Purchase this article with an account.
S.L. Mansberger, G.A. Cioffi; Accuracy of ophthalmologists in predicting glaucoma from ocular hypertension based on the results of the Ocular Hypertension Treatment Study (OHTS) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5565.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Ophthalmologists should balance the probability of developing glaucoma with the risks of ocular hypotensive treatment before treating an ocular hypertensive patient. We investigated the ability of ophthalmologists to predict the probability of glaucoma from ocular hypertension based on the results of The Ocular Hypertension Treatment Study (OHTS). Methods: Twenty–three ophthalmologists estimated the probability of glaucoma over the next 5 years in 5 ocular hypertensive patients after reviewing the results of the OHTS. All representative patients had a pattern standard deviation (PSD) of 1.9 and did not have diabetes mellitus. Patient #1 had an age of 60 years, intraocular pressure (IOP) of 24 mm Hg, cup to disc ratio (C/D) of 0.3, and corneal thickness of 540 microns. Patient #2 had an age of 72 years, IOP of 25 mm Hg, a C/D of 0.6, and a corneal thickness of 510 microns. Patient #3 had an age of 60 years, IOP of 28 mm Hg, a C/D of 0.1, and a corneal thickness of 600 microns. Patient #4 had an age of 60 years, IOP of 24 mm Hg, C/D of 0.5, and a corneal thickness of 490 microns. Patient #5 had an age of 60 years, IOP of 24 mm Hg, a C/D of 0.1, and a corneal thickness of 540 microns. We compared the ophthalmologist estimates to a risk calculator developed from the OHTS. Results: Ophthalmologists estimated the mean probability +/– SD of developing glaucoma over the next five years in Patient #1, Patient #2, Patient #3, patient #4, and patient #5 as 9.1% +/– 12.1 (range 0 to 50), 31.5% +/– 26.0 (range 1 to 100), 7.4% +/– 5.0 (range 0–20), 15.8% +/– 15.4 (range 0–50), and 6.5% +/– 8.1 (range 0 to 25), respectively. The risk calculator estimated a probability of glaucoma in these same patients of 6.9%, 33.1%, 2.6%, 23.5%, and 4.0%, respectively. Conclusions: Ophthalmologists estimate a wide range of probability of developing glaucoma from ocular hypertension. Ophthalmologists may under or over treat their patients based on this estimate. More exact methods of determining the probability of glaucoma from ocular hypertension are needed.
This PDF is available to Subscribers Only