Prateep Vyas

The meeting was attended by around 250 glaucomatologists from all over the country. There were 55 scientific lectures covering various aspects of Glaucoma and 25 free papers, and 21 scientific posters were displayed.

• In an epidomiology study of glaucoma in India reported prevalence of POAG was 0.41% to 2.56%. There is an increase in prevalence with age. Prevalence of angle closure glaucoma was 1.58% and females were three times more likely to have angle closure than males. The overall prevalence of glaucoma in this study (Chennai Glaucoma Survey) was 4.17% and 98.2% of cases did not have prior diagnosis of disease.
• Automated perimetry continues to be the best way of judging deterioration in visual fields. Of the various programs available for this purpose glaucoma progression analysis (GAP) currently are the most useful. The role of establishing disease progression in a clinical setting is different from that in a randomised study. This difference helps in planning a relatively safe management of glaucoma.
• The Consensus meeting on structural and functional damage in glaucoma was held in November 2003. Essentials of the proceedings were presented. It was mentioned that digital imaging earned its place in our diagnostic armamentarium. In the absence of a true gold standard it seems prudent to include a measure of progression as a part of the standard.
• Intraocular pressure after intravitreal injection of Triamcinolone acetonide was presented in a study of consecutive 280 eyes. IOPs higher than 21 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, respectively were measured in 36.2%, 8.5%, 4.2%, 1.5% patients. Younger age and base line diagnosis of glaucoma were significantly associated with drug induced high IOP.
• Global perspective on RCT's: An Indian review. In the ocular hypertension study, relative risk (RR) of 2.2% and a relative risk reduction (RRR) of 54%. The number needed to treat is only 20, but the threat of blindness is small. After the relative risk reduction (RRR) is the same across the board, it may be better to treat those at higher risk (IOP 26 with thin cornea, etc.) and lower NNTS.
• In a study on surgical management of childhood glaucoma, results of trabeculotomy with trabeculectomy were presented. The probability of success (IOP less than 21 mmHg) was 94.5%, 92.1%, 86.7%, 79.4%, 72.9% and 63.1% at the first, second, third, fourth, fifth and sixth year respectively.
• In a study on UBM to compare the measurement with angle assessment by gonioscopy it was found that UBM measurements were highly co-related to the gonioscopy assessment. All UBM parameters were narrower than that reported in western literature. This explains the high incidence of PAC in the Indian population.
• Pulsatile ocular blood flow in primary open angle glaucoma was shown to be lower. It was found that ocular pulsatile blood flow improved by almost 60% at 3 months follow-up after trabeculectomy in comparison to medical therapy with Thimolol and Brimonidine.
• A new modality of neuro protection was developed which promises to prevent most of the problems associated with functional neuroprotective drugs. Neuroprotection achieved by vaccinating the patients with a low specificity antigen is now under an early phase of clinical trial in chronic open angle glaucoma patients.
• In a study of intraocular pressure in normal paediatric population was presented. IOP was measured in 810 eyes with a Perkins tonometer in paediatric patients, age ranging from new born 0 to 12 years. It was found that IOP showed an increasing trend with age. The mean IOP at 0-1 year of age was 8 ± 2.55 mmHg and at 11-12 years of age 14.9 ± 3 mmHg.

Issue 7-2

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