Photo Credit: Emilija Randjelovic

The following is a summary of “Does the visual field improve after initiation of intraocular pressure lowering in the United Kingdom Glaucoma Treatment Study?” published in the August 2024 issue of Ophthalmology by Reddingius et al.

There is debate about whether visual field (VF) improvements can happen after starting treatment to lower intraocular pressure (IOP).

Researchers conducted a prospective study verifying if the IOP-lowering treatment helps improve VF status in newly diagnosed patients with glaucoma compared to a placebo.

They conducted a multicentre, randomized, triple-masked, placebo-controlled trial with 407 newly diagnosed open-angle patients with glaucoma. Participants received either a topical prostaglandin analog or a placebo. Researchers compared VF mean deviation (MD) changes and other factors like IOP, VF loss level, and age between groups. 

The result showed the mean time between eligibility and baseline visits was 12 weeks. IOP reduction averaged 4.8 mmHg in treated eyes and 1.0 mmHg in placebo eyes. Mean MD change was similar for both groups (-0.03 dB treated, +0.08 dB placebo; P=0.47). No differences in MD improvement or association with IOP lowering were found. Stratifying by IOP, VF loss, and age showed no significant differences between groups. 

Investigators concluded that short-term visual field changes were similar in both treatment and placebo groups, and there was no evidence that initial IOP reduction improved visual field status in newly diagnosed non-advanced patients with glaucoma.

Source: ajo.com/article/S0002-9394(24)00384-2/abstract#%20