Initial intraocular pressure reduction by mono- versus multi-therapy in patients with open-angle glaucoma : results from the Glaucoma Intensive Treatment Study
Lindén, Christina ; Heijl, Anders LU ; Jóhannesson, Gauti ; Aspberg, Johan LU
; Andersson Geimer, Sabina
LU
and Bengtsson, Boel
LU
(2018)
In Acta Ophthalmologica
96((6)).
p.567-572
- Abstract
PURPOSE: To study newly diagnosed glaucoma patients given mono- or multi-therapy regarding differences in initial intraocular pressure (IOP) reduction, target IOP levels reached and influence of untreated baseline IOP on IOP reduction.
METHODS: Patients newly diagnosed with manifest primary open-angle glaucoma and included in the Glaucoma Intensive Treatment Study (GITS) were randomized to immediate intensive treatment with any of three different IOP-lowering substances supplied in two bottles plus 360° laser trabeculoplasty or to conventional stepwise treatment starting with a single-drug. Intraocular pressure reduction was analysed 1 month after initiation of treatment.
RESULTS: One hundred eighteen patients (143 eyes)... (More)
PURPOSE: To study newly diagnosed glaucoma patients given mono- or multi-therapy regarding differences in initial intraocular pressure (IOP) reduction, target IOP levels reached and influence of untreated baseline IOP on IOP reduction.
METHODS: Patients newly diagnosed with manifest primary open-angle glaucoma and included in the Glaucoma Intensive Treatment Study (GITS) were randomized to immediate intensive treatment with any of three different IOP-lowering substances supplied in two bottles plus 360° laser trabeculoplasty or to conventional stepwise treatment starting with a single-drug. Intraocular pressure reduction was analysed 1 month after initiation of treatment.
RESULTS: One hundred eighteen patients (143 eyes) received mono-therapy and 122 patients (152 eyes) multi-therapy. Median baseline IOP was 24.0 (min: 9.7, max: 56.0) mmHg in mono-therapy eyes and 24.0 (min: 12.3, max: 48.5) mmHg in multi-therapy eyes (p = 0.56). After 1 month in the two groups, respectively, values for median IOP reduction were 6.3 (range: -5.3-31.0) and 11.0 (range: 0.7-34.5) mmHg, and for mean relative decline 26.8 (range: -32.0-55.4) and 46.0 (range: 4.6-81.6) % (p = 0.000). A larger proportion of the multi-therapy patients reached each target IOP level (p = 0.000). The higher the baseline IOP, the larger the observed pressure reduction, considering both absolute and relative figures. The effect was more pronounced in eyes with multi-therapy than in those with mono-therapy (p = 0.000). For every mmHg higher IOP at baseline, the IOP was reduced by an additional 0.56 (mono-therapy) or 0.84 (multi-therapy) mmHg.
CONCLUSION: Intensive treatment led to considerably greater IOP reduction than mono-therapy. Among patients with IOP ≥30 mmHg at diagnosis an IOP of <16 was reached in 2/3 of those with multi-therapy but in none with mono-therapy. The IOP reduction was highly dependent on the untreated IOP level.
(Less)
- author
- Lindén, Christina
; Heijl, Anders
LU
; Jóhannesson, Gauti
; Aspberg, Johan
LU
; Andersson Geimer, Sabina
LU
and Bengtsson, Boel
LU
- organization
- publishing date
- 2018-09-21
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Ophthalmologica
- volume
- 96
- issue
- (6)
- pages
- 567 - 572
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85053663670
- pmid:30242986
- ISSN
- 1755-3768
- DOI
- 10.1111/aos.13790
- language
- English
- LU publication?
- yes
- id
- 5c3f9c68-af66-41f9-88e8-fded5d903b49
- date added to LUP
- 2018-09-23 14:04:00
- date last changed
- 2025-10-30 03:13:34
@article{5c3f9c68-af66-41f9-88e8-fded5d903b49,
abstract = {{<p>PURPOSE: To study newly diagnosed glaucoma patients given mono- or multi-therapy regarding differences in initial intraocular pressure (IOP) reduction, target IOP levels reached and influence of untreated baseline IOP on IOP reduction.</p><p>METHODS: Patients newly diagnosed with manifest primary open-angle glaucoma and included in the Glaucoma Intensive Treatment Study (GITS) were randomized to immediate intensive treatment with any of three different IOP-lowering substances supplied in two bottles plus 360° laser trabeculoplasty or to conventional stepwise treatment starting with a single-drug. Intraocular pressure reduction was analysed 1 month after initiation of treatment.</p><p>RESULTS: One hundred eighteen patients (143 eyes) received mono-therapy and 122 patients (152 eyes) multi-therapy. Median baseline IOP was 24.0 (min: 9.7, max: 56.0) mmHg in mono-therapy eyes and 24.0 (min: 12.3, max: 48.5) mmHg in multi-therapy eyes (p = 0.56). After 1 month in the two groups, respectively, values for median IOP reduction were 6.3 (range: -5.3-31.0) and 11.0 (range: 0.7-34.5) mmHg, and for mean relative decline 26.8 (range: -32.0-55.4) and 46.0 (range: 4.6-81.6) % (p = 0.000). A larger proportion of the multi-therapy patients reached each target IOP level (p = 0.000). The higher the baseline IOP, the larger the observed pressure reduction, considering both absolute and relative figures. The effect was more pronounced in eyes with multi-therapy than in those with mono-therapy (p = 0.000). For every mmHg higher IOP at baseline, the IOP was reduced by an additional 0.56 (mono-therapy) or 0.84 (multi-therapy) mmHg.</p><p>CONCLUSION: Intensive treatment led to considerably greater IOP reduction than mono-therapy. Among patients with IOP ≥30 mmHg at diagnosis an IOP of <16 was reached in 2/3 of those with multi-therapy but in none with mono-therapy. The IOP reduction was highly dependent on the untreated IOP level.</p>}},
author = {{Lindén, Christina and Heijl, Anders and Jóhannesson, Gauti and Aspberg, Johan and Andersson Geimer, Sabina and Bengtsson, Boel}},
issn = {{1755-3768}},
language = {{eng}},
month = {{09}},
number = {{(6)}},
pages = {{567--572}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Ophthalmologica}},
title = {{Initial intraocular pressure reduction by mono- versus multi-therapy in patients with open-angle glaucoma : results from the Glaucoma Intensive Treatment Study}},
url = {{http://dx.doi.org/10.1111/aos.13790}},
doi = {{10.1111/aos.13790}},
volume = {{96}},
year = {{2018}},
}