OBJECTIVE: To investigate differences in peripapillary choroidal thickness (PPCT) between primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and healthy eyes, additionally comparing differences between POAG and NTG eyes.
CONCLUSIONS: Peripapillary choroidal thickness is a well-established OCT parameter in eyes with glaucoma and other ocular pathologies. The relationship between PPCT and glaucoma, if better understood, may facilitate the development of PPCT as a potential diagnostic and monitoring metric for glaucoma. In particular, there has yet to be a synthesis that directly compares PPCT between POAG eyes and NTG eyes.
METHODS: A comprehensive literature search was performed on PubMed, EMBASE, and Cochrane Library, identifying studies from inception to December 2022. We included studies that measured PPCT using OCT in POAG, NTG, and healthy eyes. Mean difference (MD) among groups was calculated. Statistical analysis was performed using R version 4.2.0. Risk of bias of included studies was assessed using the Newcastle Ottawa Scale (NOS).
RESULTS: Eighteen studies were included in this meta-analysis, with a pooled total of 935 healthy control eyes, 446 NTG eyes, and 934 POAG eyes. There was a significant reduction of PPCT in POAG eyes compared with healthy eyes [MD = -16.32; 95% confidence interval (CI) (-27.55 to -5.09)]. Reduction in PPCT was also significant in NTG eyes compared with healthy eyes [MD = -34.96; 95% CI (-49.97 to -19.95)]. NTG eyes had significantly reduced PPCT compared with POAG eyes [MD = -26.64; 95% CI (-49.00 to -4.28)].
CONCLUSIONS: Glaucomatous eyes appear to have significantly reduced PPCT compared with normal healthy eyes. In addition, PPCT in NTG eyes appear significantly thinner compared with that in POAG eyes.
BACKGROUND: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

OBJECTIVE: This systematic review and meta-analysis summarize the evidence for the association between Helicobacter pylori infection and Primary Open-Angle Glaucoma.
METHODS: Eligible studies reporting an association between H. pylori infection and Glaucoma were identified through an extensive search of the Excerpta Medica (EMBASE), Web of Science, Scopus, and PubMed databases and an assessment of the reference list of the top articles until October 2022. Analysis was performed with random effects model using Stata 16.
RESULTS: Twenty-four studies were included in the systematic review. This study involved 1602 glaucoma patients and 2800 control individuals. The combined RRs of cohort studies and overall combined ORs of case-control studies showed a significant correlation between H. pylori infection and Glaucoma. Subgroup analysis showed that glaucoma patients had a higher risk of having H. pylori infection if they were residents of Europe countries (Cohort: RR: 1.69; 95% CI: 1.3-2.19) and (Case-Control: RR: 3.71; 95% CI: 2.07-6.64), if they had POAG type (Cohort: RR: 1.76; 95% CI: 1.37-2.27) and (Case-Control: RR: 3.71; 95% CI: 2.934.70), if their diagnostic method of HP was histology (Cohort: RR: 1.95; 95% CI: 1.26-3.01) and (Case-Control: RR: 4.06; 95% CI: 2.28-7.22), and if they were over 60 years old (Cohort: RR: 1.63; 95% CI: 1.33-2.00) and (Case-Control: RR: 2.95; 95% CI: 2.27-3.83).
CONCLUSIONS: The results of this meta-analysis suggest a statistically significant association between Helicobacter pylori infection and Primary Open-Angle Glaucoma.

Glaucoma is the second leading cause of blindness worldwide. The proportion of cases of primary open-angle glaucoma (POAG) in China is gradually increasing. Glaucoma surgery has become more effective, safer, minimally invasive and personalized over the years. CO2 laser-assisted sclerectomy surgery (CLASS) is a minimally invasive glaucoma treatment. CLASS has recently been used to gradually lower intraocular pressure (IOP) in patients with POAG, pseudocapsular detachment syndrome and secondary glaucoma. In this operation, precise ablation of dry tissue followed by photocoagulation and effective absorption of water and percolating aqueous humor using CO2 laser are performed, and the IOP is lowered by the laser ablation of the deep sclera and the outer wall of the Schlemm\'s canal, facilitating the drainage of the aqueous humor. Compared with other filtering surgeries, CLASS has a shorter learning curve, lower technical difficulty and higher safety. The present study reviews the clinical application progress, safety and effectiveness of CLASS.

BACKGROUND: Pathophysiological overlaps exist between diabetes and primary open-angle glaucoma (POAG) and presence of diabetes increases the risk of POAG. Considering that diabetic retinopathy (DR) is an ocular complication of diabetes, one could speculate that DR as a severity measure may associate with or even predict POAG. Given that POAG is asymptomatic in early stages, an association to DR may prove clinically important and facilitate an earlier diagnosis of POAG.
OBJECTIVE: The aim of the study was to investigate if DR is associated with and predictive of POAG.
METHODS: We systematically searched 11 literature databases on May 12, 2021. We screened a total of 1,535 records and found six studies eligible for qualitative and quantitative analysis. Two independent authors reviewed the studies, extracted data, and evaluated risk of bias within individual studies. Studies were reviewed qualitatively, and meta-analyses were made based on the odds ratios (ORs) with 95% confidence intervals (CI) of the association between DR and POAG using the random-effects model. Subgroup analyses were made on the association between subtypes of DR and POAG.
RESULTS: Six studies (two longitudinal and four cross-sectional) were eligible for review with a total of 255,614 patients with diabetes, of which 20,483 patients had any degree of DR and 5,258 had POAG. All studies were based on patients with type 2 diabetes except one with both type 1 and type 2 patients. Any DR was not associated with POAG (OR 1.17; 95% CI: 0.58-2.35; p = 0.65). Further stratification revealed that neither cross-sectional (OR 1.00; 95% CI: 0.56-1.81, p = 0.99) nor longitudinal studies (OR 1.47; 95% CI: 0.57-3.78, p = 0.43) demonstrated an association between DR and POAG.
CONCLUSIONS: We did not find convincing evidence of an associations between DR and prevalent or incident POAG.

OBJECTIVE: It had been reported that mutations in CYP1B1 gene probably play an important role in the pathogenesis of primary open angle glaucoma (POAG) but the existing genetic association studies show contradictory results. Thus, the objective of our study was to perform a systematic review and meta-analysis to characterize more precisely the potential association between given polymorphisms in CYP1B1 gene and the risk of suffering POAG.
METHODS: A systematic review of studies that related the risk of carrying CYP1B1 gene polymorphisms with POAG development was conducted. We selected 19 case-control studies including 3855 POAG patients and 4125 control subjects in our meta-analyses. A random effects model was used. Sensitivity analysis and assessment of bias were also included.
RESULTS: The prevalence of CYP1B1 gene polymorphisms were significantly more frequent among POAG patients compared to all controls (OR = 2.91, 95% CI = 1.37 - 6.21; P = 0.006). Moreover, their prevalence was significantly higher in juvenile-onset patients than in adult-onset ones (OR = 2.27, 95% CI = 1.20-4.28; P = 0.001).
CONCLUSIONS: The results of this meta-analysis uphold that being a carrier of polymorphic genetic variants in CYP1B1 gene would increase the risk of POAG, especially the juvenile onset.

Glaucoma is a mixed group of optic neuropathies that lead to irreversible visual field loss and blindness if left untreated. It is estimated that 3.5% of the global population aged 40 to 80 years have any glaucoma, being the primary open-angle and the primary angle-closure glaucoma the most prevalent forms. Although the age-standardised prevalence of blindness caused by glaucoma has decreased substantially over the last decades, population growth and ageing impose many challenges in preventing glaucoma-related morbidities on a global level. In addition, difficulties in diagnoses and treatment, along with its chronic and irreversible nature, urge the development and implementation of innovative approaches in confronting the disease. This manuscript reviews recent literature related to the epidemiology of primary glaucomas in adults, the risk factors attributed to the development of the disease, and discuss challenges and potential solutions from a public health perspective.

OBJECTIVE: This study aimed to use the available evidence to model a glaucoma surgical rate (GSR), which could serve as a target for West Africa.
METHODS: A comprehensive literature search was performed in Medline, Embase, Global Health, and CINAHL, and studies published between January 1, 2000, and June 19, 2020, were retrieved. Study selection, quality appraisal, and data extraction were performed and the results of individual studies aggregated and presented using a narrative synthesis. Using these data, we aimed to construct a target GSR per million population per year that is sufficient to offer trabeculectomy to most patients with glaucoma who are diagnosed, and for whom other treatment options are either ineffective or inappropriate. The findings were then used to develop a trabeculectomy target for West Africa.
RESULTS: Initial searches returned 633 references, of which 33 unique studies were eligible for inclusion. The glaucoma prevalence population-based surveys identified, reported a wide range of prevalence of primary open-angle glaucoma (POAG) ranging from 1.0 to 8.4%. The studies on glaucoma medications reported intraocular pressure (IOP)-lowering effects ranging from 12.8% (beta-blockers) to 63.7% (Timolol-Latanoprost combinations). The adherence rate to antiglaucoma medications spanned from 10.3 to 82.3%. Regarding selective laser trabeculoplasty (SLT), only two studies were found. All the studies on trabeculectomy showed a significant reduction in IOPs at different follow-up periods with many reporting the absence of vision-threatening complications. From these available data, a GSR of 50 trabeculectomies was suggested for countries in West Africa.
CONCLUSIONS: This trabeculectomy target metric is expected to minimize POAG blindness in the West African subregion.
CONCLUSIONS: The proposed GSR will enable eye care workers involved in glaucoma care in West Africa to assess their efforts compared with the proposed target. The gap will signal the potential for improvement.
UNASSIGNED: Eni EN, Nolan W, Eval B, et al. What Glaucoma Surgical Rate could Serve as a Target for West Africa? A Systematic Review. J Curr Glaucoma Pract 2021;15(1):19-27.

Primary open-angle glaucoma (POAG) remains a leading cause of irreversible blindness globally. Recent evidence further substantiates sustained oxidative stress, and compromised antioxidant defenses are key drivers in the onset of glaucomatous neurodegeneration. Overwhelming oxidative injury is likely attributed to compounding mitochondrial dysfunction that worsens with age-related processes, causing aberrant formation of free radical species. Thus, a compromised systemic antioxidant capacity exacerbates further oxidative insult in glaucoma, leading to apoptosis, neuroinflammation, and subsequent tissue injury. The purpose of this systematic review is to investigate the neuroprotective benefits of the macular carotenoids lutein, zeaxanthin, and meso-zeaxanthin on glaucomatous neurodegeneration for the purpose of adjunctive nutraceutical treatment in glaucoma. A comprehensive literature search was conducted in three databases (PubMed, Cochrane Library, and Web of Science) and 20 records were identified for screening. Lutein demonstrated enhanced neuroprotection on retinal ganglion cell survival and preserved synaptic activity. In clinical studies, a protective trend was seen with greater dietary consumption of carotenoids and risk of glaucoma, while greater carotenoid levels in macular pigment were largely associated with improved visual performance in glaucomatous eyes. The data suggest that carotenoid vitamin therapy exerts synergic neuroprotective benefits and has the capacity to serve adjunctive therapy in the management of glaucoma.

At present, physical methods of chemical analysis are constantly improving providing large amount of data on elemental composition of organs and tissues. However, only few works describe the correlation (or the potential connection) between the general or local bioelemental imbalances and specific biochemical reactions that are involved in pathogenesis of certain diseases. This review describes primary open-angle glaucoma (POAG) - one of the most common ophthalmic diseases - in terms of elemental chemistry. The authors look into the impact that various subgroups of elements have on passive and active processes of homeostasis regulation and hydrodynamic balance in the eye. Alkaline metals and their analogues (K, Na, Li, Rb, Cs) influence hydrostatics and hydrodynamics by means of both K-Na pumps and osmosis. Alkaline-earth elements and their analogues (Ca, Mg, Sr, Ba, Be) are involved in biomineralization and intercellular interaction in the drainage areas. Chalcophile metals and their analogues (Zn, Cu, Hg, Co, Ni, Cd, Pb, Mo, Sb) regulate redox reactions. They are the cofactors of enzymes that support structural homeostasis of the drainage area. Siderophile metals (Fe, Mn, Cr, Rh) regulate oxidation-reduction reactions, including those associated with limited nutrition of tissues in glaucoma. The role of amphoteric metals and nonmetals (Al, Si, Ga, V, TI, Sn, Ge, Zr, W) in POAG has not been described properly, but they were noted to participate in mineralization. Structure-forming non-metals and their analogues (N, S, Se, As) are directly involved in the formation of protein and non-protein aggregates that prevent aqueous humor outflow. The specific role of phosphorus in the pathogenesis of glaucoma has not been described previously. The authors analyze the involvement of phosphorus in energy-dependent processes of cellular activity, which are aimed at the reprocessing of aggregates that cause aqueous humor retention.

Glaucoma is a group of progressive optic neuropathies that have in common characteristic optic nerve head changes, loss of retinal ganglion cells and visual field defects. Among the large family of glaucomas, primary open‑angle glaucoma (POAG) is the most common type, a complex and heterogeneous disorder with environmental and genetic factors contributing to its pathogenesis. Approximately 5% of POAG is currently attributed to single‑gene or Mendelian forms of glaucoma. Genetic linkage analysis and genome‑wide association studies have identified various genomic loci, paving the path to understanding the pathogenesis of this enigmatic, blinding disease. In this review we summarize the most common variants reported thus far and their possible clinical correlations.