Two-Year Visual Field Outcomes of the Treatment of Advanced Glaucoma Study (TAGS).
Montesano Giovanni, Ometto Giovanni, King Anthony, Garway-Heath David F, Crabb David P
AI Summary
This study compared visual field progression in advanced glaucoma patients, finding no significant difference in progression rates after two years between initial trabeculectomy and medication, suggesting similar short-term stability.
Abstract
Purpose
to compare visual field (VF) progression between the 2 arms of the Treatment of Advanced Glaucoma Study (TAGS).
Design
Post hoc analysis of VF data from a 2-arm, multicenter, randomized controlled clinical trial.
Methods
A total of 453 patients with newly diagnosed advanced open-angle glaucoma in at least 1 eye from 27 centers in the United Kingdom were randomized to either trabeculectomy (n = 227) or medication in their index eye (n = 226) and followed-up for 2 years with 2 24-2 VF tests at baseline, 4, 12, and 24 months. Data were analyzed for participants with a reliable VF (false positive rate < 15%) at baseline and at least 2 other time points. Average difference in rate of progression (RoP) was analyzed using a hierarchical Bayesian model. Time for each eye to progress from baseline beyond specific cut-offs (0.5, 1, 1.5, and 2 dB) was compared using survival analysis.
Results
This study analyzed 211 eyes in the trabeculectomy first arm and 203 eyes in the medication first arm. The average RoP (estimate [95% credible intervals]) was -0.59 [-0.88, -0.31] dB/year in the medication first arm and -0.40 [-0.67, -0.13] dB/year in the trabeculectomy first arm. The difference was not significant (Bayesian P-value = .353). More eyes progressed in the medication first arm, but this difference was not significant.
Conclusions
There was no significant difference in the average RoP at 2 years.
MeSH Terms
Shields Classification
Key Concepts4
The average rate of visual field progression in patients with newly diagnosed advanced open-angle glaucoma treated with medication first was -0.59 dB/year (95% credible intervals: -0.88, -0.31) over 2 years.
The average rate of visual field progression in patients with newly diagnosed advanced open-angle glaucoma treated with trabeculectomy first was -0.40 dB/year (95% credible intervals: -0.67, -0.13) over 2 years.
There was no significant difference in the average rate of visual field progression over 2 years between patients with newly diagnosed advanced open-angle glaucoma randomized to trabeculectomy first or medication first (Bayesian P-value = 0.353).
The Treatment of Advanced Glaucoma Study (TAGS) was a 2-arm, multicenter, randomized controlled clinical trial that randomized 453 patients with newly diagnosed advanced open-angle glaucoma in at least 1 eye to either trabeculectomy (n = 227) or medication (n = 226) in their index eye and followed them for 2 years.
Related Articles5
Medical vs surgical therapy in preventing visual field loss.
Randomized Controlled TrialEvaluating High Intraocular Pressure Criteria for Failure in Glaucoma Surgery: Impact on Estimated Success and Visual Field Rates.
Systematic ReviewThe Glaucoma Intensive Treatment Study (GITS): A Randomized Controlled Trial Comparing Intensive and Standard Treatment on 5 Years Visual Field Development.
Randomized Controlled TrialVisual Field Outcomes in the Primary Tube Versus Trabeculectomy Study.
Clinical TrialEffect of trabeculectomy on the rate of progression of visual field damage.
Cohort StudyIs this article assigned to the wrong chapter(s)? Let us know.