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      European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Part 1
      Supported by the EGS Foundation

      The British Journal of Ophthalmology

      BMJ Publishing Group

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Foreword

          It gives me pleasure to introduce the 4th edition of the EGS Guidelines. The Third edition proved to be extremely successful, being translated into 7 languages with over 70000 copies being distributed across Europe; it has been downloadable, free, as a pdf file for the past 4 years. As one of the main objectives of the European Glaucoma Society has been to both educate and standardize glaucoma practice within the EU, these guidelines were structured so as to play their part.

          Glaucoma is a living specialty, with new ideas on causation, mechanisms and treatments constantly appearing. As a number of years have passed since the publication of the last edition, changes in some if not all of these ideas would be expected.

          For this new edition of the guidelines a number of editorial teams were created, each with responsibility for an area within the specialty; updating where necessary, introducing new diagrams and Flowcharts and ensuring that references were up to date. Each team had writers previously involved with the last edition as well as newer and younger members being co-opted.

          As soon as specific sections were completed they had further editorial comment to ensure cross referencing and style continuity with other sections.

          Overall guidance was the responsibility of Anders Heijl and Carlo Traverso. Tribute must be made to the Task Force whose efforts made the timely publication of the new edition possible.

          Roger Hitchings

          Chairman of the EGS Foundation

          www.eugs.org

          The Guidelines Writers and Contributors 

          Augusto Azuara Blanco

          Luca Bagnasco

          Alessandro Bagnis

          Keith Barton

          Christoph Baudouin

          Boel Bengtsson

          Alain Bron

          Francesca Cordeiro

          Barbara Cvenkel

          Philippe Denis

          Christoph Faschinger

          Panayiota Founti

          Stefano Gandolfi

          David Garway Heath

          Francisco Goni

          Franz Grehn

          Anders Heijl

          Roger Hitchings

          Gabor Hollo

          Tony Hommer

          Michele Iester

          Jost Jonas

          Yves Lachkar

          Giorgio Marchini

          Frances Meier Gibbons

          Stefano Miglior

          Marta Misiuk-Hojo

          Maria Musolino

          Jean Philippe Nordmann

          Norbert Pfeiffer

          Luis Abegao Pinto

          Luca Rossetti

          John Salmon

          Leo Schmetterer

          Riccardo Scotto

          Tarek Shaarawy

          Ingeborg Stalmans

          Gordana Sunaric Megevand

          Ernst Tamm

          John Thygesen

          Fotis Topouzis

          Carlo Enrico Traverso

          Anja Tuulonen

          Ananth Viswanathan

          Thierry Zeyen

          The Guidelines Task Force 

          Luca Bagnasco

          Anders Heijl

          Carlo Enrico Traverso

          Augusto Azuara Blanco

          Alessandro Bagnis

          David Garway Heath

          Michele Iester

          Yves Lachkar

          Ingeborg Stalmans

          Gordana Sunaric Mégevand

          Fotis Topouzis

          Anja Tuulonen

          Ananth Viswanathan

          The EGS Executive Committee 

          Carlo Enrico Traverso (President)

          Anja Tuulonen (Vice President)

          Roger Hitchings (Past President)

          Anton Hommer (Treasurer)

          Barbara Cvenkel

          Julian Garcia Feijoo

          David Garway Heath

          Norbert Pfeiffer

          Ingeborg Stalmans

          The Board of the European Glaucoma Society Foundation 

          Roger Hitchings (Chair)

          Carlo E. Traverso (Vice Chair)

          Franz Grehn

          Anders Heijl

          John Thygesen

          Fotis Topouzis

          Thierry Zeyen

          The EGS Committees 

          CME and Certification 

          Gordana Sunaric Mégevand (Chair)

          Carlo Enrico Traverso (Co-chair)

          Delivery of Care 

          Anton Hommer (Chair)

          EU Action 

          Thierry Zeyen (Chair)

          Carlo E. Traverso (Co-chair)

          Education 

          John Thygesen (Chair)

          Fotis Topouzis (Co-chair)

          Glaucogene 

          Ananth Viswanathan (Chair)

          Fotis Topouzis (Co-chair)

          Industry Liaison 

          Roger Hitchings (Chair)

          Information Technology 

          Ingeborg Stalmans (Chair)

          Carlo E. Traverso (Co-chair)

          National Society Liaison 

          Anders Heijl (Chair)

          Program Planning 

          Fotis Topouzis (Chair)

          Ingeborg Stalmans (Co-chair)

          Quality and Outcomes 

          Anja Tuulonen (Chair)

          Augusto Azuara Blanco (Co-chair)

          Scientific 

          Franz Grehn (Chair)

          David Garway Heath (Co-chair)

          Related collections

          Most cited references 116

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          Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey.

          A detailed ocular examination, including perimetry, was conducted on 5308 black and white subjects aged 40 years and older in a population-based prevalence survey in east Baltimore, Md. Repeated, detailed examinations were carried out on selected subjects. Roughly half of all subjects with optic nerve damage from primary open angle glaucoma, regardless of race, were unaware that they had the condition. The average intraocular pressure (IOP) among black patients with glaucoma who were receiving treatment was virtually identical to that in those black patients who were not receiving treatment (median IOP, 20 mm Hg); treated eyes of white patients had a lower IOP than those eyes of white patients who were not receiving treatment (mean [+/- SD] IOP, 18.69 +/- 3.23 mm Hg vs 24.15 +/- 5.23 mm Hg; P less than .001). The risk of glaucomatous optic nerve damage increased with the height of the screening IOP, particularly at levels of 22 to 29 and 30 mm Hg and above (relative rate compared with IOP of 15 mm Hg or lower, 12.8 and 40.1 mm Hg, respectively). More than half of all glaucomatous eyes had a screening IOP below 21 mm Hg, whether these eyes were receiving treatment or not. The IOP in glaucomatous eyes tended to rise on follow-up, in contrast with nonglaucomatous eyes in which the IOP was as likely to rise as to fall. Results confirmed that IOP is an important factor in glaucoma, but did not support the traditional distinction between "normal" and "elevated" pressure, nor its corollaries, "low-tension" glaucoma and "high-tension" glaucoma.
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            • Record: found
            • Abstract: found
            • Article: not found

            Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study.

            The purpose of this study was to determine the prevalence of open-angle glaucoma and ocular hypertension in an Australian community whose residents are 49 years of age or older. There were 3654 persons, representing 82.4% of permanent residents from an area west of Sydney, Australia, who were examined. The population was identified by a door-to-door census of all dwellings and by closely matched findings from the national census. All participants received a detailed eye examination, including applanation tonometry, suprathreshold automated perimetry (Humphrey 76-point test), and Zeiss stereoscopic optic disc photography. Glaucoma suspects were asked to return for full threshold fields (Humphrey 30-2 test), gonioscopy, and repeat tonometry. A 5-point hemifield difference on the 76-point test was found in 616 persons (19% of people tested). Humphrey 30-2 tests were performed on 336 glaucoma suspects (9.2% of population), of whom 125 had typical glaucomatous field defects. Two hundred three persons had enlarged or asymmetric cup-disc ratios (> or = 0.7 in 1 or both eyes or a cup-disc ratio difference of > or = 0.3). Open-angle glaucoma was diagnosed when glaucomatous defects on the 30-2 test matched the optic disc changes, without regard to the intraocular pressure level. This congruence was found in 87 participants (2.4%), whereas an additional 21 persons (0.6%) had clinical signs of open-angle glaucoma but incomplete examination findings. Open-angle glaucoma was thus found in 108 persons, a prevalence of 3.0% (95% confidence interval [CI], 2.5-3.6), of whom 49% were diagnosed previously. An exponential rise in prevalence was observed with increasing age. Ocular hypertension, defined as an intraocular pressure in either eye greater than 21 mmHg, without matching disc and field changes, was present in 3.7% of this population (95% CI, 3.1-4.3), but there was no significant age-related increase in prevalence. The prevalence of glaucoma was higher in women after adjusting for age (odds ratio, 1.5; CI, 1.0-2.2). There was no sex difference in the age-adjusted prevalence of ocular hypertension. These data provide detailed age and sex-specific prevalence rates for open-angle glaucoma and ocular hypertension in an older Australian population.
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              • Record: found
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              Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease.

              To provide a reliable, comprehensive staging system to assess glaucoma stage in the absence of an universally accepted glaucoma staging system (GSS) on the basis of visual field results. Literature review and GSS adaptation. After a review of published GSSs was conducted, the Bascom Palmer (Hodapp-Anderson-Parrish) GSS was selected as an appropriate platform for a retrospective GSS on the basis of visual fields. The system was modified by a panel of glaucoma specialists, and additional modifications were made after pilot testing to cover the full range of disease progression, from preglaucoma diagnosis to complete blindness; the ordered stages reflect the typical progression of glaucoma. The GSS is comprised of six ordered stages and is on the basis of the Humphrey visual field. The completed GSS was validated by reviewing patient charts from 12 US glaucoma centers. The GSS allows accurate staging of 100% of glaucoma on the basis of visual fields and other data, enabling evaluation of disease progression and resource utilization at various glaucoma stages. Additionally, treatment costs may be assigned to determine cost-effectiveness of treatment. Research utilizing the GSS has found that cost of care increases with increasing disease severity. The GSS may be used as the basis for creating treatment guidelines, which have the potential to delay glaucoma progression and lower treatment costs.
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                Author and article information

                Journal
                Br J Ophthalmol
                Br J Ophthalmol
                bjophthalmol
                bjo
                The British Journal of Ophthalmology
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0007-1161
                1468-2079
                April 2017
                21 March 2017
                : 101
                : 4
                : 1-72
                Article
                bjophthalmol-2016-EGSguideline.001
                10.1136/bjophthalmol-2016-EGSguideline.001
                5583682
                27378485
                Copyright © 2014 European Glaucoma Society

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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                Ophthalmology & Optometry

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