Intro to Glaucoma

Question 1

what is glaucoma?

Answer 1

a group of diseases defined by a characteristic optic neuropathy that is consistent with excavation and undermining or neural and CT elements of the optic disc, and by eventual development of distinctive patterns of visual dysfunction

Question 2

What is Primary Open Angle Glaucoma?

Answer 2

glaucoma with no identifiable underlying anatomic cause of events that lead to obstruction of aqueous outflow and subsequent increased IOP

Question 3

What is Secondary Glaucoma?

Answer 3

When an abnormality has been identified and a putative role can be associated with it

Question 4

What is Ocular Hypertension?

Answer 4

A normal optic disc and visual field in the presence of increased IOP

Question 5

What is the prevalence of Glaucoma in the US in people older than 40?

Answer 5

1.86% (2.22 million) Americans

Question 6

Where does glaucoma rank as a cause of blindness worldwide? Whats ranked first?

Answer 6

Glaucoma is the 2nd leading cause

Cataracts are the #1 cause of blindness worldwide

Question 7

What are risk factors for glaucoma?

Answer 7

• Increased Age - AA/Hispanic ethnicity

- increased IOP - decreased perfusion pressure - thin CCT - (+) Fam Hx

Question 8

What is the risk of angle closure glaucoma amonst Inuits compared to that of caucasians?

Answer 8

the risk for inuits is 20-40x higher for Inuits compared to Caucasians

Question 9

Is there a gender predominance for closed angle glaucoma? If so, why?

Answer 9

ACG is more common in females due to a more shallow AC

Question 10

Does the risk of angle closure increase with age? If so, why?

Answer 10

Yes, risk of ACG (with pupillary block) increases with age 2/2 decreased AC depth and volume

Question 11

What are risk factors for ACG?

Answer 11

Race (inuit, asian)
Gender (female predominance)
Age (increased age)
Hyperopia
(+) Fam Hx

Question 12

What is the prevalence of glaucoma amongst siblings?

Answer 12

10%

Question 13

What genetic mutations are associated with open angle, closed angle, and congenital glaucoma?

Answer 13

GLC1: Open Angle Glaucoma
GLC2: Closed Angle Glaucoma
GLC3: Congenital Glaucoma

Question 14

What does GLC1e code for? What disease is it associated with?

Answer 14

It codes for Optineurin, and mutations lead to NTG (normal tension glaucoma)

Question 15

What does GLC3a code for, and what kind of glaucoma does it cause?

Answer 15

It codes for a CYP1B1 (a part of the cytochrome system in the liver), and causes a congenital glaucoma

Question 16

What genetic mutation is associated with pseudo exfoliation syndrome?

Answer 16

LOXL1 mutations are associated with pseudo exfoliation syndrome. Mutations caused dysregulation of the proteins that regulate elastin canalization, leading to zonular relaxation)