Canadian Glaucoma Study update (Dr Fred Mikelberg)

03Jun2011 from talk given 26Jun2010 1700hrs presented at the COS Annual Meeting in Quebec City by Dr Fred Mikelberg.

Dr Mikelberg started by reviewing some of the prior data and also some of the data recently shown at ARVO and that was still in press at the time this talk was given.

This longitudinal Canadian Glaucoma Study was designed in 1992 and began recruitment in 1994.  Data collection terminated in 2005. The multicentre study was designed to look at risk factors, subgroups, identify those benefit from IOP reduction, etc.

Material & Methods:

  • Inclusion & exclusion criteria were reviewed.
  • Bloodwork, tests for vasospasm, stereo deisc, HRT, SAP, SWAP
  • Progression criteria reviewed
  • Reduce IOP >=30% from baseline IOP
  • Real life protocol allowed including whichever available topical med treating physician wanted


  • 131 M to 127 F
  • 65% completed 5 year f/u
  • Cumulative overall progression rates each year were determined and were comparable between study centers
  • Four factors for progression
    • ACA +ve (Anti Cardiolipin Antibody as marker for autoimmune disease)
    • Female
    • Mean IOP
    • Baseline Age

Newest study results in press:

  • Mean rate of change per year
  • Of those patients who did reach an end point, they had a greater mean deviation rate dB/yr
  • 33 patients slowed rate of progression and 16 different for the group reaching 1st end point


  • +ve ACA titters 4x RR
  • F > M 2x risk
  • other stuff flew by too fast
  • Rates of VF  change shown
  • Future analysis role of SWAP and of HRT

For more details of the results, please refer to the published paper that is alluded to in this talk.

Arch Ophthalmol. 2010 Oct;128(10):1249-55. Epub 2010 Aug 9.