Clinical Presentation and Initial Treatment Patterns in Patients With Exfoliation Glaucoma Versus Primary Open-Angle Glaucoma

Konstas, Anastasios G. P.; Stewart, William C.; Stroman, Gesa A.; Sine, Cheryl S.

doi:10.3928/1542-8877-19970201-05

Cited by 75 publications

(15 citation statements)

References 25 publications

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“…Pigmentary and pseudoexfoliative glaucoma are known to have faster rates of progression. [50][51][52] In this context, surgeons may have favored the NPDS in so far as it is a procedure; they are more used to performing with thereby more predictable outcomes. Another limitation is that patients were not matched by the surgeon.…”

Section: Discussionmentioning

confidence: 99%

One-Year Outcomes of Standalone XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy

Touboul¹,

Fels

Morin³

et al. 2022

Journal of Glaucoma

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Précis: The nonpenetrating deep sclerectomy (NPDS) procedure resulted in significantly more surgical success than the standalone XEN gel stent procedure without differences in safety profile. Purpose:The purpose of this study was to compare surgical success and safety profile of NPDS and XEN gel stent.Methods: A retrospective chart review of 328 eyes of 282 patients who were scheduled for standalone XEN gel stent surgery (n = 140) or NPDS (n = 188) at Groupe Hospitalier Paris Saint-Joseph between January 2017 and December 2018 was conducted. Primary outcome measure was the proportion of surgical success 12 months after surgery. Complete and qualified surgical successes were defined by intraocular pressure (IOP) ≤ 18 mm Hg and a reduction of IOP ≥ 20% without or with hypotensive medication, respectively.Results: In total, 82 eyes were included in the XEN group and 124 eyes in the NPDS group. In the 1-eye analysis, rates of "complete success" and "qualified success" were, respectively, at the end of follow-up, 28.57% and 20.00% in the XEN group, and 42.72% and 16.50% in the NPDS group (P = 0.17). Success probability plots based on the Kaplan-Meier estimate for overall surgical success demonstrated a median success probability time of 3.73 years for the NPDS group and 2.38 years for the XEN group (P < 0.0001). After adjustment for confounding variables using Cox regression, the NPDS procedure was significantly more associated with surgical success than the XEN gel stent implantation (P < 0.001). No difference was demonstrated in terms of reduction of antiglaucoma medications, needling procedures, or reoperations. Conclusions:The NPDS procedure may be more effective than the XEN gel stent in reducing IOP in patients with open angle glaucoma and may result in longer surgical success. However, a well-conducted prospective randomized study is required to confirm these results.

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Section: Discussionmentioning

confidence: 99%

One-Year Outcomes of Standalone XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy

Touboul¹,

Fels

Morin³

et al. 2022

Journal of Glaucoma

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“…When PXG develops, it is well known to have more rapid disease progression and a poorer prognosis than POAG. [ 23 ] In patients with XFS, types of glaucoma other than OAG with high IOP are also observed. In some XFS patients, OAG with low IOP is sometimes observed.…”

Section: Discussionmentioning

confidence: 99%

Lack of association between SIX1/SIX6 locus polymorphisms and pseudoexfoliation syndrome in a population from the Republic of Korea

Lee

Shin

2022

Medicine

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Previous studies have reported the association of the SIX1/SIX6 locus with open-angle glaucoma in various ethnic populations. However, the relevance of the SIX1/SIX6 locus to pseudoexfoliation syndrome (XFS) appears uncertain at present. Thus, we investigated the relationship between polymorphisms in the SIX1/SIX6 locus and XFS in a Korean XFS cohort. A total of 246 participants comprising 167 unrelated Korean patients with XFS and 79 ethnically matched control subjects were recruited. Four polymorphisms of the SIX1/SIX6 locus (rs33912345, rs12436579, rs2179970, and rs10483727) were genotyped using a TaqMan® allelic discrimination assay. Genotypic and allelic associations were analyzed using logistic regression. The minor allele frequency (MAF) of rs33912345 was found to be 0.287 and 0.247 in the XFS cases and controls, respectively, and the MAF of rs12436579 was found to be 0.383 and 0.361 in the XFS cases and control subjects, respectively. The MAF of rs2179970 was found to be 0.090 and 0.095 in the XFS cases and control subjects, respectively, and the MAF of rs10483727 was found to be 0.293 and 0.253 in the XFS cases and control subjects, respectively. Genetic association analysis of 4 SIX1/SIX6 locus single nucleotide polymorphisms (SNPs) revealed no significant difference in genotype distribution between the XFS cases and control subjects in the allelic, dominant, or recessive models (all, P > .05). The current study suggested that SIX1/SIX6 locus polymorphisms (rs33912345, rs12436579, rs2179970, and rs10483727) may not be associated with a genetic susceptibility to XFS in a Korean cohort.

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“…31 PEX glaucoma differs from POAG in many ways, including a more severe clinical course, greater visual field loss, wider fluctuations in daily IOP, and poorer responses to medical therapy. 32,33 It has been shown that glaucomatous optic neuropathy is more severe in PEX glaucoma patients who have similar IOP values. 34,35 In our study, PEX glaucoma patients with similar glaucoma severity had shorter glaucoma times, which supports the more aggressive course of this glaucoma type.…”

Section: Discussionmentioning

confidence: 99%

“…PEX glaucoma is a type of secondary open‐angle glaucoma that occurs as a result of the extracellular matrix fibrillary material accumulating in the eye occluding the trabecular network 31 . PEX glaucoma differs from POAG in many ways, including a more severe clinical course, greater visual field loss, wider fluctuations in daily IOP, and poorer responses to medical therapy 32,33 . It has been shown that glaucomatous optic neuropathy is more severe in PEX glaucoma patients who have similar IOP values 34,35 .…”

Section: Discussionmentioning

confidence: 99%

Usability of Real‐Time Elastography for the Diagnosis of Primary Open Angle and Pseudoexfoliation Glaucoma

İncekalan

Peköz

2022

J of Ultrasound Medicine

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Objectives This study aims to investigate real‐time elastography (RTE) use in the evaluation of the optic nerve head (ONH) and peripapillary structures for the diagnosis of primary open angle (POAG) and pseudoexfoliation (PEX) glaucoma. Methods This case–controlled study included 30 patients with POAG, 30 patients with PEX glaucoma, and 30 age‐matched control subjects. All of the participants underwent comprehensive ophthalmological examinations covering vessel density of optic nerve and retinal nerve fiber layer (RNFL) thickness measurements with optical cohorence tomography angiography and mean deviation (MD) measurements with Humphrey II Perimetry Visual Field Analyzer. In vivo evaluation of the biomechanical properties of the ONH and peripapillary structures were performed with RTE in all participants. Results We observed higher ratios of orbital fat to optic nerve head (ROFON) values (P = .008) and strain ratios of orbital fat to scleral–choroidal–retinal complex (ROFSCR) values (P = .004) in the POAG group compared with PEX glaucoma group and higher ROFON (P = .012) and ROFSCR values (P = .004) in PEX glaucoma group than the control group. ROFON and ROFSCR values were positively correlated with glaucoma duration and negatively correlated with MD, radial peripapillary vessel density (RPCVD), and inside disc vessel density in both glaucoma groups (P < .005; only in the PEX glaucoma group for MD and ROFSCR, P = .445). Conclusion Determining the biomechanical properties of ONH and peripapillary structures with RTE in glaucomatous eyes may offer a new perspective on the diagnosis and follow‐up of the progression of the disease.

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Clinical Presentation and Initial Treatment Patterns in Patients With Exfoliation Glaucoma Versus Primary Open-Angle Glaucoma

Cited by 75 publications

References 25 publications

One-Year Outcomes of Standalone XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy

One-Year Outcomes of Standalone XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy

Lack of association between SIX1/SIX6 locus polymorphisms and pseudoexfoliation syndrome in a population from the Republic of Korea

Usability of Real‐Time Elastography for the Diagnosis of Primary Open Angle and Pseudoexfoliation Glaucoma

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