Study finds treatment not always needed in patients with elevated eye pressure

A study monitoring 1600 patients with high intraocular pressure over 20 years found that only one in four developed vision loss

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New US research has highlighted that patients with elevated eye pressure do not always need treatment to prevent vision loss from glaucoma.

The research, which was published in JAMA Ophthalmology, described results from the Ocular Hypertension Treatment Study.

The study was funded by the National Eye Institute and led by researchers at Washington University School of Medicine in St. Louis.

A total of 1636 patients with high intraocular pressure were regularly monitored between February 1994 and December 2008. Observations were also taken after 20 years of follow up.

Initially, the participants were either randomly assigned to receive daily treatment with eye drops to lower eye pressure or did not receive treatment.

After seven years, it became clear that the treatment was highly effective so both groups were assigned daily eye drops.

In the latest research, scientists examined which patients went on to develop glaucoma following the conclusion of the study period.

Researchers found that around one in four participants went on to develop vision loss in at least one eye from glaucoma – which was lower than expected.

Professor Michael A Kass shared that treating elevated eye pressure can be expensive and inconvenient, so researchers wanted to determine whether all patients with high intraocular pressure should be treated.

“With only 25% of the individuals in the study developing vision loss in one or both eyes after all these years, we know now that not all of those patients needed to be treated,” he said.

During the course of the research, scientists identified five factors that predicted whether patients were at a higher risk of developing glaucoma: age, level of intraocular pressure, thickness of the cornea, a measurement of the appearance of the optic nerve head, and another measurement derived from standard visual field tests.

Researchers determined that these factors could be useful in determining how often patients needed to be examined and whether they may benefit from preventative treatment.