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Abstract
Abstract
Ocular Hypertension: To treat or not to treat?
Pfeiffer N.
Department of Ophthalmology, Mainz University, Germany
Ocular hypertension is defined as elevated intraocular pressure (IOP) in the absence of glaucomatous visual field or optic disc damage. Ocular hypertension may progress to glaucoma. So far, there is disagreement wether or not prophylactic treatment of ocular hypertension by means of lowering IOP is warranted. Two large multicenter studies investigated this question, namely the Ocular Hypertension Treatment Study (OHTS) and the European Glaucoma Prevention Study (EGPS). The EGPS has finished recruitment but has not been terminated. Results from the OHTS demonstrate after 60 months of follow-up a cumulative probability of developing glaucoma in the observation group to be 9.5% versus 4.4% in the medication group. An analysis of baseline factors revealed older age, large vertical or horizontal cup-disc-ratio, higher IOP and thinner central corneal measurements as significant predictors for the development of glaucoma.
The conversion rate from ocular hypertension to glaucoma may be higher than previously assumed. However, more than 90% of ocular hypertensive patients did not convert within five years. Additional risk factors should be considered before initiating therapy in any given patient.