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Argon Laser Trabeculoplasty Plus Topical Betaxolol Halves Progression Risk Of Open-Angle Glaucoma
A DGReview of :"Factors for Glaucoma Progression and the Effect of Treatment"
Archives of Ophthalmology
03/03/2003
By Mark Greener
Patients with open-angle glaucoma who received argon laser trabeculoplasty plus topical betaxolol halved their progression risk, compared to control patients who received no immediate treatment, study results show.
Magnitude of the initial intraocular pressure (IOP) reduction represented a major influence on outcome, researchers add.
The researchers, from Stony Brook University School of Medicine, New York and other centres in the United States and Sweden, participated in the Early Manifest Glaucoma Trial (EMGT). They treated 129 patients with laser trabeculoplasty plus betaxolol, while 126 patients acted as untreated controls. The patients were followed-up every 3 months. Fifty-three percent progressed over 6 years follow up.
High baseline intraocular pressure (IOP), exfoliation, having both eyes eligible, worse mean deviation and advanced age were all associated with an increased risk of progression. For example, exfoliation and having both eyes eligible each doubled the risk. Frequent disc haemorrhages during follow-up were also associated with an increased risk of progression.
On the other hand, each 1 mmHg reduction in IOP between baseline and the first follow up visit reduced the risk of progression by around 10%. The first IOP at the first visit and the mean IOP at follow up were associated with increased risk of progression: by around 11 and 13% per mmHg respectively. Frequent disc haemorrhages during follow-up were also associated with an increased risk of progression.
Arch Ophthalmol 2003;121:1:48-56.
"Factors for Glaucoma Progression and the Effect of Treatment"
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