World Glaucoma Association
Glaucoma Screening
Robert N. Weinreb, Paul R. Healey and Fotis Topouzis
Consensus Series - 5
Kugler Publications, The Hague, The Netherlands
GLAUCOMA SCREENING
Robert N. Weinreb |
Paul R. Healey |
Fotis Topouzis |
My awareness of constructing an objective truth would never provide me with anything more than an objective truth for me, and my greatest attempt at impartiality would never enable me to prevail over my subjectivity … if I had not, underlying my judgments, the primordial certainty of being in contact with being itself, if, before any voluntary adoption of a position, I were not already situated in an intersubjective world.
M. Merleau-Ponty
GLAUCOMA SCREENING
Screening for Open Angle Glaucoma,
Primary Angle-Closure and
Primary Angle-Closure Glaucoma
The 5th Consensus Report of the
World Glaucoma Association
edited by
Robert N. Weinreb
Paul R. Healey
and
Fotis Topouzis
Kugler Publications/Amsterdam/The Netherlands
ISBN 10: 90-6299-218-8
ISBN 13: 978-90-6299-218-8
Distributors:
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1001 NM Amsterdam, The Netherlands Telefax (+31.20) 68 45 700
website: www.kuglerpublications.com
© World Glaucoma Association (WGA) Published under a licence by 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 20538
1001 NM Amsterdam, The Netherlands
Contents |
v |
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This publication is the fifth of a series on
Consensus meetings in Glaucoma under the auspices of the
World Glaucoma Association
WGA
vi
Glaucoma Screening Consensus Meeting participants. Fort Lauderdale, April 26, 2008.
Contents
Contents |
vii |
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FACULTY
Program Chairs |
Daniel Grigera, Argentina |
Robert N. Weinreb, USA |
Neeru Gupta, Canada |
Anne Coleman, USA |
Paul Harasymowycz, Canada |
Ravi Thomas, India |
Mingguang He*, China |
Fotis Topouzis, Greece |
David Henson, UK |
Ningli Wang, China |
Aiko Iwase, Japan |
Section Leaders OAG |
Henry Jampel, USA |
N. Jansonius, The Netherlands |
|
Paul R. Healey, Australia |
Kenji Kashiwagi, Japan |
Anders Heijl, Sweden |
Michael Kass, USA |
Linda Zangwill, USA |
Changwon Kee, South Korea |
Section Leaders AC(G) |
Dan Kiage, |
Elliot Kirstein, USA |
|
Tin Aung, Singapore |
Theodore Krupin, USA |
Paul Foster, UK |
Steven Kymes*, USA |
David Friedman, USA |
Dennis Lam, Hong Kong |
Robert Ritch, USA |
George Lambrou, Greece |
Participants |
Paul Lee*, USA |
Fabian Lerner, Argentina |
|
Benedictus Ajayi, Nigeria |
Cristina Leske, USA |
Douglas Anderson, USA |
Christopher Leung, Singapore |
Makato Araie*, Japan |
Dexter Leung, Hong Kong |
Yinka Ashaye, Nigeria |
Joao Lopes, Chile |
Augusto Azuaro Blanco*, UK |
Mackey, D, Australia |
Yaniv Barkana, Israel |
Baskaran Mani, India |
Khaled Ben Amor, Tunesia |
Choka Melamed, Israel |
Boel Bengtsson, Sweden |
Clive Migdal, UK |
Rupert Bourne, UK |
Richard Mills, USA |
Jennifer Burr, UK |
Marcello Nicolela, Canada |
Robert Casson, Australia |
Winnie Nolan*, UK |
Paul Chew, Singapore |
Rajul Parikh, India |
Nathan Congdon, Hong Kong |
Ki-Ho Park, Korea |
Collin Cook, South Africa |
Michael Patella, USA |
Tanuj Dada, India |
Harry Quigley*, USA |
P. De Jong, The Netherlands |
R. Ramakrishnan, India |
S. Deokhole, USA |
Tony Realini, USA |
Syril Dorairaj, USA |
Prin RojanaPongpun, Thailand |
Amish Doshi, USA |
Lisandro Sakata, Brazil |
Murray Fingeret, USA |
Garudadri Chandra Sekhar, |
Ronnie George, India |
Ramanjit Sihota*, India |
Christopher Girkin, USA |
Michael Sinai,USA |
David Greenfield, USA |
Arthur Sit, USA |
*Subsection co-chairs
viii |
Faculty |
Jim Standefer*, USA |
Consensus Development Panel |
Remo Susanna, Brazil |
Tin Aung, Singapore |
Celso Tello, USA |
Anne Coleman, USA |
Clement Tham*, Hong Kong |
Jonathan Crowston, Australia |
Suman Thapa, Nepal |
Paul Foster, UK |
John Thygesen, Denmark |
David Friedman, USA |
Atsuo Tomidokoro, Japan |
Franz Grehn, Germany |
Carlo Traverso, Italy |
Paul R. Healey, Australia |
Anja Tuulonen*, Finland |
Anders Heijl, Sweden |
Rohit Varma, USA |
Robert Ritch, USA |
Lingam Vijaya, India |
Kuldev Singh, USA |
Gianmarco Vizzeri, USA |
Remo Susanna, Brazil |
Tsing Hong Wang, Taiwan |
Ravi Thomas, India |
Roy Wilson, USA |
Fotis Topouzis, Greece |
Tien Wong, Australia |
Ningli Wang, China |
Richard Wormald,UK |
Robert N. Weinreb, USA |
Laing Xu, Hong Kong |
Linda Zangwill, USA |
Tetsuya Yamamoto, Japan |
Recording Secretaries |
Jennifer Yip, Singapore |
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Thierry Zeyen, Belgium |
A. Doshi |
Chun Zhang, China |
M. Vizzeri |
Gerhard Zinser, Germany |
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Glaucoma Societies / Sections of the following countries and regions have agreed to review this report:
America, Argentina, Asia-Oceania, Australia and New Zealand, Austria, Azerbaijan, Belgium, Brazil, Bulgaria, Canada, Central America, Chile, China, Colombia, Croatia, Czech Republic, Denmark, Egypt, Estonia, Europe, Finland, France, Georgia, Germany, Ghana, Greece, Hungaria, Iceland, India, Indonesia, Iran, Israel, Italy, Japan, Korea, Latin-America, Lesotho, Lithuania, Mexico, Netherlands, Nigeria, Norway, Pakistan, Pan-America, Pan Arab Africa, Peru, Philippines, Poland, Portugal, Rumania, Russia, Serbia and Montenegro, Slovenia, Spain, South-Africa, South East Asia, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Kingdom and Eire, Glaucoma Research Society, Optometric Glaucoma Society, International Society of Glaucoma Surgery.
* Subsection co-chairs
Contents |
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CONTENTS
Preface |
xi |
Welcome |
xiii |
SCREENING FOR OPEN-ANGLE GLAUCOMA (OAG) |
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Is OAG an important health problem? |
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Co-chairs: Anders Heijl, Paul Lee |
3 |
Is there an accepted and effective treatment for patients with the |
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disease that is more effective at preventing morbidity when initiated |
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in the early, asymptomatic stage than when begun in the later, |
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symptomatic stages? |
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Co-chairs: Makoto Araie, Linda Zangwill |
13 |
Are facilities for diagnosis and treatment available? |
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Co-chairs: Paul R. Healey, Ramanjit Sihota |
25 |
Is there an appropriate, acceptable, and reasonably accurate |
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screening test? |
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Co-chairs: Augusto Azuara Blanco, Linda Zangwill |
33 |
Is the natural history of the condition, including development from |
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latent to manifest disease, adequately understood? |
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Co-chairs: Anders Heijl, Harry Quigley |
51 |
Is the cost of case finding (including diagnosis and treatment of |
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patients diagnosed) economically balanced in relation to possible |
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expenditure on medical care as a whole? |
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Co-chairs: Paul R. Healey, Anja Tuulonen |
55 |
SCREENING FOR PRIMARY ANGLE CLOSURE AND |
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PRIMARY ANGLE-CLOSURE GLAUCOMA |
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Are angle closure (AC) and angle-closure glaucoma (ACG) important |
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health problems? |
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Co-chairs: Paul Foster, Mingguang He |
65 |
Is there an accepted and effective treatment for patients with |
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angle-closure glaucoma (ACG) that is more effective at preventing |
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morbidity when initiated in the early, asymptomatic stage than when |
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begun in the later, symptomatic stages? |
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Co-chairs: Robert Ritch, Clement Tham |
79 |
Are facilities for diagnosis and treatment available? |
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Co-chairs: Robert Ritch, Jim Standefer |
93 |
x |
Contents |
Is there an appropriate, acceptable, and reasonably accurate |
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screening test? |
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Co-chairs: Tin Aung, Winnie Nolan |
99 |
Is the natural history of the condition, including development from |
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latent to manifest disease, adequately understood? |
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Co-chairs: Paul Foster, Ravi Thomas |
111 |
Is the cost of case finding (including diagnosis and treatment of |
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patients diagnosed) economically balanced in relation to possible |
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expenditure on medical care as a whole? |
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Co-chairs: David Friedman, Steve Kymes |
125 |
Photo Section |
136 |
Index of Authors |
145 |
Summary of Consensus Points |
146 |
Contents |
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PREFACE
This is the Þfth glaucoma World Glaucoma Association Consensus. As with other consensus topics, the discussion and conclusions of Glaucoma Screening, the subject for the 2008 consensus, will have broad impact. The global faculty, consisting of leading authorities on various aspects of glaucoma screening, met in Fort Lauderdale on April 26, 2008 to discuss the reports and reÞne the consensus statements. The Consensus Panel also met at that time, as well as electronically during the subsequent four weeks.
Obtaining consensus on how best to conduct glaucoma screening is quite a challenge, especially since the epidemiology and testing paradigms are so different for open-angle and angle-closure glaucoma. As with the previous WGA consensuses, the Glaucoma Screening consensus was based on the published literature and expert experience. Although consensus does not replace and is not a surrogate for scientiÞc investigation, it does provide considerable value, especially when the desired evidence is lacking. The goal of this consensus was to establish the best practice for glaucoma screening, as well as to identify those areas for which we have little evidence and, therefore, need additional research. We hope that this consensus will serve as a benchmark of our understanding, and that it will be revised and improved with the emergence of new evidence.
Robert N. Weinreb
Paul R. Healey
Fotis Topouzis
Anne Coleman
Ningli Wang
xii |
Contents |
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Consensus Panel meeting to clarify consensus statements
Consensus Panel deep in thought
Contents |
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WELCOME
For the World Glaucoma Association Consensus V, our topic was Glaucoma Screening, both for open-angle glaucoma and angle-closure glaucoma. Global experts were assembled beginning in January 2008 to participate in the Project Forum E-Room, a unique aspect to facilitate discussion of each of the consensus meetings.
With each of the prior meetings, arriving at the consensus was circuitous and Þlled with compromises, and this meeting had a similar path. The consensus process provided an excellent opportunity to critically assess the evidence relating to glaucoma screening and develop consensus statements. As with previous ones, the entire process was stimulating, educational, and thought-provoking for all participants and attendees.
Robert N. Weinreb
Erik L. Greve
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Contents |
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Anders Heijl presenting Open Angle Consensus
Consensus Panel deliberating
Is OAG an important health problem? |
1 |
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SCREENING
FOR
OPEN-ANGLE GLAUCOMA (OAG)
2 |
A. Heijl and P. Lee |
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Sunil Deokhole and Pam Sample
Iwase and Mokoto Araie