Submit to Special Issue Submit Abstract to Special Issue Review for Biomedicines Propose a Special Issue

Journal Menu

Journal Browser

Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition

Editor
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 6495

Share This Special Issue

Editor

Dr. Da-Wen Lu

E-Mail Website
Guest Editor

Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Interests: ocular pharmacology; clinical trial; neuro-protection; rho-kinase inhibitor; glaucoma surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to present this Special Issue, entitled “Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition”, focusing on the latest advancements in the field of glaucoma management. Glaucoma remains one of the leading causes of irreversible blindness worldwide, necessitating the continuous exploration of novel approaches to improve patient outcomes. This Special Issue aims to provide a comprehensive overview of cutting-edge research and innovations in glaucoma management, highlighting emerging techniques and interventions that hold promise in the diagnosis, monitoring, and treatment of this complex ocular disease.

This Special Issue seeks to foster collaboration among researchers, clinicians, and industry professionals, facilitating the dissemination of knowledge and the exchange of ideas in the field of glaucoma. We invite original research articles, comprehensive reviews, and perspectives that cover a broad range of topics, including, but not limited to, the following:

Novel diagnostic techniques—articles elucidating the development and clinical application of innovative imaging modalities, genetic testing, and biomarkers for early detection and accurate diagnosis.

Advanced therapeutic interventions—pharmacological advancements and emerging therapies for glaucoma management, with an emphasis on their efficacy, safety, and long-term outcomes.

Artificial intelligence and digital health—research exploring the integration of artificial intelligence, machine learning, and digital health technologies in glaucoma screening, monitoring, and personalized treatment approaches.

Dr. Da-Wen Lu
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly 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

glaucoma
ocular pharmacology
ocular disease

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (7 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

14 pages, 3108 KB

Open AccessArticle

Association Between Geriatric Assessment Scores and Corneal Biomechanical Parameters in Patients with Glaucoma

by Yuto Yoshida, Yuri Fujino, Yuya Kato, Mayumi Furue, Hinako Ohtani, Chisako Ida, Kana Murakami, Mizuki Koike, Keigo Takagi, Kazunobu Sugihara and Masaki Tanito

Biomedicines 2026, 14(7), 1546; https://doi.org/10.3390/biomedicines14071546 - 10 Jul 2026

Viewed by 269

Abstract

Background/Objectives: Multiple age-related systemic conditions, including frailty, cognitive impairment, and comorbid diseases, have been suggested to be associated with glaucoma. However, their relationship with corneal biomechanical properties in patients with glaucoma remains unclear. Methods: This retrospective cross-sectional study included patients with glaucoma who attended the Department of Ophthalmology at Shimane University Hospital between May 2019 and August 2024. Corneal biomechanical parameters, including corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg), were measured using the Ocular Response Analyzer (ORA; Reichert Technologies, Depew, NY, USA). Geriatric assessments, including the Geriatric 8 (G8), Mini-Cog, and Charlson Comorbidity Index (CCI), were also evaluated. Associations between geriatric assessment measures and ocular parameters were examined using multivariable linear mixed-effects models adjusted for age, sex, medication score, and glaucoma subtype. Results: A total of 280 patients (456 eyes) were included. The mean age was 70.2 ± 11.1 years, and 126 patients (45.0%) were women. In multivariable linear mixed-effects models, lower G8 scores were significantly associated with lower CRF (β = 0.18, 95% CI: 0.05 to 0.30), lower IOPcc (β = 0.55, 95% CI: 0.18 to 0.92), and lower IOPg (β = 0.62, 95% CI: 0.25 to 1.00). In contrast, no significant association was observed between G8 scores and CH (β = −0.02, 95% CI: −0.12 to 0.09). Neither Mini-Cog nor CCI was significantly associated with any ocular parameters. Conclusions: In patients with glaucoma, frailty may be associated with corneal biomechanical properties, particularly CRF and intraocular pressure-related parameters. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Figure 1

16 pages, 257 KB

Open AccessArticle

Differential Associations of Cognitive Function, Frailty, and Comorbidity Burden with Visual Field Sensitivity and Reliability in Glaucoma

by Yuya Kato, Mayumi Furue, Chisako Ida, Hinako Ohtani, Kana Murakami, Mizuki Koike, Keigo Takagi, Yuto Yoshida, Kazunobu Sugihara and Masaki Tanito

Biomedicines 2026, 14(7), 1513; https://doi.org/10.3390/biomedicines14071513 - 5 Jul 2026

Viewed by 303

Abstract

Background/Objectives: Cognitive impairment, frailty, and systemic comorbidity burden are common in elderly patients with glaucoma and may influence both visual field (VF) performance and glaucoma severity. This study investigated the associations of comprehensive geriatric assessment (CGA) parameters, including Mini-Cog, G8, and Age-Adjusted Charlson Comorbidity Index (ACCI), with VF sensitivity and VF reliability indices in glaucoma patients. Methods: This retrospective cross-sectional study included 1125 eyes of 622 glaucoma patients who underwent Humphrey VF testing and CGA at a tertiary referral center. Associations between CGA parameters and VF indices, including mean deviation (MD), pattern standard deviation (PSD), foveal sensitivity, fixation loss rate (FL), false-negative rate (FN), and false-positive rate (FP), were evaluated. Generalized linear mixed models were used to assess independent associations after adjustment for demographic, systemic, and ocular covariates. Results: In univariate analyses, lower Mini-Cog and G8 scores and higher ACCI scores were associated with several VF sensitivity and reliability indices. After multivariable adjustment, ACCI remained independently associated with lower MD (estimate = −0.52, p = 0.004), higher PSD (estimate = 0.27, p = 0.04), and lower foveal sensitivity (estimate = −0.36, p = 0.01). Lower G8 scores and higher ACCI scores were independently associated with increased FN rates, whereas higher G8 scores were associated with increased FP rates. Conclusions: Systemic comorbidity burden, assessed using ACCI, was independently associated with both glaucomatous functional impairment and selected VF reliability indices. Frailty, assessed using G8, was associated with VF reliability but not VF sensitivity. Although cognitive function measured by Mini-Cog was associated with VF parameters in univariate analyses, these associations were not retained after multivariable adjustment. Consideration of systemic health status and geriatric vulnerability may improve interpretation of VF results in patients with glaucoma. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

13 pages, 1221 KB

Open AccessArticle

Outcomes of the Paul Glaucoma Implant in an Ambispective Multicenter Study: 12-Month Follow-Up

by Celina Logioco, Anahí Lupinacci, Ignacio Lischinsky, Mariel A. Ytques, Gabriel Bercovich, María A. Moussalli, Agustina De Gainza, Mario O. Roux, Nicolás Levaggi, Ana Sanseau, Karina B. Giannone, Arturo Burchakchi, Leila Galetto, Natanael Serrano, Eimi Olivares Sefair, Guillermo Roux and Rodrigo M. Torres

Biomedicines 2026, 14(6), 1230; https://doi.org/10.3390/biomedicines14061230 - 29 May 2026

Viewed by 310

Abstract

Objective: The aim of this study was to evaluate the safety and efficacy of the Paul Glaucoma Implant (PGI) in a multicenter Argentine cohort with 12 months of follow-up. Methods: This ambispective multicenter study included patients who underwent PGI implantation between November 2022 and July 2024 by glaucoma specialists across Argentina, with a minimum follow-up of 12 months. Primary outcomes were intraocular pressure (IOP) reduction and success rates, defined as complete success (≥20% IOP reduction with IOP ≥6 and ≤21 mmHg without medications), qualified success (same criteria with ≥1 medication), and failure based on predefined efficacy and safety criteria, including additional glaucoma surgery, device removal, or clinically significant hypotony. Secondary outcomes included changes in medication use, best-corrected visual acuity (BCVA), and postoperative complications. Results: Sixty-six eyes were included in the overall analysis. Mean IOP decreased from 31.2 ± 9.1 mmHg preoperatively to 12.8 ± 4.7 mmHg at 12 months (p < 0.01). Medications were reduced from 3.5 ± 0.8 to 1.3 ± 1.2 (p < 0.01). Among the 65 eyes with evaluable 12-month follow-up, 50 eyes (76.9%) achieved complete success, 14 (21.5%) qualified success, and 1 (1.5%) failure. Complications were ocular hypertension (25%), tube or plate exposure (10%), choroidal detachment (7%), and hypotony (5%). BCVA remained stable in 28 eyes (43.8%), improved in 15 (23.4%), and worsened in 21 (32.8%). Conclusions: The PGI achieved significant and sustained IOP reduction with marked medication decrease at 12 months. Most complications were mild or moderate. These findings support the PGI as an effective and safe non-valved implant for refractory glaucoma in Latin American populations. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Figure 1

12 pages, 872 KB

Open AccessArticle

Possible Effects of Topical Rho-Kinase Inhibitor on Schlemm’s Canal Morphology Parameters

by Aysha Siddika Mukta, Aika Tsutsui, Teruhiko Hamanaka, Sachiko Kaidzu, Kanae Kobayashi, Nobuo Ishida and Masaki Tanito

Biomedicines 2026, 14(2), 470; https://doi.org/10.3390/biomedicines14020470 - 20 Feb 2026

Viewed by 1150

Abstract

Background: To evaluate the effects of preoperative topical ripasudil, a Rho-associated protein kinase (ROCK) inhibitor, on Schlemm’s canal (SC) morphology in patients with primary open-angle glaucoma (POAG). Methods: This study included 95 SC specimens obtained during trabeculectomy from 95 patients with POAG. Based on preoperative treatment, patients were divided into two groups: ripasudil (−) group (n = 68) receiving four topical medications [FP receptor agonist, β-blocker, carbonic anhydrase inhibitor (CAI), and α₂ agonist], and ripasudil (+) group (n = 27) receiving the same four medications plus ripasudil. SC morphology parameters were assessed in thrombomodulin (TBM)-stained sections, including length parameters [TBM-positive/negative and opened/closed SC lengths] and area parameters [TBM-positive/negative and opened SC areas]. Between-group comparisons were performed using unpaired t-tests, and multiple regression analysis was conducted to adjust for age, gender, preoperative intraocular pressure (IOP), and oral CAI use. Results: The ripasudil (+) group had significantly longer total SC length (TSC: 302.5 µm) than the ripasudil (−) group (273.0 µm, p = 0.023). Among area parameters, the ripasudil (+) group showed significantly larger opened SC area (OSC-A: 2689 µm² vs. 1881 µm², p = 0.008) and TBM-negative opened SC area (NOSC-A: 716 µm² vs. 305 µm², p = 0.001), whereas TBM-positive opened SC area (POSC-A) was not significantly different between groups (2001 µm² vs. 1575 µm², p = 0.096). After multivariate adjustment, ripasudil use remained significantly associated with longer TSC (p = 0.011) and larger OSC-A (p = 0.014) and NOSC-A (p = 0.001). Conclusions: Preoperative use of topical ripasudil was associated with preservation of SC lumen morphology, particularly in regions lacking SC endothelium. These findings provide a theoretical basis for therapeutic strategies employing ROCK inhibitors to maintain SC morphology and function. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Figure 1

10 pages, 303 KB

Open AccessArticle

Real World Comparison of Direct Selective Laser Trabeculoplasty Versus Selective Laser Trabeculoplasty: 12-Month Retrospective Study of a Tertiary Center in the UK

by Piero Zollet, Federico Macario, Rachel Healy, Demetri T. Manasses, Rani T. Sebastian and Mario R. Romano

Biomedicines 2026, 14(1), 156; https://doi.org/10.3390/biomedicines14010156 - 12 Jan 2026

Viewed by 1297

Abstract

Background: Direct selective laser trabeculoplasty (DSLT) is a novel option for intraocular pressure (IOP) control in patients with glaucoma or ocular hypertension. The automated and touchless translimbal delivery of laser energy to 360 degrees of the trabecular meshwork (TM) improves aqueous outflow and lowers IOP. DSLT is faster, simpler, and less invasive than routinely performed SLT. Few studies have compared the two techniques. Objective: To retrospectively compare the safety and efficacy of DSLT and SLT over a 1-year follow-up period. Methods: In total, 16 eyes that underwent DSLT and 16 eyes that underwent SLT were included. The primary outcome measures were mean absolute and percent IOP reduction, number of medications, and BCVA at 1, 3, 6, and 12 months. Survival analysis on 1-year data was performed based on the presence of one or more of the following failure criteria: (1) IOP > 21 mmHg or less than 20% reduction in IOP from baseline at two consecutive visits; (2) increase in the number of IOP-lowering drops from baseline at two consecutive visits; (3) further procedures. Results: The survival rates in the DSLT vs. SLT group were 81% vs. 78%, 44% vs. 62%, and 37% vs. 43% at 3, 6, and 12 months, respectively. No statistically significant differences were reported. DSLT does not seem inferior to conventional SLT in terms of safety and efficacy in reducing IOP. Conclusions: The advantages of an automated, rapid, contactless technique may enlarge the cohort of patients eligible for a drop-free first-line IOP control procedure. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Figure 1

12 pages, 997 KB

Open AccessArticle

An Exploratory Study of Machine Learning-Based Open-Angle Glaucoma Detection Using Specific Autoantibodies

by Naoko Takada, Makoto Ishikawa, Takahiro Ninomiya, Yukitoshi Izumi, Kota Sato, Hiroshi Kunikata, Yu Yokoyama, Satoru Tsuda, Eriko Fukuda, Kei Yamaguchi, Chihiro Ono, Tomoko Kirihara, Chie Shintani, Akiko Hanyuda, Naoki Goshima, Charles F. Zorumski and Toru Nakazawa

Biomedicines 2025, 13(12), 3031; https://doi.org/10.3390/biomedicines13123031 - 10 Dec 2025

Viewed by 1226

Abstract

Objectives: Previously, we identified four open-angle glaucoma (OAG)-associated autoantibodies (anti-ETNK1, anti-VMAC, anti-NEXN, and anti-SUN1) using proteome-wide autoantibody screening by wet protein arrays. The objective of this exploratory study was to evaluate the diagnostic performance of these four glaucoma-associated autoantibodies using automated machine learning. Methods: Plasma samples from 119 patients with OAG and 35 patients with cataracts as controls were enrolled for the study. All machine-learning analyses were performed in Python 3.9.16 (GCC 11.2.0) using scikit-learn 1.2.2 and PyCaret 3.0.1. Variables included plasma levels of the autoantibodies, age, sex, and intra-ocular pressure (IOP). Probability calibration (Platt/sigmoid and isotonic) was assessed with reliability curves and Brier scores. Model explainability was examined with permutation importance, SHAP values, and an ablation analysis removing one autoantibody at a time. Results: The tuned random forest achieved an out-of-fold (OOF) area under the receiver-operating characteristic curve (ROC–AUC) of 0.852 (±0.040), an average precision (AP) of 0.950, and an F1 score of 0.865. Isotonic mapping improved agreement between predicted and empirical probabilities. Among these four autoantibodies, VMAC was the most important factor for the model’s prediction. Conclusions: A machine learning model using four autoantibodies from blood samples showed potential for diagnosing OAG. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Figure 1

16 pages, 1191 KB

Open AccessArticle

Association of Heart Rate Variability and Acceleration Plethysmography with Systemic Comorbidity Burden in Patients with Glaucoma

by Yuto Yoshida, Hinako Takei, Misaki Ukisu, Keigo Takagi and Masaki Tanito

Biomedicines 2025, 13(9), 2155; https://doi.org/10.3390/biomedicines13092155 - 4 Sep 2025

Viewed by 1262

Abstract

Background: Autonomic nervous system (ANS) and vascular factors are associated with glaucoma. However, the association between systemic comorbidity burden and ANS and hemodynamic function in patients with glaucoma remains unclear. This study aimed to examine the association between heart rate variability (HRV) and acceleration plethysmography (APG) parameters and the age-adjusted Charlson Comorbidity Index (ACCI) in patients with glaucoma. Methods: A total of 260 subjects (260 eyes), including 186 with primary open-angle glaucoma (PG) and 74 with exfoliation glaucoma (EG), were enrolled at Shimane University Hospital from June 2023 to July 2024. HRV and APG were assessed using a sphygmograph (TAS9 Pulse Analyzer Plus View). HRV parameters included time-domain measures (SDNN, RMSSD, CVRR) and frequency-domain measures (TP, VLF, LF, HF, LF/HF). APG parameters included the a, b, c, d, and e components of the accelerated pulse wave, and the following vascular types: Type A, Type B, and Type C. The association between ACCI and HRV and APG parameters was evaluated using Spearman’s rank correlation and multivariate regression adjusted for sex, body mass index, pulse rate, systolic and diastolic blood pressure, intraocular pressure, medication score, mean deviation, and glaucoma type. Results: By univariate analysis, against ACCI, significant inverse correlations were observed for several parameters: LnLF (R = −0.17, p = 0.0062); LnLF/LnHF (R = −0.24, p = 0.00012); b peak (R = −0.14, p = 0.031); d peak (R = −0.17, p = 0.0072); and e peak (R = −0.15, p = 0.015). Regarding HRV parameters, multivariate linear regression models showed that ACCI was significantly positively associated with RMSSD (coefficient: 2.861; 95% CI: 0.447 to 5.274) and significantly negatively associated with the frequency-domain parameters LnLF (coefficient: −0.127; 95% CI: −0.245 to −0.009) and LnLF/LnHF (coefficient: −0.038; 95% CI: −0.062 to −0.014). In APG parameters, the c peak was significant associated with ACCI (coefficient: −12.6; 95% CI: −22.5 to −2.69). ACCI was significantly associated with Type B (coefficient: 0.305; 95% CI: 0.057 to 0.552). Conclusions: Greater systemic comorbidity burden may be related to impaired ANS regulation and increased vascular stiffness in glaucoma patients. Full article

(This article belongs to the Special Issue Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition)

► Show Figures

Journal Menu

Journal Browser

Glaucoma: New Diagnostic and Therapeutic Approaches, 3rd Edition

Share This Special Issue

Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (7 papers)

Research

Further Information

Guidelines

MDPI Initiatives

Follow MDPI