Lec.6: POAG

Question 1

what are common signs and symptoms of POAG?

Answer 1

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

Question 2

what process does glaucoma accelerate?

Answer 2

apoptosis of retinal ganglion cells

Question 3

name common glaucoma risk factors.

Answer 3

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

Question 4

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?

Answer 4

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

Question 5

what percentage of patients with elevated IOP have VF loss?

Answer 5

1/10th of patients (Sommer 1991)

Question 6

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

Answer 6

1/6th

Question 7

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

Answer 7

15%-40%

Question 8

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

Answer 8

8x

Question 9

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

Answer 9

47.1%

Question 10

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

Answer 10

15-20 microns

Question 11

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

Answer 11

VF, OCT, Fundus

Question 12

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

Answer 12

4 times a year

Question 13

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

Answer 13

20-30% decrease in IOP

Question 14

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

Answer 14

40% decrease in IOP

Question 15

what is the equation for target pressure?

Answer 15

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

Question 16

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

Answer 16

1 time a year

Question 17

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

Answer 17

once in a lifetime

Question 18

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

Answer 18

27% vs. 9%

Question 19

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

Answer 19

12% treated group 35% control group

Question 20

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

Answer 20

38% treated group 14% control group

Question 21

what does argon laser trabecularplasty (ALT) do?

Answer 21

causes shrinking of TM

Question 22

can SWAP and FDT aid in early diagnosis of POAG?

Answer 22

no, but it was once believed they did

Question 23

what is the definition of regression to the mean?

Answer 23

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

Question 24

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

Answer 24

4.4% treated group 9.5% untreated group

Question 25

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

Answer 25

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

Question 26

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

Answer 26

lower corneal thickness

Question 27

what is the primary glaucoma indicator?

Answer 27

optic disc changes

Question 28

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

Answer 28

2/3rds

Question 29

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

Answer 29

1/3 or (35%)

Question 30

describe the average corneal thickness of a patient with OHT?

Answer 30

they tend to have thicker corneas

Question 31

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

Answer 31

70%

Question 32

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

Answer 32

false

Question 33

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

Answer 33

trabeculectomy

Question 34

what is the goal IOP for patients with advanced glaucoma?

Answer 34

12 mmHg and lower

Question 35

which ethnicity has lesser VF loss with trabeculectomy?

Answer 35

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

Question 36

which ethnicity had less progression of glaucoma with laser trabeculoplasty?

Answer 36

African Americans

Question 37

what does a trabeculectomy do?

Answer 37

creates a cut to allow for aqueous humor exchange

Question 38

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

Answer 38

yes

Question 39

describe the following:

Answer 39

notching at 6 oclock

Question 40

describe the following:

Answer 40

endstage glaucoma