Top-Fourteen of the Australian and New-Zealand Glaucoma Interest Group Annual Meeting

July 21-22, 2006, Sydney, Australia

Anne Brooks

The Australian and New Zealand Glaucoma Interest Group (previously the Australian and New Zealand Glaucoma Club) held its Annual Scientific Meeting in Sydney from July 21-22, 2006. The invited speaker was Dr Anne Coleman from UCLA. Scientific papers presented included both clinical and basic research, as well as two Clinical Case sessions. Anne Brooks introduced the Inaugural Gillies Lecture in honour of Dr Bill Gillies, who founded the Australian and New Zealand Glaucoma Club as a time when there were no other special interest groups within the Royal Australian and New Zealand College of Ophthalmologists. He saw the Club as a way to bring together people with an interest in glaucoma to foster a special interest group within ophthalmology on the basis of equality and informality. Dr Gillies was Chair of the Club from 1988 until 2005. After a very distinguished career in Ophthalmology, including a term as President of the College and the award of the Medal of the Order of Australia, he retired from clinical practice on 30 June 2006. The Inaugural Gillies lecture was given by Jonathan Crowston.

• Nutrition and Glaucoma - fruits and vegetables are associated with a decreased risk of glaucomatous optic nerve damage in older women.
• Falls, Fractures and Visual Field Loss and Glaucoma - binocular visual field loss is associated with an increased risk of falls and fractures in older women. There is a greater risk of falls and fractures as binocular visual field loss increases.
• Most HRT parameters, particularly the Moorfields Regression Analysis parameters were significant in predicting the conversion to glaucoma in participants in the Ocular Hypertension Treatment Study.
• Through imaging of live cells in a transgenic mouse model scientists will be able to follow ganglion cell death longitudinally.
• Retrospective analysis of de-identified billing data from the Australian Pharmaceutical Benefits Scheme for the potentially  inappropriate practice of co-prescribing topical and systemic beta-blockers showed that approximately 20,000 concessional patients per annum are affected. Healthcare stakeholders must alert professionals and patients for the reduced hypotensive efficacy and increased potential for systemic side effects from this practice.
• Optic nerve injury after excitotoxic injury to the retinal ganglion cell somata show early pathological changes in the distal axon characteristic of a dying back-type process.
• Eighty percent or more of glaucoma patients did not think that ocular medication could have systemic side effects.
• Trypan Blue can identify the likely sites of cyclodialysis clefts in patients who have had multiple operations, allowing a precise application of surgery or laser therapy.
• After an acute rise in intraocular pressure, changes to the ganglion cell cytoskeleton in the pig optic nerve head were seen. Fractional axonal transport inhibition across the post lamina and lamina regions was also demonstrated.
• A stepwise decrease in the mean age at diagnosis across Australian patients with the Gln368STOP, Thr377Met and Pro370Leu MYOC mutations is mirrored by a reciprocal increase in maximum recorded IOP and the proportion of subjects requiring trabeculectomy.
• LMX1B has been implicated in Nail Patella Syndrome (NPS). LMX1B mutations were identified in 5/8 NPS probands. In total one case of NPS with glaucoma and a LMX1B mutation, two cases of NPS with ocular hypertension and mutations in LMX1B and one case of NPS with glaucoma without a LMX1B mutation were found.
• CYP1B1 mutations have been identified in 16.2% of Australian probands with Primary Congenital glaucoma. This is noticeably lower than that reported in the Slovakian Gypsy and Saudi Arabian populations.
• The translation of genotype-phenotype and gene-mutation frequencies are valuable to the clinician allowing a complete understanding of the likely natural history and appropriate provision of genetic counselling.
•  Eight shot argon laser peripheral iridoplasty for angle closure eyes is effective.

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