Purpose: The purpose of this research was to assess the agreement between the new optical coherence tomography (OCT) glaucoma staging system (GSS) and the visual field (VF) GSS 2 (GSS2). Methods: This is a cross-sectional study of 161 eyes of 110 patients with controlled primary open-angle glaucoma (POAG). All eyes were subjected to VF examination using standard automated perimetry and Humphrey field analyzer II 750. GSS2 was used for the classification of the VF defects’ severity. OCT of the optic disc and the macular ganglion cell complex (GCC) was performed using RTVue. Patients were classified by OCT GSS into six stages. Results: The study examined 161 eyes of 110 patients with controlled POAG. The staging according to VF GSS2 was as follows: stage 0 (12.42%), border stage (12.42%), stage 1 (13.04%), stage 2 (14.29%), stage 3 (14.28%), stage 4 (14.28%), and stage 5 (19.25%). The staging by OCT GSS was as follows: stage 0 (18.6 %), border stage (17.3%), stage 1 (6.8%), stage 2 (9.31%), stage 3 (6%), stage 4 (11.8%), and stage 5 (30.43%). The sensitivity of the new OCT GSS was different in different stages of glaucoma. In this study, no normal control group was considered; thus, the specificity could not be calculated. There was moderate agreement between the two staging systems. Conclusions: OCT GSS is a reliable and objective method for diagnosing and monitoring glaucoma. Correlations were found between GSS2, inferior and total macular GCC thickness values, and cup-to-disc ratios, so considering these items as additional parameters may make this new classification even more sensitive than VF GSS2.
Purpose: is to compare the success rate of Ex-PRESS implantation vs deep sclerotomy (DS) in patients with primary open-angle glaucoma (POAG). Patients and methods:This is a randomized prospective interventional comparative study between Ex-PRESS and DS maneuvers in patients with POAG. The study included 47patients (50 eyes) with POAG. The patients were divided into two groups. Group 1 included 25 patients (25 eyes) who underwent Ex-PRESS device implantation. Group 2 included 22 patients (25 eyes) who underwent DS. All included patients underwent a thorough ophthalmic examination. At the end of the 1 st year postoperatively, best corrected visual acuity (BCVA) [logMAR], intraocular pressure (IOP), number of anti-glaucoma medications in use were obtained. Results: In group 1, complete success rate was 76%, qualified success rate was 20% and failure rate 4% occurred in 1 eye of patients which needed explantation of the device and another glaucoma filtering surgery due to device-corneal touch. Meanwhile in group 2, complete success rate was36% and qualified success rate was 64% without any recorded failure in this group (Both Ps<0.01) in both groups. Conclusion: favorable effects on IOP and the need for IOPlowering medications in both Ex-PRESS and DS groups. However, in DS group, higher preoperative IOP is associated with increased failure rate necessitating more postoperative IOP adjustments than Ex-PRESS group.
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