The following Japanese multicenter, retrospective cohort study evaluated the surgical outcomes of trabeculotomy for steroid-induced glaucoma and found that it was effective for controlling IOP <21 mmHg in steroid-induced glaucoma eyes.

At 17 clinical centers, 121 steroid-induced glaucoma patients who underwent trabeculotomy between 1997 and 2006 were reviewed. Surgical failure was defined by the need for additional glaucoma surgery, deterioration of visual acuity to no light perception or IOP ≥21 mmHg (criterion A) and ≥18 mmHg (criterion B). Surgical outcomes were compared with those of 108 primary open-angle glaucoma (POAG) patients who underwent trabeculotomy and 42 steroid-induced glaucoma patients who underwent trabeculectomy. Additionally, prognostic factors for failure were evaluated using the Cox proportional hazards model.

The probabilities of success at 3 years for trabeculotomy for steroid-induced glaucoma vs trabeculotomy for POAG was 78.1% vs 55.8% for criterion A (p=.0008) and 56.4% vs 30.6% for criterion B (p<.0001), respectively. It was found that at 3 years, the success of trabeculotomy for steroid-induced glaucoma was comparable to trabeculectomy for steroid-induced glaucoma for criterion A (83.8%, p=.3636), but lower for criterion B (71.6%; p=.0352). Prognostic factors for failure of trabeculotomy for steroid-induced glaucoma were previous vitrectomy (relative [RR] = 5.340; p=0452 on criterion A, RR = 3.898; p=.0360 for criterion B) and corticosteroid administration other than ocular instillation (RR = 2.752; p=.0352 for criterion B).

Japanese researchers sought to determine whether a significant correlation exists between the ocular vascular endothelial growth factor (VEGF) levels and the amplitudes and implicit times of different components of the electroretinogram (ERG) in eyes with a central retinal vein occlusion (CRVO).

They reviewed the medical records of the 20 consecutive patients who had macular edema secondary to CRVO and were examined at the Nagoya University Hospital from November 2008 to February 2010. Because all patients were scheduled to receive an intravitreal injection of bevacizumab (IVB), it was possible to collect samples of the aqueous humor prior to the IVB. Additionally, the researchers determined the correlation between the different components of the ERGs and the VEGF concentration in the aqueous.

They found that the mean VEGF concentration of the aqueous humor was 416 pg/ml with a range of 100 to 1260 pg/ml. They also noted that the b/a ratio of the single flash ERGs (p=0.049; p= –0.45), implicit times of the cone a-wave (p=0.028; p=0.50), cone b-wave (p=0.0059; p=0.63) and 30 Hz flicker ERGs (p=0.0058; p=0.63) were significantly correlated with the VEGF concentration in the aqueous.

The significant correlations between the different components of the ERGs and the aqueous VEGF concentration indicate that full-field ERGs can be used to detect the CRVO patients at a high risk of developing neovascularization of the iris.

The authors of the following retrospective, longitudinal, cohort study sought to determine the incidence and prevalence of different glaucoma types among Asian Americans and other races, and evaluate the hazard for glaucoma among different races and Asian ethnicities.

They included a group of 2,259,061 eyecare recipients, aged ≥40 years, who were enrolled in a U.S. managed care network in 2001–2007. They calculated incidence and prevalence rates of open-angle glaucoma (OAG), narrow-angle glaucoma (NAG) and normal-tension glaucoma (NTG) and stratified these by race and Asian ethnicity. The study authors also performed Cox regression to assess the hazard of developing OAG, NAG and NTG for Asian Americans and other races, and among different Asian ethnicities, with adjustment for potentially confounding variables. Main outcome measures were multivariable adjusted hazard of OAG, NAG and NTG among different races and Asian ethnicities.

The OAG prevalence rate for Asian Americans, 6.52%, was similar to that of Latinos (6.40%) and higher than that of non-Hispanic whites (5.59%), the authors found. They also discovered that the NAG and NTG prevalence rates were considerably higher among Asian Americans (3.01% and 0.73%, respectively) relative to other races. After adjustment for potential confounding factors, Asian Americans had a 51% increased hazard of OAG (adjusted hazard ratio [HR], 1.51 [95% confidence interval (CI), 1.42–1.60]), a 123% increased hazard of NAG (adjusted HR, 2.23; CI, 2.07–2.41) and a 159% increased hazard of NTG (adjusted HR, 2.59; CI, 2.22–3.02) compared with non-Hispanic whites.

According to the authors, Vietnamese Americans (adjusted HR, 3.78; CI, 3.19–4.48), Pakistani Americans (adjusted HR, 2.45, CI 1.50–4.01) and Chinese Americans (adjusted HR, 2.31, CI 2.06–2.59) had considerably higher hazards of NAG, whereas Japanese Americans (adjusted HR, 4.37, CI 3.24–.89) had a substantially higher hazard of NTG, compared with non-Asian Americans.

In conclusion, given the rapid rise in the number of Asian Americans in the U.S. population, resource should be devoted to identifying and treating glaucoma in these patients. Eyecare providers should be aware of the increased risk for OAG, NAG and NTG among Asian Americans relative to other races. Knowing Asian-American patients' ancestral country of origin may permit more precise estimation of their risks for OAG, NAG and NTG.