Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 58) Show all publications
Hujanen, P., Tuulonen, A., Leinonen, S., Vepsäläinen, K., Jóhannesson, G., Vaajanen, A., . . . Uusitalo-Jarvinen, H. (2025). Prototype master protocol for benchmarking of real-world follow-up data in glaucoma. Acta Ophthalmologica
Open this publication in new window or tab >>Prototype master protocol for benchmarking of real-world follow-up data in glaucoma
Show others...
2025 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: The purpose of this study was to create a prototype master protocol for benchmarking glaucoma real-world data (RWD). Benchmarking is part of the digital innovation strategy of the Finnish aces-rwm ecosystem (automation of care and evaluation of the system with real-world monitoring).

Methods: We collected glaucoma RWD in 2012–17 at Tampere University Hospital (Tays) and compared them to six published RWD sets (one in Sweden and five in England). Visual field (VF) data at Tays were retrieved from the perimeter, and clinical RWD were collected manually. At baseline, VF data were available in 2511 of 4121 glaucoma patients (61%), of whom 1413 patients (56%) had 5 years of VF follow-up by 2017 (34% of all 4121 patients). Mean deviation (MD) data were analysed in multiple ways, considering also age and intraocular pressure (IOP).

Results: In most data sets, higher age was related to faster progression. At Tays, the distributions of progression rates were similar in better and worse eyes. The proportions of eyes at Tays with the medium rate of MD progression (17% for 0.5–1.5 dB/year) and the fast rate (6% for >1.5 dB/year) were similar to the published RWD trial in England. The published datasets show significant variability in how their findings were reported.

Conclusions: This study represents a first step toward the development of a master protocol for real-world benchmarking of glaucoma care. Further refinement of the protocol will encourage and require national and international collaboration in order to produce comprehensive and comparable real-world EHR data sets.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
benchmarking, glaucoma, master protocol, progression, real-world data
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-236247 (URN)10.1111/aos.17453 (DOI)001421017000001 ()39943889 (PubMedID)2-s2.0-85218823774 (Scopus ID)
Available from: 2025-04-01 Created: 2025-04-01 Last updated: 2025-04-01
Kristiansen, M., Holmlund, P., Linden, C., Eklund, A. & Jóhannesson, G. (2024). Author response: deficient optic nerve sheath occlusion in ntg patients: optic nerve damage due to translaminar pressure imbalance, glymphatic failure, or both? [Letter to the editor]. Investigative Ophthalmology and Visual Science, 65(5), Article ID 19.
Open this publication in new window or tab >>Author response: deficient optic nerve sheath occlusion in ntg patients: optic nerve damage due to translaminar pressure imbalance, glymphatic failure, or both?
Show others...
2024 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 65, no 5, article id 19Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Association for Research in Vision and Ophthalmology (ARVO), 2024
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-224851 (URN)10.1167/iovs.65.5.19 (DOI)001242507100005 ()38717422 (PubMedID)2-s2.0-85192594501 (Scopus ID)
Available from: 2024-06-11 Created: 2024-06-11 Last updated: 2025-04-24Bibliographically approved
Rasmuson, E., Linden, C., Lundberg, B. & Jóhannesson, G. (2024). Changes in intraocular pressure during the first 24 h after transscleral cyclophotocoagulation. Acta Ophthalmologica, 102(6), 662-666
Open this publication in new window or tab >>Changes in intraocular pressure during the first 24 h after transscleral cyclophotocoagulation
2024 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 102, no 6, p. 662-666Article in journal (Refereed) Published
Abstract [en]

Aims: To estimate the changes in intraocular pressure (IOP) during the first 24 h after transscleral cyclophotocoagulation (TCP).

Methods: A prospective single-centre study, where patients with glaucoma destined for treatment with TCP were asked for participation. The IOP was measured prior to TCP and at 1, 2, 4, 6 and 24 h post-TCP. An IOP spike was defined as an elevation of IOP of ≥5 mmHg compared with baseline. The visual acuity (VA) was examined at baseline and after 24 h.

Results: The mean IOP prior to TCP in 58 eyes of 58 patients was 26.2 (±8.9 SD) mmHg. Twenty-three eyes (40%) experienced an IOP spike at some examination timepoint during the first 24 h. The mean value of the IOP spike was 12.1 (±6.9) mmHg. Fifty-six per cent of the eyes with pseudoexfoliation glaucoma (PEXG) experienced an IOP spike, and 16% had an IOP spike ≥20 mmHg. The IOP was significantly reduced at the 24 h examination by 8.1 (±7.8) mmHg (n = 58). The VA 24 h after TCP was unchanged compared with baseline.

Conclusion: Clinically significant IOP spikes were common in the first 24 h post-TCP. Almost one in five eyes had an increase of 10 mmHg and in almost one in 10 eyes, the IOP increase was 20 mmHg or higher. Eyes with PEXG had a higher occurrence of IOP spikes and displayed a greater magnitude of IOP elevation. Prophylactic post-operative IOP-lowering medication should be considered to prevent further glaucoma damage.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
glaucoma, glaucoma treatment, intraocular pressure, laser treatment, prospective study, transscleral cyclophotocoagulation
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-221046 (URN)10.1111/aos.16652 (DOI)001157669600001 ()38324394 (PubMedID)2-s2.0-85184467199 (Scopus ID)
Funder
Knut and Alice Wallenberg FoundationRegion Västerbotten
Available from: 2024-02-21 Created: 2024-02-21 Last updated: 2024-08-21Bibliographically approved
Azuara-Blanco, A., McCorry, N., Tatham, A. J., Georgoulas, S., Founti, P., Schweitzer, C., . . . Topouzis, F. (2024). European Glaucoma Society research priorities for glaucoma care. British Journal of Ophthalmology, 108(8), 1088-1093
Open this publication in new window or tab >>European Glaucoma Society research priorities for glaucoma care
Show others...
2024 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 108, no 8, p. 1088-1093Article in journal (Refereed) Published
Abstract [en]

Background/Aims: The goal of health research is to improve patients care and outcomes. Thus, it is essential that research addresses questions that are important to patients and clinicians. The aim of this study was to develop a list of priorities for glaucoma research involving stakeholders from different countries in Europe.

Methods: We used a three-phase method, including a two-round electronic Delphi survey and a workshop. The clinician and patient electronic surveys were conducted in parallel and independently. For phase I, the survey was distributed to patients from 27 European countries in 6 different languages, and to European Glaucoma Society members, ophthalmologists with expertise in glaucoma care, asking to name up to five research priorities. During phase II, participants were asked to rank the questions identified in phase I using a Likert scale. Phase III was a 1 day workshop with patients and clinicians. The purpose was to make decisions about the 10 most important research priorities using the top 20 priorities identified by patients and clinicians.

Results: In phase I, 308 patients and 150 clinicians were involved. In phase II, the highest-ranking priority for both patients and clinicians was € treatments to restore vision'. In phase III, eight patients and four clinicians were involved. The top three priorities were € treatments to stop sight loss', € treatments to restore vision' and € improved detection of worsening glaucoma'.

Conclusion: We have developed a list of priorities for glaucoma research involving clinicians and patients from different European countries that will help guide research efforts and investment.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
clinical trial, diagnostic tests/investigation, glaucoma, treatment medical, treatment surgery
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-217025 (URN)10.1136/bjo-2023-323648 (DOI)001094788800001 ()37923373 (PubMedID)2-s2.0-85176602136 (Scopus ID)
Available from: 2023-11-23 Created: 2023-11-23 Last updated: 2024-08-20Bibliographically approved
Jóhannesson, G., Stille, U., Taube, A. B., Karlsson, M., Kalaboukhova, L., Bergström, A., . . . Lindén, C. (2024). Guidelines for the management of open-angle glaucoma: national program area eye diseases, national working group glaucoma. Acta Ophthalmologica, 102(2), 135-150
Open this publication in new window or tab >>Guidelines for the management of open-angle glaucoma: national program area eye diseases, national working group glaucoma
Show others...
2024 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 102, no 2, p. 135-150Article in journal (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
glaucoma, guidelines, management, Sweden
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-219315 (URN)10.1111/aos.16599 (DOI)001134659800001 ()38164112 (PubMedID)2-s2.0-85181192008 (Scopus ID)
Available from: 2024-01-15 Created: 2024-01-15 Last updated: 2024-04-30Bibliographically approved
Barkander, A., Nolan, A. S., Jóhannesson, G. & Economou, M. A. (2024). Influence of laser trabeculoplasty on combined phacoemulsification/Kahook Dual Blade goniotomy. Clinical Ophthalmology, 18, 1811-1817
Open this publication in new window or tab >>Influence of laser trabeculoplasty on combined phacoemulsification/Kahook Dual Blade goniotomy
2024 (English)In: Clinical Ophthalmology, ISSN 1177-5467, E-ISSN 1177-5483, Vol. 18, p. 1811-1817Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate the influence of laser trabeculoplasty (LTP) on subsequent surgery with combined phacoemulsification/ Kahook Dual Blade goniotomy (phaco-KDB) in patients with open-angle glaucoma or intraocular hypertension.

Patients and Methods: Patients undergoing phaco-KDB between 2019 and 2021 were divided into previously LTP treated and previously non-LTP treated, and LTP-treatment included argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). The primary goal was to investigate if previous LTP influenced later surgical outcome of phaco-KDB. The secondary goal was to investigate if the outcome of LTP could be predictive of the outcome of subsequent phaco-KDB. We also compared IOP-and medication reductions between LTP and non-LTP treated patients.

Results: A total of 111 LTP treated patients were compared to 139 non-LTP treated patients. In LTP treated patients, surgical success of phaco-KDB was 82.9%, compared to 88.5% in non-LTP treated patients (P=0.20). Reductions in IOP and medications were similar between groups. Furthermore, within the LTP group, patients with successful LTP-treatment had a subsequent surgical success of phaco-KDB in 80.7%, compared to 83.0% in patients with unsuccessful LTP-treatment (P=0.765).

Conclusion: Previous LTP treatment does not predict the outcome of phaco-KDB. Furthermore, no correlation was found between the LTP effect and a later surgical success of phaco-KDB.

Place, publisher, year, edition, pages
Dove Medical Press, 2024
Keywords
glaucoma, goniotomy, Kahook Dual Blade, laser trabeculoplasty, phacoemulsification
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-227830 (URN)10.2147/OPTH.S468809 (DOI)001253260900001 ()38948342 (PubMedID)2-s2.0-85197387170 (Scopus ID)
Funder
Region Jämtland HärjedalenRegion VästerbottenKnut and Alice Wallenberg Foundation
Available from: 2024-07-12 Created: 2024-07-12 Last updated: 2024-07-12Bibliographically approved
Rasmuson, E., Bengtsson, B., Linden, C., Heijl, A., Aspberg, J., Andersson-Geimer, S. & Jóhannesson, G. (2024). Long-term follow-up of laser trabeculoplasty in multi-treated glaucoma patients. Acta Ophthalmologica, 102(2), 179-185
Open this publication in new window or tab >>Long-term follow-up of laser trabeculoplasty in multi-treated glaucoma patients
Show others...
2024 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 102, no 2, p. 179-185Article in journal (Refereed) Published
Abstract [en]

Purpose: To evaluate the long-term effect of laser trabeculoplasty (LTP) in patients randomized to multi-treatment in the Glaucoma Intensive Treatment Study (GITS).

Methods: Patients with untreated newly diagnosed open-angle glaucoma were treated with three intraocular pressure (IOP)-lowering substances for 1 week and then 360 degrees argon or selective LTP was performed. IOP was measured just before LTP and repeatedly during the 60-month study period. Our previous report on 12 months follow-up data revealed no effect of LTP in eyes having an IOP <15 mmHg before the laser treatment.

Results: Before LTP, the mean IOP +/- standard deviation in all 152 study-eyes of 122 multi-treated patients was 14.0 +/- 3.5 mmHg. Three eyes of three deceased patients were lost to follow-up during the 60 months. After exclusion of eyes that received increased therapy during follow-up, the IOP was significantly reduced at all visits up to 48 months in eyes with pre-LTP IOP >= 15 mmHg; 2.6 +/- 3.1 mmHg at 1 month and 1.7 +/- 2.8 mmHg at 48 months, n = 56 and 48, respectively. No significant IOP reduction was seen in eyes with pre-LTP IOP <15 mmHg. Seven eyes, i.e., <13%, with pre-LTP IOP >= 15 mmHg at baseline had required increased IOP-lowering therapy at 48 months.

Conclusion: LTP performed in multi-treated patients may provide a useful IOP reduction that is maintained over several years. This was true on a group level when the initial IOP was >= 15 mmHg, but if the pre-laser IOP was lower than that, chances of LTP success were small.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
ALT, intraocular pressure, laser trabeculoplasty, long-term follow-up, multi-therapy, open-angle glaucoma, pseudoexfoliation glaucoma, SLT
National Category
Clinical Medicine Ophthalmology
Identifiers
urn:nbn:se:umu:diva-206002 (URN)10.1111/aos.15718 (DOI)001001069900001 ()37278271 (PubMedID)2-s2.0-85161487517 (Scopus ID)
Funder
Kronprinsessan Margaretas MinnesfondUmeå UniversityLund UniversityEye FoundationKonung Gustaf V:s och Drottning Victorias FrimurarestiftelseThe Swedish Medical AssociationSwedish Society for Medical Research (SSMF)Västerbotten County Council
Note

Originally included in thesis in manuscript form.

Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2024-05-06Bibliographically approved
Tuulonen, A., Leinonen, S. & Jóhannesson, G. (2024). Missed opportunities in screening for glaucoma. Journal of glaucoma, 33, 54-59
Open this publication in new window or tab >>Missed opportunities in screening for glaucoma
2024 (English)In: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 33, p. 54-59Article, review/survey (Refereed) Published
Abstract [en]

PURPOSE: To create a holistic and realistic view regarding current knowledge, understanding, and challenges of screening in general and in glaucoma.

METHODS/RESULTS: Based upon available literature, all systems suffer from the same challenges: huge variability of care practices (despite guidelines), simultaneous under care and over care, as well as the unsustainable increase of costs. While the magnitude of these challenges differs immoderately between well-off and developing countries, the Western world has already demonstrated that simply doing more than what we currently do is not the solution. System outcomes also matter in screening, that is, its benefits should outweigh any harms (over-care, false positives/negatives, uncertain findings, etc.) and be cost-effective. However, even when the evidence does not support screening (as is currently the case in glaucoma), it may feel justified as "at least we are doing something." Strong commercial interests, lobbying and politics star as well and will influence the control arm even in high-quality randomized screening trials (RCT).

CONCLUSIONS: As resources will never be sufficient for all health care activities that providers wish to deliver and what people wish to receive, we need to ask big questions and adopt a public health perspective in glaucoma and eye care. How can we create and maintain a sustainable balance between finding and treating underserved high-risk patients without burdening the broader patient population and societies with over-diagnostics and treatments? Considering numerous biases related to screening, including the variability in care practices, a high-quality RCT for the screening of glaucoma would be very challenging to organize and evaluate its universal usefulness.

Place, publisher, year, edition, pages
Wolters Kluwer, 2024
Keywords
screening, glaucoma, cost-effectiveness
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-228814 (URN)10.1097/IJG.0000000000002389 (DOI)001298930200001 ()38573956 (PubMedID)2-s2.0-85201437625 (Scopus ID)
Available from: 2024-08-26 Created: 2024-08-26 Last updated: 2025-04-24Bibliographically approved
Tribble, J. R., Jöe, M., Varricchio, C., Otmani, A., Canovai, A., Habchi, B., . . . Williams, P. A. (2024). NMNAT2 is a druggable target to drive neuronal NAD production. Nature Communications, 15(1), Article ID 6256.
Open this publication in new window or tab >>NMNAT2 is a druggable target to drive neuronal NAD production
Show others...
2024 (English)In: Nature Communications, E-ISSN 2041-1723, Vol. 15, no 1, article id 6256Article in journal (Refereed) Published
Abstract [en]

Maintenance of NAD pools is critical for neuronal survival. The capacity to maintain NAD pools declines in neurodegenerative disease. We identify that low NMNAT2, the critical neuronal NAD producing enzyme, drives retinal susceptibility to neurodegenerative insults. As proof of concept, gene therapy over-expressing full length human NMNAT2 is neuroprotective. To pharmacologically target NMNAT2, we identify that epigallocatechin gallate (EGCG) can drive NAD production in neurons through an NMNAT2 and NMN dependent mechanism. We confirm this by pharmacological and genetic inhibition of the NAD-salvage pathway. EGCG is neuroprotective in rodent (mixed sex) and human models of retinal neurodegeneration. As EGCG has poor drug-like qualities, we use it as a tool compound to generate novel small molecules which drive neuronal NAD production and provide neuroprotection. This class of NMNAT2 targeted small molecules could have an important therapeutic impact for neurodegenerative disease following further drug development.

Place, publisher, year, edition, pages
Springer Nature, 2024
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-228124 (URN)10.1038/s41467-024-50354-5 (DOI)001276353800023 ()39048544 (PubMedID)2-s2.0-85199429355 (Scopus ID)
Funder
Eye FoundationThe Karolinska Institutet's Research FoundationLoo och Hans Ostermans Stiftelse för medicinsk forskningLars Hierta Memorial FoundationKnut and Alice Wallenberg FoundationRegion VästerbottenKarolinska InstituteSwedish Research Council, 2018-02124Swedish Research Council, 2022-00799Stiftelsen Kronprinsessan Margaretas arbetsnämnd för synskadadeHedlund foundation
Note

Errata:

Tribble, J.R., Jöe, M., Varricchio, C. et al. Author Correction: NMNAT2 is a druggable target to drive neuronal NAD production. Nat Commun 15, 8143 (2024). https://doi.org/10.1038/s41467-024-52439-7

Available from: 2024-08-05 Created: 2024-08-05 Last updated: 2025-04-24Bibliographically approved
Huang, L., Fallahzadeh, F. & Jóhannesson, G. (2024). Occult GCA: a rare variant of giant cell arteritis. Acta Ophthalmologica, 102(8), 968-973
Open this publication in new window or tab >>Occult GCA: a rare variant of giant cell arteritis
2024 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 102, no 8, p. 968-973Article in journal (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
AION, arteritis, bilateral, cell, Giant, occult, temporal, visual
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-227589 (URN)10.1111/aos.16731 (DOI)001252773400001 ()2-s2.0-85196669855 (Scopus ID)
Available from: 2024-07-01 Created: 2024-07-01 Last updated: 2025-01-12Bibliographically approved
Projects
The Swedish Glaucoma Nicotinamide Trial (SGNT) [2019-06076_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0218-4563

Search in DiVA

Show all publications