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Vision
Special Issues
Recent Advances in Glaucoma: Diagnosis and Treatment
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Recent Advances in Glaucoma: Diagnosis and Treatment

A special issue of Vision (ISSN 2411-5150).

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 18112

Special Issue Editor

Dr. Nicoleta Anton

E-Mail
Guest Editor
Department of Ophthalmology, Grigore T. Popa University of Medicine and Pharmacy, University Street, no 16, 700115 Iasi, Romania
Interests: new device glaucoma surgery; cataract surgery; medical retina; neuroophthalmology; artificial intelligence applications in opthalmology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Glaucoma is a condition with an increased prevalence all over the world; after cataracts it is the main cause of visual impairment. The identification of the disease and its etiopathogenesis as well as risk factors leads to its early diagnosis and a reduction in the risk of progression at an important moment of the disease.

Once diagnosed, there are new innovations in its management and in reducing intraocular pressure, such as laser therapy and minimally invasive surgery.

The prediction of glaucoma progression through artificial intelligence tools is a widely debated topic recently.

Dear colleagues, this Special Issue addresses articles and reviews that include new methods for the diagnosis and treatment of glaucoma.

Dr. Nicoleta Anton
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 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. Vision is an international peer-reviewed open access quarterly 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 1600 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
  • pathogenesis
  • laser therapy
  • shunt therapy
  • new technology
  • artificial intelligence

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Published Papers (6 papers)

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Research

Jump to: Review

7 pages, 428 KiB  
Communication
“Air and Visco” Technique: A Promising Innovation in the Surgical Implantation of the Xen Gel Stent Device
by Fabrizio Franco, Federica Serino and Fabrizio Giansanti
Vision 2023, 7(4), 71; https://doi.org/10.3390/vision7040071 - 2 Nov 2023
Cited by 1 | Viewed by 1540
Abstract
We aimed to describe a variation of the surgical technique for the ab interno implantation of the XEN Gel Stent, which, in our experience, is yielding very successful results. The injection of 0.1 mL of air and then of 0.1 mL of a [...] Read more.
We aimed to describe a variation of the surgical technique for the ab interno implantation of the XEN Gel Stent, which, in our experience, is yielding very successful results. The injection of 0.1 mL of air and then of 0.1 mL of a dispersive viscoelastic into the subconjunctival space at the beginning of the surgery allows one to perform a mechanical dissection between the conjunctiva and the Tenon’s capsule, creating a real space. In total, 20 eyes of 16 patients underwent the implantation of a stent gel through the “Air and Visco” technique. We retrospectively analyzed the results. We obtained a reduction in the IOP from an average of 18.3 ± 2.2 mmHg preoperatively to at 13.5 ± 3.5 mmHg at month 12. The needling rate was 20%. We did not register any cases of hypotony (IOP < 6 mmHg), hypotony maculopathy or choroidal detachment. The “Air and Visco” technique allows one to correctly place the device in the subconjunctival space, which the pneumo- and visco-dissection transforms into a real space. This enables an easier surgical performance and more predictable postoperative results, with a low needling rate and reintervention in the follow-up period. It also ensures a greater safety profile because the presence of the OVD on the bleb prevents a sudden lowering of the IOP, eliminating complications such as hypotony, hypotony maculopathy and choroidal detachment in our cohort. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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31 pages, 36474 KiB  
Article
Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics
by Vinod Kumar, Andrey Igorevich Bezzabotnov, Zarina Shaykuliyevna Rustamova, Galina Nikolaevna Dushina, Kamal Abdulmuhsen Abu Zaalan, Ahmad Saleh Soliman Shradqa and Mikhail Aleksandrovich Frolov
Vision 2023, 7(3), 59; https://doi.org/10.3390/vision7030059 - 5 Sep 2023
Viewed by 1771
Abstract
A surgical technique was developed to enhance aqueous humor (AH) flow through the non-trabecular outflow pathway by rerouting it from the anterior chamber (AC) to the suprachoroidal space (SCS) without detaching the ciliary body from the scleral spur. Medium- and long-term surgical outcomes [...] Read more.
A surgical technique was developed to enhance aqueous humor (AH) flow through the non-trabecular outflow pathway by rerouting it from the anterior chamber (AC) to the suprachoroidal space (SCS) without detaching the ciliary body from the scleral spur. Medium- and long-term surgical outcomes were retrospectively analyzed in a case series of 58 glaucoma patients. At 6, 12, and 24 months, the mean IOP decreased from 27.8 ± 8.3 to 14.9 ± 5.0 mmHg, median 15.0 (25th percentile (p25)13.0; 75th percentile (p75) 18.0) and 15.2 ± 3.3 mmHg, and hypotensive medication use reduced from a median (p25; p75) of 3 (2; 3) to 0 (0; 2), 0 (0; 2), and 0 (0; 1.5), respectively. Intra- and postoperative complications were few and manageable. Following surgery, no bleb formation occurred in any of the cases (as confirmed by optical coherence tomography). Conjunctival lymphatic vessels (CLVs) developed in 50% of eyes (29/58). Clinically, they developed directly from sclera and had no connection to the surgical site. Analysis further showed that the development of CLVs and their longer visibility period had poor prognostic value for IOP control. If the fluid flow from the SCS to CLVs was resistance-free, no CLV development was evident. However, if any resistance existed in the flow, the fluid accumulated in lymphatics, resulting in their engorgement. The proposed technique was safe and effective in decreasing IOP in glaucoma patients by enhancing AH flow from the SCS to CLVs via connecting intrascleral microchannels. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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11 pages, 1898 KiB  
Article
Dexamethasone Modulates the Dynamics of Wnt Signaling in Human Trabecular Meshwork Cells
by Chi Zhang, Elizabeth Tannous, Alseena Thomas, Natalia Jung, Edmond Ma and Jie J. Zheng
Vision 2023, 7(2), 43; https://doi.org/10.3390/vision7020043 - 25 May 2023
Cited by 1 | Viewed by 1937
Abstract
Trabecular meshwork (TM) tissue is highly specialized, and its structural integrity is crucial for maintaining homeostatic intraocular pressure (IOP). The administration of glucocorticoids, such as dexamethasone (DEX), can perturb the TM structure and significantly increase IOP in susceptible individuals, resulting in ocular diseases [...] Read more.
Trabecular meshwork (TM) tissue is highly specialized, and its structural integrity is crucial for maintaining homeostatic intraocular pressure (IOP). The administration of glucocorticoids, such as dexamethasone (DEX), can perturb the TM structure and significantly increase IOP in susceptible individuals, resulting in ocular diseases such as steroid-induced glaucoma, a form of open-angle glaucoma. Although the exact mechanism involved in steroid-induced glaucoma remains elusive, increasing evidence suggests that DEX may act through various signaling cascades in TM cells. Despite uncertainty surrounding the specific process by which steroid-induced glaucoma occurs, there is growing evidence to indicate that DEX can impact multiple signaling pathways within TM cells. In this study, we examined the impact of DEX treatment on the Wnt signaling pathway in TM cells, given that Wnt signaling has been reported to play a crucial role in regulating extracellular matrix (ECM) levels in the TM. To further elucidate the role of Wnt signaling in the glaucomatous phenotype, we examined mRNA expression patterns between Wnt signaling markers AXIN2 and sFRP1 and DEX-mediated induction of myocilin (MYOC) mRNA and protein levels over 10 days in DEX-treated primary TM cells. We observed a sequential pattern of peak expression between AXIN2, sFRP1, and MYOC. Based on the study, we propose that sFRP1 upregulation could be a result of a negative feedback mechanism generated by stressed TM cells to suppress abnormal Wnt signaling activities. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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10 pages, 665 KiB  
Article
Internal Tube Occlusion with An Easily Removable Non-Absorbable Double Suture: A Novel Surgical Technique Adjunct for Non-Valved Glaucoma Drainage Devices
by Alfonso Savastano, Gloria Gambini, Maria Cristina Savastano, Matteo Mario Carlà, Clara Rizzo, Tomaso Caporossi, Emanuele Crincoli and Stanislao Rizzo
Vision 2023, 7(1), 14; https://doi.org/10.3390/vision7010014 - 24 Feb 2023
Viewed by 2109
Abstract
To describe a surgical variant for non-valved glaucoma drainage device implants using an easily removable non-absorbable double suture into the lumen of the tube. A retrospective, non-comparative case series of 10 patients who underwent a non-valved glaucoma drainage device implant with an endoluminal [...] Read more.
To describe a surgical variant for non-valved glaucoma drainage device implants using an easily removable non-absorbable double suture into the lumen of the tube. A retrospective, non-comparative case series of 10 patients who underwent a non-valved glaucoma drainage device implant with an endoluminal double-suture for refractory glaucoma. The sutures were easily removed postoperatively without the need for an operating room. Intraocular pressure, number of medications, and early and late complications were evaluated with a follow-up of 12 months. None of the eyes that underwent an operation developed early or late complications. The first endoluminal suture was removed in all eyes with a mean time of removal of 30 ± 7 days. The second suture was removed in all eyes with a mean time of removal of 90 ± 7 days. No complications were noted, either, after or during suture removal. The mean preoperative IOP was 27.3 ± 4.0 and the postoperative IOP, at the end of the follow-up, was 12.7 ± 1.4. At the end of the follow-up, six patients (60%) achieved complete success and four patients (40%) achieved qualified success. In conclusion, in our case series, the surgical variant allowed for a safe and gradual regulation of the flow during postoperative management. Considering the efficacy of non-valved glaucoma drainage devices, an improvement in the safety profile allows surgeons to broaden the surgical indications. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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Review

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18 pages, 735 KiB  
Review
Minimally Invasive Glaucoma Surgery: A Review of the Literature
by Michael Balas and David J. Mathew
Vision 2023, 7(3), 54; https://doi.org/10.3390/vision7030054 - 21 Aug 2023
Cited by 19 | Viewed by 6024
Abstract
Minimally invasive glaucoma surgery (MIGS) has emerged as a novel approach in the glaucoma treatment spectrum, offering a range of diverse procedures and devices aimed at reducing intraocular pressure (IOP). MIGS can be broadly classified into several categories: those that enhance trabecular outflow [...] Read more.
Minimally invasive glaucoma surgery (MIGS) has emerged as a novel approach in the glaucoma treatment spectrum, offering a range of diverse procedures and devices aimed at reducing intraocular pressure (IOP). MIGS can be broadly classified into several categories: those that enhance trabecular outflow (Trabectome, iStent, Hydrus Microstent, Kahook Dual Blade, high frequency deep sclerotomy, and gonioscopy-assisted transluminal trabeculotomy), those that augment suprachoroidal outflow (CyPass Microstent and iStent Supra), those that target Schlemm’s canal (TRAB360 and the OMNI Surgical System, Streamline, and Ab Interno Canaloplasty), and conjunctival bleb-forming procedures (EX-PRESS Glaucoma Filtration Device, Xen Gel Stent and PreserFlo MicroShunt). MIGS is considered to have a shorter surgical time and fewer severe complications when compared to traditional glaucoma surgeries such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves). This literature review comprehensively examines the distinct MIGS devices and procedures, their underlying mechanisms, and clinical outcomes, emphasizing the importance of evaluating the efficacy and complications of each approach individually. As the field of MIGS continues to evolve, it is crucial to prioritize high-quality, long-term studies to better understand the safety and effectiveness of these innovative interventions in glaucoma management. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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14 pages, 4497 KiB  
Review
Ocular Biomechanics and Glaucoma
by Rodrigo Brazuna, Ruiz S. Alonso, Marcella Q. Salomão, Bruno F. Fernandes and Renato Ambrósio, Jr.
Vision 2023, 7(2), 36; https://doi.org/10.3390/vision7020036 - 23 Apr 2023
Cited by 9 | Viewed by 3008
Abstract
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also [...] Read more.
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also influences the accurate measurement of intraocular pressure. We reviewed the pertinent literature to help increase our understanding of the biomechanics of the cornea and other ocular structures and how they can help optimize clinical and surgical treatments, taking into consideration individual variabilities, improve the diagnosis of suspected patients, and help monitor the response to treatment. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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