International Glaucoma Review

Top-Ten of the Symposium of the Bulgarian National Academy Glaucoma Foundation
November 9, 2013, Sofia, Bulgaria

The management of glaucoma typically includes the use of medication(s). Compliance rates vary between 25-59%. Seventythree patients with glaucoma filled out a Treatment Satisfaction Questionnaire for Medication-Version II. Satisfaction score for effectiveness, side effects, convenience and overall satisfaction have not showed statistically significant difference. The patients showed a high level of satisfaction with therapy. (Nevena Bjelovic', Serbia)

By a single method it is not possible to obtain complete information on the state of the visual field in different stages of the disease. Choosing the right perimeter test strategy and program depends not only on the stage of the disease but also on the age of the patient, physical and mental readiness, the purpose of the study, etc. (Maria Benova, Bulgaria)

Pre-perimetric glaucoma includes glaucomatous excavation of the optic nerve with/without elevated IOP, but without visual field defects. A number of cases show the significance of OCT in detecting pre-perimetric glaucoma. Standard automatic perimetry (24-2 SITA) and SD-OCT of peripapillary RNFL was done. All patients presented RNFL thinning a year before visual field defects. (Maja �ivkovic', Serbia)

Evaluation of GCC, Focal Loss Volume and Global Loss Volume- GLV with OCT has high sensitivity and specificity in differentiating healthy from glaucoma patients. Diagnostic accuracy of these parameters was above 0.95 and it was comparable and even better than that of RNFL. GLV had the highest diagnostic accuracy according to the ROC analysis in detecting early and pre-perimetric glaucoma. (Kremena Petrova, Bulgaria)

Glaucoma is considered to be a neurodegenerative pathology. There is substantial evidence that not only retinal ganglion cells and optic nerve, but also upstream components of the visual pathway and cortex are affected. Modern imaging techniques like magnetic resonance and spectroscopy can give detailed information about the affected components of the visual system, especially in advanced glaucoma. (Bilyana Gagova, Bulgaria)

We have developed a new staging system for glaucoma. It is based on morphometric analysis of optic nerve head performed with HRT. Its standardized criteria include global and sectoral topographic parameters of the optic disk. This system takes into account the presence of some important risk factors for glaucoma progression - β-zone of peripapillary atrophy and splinter disc hemorrhages. (Anani Toshev, Bulgaria)

Cases of patients with POAG, PEX glaucoma and ocular hypertension, who underwent SLT are presented. The trabeculum was treated on 360 degrees. IOP drop was achieved in all patients. SLT is an effective and safe method for IOP reduction. Some problems associated with chronic drug therapy in glaucoma patients could be solved by using SLT which improves patient compliance. (Nikolai Dakov, Bulgaria)

Our aim was to evaluate the long term pressure control in POAG and in exfoliative glaucoma after primary trabeculectomy. This study involved retrospective evaluation of 120 eyes with POAG and 120 eyes with exfoliative glaucoma. There was no significant difference in complete success rates between eyes from both groups. The IOP-reducing effect of trabeculectomy decreased gradually. (Vesna Babic', Serbia)

High frequency deep sclerotomy was performed in 23 eyes with POAG and 13 eyes with secondary glaucoma. The intervention was performed with a high-frequency dissection probe. Six pockets (1 mm deep, 0.3 mm high and 0.6 mm wide) were made in nasal sclera, ab interno, through trabecular meshwork and Schlem's canal. It is safe and efficient technic although longer follow-up is needed. (Marko Kontic, Serbia)

Single-step implantation of two implants with a different mechanism of action - Ex-PRESS® and OlogenTM was performed in 15 eyes. IOP drop and discontinuing of the drug therapy were achieved in 14 eyes during the follow-up (between 20 months and one month). At the last follow-up visit, the mean IOP drop from the baseline pre-op was 13.93 mmHg. Our new surgical approach is an alternative to trabeculectomy (with or without the use of antimetabolites). (Botio Anguelov, Bulgaria)