Interventional Glaucoma

Although there are no scientifically proven ways to prevent glaucoma, healthy habits–such as moderate exercise, regular visual check-ups, and eating green, leafy vegetables–represent a good starting point for a prevention strategy.

Investigations of the biomechanical changes in the optic nerve head may eventually lead to improvements in therapies for patients with glaucoma.

A portable device for detecting multifocal steady-state visual evoked potentials associated with visual field stimulation is being developed as an objective test for identifying glaucoma-related visual function loss.

A review of glaucoma drugs in various clinical study phases reveals that at least seven new glaucoma drugs were in trials and two others were approved by the FDA in 2017. Many drugs that have progressed the most act on prostaglandin receptors, though some combine this with other mechanisms of action.

When customizing treatment plans for glaucoma patients, selective laser trabeculoplasty (SLT) can be as useful in diagnosis as it is in reducing IOP, explains Inder Paul Singh, MD, FEBOphth.

After decades of slow, but steady, progress in the advancement of glaucoma as a subspecialty, the last quarter century has seen tremendous innovation in this field.

The 2017 Charles D. Kelman Lecture touched on three main areas-from the teaching of the phaco technique during the early years of phaco to use of phaco in glaucoma patients to the introduction of phaco to surgeons in developing countries.

Persistent bleeding in a glaucoma patient with neovascular glaucoma after metastatic renal carcinoma requires a range of surgical methods to treat.

A prospective, observational study found that eyes with mild POAG could be differentiated from pre-perimetric glaucomatous eyes, which also could be differentiated from normal eyes using OCTA-derived retinal vessel density measurements.

A phase III trial for the fixed-combination netarsudil/latanoprost agent (Roclatan, Aerie Pharmaceuticals)reports positive results. The company plans to submit a NDA for the drug in early 2018.

Innovations in sustained-drug delivery and neuroprotection are bringing glaucoma specialists one step closer to additional therapeutic options.

A new imaging technique can show the deaths of individual cells in people with glaucoma by labelling the cells with fluorescent dye, according to researchers. The approach might eventually be used to diagnosis the disease in its early stages or measure its progression.

Prostaglandin-based topical therapy has been the ‘go-to treatment’ for open-angle glaucoma for decades. In contrast, laser trabeculoplasty has conventionally remained reserved for patients unresponsive or unable to adhere to medication-based therapy.

For 20 years I have effectively employed endoscopic cyclophotocoagulation (ECP) as a primary or secondary line of glaucoma treatment. ECP is a minimally invasive glaucoma surgical (MIGS) option capable of reducing IOP in the majority of patients and can potentially eliminate the need for drainage surgery, including trabeculectomy (trab) and glaucoma drainage devices (GDDs).

Despite the legalization of marijuana by several state governments, physicians should not recommend smoking it as a treatment for glaucoma, said Sunita Radhakrishnan, MD. “It has been approved by public opinion rather than regulatory process,” said Sunita Radhakrishnan, MD. 

An analysis of U.S. claims data reveals a substantial proportion of patients (17%) remained untreated 4 years after their initial diagnosis of open-angle glaucoma.

Reading speed is reduced in patients with glaucomatous visual field loss and normal visual acuity, and the reduction in performance is directly proportional to the extent of the visual field loss, said Aron Guimaraes, MD.

As more state legislatures are relaxing anti-marijuana laws, doctors are being put in the middle by patients requesting prescriptions or authorizations for its use for medical needs, said Marc F. Lieberman, MD.

Research in glaucoma that evaluates the molecular interactions between resident and systemic immune cells and neurons is progressing with the goal of providing translational applications for immunomodulation as a neuroprotective strategy in patients with glaucoma, said Gülgün Tezel, MD.

A glaucoma specialist explores endoscopic visualization for the diagnosis and treatment of uveitic-glaucoma-hyphema syndrome.

Although surgical intervention is not always necessary in eyes with choroidal detachment, drainage should be performed if spontaneous resolution does not occur in order to restore normal anatomy and prevent trabeculectomy failure.

Hydrogel punctal plugs may be a safe and viable method for delivery of anti-glaucoma drugs in the future.