Journal of Glaucoma

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PRECIS: In recent years, ChatGPT has been widely used as a source of information. In our study, it was revealed that ChatGPT gives accurate information about glaucoma. PURPOSE: We examined the knowledge of ChatGPT about glaucoma. PATIENTS AND METHODS: Frequently asked questions about glaucoma found on websites of ophthalmology associations and hospitals, and social media applications were assessed. Evidence-Based Recommendations in the European Glaucoma Society Terminology and Guidelines for Glaucoma 5th Edition were evaluated...

PURPOSE: To investigate the relationship of smoking and smoking intensity, with the rate of optic nerve head (ONH) whole image capillary density (wiCD) loss in primary open angle glaucoma (POAG) and glaucoma suspect patients. METHODS: In this longitudinal study, POAG patients who had at least 2 years of follow-up and optical coherence tomography angiography (OCTA) performed at a minimum of 4 visits were selected for study. The smoking intensity was calculated as the pack-year at the baseline OCTA...

PRCIS: Children with glaucoma had an average of 1.3 visual field tests per year. Self-reported black and multiracial patients had lower visual field testing rates, while older children with better visual acuity had more frequent testing. PURPOSE: To evaluate frequency of visual field (VF) testing in children with glaucoma and identify characteristics associated with VF frequency. METHODS: Retrospective cohort study of 82 children aged 6-18 years with glaucoma seen between August 2018-May 2023...

PURPOSE: Glaucoma is a leading public health concern globally and its detection and management are way more complex and challenging in the developing world. This review article discusses barriers to glaucoma screening in developing countries from the perspective of different key stakeholders and proposes solutions. METHODS/RESULTS: A literature search was carried out in the electronic catalogs of PubMed, Medline, and Cochrane database of systematic reviews to find studies that focused on barriers and enablers to glaucoma screening...

PRCIS: This article delves into the imperative of screening family members of patients with glaucoma due to the disease's hereditary nature. It discusses the significant risks faced by first-degree relatives, approaches for identification, and challenges in implementing effective screening strategies. Emphasizing education, targeted campaigns, community involvement, and collaborative healthcare approaches, the article highlights the potential for mitigating undiagnosed glaucoma cases through strategic interventions targeting high-risk individuals...

This case study reports on the presence of vitamin A deficiency in an adult with asymmetric normal tension glaucoma. The retinal OCT findings demonstrated expected loss of the outer retinal layers, typically seen in Vitamin A deficiency, but also severe and bilateral loss of the inner retinal layers. After Vitamin A supplementation, visual acuity, dark adaptation, and color vision normalized. The outer retinal layers had a restoration of the thickness after vitamin A supplementation but the inner layers did not change...

PURPOSE: To investigate factors associated with optic disc microvasculature dropout (MvD-D) in pre-perimetric primary open-angle glaucoma (PPG) patients. METHODS: 139 eyes of PPG patients were categorized according to the presence of MvD-D with optical coherence tomography angiography (OCTA). Factors including visual field (VF) mean deviation (MD), retinal nerve fiber layer (RNFL) thickness, focal lamina cribrosa (LC) defect, optic disc hemorrhage (DH), and parapapillary deep-layer microvasculature dropout (MvD-P) were compared between eyes with and without MvD-D...

PRECIS: Using OCT, eyes with advanced glaucoma were found to have a wide range of patterns of damage that were consistent with the natural history of progression based upon a model of macular progression. PURPOSE: To understand the patterns of preserved retinal ganglion cells in eyes with advanced glaucoma using OCT and a model of progression of the central macula. METHODS: OCT GCL thickness was measured in 94 eyes with advanced glaucoma, defined as glaucomatous eyes with a 24-2 MD (mean deviation) worse than -12 dB...

PRCIS: Online circular contrast perimetry has good test repeatability and reliability that is comparable with standard automated perimetry. It holds promise for use in disease screening and surveillance to expand the provision of glaucoma care. PURPOSE: To evaluate the repeatability of online circular contrast perimetry (OCCP) compared to standard automated perimetry (SAP) in normal participants and patients with stable glaucoma over 18 weeks. METHODS: Thirty-six participants (13 normal controls and 23 patients with open angle glaucoma) were recruited...

Patient outcomes in ophthalmology are greatly influenced by adherence and patient participation, which can be particularly challenging in diseases like glaucoma where medication regimens can be complex. A well-studied and evidence-based intervention for behavioral change is Motivational Interviewing (MI), a collaborative and patient-centered counseling approach, which has been shown to improve medication adherence in glaucoma patients. However, there are many barriers to clinicians being able to provide motivational interviewing in-office, including short visit durations within high-volume ophthalmology clinics and inadequate billing structures for counseling...

Exposure of glaucoma tube shunts is an uncommon post-operative complication which poses a significant risk to the patient and may be difficult to repair. In this case series, the authors present two cases utilizing a novel surgical technique, the "pocket" technique, to place a scleral patch graft to address tube exposure. Patient 1 remained free of tube exposure at most recent follow up visit after 21 months, and patient 2 remained free of tube exposure at most recent follow up visit after 4 months. This technique offers an elegant surgical option that has multiple benefits; It allows for stability of the scleral patch graft even in cases of scarred down, thinned conjunctiva with minimal Tenons, allows for repair along the entire length of the tube shunt including perilimbal exposures, and allows for secondary healing when there is not enough conjunctiva to cover both the opening and the patch...

PRECIS: Analysis of surgical success and intraocular pressure (IOP), best-corrected visual acuity (BCVA) and antiglaucomatous medication (AGM) changes between segmental 180-degree and 360-degree gonioscopy-assisted transluminal trabeculectomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG) showed no significant difference. PURPOSE: To compare surgical outcomes of segmental 180-degree and 360-degree GATT in PEXG patients. MATERIALS AND METHODS: Prospective, comparative study of 65 PEXG eyes, who underwent segmental 180-degree GATT (GATT 180° group, 31 eyes) and 360-degree GATT (GATT 360° group, 34 eyes) in a tertiary academic center over a 12-month of follow-up...

PURPOSE: To create a holistic and realistic view regarding current knowledge, understanding, and challenges of screening in general and in glaucoma. METHODS/RESULTS: Based upon available literature, all systems suffer from the same challenges: huge variability of care practices (despite guidelines), simultaneous under-care and over-care, as well as the unsustainable increase of costs. While the magnitude of these challenges differs immoderately between well-off and developing countries, the Western world has already demonstrated that simply doing more than what we currently do is not the solution...

UNLABELLED: The increasing lens vault (LV) and lens thickness (LT) is a recognized mechanism for primary angle closure glaucoma (PACG). Zonulopathy, causing the abnormal lens position, is an important factor in this mechanism. Several anatomically distinct sets of zonular fibers are present in primate eyes, including ciliary zonules, vitreous zonules and attachments between the posterior insertion zone of the vitreous zonules and the posterior lens equator (PVZ INS-LE strands). Zonulopathy, as a clinical diagnosis, exhibits zonular laxity and loss, long anterior lens zonules (LAZ)...

PRECIS: There is evidence that cataract surgery can reduce intraocular pressure in patients with primary open angle-, normal tension-, or exfoliative glaucoma. The complete effect of phacoemulsification is masked by topical intraocular pressure-lowering medications. PURPOSE: To assess the impact of phacoemulsification and intraocular lens implantation on intraocular pressure (IOP) level in individuals with primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG), exfoliation syndrome (XFS), normal tension glaucoma (NTG), ocular hypertension (OH) or healthy controls 12 months after the surgery...

PURPOSE: To describe the neighborhood-level social risk factors across the three SIGHT Study sites and assess potential characteristics of these populations to help other researchers effectively design and implement targeted glaucoma community-based screening and follow-up programs in high-risk groups. METHODS/RESULTS: In 2019, Columbia University, University of Michigan, and University of Alabama at Birmingham each received 5 years of CDC funding to test a wide spectrum of targeted telehealth delivery methods to detect glaucoma in community-based health delivery settings among high-risk populations...

PRCIS: Deep sclerectomy with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing non-allergenic, non-toxic and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. PURPOSE: To evaluate short- and medium-term postoperative results of deep sclerectomy (DS) with a fibrin sealant. PATIENTS AND METHODS: This prospective, noncomparative, interventional case-series involves 12 eyes of 12 patients with uncontrolled open-angle glaucoma (OAG) who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022...

PRCIS: In the largest clinic-based study to date, our review of 588 patients presenting with glaucoma in Northern Ghana revealed 36% of these had primary angle closure glaucoma. PURPOSE: Glaucoma is the second leading cause of blindness worldwide. In Africa, glaucoma is an established public health problem, and primary angle-closure glaucoma (PACG) is not commonly discussed. Recognizing it is important because of its negative impact on visual morbidity, and also because its treatment is different from primary open angle glaucoma (POAG)...

PURPOSE: The aim was to compare the effectiveness of clinical discriminant rules and machine learning classifiers in identifying glaucomatous fundus images based on optic disc topographic features. DESIGN: Retrospective case-control study. METHODS: The study used a total of 800 fundus images, half of which were glaucomatous cases and the other half non- glaucomatous cases obtained from an open database and clinical work. The images were randomly divided into training and testing sets with equal numbers of glaucomatous and non-glaucomatous images...