively.Conclusions: We analyzed the routes to diagnosis and the clinical characteristics of patients with advanced glaucoma. In those with binocular disease, glaucoma was most commonly diagnosed on incidental ophthalmic examination. Central-island visual field defects were the most common defects in patients with binocular and high-pressure glaucoma, and the pseudophakic group. A multi-center longitudinal study on risk factors for delayed glaucoma diagnosis is needed.
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Jang Y, Jee D, Lee D, Choi NK, Bae S. Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084106. [PMID: 33924601 PMCID: PMC8069643 DOI: 10.3390/ijerph18084106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to analyze medication adherence and persistence among open-angle glaucoma patients in Korea. A retrospective study was conducted using the Korean National Health Insurance (NHI) claims database from 2016 to 2019. Newly diagnosed open-angle glaucoma patients who were prescribed with the intraocular pressure (IOP)-lowering eyedrops were included. Adherence was measured using the medication possession ratio (MPR), and persistence was measured using the duration of therapy during the 24 month follow-up period. During the study period, 14,648 open-angle glaucoma patients were identified, and 3118 (21.3%) and 4481 patients (30.6%) were adherent to and persistent with their glaucoma treatment, respectively. The mean MPR was 48.8%, and the mean duration of therapy was 357.2 days. Logistic regression analysis showed that patients who are older, female, using prostaglandins as the index medication, and visiting secondary or tertiary hospitals were significantly associated with greater rates of adherence (odds ratio (OR) = 1.21, 1.12, 1.27, and 1.73, respectively) and persistence (OR = 1.11, 1.17, 1.16, 1.17, and 1.36, respectively) during the study period. Patients with open-angle glaucoma in Korea had substandard medication adherence and discontinued their treatment. Ophthalmologists should pay more attention to younger, male patients to improve adherence.
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Affiliation(s)
- Yunjeong Jang
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea;
| | - Donghyun Jee
- St. Vincent’s Hospital, College of Medicine, The Catholic University, Seoul 16247, Korea;
| | - Donghwan Lee
- Department of Statistics, Ewha Womans University, Seoul 03760, Korea;
| | - Nam-Kyong Choi
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea;
| | - SeungJin Bae
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea;
- Correspondence: ; Tel.: +82-2-3277-3056
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11
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Kim H, Koo H, Han E. Socioeconomic and physical health status changes after visual impairment in Korea using difference-in-difference estimations. Sci Rep 2021; 11:820. [PMID: 33686137 PMCID: PMC7940481 DOI: 10.1038/s41598-020-79760-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 12/10/2020] [Indexed: 12/04/2022] Open
Abstract
This study analyzed the impact of visual impairment on socioeconomic and physical health status and its heterogeneity by severity of visual impairment. We used nationally representative cohort data based on Korean national health insurance claims (2002–2013), which were extracted for 11,030 persons (2206 visually impaired, 8824 control). This was restructured as monthly data for each person (person-month). Multivariate and ordered logistic regressions were conducted, and the pre-impairment status between the visually impaired and non-visually impaired people was adjusted by difference-in-difference (DiD) estimation. Focusing on medical aid (a public healthcare service assistance program for people who cannot afford health insurance premiums), the DiD estimate showed that the likelihood of receiving aid was higher among visually impaired compared with non-impaired people. Mildly and severely visually impaired people were more likely to be medical aid recipients than their counterparts. The severely visually impaired group was more likely to be unemployed. The visually impaired group were less likely to have no comorbidity. Our findings show that the socioeconomic and physical health status of visually impaired people is more likely to deteriorate than that of their non-visually impaired counterparts following onset of impairment.
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Affiliation(s)
- Hyero Kim
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea
| | - Heejo Koo
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea.
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12
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Koh V, Tham YC, Tan NYQ, Yu M, Thakur S, Teo ZL, Mani B, Wong TY, Aung T, Cheng CY. Six-Year Incidence and Risk Factors of Primary Glaucoma in the Singapore Indian Eye Study. Ophthalmol Glaucoma 2020; 4:201-208. [PMID: 32947057 DOI: 10.1016/j.ogla.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the 6-year incidence of primary glaucoma and its risk factors in an Indian population in Singapore. DESIGN Cohort population-based study. PARTICIPANTS Indian adults between 40 and 80 years of age living in Singapore. A total of 3400 participants underwent the baseline examination between 2007 and 2009. Of them, 2200 (response rate, 75.5% of those eligible) participated in the 6-year follow-up visit between 2013 and 2015. METHODS Standardized examination and investigations were performed, including indentation gonioscopy, intraocular pressure (IOP) measurement, optic disc examination, and static automated perimetry. Glaucoma was defined according to the International Society Geographical and Epidemiological Ophthalmology criteria. MAIN OUTCOME MEASURES Incidences of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). RESULTS The age-standardized incidences of primary glaucoma, POAG, and PACG were 1.68% (95% confidence interval [CI], 1.21%-2.32%), 1.37% (95% CI, 0.94%-1.96%), and 0.32% (95% CI, 0.15%-0.66%), respectively. For eyes with ocular hypertension (n = 45) at baseline, the incidence of POAG was 4.83% (95% CI, 1.24%-17.21%) and for eyes with primary angle closure (n = 14) or suspected primary angle closure (n = 101), the incidence of PACG developing was 1.82% (95% CI, 0.37%-9.68%). Baseline factors associated significantly with risk of primary glaucoma developing included older age (per decade; odds ratio [OR], 1.84; 95% CI, 1.44-2.36; P < 0.001), larger vertical cup-to-disc ratio (per 0.1 unit; OR, 2.78; 95% CI, 2.12-3.64; P < 0.001), and higher IOP (per millimeter of mercury; OR, 1.25; 95% CI, 1.13-1.38; P < 0.001). However, 71 of 85 eyes (84.5%) diagnosed with incident glaucoma had IOP of less than 21 mmHg at the time of examination. CONCLUSIONS Our study showed that the overall age-standardized incidence of primary glaucoma was 1.68% in an Indian population in Singapore. In our population, the incidence of POAG was only half and the incidence of PACG was similar to the incidence reported by the Chennai Eye Disease Study.
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Affiliation(s)
- Victor Koh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Nicholas Y Q Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Republic of Singapore
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Zhen Ling Teo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Baskaran Mani
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS, National University of Singapore, Singapore, Republic of Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore; Duke-NUS, National University of Singapore, Singapore, Republic of Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore; Duke-NUS, National University of Singapore, Singapore, Republic of Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore; Duke-NUS, National University of Singapore, Singapore, Republic of Singapore.
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13
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Oh SA, Ra H, Jee D. Socioeconomic Status and Glaucoma: Associations in High Levels of Income and Education. Curr Eye Res 2018; 44:436-441. [PMID: 30433828 DOI: 10.1080/02713683.2018.1548129] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Glaucoma affects millions of people globally, and socioeconomic status is known to be associated with glaucoma. This study expands the understanding of the relationship between socioeconomic factors and glaucoma. METHODS This study used Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2012, with 24,664 persons who did not have missing records on the key variables. The combined relationship between levels of income and education and the prevalence of glaucoma was examined, as well as the occupational difference in the prevalence of glaucoma. Logistic regression models were constructed to generate odds ratios with 95% confidence intervals for predictors of glaucoma. All analyses were adjusted for strata, cluster, and weight. RESULTS The prevalence of glaucoma generally decreased with increasing levels of education and income, but this trend did not hold at the top two levels of education and income, wherein the prevalence was either the same or somewhat higher. Occupation types were shown to be significantly associated with glaucoma (p < 0.0001), and among all the occupations in the survey, farming/forestry/fishing showed the highest percentage of those with glaucoma (4.9%), and service/retail showed the lowest percentage (1.3%). In the multivariable adjusted model, the odds of glaucoma decreased with increasing income level, and increased at the highest income quartile, though the odds were significant only for the top two quartiles. The odds of glaucoma showed neither a nonlinear relationship nor statistical significance with education level when adjusted for other factors. In contrast, age and gender remained significant even after adjusting for other factors. CONCLUSIONS There exists a nonlinear relationship between key socioeconomic factors and the prevalence of glaucoma, though the exact nature of the relationship requires further investigation. These findings merit attention in studies that relate disease prevalence to education and income.
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Affiliation(s)
- Shin Ah Oh
- a Department of Ophthalmology and Visual Science, Suwon, St. Vincent's Hospital , College of Medicine, Catholic University of Korea , Seoul , Kyunggi-do , South Korea
| | - Ho Ra
- b Department of Ophthalmology and Visual Science, Bucheon St. Mary's Hospital, College of Medicine , Catholic University of Korea , Seoul , South Korea
| | - Donghyun Jee
- a Department of Ophthalmology and Visual Science, Suwon, St. Vincent's Hospital , College of Medicine, Catholic University of Korea , Seoul , Kyunggi-do , South Korea
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14
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Choi JA, Kwon JW, Jee D. Cost-utility Analysis of Primary Open-angle Glaucoma according to Follow-up Observation Period. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.9.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jin A Choi
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Woo Kwon
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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