Premium
Quantifying the effect of intraocular pressure reduction on the occurrence of glaucoma
Author(s) -
Peeters Andrea,
Webers Carroll A. B.,
Prins Martin H.,
Zeegers Maurice P.,
Hendrikse Fred,
Schouten Jan S. A. G.
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.01452.x
Subject(s) - glaucoma , medicine , intraocular pressure , relative risk , meta analysis , ocular hypertension , ophthalmology , placebo , confidence interval , randomized controlled trial , open angle glaucoma , alternative medicine , pathology
. 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.