Generic Vs Brand Name

Question 1

Difference between brand name and generic drugs

Answer 1

Brand name has tight manufacturing control, generic is not so tight manufacturing control

Question 2

Why will generic possibly not lowering IOP as well as brand name

Answer 2

• ingredients may react with the plastics etc
• ingredients are more prone to degradation
• other reasons that are unlikely: drop size variability, differnt preservatives

Question 3

OHT definition

Answer 3

• elevated IOP (>21mmHg) without any identifiable damage
• 24mmHg is used as criteria in OHTN
• consistently elevates pressure
• VF normal-white on white perimetry
• ONH normal

Question 4

How to use CCT data in glaucoma managment

Answer 4

• error in IOP measurements

- OHTN patients: thinner cornea at greater risk of developing glaucoma

Question 5

STAR calculator

Answer 5

• OHTS and EGPS data
• intended for use only in untreated OHT patients
• Age (30-80)
• IOP (20-32)
• CCT (475-650)
• PSD 0.50 to 3.00 dB
• CD ratio

Gives us a probability of conversion in g5 years
- <5% observe
-5-15% consider treatemtn
>15% treat

Question 6

Efficacy of topical hypotension medications in delaying or preventing onset of glaucoma in OHTN

Answer 6

• mean IOP was 22.5%
• treatment definitely shows reduction of risk of glaucoma in OHTN
• cataract formation was greater in the treated group

Question 7

OHTN factors that are important

Answer 7

• age
• larger CD ratio
• greater PSD
• higher IOP
• strongest association was CCT
• disc hemorrhage-increases risk of POAG development

Question 8

Types of glaucoma suspects

Answer 8

Suspects due to elevated IOP
Suspects due to nerve
Suspect due to VF

Question 9

Elevated IOP

Answer 9

Pay attention to type of measurement
-obese patient- valsalva maneuver

Is IOP consistently high

Diurnal measures at different hours 
Use of steroids 
-direct-dry eye
-indirect-any steroid creams near eye 
-nasal steroids 

FamHX
I consistently high-falls in category of ocualr HTN

Question 10

Two things that are important for OHTN patients

Answer 10

Fundus photos (stereo)
OCT

Question 11

AngioVue OCTA

Answer 11

• uses motion contrast to detect blood flow
• rapidly acquire multiple cross sectional images from a single location on the retina
• flow is the difference between two sequential scans

Question 12

What does OCTA essentially tell us in glaucoma

Answer 12

Structure and function of optic nerve

Question 13

Pulsar perimetry

Answer 13

SAP using pulsar target targets magnocellulat retinal ganglion cells specifically

If the M cells are not working properly, they have early disease

Question 14

Electrophysiology for glaucoma

Answer 14

PERG

VEP can tell us damage anywhere in the visual pathway

Question 15

Subjective: structure and function

Answer 15

Fundus photo

VF

Question 16

Objective structure and function

Answer 16

OCT

electrophysiology

Question 17

PERG indications

Answer 17

Glaucoma
Macuolpahties
-AMD, ERM, DME, etc

Question 18

Summary of managing glaucoma suspects

Answer 18

Huge burden and needed
0large population need follow up 
-there is science in managment
-there is also some art to this 
-early detection is must bc cannot turn the clock back 
-vision loss in glaucoma is irreversible