The following is a summary of “Survival of medical treatment success in primary open-angle glaucoma and ocular hypertension,” published in the April 2024 issue of Ophthalmology by Fu et al.
Using topical agents such as eye drops is one of the most common initial steps to lower intraocular prevention (IOP), leading to glaucoma prevention.
Researchers conducted a retrospective study verifying the duration of treatment success among patients initiating or intensifying topical glaucoma medication.
They used medical records from adults starting or increasing the dosage of glaucoma eye drops between 2013 and 2018 in five U.K. clinics. The primary outcomes of this study included treatment initiation/intensification to treatment failure (<20% IOP reduction or IOP>21mm Hg at consecutive clinic visits, intensification of glaucoma treatment) and time for a change in treatment to lead to stronger medication.
The results showed that a total of 6,587 eyes changed glaucoma treatment, with most events involving going from 0 to 1 eye (5,358 events), followed by increases to 2 drops (1,469 events) and three drops (857 events). The median time to treatment failure after changing to 1 drop was about 1.60 years (95% CI, 1.57 – 1.65), while for two drops it was 1.00 years (95% CI, 0.94 – 1.07), and for three drops it was 0.92 years (95% CI, 0.81 – 1.02). Treatment intensification without IOP-based criteria occurred at around 4.68 years (95% CI, 4.50 – 5.08) for new treatment users, 3.83 years ( 95% CI 3.36 – 4.08) for those going from 1 to 2 drops, and 4.35 years (95% CI, 3.82 – 4.88) for those increasing from 2 to 3 drops. Lower baseline visual field, primary open-angle glaucoma, and fewer eyedrops in the fellow eye were risk factors for treatment failure and intensification; lower baseline IOP related to failure, higher to intensification.
Investigators concluded that large-scale survival analysis showed the expected time of treatment success from topical glaucoma medication.
Source: bjo.bmj.com/content/early/2024/04/25/bjo-2023-323708
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