aao glaucoma 2013_gla_syllabus.pdf
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Glaucoma 2013: The Future Is Now! #Glaucoma2013
Glaucoma 2013: The Future Is Now! #Glaucoma2013
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2013 Ameri can Academy of Oph thal mology. All rights reserved. No por tion may be repro duced with out express writ ten con sent of the Ameri can Academy of Oph thal mology.
Glaucoma 2013The Future Is Now! #Glaucoma2013 Under Pressure
Program DirectorsThomas W Samuelson MD andDavid S Friedman MD MPH PhD
In conjunction with the American Glaucoma Society
Ernest N Morial Convention CenterNew Orleans, LouisianaSaturday, Nov. 16, 2013
Presented by:The American Academy of Ophthalmology
Commercial Support for the Glaucoma Syllabus provided by
Glaucoma 2013 Planning GroupThomas W Samuelson MDProgram Director
David S Friedman MD MPH PhDProgram Director
Teresa C Chen MDRobert M Feldman MDDavid S Greenfield MDFelipe A Medeiros MD Eydie G Miller-Ellis MDJonathan S Myers MDKouros Nouri-Mahdavi MD Pradeep Y Ramulu MD PhD Kuldev Singh MD MPH
Former Program Directors2012 Wallace L M Alward MD Thomas W Samuelson MD2011 Leon W Herndon MD Wallace LM Alward MD2010 Rohit Varma MD MPH Leon W Herndon MD2009 Donald L Budenz MD MPH Rohit Varma MD MPH
2008 Henry D Jampel MD MHS Donald L Budenz MD MPH2007 Anne Louise Coleman MD PhD Henry D Jampel MD MHS2006 Christopher A Girkin MD Anne Louise Coleman MD PhD2005 Claude F Burgoyne MD Christopher A Girkin MD2004 David S Greenfield MD Claude F Burgoyne MD2003 Kuldev Singh MD MPH David S Greenfield MD2002 Theodore Krupin MD Kuldev Singh MD MPH2001 Robert D Fechtner MD Theodore Krupin MD2000 Jeffrey M Liebmann MD Robert D Fechtner MD1999 Robert N Weinreb MD Jeffrey M Liebmann MD1998 George A Cioffi MD Robert N Weinreb MD1997 Richard A Lewis MD George A Cioffi MD1996 M Bruce Shields MD E Michael Van Buskirk MD
1995 Reay H Brown MD Mary Gerard Lynch MD1994 Richard A Lewis MD
Subspecialty Day Advisory CommitteeWilliam F Mieler MDAssociate Secretary
Donald L Budenz MD MPHDaniel S Durrie MDRobert S Feder MD R Michael Siatkowski MDNicolas J Volpe MD
Jonathan B Rubenstein MD Secretary for Annual Meeting
StaffMelanie R Rafaty CMP, Director, Scientific
Meetings Ann LEstrange, Scientific Meetings SpecialistBrandi Garrigus, Presenter CoordinatorDebra Rosencrance CMP CAE, Vice
President, Meetings & ExhibitsPatricia Heinicke Jr, EditorMark Ong, DesignerGina Comaduran, Cover Design
ii 2013 Subspecialty Day | Glaucoma
On behalf of the American Academy of Ophthalmology and the American Glaucoma Society (AGS), it is our pleasure to welcome you to New Orleans and The Future Is Now! #Glaucoma2013.
As cochairs of the Glaucoma Subspecialty Day Program, we have been honored to work with a superb planning group in organizing this years meeting. The goal for this years Glaucoma Sub-specialty Day is to deliver clinically relevant information for clinicians. We want both general ophthalmologists and specialists to walk away with new concepts to help fine-tune their glaucoma management skills. We worked very hard to involve highly qualified, expert speakers and modera-tors from all over the world to engage the audience throughout the day. We anticipate that this will be an extraordinary educational event, and we are grateful that you have chosen to spend your day at Glaucoma Subspecialty Day.
We have built in ample time for audience response and feedback. The program is structured to be dynamic and interactive. Many of the sessions have been organized in a case presentation platform. Most sessions will include lively, engaging panels that will challenge many of our long-held beliefs concerning glaucoma management. This year we are emphasizing the role of the native lens in glau-coma management, both in terms of combining cataract and glaucoma surgery and regarding the role of the lens in the pathogenesis of narrow and some open-angle glaucomas. The afternoon will feature a session on microinvasive glaucoma surgery and its role in surgical glaucoma management, as well as an in-depth discussion on angle-closure glaucoma. Advances in imaging, diagnosis, and drug therapy will also be featured, including a debate on branded products vs. generics.
We are excited to have Joseph Caprioli MD FACS as the American Glaucoma Society Subspecialty Day Lecturer. His talk is entitled Regional Rates of Field Loss in Glaucoma: Differential Effects of Trabeculectomy. Dr. Caprioli has long been recognized as a leading expert in structural and func-tional correlation and glaucoma progression, and we are grateful to him for sharing his work as our keynote speaker.
In an effort further improve future Subspecialty Day meetings, we request that you assist us by com-pleting the evaluation form. We carefully review all comments to better understand your needs, so please indicate the strengths and shortcomings of todays program.
Again, we welcome you to The Future Is Now! #Glaucoma2013. We hope you find it educational and enjoyable.
Thomas W Samuelson MD David S Friedman MD MPH PhD Program Director Program Director
2013 Subspecialty Day | Glaucoma iii
Glaucoma 2013 Contents
Program Directors Welcome Letter ii
Faculty Listing vi
Program Schedule xiii
Section I: Diagnostic Tests in Glaucoma 1
Section II: Meds, Laser Trabeculoplasty, and Clinical Management Pearls 22
Section III: Challenging GlaucomasOld and New 32
The American Glaucoma Society (AGS) Subspecialty Day Lecture: Regional Rates of Field Loss in GlaucomaDifferential Effects of Trabeculectomy 43
Section IV: The Lens and Glaucoma ManagementCataract Surgery and Combined Procedures 44
Section V: Individualizing Glaucoma Surgery 58
Advocating for Patients 58
Section VI: The Lens and Glaucoma ManagementNarrow Angle, Angle Closure 63
Faculty Financial Disclosure 73
Presenter Index 78
Electronic version of syllabi available at www.aao.org / 2013syllabi
iv 2013 Subspecialty Day | Glaucoma
Academys CME Mission Statement
The purpose of the American Academy of Ophthalmologys Continuing Medical Education (CME) program is to pres-ent ophthalmologists with the highest quality lifelong learning opportunities that promote improvement and change in physi-cian practices, performance or competence, thus enabling such physicians to maintain or improve the competence and profes-sional performance needed to provide the best possible eye care for their patients.
2013 Glaucoma Subspecialty Day Meeting Learning Objectives
Upon completion of this activity, participants should be able to:
Describeinnovationsinthediagnosisandmanagementofglaucoma within their historical context
Comparenewideasregardingthepathophysiologyofglaucomatous vision loss
Evaluatethecurrentstatusofopticdiscandretinalnervefiber layer imaging and its role in diagnosing and manag-ing glaucoma
Demonstratefamiliaritywithcurrentissuesinmedicalandsurgical therapy for glaucoma
2013 Glaucoma Subspecialty Day Meeting Target Audience
This activity has been designed to meet the educational needs of general ophthalmologists, glaucoma specialists and other oph-thalmologic subspecialists, and allied health personnel who are involved in the management of glaucoma patients.
2013 Glaucoma Subspecialty Day CME Credit
The American Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education to pro-vide continuing medical education for physicians.
The American Academy of Ophthalmology designates this live activity for a maximum of 7 AMA PRA Category 1 Cred-its. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets theSelf-Assessment CME requirements defined by the American Board of Ophthalmology (ABO). Please be advised that the ABO is not an accrediting body for purposes of any CME program. ABO does not sponsor this or any outside activity, and ABO does not endorse any particular CME activ-ity. Complete information regarding the ABO Self-Assessment CME Maintenance of Certification requirements are available at: http://abop.org/maintain-certification/part-2-lifelong-learning -self-assessment/cme/.
NOTE: Credit designated as self-assessment isAMA PRA Category 1 Creditand is also pre-approved by the ABO for the Maintenance of Certification (MOC) Part II CME requirements.
Teaching at a Live Activity
Teaching instruction courses or delivering a scientific paper or poster is not anAMA PRA Category 1 Creditactivity and should not be included when calculating your totalAMA PRA Category 1 Credits. Presenters may claimAMA PRA Cat-egory 1 Creditsthrough the American Medical Association. Please contact the AMA to obtain an application form at www.ama-assn.org.
Scientific Integrity and Disclosure of Financial Interest
The American Academy of Ophthalmology is committed to ensuring that all continuing medical education (CME) informa-tion is based on the application of research findings and the implementation of evidence-based medicine. It seeks to promote balance, objectivity and absence of commercial bias in its con-tent. All persons in a position to control the content of this activ-ity must disclose any and all financial interests. The Academy