Identifying and Managing Glaucoma: A Deep Dive Into Pharmacotherapy and Patient-Centered Care
This document provides an overview of glaucoma, including what it is, the different types, risk factors, diagnosis methods, treatment options, and factors that affect treatment adherence. Glaucoma is a group of diseases that can cause optic nerve damage and vision loss due to increased pressure in the eye. It is often asymptomatic in early stages. Risk factors include older age, higher eye pressure, thin cornea, and family history. Diagnosis involves eye pressure measurements, optic nerve exams, visual field tests, and imaging. Treatment goals are to lower eye pressure through eye drops that increase outflow of fluid from the eye. Setting individualized pressure targets and considering additional risk factors, damage level, life expectancy and patient preferences can help determine
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Identifying and Managing Glaucoma: A Deep Dive Into Pharmacotherapy and Patient-Centered Care
- 1. What Is Glaucoma?1 Early/Mild Glaucoma1 Diagnosis of Glaucoma Types of Glaucoma2 Open angle Closed angle What Is High IOP?3-6 Typically >21 mmHg; 30% to 80% of patients with glaucoma have IOP <21 mmHg Ocular Hypertension Treatment Study: Development of Primary Open-Angle Glaucoma9 Risk Calculators Evaluation of Risk Factors10,11 • https://deverseye.org/grc/ • https://ohts.wustl.edu/risk/ • https://oil.wilmer.jhu.edu/risk/ • IOP measurements • Corneal thickness • Optic nerve assessment (stereoscopic) • Visual field tests (perimetry) • Optical coherence tomography (OCT) Medication Observation 5% 10% High risk Low risk High risk What Are the Risk Factors?7,8 Older age, higher IOP, thin cornea, greater cup-to-disc ratio, greater pattern deviation on visual field test • Often undiagnosed until there is advanced damage • ASYMPTOMATIC optic disc excavation, and visual field loss damage, in which patients develop nerve fiber layer damage, A group of diseases with a common endpoint of optic nerve Treat MonitorVS Identifying and Managing Glaucoma: A Deep Dive Into Pharmacotherapy and Patient-Centered Care Full references, accreditation, and disclosure information available at www.peerview.com/RDA930.
- 2. Management of Glaucoma12,13 ↑ Uveoscleral Outflow10,15 ↓ Aqueous Formulation10,18-23 Prostaglandins β-blockers Carbonic anhydrase inhibitors α2-adrenergic agonists ↑ Trabecular Outflow Cholinergic drugs Rho kinase inhibitors Nitric oxide ↑ Higher Target IOP ↑ ↓ Lower Target IOP ↓ Setting Individual IOP Ranges14 Uveoscleral and Trabecular Outflows25,26 Latanoprostene bunod Aqueous Formulation and Trabecular Outflow27-29 Netarsudil 0.02% Slow High No Early Short Rate of progression? Untreated IOP? Additional risk factors? Glaucoma damage? Life expectancy? Fast Low Yes Advanced Long or Convenience Cost Adverse events Beliefs Understanding of risks Lowering IOP16,17 Factors Affecting Adherence10,16,24 Treatment Options VS + Identifying and Managing Glaucoma: A Deep Dive Into Pharmacotherapy and Patient-Centered Care Full references, accreditation, and disclosure information available at www.peerview.com/RDA930.