Purpose: The aim of this study was to evaluate the diagnostic accuracy of optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. Methods: A population-based sample of 4113 persons was randomly selected. The screening examination included a fundus photograph and OCT images. Images were evaluated on a deferred basis. All participants were then invited to a complete glaucoma examination, including gonioscopy, visual field, and dilated fundus examination. The detection rate, sensitivity, specificity, and positive and negative predictive values were calculated. Results: We screened 1006 persons. Of these, 201 (19.9%) were classified as glaucoma suspects; 20.4% were identified only by retinographs, 11.9% only by OCT images, and 46.3% by both. On ophthalmic examination at the hospital (n = 481), confirmed glaucoma was found in 58 (12.1%), probable glaucoma in 76 (15.8%), and ocular hypertension in 10 (2.1%), and no evidence of glaucoma was found in 337 (70.0%). The detection rate for confirmed or probable glaucoma was 9.2%. Sensitivity ranged from 69.4% to 86.2% and specificity from 82.1% to 97.4%, depending on the definition applied. Conclusions: The combination of OCT images and fundus photographs yielded a detection rate of 9.2% in a population-based screening program with moderate sensitivity, high specificity, and predictive values of 84–96%.

The role of nutraceuticals in the treatment of glaucoma remains controversial. The aim of this study was to evaluate the effect of citicoline, vitamin C, and docosahexaenoic acid (DHA) in patients with glaucoma. Methods: This was a prospective, randomized study. Patients with glaucoma were randomized to one of four groups and treated for 3 months with vitamin C, DHA, citicoline, or a combination of DHA and citicoline. We conducted a complete ophthalmic examination and visual fields each month and calculated the slopes of field indices. Changes in visual field indices (VFIs) and their slopes were assessed in each group and compared. Results: Seventy-three persons were included in the study. Mean defect (MD) significantly improved (p = 0.001) from −9.52 ± 4.36 to −7.85 ± 4.36 dB during the study period in persons taking DHA + citicoline. Similarly, the mean VFI significantly improved (p = 0.001) in this group. The only treatment group showing a statistically significant improvement (p = 0.006) in the MD (from −0.1041 ± 0.2471 to 0.1383 ± 0.2544 dB/month) and VFI slope was the group treated with DHA+citicoline. Conclusions: The combination of oral treatment with DHA + citicoline significantly improved VF indices and their slopes in patients with glaucoma after 3 months of treatment.

Purpose: To evaluate refractive outcomes and associated factors in patients undergoing combined filtering glaucoma surgery (trabeculectomy or non-penetrating deep sclerectomy (NPDS)) and cataract extraction with toric intraocular lens implantation. Design: Prospective consecutive case series. Methods: This prospective case series included 43 eyes of 32 patients with preoperative corneal astigmatism ≥ 0.75 diopters (D) and moderate-to-severe open-angle glaucoma. Patients underwent trabeculectomy or NPDS and cataract surgery with toric intraocular lens (IOL) implantation. Main outcomes included refractive astigmatism (vector and refractive analysis), spherical equivalent (SE), mean absolute error (MAE), prediction error, intraocular pressure (IOP), and the influence of surgical technique and IOL characteristics. Results: Mean refractive astigmatism decreased from 2.29 ± 1.02 D to 0.57 ± 0.44 D at 6 months ( p < 0.001). Mean SE improved from −1.38 ± 3.52 D to 0.06 ± 0.45 D. The MAE was 0.59 ± 0.40 D. No significant correlation was found between refractive results and surgical technique or IOL type. Complete IOP control without medication was achieved in 88.3% of eyes. Visual acuity improved in 97.6% of patients Conclusions: Combined glaucoma filtering surgery with toric IOL implantation yields effective astigmatism correction and favorable refractive outcomes without compromising IOP control. This approach is a valuable option for patients with moderate-to-severe glaucoma and preexisting corneal astigmatism.