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Top-fourteen European Glaucoma Society Closed Meeting
Lyon, France, August 28-29, 2009
Stephen Vernon
From case finding, through genetics, detection of progression, neuroprotection, health economics, quality of life, to the management of the child with glaucoma, the 2009 closed meeting of the EGS presented and discussed issues in glaucoma that influence our everyday care of patients. Mini-symposia divided the participants on the Saturday morning.
- It was almost always better to perform iridoplasty after Yag iridotomy has been tried. (Paul Foster, London, UK)
- Glaucoma, even in its milder forms, can have a detrimental effect on everyday living from increasing falls to increased risk of motor vehicle accidents. (George Lambrou, Athens, Greece)
- Psychological effects of the diagnosis should not be forgotten with fear of blindness rating highly as well as anxiety and depression. (Tor Odberg, Hamar, Norway)
- Methods and rates of detection were shown to vary widely in a review of Case finding in Europe. (Augusto Azuara-Blanco, Aberdeen, UK)
- Data from the Thessalonica study suggests that previously undetected glaucoma patients have similar field scores to those already known to have glaucoma emphasing the importance of early detection. (Ananth Viswananathan, London, UK)
- Screening MEPs is an innovative approach to increasing awareness for glaucoma. It is expected that an EU declaration on glaucoma encouraging member states to promote early detection by screening high risk groups will receive ratification shortly. (Thierry Zeyen, Antwerp, Belgium)
- Detection of progression is moving from event analysis to trend analysis allowing clinicians to determine the rate of functional or structural loss, thus aiding the prediction of important milestones such as the loss of a driving licence. (Ted Garway-Heath, London, UK)
- 'Weighting' the field score by utilising the position of defects enabled a 'break point' to be identified at which good correlation with quality of life was found. (Stefano Gandolfi, Parma, Italy).
- Eyetracking can be used to measure difficulties in everyday tasks that increase with severity of disease. (David Crabb, London, UK)
- In neuroprotection and ocular blood flow the links between Alzheimer's disease and glaucoma were explored as well as the association between cerebral blood flow abnormalities and NTG. Similarities were proposed between anterior ischaemic optic neuropathy and glaucomatous damage with relation to the 'compartment syndrome' where ischaemia occurs in the intrascleral nerve head. (Conclusion minisymposium on neuroprotection and ocular blood flow)
- Surgical approaches to congenital and aphakic glaucoma indicate a move towards the use of tube devices. A call for the establishment of an international network of specialists to improve outcome and co-ordinate research was well received by those who attended. (Conclusion minisymposium on pediatrics)
- Anterior-segment imaging probably overestimates the number at risk of angle closure as well as missing PAS, and should not be used as a substitute for gonioscopy. (Winifred Nolan, Birmingham, UK)
- Drop instillation technique was negatively associated with degree of field loss, whereas compliance was positively associated. (Pilippe Denis, Paris, France)
- The final session 'From bench to bedside' showed how advances
from research into basic mechanisms could relate to patient
treatment. This was perhaps best illustrated by the possibility of
drugs aimed at altering cytoskeletal properties of the trabecular
meshwork or even more impressively, transgene delivery therapy
aiming at the same target. (Darryl Overby, London, UK)
