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Top-Ten Asia Oceanic Glaucoma Society Meeting

October 19-21, 2001, Seoul, Korea

Young Jae Hong

The Third Congress of the Asia Oceanic Glaucoma Society was held in Seoul, Korea in October 2001. Approximately 400 participants registered at this meeting. Plenary lectures were given by Professor Hai Ryun Jung, Professor Ivan Goldberg, and Professor Makoto Araie. There were seven symposia and three luncheon seminars, four problem-case discussions, as well as 40 free papers and 45 poster presentations. The topics covered at the meeting went broadly as well as deeply into the glaucoma field, from blood flow and neuroprotection to diagnosis and the treatment of glaucoma.

• Lomerizine, a Ca²⁺ antagonist that selectively increases cerebral blood flow with few systemic hypotensive effects, was found to increase the retinal and optic nerve head blood flow with little effect on the choroidal blood flow. Lomerizine has potential for being used as a Ca²⁺ antagonist for NTG.
• Scanning laser polarimetry was capable of differentiating early to moderate glaucomatous eyes from nonglaucomatous populations in this Korean cohort study; however, considerable measurement overlap was also observed among normals, glaucoma suspects, and early glaucomatous eyes.
• One of the strategies for protecting the optic nerve in glaucoma is to reduce IOP to orbital venous pressure levels, by performing filtering surgery with antimetabolites. The mean deviation and pattern deviation of patients was stabilized for five or more years, with 95% of the patients remaining stable.
• The improvement in mean deviation following cataract surgery was greater in blue-on-yellow perimetry than in white-on-white perimetry by a factor of 2.4 times. The magnitude of the effect may depend on the type of cataract.
• The consequence of the present state of our knowledge on glaucoma surgery is that there is little or no idea what is happening to the glaucoma patient's life when he or she undergoes glaucoma surgery. Suggested solutions: 
  1. stop considering glaucoma surgery 'successful' or 'unsuccessful' based solely on the absolute level of IOP;
  2. 'require' that a quality-of-life or functional assessment of the patient be performed before and after glaucoma surgery.
• While lower target IOPs require penetrating techniques, non-penetrating approaches can be considered when a high-normal IOP is thought to be adequate.
• The mechanisms of PACG include papillary block and plateau iris syndrome. Our previous study indicated that both mechanisms could co-exist in the same PACG patient, especially with advancing age, and in Asians, especially Mongolians and Chinese.
• Angle-closure eyes have other contributing abnormal mechanisms in addition to pupillary block, possibly including low fluid transmission through the vitreous humor and vigorous expansion of the choroidal volume. The spectra of diseases that are explained by these mechanisms include plateau iris, malignant glaucoma, and nanophthalmos.
• Stromelysin, a functional gene, can be transferred in vivo into rat eyes and in vitro into cultured human trabecular cells, using a replication-deficient adenovirus vector. This proves the possibility of gene therapy in glaucoma.
• These heat-shock protein-related studies provide the possibility of a novel therapeutic approach to glaucoma through an enhanced endogenous stress response. Zinc could be another positive candidate for the neuroprotection strategy.