Interventional Glaucoma

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.

An investigational glaucoma device that shunts aqueous from the anterior chamber to a sub-conjunctival/sub-Tenon’s pouch is being evaluated in a prospective study of 35 eyes operated on at two centers.

A nanophotonics-based device implanted in the eye may one day enable patients with glaucoma to monitor their IOP from home.

Advances in ultrasound biomicroscopy enable the capture of higher quality images to ophthalmic surgeons who seek accurate diagnoses or anatomic measurements.

The "Glaucoma 360 Annual Gala" raises money for GRF research and education. The gala includes a reception, silent and lives auctions, dinner, entertainment, and awards. For a glimpse of the evening's festivities, view the slide show.

The advent of 24-hour IOP monitoring will transform the care of patients with glaucoma and usher in a new era of personalizing IOP.24-hour IOP monitoring set to revolutionize glaucoma research and clinical care.