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Am J OphthalmolMarch 201842 citations

What We Have Learned From the Ocular Hypertension Treatment Study.

Gordon Mae O, Kass Michael A


AI Summary

OHTS showed medication reduced glaucoma development in ocular hypertension patients, and a 5-factor model identifies high-risk individuals, guiding personalized treatment decisions.

Abstract

Purpose

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

Design

Perspective.

Results

At 60 months, the cumulative frequency of developing primary open-angle glaucoma (POAG) was 4.4% in the medication group and 9.5% in the observation group (hazard ratio for medication, 0.40; 95% confidence interval [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 (complementary log-log x 2 P = .009). A 5-factor model (older age, higher IOP, thinner central corneal thickness, larger cup-to-disc ratio, and higher visual field pattern standard deviation) separated participants at high and low risk of developing POAG.

Conclusions

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.


MeSH Terms

Age FactorsAntihypertensive AgentsDisease ProgressionEvidence-Based MedicineGlaucoma, Open-AngleHumansIntraocular PressureLife ExpectancyOcular HypertensionProportional Hazards ModelsRandomized Controlled Trials as TopicRisk FactorsSecondary PreventionVision DisordersVisual Fields

Key Concepts4

At 60 months, the cumulative frequency of developing primary open-angle glaucoma (POAG) was 4.4% in the medication group and 9.5% in the observation group in the Ocular Hypertension Treatment Study (hazard ratio for medication, 0.40; 95% confidence interval [CI], 0.27-0.59; P < .0001).

TreatmentCohortProspective Cohort Studyn=Participants from the Ocular Hyperten…Ch11Ch28

At 13 years, the cumulative proportion of participants who developed primary open-angle glaucoma (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 in the Ocular Hypertension Treatment Study (complementary log-log x 2 P = .009).

TreatmentCohortProspective Cohort Studyn=Participants from the Ocular Hyperten…Ch11Ch28

A 5-factor model, including older age, higher intraocular pressure (IOP), thinner central corneal thickness, larger cup-to-disc ratio, and higher visual field pattern standard deviation, separated participants at high and low risk of developing primary open-angle glaucoma (POAG) in the Ocular Hypertension Treatment Study.

PrognosisCohortProspective Cohort Studyn=Participants from the Ocular Hyperten…Ch10Ch11

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

TreatmentExpert OpinionPerspectiven=Not applicableCh11Ch28

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