New findings in glaucoma

Priscilla Lynch

Posted: Wednesday, November 1, 2017

Glaucoma remains under-recognised, despite being a major cause of irreversible blindness worldwide, leading international experts on the disease told the 2017 Irish College of Ophthalmologists Annual Conference.

Glaucoma affects 2% of the population over the age of 40 and 3.5% over the age of 80, but remains difficult to diagnose in time, as it is essentially symptomless in the early stages and damages peripheral vision. While glaucoma is an increasing issue due to the rising ageing population, there have been a number of promising new developments in diagnosing, treating and preventing it, the conference heard.

Prof Augusto Azuara-Blanco MD, Professor of Ophthalmology at Queen’s University Belfast, highlighted the recent key findings of the EAGLE trial, of which he is Chief Investigator, and published in The Lancet in October 2016. This data supports the superiority of clear-lens extraction (CLE) in terms of patient, clinical and economic outcomes for treating primary angle-closure glaucoma compared with laser iridotomy (up to now the currently preferred treatment).

“One-in-five glaucoma cases is angle closure so it is important to recognise the disease. The other issue is that CLE works very well, better compared to the standard laser treatment, and it is an option that should be offered to patients,” he told EuroTimes.

Meanwhile, also speaking during the glaucoma session, Mr Leon Au MD, Glaucoma specialist Ophthalmic Consultant from Manchester Royal Eye Hospital, UK, argued the importance of perfecting existing surgical techniques and increasing detection of glaucoma over the myriad of new “wonder treatments” and dependence on technology.

He noted that while some of the latest technologies have assisted in making glaucoma surgery less invasive, and some new procedures are quick with little risk, they do not lower pressure as effectively as traditional surgeries such as trabeculectomy, and their longevity remains uncertain. There is little doubt that given the appropriate patients these new procedures work well, but a complete replacement for tradition filtration surgery they are not, he said.

However, the “competition” in glaucoma treatment has highlighted the need to “do better” and refine, shorten and make existing established surgery more patient-friendly, Mr Au acknowledged.

“In glaucoma, the amount of investment interest and the expansion of technology is so vast. It is not like the odd one or two ‘wonder treatments’ appearing; it is one after another. There is a huge amount of patient and commercial interest in this field. It comes with a good side, but also a downside. I think some of these devices will come and go, some of the concepts will stay but the concept of minimally invasive eye surgery is something we should embrace. It is what our patients want,” Mr Au told EuroTimes.

Augusto Azuara-Blanco:
Leon Au: