Abstract
To investigate the safety and potential savings of decreasing medication use in low-risk patients with ocular hypertension (OH). Patients with OH receiving pressure-lowering medication identified by medical record review at a university hospital underwent examination by a glaucoma specialist with assessment of visual field (VF), vertical cup-to-disc ratio (vCDR), central corneal thickness and intraocular pressure (IOP). Subjects with estimated 5-year risk of glaucoma conversion <15% were asked to discontinue ≥1 medication, IOP was remeasured 1 month later and risk was re-evaluated at 1 year. Among 212 eyes of 126 patients, 44 (20.8%) had 5-year risk >15% and 14 (6.6%) had unreliable baseline VF. At 1 month, 15 patients (29 eyes, 13.7%) defaulted follow-up or refused to discontinue medication and 11 eyes (5.2%) had risk >15%. The remaining 69 patients (107 eyes, 50.7%) successfully discontinued 141 medications and completed 1-year follow-up. Mean IOP (20.5±2.65 mm Hg vs 20.3±3.40, p=0.397) did not change, though mean VF pattern SD (1.58±0.41 dB vs 1.75±0.56 dB, p=0.001) and glaucoma conversion risk (7.31±3.74% vs 8.76±6.28%, p=0.001) increased at 1 year. Mean defect decreased (-1.42±1.60 vs -1.07±1.52, p=0.022). One eye (0.47%) ...Continue Reading
References
Apr 1, 1981·Archives of Ophthalmology·H A QuigleyA E Maumenee
May 1, 1981·Archives of Ophthalmology·T KrupinB Becker
Sep 1, 1994·Ophthalmology·M Schulzer
May 18, 1999·Archives of Ophthalmology·M O Gordon, M A Kass
Jun 7, 2002·Archives of Ophthalmology·Michael A KassMae O Gordon
Jun 7, 2002·Archives of Ophthalmology·Mae O GordonMichael A Kass
Sep 15, 2004·American Journal of Ophthalmology·Robert N WeinrebWilliam B Kannel
Mar 5, 2005·Ophthalmology·Stefano MigliorUNKNOWN European Glaucoma Prevention Study (EGPS) Group
May 17, 2005·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Elliott H MyrowitzTerrence P O'Brien
Jun 21, 2005·La Presse médicale·Marc LabetoulleClaire Le Jeunne
Jan 4, 2006·American Journal of Ophthalmology·George SpaethJohn Keener
Feb 21, 2006·The British Journal of Ophthalmology·H A Quigley, A T Broman
Jul 15, 2006·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Michael Sullivan-MeeClifford Qualls
Nov 11, 2006·Ophthalmology·UNKNOWN Ocular Hypertension Treatment Study GroupMichael A Kass
Aug 19, 2007·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Jennifer M BurrMandy Ryan
Jan 2, 2008·Ophthalmology·William C StewartMarko A Mychaskiw
Sep 5, 2008·Current Medical Research and Opinion·Louis B CantorJohn W Peabody
Sep 20, 2008·Ophthalmology·UNKNOWN Ocular Hypertension Treatment Study Group and the European Glaucoma Prevention Study Group
Dec 19, 2008·Journal of Glaucoma·Michael V BolandHarold P Lehmann
Nov 9, 2010·Eye·A van GestelJ S A G Schouten
Jun 13, 2012·Health Technology Assessment : HTA·J M BurrJ Cook
Dec 21, 2013·The British Journal of Ophthalmology·Yemisi TakwoingiUNKNOWN Surveillance for Ocular Hypertension Study Group
Citations
Jun 3, 2018·The British Journal of Ophthalmology·Poemen P ChanMandy O Wong
Sep 1, 2017·Journal of Glaucoma·Poemen P ChanClement C Tham
Nov 17, 2015·Current Opinion in Ophthalmology·Anja Tuulonen
Dec 4, 2019·Asia-Pacific Journal of Ophthalmology·Jacky W Y LeeJost B Jonas