{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T18:09:59Z","timestamp":1775758199464,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,2,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glaucoma, a leading cause of irreversible blindness worldwide, affects over 60\u2009million people globally and 700\u2009000 in the UK. Elevated intraocular pressure (IOP) is the only modifiable risk factor for disease progression. Micropulse trans-scleral cyclophotocoagulation (MP-TSCPC) offers a promising alternative to conventional treatments by reducing IOP with minimal complications. Although MP-TSCPC is hypothesised to lower IOP by decreasing aqueous humour production and altering aqueous outflow, the precise mechanisms remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effects of MP-TSCPC on aqueous humour dynamics in patients with open-angle glaucoma and ocular hypertension (OHT), focusing on IOP, aqueous humour production and outflow pathways 6\u2009months post treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 31 patients undergoing MP-TSCPC, 61% were men, of which 71% were of black ethnicity, with 28 patients completing the 6-month follow-up. A significant 10% reduction in mean IOP (25.08\u00b15.06\u2009mm Hg to 22.56\u00b14.89\u2009mm Hg, p=0.005) and a 26.08% reduction in aqueous humour production (from 2.34\u00b10.64\u2009to 1.74\u00b10.4\u2009\u00b5L\/min, p=0.0001) were observed. There were no statistically significant changes in tonographic outflow facility or uveoscleral outflow. Treatment was well-tolerated, with few mild adverse events reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that MP-TSCPC reduces IOP primarily through decreased aqueous humour production, with no discernible impact on outflow pathways. These findings refine the understanding of MP-TSCPC\u2019s mechanism of action, highlighting its potential as a safe and effective treatment for glaucoma and OHT. Future studies should explore ways to enhance efficacy and long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327787","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T17:20:23Z","timestamp":1775755223000},"page":"bjo-2025-327787","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of micropulse trans-scleral cyclophotocoagulation (MP-TSCPC) on aqueous humour dynamics in patients with glaucoma and ocular hypertension: an observational study"],"prefix":"10.1136","author":[{"given":"Arij","family":"Daas","sequence":"first","affiliation":[{"name":"Ophthalmology, St Thomas\u2019 Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavin","family":"Patel","sequence":"additional","affiliation":[{"name":"KCL Frost Eye Research Department, St Thomas\u2019 Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananth","family":"Ranjit","sequence":"additional","affiliation":[{"name":"KCL Frost Eye Research Department, St Thomas\u2019 Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth Angela","family":"Galvis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"},{"name":"LONDON, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Madekurozwa","sequence":"additional","affiliation":[{"name":"Bioengineering, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Amon","sequence":"additional","affiliation":[{"name":"Eye Research Department, St Thomas\u2019 Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Goyal","sequence":"additional","affiliation":[{"name":"Ophthalmology, St Thomas\u2019 Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3897-1633","authenticated-orcid":false,"given":"Kin Sheng","family":"Lim","sequence":"additional","affiliation":[{"name":"Ophthalmology, St Thomas\u2019 Hospital, London, UK"},{"name":"King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"2026040910201017000_bjo-2025-327787v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2005.081224"},{"key":"2026040910201017000_bjo-2025-327787v1.2","unstructured":"Glaucoma UK . 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Transcleral laser induces aqueous outflow pathway motion & reorganization. 2017. Available: https:\/\/www.iridex.wsivirtual.com\/portals\/0\/pdf\/Transcleral-induces-aqueousoutflow-pathway-motion-and-reorganization-Dr.pdf. [Accessed 12 Dec 2019]."},{"key":"2026040910201017000_bjo-2025-327787v1.10","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-20675-w","article-title":"Ciliochoroidal effusion and its association with the outcomes of micropulse transscleral laser therapy in glaucoma patients: a pilot study","volume":"12","author":"Chansangpetch","year":"2022","journal-title":"Sci Rep"},{"key":"2026040910201017000_bjo-2025-327787v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(00)00843-6"},{"key":"2026040910201017000_bjo-2025-327787v1.12","unstructured":"Brubaker RF . Clinical measurements of aqueous dynamics: implication for addressing glaucoma. In: Civan MM , ed. The eye\u2019s aqueous humor from secretion to glaucoma. 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