Symptoms Of Glaucoma Research Articles

Acupuncture as Adjuvant Therapy for Glaucoma: Protocol for a Randomized Controlled Trial.

Glaucoma is a chronic progressive optic neuropathy that necessitates lifelong treatment to reduce the decline of the optic nerve. Due to the extended and continuous treatments required for patients, complementary therapies are often considered alongside conventional treatments to enhance the effectiveness of the treatment. Acupuncture has demonstrated the potential to lower intraocular pressure in previous clinical trials, making it a promising glaucoma intervention. The primary objective of this study is to conduct a single-center randomized control trial involving patients with glaucoma. Acupuncture will be evaluated as an adjunctive therapy. The trial aims to explore its effectiveness for glaucoma. In this single-center randomized controlled trial, participants (N=50) with primary open-angle glaucoma will be randomly assigned to the treatment group, receiving ophthalmic acupuncture with "De Qi" sensation, or the control group, receiving minimum acupuncture stimulation on nonophthalmic acupoints. The intervention will consist of weekly acupuncture treatments for a total of 6 sessions. Participants will be assessed at 8 time points, which are baseline, during the intervention (6 times), and at a 3-month follow-up. The primary outcome measure is a change in the intraocular pressure before and after each acupuncture treatment. Secondary outcomes will include measurements of heart rate and blood pressure before and after acupuncture, best-corrected visual acuity, visual field, optical coherence tomography, optical coherence tomography angiography, the Glaucoma Symptom Scale, and the Glaucoma Quality of Life-15 questionnaire. Recruitment of participants for the trial commenced on June 28, 2023. A total of 10 participants have been enrolled to test the feasibility of the experiment. We anticipate that the preliminary data from this trial will be completed by December 2025. This trial uses rigorous methodology and comprehensive outcome measurements to assess the clinical efficacy of acupuncture as an adjunctive therapy for glaucoma, providing valuable insights for future clinical treatment guidelines. ClinicalTrials.gov NCT05753137; https://clinicaltrials.gov/study/NCT05753137. DERR1-10.2196/57888.

Comparative proteomic analysis of retinal hypoxia-ischemia in an acute ocular hypertension model using tandem mass tag-based quantitative proteomics

The main symptom of acute glaucoma is acute ocular hypertension (AOH), which leads to the death of retinal ganglion cells (RGCs) and permanent loss of vision. However, effective treatments for these conditions are lacking. This study aimed to identify major regulators and overall protein changes involved in AOH-induced RGC death. Proteomic patterns of the retinal protein extracts from the AOH and sham groups were analyzed using mass spectrometry (MS), followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses.Proteomic analysis revealed 92 proteins in the AOH group compared to the control group; 58 proteins were upregulated and 34 were downregulated. Alterations in fatty acid-binding protein 7 (FABP7) and caveolin-1 (Cav-1), which are related to fatty acid metabolism and ocular inflammatory signaling, were detected using western blotting and biochemical assays. Variations in the expression of galectin-1 (Gal-1), S100 calcium-binding protein A6 (S100a6), and visinin-like protein-1 (VILIP) have been associated with neuronal ischemia. Our investigation demonstrates that neuroinflammation and fatty acid metabolism are involved in retinal impairment following AOH, suggesting a possible treatment approach for acute glaucoma.

Microglial cGAS–STING signaling underlies glaucoma pathogenesis

Characterized by progressive degeneration of retinal ganglion cells (RGCs) and vision loss, glaucoma is the primary cause of irreversible blindness, incurable and affecting over 78 million patients. However, pathogenic mechanisms leading to glaucoma-induced RGC loss are incompletely understood. Unexpectedly, we found that cGAS-STING (2'3'-cyclic GMP-AMP-stimulator of interferon genes) signaling, which surveils displaced double-stranded DNA (dsDNA) in the cytosol and initiates innate immune responses, was robustly activated during glaucoma in retinal microglia in distinct murine models. Global or microglial deletion of STING markedly relieved glaucoma symptoms and protected RGC degeneration and vision loss, while mice bearing genetic cGAS-STING supersensitivity aggravated retinal neuroinflammation and RGC loss. Mechanistically, dsDNA from tissue injury activated microglial cGAS-STING signaling, causing deleterious macroglia reactivity in retinas by cytokine-mediated microglia-macroglia interactions, progressively driving apoptotic death of RGCs. Remarkably, preclinical investigations of targeting cGAS-STING signaling by intraocular injection of TBK1i or anti-IFNAR1 antibody prevented glaucoma-induced losses of RGCs and vision. Therefore, we unravel an essential role of cGAS-STING signaling underlying glaucoma pathogenesis and suggest promising therapeutic strategies for treating this devastating disease.

A review on glaucoma: causes, symptoms, pathogenesis & treatment

If glaucoma is not treated, it can worsen and cause irreparable vision loss. It results from elevated intraocular pressure that gradually deteriorates the optic nerve. It is unclear exactly what causes this build-up of pressure, but several factors, including age, genetics, and specific medical disorders, may be involved. Glaucoma frequently has mild symptoms that take time to manifest and may not be apparent until considerable harm has already been done. Early detection and treatment can help prevent additional vision loss, which is why routine eye exams are so crucial. In order to reduce intraocular pressure, glaucoma is usually treated with medication or surgery. Eye drops, tablets, or a mix of the two can be prescribed. Traditional filtration surgery is one of the surgical options or more recently less invasive techniques. Glaucoma is a dangerous eye condition that needs to be closely watched over and managed. Although early diagnosis and therapy can help protect vision and prevent additional impairment, there is currently no treatment for the disease. People who are at elevated risk for glaucoma, including those who have a family history of the condition or who are older than 60, should make an appointment for regular checkups with an ophthalmologist to be checked for glaucoma symptoms. The article's summary will aid researchers in their efforts to improve glaucoma treatment.

Monitoring, treatment and care of glaucoma

Glaucoma is a serious ophthalmic disease with extremely high blindness rates, second only to cataracts. Glaucoma can be divided into 3 types according to clinical practise: primary glaucoma, secondary glaucoma, and congenital glaucoma. If glaucoma is not treated in a timely manner, it can lead to irreparable results. Therefore, the prevention and treatment of glaucoma is particularly important, and it is necessary to emphasize early detection, diagnosis, and treatment. The main symptom of glaucoma is an increase in intraocular pressure caused by aqueous humor and excessive generation of blocked discharge, but intraocular pressure is controllable. When intraocular pressure increases, it can cause many irreversible damage in the eye, such as optic disc atrophy, visual field loss, visual loss, and severe pain. This article will review the monitoring, treatment, and care of glaucoma. Monitoring mainly includes traditional equipment and new equipment. Treatment can also be divided into traditional methods and new methods, and their advantages and limitations are compared. In the end, the article will provide some suggestions for daily care of glaucoma patients.

The Effects of ROCK Inhibitor on Prevention of Dexamethasone-Induced Glaucoma Phenotype in Human Trabecular Meshwork Cells.

This study investigated the effects of dexamethasone (Dex) on human trabecular meshwork (TM) cells, a model of glucocorticoid-induced glaucoma, and evaluated the impact of ripasudil (Rip) as a co-delivery or sequential dosing strategy. In vitro experiments were conducted to assess the effects of Dex and Rip on TM cells. Confocal microscopy was used to evaluate the impact of Dex and Rip on F-actin staining signals. Contractility of the TM cells upon Dex and Rip treatment mimicking co-delivery and sequential delivery was quantified using collagen gel contraction assay. Transepithelial electrical resistance (TEER) values and fluorescein isothiocyanate (FITC)-dextran permeability were also measured to assess the impact of Dex and Rip on TM cells. Dex and Rip did not exhibit cytotoxicity at the maximum tested concentration (20 µM). Dex-treated TM cells exhibited higher F-actin staining signals compared to controls, which were reduced when co-treated with Rip. Rip inhibited Dex-induced collagen gel contraction activity in both co-delivery and sequential treatments. Dex resulted in increased TEER values as the dose increased, whereas TEER values were maintained when co-treated with Rip. Co-delivery of Rip has the potential to prevent glaucoma symptoms when patients are treated with Dex. This study highlights the importance of identifying strategies to reduce the side effects of prolonged use of glucocorticoids, such as Dex, in the treatment of various diseases. This study demonstrates the potential of co-delivering ripasudil with dexamethasone to mitigate glucocorticoid-induced ocular hypertension and a secondary glaucoma that resembles primary open-angle glaucoma, providing insights for the development of novel preventive strategies in clinical care.

Treatment Preferences and Factors Influencing the Management of Primary Angle-Closure Suspect in China: A National Survey Study.

This study explored the current views of ophthalmologists in China on the preferred strategy and the primary influencing factors in managing primary angle-closure suspect (PACS). An online survey was distributed via WeChat to ophthalmologists working in hospitals at all levels throughout China to investigate the optimal management strategy and factors influencing the strategy for treating PACS from February to March 2023. Management strategies examined included regular observation (RO), laser peripheral iridectomy (LPI), and phacoemulsification with intraocular lens implantation (PEI). The study explored the factors that influenced clinical decision-making processes and collected demographic information from the respondents for analysis. A total of 1009 ophthalmologists responded; 442 responders considered RO as a reasonable option for patients with PACS, while the majority opted for more positive treatments, with 460 choosing LPI and 107 selecting PEI. Further grouping analysis revealed significant differences between tertiary and lower-level hospitals (P < 0.01) and between public and private hospitals (P < 0.05). Significant differences were found among resident, attending, and senior doctors and between northern and southern hospitals. The top three considerations for ophthalmologists who selected RO were ultrasound biomicroscopy (UBM) without pupillary block, absence of a family history of glaucoma, and good compliance with regular follow-up. For LPI, the factors were UBM indicating pupillary block, glaucoma symptoms, and poor compliance with regular follow-up. For PEI the factors were age, family history of glaucoma, and poor compliance with regular follow-up. The majority of ophthalmologists prefer aggressive treatments such as LPI or PEI over RO when dealing with patients with PACS. Disparity existed among ophthalmologists based on their level of experience, hospital ownership and level, and geographical location. The survey underscores the complexity and multifactorial nature of PACS management and highlights the need for further research and standardization of treatment protocols to ensure optimal patient outcomes.

Awareness and Knowledge About Glaucoma in the Western Region of Saudi Arabia: A Population-Based Survey.

Background Glaucoma is a leading cause of irreversible blindness worldwide. This study aimed to assess the Saudi population's levels of awareness and knowledge regarding glaucoma risk factors, symptoms, treatment, and outcomes. Methods A cross-sectional study was conducted among the Glaucoma Awareness Campaign attendees during the World Glaucoma Week (2015-2016). A structured questionnaire was used, and a knowledge score (0-25) was calculated as the sum of all correct answers. Sociodemographic factors, personal and family history of glaucoma, and the presence of risk factors were investigated and analyzed as factors affecting knowledge. Results The study included 1751 participants, with amean age of 40.23 (SD ±13.86) years; 51.5% were males, 3.7% hadglaucomaand 22.6% had a family history of glaucoma. The overall awareness rate was 65.6%, which was moderately higher among females (71.6%), older participants (≥40 years, 69.7%), and highly educated participants (70.6%). Concerning knowledge, 15.4% had fair to good knowledge (score 15-25). Participants with a personal history of glaucoma had relatively greater knowledge regarding glaucoma-specific questions, such as optic nerve damage (p=0.001) and the requirement of lifetime treatment (p<0.001). Conclusion Awareness and knowledge about glaucoma are limited among the Saudi population, regardless of socioeconomic class or educational status. Knowledge about glaucoma should be further promoted to enable early screening and prevention.

Changes in the morphofunctional parameters of the eye in neovascular glaucoma on the after vitreoretinal surgery

Purpose: to assess morphological and functional parameters of the eyeball in patients with neovascular glaucoma (NVG) and diabetic macular edema (DME) after vitreoretinal interventions.Material and methods. This study involved 60 patients (60 eyes), aged 59 ± 12 including 34 men and 26 women. The patients were divided into three groups: group 1 — 19 patients (19 eyes) with NVG and DME after a vitreoretinal surgery (VRS) for proliferative diabetic retinopathy performed no earlier than a year ago. If DME was found within 6 months after the surgery, a drug was administered intravitreally (3 loading injections given with monthly intervals). The patients’ history contained cataract phacoemulsification with an implantation of an intraocular lens (IOL). Group 2 (23 patients, 23 eyes) consisted of persons with stage III primary open-angle glaucoma (POAG) with the duration of the glaucomatous process of up to 5 years, who received no laser or surgical antiglaucomatous interventions. The history of these patients also contained phacoemulsification operations with IOL implantation. Group 3 (18 patients, 18 eyes), which was composed of patients with pseudophakia but no symptoms of glaucoma or other eye pathology, served as control.Results. The opening of the anterior chamber angle (ACA) in NVG (group 1) was 2.73 times smaller (p = 0.034) than in POAG (Group 2) and 3.69 times smaller than in the control group (p = 0.034). Neovascularization of the iris and the ACA could primarily be seen in patients with NVG (84 %). Goniosynechiae in the ACA of group 1 patients were seen 6.35 times more often than in group 2 patients and 14.45 times more often than in group 3 patients. Rubeosis occurred in group 1 patients 4.65 times as often as in group 2 and 6.64 times more often than in group 3 patients (p = 0.034). Statistically significant differences of morphometric parameters of the optic disc between groups 1 and 2, on the one hand, and group 3, on the other hand were found. Meanwhile, the figures for groups 1 and 2 were statistically comparable, which is explained by the same degree of severity of the glaucomatous process in these groups. The analysis of indices of computer perimetry MD, MS and sLV showed a developed glaucomatous process in groups 1 and 2. The revealed changes are based on pathognomonic factors. In particular, they may be caused by the prior surgical intervention affecting the vitreoretinal interface in group 1 patients.Conclusion. The onset of NVG is primarily caused by a grave course of proliferative diabetic and changes in the ACA profile, due to the formation of synechiae. Regardless of the risk factors, the result of surgical treatment depends on the condition of the ischemic retina and the anterior segment of the eye. Thus, the assessment of the morphofunctional parameters of the eye in patients with NVG and DME after VRS is of great interest. Changes in such parameters as the degree of openness of the ACA, distance from the iris to the IOL, the presence of rubeosis and synechia may be used to determine the methods and tactics of surgery, which will eliminate the pathophysiological factors of the onset and progression of CVH, and reduce postoperative complications.

Correlation between visual field index and quality of life in glaucoma patients: a new tool to screen quality of life perception?

To evaluate the correlation between the visual field index (VFI) and vision-related quality of life (QoL) considering several confounding variables that may have a positive or negative effect. We conducted a cross-sectional, mono-centric study on glaucoma patients. Quality of life was examined with the NEI-VFQ 25 and the Glaucoma Symptom Scale (GSS). The visual field was examined with the Humphrey Field Analyzer. The variables considered were age, gender, comorbidities, years (at diagnosis and duration of the illness), treatment and related active principles, intraocular pressure, and visual acuity. The analysis was performed on both the better and the worse eye. The linear regression univariate analysis and the multivariate analyses were performed. In total, 193 patients enrolled in the study. The mean age was 70.8 ± 10.4 years. The mean follow-up period since diagnosis 11.4 ± 9.2 years. Approximately 50% of the patients suffered from primary open angle glaucoma (POAG) and 45% were on monotherapy. The mean VFI was 81.3 ± 26. Regarding QoL, the NEI-VFQ total mean was 80.4 ± 17.8 and the GSS total score was 77.2 ± 21. Regarding NEI-VFQ 25, the single linear regression analysis found the following relations: age at time of visit (r = -0.30, p = 0.016), years of illness (r = -0.32, p = 0.020), the minimum and maximal visual acuity (r = 2.04 and r = 3.96, p < 0.001), the IOP min (r = 1.13, p = 0.002) and max (r = -0.52, p = 0.017), and the number of previous surgeries (r = -3.94, p < 0.001). The multivariate analysis found the following relations: gender (r = 5.13, p = 0.019), visual acuity max (r = 3.16, p < 0.001), and previous surgeries (r = -1.80, p = 0.032). Regarding GSS, the single linear regression analysis found relations with visual acuity (r = 2.37, p < 0.001), VFI (r = 0.41, p < 0.001), previous surgeries in the eye considered (r = -7.27, p < 0.001), and number of instillations (r = -3.67, p = 0.031). Data confirmed that a higher VFI has a positive impact on the score of both the NEI-VFQ 25 (r = 0.22, p = < 0.001) and the GSS questionnaire (r = 0.36, p < 0.001). The study demonstrated a correlation between the VFI and QoL of patients and their visual and non-visual ocular symptoms and function both in the worst and in the better eye, even when accounting for several clinical and demographic confounding variables. Our data support that the visual field index is an important metric instrument in the follow up of patients with glaucoma.

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.

RISK FACTORS FOR DEVELOPMENT OF PHACOMORPHIC GLAUCOMA IN MATURE CATARACT - A HOSPITAL BASED STUDY, JHANSI

Aim:To study the roles of axial length and anterior chamber depth as risk factors for the development of phacomorphic glaucoma in eyes with mature cataract. Material and Methods: This is a prospective case-control study done in the year 2023 at Department of Ophthalmology, MLB Medical College, Jhansi. Phacomorphic glaucoma was diagnosed by Intraocular Pressure of more than 21 mmHg, intumescent cataract with signs and symptoms of phacomorphic glaucoma, axial length and anterior chamber depth.All patients examined by slit lamp examination . Results: The Mean Intra ocular pressure of phacomorphic glaucoma was 49±8 mmHg and of mature cataract was 15±6 mmHg. Vision was Light perception in phacomorhic glaucoma and Hand movement observed was mature cataract. The mean axial length was 23.08±0.32mmHg among phacomorphic glaucoma, shorter than mature cataract, where the mean axial length was 23.71±0.78mm. Conclusion:Patients with shorter axial lengths are at increased risk for phacomorphic glaucoma.

Glaucomatous optic nerve damage in the contralateral eye of a patient with peripapillary retinoschisis: a case report

BackgroundPeripapillary retinoschisis (PPRS) is often associated with glaucomatous eyes. It usually occurs in eyes with a more advanced stage of glaucoma with obvious optic nerve damage. We report a patient who was found to have PPRS in one eye during a routine physical examination without obvious glaucoma symptoms. Further examination revealed glaucomatous visual field loss and retinal nerve fiber layer defects in the contralateral eye.Case presentationA 55-year-old man presented for a routine physical examination. The anterior segment was normal in both eyes. Fundus examination revealed an elevated and red optic disc in the right eye. In addition, scattered patchy red lesions were seen on the retina on the temporal side of the optic disc. The color and boundary of the left optic disc were normal, and the cup-to-disc ratio was 0.6. Optical coherence tomography showed retinoschisis on the optic nerve head of the right eye throughout the entire circumference, extending to the retina on the temporal side of the optic disc. The intraocular pressure was 18 mmHg OD and 19 mmHg OS. The patient was diagnosed with PPRS (OD). However, no optic disc pit or optic disc coloboma was found. Further examination showed that the visual field of the patient’s right eye was generally normal, while a glaucomatous visual field defect was found in the left eye, which manifested as a nasal step visual field defect. Moreover, stereophotography and a red-free fundus image revealed two retinal nerve fiber layer defects in the supratemporal and infratemporal regions of the retina of the left eye. Continuous intraocular pressure measurement found that the intraocular pressure fluctuated between 18 and 22 mmHg OD and 19–26 mmHg OS during the daytime. Primary open-angle glaucoma was then diagnosed.ConclusionsIn this case, we found that PPRS was associated with glaucomatous optic nerve changes and visual field defects in the fellow eye.

Recent Progress in Chitosan-Based Nanomedicine for Its Ocular Application in Glaucoma.

Glaucoma is a degenerative, chronic ocular disease that causes irreversible vision loss. The major symptom of glaucoma is high intraocular pressure, which happens when the flow of aqueous humor between the front and back of the eye is blocked. Glaucoma therapy is challenging because of the low bioavailability of drugs from conventional ocular drug delivery systems such as eye drops, ointments, and gels. The low bioavailability of antiglaucoma agents could be due to the precorneal and corneal barriers as well as the low biopharmaceutical attributes of the drugs. These limitations can be overcome by employing nanoparticulate drug delivery systems. Over the last decade, there has been a lot of interest in chitosan-based nanoparticulate systems to overcome the limitations (such as poor residence time, low corneal permeability, etc.) associated with conventional ocular pharmaceutical products. Therefore, the main aim of the present manuscript is to review the recent research work involving the chitosan-based nanoparticulate system to treat glaucoma. It discusses the significance of the chitosan-based nanoparticulate system, which provides mucoadhesion to improve the residence time of drugs and their ocular bioavailability. Furthermore, different types of chitosan-based nanoparticulate systems are also discussed, namely nanoparticles of chitosan core only, nanoparticles coated with chitosan, and hybrid nanoparticles of chitosan. The manuscript also provides a critical analysis of contemporary research related to the impact of this chitosan-based nanomedicine on the corneal permeability, ocular bioavailability, and therapeutic performance of loaded antiglaucoma agents.

Implementation of convolutional neural network for predicting glaucoma from fundus images

The contributions of this paper are two-fold. First, it uses machine learning tools to detect and monitor glaucoma. Second, it provides insight into medicine, which can assist healthcare professionals in improving disease diagnostic accuracy and help to reduce the progression and degeneration of retinal ganglion cells in patients. Glaucoma is a group of eye diseases that damage the optic nerve, which can cause vision loss and blindness at any age. The main symptom of glaucoma in the early stages is high internal eye pressure. It is still unknown what causes these diseases to develop, but if not treated, they result in optic nerve atrophy. For this reason, in this paper we propose a novel deep learning system for the automatic diagnosis of glaucoma using a convolutional neural network for classification, which demonstrates improved performance and records computation time for fundus images. The results showed an accuracy of 94 % and a loss value of only 0.27. The model we have created to investigate with Keras helped us achieve good results in our training and testing process. These study results demonstrate the ability of a deep learning model to identify glaucoma from fundus images. Increasing the filter size and training the model resulted in a higher accuracy rate. A population survey that was conducted in 2019 shows that most patients with glaucoma become aware of their disease late, after the disease causes a high level of optic nerve damage and a high percentage of vision loss. Early diagnosis and detection of glaucoma using optic nerve imaging technology have gained wide clinical interest in stopping or slowing the progression of the disease, allowing the development of new algorithms to automate the diagnosis of eye diseases

How Could Medical and Surgical Treatment Affect the Quality of Life in Glaucoma Patients? A Cross-Sectional Study.

To evaluate and compare the visual function and the quality of life (QoL) in glaucomatous patients treated with topical medical therapy (TMT) alone, canaloplasty (CP), or trabeculectomy (TB). A total of 291 eyes of 167 patients with primary open-angle glaucoma or secondary pseudoexfoliative glaucoma in TMT or surgically treated with CP or TB were included. Eligibility criteria for surgical patients included not needing TMT after surgery. Each patient underwent a visual field assessment and peripapillary retinal nerve fiber layer (pRNFL) optical coherence tomography and filled out the Glaucoma Symptoms Scale (GSS) questionnaire and the 25-Item National Eye Institute Visual Functioning Questionnaire (25-NEI-VFQ). Comparison between the QoL level of the three groups and its correlation with optic nerve's anatomical and functional status was the primary outcome. CP patients reported the best general vision (p = 0.01), a lower incidence of eye burning (p = 0.03), and the lowest annoyance level of non-visual symptoms (p = 0.006). QoL positively correlated with pRNFL thickness, whereas no correlation was found with visual field damage. CP provides a better QoL when compared both to TB and TMT, regardless of glaucoma stage. pRNFL seems to provide additional information for predicting change in QoL.

Correlation between visual field index (VFI) and quality of life in glaucoma patients

AbstractPurpose: The goal of glaucoma treatment is to avoid progression, to preserve vision and to maintain a sustainable quality of life (QoL). Aim of the study was to investigate the correlation between QoL and visual field index (VFI).Methods: Cross‐sectional, monocentric study. Quality of life was examined with the 25‐item National Eye Institute‐Visual Functioning Questionnaire (NEI‐VFQ‐25) and the Glaucoma Symptom Scale (GSS). The visual field was performed with the Humphrey Field Analyser, with SITA fast 24‐2 program. The variables considered were: age, gender, comorbidities, years at visit (at diagnosis and duration of the illness), treatment and related active principles (n. of bottles and n. instillation and/or previous surgery), IOP min and max, visual acuity min and max. The analysis has been performed on both the better and the worse eye. Statistical analysis: linear regression univariate analysis and multivariate analyses.Results: 193 patients (103 females) have been enrolled. The mean age (±SD) was 71 ± 10 ys, most patients presented hypertension (109, 62%) as main comorbidity. Patients were mostly on monotherapy (176, 45%). The mean value of the VFI was 81 ± 26, the total mean of the NEI‐VFQ was 80 ± 18, and the GSS total score was 77 ± 2. The linear regression analysis of the association between the variables and NEI VFQ‐25 found relation to: age (r = −0.29, p = 0.016); years of illness (r = −0.32, p = 0.02); visual acuity (r = 2.03, p &lt; 0.001); IOP (r = 1.12, p = 0.002); number of previous surgeries (r = −3.93, p &lt; 0.001). The multivariate analysis found relation to: gender (r = 5.13, p = 0.02), VA (r = 3.16, p &lt; 0.001) previous surgeries (r = −1.8, p = 0.03). Regarding GSS, the linear regression analysis found relation to visual acuity; VFI, previous surgeries and number of instillations. A higher VFI has a positive impact on QoL questionnaires.Conclusions: The study demonstrated the correlation between the VFI and the QoL, supporting a role of VFI as a metric instrument in the follow up.

Self‐reported preference of eyedrops in the treatment of glaucoma – Relation, symptoms, and quality of life

AbstractPurpose: The purpose of this questionnaire was to investigate how glaucoma patients relate to preservatives in eyedrops and the impact on their quality of life and eye discomfort.Methods: This study was designed as a questionnaire‐based cross‐sectional study. Inclusion criteria included the use of IOP‐lowering eyedrops, age ≥ 18, and the ability to read and understand Danish. Questionnaires with inadequate replies or self‐rated compliance ≤60% were excluded. Participants were classified into two groups: participants using only preservative‐free eyedrops (PF) and participants using preservative‐containing (PC) – including individuals using a combination of both types of eyedrops. A total of 146 questionnaires were included. These were further divided into 3 groups depending on complete data: questionnaires with complete data in the Glaucoma Symptom Scale (GSS) (133/146), the Glaucoma Quality of Life‐15 (GQL‐15) (135/146), and eye discomfort data (140/146).Results: No statistically significant differences were found between the groups concerning the total GSS score (PC: 66.16 ± 21.49 vs. PF: 67.55 ± 21.77; p &gt; 0.05), the total GQL‐15 score (PC 30.31 ± 15.13 vs. 31.33 ± 16.80; p &gt; 0.05), or the total eye discomfort score (PC/PF OR; 0.90, 95% CI; 0.66–1.21, p &gt; 0.05). Moreover, we found that the majority of the participants in the PC group were unaware of the preservative status of their eyedrops (PC; 74%), as well as the possibility to avoid preservatives (PC; 67%), by using a preservative‐free alternative. Similarly, most participants of both groups were willing to pay more for preservative‐free eyedrops (PC; 83%, PF; 93%).Conclusions: No significant difference in GSS, GQL‐15 or eye discomfort was observed between persons treated with PC and PF. A severe lack of information was however observed regarding patient awareness of the preservative status of IOP‐lowering eyedrops, as well as a willingness to pay more to avoid preservatives.

Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial: Six-Year Results of Primary Selective Laser Trabeculoplasty versus Eye Drops for the Treatment of Glaucoma and Ocular Hypertension

The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial has shown selective laser trabeculoplasty (SLT) to be clinically and cost-effective as a primary treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT) at 3 years. This article reports health-related quality of life (HRQoL) and clinical effectiveness of initial treatment with SLT compared with intraocular pressure (IOP)-lowering eye drops after 6 years of treatment. Prospective, multicenter randomized controlled trial. Treatment-naive eyes with OAG or OHT initially treated with SLT or IOP-lowering drops. Patients were allocated randomly to initial SLT or eye drops. After the initial 3 years of the trial, patients in the SLT arm were permitted a third SLT if necessary; patients in the drops arm were allowed SLT as a treatment switch or escalation. This study is registered at controlled-trials.com (identifier, ISRCTN32038223). The primary outcome was HRQoL at 6 years; secondary outcomes were clinical effectiveness and adverse events. Of the 692 patients completing 3 years in the LiGHT Trial, 633 patients (91.5%) entered the extension, and 524 patients completed 6 years in the trial (82.8% of those entering the extension phase). At 6 years, no significant differences were found for the EuroQol EQ-5D 5 Levels, Glaucoma Utility Index, and Glaucoma Quality of Life-15 (P > 0.05 for all). The SLT arm showed better Glaucoma Symptom Scale scores than the drops arm (83.6 ± 18.1 vs. 81.3 ± 17.3, respectively). Of eyes in the SLT arm, 69.8% remained at or less than the target IOP without the need for medical or surgical treatment. More eyes in the drops arm exhibited disease progression (26.8% vs. 19.6%, respectively; P= 0.006). Trabeculectomy was required in 32 eyes in the drops arm compared with 13 eyes in the SLT arm (P < 0.001); more cataract surgeries occurred in the drops arm (95 compared with 57 eyes; P= 0.03). No serious laser-related adverse events occurred. Selective laser trabeculoplasty is a safe treatment for OAG and OHT, providing better long-term disease control than initial drop therapy, with reduced need for incisional glaucoma and cataract surgery over 6 years.

Glaucoma Medication and Quality of Life after Phacoemulsification Combined with a Xen Gel Stent.

Glaucoma has a significant impact on quality of life. Here, we aimed to evaluate the influence of a reduction in glaucoma medications on quality of life and patient satisfaction after phacoemulsification combined with the Xen gel stent. We carried out a cross-sectional survey of patients who underwent phacoemulsification with the Xen gel stent at the Medical University of Graz, Austria. Quality of life was assessed using the German version of the Glaucoma Symptoms Scale (GSS)—questionnaire. Patients were also asked whether the operation reduced glaucoma medications and to indicate their overall satisfaction from 1 (totally discontented) up to 10 (totally contented). Questionnaires of 80 patients were evaluated. A total of 36 patients (45.0%) reported a reduction in glaucoma medications. Three items of the GSS were significantly better in patients who needed fewer glaucoma medications after the operation (“hard to see in daylight”, 75.0 ± 31.1 vs. 57.7 ± 39.1, p = 0.035; “hard to see in dark places”, 81.1 ± 28.7 vs. 54.9 ± 41.2, p = 0.002; and “halos around lights”, 88.3 ± 25.9 vs. 68.8 ± 38.6, p = 0.002). Patient satisfaction was significantly higher when the procedure led to a reduction in glaucoma medication (8.3 ± 2.0 vs. 6.8 ± 3.1; p = 0.034). The reported quality of life and patient satisfaction were significantly better when phacoemulsification with the Xen gel stent reduced the number of glaucoma medications needed.