Glaucoma clinical trial and what they mean for our patient

Purpoe To InternetAdvance publication at ajo.com May 15, 2003. provide a perpective on the everal randomized clinical trial in glaucoma, to ugget how their reult can be ued in clinical practice, and to look to the future of glaucoma therapy. Deign A earch and review of the glaucoma clinical trial literature, the glaucoma obervational tudie literature, and the evidence–baed medicine literature. Method Analyi of the ignificance of glaucoma clinical trial data on patient management along with ue of patient data to demontrate how treatment deciion can be ued in the practice etting. Reult Glaucoma clinical trial and obervational tudie trongly upport the need to reduce intraocular preure (IOP) ubtantially and to maintain thoe preure in patient with advanced glaucoma. Whether thi aggreive therapy occur by medication or by filtering urgery doe not eem a important a that the treatment i effective and utained. However, there i not the ame trength of evidence for aggreive treatment or even any treatment for mot patient with ocular hypertenion and for ome cae of early glaucoma. Becaue about half of the patient with open-angle glaucoma will have IOP le than 21 mm Hg, thee patient need to be detected through careful optic dik and viual field aement. Once patient are detected and treated appropriately, blindne from open-angle glaucoma i unlikely. Concluion The goal of managing ocular hypertenion and glaucoma i not to preerve every ganglion cell, but rather to preerve a patient’ viual ability to conduct activitie of daily living. Rik factor for damage need to be aeed for individual patient and each patient managed a an individual and not a the “average” patient depicted in the reult of clinical trial. In the future, neuroprotective therapy other than IOP reduction will provide another mean to control glaucoma damage.