Characterising progression key for glaucoma management

Best tools seem inadequate to detect slower rates of progression

Cheryl Guttman Krader

Posted: Saturday, September 14, 2019

Fotis Topouzis

OPTIMISING individualised management for glaucoma will require new tools and algorithms for identifying fast progressors. Ideally, a calculator for predicting glaucoma progression and fast progression will be developed similar to what is available for predicting progression from ocular hypertension to glaucoma, said Fotis Topouzis MD at the ESCRS/EGS Glaucoma Day meeting.

“Currently, our best tools, methods and proposed strategies aiming to detect fast progressors seem inadequate to detect slower rates of progression that would result in visual impairment or blindness during a lifetime in the majority of patients,” said Dr Topouzis, Aristotle University of Thessaloniki, Greece.

“What we need is knowledge on the stage of visual damage to be prevented, strategies and tools to calculate tolerable rates of progression for the individual patient, the ability to define fast progressors at the individual level according to their tolerable rate of progression and strategies and tools to identify fast progressors,” he said.

Dr Topouzis said that potential tools for improving individualised management in the future include identification of new risk factors and biomarkers for fast progression as well as candidate biomarkers for assessing angle-based surgery.

“Genetics is also a promising pathway for the future. Potentially the calculator for predicting glaucoma progression will integrate genetic information,” Dr Topouzis said.