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Top-Five of the Optometric Glaucoma Society Meeting
Denver, Colorado, USA, November 10-12, 2014

Murray Fingeret, John Flanagan, Tony Realini

1.  Future clinical trial design can be shortened by using structure and function in combined hierarchical models in order to:
   • compare the power of rate-based analyses with conventional survival analysis, using data acquired to optimize the measurement of rates;
   • evaluate the (potential) gain to be derived from adding structure to function measurements;
   • provide data on rate (velocity) of progression to power future trials and identify the shortest feasible trial duration.
   (Ted-Garway Heath, London, UK)
2. Progression can occur at all levels of intraocular pressure (IOP), which has motivated us to find additional susceptibility factors. It is intriguing to ask whether IOPfs weak association with progression is attributable to other factors, or whether we are falling short in our approach to measuring IOP. (Ted-Garway Heath, London, UK)
3. The relationship between IOP fluctuation and glaucoma progression remains inconclusive. An analysis of the data from the Advanced Glaucoma Intervention Study was among the first to demonstrate that patients with greater IOP variability were more likely to have progressive visual field changes over time. Other studies, such as the Early Manifest Glaucoma Trial, have failed to confirm this. Peak IOP, however, has been shown to be associated with disease progression. (Steve Mansberger, Portland, OR, USA)
4. Our observation of early preferential loss of inferior macular ganglion cells led us to examine the relationship between structural and functional loss in glaucoma. To compare OCT of the macula to visual fields, we utilize a 10-2 testing pattern. With 24-2, only four of the test locations fall within the macula; with 10-2 testing, most of its points fall within the same region. We found that a 10-2 field often showed small paracentral defects attributable to early macular ganglion cell loss. (Donald Hood, New York, NY, USA)
5. Non-adherence is a significant problem in glaucoma. Studies have demonstrated that patients who do not adhere to their treatment regimen are more likely to progress than those who do. In one study, the risk of progression was nearly twofold higher among non-adherent patients. (Steve Mansberger, Portland, OR, USA)

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