1: J Glaucoma. 2008 April/May;17(3):251. 

In Response.

Mansberger SL, Lin S, Netland PA.

*Devers Eye Institute, Legacy Health System, Portland, OR daggerUniversity of
California San Francisco, CA double daggerHamilton Eye Institute, University of
Tennessee Health Science Center Memphis, TN.

PMID: 18414118 [PubMed - as supplied by publisher]

2: J Glaucoma. 2008 April/May;17(3):250-251. 

Uncontrolled Intraocular Pressure After Endoscopic Cyclophotocoagulation.

Noecker RJ, Kahook MY, Berke SJ, Nichamin LD, Weston JM, Mackool R, Tyson F,
Lima F, Kleinfeldt N.

*Department of Ophthalmology University of Pittsburgh School of Medicine
Pittsburgh, PA daggerDenver, CO double daggerLynbrook, NY  section
signBrookeville, PA  parallelRoseburg, OR  paragraph signAstoria, NY musical
sharpCape Coral, FL **Goias, Brazil daggerdaggerDearborn, MI.

PMID: 18414117 [PubMed - as supplied by publisher]

3: J Glaucoma. 2008 April/May;17(3):249-250. 

Prevalence of Open-angle Glaucoma, Glaucoma Suspect, and Ocular Hypertension in
Thyroid-related Immune Orbitopathy.

Skalicky SE, Borovik AM, Masselos K, Pandya VB, Wang LW, Figueira EC, Wilcsek G,
Francis IC.

*The Ocular Plastics Unit, Prince of Wales Hospital, High Street, Randwick
daggerThe University of New South Wales, Sydney, Australia.

PMID: 18414116 [PubMed - as supplied by publisher]

4: J Glaucoma. 2008 April/May;17(3):249-250. 

In Response.

Behroozi Z, Rabie HM, Mohammadpour M.

*Imam Hossein Hospital, Opthalmic Research Center, Shahid Beheshti Medical
University daggerFarabi Eye Hospital, Eye Research Center, Tehran Medical
University, Tehran, Iran.

PMID: 18414115 [PubMed - as supplied by publisher]

5: J Glaucoma. 2008 April/May;17(3):248. 

Atypical Retinitis Pigmentosa Masquerading as Primary Open Angle Glaucoma.

Dauber SL, Masselos K, Brown TM, Figuera EC, Pandya VB, Francis IC.

*Department of Ophthalmology Prince of Wales Hospital High Street, Randwick
daggerThe University of New South Wales Sydney, Australia.

PMID: 18414114 [PubMed - as supplied by publisher]

6: J Glaucoma. 2008 Apr-May;17(3):248-9. 

In response.

Vander J, Lin JC, Katz J.

Wills Eye Institute, Philadelphia, PA.

PMID: 18414113 [PubMed - in process]

7: J Glaucoma. 2008 Apr-May;17(3):238-47. 

Endoscopic and transscleral cyclophotocoagulation for the treatment of
refractory glaucoma.

Lin SC.

University of California, San Francisco, CA.

PURPOSE: Cyclophotocoagulation (CPC) is traditionally used in cases of glaucoma
that are refractory to medical and surgical therapy. The goal of this review is
to provide an update on the methods, efficacy, complications, indications, and
histopathology of transscleral and endoscopic CPC. METHODS: A literature review
was conducted for transscleral and endoscopic CPC. Relevant studies were
included for evaluation of the procedures. RESULTS: For transscleral CPC (TCP),
there is a wide range of success rates reported in the literature, depending on
energy settings, follow-up period, and definitions of success. Repeat TCP is
often required. Serious complications have included significant vision loss,
hypotony, and phthisis. TCP has mostly been performed in very severe forms of
glaucoma, in eyes with limited visual potential, or after filtration surgery has
failed, although more recently TCP has been used as a primary surgery in eyes
with good visual potential. There are more limited published results on
endoscopic CPC (ECP), which have demonstrated overall good success. Complication
rates are relatively low with ECP, however, large studies with long-term
follow-up are lacking. ECP has also been used in difficult, refractory cases,
but often used earlier when combined with cataract surgery. CONCLUSIONS: Both
TCP and ECP are effective surgeries with potential for serious complications.
Recent studies suggest they may be used increasingly as the primary surgery for
various stages of glaucoma.

PMID: 18414112 [PubMed - in process]

8: J Glaucoma. 2008 Apr-May;17(3):233-7. 

Comparison of ocular hypotensive effect and safety of brinzolamide and timolol
added to latanoprost.

Miura K, Ito K, Okawa C, Sugimoto K, Matsunaga K, Uji Y.

Department of Ophthalmology, Mie University School of Medicine, Tsu, Japan.

PURPOSE: To compare the ocular hypotensive effect and safety of brinzolamide and
timolol added to latanoprost monotherapy. METHODS: In prospective randomized
fashion, we evaluated the ocular hypotensive effect and safety of brinzolamide
or timolol in 1 eye of 32 patients with primary open-angle glaucoma,
normal-tension glaucoma, or ocular hypertension who had been treated with
latanoprost for more than 1 month. Intraocular pressure (IOP), blood pressure,
and pulse were measured before and at 4, 8, and 12 weeks. Corneal endothelial
cell density was measured at baseline and at 12 weeks. RESULTS: The IOP was
17.8+/-1.7 mm Hg (mean+/-SD) before the addition of brinzolamide (n=15) and
15.7+/-2.1 mm Hg at 12 weeks (P<0.01). In comparison, the IOP was 18.5+/-3.7 mm
Hg before the addition of timolol (n=15) and 15.8+/-3.2 mm Hg at 12 weeks
(P<0.01). Both brinzolamide and timolol significantly decreased IOP at 12 weeks,
by a mean of 2.0 mm Hg and mean 2.7 mm Hg, respectively, and were more effective
than latanoprost alone (P<0.01), but there were no significant differences
between the drugs and no significant differences in corneal endothelial cell
density and blood pressure before and after addition of either drug. At 12
weeks, pulse was decreased in patients receiving timolol (P<0.01). As systemic
adverse events, there was one instance of malar flushing after brinzolamide
addition and episodes of chest discomfort after timolol addition in 1 patient.
Ocular adverse events were slight. CONCLUSIONS: Brinzolamide and timolol added
to latanoprost have similar ocular hypotensive effects and safety in primary
open-angle glaucoma, normal-tension glaucoma, or ocular hypertension.

PMID: 18414111 [PubMed - in process]

9: J Glaucoma. 2008 April/May;17(3):227-232. 

Characteristics of Patients who Dropout From a Glaucoma Clinic.

Ashaye AO, Adeoye AO.

*Departments of Ophthalmology, College of Medicine, University of Ibadan
daggerCollege of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

PURPOSE: To find the dropout rate and identify the clinical characteristics of
patients who drop out in the first year of follow-up from a glaucoma clinic.
DESIGN: Descriptive hospital-based study at a tertiary hospital eye department.
METHODS: Clinical characteristics of consecutive patients newly diagnosed with
glaucoma who dropped out (n=452) were compared with patients who did not drop
out (n=295) within 12 months. RESULTS: The rate of dropout from follow-up was
60.5% within 1 year; 43.1% of the study group dropped out after their first
follow-up visit. The dropout rate was high in all age groups, but higher in the
age groups 21 to 30 years, 41 to 50 years, and over 70 years. Males had a higher
dropout rate than females (78.6% vs. 34.5%). Dropout rate was higher among those
with mild/moderate glaucoma than those with severe disease (88.2% vs. 37.2%);
those who lived further away from the hospital than those who lived nearer to
the hospital (72.5% vs. 40.8%), those who were referred from screening clinics
for nonblinding eye disease compared with those referred because of a blinding
eye disease (72.2% vs. 58.9%). More patients (63.8%) unsure of their family eye
disease history dropped out, compared with 34.3% of those with positive family
history of glaucoma and other potentially blinding diseases. More patients who
had no systemic disease dropped out, than those with systemic disease (54.6% vs.
39.6%); whereas patients on 2 medications or more had a higher dropout rate than
those on less than 2 medications (68.1% vs. 52.1%). Of the study factors, those
that were statistically significantly associated with dropping out of follow-up
from the glaucoma clinic were age, sex, place of domicile, diagnosis at
referral, severity of disease, family history, and polydrug use. CONCLUSIONS:
The dropout rate from this glaucoma clinic in the first year was high (60.5%).
Patients who were more likely to dropout were younger patients, male, those who
travelled far distances to the clinic, those with mild to moderate glaucoma,
those with no family history of blinding eye diseases, and patients taking 2 or
more eyedrops. Patients who seem to perceive their problems as not serious
dropped out of follow-up. These findings have great implications in planning
future studies and intervention to improve the follow-up of glaucoma patients in
the study area.

PMID: 18414110 [PubMed - as supplied by publisher]

10: J Glaucoma. 2008 April/May;17(3):223-226. 

No Association Between Helicobacter pylori Infection or CagA-bearing Strains and
Glaucoma.

Kurtz S, Regenbogen M, Goldiner I, Horowitz N, Moshkowitz M.

Departments of *Ophthalmology double daggerGastroenterology, Tel-Aviv Sourasky
Medical Center daggerSackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv,
Israel.

BACKGROUND AND PURPOSE: Accumulating evidence indicates that a variety of
infections contribute to the pathogenesis of glaucoma. The role of Helicobacter
pylori infection in glaucoma is controversial. DESIGN: Prospective,
population-based study. PARTICIPANTS: Patients with various types of glaucoma
and a control group of patients with cataract. METHODS: We evaluated
seropositivity to H. pylori and to its cytotoxin-associated gene A (CagA)
product in patients with various types of glaucoma and compared the findings to
those of a control group of patients with cataract. RESULTS: H. pylori infection
and CagA seropositivity were detected in 31/51 (60.8%) and 26/51 (51%) glaucoma
patients compared with 22/36 (61.1%) and 19/36 (52%) control patients,
respectively (P=0.88, 0.67, not significant). Similar rates of H. pylori
infection and CagA-positive strain were found in all glaucoma subgroups, and
none of them was statistically different from those of controls. CONCLUSIONS:
Neither H. pylori infection nor seropositivity for virulent CagA-bearing H.
pylori strains have significant association with the occurrence of glaucoma of
any type.

PMID: 18414109 [PubMed - as supplied by publisher]

11: J Glaucoma. 2008 April/May;17(3):217-222. 

Duration of IOP Reduction With Travoprost BAK-free Solution.

Gross RL, Peace JH, Smith SE, Walters TR, Dubiner HB, Weiss MJ, Ochsner KI.

*Ophthalmology, Baylor College of Medicine, Houston  section signTexan Eye Care,
Austin, TX daggerDiabetic Eye Medical Clinic, Inglewood, CA double daggerEye
Associates of Fort Myers, Fort Myers, FL  parallelClayton Eye Center, Morrow, GA
 paragraph signThe Eye Institute, Tulsa, OK musical sharpEye Associates of
Wilmington, Wilmington, NC.

PURPOSE: To compare the duration of action of travoprost ophthalmic solution
0.004% (Travatan Z)trade mark formulated without benzalkonium chloride (BAK) to
travoprost ophthalmic solution 0.004% formulated with BAK (Travatan). METHODS:
This was a prospective, randomized, double-masked study. Patients with
open-angle glaucoma or ocular hypertension were randomized to receive 2 weeks of
once-daily therapy with travoprost BAK-free or travoprost with BAK. Patients
received the last dose of medication on day 13 and then intraocular pressure
(IOP) was assessed every 12 hours for 60 hours. Statistical analysis included
change in IOP from baseline for each group and comparison of mean IOP between
groups. RESULTS: Of the 109 patients enrolled, 106 patients completed the study.
Untreated mean baseline IOP at 8 AM was 26.9 mm Hg in the travoprost BAK-free
group and 27.1 mm Hg in the travoprost with BAK group. At 12, 24, 36, 48, and 60
hours after the last dose, mean IOP in the travoprost BAK-free group was 18.7,
17.2, 19.5, 18.7, and 20.8 mm Hg, respectively; whereas mean IOP in the
travoprost with BAK group was 18.5, 16.8, 19.7, 18.0, and 20.8 mm Hg,
respectively. Mean IOP at all time points after the last dose of medication was
>6 mm Hg lower than the 8 AM baseline in both groups. Between-group differences
were within +/-0.6 mm Hg at all postdose time points. There were no
statistically significant differences between the 2 treatment groups at baseline
or at any postdose time point. Drug-related side effects were uncommon, mild in
intensity, and comparable between groups. CONCLUSIONS: Travoprost without BAK
has similar IOP-lowering efficacy and safety compared with travoprost preserved
with BAK. Both formulations of travoprost have a prolonged duration of action,
with statistically and clinically significant reductions from baseline
persisting up to 60 hours after the last dose.

PMID: 18414108 [PubMed - as supplied by publisher]

12: J Glaucoma. 2008 April/May;17(3):211-216. 

Bimatoprost/Timolol Fixed Combination: A 3-month Double-masked, Randomized
Parallel Comparison to Its Individual Components in Patients With Glaucoma or
Ocular Hypertension.

Brandt JD, Cantor LB, Katz LJ, Batoosingh AL, Chou C, Bossowska I; for the
Ganfort Investigators Group II.

University of California, Davis, Sacramento, CA.

PURPOSE: To evaluate the safety and efficacy of a fixed combination (FC) of
bimatoprost (BIM) and timolol (TIM) compared with each of the active components
for 3 months. PATIENTS AND METHODS: Two double-masked, randomized, multicenter
parallel studies of FC (once-daily, mornings), BIM (once-daily, evenings), or
TIM (twice-daily) were conducted in 1061 patients with glaucoma or ocular
hypertension. RESULTS: Mean diurnal decreases from baseline intraocular pressure
(IOP) at month 3 were 8.1, 7.9, and 6.4 mm Hg for the FC, BIM, and TIM groups,
respectively. The proportion of patients with a mean diurnal percent reduction
from baseline in IOP of more than 20% across all visits was 81.8% (436/533),
72.1% (191/265), and 49.8% (131/263) for the FC, BIM, and TIM groups,
respectively (P<0.001 for FC vs. BIM and FC vs. TIM). The proportion of patients
achieving an IOP of less than 18 mm Hg at all time points was 39.2% (209/533),
28.7% (76/265), and 12.2% (32/263) for the FC, BIM, and TIM groups, respectively
(P=0.003 for FC vs. BIM, and P<0.001 for FC vs. TIM). The most commonly reported
treatment-related adverse event was conjunctival hyperemia, with the greatest
incidence in BIM (38.5%, 102/265), followed by FC (22.7%, 121/533, P<0.0001 vs.
BIM) and TIM (6.8%, 18/263; P<0.001 vs. FC). CONCLUSIONS: FC was statistically
significantly more effective than BIM or TIM for most comparisons, and safer
than BIM with respect to common ocular adverse events. FC represents a
convenient, therapeutic advantage over separate bottles.

PMID: 18414107 [PubMed - as supplied by publisher]

13: J Glaucoma. 2008 April/May;17(3):203-210. 

Relationship Between Humphrey 30-2 SITA Standard Test, Matrix 30-2 Threshold
Test, and Heidelberg Retina Tomograph in Ocular Hypertensive and Glaucoma
Patients.

Bozkurt B, Ylmaz PT, Irkec M.

*Private Practice daggerDepartment of Ophthalmology, Hacettepe University School
of Medicine, Ankara, Turkey.

PURPOSE: To evaluate the relationship between global indices of Humphrey
standard automated perimetry (SAP, 30-2 SITA standard test), Humphrey Matrix
frequency doubling technology (FDT, 30-2 threshold test), and Heidelberg Retina
Tomograph (HRT II) parameters and measure the level of agreement among these 3
tests in classifying eyes as normal or abnormal. METHODS: The study included 1
eye of 29 ocular hypertensive and 56 glaucoma patients with a mean age of
60.9+/-10.5 years. All subjects had reliable visual fields and HRT measurements
performed within a 2-week period. The eyes were classified as normal/abnormal
according to visual field criteria and Moorfields regression analysis (MRA).
Correlations between visual field indices (mean deviation and pattern standard
deviation) and HRT parameters were analyzed using Spearman correlation
coefficient (r) and the agreement between the tests in classifying eyes was
defined with kappa value. RESULTS: FDT Matrix mean deviation and pattern
standard deviation parameters were found to be highly correlated with those of
SAP (r=0.66 and 0.69, respectively). Visual field indices showed statistically
significant correlations with cup area, rim area, cup/disc (C/D) area, linear
C/D, cup shape, mean retinal nerve fiber layer thickness and retinal nerve fiber
layer area parameters (P<0.05). Fifty-eight patients (68.2%) had abnormal
results at least with 1 of the tests and 21 subjects (24.7%) had abnormal
results with all 3 tests. The kappa values were 0.6 for SAP and Matrix
(P<0.001), 0.33 for SAP and MRA (P=0.002), and 0.31 for Matrix and MRA
(P=0.004). CONCLUSIONS: FDT Matrix results are highly comparable with SAP in the
assessment of glaucoma. Visual field global indices show statistically
significant, but low-moderate correlations with most of the HRT parameters. The
agreement among MRA and visual fields for abnormality is fair. Either HRT or
visual fields may show the first evidence of glaucomatous damage; therefore, the
combination of optic nerve head parameters and visual field results could
improve glaucoma diagnosis and follow-up.

PMID: 18414106 [PubMed - as supplied by publisher]

14: J Glaucoma. 2008 April/May;17(3):197-202. 

Evaluation of a Modified Protocol for Selective Laser Trabeculoplasty.

George MK, Emerson JW, Cheema SA, McGlynn R, Ford BA, Martone JF, Shields MB,
Wand M.

*Department of Ophthalmology and Visual Science, Yale University School of
Medicine New Haven, CT daggerDepartment of Statistics, Yale University, New
Haven, CT  section signDepartment of Ophthalmology, University of Connecticut,
Farmington, CT double daggerDepartment of Ophthalmology, University of Calgary,
Calgary, Alberta, Canada.

PURPOSE: To compare the intraocular pressure (IOP) response to a modified
protocol for selective laser trabeculoplasty (SLT) to standard protocols for SLT
and argon laser trabeculoplasty (ALT). MATERIALS AND METHODS: A retrospective
study of 318 eyes of 284 patients diagnosed with either primary open angle,
pigmentary or pseudoexfoliation glaucoma who underwent laser trabeculoplasty
from September 1997 to September 2005. One hundred and two patients, who
underwent a modified SLT protocol with 100 overlapping laser spots over 180
degrees of trabecular meshwork were compared with 89 patients who received SLT
with 100 nonoverlapping spots over 360 degrees and another 127 patients who
received ALT with 50 spots over 180 degrees. IOPs were measured at baseline and
postoperatively at 1 hour, 6 weeks, 4 months, and 14 months. Regression models,
based on the observed data, were used to predict the fall in IOP in the 3
groups, controlling for differences in baseline pressure. RESULTS: The IOP
response to overlapping SLT was significantly worse than to nonoverlapping SLT
or ALT, both of which had similar responses. Baseline IOP was the only
preoperative factor that predicted response to ALT (P<0.0001) and nonoverlapping
SLT (P=0.0019) at all follow-up times. There were no statistically significant
predictive factors for IOP reduction in the overlapping SLT group. CONCLUSIONS:
Overlapping application of SLT results in a poorer IOP response compared with
ALT and nonoverlapping SLT.

PMID: 18414105 [PubMed - as supplied by publisher]

15: J Glaucoma. 2008 April/May;17(3):193-196. 

Three-dimensional Anterior Segment Optical Coherence Tomography of Filtering
Blebs After Trabeculectomy.

Miura M, Kawana K, Iwasaki T, Kiuchi T, Oshika T, Mori H, Yamanari M, Makita S,
Yatagai T, Yasuno Y.

*Computational Optics and Ophthalmology Group daggerComputational Optics Group
in the University of Tsukuba  section signDepartment of Ophthalmology, Institute
of Clinical Medicine  parallelInstitute of Applied Physics, University of
Tsukuba double daggerDepartment of Ophthalmology, Tokyo Medical University,
Tsukuba, Ibaraki, Japan.

PURPOSE: To evaluate trabeculectomy blebs by using 3-dimensional anterior
segment optical coherence tomography (OCT). METHODS: We prospectively examined 4
eyes of 4 patients who developed filtering blebs after trabeculectomy. A 1310-nm
high-speed OCT prototype was used to image the 3-dimensional structure of the
filtering blebs. RESULTS: The 3-dimensional structure of the filtering blebs was
clearly observed in the OCT images. Three types of filtering blebs were
observed: diffuse blebs in 2 eyes, an encapsulated bleb in 1 eye, and a
nonfunctioning cystic bleb in 1 eye. The volume of each bleb was 9.97, 1.10,
0.76, and 0.88 mm, respectively. En-face OCT images clearly showed the aqueous
outflow channels at the margins of the scleral flaps. CONCLUSION:
Three-dimensional OCT allows objective and noninvasive assessment of filtering
blebs after trabeculectomy.

PMID: 18414104 [PubMed - as supplied by publisher]

16: J Glaucoma. 2008 April/May;17(3):189-192. 

Contribution of CYP1B1 Mutations and Founder Effect to Primary Congenital
Glaucoma in Mexico.

Zenteno JC, Hernandez-Merino E, Mejia-Lopez H, Matias-Florentino M, Michel N,
Elizondo-Olascoaga C, Korder-Ortega V, Casab-Rueda H, Garcia-Ortiz JE.

Departments of *Genetics-Research Unit double daggerGlaucoma, Institute of
Ophthalmology "Conde de Valenciana" daggerDepartment of Glaucoma, Hospital
"Nuestra Senora de La Luz", Mexico City  section signDivision of Genetics,
Western Biomedical Research Center, Mexican Institute on Social Security,
Guadalajara, Mexico.

PURPOSE: The frequency of primary congenital glaucoma (PCG)-causing CYP1B1
mutations varies importantly among distinct populations, ranging from 20% in
Indonesians and Japanese to about 100% among the Saudi Arabians and Slovakian
Gypsies. Thus, the molecular characterization of large groups of PCG from
different ethnic backgrounds is important to establish the actual CYP1B1
contribution in specific populations. In this work, the molecular analysis of
the CYP1B1 gene in a group of Mexican PCG patients is reported. MATERIAL AND
METHODS: Thirty unrelated Mexican patients fulfilling the clinical criteria for
PCG were included. Two cases were familial and with proven consanguinity,
originating from distinct regions of the country. Polymerase chain reaction
amplification and direct automated sequencing of the CYP1B1 coding region was
performed in each participating subject. RESULTS: An identical pathogenic CYP1B1
mutation was demonstrated in 2 unrelated PCG subjects. The mutation consisted of
a homozygous G to A transition at nucleotide position 1505 in exon 3, which
predicted a substitution of glutamic acid for lysine at residue 387 of the
protein (E387K). In the remaining 28 PCG subjects, no deleterious mutations were
identified. Both subjects with the E387K mutation shared a same haplotype for 5
CYP1B1 intragenic single nucleotide polymorphisms, indicating a common origin of
the allele. CONCLUSIONS: Mexican patients with PCG are rarely (less than 10%)
due to CYP1B1 mutations. Available data indicate that most of the non-Brazilian
Latin American PCG patients investigated to date are not due to CYP1B1 defects.
Populations with low incidence of CYP1B1 mutations are appropriate candidates
for the identification of novel PCG-causing genes.

PMID: 18414103 [PubMed - as supplied by publisher]

17: J Glaucoma. 2008 Apr-May;17(3):183-8. 

Detection of Early Glaucoma With Optical Coherence Tomography (StratusOCT).

Nouri-Mahdavi K, Nikkhou K, Hoffman DC, Law SK, Caprioli J.

Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine,
University of California Los Angeles, Los Angeles, CA.

PURPOSE: To evaluate the performance of optical coherence tomography
(StratusOCT) for discriminating eyes with early glaucoma from normal eyes.
METHODS: Thirty eyes with established early glaucomatous visual field defects
(EGVF group), 30 eyes with evidence of early glaucomatous optic neuropathy with
normal standard achromatic perimetry [early glaucoma by disc (EGD)], and 33
age-matched normal eyes with good quality StratusOCT nerve fiber layer (NFL)
images were enrolled. Average NFL thickness and NFL thickness at quadrants and
sectors, areas under receiver operator characteristic curves, and sensitivities
at 80% and 90% specificity were evaluated. RESULTS: The average (+/-SD) mean
deviation in the EGVF group was -3.4 (+/-1.7) dB. Receiver operator
characteristic curves showed areas under the curve (AUC) for NFL thickness in
the superior quadrant (AUC=0.75+/-0.07) and in the inferior quadrant
(AUC=0.94+/-0.03) to be the best StratusOCT parameters for discrimination of
normal controls from EGD and EGVF eyes, respectively. The best parameter for
detection of EGD eyes at 80% and 90% specificities was NFL thickness at superior
quadrant (51% and 36% sensitivities, respectively). The best parameter for
detection of EGVF eyes at 80% and 90% specificities was NFL thickness in the
inferior quadrant (90% and 87% sensitivities, respectively). CONCLUSIONS:
Optical coherence tomography (StratusOCT) showed good sensitivity and
specificity in a group of glaucoma patients with early visual field loss. In
patients with normal visual fields in whom the optic disc appeared glaucomatous
to glaucoma specialists, half were confirmed to have StratusOCT findings
consistent with damage from glaucoma.

PMID: 18414102 [PubMed - in process]

18: J Glaucoma. 2008 April/May;17(3):175-182. 

Effect of Recording Duration on the Diagnostic Performance of Multifocal
Visual-evoked Potentials in High-risk Ocular Hypertension and Early Glaucoma.

Fortune B, Zhang X, Hood DC, Demirel S, Patterson E, Jamil A, Mansberger SL,
Cioffi GA, Johnson CA.

*Discoveries in Sight, Devers Eye Institute, Legacy Health System, Portland, OR
daggerDepartment of Psychology, Columbia University, New York, NY.

PURPOSE: To evaluate the effect on diagnostic performance of reducing multifocal
visual-evoked potential (mfVEP) recording duration from 16 to 8 minutes per eye.
METHODS: Both eyes of 185 individuals with high-risk ocular hypertension or
early glaucoma were studied. Two 8-minute mfVEP recordings were obtained for
each eye in an ABBA order using VERIS. The first recording for each eye was
compared against single run (1-Run) mfVEP normative data; the average of both
recordings for each eye was compared against 2-Run normative data. Visual fields
(VFs) were obtained by standard automated perimetry (SAP) within 22.3+/-27.0
days of the mfVEP. Stereo disc photographs and Heidelberg Retina Tomograph
images were obtained together, within 24.8+/-50.4 days of the mfVEP and
33.1+/-62.9 days of SAP. Masked experts graded disc photographs as either
glaucomatous optic neuropathy or normal. The overall Moorfields Regression
Analysis result from the Heidelberg Retina Tomograph was used as a separate
diagnostic classification. Thus, 4 diagnostic standards were applied in total, 2
based on optic disc structure alone and 2 others based on disc structure and
SAP. RESULTS: Agreement between the 1-Run and 2-Run mfVEP was 90%. Diagnostic
performance of the 1-Run mfVEP was similar to that of the 2-Run mfVEP for all 4
diagnostic standards. Sensitivity was slightly higher for the 2-Run mfVEP,
whereas specificity was slightly higher for the 1-Run mfVEP. CONCLUSIONS: If
higher sensitivity is sought, the 2-Run mfVEP will provide better discrimination
between groups of eyes with relatively high signal-to-noise ratio (eg, early
glaucoma or high-risk suspects). But if higher specificity is a more important
goal, the 1-Run mfVEP provides adequate sensitivity and requires only half the
test time. Considered alongside prior studies, the present results suggest that
the 1-Run mfVEP is an efficient way to confirm (or refute) the extent of VF loss
in patients with moderate or advanced glaucoma, particularly in those with
unreliable VFs, including malingering or other "functional" forms of VF loss.

PMID: 18414101 [PubMed - as supplied by publisher]

19: J Glaucoma. 2008 Apr-May;17(3):169-74. 

Discrepancy of the Intraocular Pressure Response Between Fellow Eyes in One-eye
Trials Versus Bilateral Treatment: Verification With Normal Subjects.

Takahashi M, Higashide T, Sakurai M, Sugiyama K.

Department of Ophthalmology and Visual Science, Kanazawa University Graduate
School of Medical Science, Kanazawa, Japan.

PURPOSE: To compare the correlation of the fellow-eye\'s intraocular pressure
(IOP) response in one-eye trials performed separately for each eye with that of
bilateral treatment in normal subjects. METHODS: A one-eye trial with topical
latanoprost applied once daily for 7 days was carried out in the right eye and
then in the left eye of 41 normal subjects. Bilateral treatment was performed in
a different set of 41 normal subjects. IOPs were measured at 3 time points on
day 0 and on day 7. RESULTS: Latanoprost significantly reduced IOP of treated
eyes in one-eye trials (2.8+/-1.6 and 2.7+/-1.6 mm Hg in the first and second
trial, respectively) and in bilateral treatments (2.8+/-1.3 and 2.6+/-1.4 mm Hg
in the right and left eye, respectively). Correlation of mean diurnal IOP
reduction between 2 one-eye trials was poor (r=0.102), even after subtracting
the nontreated eye IOP fluctuations from the treated eye IOPs (r=0.097), but
that between fellow eyes in bilateral treatment was excellent (r=0.849).
Correlation of baseline IOP at each time point between fellow eyes in one-eye
trials and bilateral treatment (r=0.729 to 0.949) was better than that in the
same eye between 2 one-eye trials (r=0.319 to 0.631). CONCLUSIONS: Fellow eyes
in normal subjects showed a symmetrical IOP response to short-term bilateral
treatment with latanoprost, although they did not respond symmetrically to
one-eye trials performed separately for each eye. Poor correlation of IOP
changes between 2 one-eye trials may be caused by different IOP responsiveness
to latanoprost at each trial, rather than asymmetrical IOP fluctuations.

PMID: 18414100 [PubMed - in process]

20: J Glaucoma. 2008 April/May;17(3):159-168. 

Screening for Open Angle Glaucoma: Systematic Review of Cost-effectiveness
Studies.

Hernandez R, Rabindranath K, Fraser C, Vale L, Blanco AA, Burr JM; for the OAG
Screening Project Group.

*Health Economics Research Unit daggerHealth Services Research Unit, Institute
of Applied Health Sciences, College of Life Sciences and Medicine, University of
Aberdeen double daggerDepartment of Ophthalmology, Grampian University Hospitals
NHS Trust, Aberdeen, Scotland, UK.

PURPOSE: To systematically review current evidence on the cost-effectiveness of
screening strategies for open angle glaucoma (OAG). MATERIALS AND METHODS:
Studies that reported both costs and outcomes of alternative screening
strategies for OAG were identified by a highly sensitive search of electronic
databases (eg, MEDLINE, EMBASE, NHS EED, HTA Database), last search December
2005. Data on costs regarding cases and years of visual impairment prevented,
cases of blindness prevented, and cases of OAG detected were extracted.
Incremental cost-effectiveness ratios were calculated using data provided in the
included studies. RESULTS: Four studies met the inclusion criteria. The latest
of these was published in 1997. The screening tests and treatments reported in
these studies are now not considered to be best practice. Furthermore, data were
not reported in sufficient detail to reinterpret the results of the studies in
terms of a common outcome measure. Finally, these studies suffered from
methodologic weaknesses that further limit their usefulness for decision making.
CONCLUSIONS: Currently, there is insufficient economic evidence on which to base
recommendations regarding screening for OAG. New technologies, potentially
suitable as screening devices, and new treatments are available. Further
research, both in terms of economic models and conduct of clinical trials with
concurrent economic evaluation, may help inform policy makers regarding
cost-effectiveness and acceptability of screening for OAG.

PMID: 18414099 [PubMed - as supplied by publisher]