Glaucoma Insights of 2024: Breakthroughs in Testing, Treatment, and Surgery
1. Clustered testing approach may identify fast-progressing glaucoma
The Fast Progression Assessment through Clustered Evaluation (Fast-PACE) Study demonstrated that an intensive clustered testing methodology effectively detected fast-progressing glaucoma, with a sensitivity of 93% and specificity of 85% for identifying rapid progression over a 6-month period. Conducted at two major eye centers, the study highlights the potential utility of clustered testing for assessing high-risk individuals and guiding interventions to slow glaucoma progression.
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2. Higher BMI appears to be protective against glaucoma progression
A study found that tobacco and alcohol use did not significantly affect glaucoma progression, but being underweight was linked to faster retinal nerve fiber layer (RNFL) loss (P = 0.002). In contrast, a higher body mass index was associated with slower rates of RNFL loss (P = 0.011).
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3. New trabecular MIGS device shows promise in treating glaucoma
The iStent infinite trabecular micro-bypass device, with or without adjunctive goniotomy, effectively reduced intraocular pressure (IOP) and medication burden in patients with open-angle glaucoma who had prior unsuccessful laser trabeculoplasty, showing a 22% decrease in IOP and an 82% drop in medication use at 6 months. The study of 14 eyes reported no intraoperative complications or postoperative adverse events, highlighting its safety and efficacy.
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4. Baseline IOP key to choosing between SLT and eye drops in glaucoma treatment
A study from the LiGHT trial found that selective laser trabeculoplasty (SLT) is more effective at lowering intraocular pressure (IOP) in patients with higher baseline IOP, while prostaglandin analogue (PGA) drops are more effective at lower baseline IOP levels. SLT was superior for achieving ≥20% IOP reduction at baseline IOP ≥23.4 mmHg, whereas PGA drops performed better when baseline IOP was ≤17 mmHg, highlighting the importance of pretreatment IOP in guiding glaucoma management.
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5. Quiz: Advancements in Glaucoma Surgery
This quiz assesses knowledge of recent developments in surgical treatments for glaucoma. It covers minimally invasive glaucoma surgeries, new surgical devices, and innovative techniques to improve patient outcomes.
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