Abstract #86831 Published in IGR 21-2

The Diagnosis and Treatment of Glaucoma

Schuster AK; Erb C; Hoffmann EM; Dietlein T; Pfeiffer N
Deutsches Ärzteblatt international 2020; 117: 225-234

BACKGROUND: Glaucoma is a group of chronically progressive disorders of the optic nerve. In this article, we present the epidemiology of and risk factors for glaucoma, as well as the diagnostic work-up and treatment options. METHODS: This review is based on pertinent publications retrieved by a selective search in Medline and the Cochrane Library, supplemented by further articles chosen by the authors. RESULTS: In Europe, the prevalence of glaucoma is 2.93% among persons aged 40 to 80 years. The prevalence rises with age, reaching 10% in persons over 90 years old. The available diagnostic methods include ophthalmoscopy, tonometry, perimetry, and imaging techniques. The treatment of glaucoma is focused on lowering the intraocular pressure with topical drugs, laser therapy, and glaucoma surgery. In patients with manifest glaucoma, lowering the intraocular pressure prevents the progression of visual field defects, with a number needed to treat of 7. CONCLUSION: The diagnostic evaluation of glaucoma rests on multiple pillars, all of which must be considered for establishing the diagnosis and defining the desired target pressure: these are, among others, the intraocular pressure and ocular function and morphology. Individually tailored pressure-lowering treatment should be evaluated in regularly scheduled follow-up visits for assessment of function and morphology and adjusted as necessary to minimize the risk of progression.

Department of Ophthalmology, University Medical Center Mainz; Private Institute of Applied Ophthalmology Berlin; Department of Ophthalmology, University Hospital Cologne.

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6 Clinical examination methods
11 Medical treatment
12 Surgical treatment

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