advertisement

---

Top-Ten of the Optometric Glaucoma Society Meeting

December 8, 2004, Tampa, Florida

Mike Patella

The third annual meeting of the Optometric Glaucoma Society honored the many scientific and professional contributions of Douglas R. Anderson. Topics presented centered around optic nerve micro-structure, biomechanics, and clinical assessment. Guests included Claude Burgoyne, David Garway-Heath, Ross Ethier, Carl Camras, and Erik Greve. Douglas Anderson delivered the keynote lecture.

• Actin architecture in the trabecular meshwork is markedly different in glaucoma vs. normals, correcting for age.
• IOP-induced stress and strain within the optic nervehead likely influence physiologic aging of laminar extra-cellular matrix and also astrocyte molecular biology. Connective tissue damage may be a primary and early event in glaucoma.
• Microscopic changes in laminar deformation might precede both nerve head change and RNFL damage.
• In glaucoma, optic nerve connective tissue changes cause the changes in optic nerve appearance that we have learned to associate with the disease. True cupping is rare in non-IOP related optic neuropathies.
• Future biomechanical modeling of IOP effects on the optic nerve need to characterize scleral properties - especially scleral stiffness - as well as variations in tissue properties from eye to eye.
• When appropriately scaled, a clear relationship exists between perimetric sensitivity and available structural surrogates of ganglion cell numbers. However, using a linear scale for both structure and function may complicate observations of the relationship because of how perimetric measurements are taken.
• IOP measurements performed using Dynamic Contour Tonometry appear to be largely independent of central corneal thickness. Goldmann tonometry progressively overestimates IOP with increasing CCT.
• Diurnal variations in IOP were similar for glaucoma patients and normal subjects when scaled to the maximum pressure measured. However, percentage change in Mean Ocular Perfusion Pressure did provide good separation between POAG patients and normals.
• In a rat model, retinal vasculature showed auto-regulation over a larger range of acutely elevated IOPs than did the choroid.
• IOP related stress is high at the optic nerve head.