Patient-reported Outcomes, Functional Assessment, and Utility Values in Glaucoma

Authors: Simon Skalicky; Ecosse Lamoureux; David Crabb; Pradeep Ramulu

Abstract:

In clinical glaucoma research, the measurement of patient reported outcomes, functional assessment of disability, and health economic impact is critical. However, valid, time-efficient and comprehensive tools are not available and several current instruments lack in the appropriate precision for measuring the various dimensions of glaucoma-related quality of life (QoL), including functioning and mobility. Furthermore, statistical methods are inconsistently and sometimes incorrectly used in otherwise sound clinical studies. Standardizing and improving methods of patient-centered data collection and analysis in  glaucoma studies are imperative. This paper outlines recommendations and provides a discussion of some of the pertinent issues relating to the optimization of patient-reported outcomes research in glaucoma.

A Case of Glaucoma in Hereditary Spherocytosis.

Authors: Skalicky, Simon E, Chen, Haiying, Symons, Robert C.A.; Mayson, Eleni.

Abstract: 

Purpose: To report a case of glaucoma and the inherited red cell membranopathy hereditary spherocytosis diagnosed simultaneously in 2 individuals in a family.

Patient: A 66-year-old man with normal pressure glaucoma and hereditary spherocytosis.

Results: This patient presented with a branch retinal vein occlusion, and normal tension glaucoma that was incidentally detected. Further history revealed that the patient’s maternal grandmother also had hereditary spherocytosis and glaucoma.

Conclusions: We hypothesize that glaucoma and hereditary spherocytosis may be associated. Hereditary spherocytosis may be a potential risk factor for glaucoma by causing impaired blood supply to the optic nerve.

Sight-threatening complications of cosmetic iris implants.

Authors: Simon E Skalicky PhD, Nathan M Kerr MD, Yu Xiang George Kong PhD, Catherine Green

Objective Assessment of Activity Limitation in Glaucoma with Smartphone Virtual Reality Goggles: A Pilot Study.

Authors: Skalicky,Goh, Kong, McAlinden, Liu, Crowston.

Abstract:

Purpose To evaluate the use of smartphone-based virtual reality to objectively assess activity limitation in glaucoma.

Bilateral Scheie's procedure with Ophthalmic Viscoelastic Device and 5-Fluorouracil.

Authors: Simon E. Skalicky, Gursimrat K. Bhullar, Henry R. Lew

Abstract: 

Introduction: The surgical management of glaucoma has evolved over time.

Case report: This report describes the first ever case, to our knowledge, of bilateral Scheie’s procedures performed with retention of an ophthalmic viscoelastic device and intraoperative and post-operative 5-fluorouracil injections.

A Retrospective Review Comparing the Safety and Efficacy of 120 Versus 160 Applications of Selective Laser Trabeculoplasty.

Authors: Skalicky, Wong, Tao.

Abstract:

PURPOSE: To compare the effectiveness and safety of 120 applications versus 160 applications of selective laser trabeculoplasty (SLT) at reducing intraocular pressure (IOP) from baseline in glaucoma patients over a 1-year period.

METHODS: retrospective chart review was conducted, comprising 376 eyes from 199 patients who underwent SLT treatment performed by the same glaucoma subspecialist from 2014 to 2015. Data were obtained on patients' clinical features, management, and outcomes. Patients were treated with either 120 applications or 160 applications of SLT per 360 degrees of trabecular meshwork over 2 sessions. Statistical analyses were performed comparing baseline IOP with IOP at 6 weeks and 1-year follow-up after completion of treatment. The incidence and severity of transient IOP rises immediately post-SLT was also recorded.

Drug-induced Myopia and Bilateral Angle Closure Secondary to Zolmitriptan.

Authors: Skalicky SE, Lee J, , Lin ML.

Abstract:

PURPOSE: To describe a unique case of drug-induced transient myopia with angle-closure glaucoma in a patient being treated with zolmitriptan for migraines.

METHODS: A 42-year-old woman who had been using increasing amounts of zolmitriptan over the previous 12 months presented with an acute myopic shift and raised intraocular pressures (IOP) with anterior chamber shallowing. Clinical examination findings at presentation and at follow-up visits were reviewed.

Glaucoma Australia educational impact study: a randomized short-term clinical trial evaluating the association between glaucoma education and patient knowledge, anxiety and treatment satisfaction.

Authors: Skalicky SE1,2,3, D'Mellow G4,5, House P6, Fenwick E3,7,8; Glaucoma Australia Educational Impact Study Contributors

Abstract:

IMPORTANCE: Targeted education may impact glaucoma patients' clinical experience.

BACKGROUND: The aim of this study was to measure the impact of patient-centred glaucoma-related education on knowledge, anxiety and treatment satisfaction.

Knocked by the shuttlecock: twelve sight-threatening blunt-eye injuries in Australian badminton players.

Authors: Skalicky SE, Jao KK, Atik A, Jamieson MP, Sheales MP, Lee MH, Porter A3, Roufas A, Goldberg I, Zamir E, White A,

Abstract:

BACKGROUND: Non-penetrating ocular injuries from badminton shuttlecocks can result in severe damage and life-long complications. This case series highlights the morbidity of such injuries, particularly in regard to post-traumatic glaucoma.

METHODS: This is a retrospective case series of 12 patients with shuttlecock-related blunt eye injuries sustained during badminton play without eye protection. By approaching colleagues through conference presentations and networking, the authors have attempted to gather all known cases of shuttlecock ocular injury managed in tertiary ocular emergency departments or private ophthalmological clinics in Victoria and New South Wales, Australia in 2015.

Activity Limitation in Glaucoma: Objective Assessment by the Cambridge Glaucoma Visual Function Test.

Authors: Skalicky SE1, McAlinden C2, Khatib T3, Anthony LM3, Sim SY3, Martin KR4, Goldberg I5, McCluskey P6.

Abstract:

BACKGROUND: Non-penetrating ocular injuries from badminton shuttlecocks can result in severe damage and life-long complications. This case series highlights the morbidity of such injuries, particularly in regard to post-traumatic glaucoma.

METHODS: This is a retrospective case series of 12 patients with shuttlecock-related blunt eye injuries sustained during badminton play without eye protection. By approaching colleagues through conference presentations and networking, the authors have attempted to gather all known cases of shuttlecock ocular injury managed in tertiary ocular emergency departments or private ophthalmological clinics in Victoria and New South Wales, Australia in 2015.

The Visual Function Questionnaire: Utility Index: Does It Measure Glaucoma-related Preference-based Status?

Authors: Skalicky SE., Goh RL, Fenwick E.

Abstract:

PURPOSE: As health budgets tighten globally, evaluating the cost-effectiveness of glaucoma services is vital; however, there is a lack of validated instruments that measure utility specific to glaucoma patients. We thus evaluated the validity of the Visual Function Questionnaire-Utility Index (VFQ-UI) as a measure of vision-related function and preference-based status in glaucoma.

PATIENTS AND METHODS: Cross-sectional study of 141 volunteer patients over 40 years of age with moderate (n=64) or severe (n=36) glaucoma, and 41 controls. Sociodemographic information, visual acuity, and visual field test parameters were obtained. The VFQ-UI and Glaucoma Activity Limitation-9 patient-reported outcome tools were administered, and their psychometric properties explored using Rasch analysis. Criterion, convergent, and divergent validity of the VFQ-UI were also assessed.

Selective Laser Trabeculoplasty Reduces Intraocular Pressure Peak in Response to the Water Drinking Test.

Authors: Skalicky SE., Kerr NM1, Lew HR

Abstract:

PURPOSE: To determine the effect of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) peak and fluctuation induced by the water drinking test (WDT) in patients with open-angle glaucoma and ocular hypertension.

METHODS: Patients with open-angle glaucoma or ocular hypertension underwent the WDT before and after SLT within a 12-month period. No other changes to therapeutic regimen were permitted. IOP was measured with a Goldmann applanation tonometer at baseline and every 15 minutes for 45 minutes following a fluid challenge of 800 mL over 15 minutes. Baseline, peak, and percentage

fluctuation in IOP from baseline were compared using a repeated measures analysis of variance with Bonferroni adjustment.

Surgical Outcomes of Combined Trabeculectomy-Cyclodialysis for Glaucoma: Author Reply

Authors: Skalicky, Simon E., Lew, Henry R.

Impact of age-related macular degeneration in patients with glaucoma: understanding the patients' perspective.

Authors: Skalicky SE, Fenwick E, Martin KR, Crowston J, Goldberg I, McCluskey P.

Abstract:

BACKGROUND: The aim of the study is to measure the impact of age-related macular degeneration on vision-related activity limitation and preference-based status for glaucoma patients.

DESIGN: This was a cross-sectional study.

PARTICIPANTS: Two-hundred glaucoma patients of whom 73 had age-related macular degeneration were included in the research.

Syphilitic uveitis and optic neuritis in Sydney, Australia.

Authors: Skalicky SE, Northey LC, Gurbaxani A, McCluskey PJ.

Abstract: 

AIMS: To describe ocular syphilis presentations to a tertiary referral eye hospital over a 5-year period and to document HIV coinfection frequency.

METHODS: A retrospective chart review was conducted of consecutive ocular syphilis presentations to Sydney Eye Hospital from 2007 to 2012. Inclusion criteria were positive syphilis serology, ocular inflammation on clinical examination and appropriate syphilis treatment. Outcome measures were clinical features at presentation and best-corrected visual acuity (BCVA) at interval follow-up.

Cataract and quality of life in patients with glaucoma.

Authors: Skalicky SE1, Martin KR, Fenwick E, Crowston JG, Goldberg I1, McCluskey P.

Abstract

BACKGROUND: To assess the impact of cataract on quality of life (QoL) for patients with glaucoma.

Brinzolamide plus brimonidine for the treatment of glaucoma: an update.

Authors: Skalicky SE, Chew SK, , Goldberg I.

Abstract

INTRODUCTION: Glaucoma is a common sight-threatening condition that is primarily treated by lowering intraocular pressure (IOP). Today the mainstay of treatment is topical ocular hypotensive medications; many patients require more than one agent to achieve target IOP. For such patients, fixed combination formulations have several advantages including simplicity of treatment regimen, adherence to the treatment regimen, efficacy, improved ocular surface comfort and reduced cost. All currently available fixed combinations contain a β-blocker, which is contraindicated in some patients. Hence there is a clinical need for fixed-combination preparations without a β-blocker. This paper reviews the current literature on a new fixed-combination drug containing brinzolamide 1% and brimonidine 0.2% (BBFC).

P2Y2 receptor agonists for the treatment of dry eye disease: a review.

Authors:  Skalicky SE., Lau OC, Samarawickrama C.

Abstract

Recent advances in the understanding of dry eye disease (DED) have revealed previously unexplored targets for drug therapy. One of these drugs is diquafosol, a uridine nucleotide analog that is an agonist of the P2Y2 receptor. Several randomized controlled trials have demonstrated that the application of topical diquafosol significantly improves objective markers of DED such as corneal and conjunctival fluorescein staining and, in some studies, tear film break-up time and Schirmer test scores. However, this has been accompanied by only partial improvement in patient symptoms. Although evidence from the literature is still relatively limited, early studies have suggested that diquafosol has a role in the management of DED. Additional studies would be helpful to delineate how different subgroups of DED respond to diquafosol. The therapeutic combination of diquafosol with other topical agents also warrants further investigation.

A comparison of lamellar and penetrating keratoplasty outcomes: a registry study.

Authors: Coster DJ, Lowe MT, Keane MC, Williams KA; Australian Corneal Graft Registry Contributors.

Abstract

OBJECTIVES: To investigate changing patterns of practice of keratoplasty in Australia, graft survival, visual outcomes, the influence of experience, and the surgeon learning curve for endothelial keratoplasty.

DESIGN: Observational, prospective cohort study.

PARTICIPANTS: From a long-standing national corneal transplantation register, 13 920 penetrating keratoplasties, 858 deep anterior lamellar keratoplasties (DALKs), and 2287 endokeratoplasties performed between January 1996 and February 2013 were identified.

Microphthalmia, anophthalmia, and coloboma and associated ocular and systemic features: understanding the spectrum.

Authors: Skalicky SE, White AJ, Grigg JR, Martin F, Smith J, Jones M, Donaldson C, Smith JE, Flaherty M, Jamieson RV.

Abstract

IMPORTANCE: Microphthalmia, anophthalmia, and coloboma form an interrelated spectrum of congenital eye abnormalities.

OBJECTIVE: To document the ocular and systemic findings and inheritance patterns in patients with microphthalmia, anophthalmia, and coloboma disease to gain insight into the underlying developmental etiologies.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective consecutive case series was conducted at a tertiary referral center. Included in the study were 141 patients with microphthalmia, anophthalmia, and coloboma disease without a recognized syndromic etiology who attended the Westmead Children's Hospital, Sydney, from 1981-2012.