Eyeworld

EW MEETING REPORTER August 2011 65 spectrum from untreated ocular hy- pertension to advanced glaucoma. They discovered that both OSDI and GQL scores increased with increas- ing glaucoma severity, and these two scores were highly correlated with each other. They concluded that oc- ular surface disease is more common in patients with worse glaucoma and negatively impacts glaucoma-related quality of life. Dr. Dada and colleagues from the All India Institute for Medical Sciences, New Delhi, evaluated the repeatability of diurnal IOP from day to day in 30 glaucoma patients on chronic IOP-lowering therapy. IOP was measured every 3 hours from 7 a.m. to 10 p.m. on two differ- ent days a few weeks apart. They found that IOP on the first day did not correlate well with IOP on the second day. They concluded that pa- tients with primary open-angle glau- coma do not manifest a reproducible IOP pattern from day to day. The clinical implication of this observa- tion is that a single-day diurnal IOP curve may inadequately characterize diurnal IOP variability. Oscar Albis-Donado, M.D., and colleagues from the Asociacion Para Evitar la Ceguera en Mexico, Mexico City, explored the basis of the ob- served IOP reduction following cataract surgery. They asked whether there was a true IOP reduction or merely a change in corneal biome- chanical properties mimicking an IOP reduction. They measured pre- op and post-op IOP (using Gold- mann tonometry) and corneal biomechanical properties (using the Reichert ORA) on 46 otherwise healthy subjects undergoing uncom- plicated phacoemulsification. They found that central corneal thickness was transiently elevated, and corneal hysteresis and corneal resistance fac- tor were decreased after surgery, but all of these biomechanical parame- ters returned to baseline by 3 months post-surgery. In contrast, IOP was significantly reduced imme- diately post-surgery and remained reduced at 3 months post-surgery. They also used the PASCAL Dynamic Contour Tonometer (DCT, Zeimer, Port, Switzerland), which corrobo- rated a real IOP reduction. The re- searchers concluded that the IOP re- ductions observed following uncom- plicated cataract surgery are real and not attributable to changes in corneal biomechanical properties. Paul Ernest, M.D., and col- leagues from Maastricht University, the Netherlands, have developed a model to predict glaucomatous vi- sual field progression using baseline clinical data. Using data from 333 patients followed for up to 10 years, they found that age, baseline IOP, and baseline visual field status effec- tively predicted patients whose vi- sual field index (VFI) worsened at a rate of 3% or more per year. Such a model can help identify patients who should be more aggressively treated from the start. Chan Kee Park, M.D., and col- leagues from the Catholic University of Korea, reported that nail bed hemorrhages predict optic disc hem- orrhage in both low-tension and high-tension glaucoma patients. Pa- tients with a nail bed hemorrhage were more than 80 times more likely to have a disc hemorrhage than pa- tients without nail bed hemor- rhages. Because disc hemorrhages are often overlooked by clinicians, the presence of a nail bed hemor- rhage should prompt a thorough ex- amination for disc hemorrhage. Klaus Rosbach, M.D., and col- leagues from the University of Mainz, Germany, conducted a prospective, open-label trial to eval- uate the additivity of the brinzo- lamide/timolol fixed combination to prostaglandin monotherapy in pa- tients inadequately controlled on a prostaglandin alone. Overall, 47 sub- jects completed the 12-week study in which the fixed combination was dosed twice daily. At 12 weeks, IOP was reduced by 5.4 mm Hg, repre- senting a further 24% reduction from prostaglandin baseline. The regimen was well tolerated and no safety issues were noted. These re- sults support the use of brinzo- lamide/timolol fixed combination as adjunctive therapy in patients inade- quately controlled on prostaglandin monotherapy. Heydar Amini, M.D., and col- leagues from Tehran University, Iran, reported a series of patients with early onset of pseudoexfolia- tion syndrome and suggested that this may have arisen due to multiple intraocular surgeries. Four patients ranging in age from 18 to 36 years were described. All had complex oc- ular histories and had undergone three to five intraocular surgical pro- cedures prior to the onset of pseu- doexfoliation, which was unilateral in the operated eye in all cases. Pseu- doexfoliation is known to be a ge- netic disorder associated with the LOXL1 gene, but the investigators hypothesized that surgical trauma may accelerate the disease process in genetically predisposed individuals. Editors' note: Dr. Albis-Donado has no financial interests to disclose. Dr. Stalmans has financial interests with Allergan, Alcon, MSD, and Pfizer. Polishers for a clean capsule ;4 August 2011 World Glaucoma Congress

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