how do i know my glaucoma treatment is working? dr catherine green head: glaucoma unit rveeh
TRANSCRIPT
How Do I Know My Glaucoma Treatment is
Working?
Dr Catherine GreenHead: Glaucoma Unit
RVEEH
Outline
• What is glaucoma?• What do glaucoma patients notice?• Intraocular pressure• Functional testing• Structural testing• Frequency of testing
What is glaucoma?
Treatment
What patients notice
Module 1
Blacktunnel
Blurredtunnel
Blackparts
Blurredparts
Missingparts
Notaware
Crabb et al. Ophthalmology 2013;120:1120–6.
Crabb et al. Ophthalmology 2013;120:1120–6.
Missing patchesUnmodified image
Slide courtesy of Allergan SSY Program
What patients notice
Blurred parts
Blurred tunnel
Pictures courtesy of Allergan SSY Program
Target IOP
Function
Frequency of Testing
• Detect rate of progression sooner with more frequent fields
MD change (dB/year)*
Years required to detect change1
field/year2
fields/year3
fields/year
0.25 19 9.5 6.3
0.5 13 6.5 4.3
1.0 9 4.5 3
2.0 6 3 2*80% power in visual fields with moderate degrees of variability
Chauhan et al. Br J Ophthalmol 2008;92:569–73.
Objective progression analysis
Rate of progression -3.9Slope significant P < 5%
Post-surgery 2008
Slope not significant
10-2
2008 2009 2010 2011
2012 2013 2014 2015
Optic nerve photos2007 2010
Conclusions
• Glaucoma patients usually don’t have symptoms
• Glaucoma is treatable• Regular monitoring is essential• Need to consider IOP, structure and function• Frequency of testing tailored to individual –
based on risk and response to treatment