Evidence map›Paper›PMID 40965900›Full record

ArticleJAMA ophthalmology2025

Acute Angle Closure Incidence in a Large Countywide Safety Net Teleretinal Screening Program.

Tracy Z Lang, Benjamin Y Xu, Zhiwei Li, Sreenidhi Iyengar, Carl Kesselman, Jose-Luis Ambite, Kyle Bolo, Jiun Do, Brandon Wong, Lauren P Daskivich

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Retinopathy of prematurity screening and treatment practice patterns: an African multi-country survey.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Tracy Z LangRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
Benjamin Y XuRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
Zhiwei LiInformation Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles.
Sreenidhi IyengarInformation Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles.
Carl KesselmanInformation Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles.
Jose-Luis AmbiteInformation Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles.
Kyle BoloRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
Jiun DoRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
Brandon WongRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
Lauren P DaskivichRoski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.

Funding

Clinical Evaluation and Risk Stratification of Angle Closure Disease Using Quantitative OCTR01EY035677 · NEI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Benjamin Y. Xu · 2024 to 2026
$1.4M
NEI NIH HHS R01 EY035677
6 · The paper itself

Abstract

Importance: Pharmacologic pupillary dilation is vital for eye disease screening but is often avoided due to concerns about triggering acute angle closure (AAC), a sight-threatening ophthalmic emergency. Objective: To assess AAC incidence after dilation and validate the use of International Classification of Diseases (ICD) codes for identifying AAC cases. Design, Setting, and Participants: This retrospective cohort study used data from a primary care-based teleretinal diabetic retinopathy screening (TDRS) program. Eligible participants were Los Angeles County Department of Health Services patients who underwent teleretinal screening by dilated fundus photography between August 23, 2013, and March 1, 2024. Potential AAC cases were identified using ICD codes for angle closure, including AAC glaucoma, primary angle-closure glaucoma, and anatomical narrow angle, within 3 months of dilation. All urgent care, emergency department, and eye clinic encounters within the next calendar day after TDRS and encounters with Current Procedural Terminology codes for iridectomy/iridotomy or lens extraction within 14 calendar days of TDRS were also identified. Manual medical record review was conducted to verify AAC cases and extract clinical information. Data were analyzed from July 2024 to June 2025. Exposures: Dilation with tropicamide, 1.0%, or tropicamide, 0.5%. Main Outcomes and Measures: Cumulative incidence of AAC after dilation. Results: Of 84 008 included patients, 46 255 (55.1%) were female, and the mean (SD) age was 55.4 (10.7) years. There were a total of 168 796 dilations, with a mean (SD) of 2.01 (1.50) dilations per patient. Manual medical record review confirmed 4 AAC cases after dilation: 3 coded as AAC glaucoma and 1 as anatomical narrow angle. The AAC risk was 2.4 (95% CI, 0.05-4.69) per 100 000 dilations (0.002%) or 4.8 (95% CI, 0.10-9.43) per 100 000 patients (0.005%). All 4 AACs occurred in female patients, had narrow angles in the nonpresenting eye on gonioscopy, and presented within 1 day with AAC symptoms, including eye pain and blurry vision. Conclusions and Relevance: AAC risk was less than 1 in 40 000 per dilation in a high-volume TDRS program serving a diverse safety net population, supporting the overall safety of dilation in this setting. Further discussion about AAC risk as a contraindication to dilation is warranted.

Indexed as

Diabetic RetinopathyGlaucoma, Angle-ClosureMass ScreeningAcute DiseaseAgedFemaleHumansIncidenceIntraocular PressureLos AngelesMaleMiddle AgedMydriaticsRetrospective StudiesTelemedicineMydriatics

Identifiers

PMID40965900
PMCPMC12447281

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.