Comparing Five Criteria for Evaluating Glaucomatous Visual Fields

Precis: This retrospective study found a statistically significant reduction in mean intraocular pressure and number of medications after intracameral Bimatoprost SR injection in patients with glaucoma. A history of selective laser trabeculoplasty did not impact treatment outcomes. Purpose: To determine outcomes of Bimatoprost sustained release (Bimatoprost SR) on intraocular pressure (IOP) and number of topical IOP lowering medications in patients with glaucoma. A secondary objective was to determine the outcomes of Bimatoprost SR in patients with a prior history of selective laser trabeculoplasty (SLT). Methods: Retrospective case series. One hundred and eighteen eyes from 84 patients that received Bimatoprost SR by 6 glaucoma specialists at Wills Eye Hospital from March 2020 to September 2021 were examined. The intervention was a single injection of intracameral Bimatoprost SR. Main outcome measures included IOP and number of medications. Results: The mean most recent follow-up time for all eyes was 27.8±18.6 weeks. Mean post-treatment IOP at most recent follow-up of 16.6±5.3 mmHg was significantly lower than mean under therapy pre-treatment IOP of 18.5±5.7 mmHg for all eyes (P<0.01). Mean post-treatment number of medications at most recent follow-up of 1.3±1.3 decreased compared to number of pre-treatment medications of 2.1±1.4 for all eyes (P<0.01). Analysis of multilevel models controlling for demographic variables demonstrated a statistically significant reduction in IOP and number of medications post-treatment (P<0.01). A prior history of SLT (n=54) had no impact on treatment for both IOP and number of medications (P>0.1 for both). Conclusions: Intracameral Bimatoprost SR reduced IOP and decreased the number of medications. Prior history of SLT did not impact Bimatoprost SR treatment outcomes.

Section: Data Collectionmentioning

confidence: 99%

Short-Term Outcomes of Bimatoprost Sustained-Release Intracameral Implant in Glaucoma

Wong,

Bowers,

Ventimiglia

et al. 2023

“…Automated VF testing is a key tool to assess glaucoma severity and monitor progression. [3][4][5] The reliability and testretest variability of the testing can limit its usefulness. [6][7][8][9] VF testing requires time and effort for both patient and examiner.…”

mentioning

confidence: 99%

“…Automated VF testing is a key tool to assess glaucoma severity and monitor progression 3–5. The reliability and test-retest variability of the testing can limit its usefulness 6–9.…”

mentioning

confidence: 99%

Perimetric Comparison Between the IMOvifa and Humphrey Field Analyzer

Nishida

Eslani

Weinreb

et al. 2022

Précis: IMO visual function analyzer (IMOvifa), a binocular perimeter, has similar output to the Humphrey Field Analyzer (HFA), but reduced the measurement time. Purpose: The purpose of this study is to evaluate the performance of IMOvifa, a perimeter that performs binocular visual field (VF) testing, and to compare its results with standard automated perimetry. Methods: All patients underwent HFA 24–2 SITA-Fast and IMOvifa 24–2 AIZE-Rapid on the same day. Mean deviation (MD), pattern SD (PSD), foveal threshold, and visual field index (VFI) were compared between the 2 perimeters using Wilcoxon signed-rank tests, Pearson correlation, and Bland-Altman plot. Measurement time for performing VF for both eyes was also collected for each device. Results: In this cross-sectional study, 138 eyes (including 25 healthy, 48 glaucoma suspects, and 65 primary open angle glaucoma) of 69 patients were evaluated. Measurement time was significantly faster for IMOvifa compared with HFA (256 vs. 419 s, P<0.001). No significant differences were seen in MD and VFI between HFA and IMOvifa (both P>0.05). Significant differences were seen in mean PSD 3.2 (2.7, 3.6) dB for HFA versus 4.1 (3.5, 4.6) for IMOvifa (P<0.001), and foveal threshold 33.9 (33.1, 34.6) dB for HFA versus 30.6 (29.3, 31.9) dB for IMOvifa (P<0.001). Pearson r was strong for MD (r=0.90, P<0.001), PSD (r=0.78, P<0.001), and VFI (r=0.94, P<0.001). The mean difference (95% limits of agreement) was −0.1 (−3.8, 3.5) dB for MD, −0.4 (−3.4, 2.5) dB for PSD, and 0.1 (−8.9, 9.1) dB for VFI, respectively. Conclusions: IMOvifa reduced measurement time by 39%. MD, PSD, and VFI values for IMOvifa showed good agreement with HFA SITA-Fast strategy. This perimeter reduced fatigue for both patient and examiner. Additional studies are needed to determine whether it will be useful for routine VF testing.

“…Several studies have shown that laser trabeculoplasty is a viable first-line option. 11,14,15 On the other end of the treatment ladder, SLT is seldom considered following incisional glaucoma procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Severity of glaucoma was defined based on visual field data using the Hoddap-Parrish-Anderson criteria. 14 Baseline data were collected from the last office visit before SLT, including age, sex, race, type of glaucoma, severity of glaucoma, eye laterality, baseline IOP, and glaucoma medications. The following data were recorded at baseline and each post-SLT visit: IOP, glaucoma medications, and complications.…”

Section: Institutional Review Board Approval From Wills Eyementioning

confidence: 99%

Outcomes of Selective Laser Trabeculoplasty After Prior Incisional Surgery for Open Angle Glaucoma

Kuley

Zheng

et al. 2023

This retrospective case series of patients with open angle glaucoma and prior trabeculectomy or tube shunt surgery found that selective laser trabeculoplasty (SLT) resulted in significant intraocular pressure (IOP) reductions in the intermediate follow-up period in select cases. Purpose:The purpose of this study was to assess the IOP-lowering effect and tolerability of SLT after prior trabeculectomy or tube shunt surgery.Materials and Methods: Open angle glaucoma patients at Wills Eye Hospital who previously underwent incisional glaucoma surgery and subsequently received SLT between 2013 and 2018 were included, along with an age-matched control group. Baseline characteristics, procedural data, and post-SLT data were recorded at 1, 3, 6, 12 months, and most recent visit. The primary success of SLT treatment was defined as IOP reduction of 20% or greater without the use of additional glaucoma medications compared to pre-SLT IOP. Secondary success was defined as IOP reduction ≥ 20% with the use of additional glaucoma medications compared to pre-SLT IOP.Results: There were 45 eyes in the study group and 45 eyes in the control group. In the study group, IOP decreased from a baseline of 19.5 ± 4.7 mm Hg on 2.2 ± 1.2 medications to 16.7 ± 5.2 mm Hg (P = 0.002) on 2.2 ± 1.1 glaucoma medications (P = 0.57). In the control group, IOP decreased from 19.5 ± 4.2 mm Hg on 2.4 ± 1.0 medications to 16.4 ± 5.2 mm Hg (P = 0.003) on 2.1 ± 1.3 medications (P = 0.36). There was no difference in IOP reduction or change in number of glaucoma medications after SLT at any postoperative visit between the 2 groups (P ≥ 0.12 for all). Primary success rates at 12 months were 24.4% for the control group and 26.7% for the prior incisional glaucoma surgery group with no significant difference between the groups (P = 0.92). There were no persistent complications after SLT treatment in either group. Conclusion:SLT may effectively lower IOP in patients with open angle glaucoma who have had previous incisional glaucoma surgery and should be considered in select cases.