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Glaucoma in Adults—Screening, Diagnosis, and ManagementA Review

Educational Objective
To review the clinical management of glaucoma.
1 Credit CME
Abstract

Importance  Glaucoma is the most common cause of irreversible blindness worldwide. Many patients with glaucoma are asymptomatic early in the disease course. Primary care clinicians should know which patients to refer to an eye care professional for a complete eye examination to check for signs of glaucoma and to determine what systemic conditions or medications can increase a patient’s risk of glaucoma. Open-angle and narrow-angle forms of glaucoma are reviewed, including a description of the pathophysiology, risk factors, screening, disease monitoring, and treatment options.

Observations  Glaucoma is a chronic progressive optic neuropathy, characterized by damage to the optic nerve and retinal nerve fiber layer, that can lead to permanent loss of peripheral or central vision. Intraocular pressure is the only known modifiable risk factor. Other important risk factors include older age, nonwhite race, and a family history of glaucoma. Several systemic medical conditions and medications including corticosteroids, anticholinergics, certain antidepressants, and topiramate may predispose patients to glaucoma. There are 2 broad categories of glaucoma, open-angle and angle-closure glaucoma. Diagnostic testing to assess for glaucoma and to monitor for disease progression includes measurement of intraocular pressure, perimetry, and optical coherence tomography. Treatment of glaucoma involves lowering intraocular pressure. This can be achieved with various classes of glaucoma medications as well as laser and incisional surgical procedures.

Conclusions and Relevance  Vision loss from glaucoma can be minimized by recognizing systemic conditions and medications that increase a patient’s risk of glaucoma and referring high-risk patients for a complete ophthalmologic examination. Clinicians should ensure that patients remain adherent with taking glaucoma medications and should monitor for adverse events from medical or surgical interventions used to treat glaucoma.

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Article Information

Corresponding Author: Joshua D. Stein, MD, MS, Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall St, Ann Arbor, MI 48105 (jdstein@med.umich.edu).

Accepted for Publication: October 19, 2020.

Author Contributions: Dr Stein had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Weizer.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: Khawaja, Weizer.

Administrative, technical, or material support: Khawaja, Weizer.

Supervision: Weizer.

Conflict of Interest Disclosures: Dr Stein reported receipt of grants from the National Eye Institute, the Lighthouse Guild, and Research to Prevent Blindness during the conduct of the study. Dr Khawaja reported receipt of personal fees from Allergan, Novartis, Thea, Aerie, Santen, and from Google Health outside the submitted work. No other disclosures were reported.

Funding/Support: The Lighthouse Guild, National Eye Institute (1R01EY026641-01A1), and Dr Beverley and Gerson Geltner Fund (Dr Stein); Research to Prevent Blindness (Drs Stein and Weizer); Moorfields Eye Charity Career Development Fellowship (Dr Khawaja).

Role of the Funder/Sponsor: None of the funders or sponsors had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
National Eye Institute.  Glaucoma awareness can help save vision for millions. Published December 22, 2015. Accessed December 20, 2020. https://nei.nih.gov/about/news-and-events/news/glaucoma-awareness-can-help-save-vision-millions
2.
Tham  YC , Li  X , Wong  TY , Quigley  HA , Aung  T , Cheng  CY .  Global prevalence of glaucoma and projections of glaucoma burden through 2040.   Ophthalmology. 2014;121(11):2081-2090. doi:10.1016/j.ophtha.2014.05.013PubMedGoogle Scholar
3.
Bourne  RRA , Flaxman  SR , Braithwaite  T ,  et al.  Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment.   Lancet Glob Health. 2017;5(9):e888-e897. doi:10.1016/S2214-109X(17)30293-0PubMedGoogle Scholar
4.
Javitt  JC , McBean  AM , Nicholson  GA , Babish  JD , Warren  JL , Krakauer  H .  Undertreatment of glaucoma among black Americans.   N Engl J Med. 1991;325(20):1418-1422. doi:10.1056/NEJM199111143252005PubMedGoogle Scholar
5.
Racette  L , Wilson  MR , Zangwill  LM , Weinreb  RN , Sample  PA .  Primary open-angle glaucoma in blacks: a review.   Surv Ophthalmol. 2003;48(3):295-313. doi:10.1016/S0039-6257(03)00028-6PubMedGoogle Scholar
6.
Stein  JD , Kim  DS , Niziol  LM ,  et al.  Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups.   Ophthalmology. 2011;118(6):1031-1037. doi:10.1016/j.ophtha.2010.10.024PubMedGoogle Scholar
7.
Hollands  H , Johnson  D , Hollands  S , Simel  DL , Jinapriya  D , Sharma  S .  Do findings on routine examination identify patients at risk for primary open-angle glaucoma?   JAMA. 2013;309(19):2035-2042. doi:10.1001/jama.2013.5099PubMedGoogle Scholar
8.
Weinreb  RN , Aung  T , Medeiros  FA .  The pathophysiology and treatment of glaucoma: a review.   JAMA. 2014;311(18):1901-1911. doi:10.1001/jama.2014.3192PubMedGoogle Scholar
9.
Sommer  A , Tielsch  JM , Katz  J ,  et al.  Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans: the Baltimore Eye Survey.   Arch Ophthalmol. 1991;109(8):1090-1095. doi:10.1001/archopht.1991.01080080050026PubMedGoogle Scholar
10.
Quigley  HA , West  SK , Rodriguez  J , Munoz  B , Klein  R , Snyder  R .  The prevalence of glaucoma in a population-based study of Hispanic subjects: Proyecto VER.   Arch Ophthalmol. 2001;119(12):1819-1826. doi:10.1001/archopht.119.12.1819PubMedGoogle Scholar
11.
Topouzis  F , Coleman  AL , Harris  A ,  et al.  Factors associated with undiagnosed open-angle glaucoma: the Thessaloniki Eye Study.   Am J Ophthalmol. 2008;145(2):327-335. doi:10.1016/j.ajo.2007.09.013PubMedGoogle Scholar
12.
McCann  P , Hogg  R , Wright  DM ,  et al.  Glaucoma in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).   Br J Ophthalmol. 2020;bjophthalmol-2019-315330. doi:10.1136/bjophthalmol-2019-315330PubMedGoogle Scholar
13.
Shaikh  Y , Yu  F , Coleman  AL .  Burden of undetected and untreated glaucoma in the United States.   Am J Ophthalmol. 2014;158(6):1121-1129.e1. doi:10.1016/j.ajo.2014.08.023PubMedGoogle Scholar
14.
Chua  J , Baskaran  M , Ong  PG ,  et al.  Prevalence, risk factors, and visual features of undiagnosed glaucoma.   JAMA Ophthalmol. 2015;133(8):938-946. doi:10.1001/jamaophthalmol.2015.1478PubMedGoogle Scholar
15.
Crabb  DP , Smith  ND , Glen  FC , Burton  R , Garaway-Heath  DF .  How does glaucoma look?   Ophthalmology. 2013;120(6):1120-1126. doi:10.1016/j.ophtha.2012.11.043PubMedGoogle Scholar
16.
Ramulu  PY , Swenor  BK , Jefferys  JL , Friedman  DS , Rubin  GS .  Difficulty with out-loud and silent reading in glaucoma.   Invest Ophthalmol Vis Sci. 2013;54(1):666-672. doi:10.1167/iovs.12-10618PubMedGoogle Scholar
17.
Ong  EL , Baasanhu  J , Nolan  W ,  et al.  The utility of symptoms in identification of primary angle-closure in a high-risk population.   Ophthalmology. 2008;115(11):2024-2029. doi:10.1016/j.ophtha.2008.06.023PubMedGoogle Scholar
18.
Stowell  C , Burgoyne  CF , Tamm  ER , Ethier  CR ,  et al.  Biomechanical aspects of axonal damage in glaucoma: a brief review.   Exp Eye Res. 2017;157:13-19. doi:10.1016/j.exer.2017.02.005PubMedGoogle Scholar
19.
Flammer  J , Orgül  S , Costa  VP ,  et al.  The impact of ocular blood flow in glaucoma.   Prog Retin Eye Res. 2002;21(4):359-393. doi:10.1016/S1350-9462(02)00008-3PubMedGoogle Scholar
20.
Helmer  C , Malet  F , Rougier  MB ,  et al.  Is there a link between open-angle glaucoma and dementia ?  Ann Neurol. 2013;74(2):171-179.PubMedGoogle Scholar
21.
Ko  F , Muthy  ZA , Gallacher  J ,  et al.  Association of retinal nerve fiber layer thinning with current and future cognitive decline.   JAMA Neurol. 2018;75(10):1198-1205. doi:10.1001/jamaneurol.2018.1578PubMedGoogle Scholar
22.
Wang  K , Gaitsch  H , Poon  H , Cox  NJ , Rzhetsky  A .  Classification of common human diseases derived from shared genetic and environmental determinants.   Nat Genet. 2017;49(9):1319-1325. doi:10.1038/ng.3931PubMedGoogle Scholar
23.
Wolfs  RC , Klaver  CC , Ramrattan  RS , van Duijn  CM , Hofman  A , de Jong  PT .  Genetic risk of primary open-angle glaucoma: population-based familial aggregation study.   Arch Ophthalmol. 1998;116(12):1640-1645. doi:10.1001/archopht.116.12.1640PubMedGoogle Scholar
24.
Sears  NC , Boese  EA , Miller  MA , Fingert  JH .  Mendelian genes in primary open angle glaucoma.   Exp Eye Res. 2019;186:107702. doi:10.1016/j.exer.2019.107702PubMedGoogle Scholar
25.
Souzeau  E , Tram  KH , Witney  M ,  et al.  Myocilin predictive genetic testing for primary open-angle glaucoma leads to early identification of at-risk individuals.   Ophthalmology. 2017;124(3):303-309. doi:10.1016/j.ophtha.2016.11.011PubMedGoogle Scholar
26.
Jain  A , Zode  G , Kasetti  RB ,  et al.  CRISPR-Cas9-based treatment of myocilin-associated glaucoma.   Proc Natl Acad Sci U S A. 2017;114(42):11199-11204. doi:10.1073/pnas.1706193114PubMedGoogle Scholar
27.
Khawaja  AP , Cooke Bailey  JN , Wareham  NJ ,  et al.  Genome-wide analyses identify 68 new loci associated with intraocular pressure and improve risk prediction for primary open-angle glaucoma.   Nat Genet. 2018;50(6):778-782. doi:10.1038/s41588-018-0126-8PubMedGoogle Scholar
28.
Springelkamp  H , Iglesias  AI , Mishra  A ,  et al.  New insights into the genetics of primary open-angle glaucoma based on meta-analyses of intraocular pressure and optic disc characteristics.   Hum Mol Genet. 2017;26(2):438-453. doi:10.1093/hmg/ddw399PubMedGoogle Scholar
29.
Choquet  H , Wiggs  JL , Khawaja  AP .  Clinical implications of recent advances in primary open-angle glaucoma genetics.   Eye (Lond). 2020;34(1):29-39. doi:10.1038/s41433-019-0632-7PubMedGoogle Scholar
30.
Scheetz  TE , Faga  B , Ortega  L ,  et al.  Glaucoma risk alleles in the Ocular Hypertension Treatment Study.   Ophthalmology. 2016;123(12):2527-2536. doi:10.1016/j.ophtha.2016.08.036PubMedGoogle Scholar
31.
Salim  S , Shields  MB .  Glaucoma and systemic diseases.   Surv Ophthalmol. 2010;55(1):64-77. doi:10.1016/j.survophthal.2009.03.006PubMedGoogle Scholar
32.
Gamell  LS and Chen  BH .  Glaucoma Today website. Glaucoma associated with systemic disease. Published November 2013. Accessed October 6, 2020. https://glaucomatoday.com/articles/2013-nov-dec/glaucoma-associated-with-systemic-disease
33.
Achiron  A , Sharif  N , Haddad  F.   American Academy of Ophthalmology EyeWiki website. Drug-induced acute angle closure glaucoma. Page modified on November 8, 2019. Accessed October 4, 2020. https://eyewiki.aao.org/Drug-induced_Acute_Angle_Closure_Glaucoma
34.
Memarzadeh  F , Ying-Lai  M , Chung  J , Azen  SP , Varma  R .  Blood pressure, perfusion pressure, and open-angle glaucoma.   Invest Ophthalmol Vis Sci. 2010;51(6):2872-2877. doi:10.1167/iovs.08-2956PubMedGoogle Scholar
35.
De Moraes  CG , Cioffi  GA , Weinreb  RN , Liebmann  JM .  New recommendations for the treatment of systemic hypertension and their potential implications for glaucoma management.   J Glaucoma. 2018;27(7):567-571. doi:10.1097/IJG.0000000000000981PubMedGoogle Scholar
36.
Fraunfelder  FW , Fraunfelder  FT , Keates  EU .  Topiramate-associated acute, bilateral, secondary angle-closure glaucoma.   Ophthalmology. 2004;111(1):109-111. doi:10.1016/j.ophtha.2003.04.004PubMedGoogle Scholar
37.
Ulusoy  S , Erden  M , Dinc  ME ,  et al.  Effects of use of a continuous positive airway pressure device on glaucoma.   Med Sci Monit. 2015;21:3415-3419. doi:10.12659/MSM.895897PubMedGoogle Scholar
38.
Stein  JD , Newman-Casey  PA , Talwar  N , Nan  B , Richards  JE , Musch  DC .  The relationship between statin use and open-angle glaucoma.   Ophthalmology. 2012;119(10):2074-2081. doi:10.1016/j.ophtha.2012.04.029PubMedGoogle Scholar
39.
McCann  P , Hogg  RE , Fallis  R , Azuara-Blanco  A .  The effect of statins on intraocular pressure and on the incidence and progression of glaucoma.   Invest Ophthalmol Vis Sci. 2016;57(6):2729-2748. doi:10.1167/iovs.15-18595PubMedGoogle Scholar
40.
Boland  MV , Ervin  AM , Friedman  DS ,  et al.  Comparative effectiveness of treatments for open-angle glaucoma: a systematic review for the US Preventive Services Task Force.   Ann Intern Med. 2013;158(4):271-279. doi:10.7326/0003-4819-158-4-201302190-00008PubMedGoogle Scholar
41.
Prum  BE  Jr , Rosenberg  LF , Gedde  SJ ,  et al.  Primary open-angle glaucoma preferred practice pattern guidelines.   Ophthalmology. 2016;123(1):P41-P111. doi:10.1016/j.ophtha.2015.10.053PubMedGoogle Scholar
42.
Garcia  GGP , Lavieri  MS , Andrews  C ,  et al.  Accuracy of Kalman filtering in forecasting visual field and intraocular pressure trajectory in patients with ocular hypertension.   JAMA Ophthalmol. Published online November 14, 2019. doi:10.1001/jamaophthalmol.2019.4190PubMedGoogle Scholar
43.
Garcia  GP , Nitta  K , Lavieri  MS ,  et al.  Using Kalman filtering to forecast disease trajectory for patients with normal tension glaucoma.   Am J Ophthalmol. 2019;199:111-119. doi:10.1016/j.ajo.2018.10.012PubMedGoogle Scholar
44.
Wang  M , Shen  LQ , Pasquale  LR ,  et al.  An artificial intelligence approach to detect visual field progression in glaucoma based on spatial pattern analysis.   Invest Ophthalmol Vis Sci. 2019;60(1):365-375. doi:10.1167/iovs.18-25568PubMedGoogle Scholar
45.
Kazemian  P , Lavieri  MS , Van Oyen  MP , Andrews  C , Stein  JD .  Personalized prediction of glaucoma progression under different target intraocular pressure levels using filtered forecasting methods.   Ophthalmology. 2018;125(4):569-577. doi:10.1016/j.ophtha.2017.10.033PubMedGoogle Scholar
46.
Kass  MA , Heuer  DK , Higginbotham  EJ ,  et al.  The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma.   Arch Ophthalmol. 2002;120(6):701-713. doi:10.1001/archopht.120.6.701PubMedGoogle Scholar
47.
Ertel  MK , Aref  AA , Akkara  JD , Seibold  LK , Fernández  MAM , Tabernero  SS .  American Academy of Ophthalmology EyeWiki website. Clinical trials in glaucoma. Published May 19, 2020. Accessed September 24, 2019. https://eyewiki.aao.org/Clinical_Trials_in_Glaucoma
48.
Washington University School of Medicine in St Louis.  Ocular Hypertension Treatment Study (OHTS) risk calculator. Accessed June 14, 2020. https://ohts.wustl.edu/risk/
49.
Leske  MC , Heijl  A , Hyman  L , Bengtsson  B , Dong  L , Yang  Z ; EMGT Group.  Predictors of long-term progression in the early manifest glaucoma trial.   Ophthalmology. 2007;114(11):1965-1972. doi:10.1016/j.ophtha.2007.03.016PubMedGoogle Scholar
50.
Musch  DC , Gillespie  BW , Lichter  PR , Niziol  LM , Janz  NK ; CIGTS Study Investigators.  Visual field progression in the Collaborative Initial Glaucoma Treatment Study the impact of treatment and other baseline factors.   Ophthalmology. 2009;116(2):200-207. doi:10.1016/j.ophtha.2008.08.051PubMedGoogle Scholar
51.
Anderson  DR ; Normal Tension Glaucoma Study.  Collaborative normal tension glaucoma study.   Curr Opin Ophthalmol. 2003;14(2):86-90. doi:10.1097/00055735-200304000-00006PubMedGoogle Scholar
52.
Garway-Heath  DF , Lascaratos  G , Bunce  C , Crabb  DP , Russell  RA , Shah  A .  The United Kingdom Glaucoma Treatment Study.   Ophthalmology. 2013;120(1):68-76. doi:10.1016/j.ophtha.2012.07.028PubMedGoogle Scholar
53.
Collaborative Normal-Tension Glaucoma Study Group.  Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures.   Am J Ophthalmol. 1998;126(4):487-497. doi:10.1016/s0002-9394(98)00223-2PubMedGoogle Scholar
54.
The AGIS Investigators.  The Advanced Glaucoma Intervention Study (AGIS), 7: the relationship between control of intraocular pressure and visual field deterioration.   Am J Ophthalmol. 2000;130(4):429-440. doi:10.1016/s0002-9394(00)00538-9PubMedGoogle Scholar
55.
Lichter  PR , Musch  DC , Gillespie  BW ,  et al.  Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery.   Ophthalmology. 2001;108(11):1943-1953. doi:10.1016/s0161-6420(01)00873-9PubMedGoogle Scholar
56.
Kass  MA , Heuer  DK , Higginbotham  EJ ,  et al.  The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma.   Arch Ophthalmol. 2002;120(6):701-713. doi:10.1001/archopht.120.6.701PubMedGoogle Scholar
57.
Heijl  A , Leske  MC , Bengtsson  B , Hyman  L , Bengtsson  B , Hussein  M ; Early Manifest Glaucoma Trial Group.  Reduction of intraocular pressure and glaucoma progression.   Arch Ophthalmol. 2002;120(10):1268-1279. doi:0.1001/archopht.120.10.1268PubMedGoogle Scholar
58.
Gedde  SJ , Heuer  DK , Parrish  RK  II .  Review of results from the Tube Versus Trabeculectomy study.   Curr Opin Ophthalmol. 2010;21(2):123-128. doi:10.1097/ICU.0b013e3283360b68PubMedGoogle Scholar
59.
Gedde  SJ , Herndon  LW , Brandt  JD , Budenz  DL , Feuer  WJ , Schiffman  JC .  Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up.   Am J Ophthalmol. 2012;153(5):804-814.e1. doi:10.1016/j.ajo.2011.10.024PubMedGoogle Scholar
60.
Azuara-Blanco  A , Burr  J , Ramsay  C ,  et al.  Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE).   Lancet. 2016;388(10052):1389-1397. doi:10.1016/S0140-6736(16)30956-4PubMedGoogle Scholar
61.
Gazzard  G , Konstantakopoulou  E , Garway-Heath  D ,  et al.  Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT).   Lancet. 2019;393(10180):1505-1516. doi:10.1016/S0140-6736(18)32213-XPubMedGoogle Scholar
62.
He  M , Jiang  Y , Huang  S ,  et al.  Laser peripheral iridotomy for the prevention of angle closure.   Lancet. 2019;393(10181):1609-1618. doi:10.1016/S0140-6736(18)32607-2PubMedGoogle Scholar
63.
Gedde  SJ , Feuer  WJ , Sheng Lim  K ,  et al.  Treatment outcomes in the Primary Tube Versus Trabeculectomy Study after 3 years of Follow-up.  2020;127(3):333-345. doi:10.1016/j.ophtha.2019.10.002PubMed
64.
Zuccotti  G .  Glaucoma.   JAMA. 2021;325(2). doi:10.1001/jama.2020.10269Google Scholar
65.
Spratt  A , Ogunbowale  L , Khawaja  A , Franks  W .  Drops and falls.   Age Ageing. 2006;35(6):646. doi:10.1093/ageing/afl113PubMedGoogle Scholar
66.
Jampel  H .  American Glaucoma Society Position Statement: Marijuana and the Treatment of Glaucoma.   J Glaucoma. 2010;19(2):75-76. doi:10.1097/IJG.0b013e3181d12e39PubMedGoogle Scholar
67.
AAO Complementary Therapy Task Force; Hoskins Center for Quality Eye Care.  American Academy of Ophthalmology ONE Network website. Marijuana in the Treatment of Glaucoma CTA—2014. Published June 2014. Accessed April 20, 2020. https://www.aao.org/complimentary-therapy-assessment/marijuana-in-treatment-of-glaucoma-cta--may-2003
68.
Schwartz  GF , Quigley  HA .  Adherence and persistence with glaucoma therapy.   Surv Ophthalmol. 2008;53(suppl 1):S57-S68. doi:10.1016/j.survophthal.2008.08.002PubMedGoogle Scholar
69.
Robin  AL , Muir  KW .  Medication adherence in patients with ocular hypertension or glaucoma ,  Expert Review of Ophthalmology 2019, 14(4-5):199-210. doi:10.1080/17469899.2019.1635456Google Scholar
70.
Craven  ER , Walters  T , Christie  WC ,  et al; Bimatoprost SR Study Group.  24-Month phase i/ii clinical trial of bimatoprost sustained-release implant (Bimatoprost SR) in glaucoma patients.   Drugs. 2020;80(2):167-179. doi:10.1007/s40265-019-01248-0PubMedGoogle Scholar
71.
Newman-Casey  PA , Niziol  LM , Mackenzie  CK ,  et al.  Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design.   Pilot Feasibility Stud. 2018;4:128. doi:10.1186/s40814-018-0320-6PubMedGoogle Scholar
72.
Stein  JD , Challa  P .  Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty.   Curr Opin Ophthalmol. 2007;18(2):140-145. doi:10.1097/ICU.0b013e328086aebfPubMedGoogle Scholar
73.
Zhou  Y , Aref  AA .  A review of selective laser trabeculoplasty: recent findings and current perspectives.   Ophthalmol Ther. 2017;6(1):19-32. doi:10.1007/s40123-017-0082-xPubMedGoogle Scholar
74.
Stein  JD , Kim  DD , Peck  WW , Giannetti  SM , Hutton  DW .  Cost-effectiveness of medications compared with laser trabeculoplasty in patients with newly diagnosed open-angle glaucoma.   Arch Ophthalmol. 2012;130(4):497-505. doi:10.1001/archophthalmol.2011.2727PubMedGoogle Scholar
75.
The AGIS Investigators.  The Advanced Glaucoma Intervention Study (AGIS): 7. the relationship between control of intraocular pressure and visual field deterioration.   Am J Ophthalmol. 2000;130(4):429-440. doi:10.1016/S0002-9394(00)00538-9PubMedGoogle Scholar
76.
Rasmuson  E , Lindén  C , Lundberg  B , Jóhannesson  G .  Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients.   Acta Ophthalmol. 2019;97(8):764-770. doi:10.1111/aos.14125PubMedGoogle Scholar
77.
Rathi  S , Radcliffe  NM .  Combined endocyclophotocoagulation and phacoemulsification in the management of moderate glaucoma.   Surv Ophthalmol. 2017;62(5):712-715. doi:10.1016/j.survophthal.2017.01.011PubMedGoogle Scholar
78.
Fellman  RL , Mattox  C , Singh  K ,  et al.  American Glaucoma Society Position Paper: Microinvasive Glaucoma Surgery.   Ophthalmol Glaucoma. 2020;3(1):1-6. doi:10.1016/j.ogla.2019.12.003PubMedGoogle Scholar
79.
Samuelson  TW , Chang  DF , Marquis  R ,  et al; HORIZON Investigators.  A schlemm canal microstent for intraocular pressure reduction in primary open-angle glaucoma and cataract: the HORIZON study.   Ophthalmology. 2019;126(1):29-37. doi:10.1016/j.ophtha.2018.05.012PubMedGoogle Scholar
80.
Ahmed  IIK , Fea  A , Au  L ,  et al; COMPARE Investigators.  A prospective randomized trial comparing Hydrus and iStent microinvasive glaucoma surgery implants for standalone treatment of open-angle glaucoma: the COMPARE Study.   Ophthalmology. 2020;127(1):52-61. doi:10.1016/j.ophtha.2019.04.034PubMedGoogle Scholar
81.
Rosdahl  JA , Gupta  D .  Prospective studies of minimally invasive glaucoma surgeries: systematic review and quality assessment.   Clin Ophthalmol. 2020;14:231-243. doi:10.2147/OPTH.S239772PubMedGoogle Scholar
82.
Radhakrishnan  S , Chen  PP , Junk  AK , Nouri-Mahdavi  K , Chen  TC .  Laser peripheral iridotomy in primary angle closure: a report by the American Academy of Ophthalmology.   Ophthalmology. 2018;125(7):1110-1120. doi:10.1016/j.ophtha.2018.01.015PubMedGoogle Scholar
83.
Malihi  M , Moura Filho  ER , Hodge  DO , Sit  AJ .  Long-term trends in glaucoma-related blindness in Olmsted County, Minnesota.   Ophthalmology. 2014;121(1):134-141. doi:10.1016/j.ophtha.2013.09.003PubMedGoogle Scholar
84.
Zheng  C , Johnson  TV , Garg  A , Boland  MV .  Artificial intelligence in glaucoma.   Curr Opin Ophthalmol. 2019;30(2):97-103. doi:10.1097/ICU.0000000000000552PubMedGoogle Scholar
85.
Hauser  MA , Allingham  RR , Aung  T ,  et al; Genetics of Glaucoma in People of African Descent (GGLAD) Consortium.  Association of genetic variants with primary open-angle glaucoma among individuals with African ancestry.   JAMA. 2019;322(17):1682-1691. doi:10.1001/jama.2019.16161PubMedGoogle Scholar
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