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New Insights into Glaucoma
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New Insights into Glaucoma

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

Deadline for manuscript submissions: 31 August 2025 | Viewed by 4123

Special Issue Editors

Dr. Su-Ho Lim

E-Mail Website
Guest Editor
Department of Ophthalmology, Daegu Veterans Health Service Medical Center, Daegu 42835, Republic of Korea
Interests: cataract; glaucoma; clinical ophthalmology
Dr. Daniel Laroche

E-Mail Website
Guest Editor
1. Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10029, USA
2. Advanced Eyecare of New York, New York, NY 10027, USA
Interests: glaucoma; cataract

Special Issue Information

Dear Colleagues,

We are delighted to introduce “New Insights into Glaucoma”, a new Special issue of the Journal of Clinical Medicine (JCM) dedicated to diagnosis, medical treatment, and surgical treatments including cataract surgery, minimally invasive glaucoma surgery (MIGS), trabeculectomy, glaucoma drainage devices, and other new surgical options. And this special issue also covers the update on artificial intelligence and glaucoma.

In recent years, there have been great advances in the diagnosis and new surgical approaches for glaucoma. However, glaucoma are still the major cause of irreversible blindness. Thus, early diagnosis of glaucoma with risk calculation and proper management are still important unmet needs to address.

Our Special Issue covers a broad range of topics related to mentioned above. First, we address a novel, acceptable cost glaucoma risk calculator to identify glaucoma patients and stratify management. Second, there are not yet clear consensus guiding minimally invasive glaucoma surgery or interventional glaucoma choices such as Phacoemulsification with/without goniotomy (BANG, GATT), Hydrus, iStent inject, OMNI and subconjunctival bleb forming procedures. Third, in this special issue, we will explore the technical variation of conventional glaucoma surgery (pars plana approach of glaucoma drainage devices, Novel Retrobulbar Tube options for advanced glaucoma etc). Finally, we call the research regarding the recent update on artificial intelligence and glaucoma.

This Special Issue aims to share expert views on the new insight into glaucoma in diagnosis and management of glaucoma. We invite authors to submit original research, reviews and clinical cases relating to these topics. We also encourage contribution from all regions of the world and look forward to receiving your recent valuable research.

Dr. Su-Ho Lim
Dr. Daniel Laroche
Guest Editors

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

  • glaucoma
  • intraocular pressure (IOP)
  • risk calculators
  • glaucoma screening glaucoma surgery
  • cataract surgery
  • trabeculectomy
  • glaucoma drainage devices
  • minimally invasive glaucoma surgery (MIGS)
  • artificial intelligence (AI)

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

Published Papers (4 papers)

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Research

18 pages, 1527 KiB  
Article
Comparison of Efficacy and Ocular Surface Assessment Between Preserved and Preservative-Free Brimonidine/Timolol Fixed-Combination Eye Drops in Glaucoma Patients: A Parallel-Grouped, Randomized Trial
by Myungjin Kim, Chang-Kyu Lee, Jonghoon Shin, Doah Kim and Seungsoo Rho
J. Clin. Med. 2025, 14(5), 1587; https://doi.org/10.3390/jcm14051587 - 26 Feb 2025
Viewed by 580
Abstract
The objectives of the study were to compare the efficacy and safety using ocular surface assessment between preserved and preservative-free brimonidine/timolol fixed-combination eye drops in glaucoma or ocular hypertension patients. Methods: This study was designed as a prospective, multicenter (three institutions), investigator-masked, [...] Read more.
The objectives of the study were to compare the efficacy and safety using ocular surface assessment between preserved and preservative-free brimonidine/timolol fixed-combination eye drops in glaucoma or ocular hypertension patients. Methods: This study was designed as a prospective, multicenter (three institutions), investigator-masked, parallel-grouped randomized clinical trial. The primary outcomes were corneal and conjunctival staining score, ocular surface disease index (OSDI) score, drug tolerance, and adherence rates at 12-week visits. The secondary outcomes were corneal and conjunctival staining score, OSDI score at 4-week visits and intraocular pressure (IOP), tear-film break-up time (TBUT), and bulbar/limbal hyperemia score at the 4- and 12-week visits. For safety assessment, best-corrected visual acuity (BCVA), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and physical examination at 4 and 12 weeks and adverse events during the whole study period were analyzed. Results: Overall, 59 patients were enrolled and randomized into each group (29 preserved and 30 preservative-free). At the endpoint, 5 patients in the preserved group and 2 patients in the preservative-free group dropped out, leaving 24 and 28 patients in the preserved and preservative-free groups, respectively. Baseline characteristics showed no significant difference between the groups including age and sex. At the 12-week visit, intra-group change of OSDI scores did not change significantly compared to the baseline scores in both preserved and preservative-free groups (p = 0.791, 0.478, respectively). On the contrary, the corneal staining score and the conjunctival staining score showed a significant increase compared to the baseline score in the preserved group (p = 0.015, 0.009, respectively). Regarding drug satisfaction, higher proportions of patients in the preservative-free group reported convenience of installation (p = 0.002). Also, stinging and burning sensations in drug tolerance showed better results in the preservative-free group with a significant difference (p = 0.011). Safety assessment regarding systemic side effects such as SBP, DBP, and HR showed similar results between the preserved and preservative-free groups (p = 0.711, 0.232, 0.666, respectively). Conclusions: Preservative-free brimonidine/timolol showed comparable efficacy and safety, better corneal and conjunctival staining score with convenience of installation, and lower stinging and burning sensation. It is expected to be a proper treatment option for patients with glaucoma or ocular hypertension. Full article
(This article belongs to the Special Issue New Insights into Glaucoma)
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13 pages, 1494 KiB  
Article
Potential Causal Association Between Atrial Fibrillation/Flutter and Primary Open-Angle Glaucoma: A Two-Sample Mendelian Randomisation Study
by Young Lee and Je Hyun Seo
J. Clin. Med. 2024, 13(24), 7670; https://doi.org/10.3390/jcm13247670 - 16 Dec 2024
Viewed by 890
Abstract
Background: A few studies have reported controversial relationships between atrial fibrillation/flutter (AF/L) and primary open-angle glaucoma (POAG). This study aimed to investigate the potential causal relationship between AF/L and POAG. Methods: Single-nucleotide polymorphisms associated with exposure to AF/L were selected as [...] Read more.
Background: A few studies have reported controversial relationships between atrial fibrillation/flutter (AF/L) and primary open-angle glaucoma (POAG). This study aimed to investigate the potential causal relationship between AF/L and POAG. Methods: Single-nucleotide polymorphisms associated with exposure to AF/L were selected as instrumental variables with significance (p < 5.0 × 10−8) from a genome-wide association study (GWAS) by FinnGen. The GWAS summary of POAG from the UK Biobank was used as the outcome dataset. A two-sample Mendelian randomisation (MR) study was performed to assess the causal effects of AF/L on POAG. In addition, potential confounders, including hypertension, autoimmune hyperthyroidism, sleep apnoea, and alcohol use disorder, were assessed using multivariable MR analysis. Results: There was a significant causal association of AF/L with POAG (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.07–1.48, p = 0.005 using inverse-variance weighting [IVW]). Multivariable MR analysis confirmed a causal association of AF/L with POAG (OR = 1.24, 95% CI = 1.02–1.51, p = 0.034 using IVW), but hypertension, hyperthyroidism, sleep apnoea and alcohol use disorder did not show significant causal associations with POAG (all p > 0.05). Conclusions: This established causal relationship between AF/L and POAG supports the need for further investigation into the role of AF/L as a possible risk factor for POAG. Further research is required to confirm these findings. Full article
(This article belongs to the Special Issue New Insights into Glaucoma)
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14 pages, 2192 KiB  
Article
Five-Year Outcomes of Deep Sclerectomy in Pseudoexfoliation Glaucoma Compared to Primary Open-Angle Glaucoma
by Carlo Fiore, Xiao Shang, Joel-Benjamin Lincke, Nathanael Urs Häner, Martin Sebastian Zinkernagel and Jan Darius Unterlauft
J. Clin. Med. 2024, 13(23), 7434; https://doi.org/10.3390/jcm13237434 - 6 Dec 2024
Viewed by 727
Abstract
Objectives: This study aimed to investigate the five-year outcomes of deep sclerectomy (DS) in patients with pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG). Methods: This retrospective, observational, unicentric study analyzed POAG and PEXG patients. Intraocular pressure (IOP), the number of [...] Read more.
Objectives: This study aimed to investigate the five-year outcomes of deep sclerectomy (DS) in patients with pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG). Methods: This retrospective, observational, unicentric study analyzed POAG and PEXG patients. Intraocular pressure (IOP), the number of IOP-lowering medications, peripapillary retinal nerve fiber layer (RNFL) thickness, the number of postoperative interventions, surgical success rates, and secondary surgery rates were evaluated at baseline and during follow-up appointments. Results: A total of 109 POAG and 153 PEXG eyes were included. Over the 5-year follow-up, IOP decreased in both groups (p = 0.17), from 22.8 ± 0.7 to 13.3 ± 0.6 mmHg (p < 0.001; POAG) and from 24.3 ± 0.8 to 16.6 ± 1.2 mmHg (p < 0.001; PEXG). The number of IOP-lowering medications decreased comparably (p = 0.99), from 3.1 ± 0.1 to 1.7 ± 0.3 (p = 0.001; POAG) and from 3.4 ± 0.1 to 1.7 ± 0.2 (p < 0.001; PEXG). Peripapillary RNFL thickness decreased in both groups (p = 0.31), from 60.6 ± 1.9 to 54.2 ± 2.4 µm (p < 0.001; POAG) and from 63.1 ± 1.7 to 58.0 ± 2.3 µm (p < 0.001; PEXG). The 5-year complete success rates were 33% and 12% for the POAG and PEXG groups, respectively (p = 0.01). The qualified success rates were 63% and 40% (p = 0.03). Secondary glaucoma surgery was required in 8% of POAG eyes and 21% of PEXG eyes (p = 0.04). Conclusions: DS resulted in comparable results for IOP, medications, and RNFL development in the PEXG and POAG groups but in less favorable outcomes concerning surgical success and further necessary repeated glaucoma surgery in patients with PEXG over the 5-year follow-up period. Full article
(This article belongs to the Special Issue New Insights into Glaucoma)
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10 pages, 434 KiB  
Article
Asymmetric Glaucoma and Corresponding Hearing Impairment
by Laura Antonia Meliante, Giulia Coco, Beatrice Francavilla, Matilde Bianchi, Gianluca Velletrani, Stefano Di Girolamo and Gianluca Manni
J. Clin. Med. 2024, 13(21), 6501; https://doi.org/10.3390/jcm13216501 - 30 Oct 2024
Viewed by 856
Abstract
Background/Objectives: This study aims to explore the potential relationship between unilateral or asymmetric glaucoma and ipsilateral hearing impairment. Methods: In this retrospective study, visual and hearing functions were assessed in patients with unilateral or asymmetric glaucoma. Correlations between retinal nerve fiber [...] Read more.
Background/Objectives: This study aims to explore the potential relationship between unilateral or asymmetric glaucoma and ipsilateral hearing impairment. Methods: In this retrospective study, visual and hearing functions were assessed in patients with unilateral or asymmetric glaucoma. Correlations between retinal nerve fiber layer (RNFL) thickness, visual field mean deviation (MD) values, and pure tone audiometry (PTA) measurements across various frequencies were analyzed to explore potential associations between visual and ipsilateral hearing functions. Differences in PTA values between ears ipsilateral to the more affected glaucomatous eyes and the contralateral ears were studied for statistical significance. Results: Twenty-six patients with unilateral or asymmetric glaucoma were included in the study. Significant differences in hearing thresholds between the ears corresponding to the more severely glaucomatous eyes and the contralateral ears were found at 0.7, 1, 1.5, and 3 kHz (p < 0.05). Additionally, a statistically significant difference was observed in the speech frequencies (0.5, 0.7, 1, 1.5, 2, 3, and 4 kHz) between ears corresponding to glaucomatous or more affected glaucomatous eyes and the contralateral ears (p = 0.016). Furthermore, a moderately positive correlation was found between differences in MD and PTA values at 0.125 kHz (r = 0.50; p = 0.01). Conclusions: This study highlights a potential association between unilateral or asymmetric glaucoma and ipsilateral hearing impairment, particularly at speech-relevant frequencies. These findings underscore the importance of integrated sensory assessment in the management of glaucoma patients, suggesting that early detection and intervention for concurrent hearing loss could enhance overall quality of life. Full article
(This article belongs to the Special Issue New Insights into Glaucoma)
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