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Glaucoma at ARVO - The Program Committee's Choice
May 4-9, 2003, Fort Lauderdale, Florida, USA
Jeff Liebmann
- Standard HFA automated perimetry, High Pass Resolution Perimetry and Frequency Doubling Technology Perimetry had a relatively poor overlap in the patients classified as progressive
- Neural losses from glaucoma are predictable from visual sensitivity measurements by clinical perimetry
- Ten locations selected by machine learning classifiers performed as well as 52 locations of the HFA 24-2 program
- Models of the optic nerve head allow a satisfactory description of connective tissue mechanical behavior. In early glaucoma, large strains inferiorly and nasally suggest that early connective tissue damage may be greater in these regions
- Pattern matching algorhitms, such as artificial neural networks, could be used to detect glaucoma based on specific auto-antibody patterns
- Long distance in vivo regeneration of retinal ganglion cell axons after injury was demonstrated in Bcl-2 transgenic mice
- Robotic implantation of microfistula drainage devices via the anterior chamber has been successfully performed in animals
- Vaccination with Cop-1 was neuroprotective in hypertensive rats
- A new type of human trabecular meshwork cells in culture possibly derived from Schwalbe s cells has been described
- YAG-laser iridotomy showed a ten-year protective effect in eyes
with high risk pigment dispersion
Glaucoma at ARVO
Glaucoma Mini Symposium
Jack Cioffi on the biology of progressive optic nerve injury in glaucoma
Over the last several decades, the normal biology and physiology of the
optic nerve, and the pathophysiological mechanisms involved in the development
of glaucomatous optic neuropathy have been studied extensively. As our understanding
of neurobiology has expanded, insights into the cellular mechanisms of retinal
ganglion cell death continue to be elucidated. These insights not only describe
the culminating structural event (retinal ganglion cell death and atrophy),
but also help us understand the progressive changes as a cell moves from
health to sickness to death. Today's symposium is focused on the characterization
of progressive injury to retinal ganglion cells and their axons, changes
in optic disc topography, and associated functional deficits. Relating the
exact structural changes of the retinal ganglion cells and their axons to
the functional defects manifested in glaucoma is difficult, especially in
early disease. Correlation of the structural changes to detectable functional
changes may help us understand glaucomatous optic neuropathy better, and
thereby offer potential therapeutic opportunities for the future.
Our understanding of the structure-function relationship continues to evolve,
mainly through our increased understanding of neurobiology. This understanding
is re-focusing our development of structural and functional measurement
techniques. We have progressed from a macro-view (or whole organ view)
of the disease to a micro-view, in which we examine the eye at a much finer
level. This has led to an enhancement in the sensitivity of techniques
for measuring progression. Both structural and functional changes are more
detectable. We are now examining smaller populations of retinal ganglion
cells, and even single cell or sub-cellular measurements are possible. However,
we must be clear, when discussing the structure/function relationship, to
qualify between clinical practicalities and theoretical possibilities.
In conclusion, the structure and function of the optic nerve remain
intimately linked, and perhaps changes even occur simultaneously.
Glaucoma at ARVO - Top 10
Bal Chauhan
- After inducing focal laser-induced damage to the peripapillary nerve fiber layer in a monkey, functional losses at a more distant site along the bundle were detectable using multifocal electroretinography
- Evidence from experimental pressure-induced optic disc damage suggests that, by the time disc changes are seen with scanning laser tomography, changes to the lamina cribrosa are profound and permanent.
- Diabetes, lower IOP during follow-up, and aspirin use are significantly associated with the presence of optic disc hemorrhages.
- Central retinal vein collapse pressure is significantly higher in glaucoma patients compared to control subjects, suggesting increased resistance in the vein as it exits the eye.
- A biodegradable microfistula drainage device implanted via the anterior chamber provides a long-term patent drainage channel with minimal damage and complications.
- Inducible nitric oxide synthase levels were not found to be elevated in either rats that had chronic optic nerve damage due to hypertonic saline-induced occlusion of the trabecular meshwork, or DBA/2J mice that develop spontaneous acute pressure-induced optic nerve damage.
- In the Ocular Hypertension Treatment Study, those eyes that developed a visual field end-point first had a high preponderance of nasal visual field defects compared to those eyes that first developed an optic disc end-point.
- Ultrahigh resolution optic coherence tomography moves closer to the clinical realm.
- The association between central corneal thickness and IOP was confirmed in a study in which patients undergoing cataract surgery had transducer-measured pressures correlated to those measured by applanation.
- After a six-year follow-up in a Singaporean population, almost 18% of subjects presenting with acute-angle closure were blind in the affected eye, while almost half developed glaucomatous nerve damage.
Norbert Pfeiffer
- EMGT progression criteria identified glaucomatous progression earlier than AGIS and CIGTS criteria
- IOP reducing ability was equivalent for latanoprost, bimatoprost and travoprost
- Thrombospondin-1 might act as a potent local endogenous activator of TGF-beta in the aqueous humor
- Live imaging of collagen fibril organization in response to fibroblast motility was demonstrated for the first time
- Treatment of ocular hypertensives with additional risk factors may be cost-effective
- In cultured fibroblasts reduction of cell growth was seen after treatment with a mixture of polycationics lipids and p53 antisense oligonucleotides
