Is There a Penalty for Delayed Treatment in Ocular Hypertensives? Evidence from the Ocular Hypertension Treatment Study (OHTS)

Abstract

Abstract: : Purpose: To compare the incidence of POAG in fellow eyes of participants in the observation group and medication group of OHTS who develop unilateral POAG. Methods: 116 participants developed unilateral POAG (35 in the medication group and 81 in the oservation group). When participants developed POAG, they were treated vigorously in both eyes. Treatment prescribed was at the discretion of the treating clinician and was not dependent upon the original randomization status. For this analysis, we excluded "concurrent" cases of POAG, which were defined as those occurring in less than 6 months of the initial POAG endpoint. Results: POAG developed 6 months or more after the initial endpoint in 1of 35 fellow eyes of participants in the medication group compared to 9 of 81 fellow eyes of participants in the observation group (rate ratio, 0.165; 95% confidence interval of 0.021 to 1.31; Mantel Haenszel log rank p-value = 0.052). Conclusion: Fellow eyes that were on treatment all along faired better over the subsequent months than did the fellow eyes from the observation group which were started on treatment only after they reached a POAG endpoint in the opposite eye. The duration of follow-up after the first eye developed POAG is still too short (median 24 months) to draw definite conclusions, but this is a thought-provoking finding. CR: None Support: NIH grants EY 09307, EY 09341 and Unrestricted Grants from Research to Prevent Blindness, Inc.  

Keywords: clinical (human) or epidemiologic studies: tre • optic disc • visual fields