A Randomized, Controlled Comparison of 180 Versus 360 Degrees Selective Laser Trabeculoplasty in Open Angle Glaucoma and Glaucoma Suspects.

PRCIS: Three hundred sixty degrees selective laser trabeculoplasty (SLT) produces greater intraocular pressure (IOP) lowering effects with no changes in safety profile compared with 180 degrees SLT. PURPOSE: To determine whether there is any difference in the IOP lowering effects and safety profiles of 180 versus 360 degrees SLT, using a paired-eye design to limit confounders. METHODS: This single-center randomized control trial included patients presenting with treatment naïve open angle glaucoma or glaucoma suspects. Once enrolled, 1 eye was randomized to 180 degrees SLT, and the other was treated with 360 degrees SLT. Patients were followed for 1 year and assessed for change in visual acuity, Goldmann IOP, Humphrey visual fields, retinal nerve fiber layer thickness, optical coherence tomography derived cup to disc ratio, and any adverse events or requirements for additional medical interventions. RESULTS: A total of 40 patients (80 eyes) were included in the study. IOP in the 180 degrees group was reduced from 25.3±2.3 mm Hg to 21.5±2.7 mm Hg, and in the 360 degrees group, from 25.5±2.1 mm Hg to 19.9±2.6 mm Hg ( P <0.01), both at 1 year. There was no significant difference in the number of adverse events or serious adverse events in the 2 groups. There were no statistically significant differences in visual acuity, Humphrey visual field mean deviation, retinal nerve fiber layer thickness, or C:D ratio at 1-year follow-up. CONCLUSION: At 1 year, 360 degrees SLT was more efficacious at lowering IOP compared with 180 degrees SLT with a similar safety profile in patients with open angle glaucoma and glaucoma suspects. Further studies are needed to determine the long-term effects.

Dietary supplement use in the prevention of age-related macular degeneration progression.

PURPOSE: The Age-Related Eye Disease Study Group (AREDS) has found high-dose vitamin supplementation may have a role in preventing the progression of Category 3 and 4 age-related maculopathy. The aim of this study is to compare dietary antioxidant, zinc, and copper intakes of Australia, New Zealand, United Kingdom, and the United States to determine the difference between the actual and suggested AREDS intakes for these nutrients. A further aim is to investigate the constituents of commonly available single and multivitamin preparations in New Zealand and carry out a cost analysis. METHODS: The total median intake of vitamins A, C, and E; zinc; and copper is analysed from the most recent nutrition data published by the four countries. Forty multivitamin brands and 32 individual nutrient brands were analysed. An average price per tablet for each brand has been calculated in New Zealand dollars. RESULTS: The median intakes of antioxidants, zinc, and copper for these countries were comparable, but lower than the AREDS suggested intakes. Sixteen of the 40 multivitamin preparations contained all recommended nutrients. Of these, only two fulfilled the AREDS-recommended levels. The cost of different preparations is similar. CONCLUSION: Dietary supplementation is required to achieve the AREDS nutrient intake recommendations. This may be achieved by using any combination of multivitamin and individual supplement preparations available. Comprehensive tables have been constructed to guide ophthalmologists in the process of suggesting supplementation to prevent the progression of Category 3 and 4 age-related maculopathy.