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. 2017 Jun;101(6):130-195.
doi: 10.1136/bjophthalmol-2016-EGSguideline.003.

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 3: Treatment principles and options Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 3 Treatment principles and options

No authors listed

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 3: Treatment principles and options Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 3 Treatment principles and options

No authors listed. Br J Ophthalmol. 2017 Jun.
No abstract available

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Figures

Figure 3.1.
Figure 3.1.
THE WHOM -TO -TREAT GRAPH The rate of ganglion cell loss and resulting functional decay is very different among different glaucoma eyes. Quality of life is clearly reduced when visual field defects become severe, cf. the severe functional impairment. Line A represents the effect of aging alone. In glaucoma loss of visual function is often much more rapid. An older patient, diagnosed late in life, with a moderate rate of progression (B) has a much lower risk of developing severe functional impairment than a younger patient with the same amount of field loss at diagnosis and rate of progression (C). A very slow rate of progression may be tolerated by the patient and treatment left unchanged (D), while a rapid rate of progression (E) needs a considerably lower target pressure. It needs to be remembered that it is the extent of binocular visual field or the field of the better eye that largely determines the patient’s quality of life, while the rates of progression of each eye separately are needed to determine treatment.
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FC XIII - Medical Management - Choosing Therapy
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FC XIV - Therapeutical Algorithm in Glaucoma Topical Therapy
Figure 3.2.
Figure 3.2.
The Pre - Post IOP Graph. A simple graph can be used to show the IOP lowering effect. Different shapes/colours can be used to show different patient series or different observation times. Vertical and horizontal lines show respectively Pre and Post Treatment IOP levels of interest, here placed as examples at 15 and 21 mmHg. Areas of desired effect under the oblique “no effect” line can thus be defined. Treatment “A” blue dots: eye n 1 lies on the “no effect” line. Eyes n 2 and n 3 both show a large effect, with only the former below the 15 mmHg line. Eye n 4 shows a sizeable decrease of IOP but the absolute level is still >21 mmHg. Treatment “B” red dots. Eyes n 1 and n 2 show a slight increase and a slight decrease of IOP, respectively; eye n 3 shows a very large effect, as well as eye n 4, both remaining below the 15 mmHg line.
Figure 3.3.
Figure 3.3.
IOP lowering molecules and year of first clinical use. FC: fixed combination. In black: monotherapy.
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References

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