The Education Committee of the World Glaucoma has highlighted the following WGC-2015 sessions from the Educational Portal. From among the many high quality videos online, the committee selects for these Highlights that are of broad interest and significantly advance knowledge or provide new concepts or approaches that extend our understanding.
1. Finding Solutions to glaucoma in the developing world – overcoming barriers to glaucoma care in the developing world
Speaker gave a very detailed overview of the challenges faced in the developing world. Three major areas highlighted that deserve immediate attention were the financial constraints of those most needing treatment, poor awareness and screening of at risk population resulting in individuals seeking help only at advanced stages of their disease, and public health delivery to the more rural areas containing the greatest population at risk of glaucoma. The speaker went on to present her thoughts on how some of the above-mentioned barriers could be overcome. Telemedicine was suggested as a possible tool to help improve on the screening process. In all, a very thought provoking and frank presentation reminding us of the sheer magnitude of the global problem of blindness caused by glaucoma.
2. Glaucoma Surgery – New Surgical Techniques & Unmet needs
Speaker gave a comprehensive overview of the advantages and shortfalls of surgical procedures and surgical implants available. The speaker illustrates this with clear videos and also provides tips and tricks for improving the outcome of the surgery e.g. Tube surgery, and how to minimize post-operative complications. A comprehensive summary of the latest development of glaucoma surgeries for those who want a quick overview.
3. Advances in Medical treatment of NTG
Speaker described the therapeutic targets that are being focused in the treatment of NTG. Neuroprotection is the key and approach to protecting the optic nerve include limiting the ischaemic effects, reducing axonal damage with modulation of the surrounding microglial activity, increasing the presence of anti-oxidant protective agents. Three candidate therapeutics were described by the speaker which included alpha agonist and calcium channel blockers both to increase blood flow and antioxidants as dietary supplements. The speaker gave a well-rounded overview of the latest research efforts in advancing the treatment options for NTG, and provides a good summary for those who are interested in updating on what’s new in NTG management.
1. Translational Glaucoma ‒ Protecting retinal ganglion cells
In this presentation, Dr. Crowston demonstrated that the retinal ganglion cells that are injured by increased intraocular pressure can be characterized and evaluated. These cells do have the ability to recover even after prolonged period of functional loss and Dr. Crowston showed that the ability of these cells to recover can be modified. These strategies would open up avenues to protect the injured ganglion cells and reduce the loss.
2. Understanding IOP ‒ CSF Pressure: Interesting Trivia or the Key to Glaucoma?
Dr. Jonas presented a detailed discussion on the association between CSF pressure and glaucoma. He also discussed the possible associations between CSF pressure and other ocular pathologies like retinal vein occlusion and diabetic retinopathy. He proposed glaucomatous optic neuropathy to be caused by a misbalance of blood pressure, CSF pressure and intraocular pressure. It may be worthwhile in the clinics to consider the interplay of these factors while evaluating and managing patients of normal tension glaucoma.
3. Glaucoma Innovations and Opportunities ‒ Personalizing IOP
Robert N. Weinreb
Dr. Weinreb presented the importance of evaluating 24-hour intraocular pressure in the treatment of glaucoma. He also gave an overview of the effect of the commonly used anti-glaucoma medications on the 24-hour IOP curves. He predicted that the future would see development of methods for measuring 24-hour IOP and that this would help us in personalizing target pressures and personalizing medical and surgical treatments.
1. Presidents Symposium: Glaucoma Innovations and Opportunities – Applying regenerative medicine techniques and technology tomorrow
Speaker gave an interesting overview on current regenerative medicine – the wide process of replacing, repairing or regenerating human cells, tissues, organs to restore or establish normal function.
Presenter was talking about different strategies for glaucoma – ganglion cell replacement, stem cell neuroprotection and optic nerve regeneration. Experimental studies show that retinal ganglion cell axon regeneration is feasible. If some optic nerve regeneration is possible, the question is will it be functionally useful? Looking for the future – regenerative treatments are coming to the eye. Cell therapy for neuroprotection is realistic and tissue engineering techniques are advancing very fast.
2. Glaucoma Surgery – New surgical Techniques & Unmet needs
Speaker gave a nice overview of several choices of new glaucoma surgical techniques, predicted results and unmet needs. Characteristics of surgeries are analyzed based on outflow location, use of outflow system, material of devices, with or without cataract surgery. Unmet needs focus is on an individual patient.
3. Updates on Normal Tension Glaucoma – 04 CSF pressure and NTG
Interesting presentation looking into different mechanisms of normal tension glaucoma and discussing a possible influence of cerebrospinal fluid pressure to the optic nerve damage. Normal tension glaucoma patients may have abnormally low cerebrospinal fluid pressure. Emerging evidence is showing it is possible to estimate translaminar pressure difference using currently available imaging technologies.
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