Patients with glaucoma or ocular hypertension (OHT) make more than one million National Health Service visits in England and Wales each year, a recent study notes. As the population ages and optometric testing becomes more readily available, the economic cost of glaucoma-related visits is predicted to increase. Hoping to reduce this burden, researchers recently found that less than one-fifth of OHT patients managed in English clinics converted to primary open-angle glaucoma (POAG) over a five-year period. This suggests that many patients require less intensive follow-up care.
This retrospective study evaluated the electronic medical records of 45,309 patients from five glaucoma clinics throughout England. The team defined conversion from OHT to POAG as a deterioration in visual fields (two consecutive tests classified as stage one or worse). They examined factors associated with conversion such as age, sex, treatment status and baseline intraocular pressure (IOP).
The investigators reported a cumulative risk of conversion to POAG of 17.5% at five years. They noted that older age was associated with a higher risk of conversion while IOP-lowering therapy, not surprisingly, was associated with a lower risk of conversion. They added that predicted five-year conversion rates for treated and untreated groups were 14.0% and 26.9%, respectively.
“Our study provides real-world evidence for the efficacy of current management (including IOP-lowering treatment) at reducing risk of conversion,” the study authors concluded in their paper.
|Kelly SR, Khawaja AP, Bryan SR, et al. Progression from ocular hypertension to visual field loss in the English hospital eye service. Br J Ophthalmol. March 25, 2020. [Epub ahead of print].|