Search Results (4)

Background/Objectives: Trabeculotomy using the Tanito microhook (TMH) is a minimally invasive glaucoma surgery (MIGS) technique that effectively reduces intraocular pressure (IOP). The optimal incision extent for standalone TMH remains unclear. This study aimed to compare the surgical efficacy and safety of unilateral (120-degree) and bilateral (240-degree) incisions in standalone TMH for primary open-angle glaucoma or late-onset juvenile open-angle glaucoma in patients without a history of intraocular surgery. Methods: This retrospective study analyzed 81 eyes of 48 patients who underwent standalone TMH at Shimane University Hospital. Patients were categorized into unilateral (29 eyes) or bilateral (52 eyes) incision groups. The primary outcomes were IOP reduction and medication score changes over 12 months. Secondary outcomes included best-corrected visual acuity (BCVA), anterior chamber (AC) flare, corneal endothelial cell density (CECD), and postoperative complications, particularly hyphema, assessed using the Shimane University Postoperative Hyphema Scoring System (SU-RLC). Multivariate mixed-effects regression and Kaplan–Meier survival analyses were performed. Results: At 12 months, IOP reduction was comparable between the unilateral (23%) and bilateral (28%) groups (p = 0.29). The unilateral group had a significantly lower medication score at postoperative day 3 (p = 0.0057) and week 2 (p = 0.033). No significant differences were observed in BCVA, AC flare, CECD, or visual field mean deviation (MD). However, the bilateral group had significantly higher hyphema scores (p = 0.017), with more cases of layered hyphema. Conclusions: Unilateral standalone TMH achieved equivalent IOP and medication score reductions compared to bilateral incisions, with a lower risk of early postoperative hyphema. The unilateral approach may be preferable for faster visual recovery. Full article

Background/Objectives: Juvenile Open Angle Glaucoma (JOAG) is a condition that presents peculiar issues because it starts at a very early age and, in the end, causes substantial vision loss. This study aimed to analyze the age and gender distribution and treatment outcomes in JOAG patients. Methods: We carried out a retrospective study at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, from 2015 to 2022. We extracted data from the medical records. Visual acuity data were converted to the logarithm of the minimum angle resolution (LogMAR) for standardized analysis. The CARL ZEISS Humphrey 745i Field Analyzer/HFA II-i Visual Field Analyzer was used to perform visual field examinations under the 24-2 program SITA standard. Results: The study involved 45 JOAG patients (87 affected eyes) with a mean age of 26.91 years. Myopia was the prevailing trait (93%), and a family history of glaucoma was found in 51.1% of cases. Most of the patients presented with severe visual field defects in both eyes (right—57.1%, left—44.4%). Regarding visual acuity, we found that the majority of affected categories belonged to either mild or moderate in both eyes. Initial and final Intraocular pressure (IOP) measurements together showed a significant reduction (p < 0.001) and clearly demonstrated the need for IOP control. Surgical and non-surgical treatments significantly reduced IOP, with no gender or eye differences Conclusions: This research offers important data concerning JOAG demographics (age and gender), clinical picture, and treatment results. Though early-onset presents challenges, multidimensional therapeutic methods have great potential to get JOAG under control and maintain visual function. Additional research is needed to study the genetic causes of JOAG and assess the long-term treatment outcomes. Full article

Juvenile open angle glaucoma (JOAG), which is an uncommon form of primary open angle glaucoma, is a clinically and genetically heterogeneous disorder. We report on a family with a recessively inherited form of JOAG. The proband has a superior and an inferior never fiber layer thinning in both the eyes and the nasal visual field (VF) defects in the left eye, which are clinical findings consistent with glaucomatous optic neuropathy. Whole exome sequencing revealed two novel compound heterozygous variants [c.2966C>G, p.(Pro989Arg); c.5235T>G, p.(Asn1745Lys)] in latent transforming growth factor-beta-binding protein 2 (LTBP2) segregating with the phenotype. Both these variants are predicted to replace evolutionary conserved amino acids, have a pathogenic effect on the encode protein, and have very low frequencies in the control databases. Mutations in LTBP2 are known to cause the Weill-Marchesani syndrome and a Weill-Marchesani-like syndrome, which include glaucoma in their clinical presentation. However, to our knowledge, this is the first published case of a JOAG subject associated with recessively inherited variants of LTPB2 and, thus, expands the repertoire of the known genetic causes of JOAG and the phenotypic spectrum of LTBP2 alleles. Full article

MYOC encodes a secretary glycoprotein of 504 amino acids named myocilin. MYOC is the first gene to be linked to juvenile open-angle glaucoma (JOAG) and some forms of adult-onset primary open-angle glaucoma (POAG). The gene was identified as an up-regulated molecule in cultured trabecular meshwork (TM) cells after treatment with dexamethasone and was originally referred to as trabecular meshwork-inducible glucocorticoid response (TIGR). Elevated intraocular pressure (IOP), due to decreased aqueous outflow, is the strongest known risk factor for POAG. Increasing evidence showed that the modulation of the wild-type (wt) myocilin protein expression is not causative of glaucoma while some misfolded and self-assembly aggregates of mutated myocilin may be associated with POAG in related or unrelated populations. The etiology of the disease remains unclear. Consequently, a better understanding of the molecular mechanisms underlyingPOAG is required to obtain early diagnosis, avoid potential disease progression, and develop new therapeutic strategies. In the present study, we review and discuss the most relevant studies regarding structural characterizations, expressions, molecular interactions, putative functions of MYOC gene and/or its corresponding protein in POAG etiology. Full article