Christopher A. Girkin

24-2 Visual Fields Miss Central Defects Shown on 10-2 Tests in Glaucoma Suspects, Ocular Hypertensives, and Early Glaucoma.

Central visual field damage seen on the 10-2 test is often missed with the 24-2 strategy in all groups. This finding has implications for the diagnosis of glaucoma and classification of severity.

Deep Learning Approaches Predict Glaucomatous Visual Field Damage from OCT Optic Nerve Head En Face Images and Retinal Nerve Fiber Layer Thickness Maps.

Deep learning models had high accuracy in identifying eyes with GFVD and predicting the severity of functional loss from SD OCT images.

Detection of Glaucoma Progression in Individuals of African Descent Compared With Those of European Descent.

Patients of African descent with glaucoma showed increased visual field variability compared with those of European descent, resulting in delayed detection of progression that may contribute to explain higher rates of glaucoma-related visual impairment in…

Effects of Study Population, Labeling and Training on Glaucoma Detection Using Deep Learning Algorithms.

Deep learning glaucoma detection can achieve high accuracy across diverse datasets with appropriate training strategies.

Factors Influencing Central Lamina Cribrosa Depth: A Multicenter Study.

Central LD was deeper in African descent eyes and influenced least by age, axial length, and sex, but more by ASCO area, when measured relative to the ASCO and sclera.

Rates of Local Retinal Nerve Fiber Layer Thinning before and after Disc Hemorrhage in Glaucoma.

Although the rate of RNFL thinning worsened in a DH quadrant after DH, glaucoma treatment intensification may have a beneficial effect in reducing this rate of thinning.

Genetic Architecture of Primary Open-Angle Glaucoma in Individuals of African Descent: The African Descent and Glaucoma Evaluation Study III.

A novel association with advanced POAG in the EN04 locus was identified putatively in persons of AD.

Detecting Glaucoma in the Ocular Hypertension Study Using Deep Learning.

The model's high diagnostic accuracy using OHTS photographs suggests that DL has the potential to standardize and automate POAG determination for clinical trials and management.

A Novel Tree Shrew (Tupaia belangeri) Model of Glaucoma.

Tree shrews with experimental glaucoma show key pathologic characteristics of the human disease. The tree shrew model of glaucoma has the potential to help researchers accelerate our understanding of glaucoma pathophysiology.

The Magnitude of Intraocular Pressure Elevation Associated with Eye Rubbing.

: Rubbing the eyes causes momentary IOP elevations that average 109 mmHg above baseline IOP and can exceed 300 mmHg above baseline IOP in NHP eyes.

Baseline 24-2 Central Visual Field Damage Is Predictive of Global Progressive Field Loss.

The presence of central VF damage at baseline is significantly associated with more rapid global progression. Detection of central VF damage aids in stratification of high-risk patients who may need intensive surveillance and aggressive treatment.

Peripapillary Scleral Bowing Increases with Age and Is Inversely Associated with Peripapillary Choroidal Thickness in Healthy Eyes.

In non-highly myopic healthy eyes, outward peripapillary scleral bowing achieved substantial levels, was markedly increased with age, and was independently associated with decreased peripapillary choroidal thickness.

Comparing 10-2 and 24-2 Visual Fields for Detecting Progressive Central Visual Loss in Glaucoma Eyes with Early Central Abnormalities.

Trend-based analyses using 10-2 MD resulted in a mild reduction (7-9%) in the time to detect central visual field progression compared to C24-2 MD in glaucoma eyes with early central visual field abnormalities.

Impact of Smoking on Visual Field Progression in a Long-term Clinical Follow-up.

Heavy smokers are more likely to sustain VF loss in eyes with glaucoma.

Racial Differences in Rate of Change of Spectral-Domain Optical Coherence Tomography-Measured Minimum Rim Width and Retinal Nerve Fiber Layer Thickness.

Race is an important consideration when assessing structural change, particularly minimum rim width, in glaucoma suspect eyes. Differences in rate of structural change may help explain racial disparities in glaucoma susceptibility.

The Magnitude and Time Course of IOP Change in Response to Body Position Change in Nonhuman Primates Measured Using Continuous IOP Telemetry.

Body position has a significant effect on IOP and those changes persist over time.

Fast Progressors in Glaucoma: Prevalence Based on Global and Central Visual Field Loss.

This study found that approximately 1 in 8 eyes with glaucoma receiving routine care showed fast progression based on global MD values (< -1.0 dB/year) and that nearly 1 in 3 eyes showed a < -0.5 dB/year decline centrally.

Deep Learning Estimation of 10-2 and 24-2 Visual Field Metrics Based on Thickness Maps from Macula OCT.

Deep learning models improved estimates of functional loss from SD OCT imaging. Accurate estimates can help clinicians to individualize VF testing to patients.

Automated Beta Zone Parapapillary Area Measurement to Differentiate Between Healthy and Glaucoma Eyes.

Larger βPPA area, as determined by automated OCT assessment, is significantly associated with a diagnosis of glaucoma, even after adjusting for age and AL, and may aid in differentiating healthy from glaucomatous eyes.

Glaucoma Patient Knowledge, Perceptions, and Predispositions for Telemedicine.

Knowledge of telemedicine was variable but between one third and one half of patients had favorable attitudes toward using telemedicine for glaucoma care.

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma.

Adherence to ocular hypotensive medication worsened during the COVID-19 pandemic and seems to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.

A Longitudinal Analysis of Peripapillary Choroidal Thinning in Healthy and Glaucoma Subjects.

The rate of peripapillary choroidal thinning was not significantly different between healthy and glaucoma eyes during this relatively short follow-up period.

β-Zone Parapapillary Atrophy and Rates of Glaucomatous Visual Field Progression: African Descent and Glaucoma Evaluation Study.

Race had a significant effect on the association between baseline βPPA and rates of visual field progression in eyes with GON.

Individualized Glaucoma Change Detection Using Deep Learning Auto Encoder-Based Regions of Interest.

Eye-specific ROIs identified using DL-AE analysis of OCT images show promise for improving assessment of glaucomatous progression.

Relationship of Corneal Hysteresis and Anterior Lamina Cribrosa Displacement in Glaucoma.

Lower corneal hysteresis was significantly associated with posterior displacement of the anterior lamina cribrosa over time. These data provide additional support for lower corneal hysteresis being a risk factor for glaucoma progression.

Association of Intraocular Pressure With Retinal Nerve Fiber Layer Thinning in Patients With Glaucoma.

In this study, intraocular pressure variability was independently associated with structural change in patients with glaucoma, even after adjustment for mean intraocular pressure, supporting its potential value in clinical management.

Qualitative Evaluation of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma.

The similarity in performance of the 10-2 and C24-2 test suggests that the increased sampling density of the former does not significantly improve the detection of central visual field abnormalities, even when based on expert assessment.

Deep Learning Estimation of 10-2 Visual Field Map Based on Circumpapillary Retinal Nerve Fiber Layer Thickness Measurements.

The proposed CNNmodel improved the estimation of 10-2 VF map based on circumpapillary SD-OCT RNFL thickness measurements.

Racial Differences in the Association of Anterior Lamina Cribrosa Surface Depth and Glaucoma Severity in the African Descent and Glaucoma Evaluation Study (ADAGES).

This study demonstrates that a deeper ALCSD, regardless of the ALCSD reference plane used, is associated with more severe glaucoma and higher IOP in the ADAGES cohort, particularly in individuals of AD.

The African Descent and Glaucoma Evaluation Study (ADAGES) III: Contribution of Genotype to Glaucoma Phenotype in African Americans: Study Design and Baseline Data.

With its large sample size, extensive specimen collection, and deep phenotyping of AD and ED glaucoma patients and control participants from different regions in the United States, the ADAGES III genomics study will address gaps in…

Relative Contributions of Intraocular and Cerebrospinal Fluid Pressures to the Biomechanics of the Lamina Cribrosa and Laminar Neural Tissues.

Whereas TLP has been hypothesized to play a prominent role in ONH biomechanics, the IOP and CSFP effects are not equivalent, as IOP-driven stress, strain, and deformation play a more dominant role than CSFP effects.

Deep Learning Identifies High-Quality Fundus Photographs and Increases Accuracy in Automated Primary Open Angle Glaucoma Detection.

The DL quality model was able to accurately assess fundus photograph quality. Using automated quality assessment to filter out low-quality photographs increased the accuracy of a DL POAG detection model.

Compliance With Primary Open-angle Glaucoma and Primary Open-angle Glaucoma Suspect Preferred Practice Patterns in a Retail-based Eye Clinic.

Compliance with PPP guidelines for glaucoma care was very high for most elements but lower for performing dilated fundus examination, CCT, visual field, gonioscopy, and target IOP.

Comparison of Bruch's Membrane Opening Minimum Rim Width Among Those With Normal Ocular Health by Race.

BMO-MRW was not statistically different between those of AD and ED. Race-specific normative data may not be necessary for the deployment of BMO-MRW in AD patients.

Vision-Related Quality of Life Among Healthy, Preperimetric Glaucoma, and Perimetric Glaucoma Patients.

These findings suggest that patients with perimetric and preperimetric glaucoma have worse VRQOL than patients with healthy eyes.

Comparative Cost-effectiveness of Trabeculectomy versus MicroShunt in the US Medicare System.

Trabeculectomy appears to be a dominant treatment strategy over the MicroShunt in the surgical management of glaucoma.

Glaucomatous Visual Field Progression in the African Descent and Glaucoma Evaluation Study (ADAGES): Eleven Years of Follow-up.

Rates of VF progression were similar despite higher treated IOP in the Black race group.

Detection of Progression With 10-2 Standard Automated Perimetry: Development and Validation of an Event-Based Algorithm.

A new event-based progression algorithm using the 10-2 VF can identify eyes experiencing more rapid MD progression and may be used as a tool to assess progressive macular functional changes in glaucoma.

Disc Hemorrhages Are Associated With the Presence and Progression of Glaucomatous Central Visual Field Defects.

DH was associated with the presence and progression of central VF defects. DH identification should prompt intensive central VF monitoring and surveillance with 10-2 fields to detect progression.

Association Between Rate of Ganglion Cell Complex Thinning and Rate of Central Visual Field Loss.

In this cohort study, rapid GCC thinning during an initial follow-up period was associated with faster rates of central visual field decline.

A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor of Central Visual Field Progression in Glaucoma.

Lower CH was associated with a statistically significant, but relatively small, increased risk of central VF progression on the 10-2 test grid.

Central Visual Field Defects in Patients with Distinct Glaucomatous Optic Disc Phenotypes.

The severity and prevalence of central VF loss varied among different glaucomatous optic disc phenotypes.

Association of Rates of Ganglion Cell and Inner Plexiform Thinning With Development of Glaucoma in Eyes With Suspected Glaucoma.

This study found that faster rates of GCIPL and cpRNFL thinning were associated with higher risks of developing perimetric glaucoma.

A Deep Learning Approach to Improve Retinal Structural Predictions and Aid Glaucoma Neuroprotective Clinical Trial Design.

Our deep learning models were able to accurately estimate both macula GCIPL and ONH RNFL hemiretinal thickness.

Characteristics of Central Visual Field Progression in Eyes with Optic Disc Hemorrhage.

Central VF loss is accelerated in glaucoma eyes with DH and it corresponds topographically to the DH location.

Alabama Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (AL-SIGHT): Study Design and Methodology.

The study aims to develop a model eye health system using telemedicine to prevent vision loss and address eye health among underserved and at-risk populations.

Racioethnic Differences in Human Posterior Scleral and Optic Nerve Stump Deformation.

Our results suggest that, assuming glaucomatous nerve loss is caused by mechanical strains in the vicinity of the optic nerve head, the mechanism of increased glaucoma prevalence may be different in those of AD versus HIS.

Association between Rates of Retinal Nerve Fiber Layer Thinning and Previous Disc Hemorrhage in Glaucoma.

A history of DH is an independent risk factor for faster rates of RNFL thinning in non-DH quadrants and in DH quadrants; this risk is present even in eyes that exhibited DH several years earlier.

Frequency of Optical Coherence Tomography Testing to Detect Progression in Glaucoma.

With high specificity and less variability than perimetry, a 6-month testing interval provides a reasonable trade-off for following glaucoma patients using OCT.

The Relationship Between Intraocular Pressure and Rates of Central Versus Peripheral Visual Field Progression.

The effect of IOP parameters on VF progression was statistically similar between central and peripheral VF regions.

Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT): Baseline Results.

The high percentage of patients diagnosed with treatable eye conditions at telemedicine screening suggest these programs in FQHCs can be effective and scalable nationwide.

Progressive Visual Field Loss and Subsequent Quality of Life Outcomes in Glaucoma.

Baseline severity and initial rates of change of VF damage are associated with QOL outcomes over an extended follow-up.

Racial Differences in Detection of Glaucoma Using Retinal Nerve Fiber Layer Thickness and Bruch Membrane Opening Minimum Rim Width.

RNFLT and BMO-MRW had consistently lower diagnostic performance in AD individuals compared with ED individuals.

Smoking Cessation May Reduce Risk of Visual Field Progression in Heavy Smokers.

After ≥25 years of smoking cessation, the risk of VF progression in former heavy smokers becomes similar to never smokers. Long-term smoking cessation may be associated with lower VF progression in glaucoma patients.

Long-Term Blood Pressure Variability and Visual Field Progression in Glaucoma.

In this cohort study, higher mean blood pressure and higher SD of blood pressure were associated with faster VF progression.

Time to Glaucoma Progression Detection by Optical Coherence Tomography in Individuals of African and European Descents.

Time to progression detection was similar for both races when assuming identical RNFLT baseline/thinning rates, and shorter in AD eyes under real-world simulation when AD had faster RNFLT thinning.

Clinical Factors Associated With Long-Term OCT Variability in Glaucoma.

Relevant clinical factors affecting long-term RNFLT variability in glaucoma were identified.

Association Between Ganglion Cell Complex Thinning and Vision-Related Quality of Life in Glaucoma.

These findings suggest that faster and sectoral central location of ganglion cell complex thinning provides useful information in determining the risk of vision-related quality of life in glaucoma.

Racial Differences in the Rate of Change in Anterior Lamina Cribrosa Surface Depth in the African Descent and Glaucoma Evaluation Study.

Glaucomatous remodeling of the lamina cribrosa differs between AD and ED patients with glaucoma.

Progressive Thinning of Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer in Glaucoma Eyes with Disc Hemorrhage.

The rate of mGCIPL and cpRNFL thinning was faster in DH eyes than non-DH eyes.

Time to Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field in Glaucoma Individuals of African Descent.

Computer simulation showed a potentially shorter time to detect RNFLT progression than VF MD progression in eyes from individuals of AD.

Association Between Longitudinal 10-2 Central Visual Field Change and the Risk of Visual Acuity Loss in Mild-to-Moderate Glaucoma.

Faster 10-2 VF MD and hemifield MS worsening are associated with the development of VA loss. Monitoring the longitudinal central 10-degree VF change may suggest that there is impending VA impairment in glaucoma.

Association between Rates of Retinal Nerve Fiber Layer Thinning after Intraocular Pressure-Lowering Procedures and Disc Hemorrhage.

POAG or glaucoma suspect eyes with a history of DH should be carefully followed after IOP-lowering procedures.

Differential Impact of Central and Global Visual Field Progression on Quality of Life in Glaucoma.

Central VF change had a greater impact on VRQOL compared to global VF change.

Risk of Falls, Fear of Falling, and Rates of Visual Field Progression in Glaucoma in the African Descent and Glaucoma Evaluation Study.

A faster rate of MD progression is associated with a greater fear of falling and history of falls among AD and ED treated glaucoma patients.

Optic Disc Size and Circumpapillary Retinal Nerve Fiber Layer Thinning in Glaucoma.

Larger optic disc size is associated with faster cpRNFL thinning in glaucoma, independent of race.

Comparison of Glaucoma Diagnosis by Telemedicine, In-Person Ophthalmologist, and Optometrist.

The simulated telemedicine approach had comparable levels of agreement in glaucoma diagnosis with in-person fellowship-trained ophthalmologists, presenting a crucial complementary role in screening and increasing access to care, particularly in rural or underserved settings.

Association of Long-Term Intraocular Pressure Variability and Rate of Ganglion Complex Thinning in Patients With Glaucoma.

IOP variability showed an independent association with macular change in patients with glaucoma regardless of severity at baseline, even after adjustment for mean IOP, supporting its potential value as a therapeutic target for clinical decision-making.

Racial Differences in Diagnostic Accuracy of Retinal Nerve Fiber Layer Thickness in Primary Open-Angle Glaucoma.

OCT-RNFLT has lower diagnostic accuracy in eyes of AD compared to those of ED.

Cost Utility of Schlemm's Canal Microstent Injection With Cataract Surgery for Open-angle Glaucoma in the US Medicare System.

HMS implantation during cataract surgery appears to be cost-effective for patients with mild-to-moderate glaucoma. Nevertheless, more long-term safety and efficacy data are required.

Rates of Retinal Nerve Fiber Layer Thinning in Distinct Glaucomatous Optic Disc Phenotypes in Early Glaucoma.

Rates of cpRNFL thinning were different among the 4 glaucomatous optic disc phenotypes.

Protruded retinal layers within the optic nerve head neuroretinal rim.

Protruded retinal layers are a component of MRW measurements in most normal subjects, occurring in almost 12% of all measurement points analysed.

Performance of General-Purpose Vision Language Models and Ophthalmology Foundation Models in Glaucoma Detection and Function Prediction.

Fine-tuned VLMs demonstrated high performance in glaucoma detection and VF MD prediction, matching or exceeding specialized foundation models and traditional convolutional neural network (CNN)-based methods.

Impact of Physical Activity Levels on Visual Field Progression in Individuals With Glaucoma.

Higher PA amounts are an independent predictor of a slower rate of VF MD loss. Further research is needed to explore whether increased PA protects against glaucoma progression.

Feasibility of Glaucoma Detection Programs for At-Risk Populations Using Existing Health Care Infrastructure.

Telemetric care delivery programs that capitalize on existing infrastructure within a retail-based care setting or FQHCs may provide a promising setting to cost-effectively screen for glaucoma and other eye diseases that are potentially expandable nationwide.

Characterization of Temporal Delay and Modeling of Intraocular Pressure and Visual Field Progression in the African Descent and Glaucoma Evaluation Study (ADAGES).

ROP changes trail IOP changes by 4-7 months, an important consideration when obtaining additional VFs to capture or rule-out progression.

Proportion of Fast Progressors in the Central versus Global Visual Field Across Varying Glaucoma Severity Groups.

Selective analysis of the MTDdetected a greater proportion of eyes that exhibited fast progression across all disease severity groups compared to measurements from the entire VF, underscoring the importance of close monitoring for progressive central…

Automated Spectral-Domain Versus Swept-Source OCT Angiography in Relation to Glaucoma Severity.

OCT-A-derived RPC density is an independent correlate of VF MD across both SD-OCT and SS-OCT platforms.

Comparison of Methods for Visual Field Progression in Eyes With Central Visual Field Defects.

Agreement among methods for central VF progression monitoring is low to moderate. Concordance between 24-2 and 10-2 VF methods is variable, with 10-2 detecting a higher proportion of central progression.

Initial circumpapillary retinal nerve fibre layer rates of change predict glaucomatous progression.

The rate of initial cpRNFL change observed within half the monitoring period may effectively predict the subsequent structural progression and can be used by clinicians to predict the course of glaucoma when monitoring patients.

Number of macula optical coherence tomography scans needed to detect glaucoma progression.

Increasing the frequency of macular OCT testing to three times per year more sensitively detects progression compared with two times per year.

Response to Letter to the Editor: Cost Utility of Schlemm Canal Microstent Injection With Cataract Surgery for Open Angle Glaucoma in the US Medicare System.

Imaging the deep optic nerve: developing mechanistic biomarkers for glaucoma.

Long-term variability of retinal nerve fibre layer thickness measurement in patients with glaucoma of African and European descents.

Although some predictors were identified, long-term RNFLT variability appeared small for both AD and ED eyes.

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography.

Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT.

Structural Change Can Be Detected in Advanced-Glaucoma Eyes.

Ganglion cell-inner plexiform layer and 3D volume BKDS show promise for identifying change in severely advanced glaucoma.

African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.

Subjects of ED are at higher risk for developing DH compared with AD subjects, whereas AD subjects have greater prevalence of βPPA.

Unsupervised Gaussian Mixture-Model With Expectation Maximization for Detecting Glaucomatous Progression in Standard Automated Perimetry Visual Fields.

GEM-POP was significantly more sensitive to PGON than PoPLR and linear regression of MD and VFI in our sample, while providing localized progression information.

Rate and Pattern of Rim Area Loss in Healthy and Progressing Glaucoma Eyes.

Compared with healthy eyes, the mean rate of global rim area loss was 3.7 times faster and the mean rate of global percentage rim area loss was 5.4 times faster in progressing glaucoma eyes.

Diagnostic Accuracy of the Spectralis and Cirrus Reference Databases in Differentiating between Healthy and Early Glaucoma Eyes.

The Spectralis and Cirrus reference databases have a high specificity for identifying healthy eyes and good agreement for detection of eyes with early glaucoma damage.

Bruch's Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Thickness in a Normal White Population: A Multicenter Study.

There was significant age-related loss of BMO-MRW in healthy subjects and notable differences between BMO-MRW and RNFLT in their relationship with age and between each other.

Quantitative Trait Locus Analysis of SIX1-SIX6 With Retinal Nerve Fiber Layer Thickness in Individuals of European Descent.

Each copy of the T risk allele has an additive effect and was associated with thinner global and sectoral RNFL. Findings from this QTL analysis further support a genetic contribution to glaucoma pathophysiology.

The African Descent and Glaucoma Evaluation Study (ADAGES): predictors of visual field damage in glaucoma suspects.

In this cohort of glaucoma suspects with similar access to treatment, multivariate analysis revealed that at higher mean IOP during follow-up, individuals of African descent were more likely to develop VF damage than individuals of…

Biogeographic Ancestry in the African Descent and Glaucoma Evaluation Study (ADAGES): Association With Corneal and Optic Nerve Structure.

The BGA correlates with variation in ocular features that significantly differ across racial groups and that have been associated with the development of glaucoma.

Binocular visual field impairment in glaucoma and at-fault motor vehicle collisions.

On the basis of clinical measures of visual field routinely used in the management of glaucoma, drivers with glaucoma with severe PD field defects in the binocular field have a higher rate of at-fault MVC…