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Top-Ten of the European Glaucoma Society Meeting
June 17-22, 2012, Copenhagen, Denmark
Fotis Topouzis and Francisco Goni
- Optic Nerve Head Biomechanics is a conceptual framework that attempts to explain how the risk factors contributing to glaucomatous vision loss likely interact. In this lecture, the role and clinical importance of connective tissue deformation and remodeling in glaucomatous cupping were discussed. (C. Burgoyne)
- Etiopathogenesis of Retinal Ganglion Cells' death is multifactorial. Thus, effective neuroprotection considering one mechanism of action strategies alone, is likely to be not sufficiently achieved. (N. Osborne)
- New evidence calls into question current neuroretinal rim assessment. Alternative methods of data capture, analysis and interpretation with OCT were presented as a paradigm change for examination of the optic nerve head in glaucoma. (B. Chauhan)
- Further evidence is required to better understand those mechanisms involved in the new ab interno and ab externo surgical hypotensive procedures, and to establish their efficacy and role in glaucoma management. (R.N. Weinreb)
- Preservative-free medical treatments are advocated especially in patients with a long life expectation, when two or more drugs are required, in stages of damage close to surgical intervention, and in front of signs or symptoms of ocular surface disease. (F. Meier Gibbons)
- Primary angle-closure treatment with Laser Peripheral Iridoplasty (LPI) in Asia shows that in 20-30% of subjects, significant appositional closure still remains after the procedure, and only 10% of those with glaucomatous optic neuropathy are effectively controlled. Angle-closure mechanisms must be properly determined through an accurate gonioscopy before and after LPI. (P. Chew)
- Behavioral strategies, like electronic reminder systems with audible and visual alarms, allow increasing patients' adherence to medical therapy, improving the frequency and pacing of eye drop instillation. (M. Diestelhorst)
- A more realistic approach to patient's self-experience of visual field defects relates to perception of blur or missing areas, rather than classical descriptions of dark and opaque scotomas. (D. Crabb)
- Dynamic response of sclera may be key in glaucoma pathogenesis. Link of central corneal thickness to glaucoma may act through effect of collagen 8 variants on scleral response to IOP. In the future, potential therapies may aim at scleral state and responsiveness. (H. Quigley)
- In population-based studies, 50% or more of individuals with glaucoma are undiagnosed. It is not cost effective to screen general population for glaucoma only. Recommendations for glaucoma screening include: a. Screen for other eye diseases along with glaucoma in the general population; b. Focus on moderate visual impairment and eye diseases, instead of aiming for earliest stages of disease; c. Approach screening via a triage method, which will prioritize those at immediate risk of blindness or significant vision loss. (A.L. Coleman)
