Primary care screening for ocular hypertension and primary open-angle glaucoma: evidence synthesis
Fleming C, Whitlock E, Beil T, Smit B
Record ID 32005000170
English
Authors' objectives:
Primary open-angle glaucoma (POAG) is a leading cause of blindness and vision-related disability. This review examines the effectiveness of screening and treatment of asymptomatic individuals with early POAG.
Authors' results and conclusions:
No randomized, controlled trials of population screening for POAG have been reported. We found no population-based studies demonstrating that screening is feasible, accurate, or reliable for detecting early glaucoma. Two randomized, controlled trials examined the efficacy of treatment to lower intraocular pressure (IOP) compared with no treatment for persons with early primary open-angle glaucoma. In a Swedish trial, treatment reduced progression at 5 years from 62% without treatment to 45% with treatment (ARR 17%, NNT 5.8, p = 0.007). In a U.S. trial of patients with early POAG and normal IOP, progression at 5 years was observed in 39% without treatment and 33% with treatment (p = 0.21). The benefit of delaying progression of visual field loss on vision-related function in patients with early POAG is unclear. The principal harm of treatment is loss of visual acuity due to an increased risk of cataract formation.
Authors' recommendations:
Treatment to lower intraocular pressure may delay progression of visual field deficits in some asymptomatic individuals with early POAG. Further studies of population screening are needed to demonstrate that early recognition and treatment of glaucoma in asymptomatic patients is effective in improving vision-specific functional outcomes and health-related quality of life.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.ahrq.gov/clinic/uspstf/uspsglau.htm
Year Published:
2005
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Glaucoma
- Glaucoma, Open-Angle
- Intraocular Pressure
- Mass Screening
- Ocular Hypertension
- Primary Health Care
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
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