But that study found that the risk of progressing was 19% lower per mmHg reduction in IOP. In similar trials, the reduction in risk ranged from 10% to 19%. Such reductions in risk with reductions in IOP have been documented since at least 1987, he added.
In the advanced glaucoma intervention study (Am J Ophthalmol. 2000), those patients who maintained an IOP less than 18 mm Hg at all visits did not progress at all for 8 years.
He cautioned that these findings apply to "real manifest glaucoma" and not ocular hypertension or early glaucoma.
The findings in glaucoma recall the results of trials in diabetes and blood pressure in which patients fared much better when their disease levels were managed more intensively, with fluctuations as well as levels kept under control, Dr. Ahmed said.