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Clinical Advances and Challenges in Glaucoma and Glaucoma Surgery
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Clinical Advances and Challenges in Glaucoma and Glaucoma Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 22 November 2024 | Viewed by 1431

Special Issue Editor

Dr. Barbara Wirostko

E-Mail Website
Guest Editor
John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT 84132, USA
Interests: ophthalmology; glaucoma; exfoliation syndrome; iCare Home IOP monitoring; clinical trials; drug and device development

Special Issue Information

Dear Colleagues,

The progress in glaucoma over the last decade has been remarkable. From emerging glaucoma genetic insights into the disease pathology to the development of new optimized minimally invasive glaucoma (MIGs) procedures, we now have numerous opportunities to better understand this disease as well as surgically intervene to effectively lower IOP. Moreover, the new development of and insight into potential neuroprotective compounds such as nicotinamide in clinical studies make us hopeful that we may have a handle and opportunity for neuro preservation and even neuro regeneration of the optic nerve in the future. An understanding of relevant pathologic mechanisms has expanded steadily, especially in terms of the value of home IOP monitoring, as well as new therapies that have never existed. These are being developed and implemented in ongoing clinical trials including an approach for lowering episcleral venous pressure (EVP). For this Special Issue, we welcome authors to submit papers on the clinical advance of MIGs, neuroprotective and optic nerve perfusion innovations, stem cell and regenerative developments, as well as clinical cases, surgical insights and diagnosis and treatment advancements that can help move our field forward.

Dr. Barbara Wirostko
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ophthalmology
  • glaucoma
  • glaucoma surgery
  • exfoliation syndrome
  • iCare Home IOP monitoring
  • clinical trials
  • drug and device development
  • MIGs procedures
  • EVP
  • neuroprotection

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Published Papers (2 papers)

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Research

10 pages, 1069 KiB  
Article
Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases
by Craig J. Chaya, Leon W. Herndon, Jorge Lince, Nathan Radcliffe, Ehsan Sadri, Arkadiy Yadgarov and Tsontcho Ianchulev
J. Clin. Med. 2024, 13(16), 4593; https://doi.org/10.3390/jcm13164593 - 6 Aug 2024
Viewed by 363
Abstract
Background: To report the surgical safety of reinforced bio-interventional cyclodialysis with scleral allograft reinforcement. Methods: This was a consecutive case series of 243 eyes with open-angle glaucoma who underwent a bio-scaffolded cyclodialysis (BSC) procedure for uveoscleral outflow enhancement using allogeneic bio-spacers to maintain [...] Read more.
Background: To report the surgical safety of reinforced bio-interventional cyclodialysis with scleral allograft reinforcement. Methods: This was a consecutive case series of 243 eyes with open-angle glaucoma who underwent a bio-scaffolded cyclodialysis (BSC) procedure for uveoscleral outflow enhancement using allogeneic bio-spacers to maintain patency of the internal filtration conduit. Results: 79% of the eyes underwent concomitant phacoemulsification cataract surgery prior to BSC intervention, while the remaining eyes underwent stand-alone BSC surgery. All patients had a postoperative surgical safety period of at least 30 days. There were no sight-threatening or serious ocular adverse events. There was one case of prolonged iritis beyond 30 days, which resolved with topical treatment. Two cases (0.8%) of intraoperative and five (2%) of postoperative non-sight-threatening hyphema were without clinical sequelae, which resolved with conservative management. There were 11 cases of IOP elevation and one case of numeric hypotony without maculopathy, which resolved within the study period. The rate of secondary surgical intervention for IOP control was low, and overall, IOP for the cohort improved in the postoperative period, with 78.6% of eyes achieving IOP ≤ 18 mmHg without an increase in medications. Conclusions: Allogeneic biotissue for cyclodialysis intervention demonstrates a biocompatible ocular profile as an implantable material for internal scleral reinforcement during uveoscleral outflow enhancement surgery. Full article
(This article belongs to the Special Issue Clinical Advances and Challenges in Glaucoma and Glaucoma Surgery)
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14 pages, 1650 KiB  
Article
Diagnostic Capability of OCTA-Derived Macular Biomarkers for Early to Moderate Primary Open Angle Glaucoma
by Alice Verticchio Vercellin, Alon Harris, Francesco Oddone, Carmela Carnevale, Brent A. Siesky, Julia Arciero, Brendan Fry, George Eckert, Paul A. Sidoti, Gal Antman, Denise Alabi, Janet C. Coleman-Belin and Louis R. Pasquale
J. Clin. Med. 2024, 13(14), 4190; https://doi.org/10.3390/jcm13144190 - 18 Jul 2024
Viewed by 648
Abstract
Background/Objectives: To investigate macular vascular biomarkers for the detection of primary open-angle glaucoma (POAG). Methods: A total of 56 POAG patients and 94 non-glaucomatous controls underwent optical coherence tomography angiography (OCTA) assessment of macular vessel density (VD) in the superficial (SCP), [...] Read more.
Background/Objectives: To investigate macular vascular biomarkers for the detection of primary open-angle glaucoma (POAG). Methods: A total of 56 POAG patients and 94 non-glaucomatous controls underwent optical coherence tomography angiography (OCTA) assessment of macular vessel density (VD) in the superficial (SCP), and deep (DCP) capillary plexus, foveal avascular zone (FAZ) area, perimeter, VD, choriocapillaris and outer retina flow area. POAG patients were classified for severity based on the Glaucoma Staging System 2 of Brusini. ANCOVA comparisons adjusted for age, sex, race, hypertension, diabetes, and areas under the receiver operating characteristic curves (AUCs) for POAG/control differentiation were compared using the DeLong method. Results: Global, hemispheric, and quadrant SCP VD was significantly lower in POAG patients in the whole image, parafovea, and perifovea (p < 0.001). No significant differences were found between POAG and controls for DCP VD, FAZ parameters, and the retinal and choriocapillaris flow area (p > 0.05). SCP VD in the whole image and perifovea were significantly lower in POAG patients in stage 2 than stage 0 (p < 0.001). The AUCs of SCP VD in the whole image (0.86) and perifovea (0.84) were significantly higher than the AUCs of all DCP VD (p < 0.05), FAZ parameters (p < 0.001), and retinal (p < 0.001) and choriocapillaris flow areas (p < 0.05). Whole image SCP VD was similar to the AUC of the global retinal nerve fiber layer (RNFL) (AUC = 0.89, p = 0.53) and ganglion cell complex (GCC) thickness (AUC = 0.83, p = 0.42). Conclusions: SCP VD is lower with increasing functional damage in POAG patients. The AUC for SCP VD was similar to RNFL and GCC using clinical diagnosis as the reference standard. Full article
(This article belongs to the Special Issue Clinical Advances and Challenges in Glaucoma and Glaucoma Surgery)
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