Gandolfi (UniPr): ‘Long-lasting drugs revolution for glaucoma patients’

It is an extremely disabling disease, the incidence of which is destined to increase with the aging of the population. We are talking about glaucoma, the ‘silent thief of sight’. About 900 thousand Italians suffer from this disease, but only one in three people know they have it. And glaucoma was the focus of the XVII Congress of the Italian Society of Glaucoma (Sigla), which was held from 17 to 19 June at the Palacongressi di Parma in life and remotely. “There are so many innovations that have emerged from the diagnostic, therapeutic and management point of view of the disease – says Stefano Gandolfi, director of the Ophthalmology Clinic of the University of Parma, president of Sigla and organizer of the Congress – You cannot cure glaucoma, however We have powerful weapons at our disposal: from increasingly sophisticated systems for early diagnosis to the latest generation drugs that can be administered inside the eye every 4-5 months, and which I hope in the future will make people forget the administration in In addition, we can count on laser treatments that are performed on an outpatient basis, as well as sophisticated minimally invasive surgery without abandoning traditional surgery, which is now increasingly safe and effective “. The disease affects the optic nerve. In most cases it is due to an increase in the internal pressure of the eye (which often, paradoxically, is recorded in those with low blood pressure) which causes, over time, a wearing down of the optic nerve head (called ‘optic disc ‘and visible upon examination of the fundus) with consequent permanent damage to vision represented by the reduction of the visual field (that is, the space that the eye can perceive without moving the head narrows). Most of the time we opt for the therapy in drops. “In this case – warns the expert – it is better not to administer the eye drops by yourself, because do-it-yourself is ineffective. For this reason the patient must be helped, otherwise the drug, not entering the eye correctly, will not it will produce no benefit. And a drug, as well as being tolerable, must work. ” When the disease progresses and the drops are no longer enough, new possibilities open up for the patient. “Laser technique, eye drops and long-lasting drugs are on the same level – Gandolfi points out – But when none of these therapeutic options manages to keep eye pressure at a safe level, strategy is changed and action is taken. surgically “. Glaucoma still represents one of the main causes of irreversible blindness in the world, which is why it has a devastating impact on those affected. “In young people it causes anxiety, fear and worry – recalls Gandolfi – while in elderly people it causes depression and resignation, because they know that they will have to live with a very unpleasant travel companion for life”. And the Covid-19 pandemic did not help them, quite the contrary. “In the first lockdown, many clinics and hospital wards were closed and many patients were unable to carry out checks at their reference centers. Let’s not forget that glaucomatous is a chronic patient, therefore extremely vulnerable”, underlines the director of the Eye Clinic. of the University of Parma. On the occasion of the Sigla Congress, ample space was dedicated to the theme ‘It looks like glaucoma but it isn’t’. Gandolfi himself explains why: “Glaucoma – he says – affects the nerve that carries vision from the eye to the brain. But the optic nerve can also be damaged due to other pathologies, similar to glaucoma, but which are not glaucoma. . Today, thanks to technology, we are able to guarantee greater accuracy at the time of diagnosis “. For the future of glaucoma management, the specialist has no doubts: “In addition to the possibility of administering new long-lasting therapies, an increasingly intense use of telemedicine is expected, even if we Italians still don’t like it because we have always preferred intercourse. direct doctor-patient. For this reason it is necessary to focus on an intelligent mix between medicine in the presence and remote assistance.