World Glaucoma Association
Medical Treatment
of Glaucoma
Robert N. Weinreb, Makoto Araie, Remo Susanna,
Ivan Goldberg, Clive Migdal, Jeffrey Liebmann
Consensus Series - 7
Kugler Publications, Amsterdam, The Netherlands
MEDICAL TREATMENT OF GLAUCOMA
Robert N. Weinreb |
Jeffrey Liebmann |
MEDICAL TREATMENT OF
GLAUCOMA
The 7th Consensus Report of the
World Glaucoma Association
Editors
Robert N. Weinreb
and
Jeffrey Liebmann
Kugler Publications/Amsterdam/The Netherlands
ISBN 10: 90-6299-226-9
ISBN 13: 978-90-6299-226-3
Distributors:
For the USA and Canada:
Pathway Book Service
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website: www.kuglerpublications.com
© 2010 Kugler Publications, Amsterdam, The Netherlands
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 seventh of a series on
Consensus meetings in Glaucoma under the auspices of the World Glaucoma Association
WGA
vi
Medical Therapy of Glaucoma Consensus Meeting participants, Fort Lauderdale, May 1, 2010.
Contents
Contents |
vii |
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FACULTY |
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Consensus Chair |
Sanjay Asrani, USA |
Robert N. Weinreb, USA |
Tin Aung, Singapore |
Section leaders |
Ramesh Ayyala, USA |
Keith Barton, UK |
|
Makoto Araie, Japan |
Eytan Blumenthal, Israel |
Ivan Goldberg, Australia |
Michael Boland, USA |
Jeffrey Liebmann, USA |
Rupert Bourne, UK |
Clive Migdal, UK |
James Brandt, USA |
Remo Susanna, Brasil |
David Broadway, UK |
Co-leaders |
Alain Bron, France |
Robert Casson, Australia |
|
Augusto Azuaro-Blanco, UK |
Garudadri Chandra Sekhar, India |
Anne Coleman, USA |
Abbott Clark, USA |
Jonathan Crowston, Australia |
Francesca Cordeiro, UK |
David Friedman, USA |
Ranier Covar, Australia |
Ronnie George, India |
Tanuj Dada, India |
Chris Girkin, USA |
Karim Damji, Canada |
David Greenfield, USA |
Helen Danesh-Meyer, New Zealand |
Neeru Gupta, Canada |
Gustavo de Moreas, USA |
Mingguang He, China |
Renato de Natale, Italy |
Paul Healey, Australia |
Philippe Denis, France |
Megumi Honjo, Japan |
Sunil Deokule, USA |
Jost Jonas, Germany |
Seng Kheong Fang, Malaysia |
Kenji Kashiwagi, Japan |
Robert Fechtner, USA |
Fabian Lerner, Argentina |
Julio Garcia Feijoo, Spain |
Chris Leung, Singapore |
Robert Feldman, USA |
Keith Martin, UK |
Sandra Fernando, USA |
Felipe Medeiros, USA |
Murray Fingeret, USA |
Norbert Pfeiffer, Germany |
Josef Flammer, Switzerland |
Robert Ritch, USA |
Stefano Gandolfi, Italy |
Tarek Shaarawy, Switzerland |
Jian Ge, China |
Kuldev Singh, USA |
Franz Grehn, Germany |
Arthur Sit, USA |
Ian Grierson, UK |
Clement Tham, Hong Kong |
Daniel Grigera, Argentina |
Carlo Traverso, Italy |
Franz Grus, Germany |
Tina Wong, Singapore |
Masanori Hangai, Japan |
Participants |
Alon Harris, USA |
Tomomi Higashide, Japan |
|
Makoto Aihara, Japan |
Ching Lin Ho, Singapore |
Oscar Albis, Mexico |
Sek-Tien Hoh, Singapore |
Luciana Alencar, USA |
Gábor Holló, Hungary |
Albert Alm, Sweden |
Anton Hommer, Austria |
Alfonso Anton, Spain |
Michel Iester, Italy |
Norman Aquino, Philippines |
Masaru Inatani, Japan |
viii |
Faculty |
Aiko Iwase, Japan |
Nathan Radcliffe, USA |
Henry Jampel, USA |
Sushma Rai, USA |
Malik Kahook, USA |
Anthony Realini, USA |
Michael Kass, USA |
Douglas Rhee, USA |
L. Jay Katz, USA |
Robert Ritch, USA |
Paul Kaufman, USA |
Prin RojanaPongpun, Thailand |
Changwon Kee, South Korea |
Lucca Rosetti, Italy |
Peng Khaw, UK |
Lisandro Sakata, Brasil |
Anthony King, UK |
Patricio Schlottmann, Argentina |
Jonathan Kipnis, USA |
Leopold Schmetterer, Austria |
Anastasios Konstas, Greece |
Joel Schuman, USA |
Michael Kook, South Korea |
Gail Schwartz, USA |
Günter Krieglstein, Germany |
Stephen Schwartz, USA |
Ted Krupin, USA |
Michal Schwartz, Israel |
Steven Kymes, USA |
Jovina See, Singapore |
Jimmy Lai, Hong Kong |
Janet Serle, USA |
Dennis Lam, Hong Kong |
Peter Shah, UK |
Simon Law, USA |
Anurag Shrivastava, USA |
Paul Lee, USA |
Kwok-Fai So, Hong Kong |
Dexter Leung, Hong Kong |
George Spaeth, USA |
Len Levin, Canada |
Ingeborg Stalmans, Belgium |
Hani Levkovitch-Verbin, Israel |
Kazuhisa Sugiyama, Japan |
Richard Lewis, USA |
Hidenobu Tanihara ,Japan |
Shan Lin, USA |
Ivan Tavares, Brasil |
Stuart Lipton, USA |
Hagen Thieme, Germany |
John Liu, USA |
Ravi Thomas, Australia |
Eugenio Maul, Chile |
John Thygesen, Denmark |
Peter McCluskey, Australia |
Atsuo Tomidokoro, Japan |
Stuart McKinnon, USA |
Fotis Topouzis, Greece |
Grant McLaren, South Africa |
Carol Toris, USA |
Stefano Miglior, Italy |
Ian Trounce, Australia |
James Morgan, UK |
James Tsai, USA |
Sayoko Moroi, USA |
Anja Tuulonen, Finland |
Sameh Mosaed, USA |
Rohit Varma, USA |
Maneli Mozaffaraieh, Switzerland |
Lori Ventura, USA |
Ronit Nesher, Israel |
Manuel Vidal-Sanz, Spain |
Kouros Nouri-Mahdavi, USA |
Ananth Viswanathan, UK |
Carlo Nucci, Italy |
Marco Vizzeri, USA |
Robert Nussenblatt, USA |
Ningli Wang, China |
Neville Osborne, UK |
He Wei, China |
Augusto Paranhos, Brasil |
Tony Wells, New Zealand |
Rajul Parikh, India |
Lingling Wu, China |
Vincenzo Parisi, Italy |
Tetsuya Yamamoto, Japan |
Ki Ho Park, South Korea |
Takeshi Yoshitomi, Japan |
Sung Chul Park, South Korea |
Yeni Yücel, Canada |
Rodolfo Perez Grossmann, Peru |
Thierry Zeyen, Belgium |
Bruce Prum, USA |
|
Harry Quigley, USA |
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Faculty |
ix |
Consensus Development Panel |
Ivan Goldberg, Australia |
David Greenfield, USA |
Jeff Liebmann, USA |
Jonathan Crowston, Australia |
Clive Migdal, UK |
Felipe Medeiros, USA |
Remo Susanna, Brasil |
Robert Ritch, USA |
Robert N. Weinreb, USA |
Kuldev Singh, USA |
|
Chris Leung, Singapore |
|
Carlo Traverso, Italy |
Recording Secretaries |
Ningli Wang, China |
Mauro Leite, Brasil |
Makoto Araie, Japan |
Harsha Rao, India |
Glaucoma Societies/Sections of the following countries and regions have agreed to review the report:
Africa,Argentina,Asian-Oceanic,Australia and New Zealand,Austria,Azerbaijan, Bangladesh, Belgium, Bolivia, Brazil, Bulgaria, Canada, Chile, China, Colombia, Costa Rica, Croatia, Czech Republic, Denmark, Ecuador, Egypt, Estonia, Europe, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, India, Indonesia, Iran, Ireland, Israel, Italy, Japan, Kenya, Korea, Latin-America, Latvia, Lesotho, Lithuania, Mexico, Netherlands, Nigeria, Norway, Pakistan, Pan America, Pan Arab, Paraguay, Peru, Philippines, Poland, Portugal, Puerto Rico, Romania, Russia, SaudiArabia, Serbia, Singapore, Slovakia, Slovenia, SouthAfrica, South-EastAsia, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Kingdom, USA, Venezuela, Zambia, Optometric Glaucoma Society and International Society for Glaucoma Surgery
Consensus Chairs: Ivan Goldberg, Robert N. Weinreb, Makoto Araie (bottom row), Remo Susanna, Jeffrey Liebmann (top row).
Clive Migdal
Contents |
xi |
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CONTENTS |
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Preface |
xv |
Introduction |
xvii |
1. Who should be treated? |
|
Felipe A. Medeiros, Remo Susanna, Kuldev Singh |
1 |
2.Treatment goals. Target IOP
Augusto Azuaro-Blanco and Henry Jampel |
23 |
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3. Drugs |
|
29 |
I. |
Cholingergic agents |
|
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Changwon Kee, Takeshi Yoshitomi, Neeru Gupta |
31 |
II. |
Beta-blockers |
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John H.K. Liu |
37 |
III. Alphaand Beta-adrenergic antagonists |
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Atsuo Tomidokoro |
44 |
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Beta-blockers with intrinsic sympathomimetic activity |
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Allison Ungar, Gadi Wollstein and Joel Schuman |
46 |
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Carbonic anhydrase inhibitors |
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Gabor Holló, Megumi Honjo, Anthony Realini, |
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Leopold Schmetterer |
51 |
IV. Alpha-adrenergic agents. Non-selective alpha-adrenergic |
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agonists |
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Atsuo Tomidokoro, Makoto Araie |
59 |
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Selective alpha-adrenergic agonists |
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Arthur Sit |
62 |
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Alpha-adrenergic antagonists |
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Makoto Araie |
67 |
V. |
Prostaglandins |
|
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Gabor Holló, Makoto Araie, Albert Alm |
74 |
VI. Fixed combination preparations of IOP-lowering agents |
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in open-angle glaucoma |
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Philippe Denis, Hagen Thieme, Norbert Pfeiffer |
86 |
VII. Investigational and future drugs |
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Carol Toris, Malik Kahook, Paul Kaufman, |
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Hidenobu Tanihara |
105 |
VIII. Preservatives in topical ophthalmic medications |
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Malik Y. Kahook |
110 |
xii |
Contents |
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IX. Applying pharmacogenomics to improve open-angle |
|
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glaucoma treatment outcomes |
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Stephen G. Schwartz, Tomomi Higashide, |
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Sayoko E. Moroi |
116 |
4. |
Selection of drugs |
131 |
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Initial therapy options |
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Christopher Girkin and Ivan Goldberg |
132 |
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Adjunctive therapy |
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Fabian Lerner and Ivan Goldberg |
133 |
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Combination therapy – fixed-dose combination (FC) |
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Carlo E. Traverso, Anton Hommer, Stefano Gandolfi, |
|
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Francesca Cordeiro, Rajul Parikh, Ivan Goldberg |
136 |
5. Medical treatments of other types of open-angle glaucoma |
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Paul Healey, Robert Ritch, Franz Lerner, Daniel Grigera, |
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K. Barton, S. Gandolfi, K. Kashiwagi, Remo Susanna |
141 |
6. |
Drug delivery |
|
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David Friedman, Jost Jonas, David Greenfield, Ivan Goldberg |
157 |
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Adherence/Perseverance/Dyscompliance |
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David Friedman, David Greenfield and Ivan Goldberg |
158 |
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Delivery sytems |
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Jost Jonas, David Greenfield and Ivan Goldberg |
162 |
7. |
Health economics |
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Ronnie George, Anne Coleman, Steven Kymes |
167 |
8. Non-pharmaceutical medications and approaches |
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Quercetin and quercetin glycosides |
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Makoto Araie |
177 |
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Methylcobalamin |
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Makoto Aihara |
181 |
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Curcumin |
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Makoto Araie |
182 |
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Ginkgo biloba extract |
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Robert Ritch |
192 |
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Grape seed extract |
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Robert Ritch |
196 |
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Resverayrol |
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Robert Ritch |
196 |
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Pycnogenol |
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Robert Ritch |
199 |
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Fish oil and omega-3 fatty acids |
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Sandra Fernando |
201 |
Contents |
xiii |
Alpha-lipoic acid |
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Sandra Fernando |
205 |
Soy sauce |
|
Aiko Iwase |
208 |
Green tea |
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Aiko Iwase |
209 |
Non-pharmaceutical approaches to the treatment of glaucoma. |
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Coffee, chocolate and cocoa |
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Michael S. Kook |
213 |
N-acetyl cysteine |
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Robert Nussenblatt |
215 |
Taurine |
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Robert Nussenblatt |
217 |
Citicoline |
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Vincenzo Parisi |
219 |
Carnosine |
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Vincenzo Parisi and Robert Ritch |
222 |
Carnitine |
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Vincenzo Parisi and Robert Ritch |
223 |
Coenzyme Q10 |
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Nathan Radcliffe |
224 |
Folic acid |
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Nathan Radcliffe |
225 |
Glutathione |
|
Nathan Radcliffe |
227 |
Melatonin |
|
Nathan Radcliffe |
228 |
Salvia miltiorrhiza |
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Douglas Rhee |
229 |
Trifolium pratense (red clover) |
|
Douglas Rhee |
234 |
Bear bile |
|
Douglas Rhee |
235 |
Ginseng |
|
Kwok-Fai So and Raymond Chuen-Chung Chang |
237 |
Wolfberry |
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Kwok-Fai So and Raymond Chuen-Chung Chang |
239 |
Bilberry |
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Kwok-Fai So and Raymond Cheun-Chung Chang |
242 |
Acupuncture and glaucoma |
|
Simon Law |
243 |
Exercise |
|
Clement C.Y. Tham |
249 |
Stress in glaucoma |
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Lori Ventura |
252 |
xiv |
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Contents |
9. |
Neuroprotection |
261 |
10. |
Medical management of glaucoma in infants and children |
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James D. Brandt and Elizabeth Hodapp |
267 |
11. |
Treatment of glaucoma in pregnancy |
|
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Elizabeth Hodapp |
273 |
12. |
Unmet needs |
|
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Christopher Leung |
279 |
Summary Consensus statements |
287 |
|
Disclosure codes definitions – Category code specific financial interests |
297 |
Index of authors |
310 |
Contents |
xv |
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PREFACE
Medical Treatment of Glaucoma is the topic of the seventh World Glaucoma Association Consensus. Medical treatment of glaucoma continues to be at the core of glaucoma management. Hence, the results of this report will have broad and significant impact on glaucoma research and clinical practice. The global faculty, consisting of leading authorities on the clincial and scientific aspects of medical management, met in Fort Lauderdale on May 1, 2010 to discuss the reports and refine the consensus statements.
As with prior meetings, it was a daunting task to seek and obtain consensus on such a complicated and nuanced subject. It is unclear how each of us decides how we practice, and evidence to guide us often is sparse. Hence, this consensus, as with the others, is based not only on the published literature, but also on expert opinion. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking. The goal of this consensus is to provide a foundation for medical treatment of glaucoma and how it can be best employed in clinical practice. Identification of those areas for which we have little evidence and, therefore, the need for additional research always is a high priority. We hope that this consensus report will serve as a benchmark of our understanding. However, this consensus report, as with each of the others, is intended to be fluid. It is expected that it will be revised and improved with the emergence of new evidence.
Robert N. Weinreb, Chair
Makoto Araie
Ivan Goldberg
Jeffrey Liebmann
Clive Migdal
Remo Susanna
Co-Chairs
Robert N. Weinreb, Consensus Chair.
Medical Treatment Chairs and Section Leaders.
Contents |
xvii |
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INTRODUCTION
We mark the seventh consecutive year for the World Glaucoma Association Glaucoma Consensus with Consensus VII. Our topic is the Medical Treatment of Glaucoma.
Global experts were invited and assembled by our international co-Chairs beginning in November 2009, to participate in the Project Forum E-Room, a unique online opportunity to facilitate discussion of each of the consensus meetings. Participants then were engaged in the discussion of ten topical areas to reach consensus on key issues that surround and permeate all aspects of the medical treatment of glaucoma. The results of these thoughtful discussions then were summarized by each of the sections with preliminary consensus statements. The Draft of the Consensus Report, including the preliminary consensus statements, was distributed to the Societies and Partners for review and comments prior to the Consensus Meeting that took place in Fort Lauderdale on Saturday, May 1, 2010. Relevant stakeholders engaged on this day in a stimulating, educational, and thought-provoking session that highlighted the review and revision of the consensus statements. In reponse to comments during the discussion, sections on medical treatment of glaucoma during pregnancy and childhood glaucoma were added, along with Consensus Statments on these topics. The Consensus Report then was finalized by Consensus co-Chairs and Editors. Consensus statements were reviewed and finalized by the expert Consensus Panel.
Robert N. Weinreb and Jeff Liebmann, Editors
Stefano Miglior and Fotis Topouzis.
Bruce Prum, Augusto Paranhos, Tanuj Dada and others.