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Glaucoma: HELP
Articles from University of North Carolina Chapel Hill
Based on 84 articles published since 2008
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These are the 84 published articles about Glaucoma that originated from University of North Carolina Chapel Hill during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Review Drop instillation and glaucoma. 2018

Davis, Scott A / Sleath, Betsy / Carpenter, Delesha M / Blalock, Susan J / Muir, Kelly W / Budenz, Donald L. ·Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy. · Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina. · Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ·Curr Opin Ophthalmol · Pubmed #29140818.

ABSTRACT: PURPOSE OF REVIEW: To describe the current state of knowledge regarding glaucoma patients' eye drop technique, interventions attempting to improve eye drop technique, and methods for assessing eye drop technique. RECENT FINDINGS: In observational studies, between 18.2 and 80% of patients contaminate their eye drop bottle by touching their eye or face, 11.3-60.6% do not instill exactly one drop, and 6.8-37.3% miss the eye with the drop. Factors significantly associated with poorer technique include older age, lack of instruction on eye drop technique, female sex, arthritis, more severe visual field defect, lack of positive reinforcement to take eye drops, lower educational level, low self-efficacy, and being seen at a clinic rather than a private practice. Among intervention studies, four of five studies using a mechanical device and three of four studies using educational interventions to improve technique showed positive results, but none of the studies were randomized controlled trials. SUMMARY: Poor eye drop technique is a significant impediment to achieving good control of intraocular pressure in glaucoma. Both mechanical device interventions and educational interventions offer promise to improve patients' technique, but studies with stronger designs need to be done followed by introduction into clinical practice.

2 Review New developments in optical coherence tomography imaging for glaucoma. 2018

Mwanza, Jean-Claude / Budenz, Donald L. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ·Curr Opin Ophthalmol · Pubmed #29140817.

ABSTRACT: PURPOSE OF REVIEW: Since its introduction in ophthalmology, optical coherence tomography (OCT) has undergone significant advances in imaging protocols, algorithms, and addition of new parameters which have maximized its potential for diagnosing, evaluating the response to treatment, and assessing the progression of various ocular diseases, including glaucoma. This review provides an update on recent developments in OCT with respect to the management of glaucoma. RECENT FINDINGS: Most recent notable developments include the introduction of the minimum distance band, which is a three-dimensional optic nerve head parameter, and Swept-Source OCT with its single wide-field scanning capability. The introduction of OCT angiography provides additional structural and functional measures for glaucoma management. Adaptive optics helps visualize individual RNFL bundles and measure their widths. SUMMARY: Continued improvements in OCT technology is both enhancing our understanding of glaucoma and improving our ability to manage the disease.

3 Review Detecting Visual Field Progression. 2017

Aref, Ahmad A / Budenz, Donald L. ·Illinois Eye & Ear Infirmary, University of Illinois at Chicago College of Medicine, Chicago, Illinois. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: donald_budenz@med.unc.edu. ·Ophthalmology · Pubmed #29157362.

ABSTRACT: Timely detection of glaucomatous progression is crucial in the delivery of glaucoma care. Clinical judgment may be used to make this assessment, but relatively modest agreement among practitioners supports the use of complementary methods. Event-based analyses take into account expected localized test-retest variabilities in sensitivity, and trend-based analyses are helpful for determining and predicting overall visual function. Landmark clinical trials have used various visual field progression criteria as end points with variable performances. Short- and long-term fluctuations as well as inadequate testing frequency are limitations in visual field analysis for glaucomatous progression. Ongoing improvements in statistical techniques as well as incorporation of functional and structural measures into a single model likely will lead to an enhanced ability to detect glaucomatous progression and will allow for more timely and appropriate therapy.

4 Review The Pathway From Genes to Gene Therapy in Glaucoma: A Review of Possibilities for Using Genes as Glaucoma Drugs. 2017

Borrás, Teresa. ·Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. ·Asia Pac J Ophthalmol (Phila) · Pubmed #28161916.

ABSTRACT: Treatment of diseases with gene therapy is advancing rapidly. The use of gene therapy has expanded from the original concept of re-placing the mutated gene causing the disease to the use of genes to con-trol nonphysiological levels of expression or to modify pathways known to affect the disease. Genes offer numerous advantages over conventional drugs. They have longer duration of action and are more specific. Genes can be delivered to the target site by naked DNA, cells, nonviral, and viral vectors. The enormous progress of the past decade in molecular bi-ology and delivery systems has provided ways for targeting genes to the intended cell/tissue and safe, long-term vectors. The eye is an ideal organ for gene therapy. It is easily accessible and it is an immune-privileged site. Currently, there are clinical trials for diseases affecting practically every tissue of the eye, including those to restore vision in patients with Leber congenital amaurosis. However, the number of eye trials compared with those for systemic diseases is quite low (1.8%). Nevertheless, judg-ing by the vast amount of ongoing preclinical studies, it is expected that such number will increase considerably in the near future. One area of great need for eye gene therapy is glaucoma, where a long-term gene drug would eliminate daily applications and compliance issues. Here, we review the current state of gene therapy for glaucoma and the possibilities for treating the trabecular meshwork to lower intraocular pressure and the retinal ganglion cells to protect them from neurodegeneration.

5 Review A single gene connects stiffness in glaucoma and the vascular system. 2017

Borrás, Teresa. ·Department of Ophthalmology, University of North Carolina School of Medicine, 4109C Neuroscience Research Building CB 7041, 105 Mason Farm Road, Chapel Hill, NC 27599-7041, USA. Electronic address: tborras@med.unc.edu. ·Exp Eye Res · Pubmed #27593913.

ABSTRACT: Arterial calcification results in arterial stiffness and higher systolic blood pressure. Arterial calcification is prevented by the high expression of the Matrix-Gla gene (MGP) in the vascular smooth muscle cells (VSMC) of the arteries' tunica media. Originally, MGP, a gene highly expressed in cartilage and VSMC, was found to be one of the top expressed genes in the trabecular meshwork. The creation of an Mgp-lacZ Knock-In mouse and the use of mouse genetics revealed that in the eye, Mgp's abundant expression is localized and restricted to glaucoma-associated tissues from the anterior and posterior segments. In particular, it is specifically expressed in the regions of the trabecular meshwork and of the peripapillary sclera that surrounds the optic nerve. Because stiffness in these tissues would significantly alter outflow facility and biomechanical scleral stress in the optic nerve head (ONH), we propose MGP as a strong candidate for the regulation of stiffness in glaucoma. MGP further illustrates the presence of a common function affecting key glaucomatous parameters in the front and back of the eye, and thus offers the possibility for a sole therapeutic target for the disease.

6 Review Optical coherence tomography platforms and parameters for glaucoma diagnosis and progression. 2016

Mwanza, Jean-Claude / Budenz, Donald L. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ·Curr Opin Ophthalmol · Pubmed #26569530.

ABSTRACT: PURPOSE OF REVIEW: Optical coherence tomography (OCT) aids in the diagnosis and long-term monitoring of various ocular diseases, including glaucoma. Initially, the retinal nerve fiber layer was the only OCT structural parameter used in glaucoma. Subsequent research has resulted in more retinal and optic nerve head parameters. In addition, OCT is being investigated for its ability to assess ocular hemodynamics. This review summarizes these spectral domain-optical coherence tomography (SDOCT) parameters in the context of glaucoma. RECENT FINDINGS: Several new SDOCT retinal nerve fiber layer, optic nerve head, and macular parameters with good glaucoma diagnostic ability have been added to existing ones recently. The combination of SDOCT and Doppler or angiography has also resulted in hemodynamic parameters that may prove to be useful in the functional assessment in glaucoma. SUMMARY: OCT technology is advancing not only as a tool for structural assessment, but also as a multimodality tool to assess both structure and function to enhance our understanding of glaucoma, and ultimately clinical decisions.

7 Review The cellular and molecular biology of the iris, an overlooked tissue: the iris and pseudoexfoliation glaucoma. 2014

Borrás, Terete. ·Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, NC. ·J Glaucoma · Pubmed #25275904.

ABSTRACT: Located between the cornea and the lens, the Iris is fully immersed in aqueous humor. During exfoliation syndrome, a disorder of the elastic fibers, an abnormal fibrillar material (XFM) is deposited on the anterior lens capsule underneath the pigment epithelium of the Iris. Release of this material to the aqueous humor reaches the trabecular meshwork where its presence is associated with elevated intraocular pressure. Ultrastructural studies suggest that the XFM material is produced by the lens capsule, lens epithelial and iris pigment epithelial cells (IPE). The involvement of the IPE in pseudoexfoliation glaucoma has not been extensively addressed. Immunohistochemistry studies have shown higher levels of LOXL1 and clusterin in the IPE extracellular space of specimens from exfoliation patients. But studies using IPE cells to understand the formation of the XFM in vitro and/or in vivo are scarce. A focus on the Iris and its IPE cells would be key for the elucidation of XFM and the understanding of the development of pseudoexfoliation glaucoma.

8 Review The effects of myocilin expression on functionally relevant trabecular meshwork genes: a mini-review. 2014

Borrás, Teresa. ·Department of Ophthalmology, University of North Carolina School of Medicine , Chapel Hill, North Carolina. ·J Ocul Pharmacol Ther · Pubmed #24564495.

ABSTRACT: Myocilin is a secreted glaucoma-associated protein, specifically induced by dexamethasone in human trabecular meshwork cells, where it was discovered. Myocilin is expressed in several tissues of the body, but it causes disease only in the eye. The protein contains two domains: an N-terminal region with significant homologies to nonmuscle myosin, and a C-terminal region, which is similar to the olfactomedin proteins. Forty percent of myocilin undergoes an intracellular endoproteolytic cleavage by calpain II, a calcium-dependent cysteine protease, which releases the 2 domains. The protein is known to interact with intracellular and extracellular matrix proteins, and some is released into the extracellular space associated with exosomes. Myocilin mutations are linked to glaucoma and induce elevated intraocular pressure. Most of the glaucoma-causative mutations map to the olfactomedin domain, which appears to be a critical domain for the function of the protein. Myocilin mutants are misfolded, aggregate in the endoplasmic reticulum, and are not secreted. Overexpression of myocilin and of its mutants in primary human trabecular meshwork cells triggers changes in the expression of numerous genes, many of which have been known to be involved in mechanisms important for the physiology and pathology of the tissue. Here we review recent studies from our laboratory and those of others that deal with trabecular meshwork genes, which are altered by the overexpression of wild-type and glaucoma-causative mutant myocilin genes.

9 Review Sustained drug delivery in glaucoma. 2014

Knight, O'Rese J / Lawrence, Scott D. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ·Curr Opin Ophthalmol · Pubmed #24463419.

ABSTRACT: PURPOSE OF REVIEW: This article reviews recently published studies and important clinical trials of novel drug delivery systems for glaucoma and evaluates the potential of these systems to provide sustained therapeutic benefits. RECENT FINDINGS: The efficacy of topical medications to lower intraocular pressure (IOP) is limited by poor patient adherence, low bioavailability of drug and the potential for local and systemic side effects. Recent studies highlight the potential for sustained drug delivery through innovative delivery platforms. Nanoparticle-based formulations, drug-eluting contact lenses, punctum inserts and bioadhesive matrices placed in the conjunctival sac can enhance drug delivery by increasing precorneal residence time, enhancing corneal permeation and lowering the systemic absorption of drug. Periocular injections and surgically implanted drug reservoirs could offer even greater duration of drug delivery, particularly when the drug is packaged within stable vehicles. SUMMARY: Novel platforms for providing sustained drug delivery in glaucoma continue to evolve. The ability to incorporate effective commercially available drugs into more stable compounds is an important element. Although more research is needed to establish their clinical efficacy, novel delivery systems will allow for more targeted medical therapy and for the opportunity to further explore neuroprotective and gene-based therapies.

10 Review New options for combined cataract and glaucoma surgery. 2014

Budenz, Donald L / Gedde, Steven J. ·aDepartment of Ophthalmology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina bBascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA. ·Curr Opin Ophthalmol · Pubmed #24389806.

ABSTRACT: PURPOSE OF REVIEW: To review the current literature regarding the effectiveness and risks of new surgeries that can be combined with phacoemulsification in the management of cataract and glaucoma. RECENT FINDINGS: Surgical options for concurrently managing cataract and glaucoma have expanded in recent years. Endoscopic cyclophotocoagulation, trabecular micro-bypass stent, ab interno trabeculectomy, and canaloplasty may be performed in conjunction with cataract extraction to provide additional intraocular pressure (IOP) reduction. Studies evaluating these new glaucoma procedures combined with phacoemulsification generally include retrospective case series without a comparison group. Because cataract surgery alone is associated with IOP reduction, the relative contribution of the glaucoma procedure in lowering IOP cannot be determined in these studies. Randomized clinical trials are needed to better evaluate the efficacy and safety of newer glaucoma procedures in combination with cataract surgery. SUMMARY: The newer glaucoma procedures appear less effective than trabeculectomy, but they are associated with a lower risk of surgical complications.

11 Review What's new in laser treatment for glaucoma? 2012

Meyer, Jay J / Lawrence, Scott D. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7040, USA. ·Curr Opin Ophthalmol · Pubmed #22186007.

ABSTRACT: PURPOSE OF REVIEW: This review highlights recently published studies on prevailing and newer laser therapies in glaucoma and critically evaluates their roles in the treatment algorithm. RECENT FINDINGS: Recently published studies suggest a role for selective laser trabeculoplasty (SLT) as initial therapy for open-angle glaucoma and ocular hypertension and have demonstrated efficacy in other glaucoma subtypes. Novel laser applications (micropulse diode laser trabeculoplasty, titanium sapphire laser trabeculoplasty and excimer laser trabeculotomy) have shown favorable early results. Endoscopic and transscleral cyclophotocoagulation (ECP, TCP) are generally reserved for refractory glaucomas, although some recent studies report its use in patients with good visual acuity. The effectiveness of laser iridotomy with or without iridoplasty for long-term prevention of primary angle closure glaucoma is undetermined. Laser goniopuncture is an important adjunct to nonpenetrating surgery, but wide adoption of the procedure is lacking. SUMMARY: The use of lasers in glaucoma continues to evolve, with a trend towards primary and earlier intervention. SLT is assuming an expanded role in the treatment of additional subtypes of glaucoma, whereas ECP and TCP are generally reserved for refractory glaucomas. Newer laser modalities show promise as alternatives and adjuncts to topical medications and nonpenetrating surgery. Additional research is needed to better define their safety and efficacy.

12 Review Predisease: when does it make sense? 2011

Viera, Anthony J. ·Department of Family Medicine, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7595, USA. anthony_viera@med.unc.edu ·Epidemiol Rev · Pubmed #21624963.

ABSTRACT: Screening often leads to finding conditions that are not at the stage or level that would classify them as disease but, at the same time, are not at a stage or level at which people can be declared entirely disease free. These "in-between" states have sometimes been designated as "predisease." Examples include precancerous lesions, increased intraocular pressure ("preglaucoma"), prediabetes, and prehypertension. When the goal of preventing adverse health outcomes is kept in mind, this review poses the idea that "predisease" as a category on which to act makes sense only if the following 3 conditions are met. First, the people designated as having predisease must be far more likely to develop disease than those not so designated. Second, there must be a feasible intervention that, when targeted to people with predisease, effectively reduces the likelihood of developing disease. Third, the benefits of intervening on predisease must outweigh the harms in the population. A systematic review of screening guidelines (published in 2003-2010) for 4 sample conditions (cervical cancer, glaucoma, diabetes, and hypertension) is included to assess whether they address these issues, followed by a discussion of the framework questions as they pertain to each condition.

13 Article Genome-wide association study identifies seven novel susceptibility loci for primary open-angle glaucoma. 2018

Shiga, Yukihiro / Akiyama, Masato / Nishiguchi, Koji M / Sato, Kota / Shimozawa, Nobuhiro / Takahashi, Atsushi / Momozawa, Yukihide / Hirata, Makoto / Matsuda, Koichi / Yamaji, Taiki / Iwasaki, Motoki / Tsugane, Shoichiro / Oze, Isao / Mikami, Haruo / Naito, Mariko / Wakai, Kenji / Yoshikawa, Munemitsu / Miyake, Masahiro / Yamashiro, Kenji / Anonymous391123 / Kashiwagi, Kenji / Iwata, Takeshi / Mabuchi, Fumihiko / Takamoto, Mitsuko / Ozaki, Mineo / Kawase, Kazuhide / Aihara, Makoto / Araie, Makoto / Yamamoto, Tetsuya / Kiuchi, Yoshiaki / Nakamura, Makoto / Ikeda, Yasuhiro / Sonoda, Koh-Hei / Ishibashi, Tatsuro / Nitta, Koji / Iwase, Aiko / Shirato, Shiroaki / Oka, Yoshitaka / Satoh, Mamoru / Sasaki, Makoto / Fuse, Nobuo / Suzuki, Yoichi / Cheng, Ching-Yu / Khor, Chiea Chuen / Baskaran, Mani / Perera, Shamira / Aung, Tin / Vithana, Eranga N / Cooke Bailey, Jessica N / Kang, Jae H / Pasquale, Louis R / Haines, Jonathan L / Anonymous401123 / Wiggs, Janey L / Burdon, Kathryn P / Gharahkhani, Puya / Hewitt, Alex W / Mackey, David A / MacGregor, Stuart / Craig, Jamie E / Allingham, R Rand / Hauser, Micheal / Ashaye, Adeyinka / Budenz, Donald L / Akafo, Stephan / Williams, Susan E I / Kamatani, Yoichiro / Nakazawa, Toru / Kubo, Michiaki. ·Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. · Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan. · Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan. · Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan. · Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Japan. · Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan. · Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. · Institute of Medical Science, The University of Tokyo, Tokyo, Japan. · Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan. · Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. · Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. · Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan. · Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan. · Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. · Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan. · Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan. · Division of Molecular and Cellular Biology, National Institute of Sensory Organs, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan. · Department of Ophthalmology, University of Tokyo, Tokyo, Japan. · Ozaki Eye Hospital, Hyuga, Miyazaki, Japan. · Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. · Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan. · Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan. · Department of Ophthalmology and Visual Sciences, Hiroshima University, Hiroshima, Japan. · Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Fukuiken Saiseikai Hospital, Fukui, Japan. · Tajimi Iwase Eye Clinic, Tajimi, Japan. · Yotsuya Shirato Eye Clinic, Tokyo, Japan. · Oka Eye Clinic, Fukuoka, Japan. · Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan. · Department of Integrative Genomics, Tohoku Medical Megabank Organization, Miyagi, Japan. · Department of Education and Training, Tohoku Medical Megabank Organization, Miyagi, Japan. · Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. · Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore. · Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Genome Institute of Singapore, Singapore. · Department of Population and Quantitative Health Sciences, Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. · Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA. · Department of Ophthalmology, Harvard Medical School, Boston, MA, USA. · Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia. · Department of Ophthalmology, Flinders University, Adelaide, SA, Australia. · QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. · Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia. · Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia. · Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, WA, Australia. · Department of Ophthalmology, Duke University, Durham, NC, USA. · Duke University Medical Center, Durham, NC, USA. · Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria. · Department of Ophthalmology, University of North Carolina at Chapel Hill, USA. · University of Ghana School of Medicine and Dentistry, Ghana. · Division of Ophthalmology, Department of Neurosciences, University of the Witwatersrand, South Africa. · Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. ·Hum Mol Genet · Pubmed #29452408.

ABSTRACT: Primary open-angle glaucoma (POAG) is the leading cause of irreversible blindness worldwide for which 15 disease-associated loci had been discovered. Among them, only 5 loci have been associated with POAG in Asians. We carried out a genome-wide association study and a replication study that included a total of 7378 POAG cases and 36 385 controls from a Japanese population. After combining the genome-wide association study and the two replication sets, we identified 11 POAG-associated loci, including 4 known (CDKN2B-AS1, ABCA1, SIX6 and AFAP1) and 7 novel loci (FNDC3B, ANKRD55-MAP3K1, LMX1B, LHPP, HMGA2, MEIS2 and LOXL1) at a genome-wide significance level (P < 5.0×10-8), bringing the total number of POAG-susceptibility loci to 22. The 7 novel variants were subsequently evaluated in a multiethnic population comprising non-Japanese East Asians (1008 cases, 591 controls), Europeans (5008 cases, 35 472 controls) and Africans (2341 cases, 2037 controls). The candidate genes located within the new loci were related to ocular development (LMX1B, HMGA2 and MAP3K1) and glaucoma-related phenotypes (FNDC3B, LMX1B and LOXL1). Pathway analysis suggested epidermal growth factor receptor signaling might be involved in POAG pathogenesis. Genetic correlation analysis revealed the relationships between POAG and systemic diseases, including type 2 diabetes and cardiovascular diseases. These results improve our understanding of the genetic factors that affect the risk of developing POAG and provide new insight into the genetic architecture of POAG in Asians.

14 Article A Naturally Fluorescent Mgp Transgenic Mouse for Angiogenesis and Glaucoma Longitudinal Studies. 2018

Asokan, Priyadarsini / Mitra, Rajendra N / Periasamy, Ramesh / Han, Zongchao / Borrás, Teresa. ·Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States. · UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, United States. · Gene Therapy Center, University of North Carolina, Chapel Hill, North Carolina, United States. ·Invest Ophthalmol Vis Sci · Pubmed #29392320.

ABSTRACT: Purpose: Our goal was to generate and characterize a new mouse model in which only angiogenesis- and glaucoma-relevant tissues would be naturally fluorescent. The Matrix Gla (MGP) gene is highly expressed in vascular smooth muscle cells (VSMC) and trabecular meshwork (TM). We sought to direct our Mgp-Cre.KI mouse recombinase to VSMC/TM cells to produce their longitudinal fluorescent profiles. Methods: Homozygous Mgp-Cre.KI mice were crossed with Ai9 homozygous reporter mice harboring a loxP-flanked STOP cassette preventing transcription of a DsRed fluorescent protein (tdTomato). The F1 double-heterozygous (Mgp-tdTomato) was examined by direct fluorescence, whole mount, histology, and fundus photography. Custom-made filters had 554/23 emission and 609/54 exciter nanometer wavelengths. Proof of concept of the model's usefulness was conducted by inducing guided imaging laser burns. Evaluation of a vessel's leakage and proliferation was followed by noninvasive angiography. Results: The Mgp-tdTomato mouse was viable, fertile, with normal IOP and ERG. Its phenotype exhibited red paws and snout (cartilage expression), which precluded genotyping. A fluorescent red ring was seen at the limbus and confirmed to be TM expression by histology. The entire retinal vasculature was red fluorescent (VSMC) and directly visualized by fundus photography. Laser burns on the Mgp-tdTomato allowed separation of leakiness and neovascularization evaluation parameters. Conclusions: The availability of a transgenic mouse naturally fluorescent in glaucoma-relevant tissues and retinal vasculature brings the unique opportunity to study a wide spectrum of single and combined glaucomatous conditions in vivo. Moreover, the Mgp-tdTomato mouse provides a new tool to study mechanisms and therapeutics of retinal angiogenesis longitudinally.

15 Article Testosterone Pathway Genetic Polymorphisms in Relation to Primary Open-Angle Glaucoma: An Analysis in Two Large Datasets. 2018

Bailey, Jessica N Cooke / Gharahkhani, Puya / Kang, Jae H / Butkiewicz, Mariusz / Sullivan, David A / Weinreb, Robert N / Aschard, Hugues / Allingham, R Rand / Ashley-Koch, Allison / Lee, Richard K / Moroi, Sayoko E / Brilliant, Murray H / Wollstein, Gadi / Schuman, Joel S / Fingert, John H / Budenz, Donald L / Realini, Tony / Gaasterland, Terry / Scott, William K / Singh, Kuldev / Sit, Arthur J / Igo, Robert P / Song, Yeunjoo E / Hark, Lisa / Ritch, Robert / Rhee, Douglas J / Vollrath, Douglas / Zack, Donald J / Medeiros, Felipe / Vajaranant, Thasarat S / Chasman, Daniel I / Christen, William G / Pericak-Vance, Margaret A / Liu, Yutao / Kraft, Peter / Richards, Julia E / Rosner, Bernard A / Hauser, Michael A / Craig, Jamie E / Burdon, Kathryn P / Hewitt, Alex W / Mackey, David A / Haines, Jonathan L / MacGregor, Stuart / Wiggs, Janey L / Pasquale, Louis R / Anonymous2730935. ·Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States. · Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States. · Statistical Genetics, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Australia. · Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States. · Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States. · Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, University of California at San Diego, La Jolla, California, United States. · Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, United States. · Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States. · Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States. · Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States. · Center for Human Genetics, Marshfield Clinic Research Institute, Marshfield, Wisconsin, United States. · Department of Ophthalmology, NYU Langone Medical Center, NYU School of Medicine, New York, New York, United States. · Departments of Ophthalmology and Anatomy/Cell Biology, University of Iowa, College of Medicine, Iowa City, Iowa, United States. · Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States. · Department of Ophthalmology, WVU Eye Institute, Morgantown, West Virginia, United States. · Scripps Genome Center, University of California at San Diego, San Diego, California, United States. · Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States. · Department of Ophthalmology, Stanford University, Palo Alto, California, United States. · Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States. · Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania, United States. · Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States. · Department of Ophthalmology, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States. · Department of Genetics, Stanford University, Palo Alto, California, United States. · Wilmer Eye Institute, Johns Hopkins University Hospital, Baltimore, Maryland, United States. · Department of Ophthalmology, University of Illinois College of Medicine at Chicago, Chicago, Illinois, United States. · Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States. · Department of Cellular Biology and Anatomy, Augusta University, Augusta, Georgia, United States. · Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, United States. · Department of Ophthalmology, Flinders University, Adelaide, SA, Australia. · School of Medicine, Menzies Research Institute of Tasmania, Hobart, Australia. · Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia. · Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States. ·Invest Ophthalmol Vis Sci · Pubmed #29392307.

ABSTRACT: Purpose: Sex hormones may be associated with primary open-angle glaucoma (POAG), although the mechanisms are unclear. We previously observed that gene variants involved with estrogen metabolism were collectively associated with POAG in women but not men; here we assessed gene variants related to testosterone metabolism collectively and POAG risk. Methods: We used two datasets: one from the United States (3853 cases and 33,480 controls) and another from Australia (1155 cases and 1992 controls). Both datasets contained densely called genotypes imputed to the 1000 Genomes reference panel. We used pathway- and gene-based approaches with Pathway Analysis by Randomization Incorporating Structure (PARIS) software to assess the overall association between a panel of single nucleotide polymorphisms (SNPs) in testosterone metabolism genes and POAG. In sex-stratified analyses, we evaluated POAG overall and POAG subtypes defined by maximum IOP (high-tension [HTG] or normal tension glaucoma [NTG]). Results: In the US dataset, the SNP panel was not associated with POAG (permuted P = 0.77), although there was an association in the Australian sample (permuted P = 0.018). In both datasets, the SNP panel was associated with POAG in men (permuted P ≤ 0.033) and not women (permuted P ≥ 0.42), but in gene-based analyses, there was no consistency on the main genes responsible for these findings. In both datasets, the testosterone pathway association with HTG was significant (permuted P ≤ 0.011), but again, gene-based analyses showed no consistent driver gene associations. Conclusions: Collectively, testosterone metabolism pathway SNPs were consistently associated with the high-tension subtype of POAG in two datasets.

16 Article Longitudinal Change in Central Corneal Thickness in the Tema Eye Survey. 2018

Mwanza, Jean-Claude / Tulenko, Samantha E / Budenz, Donald L / Mathenge, Elizabeth / Herndon, Leon H / Kim, Hanna Y / Hall, Alyson / Hay-Smith, Graham / Spratt, Alexander / Barton, Keith. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: donald_budenz@med.unc.edu. · Duke Eye Center, Duke University, Durham, North Carolina. · Department of Ophthalmology, Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, California. · Department of Ophthalmology, The Glaucoma Center, Bowie, Maryland. · The Moreton Eye Group, Brisbane, Queensland, Australia. · South Florida Eye Health, Hollywood, Florida. · Moorefields Eye Hospital and Department of Epidemiology and Genetics, Institute of Ophthalmology, University College of London, London, United Kingdom. ·Am J Ophthalmol · Pubmed #29141198.

ABSTRACT: PURPOSE: To determine the change and rate of change in central corneal thickness (CCT) and their determinants. DESIGN: Longitudinal observational population-based study. METHODS: A total of 758 normal and 58 glaucomatous subjects underwent complete eye examination, with CCT measurements at 2 separate visits. Change and rate of change in CCT were determined. Univariate and multivariate linear regression analyses were performed to determine the factors associated with change and rate of change. RESULTS: The mean follow-up duration was 8.4 ± 0.7 years. The overall change was -8.9 ± 16.7 μm in OD and -9.8 ± 16.2 μm in OS, both P < .0001. Changes in glaucomatous and normal subjects were -14.1 ± 2.2 μm vs -8.6 ± 0.6 μm in OD (P = .02) and -14.5 ± 2.2 μm vs -9.5 ± 0.6 μm in OS (P = .03), respectively. The overall rate of thinning was -1.1 μm/year (OD) and -1.2 μm/year (OS). Rates in glaucomatous and normal eyes were -1.7 ± 0.3 μm/year vs -1.0 ± 0.1 μm/year in OD (P = .02) and -1.7 ± 0.3 μm/year vs -1.1 ± 0.1 μm/year in OS (P = .03), respectively. Change and rate of change were associated with baseline CCT (ß = -0.1 to -0.09 and -0.011, respectively, all P < .001) and glaucoma (ß = -6.8 to -5.6, P ≤ .009, and -0.75 to -0.69, P ≤ .007, respectively). CONCLUSION: CCT decreased significantly over time. The change and rate of change were greater in glaucomatous than normal eyes, and were greater than described in cross-sectional studies.

17 Article Patient-Physician Communication on Medication Cost during Glaucoma Visits. 2017

Slota, Catherine / Davis, Scott A / Blalock, Susan J / Carpenter, Delesha M / Muir, Kelly W / Robin, Alan L / Sleath, Betsy. ·Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina. · Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina. · Health Services Research & Development, Durham VA Medical Center, Durham, North Carolina. · Department of Ophthalmology, University of Maryland, Baltimore, Maryland. · Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan. · Department of International Health, Bloomberg School of Public Health, and Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland *cgutpta@rti.org. ·Optom Vis Sci · Pubmed #29194229.

ABSTRACT: SIGNIFICANCE: This article is the first to investigate the nature of medication cost discussions between ophthalmologists and glaucoma patients. Only 87 of the 275 office visits analyzed had a discussion of medication cost. Providers should consider discussing medication cost with patients to identify potential cost-related barriers to medication use. PURPOSE: Glaucoma is an incurable chronic eye disease affecting a growing portion of the aging population. Some of the most commonly utilized treatments require lifelong use, requiring high patient adherence to ensure effectiveness. There are numerous barriers to glaucoma treatment adherence in the literature, including cost. The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. METHODS: This was a mixed-methods secondary analysis of video-recorded participant office visits (n = 275) from a larger observational study of glaucoma communication. We analyzed medical information, demographic characteristics, and interviewer-administrated questionnaires, as well as verbatim transcripts of interviews. RESULTS: Only 87 participants discussed medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51%), took one glaucoma medication (63%), and had Medicare (49%) as well as a form of prescription insurance (78%). The majority of glaucoma office visits did not discuss medication cost, and providers often did not ask about cost problems. Of the few conversations related to cost, most focused on providers offering potential solutions (n = 50), medical and prescription service coverage (n = 41), and brand or generic medication choices (n = 41). CONCLUSIONS: Our findings are similar to previous studies showing few patients have conversations with providers about the cost of glaucoma medications. Providers should consider bringing up medication cost during glaucoma office visits to prompt a discussion of potential cost-related barriers to medication use.

18 Article Differences in Optical Coherence Tomography Assessment of Bruch Membrane Opening Compared to Stereoscopic Photography for Estimating Cup-to-Disc Ratio. 2017

Mwanza, Jean-Claude / Huang, Linda Y / Budenz, Donald L / Shi, Wei / Huang, Gintien / Lee, Richard K. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Bascom Palmer Eye Institute, University of Miami, Miami, Florida. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: donald_budenz@med.unc.edu. · Bascom Palmer Eye Institute, University of Miami, Miami, Florida. Electronic address: rlee@med.miami.edu. ·Am J Ophthalmol · Pubmed #28964804.

ABSTRACT: PURPOSE: To compare the vertical and horizontal cup-to-disc ratio (VCDR, HCDR) by an updated optical coherence tomography (OCT) Bruch membrane opening (BMO) algorithm and stereoscopic optic disc photograph readings by glaucoma specialists. DESIGN: Reliability analysis. METHODS: A total of 195 eyes (116 glaucoma and 79 glaucoma suspect) of 99 patients with stereoscopic photographs and OCT scans of the optic discs taken during the same visit were compared. Optic disc photographs were read by 2 masked glaucoma specialists for VCDR and HCDR estimation. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used to assess the agreement between photograph reading and OCT in estimating CDR. RESULTS: OCT images computed significantly larger VCDR and HCDR than photograph reading before and after stratifying eyes based on disc size (P < .001). The difference in CDR estimates between the 2 methods was equal to or greater than 0.2 in 29% and 35% of the eyes for VCDR and HCDR, respectively, with a mean difference of 0.3 in each case. The ICCs between the readers and OCT ranged between 0.50 and 0.63. The size of disagreement in VCDR correlated weakly with cup area in eyes with medium (r CONCLUSIONS: OCT and photograph reading by clinicians agree poorly in CDR assessment. The difference in VCDR between the 2 methods was depended on cup area in medium and large discs. These differences should be considered when making conclusions regarding CDRs in clinical practice.

19 Article Genetic correlations between intraocular pressure, blood pressure and primary open-angle glaucoma: a multi-cohort analysis. 2017

Aschard, Hugues / Kang, Jae H / Iglesias, Adriana I / Hysi, Pirro / Cooke Bailey, Jessica N / Khawaja, Anthony P / Allingham, R Rand / Ashley-Koch, Allison / Lee, Richard K / Moroi, Sayoko E / Brilliant, Murray H / Wollstein, Gadi / Schuman, Joel S / Fingert, John H / Budenz, Donald L / Realini, Tony / Gaasterland, Terry / Scott, William K / Singh, Kuldev / Sit, Arthur J / Igo, Robert P / Song, Yeunjoo E / Hark, Lisa / Ritch, Robert / Rhee, Douglas J / Gulati, Vikas / Haven, Shane / Vollrath, Douglas / Zack, Donald J / Medeiros, Felipe / Weinreb, Robert N / Cheng, Ching-Yu / Chasman, Daniel I / Christen, William G / Pericak-Vance, Margaret A / Liu, Yutao / Kraft, Peter / Richards, Julia E / Rosner, Bernard A / Hauser, Michael A / Anonymous6180917 / Klaver, Caroline C W / vanDuijn, Cornelia M / Haines, Jonathan / Wiggs, Janey L / Pasquale, Louis R. ·Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, MA, USA. · Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Department of Epidemiology, Genetic Epidemiology Unit, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Twin Research and Genetic Epidemiology, King's College London, London, UK. · Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. · Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. · Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK. · Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA. · Department of Medicine, Duke University Medical Center, Durham, NC, USA. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA. · Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA. · Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, WI, USA. · Department of Ophthalmology, NYU Langone Medical Center, NYU School of Medicine, New York, NY, USA. · Departments of Ophthalmology and Anatomy/Cell Biology, University of Iowa, College of Medicine, Iowa City, IO, USA. · Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA. · Department of Ophthalmology, WVU Eye Institute, Morgantown, WV, USA. · Scripps Genome Center, University of California at San Diego, San Diego, CA, USA. · Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA. · Department of Ophthalmology, Stanford University, Palo Alto, CA, USA. · Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA. · Wills Eye Hospital, Glaucoma Research Center, Philadelphia, PA, USA. · Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. · Department of Ophthalmology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. · Department of Ophthalmology &Visual Sciences, University of Nebraska Medical Center, Omaha, NE, USA. · Department of Genetics, Stanford University, Palo Alto, CA, USA. · Wilmer Eye Institute, Johns Hopkins University Hospital, Baltimore, MD, USA. · Department of Ophthalmology, Hamilton Eye Center, University of California at San Diego, San Diego, CA, USA. · Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore. · Ophthalmology &Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore. · Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA. · Department of Cellular Biology &Anatomy, Augusta University, Augusta, GA, USA. · Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, MA, USA. · Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA. ·Eur J Hum Genet · Pubmed #28853718.

ABSTRACT: Primary open-angle glaucoma (POAG) is the most common chronic optic neuropathy worldwide. Epidemiological studies show a robust positive relation between intraocular pressure (IOP) and POAG and modest positive association between IOP and blood pressure (BP), while the relation between BP and POAG is controversial. The International Glaucoma Genetics Consortium (n=27 558), the International Consortium on Blood Pressure (n=69 395), and the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database (n=37 333), represent genome-wide data sets for IOP, BP traits and POAG, respectively. We formed genome-wide significant variant panels for IOP and diastolic BP and found a strong relation with POAG (odds ratio and 95% confidence interval: 1.18 (1.14-1.21), P=1.8 × 10

20 Article The Association Between Glaucoma, Anxiety, and Depression in a Large Population. 2017

Zhang, Xinxin / Olson, Daniel James / Le, Patrick / Lin, Feng-Chang / Fleischman, David / Davis, Richard Marc. ·University of North Carolina School of Medicine, Chapel Hill, North Carolina. · University of Washington School of Medicine, Seattle, Washington. · North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: richdavis@unc.edu. ·Am J Ophthalmol · Pubmed #28760639.

ABSTRACT: PURPOSE: To investigate the association between glaucoma and each of anxiety and depression. DESIGN: Retrospective case-control study. METHODS: Settings: University of North Carolina hospitals and outpatient clinics. STUDY POPULATION: All patients over the age of 18 years seen between July 1, 2008 and October 1, 2015 were included. OBSERVATION PROCEDURE: International Classification of Diseases codes were used to identify cases of glaucoma, as well as anxiety and depression. OUTCOME MEASURE: Odds ratios (OR) were calculated for glaucoma and each of anxiety and depression. OR were also calculated for above diagnoses separated by age group and sex. RESULTS: A total of 4 439 518 patients were screened, of which 11 234 (0.3%) have glaucoma, 96 527 (2.2%) have anxiety, and 103 476 (2.3%) have depression. The adjusted OR was 10.6 (95% confidence interval [CI] 10.0-11.0) for glaucoma and anxiety and 12.3 (95% CI 11.8-12.9) for glaucoma and depression. The likelihood of having anxiety and depression along with glaucoma did not change with age (P = .088, P = .736). CONCLUSION: There was a statistically significant association between glaucoma and each of anxiety and depression.

21 Article A comparison of cup-to-disc ratio estimates by fundus biomicroscopy and stereoscopic optic disc photography in the Tema Eye Survey. 2017

Mwanza, J C / Grover, D S / Budenz, D L / Herndon, L W / Nolan, W / Whiteside-de Vos, J / Hay-Smith, G / Bandi, J R / Bhansali, K A / Forbes, L A / Feuer, W J / Barton, K. ·Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. · Glaucoma Associates of Texas, Dallas, TX, USA. · Duke University Eye Center, Durham, NC, USA. · Moorfields Eye Hospital, London, UK. · Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. · Peninsula Eye Hospital, Redcliffe, Queensland, Australia. · Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA. · National Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK. ·Eye (Lond) · Pubmed #28387768.

ABSTRACT: PurposeTo determine if there are systematic differences in cup-to-disc ratio (CDR) grading using fundus biomicroscopy compared to stereoscopic disc photograph reading.MethodsThe vertical cup-to-disc ratio (VCDR) and horizontal cup-to-disc ratio (HCDR) of 2200 eyes (testing set) were graded by glaucoma subspecialists through fundus biomicroscopy and by a reading center using stereoscopic disc photos. For validation, the glaucoma experts also estimated VCDR and HCDR using stereoscopic disc photos in a subset of 505 eyes that they had assessed biomicroscopically. Agreement between grading methods was assessed with Bland-Altman plots.ResultsIn both sets, photo reading tended to yield small CDRs marginally larger, but read large CDRs marginally smaller than fundus biomicroscopy. The mean differences in VCDR and HCDR were 0.006±0.18 and 0.05±0.18 (testing set), and -0.053±0.23 and -0.028±0.21 (validation set), respectively. The limits of agreement were ~0.4, which is twice as large as the cutoff of clinically significant CDR difference between methods. CDR estimates differed by 0.2 or more in 33.8-48.7% between methods.ConclusionsThe differences in CDR estimates between fundus biomicroscopy and stereoscopic optic disc photo reading showed a wide variation, and reached clinically significance threshold in a large proportion of patients, suggesting a poor agreement. Thus, glaucoma should be monitored by comparing baseline and subsequent CDR estimates using the same method rather than comparing photographs to fundus biomicroscopy.

22 Article Strabismus surgery outcomes in eyes with glaucoma drainage devices. 2017

Osigian, Carla J / Cavuoto, Kara M / Rossetto, Julia D / Sayed, Mohamed / Grace, Sara / Chang, Ta C / Capo, Hilda. ·Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida. · Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil. · University of North Carolina at Chapel Hill, Kittner Eye Center, Chapel Hill, North Carolina. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida. Electronic address: hcapo@med.miami.edu. ·J AAPOS · Pubmed #28286307.

ABSTRACT: PURPOSE: To report strabismus surgery outcomes in eyes with prior implantation of glaucoma drainage devices (GDD). METHODS: The medical records of patients who underwent strabismus surgery for ocular misalignment that developed after implantation of a GDD over a 13-year period at a single institution were examined retrospectively. Patient characteristics, deviation types, preoperative measurements, surgical procedures, and postoperative measurements were analyzed. RESULTS: Of the 16 patients included, 14 had exotropia (34 CONCLUSIONS: Strabismus surgery with preservation of the filtering bleb following implantation of a glaucoma drainage device is a low risk procedure that can improve ocular alignment and related symptoms, despite a low motor success rate by standard criteria.

23 Article African American Patient Preferences for Glaucoma Education. 2017

Sleath, Betsy / Davis, Scott / Sayner, Robyn / Carpenter, Delesha M / Johnson, Terence / Blalock, Susan J / Robin, Alan L. ·*PhD †MA ‡PharmD §BS ∥MD UNC Eshelman School of Pharmacy and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (BS) · Department of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (SD, RS, DMC, TJ, SJB) · and Department of Ophthalmology, University of Maryland, Baltimore, Maryland, Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland (ALR). ·Optom Vis Sci · Pubmed #28234794.

ABSTRACT: PURPOSE: The objectives of the study were to examine (a) the types of questions that African American patients have about glaucoma for their providers and (b) how patients' sociodemographic characteristics are associated with where and from whom they would like to learn about glaucoma and glaucoma medications. METHODS: Forty-nine adult African American patients with glaucoma were recruited at a private ophthalmology clinic where they completed a questionnaire for this cross-sectional study. RESULTS: African American patients had a mean of 3.9 questions for their ophthalmologists; the questions that patients checked as having most often were "What is my prognosis with glaucoma?" (49%) and "What is my intraocular pressure?" (45%). Seventy-six percent of patients preferred that an educational program about glaucoma be offered at the doctor's office and 39% preferred it be offered at a community or senior citizen center. Ninety percent said that the education program should be offered by doctors. Patients under the age of 70 were significantly more likely to want a program on the Internet than patients age 70 and over (Pearson χ = 4.7, P = .03). If an educational program was developed patients reported being most interested in the following topics, glaucoma medications (84%), what is glaucoma and what does it mean to have it? (83%). CONCLUSIONS: African American patients have many questions about glaucoma for their eye care providers. African American patients would prefer glaucoma educational programs be offered at their provider's office. Our findings could be used to develop educational programs for African American patients with glaucoma.

24 Article Vitamin B 2017

Williams, Pete A / Harder, Jeffrey M / Foxworth, Nicole E / Cochran, Kelly E / Philip, Vivek M / Porciatti, Vittorio / Smithies, Oliver / John, Simon W M. ·The Jackson Laboratory, Bar Harbor, ME 04609, USA. · Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA. · Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. · The Jackson Laboratory, Bar Harbor, ME 04609, USA. simon.john@jax.org. · Department of Ophthalmology, Tufts University of Medicine, Boston, MA 02111, USA. · The Howard Hughes Medical Institute, Bar Harbor, ME 04609, USA. ·Science · Pubmed #28209901.

ABSTRACT: Glaucomas are neurodegenerative diseases that cause vision loss, especially in the elderly. The mechanisms initiating glaucoma and driving neuronal vulnerability during normal aging are unknown. Studying glaucoma-prone mice, we show that mitochondrial abnormalities are an early driver of neuronal dysfunction, occurring before detectable degeneration. Retinal levels of nicotinamide adenine dinucleotide (NAD

25 Article Five-Year Pooled Data Analysis of the Ahmed Baerveldt Comparison Study and the Ahmed Versus Baerveldt Study. 2017

Christakis, Panos G / Zhang, Dongyu / Budenz, Donald L / Barton, Keith / Tsai, James C / Ahmed, Iqbal I K / Anonymous950894. ·Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto, Canada. · Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina. · Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: dbudenz@med.unc.edu. · NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, United Kingdom. · Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, New York. ·Am J Ophthalmol · Pubmed #28104418.

ABSTRACT: PURPOSE: To determine the relative efficacy of the Ahmed-FP7 and Baerveldt BG101-350 implants. DESIGN: Pooled analysis of 2 multicenter, randomized clinical trials. METHODS: A total of 514 patients aged 18 or older with uncontrolled glaucoma that had failed or were at high risk of failing trabeculectomy were randomized to receive an Ahmed implant (n = 267) or Baerveldt implant (n = 247). Cumulative failure rates (using an intraocular pressure [IOP] target of 6-18 mm Hg inclusive), de novo glaucoma surgery rates, mean IOP, mean glaucoma medication use, and visual acuity were compared. RESULTS: Baseline characteristics were similar between groups. Mean preoperative IOP of the study population was 31.5 ± 11.3 mm Hg on an average of 3.3 ± 1.1 glaucoma medications. At 5 years, mean IOP was 15.8 ± 5.2 mm Hg in the Ahmed group and 13.2 ± 4.7 mm Hg in the Baerveldt group (P < .001). Mean glaucoma medication use was 1.9 ± 1.5 in the Ahmed group and 1.5 ± 1.4 in the Baerveldt group (P = .007). The cumulative failure rate at 5 years was 49% in the Ahmed group and 37% in the Baerveldt group (P = .007). High IOP was the most common reason for failure in both groups, and de novo glaucoma surgery was required in 16% of the Ahmed group and 8% of the Baerveldt group (P = .006). Failure owing to hypotony occurred in 0.4% of the Ahmed group and 4.5% of the Baerveldt group (P = .002). Visual outcomes were similar between groups (P = .90). CONCLUSIONS: The Baerveldt group had a lower failure rate, lower rate of de novo glaucoma surgery, and lower mean IOP on fewer medications than the Ahmed group. Baerveldt implantation carried a higher risk of hypotony.

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