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Top-Ten of the Canadian Glaucoma Society Meeting (CanGS)
June 22, 2007, Montreal, Canada
Yvonne Buys
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The Canadian Glaucoma Study followed 258 patients from 1994-2005 to evaluate risk factors for progression of POAG. Significant risk factors included the presence of anticardio-lipin antibodies, female gender, increasing age (4% increase per year) and higher IOP (20% increase per mmHg). Factors previously associated with progression that were not found to be significant in this study included diabetes, hypertension and a history of cardiovascular disease. (B. Chauhan, Halifax)
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A comparison of HRTII, Stratus OCT and GDx-VCC in detecting localized retinal nerve fiber layer defects previously identified in photographs found similar sensitivies however almost half of the defects were not detected by each technique individually. The GDx showed lower specificity than the other devices in the present study. (B.K. Windisch, Nova Scotia)
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A prospective randomized comparison of 79 eyes undergoing one versus two-site phaco-trabeculectomy found no significant difference in IOP lowering between the groups at two years. There was however, significantly greater endothelial cell loss in the two-site group as compared to the one-site group at three months and one year. This difference was no longer statistically significant at two years. (Y.M. Buys, Toronto)
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Canadian national and provincial data regarding glaucoma laser and surgical procedure rates from 1992-2005 were analyzed. Laser trabeculoplasty rates were found to have doubled since 2002, coinciding with the introduction of selective laser trabeculoplasty. Trabeculectomy rates decreased by 29% since 1996 while glaucoma drainage device implantation rates increased twelve-fold during the study period. (R.J. Campbell, Kingston)
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A retrospective review of 522 filtration surgeries with a mean follow-up of 5.3 years found five (1.3%) cases of blebitis/endophthalmitis. Black race, bleb manipulation and bleb leaks were identified as significant risk factors. The use of antimetabolites and diabetes were not found to be risk factors in this study. (S. Sharan, Toronto)
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Abnormal Tau protein is associated with neurodegenerative diseases, known as tauopathies, such as Alzheimer's disease. Measurements of normal and abnormal Tau proteins were made in eleven glaucoma eyes and ten age-matched controls. Normal Tau was decreased and abnormal Tau was significantly increased in the glaucoma retinas as compared to controls. The abnormal Tau was localized to the horizontal cells of the glaucoma retinas, implicating involvement of these cells in the neurodegenerative process in glaucoma. (N. Gupta, Toronto)
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A prediction rule analysis was performed to determine which parameters were most predictive of an outcome of > 20% pressure reduction from baseline following selective laser trabeculoplasty (SLT). The univariate analysis identified: gender, diagnosis (primary open angle glaucoma vs ocular hypertension vs normal tension glaucoma vs secondary open angle glaucoma), pigment of anterior chamber, washout of eye drops, pre-SLT IOP and maximum IOP as potential predictors while the multivariate analysis pinpointed maximum IOP ever measured and IOP immediately prior to SLT (within four weeks) as the strongest predictors. (C. Hutnick, London)
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Using HRT II for diagnosing glaucoma by combining rim area to disc area asymmetry ratio (RADAAR) and Moorfields Regression Analysis increased sensitivity while specificity remained essentially unchanged. (A.A. Kamdeu Fansi, Montreal)
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Similar to previous reports with standard automated perimtery, minimal light scattering, such as might be caused by a mild cataract, may influence the threshold values measured by frequency-doubling technology. (M.J. Fredette, Quebec City)
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The Québec Glaucoma Network researchers have shown that mutations in the myocilin gene are responsible for about 4% of all primary open-angle glaucoma genes in French-Canadians. Moreover, using a huge juvenile open-angle glaucoma family, they have demonstrated that age at onset can predict severity of disease. Researchers also have identified at least one modifier gene or loci that alters the severity of glaucoma caused by a particular myocilin mutation. (V. Raymond, Quebec City)
