The Japan Glaucoma Society guidelines for glaucoma 5th edition

Kiuchi, Yoshiaki; Inoue, Toshihiro; Shoji, Nobuyuki; Nakamura, Makoto; Tanito, Masaki

doi:10.1007/s10384-022-00970-9

Cited by 27 publications

(30 citation statements)

References 291 publications

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“…The patients in both groups were at risk of irreversible progression from PACS to primary angle closure (PAC), followed by PACG, unilateral blindness, and bilateral blindness [ 9 – 11 ]. All patients with progression to PAC underwent lens extraction in accordance with the treatment guidelines in Japan [ 12 ]. Patients with PACG, whose intraocular pressure could not be controlled with medication, underwent trabeculectomy [ 13 ].…”

Section: Materials/subjects and Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of prophylactic laser peripheral iridotomy for primary angle-closure suspect in Japan

Fujita,

Konishi,

Sakata

et al. 2023

Eye

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Background/Objectives This study aimed to compare the cost-effectiveness of prophylactic laser peripheral iridotomy (LPI) with that of observation for primary angle-closure suspect (PACS) in Japan. Subjects/Methods A Markov model was developed to compare the costs and utilities of prophylactic LPI with those of observation of 40-year-old patients with PACS. In the model with a yearly cycle over a 20-year time horizon, the disease was postulated to irreversibly progress from PACS to primary angle closure, followed by primary angle-closure glaucoma, unilateral blindness, and bilateral blindness. The parameters were estimated mainly based on a recent randomised controlled trial and analyses of Japanese claims data. The incremental cost-effectiveness ratio was estimated from the healthcare payer’s perspective and evaluated at the willingness-to-pay 5 million Japanese Yen per quality-adjusted life-year. The observation period and the age at entry into the cohort was changed to account for a variety of clinical courses in sensitivity analyses. We conducted one-way deterministic sensitivity analysis and probabilistic sensitivity analysis with Monte Carlo simulations with 10 000 iterations. Results The incremental cost-effectiveness ratio of LPI was 2,287,662 Japanese Yen (14,298 pounds sterling) per quality-adjusted life-year, which was below the willingness-to-pay threshold. The ratios were approximately 4 and 8 million in the 15-year and 10-year time horizons, respectively. Increasing the age at entry had little influence on the incremental cost-effectiveness ratio. The deterministic and probabilistic sensitivity analyses indicated that the results were robust. Conclusions Our results indicate that prophylactic LPI for middle-aged patients with PACS is cost-effective in Japan.

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Section: Materials/subjects and Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of prophylactic laser peripheral iridotomy for primary angle-closure suspect in Japan

Fujita,

Konishi,

Sakata

et al. 2023

Eye

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“…α1 blockers [12], and ion channel openers [13,14]. Among these categories, prostanoid receptor-related drug monotherapy is most commonly administered for the initial treatment of chronic open-angle glaucoma [15].…”

Section: Introductionmentioning

confidence: 99%

Ocular Distribution of Brimonidine and Brinzolamide after Topical Instillation of a 0.1% Brimonidine Tartrate and 1% Brinzolamide Fixed-Combination Ophthalmic Suspension: An Interventional Study

Orii

Kunikane

Yamada

et al. 2023

JCM

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Purpose: To evaluate the concentrations of brimonidine and brinzolamide in the vitreous and aqueous humor after instillation of a 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Methods: The present investigation involved patients with macular holes or idiopathic epiretinal membranes who were planning to undergo vitrectomy. One week prior to surgery, the patients received twice-daily topical treatment with 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Before vitrectomy, vitreous and aqueous humor samples were collected, and the mean concentrations of brimonidine and brinzolamide were determined through liquid chromatography-tandem spectrometry. Results: Ten eyes (nine phakic and one pseudophakic eyes; 10 patients) were examined. The concentration of brimonidine in vitreous and aqueous humor samples was 5.02 ± 2.24 and 559 ± 670 nM, respectively. The concentration of brimonidine in the vitreous humor, which is needed to activate α2 receptors, was >2 nM in all patients. The concentration of brinzolamide was 8.96 ± 4.65 and 1100 ± 813 nM, respectively. However, there was no significant correlation between the concentrations of brimonidine in the vitreous and aqueous humor samples. Conclusions: Sufficient concentrations of brimonidine were detected in all vitreous samples. The dissociated correlation of the drug concentrations between aqueous and vitreous humors implies the possibility of another pathway to vitreous humor, different from the pathway to aqueous humor.

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“…In contrast, the conventional pathway is not a primary target in glaucoma medications. There are eight categories of glaucoma medications in Japan (Kiuchi et al, 2023): (1) prostanoid receptor‐related drugs (FP receptor agonists and selective EP2 receptor agonists), (2) β‐blockers, (3) carbonic anhydrase inhibitors (CAIs), (4) an α2 adrenergic agonist, (5) a Rho‐kinase inhibitor, (6) an α1 adrenergic antagonist, (7) an ion‐channel opener and (8) a parasympathomimetic. The latter three types of drugs have seen limited use in recent years due to their weak IOP‐lowering effects.…”

Section: Introductionmentioning

confidence: 99%

Impact of glaucoma medications on subsequent Schlemm's canal surgery outcome: Cox proportional hazard model and propensity score‐matched analysis

Okuda‐Arai,

Mori,

Takano

et al. 2023

Acta Ophthalmologica

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PurposeThe impact of various preoperative glaucoma medications on Schlemm's canal surgery outcomes remains unclear. This study aimed to investigate the impact of preoperative glaucoma medications on the postoperative 1‐year outcomes of μTLO.MethodsWe analyzed the medical records of 218 patients who underwent their first μTLO to investigate the 1‐year postoperative outcomes. Cox proportional hazard regression analysis was performed with surgical failure as the dependent variable and each type of preoperative medication as the independent variable. We also compared the 1‐year outcomes of μTLO between users and non‐users of specific medications using propensity score matching. Surgical success was defined as a postoperative intraocular pressure ranging from 5 to 21 mmHg, a ≥20% reduction in IOP from baseline, and no additional glaucoma surgery within 1 year postoperatively.ResultsThe Cox proportional hazard analysis showed that all drugs that do not increase the conventional outflow exhibited hazard ratios greater than 1.0, and the preoperative use of β‐blockers and oral CAI was a significant surgical risk factor (hazard ratio: 2.65 and 2.45, p = 0.04 and <0.001). In the propensity score matching analysis, success rates at 1 year postoperatively were 55/85, 54/79, 60/73, and 40/76% for users/non‐users of β‐blockers, topical CAIs, an alpha‐2 adrenergic agonist, and an oral CAI, respectively. Kaplan–Meier survival curves in these comparisons also demonstrated that preoperative β‐blockers and oral CAI use were significant surgical risks (p = 0.01, <0.001).ConclusionOur study suggests that preoperative medications that do not involve conventional pathway outflow have a detrimental effect on subsequent Schlemm's canal surgery outcomes.

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The Japan Glaucoma Society guidelines for glaucoma 5th edition

Cited by 27 publications

References 291 publications

Cost-effectiveness analysis of prophylactic laser peripheral iridotomy for primary angle-closure suspect in Japan

Cost-effectiveness analysis of prophylactic laser peripheral iridotomy for primary angle-closure suspect in Japan

Ocular Distribution of Brimonidine and Brinzolamide after Topical Instillation of a 0.1% Brimonidine Tartrate and 1% Brinzolamide Fixed-Combination Ophthalmic Suspension: An Interventional Study

Impact of glaucoma medications on subsequent Schlemm's canal surgery outcome: Cox proportional hazard model and propensity score‐matched analysis

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