Journal of Glaucoma

PRECIS: We report the survival of surgical revision to glaucoma drainage devices for several indications in a large cohort of patients, with an overall success rate of 45% at 36 months. PURPOSE: To evaluate the outcomes of surgical revision for complications of glaucoma drainage devices. METHODS: 335 eyes of 318 patients who underwent tube revision or removal at UCLA Jules Stein Eye Institute between 1997 and 2019 were included. The pre-defined primary outcome measure was surgical success of the initial revision, defined as resolution of the condition with no additional revisions required, no functionally significant change in vision, and no instances of IOP > 21 mmHg at two consecutive visits postoperatively...

PRCIS: We report three novel variants in FBN1 and LTBP2 in three families with isolated ectopia lentis (EL), which shed new lights on the diagnosis and genetic counseling of EL and secondary glaucoma in clinical settings. PURPOSE: To explore the genetic mechanism in three families with isolated ectopia lentis (EL) and secondary angle closure glaucoma. METHODS: Three Han Chinese families with EL and glaucoma were recruited. All of the participants underwent complete ocular and general physical examinations and DNA samples were extracted from peripheral venous blood and screened for disease-causing variants using whole exome and Sanger sequencing...

PURPOSE: To characterize the incidence of postoperative hypertensive phase (HP) in patients receiving anterior chamber (AC) washout at the time of Ahmed glaucoma implant (AGI). PATIENTS AND METHODS: A total of 24 patients with medically refractory glaucoma who underwent AGI surgery at a tertiary academic medical center in Southern California from December 2018 through March 2021 were included in this retrospective comparative case series. Patients who received a pediatric implant, underwent concurrent intraocular surgery, or did not complete a minimum of 6 months follow-up were excluded...

PRCIS: This study examined the association between dietary niacin intake and glaucoma in the 2005-2008 National Health and Nutrition Examination Survey. Increased niacin intake was associated with lower odds of glaucoma overall and among women. PURPOSE: To examine the association between dietary niacin intake and glaucoma in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). METHODS: This cross-sectional study included adult participants of the 2005-2008 NHANES...

Bilateral acute iris transillumination (BAIT) is characterized by abundant pigment discharge into the anterior chamber. Atonic pupil and severe intraocular pressure elevations may be observed. Generally, there is a viral upper respiratory tract infection or systemic fluoroquinolone usage before BAIT. Two cases with a recent history of Covid-19 presented with a complaint of decreased vision. Elevated intraocular pressure (IOP) and iris transillumination defects were observed in both patients. Both patients were diagnosed with BAIT...

A non-comparative retrospective case-series study was performed on 6 patients (12 eyes) with a confirmed diagnosis of ocular cicatricial pemphigoid (OCP), treated with MicroPulse® Transscleral Laser Therapy (MP-TLT), between January 2018 and 2020, with a minimum follow-up of 2 years, in a private ophthalmology practice with offices in Argentina and Colombia. Mean age was 75±6.3 years (66-83yrs). The severity of OCP remained stable 2 years after MP-TLT. Baseline mean IOP was 19.5±5.9 mmHg (13-30 mmHg) and, 24 months after treatment, IOP decreased to a mean of 13...

PRECIS: Ab externo transconjunctival placement of the Xen 45 gel stent offers a faster surgical approach and more rapid visual recovery with similar pressure-lowering and complication rates when compared with implantation by the ab interno approach. PURPOSE: Compare outcomes of closed conjunctival Xen-45 implantation techniques: ab interno versus ab externo transconjunctival. METHODS: Single-center, retrospective study of 70 patients undergoing Xen-45 implantation between 2017-2020...

PRCIS: This retrospective study of 264 eyes having inferior-quadrant trabectome surgery confirms its safety and relatively effectiveness. Most patients however still require IOP-lowering agents and a considerable proportion may need additional glaucoma surgery. PURPOSE: To report outcomes from a large single-centre cohort of inferiorly-applied trabectome surgery. PATIENTS METHODS: Retrospective review of patients undergoing trabectome surgery for chronic open angle glaucoma (COAG) at the University Eye Clinic Bonn, Germany, from 2012 to 2020...

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PRECIS: Global peripapillary retinal nerve fiber layer thickness/Bruch membrane opening- minimum rim width ratio is an objective and effective parameter to separate glaucomatous optic neuropathies (GONs) from nonglaucomatous optic neuropathies (NGONs). PURPOSE: This study was undertaken to evaluate the diagnostic capability of the peripapillary retinal nerve fiber layer (pRNFL)/ Bruch membrane opening-minimum rim width (BMO-MRW) ratio to differentiate glaucomatous optic neuropathies (GONs) from nonglaucomatous optic neuropathies (NGONs)...

PRECIS: XEN gel-stent and non-penetrating deep sclerectomy, either alone or in combination with cataract surgery, significantly lowered the intraocular pressure and reduced the number of antiglaucoma medications in open-angle-glaucoma patients; with no significant differences between them. PURPOSE: To compare the surgical outcomes of XEN45-implant and non-penetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular-hypertension (OHT) and open-angle glaucoma (OAG)...

PURPOSE: To report a case with bilateral paravascular inner retinal defects (PIRDs) enlarging with progressive myopia, which had different structural characteristics from glaucomatous retinal nerve fiber layer (RNFL) defect. PATIENTS AND METHODS: A 10-year-old girl with high myopia was referred to glaucoma clinic for evaluation of RNFL defects shown in color fundus photographs. Fundus photographs and optical coherence tomography (OCT) examinations were serially reviewed to examine the changes in the RNFL...

PRCIS: The morphological alterations in lamina cribrosa may be related to the location of visual field defects. PURPOSE: The aim of this study was to investigate morphologic differences in the lamina cribrosa (LC) in normal-tension glaucoma (NTG) according to the location of visual field (VF) defects. DESIGN: This study was a retrospective, cross-sectional study. METHODS: Ninety-six eyes of 96 patients with NTG were included in this study...

PURPOSE: The aim of our study was to evaluate the subclinical changes in the macula, retinal nerve fiber layer (RNFL) and choroidal thickness after COVID-19 infection using spectral domain optical coherence tomography (OCT). METHODS: Our study was prospectively designed and involved 170 eyes of 85 patients. Patients with PCR positive COVID-19 infection were examined in the ophthalmology clinic before and after infection were included. All included patients had mild COVID-19 with no hospitalization and no need for intubation...

PRCIS: We developed a deep learning-based classifier that can discriminate primary angle-closure suspects, primary angle-closure/primary angle-closure glaucoma, and also control eyes with open-angle with acceptable accuracy. PURPOSE: To develop a deep learning (DL) based classifier for differentiating subtypes of primary angle closure disease (PACD), including primary angle-closure suspect (PACS) and primary angle-closure/primary angle-closure glaucoma (PAC/PACG) and also normal control eyes...

PRECIS: Adding TBS to phacoemulsification creates unpredictable short-term IOP control that may be undesirable for patients with advanced glaucoma. AO responses after TBS are complex and probably multifactorial. PURPOSE: To assess intraocular pressure spikes in patients with open angle glaucoma up to one month following iStent Inject and their relationship to aqueous outflow patterns measured by Hemoglobin Video Imaging. PARTICIPANTS AND METHODS: We studied IOP for 4 weeks after trabecular bypass surgery (TBS) with iStent Inject in 105 consecutive eyes with open-angle glaucoma (6 TBS only and 99 combined with phacoemulsification)...

PRECIS: Remote contrast sensitivity testing via a free downloadable home test correlates with glaucomatous macular damage measured by 10-2 visual field testing. PURPOSE: To assess the feasibility and validity of home contrast sensitivity monitoring as a measure of glaucomatous damage using a free downloadable smart phone application. METHODS: 26 participants were asked to remotely use the Berkeley Contrast Squares application, a free downloadable tool that records users' contrast sensitivity for varying degrees of visual acuity...

PRECIS: The peripapillary vessel density decreased significantly in the affected hemiretina compared to that in the intact hemiretina in glaucomatous eyes with a single-hemifield retinal nerve fiber layer defect. PURPOSE: To evaluate the difference in the change rates of peripapillary vessel density (pVD) and macular vessel density (mVD) measured using optical coherence tomography angiography (OCTA) in glaucomatous eyes with a single-hemifield retinal nerve fiber layer (RNFL) defect...

PRCIS: Central retinal vessel trunk displacement is an important factor in the generation and development of deep-layer microvasculature dropout in primary open-angle glaucoma. PURPOSE: To investigate the association between the microvasculature dropout and the central retinal vessel trunk in primary open-angle glaucoma eyes. METHODS: In total, 112 eyes from 112 patients with primary open-angle glaucoma were included. Matched 26 no microvasculature dropout eyes and 26 microvasculature dropout eyes, they had similar axial length and global retinal nerve fiber layer thickness...

The use of marijuana for the treatment of glaucoma has been widely debated amongst ophthalmologists and glaucoma specialists. Recent evidence suggests the majority of ophthalmologists do not support the use of marijuana as active treatment for glaucoma. However, there has been no investigation into understanding the public's direct perception of the efficacy of marijuana in glaucoma treatment. By using Twitter as a tool to understand the public's thoughts, tweets were analyzed over the last two years. Of the 700 tweets analyzed, 72% (n=503) of tweets were in favor of cannabis use in the treatment of glaucoma, while 18% (n=124) were evidently opposed...