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Editors Selection IGR 7-1

Types of glaucoma: EGPS

Comment by Tetsuya Yamamoto on:

11885 Results of the European Glaucoma Prevention Study, Miglior S; Zeyen T; Pfeiffer N et al., Ophthalmology, 2005; 112: 366-375

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The European Glaucoma Prevention Study Group, Miglior et al. (207), has completed a five-year, multi-country, collaborative study to investigate the efficacy of dorzolamide in preventing POAG in OHT patients. The result is quite interesting. A mean of 22% of IOP reduction achieved by dorzolamide treatment did NOT prevent OHT patients from development of POAG with statistical significance. This result is apparently different from that of the OHTS study. The OHTS study along with the EMGT study showed us some 10% reduction in development or progression of glaucoma per 1-mmHg reduction of IOP. However, as discussed in the EGPS paper, this discrepancy probably resulted from unexpected reduction of IOP in placebo-treated eyes. In fact, the IOP difference between dorzolamide-treated and placebo-treated groups ranged between 1.1 and 1.3 mmHg only throughout the treatment period. The calculated protective effect of dorzolamide, shown as a hazards ratio of 0.86, was quite consistent with the 12% protective effect per 1-mmHg IOP reduction reported in the EMGT study. Apart from the result on primary end point analysis of the study, I believe that it strongly suggests us to treat OHT patients with ocular hypotensives as advocated by the OHTS study. This collaborative study has created a new evidence for the management of OHT patients.

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