Editorial
Clinical practice guidelines on progression and advanced glaucoma
Guías de práctica clínica en progresión y glaucoma avanzado
L.E. Pablo
Corresponding author
Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain
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"apellidos" => "Uría Mundo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669122002313" "doi" => "10.1016/j.oftal.2022.09.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669122002313?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579422001748?idApp=UINPBA00004N" "url" => "/21735794/0000009800000001/v1_202301060758/S2173579422001748/v1_202301060758/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Clinical practice guidelines on progression and advanced glaucoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "1" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L.E. Pablo" "autores" => array:1 [ 0 => array:4 [ "nombre" => "L.E." "apellidos" => "Pablo" "email" => array:1 [ 0 => "lpablo@unizar.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Guías de práctica clínica en progresión y glaucoma avanzado" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The practice of clinical medicine has an obvious scientific component that must be combined with the "art" of implementing the knowledge of professionals in the real world. When faced with a given patient or clinical situation, experience, an individual point of view and the wealth of knowledge and resources currently available to us enable the development of the most appropriate solution for the treatment and management of our patients.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Glaucoma is still a complex syndrome in which many factors are involved, depending on the disease itself, the patient and even the patient's environment and circumstances. The new diagnostic and therapeutic means available to the clinician allow for a personalised and individual approach in the monitoring of the process. For this reason, the help of the experience and knowledge of other professionals is a fundamental instrument for the clinical management of our patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A Clinical Practice Guideline (CPG) is nothing more than an orderly and well-considered set of recommendations based on evidence and which represent a kind of signposting of the path to follow and of the various options available. Hence, CPGs are necessary to organise and evaluate the available knowledge and reduce variability in our practice.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The management of advanced glaucoma continues to be a challenge for the clinician, the ground effect of OCT, the difficulty of conventional campimetry to detect small changes with great clinical significance or the role of new tools such as OCT-A are peculiarities addressed in the text. The guide sheds light on questions such as where to place the target pressure or the most appropriate surgical treatment in each case.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In some cases, the progression of glaucoma is evident and a visual field analysis, OCT or the appearance of the cup itself is enough proof. In other cases it is not so simple: atypical papillae, myopia, concomitant pathologies, ageing, the subtlety of change or technological failures invalidate an otherwise simple assessment.</p><p id="par0030" class="elsevierStylePara elsevierViewall">This progression guide includes the different options that define functional and structural progression and the expected progression rates among our patients. New trends in progression assessment are based on structural-functional relationships and the role of artificial intelligence, which is gradually becoming a genuine and consolidated option in daily medical practice.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Scientific societies favour the flow of knowledge and opinions between professionals from different places and schools, who establish professional and often personal links. Research networks have allowed these relationships to become even closer and a healthy exchange of people and ideas between different groups. Said iterations have given rise to very useful initiatives such as these guidelines, which are undoubtedly a reference tool for the present and future practice of glaucomatologists and ophthalmologists in our country.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true ] "idiomaDefecto" => "en" "url" => "/21735794/0000009800000001/v1_202301060758/S2173579422001761/v1_202301060758/en/main.assets" "Apartado" => array:4 [ "identificador" => "5814" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009800000001/v1_202301060758/S2173579422001761/v1_202301060758/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579422001761?idApp=UINPBA00004N" ]
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