Evolving Paradigms in the Medical Treatment of Glaucoma

Cohen, John; Khatana, Anup K.; Greff, Linda J

doi:10.1007/s10792-005-7581-9

Cited by 7 publications

(4 citation statements)

References 78 publications

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“…Participants were followed for 1 year Cho 2010 Short-term trial: evaluation of fixed combination of brimonidine 0.2%-timolol 0.5% in people with glaucoma. Participants were followed for up to 6 months CNTGS 1998 Not intervention of interest: included any medical and surgical treatment to lower IOP, and was not limited to the agents listed in the protocol Cohen 2005 Not a randomized trial: review of ocular hypotensive agents for the treatment of glaucoma and ocular hypertension Cordeiro 2011 Not a randomized trial: editorial discussing clinical trials for neuroprotection in glaucoma Costagliola 2014 Short-term trial: RCT of palmitoylethanolamide versus no palmitoylethanolamide in people with NTG. Participants were followed for 6 months Danesh-Meyer 2011 Not a randomized trial: review of preclinical (animal and cellular) studies for neuroprotection in glaucoma Drance 1998 Short-term trial: randomized, masked study of the effects of betaxolol, timolol, and pilocarpine on visual functions in people with OAG over a 24-month period EMGT 2002 Not intervention of interest: randomized comparison of the effect of laser trabeculoplasty plus topical betaxolol hydrochloride versus no initial treatment; was excluded because laser trabeculoplasty was not a predefined intervention for this review.…”

Section: Appendicesmentioning

confidence: 99%

Neuroprotection for treatment of glaucoma in adults

Sena

Lindsley

2017

Cochrane Database of Systematic Reviews

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Background Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells, and ultimately visual field loss. It is a leading cause of blindness worldwide. Open angle glaucoma (OAG), the most common form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. Objectives The objective of this review was to systematically examine the evidence regarding the effectiveness of neuroprotective agents for slowing the progression of OAG in adults compared with no neuroprotective agent, placebo, or other glaucoma treatment. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 7), Ovid MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily (January 1946 to August 2016), Embase (January 1980 to August 2016), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 16 August 2016. Selection criteria We included randomised controlled trials (RCTs) in which topical or oral treatments were used for neuroprotection in adults with OAG. Minimum follow-up time was four years. Data collection and analysis Two review authors independently reviewed titles and abstracts from the literature searches. We obtained full-text copies of potentially relevant studies and re-evaluated for inclusion. Two review authors independently extracted data related to study characteristics, risk of bias, and outcomes. We identified one trial for this review, thus we performed no meta-analysis. Two studies comparing memantine to placebo are currently awaiting classification until study investigators provide additional study details. We documented reasons for excluding studies from the review. Main results We included one multicenter RCT of adults with low-pressure glaucoma (Low-pressure Glaucoma Treatment Study, LoGTS) conducted in the USA. The primary outcome was progression of visual field loss after four years of treatment with either brimonidine or timolol. Of the 190 adults enrolled in the study, the investigators excluded 12 (6.3%) after randomization; 77 participants (40.5%) did not complete four years of follow-up. The rate of attrition was unbalanced between groups with more participants dropping out of the brimonidine group (55%) than the timolol group (29%). Of those remaining in the study at four years, participants assigned to brimonidine showed less progression of visual field loss than participants assigned to tim...

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Section: Appendicesmentioning

confidence: 99%

Neuroprotection for treatment of glaucoma in adults

Sena

Lindsley

2017

Cochrane Database of Systematic Reviews

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“…In selecting ocular hypotensive medications, one must consider the IOP lowering efficacy of an agent and their mechanism(s) of action, in addition to potential drug interactions and their ability to achieve target levels sufficient to limit progressive glaucomatous damage 5 . Commonly used ocular hypotensive agents either decrease aqueous production by the nonpigmented ciliary epithelium or increase drainage through the conventional and/or unconventional pathways.…”

Section: Introductionmentioning

confidence: 99%

Effect of topical 0.03% flurbiprofen and 0.005% latanoprost, alone and in combination, on normal canine eyes

Pirie

Maranda

Pizzirani

2011

Veterinary Ophthalmology

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“…[14–19] The concept was, unfortunately, reinforced by a post hoc analysis from the Advanced Glaucoma Intervention Study which led some to propose that lowering IOP to below 18 mmHg on all visits or an average IOP of 12.3 mmHg would halt glaucoma progression. [20] This concept has further propagated a binary, all or nothing, approach to glaucoma care which simplifies the practitioner’s life but does not necessarily improve patient care.…”

Section: Setting a Goalmentioning

confidence: 99%

Medical management of glaucoma: Principles and practice

Singh

Shrivastava

2011

Indian J Ophthalmol

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Glaucoma care is more an art than science. The introduction of several new classes of glaucoma medications and the completion of many large randomized clinical trials have not changed this fact. While we now have better choices when initiating glaucoma therapy relative to our predecessors, the principles of glaucoma therapy have not changed much during this period. Debates continue regarding the utility of concepts such as “the monocular therapeutic trial,” “target intraocular pressure (IOP),” and “maximal medical therapy.” Our tools for detecting and following glaucomatous disease have improved but are not precise enough for us to prospectively predict which patients will do better or worse than others. Much attention has been given to disease stage, rate of progression, and compliance with medications but regular patient follow-up, an area that has received little attention, may be among the most important predictors of patient outcomes.

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Evolving Paradigms in the Medical Treatment of Glaucoma

Cited by 7 publications

References 78 publications

Neuroprotection for treatment of glaucoma in adults

Neuroprotection for treatment of glaucoma in adults

Effect of topical 0.03% flurbiprofen and 0.005% latanoprost, alone and in combination, on normal canine eyes

Medical management of glaucoma: Principles and practice

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