Debates are great — but in medicine, we need more than
an expert opinion to determine the course of treatment.
This is where randomized controlled trials (RCTs) come into play.
Loaded topics — like to MIGS or not to MIGS and early versus late treatment — were some of the debates covered
in a session from Glaucoma Organization of the Austrian Ophthalmological Society and Glaucoma Group of the Swiss Society of Ophthalmology, which was co-chaired
by Drs. Gordana Sunaric-Megevand (Switzerland) and Anton Hommer (Austria).
The pros and cons of pro and con sessions According to Prof. Leopold Schmetterer from ลาวสามัคคี
the Singapore Eye Research Institute, there are certain takeaways we can obtain from pro-con debates Walking a Tightrope.
“We can discuss novel ideas for RCTs according to gaps in knowledge … and the question of how can we implement RCTs into clinical practice?
And an important question is what is the difference between efficacy and effectiveness in a real world setting?”
These were interesting points to keep in mind as the session continued.
Early versus late onset treatment Presenting on the pro side of early treatment was Assoc.
Prof. Gerhard Garhöfer from the Medical University of Vienna (Austria).
He said that early changes in visual field (VF) already reflect considerable loss of ganglion cells and pronounced VF loss is associated with faster progression Walking a Tightrope.
He concluded: “Early treatment should be considered to provide lifetime preservation of visual function and quality of life.”
Arguing for late onset treatment was Dr. Marc Töteberg-Harms from University Hospital Zurich (Switzerland).
He provided an example from a study on ocular hypertension (OHT):
“If we treat OHT too early, we would unnecessarily treat a lot of patients which never develop glaucoma.”
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