Glaucoma Fellowship Programme

• Up to 4 Glaucoma Clinics per week at Hong Kong Eye Hospital and Prince of Wales Hospital
• At least 1 Glaucoma Operating List per week
• At least 1 Glaucoma Imaging Session per week
• At least 1 Glaucoma Laser Session per month

• Trabeculectomy +/- phacoemulsification +/- adjunctive chemotherapy
• Glaucoma drainage device implantation (Ahmed / Baerveldt)
• Needling revision of trabeculectomy +/- adjunctive chemotherapy
• Goniotomy
• Non-penetrating trabecular surgery (NPTS)
• Goniosynechialysis +/- phacoemulsification
• Cyclocryosurgery

• Argon / diode laser peripheral iridoplasty (A/DLPI)
• Argon / selective / pattern laser trabeculoplasty (ALT/ SLT/ PLT)
• Laser peripheral iridotomy
• Transscleral cyclophotocoagulation / endoscopic cyclophotocoagulation (ECP)

Angle Closure Glaucoma (ACG)

The CUHK Glaucoma Subspecialty has strong track record in research on the treatment of angle closure glaucoma. Our randomized controlled trials established a role for immediate laser peripheral iridoplasty and early lens extraction in acute attacks of angle closure glaucoma, and compared lens extraction alone against combined phaco-trabeculectomy in chronic ACG. Other studies by our research team have investigated various other important aspects of angle closure glaucoma, including the clinical applications of goniosynechialysis, cyclodestructive procedures, glaucoma drainage devices, and the management of phacomorphic glaucoma and plateau iris syndrome. The investigators are internationally recognized experts in the field of ACG, and have been invited by major journals to write reviews on PACG management.

Glaucoma Imaging

Optic disc and nerve fiber layer imaging
Measurement of optic disc parameters and retinal nerve fiber layer thickness is important for detecting and following glaucoma. High speed, high resolution imaging of the retina and optic disc is now possible with the availability of new imaging technologies including spectral domain optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy. The investigators are developing new algorithms to detect and analyze progressive damage of the optic nerve head and nerve fiber layer in glaucoma.

Retinal ganglion cells imaging and neuroprotection
In collaboration with Prof. Robert Weinreb at the Hamilton Glaucoma Center of UCSD, an animal model was developed to visualize individual retinal neurons in vivo. This model provides a non-invasive approach for longitudinal study of the mechanism of retinal ganglion cell degeneration and the effect of neuroprotective agents.

Anterior chamber angle imaging
Angle closure glaucoma is a major cause of blindness in Asia. In collaboration with Prof. Robert Ritch at the New York Eye and Ear Infirmary, the investigators are investigating the morphology of the anterior chamber angle and other biometric risk factors in relation to angle closure glaucoma.

Normal Tension Glaucoma

1. Chan PP, Chiu V, Wong MO. Variability of vertical cup to disc ratio measurement and the effects of glaucoma 5-year risk estimation in untreated ocular hypertensive eyes. Br J Ophthalmol. 2019 Mar;103(3):361-368. (Impact Factor: 3.384) [https://www.ncbi.nlm.nih.gov/pubmed/29858183]
2. Rong SS, Lu SY, Matsushita K, Huang C, Leung CKS, Kawashima R, Usui S, Tam POS, Young AL, Tsujikawa M, Zhang M, Nishida K, Wiggs JL, Tham CC, Pang CP, Chen LJ. Association of the SIX6 locus with primary open angle glaucoma in southern Chinese and Japanese. Exp Eye Res. 2019 Mar;180:129-136. (Impact Factor: 3.152) [https://www.ncbi.nlm.nih.gov/pubmed/30586556]
3. Heijl A, Patella VM, Chong LX, Iwase A, Leung CK, Tuulonen A, Lee GC, Callan T, Bengtsson B. A new SITA perimetric threshold testing algorithm; construction and a multi-center clinical study. Am J Ophthalmol. 2019 Feb;198:154-165. (Impact Factor: 4.795) [https://www.ncbi.nlm.nih.gov/pubmed/30336129]
4. Cao X, Yung J, Mak H, Leung CKS. Factors governing the transduction efficiency of adeno-associated virus in the retinal ganglion cells following intravitreal injection. Gene Ther. 2019 Jan 28. [Epub ahead of print] (Impact Factor: 3.203) [https://www.ncbi.nlm.nih.gov/pubmed/30692605]
5. Chan PP, Pang JC, Tham CC. Acute primary angle closure-treatment strategies, evidences and economical considerations. Eye (Lond). 2019 Jan;33(1):110-119. Review. (Impact Factor: 2.478) [https://www.ncbi.nlm.nih.gov/pubmed/30467424]
6. Zheng F, Wu Z, Leung CKS. Detection of Bruch’s Membrane Opening in Healthy Individuals and Glaucoma Patients with and without High Myopia. Ophthalmology. 2018 Oct;125(10):1537-1546. (Impact Factor: 7.479) [https://www.ncbi.nlm.nih.gov/pubmed/29934269]
7. Wan KH, Lam AKN, Leung CK. Optical Coherence Tomography Angiography Compared With Optical Coherence Tomography Macular Measurements for Detection of Glaucoma. JAMA Ophthalmol. 2018 Aug 1;136(8):866-874. (Impact Factor: 6.669) [https://www.ncbi.nlm.nih.gov/pubmed/29852029]
8. Hou HW, Lin C, Leung CK. Integrating Macular Ganglion Cell Inner Plexiform Layer and Parapapillary Retinal Nerve Fiber Layer Measurements to Detect Glaucoma Progression. Ophthalmology. 2018 Jun;125(6):822-831. (Impact Factor: 7.479) [https://www.ncbi.nlm.nih.gov/pubmed/29433852]
9. Wan KH, Leung CKS. Optical coherence tomography angiography in glaucoma: a mini-review
   F1000Res. 2017 Sep 14;6:1686. [https://www.ncbi.nlm.nih.gov/pubmed/28928966]
10. Chan PP, Li EY, Tsoi KKF, Kwong YY, Tham CC. Cost-effectiveness of Phacoemulsification versus Combined Phacotrabeculectomy for Treating Primary Angle Closure Glaucoma.
    J Glaucoma. 2017 Oct;26(10):911-922. (Impact Factor: 2.263) [https://www.ncbi.nlm.nih.gov/pubmed/28858162]
11. Tang FY, Ma L, Tam POS, Pang CP, Tham CCY, Chen LJ. Genetic Association of the PARL-ABCC5-HTR3D-HTR3C Locus With Primary Angle-Closure Glaucoma in Chinese.
    Invest Ophthalmol Vis Sci. 2017 Aug 1;58(10):384-4389. (Impact Factor: 3.303) [https://www.ncbi.nlm.nih.gov/pubmed/28813580]
12. Leung CK. Evaluation of Retinal Nerve Fiber Layer Thinning With Fourier-Domain Optical Coherence Tomography. JAMA Ophthalmol. 2017 Apr 1;135(4):337-338. (Impact Factor: 4.340) [https://www.ncbi.nlm.nih.gov/pubmed/28253392]
13. Tan S, Baig N, Hansapinyo L, Jhanji V, Wei S, Tham CC. Comparison of self-measured diurnal intraocular pressure profiles using rebound tonometry between primary angle closure glaucoma and primary open angle glaucoma patients. PLoS One. 2017 Mar 23;12(3):e0173905. (Impact Factor: 3.057) [https://www.ncbi.nlm.nih.gov/pubmed/28333942]
14. Lin C, Mak H, Yu M, Leung CK. Trend-Based Progression Analysis for Examination of the Topography of Rates of Retinal Nerve Fiber Layer Thinning in Glaucoma. JAMA Ophthalmol. 2017 Mar 1;135(3):189-195. (Impact Factor: 4.340) [https://www.ncbi.nlm.nih.gov/pubmed/28152147]
15. Wu Z, Lin C, Crowther M, Mak H, Yu M, Leung CK. Impact of Rates of Change of Lamina Cribrosa and Optic Nerve Head Surface Depths on Visual Field Progression in Glaucoma. Invest Ophthalmol Vis Sci. 2017 Mar 1;58(3):1825-1833. (Impact Factor: 3.427) [https://www.ncbi.nlm.nih.gov/pubmed/28353690]
16. Cheung CY, Li SL, Chan PP, Chan NCY, et al. Intraocular pressure control and visual field changes in primary angle closure disease: the CUHK PACG Longitudinal (CUPAL) study. British Journal of Ophthalmology Published Online First: 07 August 2019