Diode transscleral cyclophotocoagulation in both micropulse and continuous modes was effective in lowering intraocular pressure. The micropulse mode provided a more consistent and predictable effect in lowering intraocular pressure with minimal ocular complications.

Micropulse TSCPC is a safe and effective method of lowering IOP in cases of refractory glaucoma and is comparable with conventional TSCPC.

Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG.

Anterior segment optical coherence tomography may be used for evaluation of underlying primary angle closure mechanism(s) in a patient and tailor the treatment accordingly.

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Aims/Purpose To determine and correlate the long-term changes in retinal nerve fibre layer (RNFL) thickness, optic nerve head (ONH) morphology, and visual fields after a single episode of acute primary angle closure (APAC). Methods This was a cross-sectional comparative study of patients at National University Hospital (Singapore) from 2000 to 2006 after an episode of unilateral APAC. The peripapillary and macular RNFL were measured using Stratus optical coherence tomography (OCT) and ONH configuration was assessed using Heidelberg Retina Tomography (HRT)-III. Humphrey perimetry was also performed, and the presence of disc pallor was noted. APAC eyes were compared with fellow eyes as matched controls. Results Twenty-five patients were assessed at a median of 33 months (range, 11-85 months) after APAC. OCT showed that there was a reduction in the peripapillary and outer macular RNFL thickness in APAC eyes compared with controls. Humphrey perimetry revealed significantly reduced mean deviation (P ¼ 0.006) and increased pattern standard deviation (P ¼ 0.045) in APAC eyes compared with controls. HRT-III showed no difference in mean rim area, rim volume, or cup-disc ratio between APAC eyes and controls. Disc pallor was present in nine APAC eyes (36%) but was absent in fellow eyes (P ¼ 0.002), and was associated with peripapillary RNFL thinning, visual field loss, and an increased interval between the onset of symptoms and normalization of intraocular pressure (P ¼ 0.023). Conclusion APAC results in peripapillary and outer macular RNFL loss, visual field defects, and optic disc pallor, even in cases in which the ONH configuration remains unchanged.

In primary open-angle glaucoma (POAG), micropulse transscleral cyclophototherapy (MPTCP) is effective in lowering intraocular pressure (IOP), but its effects are not permanent. Hence, it can serve as a temporizing measure before definitive glaucoma surgery.Purpose: There is limited data on MPTCP in POAG. This is the first study that looks at MPTCP treatment specifically in POAG patients.Patients and Methods: This is an interventional, single-institution exploratory case series with 55 eyes of 48 patients with POAG. Data was collected from clinical records, including patient demographics, clinical information, number of glaucoma medications, MPTCP laser settings, complications, and clinical outcomes.Results: Patients had a mean age of 67.3 ± 14.1 years with a preponderance of males. IOP was 24.8 ± 1.0 mm Hg before MPTCP and decreased to 19.7 ± 1.1, 21.9 ± 1.1, and 21.8 ± 1.1 mm Hg at postoperative month 3, 6, and 12 respectively. IOP remained below pretreatment levels throughout the postoperative period (P < 0.05). Visual acuity and mean deviation remained stable before and after MPTCP. No eyes had complications. Number of glaucoma medications remained the same after MPTCP. Four eyes required additional oral acetazolamide at postoperative month 1 for IOP control. Seventeen eyes subsequently required further surgical intervention after 9.84 months. Maximal IOP decrease was greater when there were higher power settings, higher preoperative IOP, and better preoperative visual acuity. Conclusions and Relevance:The IOP lowering effect of MPTCP treatment in patients with POAG was found to be modest and transient with a similar medication burden, and definitive glaucoma surgery was needed in a number of patients.

SDOCT imaging was able to show fine superficial features in the bleb wall. However, SDOCT had limited clinical utility in that it did not provide useful information about deep features such as flap position, bleb cavity formation or patency of the subflap space and internal ostium.