Costos directos y calidad de vida de los pacientes con glaucoma en Paraguay / Direct costs and quality of life of patients with glaucoma in Paraguay

Introducción:El glaucoma constituyeun problema de salud pública por su alta prevalencia, los costos directos y la calidad de vida deteriorada de los pacientes que lo sufre. Objetivo:Determinar los costos directos y calidad de vida de los pacientes adultos con glaucoma atendidos en la Clínica Central de la Fundación Visión de noviembre 2022 a febrero 2023. Material y métodos:estudio observacional, descriptivo, corte transversal que incluyó pacientes con diagnóstico de glaucoma por muestreo por conveniencia. Resultados:Se incluyeron 140 pacientes entre 29 y 90 años, 52,9% femenino, 43,6% primaria incompleta, 32,1% desempleado. El tratamiento médico se realizó en el 81%, laser en 42% y procedimiento quirúrgico en 32%. Se informó un gasto promedio anual de 3.639.800gs ($ 503.93) por paciente. El estado emocional afectado se informó en el 35,7% de los pacientes, y calidad de vida deteriorada en el 48,6%; el 55% de los pacientes tiene dependencia para sus cuidados personales. Conclusión:El glaucoma implica grandes costos directos debido al tratamiento, además los pacientes tienen deterioro de la calidad de vida.Palabras Clave:glaucoma; costos de la atención en salud; distrés psicológico; calidad de vida

Introduction.Glaucoma is still a public health problem due to its high prevalence, the socioeconomic impact it entails for the patient who suffers from it, which decreases the quality of life. Objective:To determine the direct costs and quality of life of adult patients treated WITH glaucoma in the Fundación Visión Central Clinic from November 2022 to February 2023. Material and methods:observational, descriptive, cross-sectional study that included patients diagnosed with glaucoma by sampling by convenience. Results:140 patients between 29 and 90 years old were included, 52.9% female, 43.6% incomplete primary education, 32.1% unemployed. Medical treatment was performed in 81%, laser in 42% and surgical procedure in 32%. An average annual expense of 3,639,800gs ($503.93) per patient was reported. Emotional affectation was reported in 35.7% of the patients, and 43.5% deteriorated quality of life; 55% of the patients has dependency on personal care. Conclusion:Glaucoma involves large direct costs, due to treatment, in addition patients have deterioration in the quality of life.Key words:glaucoma; health care costs;psychological distress; quality of life

Acupuncture for glaucoma-induced optic atrophy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for glaucoma-induced optic atrophy.@*METHODS@#A total of 70 patients (89 affected eyes) with glaucoma-induced optic atrophy were randomized into an observation group and a control group, 35 cases in each group. The control group was given basic western medicine treatment. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at main acupoints i.e. Baihui (GV 20), Shangjingming (Extra), Chengqi (ST 1), Fengchi (GB 20), Zusanli (ST 36), combined with supplementary acupoints based on syndrome differentiation, once every three days, twice a week. The treatment for 3 months was required in both groups. Before treatment, after treatment and in follow-up of 6 months after treatment, the best corrected visual acuity (BCVA), intraocular pressure (IOP), indexes of visual field (visual field index [VFI], mean deviation [MD], pattern standard deviation [PSD]) and mean thickness of retinal nerve fiber layer (RNFL) were observed in the two groups.@*RESULTS@#Compared before treatment, BCVA was decreased after treatment and in follow-up in the control group (P<0.05); in the follow-up, BCVA in the observation group was higher than that in the control group (P<0.05). On each time point before and after treatment, there was no significant difference within or between the two groups (P>0.05). After treatment and in the follow-up, the mean thickness of RNFL was larger than the control group (P<0.05).@*CONCLUSION@#On the basis of the basic western medicine treatment, acupuncture can delay the decline of vision and the thinning of retinal nerve fiber layer in patients with glaucoma-induced optic atrophy.

An economic analysis of selective laser trabeculoplasty versus topical prostaglandin analogues as initial therapy for primary open-angle glaucoma in a tertiary government hospital in the Philippines

Objective@# This study compared the economic viability of initial medical therapy with topical prostaglandin analogues (PGAs) versus selective laser trabeculoplasty (SLT) in the treatment of primary open-angle glaucoma (POAG).@*Method@#This was an economic analysis using actual, current treatment costs of PGA therapy versus SLT applied to theoretical, literature-derived clinical efficacy data projected for a period of 19 years. A socioeconomic and demographic survey conducted among POAG patients at the Department of Health Eye Center of the East Avenue Medical Center from March-April 2022 provided the economic context and setting for the analysis. The treatment regimens were compared in terms of total cost, clinical efficacy, cost-effectiveness and cost-utility in the setting of a tertiary government hospital.@*Results@#Thirty-one (31) patients were included in the study. The total annual cost of topical PGAs was Philippine Pesos (Php) 13,532 versus Php 6,195 for SLT. Cost-effectiveness was Php 1,933 for PGAs/mmHg reduction in intraocular pressure (IOP) versus Php 983 for SLT. Cost-utility was Php 59,793/Quality Adjusted Life Years (QALY) gained for PGAs versus Php 27,373/QALY gained for SLT projected for 19 years. With government insurance coverage, cost-utility ratio was Php 47,831/QALY gained for topical PGAs versus 16,327/QALY gained for SLT.@*Conclusion@#In POAG patients, SLT was more cost-effective versus PGAs with a lower cost per mmHg IOP reduction, and lower cost-utility ratio for every QALY gained. SLT can be recommended as initial therapy for POAG especially for patients being treated at tertiary government hospitals.

Hipertensión ocular secundaria a aceite de silicona / Ocular Hypertension Secondary to Silicone Oil

La silicona líquida es usada intravítrea cuando se requiere un taponamiento prolongado intraocular para mantener la retina aplicada. A pesar de sus ventajas, su uso se ha asociado a algunas complicaciones como catarata, queratopatía, hipertensión ocular, glaucoma entre otras. La hipertensión ocular secundaria por aceite de silicona aparece por varios mecanismos, la migración de partículas a la malla trabecular junto con el proceso inflamatorio que genera es un reto para los cirujanos, de ahí los diferentes criterios de tratamiento que existen para su completa resolución. A continuación, se presenta un paciente operado de desprendimiento de retina recidivado con hipertensión ocular secundario a aceite de silicona 9 meses después de su primera intervención. Llevó tratamiento con hipotensores oculares tópicos, orales y no resolvió por lo que se decide realizar ciclocrioterapia en dos cuadrantes. A pesar que este tratamiento no es el de elección en estos casos, podemos decir que en este paciente se logra controlar la presión intraocular luego de una sola sesión(AU)

Liquid silicone is used intravitreally when prolonged intraocular insulation is required to keep the retina applied. Despite its advantages, its use has been associated with some complications such as cataract, keratopathy, ocular hypertension, glaucoma, among others. Secondary ocular hypertension due to silicone oil appears by several mechanisms. The migration of particles to the trabecular meshwork, together with the inflammatory process it generates, represents a challenge for surgeons, hence the different treatment criteria that exist for its complete resolution. The following is a patient operated on for recurrent retinal detachment with ocular hypertension secondary to silicone oil 9 months after the first operation. He was treated with topical and oral ocular hypotensors and it did not resolve, so it was decided to perform cyclocriotherapy in two quadrants. Although this treatment is not the treatment of choice in these cases, we can say that in this patient intraocular pressure control was achieved after only one session(AU)

Trauma ocular a globo cerrado en la edad pediátrica / Closed globe injuries in pediatric age

Los traumas oculares son frecuentes en las urgencias de oftalmología. El tratamiento constituye un reto para el oftalmólogo, pues se enfrenta a un daño integral y complejo. Se presenta un paciente de 16 años, el cual fue hospitalizado en el Instituto Cubano de Oftalmología Ramón Pando Ferrer hace cuatro años por haber recibido un trauma contuso en ojo derecho el cual provocó hifema total. Durante su estadía hospitalaria se realiza lavado de cámara anterior ya que no se logró la reabsorción espontánea del mismo. Al visualizarse todas las estructuras oculares se diagnostican complicaciones como subluxación del cristalino, catarata, panuveítis, hemovítreo, desgarro retiniano y glaucoma traumáticos. Se bloquea el desgarro con láser y una vez compensado el cuadro inflamatorio, es egresado bajo tratamiento y seguimiento por oftalmología pediátrica. No se logra controlar el glaucoma y se implanta dispositivo de drenaje Molteno lo que estabiliza la tensión ocular. Se realiza posteriormente cirugía de catarata, manteniéndose compensado del glaucoma sin tratamiento y con calidad visual(AU)

Ocular traumas are frequent in ophthalmology emergencies. Treatment is a challenge for the ophthalmologist, as he faces a comprehensive and complex damage. A 16-year-old patient is presented, who was hospitalized at the Cuban Institute of Ophthalmology Ramón Pando Ferrer 4 years ago for having received a blunt trauma to the right eye which caused total hyphema. During his hospital stay, anterior chamber lavage was performed since spontaneous reabsorption was not achieved. When all ocular structures are visualized, complications such as lens subluxation, cataract, panuveitis, hemovitreous, traumatic retinal tear and glaucoma are diagnosed. The tear was blocked with a laser and once the inflammatory condition was compensated, he was discharged under treatment and monitoring by pediatric ophthalmology. The glaucoma could not be controlled and a Molteno drainage device was implanted, which stabilizes the ocular tension. Cataract surgery was subsequently performed, keeping the glaucoma compensated without treatment and with visual quality(AU)

Síndrome de Axenfeld-Rieger con glaucoma asociado / Axenfeld-Rieger syndrome associated with glaucoma

El síndrome de Axenfeld-Rieger es una enfermedad congénita que puede estar asociada a glaucoma en el 50 por ciento de los casos. Por esta razón se describen un caso clínico con síndrome de Axenfeld-Rieger y glaucoma bilateral. Se trata de un paciente masculino de 18 años con escleras azules, microcórnea, embriotoxon posterior, aniridia parcial, atrofia sectorial del iris y alteraciones sistémicas asociado a glaucoma, al que se decide realizar trabéculo-trabeculectomía en ambos ojos. Al mes de la cirugía se constata un aumento de las presiones intraoculares del ojo izquierdo y se realiza trabéculo-trabeculectomía con mitomicina C, posteriormente se hace necesario implantar válvula de Ahmed con mitomicina C en dicho ojo e implantar dispositivo de molteno en ojo derecho, el cual necesitó revisión con aguja y administración de mitomicina C para mantener presiones intraoculares dentro de límites normales con tratamiento médico asociado en ojo izquierdo(AU)

Axenfeld-Rieger syndrome is a congenital disease that can be associated with glaucoma in 50 percent of cases. For this reason, a clinical case with Axenfeld-Rieger syndrome and bilateral glaucoma is described. This is an 18-year-old male patient with blue sclera, microcornea, posterior embryotoxon, partial aniridia, sectorial atrophy of the iris, and systemic alterations associated with glaucoma, who decided to perform trabeculo-trabeculectomy in both eyes. One month after surgery, an increase in intraocular pressures in the left eye was observed and a trabeculo-trabeculectomy was performed with mitomycin C, subsequently it was necessary to implant Ahmed's valve with mitomycin C in said eye and implant a molteno device in the right eye, the which required revision with a needle and administration of mitomycin C to maintain intraocular pressures within normal limits with associated medical treatment in the left eye(AU)

In search of disambiguation: development of eye drop bottle sleeves to aid in identification and survey among possible users. A cross-sectional study

BACKGROUND: Considerable numbers of individuals present low vision, blindness, illiteracy and other conditions that could possibly impair their identification of medications, such as eye drops. Through helping these individuals to identify their eye drops, they can achieve greater autonomy. Misidentification can be avoided through use of multisensory sleeves that can be adapted to most eye drop bottles. Correct use of eye drops is important for preventing progression of diseases like glaucoma that could potentially lead to blindness. OBJECTIVE: To develop bottle sleeves to aid in identification of eye drops and then interview a group of possible users to evaluate the acceptance of the solution. DESIGN AND SETTING: Cross-sectional survey performed at an ophthalmological clinic in São Paulo (SP), Brazil. METHODS: We describe the development of multisensory sleeves to assist in identification of eye drops. To assess the acceptance of this solution, we interviewed 18 patients who were currently using three or more types of eye drops. RESULTS: We developed four prototypes for eye drop bottle sleeves and conducted an acceptance test on them. Most of the patients who answered the survey about the sleeves were elderly. Most (95%) reported believing that the sleeves would help reduce the risk of mixing up eye drops with other medications that also dispense drops. They also believed that these would increase their autonomy in using eye drops. CONCLUSION: The solution presented was well accepted and may help increase safety in using eye drops through preventing misidentification.

Glaucoma drainage devices / Dispositivos de drenagem para glaucoma

ABSTRACT Glaucoma drainage devices are important therapeutic options for cases of refractory glaucoma, in which trabeculectomy with antimetabolites has shown high risk of failure. There are devices with different sizes, designs and materials, and several studies have been conducted to test their safety and effectiveness. Despite known complications, their use has progressively increased in recent years, and they are the primary surgical option, in some situations. The aim of this review is to discuss the importance, mechanisms, biomaterials, results and complications of glaucoma drainage devices.

RESUMO Os dispositivos de drenagem para glaucoma são importante opção terapêutica em casos de glaucomas refratários, nos quais a trabeculectomia com antimetabólitos tem alta chance de falência. Há dispositivos com diferentes tamanhos, desenhos e materiais, e muitos estudos foram realizados para testar sua segurança e eficácia. Apesar de suas conhecidas complicações, seu uso tem aumentado progressivamente nos últimos anos, inclusive como primeira opção cirúrgica, em algumas situações. O objetivo desta revisão foi discutir a importância, os mecanismos, os biomateriais, os resultados e as complicações dos dispositivos de drenagem para glaucoma.

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

Awareness and Knowledge of Glaucoma among Health Workers in Butajira General Hospital, South Ethiopia

Raising awareness and knowledge of glaucoma is a key means of enhancing people alertness, increasing regular eye screening practice, and the chance of identifying undetected cases. Health professionals other than ophthalmologists are often the first point of contact when patients seek medical advice. However, little is known about the awareness and knowledge of glaucoma among health care professionals in Ethiopia.The objective of this study was to determine general awareness and knowledge of glaucoma among health workers in Butajira General Hospital. METHODS: Hospital-based cross-sectional study was conducted at Butajira Hospital in September and October 2021 among health care providers. All health workers except those on leave and the staff in the department of Ophthalmology were included in the study. The awareness and knowledge were assessed using a self-administered questionnaire. Descriptive statistics was computed to describe the study variable, and logistic regression was conducted to see associations between dependent and independent variables. Significant associations were declared at p-values <0.05. RESULT: This study showed that 184 (91.1%) had an awareness of glaucoma among the study participants, whereas 8.9% had never heard about glaucoma. Of those who were aware, only 42% have good knowledge. Professionals who had a history of eye examinations and family history of glaucoma were about 3.0 times more likely to have good knowledge. CONCLUSION: Fifty-eight percent of clinical professionals from Butajira Hospital had no awareness at all or had poor knowledge about glaucoma. Being a physician, history of eye examinations, and having a family history of glaucoma were factors related to glaucoma knowledge

Assessment of Risk Factors for Advanced Open Angle Glaucoma Presentation among Patients Visiting Jimma University Medical Center, Jimma, Ethiopia

Glaucoma is the predominant cause of irreversible blindness, particularly the late presentation. The purpose of this study is to identify the risk factors associated with late presentation in Jimma University Medical Center METHODS: A case-control study was done among patients newly diagnosed to have open angle glaucoma (of any type) at Jimma University Medical Center from July 2014 ­ January 2019. Cases were patients/eyes diagnosed to have any type of open angle glaucoma with advanced glaucomatous disc features, whereas controls were patients diagnosed with early and moderate stages of glaucoma. RESULTS: There were 205 (116 cases and 89 controls) participants. The mean age of the participants at the time of diagnosis was 58.3±13.4yrs. Family history of blindness, presenting IOP, type of glaucoma and age were independently associated with late presentation. Patients with family history of blindness had late advanced glaucoma five times higher than those with no family history of blindness. The presence of late glaucoma among patients with presenting intra ocular pressure < 30mmHg is lower than those having ≥30mmHg (Adjusted Odds Ratio= 0.136). Primary open-angle glaucoma patients were less likely to present with advanced glaucoma than pseudo exfoliative glaucoma patients (Adjusted Odds Ratio=0.39). The chance of presenting with late glaucoma was increased by 3.4% for every one-year increment of age. CONCLUSIONS: Presence of family history of blindness, high presenting intraocular pressure, pseudo exfoliative glaucoma and old age are risk factors for late presentation of glaucoma

Structural Design and Finite Element Analysis of New Type Posterior Integral Glaucoma Valve / 中国医疗器械杂志

The treatment of refractory Glaucoma is a difficult problem in clinical ophthalmology. For refractory glaucoma patients with hyphema, shallow anterior chamber, anterior conglutination of peripheral chamber angle, corneal endothelium dystrophy or decompensated, at present, there is no effective treatment. In order to solve this problem, a new type posterior integral glaucoma valve with IOP control device was designed using medical titanium alloy, and the valve model was established by Abaqus software, and the stiffness and preload of the valve were analyzed by finite element method. The results showed that the opening and closing of the valve were controlled automatically by the pressure difference between the front and back of the valve, and the opening and flow rate of the valve increase dynamically with the increase of intraocular pressure, and finally reached the set ideal IOP value of steady state.

Research Progress of Intraocular Pressure Detection and Dynamic Monitoring Technology / 中国医疗器械杂志

The detection and dynamic monitoring of intraocular pressure have important clinical significance for the diagnosis and treatment of glaucoma. The current status of clinical intraocular pressure detection and dynamic intraocular pressure monitoring are reviewed. The technical challenges encountered, and the shortcomings of the existing technology are analyzed, in order to expect better intraocular pressure monitoring technology to be applied to patients.

A traction suture holding device for glaucoma procedures

Objective@#We described an adjustable traction technique for glaucoma surgeries that provided adequate visualization of the surgical field.@*Methods@#A prototype device was designed to provide good exposure of the surgical site by using a peripheral lamellar trans-corneal suture capable of applying and sustaining tension. Adjustments to the amount of traction required were made through the device.@*Results@#The device was used in 9 cases of glaucoma surgeries: 5 trabeculectomies and 4 glaucoma drainage device implantations. No significant complications were observed.@*Conclusions@#The device was easy to use and allowed more flexibility for the surgeon.

Juvenile onset open-angle glaucoma in a large family in Cebu, Philippines

Objective@#This study described the clinical profile of a four-generation Cebuano family with juvenile-onset open-angle glaucoma (JOAG).@*Methods@#Thisis a case series conducted in the out-patient department of Cebu Velez General Hospital. Thirtyeight (38) members in a four-generation family from the northern part of Cebu province were investigated. General medical and ophthalmologic histories were taken. Complete ophthalmologic examination was done.@*Results@#Forty-two (42%) percent of participants examined had increased intraocular pressures (IOP); 15 were diagnosed with JOAG, one had ocular hypertension. There were more females than males affected. Mean age when symptoms were first noted was 14.56 ±6.63 years and mean age at diagnosis was 16.3 ±7.84 years. The most common initial symptom was rainbow or halos around lights (87.5%). Mean refraction was -3.09 ±2.54 diopters for both eyes. Mean IOP on examination was 24.56 ± 20.17 mmHg. Gonioscopy showed open angles with flat iris plane. All affected participants underwent medical treatment and 69% needed surgical interventions.@*Conclusion@#This family demonstrated the typical JOAG phenotype consisting of early age of onset, strong family history with an autosomal dominant pattern of inheritance, myopia, open angles, and increased IOP refractory to medical treatment.

The effect of wearing N95 respirator masks on intraocular pressure of health care workers

Objective@#We determined if there was a significant change in the intraocular pressure (IOP) of healthcare workers with extended use of N95 masks.@*Methods@#This was a prospective time-series study involving 58 eyes of 29 healthcare workers who were assigned to 3 groups: surgical mask (control) and 2 intervention arms consisting of valved N95 (8511, 3M, USA) and non-valved N95 (8210, 3M, USA) masks. Each participant underwent IOP measurements of both eyes by Goldmann applanation tonometry at baseline, 5 minutes, 1 and 4 hours of mask use on three separate days. The primary outcome was the difference in IOP between the N95 and surgical mask groups.@*Results@#Mean baseline IOP of the cohort was 13.85 ± 1.11 mmHg with no significant difference among the groups. Compared to surgical mask use, mean IOP was increased at the 1 hour and 4 hour time points with valved N95 use (+0.88, p<0.001; +1.48, p<0.001 respectively) and increased at the 5 minute, 1 hour and 4 hour time points with nonvalved N95 use (+0.52, p=0.01; +1.07 p<0.001; +1.62, p<0.001, respectively).@*Conclusion@#There was a statistically significant increase in IOPs with prolonged N95 mask use. However, the levels of IOP increase were less than 2 mmHg and may be not clinically significant.

The Filipino adaptation of the glaucoma medication adherence self-efficacy questionnaire

Objectives@#This study translated the Glaucoma Medication Adherence Self-Efficacy Questionnaire (GMASQ) and tested the reliability of Filipino-adapted GMASQ.@*Methods@#A Filipino-adapted GMASQ was developed using the guidelines recommended for translating a validated health-related questionnaire into a culturally-adapted one. The methods included: (1) forward translation, (2) back-translation, (3) review and modification, (4) pre-testing and cognitive interviewing, and (5) final version testing. The provisional questionnaire was pre-tested on 20 glaucoma patients to determine its value and correspondence, generating a final forward questionnaire. The final version was administered to 48 patients. Its reliability was determined by computing for the Cronbach’s α for each item, per section, and overall. An item was removed if the α was <0.7.@*Results@#Eleven (11) pre-test subjects (55%) preferred the Filipino-adapted questionnaire, 6 (20%) had no preference, and 3 (25%) preferred the source questionnaire. The provisional Filipino-adapted GMASQ proved to be acceptable and with no changes made, the questionnaire was marked as the final version. The medication adherence self-efficacy scale showed Cronbach’s α of > 0.8 for all items with a section α = 0.84. The eye-drop technique had an α > 0.7 for each item and a section α = 0.80.@*Conclusion@#This study provided preliminary evidence of the feasibility, acceptance and reliability of the Filipino GMASQ.

Structure-function correlations of glaucoma in Filipinos

Introduction@#To determine the structure-function correlations of glaucoma in Filipinos using the average peripapillary retinal nerve fiber layer (RNFL) thickness and rim area (RA) of the spectral-domain optical coherence tomography (SD-OCT) and mean defect (MD), pattern standard deviation (PSD), and visual field (VF) clusters of standard automated perimetry (SAP)@*Methods@#Consecutive tests consisting of SD-OCT, SAP, and disc photos were reviewed and selected based on abnormalities in VFs or OCTs or both. Each set of tests was classified as to VF defect type and severity. Mean threshold of VF clusters, MD, and PSD were correlated with average and sectoral RNFL thicknesses and RA. @*Results@#One hundred eighty-six (168) eyes of 121 patients with mean age of 60.2 ± 14.7 years had an average MD, PSD, RNFL thickness, RA of -9.5 ± 8.5 dB, 5.4 ± 3.3 dB, 75.9 ± 15.9 μm, and 0.9 ± 0.4 mm2, respectively. Among VF tests, 23.1% were normal, 16.5% had early, 9.1% moderate, 12.4% advanced, and 8.3% severe glaucoma damage. Most common VF defect types were central islands, combined, and paracentral (16.5%, 14.4%, and 12.2%, respectively). The most commonly affected RNFL segments were inferior, followed by superior, and combined superior and inferior (51.2%, 47.1, and 34%, respectively). Among the OCT parameters, RNFL thickness and RA were strongly correlated (p<0.0001). Between the VF and OCT parameters, the strongest correlation was between the clusters of superior VF defects and the 6-8 o’clock RNFL thinning, followed by the inferior VF defects and the 12-1 o’clock RNFL thinning. Inferior RNFL thinning was strongly correlated with MD and PSD. @*Conclusion@#Among Filipino glaucomatous eyes monitored with SD-OCT and SAP, correlation was strongest between the superior VF defects and the infero-temporal RNFL thinning.

Peripapillary microvascular parameters in unilateral open-angle glaucoma using the optical coherence tomography-angiography

Objective@#This study compared the peripapillary retinal nerve fiber layer (pRNFL) microangiographic properties [vessel area density (VAD) and blood flux index (BFI)] of unilateral open-angle glaucomatous eyes to contralateral eyes-at-risk, and to eyes of healthy age- and sex-matched subjects.@*Methods@#This was a single-center, case-control study of Filipinos diagnosed with unilateral primary openangle glaucoma (POAG) or normal-tension glaucoma (NTG). Mean overall and quadrantal VAD and BFI of the three groups were measured with optical coherence tomography- angiography (OCT-A). Area under the receiver operating characteristic (AROC) was used to measure diagnostic ability.@*Results@#Twenty-two (22) glaucomatous subjects (15 POAG and 7 NTG eyes), 22 contralateral eyes-at-risk, and 22 normal eyes from age- and sex-matched control subjects completed the study. Eyes with glaucoma showed lower mean overall VAD (40%) and BFI (0.37) compared to eyes-at-risk (44.4% and 0.42, respectively; p <0.001) and control eyes (45.6% and 0.44, respectively; p <0.001). Mean VAD and BFI values of eyes-at-risk and control groups did not significantly differ from each other. Overall pRNFL thickness showed highest diagnostic accuracy for glaucoma (AROC = 0.97), followed by VAD (0.94), and BFI (0.88) (p=0.46).@*Conclusion@#VAD and BFI were significantly diminished in unilateral open-angle glaucoma, suggesting that the utility of OCT-A in the detection of glaucoma is comparable to pRNFL thickness.