23 months ago

david 4.2k

@david_fe

Abstract

Purpose

To utilize results from the Ocular Hypertension Study that can aid patients and clinicians to make evidence based decisions about the management of ocular hypertension.

Design

1636 participants with ocular hypertension were randomized to treatment with topical ocular hypotensive treatment or close observation. The goal of treatment was a 20% reduction in intraocular pressure and an intraocular pressure of ≤ 24 mmHg. After a mean of 7.5 years, participants in the observation group also received treatment. Visual field tests that were performed twice a year and optic disc photographs once a year.

Results

At 60 months, the cumulative frequency of developing POAG was 4.4% in the medication group and 9.5% in the observation group (hazard ratio for medication, 0.40; 95% CI, 0.27–0.59; P <.0001). At 13 years the cumulative proportion of participants who developed POAG was 0.22 (95% CI 0.19–0.25) in the original observation group and 0.16 (95% CI 0.13–0.19) in the original medication group (complimentary log-log x2 P = .009). A 5 factor model (older age, higher IOP, thinner central cornea thickness, larger cup/disc ratio and higher visual field pattern standard deviation) separated participants at high and low risk of developing POAG.

Conclusion

Clinicians and patients can make evidence based decisions about the management of ocular hypertension using the risk model and considering patient age, medical status, life expectancy and personal preference.

The OHTS project has been funded for a 20-year follow-up of the original study participants.

Elevated intraocular pressure (IOP) is a leading risk factor for the development of primary open angle glaucoma (POAG) and the only modifiable risk factor at present.

• Published online 2018 Mar 1.
• PMID: 29501371
• doi: 10.1016/j.ajo.2018.02.016

What we have learned from the Ocular Hypertension Treatment Study - PMC