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Top-Three of the XIV Symposium of the Bulgarian Glaucoma Society
Sofia, Bulgaria, March 18–19, 2016

Nataliya Petkova, Sofia, Bulgaria

1. Congenital glaucoma: pathogenesis, diagnosis, treatment
   Pathogenesis ,diagnosis and treatment of primary and secondary congenital glaucoma were reviewed. Congenital glaucoma surgery is a pivotal step in the life of a glaucoma child. Retrospective analyses show equal efficacy of goniotomy and trabeculotomy in many studies, but often more than one or two interventions are needed and the success rate is still unsatisfactory. 360-degree trabeculotomy allows circular visual control of the position of the catheter tip and misdirection can be avoided. Recent own experience with this technique has shown superiority over conventional trabeculotomy and goniotomy. Treatment of congenital glaucoma can be improved by early diagnosis, experienced surgery and consistent follow-up to achieve and preserve lifelong visual functions.
   (Franz Grehn, Würzburg and Mainz)
2. OCT update
   Identification of structural glaucomatous damage and progression overtime in OCT images is very useful for glaucoma diagnosis and follow-up. During the last 15 years, OCT has evolved significantly and it is now present in most ophthalmic facilities. The evolution of the technique through optical domain, spectral domain, en-face and swept, their advantages, disadvantages and usefulness were described. The information contained in the different print outs and algorithms were reviewed. A methodical interpretation of OCT results were described and recommended. Practical cases were used to explain the different instruments, algorithms and the interpretation of the results.
   (Alfonso Antón, Barcelona, Spain)
3. Exfoliation syndrome / Exfoliation Glaucoma: Lessons from the Thessaloniki Eye Study
   The Thessaloniki Eye Study (TES) assessed the prevalence of (pseudoexfoliation) PEX and pseudoexfoliative glaucoma (PEXG) and reported on PEX and PEXG characteristics and risk factors. The association of PEX with the level of intraocular pressure (IOP), the degree of optic disc damage and the presence of systemic diseases including cardiovascular disease and the association of IOP with PEX location were specifically studied. In addition, the TES showed that there is increased likelihood of glaucoma at the same screening intraocular pressure in subjects with PEX. Finally, risk factors for PEXG were studied and presented, as well as associations with LOXL1 polymorphisms.
   (F. Topouzis, Thessaloniki, Greece)