Ocular Hypertension

Summary of Evidence

Topical ocular hypotensive medication was effective in delaying or preventing the onset of POAG in individuals with elevated IOP.(OHTS, 2002) {Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30.}

There was no difference between medical therapy and placebo in reducing the incidence of POAG in OHT patients at moderate risk of developing POAG.(EGPS, 2005) {Miglior S, Zeyen T, Pfeiffer N, Cunha-Vaz J, Torri V, Adamsons I; European Glaucoma Prevention Study (EGPS) Group. Results of the European Glaucoma Prevention Study. Ophthalmology. 2005 Mar;112(3):366-75.}

Evidence

1. General Principles

1.1 Lower intraocular pressure

Clinical Trial

2002 Kass et.al. (OHTS)

Article link | Archive link

2002
Clinical Trial

Topical ocular hypotensive medication was effective in delaying or preventing the onset of POAG in individuals with elevated IOP {Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30.}

Randomized controlled trial of topical hypotensive drops vs observation in Ocular hypertension (1636 patients).
Findings:
- The cumulative probability of developing POAG was 4.4% in the medication group and 9.5% in the observation group at 5 years

Kass et.al. (OHTS)
Journal full text Archive

Clinical Trial

2005 Miglior et.al. (EGPS)

Article link | Archive link | Metrics

2005
Clinical Trial

There was no difference between medical therapy and placebo in reducing the incidence of POAG in OHT patients at moderate risk of developing POAG {Miglior S, Zeyen T, Pfeiffer N, Cunha-Vaz J, Torri V, Adamsons I; European Glaucoma Prevention Study (EGPS) Group. Results of the European Glaucoma Prevention Study. Ophthalmology. 2005 Mar;112(3):366-75.}

Randomized controlled trial of topical dorzolamide vs placebo in ocular hypertension (1081 patients)
Findings
- The mean IOP declined 22% in the treatment and 19% in the placebo group.
- The cumulative probability of converting to an efficacy end point (visual field or optic disc changes) was 13.4% in the dorzolamide group and 14.1% in the placebo group

2. Medical treatment

Main article: Chapter 3.11 Medical treatment of Glaucoma

3. Laser treatment

Main article: Chapter 3.12 Laser treatment of Glaucoma

4. Microinvasive Glaucoma Surgery

Main article: Chapter 3.13 Microinvasive Glaucoma Surgery

5. Surgical treatment

Main article: Chapter 3.14 Surgical treatment of Glaucoma

References

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