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IVth Polish Glaucoma Symposium - Top 9
April 15-17, 2004, Wroclaw, Poland
Maria Hanna Nizankowska
- Epidemiological Study on Glaucoma and Ocular Hypertension in representative group of 4853 inhabitants of Wroclaw aged 40-79 years, recruited by a proportional simple random sampling selection with stratification determined the overall prevalence of glaucoma as 1,6% (from 0,4% in the group aged 40-49 years to 4,6% in the group aged 70-79 years). The most frequent form of glaucoma was OAG (POAG 60%, NTG 16%, Capsular Glaucoma 15%). Glaucoma detection level was very low - 29%. Undiagnosed glaucoma is a serious health problem in Poland.
- Gene expression analysis of lymphocytes gives further insight into the pathomechanisms of individual patients and indicates, whether a glaucomatous damage is present or not.
- For the early detection of preperimetric glaucomatous optic nerve damage the most important parapapillary parameters are segmentally decreased visibility of the retinal fibre layer and occurrence of localised nerve fibre layer defects and disc hemorrhages.
- The fluorescein filling defects of the optic nerve head are larger in patients with glaucoma in comparison with healthy subjects. The areas of optic nerve head hypoperfusion are not significantly different in patients with POAG, NTG and PEXG. The fluorescein filling defects correlate with functional defects in glaucomatous optic neuropathy.
- In eyes with POAG confocal laser scanning measurements of the capillary blood flow in the optic disc and in the parapapillary retina are significantly decreased in comparison to the control group, and correlated with presence and degree of glaucomatous optic nerve damage.
- The level of nitric oxide in the aqueous humour was significantly lower in patients with primary open angle glaucoma than in patients with primary angle closure and than in control group.
- Significant differences were observed in the optic disc parameters measured by HRT in patients with moderate and advanced glaucomatous neuropathy after 50% pressure reduction, received by surgical or surgical-pharmacological management. The moderate glaucomatous group presented the partial reversibility of optic disc cupping and MD values during 2.5 years of observation, while patients with advanced glaucoma presented stability of disc appearance, as well as the VF parameters.
- Photodynamic therapy is a new approach in modulating postoperative wound healing in human eyes undergoing glaucoma filtration surgery.
- Artificial drainage devices are preferred then cyclodestructive procedures for refractory glaucoma after penetrating keratoplasty. Long-term results of nonvalved Baerveldt Glaucoma Implants reveal good control of intraocular pressure and acceptable complication-rate. Prevention of postoperative hypotony by temporary occlusion and ligation technique of implantation is fundamental.
