Editorial

3 pages, 179 KiB

Open AccessEditorial

Special Issue “Recommendations for Clinical Management of Glaucoma”

by Paolo Fogagnolo

J. Clin. Med. 2022, 11(6), 1499; https://doi.org/10.3390/jcm11061499 - 09 Mar 2022

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Glaucoma is a group of eye conditions that damage the optic nerve head and affect visual function, potentially leading to blindness [...] Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

Research

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10 pages, 258 KiB

Open AccessArticle

Comparison of Corvis ST Parameters between Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma

by Yuta Nakaniida, Kana Tokumo, Hiromitsu Onoe, Naoki Okada, Shunsuke Nakakura, Ryo Asaoka and Yoshiaki Kiuchi

J. Clin. Med. 2023, 12(15), 5108; https://doi.org/10.3390/jcm12155108 - 03 Aug 2023

Viewed by 754

Abstract

Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: A retrospective analysis was performed on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. [...] Read more.

Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: A retrospective analysis was performed on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. CST parameters were compared between eyes with POAG and those with PACG using a linear mixed model (LMM). Results: No differences were observed in age, central corneal thickness, intraocular pressure, or use of antiglaucoma eye drops between the two groups. Patients with PACG had a significantly shorter axial length (AL), a higher proportion of females, CST parameters, longer applanation 2 (A2) time, deeper A2 deformation amplitude, shorter peak distance, longer whole eye movement, and longer whole eye movement time than patients with POAG. The highest concavity (HC) length and PD showed a significant positive correlation with AL. However, A1 length, A1 deformation amplitude, A2 time, A2 velocity, A2 length, A2 deformation amplitude, HC time, whole eye movement, and whole eye movement time were negatively correlated with AL. Conclusions: The biomechanical properties of the cornea differed between POAG and PACG. In some parts, AL differences between the POAG and PACG groups might contribute to the variation in CST parameters. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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Graphical abstract

8 pages, 465 KiB

Open AccessArticle

Inter-Eye Comparison of the Ocular Surface of Glaucoma Patients Receiving Surgical and Medical Treatments

by Dario Romano, Valentino De Ruvo, Paolo Fogagnolo, Roberta Farci and Luca Mario Rossetti

J. Clin. Med. 2022, 11(5), 1238; https://doi.org/10.3390/jcm11051238 - 24 Feb 2022

Cited by 8 | Viewed by 1237

Abstract

Background: Ocular surface frequently affects glaucoma patients. In this paper we aimed at evaluating the impact of glaucoma surgery on the ocular surface of patients who received unilateral trabeculectomy. Methods: 26 consecutive patients successfully treated with trabeculectomy on one eye (Trab Eye) and [...] Read more.

Background: Ocular surface frequently affects glaucoma patients. In this paper we aimed at evaluating the impact of glaucoma surgery on the ocular surface of patients who received unilateral trabeculectomy. Methods: 26 consecutive patients successfully treated with trabeculectomy on one eye (Trab Eye) and under control with topical treatments on the fellow eye (Med Eye) were included in this observational study. They received IDEEL and OSDI questionnaires, Tear Film Osmolarity (TFO), grading of conjunctival hyperemia, fluorescein tear break-up time (tBUT), grading of corneal staining and Schirmer test. Results: IDEEL and OSDI scores were 48 ± 38 and 11 ± 12, respectively, with moderate correlation (r = 0.50, p = 0.03). Compared with Med eyes, Trab Eyes had higher tBUT (6.5 ± 3.5 vs. 5.1 ± 2.7 s, p = 0.004), lower conjunctival hyperemia (0.8 ± 0.9 and 1.7 ± 1.1 respectively, p < 0.001) and lower corneal staining (0.3 ± 0.5 and 0.6 ± 0.5, respectively, p = 0.03). Correlation between corneal staining and conjunctival hyperemia was 0.55 in Trab Eyes (p = 0.01) and 0.44 in Med Eyes (p > 0.05). Patients with bilateral corneal staining had had threefold worse questionnaire scores (p < 0.05). The duration of treatment and the daily exposure to preservatives did not directly affect OS parameters in this cohort of patients. Conclusions: Patients receiving successful trabeculectomy showed better OS homeostasis (higher TBUT, lower grading of conjunctival hyperemia and corneal staining) than fellow medically treated eyes. Presence of corneal epithelial damage in both eyes is the factor more consistently affecting questionnaire scores. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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14 pages, 436 KiB

Open AccessArticle

First Results from the Prospective German Registry for Childhood Glaucoma: Phenotype–Genotype Association

by Julia V. Stingl, Stefan Diederich, Heidi Diel, Alexander K. Schuster, Felix M. Wagner, Panagiotis Chronopoulos, Fidan Aghayeva, Franz Grehn, Jennifer Winter, Susann Schweiger and Esther M. Hoffmann

J. Clin. Med. 2022, 11(1), 16; https://doi.org/10.3390/jcm11010016 - 21 Dec 2021

Cited by 7 | Viewed by 2653

Abstract

Childhood glaucoma is a heterogeneous disease and can be associated with various genetic alterations. The aim of this study was to report first results of the phenotype–genotype relationship in a German childhood glaucoma cohort. Forty-nine eyes of 29 children diagnosed with childhood glaucoma [...] Read more.

Childhood glaucoma is a heterogeneous disease and can be associated with various genetic alterations. The aim of this study was to report first results of the phenotype–genotype relationship in a German childhood glaucoma cohort. Forty-nine eyes of 29 children diagnosed with childhood glaucoma were prospectively included in the registry. Besides medical history, non-genetic risk factor anamnesis and examination results, genetic examination report was obtained (23 cases). DNA from peripheral blood or buccal swab was used for molecular genetic analysis using a specific glaucoma gene panel. Primary endpoint was the distribution of causative genetic mutations and associated disorders. Median age was 1.8 (IQR 0.6; 3.8) years, 64% participants were female. Secondary childhood glaucoma (55%) was more common than primary childhood glaucoma (41%). In 14%, parental consanguinity was indicated. A mutation was found in all these cases, which makes consanguinity an important risk factor for genetic causes in childhood glaucoma. CYP1B1 (30%) and TEK (10%) mutations were found in primary childhood glaucoma patients. In secondary childhood glaucoma cases, alterations in CYP1B1 (25%), SOX11 (13%), FOXC1 (13%), GJA8 (13%) and LTBP2 (13%) were detected. Congenital cataract was associated with variants in FYCO1 and CRYBB3 (25% each), and one case of primary megalocornea with a CHRDL1 aberration. Novel variants of causative genetic mutations were found. Distribution of childhood glaucoma types and causative genes was comparable to previous investigated cohorts. This is the first prospective study using standardized forms to determine phenotypes and non-genetic factors in childhood glaucoma with the aim to evaluate their association with genotypes in childhood glaucoma. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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10 pages, 489 KiB

Open AccessArticle

XEN Glaucoma Implant for the Management of Glaucoma in Naïve Patients versus Patients with Previous Glaucoma Surgery

by Katarzyna Lewczuk, Joanna Konopińska, Joanna Jabłońska, Jacek Rudowicz, Patrycja Laszewicz, Diana Anna Dmuchowska, Zofia Mariak and Marek Rękas

J. Clin. Med. 2021, 10(19), 4417; https://doi.org/10.3390/jcm10194417 - 26 Sep 2021

Cited by 13 | Viewed by 1776

Abstract

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term [...] Read more.

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term follow-up period. Patients were divided into two groups: naïve patients (Group 1) and patients with previous glaucoma surgery (Group 2). Eyes that received a XEN Gel Stent placement from December 2014 to October 2019 were included. Intraocular pressure (IOP) change, corrected distance visual acuity (CDVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. In Group 1, the mean IOP before surgery was decreased significantly from 25.00 ± 7.52 mmHg to 16.83 ± 5.12 mmHg by the end of the study. In Group 2, the mean IOP decreased significantly from 25.35 ± 7.81 mmHg to 17.54 ± 5.34 mmHg. The mean IOP decrease from baseline was 29% in Group 1 and 27% in Group 2 (p = 0.567). There were no significant differences between the groups in the IOP baseline level, the final level, or the change between preoperative and final levels. The qualified success rate for Group 2 was 68.7% versus 76.5% for Group 1 for the initial procedure and 15.4% vs. 20.2%, respectively, for complete success rate (p > 0.05). However, at the end of the follow-up, more patients achieved an IOP < 18 mmHg in Group 1 than in Group 2. Despite the need for more anti-glaucoma medications, repeat XEN Gel implantation appears to show promising results in patients with previously failed anti-glaucoma procedures, owing to its minimal invasiveness. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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11 pages, 1980 KiB

Open AccessArticle

Comparison of Compass Suprathreshold Screening Strategies

by Paolo Fogagnolo, Dario Romano, Giovanni Montesano, Valentino De Ruvo and Luca Mario Rossetti

J. Clin. Med. 2021, 10(19), 4330; https://doi.org/10.3390/jcm10194330 - 23 Sep 2021

Cited by 3 | Viewed by 1607

Abstract

Screening programs may be useful to reduce the rate of undetected glaucoma. Compass (CMP, CenterVue, Padova, Italy) Standard Suprathreshold strategy (SST) analyses the visual function at 52 retinal locations. A new Quick Suprathreshold strategy (QST) reduces the number of tested locations to 24. [...] Read more.

Screening programs may be useful to reduce the rate of undetected glaucoma. Compass (CMP, CenterVue, Padova, Italy) Standard Suprathreshold strategy (SST) analyses the visual function at 52 retinal locations. A new Quick Suprathreshold strategy (QST) reduces the number of tested locations to 24. With both tests, the CMP also provides an image of the central retina and a detail of the optic nerve head. The aim of this paper is to measure the performances of SST and QST compared with clinical diagnosis. 63 consecutive healthy subjects and 60 consecutive patients with perimetric defects from glaucoma in both eyes were recruited. They received one test per eye (SST or QST in randomized order); results were classified into normal, suspect and abnormal according to a global index provided in the report and called SupraThreshold Response (STR). Agreement between clinical diagnosis and test output were calculated, and test time was also measured. The agreement with the clinical diagnosis was 95.7% for SST and 95.1% for QST. When two suspect tests were excluded, agreement for QST increased to 96.7%. Test duration was 164 ± 82 s for SST and 71 ± 41 s for QST (p < 0.0001). Such a difference was similar in both glaucoma patients (respectively 231 ± 65 s vs. 105 ± 33 s, p < 0.0001) and normal subjects (98 ± 17 and 39 ± 9 s, p < 0.0001). In conclusion, SST and QST showed similar, high agreement with clinical judgement. Morphological analysis is potentially helpful in further improving the clinical usefulness of suprathreshold tests. QST is characterized by a strong time saving compared with SST. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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10 pages, 229 KiB

Open AccessArticle

Risk Factors for the Structural Progression of Myopic Glaucomatous Eyes with a History of Laser Refractive Surgery

by Kwanghyun Lee, Bo Yi Kim, Gong Je Seong, Chan Yun Kim, Hyoung Won Bae and Sang Yeop Lee

J. Clin. Med. 2021, 10(11), 2408; https://doi.org/10.3390/jcm10112408 - 29 May 2021

Cited by 1 | Viewed by 1681

Abstract

As laser refractive surgeries (LRS) have been widely performed to correct myopia, ophthalmologists easily encounter patients with glaucoma who have a history of LRS. It is well known that intraocular pressure (IOP) in eyes with glaucoma is not accurate when measured using Goldmann [...] Read more.

As laser refractive surgeries (LRS) have been widely performed to correct myopia, ophthalmologists easily encounter patients with glaucoma who have a history of LRS. It is well known that intraocular pressure (IOP) in eyes with glaucoma is not accurate when measured using Goldmann applanation tonometry. However, risk factors for glaucoma progression, particularly those associated with measured IOP, have rarely been studied. We analysed data for 40 patients with a history of LRS and 50 age-matched patients without a history of LRS. Structural progression was defined as significant changes in thickness in the peripapillary retinal nerve fibre layer as identified using optical coherence tomography event-based guided progression analysis. Risk factors were determined via Cox regression analysis. Disc haemorrhage (DH) was associated with glaucoma progression in both the non-LRS group and LRS group (hazard ratio (HR): 4.650, p = 0.012 and HR: 8.666, p = 0.019, respectively). However, IOP fluctuation was associated with glaucoma progression only in the LRS group (HR: 1.452, p = 0.023). Our results show that DH was a significant sign of progression in myopic glaucoma eyes. When treating patients with myopia and glaucoma, IOP fluctuation should be monitored more carefully, even if IOP seems to be well controlled. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

12 pages, 1286 KiB

Open AccessArticle

Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

by Gerasimos Kopsinis, Dimitrios Tsoukanas, Dimitra Kopsini and Theodoros Filippopoulos

J. Clin. Med. 2021, 10(10), 2054; https://doi.org/10.3390/jcm10102054 - 11 May 2021

Cited by 7 | Viewed by 1706

Abstract

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = [...] Read more.

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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11 pages, 1170 KiB

Open AccessArticle

Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature

by Huub J. Poelman, Jan Pals, Parinaz Rostamzad, Wichor M. Bramer, Roger C. W. Wolfs and Wishal D. Ramdas

J. Clin. Med. 2021, 10(5), 1118; https://doi.org/10.3390/jcm10051118 - 07 Mar 2021

Cited by 17 | Viewed by 2822

Abstract

Background: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 [...] Read more.

Background: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies. Results: A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up (p < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study). Conclusion: XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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11 pages, 1706 KiB

Open AccessArticle

Combined Phacoemulsification and Ex-PRESS Implant with Everting Suture in Primary Angle-Closure Glaucoma: Survival Analysis and Predictive Factors

by Giuseppe Covello, Pasquale Loiudice, Maria Novella Maglionico, Marco Nardi, Michele Figus and Chiara Posarelli

J. Clin. Med. 2021, 10(4), 774; https://doi.org/10.3390/jcm10040774 - 15 Feb 2021

Cited by 3 | Viewed by 1920

Abstract

The purpose of this study was to evaluate the efficacy and safety of combined phacoemulsification and Ex-PRESS implant with everting suture in primary angle-closure glaucoma (PACG) and to examine predictive factors of failure. Twenty-three eyes of 18 patients were enrolled. Data about time [...] Read more.

The purpose of this study was to evaluate the efficacy and safety of combined phacoemulsification and Ex-PRESS implant with everting suture in primary angle-closure glaucoma (PACG) and to examine predictive factors of failure. Twenty-three eyes of 18 patients were enrolled. Data about time of removal of releasable sutures and traction of the everting suture and about changes in intraocular pressure (IOP) were collected, as well as comprehensive ophthalmic examinations. Success was defined by the following criteria: IOP ≤ 18 mmHg (criterion 1); IOP ≤ 15 mmHg (criterion 2); and IOP ≤ 12 mmHg (criterion 3). Success was categorized as complete or qualified, depending on whether it was reached without or with drugs, respectively. Success rate was assessed with Kaplan–Meier survival analysis with a Cox proportional hazard model to adjust for potential confounders. The lowering of IOP and the reduction of medications were statistically significant at every follow-up visit compared with the baseline (p < 0.05). The complete success rates were 87%, 70%, and 17% accordingly to criterion 1, 2, and 3; the qualified success rates were 93%, 70%, and 20%, respectively. Most of the complications resolved spontaneously and conservatively. In conclusion, combined phacoemulsification and Ex-PRESS Minishunt implant with everting suture is a safe and effective surgery, even in PACG, lowering IOP and number of medications. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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8 pages, 483 KiB

Open AccessArticle

Evaluation of Systemic Renin and Angiotensin II Levels in Normal Tension Glaucoma

by Soo Ji Jeon, Hyung Bin Hwang and Na Young Lee

J. Clin. Med. 2020, 9(12), 3838; https://doi.org/10.3390/jcm9123838 - 26 Nov 2020

Cited by 3 | Viewed by 1369

Abstract

The purpose of this study was to investigate the function of the renin–angiotensin–aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were [...] Read more.

The purpose of this study was to investigate the function of the renin–angiotensin–aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were included in this study. Renin and AngII were measured in the blood samples of all subjects by enzyme-linked immunosorbent assay (ELISA). No significant differences were found in the complete blood count, fasting glucose, low-density lipoprotein (LDL), and high-sensitivity C-reactive protein (hs-CRP) levels between the control and NTG groups. The systemic concentration and variability of the renin concentration in the blood was significantly higher in the NTG group (p = 0.005 and 0.005, respectively). According to multivariate logistic regression analysis, the variability of the renin concentration was associated with NTG (p = 0.006). In conclusion, the systemic concentration and variability of renin levels were elevated in NTG patients. An altered renin concentration could represent a difference in RAAS function in NTG patients. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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12 pages, 626 KiB

Open AccessArticle

Effects of Topical Prostaglandin Analog on Macular Thickness Following Cataract Surgery with Postoperative Topical Bromfenac Treatment

by Kee Sup Park, Kyoung Nam Kim, Kyeung Min Kim, Han Min Lee, Sung Bok Lee, Nam Ho Lee and Chang-Sik Kim

J. Clin. Med. 2020, 9(9), 2883; https://doi.org/10.3390/jcm9092883 - 07 Sep 2020

Cited by 3 | Viewed by 3394

Abstract

Purpose: To evaluate changes in macular thickness in patients continuing prostaglandin analog (PGA) treatment during the perioperative period involving bromfenac treatment. Methods: Patients with glaucoma who were using a topical PGA were randomly assigned to two groups in this randomized controlled trial: PGA [...] Read more.

Purpose: To evaluate changes in macular thickness in patients continuing prostaglandin analog (PGA) treatment during the perioperative period involving bromfenac treatment. Methods: Patients with glaucoma who were using a topical PGA were randomly assigned to two groups in this randomized controlled trial: PGA continuing study group and PGA discontinued glaucoma control group. Patients without ocular diseases other than cataract were enrolled into the non-glaucomatous group. After the cataract surgery, the patients used bromfenac twice per day for 4 weeks. Optical coherence tomography was performed in all patients preoperatively and at 1 month postoperatively. Changes in macular thickness were compared among the three groups. Results: There were 32 eyes in the study group, 33 eyes in the glaucoma control group, and 58 eyes in the non-glaucomatous group. We found statistically significant postoperative changes in central macular thickness in all groups (4.30 ± 8.01 μm in the PGA continuing group, 9.20 ± 13.88 μm in the PGA discontinued group, and 7.06 ± 7.02 μm in the non-glaucomatous group, all p < 0.008), but no significant difference among the three groups (p = 0.161). Cystoid macular edema occurred in only one patient in the non-glaucomatous group (p = 0.568). Conclusions: Continuous use of PGAs during the perioperative period was not significantly associated with increased macular thickness after uncomplicated cataract surgery. In the absence of other risk factors (e.g., capsular rupture, uveitis, or diabetic retinopathy), discontinuing PGAs for the prevention of macular edema after cataract surgery with postoperative bromfenac treatment is unnecessary in patients with glaucoma. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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Review

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10 pages, 2389 KiB

Open AccessReview

Latanoprostene Bunod 0.024% in the Treatment of Open-Angle Glaucoma and Ocular Hypertension: A Meta-Analysis

by Tzu-Chen Lo, Yu-Yen Chen, Man-Chen Hung and Pesus Chou

J. Clin. Med. 2022, 11(15), 4325; https://doi.org/10.3390/jcm11154325 - 26 Jul 2022

Cited by 4 | Viewed by 1882

Abstract

Latanoprostene bunod (LBN) 0.024%, a newly approved glaucoma eye drop, is metabolized into latanoprost acid and a nitric oxide (NO)-donating moiety, thus increasing the outflow of aqueous humor through the uveoscleral and trabecular routes, respectively. This study aimed to evaluate the intraocular pressure [...] Read more.

Latanoprostene bunod (LBN) 0.024%, a newly approved glaucoma eye drop, is metabolized into latanoprost acid and a nitric oxide (NO)-donating moiety, thus increasing the outflow of aqueous humor through the uveoscleral and trabecular routes, respectively. This study aimed to evaluate the intraocular pressure (IOP)-lowering effect of LBN among patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). The effectiveness of LBN was also compared with timolol maleate 0.5% and latanoprost 0.005%. We searched PubMed and Embase between 1 January 2010, and 31 March 2022 and adopted only peer-reviewed clinical studies in our meta-analysis. A total of nine studies (2389 patients with OAG or OHT) assessing the IOP-reduction effect of LBN were included. Standardized mean differences (SMDs) of IOP between post-treatment time points (2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months) and baseline were calculated. The pooled analysis according to each time point revealed a significant IOP drop after LBN treatment (all p values for SMD < 0.05). In addition, LBN revealed a significantly stronger efficacy in decreasing IOP than timolol maleate 0.5% and latanoprost 0.005% during the follow-up period of three months. No serious side effects of LBN 0.024% were reported. Our study concluded that LBN could achieve good performance for IOP reduction in patients with OAG and OHT. The safety was favorable with no severe side effects. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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20 pages, 2094 KiB

Open AccessReview

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

by Aleksandra Zgryźniak, Joanna Przeździecka-Dołyk, Marek Szaliński and Anna Turno-Kręcicka

J. Clin. Med. 2021, 10(15), 3307; https://doi.org/10.3390/jcm10153307 - 27 Jul 2021

Cited by 2 | Viewed by 4285

Abstract

Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current [...] Read more.

Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current publications on SLT and summarize its efficacy and safety for different indications in open-angle glaucoma (OAG) and ocular hypertension (OHT) treatment. SLT effectively reduces IOP when used as a primary treatment. In patients whose IOP is medically controlled, SLT helps to reduce medication use, and when maximally tolerated topical therapy is ineffective, SLT facilitates the realization of the target IOP. SLT is a repeatable procedure for which the vast majority of complications are mild and self-limiting. With effective IOP reduction, low complication rates and the potential to repeat the procedure, SLT offers the possibility of delaying the introduction of medical therapy and other more invasive treatment modalities while simultaneously avoiding the accompanying complications. With this knowledge, we suggest that SLT be considered as an essential primary treatment option in OAG and OHT, switching to other treatment modalities only when laser procedures are insufficient for achieving the required target IOP. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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19 pages, 577 KiB

Open AccessSystematic Review

Glaucoma, Pseudoexfoliation and Hearing Loss: A Systematic Literature Review

by Laura Antonia Meliante, Giulia Piccotti, Lucia Tanga, Sara Giammaria, Gianluca Manni and Giulia Coco

J. Clin. Med. 2024, 13(5), 1379; https://doi.org/10.3390/jcm13051379 - 28 Feb 2024

Viewed by 543

Abstract

Purpose: To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). Methods: A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. Results: Thirty studies out [...] Read more.

Purpose: To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). Methods: A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. Results: Thirty studies out of the 520 records screened met the inclusion criteria and were included. Most articles (n = 20) analysed the association between pseudoexfoliation syndrome (XFS) and HL, showing XFS patients to have higher prevalence of sensorineural hearing loss (SNHL) at both speech frequencies (0.25, 0.5, 1 and 2 kHz), and higher frequencies (4 and 8 kHz) compared to controls in most cases. No significant differences in prevalence or level of HL between XFS and pseudoexfoliative glaucoma (XFG) were detected in most studies. Eight articles analysed the relationship between primary open-angle glaucoma (POAG) and HL. Overall, a positive association between the two conditions was highlighted across all studies except for two cases. Similarly, articles focusing on NTG and HL (n = 4) showed a positive association in most cases. The role of autoimmunity and, in particular, the presence of antiphosphatidylserine antibodies (APSA) in patients with NTG and HL suggested an underlying autoimmune or vascular mechanism contributing to their pathogenesis. Only one study analysed the relationship between angle-closure glaucoma (ACG) and HL, showing higher incidence of ACG in patients with SNHL compared to normal hearing controls. Conclusions: Most studies detected an association between XFS and HL as well as POAG/NTG/ACG and HL, suggesting the presence of a similar pathophysiology of neurodegeneration. However, given the strength of the association of XFS with HL, it remains unclear whether the presence of XFG is further associated with SNHL. Further research specifically targeted to assess the correlation between glaucoma, XFS and HL is warranted to provide a more comprehensive understanding of this association. Full article

(This article belongs to the Special Issue Recommendations for Clinical Management of Glaucoma)

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