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Editorial IGR 3-1
Dear Reader,
The world of glaucoma is buzzing with activity. Studies, publications, meetings, societies, plenty of it. Although activity is not synonymous with progress, progress is there in the concept of glaucoma, diagnosis, and treatment. The future looks bright.
Clouds appeared in two editorials. One regarding the 'choice of glaucoma' by residents, another regarding the future of 'clinician scientists'. Enthusiasm for analytical thinking and science is indispensable for future developments in glaucoma, and in addition economic support (see Editors Selection).
Defining glaucoma and its relationship to treatment
What is glaucoma? An optic neuropathy with characteristic functional and structural damage. Should progression be included in the diagnosis? Is it a progressive optic neuropathy? After all, it's only the potential progression that will lead to blindness. So we include progression. Then, should we treat a glaucoma patient in the absence of proven progression? Probably not, with the possible exception of advanced, potentially vision-threatening damage. What if the risk of progression is very high, such as when IOP is over 40 mmHg? OK, we add that to our willingness to treat. If we accept that the high risk of progression is the reason for treatment, then what is progression? White-on-white perimetry? Structural changes on photographs or imaging? If we agree on a particular white-on-white perimetric progression step - after all, it is visual function that counts - then every other progression step, whether functional or structural, should have a high, agreed upon, probability to predict the agreed upon particular progression. Every conceived high risk should have a similar high probability to lead to progression. Established evidence-based progression is the most valid reason for placing the burden of diagnosis and treatment on the patient.
IGR Award
The winners of the IGR Award 2000 have been selected. Congratulations to Douglas Gaasterland, Paul Palmberg, and Harry Quigley (see)
Eternal youth
Who
was the youthful glaucomatologist who appeared in IGR II/3? Several
responses arrived at the editorial office, ranging from Spaeth to Quigley,
via Krupin, Greve, and others. Young glaucomatologists must have some
similarity (or must have some common risk factor for being recognized).
One colleague found the correct answer: Oscar Canlas. The answer is
in this issue of IGR.
(or you can click on the image to see a more up to date photo)
Dancing
Pharmacia, the sponsor of IGR, organized a two-day glaucoma meeting for 1000 glaucomatophils. The scientific program reviewed the most pressing subjects in today's glaucoma, brightened up by lively interactive sessions. The extra scientific part was sparkling and funny. 'Der Kongress tanzt', as it did in Vienna many years ago. The congress dances and so it should!
Contents
The reader may not have noticed, but IGR also provides abstracts for selected papers that do not have abstracts of their own, such as editorials, case reports, letters, discussions, etc. Adding value to the journal.
On the Attention page, the reader will find a selection of interesting reviews on or related to glaucoma. Special attention is requested for a review on stroke. After all, the eye is part of the brain. The attempts to treat stroke with neuroprotective drugs have been disappointing. How different is the eye?
This issue of IGR contains two short comments, one by Richard Brubaker on the Importance on outflow facility, the other by Douglas Johnson on the Survival of vision after glaucoma filtration surgery.
There is a host of reports on glaucoma meetings, all of them in the IGR staccato style: what the author found most interesting at the meeting. Quick, informative, and easy. High time-benefit ratio. Readers!, do not forget to have a careful look at the ARVO Top-Ten (-seven or -eight). No doubt you will see that your colleagues saw things you didn't, or that you interpreted differently. Very instructive!
The Editor's Selection contains the important issue of so-called pre-perimetric glaucoma and quality of life of the patient. Furthermore, the above-mentioned choice of glaucoma and clinical science, the concept of immune neuroprotection against secondary neurodegeneration, the incidence of glaucoma, the role of myocillin, glaucoma and vascular disease, progression in NPG, and insufficiency of peripheral iridectomy in APACG, are discussed, and there's lots on non-penetrating filtering surgery: no less than three editorials are devoted to non-perforating surgery.
There was just too much to put all of it into print, so part of this exciting stuff can be found on our website, www.glaucom.com (see table of contents)
Enjoy IGR!
Erik L. Greve
