Management Patterns of Glaucoma Treatment in the Thessaloniki Eye Study (TES)

Abstract

Purpose: : To report the patterns of glaucoma treatment in open-angle glaucoma (OAG) patients and OAG suspects in a population-based sample of subjects 60 years of age or older in Thessaloniki, Greece.

Methods: : A total of 2554 subjects randomly identified from municipality registers in Thessaloniki were interviewed with a questionnaire and underwent a complete ophthalmologic examination. Participants were classified as OAG (either primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PEXG)) and OAG suspects according to specific criteria. Distribution of glaucoma medications use and the proportion using monotherapy among OAG patients and OAG suspects were assessed. Comparisons among OAG patients and OAG suspects were based on Fisher exact tests.

Results: : There were 141 OAG (98 POAG/43 PEXG) subjects identified in TES. Of those with OAG, 50.4% were previously undiagnosed. Of OAG subjects, 40.4% were receiving glaucoma medications and 11% of OAG had prior glaucoma surgery including laser.Among the 2261 clinic-visit participants, there were 52 OAG patients and 45 OAG suspects receiving glaucoma medications. 78% of OAG suspects used b-blockers compared to 58% of OAG subjects (p=0.05), while 33% of OAG suspects used prostaglandin analogues compared to 65% of OAG subjects (p=0.002). OAG subjects were also more likely to use carbonic anhydrase inhibitors (11% vs 42%, p<0.001) and alpha 2-agonists (2.2% vs. 17%, p=0.018) than OAG suspects. 25/52 (48%) OAG subjects and 33/45 (73%) OAG suspects were on glaucoma monotherapy (p=0.014). Among those receiving monotherapy, indicating first choice glaucoma treatment preference, 76% of OAG suspects used b-blockers compared to 28% of OAG subjects (p<0.001), while 21% of OAG suspects used prostaglandin analogues compared to 56% of OAG subjects (p=0.012).

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials