Current Opinion In Ophthalmology[JOURNAL]
Sun
200 papers
Promising therapeutic targets for neuroprotection in retinal disease.
Pan WW, Wubben TJ, Zacks DN
Curr Opin Ophthalmol · 2025 May · PMID 39927457 · Publisher ↗
PURPOSE OF REVIEW: Neurodegeneration is a common endpoint of various blinding retinal diseases. Yet, despite exciting advances in disease treatment, there continues to exist a critical need for the development of neuropr...
PURPOSE OF REVIEW: Neurodegeneration is a common endpoint of various blinding retinal diseases. Yet, despite exciting advances in disease treatment, there continues to exist a critical need for the development of neuroprotective strategies to prevent retinal cell death. Here, we summarize the recent advances in neuroprotective strategies. RECENT FINDINGS: From laboratory deciphering of the mechanisms involved in disease, many novel neuroprotective strategies have emerged and are currently under investigation for the treatment of various retinal and ocular diseases such as inherited retinal degeneration, retinal detachment, diabetic retinopathy, age-related macular degeneration, macular telangiectasia type 2, and glaucoma. These strategies include gene therapies, Fas inhibition, and targeting inflammatory, metabolic and reduction-oxidation abnormalities. Interestingly, investigation of several treatments across different diseases suggests shared neuroprotection mechanisms that can be targeted regardless of the particular disease. SUMMARY: Retinal neuroprotection can improve treatment of different retinal diseases. Fortunately, the current landscape, with a plethora of novel neuroprotective therapies, portends a better future for patients.
Reducing rates of endophthalmitis from intravitreal injections - strategies and areas of controversy.
Durrani AF, Chaudhary V, Garg SJ
Curr Opin Ophthalmol · 2025 May · PMID 39917844 · Publisher ↗
PURPOSE OF REVIEW: Post-injection endophthalmitis (PIE) is the most concerning complication that accompanies intravitreal injections. This review discusses the recent literature in endophthalmitis prophylaxis including t...
PURPOSE OF REVIEW: Post-injection endophthalmitis (PIE) is the most concerning complication that accompanies intravitreal injections. This review discusses the recent literature in endophthalmitis prophylaxis including types of antisepsis, the use of topical antibiotics, methods of anesthesia, masking, and office-based versus operating room-based injections. RECENT FINDINGS: Povidone iodine (PI) remains the gold standard for PIE prophylaxis. Chlorhexidine gluconate (CHG) is an alternative antiseptic agent utilized in other areas of medicine with similar broad spectrum antibacterial activity. Recent clinical trials have demonstrated that the rate of endophthalmitis is similar with CHG prophylaxis compared to PI prophylaxis while offering improved patient comfort at a similar cost. Routine use of topical antibiotics should be avoided as they do not appear to reduce endophthalmitis risk and may promote bacterial resistance. All methods of anesthesia appear to be acceptable. In-office injections are not associated with an increased rate of endophthalmitis compared to operating room injections. SUMMARY: The rate of post-injection endophthalmitis is extremely low due to a myriad of measures employed by retina specialists. Topical antisepsis is the most important tool to combat post-injection endophthalmitis. CHG is emerging as an alternative to PI due to its efficacy and enhanced patient comfort.
Recent advances in pharmacological treatments of proliferative vitreoretinopathy.
Sanchez-Suarez J, Kim YJ, Miller WP … +1 more , Kim LA
Curr Opin Ophthalmol · 2025 May · PMID 39868554 · Publisher ↗
PURPOSE OF REVIEW: Proliferative vitreoretinopathy (PVR) is a severe complication of retinal detachment and trauma, posing significant challenges to surgical success and visual prognosis. Despite advancements in vitreore...
PURPOSE OF REVIEW: Proliferative vitreoretinopathy (PVR) is a severe complication of retinal detachment and trauma, posing significant challenges to surgical success and visual prognosis. Despite advancements in vitreoretinal surgery, PVR incidence remains unchanged, this review presents a synthesis of the principal clinical and preclinical research findings from recent years. RECENT FINDINGS: Recent research has focused on anti-inflammatory, antiproliferative, and antifibrotic agents. Corticosteroids, such as triamcinolone and dexamethasone, show promise in reducing inflammation but have inconsistent results. Methotrexate and mitomycin C demonstrate efficacy in preclinical and select clinical scenarios. Anti-vascular endothelial growth factor agents and immunotherapies, like infliximab, have shown limited clinical benefits despite promising preclinical data. Novel approaches, including CB2 receptor agonists, exosome-based drug delivery, and nuclear factor kappa B pathway inhibitors, are gaining traction. Additionally, RNA-based and multitargeted therapies highlight the importance of addressing inflammation, fibrosis, and proliferation simultaneously. SUMMARY: Effective management of PVR requires multifaceted therapies targeting its complex pathogenesis. While current treatments are limited, ongoing research in precision drug delivery and combination therapies offers hope for improved outcomes. Future strategies should focus on translating promising preclinical findings into robust clinical applications.
New treatments for glaucoma.
Mai AP, Ferguson TJ, Radcliffe N
Curr Opin Ophthalmol · 2025 Mar · PMID 39787001 · Publisher ↗
PURPOSE OF REVIEW: This review highlights new Federal Drug Administration (FDA) approved glaucoma treatments to familiarize providers with immediately available options. RECENT FINDINGS: New FDA-approved treatments inclu...
PURPOSE OF REVIEW: This review highlights new Federal Drug Administration (FDA) approved glaucoma treatments to familiarize providers with immediately available options. RECENT FINDINGS: New FDA-approved treatments include the bimatoprost implant, travoprost implant, direct selective laser trabeculoplasty (DSLT), and ocular pressure adjusting pump. The bimatoprost implant is approved for a single administration with effects lasting for about 1 year, as opposed to the nearly 3-year effect for the travoprost implant. Meanwhile, the DSLT lowers intraocular pressure (IOP) by applying a laser through the limbus within 2 s. Lastly, the ocular pressure adjusting pump is a noninvasive, nonpharmaceutical device that lowers IOP with negative pressure within a pair of goggles. Not only do these modalities lower IOP, but they also improve the patient experience by reducing drop burden, decreasing laser duration, or lowering side effects. Although the list of therapies still in development is extensive, another two promising devices under review include a supraciliary stent and an adjustable aqueous tube shunt. SUMMARY: Glaucoma treatment has considerably evolved over the last decade with the introduction of novel topical medications, minimally invasive glaucoma surgeries, sustained-release drug delivery systems, and wearable devices. This expansion in glaucoma has enabled more patient-centric decision-making regarding treatment.
Is minimally invasive glaucoma surgery killing trabeculectomies?
Loon SC, Ang BCH, White A
Curr Opin Ophthalmol · 2025 Mar · PMID 39774269 · Publisher ↗
PURPOSE OF REVIEW: The introduction of minimally invasive glaucoma surgery (MIGS) has changed the surgical landscape of glaucoma surgery. For more than four decades, the most commonly performed glaucoma surgery around th...
PURPOSE OF REVIEW: The introduction of minimally invasive glaucoma surgery (MIGS) has changed the surgical landscape of glaucoma surgery. For more than four decades, the most commonly performed glaucoma surgery around the world has been the trabeculectomy. This article examines whether trabeculectomy is still the predominant procedure in glaucoma today, in the context of rapidly emerging MIGS devices and procedures. RECENT FINDINGS: There is a growing trend of mild to moderate glaucoma cases undergoing MIGS procedures instead of trabeculectomy. Glaucoma drainage device implantation may also have taken away a significant share of the filtering surgery performed for more severe glaucoma. In addition, the availability and economics of implants has an influence on the prevalence of trabeculectomy. SUMMARY: Currently, trabeculectomy surgery is still the most common glaucoma surgery performed around the world. However, the proportion of glaucoma surgeries undergoing MIGS is increasing rapidly.
Clinical pearls from glaucoma clinical trials: a case-based approach.
Barna LE, Chung IY, Shen LQ
Curr Opin Ophthalmol · 2025 Mar · PMID 39774259 · Publisher ↗
Abstract loading — click title to view on PubMed.
Scleral fixated intraocular lens techniques for the vitreoretinal surgeon: an update.
Khan MA
Curr Opin Ophthalmol · 2025 May · PMID 39705213 · Publisher ↗
PURPOSE OF REVIEW: To describe recent evidence regarding surgical techniques for secondary scleral fixation of intraocular lenses (IOLs), with attention to information most relevant to the surgical practice of vitreoreti...
PURPOSE OF REVIEW: To describe recent evidence regarding surgical techniques for secondary scleral fixation of intraocular lenses (IOLs), with attention to information most relevant to the surgical practice of vitreoretinal surgeons. RECENT FINDINGS: Recent studies have reported favorable outcomes in patients treated with scleral fixation of IOLs using Gore-Tex suture and flanged intrascleral haptic fixation (ISHF). ISHF can be achieved using trocar-cannulas or double needle-based techniques. Recent data has focused on refractive outcomes data, as well as postoperative complications related to specific IOL choices, including haptic breakage, rotation/ tilt, and opacification. Studies directly comparing Gore-Tex sutured and ISHF techniques offer additional insights. SUMMARY: Favorable refractive and surgical outcomes can be achieved using both sutured and sutureless scleral fixation techniques. These techniques can be combined effectively with pars plana vitrectomy (PPV) and are thus well suited for the skillset of a vitreoretinal surgeon. Future studies on iris-based fixation techniques and IOL types not yet available in the United States will be of interest. As these techniques are more widely used, prospective data as well as longer term outcomes will continue to clarify their risk/benefit profile.
Implications of myopia in diagnosis and screening of open angle glaucoma.
Iwase A, Araie M
Curr Opin Ophthalmol · 2025 Mar · PMID 39705201 · Publisher ↗
PURPOSE OF REVIEW: Rapid increase in the prevalence of myopia has been documented worldwide. Myopia, especially high myopia, is not only an important risk factor for having open angle glaucoma (OAG), but also has a stron...
PURPOSE OF REVIEW: Rapid increase in the prevalence of myopia has been documented worldwide. Myopia, especially high myopia, is not only an important risk factor for having open angle glaucoma (OAG), but also has a strong linking with the progression of OAG. Since myopic axial length (AXL) elongation is associated with nonglaucomatous optic nerve head (ONH) and visual field abnormalities, myopia poses a challenge in differential diagnosis of OAG. This review provides an overview of literature studying relationships between myopic AXL-elongation and diagnosis and prognosis of OAG, and functional and structural changes in the eye. RECENT FINDINGS: Studies using optical coherence tomography (OCT), OCT-angiography, those using standard automated perimetry (SAP), other perimetric or electrophysiological methods showed dose-dependent effects of myopic AXL elongation on the structural changes in the ONH and parapapillary tissues, and functional abnormalities of an eye. Large cohort studies showed approximately one quarter of eyes with nonpathologic high myopia were complicated with various patterns of visual field defects including glaucoma-like ones. SUMMARY: Findings of cross-sectional and longitudinal studies obtained using various fundus imaging devices must be integrated to perimetric results to improve differential diagnosis of OAG in myopic eyes, in which artificial intelligence technology may be useful.
Minimally invasive glaucoma surgery in angle closure.
Chan NS, Sng CCA
Curr Opin Ophthalmol · 2025 Mar · PMID 39693263 · Publisher ↗
PURPOSE OF REVIEW: This review discusses the evidence on the efficacy, safety and role of minimally invasive glaucoma surgery (MIGS) in eyes with angle closure glaucoma. While cataract surgery remains the most establishe...
PURPOSE OF REVIEW: This review discusses the evidence on the efficacy, safety and role of minimally invasive glaucoma surgery (MIGS) in eyes with angle closure glaucoma. While cataract surgery remains the most established surgical treatment for primary angle closure glaucoma (PACG), the intraocular pressure (IOP) may remain elevated after cataract surgery despite open angles due to trabecular meshwork damage from chronic iridotrabecular contact. RECENT FINDINGS: There is emerging evidence that combining cataract surgery with MIGS in eyes with PACG, though an off-label indication for some MIGS devices, can achieve greater IOP and glaucoma medication reduction than cataract surgery alone. SUMMARY: Trabecular bypass MIGS procedures and less destructive forms of ciliary body treatment have been shown to be effective in PACG and are safer alternatives to traditional incisional surgeries. Evidence for the use of subconjunctival MIGS and suprachoroidal MIGS in angle closure eyes is lacking at present, and further investigation is indicated.
Global prevalence of cataract surgery.
Hashemi H, Fayaz F, Hashemi A … +1 more , Khabazkhoob M
Curr Opin Ophthalmol · 2025 Jan · PMID 39638415 · Publisher ↗
PURPOSE OF REVIEW: The objective of this review article is to ascertain the global distribution of cataract surgery and evaluate the extent of its coverage in recent years. RECENT FINDINGS: The cataract surgical rate (CS...
PURPOSE OF REVIEW: The objective of this review article is to ascertain the global distribution of cataract surgery and evaluate the extent of its coverage in recent years. RECENT FINDINGS: The cataract surgical rate (CSR) has been reported from 36 to 12 800 (per million population) across different countries. The average cataract surgical coverage (CSC) in the majority of countries was around 50% or lower. Additionally, in many countries, the efficient CSC (eCSC) deviates from the CSC, emphasizing the importance of attention to the quality of surgical procedures. Socioeconomic status and access to health services are key determinants in the distribution of cataract surgery. This procedure is more prevalent among older individuals, with a higher incidence among men and private insurances tend to cover a larger portion of cataract surgeries. The pandemic of COVID-19 has had a detrimental effect on cataract surgery rates in numerous countries. SUMMARY: The rate of cataract surgery and its extent of coverage in certain countries is inadequate. The primary factor influencing the quantity and coverage of cataract surgeries is the economic status of the countries. Additionally, government support through insurance and the provision of appropriate healthcare services can contribute to an increase in cataract surgeries.
Update on intraocular lens formulas.
Raimundo M, Findl O
Curr Opin Ophthalmol · 2025 Jan · PMID 39638414 · Publisher ↗
PURPOSE OF REVIEW: This review aims to discuss recent advances in intraocular lens (IOL) power calculation, including newly introduced formulas, classification updates, comparative analyses between formulas, and emerging...
PURPOSE OF REVIEW: This review aims to discuss recent advances in intraocular lens (IOL) power calculation, including newly introduced formulas, classification updates, comparative analyses between formulas, and emerging trends in the field. RECENT FINDINGS: A significant number of modern IOL power calculation formulas have become available, incorporating both established and novel concepts such as artificial intelligence and ray tracing. A revised classification system has been introduced, reflecting the underlying principles of each formula. Recent comparative studies demonstrate the excellent refractive outcomes achievable with modern formulas. Emerging trends, such as the use of sum-of-segments axial length and the incorporation of measured posterior corneal data, hold promise for refining predictions in cases of extreme axial lengths and nonphysiological corneas, respectively. Advances in optimization and analytical methods also have the potential to further enhance refractive results. SUMMARY: The field of IOL power calculation is continually evolving through iterative improvements in formula design, driven by new technologies, advanced instrumentation, and innovative analytical approaches. These advancements enable excellent refractive outcomes, even in atypical eyes.
The global burden of blindness.
Lee BJ, Afshari NA
Curr Opin Ophthalmol · 2025 Jan · PMID 39638413 · Publisher ↗
Abstract loading — click title to view on PubMed.
Artificial intelligence in ophthalmology.
Khossravi AS, Chen Q, Adelman RA
Curr Opin Ophthalmol · 2025 Jan · PMID 39607311 · Publisher ↗
PURPOSE OF REVIEW: To review role of artificial intelligence in medicine. RECENT FINDINGS: Artificial intelligence is continuing to revolutionize access, diagnosis, personalization of medicine, and treatment in healthcar...
PURPOSE OF REVIEW: To review role of artificial intelligence in medicine. RECENT FINDINGS: Artificial intelligence is continuing to revolutionize access, diagnosis, personalization of medicine, and treatment in healthcare. As a matter of fact, artificial intelligence contributed to the research that resulted in 2024 Nobel Prizes in physics, chemistry, and economics. We are only at the tip of the iceberg in utilizing the abilities of artificial intelligence in medicine to improve accuracy of diagnoses and to enhance patient outcomes. Artificial intelligence has allowed better image analysis, prediction of progression of disease, personalized treatment plans, incorporations of genomics, and improved efficiency in care and follow-up utilizing home monitoring. In ocular health diagnosis and treatment of diabetic retinopathy, macular degeneration, glaucoma, corneal infections, and ectasia are only a few examples of how the power of artificial intelligence has been harnessed. Even though there are still challenges that need more work in the areas of patient privacy, Health Insurance Portability and Accountability Act (HIPAA) compliance, reliability, and development of regulatory frameworks, artificial intelligence has revolutionized and will continue to revolutionize medicine. SUMMARY: Artificial intelligence is enhancing medical diagnosis and treatment, as well as access and prevention. Ocular imaging, visual outcome, optics, intraocular pressure, and data points will continue to see growth it the field of artificial intelligence.
The effect of cataract surgery on lowering intraocular pressure.
Shah YS, Garg AK, Ramulu PY
Curr Opin Ophthalmol · 2025 Jan · PMID 39601279 · Publisher ↗
PURPOSE OF REVIEW: To review the literature evaluating the effectiveness of cataract surgery alone and cataract surgery in combination with other procedures and surgeries on intraocular pressure (IOP) in patients with oc...
PURPOSE OF REVIEW: To review the literature evaluating the effectiveness of cataract surgery alone and cataract surgery in combination with other procedures and surgeries on intraocular pressure (IOP) in patients with ocular hypertension and glaucoma. RECENT FINDINGS: Recent studies of large trials have shown the IOP-lowering effect of cataract surgery and the beneficial effect of minimally invasive glaucoma surgery (MIGS). More studies are being published on when to use cataract surgery alone, with MIGS, or with traditional glaucoma surgeries for both primary open angle glaucoma and primary angle closure glaucoma. SUMMARY: Patients with ocular hypertension and visually significant cataracts would benefit from cataract surgery alone to lower intraocular pressure. Patients with mild to moderate glaucoma would likely benefit from cataract surgery and MIGS to achieve a lower IOP. Patients with more advanced glaucoma would benefit from cataract surgery combined with a traditional incisional glaucoma surgery. Clear lens extraction can be used in patients with primary angle closure and early primary angle closure glaucoma. In patients with more advanced disease, phacoemulsification and another glaucoma surgery is likely to be required to achieve IOP control. MIGS are starting to be used in angle closure glaucoma, although more research needs to be done to define its role.
A comprehensive update on over the counter artificial tears.
Simon L, Murillo BA, Sabater AL
Curr Opin Ophthalmol · 2025 Jan · PMID 39513931 · Publisher ↗
PURPOSE OF REVIEW: Artificial tears play a critical role in the management of dry eye disease (DED), providing patient symptomatic relief and improving ocular surface health. Its clinical importance has driven pharmaceut...
PURPOSE OF REVIEW: Artificial tears play a critical role in the management of dry eye disease (DED), providing patient symptomatic relief and improving ocular surface health. Its clinical importance has driven pharmaceutical innovation in terms of its formula and ingredients. The following article is an overview of the artificial tear products on the market. RECENT FINDINGS: The artificial tears on the market vary in terms of their active ingredients, inactive ingredients, preservatives, and formulation. The particular chemical composition of ingredients and formulation plays a clinical role in treating ocular pathology. Conversely, certain ingredients can cause more ocular damage than other ingredients. SUMMARY: Upon review of the artificial tears on the market, the authors conclude that clinicians should consider the products' composition when designating a treatment for DED. Different artificial tear composition may benefit specific causes of DED such as evaporative, aqueous-deficient, glaucoma, ocular surface tumors, corneal ulcers, and viral conjunctivitis.
Challenges and outcomes of cataract surgery after vitrectomy.
Lee BJ, Jun JH, Afshari NA
Curr Opin Ophthalmol · 2025 Jan · PMID 39513929 · Publisher ↗
PURPOSE OF REVIEW: This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management. RECENT FINDINGS: Cataract f...
PURPOSE OF REVIEW: This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management. RECENT FINDINGS: Cataract formation remains the primary complication post-PPV, affecting approximately 80-100% of patients within two years. Nuclear sclerotic cataracts are most common, occurring in 60-100% of patients over 50, followed by posterior subcapsular cataracts (4-34%), which primarily affect younger and diabetic patients. PPV disrupts the normal oxygen gradient in the vitreous, resulting in a more uniform oxygen distribution and accelerating cataract formation.Post-PPV eyes present unique surgical challenges due to anatomical alterations, including zonular instability and capsular changes characterized by increased fragility, the potential for tears, and altered elasticity. Newer intraocular lens power calculations show promise, but unexpected refractive outcomes may occur. The choice between combined phacovitrectomy and sequential surgeries remains debated, with patient-specific factors guiding the approach. Visual outcomes vary depending on preexisting vitreoretinal pathologies and baseline vision before PPV. Further randomized controlled trials are needed to establish treatment guidelines and improve predictive models. SUMMARY: Post-PPV cataract surgery presents unique challenges, including anatomical alterations and an increased risk of capsular complications. These necessitate careful consideration of the surgical approach and highlight the need for further research to optimize outcomes and establish treatment guidelines.
Cataract surgery combined with glaucoma surgery.
Torbey J, Mansouri K
Curr Opin Ophthalmol · 2025 Jan · PMID 39508422 · Publisher ↗
PURPOSE OF REVIEW: This review evaluates the surgical management of glaucoma in patients undergoing cataract surgery. Combining both procedures present challenges in balancing intraocular pressure (IOP) control, minimizi...
PURPOSE OF REVIEW: This review evaluates the surgical management of glaucoma in patients undergoing cataract surgery. Combining both procedures present challenges in balancing intraocular pressure (IOP) control, minimizing postoperative complications, and achieving optimal refractive outcomes. RECENT FINDINGS: Recent studies highlight the effectiveness of combined glaucoma and cataract surgeries, with traditional filtering surgeries and MIGS showing significant IOP reduction. The abundance of long-term studies shows that MIGS can offer an effective and safer alternative when carefully tailored to meet the specific needs of each patient. SUMMARY: Combining glaucoma and cataract surgery is a promising approach for patients with coexisting conditions. While traditional surgeries offer robust IOP reduction, MIGS procedures offer better safety profiles with fewer complications and more predictable refractive results. Surgeons must carefully consider the timing and choice of procedures, with further research required to develop standardized treatment algorithms.
Overlap syndrome: a case series and literature review of concurrent pigment dispersion and pseudoexfoliation syndromes.
Shah P, Soundararajan S, Fleischman D
Curr Opin Ophthalmol · 2025 Mar · PMID 39508410 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to present two cases of overlap syndrome, or concurrent pigment dispersion syndrome and pseudoexfoliation syndrome. The summary of existing literature highlights the impor...
PURPOSE OF REVIEW: The purpose of this review is to present two cases of overlap syndrome, or concurrent pigment dispersion syndrome and pseudoexfoliation syndrome. The summary of existing literature highlights the importance of accurate diagnosis and potential treatment options of overlap syndrome. RECENT FINDINGS: The cases describe two patients with overlap syndrome and resulting progressive glaucoma. The condition tends to present after age 50 years old, with presence of both pseudoexfoliative material and pigment dispersion signs. The pigment dispersion syndrome may be quiescent at the time of pseudoexfoliation onset and may have gone undiagnosed. This form of glaucoma poses challenges in controlling intraocular pressure and may progress rapidly, often requiring surgical intervention. SUMMARY: This paper reviews the common examination findings of pigment dispersion syndrome and pseudoexfoliation, which may aid clinicians in the diagnosis of the rare condition, overlap syndrome. The connection between the two conditions remains unclear, though studies of possible genetic associations are underway. The two-hit theory, or initial damage to the trabecular meshwork increasing susceptibility to future damage, is plausible given the severe nature of the condition. Though definitive conclusions regarding treatment strategies and outcomes of overlap syndrome are lacking, increased awareness, diagnosis, and study of the condition may help guide the management of overlap syndrome.
Diagnosing glaucoma progression with optical coherence tomography.
Palmer LD, Thompson AC, Asrani S
Curr Opin Ophthalmol · 2025 Mar · PMID 39508405 · Publisher ↗
PURPOSE OF REVIEW: Optical coherence tomography (OCT) is a widely used tool to diagnose and monitor glaucoma by objectively measuring the ganglion cell layer and the retinal nerve fiber layer (RNFL) thickness. The presen...
PURPOSE OF REVIEW: Optical coherence tomography (OCT) is a widely used tool to diagnose and monitor glaucoma by objectively measuring the ganglion cell layer and the retinal nerve fiber layer (RNFL) thickness. The presence of RNFL thinning raises suspicion for glaucoma progression. Therefore, this review aims to discuss current approaches to using OCT for detecting glaucomatous change, limitations, and recent advancements. RECENT FINDINGS: Previously established approaches to determining glaucomatous progression on OCT include quantitative and qualitative methods. The most common quantitative methods include event-based and trend-based analysis. Decreasing RNFL thickness or loss of the ganglion cell layer are indicative of glaucomatous changes. However, interpretation of OCT scans is strongly impacted by artifacts, which can be because of epiretinal membrane or posterior vitreous detachment. Race and aging also may impact interpretation of RNFL progression. More recent research focuses on loss of the RNFL because of the effects of systemic conditions. Given the limitations in the current approaches, recent advancements indicate a promising role for artificial intelligence in determining true glaucomatous progression. SUMMARY: This review highlights current approaches to identifying glaucoma progression on OCT, limitations to these approaches, and the potential role for artificial intelligence.
Reporting outcomes of minimally invasive glaucoma surgery.
Gutkind NE, Gedde SJ
Curr Opin Ophthalmol · 2025 Mar · PMID 39470463 · Publisher ↗
PURPOSE OF REVIEW: This review presents guidelines for designing studies and reporting efficacy and safety outcomes in minimally invasive glaucoma surgery (MIGS) research. RECENT FINDINGS: Adherence to reporting guidelin...
PURPOSE OF REVIEW: This review presents guidelines for designing studies and reporting efficacy and safety outcomes in minimally invasive glaucoma surgery (MIGS) research. RECENT FINDINGS: Adherence to reporting guidelines in MIGS studies is crucial for providers and patients to appraise surgical options. Recent guidelines have outlined appropriate methodology, efficacy outcomes, and safety reporting, so that study results are presented in an interpretable and uniform manner. SUMMARY: MIGS are changing the glaucoma treatment paradigm by offering safer, less invasive alternatives to traditional filtering surgery. However, inconsistent reporting of outcomes in MIGS trials hampers comparison and clinical decision-making. Recent guidelines have aimed to highlight appropriate methodology and encourage standardization in reporting outcomes to improve the quality of MIGS literature. Key considerations include defining baseline intraocular pressure, reporting standardized demographic data, using consistent endpoints, presenting standardized figures, evaluating medication use, and documenting adverse events. By adhering to these guidelines, MIGS trials can offer clearer insights into surgical outcomes, aiding both surgeons and patients in treatment decisions.
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