青光眼的药物治疗参考.pptVIP

* * NOTE TO THE PRESENTER- Slides 15 and 16 can be used with any data slides to provide an abbreviated summary of these trials and their results. Slide 16 summarizes the overall results of the trials and restates the information on slide 35. In each of these trials, patients who reached lower pressures had better visual outcomes. Treatment prevented the development of glaucoma in individuals with OHT, and it reduced and delayed the progression of early glaucoma. The results of EMGT show that aggressive treatment is beneficial in early glaucoma. Glaucoma progression was reduced and delayed in patients with newly detected glaucoma who were treated to reduce IOP. Treatment was beneficial for both POAG and NTG patients. This study was planned in the early 1990s and used treatment available at the time that was believed to be safe. (This statement is in response to the criticism that the trial used an unusual combination of medication with ALT for the treatment group.) Every 1 mm Hg of additional IOP lowering led to a 10% decrease in the risk of glaucoma progression. The average sustained IOP reduction in treated patients was 25%. Together the results of this study suggest that aggressive treatment providing 30% or 35% mean IOP reductions will protect the visual function of more patients. [1] CIGTS Results Both medical treatment and surgery effectively reduced IOP by 38% to 46% and the risk of progression to 10.7% to 13.5% over 5 years Target pressures used were aggressive A target IOP reduction of ? 25% from baseline was required for a patient with baseline IOP of 25 mm Hg and no field damage; if minor field damage (scored as 5) was present, the target was a ? 30% reduction from baseline IOP Patients with optic disc abnormalities or any field loss should be treated aggressively to reach low pressures that reduce the risk of progression [2] The results of EMGT and CIGTS have suggested changes in our approach to the management of early glaucoma. Patie