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Preface Open angle glaucoma (OAG) is one of the leading causes of impaired vision worldwide. The pathogenesis of glaucomatous optic neuropathy remains poorly understood, and several pathogenic mechanisms are proposed to coexist. As the world population ages, OAG will become more prevalent and advances in the diagnosis and treatment of glaucomatous optic neuropathy are important to protect and improve the quality of life of our aging population. Treatment of OAG has been directed at lowering intraocular pressure (IOP) which is the only current therapeutic strategy available to patients with glaucoma. While a wide variety of studies have demonstrated that lowering IOP decreases the risk of glaucoma development and/or progression, many studies have also shown that some patients continue to lose vision despite significant lowering of IOP. There have been many attempts to elucidate the etiology for the deterioration in glaucomatous optic neuropathy despite low levels of IOP. Over the past several decades, deficits in the ocular circulation of patients with OAG have become well established and these may explain the continued progression of OAG patients despite lowered IOP. The purpose of the present publication is to provide an updated view of ocular blood flow and vascular dysregulation in OAG. The importance of the topic was demonstrated by the focus of the 2009 6th Consensus meeting of the World Glaucoma Association which focused entirely on blood flow deficits in patients with OAG. Although a great deal of knowledge on vascular risk factors in glaucoma has already been established, many questions remain. Do ocular blood flow deficits precede glaucoma progression? How does ocular perfusion pressure fit into the IOP and blood flow paradigm? What conclusions can be drawn from recent evidence showing the fluctuation of OAG risk factors including IOP, blood pressure and ocular perfusion pressure? We hope this update d current prospective will serve as a foundation for future investigations which will be designed to answer these and other important considerations in the management of glaucoma. Alon Harris, MS, PhD, FARVO Director of Clinical Research Lois Letzter Professor of Ophthalmology Professor of Cellular and Integrative Physiology
Glaucoma Update VI comprises the latest progress in scientific glaucomatology. Forty-one articles of highly reputed experts in the field cover the genetics and other risk factors of the disease and provide new insights into the pathophysiology of blood flow, visual function and optic neuropathy in glaucoma. Special emphasis is placed on innovative treatment options, both medical and surgical.
Glaucoma medical therapy has evolved with the advent of each new drug. This evolution has moved quickly and generated new information that clinicians need to understand, synthesize, and implement about medications that have specific benefits and risks for their glaucoma patients. This book aims to provide clinicians with an accessible guide to the current art and science of using clinically available drugs for the medical therapy of glaucoma. The contributors have attempted to present evidence-based information, while providing perspective from their clinical experience. In order to reflect the extensive changes that have occurred since the publication of the first edition in 1999, new chapters have been added about fixed combination drugs and the medical treatment of pediatric patients, and existing chapters have been thoroughly revised and updated. Glaucoma Medical Therapy will be a valuable reference for ophthalmologists in both practice and training, as well as for other practitioners who have clinical contact with glaucoma patients.
This is the sixth World Glaucoma Association Consensus. The relationship between ocular blood flow and glaucoma has been discussed for more than a century, and still it uniformly fuels debates at glaucoma meetings throughout the world. Clearly, the results of this report will have broad and significant impact on glaucoma research and clinical practice. The global faculty, consisting of leading authorities on the scientific and clinical aspects of ocular blood flow, have met in Fort Lauderdale on May 2, 2009 to discuss the reports and refine the consensus statements.
Some people suffer from chronic, debilitating disorders for which no conventional treatment brings relief. Can marijuana ease their symptoms? Would it be breaking the law to turn to marijuana as a medication? There are few sources of objective, scientifically sound advice for people in this situation. Most books about marijuana and medicine attempt to promote the views of advocates or opponents. To fill the gap between these extremes, authors Alison Mack and Janet Joy have extracted critical findings from a recent Institute of Medicine study on this important issue, interpreting them for a general audience. Marijuana As Medicine? provides patientsâ€"as well as the people who care for themâ€"with a foundation for making decisions about their own health care. This empowering volume examines several key points, including: Whether marijuana can relieve a variety of symptoms, including pain, muscle spasticity, nausea, and appetite loss. The dangers of smoking marijuana, as well as the effects of its active chemical components on the immune system and on psychological health. The potential use of marijuana-based medications on symptoms of AIDS, cancer, multiple sclerosis, and several other specific disorders, in comparison with existing treatments. Marijuana As Medicine? introduces readers to the active compounds in marijuana. These include the principal ingredient in Marinol, a legal medication. The authors also discuss the prospects for developing other drugs derived from marijuana's active ingredients. In addition to providing an up-to-date review of the science behind the medical marijuana debate, Mack and Joy also answer common questions about the legal status of marijuana, explaining the conflict between state and federal law regarding its medical use. Intended primarily as an aid to patients and caregivers, this book objectively presents critical information so that it can be used to make responsible health care decisions. Marijuana As Medicine? will also be a valuable resource for policymakers, health care providers, patient counselors, medical faculty and studentsâ€"in short, anyone who wants to learn more about this important issue.
The proceedings of an international conference on ophthalmology are presented in this volume, which covers all aspects of glaucoma. The contributors investigate basic mechanisms of morphology, electrophysiology and changes in the aqueous humour dynamics, neurobiology, biomorphometry and long-term changes of the optic nerve head. Special emphasis is placed on the relationship of morphological and functional changes in the early phases of the disease. Psychophysical tests covering sensitivity, specificity and reliability indices are examined. The effectiveness of various therapy modalities - medical, laser and surgical - are compared, and new antiglaucomatous medications as well as new surgical procedures are introduced.
Glaucoma affects all age groups and is a leading cause of blindness worldwide. It is imperative that practicing clinicians and surgeons recognize both primary and secondary glaucoma as well as cases of glaucoma associated with other disorders. Atlas of Glaucoma, Third Edition provides an in-depth review and analysis of the management of glaucoma and discusses research advancements that have resulted in the latest therapies. See What's New in the Third Edition: The influence of the cornea on intraocular pressure measurements and new devices designed to account for this Spectral domain optical coherence tomography (OCT) New statistical methods for tracking rates of progression New medications released since 2006 New chapter on trabecular bypass surgery Additional topics include: Classification of glaucoma Measurement of intraocular pressure and gonioscopy The optic nerve Psychophysical and electrophysiological testing in glaucoma Primary open-angle, secondary open-angle, and angle closure glaucomas Ocular blood flow and metabolism Medical therapy and surgical treatments Aqueous shunts Combined cataract and glaucoma surgery Treatment of developmental glaucoma This colorful atlas contains detailed captions for each illustration, making it ideal for teaching purposes as well as a reference for the practicing ophthalmologist. Glaucoma encompasses a wide variety of clinical entities, clinical findings, diagnostic techniques, and treatment options. This book presents a vast assemblage of insight from internationally recognized experts.