Top-eight South African Glaucoma Society Meeting
Cape Town, South Africa, June 19-21, 2009
Ellen Ancker
Both structural and functional measurements are necessary to detect
progression.
When evaluating a HA 24-2 test, always ask: is it the right visual
field? Was it carried out correctly? How should I interpret the results?
Gene associations can be investigated using linkage analysis and,
more recently, genome-wide association studies. Using these methods
at least 14 loci (as well as numerous other gene variants) have been
identified that are associated with primary openangle glaucoma (POAG).
Within these loci only three genes have been identified - mycocilin
in the GLC1A locus of chromosome 1 (accounts for 3 to 6% of POAG), optineurin
in the GLC1E locus on chromosome 10 (associated with normal tension
glaucoma) and WDR36 in the GLC1G locus on chromosome 5. A recent genome-wide
association study found a highly statistically significant association
with the LOXL1 gene on chromosome 15 and exfoliation syndrome and exfoliative
glaucoma that has subsequently been replicated around the world. Three
genetic loci have been found to be associated with congenital glaucoma
and one of these loci (GLC3A on chromosome 14) yielded the CYP1B1 gene
(cytochrome P450 1B1). (Susan Williams, Johannesburg, South Africa)
Frequency doubling technology is not better than SAP in detecting
glaucoma.
In 92% of 416 patients SAP showed glaucoma defects prior to or simultaneously
with SWAP
Measurable structural changes probably precede SAP in most glaucomatous
eyes. The most sensitive structural measure currently available clinically
is obtained with the GDx imaging device of the RNF layer.
Automated optic disc analysis by imaging devices (GDx, HRT) appears
to yield better diagnostic classification than clinical judgment of
the optic disc. Optic disc stereo photos offer objective documentation
for follow-up. (Hans Lemij, Rotterdam, Netherlands; bullets 1-6)
HIV vasculopathy may lead to neovascular glaucoma. It responds well
toPRP, Ahmed drainage device augmented with MMC and intra-cameral Bevacizumab.
(Sven Obholzer, Cape Town, South Africa)