VIII International Controversies in Ophthalmology.
Should the accompanying eye in patient with unilateral glaucoma be treated?
In most cases, the unilateral glaucoma is secondary and a careful systematic examination will help detect the reason for hypertension. However, the case of unilateral primary open angle glaucoma is not always obvious. When it comes to prevalence, as early as in 1972, Etienne (Brit. J. Ophthal. (1972) 56, 258) examined 1373 cases from which 289 (28%) were unilateral. However, only 2.3% were diagnosed as primary. This included 33 cases of chronic simple glaucoma; 12 cases of exfoliation and glaucoma and one case of pigmentary glaucoma. Etienne argued that if one accepts a hydrodynamic definition of glaucoma, unilateral glaucoma does not exist: there are only asymmetrical glaucomatous eyes. Our recent findings show that glaucoma suspects have similar biomechanical characteristics to those of glaucoma patients, particularly in the shape of lamina cribrosa as well as in the parameters describing corneal microstructure. Moreover, it was found that seemingly nominal intraocular pressure in the suspects group is sufficiently high for the reorganization of the corneal microstructure of similar character to that exhibited in the glaucoma group. Similarly Hirneiß et al. (Acta Ophthalmol. 2011: 89: e189–e192) reported that corneal biomechanical properties do not differ in both eyes of patients with unilateral primary open angle glaucoma. All this indicates that in the rare case of unilateral primary open angle glaucoma the fellow eye needs to be carefully monitored and treated.
IV Scientific and Training Conference. OCT in Ophthalmology.
The use of information contained in the corneal OCT speckle in the diagnosis of glaucoma
Corneal imaging, especially by means of optical coherence tomography (OCT), is associated with glaucoma studies mainly with the measurement of the anterior chamber angles to determine the type of glaucoma (closed / open angle). Studies show that imaging of the anterior segment of the eye, especially the study of statistical parameters of speckle in OCT images of the cornea, can also help in understanding the aetiology of normal tension glaucoma and help physicians in the diagnosis. The lecture discussed the latest scientific research on the assessment of OCT speckle, and its relationship with changes in corneal microstructure associated with age, swelling and intraocular pressure. In addition, results of a study were presented that was conducted on three groups of subjects: (i) with open-angle glaucoma, (ii) suspects due to the appearance of the optic disc and (iii) controls, in which the assessment of the corneal OCT speckle gives new light to the problem of normal tension glaucoma.
Autumn Ophthalmology Workshop. Military Institute of Medicine.
Advanced methods of measuring the ocular pulse
The ocular pulse concerns a number of phenomena related to the expansion of the eyeball caused by fluctuations of intraocular pressure, pulsed blood flow in the ocular circulation, as well as longitudinal eye movements in the orbit. The lecture discussed the latest research related to advanced measurements of dynamic changes in the intraocular pressure using Dynamic Contour Tonometry and in the blood flow in the ocular circulation using Color Doppler Imaging. In particular, the emphasis was placed on the usefulness of these techniques to help diagnose glaucoma and characterize the ocular pulse in glaucoma suspects.