Treating abnormal intraocular pressure (IOP) is a mainstay of glaucoma treatment, but researchers find that there’s another risk factor that doctors should focus on, as well. A new study investigated the incidence of primary open-angle glaucoma (POAG) in people with ocular hypertension.

What They Did

In the Ocular Hypertension Treatment Study (OHTS), 1,636 participants with ocular hypertension were analyzed during three phases of the study. In the first phase, participants were either prescribed topical ocular hypotensive medication (medication group) or  monitored for ocular hypotensive disorder (observation group). In the second phase, both groups were given medication, and in the final phase, participants underwent visual function tests and ophthalmic examinations. 

Data was gathered over a 20-year period, and researchers measured for incidence rate, the number of people who develop a condition during a particular time period.

What They Found 

In this population, the risk of visual field loss was steady over the 20-year study period. 

Statistically, the researchers found that, at the end of 20 years:

• Approximately 30% of all participants developed POAG in one or both eyes.
• The overall cumulative incidence of visual field loss was 25% among study participants.
• The 20-year cumulative incidence rate of POAG was:
  • 48% in all participants, 
  • 44% in the observation group, and 
  • 38% in those given medication.

What It Means

The study results indicate that visual field loss may be an early sign of ocular hypertension. Ocular hypertension comes with a higher risk of developing POAG, as indicated by the worsening visual field loss, whether a person is on medication or not.

“Retrospective analyses of landmark studies are so important in that they shape our understanding of disease progression over time,” said Optometry Times® Chief Optometric Editor Dr. Benjamin Casella about the findings. “The fact that only about 25% of the patients in this cohort progressed on visual field studies will aid in shedding light on those ocular hypertensives who do not require IOP-lowering therapy.” 

“Our information,” added the study authors, “together with a prediction model, may help clinicians and patients make informed personalized decisions about the management of ocular hypertension.” 

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The treatment discussed in this article is experimental and has not been approved by the FDA or any regulatory authorities for any use outside of clinical trials. Its safety and efficacy have not been evaluated by the U.S. federal government. If you are considering participating in a clinical trial, learn more about the risks and potential benefits of clinical studies and talk to your healthcare provider before joining.

*Beery, B. (2021, July 28). Study results show visual field loss may be an early sign of ocular hypertension. Optometry Times. https://www.optometrytimes.com/view/study-results-show-visual-field-loss-may-be-an-early-sign-of-ocular-hypertension