Publications

Objectives

Glaucoma is a chronic progressive optic neuropathy leading to impaired vision and sometimes
blindness if untreated. Open angle glaucoma (OAG) is the most common form of glaucoma, affecting
about 2% of the population aged over 40, and is second to age related macular degeneration as a
main cause of blindness in the UK. IOP is the most important risk factor to develop OAG and the only
one treatable.
We aim to determine the optimal monitoring criteria in individuals with ocular hypertension. This
involves: a) Identifying the optimal number of measurements required to quantify IOP risk; b) Estimate
3 components of the apparent IOP variability: average true long-term, a short-term variability, and the
long-term variability.

Method

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Data from a treatment-placebo randomise controlled trial will be used. Two independent analyses will
be carried out, one over each arm. Descriptive statistical analysis will be carried out. Imputation
method for missing data will be explored. The components of IOP variability will be estimated using a
direct method, and a linear mixed-effects model.

Results

This study will provide a guide for clinicians with respect to the optimal monitoring frequency, and a
method to identify individuals most at risk of developing significant OAG, and individuals most likely to
benefit from treatment. It will also provide estimates to inform models of the impact different plausible
surveillance regimes for monitoring ocular hypertension have, and identify future research needs.

Conclusions

This study will increase the possibility to treat early disease and thus reduce the costs and disability
associated with OAG.