EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78788
February 2011August 2012 EW GLAUCOMA 35 trabecular meshwork," he said. "So we've got a velocity map." In addi- tion, with the aid of a color map, it is possible to view phase lag, quanti- tatively measuring the pulse inten- sity in the meshwork and then how it goes through the tissue. This motion-based technology has been dubbed an ocular trabecu- lar gram (OTG) and is already being studied in the clinic. From a glau- coma management standpoint, Dr. Johnstone sees the OTG technology as a breakthrough. "We measure intraocular pressure maybe three to four times a year, each time for about 3 seconds," he said. "That's about 12 seconds per year, and we miss out on what's going on in the other 31 million seconds." In addi- tion, he pointed out there are issues with how the pressure is measured with the eye looking straight ahead with no movements and when— during office hours in the daytime. This does not capture diurnal fluctu- ations, which may be telling in whether or not a medication is working. With the OTG, practitioners can measure the mechanical properties of the meshwork and see if move- ment is affected. "If we see reduced movement over time, we're in a po- sition to say this person is getting into trouble, and we need to more aggressively treat him to avoid going on to structural and functional damage to the visual system," Dr. Johnstone said. He sees the OTG technology as helping to rapidly discern which glaucoma medications are working for patients, which patients are likely to succeed with ALT or SLT, and even where to best place the iStent and the Hydrus to maximize efficacy. He is hopeful that the OTG will soon be available. "Ideally if someone picked up the technology quickly, it would be in place in a couple of years," he said. Going forward, Dr. Kahook is optimistic. "We're entering into an exciting time in glaucoma surgery and a better understanding of the outflow system of the eye," he said. EW Editors' note: Dr. Johnstone has finan- cial interests with Alcon, Allergan (Irvine, Calif.), Healionics (Seattle), and Cascade Ophthalmics (Irvine, Calif.). Dr. Kahook has financial interests with Alcon, Allergan, Glaukos, and Ivantis. Dr. Lewis has financial interests with Alcon, AqueSys, Glaukos, iScience Interventional (Menlo Park, Calif.), and Ivantis. Dr. Vold has financial interests with Alcon, AqueSys, Glaukos, iScience Interventional, Ivantis, NeoMedix, SOLX (Waltham, Mass.), and Transcend Medical. Contact information Johnstone: 206-719-8520, johnstone.murray@gmail.com Kahook: 720-848-2500, malik.kahook@gmail.com Lewis: 916-649-1515, rlewiseyemd@yahoo.com Vold: 479-442-8653, svold@cox.net ᑇᑙᑔᑦᑔᑕᑨᑗᑦᑠᑱᑔᑨᑠᑤᑣᑀᑤᑘᑀᑉᑣᑨᑦᑔᑤᑕᑩᑡᑔᑦᑀᑡᑗᑣᑧᑗᑧᑀᑁᑉᑒᑐᑂᑀ ᑠᑣᑀᑔᑠᑦᑀᑤᑦᑀᑠᑣᑀᑧᑠᑨᑩᑀᑠᑣᑀᑔᑀᑢᑤᑖᑗᑡᑀᑗᑰᑗᑀᑕᑤᑢᑥᑡᑠᑔᑣᑨᑀ ᑨᑤᑀᑨᑙᑗᑀᑈᑑᑃᑉᑓᑒᑀᑄᑄᑆᑅᑆ ᑣ!ᑦ&#∗ᑀ+∋ᑀᑦᑀ!∀ !ᑀᑦᑨᑨ,)ᑦᑨ/ᑀ.ᑦ−ᑰᑱ)∋&+ᑀ%ᑰᑦ∗,)ᑰ%ᑰ&+ᑀ +!ᑰᑀᑥᑦ−ᑰᑘᑦ∗+ᑰ)ᑀ ᑖᑙᑗᑀᑦ∃∃∋.∗ᑀᑱ∋)ᑀ+!ᑰᑀᑦ&ᑦ∃/∗∀∗ᑀ∋ᑱᑀᑖᑙᑗ∗ᑀ .∀+!ᑀ∗(!ᑰ)∀ᑨᑦ∃ᑄᑀᑦ∗(!ᑰ)∀ᑨᑀ∋)ᑀ+∋)∀ᑨᑀ∗!ᑦ(ᑰᑅᑀ ᑣ!ᑰᑀᑱ∋∃∃∋.∀& ᑀ(ᑦ)ᑦ%ᑰ+ᑰ)∗ᑀᑦ)ᑰᑀᑰ−ᑦ∃,ᑦ+ᑰᑩᑀ ᑱ)∋%ᑀ+!ᑰᑀ.ᑦ−ᑰᑱ)∋&+ᑉ ᑀ ᑒ∀∋(+)∀ᑨᑀ(∋.ᑰ)ᑄᑀᑨ/∃∀&ᑩᑰ) ᑀ ᑕ∀ !ᑀ)ᑰ∗∋∃,+∀∋&ᑀ(∋.ᑰ)ᑀ%ᑦ((∀& ᑀ∋−ᑰ)ᑀ+!ᑰᑀ ᑨ∋%(∃ᑰ+ᑰᑀ∃ᑰ&∗ᑀᑦ(ᑰ)+,)ᑰ ᑀ ᑓᑱᑱᑰᑨ+∀−ᑰᑀᑔ∋ᑨᑦ∃ᑀᑗᑰ& +!ᑀᑂᑓᑔᑗᑃ ᑀ ᑗ∋.ᑰ)ᑀᑦ&ᑩᑀ!∀ !ᑰ)ᑀ∋)ᑩᑰ)∗ᑀ∃ᑰ&∗ᑀᑦᑧᑰ))ᑦ+∀∋&∗ ᑂᑦ∗+∀ %ᑦ+∀∗%ᑄᑀ∗(!ᑰ)∀ᑨᑦ∃ᑀᑦᑧᑧᑰ)ᑦ+∀∋&∗ᑄᑀ ᑨ∋%ᑦᑅᑅᑅᑃ ᑀ ᑘ∋ᑩ,∃ᑦ+∀∋&ᑀᑣ)ᑦ&∗ᑱᑰ)ᑀᑔ,&ᑨ+∀∋&ᑀᑂᑘᑣᑔᑃ ᑀ ᑠ∋∀&+ᑀᑢ()ᑰᑦᑩᑀᑔ,&ᑨ+∀∋&ᑀᑂᑠᑢᑔᑃ ᑤ∀∗∀+ᑀ,∗ᑀᑦ+ᑀᑓᑢᑑᑡᑢᑀ ∀&ᑀᑘ∀∃ᑦ&ᑄᑀᑐ∋∋+!ᑀᑁᑠᑆᑈᑇ