Allingham- Glaucoma, 7ed

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Sección III • Manejo del glaucoma

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Part 1: Foreword; Introduction; Glossary; Chapter 3: Treatment principles and options. Br J Ophthalmol . 2017;101:130-195. 29. Wilson R, Leske C, Lee P, et al., for the World Glaucoma Association. Screening for Open-Angle Glaucoma . 2008. Available at https://wga.one/ wga/screening-for-open-angle-glaucoma/. Accessed May 10, 2020. 30. Asia Pacific Glaucoma Society. Asia Pacific Glaucoma Guidelines . 3rd ed. Amsterdam, the Netherlands: Kugler Publications; 2016. 31. Kymes SM, Kass MA, Anderson DR, Miller JP, Gordon MO; Ocular Hypertension Treatment Study Group. Management of ocular hyper- tension: a cost-effectiveness approach from the Ocular Hypertension Treatment Study. Am J Ophthalmol . 2006;141(6):997-1008. 32. Fellman RL, Mattox CG, Ross KM, Vicchrilli S. Know the new glaucoma staging codes. EyeNet Mag . 2011:65-66. 33. Marchini G, Chemello F, Berzaghi D, Zampieri A. New findings in the diagnosis and treatment of primary angle-closure glaucoma. Prog Brain Res . 2015;221:191-212. 34. Leske MC, Wu SY, Nemesure B, Hennis A. Incident open-angle glau- coma and ocular perfusion pressure. Invest Ophthalmol Vis Sci . 2011;52 (11):7943. 1 1 7 PUNTOS CLAVE c Se tiene evidencia sólida para informar a los pacientes con glaucoma recién diagnosticado sobre los factores de riesgo, los resultados esperados y el impacto de esta enfermedad crónica y de varios tratamientos en su calidad de vida. c La comunicación centrada en el paciente acerca de la en- fermedad, el tratamiento, el régimen médico simplificado, los posibles efectos secundarios de los medicamentos y la administración adecuada de gotas para los ojos es esencial para el apego adecuado al tratamiento. c La elevación relativa de la PIO es el principal factor de riesgo causante del desarrollo y progresión del glaucoma. Debe esta- blecerse una PIO meta con una mínima fluctuación a lo largo de un periodo de 24 horas bajo tratamiento para glaucoma. Es posible que se requiera revalorar esta PIO meta inicial si hay progresión del glaucoma. c Los objetivos de la terapia deben ser la prevención del daño glaucomatoso progresivo, con la menor cantidad de medica- mentos, en la concentración más baja necesaria para lograr la PIO meta, y considerar la calidad de vida del paciente. c Cuando el tratamiento médico sea ineficaz, primero sustituya (en lugar de agregar) medicamentos.