The prognosis of trabeculectomy in primary angle- closure glaucoma patients

Zhu, Jingjing; Xie, Lang; Li, Zhiyuan; Lu, Xiaoyan

doi:10.18240/ijo.2019.01.10

Cited by 5 publications

(9 citation statements)

References 30 publications

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“…While many studies looked at entire metabolomic or proteomic profiles to determine changes in POAG, there was heterogeneity in the data with reporting of over 175 unique, differentially expressed biomarkers, over 75 biological pathways implicated in POAG development, and over 50 unique biomarkers determined to be non-significant. 8 , 9 , 25 , 27 , 28 , 33 , 34 , 36 , 41 – 49 , 51 – 53 , 55 , 58 – 61 , 63 , 64 Studies each identified between one and 773 differentially expressed biomarkers. Many studies using unsupervised AI to look for differentially expressed markers did not report all non-significant biomarkers investigated.…”

Section: Resultsmentioning

confidence: 99%

“… 27 , 36 The accuracy of tools was most commonly reported as area under receiver operating curve (AUROC), a graphical description of sensitivity and specificity; reported AUROCs ranged from 0.58–0.93, with the majority being >0.85. 9 , 25 , 26 , 34 , 48 , 52 , 58 , 60 , 70 Sharma et al developed a predictive model using bioinformatics in Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity Pathway Analysis (IPA) and regression analysis, demonstrating AUROCs >0.75. 51 However, this model used previously identified risk factors rather than a complete biofluid profile.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 14 papers used regression models exclusively to identify independent factors related to an outcome of interest. 9 , 35 , 37 , 44 – 46 , 53 , 62 , 64 – 69 As regression analysis is less useful in the study of highly dimensional data, studies using regression alone focused on a smaller number of biofluid markers and clinical characteristics as opposed to the entire metabolic, proteomic, or lipidomic profile as seen in the supervised and unsupervised AI analyses. Regression was typically used to determine longitudinal association between a biomarker and a clinical outcome or condition with the intention of identifying risk factors or an intervention to prevent an outcome or disease progression.…”

Section: Resultsmentioning

confidence: 99%

“… 7 These biomarkers are often contained in biofluids such as serum, tears, aqueous humour, and vitreous humour, which may be obtained in clinical and surgical contexts. 8 , 9 Given the complexity of interactions between various biomarkers and their relationship with a multitude of clinical characteristics, advanced strategies are required to uncover meaningful trends for paradigm shift in the field of research and more personalized glaucoma management strategies.…”

Section: Introductionmentioning

confidence: 99%

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The role of artificial intelligence in analysis of biofluid markers for diagnosis and management of glaucoma: A systematic review

Pucchio

Krance

Pur

et al. 2022

European Journal of Ophthalmology

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Purpose This review focuses on utility of artificial intelligence (AI) in analysis of biofluid markers in glaucoma. We detail the accuracy and validity of AI in the exploration of biomarkers to provide insight into glaucoma pathogenesis. Methods A comprehensive search was conducted across five electronic databases including Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science. Studies pertaining to biofluid marker analysis using AI or bioinformatics in glaucoma were included. Identified studies were critically appraised and assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal tools. Results A total of 10,258 studies were screened and 39 studies met the inclusion criteria, including 23 cross-sectional studies (59%), nine prospective cohort studies (23%), six retrospective cohort studies (15%), and one case-control study (3%). Primary open angle glaucoma (POAG) was the most commonly studied subtype (55% of included studies). Twenty-four studies examined disease characteristics, 10 explored treatment decisions, and 5 provided diagnostic clarification. While studies examined at entire metabolomic or proteomic profiles to determine changes in POAG, there was heterogeneity in the data with over 175 unique, differentially expressed biomarkers reported. Discriminant analysis and artificial neural network predictive models displayed strong differentiating ability between glaucoma patients and controls, although these tools were untested in a clinical context. Conclusion The use of AI models could inform glaucoma diagnosis with high sensitivity and specificity. While insight into differentially expressed biomarkers is valuable in pathogenic exploration, no clear pathogenic mechanism in glaucoma has emerged.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of artificial intelligence in analysis of biofluid markers for diagnosis and management of glaucoma: A systematic review

Pucchio

Krance

Pur

et al. 2022

European Journal of Ophthalmology

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“…TSP-1 can activate TGF-β 1-3 isoforms, whereas integrin-dependent TGF-β activation affects only TGF-β1 and 3 activation: since TGF-β2 is a primary factor in glaucoma, this suggests a significant role for TSP-1 in regulating TGF-β1 and 2 activity in glaucoma (Murphy-Ullrich and Downs, 2015;Murphy-Ullrich and Suto, 2018). Post-surgical levels of TSP-1 and TGF-β2 levels in aqueous humor are major independent predictors of trabeculectomy failure associated with fibrotic responses in primary open angle glaucoma patients (Zhu et al, 2019). Another pilot study confirmed elevated aqueous humor TGF-β2 levels in patients with failed trabeculectomy (Gajda-Derylo et al, 2019).…”

Section: Relevance To Glaucomamentioning

confidence: 98%

Thrombospondin-1 Signaling Through the Calreticulin/LDL Receptor Related Protein 1 Axis: Functions and Possible Roles in Glaucoma

Murphy-Ullrich

2022

Front. Cell Dev. Biol.

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Thrombospondin-1 (TSP-1) is a matricellular extracellular matrix protein. Matricellular proteins are components of the extracellular matrix (ECM) that regulate key cellular functions and impact ECM organization, but which lack direct primary structural roles in the ECM. TSP-1 expression is upregulated in response to injury, hypoxia, growth factor stimulation, inflammation, glucose, and by reactive oxygen species. Relevant to glaucoma, TSP-1 is also a mechanosensitive molecule upregulated by mechanical stretch. TSP-1 expression is increased in ocular remodeling in glaucoma in both the trabecular meshwork and in the optic nerve head. The exact roles of TSP-1 in glaucoma remain to be defined, however. It plays important roles in cell behavior and in ECM remodeling during wound healing, fibrosis, angiogenesis, and in tumorigenesis and metastasis. At the cellular level, TSP-1 can modulate cell adhesion and migration, protease activity, growth factor activity, anoikis resistance, apoptosis, and collagen secretion and matrix assembly and cross-linking. These multiple functions and macromolecular and receptor interactions have been ascribed to specific domains of the TSP-1 molecule. In this review, we will focus on the cell regulatory activities of the TSP-1 N-terminal domain (NTD) sequence that binds to cell surface calreticulin (Calr) and which regulates cell functions via signaling through Calr complexed with LDL receptor related protein 1 (LRP1). We will describe TSP-1 actions mediated through the Calr/LRP1 complex in regulating focal adhesion disassembly and cytoskeletal reorganization, cell motility, anoikis resistance, and induction of collagen secretion and matrix deposition. Finally, we will consider the relevance of these TSP-1 functions to the pathologic remodeling of the ECM in glaucoma.

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Outcomes and risk factors for failure of trabeculectomy in glaucomatous patients in Southwest China: a 325 eyes analysis

Qin¹,

Han²,

Wang³

et al. 2023

Int J Ophthalmol

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AIM: To evaluate the outcomes and elucidate the failure factors for trabeculectomy with mitomycin C (MMC) in Southwest Chinese patients. METHODS: A retrospective correlational study was conducted on the glaucomatous patients who underwent initial trabeculectomy with MMC in Southwest Hospital and had been followed up for 1-3y. A complete success for surgery is defined as a postoperative intraocular pressure (IOP) >5 and ≤21 mm Hg and 20% reduction of IOP compared to preoperative, without IOP-lowering medications. A qualified success for surgery is defined as the abovementioned postoperative IOP with or without IOP-lowering medications. The primary outcomes were IOP, the number of IOP-lowering medications, and cumulative success rate. The secondary outcomes included best corrected visual acuity (BCVA), mean deviation (MD) of visual field, major complications, and risk factors for surgical failure. RESULTS: A total of 325 eyes of 261 glaucomatous patients had been included in our study. Both the mean IOP and the number of IOP-lowering medications were significantly decreased from 32.9±12.0 to 16.4±5.7 mm Hg (P<0.0001) and 3.0±0.9 to 0.9±1.0 (P<0.0001), respectively, at the last visit. The cumulative complete success rate and qualified success rate were 77.8% and 92.0% at 1-year follow-up, and 47.2% and 77.7% at 3-year follow up. There were no significant differences in surgical outcomes between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). In PACG patients, the success rates of trabeculectomy were comparable with those of phacotrabeculectomy. Hypertension (HR=1.904, P=0.011), encapsulated bleb (HR=2.756, P<0.001), and more preoperative topical medications (HR=2.475, P=0.008) were risk factors for surgical failure. CONCLUSION: The qualified success rate of trabeculectomy with MMC in glaucomatous patients in the cohort is 92.0% at 1-year, and 77.7% at 3-year follow up. Hypertension, encapsulated bleb, and more preoperative topical medications are associated with surgical failure.

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The prognosis of trabeculectomy in primary angle- closure glaucoma patients

Cited by 5 publications

References 30 publications

The role of artificial intelligence in analysis of biofluid markers for diagnosis and management of glaucoma: A systematic review

The role of artificial intelligence in analysis of biofluid markers for diagnosis and management of glaucoma: A systematic review

Thrombospondin-1 Signaling Through the Calreticulin/LDL Receptor Related Protein 1 Axis: Functions and Possible Roles in Glaucoma

Outcomes and risk factors for failure of trabeculectomy in glaucomatous patients in Southwest China: a 325 eyes analysis

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