How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.
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Transcript of How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.
![Page 1: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/1.jpg)
How Do I Know My Glaucoma Treatment is
Working?
Dr Catherine GreenHead: Glaucoma Unit
RVEEH
![Page 2: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/2.jpg)
Outline
• What is glaucoma?• What do glaucoma patients notice?• Intraocular pressure• Functional testing• Structural testing• Frequency of testing
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What is glaucoma?
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Treatment
![Page 5: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/5.jpg)
What patients notice
Module 1
Blacktunnel
Blurredtunnel
Blackparts
Blurredparts
Missingparts
Notaware
Crabb et al. Ophthalmology 2013;120:1120–6.
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Crabb et al. Ophthalmology 2013;120:1120–6.
Missing patchesUnmodified image
Slide courtesy of Allergan SSY Program
What patients notice
![Page 7: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/7.jpg)
Blurred parts
Blurred tunnel
Pictures courtesy of Allergan SSY Program
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Target IOP
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Function
![Page 10: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/10.jpg)
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.
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Objective progression analysis
Rate of progression -3.9Slope significant P < 5%
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Post-surgery 2008
Slope not significant
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10-2
2008 2009 2010 2011
2012 2013 2014 2015
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Optic nerve photos2007 2010
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![Page 18: How Do I Know My Glaucoma Treatment is Working? Dr Catherine Green Head: Glaucoma Unit RVEEH.](https://reader038.fdocuments.us/reader038/viewer/2022110103/5697bf871a28abf838c88f4f/html5/thumbnails/18.jpg)
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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