Topical glaucoma drops may delay or prevent the onset of primary open-angle glaucoma (POAG) in blacks who have ocular hypertension, according to the latest results of the Ocular Hypertension Treatment Study, or OHTS.

These results, published in the June Archives of Ophthalmology, are a follow-up to initial results of the study released two years ago.

Courtesy: National Eye Institute, National Institutes of Health
The entire study looked at 1,636 patients, including 408 black patients, ages 40 to 80 who had elevated IOP (24 to 32mm Hg in one eye, 21 to 32mm Hg in the other) but no evidence of glaucomatous damage. Some 17 of 203, or 8.4%, of blacks in the group that received medication developed POAG during the study vs. 33 of 205 black patients, or 16.1%, in the observation group.

The results do not imply that every black patient with elevated IOP requires treatment, says first author of the article Eve Higginbotham, M.D., chair of the Department of Ophthalmology at the University of Maryland Medical Center. 
Her advice: When determining treatment, doctors should take into account several risk factors, including specific anatomical characteristics of the optic nerve and the cornea.

While African-Americans participating in the study were more likely than others to have these specific physical characteristics, she says, the study results underscore the importance of measuring these ocular risk factors rather than relying solely on the race or ethnicity of the individual.

Before you prescribe drops, Dr. Higginbotham suggests that you discuss with the patient his or her health status and life expectancy, and the burden of daily treatment, including cost, inconvenience and possible side effects.

Higginbotham EJ, Gordon MO, Beiser JA, et al. The Ocular Hypertension Treatment Study: topical medication delays or prevents primary open-angle glaucoma in African American individuals. Arch Ophthalmol 2004 Jun;122(6):813-20.


Vol. No: 141:07Issue: 7/15/04