EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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76 EW MEETING REPORTER Live reports from the World Glaucoma Congress, July 17-20, Vancouver September 2013 Live reports from the World Glaucoma Congress T he 5th World Glaucoma Congress kicked off in Vancouver, with officials welcoming attendees to the largest meeting of its kind. "This global meeting is a platform for scientific knowledge transfer, education, and the building of bridges between the many national and regional glaucoma societies of the world," said World Glaucoma Association President Franz Grehn, MD. According to Roger Hitchings, MD, the World Glaucoma Association consists of 80 member organizations, including 64 national societies and 16 regional societies representing more than 11,000 individual members. "Of these, five have joined the Association since our last meeting two years ago," he said. These include the Glaucoma Societies of Guatemala, Panama and Uruguay, as well as the African Glaucoma Task Force and the Asia Pacific Glaucoma Society. The presidentelect for the 2014–2015 term is Jeffrey Liebmann, MD, U.S. Additionally, new positions on the Board of Governors were extended to David Friedman, MD, U.S., Peng Khaw, MD, U.K., Jonathan Crowston, MD, Australia, Tin Aung, MMed, Singapore, Ningli Wang, MD, China, and Norbert Pfeiffer, MD, Germany. The WGC Keynote Lecture this year was given by Stephen Drance, MD, formerly of the University of British Columbia in Vancouver. Dr. Drance, 88, related that when he began in the glaucoma world 60 years ago, the most common presentation of glaucoma was a painful, red eye with decreased central vision. "We now know that this was angle closure glaucoma, an entity that became distinguished from open angle glaucoma just after the second World War," he said. He also reminisced of observing the association between disc hemorrhages and glaucoma, particularly normal-tension glau- coma. "We were not the first—they were first reported in the Danish literature in 1889, but that paper was largely overlooked until we began our investigations." His first paper on disc hemorrhages was rejected by a journal editor who requested biopsy specimens to determine their origin. "We submitted to a different journal," he said. He pointed out that these flame-shaped hemorrhages of the disc margin are sometimes difficult to spot. "What one does not look for, one does not find." They have at times been referred to as "Drance hemorrhages" or "Vancouver hemorrhages." "Fortunately those names have disappeared," he said. Both he and Douglas Anderson, MD, U.S., were the chief architects of the Collaborative Normal-Tension Glaucoma Study. He summarized the key lessons from that landmark trial. "A 30% or greater reduction of IOP favorably affected the course of the disease. About 50% of the patients achieved this 30% reduction without the need for surgery. Because so few untreated patients progressed, it is not unreasonable to watch normal-tension glaucoma without treatment until progression is documented," Dr. Drance said. Glaucoma mechanisms and management Several of the presentations from the Canadian Glaucoma Society plenary symposium are summarized below. Canadian Glaucoma Society President Neehru Gupta, MD, Canada, led the symposium with a review of her research establishing the existence and physiology of lymphatics within the eye. Her work—in collaboration with many others—has convincingly demonstrated that ocular tissues do in fact have lymphatic drainage, and that aqueous fluid gains access to this drainage system. Further, her group has demonstrated that ocular lymphatic outflow pathways are pharmacologically modifiable, offering a potential new therapeutic target for IOP reduction in glaucoma. Balwantray Chauhan, PhD, Canada, shared insight into detecting glaucoma progression, saying, "it is one of the most important and challenging aspects of glaucoma management." He pointed out that "we are doing a poor job of docu-