Noand the industrialized countries is the second cause of blindness. Let’s talk about glaucomaa pathology, chronic and irreversible, which in Italy affects about one million people even if it is estimated that only half of the sick are aware of it.
Glaucoma is in fact also called the ‘silent thief of sight’, because when it begins it gives no sign of its presence. There Early diagnosis therefore plays a vital role. And it is precisely to make people aware of the most critical aspects of this disease that the World Glaucoma Week coming back this year from 12 to 18 March with dedicated initiatives.
What is glaucoma
As they point out experts of the MultiMedica GroupThe Glaucoma is a disease of the optic nerve which determines one visual field impairmenti.e. the ability to perceive what is included in the space around the object in the center of our gaze (defined fixation point).
The vision process is possible because the images are transmitted to the brain areas through the optic nerve. In the presence of glaucoma, the nerve fibers degenerate through an apoptotic mechanism. The prime to meet this degeneration are precisely those corresponding to the peripheral portions of the visual field. As the disease progresses, the patient retains only the central part of the visual field. The lesion of the optic nerve determines a progressive alteration of the visual field, That tends to shrink gradually until its complete disappearance.
Glaucoma is also characterized by a increased pressure within the eye (intraocular pressure, IOP) due to the lack of outflow of the transparent and colorless liquid that fills that portion of the eye (aqueous humour).
Glaucoma, the silent killer
In its initial stages, however, glaucoma is asymptomatic. There loss of the peripheral portions of the visual field, in fact, initially it is not warned by the patient: only the ophthalmologist can ascertain the presence of the disease, by examining the fundus of the eye and requesting, if necessary, appropriate and further tests.
The diagnosis
For the diagnosis of glaucoma it is necessary detect an alteration in the optic nerve. As a consequence of the loss of nerve fibers, in fact, the optic nerve acquires an excavated appearance. According to the experts, it is therefore precisely the increase in the excavation of the optic nerve first factor which should raise the suspicion of glaucoma.
The diagnosis must then be confirmed byvisual field test which shows, in the case of glaucoma, typical defects such as the presence of a scotoma in the nasal portion of the visual field (the so-called “nasal jump”), and from other exams, among which the optical coherence tomography (OCT).
New software helps diagnose glaucoma
There diagnosis of glaucoma it is therefore complex but today to the aid of specialists comes one new technology.
atSan Giuseppe hospital in Milan was in fact tested a new software capable of simultaneously reading the results of several heterogeneous teststhus helping the doctor to see early any worsening of the disease.
Specifically, it is a latest generation software capable of quickly merge and analyze information from the visual field and OCT, that is, the two main tests that are used to detect and monitor glaucoma, even if conducted in different structures. This way the software facilitates early diagnosis and provides iuseful information to set up the most appropriate treatment.
Glaucoma needs to be kept under control
«Visual field and OCT (optical coherence tomography) are two exams that provide very different information: the first tells us how the eye worksthe second there returns an image of the anatomy of the organ – he explains Matthew Sacchireferral specialist for glaucoma at the San Giuseppe Hospital in Milan – MultiMedica Group, first structure in Italy to have introduced and tested the software. – Read the results simultaneously of these two investigations and knowing how to translate them into precise indications on the progression of glaucoma, intercepting any worsening and the need to redirect therapy or to opt for surgery, is not an intuitive operation. Requires specialist a lot of experience and a complex work of analysis. In the tests we are conducting iThe software performs the same task reliably in a matter of moments. We have already used it successfully in over 1,000 patients».
Thanks to the possibility of memorize all past exams, the program will support doctors and patients for optimal management of the pathology which, being chronic, requires careful and continuous surveillance over the years. «Those who suffer from glaucoma must perform the examination of the visual field and the OCT at least once a year, for life» – in fact clarifies the expert.
Free Screenings
«Early diagnosis is crucial: after the age of 50, everyone should have a regular eye examespecially if there is already someone in the family who suffers from it» – underlines again Dr. Sacchi who invites citizens to join to free initiatives offers throughout Italy.
The March 17th to Milan the San Giuseppe Hospital indeed he will offer free screenings and will be available to citizens for answer doubts and questions about the disease. To participate, you need to book on 02.8599.4802from Monday to Friday, from 11.00 to 12.00.
Glaucoma: therapeutic perspectives
Although incurable, glaucoma can be well controlled with adequate therapy, aimed at reducing intraocular pressure. Any visual damage caused by the disease they cannot be repairedtherefore, as also underlined by the Istituto Superiore di Sanità, it’s important start treatment promptly to prevent further damage.
The aim of all glaucoma treatments, whether medical or surgical, is to decrease intraocular pressure since it has been proven that with decreasing pressure it can slow the progression of glaucoma. The first and simplest therapy consists in the use of ad hoc eye drops, under strict medical supervision at a specialized centre. In addition to eye drops it is possible to perform a laser treatment. As a last resort some patients may undergo to surgery.
The first objective of the therapies, according to the international guidelines dictated by European Glaucoma Society, must be to maintain patient quality of life as much as possible.
A new study
Ophthalmologist examining patient with slit lamp
It fits right into this context, the new international clinical study just published in the magazine Graefe’s Archive for Clinical and Experimental Ophthalmology.
Indeed, the study showed that the citicoline in oral solution improves the quality of life related to the vision of patients with open-angle glaucoma (OAG), which is the most common form of glaucoma.
The clinical trial was conducted with citicoline in oral solution, in five European hospital centers, concluded in 2022, under the professor’s guide Luca Rossetti, Professor of Visual Apparatus Diseases at the University of Milan and director of the Ophthalmology Clinic of the ASST Santi Paolo e Carlo of Milan.
In the patient’s daily life, the results of this trial translate in an easier management of essential daily activities, such as walking, reading, driving and shopping, so in one greater autonomy in everyday life.
Improving the quality of life
«The trial represents an absolute novelty, as it concerns the first placebo-controlled clinical trial to evaluate the effect of a medical treatment aimed at improving quality of vision-related life in patients glaucoma, an important indicator in patient management – explains Professor Luca Rossetti. – The result of the analysis has reached important results, with more significant values in patients who, at the beginning of the trial, declared a quality of life related to the most compromised vision. We are very pleased, on the occasion of the World Glaucoma Week, to be able to bring this positive message to people with glaucomabut we would like to extend an invitation to everyone not to underestimate the importance of an early diagnosisessential for identifying the right treatment path as soon as possible ».
iO Woman © REPRODUCTION RESERVED