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Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition
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Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition

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

Deadline for manuscript submissions: 30 September 2025 | Viewed by 6556

Special Issue Editors

Dr. Manuele Michelessi

E-Mail Website
Guest Editor
IRCCS—Fondazione Bietti, Via Livenza, 3, 00198 Rome, Italy
Interests: glaucoma clinical and surgical management; diagnostic accuracy; systematic review
Special Issues, Collections and Topics in MDPI journals
Dr. Gloria Roberti

E-Mail Website
Guest Editor
IRCCS—Fondazione Bietti, Via Livenza, 3, 00198 Rome, Italy
Interests: glaucoma; visual field; medical treatment; surgical treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

On behalf of the Journal of Clinical Medicine’s Editorial team, We are delighted to present the Second Edition of the Special Issue “Diagnosis, Treatment, and Prevention of Glaucoma” (https://www.mdpi.com/journal/jcm/special_issues/X3WCT9P600).

Glaucoma is the second leading cause of blindness worldwide. It has been estimated that more than 70 million people are affected by the disease, with 8 million affected by bilateral blindness. Glaucoma is completely asymptomatic until the very advanced stages, and primary prevention is not feasible. Therefore, early diagnosis and early treatment are fundamental in preventing blindness.

Recent advances in technology have improved the diagnosis, prevention, and treatment of glaucoma. Optical coherence tomography development, a structure–function approach, and minimally invasive glaucoma surgery devices are just a few examples of these advances.

This Special Issue is focused on all aspects related to the diagnosis, treatment, and prevention of glaucoma. Authors are welcome to submit original, high-quality articles to contribute to the discussion in this field of research.

Dr. Manuele Michelessi
Dr. Gloria Roberti
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
  • OCT
  • visual field
  • blindness
  • glaucoma surgery
  • intraocular pressure
  • glaucoma prevention
  • glaucoma treatment

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Related Special Issue

Published Papers (5 papers)

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Research

13 pages, 1621 KiB  
Article
Italian XEN-Glaucoma Treatment Registry (XEN-GTR): Effectiveness and Safety at 36 Months of XEN45 Implant
by Francesco Oddone, Gloria Roberti, Sara Giammaria, Chiara Posarelli, Leonardo Mastropasqua, Luca Agnifili, Tommaso Micelli Ferrari, Vincenzo Pace, Matteo Sacchi, Romeo Altafini, Gianluca Scuderi, Andrea Perdicchi, Carmela Carnevale, Antonio Fea and Michele Figus
J. Clin. Med. 2024, 13(23), 7370; https://doi.org/10.3390/jcm13237370 - 3 Dec 2024
Viewed by 889
Abstract
Objectives: We evaluated the 3-year effectiveness and safety of XEN45, combined or not with phacoemulsification, in patients from the Italian XEN-Glaucoma Treatment Registry. Methods: Data from glaucoma patients who underwent XEN45 alone or combined with phacoemulsification were analyzed. Changes in intraocular [...] Read more.
Objectives: We evaluated the 3-year effectiveness and safety of XEN45, combined or not with phacoemulsification, in patients from the Italian XEN-Glaucoma Treatment Registry. Methods: Data from glaucoma patients who underwent XEN45 alone or combined with phacoemulsification were analyzed. Changes in intraocular pressure (IOP) and the number of ocular hypotensive medications (OHMs) were tested with repeated measures ANOVA in last observation carried forward (LOCF) and per-protocol (PP) analyses. Complete and qualified success (IOP < 18 mmHg and ≥20% IOP reduction from baseline, without or with OHMs) at 36 months and pre- and intraoperative factors predicting surgery failure were explored using survival analysis and Cox proportional-hazard models. Complications rates were evaluated to assess safety. Results: The analysis included 239 eyes (239 patients): 144 (60.2%) in the XEN alone and 95 (39.8%) in the XEN+Phaco groups. Overall success was achieved in 164 (68.1%) eyes [113 (68.9%) complete and 51 (31.1%) qualified], without significant differences in success (p = 0.07) and survival rates (p = 0.46) between groups. At the 36th month, the baseline IOP decreased from a median (IQR) of 23.0 (20.0–26.0) to 15.0 (12.0–17.5) mmHg (p < 0.01), with an overall 34.1 ± 20.1% IOP reduction. The mean ± SD number of OHMs decreased from the baseline of 2.7 ± 0.9 to 0.9 ± 1.1 at month 36 (p < 0.01). PP and LOCF analyses were comparable. Neither pre- nor intraoperative factors were significantly predictive of surgery failure. In 91 (38.1%) and 57 (23.8%) of the eyes, at least one postoperative complication occurred early (<month 1) and late (≥month 1) during follow-up, respectively, without sequelae. During follow-up, 68 (28.5%) eyes needed at least one needling. Conclusions: At 3 years, XEN45, combined or not with phacoemulsification, effectively and safely reduced IOP and OHMs need. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition)
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12 pages, 1837 KiB  
Article
Racial and Gender Disparities for Glaucoma Treatment Rates in Upstate New York
by Karen Allison, Brittany Hodges, Mohammed Mehdi Shahid and Changyong Feng
J. Clin. Med. 2024, 13(23), 7225; https://doi.org/10.3390/jcm13237225 - 28 Nov 2024
Viewed by 854
Abstract
Introduction: Glaucoma is one of the leading causes of irreversible blindness around the world. Black individuals are two times more likely to be diagnosed with glaucoma compared to White individuals. In 2019, the prevalence of glaucoma in Monroe County was highest amongst older [...] Read more.
Introduction: Glaucoma is one of the leading causes of irreversible blindness around the world. Black individuals are two times more likely to be diagnosed with glaucoma compared to White individuals. In 2019, the prevalence of glaucoma in Monroe County was highest amongst older individuals aged 85 and non-Hispanic Blacks. This study seeks to explore differences in glaucoma treatment rates that may be exacerbating disease severity and prognosis for individuals most acutely affected by glaucoma in Monroe County, NY. Methods: We used data from the Center for Disease Control’s National Vision and Eye Health Surveillance System (VEHSS) to assess the rates of glaucoma treatment for different racial, gender, and age demographic groups in Monroe County, NY. The source data were from individuals enrolled in Medicare who filed a claim. We stratified the data based on the glaucoma treatment type: laser glaucoma surgery, glaucoma drainage devices, other glaucoma surgery, or glaucoma prescription drugs. The main outcome variable was the prevalence rate of various types of glaucoma treatment in Monroe County, NY. The data were analyzed by potential risk covariates such as race/ethnicity, age, and gender. A descriptive data analysis was performed to assess for demographic trends. Results: The most common form of glaucoma treatment in Monroe County, NY was prescription drug therapy (36.82%), which was predominant across all racial, gender, and age groups. This was followed by laser surgery (3.26%), glaucoma drain (1.47%), and other forms of glaucoma surgery (0.58%). Women displayed a higher incidence of laser surgery, glaucoma drainage, and other glaucoma surgeries (3.58%, 1.77%, and 0.69%, respectively) with a lower incidence of prescription drug usage (36.14%) compared to men. Black non-Hispanic patients had a higher incidence of laser surgery and prescription drug usage (3.39% and 47.20%, respectively), but a lower incidence of glaucoma drainage and other glaucoma surgeries (1% and 0%, respectively) compared to other racial groups. Conclusions: This study elucidates the differences in glaucoma treatment types across different racial, gender, and age groups in Monroe County, NY. The results underscore the disparities in treatment rates for Medicare patients diagnosed with glaucoma in Monroe County. The results justify the need for increased interventions to increase access to a variety of glaucoma treatment options to mitigate disparities in glaucoma outcomes. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition)
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17 pages, 2031 KiB  
Article
Dysfunction and Morphological Involvement of Inner Macular Layers in Glaucoma
by Vincenzo Parisi, Lucia Ziccardi, Sara Giammaria, Lucilla Barbano, Lucia Tanga, Manuele Michelessi, Gloria Roberti, Carmela Carnevale, Carmen Dell’Aquila, Mattia D’Andrea, Gianluca Manni and Francesco Oddone
J. Clin. Med. 2024, 13(22), 6882; https://doi.org/10.3390/jcm13226882 - 15 Nov 2024
Viewed by 894
Abstract
Objectives: This study aimed to study the inner retina functional and morphological impairment of retinal ganglion cells (RGCs) from specific macular rings and sectors to identify whether selective macular regions were more vulnerable than others within the 20 central degrees in patients with [...] Read more.
Objectives: This study aimed to study the inner retina functional and morphological impairment of retinal ganglion cells (RGCs) from specific macular rings and sectors to identify whether selective macular regions were more vulnerable than others within the 20 central degrees in patients with open-angle glaucoma (OAG). Methods: In total, 21 OAG patients [mean age 50.19 ± 7.86 years, Humphrey Field Analyzer (HFA) 24-2 mean deviation (MD) between −5.02 and −22.38 dB, HFA 10-2 MD between −3.07 and −17.38 dB], providing 21 eyes, were enrolled in this retrospective case–control study. And 20 age-similar healthy subjects, providing 20 eyes, served as controls. The multifocal photopic negative response (mfPhNR) response amplitude density (RAD) from concentric rings and macular sectors and ganglion cell layer thickness (GCL-T) assessed by Spectral Domain–Optical Coherence Tomography (SD-OCT) was measured. Mean RAD and GCL-T values were compared between OAG and control ones by ANOVA. In OAG eyes, the relationship between mfPhNR and SD-OCT data was examined by linear regression analysis, and Pearson’s correlation coefficients were computed. Results: In considering all rings and sectors, compared to the controls, the OAG group showed a significant (p < 0.01) reduction in mean mfPhNR RAD and in GCL-T values with the greatest reduction in the central area. In OAG eyes, a significant (p < 0.01) correlation between all mfPhNR RAD and GCL-T values, with significant (p < 0.01) correlation coefficients, were found. Conclusions: In OAG eyes, RGC dysfunction was detectable by abnormal mfPhNR responses in localized macular areas, mainly in the central one. Localized macular RGC dysfunction was linearly correlated with the GCL morphological changes. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition)
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11 pages, 2623 KiB  
Article
Evaluation of the Effect of Topical Prostaglandin Analog Treatment on Orbital Structures in Open-Angle Glaucoma with Computed Tomography
by Berire Şeyma Durmuş Ece, Zübeyir Yozgat, Hüseyin Bayramlı, Bunyamin Ece and Sonay Aydin
J. Clin. Med. 2024, 13(19), 5808; https://doi.org/10.3390/jcm13195808 - 28 Sep 2024
Cited by 1 | Viewed by 1549
Abstract
Background/Objectives: This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. Methods: Patients with [...] Read more.
Background/Objectives: This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. Methods: Patients with open-angle glaucoma who had CT images of the orbital region taken for another reason at least one month after starting PGA treatment in one eye were included in the study. Enophthalmos measurements from thin-slice CT images, along with 3D volume measurements of orbital fat tissue, periorbital muscles, and the optic nerve, were performed. Ophthalmological examination findings and treatment information were collected. The values were compared with those of the contralateral eyes of the same patients not using PGA. Intraclass correlation coefficients (ICCs) were computed to evaluate measurement repeatability. Results: Forty patients were included in the study. Among them, 29 (72.5%) used latanoprost, 9 (22.5%) used bimatoprost, and 2 (5%) used travoprost. The mean enophthalmos values on the treated side (15.5 ± 2.0 mm) were lower than on the untreated side (16.1 ± 1.4 mm), but this difference was not statistically significant (p = 0.07). In 29 patients (72.5%), enophthalmos measurements were smaller on the treated side, with 7 patients (17.5%) showing a difference of 2 mm or more. No significant correlation was found between the duration of PGA use and enophthalmos measurements (p = 0.768 r = −0.048). Additionally, no significant differences were found in orbital fat volume, total extraocular muscle volume, and optic nerve volume (p > 0.05). ICC values demonstrated excellent reliability (ICC > 0.75) for all measurements. Conclusions: We did not find significant differences in enophthalmos measurements, orbital fat volume, total muscle volume, and optic nerve volume between the PGA-treated and untreated eyes. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition)
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12 pages, 1988 KiB  
Article
The Clinical Efficacy of Different Relaxation Exercises on Intraocular Pressure Reduction: A Meta-Analysis
by Bing-Qi Wu, Hou-Ting Kuo, Alan Y. Hsu, Chun-Ju Lin, Chun-Ting Lai and Yi-Yu Tsai
J. Clin. Med. 2024, 13(9), 2591; https://doi.org/10.3390/jcm13092591 - 28 Apr 2024
Viewed by 1864
Abstract
Objective: The aim of this study was to synthesize the available evidence on the clinical efficacy of different relaxation exercises on intraocular pressure (IOP) reduction. Methods: A systemic search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was undertaken from [...] Read more.
Objective: The aim of this study was to synthesize the available evidence on the clinical efficacy of different relaxation exercises on intraocular pressure (IOP) reduction. Methods: A systemic search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was undertaken from the earliest record to 10 April 2024. Peer-reviewed studies that reported on healthy individuals and glaucoma patients engaging in relaxation exercises for at least three weeks were included. The primary outcome was changes in IOP levels from baseline, before the commencement of relaxation exercises, to post-exercise. Our statistical analysis employed a random-effects model, with effect sizes reported using Hedges’ g. Results: Twelve studies were included, totaling 764 eyes (mean participant age ranging from 21.07 to 69.50 years). Relaxation exercises significantly reduced IOP, with Hedges’ g being −1.276 (95% CI: −1.674 to −0.879) and I2 = 84.4%. Separate subgroup analyses showed that breathing exercises (Hedges’ g = −0.860, p < 0.0001), mindfulness-based stress reduction (MBSR) (Hedges’ g = −1.79, p < 0.0001), and ocular exercises (Hedges’ g = −0.974, p < 0.0001) were associated with reduced IOP levels. The reduction in IOP following the relaxation exercises was found to be associated with baseline IOP either greater than (Hedges’ g = −1.473, p < 0.0001) or less than 21 mmHg (Hedges’ g = −1.22, p < 0.0001). Furthermore, this effect persisted with follow-up durations of less than (Hedges’ g = −1.161, p < 0.0001) and more than one month (Hedges’ g = −1.324, p < 0.0001). Conclusions: The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel treatments for glaucoma patients that deserve further evaluation. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prevention of Glaucoma: Second Edition)
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