Glaucoma is a term describing a group of ocular disorders with multi-factorial etiology united by a clinically characteristic intraocular pressure-associated optic neuropathy. It is not a single entity and is sometimes referred to in the plural as the glaucomas. All forms are potentially progressive and can lead to blindness. The diverse conditions that comprise glaucoma are united by a clinically characteristic optic neuropathy: glaucomatous optic neuropathy (GON). Evidence suggests that the primary site of neurological injury is at the optic nerve head. This fact enables the conditions to be grouped, irrespective of the causal mechanism(s). The term experimental glaucoma implies model resemblance to the human condition. We propose that 'experimental glaucoma' be restricted to animal models with demonstrable features of GON and/or evidence of a primary axonopathy at the optic nerve head. A fundamental inadequacy in this framework is any reference to the pathogenesis of GON, which remains unclear.

Multitrait analysis of glaucoma identifies new risk loci and enables polygenic prediction of disease susceptibility and progression

Purpose-To bring together information concerning the epidemiology and the economic and individual burdens of glaucoma. Design-Interpretive essay.Methods-Review and synthesis of selected literature published from 1991 through December 2010.Results-An estimated 3% of the global population over 40 years of age currently has glaucoma, the majority of whom are undiagnosed. Vision loss from glaucoma has a significant impact on health-related quality of life even in the early stages of disease. The overall burden increases as glaucomatous damage and vision loss progress. The economic burden of glaucoma is significant and increases as the disease worsens.Conclusions-Early identification and treatment of patients with glaucoma and those with ocular hypertension at high risk of developing vision loss are likely to reduce an individual's loss of health-related quality of life as well as the personal and societal economic burdens. Keywords economic burden; epidemiology; glaucoma; individual burden; health-related quality of life Glaucoma is a group of chronic eye diseases that irreversibly damages the optic nerve and that can result in serious vision loss and blindness. After cataract, it is the second leading cause of blindness worldwide and is one of the leading causes of preventable blindness. 1 © 2011 Elsevier Inc. All rights reserved.Corresponding author: Rohit Varma, MD, MPH, Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, DEI -4900, Los Angeles, CA, USA 90033, Phone: (323) 442-6411, Fax: (323) 442-6412, rvarma@usc.edu. Financial Disclosures: Drs. Varma, Lee, and Goldberg are paid consultants to Pfizer Inc and participated in the study design; data analysis and interpretation; and preparation and review of the manuscript. Mr. Kotak is an employee of Pfizer Inc and participated in the study design; data analysis and interpretation; and preparation and review of the manuscript.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Patients with glaucoma present to eye health professionals with varying severity along a continuum ( Figure 1). 2 Across much of the continuum, glaucoma damage is relatively asymptomatic because of redundancy in the sensory system and the binocular nature of vision; one eye may compensate for early losses in the other. Major risk factors for developing glaucoma include an elevated intraocular pressure (IOP), greater cup-to-disc ratio, thinner central corneal measurement, older age, and family history for glaucoma. 3,4 These and other risk factors also increase ...

Intraocular pressure (IOP) is currently the sole modifiable risk factor for primary open-angle glaucoma (POAG), one of the leading causes of blindness worldwide. Both IOP and POAG are highly heritable. We report a combined analysis of participants from the UK Biobank (n = 103,914) and previously published data from the International Glaucoma Genetic Consortium (n = 29,578) that identified 101 statistically independent genome-wide-significant SNPs for IOP, 85 of which have not been previously reported. We examined these SNPs in 11,018 glaucoma cases and 126,069 controls, and 53 SNPs showed evidence of association. Gene-based tests implicated an additional 22 independent genes associated with IOP. We derived an allele score based on the IOP loci and loci influencing optic nerve head morphology. In 1,734 people with advanced glaucoma and 2,938 controls, participants in the top decile of the allele score were at increased risk (odds ratio (OR) = 5.6; 95% confidence interval (CI): 4.1-7.6) of glaucoma relative to the bottom decile.

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Primary open-angle glaucoma (POAG) is a major cause of irreversible blindness worldwide. We performed a genome-wide association study in an Australian discovery cohort comprising 1,155 advanced POAG cases and 1,992 controls. Association of the top SNPs from the discovery stage was investigated in two Australian replication cohorts (total 932 cases, 6,862 controls) and two US replication cohorts (total 2,616 cases, 2,634 controls). Meta-analysis of all cohorts revealed three novel loci associated with development of POAG. These loci are located upstream of ABCA1 (rs2472493 [G] OR=1.31, P= 2.1 × 10-19), within AFAP1 (rs4619890 [G] OR=1.20, P= 7.0 × 10-10) and within GMDS (rs11969985 [G] OR=1.31, and P= 7.7 × 10-10). Using RT-PCR and immunolabelling, we also showed that these genes are expressed within human retina, optic nerve and trabecular meshwork and that ABCA1 and AFAP1 are also expressed in retinal ganglion cells.

Objective: To compare bimatoprost with timolol maleate in patients with glaucoma or ocular hypertension.Methods: In 2 identical, multicenter, randomized, double-masked, 1-year clinical trials, patients were treated with 0.03% bimatoprost once daily (QD) (n=474), 0.03% bimatoprost twice daily (BID) (n = 483), or 0.5% timolol maleate BID (n = 241).Main Outcome Measures: Diurnal intraocular pressure (IOP) at 8 AM, 10 AM, and 4 PM and safety variables (IOP was also measured at 8 PM at selected sites).Results: Bimatoprost QD provided significantly lower mean IOP than timolol at every time of the day at each study visit (PϽ.001). This was also true for bimatoprost CLINICAL SCIENCES

The Glaucoma Quality of Life-15 Questionnaire correlated well with objective measures of visual function and discriminated between quality of life in patients with glaucoma and subjects without glaucoma.