Lessons Learned from Landmark Studies in Glaucoma

Abstract

Background: Glaucoma is a disease characterized by progressive optic neuropathy that can be caused by a variety of etiologies, including both primary and secondary mechanisms, with the main modifiable risk factor being high intraocular pressure (IOP). Visual field defects, along with structural and functional changes, are typically seen. It is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma.
Purpose: This article aims to provide a brief review of the important early glaucoma studies with abundant evidence and thus guide us in our management decisions.
Methods: We reviewed diagnostic criteria used by landmark glaucoma clinical trials, which were prospective, multicenter, masked, randomized control trials. We included trials that were concerned mainly with open-angle glaucoma.
Result and conclusion: Landmark studies have demonstrated that lowering IOP is of benefit in preventing the onset of glaucoma in ocular hypertension and in reducing disease progression in eyes with primary open-angle glaucoma (POAG) but do not suggest that the degree of protection is related to the degree of IOP reduction.