Top-eight South African Glaucoma Society Meeting

Cape Town, South Africa, June 19-21, 2009

Ellen Ancker

• Both structural and functional measurements are necessary to detect progression.
• When evaluating a HA 24-2 test, always ask: is it the right visual field? Was it carried out correctly? How should I interpret the results?
• Gene associations can be investigated using linkage analysis and, more recently, genome-wide association studies. Using these methods at least 14 loci (as well as numerous other gene variants) have been identified that are associated with primary openangle glaucoma (POAG). Within these loci only three genes have been identified - mycocilin in the GLC1A locus of chromosome 1 (accounts for 3 to 6% of POAG), optineurin in the GLC1E locus on chromosome 10 (associated with normal tension glaucoma) and WDR36 in the GLC1G locus on chromosome 5. A recent genome-wide association study found a highly statistically significant association with the LOXL1 gene on chromosome 15 and exfoliation syndrome and exfoliative glaucoma that has subsequently been replicated around the world. Three genetic loci have been found to be associated with congenital glaucoma and one of these loci (GLC3A on chromosome 14) yielded the CYP1B1 gene (cytochrome P450 1B1). (Susan Williams, Johannesburg, South Africa)
• Frequency doubling technology is not better than SAP in detecting glaucoma.
• In 92% of 416 patients SAP showed glaucoma defects prior to or simultaneously with SWAP
• Measurable structural changes probably precede SAP in most glaucomatous eyes. The most sensitive structural measure currently available clinically is obtained with the GDx imaging device of the RNF layer.
• Automated optic disc analysis by imaging devices (GDx, HRT) appears to yield better diagnostic classification than clinical judgment of the optic disc. Optic disc stereo photos offer objective documentation for follow-up. (Hans Lemij, Rotterdam, Netherlands; bullets 1-6)
• HIV vasculopathy may lead to neovascular glaucoma. It responds well toPRP, Ahmed drainage device augmented with MMC and intra-cameral Bevacizumab. (Sven Obholzer, Cape Town, South Africa)