History Of Glaucoma Research Articles

Retrocorneal fibrous membrane after phacoemulsification in an eye with pseudoexfoliative glaucoma

ObjectifPrésenter un cas clinique d'apparition d'une membrane fibreuse rétrocornéenne et de décompensation cornéenne à la suite d'une phacoémulsification non compliquée dans un œil atteint de glaucome pseudo-exfoliatif. Nous présentons en outre une revue de synthèse de la littérature médicale sur les causes modernes de l'apparition d'une membrane fibreuse rétrocornéenne. MéthodeCas clinique et revue de la littérature médicale. RésultatsIl s'agit d'une femme de 83 ans n'ayant qu'un seul œil et présentant une décompensation cornéenne 1 an après l'extraction non compliquée d'une cataracte par phacoémulsification. La patiente, porteuse d'antécédents de glaucome pseudo-exfoliatif, avait subi 3 ans plus tôt une trabéculoplastie sélective au laser à 3 reprises dans le même œil. Compte tenu de l’œdème cornéen qui s'en est suivi, on a procédé à une kératoplastie endothéliale de la membrane de Descemet, laquelle a révélé la présence d'une membrane fibreuse rétrocornéenne. Le pelage chirurgical de la membrane s'est révélé difficile et a produit une hémorragie intraoculaire peropératoire de même qu'une légère iridodialyse en raison de l'extension de la membrane au-delà de l'angle et de l'iris. Après l'intervention, l’état de la cornée s'est rétabli, et la vision s'est améliorée de manière significative. À terme, la vision était toutefois limitée par l'atteinte maculaire. L'examen anatomopathologique a mis au jour la présence d'une membrane de Descemet à laquelle s'annexait une membrane fibrocellulaire. L'immunocoloration a permis de déceler la présence d'actine des muscles lisses dans celle-ci, signe évocateur d'une membrane rétrocornéenne. ConclusionsLes membranes fibreuses rétrocornéennes apparaissent le plus souvent après une greffe de cornée, de sorte que le retrait chirurgical risque d’être difficile. Nous présentons ici le premier cas de membrane fibreuse rétrocornéenne objectivée par examen anatomopathologique qui soit apparue au décours d'une chirurgie non compliquée de la cataracte par phacoémulsification et d'une trabéculoplastie sélective au laser.

Primary Open Angle Glaucoma

Primary open angle glaucoma is the most frequent type among the glaucomas. It is characterized by a progressive loss of retinal ganglion cells and a corresponding visual field loss. Risk factors include older age, ethnicity, family history of glaucoma and, most important, an elevated intraocular pressure (IOP). The IOP is the only modifiable risk factor for glaucoma progression. Therapeutic approaches aim to lowering the IOP and incorporate topical pressure lowering medication, laser treatment, and different surgical approaches. Surgery aims to reducing the outflow resistance of the aqueous humor. This may be achieved by surgically opening the trabecular meshwork or Schlemm's canal. Penetrating glaucoma surgery comprises classic trabeculectomy and other draining devices.

Relative Importance of Glaucoma-Referral Indicators in Retinal Images in a Diabetic Retinopathy Screening Programme in Slovenia: A Cross-Sectional Study.

Background and Objectives: Glaucoma is a major cause of irreversible visual impairment and blindness, so its timely detection is crucial. Retinal images from diabetic retinopathy screening programmes (DRSP) provide an opportunity to detect undiagnosed glaucoma. Our aim was to find out which retinal image indicators are most suitable for referring DRSP patients for glaucoma assessment and to determine the glaucoma detection potential of Slovenian DRSP. Materials and Methods: We reviewed retinal images of patients from the DRSP at the University Medical Centre Ljubljana (November 2019-January 2020, May-August 2020). Patients with at least one indicator and some randomly selected patients without indicators were invited for an eye examination. Suspect glaucoma and glaucoma patients were considered accurately referred. Logistic regression (LOGIT) with patients as statistical units and generalised estimating equation with logistic regression (GEE) with eyes as statistical units were used to determine the referral accuracy of indicators. Results: Of the 2230 patients reviewed, 209 patients (10.1%) had at least one indicator on a retinal image of either one eye or both eyes. A total of 149 (129 with at least one indicator and 20 without) attended the eye exam. Seventy-nine (53.0%) were glaucoma negative, 54 (36.2%) suspect glaucoma, and 16 (10.7%) glaucoma positive. Seven glaucoma patients were newly detected. Neuroretinal rim notch predicted glaucoma in all cases. The cup-to-disc ratio was the most important indicator for accurate referral (odds ratio 7.59 (95% CI 3.98-14.47; p < 0.001) and remained statistically significant multivariably. Family history of glaucoma also showed an impact (odds ratio 3.06 (95% CI 1.02-9.19; p = 0.046) but remained statistically significant only in the LOGIT multivariable model. Other indicators and confounders were not statistically significant in the multivariable models. Conclusions: Our results suggest that the neuroretinal rim notch and cup-to-disc ratio are the most important for accurate glaucoma referral from retinal images in DRSP. Approximately half of the glaucoma cases in DRSPs may be undiagnosed.

Study profile: the Genetics of Glaucoma Study

PurposeGlaucoma, a major cause of irreversible blindness, is a highly heritable human disease. Currently, the majority of the risk genes for glaucoma are unknown. We established the Genetics of Glaucoma...

Therapeutic drug monitoring of imipramine correlation with a case study

This article provides an overview of the pharmacokinetics, pharmacodynamics, contraindications, and precautions of imipramine, a tricyclic antidepressant (TCA) medication commonly used to treat depression and other mental health conditions. Imipramine’s pharmacokinetic properties include rapid absorption, distribution to various tissues, metabolism in the liver, and elimination through the kidneys. Imipramine’s pharmacodynamic effects are mediated through its actions on various neurotransmitters, including serotonin, norepinephrine, and dopamine. The article also discusses the contraindications and precautions associated with imipramine use. Imipramine is contraindicated in patients with a history of hypersensitivity to TCAs, recent myocardial infarction, and certain cardiac disorders. It should also be used with caution in patients with a history of seizures, urinary retention, glaucoma, and liver or kidney disease. In conclusion, imipramine is a medication with well-established pharmacokinetic and pharmacodynamic properties, but its use is associated with certain contraindications and precautions. Clinicians should carefully consider these factors when prescribing imipramine to patients with depression or other mental health conditions.

The prevalence of glaucoma in a 70-year-old Swedish population in the city area of Gothenburg.

To determine the prevalence of and risk factors for open-angle glaucoma in a population of 70-year-olds in Gothenburg, Sweden and to compare the visual function between the glaucoma population and the non-glaucoma population. Of the entire cohort (n = 1203), 1182 participants responded a questionnaire on self-reported glaucoma and were tested for blood pressure (BP) and diabetes. In all, 560 participants underwent ophthalmic examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), contrast sensitivity (CS), perimetry and photos of the retina and lens. Glaucoma prevalence was 4.8% (95% confidence interval, 3.0%-6.6%), of which 56% was previously undiagnosed. The proportion of participants with diastolic BP >90 mmHg was higher in the non-glaucomatous group (8.3%) than the glaucoma group (0%), p < 0.001. A family history of glaucoma was present in a larger proportion of the glaucoma group (39%) than of the non-glaucomatous group (1.1%), p = 0.001. Mean IOP in individuals without glaucoma was 16 mmHg, versus 21 mmHg in participants with glaucoma detected at the examination. IOP was ≤21 mmHg in 67% among participants with previously unknown glaucoma. BCVA was lower in eyes with previously unknown glaucoma than in eyes without glaucoma (p = 0.017) but BCVA in the best eye did not differ. CCT and CS were similar in all cases. The prevalence of glaucoma was comparable to that reported previously. A family history of glaucoma and higher IOP were risk factors associated with glaucoma. BCVA in the best eye did not differ significantly between subjects with and without glaucoma.

Exploring the Relationship between Anti-VEGF Therapy and Glaucoma: Implications for Management Strategies.

A short-term increase in intraocular pressure (IOP) is a common side effect after intravitreal anti-VEGF therapy, but a sustained increase in IOP with the development of secondary glaucoma has also been reported in some studies after repeated intravitreal anti-VEGF injections. The aim of this review is to present and discuss the possible pathophysiological mechanisms and factors contributing to a sustained rise in IOP, as well as treatment strategies for patients at risk. Close monitoring and adjustable IOP-lowering treatment are recommended for high-risk patients, including those with glaucoma, angle-closure anomalies, ocular hypertension or family history of glaucoma; patients receiving a high number of injections or at shorter intervals; and patients with capsulotomy. Strategies are needed to identify patients at risk in a timely manner and to prevent sustained elevation of IOP.

Prevalence of Glu323Lys Mutation of the TIGR/MYOC Gene and Risk Factors amongst Primary Open-angle Glaucoma Patients in Ouagadougou, Burkina Faso.

Glaucoma is a group of degenerative diseases of the optic nerve whose predisposing factors may be genetic. The objective of this study was to estimate the frequency of the Glu323Lys mutation as a genetic risk factor for glaucoma. A cross-sectional study over 6 months from October 2020 to March 2021 in Ouagadougou, Burkina Faso. A total of 89 samples of patients with primary open-angle glaucoma (POAG) were collected. The frequency of the Glu323Lys mutation of the myocilin, trabecular meshwork inducible glucocorticoid response (TIGR/MYOC) gene by polymerase chain reaction (PCR)-restriction fragment length polymorphism. In glaucoma patients, only homozygous nonmutated guanine-guanine (GG) and heterozygous mutated adenine-guanine (AG) genotypes were found in 96.63 and 3.37% of cases, respectively. Around 69.66% of patients had a family history of glaucoma, 28.09% had a history of hypertension, and 7.86% had a history of diabetes. The frequency of the Glu323Lys mutation of the TIGR/MYOC gene was 3.37% in the glaucoma population in Ouagadougou. A case-control study is necessary to know the contribution of the Glu323Lys mutation as a genetic risk factor for glaucoma in our study population. This study constituted the beginning of genetic investigations of glaucoma in our context and showed a low Glu323Lys mutation. Traoré L, Sanou J, Bakyono BS, et al. Prevalence of Glu323Lys Mutation of the TIGR/MYOC Gene and Risk Factors amongst Primary Open-angle Glaucoma Patients in Ouagadougou, Burkina Faso. J Curr Glaucoma Pract 2023;17(2):79-84.

Recruiting Populations at Higher Risk for Glaucoma and Other Eye Diseases Experiencing Eye Health Disparities

ABSTRACT Purpose We compared recruitment of participants at high risk for glaucoma and other eye diseases in three community-based studies designed to improve access to eye care in underserved populations in New York City, Alabama, and Michigan. Methods We used (1) participant data collected at enrollment (e.g. demographic, medical conditions, healthcare access, and method of hearing about study) and (2) interviews with study staff to assess effective recruitment strategies in enrolling people at high risk for eye disease. We analyzed participant data using descriptive statistics and interview data using content analysis to categorize responses to questions. Results In these community-based studies, all sites recruited greater proportions of populations with increased risk of eye disease compared to their estimates in the US population. High-risk characteristics varied based on the setting (i.e. Federally Qualified Health Centers or affordable housing buildings). Older adults represented 35% to 57%; 43% to 56% identified as Black; 1% to 40% as Hispanic/Latino; 20% to 42% reported a family history of glaucoma; 32% to 61% reported diabetes; and 50% to 67% reported high blood pressure. Social risk factors for under-utilization of eye care due to poverty included that 43% to 70% of participants had high school or lower education; 16% to 40% were employed; and 7% and 31% had no health insurance. From a qualitative perspective, active, personalized, culturally sensitive methods were most effective in recruiting participants. Conclusion Implementing eye disease detection interventions in community-based settings facilitated recruiting individuals at high risk for glaucoma and other eye diseases.

Netarsudil-associated reticular epithelial corneal edema after phacoemulsification

Introduction: To the authors' knowledge, this is the first reported case of netarsudil-associated reticular corneal edema noted shortly after phacoemulsification with intraocular lens (IOL) implantation. Patient and Clinical Findings: A 68-year-old woman with a history of chronic angle-closure glaucoma with a long-term history of tolerance to netarsudil presented with “honeycomb” epitheliopathy shortly after phacoemulsification with IOL implantation. Diagnosis, Intervention, and Outcomes: Netarsudil was discontinued, and the patient's reticular corneal edema resolved shortly thereafter. Conclusions: Reticular corneal epitheliopathy can be seen in patients being treated with netarsudil after phacoemulsification with IOL implantation. Fortunately, this condition resolves shortly after the drug is discontinued.

Ghost cell glaucoma secondary to vitreous hemorrhage caused due to ruptured retinal artery macroaneurysm

A 59 year old diabetic and hypertensive lady with primary open angle glaucoma and past history of non ischemic central retinal vein occlusion presented with vitreous hemorrhage(VH). The VH did not resolve over a 2 month period and led to a sudden rise in intraocular pressure(IOP). Anterior chamber had 2+ khaki colored cells. Gonioscopic examination revealed open angles and no evidence of neovascularization. The IOP was controlled with medical management and vitrectomy was performed for non-resolving VH, which revealed a ruptured retinal artery macroaneurysm (RAM). Our case report contributes to the understanding of the diverse clinical spectrum of RAM.

Clinical Features Associated with Acute Elevated Intraocular Pressure After Intravitreal Anti-VEGF Injections.

To study the effects of intravitreal injection (IVI) of anti-VEGF (vascular endothelial growth factor) agents on intraocular pressure (IOP) and find associations with acute pressure spikes. This was a three-month, prospective study of patients receiving outpatient IVI of anti-VEGF agents for diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinal vein occlusion (RVO) at the Acuity Eye Group Medical Centers. IOP was measured pre- and post-injection at 10-minute intervals up to 50 minutes after injection with a handheld tonometer. Patients with an IOP greater than 35 mmHg at 30 minutes received an anterior chamber paracentesis (ACP), while patients below 35 mmHg were monitored without intervention. A total of 617 patients (51% female, 49% male) received IVI for DR (n = 199), AMD (n = 355), and RVO (n = 63). ACP was performed in 17 patients. Average pre-injection IOP was 16 ± 4 compared to 24 ± 7 mmHg for the non-ACP vs ACP group, respectively (mean ± standard deviation), p < 0.0001. IOP returned to baseline in 98% of patients at 50 minutes. A diagnosis of glaucoma and glaucoma suspect was more prevalent in the ACP group compared to the non-ACP group, 82.3% vs 14.2% and 17.6% vs 9.0%, respectively, p < 0.0001 and p > 0.05. Patients with a pre-injection IOP >25 mmHg and a history of glaucoma had a 58.3% rate of ACP. A 31-gauge needle had a higher mean increase in IOP from baseline compared to 30-gauge needle, p < 0.0001. IOP spikes are most significant in the first 10 minutes after IVI but typically resolve within the first hour. However, utilizing a smaller 31-gauge IVI in patients with a glaucoma history and pre-injection IOP >25 mmHg may be associated with significant IOP spikes lasting longer than 30 minutes.

Assessment of Risk Factors for Primary Open-angle Glaucoma

Introduction: primary open-angle glaucoma (POAG) is a chronic and progressive anterior optic neuropathy characterized by perimetric alterations and pathological excavation of the optic disc in the absence of other ocular pathologies or congenital anomalies. It is usually accompanied by an increase in intraocular pressure. Gonioscopic examination confirms that the iridocorneal angle is open. The term "risk factor" is defined as a condition statistically leading to an increased risk of occurrence of an event. The purpose of our work is to list the main risk factors of POAG.&#x0D; Patients and Methods: This is a retrospective study carried out in our ophthalmology department over a period of 4 years between January 2018 and December 2021, involving one hundred patients with POAG followed in glaucoma consultation.&#x0D; Results: These are 100 cases, with an average age of 64.27, with a male predominance. The most found risk factors in our series are: age, intraocular hypertension (IOH), thin cornea, arterial hypertension, diabetes and family history of glaucoma.&#x0D; Conclusion: The identification of the main risk factors of POAG at the individual level is a major data of the management. Knowing these factors helps to monitor patients at risk more carefully and to adjust the treatment more appropriately in patients likely to develop glaucoma or to aggravate already known glaucoma. More efforts are required for early screening and education on POAG in communities, especially in a POAG high-risk population.

Predictors of glaucoma knowledge and its risk factors among Jordanian patients with primary open angle glaucoma at a tertiary teaching hospital: A cross-sectional survey.

To assess and compare glaucoma knowledge between Jordanian patients with glaucoma and non-glaucoma ophthalmic patients. A cross-sectional survey was developed after an extensive literature search to investigate glaucoma-related knowledge among participants with glaucoma visiting the Jordan University Hospital clinics from October 2021 to February 2022. Responses were compared to a sample of ophthalmic participants with eye conditions other than glaucoma visiting the ophthalmology clinics at the same time frame. A total of 256 participants filled out the survey, of which 53.1% were diagnosed with glaucoma while 46.9% had ophthalmic conditions other than glaucoma. Our sample of participants is characterized by a mean age of 52.2 ± 17.8 years and a male-to-female ratio of 1.04:1. Overall, participants with glaucoma were more aware of their disease than participants with other ophthalmic conditions. Compared to their ophthalmic non-glaucoma counterparts, those diagnosed with glaucoma face significantly more daily life difficulties due to their ophthalmic disease (p <0.001). Results of the independent sample t-test demonstrate that participants with glaucoma have significantly higher knowledge scores (p <0.001) and were able to recognize more glaucoma symptoms than their non-glaucoma counterparts (p = 0.002). Similarly, those with a positive family history of glaucoma displayed higher knowledge (p = 0.005). Multivariate linear regression demonstrates that family history of glaucoma, higher symptom recognition score, reliance on ophthalmologists, and the internet for glaucoma-related information are positive predictors of higher knowledge scores. We have demonstrated that both glaucoma and non-glaucoma ophthalmic patients display average levels of glaucoma knowledge. Raising awareness through various interventions may improve the lifestyles of patients with glaucoma and alleviate the economic burden associated with treating the disease.

Clinical features of the progression of primary open-angle glaucoma in patients with a burdened family history

PURPOSE. To identify clinical and epidemiological features of the course of primary open-angle glaucoma (POAG) in patients with a verified family history of the disease.METHODS. The study protocol included data from 103 people (103 eyes), among them 37 (35.9%) men and 66 (64.1%) women. Group 1 (44 people, 44 eyes) included patients with sporadic glaucoma. Group 2 consisted of patients with a hereditary form of the disease (41 people, 41 eyes). Healthy individuals (18 people, 18 eyes) comprised the control group. Mean age of all patients at the time of final examination was 60.6 (56.0; 66.3) years. In all cases, the diagnosis was established in accordance with the system of differential diagnosis of diseases. Examination was always carried out in person and included routine and specialized study methods (static automated perimetry, optical coherence tomography, examination of the thickness of the cornea in the central optical zone).RESULTS. The mean age of patients with a family history at the time of POAG diagnosis was 59.8 (53.9; 63.1) years, in patients with sporadic glaucoma — 63.85 (58.5; 67.9) years. Therefore, POAG in the group with a family history was diagnosed 4.05 years earlier. No significant differences in the structural and functional characteristics of the visual analyzer were established. A greater number of patients with the sporadic form of the disease undergo glaucoma surgery (47.7% and 34.1%, respectively) in comparable disease duration.CONCLUSION. In people with a family history of glaucoma, preventive screening should be carried out at an earlier age than the average in the population.

Immediate Rise in Intraocular Pressure After First-Time Intravitreal Injection of Bevacizumab.

Objective This study aims to report an immediate changein intraocular pressure (IOP) after the first injection of bevacizumab. Materials and methods An interventional case series was carried out at Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi, from November 2018 to April 2020. All patients with various chorioretinal diseases requiring anti-VEGF treatment were included in the study. Patients with a history of previous anti-VEGF or steroid injections and personal or family history of glaucoma were excluded. Bevacizumab in a dose of 1.25 mg (0.05 ml) was injected intravitreally under topical anesthesia maintaining sterile aseptic conditions in the operating room. IOP was checked one hour prior to the injection, and hourly monitoring of it was continued for the next six hours. Data were analyzed using SPSS Statistics to compare the mean IOP readings before and after injection. Results A total of 191 eyes of 147 patients were included in the study. Among them, 92 (62.58%) were male and 55 (37.41%) were female with a mean age of 45.5 ± 8.8 years. The mean pre-injection IOP was measured as 12.12 ± 2.11 mmHg. The frequency of IOP elevation of ˃ 21 mmHg was observed in 169 (88.5%) eyes at five minutes, 104 (54.5%) eyes at 30 minutes, 33 (17.3%) eyes at one hour, and 16 (8.4%) eyes at two hours. The raised mean post-operative IOP was 30.44 ± 6.53 mmHg at five minutes, 26.27 ± 4.65 mmHg at 30 minutes, 26.12 ± 3.31 mmHg at one hour, and 25.63 ± 3.03 mmHg at two hours. The IOP reduced to pre-injection value at three hours measuring12.12 ± 2.11 mmHg and continued to stay at that level for the next three hours. Conclusions The majority of the eyes receiving first-time intravitreal bevacizumab injection showed a significant increase in IOP levelwithin five minutes to two hours post-injection.

Axonal Transport in Coats’ Disease and Congenital Oculodentodigital Syndrome

Introduction: Axoplasmic transport blockade has been demonstrated in acute experimental glaucoma in animals but has not been documented in childhood glaucoma. The purpose of this study was to detail findings and axoplasmic transport status in one eye of a two-year old male with Coat’s disease using the two eyes from a 10-month-old female with Oculodentodigital Syndrome (ODDS) as controls for background axoplasmic transport. We document for the first-time axonal transport block in the lamina cribrosa (LC) in a blind and painful right eye associated with Coats’ disease, (Case 1). Enucleation was done for suspected retinoblastoma without imaging. Histopathology demonstrated myriad macrophages migrated from the vitreous infiltrate into the anterior chamber and meshwork explaining the glaucoma. Two eyes from Case 2, diagnosed at autopsy as having congenital Oculodentodigital Syndrome (ODDS), with a history of surgically normalized intraocular pressures were included as controls for the Coats’ case immunohistochemistry (IHC) and to report additional findings in this rare disorder. Methods: We reviewed available history and performed histopathology on one enucleated Coats’ globe and two additional autopsy eyes from an ODDS case with routine staining of paraffin-processed tissues and amyloid precursor protein (APP-A4) IHC, the only available IHC marker for orthograde axonal transport in human surgical or autopsy tissues. The two eyes from the 10-month-old infant with ODDS had normal IOPs following trabeculotomies at five months of age. Results: In addition to typical pathology for Coats’ the lamina cribrosa portion of the optic nerve from Case 1 demonstrated marked orthograde axonal transport block. Both eyes from Case 2 with ODDS had a history of congenital glaucoma treated medically before bilateral trabeculotomies at five months-age with normalization of IOPs. Descemet scrolls found OD were judged residual to goniotomy. Both globes from Case 2 demonstrated multiple anomalies previously reported in ODDS including microphthalmos, optic disc dysplasia OD, and features of persistent hyperplastic primary vitreous (PHPV) OU. The right eye also demonstrated spontaneous retinal detachment prompting an exam under general anaesthesia at 10-months age when, during induction, she expired with malignant tachycardia. Retinal ganglion cells (RCGs) labeled with APP-A4 OU, but optic nerve LC axons demonstrated only background accumulations of the IHC marker. Conclusions: Orthograde axonal transport was interrupted in the LC of the Coats’ nerve due to secondary inflammatory glaucoma. The angle remained open histologically in-spite-of-early neovascularization and pupillary margin ectropion. Block of orthograde axonal transport in the LC has been well established as the site of initial optic nerve damage in glaucoma in experimental studies and this report reinforces its importance to the pathophysiology of glaucoma optic nerve damage. The primary importance of the two ODDS globes for our report was as comparison controls for background APP-A4 staining in the Coats’ case. Our additional findings in the ODDS eyes suggest delayed spontaneous retinal detachment, and lens epithelial abnormalities are additional anomalies to add to the list of known malformations in this rare disorder. Case 2 also serves as a caution in ODDS regarding vulnerability to combinations of medications when general anaesthesia is contemplated.

Outcomes of Descemet's membrane keratoplasty in graft failure after penetrating keratoplasty.

To analyze the outcomes and identify the risk factors of failure in Descemet's membrane endothelial keratoplasty (DMEK) for graft failure after penetrating keratoplasty (PKP). Medical records and surgical videos of patients who underwent DMEK for graft failure after PKP were reviewed in this retrospective study. Demographic data, the indication for PKP, number of previous PKPs, duration between the last PKP and graft failure, graft diameter at the last PKP, best-corrected visual acuity (logMAR) before and after DMEK, preoperative additional ocular diseases, and intraoperative and postoperative complications were recorded. Descemet's membrane (DM) attachment was examined on the first day and the first month, postoperatively, and at the last follow-up visit. The patients were divided into two groups according to DM attachment at the last visit (group 1, patients with attached DM; group 2, patients with DM detachment). Twenty eyes of 20 patients were included in this study. At the last follow-up visit, DM was attached in 13 (65%) patients (Group 1) and detached in 7 (35%) cases (Group 2). The BCVA was improved significantly after DMEK in all patients (2.10 ± 0.4, preoperatively; 1.09 ± 0.8, postoperatively; p = 0.005). There were no significant differences between groups, in terms of age, the number and indication for PKP, the time between the last PKP and DMEK, or history of glaucoma. PKP was performed in all patients in group 2. DMEK is a feasible option with fast visual recovery and a low risk of complications in patients with graft failure after PKP. We found no risk factors for the DM graft detachment, so larger studies are needed to analyze intraoperative or donor-related factors as well.

Prevalence of Risk Factors Among Patients With Glaucoma in Jeddah, Saudi Arabia

Objective The objective of this study is to estimate the prevalence of risk factors among patients with glaucoma in Jeddah, Saudi Arabia. Methods This cross-sectional study was conducted on 215 patients diagnosed with glaucoma in the period between March 2022 and August 2022 at King Abdulaziz University Hospital, in Jeddah, Saudi Arabia. We used the participants’ medical records and contacted the patients to collect information on sociodemographic characteristics and known risk factors of glaucoma. Results Among the 215 patients with glaucoma, 142 (66.0%) patients had open-angle glaucoma, 15 (7.0%) patients had closed-angle glaucoma, and 58 (27.0%) patients had congenital glaucoma. Among the patients with open-angle glaucoma, 122 (85.9%) patients were aged &gt; 40 years, and 99 (69.7%) patients had myopia. Among the patients with closed-angle glaucoma, 13 (86.7%) patients had hyperopia and 10 (66.7%) patients were aged &gt; 60 years. Among the patients with congenital glaucoma, 21 (36.2%) patients had a family history of congenital glaucoma and 28 (48.3%) patients had consanguine parents. Conclusion The prevalence of advanced age, hyperopia, and consanguine parents was the highest among patients with open-angle glaucoma, closed-angle glaucoma, and congenital glaucoma, respectively. These findings could inform public health policies among practitioners involved in ophthalmological care.

Effect of Lens Status on Diabetic Vitreous Hemorrhage Resolution.

Purpose: To determine the effect of lens status (pseudophakic vs phakic) on diabetic vitreous hemorrhage (VH) resolution time. Methods: Medical records were reviewed retrospectively for each case of diabetic VH until resolution, pars plana vitrectomy (PPV), or loss to follow-up. Univariate and multivariate Cox regression models were used to determine predictors of diabetic VH resolution time through estimated hazard ratios (HRs). Kaplan-Meier survival analysis compared differences in the resolution rate by lens status and other significant factors. Results: Overall, 243 eyes were included. Pseudophakia (HR, 1.76; 95% CI, 1.07-2.90; P = .03) and prior PPV (HR, 3.28; 95% CI, 1.77-6.07; P < .001) were significant factors for faster resolution. Pseudophakic eyes resolved in 5.5 months (median, 25.1 weeks; 95% CI, 19.3-31.0) and phakic eyes in 10 months (median, 43.0 weeks; 95% CI, 36.0-50.0) (P = .001). More pseudophakic eyes than phakic eyes resolved without PPV (44.2% vs 24.8%) (P = .001). Eyes without prior PPV resolved in 9.5 months (median, 41.0 weeks; 95% CI, 35.7-46.3) compared with 5 months (median, 22.3 weeks; 95% CI, 9.8-34.8) in vitrectomized eyes (P < .001). Age, treatment with antivascular endothelial growth factor injections or panretinal photocoagulation, intraocular pressure medications, and glaucoma history were not significant predictors. Conclusions: Diabetic VH resolved almost twice as fast in pseudophakic eyes than in phakic eyes. Eyes with a history of PPV resolved 3 times quicker than those without PPV. A better understanding of VH resolution can help personalize the decision on when to proceed with PPV.