OR WAIT null SECS
Advancements in Narrow-Angle Glaucoma with Lauren Blieden, MD
Blieden describes recent advancements in the detection and treatment of narrow-angle glaucoma at TOA 2025.
Advancements in early detection and treatment for narrow-angle glaucoma are reshaping clinical approaches. In particular, breakthroughs in early lens extraction and automated imaging technologies are improving patient outcomes, with recent clinical trials offering new insights that challenge traditional approaches to risk and treatment.
In a recent interview with HCPLive, Lauren Blieden, MD, a professor of ophthalmology at Baylor College of Medicine, examined recent advancements in early detection, risk stratification, and treatment strategies of narrow-angle glaucoma. Blieden presented a talk entitled "Glaucoma/Narrow Angles” at the Texas Ophthalmological Association (TOA) Annual Meeting in Houston, Texas.
Blieden highlighted the growing evidence supporting early lens extraction as a potentially effective treatment for narrowing angles, noting that patients who underwent this procedure experienced fewer medications and interventions. Although diagnostic tools like gonioscopy remain in use, the expert emphasized the promising potential of automated anterior segment optical coherence tomography (OCT) imaging, which can detect narrow angles much earlier, offering a more reliable screening method.
She also discussed recent clinical trial findings, including the Zhongshan Angle-Closure Prevention (ZAP) trial and the EAGLE trial. The ZAP trial, which studied patients with occludable angles, showed surprisingly low rates of acute angle closure despite the high-risk perceptions of these patients. The trial extended its duration due to the low occurrence of events, suggesting that patients with occludable angles progress slowly and may not require immediate intervention. The EAGLE trial compared laser peripheral iridotomy and clear lens extraction for patients with narrow angles over 36 months, with a trend favoring lens extraction in not only reducing intraocular pressure (IOP) but also lowering the need for subsequent glaucoma surgeries.
Blieden emphasized that while the immediate risk of acute angle closure is lower than previously thought, prompt treatment is still important. Early lens extraction appears to be a promising option for these patients, with long-term benefits in IOP management and reduced need for additional glaucoma interventions. Blieden noted this evolving approach could how clinicians manage narrow-angle glaucoma, suggesting that early surgical intervention can prevent long-term complications.
Blieden reports no relevant disclosures.
References
