Ophthalmology

Motivational glaucoma coaching markedly boosts drop adherence and lowers distress

Adults with glaucoma and self-reported adherence ≤85% were randomized to a 6‑month SEE coaching program versus usual care with mailed education. Nonphysician coaches delivered motivational interviewing, in‑person visits, phone calls, multimedia education, and automated reminders. Electronically monitored adherence over 6 months was higher with SEE (77.6%) than control (58.0%), a 19.7% absolute increase. More SEE participants achieved ≥80% adherence (54.9% vs 23.7%), and glaucoma-related distress decreased more than with written education alone. 1

Preoperative brimonidine associated with higher trabeculectomy failure from high IOP

This single-center cohort of 501 eyes undergoing primary trabeculectomy examined associations between preoperative drops and surgical success. Preoperative brimonidine was linked to nearly threefold higher risk of high-IOP failure (HR 2.87; p=0.002). At 3 years, success probability from high-IOP failure was 81.9% with brimonidine versus 93.36% without. Other agents, including beta blockers, prostaglandins, and carbonic anhydrase inhibitors, showed no significant association with failure risk. 2

RVO greatly elevates early ERM formation and later peel risk

This national database study compared over 19,000 BRVO and nearly 15,000 CRVO patients with matched controls for ERM outcomes. ERM formation risk peaked at 3 months after RVO, with relative risks around 4.5–4.9 versus controls. ERM peel risk was maximal at 1 year for BRVO and 3 years for CRVO compared with controls. Anti-VEGF–treated cohorts showed higher early ERM rates and later-peaking peel risk, likely reflecting greater baseline disease severity. 3

External validation cautions against over-narrowing ROP screening windows

Using ROP Check® data from 28 US hospitals, 5058 infants and 23,557 encounters were analyzed against encounter-reducing screening proposals. Among 388 treated infants, three with gestational age 30.0–30.9 weeks would be at risk of under-screening with some modified criteria. Slightly truncating the last half-week of gestational-age screening reduced encounters by 2.5% without missing treated cases here. Using ROP Check® only when necessary for birthweight <1400 g and GA <30 weeks in non-Pacific races cut encounters 7.8% without missed treatment, but Pacific infants required more sensitive thresholds. 4