Anders Heijl, MD, is Professor, Department of Ophthalmology, Malmö University Hospital, Malmö, Sweden.
He is the study director of the Early Manifest Glaucoma Trial, an inventor of STATPAC and GPA, and a consultant of Carl Zeiss Meditec, Inc.
may be reached at +46 40 331000; firstname.lastname@example.org.
Like Dr. Quigley, Dr. Heijl
emphasized the need for more individualized treatment plans.
"We need to tailor the patient's treatment much more to the individual than we used to do," he
"The data from the modern trials show that interpatient variability is tremendously large.
When a patient first comes to us and we don't have follow-up data, the initial treatment should be based on intraocular pressure plus risk factors other than intraocular pressure, but later it's very important to determine the patient's individual rate of progression."
stated that software such as the recently released Humphrey Glaucoma Progression Analysis (GPA) software (Carl Zeiss Meditec, Inc.) will start to play an important role in the management of glaucoma in the next 2 to 5 years.
helps you decide if the eye is stable or if [the disease] is progressing, and, if it is progressing, [GPA software] shows how fast it is progressing," commented Dr. Heijl
, who went on to explain that knowing the rate of progression enables the practitioner to make the treatment decisions most suitable to the stage of disease of a particular eye (Figure 1).
then pointed out that the GPA
software is based on 10 years of experience from the Early Manifest Glaucoma Trial and has been adapted to SITA: "The nucleus of the new GPA
is glaucoma change probability maps based on pattern deviations.
explained that the GPA
software flags findings on a pointwise basis when they are reproducible and prints clear text messages of possible or likely progression.
The software automatically eliminates unreliable fields, he
said, "which here are fields with high numbers of false-positive answers.
In addition, Dr. Heijl
commented that the GPA
software "automatically eliminates untrained first fields, if those are out of line with the following fields.