TY - JOUR
T1 - Factors Associated With Favorable Laser Trabeculoplasty Response
T2 - IRISRegistry Analysis
AU - Chang, Ta C.
AU - Parrish, Richard K.
AU - Fujino, Danielle
AU - Kelly, Scott P.
AU - Vanner, Elizabeth A.
N1 - Funding Information:
Funding/Support: The project was supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, The 2019 University of Miami Institute for Advanced Study of the Americas Pilot Grant, 2018 IRIS-Registry-AGS Research Initiative Grant, and Grant Number UL1TR002736, Miami Clinical and Translational Science Institute, from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Financial Disclosures: There are no financial disclosures for any of the authors. All authors attest that they meet the current ICMJE criteria for authorship. Other Acknowledgments: The authors wish to acknowledge Mr. and Mrs. Bruce and Cynthia Sherman for their generous support of the Samuel & Ethel Balkan International Pediatric Glaucoma Center, and their tremendous foresight in the value of integrated informatics clinical research.
Funding Information:
Funding/Support: The project was supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, The 2019 University of Miami Institute for Advanced Study of the Americas Pilot Grant, 2018 IRIS-Registry-AGS Research Initiative Grant, and Grant Number UL1TR002736, Miami Clinical and Translational Science Institute, from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Financial Disclosures: There are no financial disclosures for any of the authors. All authors attest that they meet the current ICMJE criteria for authorship. Other Acknowledgments: The authors wish to acknowledge Mr. and Mrs. Bruce and Cynthia Sherman for their generous support of the Samuel & Ethel Balkan International Pediatric Glaucoma Center, and their tremendous foresight in the value of integrated informatics clinical research.
Publisher Copyright:
© 2020 Elsevier Inc.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Purpose: We examined patients in a large clinical registry to assess factors associated with laser trabeculoplasty (LTP) responses. Design: Retrospective cohort study. Methods: STUDY POPULATION: LTP patients in the Intelligent Research in Sight (IRIS) Registry, 2013-2018. OBSERVATION: IRIS Registry data were extracted if the eye had a procedural code for LTP and a glaucoma diagnosis. Eyes were excluded if LTP laterality or baseline intraocular pressure (IOP) could not be determined. Following LTP, “nonresponders” were those with <20% IOP reduction after 8 weeks, while “responders” were those with ≥20% IOP reduction. MAIN OUTCOME MEASURES: Proportion of responders, odds ratios (OR) of pre-LTP factors associated with being a nonresponder. Results: A total of 263,480 eyes were included, with mean age 71.4 ± 11.7 years. Mean baseline IOP was 19.1 ± 5.0 mm Hg, mean number of pre-LTP medications was 2.1 ± 1.5. Response rate was 36.9% overall and 68.8% for those with baseline IOP >24 mm Hg. Higher baseline IOP was associated with reduced odds of nonresponse (OR = 0.60, P < .0001 for a 3 mm Hg increase). Angle recession, uveitis, and aphakia increased the odds of a nonresponse (ORs 2.46, 1.50 (both P < .0001), and 1.55 (P = .0259), respectively). In nonresponders with at least 1 medication at baseline, 76.3% of eyes had fewer medications postoperatively. Conclusions: Lower baseline IOP, angle recession, uveitis, and aphakia were associated with increased odds of nonresponse. Future studies that analyze LTP responder survival and implementation lag would facilitate resource optimization in glaucoma therapy.
AB - Purpose: We examined patients in a large clinical registry to assess factors associated with laser trabeculoplasty (LTP) responses. Design: Retrospective cohort study. Methods: STUDY POPULATION: LTP patients in the Intelligent Research in Sight (IRIS) Registry, 2013-2018. OBSERVATION: IRIS Registry data were extracted if the eye had a procedural code for LTP and a glaucoma diagnosis. Eyes were excluded if LTP laterality or baseline intraocular pressure (IOP) could not be determined. Following LTP, “nonresponders” were those with <20% IOP reduction after 8 weeks, while “responders” were those with ≥20% IOP reduction. MAIN OUTCOME MEASURES: Proportion of responders, odds ratios (OR) of pre-LTP factors associated with being a nonresponder. Results: A total of 263,480 eyes were included, with mean age 71.4 ± 11.7 years. Mean baseline IOP was 19.1 ± 5.0 mm Hg, mean number of pre-LTP medications was 2.1 ± 1.5. Response rate was 36.9% overall and 68.8% for those with baseline IOP >24 mm Hg. Higher baseline IOP was associated with reduced odds of nonresponse (OR = 0.60, P < .0001 for a 3 mm Hg increase). Angle recession, uveitis, and aphakia increased the odds of a nonresponse (ORs 2.46, 1.50 (both P < .0001), and 1.55 (P = .0259), respectively). In nonresponders with at least 1 medication at baseline, 76.3% of eyes had fewer medications postoperatively. Conclusions: Lower baseline IOP, angle recession, uveitis, and aphakia were associated with increased odds of nonresponse. Future studies that analyze LTP responder survival and implementation lag would facilitate resource optimization in glaucoma therapy.
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U2 - 10.1016/j.ajo.2020.10.004
DO - 10.1016/j.ajo.2020.10.004
M3 - Article
C2 - 33049242
AN - SCOPUS:85097740220
VL - 223
SP - 149
EP - 158
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -