The Importance of Optimizing the Follow-Up of the Progression of Primary Open Angle Glaucoma in Clinical Practice

JOURNAL TITLE: Highlights of Ophthalmology

Author
1. María Fernanda Delgado Morales
ISSN
1024-6983
DOI
10.5005/hoe-10101-49301
Volume
49
Issue
3ENG
Publishing Year
2021
Pages
13
Author Affiliations
    1. Doctor in medicine, Universidad del Rosario, Bogotá, Colombia Ophthalmologist, Universidad del Rosario-Fundación Oftalmológica Nacional, Bogotá Colombia Fellowship in glaucoma, Glaucoma Research and Education Group, San Francisco, CA, USA Past President of Colombian Glaucoma Work Group Association, Bogotá, Colombia
  • Article keywords
    Glaucoma, optical coherent tomography, visual field, progression, optic nerve

    Abstract

    Objective: To describe how to optimize the follow-up (F/U) for patients with primary open angle glaucoma (POAG), its early diagnosis and the timely detection. Monitoring functional and structural change, will protect quality of life and avoid risk of blindness. Background: Glaucoma definition has evolved to, a multifactorial neuro-degenerative disease, where despite research developments, intraocular pressure reduction remains as mainstay for treatment and stability of the disease. Close monitoring of POAG patients is crucial for early change detection and advancing treatment to improve results. Results: Current evidence shows the benefit of the correlation between structure and function to detect glaucomatous change, favoring the use of optical coherence tomography (OCT) of the optic disc and macula, as well as perimetry studies, within the F/U scheme of patients with POAG. Numerous publications stand out the ability of OCT of the optic disc to early detect damage and change before functional changes are detectable in the visual field. The frequency of tests, as well as patient visits, are determined by the severity of damage, rate of progression and individual risk factors. Knowing the different examination strategies and applying recommendations to the clinical practice, will contribute to a better treatment of the POAG patient. Understanding the different types of exams and their advantages according to the severity of the disease, will improve rational use of resources and a better chance to detect progression and define therapeutic actions. Conclusion: Progression analysis by event and trend can be performed in structure and function tests. Progression analysis improve glaucoma F/U of POAG patients and optimize results of treatment. Clinical Relevance: Visual loss secondary to glaucoma is irreversible, and the main objective of treatment is to preserve quality of life in the patient who suffers from it. Knowing and applying change analysis in clinical practice is the key to achieve that objective.

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