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CE Traverso, CM Green, M Altieri, C Migdal; A New Algorithm to Determine Target IOP in Glaucoma, Independently From Initial IOP . Invest. Ophthalmol. Vis. Sci. 2002;43(13):291.
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Purpose: Target IOP algorithms calculate the desired final IOP value starting from the initial IOP. Except in newly diagnosed cases however, it is almost impossible to assess the initial IOP at which damage occurred. Our purpose is to describe and validate a new algorithm to determine target IOP in primary open angle glaucoma without the need to enter the initial IOP. Methods: An algorithm was developed to determine target IOP in POAG patients and will be described in detail. Patients with glaucoma are categorized into one of three target IOP levels according to the visual field staging. This initial score is then modified according to the likelihood of visual field deterioration using a formula which takes into account patient age, race, family history, vascular risk factors, myopia and disc hemorrhages. The charts of 74 consecutive POAG patients where all the data needed by this algorithm were available were reviewed retrospectively and categorized. Results: Initial score = score from visual field staging alone. Final score = score from field test corrected for risk factors. View OriginalDownload SlideView OriginalDownload Slide Conclusion: The majority of patients reviewed had moderate or advanced damage, and 68.9% were entered to level 2 or 3. After applying the algorithm level 2 and 3 included 83.8%, with 63.5% in level 3, requiring the lowest target IOP. This algorithm, in the initial stages of its development, appears to be a useful tool to apply in the estimation of a target IOP in glaucoma patients. The scoring system is easy to use and is not too time consuming. A prospective, long-term outcome study is warranted to determine whether the target IOPs set for the patients using this algorithm are adequate to prevent further progression of visual field defects.
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