Risk Factors for Failure in Glaucoma Patients Undergoing Microshunt Implantation.

Purpose: To evaluate risk factors for failure of Microshunt in glaucoma patients.

Design: Multicenter retrospective cohort study.

Methods: The study included 220 eyes from 220 consecutive glaucoma patients undergoing Microshunt implantation at six glaucoma units.

Comparison of Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness Values Using Spectral-Domain and Swept-Source OCT.

Purpose: To compare peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness measurements obtained with spectral domain optical coherence tomography (SD-OCT) and swept-source OCT (SS-OCT) using an OCT-angiography scanning protocol, and their ability to distinguish among patients with glaucoma, glaucoma suspects (GS), and healthy controls (HC).

Methods: Cross-sectional study of 196 eyes (81 glaucoma, 48 GS, and 67 HC) of 119 participants. Participants underwent peripapillary and macular OCT with SD-OCT and SS-OCT.

Treatment of Open-Angle Glaucoma and Ocular Hypertension with the Fixed-Dose Combination of Preservative-Free Tafluprost/Timolol: Clinical Outcomes from Ophthalmology Clinics in Italy.

Introduction: The VISIONARY study examined the intraocular pressure (IOP)-lowering efficacy and tolerability of the preservative-free fixed-dose combination of tafluprost (0.0015%) and timolol (0.5%) (PF tafluprost/timolol FC) in a real-world setting.

Combining Structural and Vascular Parameters to Discriminate Among Glaucoma Patients, Glaucoma Suspects, and Healthy Subjects.

Purpose: Compare the ability of peripapillary and macular structural parameters, vascular parameters, and their integration to discriminate among glaucoma, suspected glaucoma (GS), and healthy controls (HCs).

Methods: In this study, 196 eyes of 119 patients with glaucoma (n = 81), patients with GS (n = 48), and HCs (n = 67) underwent optical coherence tomography (OCT) and OCT angiography to measure peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell-inner plexiform layer (mGCIPL) thicknesses, radial peripapillary capillary perfusion density (RPC-PD), and macular GCIPL perfusion density (GCIPL-PD). Parameters were integrated regionally with logistic regression and globally with machine learning algorithms.

A case of endophthalmitis following needling procedure after PRESERFLO Micro Shunt implantation.

Purpose: To report a case of endophthalmitis following bleb needling in a patient previously implanted with a PRESERFLO MicroShunt.

Methods: Case report.

Results: A 40-year-old woman with bilateral malformative glaucoma repeatedly operated on in childhood underwent PRESERFLO MicroShunt implantation in her right eye and six needling revisions (NRs) and a surgical revision due to unsatisfactory intraocular pressure (IOP) control due to bleb encapsulation.

Needle revision outcomes after glaucoma filtering surgery: survival analysis and predictive factors.

Purpose: To evaluate the efficacy and safety of needle revision and examine factors predictive of failure.

Methods: In total, 157 eyes of 131 patients that underwent needle revision augmented with either 5-fluorouracil or betamethasone for trabeculectomy failure were included in this retrospective study. Complete failure was defined as additional glaucoma surgery, ciliodestructive procedures, loss of light perception, sight-threatening complications, hypotony maculopathy, and surgical bleb revision.

Comparison of methods to quantify macular and peripapillary vessel density in optical coherence tomography angiography.

Purpose: To compare macular and peripapillary vessel density values calculated on optical coherence tomography angiography (OCT-A) images with different algorithms, elaborate conversion formula, and compare the ability to discriminate healthy from affected eyes.

Methods: Cross-sectional study of healthy subjects, patients with diabetic retinopathy, and glaucoma patients (44 eyes in each group). Vessel density in the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and the peripapillary radial capillary plexus (RCP) were calculated with seven previously published algorithms.

22q11.2 microduplication syndrome and juvenile glaucoma.

Background: 22q11.2 microduplication is a relatively recently recognized syndrome. Findings in affected individuals range from apparent normality to a wide variety of systemic and ocular conditions.

Optical Coherence Tomography Angiography Macular and Peripapillary Vessel Perfusion Density in Healthy Subjects, Glaucoma Suspects, and Glaucoma Patients.

Purpose: To evaluate macular and peripapillary vessel perfusion density (VD) in glaucoma suspects (GS) and glaucoma patients; to correlate ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thicknesses with macular and peripapillary VD; and to evaluate the diagnostic accuracy of the structural and vascular parameters.

Methods: A consecutive series of GS, glaucoma patients, and healthy subjects was prospectively recruited from July 1, 2016, to January 31, 2017. All subjects underwent standard automated perimetry, spectral-domain optical coherence tomography (OCT), and 6 × 6-mm optical coherence tomography angiography (OCT-A) centered on the fovea and optic nerve.

Postoperative Management of Penetrating and Nonpenetrating External Filtering Procedures.

Correct postoperative management is fundamental to prevent and treat complications and to optimize the success of filtering surgery. Timely control visits and appropriate actions and prescriptions ensure the best outcomes, allow recovery from a number of untoward events, and can reestablish filtration when failure seems imminent. In contrast, a slack follow-up and wrong interventions or prescriptions can lead to the failure of any surgery, no matter how accurately it was carried out, sometimes jeopardizing vision and even the anatomy of the globe.

Optical coherence tomography angiography features of chorioretinal folds: a case series.

Purpose: To report 3 cases of ocular chorioretinal folds from different etiologies and their aspect with the new imaging technology of optical coherence tomography (OCT) angiography (OCT-A).

Methods: Baseline data, investigational process on etiology, and follow-up data of patients referred for chorioretinal folds to the Medical Retina & Imaging Unit of San Raffaele Hospital in the period January-March 2016 were collected. Multimodal imaging evaluation, comprehensive of infrared, fundus autofluorescence, multicolor, spectral-domain OCT, and OCT-A, was performed on all patients.

Assessment of lutein, zeaxanthin and -zeaxanthin concentrations in dietary supplements by chiral high-performance liquid chromatography.

We investigated the concordance between actual and declared content of the three macular carotenoids in commercially available supplements aimed at eye health. Three batches of nine products were tested for content of lutein (L), zeaxanthin (Z) and -zeaxanthin (MZ) by chiral HPLC-DAD. In every product tested, actual L concentration was close to target, but Z concentration varied greatly (47-248 % of declared concentration), and the L:Z ratio within some supplements was adversely affected in consequence.

Nd:Yag laser goniopuncture for deep sclerectomy: efficacy and outcomes.

Purpose: To report on the safety and efficacy of Nd: YAG laser goniopuncture (LGP) for postsurgical intraocular pressure increase after deep sclerectomy (DS) in a consecutive cohort of open-angle glaucoma patients.

Methods: This case series included 56 eyes from 49 consecutive patients who underwent LGP between November 2008 and March 2015. Prior to LGP, patients had undergone DS augmented with mitomycin C and injectable cross-linked hyaluronic acid implant between October 2008 and May 2014.

Deep Sclerectomy With Mitomycin C and Injectable Cross-linked Hyaluronic Acid Implant: Long-term Results.

Purpose: To evaluate the long-term efficacy and safety of deep sclerectomy (DS) augmented with mitomycin C (MMC) and injectable cross-linked hyaluronic acid implant (Healaflow) in medically refractory glaucoma patients.

Materials And Methods: Our study included 96 eyes of 83 consecutive patients with open-angle glaucoma undergoing MMC-DS with injectable cross-linked hyaluronic acid implant. Mean follow-up was 28.

Delayed suprachoroidal hemorrhage following Nd:YAG laser goniopuncture: a case report.

Purpose: To report a delayed suprachoroidal hemorrhage following Nd:YAG laser goniopuncture (LGP) in an eye with a previous deep sclerectomy.

Methods: Case report.

Results: A 75-year-old woman with advanced primary open-angle glaucoma underwent LGP due to unsatisfactory intraocular pressure (IOP) in her left eye, 1 month after undergoing deep sclerectomy in the same eye.

Glaucoma: present challenges and future trends.

The authors indicate four key issues which, in their opinion, represent the most stimulating challenges in the field of glaucoma today, and describe the present approaches and the developments that can be expected or advised in the near future: (1) Glaucoma is often undiagnosed or diagnosed too late. Accurate detection is crucial to correctly recognize and treat affected subjects, thus reducing the disability and the social burden of the disease. Is glaucoma screening advisable and cost-effective? What strategies can be implemented to achieve an earlier diagnosis? (2) What role can genetics play in glaucoma clinics? (3) What are the fundamentals and the limits of medical hypotensive and nonhypotensive treatment of glaucoma today, and what novelties could be introduced in the next few years? (4) What are the current and future options for glaucoma surgery? Should we aim at reducing aqueous production or at enhancing aqueous outflow? What are the success figures and the pros and cons of ab externo procedures with external filtration (trabeculectomy, nonpenetrating techniques and glaucoma drainage devices) and of ab externo techniques with internal filtration (viscocanalostomy and canaloplasty)? Will microinvasive procedures ever play a role in the treatment of the disease? These questions and the possible future developments in the management of glaucoma are discussed critically, based on the current clinical state of the art, on a review of the literature, and on an everyday experience in a busy university hospital glaucoma service.

Cerebrospinal fluid and serum JC virus antibody detection in multiple sclerosis patients treated with natalizumab.

Progressive multifocal leukoencephalopathy (PML) is a complication of natalizumab treatment. In order to identify natalizumab-treated patients at risk of developing PML, we assayed for anti-JC virus (JCV) antibody levels in cerebrospinal fluid (CSF). Serial CSF antibody levels were obtained, with 4 patients showing increases in anti-JCV levels indicating possibly viral activation.

Postoperative management of penetrating and nonpenetrating external filtering procedures.

Correct postoperative management is fundamental to prevent and treat complications and to optimize the success of filtering surgery: timely control visits and appropriate actions and prescriptions ensure the best outcomes, allow recovery from a number of untoward events, and can reestablish filtration when failure seems imminent. In contrast, a slack follow-up and wrong interventions or prescriptions can lead to failure of any surgery, no matter how accurately it had been carried out, sometimes jeopardizing vision and even the anatomy of the globe. The purpose of this review is to present a rational approach to postoperative follow-up and to synthetically describe how to prevent, recognize and address the most common complications of filtering surgery, pointing out the most common pitfalls in the management of the operated eye.

Viscocanalostomy in patients with glaucoma secondary to uveitis: preliminary report.

Purpose: To assess the efficacy of viscocanalostomy in eyes with uncontrolled glaucoma secondary to uveitis.

Setting: Immunology and Uveitis Service, Department of Ophthalmology and Visual Sciences, University Hospital San Raffaele, Milan, Italy.

Methods: All consecutive patients with glaucoma secondary to uveitis and inadequate intraocular pressure (IOP) control (IOP >21 mm Hg) under maximum-tolerated medical therapy had viscocanalostomy.

Viscocanalostomy versus trabeculectomy in white adults affected by open-angle glaucoma: a 2-year randomized, controlled trial.

Purpose: To compare the effectiveness and safety of viscocanalostomy and trabeculectomy in adults with uncontrolled open-angle glaucoma.

Design: Single-masked, parallel-group, prospective, randomized 24-month trial, with 90% power to detect a clinically important difference between groups.

Participants: Fifty consecutive patients (50 eyes) with primary open-angle or pseudoexfoliative glaucoma.

Treatment of hyperfiltering blebs with Nd:YAG laser-induced subconjunctival bleeding.

Purpose: To assess the feasibility of a new technique to manage hyperfiltering blebs after penetrating glaucoma surgery.

Methods: Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser bursts were used to induce bleeding in conjunctival and episcleral vessels in the bleb area to achieve local delivery of autologous blood.

Results: In the three cases reported here in which this technique was used, the treatment was successful and safe, leading to resolution of hypotony and reduction of the bleb with no complications.

Viscocanalostomy: a pilot study.

Purpose: Viscocanalostomy is a new, non-penetrating procedure for glaucoma surgery. We started a prospective study to assess the effectiveness and safety of the operation. Materials and methods.