WGC Day 4: Cherry Blossoms, Conference Finale and the Fourth of July

Japanese culture is well known for its appreciation of the cherry blossom … when the eponymous tree lets loose its flowery petals — and indeed the season is one of the busiest periods in Japan. Thousands travel to the country to witness the blossoming and many more locals travel domestically to view the staggered blooms. You can find this phenomenon in dozens of examples of indigenous art, as well as in prose and poetry.

Indeed, the cherry blossom was traditionally associated with the ancient Samurai class: fearless warriors who made up a small percentage of feudal Japanese society, but nonetheless continue to exercise remarkable cultural pull to this day. The beautiful but brief experience of the cherry blossom was held up as a metaphor for the life of the warrior, glorious yet brief, falling away from life as petals fall from the tree. A poignant reminder that nothing in life, no matter how great or wonderful, lasts forever.

And so like the cherry blossom tree, we come to the last day of the World Glaucoma e-Congress (WGC 2021) — and while the flowery analogy might be a little gushy, the Media MICE team has thoroughly enjoyed this conference and we’re sad to see it go. Despite the huge difference in time zones managed by organizers, the high production values and detailed content of the various symposiums are to be commended. We will, of course, be happy to return to sleep at more reasonable hours (and not miss the remaining Euro 2020 games or celebrate the 4th of July) but what are sleep, football and fireworks to the world of ophthalmology?

You call that glaucoma? This is glaucoma…

Now only a truly international conference like WGC 2021 would be describable using the Japanese cherry blossom metaphor, and then start its last day with a decidedly Antipodean flavor. Australian and New-Zealand Glaucoma Society — Change What You Do! Change How You Think! was one of the first symposiums of the day and provided some fantastically crikey(!) insights into glaucoma from the land Down Under and further abroad.

The first speaker of the symposium was Dr. Graham E. Lee, a professor of ophthalmology at the University of Queensland (Brisbane, Australia). Dr. Lee spoke about some of the most common surgical techniques employed by his society’s members with a particular focus on trabeculectomy. He reported that a slim majority favor no pre-treatment, around two-thirds prefer day surgery, and that a vast majority (of around 95%) prefer to use monitored local anesthesia.

The other key speaker from the symposium was Prof. Robert Casson, the head of the Discipline of Ophthalmology and Visual Science at Adelaide University (Australia). Prof. Casson presented his view on how glaucoma will progress in the coming years and identified it as a key public health issue for a number of factors. These include: the aging global population; the fact that 50% of individuals suffering from glaucoma are undiagnosed; and that there are serious shortcomings in funding for treatment in low-income countries.

Diabetes and glaucoma

Glaucoma is finally getting the recognition for the public health threat it is. But what happens when the disease is present in a patient with another condition that’s more widely associated with a large public health impact? This was the topic of a presentation by a group of researchers from the All India Institute of Medical Science (AIIMS, New Delhi, India), led by Dr. Swechya Neupane. Their research, the Prevalence of Glaucoma in Patients Having Diabetic Retinopathy (DR), examined how glaucoma impacts diabetics.

The Indian researchers wanted to identify both the prevalence of glaucoma, as well as the various types of glaucoma that may be encountered. The study ran for two years and examined subjects who were 40-years-old or over, and included screening procedures such as fundus exams and gonioscopy. The study found that 28.7% of DR patients surveyed had glaucoma, and of these, the plurality at 44.2% was primary angle-closure suspects, followed by 27.9% with primary angle-closure glaucoma.

We would be remiss if we didn’t feature a presentation focused on IOP, given its (very) close association with glaucoma. And we found a particularly interesting take on the subject: Intraocular Pressure (IOP) In Children With Acute Lymphoblastic Leukemia (ALL). Given by Dr. Noa Geffen, an ophthalmologist at the Rabin Medical Center (Petah Tikvah, Israel), the presentation revealed how elevated IOP and steroid-induced glaucoma are side effects of ALL treatment. Dr. Geffen collected data on pediatric patient demographics, as well as white blood cell counts, triglyceride levels and blast percentages in the bone marrow.

Watch for high IOP in leukemia patients

Of the 90 subjects (one of whom regrettably died during the course of the study), 71% had IOP of >21 mmHg, and 39% had IOP of >25 mmHg. Out of this group, 9% required hypotensive medical treatment to stop their IOP from rising even further. According to Dr. Geffen, increased IOP may be associated with elevated blood viscosity. The study concluded that the severity of a patient’s ALL is correlated with a higher risk of high IOP, and that patients with the highest degree of ALL severity should have their IOP closely monitored.

From starting the day with a report on Antipodean ophthalmology and glaucoma treatment to the final sessions covering tube surgery, artificial intelligence and controversies in glaucoma surgery, we’re sad to see the WGC 2021 go. (But those celebrating the 4th of July are ending the conference with full fireworks, literally!)

This is especially so, as the final session of the day was in fact a karaoke event which — while filling your Scottish correspondent with absolute and abject horror — was certainly popular among other members of the Media MICE team. Who knows, perhaps this is an idea we can carry forward until more real-world conferences make a full comeback in the post-COVID-19 era.

There are still loads of symposiums, papers, abstracts and films to check out on the WGC’s virtual platform, so make sure you swing on by — there’s some seriously cool stuff out there that we know you’ll love. In the meantime, think not on the quick blossoming of the petal and its fall into oblivion, for all good things must come to an end. The tree that gives life to the flower continues to grow, and that means there’ll be more ophthalmology conferences coming up to look forward to, so we will see you at the next one.

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