Publications by authors named "Golnoush Mahmoudinezhad"

13 Publications

  • Page 1 of 1

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

J Glaucoma 2022 Aug 2. Epub 2022 Aug 2.

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States.

Prcis: The earlier a person quits smoking the more likely is the optic nerve be spared from damage.

Purpose: To investigate the effect of smoking cessation on visual field (VF) progression in glaucoma.

Patients And Methods: Primary open-angle glaucoma patients with a minimum of 3 years follow-up and 5 visual fields (VF) were included. Linear mixed models were used to investigate the effects of smoking on the rates of 24-2 VF mean deviation loss after adjusting for confounding factors. Cox proportional hazard regression was used to identify whether different levels of smoking intensity were associated with VF progression with respect to different duration of quitting.

Results: 511 eyes of 354 patients were included over the mean follow-up of 12.4 years. Mean baseline age (95%CI) was 62.3 (61.2,63.4) years. 168 (59.8%) patients were smokers. In a multivariable model, smoking intensity was associated with faster VF loss (-0.06, 95%CI (-0.10,-0.01) dB/year per 10 pack-years, P=0.01) among smokers. Heavy smokers (≥20 pack-years) who had quit less than 25 years prior had significantly greater odds of VF progression compared to never smokers (OR=2.49 (1.01,6.08); P=0.046). There was no significant difference in odds of VF progression in heavy smokers who had quit smoking more than 25 years compared to never smokers (P=0.43). A significantly higher proportion of VF progression was found in heavy smokers who quit < 25 years compared to heavy smokers who quit ≥25 years by Kaplan-Meier analysis (P=<0.001).

Conclusions: 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IJG.0000000000002092DOI Listing
August 2022

Effects of Smoking on Optic Nerve Head Microvasculature Density in Glaucoma.

J Glaucoma 2022 Jul 19. Epub 2022 Jul 19.

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States.

Prcis: Decreased superficial whole image capillary density was observed in OAG patients with high smoking intensity.

Purpose: To investigate the effects of smoking on optic nerve head capillary density measured by optical coherence tomography angiography (OCTA) in patients with open angle glaucoma (OAG).

Methods: In this retrospective cross-sectional study, perimetric and preperimetric glaucoma patients enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) with OCTA follow up were included. Univariable and multivariable linear mixed analysis were performed to determine the effects of different variables on the superficial whole image capillary density (wiCD).

Results: A total of 432 eyes of 271 glaucoma patients comprising 63 preperimetric (106 eyes) and 208 perimetric OAG (326 eyes) were included. A history of tobacco consumption was reported in 105 (38.8%). Among smokers, mean (95% CI) smoking intensity was 12.8 (10.2, 15.5) pack-years. After adjusting for age, glaucoma severity and other confounders, each 10 pack-year increase in smoking intensity (95% CI) was associated with -0.54 (-1.06, -0.02) % lower wiCD (P=0.041).

Conclusions: Smoking intensity is associated with reduced optic nerve vessel density in glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IJG.0000000000002081DOI Listing
July 2022

Comparison of GCL and GCIPL Measures for Detection of Early Glaucoma.

Ophthalmol Glaucoma 2022 Jun 30. Epub 2022 Jun 30.

Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA. Electronic address:

Purpose: Test the hypothesis that macular ganglion cell layer (GCL) measurements detect early glaucoma with higher accuracy than ganglion cell/inner plexiform layer (GCIPL) thickness.

Design: Cross-sectional study PARTICIPANTS: The first cohort included 58 glaucoma eyes with visual field (VF) mean deviation (MD) ≥-6 dB and 125 normal eyes. The second cohort included 72 glaucoma and 73 normal/glaucoma suspect (GS) eyes with scans able to create GCL/GCIPL deviation maps.

Methods: In the first cohort, 8×8 GCL and GCIPL grids were exported and 5 superior and inferior sectors were defined. Global and sectoral GCL and GCIPL measures were used to predict glaucoma. In the second cohort, proportions of scan areas with abnormal (<5% and <1% cutoffs) and supernormal (>95% and >99% cutoffs) thickness on deviation maps were calculated. The extent of GCL and GCIPL abnormal area was used to predict glaucoma.

Main Outcome Measures: Extent of abnormal GCL/GCIPL regions and area-under-ROC curves (AUC) for prediction of glaucoma were compared between GCL or GCIPL measures.

Results: Average (±SD) MD was -3.7±1.6 and -2.7±1.8dB in glaucoma eyes in the first and second cohorts, respectively. Global GCIPL thickness (central 18˚×18˚ macular region) performed better than GCL for early detection of glaucoma (AUC: 0.928 vs. 0.884; p=0.004). Superior and inferior sector 3 thickness provided the best discrimination with both GCL and GCIPL (inferior GCL AUC: 0.860 vs. GCIPL AUC: 0.916, p=0.001; superior GCL AUC: 0.916 vs. GCIPL AUC: 0.900, p=0.24). The extent of abnormal GCL region at 1% cutoff in the central elliptical area was 17.5%±22.2% and 6.4%±10.8% in glaucoma and normal/GS eyes, respectively, vs. 17.0%±22.2% and 5.7%±10.5% for GCIPL (p=0.06 and =0.002). The extent of GCL and GCIPL supernormal regions were mostly similar in glaucoma and normal eyes. The best performance for prediction of glaucoma in the second cohort was detected at p<1% within the entire scan for both GCL and GCIPL (AUC=0.681 vs. =0.668; p=0.29).

Conclusions: Macular GCL and GCIPL thickness are equivalent for identifying early glaucoma with current OCT technology. This is likely explained by limitations of inner macular layer segmentation and concurrent changes within the inner plexiform layer in early glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ogla.2022.06.008DOI Listing
June 2022

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

JAMA Ophthalmol 2022 Jun 30. Epub 2022 Jun 30.

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla.

Importance: Faster structural changes may be associated with worse vision-related quality of life in patients with glaucoma.

Objectives: To evaluate the association between the rate of ganglion cell complex thinning and the Vision Function Questionnaire in glaucoma.

Design, Setting, And Participants: This retrospective analysis of a longitudinal cohort was designed in October 2021. Patients were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Two hundred thirty-six eyes of 118 patients with diagnosed or suspected glaucoma were followed up with imaging for a mean of 4.1 years from September 2014 to March 2020.

Main Outcomes And Measures: The Vision Function Questionnaire was evaluated using the 25-item National Eye Institute Visual Function at the last follow-up visit. Ganglion cell complex thickness was derived from macular optical coherence tomography scans and averaged within 3 circular areas (3.4°, 5.6°, and 6.8° from the fovea) and superior and inferior hemiregions. Linear mixed-effects models were used to investigate the association between the rate of ganglion cell complex thinning and Rasch-calibrated Vision Function Questionnaire score.

Results: The mean (SD) age was 73.2 (8.7) years, 65 participants (55.1%) were female, and 53 participants (44.9%) were African American. Race was self-reported by the participants. Mean composite Rasch-calibrated National Eye Institute Visual Function Questionnaire score was 50.3 (95% CI, 45.9-54.6). A faster annual rate of global ganglion cell complex thinning in the better eye was associated with a higher disability reflected by the composite National Eye Institute Visual Function Questionnaire score (-15.0 [95% CI, -28.4 to -1.7] per 1 μm faster; P = .03). When stratified by degrees from the fovea, the 5.6° and 6.8° areas were associated with the composite National Eye Institute Visual Function Questionnaire Rasch-calibrated score (-14.5 [95% CI, -27.0 to -2.0] per 1 μm faster; R2 = 0.201; P = .03; and -23.7 [95% CI, -45.5 to -1.9] per 1 μm faster; R2 = 0.196; P = .02, respectively), and -8.0 (95% CI, -16.8 to 0.8) per 1 μm faster for the 3.4° area (R2 = 0.184; P = .07) after adjusting for confounding factors.

Conclusions And Relevance: 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. Monitoring macular structure may be useful for determining the risk of functional impairment in glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaophthalmol.2022.2140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9247856PMC
June 2022

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

Ophthalmology 2022 Jun 22. Epub 2022 Jun 22.

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States. Electronic address:

Purpose: To investigate the effect of smoking on the rates of progressive visual field damage over time in glaucoma.

Design: Retrospective cohort study.

Participants: A total of 511 eyes of 354 patients with glaucoma followed from multicenter glaucoma registries.

Methods: In this longitudinal study, 354 primary open-angle glaucoma (POAG) patients with a minimum of 3 years follow-up and 5 visual field (VF) tests were enrolled from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). Univariable and multivariable linear mixed models were used to investigate the effects of smoking on the rates of 24-2 VF mean deviation loss. VF progression was defined using pointwise linear and significant negative VF MD loss. Logistic regression was used to identify baseline factors and whether different levels of smoking intensity were associated with VF progression. Kaplan-Meier survival analysis and the log-rank test were used to compare the cumulative risk ratio of progression between smoker and never smoker groups.

Main Outcome Measures: VF progression RESULTS: A total of 511 eyes of 354 patients were included over the median follow-up of 12.5 years. Median baseline age was 64.8 years. Of the 354 patients, 124 (35%) were African ethnicity , and 168 (59.8%) and 149 (42.1%) had reported a history of smoking or alcohol consumption, respectively. In a multivariable model, higher smoking intensity was associated with faster VF loss (coefficient -0.05 (-0.08,-0.01)dB/year per 10 pack-years, P=0.010). Developing VF progression in eyes of heavy smokers (≥20 pack-years) was 2.2 times greater than in eyes of patients without smoking history (OR=2.21; 95% CI: 1.02,4.76; P=0.044). Statistically significant differences were found between heavy smokers (≥20 packs-year) and never smokers by Kaplan-Meier analysis (log-rank test, P=0.011).

Conclusions: Heavy smokers are more likely to have VF loss in eyes with glaucoma. The prospective longitudinal design of this study supports the hypothesis that levels of smoking may be a significant predictor for glaucoma progression. Additionally, this information can be used for clinically relevant tobacco prevention and intervention messages.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ophtha.2022.06.017DOI Listing
June 2022

Multipressure Dial Goggle Effects on Circumpapillary Structure and Microvasculature in Glaucoma Patients.

Ophthalmol Glaucoma 2022 May 20. Epub 2022 May 20.

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA. Electronic address:

Purpose: To evaluate the effects of pressure changes induced by a multipressure dial (MPD) on circumpapillary retinal nerve fiber layer (RNFL) and capillary density (CD) measurements in patients with glaucoma using OCT angiography (OCTA).

Design: Prospective interventional study.

Participants: Twenty-four patients with primary open-angle glaucoma.

Methods: One eye of each patient underwent negative pressure application with the MPD. The MPD alters intraocular pressure (IOP) relative to atmospheric pressure by generating a negative pressure vacuum within a goggle chamber that is placed over the eye. Each participant underwent serial high density OCTA imaging (AngioVue) of the optic nerve head at different negative pressure increments of -5 mmHg, starting from 0 mmHg, ending at -20 mmHg, and then returning to baseline. Images were acquired after 2 minutes of sustained negative pressure at each target pressure to allow for stabilization of the retinal structures and microvasculature. The RNFL thickness and CD measurements were automatically calculated using the native AngioVue software, and then exported for analysis.

Main Outcome Measures: The influence of different levels of negative pressure on circumpapillary RNFL thickness and CD measurements, assessed by a linear mixed-effects model with repeated measures.

Results: The mean (± SD) age was 71.0 years (± 7.8 years), the baseline IOP was 17.5 mmHg (± 3.6 mmHg), and there was a mean 24-2 mean deviation of -2.80 dB (± 2.55 dB). Serial circumpapillary CD measurements showed a statistically significant dose-dependent increase from baseline, without negative pressure application, to the maximum negative pressure application of -20 mmHg (difference, 2.27%; P = 0.010). Capillary density measurements then decreased symmetrically when lowering the negative pressure to baseline. Circumpapillary CD measurements at target negative pressures of -10 mmHg, -15 mmHg, and -20 mmHg were significantly higher than the baseline measurements (all P values < 0.05). Circumpapillary RNFL thickness remained the same throughout different levels of negative pressure.

Conclusions: Circumpapillary CD measurements showed a dose-dependent increase with the induction of negative pressure, while RNFL thickness measurements remained unchanged.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ogla.2022.05.004DOI Listing
May 2022

Rates of Choroidal Microvasculature Dropout and Retinal Nerve Fiber Layer Changes in Glaucoma.

Am J Ophthalmol 2022 May 10;241:130-138. Epub 2022 May 10.

From the Hamilton Glaucoma Center(E.M., S.M., T.N., N.E.N., G.M., A.K., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. Electronic address:

Purpose: To evaluate the association between rates of choroidal microvasculature dropout (MvD) change and rates of circumpapillary retinal nerve fiber layer (cpRNFL) loss in primary open-angle glaucoma (POAG) eyes.

Design: Cohort study from clinical trial data.

Methods: A total of 91 eyes of 68 POAG patients with and without localized MvD at baseline with at least 4 visits and 2 years of follow-up with optical coherence tomography angiography (OCT-A) and OCT scans were included. Area and angular circumference of MvD were evaluated on OCT-A en face and B-scan choroidal vessel density images during the follow-up period. Joint longitudinal mixed effects models were used to estimate the rates of change in MvD area or angular circumference and RNFL thickness. Univariable and multivariable regressions were completed to identify the factors contributing to cpRNFL thinning.

Results: MvD was identified in 53 eyes (58.2%) at baseline. Seventeen eyes (18.6%) that did not show MvD at baseline developed it over the follow-up period. Over a mean follow-up of 4.0 years, the mean rates of change in MvD area and angular circumference (95% CI) were 0.05 (0.04, 0.06) mm per year and 13.2° (10.7°, 15.8°) per year, respectively. In multivariable models, the rate of cpRNFL thinning was significantly associated with the rates of change in MvD area and angular circumference (P = .008 and P = .009, respectively).

Conclusions: Rates of MvD area and angular circumference change over time were associated with concurrent rates of cpRNFL loss in POAG eyes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajo.2022.04.024DOI Listing
May 2022

Retinal Occlusive Vasculitis in a Patient with Hyperimmunoglobulin E Syndrome.

Case Rep Ophthalmol Med 2021 23;2021:6317358. Epub 2021 Dec 23.

Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Hyperimmunoglobulin E syndrome (HIES), or Job's syndrome, is a primary immunodeficiency disorder that is characterized by an elevated level of IgE with values reaching over 2000 IU (normal < 200 IU), eczema, and recurrent staphylococcus infection. Affected individuals are predisposed to infection, autoimmunity, and inflammation. Herein, we report a case of HIES with clinical findings of retinal occlusive vasculitis. . A 10-year-old boy with a known case of hyperimmunoglobulin E syndrome had exhibited loss of vision and bilateral dilated fixed pupil. Fundoscopic examination revealed peripheral retinal hemorrhaging, vascular sheathing around the retinal arteries and veins, and vascular occlusion in both eyes. A fluorescein angiography of the right eye showed hyper- and hypofluorescence in the macula and hypofluorescence in the periphery of the retina, peripheral arterial narrowing, and arterial occlusion. A fluorescein angiography of the left eye showed hyper- and hypofluorescence in the supranasal area of the optic disc. Macular optical coherence tomography of the right eye showed inner and outer retinal layer distortion. A genetic study was performed that confirmed mutations of the dedicator of cytokinesis 8 (DOCK 8). HSV polymerase chain reaction testing on aqueous humor and vitreous was negative, and finally, the patient was diagnosed with retinal occlusive vasculitis.

Conclusion: Occlusive retinal vasculitis should be considered as a differential diagnosis in patients with hyperimmunoglobulin E syndrome presenting with visual loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2021/6317358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718279PMC
December 2021

Risk factors for microcystic macular oedema in glaucoma.

Br J Ophthalmol 2021 Nov 5. Epub 2021 Nov 5.

Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA

Background/aims: To identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG).

Methods: We included 315 POAG eyes between 2010 and 2019 with good-quality macular volume scans that had reliable visual fields (VF) available within 6 months in this observational retrospective cohort study. Eyes with retinal pathologies except for epiretinal membrane (ERM) were excluded. The inner nuclear layer was qualitatively assessed for the presence of MME. Global mean deviation (MD) and Visual Field Index (VFI) decay rates, superior and inferior MD rates and pointwise total deviation rates of change were estimated with linear regression. Logistic regression was performed to identify baseline factors associated with the presence of MME and to determine whether MME is associated with progressive VF loss.

Results: 25 out of 315 eyes (7.9%) demonstrated MME. The average (±SD) age and MD in eyes with and without MME was 57.2 (±8.7) versus 62.0 (±9.9) years (p=0.02) and -9.8 (±5.7) versus -4.9 (±5.3) dB (p<0.001), respectively. Worse global MD at baseline (p=0.001) and younger age (p=0.02) were associated with presence of MME. ERM was not associated with the presence of MME (p=0.84) in this cohort. MME was not associated with MD and VFI decay rates (p>0.49).

Conclusions: More severe glaucoma and younger age were associated with MME. MME was not associated with faster global VF decay in this cohort. MME may confound monitoring of glaucoma with full macular thickness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bjophthalmol-2021-320137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9068828PMC
November 2021

Detection of Longitudinal Ganglion Cell/Inner Plexiform Layer Change: Comparison of Two Spectral-Domain Optical Coherence Tomography Devices.

Am J Ophthalmol 2021 11 5;231:1-10. Epub 2021 Jun 5.

From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California. Electronic address:

Purpose: We compared rates of change of macular ganglion cell/inner plexiform (GCIPL) thickness and proportion of worsening and improving rates from 2 optical coherence tomography (OCT) devices in a cohort of eyes with glaucoma.

Design: Longitudinal cohort study.

Methods: In a tertiary glaucoma clinic we evaluated 68 glaucoma eyes with ≥2 years of follow-up and ≥4 OCT images. Macular volume scans from 2 OCT devices were exported, coregistered, and segmented. Global and sectoral GCIPL data from the central 4.8 × 4.0-mm region were extracted. GCIPL rates of change were estimated with linear regression. Permutation analyses were used to control specificity with the 2.5 percentile cutoff point used to define "true" worsening. Main outcome measures included differences in global/sectoral GCIPL rates of change between 2 OCT devices and the proportion of negative vs positive rates of change (P < .05).

Results: Average (standard deviation) 24-2 visual field mean deviation, median (interquartile range) follow-up time, and number of OCT images were -9.4 (6.1) dB, 3.8 (3.3-4.2) years, and 6 (5-8), respectively. GCIPL rates of thinning from Spectralis OCT were faster (more negative) compared with Cirrus OCT; differences were significant in superonasal (P = .03) and superotemporal (P = .04) sectors. A higher proportion of significant negative rates was observed with Spectralis OCT both globally and in inferotemporal/superotemporal sectors (P < .04). Permutation analyses confirmed the higher proportion of global and sectoral negative rates of change with Spectralis OCT (P < .001).

Conclusions: Changes in macular GCIPL were detected more frequently on Spectralis' longitudinal volume scans than those of Cirrus OCT. OCT devices are not interchangeable with regard to detection of macular structural progression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajo.2021.05.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8829879PMC
November 2021

Local Macular Thickness Relationships between 2 OCT Devices.

Ophthalmol Glaucoma 2021 Mar-Apr;4(2):209-215. Epub 2020 Aug 29.

Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. Electronic address:

Purpose: To compare local ganglion cell-inner plexiform layer (GCIPL) thickness measurements between 2 OCT devices and to explore factors that may influence the difference in measurements.

Design: Cross-sectional study.

Participants: Sixty-nine glaucoma eyes (63 patients) with evidence of central damage or mean deviation (MD) of -6.0 dB or worse on a 24-2 visual field (VF).

Methods: Cirrus and Spectralis OCT macular volume scans were exported, data from the central 20° of both OCT devices were centered and aligned, and 50 × 50 arrays of 0.4° × 0.4° superpixels were created. We estimated nonparametric (Spearman's) correlations and used Bland-Altman plots to compare GCIPL thickness measurements between the two OCTs at the superpixel level. Factors that may have influenced the differences between thickness measurements between the two devices were explored with linear mixed models.

Main Outcome Measures: Pooled and individual-eye Spearman's correlation and agreement between thickness measurements from the two devices.

Results: The median 24-2 VF MD was -6.8 dB (interquartile range [IQR], -4.9 to -12.3 dB). The overall pooled Spearman's correlation between the two devices for all superpixels and eyes was 0.97 (P < 0.001). The median within-eye correlation coefficient was 0.72 (IQR, 0.59-0.79). Bland-Altman plots demonstrated a systematic bias in most individual eyes, with Spectralis GCIPL measurements becoming larger than Cirrus measurements with increasing superpixel thickness. The average superpixel thickness and distance to the fovea influenced the thickness difference between the two devices in multivariate models (P < 0.001).

Conclusions: Local macular thickness measurements from the Spectralis and Cirrus devices are highly correlated, but not interchangeable. Differences in thickness measurements between the two devices are influenced by the location of superpixels and their thickness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ogla.2020.08.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914265PMC
October 2021

COVID-19 Pandemic: Are We Back to Normal?

J Glaucoma 2020 08;29(8):611-612

Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IJG.0000000000001590DOI Listing
August 2020

Rate of visual field decay in glaucomatous eyes with acquired pits of the optic nerve.

Br J Ophthalmol 2021 03 13;105(3):381-386. Epub 2020 May 13.

Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles (UCLA), Los Angeles, California, USA

Background: To evaluate the relationship between the presence of an acquired pit of the optic nerve (APON) and the rate of visual field (VF) decay in primary open-angle glaucoma (POAG).

Methods: Consecutive patients with POAG were screened for APON by three glaucoma specialists. A control group of POAG eyes without APON were matched with the APON group for factors such as age, gender, baseline intraocular pressure and baseline mean deviation (MD). The pointwise rate of change (PRC) was used for pointwise comparisons between the two groups. MD rate, Visual Field Index (VFI) rate and Glaucoma Rate Index (GRI) were used for global rate comparisons. We compared the proportions of eyes progressing in the groups with event-based guided progression analysis (GPA), MD, VFI and GRI criteria.

Results: Mean (SD) PRC was faster in the APON group -1.00 (±2.57) %/year compared with the control group -0.25 (±2.19) %/year; p<0.001. MD rate (-0.22 (±0.27) dB/year vs 0.03 (±0.41) dB/year; p=0.009), VFI rate (-0.81 (±0.86) %/year vs -0.05 (±1.0) %/year; p=0.04) and GRI (-12.27 (±16.27) vs -3.75 (±10.6); p=0.052) were all faster in the APON group compared with controls. The proportion of progressing eyes with GPA, MD, VFI and GRI was not significantly different between the two groups (p>0.1).

Conclusions: The presence of APON in patients with POAG is associated with focal, fast rates of VF decay. Identification of patients with APON should alert clinicians to the possibility of a fast rate of functional progression and to consider appropriately aggressive treatment of their glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bjophthalmol-2020-315980DOI Listing
March 2021
-->