What Do We Really Know about the Effectiveness of Glaucoma Interventions?

Qureshı, Riaz; Azuara‐Blanco, Augusto; Michelessi, Manuele; Virgili, Gianni; Breda, João Barbosa; Cutolo, Carlo Alberto; Pazos, Marta; Katsanos, Andreas; Garhöfer, Gerhard; Kolko, Miriam; Prokosch‐Willing, Verena; Rajhi, Ali Ahmed Al; Lum, Flora; Musch, David C.; Gedde, Steven J.; Li, Tianjing

doi:10.1016/j.ogla.2021.01.007

Cited by 15 publications

(15 citation statements)

References 42 publications

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“…Glaucoma is a group of neurodegenerative optic diseases which could affect populations with various age groups and lead to irreversible blindness (9). Moreover, glaucoma is not rare, with an estimated prevalence of 3.5% in people aged over 40 years (10,11). Previous experimental studies showed that glaucoma and AD have common pathophysiological characteristics of neurodegeneration, such as reduced number of retinal ganglion cells, deposition of amyloid-β peptides, overactivated neuroinflammation, accumulation of tau proteins, and impaired insulin receptor signaling pathways (12)(13)(14).…”

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confidence: 99%

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Zhao

et al. 2021

Front. Med.

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Background: Previous studies evaluating the relationships of glaucoma with Alzheimer's disease (AD) and dementia showed inconsistent results. We performed a meta-analysis of cohort studies to evaluate the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia.Methods: Cohort studies which evaluated the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Cochrane's Library databases. A random-effects model incorporating the potential intra-study heterogeneity was used for the meta-analysis.Results: Eleven cohort studies including 4,645,925 participants were included. Results showed that compared to those without glaucoma at baseline, adult patients with glaucoma was not independently associated with increased incidence of AD [adjusted risk ratio (RR): 1.03, 95% confidence interval (CI): 0.93–1.05, P = 0.55; I2 = 83%], all-cause dementia (adjusted RR: 1.08, 95% CI: 0.97–1.19, P = 0.15; I2 = 79%), or non-AD dementia (adjusted RR: 1.05 95% CI: 0.91–1.21, P = 0.49; I2 = 82%). Sensitivity analyses by excluding one study at a time did not significantly affect the results of the meta-analyses. Moreover, subgroup analyses showed consistent results in meta-analysis of prospective or retrospective cohort studies, and in meta-analysis of patients with primary open-angle glaucoma or primary angle-closure glaucoma (P-values for subgroup difference all > 0.05).Conclusions: Current evidence from cohort studies did not support that glaucoma is an independent risk factor of AD, all-cause dementia, or non-AD dementia in adult population.

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confidence: 99%

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Zhao

et al. 2021

Front. Med.

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“…Even though medical therapy, according to the latest European Glaucoma Society (EGS) guidelines [ 19 ], is not the only first line of treatment for POAG, and even though surgery has been demonstrated to be even more effective in IOP decrease, topical drugs are still the most diffuse choice among ophthalmologists [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy Duration of Topical Therapies in Eyes with Primary Open-Angle Glaucoma

Lanza

Leone

Scognamiglio

et al. 2022

JCM

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Background: To investigate the efficacy interval of the topical therapies available for primary open-angle glaucoma (POAG) and the ocular and systemic features potentially associated. Methods: This retrospective study included 190 patients with POAG undergoing first topical therapy, throughout a follow-up of 15 years. The patients started one topical intraocular pressure (IOP)-lowering drug within single molecules such betablockers, prostaglandin or dorzolamide, or fixed combinations such as betablockers + prostaglandin, betablockers + dorzolamide, or betablockers + brimonidine. Efficacy duration was measured as the time between the start of the therapy and the change due to IOP increase or visual field worsening. For each patient, ocular and systemic features and comorbidities were analysed to detect any significant correlation with the length of effectiveness of every drug used. Results: The molecules explored showed some discrepancies in terms of mean duration of efficacy; however, no significant differences were demonstrated (p > 0.05). Furthermore, when evaluating the overall cohort, no systemic or ocular features correlated significantly with the effectiveness of the molecules explored. However, the same analysis carried out upon stratifying the different groups according to the IOP-lowering drops they received, demonstrated that the drug efficacy could be influenced by several ocular and systemic features. Conclusion: Data observed in this study suggest that there is no difference in using one of the medications evaluated as first choice of treatment of POAG if the patients are accurately evaluated and the most recent guidelines are adopted.

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“…We will assess the reliability of reviews using an adapted form used in previous studies. 33–37 Data items for the form are derived from the Critical Appraisal Skills Programme, the Assessment of Multiple Systematic Reviews and the PRISMA. This is consistent with the proposal that methodological assessment of systematic reviews within overviews should address quality of the methods and quality of the reporting.…”

Section: Methods and Analysismentioning

confidence: 99%

“…We will assess the reliability of reviews using an adapted form used in previous studies. 33–37 Data items for the form are derived from the Critical Appraisal Skills Programme, the Assessment of Multiple Systematic Reviews and the PRISMA. We will classify a systematic review as potentially reliable if it meets the following methodological criteria: (1) the review defined eligibility criteria for selection of individual studies, (2) the review conducted a comprehensive literature search for eligible studies, (3) the review assessed the risk of bias of the individual included studies using any method, (4) the review used appropriate methods for meta-analyses (criterion only assessed if meta-analysis was performed) and (5) we observed concordance between the review’s findings and conclusions ( table 1 ).…”

Section: Methods and Analysismentioning

confidence: 99%

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Effectiveness of interventions for dry eye: a protocol for an overview of systematic reviews

et al. 2022

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IntroductionDry eye is a leading cause of ocular morbidity and economic and societal burden for patients and healthcare systems. There are several treatment options available for dry eye and high-quality systematic reviews synthesise the evidence for their effectiveness and potential harms.Methods and analysisWe will search the Cochrane Eyes and Vision US satellite (CEV@US) database of eyes and vision systematic reviews for systematic reviews on interventions for dry eye. CEV@US conducted an initial search of PubMed and Embase to populate the CEV@US database of eyes and vision systematic reviews in 2007, which was updated most recently in August 2021. We will search the database for systematic reviews published since 1 January 2016 because systematic reviews more than 5 years are unlikely to be up to date. We will consider Cochrane and non-Cochrane systematic reviews eligible for inclusion. Two authors will independently screen articles. We will include studies that evaluate interventions for dry eye and/or meibomian gland dysfunction with no restriction on types of participants or review language. We will select reliable systematic reviews (ie, those meeting pre-established methodological criteria) for inclusion, assessed by one investigator and verified by a second investigator. We will extract ratings of the certainty of evidence from within each review. We will report the degree of overlap for systematic reviews that answer similar questions and include overlapping primary studies. We will present results of the overview in alignment with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions (Online Chapter 5: Overviews of Reviews), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and an overview of reviews quality and transparency checklist. The anticipated start and completion dates for this overview are 1 May 2021 and 30 April 2022, respectively.Ethics and disseminationThis overview will not require the approval of an Ethics Committee because it will use published studies. We will publish results in a peer-reviewed journal.PROSPERO registration numberCRD42021279880.

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What Do We Really Know about the Effectiveness of Glaucoma Interventions?

Cited by 15 publications

References 42 publications

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Evaluation of the Efficacy Duration of Topical Therapies in Eyes with Primary Open-Angle Glaucoma

Effectiveness of interventions for dry eye: a protocol for an overview of systematic reviews

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