(IGR: 14-1) | International Glaucoma Review #

Top-Ten of the 22nd American Glaucoma Society Meeting
March 1-4, 2012, New York, NY, USA

Rohit Varma presented a report from the Los Angeles Latino Eye Study (LALES), investigating risk factors for open-angle glaucoma, that found that higher IOP, thin CCT, and longer axial length are important predictive risk factors for the development of OAG. Lack of vision insurance was a significant risk factor for incident OAG, underlining the importance of providing vision care coverage in addition to health insurance.

Kaweh Mansouri presented a study to determine the shortterm repeatability of intraocular pressure (IOP) patterns during repeated continuous 24-hour IOP monitoring in glaucoma patients and suspects with the SENSIMED Triggerfish ocular telemetry sensor (Sensimed AG, Switzerland). Continuous 24-h IOP monitoring demonstrated moderate short-term repeatability of circadian IOP patterns in glaucoma patients and suspects. Treated patients showed flattening of the nocturnal IOP rise.

Gustavo Moraes presented a study investigating risk factors associated with visual field (VF) progression in the Low-Pressure Glaucoma Treatment Study (LoGTS). While randomization to brimonidine 0.2% was protective compared to timolol 0.5%, lower mean ocular perfusion pressure and use of systemic betaadrenergic antagonists increased the risk for reaching a progression outcome in the LoGTS.

Panos Christakis presented the three-year results of the Ahmed Versus Baerveldt Study. This study enrolled Patients with uncontrolle d or refractory glaucoma were randomized to an Ahmed- FP7 valve or a Baerveldt-350 implant, to be followed for five years. Two hundred thirty-eight patients were enrolled; 124 in the Ahmed group and 114 in the Baerveldt group. While both devices were effective in reducing IOP and glaucoma medication use, the Baerveldt had a higher success rate than the Ahmed, but required more interventions.

Ruojin Ren presented a cross-sectional study including 144 subjects who underwent 870 nm SDOCT (Heidelberg Spectralis) imaging to obtain 48 high-resolution radial B-scans centered on the ONH, and a standardized ophthalmologic examination including automated perimetry. A subset of 24 radial scans from one randomly selected eye of each patient were delineated and quantified. A random-effects model was constructed to assess the relative effects of age and age-corrected visual field (VF) sensitivity loss (mean deviation, MD) on the anterior lamina cribrosa surface depth (ALCSD) relative to Bruch's membrane opening (BMO). The study demonstrated that in older eyes, the lamina is less deep (shallower) than in younger patients with the same level of functional loss. Suggesting that the lamina in older eyes developed less posterior remodeling than in younger eyes.

David Friedman reported on the two-year incidence of IOP elevations and glaucomatous optic nerve damage in patients with uveitis randomized to either FA implants or systemic therapy from the MUST trial (Multicenter uveitis Steroid Treatment Trial). Patients receiving an FA implant had nearly a five-fold risk of developing large IOP elevations over the first two years compared to those treated with medical therapy and about one in six developed glaucomatous optic neuropathy.

Doug Rhee presented a study in which increased expression of SPARC was achieved by transferring the cloned human SPARC gene via an adenoviral vector in a human perfused trabecular meshwork model. This is the first report of the IOP regulating capacity of SPARC in human tissue.

Sophia Wang presented a study utilizing data from the National Health and Nutrition Examination Survey (NHANES) that found that participants who consumed ≥ 800 mg/day of supplementary calcium or ≥18 mg/day of supplementary-iron had significantly higher odds of self-reported glaucoma.

Jay Katz presented the results of 40 subjects implanted with two Glaukos stents through a 1-mm clear corneal incision. Preoperative medicated IOP was 20.7 mmHg; post-washout IOP was 23.8 mmHg. In 18 subjects followed through six months, IOP was 14.0 mmHg at one month and stable through six months (13.9 mmHg). Implantation of two stents resulted in significant IOP reduction through six months, significant reduction in medication burden, and a favorable safety profile.

Steven Kymes presented a glaucoma Health Policy Model (GHPM) validated in a sample of 150 patients. Benefit varied for the simulated participants, but was positive for all. It ranged from $253/year to over $2,000/year. Greater cost saving was seen in people with a more substantial loss of visual field at baseline (i.e., MD of -10); those with less loss of visual field at baseline (i.e., MD of -4) benefit from a smaller loss of QoL.