2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T4a2,Twenty individuals from 10 families (50% female and 50% male; 70% self-described as broadly European [Australian/British, British, English/German, English/Polish, European, or Scottish], 25% as Asian [Chinese or Filipino], and 5% as Latin American [Salvadoran]) were identified with FOXC1 duplications. All genetically tested individuals were diagnosed with glaucoma, demonstrating high penetrance. Seventeen individuals were referred with juvenile open-angle glaucoma (JOAG), 1 with primary open-angle glaucoma, 1 with primary congenital glaucoma, and 1 with anterior segment dysgenesis. The diagnosis of 4 individuals from 1 family with ectropion uveae was revised to anterior segment dysgenesis. Systemic features were reported for 2 participants (10.5%), including subtle dental findings and mild facial dysmorphism. Duplications encompassing FOXC1 were among the most common monogenic contributors to JOAG. In the ANZRAG group, they accounted for 13.5% (95% CI, 6.7%-25.3%) of JOAG probands with a genetic diagnosis, second to MYOC (53.8%; 95% CI, 40.5%-66.7%). In the MEE group, FOXC1 duplications accounted for 9.5% (95% CI, 2.7%-28.9%) of JOAG probands with a genetic diagnosis.31:Tb02,While FOXC1 single-nucleotide variants and deletions are well-established causes of Axenfeld-Rieger syndrome, few FOXC1 duplications have been reported. This study investigated families with duplications encompassing the FOXC1 gene to refine the associated phenotypic spectrum and contribution to glaucoma. To investigate the prevalence and phenotype of FOXC1 duplications in 2 large glaucoma registries. This retrospective observational genetic cohort study included participants recruited from the Australian & New Zealand Registry of Advanced Glaucoma (ANZRAG) and the Massachusetts Eye and Ear (MEE) cohort from 2008 through 2025. Participants with glaucoma, and available relatives, underwent genomic testing to identify duplications encompassing FOXC1 using exome sequencing and genotyping arrays (ANZRAG) or whole-genome sequencing (MEE). Data analyses were conducted from 2022 through 2025. Prevalence of FOXC1 duplications, age at glaucoma onset, and phenotype, including ocular and systemic features. Twenty individuals from 10 families (50% female and 50% male; 70% self-described as broadly European [Australian/British, British, English/German, English/Polish, European, or Scottish], 25% as Asian [Chinese or Filipino], and 5% as Latin American [Salvadoran]) were identified with FOXC1 duplications. All genetically tested individuals were diagnosed with glaucoma, demonstrating high penetrance. Seventeen individuals were referred with juvenile open-angle glaucoma (JOAG), 1 with primary open-angle glaucoma, 1 with primary congenital glaucoma, and 1 with anterior segment dysgenesis. The diagnosis of 4 individuals from 1 family with ectropion uveae was revised to anterior segment dysgenesis. Systemic features were reported for 2 participants (10.5%), including subtle dental findings and mild facial dysmorphism. Duplications encompassing FOXC1 were among the most common monogenic contributors to JOAG. In the ANZRAG group, they accounted for 13.5% (95% CI, 6.7%-25.3%) of JOAG probands with a genetic diagnosis, second to MYOC (53.8%; 95% CI, 40.5%-66.7%). In the MEE group, FOXC1 duplications accounted for 9.5% (95% CI, 2.7%-28.9%) of JOAG probands with a genetic diagnosis. These findings suggest FOXC1 duplications are an underrecognized, highly penetrant, but variably expressive, genetic variation associated with JOAG. Findings for the relatively modest number of individuals in the retrospective study were associated with wide confidence intervals. This limitation is often inherent to studies of JOAG, a rare condition for which individual genetic variants account for only a subset of cases. Despite this, the findings highlight the genetic heterogeneity of JOAG and support the potential importance of considering routine genetic copy-number variant analysis for individuals with JOAG.32:T13da, Importance While FOXC1 single-nucleotide variants and deletions are well-established causes of Axenfeld-Rieger syndrome, few FOXC1 duplications have been reported. This study investigated families with duplications encompassing the FOXC1 gene to refine the associated phenotypic spectrum and contribution to glaucoma. Objective To investigate the prevalence and phenotype of FOXC1 duplications in 2 large glaucoma registries. Design, Setting, and Participants This retrospective observational genetic cohort study included participants recruited from the Australian &amp; New Zealand Registry of Advanced Glaucoma (ANZRAG) and the Massachusetts Eye and Ear (MEE) cohort from 2008 through 2025. Participants with glaucoma, and available relatives, underwent genomic testing to identify duplications encompassing FOXC1 using exome sequencing and genotyping arrays (ANZRAG) or whole-genome sequencing (MEE). Data analyses were conducted from 2022 through 2025. Main Outcomes and Measures Prevalence of FOXC1 duplications, age at glaucoma onset, and phenotype, including ocular and systemic features. Results Twenty individuals from 10 families (50% female and 50% male; 70% self-described as broadly European [Australian/British, British, English/German, English/Polish, European, or Scottish], 25% as Asian [Chinese or Filipino], and 5% as Latin American [Salvadoran]) were identified with FOXC1 duplications. All genetically tested individuals were diagnosed with glaucoma, demonstrating high penetrance. Seventeen individuals were referred with juvenile open-angle glaucoma (JOAG), 1 with primary open-angle glaucoma, 1 with primary congenital glaucoma, and 1 with anterior segment dysgenesis. The diagnosis of 4 individuals from 1 family with ectropion uveae was revised to anterior segment dysgenesis. Systemic features were reported for 2 participants (10.5%), including subtle dental findings and mild facial dysmorphism. Duplications encompassing FOXC1 were among the most common monogenic contributors to JOAG. In the ANZRAG group, they accounted for 13.5% (95% CI, 6.7%-25.3%) of JOAG probands with a genetic diagnosis, second to MYOC (53.8%; 95% CI, 40.5%-66.7%). In the MEE group, FOXC1 duplications accounted for 9.5% (95% CI, 2.7%-28.9%) of JOAG probands with a genetic diagnosis. Conclusions and Relevance These findings suggest FOXC1 duplications are an underrecognized, highly penetrant, but variably expressive, genetic variation associated with JOAG. Findings for the relatively modest number of individuals in the retrospective study were associated with wide confidence intervals. This limitation is often inherent to studies of JOAG, a rare condition for which individual genetic variants account for only a subset of cases. Despite this, the findings highlight the genetic heterogeneity of JOAG and support the potential importance of considering routine genetic copy-number variant analysis for individuals with JOAG. 33:T410,Mean (SD) age of patients was 70 (12) years; among 1466 patients, 793 (54%) were female. By self-reported race and ethnicity, 39 patients (3%) were Asian American, 469 patients (32%) were Black, 95 (7%) were Latinx, and 831 (57%) were White. Among 1030 patients (70%) with 1 or more follow-up evaluations within 12 to 18 months following initial POAG diagnosis, 783 (76%) achieved 15% or higher IOP reduction in 1 or more eyes. Patients in the lowest wealth quartile had 5- to 9-fold lower odds of achieving 15% or greater IOP decrease compared with patients in higher quartiles; the odds of LTFU were 61% lower in the wealthiest patient quartile than in the least-wealthy group (odds ratio [OR], 0.39; 95% CI, 0.18-0.84; P = .02). Patients in rural communities (OR, 5.54; 95% CI, 1.13-27.08) were more likely than urban residents to experience LTFU. Patients with children in the household experienced, on average, a 4-mm Hg (95% CI, 0.99-7.13) greater IOP reduction compared with those without children in the household (P = .01).34:Ta7f,Various communities continue to experience relatively high rates of glaucoma-related visual impairment and blindness. Identifying potential nonmedical influences on glaucoma outcomes may lead to strategies to improve glaucoma care. To assess possible associations between nonmedical variables and quality of glaucoma care among patients with newly diagnosed primary open-angle glaucoma (POAG). This retrospective cohort study included 1466 patients with newly diagnosed POAG receiving care at health systems in the Sight Outcomes Research Collaborative (SOURCE) Consortium from January 2010 to December 2022. Data analysis was completed from March 2024 to June 2025. Various nonmedical variables, including self-reported race and ethnicity, urbanicity of residence, affluence of patients' residential community, and presence of children in the household. The primary outcomes were odds of 15% or greater intraocular pressure (IOP) reduction at 12 to 18 months following initial POAG diagnosis and odds of loss to follow-up (LTFU). Mean (SD) age of patients was 70 (12) years; among 1466 patients, 793 (54%) were female. By self-reported race and ethnicity, 39 patients (3%) were Asian American, 469 patients (32%) were Black, 95 (7%) were Latinx, and 831 (57%) were White. Among 1030 patients (70%) with 1 or more follow-up evaluations within 12 to 18 months following initial POAG diagnosis, 783 (76%) achieved 15% or higher IOP reduction in 1 or more eyes. Patients in the lowest wealth quartile had 5- to 9-fold lower odds of achieving 15% or greater IOP decrease compared with patients in higher quartiles; the odds of LTFU were 61% lower in the wealthiest patient quartile than in the least-wealthy group (odds ratio [OR], 0.39; 95% CI, 0.18-0.84; P = .02). Patients in rural communities (OR, 5.54; 95% CI, 1.13-27.08) were more likely than urban residents to experience LTFU. Patients with children in the household experienced, on average, a 4-mm Hg (95% CI, 0.99-7.13) greater IOP reduction compared with those without children in the household (P = .01). In this cohort study, patients with newly diagnosed POAG in the lowest wealth quartile were substantially less likely to achieve the US National Quality Forum's recommended IOP percentage reduction and considerably more likely to experience LTFU than those with higher wealth levels. These findings support the premise that clinicians should understand financial circumstances of patients when making management decisions and reinforce the need for clinicians and payors to find ways to ensure that patients can access IOP-lowering interventions and receive follow-up care in accordance with established guidelines.35:T1014, Importance Various communities continue to experience relatively high rates of glaucoma-related visual impairment and blindness. Identifying potential nonmedical influences on glaucoma outcomes may lead to strategies to improve glaucoma care. Objective To assess possible associations between nonmedical variables and quality of glaucoma care among patients with newly diagnosed primary open-angle glaucoma (POAG). Design, Setting, and Participants This retrospective cohort study included 1466 patients with newly diagnosed POAG receiving care at health systems in the Sight Outcomes Research Collaborative (SOURCE) Consortium from January 2010 to December 2022. Data analysis was completed from March 2024 to June 2025. Exposures Various nonmedical variables, including self-reported race and ethnicity, urbanicity of residence, affluence of patients’ residential community, and presence of children in the household. Main Outcomes and Measures The primary outcomes were odds of 15% or greater intraocular pressure (IOP) reduction at 12 to 18 months following initial POAG diagnosis and odds of loss to follow-up (LTFU). Results Mean (SD) age of patients was 70 (12) years; among 1466 patients, 793 (54%) were female. By self-reported race and ethnicity, 39 patients (3%) were Asian American, 469 patients (32%) were Black, 95 (7%) were Latinx, and 831 (57%) were White. Among 1030 patients (70%) with 1 or more follow-up evaluations within 12 to 18 months following initial POAG diagnosis, 783 (76%) achieved 15% or higher IOP reduction in 1 or more eyes. Patients in the lowest wealth quartile had 5- to 9-fold lower odds of achieving 15% or greater IOP decrease compared with patients in higher quartiles; the odds of LTFU were 61% lower in the wealthiest patient quartile than in the least-wealthy group (odds ratio [OR], 0.39; 95% CI, 0.18-0.84; P = .02). Patients in rural communities (OR, 5.54; 95% CI, 1.13-27.08) were more likely than urban residents to experience LTFU. Patients with children in the household experienced, on average, a 4-mm Hg (95% CI, 0.99-7.13) greater IOP reduction compared with those without children in the household ( P = .01). Conclusions and Relevance In this cohort study, patients with newly diagnosed POAG in the lowest wealth quartile were substantially less likely to achieve the US National Quality Forum’s recommended IOP percentage reduction and considerably more likely to experience LTFU than those with higher wealth levels. These findings support the premise that clinicians should understand financial circumstances of patients when making management decisions and reinforce the need for clinicians and payors to find ways to ensure that patients can access IOP-lowering interventions and receive follow-up care in accordance with established guidelines. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Primary Open-Angle Glaucoma: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Primary Open-Angle Glaucoma (condition). 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All summary fields are set to null as no clinical content could be extracted. Tags and suggested searches are inferred from the title only.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.08.048","tag_type":"warning","value":"The mitochondrial dysfunction hypothesis proposed is speculative and explicitly framed by the authors as requiring future longitudinal validation.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.08.048","tag_type":"warning","value":"This is a commentary/letter responding to a prior study; it does not present primary data of its own.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.08.048","tag_type":"warning","value":"This is a correspondence/commentary with no original patient data; all clinical claims are derived from cited external studies.","value_numeric":null}],"summaries":{"what_studied":"This correspondence comments on a 10-year real-world observational study (Wong et al.) linking glaucoma subtypes to subsequent neurodegenerative disease risk, arguing that mitochondrial dysfunction deserves greater emphasis as a shared biological mechanism across glaucoma subtypes and related neurodegeneration.","key_result":"The authors highlight that normal-tension glaucoma (NTG) was the subtype most clearly linked to subsequent Parkinson disease in the index study, and propose mitochondrial dysfunction — including impaired oxidative phosphorylation, defective mitophagy, and mitochondrial DNA variants — as a plausible unifying mechanism connecting glaucoma to neurodegenerative conditions such as Parkinson disease and Alzheimer disease.","limitations":"This is a commentary with no original data; arguments are hypothesis-generating and based on secondary synthesis of cited studies. The proposed role of mitochondrial dysfunction as a shared susceptibility factor remains unproven and is difficult to test in large database cohorts.","practice_takeaway":"Clinicians managing glaucoma — especially NTG — should be aware of the emerging evidence linking mitochondrial dysfunction to both ocular and central neurodegeneration, though this does not yet change practice. Future studies integrating glaucoma phenotyping with mitochondrial function assessments may clarify whether shared biological pathways underlie these epidemiological associations."}},{"doi":"10.1136/bjo-2026-329957","pmid":"42552102","title":"Risk of glaucoma among patients using tadalafil for lower urinary tract symptoms: a multinational cohort study","journal_title":"British Journal of Ophthalmology","journal_issn":"0007-1161","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1136/bjo-2026-329957","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-09T13:25:14.622Z","updated_at":"2026-08-09T13:25:14.622Z","tags":[{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"brand","value":"Cialis","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"condition","value":"Glaucoma","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"condition","value":"Lower Urinary Tract Symptoms","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"condition","value":"Ocular Hypertension","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"generic","value":"tadalafil","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"modality","value":"PDE5 Inhibitor","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"sample_size","value":"n=73854","value_numeric":73854},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"warning","value":"The absolute risk difference is modest (0.77% over 5 years), so clinical context is important when interpreting the HR-based findings.","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"warning","value":"The brand name 'Cialis' is the most recognized proprietary form of tadalafil for LUTS/BPH; the paper does not specify brand, so this tag is inferred.","value_numeric":null},{"paper_doi":"10.1136/bjo-2026-329957","tag_type":"warning","value":"TriNetX is a federated claims/EHR network — diagnosis codes were used to identify glaucoma, which may introduce misclassification bias.","value_numeric":null}],"summaries":{"what_studied":"This multinational retrospective cohort study evaluated whether tadalafil use for lower urinary tract symptoms (LUTS) increases the risk of incident glaucoma compared to non-PDE5 inhibitor users, in men aged ≥40 years followed up to 5 years (2012–2022) using the TriNetX database.","key_result":"Tadalafil was associated with a 22% higher risk of glaucoma overall (HR 1.22; 95% CI 1.12–1.33), with elevated risks for ocular hypertension (HR 1.32), primary open-angle glaucoma (HR 1.33), and glaucoma treatment initiation (HR 1.33). Five-year cumulative incidence was 3.93% vs 3.16% in non-users (p<0.001); no significant risk was seen for low-tension or primary angle-closure glaucoma.","limitations":"- Retrospective database design (TriNetX) limits ability to confirm medication adherence, dosing, or causality.\n- Residual confounding cannot be excluded despite propensity score matching.\n- Findings apply only to males using tadalafil for LUTS and may not generalize to other PDE5i indications or female populations.","practice_takeaway":"Clinicians prescribing tadalafil for LUTS — especially in men over 50 or those with existing glaucoma risk factors — should consider baseline and periodic ophthalmic evaluation. Patients should be informed of this potential association, particularly regarding ocular hypertension and primary open-angle glaucoma."}},{"doi":"10.1016/j.ajo.2026.07.051","pmid":"42546867","title":"Glaucoma and Neurodegenerative Disease Risk: A 10-Year Assessment of Real-World Global Data","journal_title":"American Journal of Ophthalmology","journal_issn":"0002-9394","published_at":"2026-08-03T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajo.2026.07.051","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:17.461Z","updated_at":"2026-08-12T13:26:17.461Z","tags":[{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Mild Cognitive Impairment","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Normal-Tension Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Parkinson's Disease","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Primary Angle-Closure Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"condition","value":"Vascular Dementia","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"sample_size","value":"n=768512","value_numeric":768512},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"warning","value":"Sample size reported as matched pairs (384,256 pairs = ~768,512 total individuals); value_numeric set to total individuals for accuracy, but the paper emphasizes pairs.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"warning","value":"Study design label 'Retrospective Cohort Study' is clear, but the use of a federated claims/EHR network (TriNetX) introduces potential for coding bias and variable data quality across institutions.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"warning","value":"Subtype-specific sample sizes are not reported, so statistical power for PACG and NTG subgroup analyses is uncertain.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.07.051","tag_type":"warning","value":"The overall AD association (HR 1.485) appears driven by factors beyond the three named subtypes, since none of POAG, PACG, or NTG individually showed significant AD associations — this discrepancy is noted in the paper but not fully explained.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used TriNetX global data (2005–2025) to assess 10-year risk trajectories of neurodegenerative diseases (MCI, Alzheimer's disease, vascular dementia, unspecified dementias, Parkinson's disease) in 384,256 propensity-matched glaucoma–control pairs, stratified by age onset (<45 vs >65 years) and glaucoma subtype (POAG, PACG, NTG).","key_result":"Glaucoma was associated with elevated 10-year risks for AD (HR 1.485), vascular dementia (HR 1.213), and Parkinson's disease (HR 1.115, peaking at 10 years); early-onset glaucoma showed a notably high AD risk at 10 years (HR 2.320). By subtype, NTG was the only subtype with a significant Parkinson's disease link (HR 1.283), while AD associations were non-significant across all three individual subtypes.","limitations":"- Observational design from a real-world database precludes causal inference; associations may reflect shared risk factors or surveillance bias.\n- ICD-10 code–based outcome ascertainment may undercount or misclassify neurodegenerative diagnoses.\n- Subtype-level analyses (especially PACG and NTG) likely had smaller sample sizes, reducing power for some comparisons.","practice_takeaway":"Clinicians managing glaucoma patients—especially those with early-onset disease or NTG—should maintain a low threshold for neurocognitive screening, given the observed associations with dementia and Parkinson's disease over 10 years. These findings are correlational, not causal, so they should inform monitoring rather than change treatment targets."}},{"doi":"10.1167/tvst.15.7.30","pmid":"42524829","title":"Reproducibility of VF, OCT, and OCTA in Glaucoma: A Prospective Multi-Visit Study","journal_title":"Translational Vision Science & Technology","journal_issn":"2164-2591","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1167/tvst.15.7.30","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:07.353Z","updated_at":"2026-08-04T18:18:07.353Z","tags":[{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"modality","value":"OCT Angiography","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"modality","value":"Optical Coherence Tomography","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"modality","value":"Visual Field Testing","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"sample_size","value":"n=38","value_numeric":38},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"warning","value":"No brand or generic drug tags are applicable; this is a diagnostic/monitoring reproducibility study with no therapeutic intervention.","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the study provides important reproducibility thresholds but is limited by small sample size (n=38) and single-center, single-device design. Independent validation in larger, more diverse cohorts is needed before broad adoption.","value_numeric":null},{"paper_doi":"10.1167/tvst.15.7.30","tag_type":"warning","value":"The moderate-to-advanced subgroup had only 20 eyes, so severity-specific thresholds for that group carry wider uncertainty intervals.","value_numeric":null}],"summaries":{"what_studied":"This prospective cohort study quantified short-interval inter-visit reproducibility of VF, OCT, and OCTA metrics in 38 POAG patients (76 eyes; 56 mild, 20 moderate-to-advanced) across 5 biweekly visits over 3 months, without treatment changes.","key_result":"OCT structural measures were consistently stable across severity (pRNFL and mGCIPL CoV ~2%). VF variability was severity-dependent: MD 95% tolerance limits widened from ±2 dB (mild) to ±4 dB (moderate-advanced), ICC fell from 0.95 to 0.75. Peripapillary OCTA perfusion density CoV rose from 5% to 9% with severity, while macular OCTA remained relatively stable (CoV ~1–2%). Worse baseline MD, older age, longer axial length, and higher false-negative rate independently predicted greater VF variability (all P ≤ 0.046).","limitations":"Small single-center cohort (n=38) skewed toward mild disease (74%), limiting precision for moderate-advanced estimates; predominantly Asian population limits generalizability; single OCT/OCTA device (Cirrus HD-OCT 6000) used, so metrics may not transfer across platforms.","practice_takeaway":"Use severity-specific thresholds when judging glaucoma progression: require >±4 dB MD change (not ±2 dB) before calling VF worsening in moderate-to-advanced disease, and rely on OCT structural metrics (pRNFL, mGCIPL) as the most stable monitoring tool across all severity stages. Confirm suspected progression with multimodal evidence before changing management."}},{"doi":"10.1001/jamaophthalmol.2026.2472","pmid":"42424069","title":"Nicotinamide Supplementation and Primary Open-Angle Glaucoma in Patients With Ocular Hypertension","journal_title":"JAMA Ophthalmology","journal_issn":"2168-6165","published_at":"2026-07-09T00:00:00.000Z","url":"https://doi.org/10.1001/jamaophthalmol.2026.2472","source_score":16,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-12T13:19:34.559Z","updated_at":"2026-07-12T13:19:34.559Z","tags":[{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"condition","value":"Ocular Hypertension","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"generic","value":"nicotinamide","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"modality","value":"Nutritional Supplement","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"sample_size","value":"n=2920","value_numeric":2920},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"warning","value":"Nicotinamide and niacin are related but distinct compounds; the study excluded niacin users from controls, but the precise formulations used by nicotinamide-exposed patients are not described.","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"warning","value":"The DOI references a 2026 publication date; this is a newly published study with no independent replication yet available.","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.2472","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — the effect size is large, but this is an observational study with unverified supplement dosing and potential for unmeasured confounding (e.g., health-conscious behavior bias).","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used propensity score-matched (1:1) EMR data from 67 US health systems (2006–2026) to evaluate whether systemic nicotinamide supplementation in adults with ocular hypertension (OHT) reduces risk of conversion to primary open-angle glaucoma (POAG) and delays need for escalated treatment, compared to controls with no nicotinamide/niacin use over a mean follow-up of 3.7 years.","key_result":"POAG developed in 3.5% of the nicotinamide group vs 9.0% of controls (HR 0.34; 95% CI 0.25–0.47; absolute risk reduction 5.5%). Initiation of topical IOP-lowering therapy was also lower (13.6% vs 21.2%; HR 0.57), as was laser trabeculoplasty (0.8% vs 1.9%; HR 0.38).","limitations":"- Observational design cannot establish causality; residual confounding likely despite propensity matching.\n- Nicotinamide dose, formulation, duration, and adherence were not captured from EMR data.\n- Supplement use may be under-documented in EMRs, risking misclassification of exposure or control status.","practice_takeaway":"In OHT patients, systemic nicotinamide was linked to a roughly two-thirds lower rate of POAG diagnosis over ~4 years — a clinically meaningful signal, but not yet proof of causation. Clinicians may consider discussing nicotinamide as an adjunct while awaiting prospective trial data."}},{"doi":"10.1167/tvst.15.6.2","pmid":"42223316","title":"Relationship Between Omega-3 Fatty Acids and Glaucoma Risk in Patients With Dry Eye Disease: A Multinational Retrospective Cohort Study","journal_title":"Translational Vision Science & Technology","journal_issn":"2164-2591","published_at":"2026-06-01T00:00:00.000Z","url":"https://doi.org/10.1167/tvst.15.6.2","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-09T13:50:39.446Z","updated_at":"2026-06-09T13:50:39.446Z","tags":[{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Dry Eye Disease","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Glaucoma","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Normal-Tension Glaucoma","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Ocular Hypertension","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Primary Angle-Closure Glaucoma","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"generic","value":"fish oil","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"generic","value":"omega-3 fatty acids","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"modality","value":"Omega-3 Fatty Acid Supplement","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"sample_size","value":"n=14168","value_numeric":14168},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"warning","value":"No statistically significant benefit was observed in Asian participants, though this may reflect small subgroup size rather than a true null effect — clinicians should interpret subgroup results carefully.","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"warning","value":"The control group index date differed from the omega-3 group (dry eye diagnosis date vs. first prescription date), which may introduce immortal time bias despite sensitivity analyses.","value_numeric":null},{"paper_doi":"10.1167/tvst.15.6.2","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the magnitude of effect is striking, but the observational design and inability to verify diagnoses or dosing mean RCT confirmation is needed before changing prescribing practice.","value_numeric":null}],"summaries":{"what_studied":"This 1:1 propensity score-matched retrospective cohort study (n=14,168 adults with dry eye disease; 2013–2023, TriNetX multinational database) compared incident glaucoma outcomes over 5 years between those prescribed omega-3 fatty acids vs. those never prescribed omega-3.","key_result":"Omega-3 users had significantly lower risks across all glaucoma outcomes: total glaucoma (HR 0.48, 95% CI 0.42–0.54), POAG (HR 0.45, 95% CI 0.33–0.63), ocular hypertension (HR 0.57, 95% CI 0.43–0.75), normal-tension glaucoma (HR 0.41, 95% CI 0.19–0.88), primary angle-closure glaucoma (HR 0.45, 95% CI 0.21–0.94), and first-line glaucoma medication use (HR 0.65, 95% CI 0.53–0.80). In absolute terms, 5.00% of omega-3 users vs. 10.43% of controls developed total glaucoma.","limitations":"- Residual confounding cannot be excluded despite propensity matching; reasons for omega-3 prescribing varied widely at baseline.\n- Dose and formulation of omega-3 were not available in the database, so a dose–response relationship could not be assessed.\n- Observational design prevents causal inference; glaucoma diagnoses could not be independently verified from the deidentified database.","practice_takeaway":"In adults with dry eye disease, omega-3 supplementation was associated with roughly half the risk of developing glaucoma over 5 years — a finding consistent across age, sex, and comorbidity subgroups. Clinicians managing dry eye patients may consider omega-3 supplementation as a potentially dual-benefit intervention, pending confirmatory randomized trials."}},{"doi":"10.1001/jamaophthalmol.2026.1183","pmid":"42096227","title":"Association of\n FOXC1\n Duplications With Juvenile Open-Angle Glaucoma","journal_title":"JAMA Ophthalmology","journal_issn":"2168-6165","published_at":"2026-05-07T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13154036/","source_score":58,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1001/jamaophthalmol.2026.1183","days":"7","issn":"2168-6165","rank":"1","field":"Clinical Medicine","score":"58","category":"Ophthalmology","categories":["Ophthalmology"],"_categories":["Ophthalmology"]},"pubmed":{"doi":"10.1001/jamaophthalmol.2026.1183","title":"Association of FOXC1 Duplications With Juvenile Open-Angle Glaucoma.","journal":"JAMA ophthalmology","methods":"","results":"$30","abstract":"$31","keywords":[],"pubmed_id":"42096227","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1001/jamaophthalmol.2026.1183","URL":"https://doi.org/10.1001/jamaophthalmol.2026.1183","ISSN":["2168-6165"],"link":[{"URL":"https://jamanetwork.com/journals/jamaophthalmology/articlepdf/2848368/jamaophthalmology_maxwell_2026_oi_260020_1776890875.22484.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Association of\n FOXC1\n Duplications With Juvenile Open-Angle Glaucoma"],"author":[{"given":"Giorgina E.","family":"Maxwell","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"}]},{"given":"Joshua M.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"}]},{"given":"Antonia","family":"Kolovos","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"},{"name":"Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia"}]},{"given":"Thi T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"},{"name":"Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia"}]},{"given":"Katherine","family":"Zamora-Alejo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"}]},{"given":"Jonathan B.","family":"Ruddle","sequence":"additional","affiliation":[{"name":"Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"},{"name":"Ocular Genetics Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia"},{"name":"Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia"}]},{"given":"Michael Alex","family":"Craig","sequence":"additional","affiliation":[{"name":"Karratha Eyecare, Karratha, Western Australia, Australia"}]},{"given":"Mark","family":"Walland","sequence":"additional","affiliation":[{"name":"Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"}]},{"given":"Anne M. V.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"}]},{"given":"Krzysztof","family":"Bernatowicz","sequence":"additional","affiliation":[{"name":"Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}]},{"given":"Carmela B.","family":"Guevarra","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts"}]},{"given":"Francis Raymond","family":"Castor","sequence":"additional","affiliation":[{"name":"Calamba Eye Center-Calamba Medical Center, Laguna, Philippines"}]},{"given":"Edward Ryan","family":"Collantes","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Manila Doctors Hospital, Manila, Philippines"},{"name":"Broad Institute of MIT and Harvard, Cambridge, Massachusetts"}]},{"given":"Michael C.","family":"Sibulo","sequence":"additional","affiliation":[{"name":"Eye Institute, St Luke’s Medical Center, Quezon City, Philippines"}]},{"given":"Owen M.","family":"Siggs","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"},{"name":"Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia"}]},{"given":"Janey L.","family":"Wiggs","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Manila Doctors Hospital, Manila, Philippines"}]},{"given":"Jamie E.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"},{"name":"Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia"}]},{"given":"Emmanuelle","family":"Souzeau","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia"}]}],"issued":{"date-parts":[[2026,5,7]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":null,"created":{"date-time":"2026-05-07T15:30:32Z","timestamp":1778167832000,"date-parts":[[2026,5,7]]},"indexed":{"date-time":"2026-05-07T16:14:20Z","timestamp":1778170460453,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2848368"}},"subtitle":[],"deposited":{"date-time":"2026-05-07T15:30:36Z","timestamp":1778167836000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"2168-6165"}],"published":{"date-parts":[[2026,5,7]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1016/j.exer.2011.01.006","key":"eoi260020r1","year":"2011","issue":"4","author":"Quigley","volume":"92","first-page":"299","unstructured":null,"article-title":"Lack of neuroprotection against experimental glaucoma in c-Jun N-terminal kinase 3 knockout mice.","journal-title":"Exp Eye Res","doi-asserted-by":"publisher"},{"DOI":"10.1097/ICU.0000000000000516","key":"eoi260020r2","year":"2018","issue":"5","author":"Thau","volume":"29","first-page":"385","unstructured":null,"article-title":"New classification system for pediatric glaucoma: implications for clinical care and a research registry.","journal-title":"Curr Opin Ophthalmol","doi-asserted-by":"publisher"},{"DOI":"10.1111/ceo.14500","key":"eoi260020r3","year":"2025","issue":"3","author":"Kolovos","volume":"53","first-page":"246","unstructured":null,"article-title":"Progress in translating glaucoma genetics into the clinic: a review.","journal-title":"Clin Exp 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They accounted for 13.5% (95% CI, 6.7%–25.3%) of JOAG probands with a genetic diagnosis in ANZRAG (second only to *MYOC* at 53.8%), and 9.5% (95% CI, 2.7%–28.9%) in the MEE cohort. Systemic features were mild and uncommon (10.5% of participants).","limitations":"- Small sample (n=20 from 10 families) yields wide confidence intervals, limiting precision of prevalence estimates.\n- Retrospective design with potential ascertainment bias toward more severely affected individuals.\n- Study of a rare condition where individual variants explain only a subset of cases, restricting generalizability.","practice_takeaway":"Consider routine copy-number variant (CNV) analysis in patients with JOAG, as *FOXC1* duplications are an underrecognized but highly penetrant monogenic cause. Unlike classic *FOXC1* deletions, these duplications may present with minimal systemic features, making genetic testing the key diagnostic trigger."}},{"doi":"10.1016/j.ophtha.2026.04.026","pmid":"42069259","title":"Comparison of Glaucoma Surgery Incidence and Outcomes in Pigmentary and Primary Open-Angle Glaucoma","journal_title":"Ophthalmology","journal_issn":"0161-6420","published_at":"2026-04-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.ophtha.2026.04.026","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-26T13:44:40.761Z","updated_at":"2026-07-26T13:44:40.761Z","tags":[{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"condition","value":"Pigmentary Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"modality","value":"Cyclophotocoagulation","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"modality","value":"Laser Trabeculoplasty","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"modality","value":"Minimally Invasive Glaucoma Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"modality","value":"Trabeculectomy","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"modality","value":"Tube Shunt Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"sample_size","value":"n=2595946","value_numeric":2595946},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"warning","value":"Failure definitions for LTP, MIGS, and trabeculectomy are not specified in the abstract; thresholds used may affect interpretation of failure rates.","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"warning","value":"Racial/ethnic subgroup analyses within PG are based on smaller numbers, so estimates for non-White subgroups carry wider uncertainty.","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"warning","value":"Sample size reported as the combined total of both cohorts (49,171 PG + 2,546,775 POAG = 2,595,946 eyes); the unit of analysis is eyes, not patients, which may introduce within-patient correlation.","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.04.026","tag_type":"warning","value":"The DOI publication date (2026-04-30) is in the future relative to standard indexing timelines but within scope given today's date of July 26, 2026.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used the IRIS® Registry (2013–2025) to compare surgery incidence and outcomes in 49,171 eyes with pigmentary glaucoma (PG) vs. 2,546,775 eyes with primary open-angle glaucoma (POAG), including trabeculectomy, tube shunt, MIGS, laser trabeculoplasty (LTP), and cyclophotocoagulation.","key_result":"PG eyes had higher 4-year cumulative procedure incidence than POAG (22.2% vs. 19.5%, P<0.001), more filtering/cyclodestructive surgeries (12.8% vs. 10.3%), and higher 1-year failure rates after both LTP (60.7% vs. 58.2%) and MIGS (66.7% vs. 60.8%). Combined trabeculectomy-cataract surgery failed more often than stand-alone trabeculectomy in both groups (PG: 56.4% vs. 33.5%; POAG: 49.1% vs. 34.9%).","limitations":"Retrospective registry design with diagnosis-code-based identification may misclassify cases; racial/ethnic subgroups in PG are small, limiting generalizability; long-term outcomes beyond the study window are unknown.","practice_takeaway":"Patients with PG need closer follow-up and earlier intervention planning, as they undergo surgery more often and have higher failure rates after LTP and MIGS than POAG patients. Non-Hispanic Black, Asian, and Hispanic patients with PG are disproportionately diagnosed at severe stages, so these groups warrant especially vigilant monitoring."}},{"doi":"10.1016/j.ajo.2026.03.024","pmid":"41912062","title":"Optic Disc Microvasculature Reduction and Visual Field Progression in Advanced Primary Open-Angle Glaucoma","journal_title":"American Journal of Ophthalmology","journal_issn":"0002-9394","published_at":"2026-03-29T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajo.2026.03.024","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:44.214Z","updated_at":"2026-05-08T13:23:44.214Z","tags":[{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"condition","value":"Primary Open-Angle Glaucoma","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"modality","value":"Optical Coherence Tomography Angiography","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"sample_size","value":"n=345","value_numeric":345},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"study_design","value":"Retrospective Case Series","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"warning","value":"ODVD was restricted to the temporal optic disc quadrant; it is unclear whether full-disc or other quadrant analyses were performed, which may affect generalizability of the metric.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"warning","value":"The 'binary ODVD reduction' definition is not fully detailed in the abstract — the specific threshold used for classifying reduction as binary is not reported here, limiting direct clinical application.","value_numeric":null},{"paper_doi":"10.1016/j.ajo.2026.03.024","tag_type":"warning","value":"The paper is dated 2026-03-29, which is within the plausible range given today's date of May 8, 2026, but it has not yet been cited widely — findings should be interpreted as early evidence pending independent replication.","value_numeric":null}],"summaries":{"what_studied":"This retrospective case series evaluated whether the rate of optic disc vessel density (ODVD) reduction on OCTA is associated with visual field (VF) progression in 345 POAG patients stratified by disease severity (early, moderate, advanced) over ≥3 years with ≥5 OCT/OCTA scans.","key_result":"ODVD reduction was linked to VF progression across all severity groups; the association was strongest in advanced glaucoma (OR = 1.48 for ODVD change rate; OR = 14.0 for binary ODVD reduction), and Cox models confirmed significant hazard ratios in both early (HR = 4.32) and moderate-to-advanced disease (HR = 2.83) for binary ODVD reduction (all P < .001).","limitations":"Retrospective design limits causal inference. Single-center study with predefined severity thresholds may reduce generalizability. ODVD was measured only in the temporal optic disc, potentially missing global microvascular changes.","practice_takeaway":"Serial OCTA monitoring of optic disc vessel density can serve as a useful marker for glaucoma progression across all severity stages — including advanced disease where structural OCT is often less informative. 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Patients in the lowest wealth quartile had 5–9-fold lower odds of achieving the IOP target than higher quartiles; LTFU odds were 61% lower in the wealthiest vs least-wealthy (OR 0.39; 95% CI 0.18–0.84; P=.02). Rural residence increased LTFU risk (OR 5.54; 95% CI 1.13–27.08). Having children in the household was associated with a 4–mm Hg greater IOP reduction (95% CI 0.99–7.13; P=.01).","limitations":"Retrospective cohort design. Thirty percent of the cohort lacked a 12–18 month follow-up visit, which may bias outcome estimates.","practice_takeaway":"For newly diagnosed POAG, lower community wealth and rural residence were linked to worse quality metrics (lower odds of meeting IOP targets and higher LTFU). Clinicians should assess financial circumstances and support access to IOP-lowering care and guideline-concordant follow-up."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Primary Open-Angle Glaucoma"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Primary Open-Angle Glaucoma"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Primary Open-Angle Glaucoma"}}}]]

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