Practitioners widely use selective laser trabeculoplasty (SLT) to treat early-stage glaucoma and often favor more aggressive therapy for patients with severe visual field (VF) loss. However, a new study presented last week at ARVO 2019 shows that SLT monotherapy may be an appropriate primary treatment option even among eyes with more advanced glaucomatous damage.

Researchers assessed intraocular pressure (IOP) change in 81 eyes that were categorized as either suspect/mild visual field loss (n=35) or moderate/severe visual field loss (n=46) based on their Enhanced Glaucoma Staging System (eGSS) stage. The study collected IOP data one, four and 12 weeks post-laser procedure. By three months, both groups achieved mean IOP reduction of 20%. At both one month and three months post-laser, the moderate/severe VF loss group had lower mean IOP than the suspect/moderate group (19.13±0.88 vs. 16.8±0.59 and 19.5±1.00 vs. 16.4±0.82, respectively).

The study concluded that its findings could help broaden the current clinical scope for SLT laser therapy.

Montelongo M, Trevino R, Sponsel WE. Is severity of glaucomatous visual field loss associated with short-term IOP lowering effect of SLT? ARVO 2019. Abstract 691.