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Issue 7-3
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IGR 7-3
In a rural Indian population, almost everyone (98.4%) was previously undiagnosed. This finding suggests that efforts to screen for advanced glaucoma in this population may be particularly rewarding
The five factors identified as the most important determinants of ONH biomechanics are, in rank order: the stiffness of the sclera, the size of the eye, IOP, the stiffness of the lamina cribrosa, and the thickness of the sclera
Women are less likely to receive any form of treatment
Machine classifiers may provide new indices for progression
Axoprotection is the latest frontline in the war against glaucomatous optic neuropathy
Retinal ganglion cells with significant dendritic arborisation changes, showed a reduction in the response to visual stimuli with higher temporal frequency
High speed ultra-high OCT has the potential to revolutionize retinal imaging
Age as a risk factor should be balanced by life expectancy
After peripheral iridotomy a high rate of appositional angle closure was seen
Close follow-up in the time period immediately after initiating therapy is a reasonable approach for improving compliance as this seems to be a critical period when many stop taking medications (Cooperation with Therapy)
Evidence to justify glaucoma screening is considerably stronger than it was a couple of decades ago (Screening OAG)
Laser treatment of trabecular meshwork cells causes the release of factors that increase the permeability of Schlemm's canal endothelia
One measurement of CCT in a patient's lifetime is probably not adequate
Observations indicate a systemic vascular dysfunction in PEX patients
SLT may be an effective alternative to medication as first line therapy
Incidence of zonular weakness was significantly higher in cases of primary angle closure glaucoma (Top-Ten ACGC Meeting)
Non-penetrating glaucoma procedures may offer a safer alternative in children (Top-Ten PAAGS)
It is entirely possible that so-called functional reserve is an artefact created by the discrepancy between structural and functional measurements. Studies have shown that the relationship between functional loss and the structure of the neuroretinal rim is linear provided the scales are matched, i.e., both logarithmic or both linear (Top-Ten OGS)
A reasonable approach to improve compliance seems to institute active surveillance systems such as structured phone calls by ancillary personnel to assess drop taking behaviour (Cooperation with Therapy)
Justification for glaucoma screening is most strongly supported in high-risk groups. However, the cut-off level of glaucoma prevalence needed to make screening desirable is not known (Screening OAG)
Accelerated aging may contribute to the pathophysiology of glaucoma
Reproducibility was lower for discs suspected to show deterioration. A measure of this ability to consistently define change, sensitivity, was only 64% to 81%
An increased resistive index was predictive of progression
Histologic studies suggest that vascular factors may also contribute to the pathogenesis of glaucoma
Diclofenac enhances the ocular hypotensive effect of latanoprost
Quantification of risk helps predicting conversion from ocular hypertension to glaucoma
Age, IOP and CCT are factors with high reproducibility that can be used in a risk calculator
Genes that control ocular growth as well as genes coding for collagen and extracellular matrix tissue may be associated with the development of PACG (Top-Ten ACGC Meeting)
3.8% had glaucoma at the time of diagnosis of APAC, and an additional 5.1% developed PACG during a mean follow-up of six years (Top-Ten ACGC Meeting)
The biometric evaluation of 77 subjects with convex irisconfiguration (CIC) and 38 with plateau iris configuration showed significant thicker lens and smaller vitreous length in CIC (Top-Ten ACGC Meeting)
Topical carbonic anhydrase inhibitors have been shown to be safe and effective in children. Prostaglandin analogues are also supposed to be safe, but their long-term efficacy is yet to be determined (Top-Ten PAAGS)
In the OHT Study, structural and functional indices were considered predictive factors, but not risk factors for glaucoma, since the definition of glaucoma is based on characteristic structural and functional damage. However, these predictive factors may actually be signs of early glaucoma not yet defined as glaucoma endpoints by the OHTS reading centers (Top-Ten OGS)
Work with patients and pharmacies to obtain a summary of the number of refills obtained by the patient in a given time period. This information would be fed back to the physician to trigger an intervention (Cooperation with Therapy)
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