The authors of this prospective cohort study assessed the relation between anthropometric measures and incident primary open-angle glaucoma (POAG) and found that among women, higher body mass index (BMI) was associated with a lower risk of POAG with IOP of 21 mmHg or less at diagnosis. They believe that the factors contributing to this tendency may yield insight into the pathogenesis of POAG.

A total of 78,777 women were included in the Nurses' Health Study and 41, 352 men in the Health Professionals Follow-up Study. The authors followed females and male health professionals prospectively from 1980 through 2004 and 1986 through 2004, respectively. Eligible participants were 40 years of age or older, did not have PAOG at baseline and reported undergoing eye examinations during follow up. Information regarding anthropometric measures, potential confounders and ophthalmic status was updated using biennial questionnaires and during follow up, 980 POAG cases were identified. The authors of this study noted that multivariate rate ratios (MVRR) of POAG and their 95% confidence intervals (CIs) served as the main outcome measures.

They reported that there was no significant relation between cumulatively averaged BMI in kilograms per meter squared and POAG overall (p=0.06, for trend). However, in relation to POAG with IOP of 22 mmHg or less at diagnosis, each unit increase in BMI was associated with a 6% reduced risk in women (MVRR, 0.94, 95% CI, 0.91–0.98; p=0.01), but not for men (MVRR, 1.02; 95% CI, 0.96–1.09; p=0.57); this gender difference was significant (p=0.03, for heterogeneity). According to the study authors, in multivariate analyses to explore the independent effects of height and weight, weight (as height-adjusted weight residuals; p=0.002, for trend), but not height (p=0.10, for trend) seemed to account for most of the inverse association between BMI and PAOG with IOP of 21 mmHg or less at diagnosis in women. They found no association between BMI and POAG with IOP of more than 21 mmHg at diagnosis for either gender (p≥0.26, for trend). Among women, analyses found that the relations between anthropometric parameters and both POAG subtypes (POAG with IOP ≤ 21 mmHg vs. POAG with IOP > 21 mmHg when diagnosed) were significantly different (p≤0.0001).

Researchers from the United Kingdom conducted a retrospective case review from a tertiary referral center to investigate whether useable visual acuity (VA) is a realistic goal in patients with congenital cataracts.

They identified 62 patients and of them, 32% of aphakic eyes had a final VA of 0.6 LogMAR or better (average 0.34 ± 0.17). They noted that the average age at the time of surgery was 5.0 ± 4.1 weeks and that the remaining 68% had vision that was less than 0.6, with 27% having vision of <1.00. The researchers reported that the group with vision less than 0.6 (68%) had an average age of 9.7 ± 6.5 weeks at the time of surgery. One case (1.6%) achieved a VA of 0.0 and also had demonstrable stereoacuity (110 arcs).

The researchers found that manifest strabismus was present in 85% of cases and that glaucoma developed in 19% of patients and 31% discontinued the occlusion regime before the age of 4 years. In most of these cases, occlusion was ceased by the age of 2 years when testing revealed dense amblyopia in the aphakic eye, even if good compliance had previously been achieved. In many cases, this coincided with the child becoming noncompliant with occlusion.

In conclusion, more than two-thirds of children in the cohort did not develop acuity better than 0.6 LogMAR in their aphakic eye.

To determine the value of daytime and 24-hour phasing in patients treated for progressive glaucoma despite apparently adequate intraocular pressure (IOP) control, a retrospective analysis of a cohort of patients that had undergone either daytime phasing (08:00–18:00) or 24-hour phasing was conducted in the United Kingdom.

IOP measurements were compared between those taken in clinic, daytime phasing and 24-hour phasing and the frequency with which phasing results changed clinical management was also compared between daytime and 24-hour phasing.

A total of 76 patients fulfilling the study criteria were identified; clinic and daytime phasing IOP were known for all 76 patients and nighttime IOP measurements were known for 41. No significant difference between mean IOP values measured in clinic and daytime phasing (p=0.062) or between clinic values and nighttime phasing (p=0.65) were noted. Also, the mean daytime phasing IOP was significantly higher than the mean nighttime phasing IOP (p=0.038) (analysis of variance [ANOVA] for three groups, p=0.058). There was no significant difference between the mean peak IOP in clinic or daytime phasing (p=0.13) or between clinic and nighttime phasing (p=0.44). It was noted that the mean daytime phasing IOP peak was significantly higher than the mean nighttime phasing IOP peak (p=0.015) (ANOVA for three groups, p=0,074). Furthermore, there was no significant difference in the frequency of a change in management that occurred as a result of phasing between the daytime and 24-hour groups (p=0.65).

In conclusion, 24-hour phasing offers little advantage over daytime phasing in the identification of IOP fluctuations or peaks in patients progressing despite acceptable IOP readings. Daytime phasing is likely to be more cost-effective than 24-hour phasing.