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Top-ten of the Annual Meeting of the American Glaucoma Society
Washington, March 6-9, 2008
Christopher Girkin
- It was demonstrated that the cross-sectional area of the iris, a surrogate of stromal volume, decreased dramatically as the pupil dilates as determined using anterior segment OCT. The loss of volume is less in patients with angle closure indicating that this may provide a marker for those at risk for meshwork closure (Harry Quigley, Baltimore, MD, USA).
- Exfoliation syndrome is the most common recognizable cause of open-angle glaucoma and should be considered an ocular manifestation of a systemic disease, associated with non-synonymous SNPs in the lysyl oxidase-like-1 gene, essential for synthesis of elastic tissue and maintenance of the extracellular matrix. It is being increasingly associated with ocular and systemic diseases, particularly ischemic disorders. As a disease characterized by low-grade inflammation and oxidative damage, it may be amenable to new treatment approaches beyond merely lowering intraocular pressure. This is a potentially reversible or preventable disorder (Robert Ritch, New York, NY, USA; Annual AGS lecture).
- Ophthalmologists were characterized as public health ambassadors who can reduce disease burden even through everyday clinical interactions by remembering to inform patients that their family members are at increased risk for glaucoma. Also discussed were the societal concerns surrounding those who cannot pay for care and the importance of pursuing related strategies to identify undiagnosed glaucoma and develop adequate systems of care (Anne Coleman, Los Angeles, CA, USA; AGS Clinician Scientist Lecture).
- The effect of diabetes on the development of glaucoma in the OHTS study was re-examined using additional information about diabetic history. The study confirmed suspicions that there was no protective effect of diabetes on the development of glaucoma and the initial finding was likely attributed to methodological issues (Michael Kass, Saint Louis, MO, USA).
- RNFL imaging with the GDx VCC had a superior performance over topographic optic disc assessment with the HRT for detecting early damage in patients suspected of having glaucoma. For glaucoma diagnosis, the results suggested that the GDx VCC might offer advantage over the HRT when these tests are combined with clinical examination of the optic nerve (Felipe Medeiros, La Jolla, CA, USA).
- A strong association was found between the relative position of optic disc hemorrhage to regions of beta zone atrophy. This may indicate a similar pathogenic mechanism, but the finding could also reflect unassociated processes that reflect advancing underling glaucomatous changes (Nathan Radcliffe, Newburgh, NY, USA).
- Low BP in the face of high IOP and high BP were associated with open angle glaucoma in the Los Angeles Latino Eye Study (Farnaz Memarzadeh, Los Angeles, CA, USA).
- Of eyes of patients treated with iridotomy for angle closure, 38.8% developed some rise in IOP after ten years, with 18.1% needing treatment (Pierre Blondeau, Sherbrooke, Canada).
- Using immunostains for lymphatic vessels it was shown that normal donor eyes had a developed uveolymphatic system within the cilliary body and glaucomatous eyes had a possible disruption of this network. that may support regulation of aqueous outflow (Neeru Gupta, Toronto, Canada).
- An association between reading speed and unilateral or bilateral
glaucoma was not demonstrated in the Salisbury eye study. Central
field loss however did affect reading speed even after adjusting for
visual acuity (Pradeep Ramulu, Baltimore, MD, USA).
