Focusing on surgical and laser advances in glaucoma management

Introduction: Lowering the IOP remains the mainstay treatment to stop the progression of glaucoma. Different modalities can be used to achieve this including IOP lowering medications, laser, and surgeries. Nowadays, minimally invasive glaucoma surgeries and newer lasers are becoming more popular due to their safety profile, and their efficacy, allowing the patients to be less dependent on life long medications and substituting more invasive procedures as trabeculectomy, and shunt operations. / Areas covered: This review will go through how lasers and surgery are used to lower the IOP, and the newest techniques, and modalities used to achieve this. / Expert opinion: the authors of this review believe that in five years’ time lasers and minimally invasive glaucoma procedures will replace eye drops and surgeries like trabeculectomy and shunt procedures

Heritability of chronic venous disease

Varicose veins without skin changes have a prevalence of approximately 20% in Northern and Western Europe whereas advanced chronic venous insufficiency affects about 3% of the population. Genetic risk factors are thought to play an important role in the aetiology of both these chronic venous diseases (CVD). We evaluated the relative genetic and environmental impact upon CVD risk by estimating the heritability of the disease in 4,033 nuclear families, comprising 16,434 individuals from all over Germany. Upon clinical examination, patients were classified according to the CEAP guidelines as either C2 (simple varicose veins), C3 (oedema), C4 (skin changes without ulceration), C5 (healed ulceration), or C6 (active ulcers). The narrow-sense heritability (h2) of CVD equals 17.3% (standard error 2.5%, likelihood ratio test P = 1.4 × 10−13). The proportion of disease risk attributable to age (at ascertainment) and sex, the two main risk factors for CVD, was estimated as 10.7% (Kullback–Leibler deviance R2). The heritability of CVD is high, thereby suggesting a notable genetic component in the aetiology of the disease. Systematic population-based searches for CVD susceptibility genes are therefore warranted