Education Committee Highlights WGC-2019 – part 11

The Education Committee carefully selects presentations from the WGC-2019 for your benefit. This month Christopher Leung introduces the sessions: Data: If a little bit is good, a lot of it is better and The brave new world in managing glaucoma.

Data: If a little bit is good, a lot of it is better

In this symposium, leading experts demonstrated how big data can provide new insights into the epidemiology, disease mechanisms, and treatment of glaucoma.

Integrating data from across the world

Dr. Rupert Bourne discussed the role of the Vision Loss Expert Group & the Global Burden of Disease Study in integrating data from the World’s population-based eye surveys into the Global Vision Database. Age-standardized prevalence of blindness and visual impairment has reduced over time since 1990 worldwide although absolute numbers are increasing because of population aging. The Global Vision Database Maps – Vision Atlas – are now accessible to any internet user to understand vision impairment and regional variation in glaucoma blindness.

UK biobank: lessons from a 500,000 person cohort study

Dr. Paul Foster highlighted the importance of UK Biobank, one of the world’s largest ophthalmic datasets comprising 503,000 participants from 22 recruitment centers in the UK, in affording mechanistic insights into glaucoma and other eye diseases. Some of the interesting discoveries from the UK Biobank include intraocular pressure-lowering effect of vitamin C, association between retinal pigment epithelium thickness and intraocular pressure, and development of genetic prediction models for primary open-angle glaucoma.

Consortia genetics and its lessons for disease mechanism

Dr. James Craig discussed how to harness information from various different international glaucoma genetic consortiums to decipher disease mechanisms of glaucoma. Through genome wide association studies, a better understanding of the interactions between genotypes and clinical phenotypes including intraocular pressure and optic disc morphology has emerged to shed light on biological pathways and tissues responsible for development of optic nerve damage in glaucoma.

Large population-based studies and their lessons from glaucoma – the KHANES study

Dr. Ki Ho Park shared some of the latest findings from the Korea National Health and Nutrition Examination Survey (KNHANES), a national surveillance system of health and nutritional status of Koreans since 1998. KNHANES reveals that the prevalence of normal tension glaucoma was 3.2% in 2017, accounting for 94% of glaucoma in Korea. Remarkably, only 25.8% of patients were aware of the disease, which underscores the importance of patient education and early diagnosis to prevent glaucoma blindness.

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The brave new world in managing glaucoma

This symposium focused on new biomarkers, AI models, imaging devices, and treatment approaches for managing glaucoma. 

What should OCT be telling you about a patient’s glaucoma

Dr. Murray Fingeret discussed how to use optical coherence tomography to evaluate glaucoma. Caution should be exercised in the interpretation of RNFL thickness measurements in myopic eyes and in eyes with vitreous floater over the parapapillary region when false positive detection may occur. In eyes with advanced glaucoma, floor effect may limit the detection of progressive RNFL thinning. Understanding the limitations of OCT is important to the management of glaucoma patients.

Glaucoma Biomarkers – hiding in the aqueous?

Identifying molecular biomarkers for glaucoma is an unmet need. Dr. Carla Siegfried identified elevation of growth differentiation factor 15 (GDF15) to be a molecular biomarker associated with retinal ganglion cell death in murine models of optic nerve injury. In patients with glaucoma, GDF15 is increased in aqueous humor and associated with worse visual field test results.

Glaucoma Care Driven by Artificial Intelligence

Dr. Sammer Trikha discussed the concepts of artificial intelligence and illustrated how artificial intelligence systems may offer new possibilities for glaucoma screening, assessment of glaucoma progression, and treatment decision support and optimization.

Drop-Free Glaucoma Treatment- The Patients’ Dream Come True

Dr. Ian Pitha presented new treatment approaches including controlled release formulation of intraocular pressure lowering medications (dorzolamide microparticles) and pressure control glaucoma drainage device incorporating biodegradable and drug releasing properties for treatment of glaucoma.

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