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Glaucoma > Lec.6: POAG > Flashcards

Lec.6: POAG Flashcards

1
Q

what are common signs and symptoms of POAG?

A

chronic, bilateral, often asymmetric, acquired optic nerve fiber loss, acquired VF loss, open chamber angle, IOP often over 21 mmHg

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2
Q

what process does glaucoma accelerate?

A

apoptosis of retinal ganglion cells

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3
Q

name common glaucoma risk factors.

A

IOP, age, race, genetics, thin cornea, vascular disease, myopia

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4
Q

is it easier to lower IOP from 15 mmHg to 12 mmHg or is it easier to lower IOP from 30 mmHg to 18 mmHg?

A

easier to drop from 30 mmHg to 18 mmHg, because 15 mmHg is already in the normal range for IOP

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5
Q

what percentage of patients with elevated IOP have VF loss?

A

1/10th of patients (Sommer 1991)

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6
Q

what percentage of patients with disc and VF damage have an IOP less than 21 mmHg?

A

1/6th

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7
Q

what percentage of patient with OHT develop glaucoma in 10 years?

A

15%-40%

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8
Q

how much more prevalent is blindness in african americans than in caucasians?

A

8x

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9
Q

IOP is a poor screening tool due to a low sensitivity, what is the sensitivity of IOP measurements?

A

47.1%

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10
Q

by how much does OCT tend to underestimate corneal thickness, when compared to ultrasound techniques?

A

15-20 microns

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11
Q

what procedures should be performed twice a year on glaucoma patients?

A

VF, OCT, Fundus

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12
Q

how many times should IOP be measured in a year for glaucoma patients?

A

4 times a year

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13
Q

what is the conventional IOP target pressure for patients with glaucoma?

A

20-30% decrease in IOP

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14
Q

what should be target IOP for a patient with SEVERE glaucoma?

A

40% decrease in IOP

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15
Q

what is the equation for target pressure?

A

Target Pressure= (Max IOP)- (Max IOP%)- (Z score)

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16
Q

how many times a year should you perform gonio on a glaucoma patient?

A

1 time a year

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17
Q

how many times should you perform pachymetry for a glaucoma patient?

A

once in a lifetime

18
Q

in POAG what is the incidence of blindness (unilateral vs. bilateral) 20 years after initial diagnosis?

A

27% vs. 9%

19
Q

what are the chances of glaucoma progression in patients being treated for glaucoma vs. a control group?

A

12% treated group 35% control group

20
Q

what are the chances of developing catarct in patients being treated for glaucoma vs. a control group?

A

38% treated group 14% control group

21
Q

what does argon laser trabecularplasty (ALT) do?

A

causes shrinking of TM

22
Q

can SWAP and FDT aid in early diagnosis of POAG?

A

no, but it was once believed they did

23
Q

what is the definition of regression to the mean?

A

on average, individuals tend to have some variance in physiological norms but they often vary around a mean (think weight loss and weight gain)

24
Q

what are the chances of progression in OHT in treated vs untreated groups?

A

4.4% treated group 9.5% untreated group

25
Q

in OHT what are the baseline factors that predict onset and progression of POAG?

A

older age, larger vertical or horizontal CD ratio, greater PSD, higher IOP

26
Q

in OHT what is the strongest association of progression of POAG?

A

lower corneal thickness

27
Q

what is the primary glaucoma indicator?

A

optic disc changes

28
Q

what percentage of glaucoma patients would be detected by optic disc changes?

A

2/3rds

29
Q

what percentage of glaucoma patients would be detected by VF changes?

A

1/3 or (35%)

30
Q

describe the average corneal thickness of a patient with OHT?

A

they tend to have thicker corneas

31
Q

what would be the chances of glaucoma damage in patients with a 40 micron decrease in corneal thickness?

A

70%

32
Q

(T/F) in the long run drugs are cheaper than laser treatment?

A

false

33
Q

according to Moorfields primary treatment trials, what procedure is greater at lowering IOP than trabeculoplasty and medicine combined?

A

trabeculectomy

34
Q

what is the goal IOP for patients with advanced glaucoma?

A

12 mmHg and lower

35
Q

which ethnicity has lesser VF loss with trabeculectomy?

A

caucasians (african americans tend to scar more and patch the passage created when compared to caucasians)

36
Q

which ethnicity had less progression of glaucoma with laser trabeculoplasty?

A

African Americans

37
Q

what does a trabeculectomy do?

A

creates a cut to allow for aqueous humor exchange

38
Q

is it true that 20% IOP reduction in OHT patients may not prevent progression?

A

yes

39
Q

describe the following:

A

notching at 6 oclock

40
Q

describe the following:

A

endstage glaucoma

Glaucoma (12 decks)

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