Student Dissertation

Agency : Scanning Laser Polarimetry; Glaucoma Prevention; Marketing Need; E-Commerce; Medical device Industry

Objective : • To map the importance of Scanning Laser Polarimetry • To determine its significance in early detection of Glaucoma • To develop the market, the need for Scanning Laser Polarimetry through e-commerce in Indian Medical Device Industry

Background : Glaucoma is an optic neuropathy characterized by a loss of-of retinal ganglion cells and their axons, the Retinal Nerve Fiber Layer (RNFL). It is one of the leading causes of blindness in the world. Prevalence of glaucoma is on the increase as the world population ages. The loss of Retinal ganglion cells in glaucoma is irreversible, therefore early detection is critical to prevent progression of the disease

Methodology : Study Design: Systematic Review and Meta-Analysis of Secondary data based on relevant data sources eg: Pubmed, Google Scholar for population-based studies of glaucoma prevalence, diagnostic modalities of glaucoma, on SLP, its marketing need, and quality life of Glaucoma patients published from 1996 up to 2017. The steps followed in this Systematic Review are Step 1: Framing the Question Step 2: Identifying Relevant Publications Step 3: Assessing Study Quality Step 4: Summarizing the Evidence Step 5: Interpreting the Findings

Findings : • Ninety-five percent of the subjects of the urban population and 98% of the rural population were absolutely unaware of the fact of suffering from glaucoma • POAG is the most predominant form of glaucoma, followed by PACG wherein NTG and exfoliative glaucoma are relatively rare • Factors associated for Glaucoma prevalence were depicted as older age, lower body mass index, lower blood concentration of hemoglobin, lower level of education, higher intraocular pressure, disc hemorrhage, myopic retinopathy, and longer axial length. • Increasing age, Male gender, Myopia of more than one Dioptre, and Pseudoexfoliation are the most important associated factors of POAG. • Higher severity of VFL among OAG impacts vision-related QOL. • Vision loss due to glaucoma has a significant impact on HRQoL even in the early stages of this disease. • Vision loss due to glaucoma has a significant impact on HRQoL even in the early stages of this disease. • Greater number of subspecialists were inclined toward retinal imaging for patients with glaucoma • GDx ECC offers better diagnostic accuracy compared with that of VCC • In resource-abundant areas, the wider spectrum of glaucoma is addressed where there is an emphasis on early detection of structural changes of Nerve Fibre Layer • SLP RNFL measurements Were absolutely independently predictive of future visual loss even When the age, IOP, CCT, vertical CDR, and SAP were there in the model. • NFL analysis targeting specific pattern of loss is extremely beneficial for differentiating normal NFL patterns from diseased NFL patterns. • GDX can well differentiate between Normal, OH and NTG subjects.

Recommendations : • A global number of people affected with glaucoma will increase by 74% from 2013 to 2040 disproportionally affecting people residing in Asia and Africa. • Higher PACG risk in Individuals who are residing in East Asia and higher POAG risk are among urban when compared with rural habitations. • With increased urbanization in Asia which are being projected for the future, glaucoma prevalence could continue increase in a definite proportion, particularly in countries where there are higher rates of urbanization, for example, China and India • GDx VCC has emerged in the Recent Clinical field as a valuable, objective tool of clinical value for the management of glaucoma • GDx ECC has even overcome the presence of ARPs and improved the diagnostic accuracy and the relationship between functional and structural measurements in glaucoma patients and is capable of neutralizing any residual anterior segment birefringence which is completely not compensated by VCC. • Its exceptionally helpful for early detection of structural damage to RNFL and to a great extent useful for Longitudinal follow-up for detecting progression. • GDx test report should be judiciously used by the clinicians in conjunction with clinical evaluation of the optic nerve head and functional testing for starting or adjusting glaucoma therapy • The best performing parameter is the NFI in GDx VCC • GDX is easy to operate, which does not require any pupillary dilatation, simultaneously it is highly reproducible, does not employ a reference plane, even does not require correction for ocular magnification and incorporates an easy age-matched normative database. • Scanning laser polarimetry’s major contribution lies in providing RNFL thickness information, which is an important indicator of early glaucoma. • The FDA, glaucoma experts, researchers, and clinicians described OCT, stereo photography, SLP, and CSLO for identifying clinically significant structural change which is related to glaucoma progression and treatment that is greater than that expected from normal aging and is associated with future visual function changes in the Medical Device industry. • At every level, structural imaging technology provides clinicians, the ability to assess the ONH and RNFL in a standardized, objective and quantitative fashion like the level of an expert observer • Evaluation of progression is most mature functionally as measured by SAP and structurally as assessed by CSLO.