Concept Library

The survival rates of PreserFlo™ MicroShunt implantation in refractory childhood glaucoma declined to 53% at 12 months and 33% at 24 months in 34 eyes from 27 children.

Overall success of PreserFlo™ MicroShunt implantation was 61.70% in 34 eyes from 27 children with refractory childhood glaucoma, with 50% achieving complete success (IOP <21 mmHg and ≥25% IOP reduction without medications) at an average follow-up time of 13.92±4.85 months.

PreserFlo™ MicroShunt implantation significantly reduced mean IOP-lowering medication numbers from 3.0±0.0 to 0.9±1.3 (P < 0.001) in 34 eyes from 27 children (mean age 4.9 ± 3.6 y) with refractory childhood glaucoma.

PreserFlo™ MicroShunt implantation significantly reduced mean intraocular pressure (IOP) from 24.29±6.05 mmHg to 17.95±8.22 mmHg (P < 0.001) in 34 eyes from 27 children (mean age 4.9 ± 3.6 y) with refractory childhood glaucoma.

The risk of endophthalmitis was significantly higher for pediatric versus adult patients following cataract surgery (P = 0.014), with an incidence of 0.11% (1 case per 871) in pediatric patients and 0.038% (1 case per 2652) in adult patients.

Early primary angle closure glaucoma (PACG) patients (n=86 eyes) are associated with thicker choroidal thickness (CT) and higher choroidal vascularity index (CVI) in 1-12 mm annular regions of the macula, independent of age and axial length.

In early primary angle closure glaucoma (PACG) patients (n=86 eyes), the mean choroidal thickness (CT) in the inferior nasal and inferior temporal peripapillary regions was thicker than that of healthy controls (n=79 eyes) (both P <0.05).

After adjusting for age and/or axial length, subfoveal choroidal thickness (CT) and choroidal vascularity index (CVI) remained significantly higher in early primary angle closure glaucoma (PACG) patients (n=86 eyes) than in healthy controls (n=79 eyes) (both P <0.01).

Increased subfoveal choroidal thickness (CT) and choroidal vascularity index (CVI) were associated with younger age, primary angle closure glaucoma (PACG) diagnosis, and/or shorter axial length (all P <0.05) in early PACG patients (n=86 eyes) and healthy controls (n=79 eyes).

Early primary angle closure glaucoma (PACG) patients (n=86 eyes) exhibited thicker choroidal thickness (CT) and higher choroidal vascularity index (CVI) in all macular regions compared with healthy controls (n=79 eyes) (all P <0.05).

Optic nerve head (ONH) vessel density (VD) positively correlated with structural parameters in eyes with previous acute primary angle closure (APAC).

Macular vessel density (VD) was less affected in eyes with previous acute primary angle closure (APAC) compared to peripapillary VD.

Eyes with previous acute primary angle closure (APAC) demonstrated marked reduction in peripapillary vessel density (VD) compared with primary angle closure suspects (PACS) and age-sex-matched healthy controls.

In treated primary angle closure disease (PACD) eyes after laser peripheral iridotomy (LPI), angle opening distance (AOD) 250/500 nasal cutoffs demonstrated high specificity (100%/96.4%) with low sensitivity for discriminating disease severity.

In treated primary angle closure disease (PACD) eyes after laser peripheral iridotomy (LPI), an anterior chamber depth (ACD) ≤1.82 mm demonstrated high sensitivity (100%) but low specificity (21.4%) for discriminating disease severity.

Acute angle closure glaucoma (AACG) had the most narrowing and highest iris-ciliary body thickness (ITC) values among the primary angle closure disease (PACD) spectrum after laser peripheral iridotomy (LPI).

Significant differences in AS-OCT parameters were observed for anterior chamber depth (ACD) (P=0.020), angle opening distance (AOD) (P <0.001), trabecular-iris space area (TISA) (P <0.001), anterior chamber area (ARA) (P <0.001), iris-ciliary body thickness (ITC) Index (P=0.001), and ITC Area (P=0.013) in treated primary angle closure disease (PACD) eyes after laser peripheral iridotomy (LPI).

Anterior segment optical coherence tomography (AS-OCT) parameters, particularly anterior chamber depth (ACD) and nasal angle parameters, show persistent structural differences across the primary angle closure disease (PACD) spectrum even after laser peripheral iridotomy (LPI) and can be a useful adjunctive tool for structural assessment and risk stratification in treated eyes.

Acute angle closure (p = 0.017, odds ratio = 5.650, 95% CI: 1.325-24.084) and younger age (p = 0.017, odds ratio = 0.937, 95% CI: 0.889-0.989) were associated with higher visibility of Berger's space in a cross-sectional observational study of 109 eyes from 81 participants with primary angle closure disease (PACD).

Eyes with visible Berger's space were younger (p = 0.008), had narrower anterior chamber angles, and anteriorly shifted lens positions (p = 0.031) compared to eyes with invisible Berger's space in a cross-sectional observational study of 109 eyes from 81 participants with primary angle closure disease (PACD).

The prevalence of visible Berger's space in the acute primary angle closure (APAC) group (36.67%) was significantly greater than in the fellow eyes of APAC (F-APAC) group (9.38%) and the chronic primary angle closure (glaucoma) (CPAC[G]) group (17.02%) (p = 0.028) in a cross-sectional observational study of 109 eyes from 81 participants with primary angle closure disease (PACD).

The acute primary angle closure (APAC) group exhibited the highest prevalence of visible Berger's space at 36.67% in a cross-sectional observational study of 109 eyes from 81 participants with primary angle closure disease (PACD).

Intraocular lens subluxation predominated in reoperations among patients with angle closure secondary to lens subluxation (ASAC-LS) (50.0%), while uncontrolled intraocular pressure (IOP) was most common in reoperations among patients with primary angle-closure glaucoma (PACG) (56.0%) after phacoemulsification combined with goniosynechialysis (Phaco-GSL).

Independent risk factors for reoperation following phacoemulsification combined with goniosynechialysis (Phaco-GSL) were age > 60 years (HR = 5.132, P < 0.001), angle closure secondary to lens subluxation (ASAC-LS) diagnosis (HR = 3.619, P = 0.004), previous glaucoma surgery (HR = 4.257, P = 0.002), and higher preoperative intraocular pressure (IOP) (HR = 1.043, P = 0.006).

Patients with angle closure secondary to lens subluxation (ASAC-LS) had a significantly higher 5-year reoperation rate (2.3%) after phacoemulsification combined with goniosynechialysis (Phaco-GSL) compared to patients with primary angle-closure glaucoma (PACG) (0.9%), with a P-value of 0.003.

Multivariate analysis identified three independent factors associated with acute primary angle closure (APAC) in a cross-sectional study of 116 patients: higher intraocular pressure (IOP) (odd ratio [OR] = 1.073, P = 0.003), lower arteriovenous ratio from quantile 4 (AVRQ4) (OR = 0.957, P = 0.025), and decreased arterial fractal dimension (FD) (OR = 0.953, P = 0.028).

Acute primary angle closure (APAC) eyes demonstrated reduced bifurcation densities, fractal dimension (FD), and branching angle for arteries and veins (all P ≤ 0.005) compared to fellow eyes in a cross-sectional study of 116 patients with unilateral APAC.

Compared to fellow eyes, acute primary angle closure (APAC) eyes showed larger retinal vein caliber (P < 0.001), increased length-to-diameter ratio in arteries and veins (P < 0.001 and = 0.001), and lower arteriovenous ratio from quantile 4 (AVRQ4) (P < 0.001) in a cross-sectional study of 116 patients with unilateral APAC.

Greater iridotrabecular contact (ITC) length in the superior sector was associated with greater risk of angle closure progression in 825 untreated eyes of participants aged 50 to 70 years with bilateral primary angle closure suspect (PACS) (HR, 1.72 per 250 µm in length; 95% CI, 1.11-2.66; P = .02; C index = 0.67).

Greater iridotrabecular contact (ITC) length in the nasal sector was associated with greater risk of angle closure progression in 825 untreated eyes of participants aged 50 to 70 years with bilateral primary angle closure suspect (PACS) (HR, 1.64 per 250 µm in length; 95% CI, 1.23-2.20; P < .001; C index = 0.70).

In age-adjusted Cox models, iridotrabecular contact (ITC) presence in the nasal sector was associated with greater risk of angle closure progression in 825 untreated eyes of participants aged 50 to 70 years with bilateral primary angle closure suspect (PACS) (hazard ratio [HR], 4.68; 95% CI, 1.80-12.17; P = .002; concordance index [C index] = 0.71).

10 out of 105 eyes that underwent optometrist-performed laser peripheral iridotomy required a redo LPI.

Transient adverse events were reported in 4 out of 105 patients who underwent optometrist-performed laser peripheral iridotomy.

Optometrist two achieved a patent iridotomy in 89% of 105 eyes on which they performed laser peripheral iridotomy.

Optometrist one achieved a patent iridotomy in 93% of 105 eyes on which they performed laser peripheral iridotomy.

In a multicenter retrospective cohort study of 156 eyes from 130 acute primary angle closure (APAC) patients, early cataract extraction (<3 months) was protective against glaucomatous optic neuropathy (GON) progression (aOR: 0.43, P =0.047), an effect partly mediated through IOP reduction (indirect effect β=-0.20, 95% CI: -0.39 to -0.04).

In a multicenter retrospective cohort study of 156 eyes from 130 acute primary angle closure (APAC) patients, worse baseline visual field mean deviation (VFMD) was an independent predictor of glaucomatous optic neuropathy (GON) progression (aOR: 1.07 per 1 dB worsening, P =0.048).

In a multicenter retrospective cohort study of 156 eyes from 130 acute primary angle closure (APAC) patients, higher mean follow-up intraocular pressure (IOP) was an independent predictor of glaucomatous optic neuropathy (GON) progression (aOR: 1.14 per mm Hg, P =0.005).

Female sex (OR = 1.19, P < .001), non-HMO insurance (OR ≥ 1.19, P ≤ .006), and Black race (OR = 1.18, P = .003) conferred higher odds of acute angle closure (AAC) diagnosis following dilation under Definition 1 (International Classification of Diseases code for AAC glaucoma within 14 days of dilation) in a nationwide cohort.

Income ≥$100,000 compared to <$40,000 (OR ≤ 0.83, P < .001), non-Northeast regions (OR ≤ 0.74, P ≤ .002), and pseudophakia status (OR ≤ 0.73, P < .001) conferred lower odds of acute angle closure (AAC) diagnosis following dilation under both definitions in a nationwide cohort.

Older age compared to <40 years (OR ≥ 3.26, P < .001), Asian race and Hispanic ethnicity compared to non-Hispanic Whites (OR ≥ 1.38, P < .001), and prior angle closure diagnosis (OR ≥ 12.74, P < .001) conferred higher odds of acute angle closure (AAC) diagnosis following dilation under both definitions in a nationwide cohort.

The incidence of acute angle closure (AAC) diagnosis per dilation in a nationwide cohort of 11,452,733 patients who underwent 26,478,250 dilations was 0.004% under Definition 2 (Definition 1 plus CPT code for iridotomy/iridectomy or lens extraction within 14 days of AAC diagnosis).

The incidence of acute angle closure (AAC) diagnosis per dilation in a nationwide cohort of 11,452,733 patients who underwent 26,478,250 dilations was 0.01% under Definition 1 (International Classification of Diseases code for AAC glaucoma within 14 days of dilation).

From 6 months to 2 years post-laser iridotomy, ganglion cell-inner plexiform layer (GCIPL) thinning averaged -1.27 μm/year in acute primary angle-closure glaucoma (AACG) eyes with optic disc swelling (ODS) versus -0.69 μm/year in controls (P = 0.006).

From 6 months to 2 years post-laser iridotomy, retinal nerve fiber layer (RNFL) thinning averaged -2.86 μm/year in acute primary angle-closure glaucoma (AACG) eyes with optic disc swelling (ODS) versus -0.77 μm/year in controls (P = 0.005).

Eyes with optic disc swelling (ODS) in acute primary angle-closure glaucoma (AACG) showed retinal nerve fiber layer (RNFL) thickening followed by sustained thinning, and ganglion cell-inner plexiform layer (GCIPL) thickness declined continuously, despite mean IOP consistently < 16 mmHg.

Larger pupil diameter (odds ratio = 15.23) and longer symptom duration (odds ratio = 2.03) were independently associated with optic disc swelling (ODS) in acute primary angle-closure glaucoma (AACG) patients.