Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern®
2020; Elsevier BV; Volume: 128; Issue: 1 Linguagem: Inglês
10.1016/j.ophtha.2020.10.023
ISSN1549-4713
AutoresSteven J. Gedde, John T. Lind, Martha M. Wright, Philip Chen, Kelly W. Muir, Kateki Vinod, Tianjing Li, Steven L. Mansberger,
Tópico(s)Retinal Diseases and Treatments
ResumoPrimary Open-Angle Glaucoma Suspect Preferred Practice Pattern® Secretary for Quality of Care Timothy W. Olsen, MD Academy Staff Ali Al-Rajhi, PhD, MPH Andre Ambrus, MLIS Meghan Daly Flora C. Lum, MD Medical Editor: Susan Garratt Approved by: Board of Trustees September 12, 2020 Copyright © 2020 American Academy of Ophthalmology® All rights reserved AMERICAN ACADEMY OF OPHTHALMOLOGY and PREFERRED PRACTICE PATTERN are registered trademarks of the American Academy of Ophthalmology. All other trademarks are the property of their respective owners. Preferred Practice Pattern® guidelines are developed by the Academy's H. Dunbar Hoskins Jr., MD Center for Quality Eye Care without any external financial support. Authors and reviewers of the guidelines are volunteers and do not receive any financial compensation for their contributions to the documents. The guidelines are externally reviewed by experts and stakeholders before publication. The Glaucoma Preferred Practice Pattern® Panel members wrote the Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern® guidelines (PPP). The PPP Panel members discussed and reviewed successive drafts of the document, meeting in person twice and conducting other review by e-mail discussion, to develop a consensus over the final version of the document. Glaucoma Preferred Practice Pattern Panel 2019–2020 Steven J. Gedde, MD, Chair John T. Lind, MD Martha M. Wright, MD, American Glaucoma Society Representative Philip P. Chen, MD Kelly W. Muir, MD Kateki Vinod, MD Tianjing Li, MD, MHS, PhD, Consultant, Cochrane Eyes and Vision US Project Steven L. Mansberger, MD, MPH, Methodologist We thank our partner, the Cochrane Eyes and Vision US Group, for identifying reliable systematic reviews that we cite and discuss in support of the PPP recommendations. The Preferred Practice Patterns Committee members reviewed and discussed the document during a meeting in May 2020. The document was edited in response to the discussion and comments. Preferred Practice Patterns Committee 2020 Roy S. Chuck, MD, PhD, Chair Steven P. Dunn, MD Christina J. Flaxel, MD Steven J. Gedde, MD Francis S. Mah, MD Kevin M. Miller, MD James P. Tweeten, MD David K. Wallace, MD, MPH David C. Musch, PhD, MPH, Methodologist The Primary Open-Angle Glaucoma Suspect PPP was then sent for review to additional internal and external groups and individuals in June 2020. All those who returned comments were required to provide disclosure of relevant relationships with industry to have their comments considered (indicated with an asterisk below). Members of the PPP Panel reviewed and discussed these comments and determined revisions to the document. Academy Reviewers Board of Trustees and Committee of Secretaries* Council* General Counsel* Ophthalmic Technology Assessment Committee Glaucoma Panel* Basic and Clinical Science Course Section 10 Subcommittee Practicing Ophthalmologists Advisory Committee for Education Invited Reviewers American College of Surgeons American Glaucoma Society American Ophthalmological Society Association for Research in Vision and Ophthalmology Association of University Professors in Ophthalmology* Consumer Reports Health Choices Canadian Ophthalmological Society* European Glaucoma Society* International Council of Ophthalmology International Society of Glaucoma Surgery International Society of Refractive Surgery National Eye Institute* National Medical Association, Section on Ophthalmology North American Neuro-Ophthalmology Society Outpatient Ophthalmic Surgery Society World Glaucoma Association* Women in Ophthalmology* Wallace L.M. Alward, MD* Ta Chen Chang, MD In compliance with the Council of Medical Specialty Societies’ Code for Interactions with Companies (available at https://cmss.org/code-signers-pdf/), relevant relationships with industry are listed. The Academy has Relationship with Industry Procedures to comply with the Code (available at www.aao.org/about-preferred-practice-patterns). A majority (85%) of the members of the Glaucoma Preferred Practice Pattern Panel 2019–2020 had no related financial relationship to disclose. Glaucoma Preferred Practice Pattern Panel 2019–2020 Steven J. Gedde, MD: No financial relationships to disclose Philip P. Chen, MD: Allergan—Consultant/Advisor John T. Lind, MD: Aerie Pharmaceuticals, Allergan—Consultant/Advisor; Aerie Pharmaceuticals, Allergan—Lecture Fees, Perrigo—Grant Support Kelly W. Muir, MD: No financial relationships to disclose Kateki Vinod, MD: No financial relationships to disclose Martha M. Wright, MD: No financial relationships to disclose Tianjing Li, MD, MHS, PhD: No financial relationships to disclose Steven L. Mansberger, MD, MPH: Allergan—Grant Support Preferred Practice Patterns Committee 2020 Roy S. Chuck, MD, PhD: No financial relationships to disclose Steven P. Dunn, MD: No financial relationships to disclose Christina J. Flaxel, MD: No financial relationships to disclose Steven J. Gedde, MD: No financial relationships to disclose Francis S. Mah, MD: Abbott Medical Optics Inc., Aerie Pharmaceuticals, Alcon Laboratories Inc., Allergan, Bausch + Lomb, Novartis Pharmaceuticals, Ocular Science, Omeros Corporation, PolyActiva—Consultant/Advisor; Abbott Medical Optics Inc., Bausch + Lomb, Novartis Pharmaceuticals—Lecture Fees; Abbott Medical Optics Inc.—Grant Support; Ocular Science—Equity Owner Kevin M. Miller, MD: Alcon Laboratories Inc., Johnson & Johnson Vision—Consultant/Advisor James P. Tweeten, MD: No financial relationships to disclose David K. Wallace, MD, MPH: No financial relationships to disclose David C. Musch, PhD, MPH, Methodologist: No financial relationships to disclose Secretary for Quality of Care Timothy W. Olsen, MD: No financial relationships to disclose Academy Staff Ali Al-Rajhi, PhD, MPH: No financial relationships to disclose Andre Ambrus, MLIS: No financial relationships to disclose Meghan Daly: No financial relationships to disclose Flora C. Lum, MD: No financial relationships to disclose Susan Garratt: No financial relationships to disclose The disclosures of relevant relationships to industry of other reviewers of the document from January to October 2020 are available online at www.aao.org/ppp. OBJECTIVES OF PREFERRED PRACTICE PATTERN GUIDELINES P157 METHODS AND KEY TO RATINGS P158 HIGHLIGHTED FINDINGS AND RECOMMENDATIONS FOR CARE P159 INTRODUCTION P160 Disease Definition P160 Clinical Findings Characteristic of Primary Open-Angle Glaucoma Suspect P160 Patient Population P160 Clinical Objectives P160 BACKGROUND P160 Prevalence P160 Risk Factors P161 DETECTION P162 CARE PROCESS P162 Patient Outcome Criteria P162 Diagnosis P162History P162Evaluation of Visual Function P163Physical Examination P163Diagnostic Testing P163Differential Diagnosis P167 Management P167Goals P167Deciding When to Treat a Glaucoma Suspect Patient P168Target Intraocular Pressure P168Choice of Therapy P169Follow-up Evaluation P174 Provider and Setting P175 Counseling and Referral P175 Socioeconomic Considerations P175 APPENDIX 1. QUALITY OF OPHTHALMIC CARE CORE CRITERIA P177 APPENDIX 2. INTERNATIONAL STATISTIC AL CLASSIFICATION OF DISEASES AND RELATED HEALTH PROBLEMS (ICD) CODES P179 APPENDIX 3. MANAGEMENT ALGORITHM FOR PATIENTS WITH PRIMARY OPEN-ANGLE GLAUCOMA SUSPECT P180 APPENDIX 4. LITERATURE SEARCHES FOR THIS PPP P181 RELATED ACADEMY MATERIALS P181 REFERENCES P183 Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern® Background: A diagnosis of primary open-angle glaucoma (POAG) suspect is established by the presence of consistently elevated intraocular pressure (IOP), also know as ocular hypertension, or a suspicious optic nerve, retinal nerve fiber layer (RNFL), or visual field in one or both eyes. Risk factors for POAG include older age, African race or Latino/Hispanic ethnicity, elevated intraocular pressure (IOP), family history of glaucoma, lower ocular perfusion pressure, type 2 diabetes mellitus, and thin central cornea. Rationale for Treatment: The decision to treat a POAG suspect patient depends on the level of IOP and other associated risk factors, or evidence of change of the optic nerve, RNFL, or visual field indicating the development of glaucoma. In the Ocular Hypertension Treatment Study, more than 90% of patients with untreated ocular hypertension did not progress to glaucoma over 5 years, but treatment to lower IOP reduced the risk of developing POAG from 9.5% to 4.5%. Care Process: The goals of managing patients who are POAG suspects are to lower IOP with treatment if the eye is likely to progress to POAG and to monitor for structural or functional changes of the optic nerve. Appropriate testing to evaluate and monitor POAG suspect patients includes gonioscopy, pachymetry, tonometry, perimetry, careful examination of the optic nerve, and imaging of the optic nerve head, RNFL and macula. Patients should be followed longitudinally for the development of glaucoma. Medical therapy is most commonly used to lower IOP, but laser trabeculoplasty exists as an alternative to medications for patients with ocular hypertension. As a service to its members and the public, the American Academy of Ophthalmology has developed a series of Preferred Practice Pattern® guidelines that identify characteristics and components of quality eye care. Appendix 1 describes the core criteria of quality eye care. The Preferred Practice Pattern® guidelines are based on the best available scientific data as interpreted by panels of knowledgeable health professionals. In some instances, such as when results of carefully conducted clinical trials are available, the data are particularly persuasive and provide clear guidance. In other instances, the panels have to rely on their collective judgment and evaluation of available evidence. These documents provide guidance for the pattern of practice, not for the care of a particular individual. While they should generally meet the needs of most patients, they cannot possibly best meet the needs of all patients. Adherence to these PPPs will not ensure a successful outcome in every situation. These practice patterns should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. It may be necessary to approach different patients’ needs in different ways. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all of the circumstances presented by that patient. The American Academy of Ophthalmology is available to assist members in resolving ethical dilemmas that arise in the course of ophthalmic practice. Preferred Practice Pattern® guidelines are not medical standards to be adhered to in all individual situations. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any recommendations or other information contained herein. References to certain drugs, instruments, and other products are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved U.S. Food and Drug Administration (FDA) labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law. Innovation in medicine is essential to ensure the future health of the American public, and the Academy encourages the development of new diagnostic and therapeutic methods that will improve eye care. It is essential to recognize that true medical excellence is achieved only when the patients’ needs are the foremost consideration. All Preferred Practice Pattern® guidelines are reviewed by their parent panel annually or earlier if developments warrant and updated accordingly. To ensure that all PPPs are current, each is valid for 5 years from the “approved by” date unless superseded by a revision. Preferred Practice Pattern guidelines are funded by the Academy without commercial support. Authors and reviewers of PPPs are volunteers and do not receive any financial compensation for their contributions to the documents. The PPPs are externally reviewed by experts and stakeholders, including consumer representatives, before publication. The PPPs are developed in compliance with the Council of Medical Specialty Societies’ Code for Interactions with Companies. The Academy has Relationship with Industry Procedures (available at www.aao.org/about-preferred-practice-patterns) to comply with the Code. Appendix 2 contains the International Statistical Classification of Diseases and Related Health Problems (ICD) codes for the disease entities that this PPP covers. Appendix 3 has an algorithm for the management of primary open-angle glaucoma (POAG) suspect. The intended users of the Primary Open-Angle Glaucoma Suspect PPP are ophthalmologists. Preferred Practice Pattern® guidelines should be clinically relevant and specific enough to provide useful information to practitioners. Where evidence exists to support a recommendation for care, the recommendation should be given an explicit rating that shows the strength of evidence. To accomplish these aims, methods from the Scottish Intercollegiate Guideline Network1Scottish Intercollegiate Guidelines Network Annex B: Key to evidence statements and grades of recommendations. SIGN 50: A guideline developer's handbook. 2008 edition, revised 2011. SIGN, Edinburgh2015Available at: www.sign.ac.ukDate accessed: November , 2020Google Scholar (SIGN) and the Grading of Recommendations Assessment, Development and Evaluation2Guyatt GH Oxman AD Vist GE et al.Grade: An emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926Crossref PubMed Google Scholar (GRADE) group are used. GRADE is a systematic approach to grading the strength of the total body of evidence that is available to support recommendations on a specific clinical management issue. Organizations that have adopted GRADE include SIGN, the World Health Organization, the Agency for Healthcare Research and Policy, and the American College of Physicians.3GRADE working group Organizations that have endorsed or that are using GRADE.Available at: www.gradeworkinggroup.org/Date accessed: November , 2020Google Scholar♦All studies used to form a recommendation for care are graded for strength of evidence individually, and that grade is listed with the study citation.♦To rate individual studies, a scale based on SIGN1Scottish Intercollegiate Guidelines Network Annex B: Key to evidence statements and grades of recommendations. SIGN 50: A guideline developer's handbook. 2008 edition, revised 2011. SIGN, Edinburgh2015Available at: www.sign.ac.ukDate accessed: November , 2020Google Scholar is used. The definitions and levels of evidence to rate individual studies are as follows:Tabled 1I++High-quality meta-analyses, systematic reviews of randomized controlled trials (RCTs), or RCTs with a very low risk of biasI+Well-conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of biasI-Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of biasHigh-quality systematic reviews of case-control or cohort studiesHigh-quality case-control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causalII+Well-conducted case-control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causalII-Case-control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causalIIINonanalytic studies (e.g., case reports, case series) Open table in a new tab ♦Recommendations for care are formed based on the body of the evidence. The body of evidence quality ratings are defined by GRADE2Guyatt GH Oxman AD Vist GE et al.Grade: An emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926Crossref PubMed Google Scholar as follows:Tabled 1Good qualityFurther research is very unlikely to change our confidence in the estimate of effectModerate qualityFurther research is likely to have an important impact on our confidence in the estimate of effect and may change the estimateInsufficient qualityFurther research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Any estimate of effect is very uncertain Open table in a new tab ♦Key recommendations for care are defined by GRADE2Guyatt GH Oxman AD Vist GE et al.Grade: An emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926Crossref PubMed Google Scholar as follows:Table 01.123Strong recommendationUsed when the desirable effects of an intervention clearly outweigh the undesirable effects or clearly do notDiscretionary recommendationUsed when the trade-offs are less certain—either because of low-quality evidence or because evidence suggests that desirable and undesirable effects are closely balanced Open table in a new tab ♦The Highlighted Findings and Recommendations for Care section lists points determined by the PPP Panel to be of particular importance to vision and quality of life outcomes.♦All recommendations for care in this PPP were rated using the system described above. Ratings are embedded throughout the PPP main text in italics.♦Literature searches to update the PPP were undertaken in March 2019 and June 2020 in the PubMed and Cochrane databases. Complete details of the literature searches are available in Appendix 4. A diagnosis of primary open-angle glaucoma (POAG) suspect is established by the presence of a consistently elevated intraocular pressure (IOP), also known as ocular hypertension, or a suspicious optic nerve, retinal nerve fiber layer (RNFL), or visual field, in one or both eyes. Established risk factors for POAG include older age, African race or Latino/Hispanic ethnicity, elevated IOP, family history of glaucoma, low ocular perfusion pressure, type 2 diabetes mellitus, myopia, and a thin central cornea. The decision to treat a POAG suspect patient depends on the level of IOP and other associated risk factors, or evidence of change of the optic nerve, RNFL, or visual field indicating the development of POAG. In the Ocular Hypertension Treatment Study (OHTS), more than 90% of patients with untreated ocular hypertension did not progress to glaucoma over 5 years, but treatment to lower IOP reduced the risk of developing POAG from 9.5% to 4.5%. A reasonable target for IOP reduction in a POAG suspect patient in whom the decision to treat has been made is 20%, based on the OHTS. Appropriate testing to evaluate and monitor patients diagnosed as a glaucoma suspect includes gonioscopy, pachymetry, tonometry, perimetry, careful examination of the optic nerve, and ocular imaging. Computer-based imaging and stereoscopic photography provide different and complementary information about optic nerve status. A glaucoma suspect is an individual with clinical findings and/or a constellation of risk factors that indicate an increased likelihood of developing primary open-angle glaucoma (POAG). An individual with an open anterior chamber angle may be diagnosed as a glaucoma suspect based on any of the following clinical findings in one or both eyes:♦Elevated intraocular pressure (IOP) associated with normal appearance of the optic disc, retinal nerve fiber layer (RNFL), and visual field♦An appearance of the optic nerve head (ONH) or RNFL suspicious for glaucomatous damage♦A visual field suspicious for glaucomatous damage in the absence of clinical signs of another optic neuropathy or retinopathy This definition excludes the angle-closure glaucomas and known secondary causes for open-angle glaucoma, such as pseudoexfoliation syndrome, pigment dispersion syndrome, and traumatic angle recession. The patient population includes adults with open anterior chamber angles with one of the clinical findings or risk factors listed in the Clinical Findings Characteristic of Primary Open-Angle Glaucoma Suspect section. ♦Identify patients at high risk of developing POAG♦Document the status of the optic nerve structure at presentation by clinical evaluation and imaging, and document visual function by visual field testing♦Perform and document gonioscopy♦Consider treatment of high-risk individuals to prevent or delay the development of POAG♦Minimize the side effects of treatment and the impact of treatment on the patient's vision, general health, and quality of life♦Educate and involve the patient and appropriate family members/caregivers in the management of the patient's condition♦Monitor the IOP and the structure and function of the optic nerve for evidence of glaucomatous damage A diagnosis of POAG suspect is established by the presence of at least one of the following conditions: a consistently elevated IOP, also known as ocular hypertension, or a suspicious optic nerve or visual field. Ocular hypertension has been defined as IOP higher than two standard deviations above the mean for the population without evidence of optic disc or visual field damage.4Foster PJ Buhrmann R Quigley HA Johnson GJ The definition and classification of glaucoma in prevalence surveys.Br J Ophthalmol. 2002; 86: 238-242Crossref PubMed Scopus (1335) Google Scholar In the United States, this definition usually includes an IOP greater than 21 mmHg. Using this definition, the prevalence of ocular hypertension in non-Hispanic whites who are 40 years and older and live in the United States is 4.5% (ranging from 2.7% in persons 43 to 49 years old to 7.7% in those 75 to 79 years old).5Klein BE Klein R Linton KL Intraocular pressure in an American community: The Beaver Dam eye study.Invest Ophthalmol Vis Sci. 1992; 33: 2224-2228PubMed Google Scholar In Latinos 40 years and older, the overall prevalence is 3.5% (ranging from 1.7% in persons 40 to 49 years old to 7.4% in those 80 years and older).6Varma R Ying-Lai M Francis BA et al.Los angeles latino eye study group. Prevalence of open-angle glaucoma and ocular hypertension in Latinos: The Los Angeles Latino eye study.Ophthalmology. 2004; 111: 1439-1448Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar There are no published population-based estimates for the prevalence of ocular hypertension in African Americans and Asian Americans. Overall, 3 to 6 million persons in the United States have ocular hypertension.7Leibowitz HM Krueger DE Maunder LR et al.The framingham eye study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973-1975.Surv Ophthalmol. 1980; 24: 335-610Abstract Full Text PDF PubMed Google Scholar, 8Gordon MO Kass MA The ocular hypertension treatment study: Design and baseline description of the participants.Arch Ophthalmol. 1999; 117: 573-583Crossref PubMed Google Scholar Many studies suggest that a large proportion of people who are glaucoma suspects are likely undiagnosed. For example, the Los Angeles Latino Eye Study (LALES) showed that 75% of Latinos with IOP greater than 21 mmHg were previously undiagnosed.6Varma R Ying-Lai M Francis BA et al.Los angeles latino eye study group. Prevalence of open-angle glaucoma and ocular hypertension in Latinos: The Los Angeles Latino eye study.Ophthalmology. 2004; 111: 1439-1448Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar Because ocular hypertension is a major risk factor for development of glaucoma, eye care providers should measure IOP in all of their patients over the age of 40 years. However, the overall likelihood of developing glaucomatous optic neuropathy may vary among individuals and increases with the number and relative strength of their risk factors for glaucoma.9Ocular Hypertension Treatment Study G, European Glaucoma Prevention Study G Gordon MO et al.Validated prediction model for the development of primary open-angle glaucoma in individuals with ocular hypertension.Ophthalmology. 2007; 114: 10-19Abstract Full Text Full Text PDF Scopus (203) Google Scholar The prevalence of patients diagnosed as glaucoma suspects is less understood because the definition of glaucoma suspect includes several criteria, including elevated IOP, suspicious visual fields or optic disc appearance, and RNFL abnormalities, and the criteria for “abnormal” may differ between clinicians.10Andersson S Heijl A Bizios D Bengtsson B Comparison of clinicians and an artificial neural network regarding accuracy and certainty in performance of visual field assessment for the diagnosis of glaucoma.Acta Ophthalmol. 2013; 91: 413-417Crossref Scopus (13) Google Scholar, 11Hong SW Koenigsman H Ren R et al.Glaucoma specialist optic disc margin, rim margin, and rim width discordance in glaucoma and glaucoma suspect eyes.Am J Ophthalmol. 2018; 192: 65-76Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar Furthermore, clinicians may consider a patient a glaucoma suspect because of a history of myopia,12Hsu CH Chen RI Lin SC Myopia and glaucoma: Sorting out the difference.Curr Opin Ophthalmol. 2015; 26: 90-95Crossref PubMed Scopus (27) Google Scholar a background including an ethnoracial group with higher risk of glaucoma,4Foster PJ Buhrmann R Quigley HA Johnson GJ The definition and classification of glaucoma in prevalence surveys.Br J Ophthalmol. 2002; 86: 238-242Crossref PubMed Scopus (1335) Google Scholar, 13Doss EL Doss L Han Y et al.Risk factors for glaucoma suspicion in healthy young Asian and Caucasian Americans.J Ophthalmol. 2014; 2014726760Crossref Scopus (3) Google Scholar, 14El-Dairi M Holgado S Asrani S Freedman SF Optical coherence tomography (OCT) measurements in black and white children with large cup-to-disc ratios.Exp Eye Res. 2011; 93: 299-307Crossref PubMed Scopus (0) Google Scholar or family history of glaucoma.15Chang TC Congdon NG Wojciechowski R et al.Determinants and heritability of intraocular pressure and cup-to-disc ratio in a defined older population.Ophthalmology. 2005; 112: 1186-1191Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar The results of epidemiological studies and clinical trials provide a framework for understanding the effects of risk factors associated with POAG. Numerous studies have identified risk factors associated with POAG (see Primary Open-Angle Glaucoma PPP for additional discussion of risk factors):♦Elevated IOP7Leibowitz HM Krueger DE Maunder LR et al.The framingham eye study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973-1975.Surv Ophthalmol. 1980; 24: 335-610Abstract Full Text PDF PubMed Google Scholar, 16Kass MA Heuer DK Higginbotham EJ et al.The ocular hypertension treatment study: A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma.Arch Ophthalmol. 2002; 120 (discussion 829-730.): 701-713Crossref PubMed Google Scholar, 17Gordon MO Beiser JA Brandt JD et al.The ocular hypertension treatment study: Baseline factors that predict the onset of primary open-angle glaucoma.Arch Ophthalmol. 2002; 120 (discussion 829-730.): 714-720Crossref PubMed Google Scholar, 18Sommer A Tielsch JM Katz J et al.Relationship between intraocular pressure and primary open angle glaucoma among white and black americans: The Baltimore eye survey.Arch Ophthalmol. 1991; 109: 1090-1095Crossref PubMed Google Scholar, 19Mitchell P Smith W Attebo K Healey PR Prevalence of open-angle glaucoma in Australia: The Blue Mountains eye study.Ophthalmology. 1996; 103: 1661-1669Abstract Full Text PDF PubMed Google Scholar, 20Leske MC Connell AM Wu SY et al.The Barbados eye studies group. Incidence of open-angle glaucoma: The Barbados eye studies.Arch Ophthalmol. 2001; 119: 89-95PubMed Google Scholar, 21Le A Mukesh BN McCarty CA Taylor HR Risk factors associated with the incidence of open-angle glaucoma: The visual impairment project.Invest Ophthalmol Vis Sci. 2003; 44: 3783-3789Crossref PubMed Scopus (184) Google Scholar, 22Dielemans I Vingerling JR Wolfs RC et al.The prevalence of primary open-angle glaucoma in a population-based study in the Netherlands: The Rotterdam study.Ophthalmology. 1994; 101: 1851-1855Abstract Full Text PDF PubMed Google Scholar, 23Leske MC Connell AM Schachat AP Hyman L The Barbados eye study. Prevalence of open angle glaucoma.Arch Ophthalmol. 1994; 112: 821-829Crossref PubMed Google Scholar, 24Quigley HA West SK Rodriguez J et al.The prevalence of glaucoma in a population-based study of Hispanic subjects: Proyecto ver.Arch Ophthalmol. 2001; 119: 1819-1826Crossref PubMed Scopus (398) Google Scholar, 25Klein BE Klein R Sponsel WE et al.Prevalence of glaucoma: The Beaver Dam eye study.Ophthalmology. 1992; 99: 1499-1504Abstract Full Text PDF PubMed Google Scholar, 26Miglior S Pfeiffer N Torri V et al.European glaucoma prevention study (EGPS) group. Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European glaucoma prevention study.Ophthalmology. 2007; 114: 3-9Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar♦Ol
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