- •Preface
- •Contributors
- •Defining Glaucoma
- •An approach to glaucoma pathogenesis
- •How do we kill the idea of low-tension glaucoma?
- •How much glaucoma damage is pressure-dependent?
- •Ocular blood flow and glaucoma
- •Microvascular changes of the human anterior optic nerve in glaucoma
- •The Angle
- •The true nature of angle-closure glaucoma
- •Gonioscopy in the laser age
- •The Optic Nerve Head
- •Psychophysics
- •Update on psychophysical tests for glaucoma
- •Questions directed to Chris Johnson in his absence
- •Treatment Issues, Problems & Repairs
- •Using combination drugs in glaucoma management
- •The use of topical anesthesia for a combined cataract and glaucoma procedure
- •Duke-Elder lectures
New Orleans Academy of Ophthalmology
GLAUCOMA
IN THE NEW MILLE
edited by Jonathan D. Nussdorf
Kugler Publications / The Hague / The Netherlands
GLAUCOMA IN THE NEW MILLENNIUM
afafasfsafsafds
GLAUCOMA
IN THE
NEW MILLENNIUM
edited by Jonathan D. Nussdorf
Proceedings of the 50th Annual Symposium on Glaucoma,
New Orleans, LA, USA, April 6-8, 2001, organized by the
New Orleans Academy of Ophthalmology
Kugler Publications/The Hague/The Netherlands
ISBN 90 6299 193 9
Distributors:
For the U.S.A. and Canada:
Pathway Book Service
4 White Brook Road
Gilsum, NH 03448
Telefax (603) 357 2073
For all other countries: Kugler Publications P.O. Box 97747
2509 GC The Hague, The Netherlands Telefax (+31.70) 3300254
http://www.kuglerpublications.com
© Copyright 2003 Kugler Publications
All rights reserved. No part of this book may be translated or reproduced in any form by print, photoprint, microfilm, or any other means without prior written permission of the publisher. Kugler Publications is an imprint of SPB Academic Publishing bv, P.O. Box 97747
2509 GC The Hague, The Netherlands
Table of contents |
v |
|
|
Table of contents
Preface |
vii |
Editor |
viii |
Contributors |
ix |
Defining Glaucoma |
|
An approach to glaucoma pathogenesis |
|
H.A. Quigley |
3 |
How do we kill the idea of low-tension glaucoma? |
|
H.A. Quigley |
13 |
How much glaucoma damage is pressure-dependent? |
|
P. Palmberg |
21 |
Ocular blood flow and glaucoma |
|
G.A. Cioffi |
29 |
Microvascular changes of the human anterior optic nerve in glaucoma |
|
G.A. Cioffi and D.-Y. Zhao |
37 |
Neuroprotection and glaucoma. How do I tell if a drug is neuroprotective? |
|
G.A. Cioffi |
43 |
The Angle |
|
The true nature of angle-closure glaucoma |
|
H.A. Quigley |
51 |
Gonioscopy in the laser age |
|
P. Palmberg |
65 |
Round table: How I make the decision to do a peripheral iridotomy: |
|
my laser, lens and settings |
|
(P. Palmberg, presiding) |
77 |
Round table: How I make the decision to do ALT: my laser, lens and |
|
settings |
|
(C.F. Burgoyne, presiding) |
89 |
The Optic Nerve Head |
|
Evaluation of optic disc and nerve fiber layer in glaucoma. Clinical |
|
techniques |
|
J. Caprioli |
107 |
Round table: How I follow the optic nerve head and nerve fiber layer: |
|
my step by step approach |
|
(C.F. Burgoyne, presiding) |
115 |
Workshop: Imaging the optic nerve head and nerve fiber layer in |
|
glaucoma |
|
(J. Caprioli and H. Quigley) |
129 |
vi |
Table of contents |
|
|
|
|
Round table: My most confusing optic nerve head |
|
|
(J. Nussdorf, presiding) |
|
133 |
Psychophysics |
|
|
Update on psychophysical tests for glaucoma |
|
|
J. Caprioli |
|
151 |
The variability of perimetry. Reassessing an important clinical tool |
|
|
E.J. Higginbotham, N. Ellish and R. Kalsi |
|
165 |
Round table: Visual field |
|
|
(E.J. Higginbotham, presiding) |
|
183 |
Update on perimetry. New developments |
|
|
C.A. Johnson |
|
185 |
Questions directed to Chris Johnson in his absence |
|
207 |
Treatment Issues, Problems & Repairs |
|
|
Using combination drugs in glaucoma management |
|
|
E.J. Higginbotham |
|
213 |
The use of topical anesthesia for a combined cataract and glaucoma |
|
|
procedure |
|
|
A.S. Crandall |
|
223 |
Update on antimetabolic use |
|
|
A.S. Crandall |
|
235 |
Plumbing pearls. An effective method for reversing hypotony maculopathy |
|
|
and how to save failing filtering blebs at the slit lamp |
|
|
P. Palmberg |
|
237 |
Round table: My procedure and antimetabolite dose of choice for a |
|
|
primary trabeculectomy |
|
|
(A. Etienne, presiding) |
|
243 |
Round table: Refractive surgery: thin corneas, inaccurate intraocular |
|
|
pressures, and the myopic disc at risk |
|
|
(D.A. Long, presiding) |
|
257 |
Duke-Elder lectures |
|
|
Lecture 1: Maintenance and pathophysiology of intraocular pressure |
271 |
|
Lecture 2: Natural history of simple open-angle glaucoma |
|
279 |
Lecture 3: Natural history of congestive narrow-angle glaucoma |
288 |
|
Appendix 1 |
|
|
Glaucoma Symposiums of the New Orleans Academy of Ophthalmology |
297 |
|
Appendix 2 |
|
|
Sponsors |
|
300 |
Preface |
vii |
|
|
Preface
The 50th annual symposium of the New Orleans Academy of Ophthalmology was held from April 6th – 8th, 2001. This was the Academy’s ninth meeting devoted to glaucoma and consisted of formal lectures, round table discussions, and workshop presentations. The New Orleans Academy of Ophthalmology maintains a strong tradition of providing the ophthalmologist with a venue for learning from exceptional mentors and innovative leaders. Inspection of the list of Academy meetings pertaining to glaucoma will highlight the fact that we have been privileged to have outstanding contributors and notable repeat performers (Appendix 1). The first symposium of this Academy was held in 1952 and, with its focus on glaucoma, the contributors were Sir Stewart Duke-Elder, Paul A. Chandler, MD, and Peter C. Kronfeld, MD. The first three lectures from that 1952 meeting were presented by Sir Stewart Duke-Elder and are published for the first time, from a copy of the original transcript, in this collection of papers. I think you will find his discussion of ‘simple’ and ‘congestive’ glaucoma enlightening and instructive.
The Program Committee chairpersons, Claude F. Burgoyne, MD and Katherine Loftfield, MD, were instrumental in putting together a strong assembly of contributors and a well-balanced meeting. Special acknowledgment for their hard work in organizing this symposium goes to committee members Rameish Ayyala, MD, Annemarie Etienne, MD, Kenneth Haik, MD, Jill B. Koury, MD, and Daniel A. Long, MD, and to executive secretaries, Emily Busby and Amber Howell. For his dedicated and thoughtful leadership, much appreciation is given to the president of the New Orleans Academy of Ophthalmology, 2000-2002, George S. Ellis, Jr, MD, and to the board of directors. The Academy acknowledges its sponsors for providing unrestricted financial support, which helped to defer the expense of this medical education meeting and subsequent publication. Special thanks go to Peter Bakker at Kugler Publications for his guidance and wisdom, as well as his unending support for the task of publishing this glaucoma specialty symposium.
The contributors to this symposium on glaucoma are outstanding. They provided chapters covering a wide range of issues that confront the general ophthalmologist, as well as the glaucoma specialist. Due to an unfortunate circumstance, Chris A. Johnson, PhD, was unable to attend the meeting; however, he was gracious enough to provide his written contribution, which is included in this compilation of papers. You will find that the lectures, round table discussions, and workshop sessions are filled with pearls of wisdom that will help guide you toward a modern, common sense approach in addressing the special needs of your glaucoma patients.
Jonathan D. Nussdorf, MD
Ochsner Clinic Foundation
New Orleans, Louisiana, USA
Contributors |
ix |
|
|
Contributors
JOSEPH CAPRIOLI, MD
Professor of Ophthalmology
Chief, Glaucoma Division
Jules Stein Eye Institute
Los Angeles, California
GEORGE CIOFFI, MD
Director, Glaucoma Service
Director, Discoveries in Sight
Portland, Oregon
ALAN S. CRANDALL, MD
Professor of Ophthalmology and
Vice Chair of Clinical Services
Director of Glaucoma and Cataract
John A. Moran Eye Center
Salt Lake City, Utah
x |
Contributors |
|
|
EVE J. HIGGINBOTHAM, MD
Professor and Chair
Department of Ophthalmology
University of Maryland
School of Medicine
Baltimore, Maryland
CHRIS A. JOHNSON, PhD
Director of Diagnostic Research
and Senior Scientist
Oregon Lions Anderson-Chenoweth-Ross
Discoveries in Sight/Devers Eye Institute
Portland, Oregon
PAUL PALMBERG, MD, PhD
Professor of Ophthalmology
Bascom Palmer Eye Institute
University of Miami School of Medicine
Miami, Florida
HARRY A. QUIGLEY, MD
Director, Glaucoma Service and Director
DANA Center for Preventive Ophthalmology
Edward Maumenee Professor of Ophthalmology
Wilmer Eye Institute
Baltimore, Maryland
