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The risks of misdiagnosing a healthy individual as glaucomatous or vice versa may be high in a population with a large majority of highly myopic individuals, due to considerable morphologic variability in high myopic fundus. This study aims to compare the diagnostic ability of the regular and long axial length databases in the RS-3000 Advance SD-OCT (Nidek) device to correctly diagnose glaucoma with high myopia. Patients with high myopia (axial length ≥ 26.0 mm) in Chang Gung Memorial Hospital, Taiwan between 2015 and 2020 were included. Glaucoma was diagnosed based on glaucomatous discs, visual field defects and corresponding retinal nerve fiber layer defects. The sensitivity, specificity, diagnostic accuracy and likelihood ratios of diagnosing glaucoma via mGCC thickness in both superior/inferior and GChart mapping using the regular and long axial length normative databases. The specificity and diagnostic accuracy of mGCC thickness for distinguishing glaucomatous eyes from nonglaucomatous eyes among highly myopic eyes were significantly improved using the long axial length database (p = 0.046). There were also significant proportion changes in S/I mapping as well as GChart mapping (37.3% and 48.0%, respectively; p < 0.01) from abnormal to normal in the myopic normal eye group when using the long axial length normative database. The study revealed that clinicians could utilize a long axial length database to effectively decrease the number of false-positive diagnoses or to correctly identify highly myopic normal eyes misdiagnosed as glaucomatous eyes. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The objective of this study was to evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implantation in Taiwanese patients with intractable glaucoma. Methods: The study was a retrospective interventional case series conducted at a single institution between January 2004 and January 2008 in Taiwan. The study population included 148 patients (148 eyes). Results: The mean preoperative intraocular pressure (IOP) was 32.6 ± 4.7 mmHg with medication (mean number of medications was 3.4 ± 1.0; range, 2–4). Postoperatively, the mean IOP declined significantly to 10.2 mmHg (range, 7–18 mmHg) on Day 1 (p < 0.01) and 17 mmHg (range, 15–23 mmHg) at the last follow-up examination (p < 0.01). Ninety-four patients (63.5%) exhibited hypertensive phase (HP); among them 73 patients (49.3%) experienced HP at 1 month and 21 (14.2%) at 2 months after the operation. The cumulative probability of success according to Kaplan–Meier life-table analysis was 78% at 12 months and 43% at 3 years. There were no serious complications involving loss of visual acuity or sight. Conclusion: AGV implantation is an acceptable treatment for intractable glaucoma in high-risk Taiwanese patients with few additional options. [Copyright &y& Elsevier]

This study aimed to characterize the changes in the visual field (VF) patterns and disc morphology of patients with thyroid-associated orbitopathy (TAO) and open-angle glaucoma (OAG). A retrospective review of the medical records at the Tri-Service General Hospital in Taiwan identified 396 eyes of 198 patients with thyroid-associated glaucoma. A final follow-up of VF examination in 140 eyes revealed 114 eyes with VF defects, indicating disease progression. The characteristics of and changes in disc morphology, optical coherence tomography findings, and VF defects were statistically analyzed. The most common VF defects at the initial diagnosis and the end of the follow-up period were inferior partial arcuate (17%) and paracentral (15%) defects, respectively. The most common VF defect in patients with unspecific disc signs was an unspecific scotoma (13%). The most common optic disc feature was disc cupping (51%), followed by parapapillary atrophy (48%). The most frequent location of nerve fiber layer thinning was the inferotemporal region (48%). VF defects showed a significantly more pronounced progression in the non-nerve fiber bundle group than in the nerve fiber bundle group (p < 0.001). This study details the characteristics and progression of disc morphology and VF defects in patients with TAO and OAG. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the longitudinal changes of visual field (VF) in Asian patients with primary angle-closure glaucoma (PACG) occurring with and without an acute attack., Methods: In this retrospective case series, 87 consecutive patients diagnosed with bilateral PACG during the period from 2000 to 2010 were included. The eyes of the enrolled patients were categorized into 2 groups: PACG with 1 documented episode of an acute episode in the affected eye (APACG); PACG without a previous documented acute episode in the fellow eye (CPACG). The historical change in the VF in both groups was assessed every 3 months for >2 years., Results: Of the 174 eyes included in the study, 87 eyes belonged to the APACG group, and 87 eyes belonged to the CPACG group. The mean deviation (MD) in the APACG group decreased significantly from -6.22 to -6.73 dB between the 6- and 9-month follow-up periods (P=0.03). There were significant differences between the 2 groups in the MD index from the 9- to 24-month follow-up. The corrected pattern standard deviation (CPSD) in the APACG group increased significantly from 3.61 to 3.71 dB between the 6- and 9-month follow-up periods (P=0.04). The CPSD index was higher in the APACG group than in the CPACG group from the 9- to 24-month follow-up, which was a statistically significant difference., Conclusions: Glaucomatous VF damage in Asian patients with APACG was detected after a 6-month follow-up period, despite the presence of laser peripheral iridotomy in this population. In the patients with CPACG, there was no significant difference in the MD and CPSD during the follow-up period. Patients with APACG would benefit from regular monitoring of the decline in the VF.

Background: To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) surgery and the optimal interval between penetrating keratoplasty (PKP) and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP., Methodology/principal Findings: In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs), graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1) and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2). Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98), but significant differences for IOP control (p = 0.049) and the maintenance of visual acuity (VA) (p<0.05) were observed. One year after surgery, the success rates of IOP control in Group 1 and Group 2 were 80% and 46.7%, respectively, and these rates fell to 70% and 37.3%, respectively, by 2 years. Factors that were associated with a high risk of AGV failure were a diagnosis of preexisting angle-closure glaucoma, a history of previous PKP, and a preoperative IOP that was >21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema., Conclusions/significance: Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation.