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Abstract #19095 Published in IGR 3-1
Management and prognosis of end-stage glaucoma
Gillies WE; Brooks AMV; Strang NTClinical and Experimental Ophthalmology 2000; 28: 405-408
PURPOSE: The authors followed, on a long-term, end-stage glaucoma patients as defined by the level of legal blindness. METHODS: Follow-up was for 7.7 ± 1.8 years (range, 2-9) for 22 patients (13 men and nine women) having 32 eyes with functional vision. Age at exit was 74.6 ± 15.5 years (range, 33-89). Humphrey computerized perimetry and applanation tonometry were used throughout. The authors attempted to hold intraocular pressure (IOP) below 15 mmHg using as much medical therapy as required. RESULTS: All visual fields were less than 10° diameter at exit, but at entry seven eyes of six patients still had a field between 10° and 20°, the rest were all less than 10°. Corrected visual acuity at entry was 6/9-6/6 in 21 eyes of 16 patients and none had less than 6/60. At exit 16 eyes had 6/9-6/6 and five eyes had less than 6/60, but no patient and complete loss of vision. Mean IOP throughout was below 15 mmHg in all but four patients, whose IOP was less than 20 mmHg, using multiple medications if necessary. All patients had undergone prior surgery and/or laser trabeculoplasty. CONCLUSIONS: Even though visual loss slowly progressed, most patients with end-stage glaucoma retained functional vision for a long period when IOP was held below 15 mmHg. More stringent early control of IOP may avoid the development of end-stage glaucoma.
Dr W.E. Gillies, Level 2, 82 Collins Street, Melbourne, Victoria 3000, Australia
Classification:
11.1 General management, indication (Part of: 11 Medical treatment)
