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Richard Filek, Zarique Zaowaad Akanda, Nathan Gorfinkel, William G Hodge; Visual Field Indices as the Primary outcome for New Glaucoma Drug Testing: A Systematic Review. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4161.
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© ARVO (1962-2015); The Authors (2016-present)
To synthesize the literature to evaluate visual field assessments as a primary outcome for new glaucoma drug testing.
A systematic search was conducted to help locate published and unpublished studies. Studies which evaluated visual field as primary outcome for new glaucoma drug assessments were identified. Research databases and conference meeting abstracts were searched for articles and included MEDLINE (OVID and PubMed), Cochrane Library (Wiley), BIOSIS (Thomson-Reuters), CINAHL (EBSCO), Web of Science (Thomson-Reuters), and EMBASE (OVID). The search strategies employed database specific subject headings and keywords for glaucoma drug treatment, visual fields and synonyms. Articles were assessed for inclusion by two independent reviewers. A meta-analysis was conducted.
Of 2135 studies reviewed, 21 were included of which only 4 were RCT’s that followed patients for at least 36 months. The mean Humphrey defect difference amongst therapeutic vs control groups was very similar at the end of the study compared to the beginning (-5.09 in therapeutic group, -5.06 in control group, p=0.62).
There was only a very small sample of studies that have looked at long term non proxy outcomes such as visual fields for new glaucoma drugs. This small sample demonstrates equivalence in VF indices amongst therapeutic and control groups when followed for at least 36 months. More glaucoma drug studies need to use non-proxy outcomes in evaluating drug efficacy in glaucoma.
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