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Top-Ten Glaucoma Society of India
September 20-21, 2003, Tamil Nadu, India
R. Ramakrishnan
- Prevalence of glaucoma in India - According to various epidemiological studies prevalence of primary glaucoma is 2.33% to 4.73%. POAG is as common as in the west. However there are conflicting results about the prevalence of angle closure glaucoma.
- Prostaglandins in glaucoma practice - All available prostaglandins are similar in clinical efficiency and systemic side effects. More ocular side effects are seen with bimatoprost and travatoprost.
- Molecular Genetics of Congentital Glaucoma in India - R368H may be the founder mutation. MYOC is the potential candidate in Primary Congenital glaucoma. Susceptible haplotypes for Primary Congenital glaucoma is CYP1B1 mutation.
- Newer visual field techniques - SITA has increased efficiency in automated perimetry. FDT has increased efficiency in glaucoma screening. SWAP and FDT have increased efficiency in early detection of glaucoma. Glaucoma progression analysis has increased efficiency in glaucoma follow up.
- Central corneal thickness in glaucoma - Patients with central corneal thickness less than 555 micrometers have a 3 fold increased risk of POAG than patients with central corneal thickness of 588 micrometers. For every 20 micron increased central corneal thickness the measured IOP is increased by 0.441 mm of Hg.
- Progression of Primary Angle Closure Suspect(PACS) to Primary Angle Closure(PAC) - A study showing 5 year progression of occludable angles to primary angle closure (PAC) and PAC to primary angle closure glaucoma (PACG) in a south indian population concluded that 22% may progress as compared to normals. The relative risk of progression is 24%. If laser peripheral iridectomy works for all PACS then the absolute risk of progression decreases by 21%
- IOP elevation following intravitreal steroids - Develops in 41% on an average in 5 weeks. Most patients are controlled with topical antiglaucoma therapy. Risk factors are young age, ocular hypertensives and known glaucoma patients.
- IOP Drop After Phacoemulsification - Average of 3 mm drop seen after phacoemulsification surgery. The release of interleukin 1 due to the ultrasound energy may be causing the increase in trabecular outflow.
- New Concepts Introduced For Primary Angle Closure Glaucoma - Eyes with greater difference of pressure between anterior and posterior chambers could be at a higher risk to develop angle closure glaucoma. Choroidal expansion of 20% raises IOP up to 60 mm of Hg. Eyes during acute primary angle closure have choroidal expansion as seen by UBM. Poor vitreous fluid conductivity may also be an additional risk factor.
- Retinal nerve fibre layer thickness measurements in normal indian population by optical coherence tomography - Mean + SD retinal nerve fiber layer thickness measurements for various quadrants superior, inferior, nasal and temporal were 140.22+21.74, 125.34+19.77, 88.59+21.16, 66.59+15.9 and 104.97+15.14 mm respectively. There was no significant difference in the measurements between males and females, and there was no significant correlation with respect to age. A significant positive correlation (p<0.05) with change of 2.8mm of thickness with 1 diopter change in spherical equivalent was noted.
- OCT In Normal And Glaucomatous Eyes - Macular thickness measurement in glaucoma suspects was more than in normal subjects. No significant difference was noted in central macular thickness between normal and glaucomatous groups. Peripaillary RNFL thickness was a more sensitive indicator of glaucoma than was central macular thickness.
- C20-1 program of the Frequency Doubling Perimeter - A prospective study showed that this program was a highly sensitive and specific screening test for glaucoma. The use of any 2 abnormal points anywhere in the field is an easy and accurate algorithm to follow.
