Quantifying the effect of intraocular pressure reduction on the occurrence of glaucoma.

A. Peeters, C.A.B. Webers, M.H. Prins, M.P. Zeegers, F. Hendrikse, J.S. Schouten

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)

Abstract

Purpose: To estimate the effect of reducing intraocular pressure (IOP) on: (i) the incidence of primary open-angle glaucoma (POAG) in patients with ocular hypertension (OH), and (ii) the progression of glaucoma. Methods: A meta-analysis of relevant randomized controlled trials was conducted. A literature search was performed to identify trials with: a randomized comparison of IOP-lowering intervention versus placebo or no treatment; visual field loss or optic disc changes as outcome; and follow-up >6 months. A pooled relative risk (RR) was calculated by a random effects model. Risk reduction of glaucoma conversion per mmHg of IOP reduction was quantified in a meta-regression model. Results: We identified nine OH and one POAG trials. A meta-analysis of OH trials gives a pooled RR of 0.61 [95% confidence interval (CI) 0.45-0.83]. A meta-regression shows a decrease of the RR of glaucoma conversion by 14% with each mmHg extra IOP reduction (P = 0.045). No meta-analysis of POAG trials was performed because only one study has been identified. Conclusion: There is sufficient evidence that OH therapy reduces the risk of conversion to glaucoma. This risk reduction increases with greater IOP reduction.

Original languageEnglish
Pages (from-to)5-11
Number of pages7
JournalActa Ophthalmologica
Volume88
Issue number1
DOIs
Publication statusPublished - Feb 2010

Keywords

  • drugs
  • glaucoma
  • meta-analysis
  • ocular hypertension
  • review
  • OPEN-ANGLE GLAUCOMA
  • RANDOMIZED CLINICAL-TRIALS
  • OCULAR HYPERTENSION
  • SYSTEMATIC REVIEWS
  • MEDICAL-TREATMENT
  • TIMOLOL THERAPY
  • METAANALYSIS
  • MANAGEMENT
  • SUSPECTS
  • EPINEPHRINE

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