| Delaying treatment of ocular hypertension: the ocular hypertension treatment study. | |
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MedLine Citation:
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PMID: 20212196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the safety and efficacy of earlier vs later treatment in preventing primary open-angle glaucoma (POAG) in individuals with ocular hypertension. METHODS: One thousand six hundred thirty-six individuals with intraocular pressure (IOP) from 24 to 32 mm Hg in 1 eye and 21 to 32 mm Hg in the fellow eye were randomized to observation or to topical ocular hypotensive medication. Median time of treatment in the medication group was 13.0 years. After a median of 7.5 years without treatment, the observation group received medication for a median of 5.5 years. To determine if there is a penalty for delaying treatment, we compared the cumulative proportions of participants who developed POAG at a median follow-up of 13 years in the original observation group and in the original medication group. MAIN OUTCOME MEASURES: Cumulative proportion of participants who developed POAG. RESULTS: The cumulative proportion of participants in the original observation group who developed POAG at 13 years was 0.22 (95% confidence interval [CI], 0.19-0.25), vs 0.16 (95% CI, 0.13-0.19) in the original medication group (P = .009). Among participants at the highest third of baseline risk of developing POAG, the cumulative proportion who developed POAG was 0.40 (95% CI, 0.33-0.46) in the original observation group and 0.28 (95% CI, 0.22-0.34) in the original medication group. There was little evidence of increased adverse events associated with medication. APPLICATION TO CLINICAL PRACTICE: Absolute reduction was greatest among participants at the highest baseline risk of developing POAG. Individuals at high risk of developing POAG may benefit from more frequent examinations and early preventive treatment. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000125. |
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Authors:
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Michael A Kass; Mae O Gordon; Feng Gao; Dale K Heuer; Eve J Higginbotham; Chris A Johnson; John K Keltner; J Philip Miller; Richard K Parrish; M Roy Wilson; |
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Publication Detail:
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Type: Clinical Trial, Phase I; Clinical Trial, Phase II; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of ophthalmology Volume: 128 ISSN: 1538-3601 ISO Abbreviation: Arch. Ophthalmol. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-09 Completed Date: 2010-04-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7706534 Medline TA: Arch Ophthalmol Country: United States |
Other Details:
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Languages: eng Pagination: 276-87 Citation Subset: AIM; IM |
Affiliation:
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Ocular Hypertension Treatment Study Coordinating Center, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Box 8203, 660 S Euclid Ave, St Louis, MO 63110, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00000125 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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therapeutic use* Female Follow-Up Studies Glaucoma, Open-Angle / diagnosis, etiology, prevention & control* Humans Intraocular Pressure / drug effects* Male Middle Aged Ocular Hypertension / drug therapy*, physiopathology Questionnaires Risk Factors Scotoma / diagnosis Sickness Impact Profile Time Factors Visual Fields |
| Grant Support | |
ID/Acronym/Agency:
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EY02687/EY/NEI NIH HHS; EY09307/EY/NEI NIH HHS; EY09341/EY/NEI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
| Comments/Corrections | |
Comment In:
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Arch Ophthalmol. 2010 Mar;128(3):363-4
[PMID:
20212209
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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