Rik aement in the management of patient with ocular hypertenion

Purpoe To develop a model for etimating the global rik of dieae progreion in patient with ocular hypertenion and to calculate the “number-needed-to-treat” (NNT) to prevent progreion to blindne a an aid to practitioner in clinical deciion making. Deign Development of a mathematical model for etimating rik of glaucoma progreion. Method Population-baed tudie of patient with ocular hypertenion and glaucoma were reviewed by a panel of glaucoma pecialit. Meaure of dieae progreion rik derived from three long-term tudie and aumption baed on the available data were ued to etimate the rik of progreion from ocular hypertenion to glaucoma and glaucoma to unilateral blindne for untreated and treated patient over a 15-year period. Uing thee etimate, the NNT (1/abolute rik reduction on treatment) to prevent unilateral blindne in one patient with ocular hypertenion wa calculated. Reult In untreated patient, the etimated rik of progreion from ocular hypertenion to unilateral blindne wa 1.5% to 10.5% and in treated patient, the etimated rik of progreion wa 0.3% to 2.4% over 15 year. From thee etimate, between 12 and 83 patient with ocular hypertenion will require treatment to prevent one patient from progreing to unilateral blindne over a 15-year period. Concluion Global rik aement that incorporate all available data play a vital role in managing patient with ocular hypertenion. A more precie undertanding of long-term viion lo hould be factored into deciion pertaining to the initiation of glaucoma therapy. Undoubtedly, thee etimate will evolve and change with the availability of new population-baed epidemiologic information and improvement in multivariable model teting.